bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of the Legitimacy of the State of Emergency in Forming Perppu Number 2 of 2022 Concerning Job Creation
Authors: Perdana Fadil Cakra , Alidrus Yogi Syahputra
Published: July 2023

This study aims to analyze the establishment of Perppu number 2 of 2022 concerning Job Creation. Is the establishment of a work copyright law by the president of the Republic of Indonesia as the head of government something objective. Therefore, in this paper, a maximum of two problem formulations are conceptualized, namely 1) Benchmarks of Compelling Crucial Issues as a runway in forming Government Regulations in Lieu of Laws, and 2) Analysis of Legal Implications of Perppu Number 2 of 2022 concerning Job Creation. Starting from these problems, this paper uses normative legal research with various literature such as books, journals, and statutory regulations (Statute Approach) and also uses a historical approach (Historical Approach) and a comparative approach (Comparative Approach) as a knife. analysis that the making of Perppu number 2 of 2022 concerning Job Creation is a policy that is very inconsistent with the needs that exist in society in Indonesia. From this conception two major findings can be found 1) Knowing the benchmarks in forming a Government Regulation in lieu of Law in accordance with the Constitutional Court Decision number 138/PUU/-VII/2009 is in line with supported theories and dogmas so as to realize findings based on a coherent and systematic concept, and 2) Knowing whether the formation of Perppu number 2 of 2022 concerning Job Creation is an effective regulation, so that effectiveness brings a black shadow in the formation of Perppu number 2 of 2022 so that the legal implications that the author analyzes are the formation Perppu number 2 of 2022 concerning work copyright is a Constitutional Disobedience regulation and is not in accordance with the Constitutional Court Decision Number 138/PUU-VII/2009 Regarding Emergency Conditions.
Workload stress and performance of nurses in government hospitals in Kenya
Authors: Lewa Susan K , Kioko Miriam Mutuku , Lewa Peter M
Published: July 2023

This paper looks at workload stress to establish how it influences nurses‘ levels of performance, morale and clinical outcomes in government hospitals in Nairobi Kenya. The study design utilized for this research is descriptive survey and correlation design. The key objective of the study is to investigate the relationship between work load stress and performance among public hospital workers in Kenya. A sample of 845 nurses was drawn from all the six levels of government hospitals in Nairobi County using Taro Yamanes sample size selection formula. Data collected was analysed using both descriptive and inferential statistical techniques. Correlation analysis was employed to explore the direction and magnitude of relationship between various constructs of work load stress and employee performance. The research findings show that work load stress influences performance of nurses. Majority of respondents (79.8%) indicated that work load stress factors influence their performance ―to a great extent‖ (11.2%) indicated ―to a small extent‖. These responses were confirmed through inferential statistical analyses as discussed in the paper. Based on the findings the study recommends that adequate and modern equipment should be provided to nurses to aid them in their work and more nurses should be employed to help reduce workload stress. This is expected to lead to the boasting of the morale of nurses in government hospitals perhaps leading to fewer strikes.
critical role universities in Africa should play in innovation for economic growth and development
Authors: Lewa Peter M , Lewa Susan K , Murigi Rachel Mwende , Mutuku Faith Mumbua
Published: July 2023

This paper examines the critical role universities in Africa ought to play in innovation in support of economic growth and development. The prime motivation for this paper is to propose ways universities can support economic growth and development through innovation initiatives in their operations. Innovation involves the generation of a creative idea or insight: the insight must be put into action to make a genuine difference in economic growth and development. There are a wide range of approaches to conceptualizing innovation in the scholarly literature. Innovation can be looked at from the context of technology, commerce, social system, economic development, and policy construction. Information for this research was obtained from both primary and secondary data. Primary data was obtained from knowledgeable individuals in terms of what they considered to be the role of the modern African university in innovation for economic growth and development. However, the paper relied more on secondary data sources available in the internet (http://en.wikipedia.org/wiki/Innovation).
The key finding is that universities in Africa have an important role to play in innovation but must change their modus operandi in terms of curriculum development, teaching and assessment of student learning among others in order to remain relevant to the needs of the modern economy.
Turnaround strategies and performance of Kenya airways
Authors: Mungai Bibiana W , Bula Hannah Orwa
Published: July 2023

Many organizations across the globe today are facing declining performance at some point intheir cycles due to internal and external factors or changes in the business environment. Mostoften, the organizations enter the state of decline due to pressures emanating from these factorswhich threaten their existence. These organizations compete for survival in the volatile andhostile market environment (the red ocean) and in order to emerge successful during the times ofdistress, most of them adopt turnaround strategies to enable them return back to their normalprofitability as well as improve their performance. As an alternative response to the crisis,turnaround strategies are applied to enhance an organization’s chances of survival and achievesustainable performance and recovery. This paper is an initiative into a study that sought todetermine the effect of turnaround strategies on performance of Kenya Airways. Specifically, thestudy sought to establish the effects of revenue generating strategy, cost reduction strategy, assetreduction strategy and financial restructuring on performance of Kenya Airways. The studyadopted a descriptive research design where data was analysed using descriptive statistics.Findings revealed that the four strategies affected the performance of Kenya Airways positivelyand contributed a lot to its turnaround.
Empirical study of Africa macroeconomic fundamentals mismatch: Impact on economic development in Kenya
Authors: Lio San
Published: July 2023

This paper is an analysis of the extent of macroeconomic fundamentals mismatch and theconsequent impact on economic development in Africa, a case of Kenya. A key contribution ofthis paper is to show that the macroeconomic variables such as finance, unemployment,international trade, government fiscal policies, as well as savings and investments by firms andhouseholds interact in the Kenya’s economy; and their total negative impacts owing tomisalignment with key trade sectors contributing the most to economic growth, account for thecountry’s weak pecuniary performance; a trend replicable in the larger Africa. The studyemployed quantitative research design using a self-administered questionnaire and targeted apopulation of 47 managers who are regulators, and commercial bankers, working withinNairobi, Kenya’s capital. Both secondary and primary sources of data were used in eliciting therequisite information essential for the research findings. Stratified random sampling wasemployed to select the sample data. The Statistical Package for the Social Sciences (SPSS)version 20.0 was used in data processing and analyses. The findings indicate that the mismatchof macroeconomic fundamentals in Kenya is significant, with a p = 0.0001, and has far reachingnegative impacts on the country’s economic development. Government fiscal policies, exports,and finance, had more devastating negative impacts on economic development in Kenya. There isa general trend indicating that firms and households tended to take advantage of investmentopportunities despite the unfavourable environment.
Consumer ethnocentrism and attitudes towards local products: A case of Kenyan consumers
Authors: Kiriri Peter N
Published: July 2023

This paper entails a study that was conducted to investigate the existence of consumer ethnocentrismand the attitudes towards locally made products among Kenyan consumers. The study is founded onthe different perspectives of consumer attitudes towards domestic and foreign made products. Thesample for this study was drawn from adult customers who live in Nairobi. Altogether, the studysampled 385 respondents to whom questionnaires were distributed and, 315 completed and returnedfor analysis. The consumer ethnocentric tendency was measured using the consumer ethnocentrismscale developed by Shimp and Sharma in 1987 while consumer attitude was measured using a scalederived from the literature. Cronbach’s Alpha values of each construct confirmed that a good reliabilityexisted, hence appropriate to make inferences. Principle component analysis was employed todetermine the important factors affecting consumer attitudes. Four components were identified throughconfirmatory factor analyses which were labelled as: Patriotism; Economic Impact; Foreign Products;and, Made in Kenya Attitude. A structural equation model was developed showing the relationshipsbetween consumer ethnocentrism components and attitude towards made in Kenya products. Consistentwith other African studies, it was found that the Kenyan consumers were not ethnocentric. They werehowever concerned with the impact of foreign products to the economy and especially on employment.On the other hand, Kenyans were found to be xenocentric (preference for foreign made products.
Factors affecting numerical growth of pentecostal churches in Embu west Sub-county
Authors: Njiru Salesio
Published: July 2023

The purpose of the study was to explore factors affecting numerical growth of among Pentecostalchurches in Embu West sub County. The authors based their argument on factors such asorganizational culture, leadership styles and organizational structure and how they affect numericalgrowth of Pentecostal churches within the Sub-County. The target population constituted 530respondents from which as sample of 165 was obtained through stratified sampling. Data was collected using questionnaires on a 5-point Likert scale obtaining a response of 121 respondents (congregation). Coefficient of determination showed that R square was 0.680 meaning that the predictor variables explained 68% of the change in numerical growth of the Pentecostal church in the sub county. This suggests that there are other factors that could explain the remaining 32% of the causes of numerical growth in Pentecostal churches in the Sub-County. The study found evidence that the constant was significant (<0.05% level of significance) (t- value 2.253) confirming that all the variables selected for the study had a significant effect on numerical growth of Pentecostal churches. In addition, the study confirmed that organizational culture (t-4.824; <0.05 level) leadership styles (t- value 4.063; <0.05 level) and organizational structure (t-value 4.168; (<0.05 level)) significantly affects numerical growth of Pentecostal churches in Embu West sub County. The study recommends capacity building on leadership styles, organizational culture and organizational structure as they influence Pentecostal church growth for church leaders.
Factors influencing poverty reduction in the mining sector in Zambia: A case of selected mines
Authors: Kanyinji Peter , Tembo Gelson , Wijk Jeroen van
Published: July 2023

The study focuses on how to reduce poverty by facilitating the inclusion of Zambian SMEs in the miningindustry and link them to global value chains. In the past 15 years, Zambia has adopted a series ofNational Development Plans aiming at the support of small and medium enterprises (SMEs). Despitethese plans, poverty levels are still high to over 60%. The main research question was what the barriersare that hold back local SMEs to join the Zambian mining chains and how to overcome them. The studyadopted an embedded multiple case study approach that included Lumwana, Konkola and Kansanshimines and the SMEs in the proximity of these mines. Primary data was collected through a surveyinvolving 150 members of the Mining Suppliers and Contractors Association of Zambia, and 35 indepth interviews with immediate stakeholders in the three selected mines, government authorities,NGOs, and experts. Data processing involved use of EQS for a structural equation modeling and selfadministered questionnaire for qualitative data. Data analysis framework focused on RMSEA values,FIT indices, and multiple regression analysis for quantitative data while theory construction involvedcoding the indicators that measure variables into themes, categories and subcategories which wereexpanded with detailed explanations, and thereafter summaries and conclusions. The conclusion of the study was that despite public and private support, SMEs continue to be excluded from supplying to the mine. The study recommends the formation of Zambia National content development and monitoring board for managing local content policies for inclusive growth, formation of Mining incubator to support SMEs upgrade to reach international requirements, formation of the mining commission of Zambia to implement mining policy, and form the supplier development working group to implement the private and public policies to improve capacity of SMEs to supply to the mines
Private sector engagement in humanitarian financing, logistics and technology and implementation of humanitarian aid projects in Kenya
Authors: Nyambura Catherine W , Rambo Charles M , Nyonje Raphael O
Published: July 2023

Humanitarian crisis across the globe continue to increase in size, frequency, and complexity in the 21stCentury challenging the ability of Organizations in disaster relief to save lives of persons in distress. This has been a challenge in Countries prone to natural disaster as well as those prone to human conflict such as Syria, Southern Sudan, Central Africa Republic, Yemen, Somalia and Democratic Republic of Congo. In Kenya, humanitarian crises have occurred in the form of recurrent drought, floods, malnutrition and food security, disease outbreak, post election violence; resource based inter-communal conflicts as well as terror attacks. These crises often require immediate response in order to save lives, as a result there is increasing need to engage private sector in humanitarian logistics, financing and technology when implementing humanitarian aid projects. The objective of this study was to examine the influence of combined private sector engagement and the implementation of humanitarian aid projects. The paradigm guiding the study is pragmatism and the study employed a cross sectional-survey design. The sample was drawn from Organizations in disaster relief programmes using both probability and non-probability sampling technique. Both primary and secondary data was utilized in data collection. Primary data was collected using self administered questionnaires, Key Informant Interview, and Focus Group Discussions Guides. Questionnaires issued were 117 out of these, 85 which is 72.6% were returned for analysis. The data was analysed using both descriptive and inferential statistics. For descriptive analysis, mean, percentages and frequencies were used. For inferential analysis, correlations and regressions were used. For p<0.05, H0 was rejected and H1 accepted. For the strength of the relationships, r values were considered where: +0.10< r <+0.29; weak correlation +0.30< r <+0.49; moderate correlation +0.5 < r <+1.0; Strong correlation. The qualitative data was analyzed using content analysis. The study findings indicate that combined private sector engagement influence on implementation of humanitarian aid projects in Kenya. The study concludes that combined private sector engagement is critical in implementation of humanitarian aid projects and there is need to put more emphasis on collaboration. The study recommended that there is need for more academic research on humanitarian aid.
Effect of trainer on entrepreneurial intention of technical and vocational education and training graduates in Kenya
Authors: Kimathi Ruth Kirigo , Njeru Felista W , Korir Michael
Published: July 2023

The purpose of the study was to assess effect of trainer attributes on entrepreneurial intention of Technical and Vocation Education and Training graduates in Kenya. Data was collected from 329 final year graduates of six public technical training institutions using a self-administered structured questionnaire. Results show there is a significant positive relationship between trainer attributes and entrepreneurial intention of Technical and Vocational Education and Training graduates in Kenya.The study found that full time lecturers constituted the largest source of influence to graduate entrepreneurial intention compared to practicing entrepreneurs and guest speakers. Ideally, practicing entrepreneurs would act as best mentors and role models to inspire entrepreneurial intention as they share their story. The study concludes that trainer attributes can be used to predict entrepreneurial intention of graduates, but this aspect is still underutilized and underdeveloped. Furthermore, effect of trainer attributes on entrepreneurial intention of graduates has not been subjected to much empirical investigation in Kenya in spite of entrepreneurship education being compulsory in technical institutions. Accordingly, the study recommends collaboration with the industry to establish a pool of practicing entrepreneurs who will be used from time to time in entrepreneurship instruction. Standardization of requisite competencies for entrepreneurship trainers as well as and continuous capacity building of entrepreneurship trainers is desirable. A tracer study should be carried out to establish the percentage of graduates who actually actualize their entrepreneurial intention.
Evaluating credit worthiness of small and growing technology businesses
Authors: Munguti Victoria Mwongeli , Ngali Richard Maala
Published: July 2023

This paper is meant to give an input to African banks, finance institutions and lenders to provide better models to evaluate creditworthiness for small but growing technology businesses. The researcher draws from the experience of technology businesses who many a times have inadequate widgets or inventories as collateral and end up being subjected to stringent requirements imposed by the financial institutions. Financial institutions lack appropriate models to evaluate credits of technology companies without collateral. This paper recommends a framework for design and implementation of a credit scoring model that is flexible to the emerging market trends and does not advocate for one methodology or technology but aggregates multiple factors to determine the credit worthiness of a small tech company.
Moderating influence of regulatory framework on the relationship between strategic leadership and financial sustainability of NGOs in Kenya
Authors: Oluoch Fredrick Ochieng , K’Aol George , Kosha Jeremiah
Published: July 2023

The aim of the research was to determine the moderating influence of regulatory framework on the relationship between strategic leadership and financial sustainability of NGOs in Kenya. The study was underpinned by strategic leadership theory and applied descriptive correlational research design. The study target population was 6,028 comprising active local NGOs. It utilized stratified random sampling to select 413 CEOs/ board members as respondents through self-administered questionnaire. Correlation results showed a positive and significant relationship with financial sustainability, r (393)= 0.482, p ≤ .05. However, the proportional odds assumption was violated [LR χ2(2) = 8.474, p ≤ .05]; and the model showed poor fit with the moderating variable. Hence, the study concluded that regulatory framework does not have a significant moderating effect. The study, therefore, recommends NGOs to strengthen their alliance/ council in order to champion for a favorable regulatory framework that focusses on both legislative environment and donor policies while exploring access to funding replacements.
Impact of covid-19 pandemic on investments in the water sector in Kenya
Authors: Julius Christine Mawia
Published: July 2023

The purpose of this study was to establish the impact of Covid-19 pandemic on water investment financing in Kenya. This paper therefore presents an analysis of the investment financing as prioritized in the water sector since the onset of the Covid-19 pandemic. The study was done through an analysis of the Government of Kenya’s capital financing trends in the water sector targeting the counties of Nairobi, Kiambu and Murang’a during the pandemic period. The findings indicate that there was increased funding to the water sector in general. However, most financing was directed towards emergency works geared towards increased access to water for hand washing to curb the spread of the pandemic. In some cases, this resulted to shifting of resources from the long-term planned and ongoing projects to short-term emergency interventions. Such a shift is likely to negatively impact on the progress made towards the attainment of the Kenya’s Vision 2030 at the national level and the sustainable development goals at the global level.
Sex differences in animal models: A case of diabetes mellitus herbal treatment
Authors: Njoroge Gladys Gakenia
Published: July 2023

Herbal extracts have been used for control of type 2 diabetes mellitus for many centuries and the use of animal models to test the potency of these remedies is imperative. Given that preclinical studies may eventually inform clinical research and therapeutic developments, the impact of sex should be taken into consideration as an important biological variable in order to produce precise and reproducible results applicable to both men and women. This paper sought to find out whether there is sex differentiated outcomes on aherbal treatment for type 2 diabetes mellitus. Alloxan induced diabetic wistar rats were the experimental subjects used in the study. Twenty-eight albino Wistar rats, fourteen males and fourteen females, aged 6-7 weeks and weighing 100-140 grams were subjected to this test. The response of interest was the change in blood glucose level 2 hours after the administration of the herbal treatment. A sharper rise in blood glucose level among the female rats was recorded compared to the males upon ingestion of glucose. On the other hand, the average change in blood glucose level was higher among the male rats compared to the females. This suggested that the course of the diabetes disease and the treatment effect was different in male and female rats. This study recommends the use of both male and female subjects in animal studies at both the experimental and analysis stages for completing the understanding about disease mechanisms and in driving the course of advanced diagnostic and therapeutic approaches.
Influence of Determining Strategic Direction on Organization Performance of Pharmaceutical Companies in Kenya
Authors: Ngaruiya Evelyn , K'aol George , Njenga Kefah
Published: July 2023

The chief executive’s ability to determine strategic direction through a unifying vision and mission and establishing social capital within the top management team influences the organization’s performance in different contexts. This study aimed at establishing the influence of determining strategic direction on the organisational performance of pharmaceutical companies in Kenya and was grounded on the strategic leadership theory. The study was anchored on positivism philosophy with a descriptive design approach. A stratified simple sampling was used to target a sample of 390 senior managers within the three strata, namely, local companies, generic companies, and research and development multinationals, proportionately to achieve a respondent rate of 82%. The strategic direction was operationalised through the leader’s vision, mission, and strategic goals, while organization performance was measured through profitability, Customer perspective and learning & growth. Five key tests were carried out: correlation analysis, chi-square test, one-way ANOVA, ordinal logistic regression, and parameter estimates to test the hypothesis. Ordinal logistic regression (Nagelkerke Pseudo R-square) results established that 8.1% variance in organizational performance was explained by strategic direction, R2 = .081. In addition, ordinal regression parameter estimates indicated that strategic direction significantly predicted organizational performance, β=0.473, p≤.05. The study concluded a significant relationship between strategic direction and organizational performance. In particular, a leader’s vision, mission and strategic goals were attributed to the positive influence on organizational performance at the pharmaceutical companies in Kenya. The study results indicate that when the leader's strategic direction is clear, communicated and aligned throughout the organization, this significantly and positively influenced organisational performance. Consequently, the study recommended that leaders embed their vision and mission within their strategic plans and ensure alignment throughout the organization.
Strategic Direction and Crises Preparedness in Manufacturing Firms within the Kenya Association of Manufacturers in Kenya
Authors: Wanyagah Paul , Ouma Caren , Okello Gabriel
Published: July 2023

The global and local business environment in the twenty first century has become complex and unstable for firms’ strategic leadership, because of rapid development, continuous change, business disruptions, and man-made as well as natural calamities. The purpose of this study was to determine how strategic direction influences crises preparedness in manufacturing firms within the Kenya Association of Manufacturers (KAM) in Kenya. The research adopted the positivism approach as the research philosophy and utilized descriptive correlational research design. The study population consisted of 783 chief executive officers from the KAM where a sample of 292 was drawn using stratified random sampling technique. Data was collected through self-administered questionnaire whereas descriptive and inferential statistical techniques were used to perform data analysis. Descriptive statistics focused on relative frequency distribution, means and standard deviation. Inferential statistics included Chi-square test for test of association, Kruskal-Wallis H Test and ordinal logistic regression. The study results are presented in form of table and numerical measures with descriptions. The study established that strategic direction had a statistically significant and positive influence on crises preparedness of manufacturing firms (β = 0.345, p < 0.05). Additionally, chi-square findings showed that manufacturing businesses' crises preparedness and strategic direction were significantly associated (χ2 = 40.705, p < 0.05). A statistically significant difference in the mean rankings of crisis preparedness for the different levels of strategic direction of the firms was also found according to the findings of the Kruskal-Wallis H test (H = 18.581, p < 0.05). The study concluded that strategic direction was an essential antecedent of crises preparedness in manufacturing companies in Kenya. The study recommends to corporate leaders to continually investigate and evaluate potential key areas of crises informed by their evolving operating environment when developing their firms’ purpose, intent, vision, mission and objectives.
The Relationship between VIII Grade of Depok Junior High School Students’ Vocabulary Mastery and the Results of Reading English
Authors: Vickry Ramdhan
Published: July 2023

The purpose of this study was to determine the relationship between vocabulary mastery and the results of learning to read English. The research method used to analyze was a correlational descriptive method. The instruments used were in the form of a vocabulary mastery test totaling 40 questions and an English reading learning achievement test totaling 40 questions after the validity test was carried out and the instrument test was reliable which was tested on 50 samples. From the research results of the Vocabulary Mastery test, the results of the Mean (M) analysis were 26.32; The median (Me) is 34; Mode (Mo) of 21; Variant (V) 83.1776 and Standard Deviation (SD) of 9.1. From the results of the English Reading Results test, the Mean (M) was 25.4, the Median (Me) was 37, the Mode (Mo) was 38.75, the Variant (V) was 121.64 and the Standard Deviation (SD) was 11.02905254. From the calculation of hypothesis testing, it is obtained that t value = 5.4 > t table = 2.484 So it can be concluded that H0 is rejected H1 is accepted. It means if there is a positive and significant relationship between the Vocabulary Mastery variable on Reading Learning Outcomes.
Analysis of Main Character Amy Dorrit in the Film "Little Dorrit" by Charles Dickens
Authors: Prasetyo Agung , Saputri Wildah
Published: July 2023

Purpose This study the author wants to analyze the main character Amy Dorrit in the film Little Dorrit by Charles Dickens (1812-1870). The author hopes that students of Indraprasta PGRI University and other readers will know more about Dickens' work and ideas. The research used descriptive qualitative method. The research was conducted in two ways; the first source of data, the author used Little Dorrit. The second source of data the author uses opinions and criticisms about the film Little Dorrit, information about the character of the girl in the Victorian era and the biography of Charles Dickens, in addition to that the author also uses a literary approach to analyze the film. The main character in the film Little Dorrit is Amy Dorrit. Amy, otherwise known as Little Dorrit, lives in the Marshalsea Prison with her father, William, who is the prison's longest serving inmate. Although born and bred in the prison, Amy is far from being downtrodden and has grown up to be a gentle and kind-hearted yet enterprising and spirited young woman. Amy became a major figure in this story because of the intensity of his presence from the beginning to the end of the story and has a relationship with each character in the story. Character that is in the main character is kind, merciful, modest, and polite. The writer analyses the subordinate leaders such as attitudes, and actions to clarify the nature and affect the main character.
First Nursing Training College - 1945
Authors: Editor-In-Chief
Published: July 2023

First Nursing Training College - 1945
Malaria
Authors: Editor-In-Chief
Published: July 2023

Malaria
Diabetes
Authors: Editor-In-Chief
Published: July 2023

Diabetes
EFFECT OF COVID PANDEMIC ON PREVALENCE OF DEPRESSION AMONG MEDICALSTUDENTS OF SIALKOT MEDICAL COLLEGE SIALKOT, PAKISTAN.
Authors: Prof. Dr. Sahibzada Masood Us Syed  , Omar Imran Butt  , Anaba Khan  , GulJaved Virk  , Taha Khan  , Manahil Khalid  , Usama Tariq  , Usama Maqboo  , Ali Raza Azam  , Aqsa Rashid  , Fatima Mubashir  , Maha Javed  , Sana aslam  , Kainat sharif  , Kainat sharif  , Fiza imran  , Muhammad shafqat
Published: July 2023

The objective the study is to assess the percentage prevalence of depression among students of SMC, and the relationship of its severity with the Year of Study (MBBS) after pandemic.
EARLY BREAST CANCER DETECTION; KNOWLEDGE AMONG FEMALE MEDICAL STUDENTS
Authors: Mujahid Huussain  , Mahnoor Mujahid  , Mohammad Arshan Shahid  , Aimen Khizar  , Aiza Usman  , Amara Asif  , Anmol Kiran  , Farina Tahir  , Hannan Dar  , Hassam Tariq  , Hira Shahid  , Huda Fatima  , Husnain Tariq  , Iqra Bilal  , Namrah Wajid  , Ramish Sohaib  , Ramsha Zahra  , Hasnain Aslam  , Rida Fatima Touqeer  , Zain Bin Zahid  , Zainab Naz  , Zainab Pervaiz  , Khadija Akhtar
Published: July 2023

The objective of this study is to assess the level of knowledge of screening for early detection of breast cancer among female medical students.
USE OF SURGICAL CONTRACEPTIVES IN WOMEN HAVING AT LEAST TWO ALIVE CHILDREN VISITING GYNAECOLOGY OPD OF CIVIL HOSPITAL
Authors: Riaz-Ul-Haq Subhani1  , Sajida Yasmeen  , Hafiz Tayyab Hamad Ul Haq  , Syed Ali Arsalan  , Amna Faisal  , Aqsa Tabasum  , Mahnoor Aslam  , Memoona Danish  , Muhammad Arsalan Ullah  , Sara Arshad  , Sheharyar Faisal  , Usman Ali1  , Zainab Tayyab  , Zobia Batool  , Maham Shabbir1  , Saba Shahzadi
Published: July 2023

The objective of this study is to assess the knowledge and use of surgical contraceptive methods among women in Sialkot.
DIETARY HABITS AND LIFESTYLE PRACTICES AMONG STUDENTS OF SIALKOT MEDICAL COLLEGE, SIALKOT
Authors: Akmal Khurshid Bhatti1  , Anum Imran Butt  , Syed Shah Hussain  , Tahir Butt  , Rabbia Nawaz  , Numera Malik  , Rukhsar Shehzadi  , Uswa Ahmad  , Saba Ghafoor  , Saira Anwer  , Saira Ashraf  , Mahlka Iqbal  , Irzam Bareera Ubaid  , Rida Fatima Mohsin  , Hira Bakhsh  , Atiya Zulfiqar  , Khizar Badar  , Zaryab Akbar1  , Umer Farooq  , Umer Bakhsh Butt  , Taimur Javed  , Hamid Saeed  , Yasir Ali  , Momina Ali  , Minahil
Published: July 2023

The objective of this study is to determine dietary habit and different lifestyle practices among University students
Plantar Fasciitis or Flexor Digitorum Brevis Myositis
Authors: Grady John F. , Nagesh Darshan , Smolinski Trevor , Ostermann Hannah C.
Published: July 2023

Background: As common as plantar fasciitis is, there’s a lack of evidence regarding the true pathophysiologic process causing plantar fasciitis and plantar heel pain in general. This may partially explain the high variability and outcomes with current treatment of recalcitrant plantar fasciitis. Although Lemont reported myxoid degeneration of plantar fascia with histologic analysis of patients with fasciitis, muscle biopsy results were not reported. So far it appears we have not focused on the muscular component that may be present with plantar heel pain in general and in patients we diagnose with plantar fasciitis in particular.

Methods: In this article we performed a retrospective analysis of biopsy results from five patients with the diagnosis of recalcitrant plantar fasciitis to determine whether this diagnosis was correct or whether other component pathologies contribute to the chronicity of symptoms or to the failure of treatment.

Results: Three of the five pathology reports included specific mention of inflammation, degeneration and atrophy of the intrinsic musculature consistent with myositis. Two of these showed lymphocytic infiltration in the muscle consistent with inflammation, with no signs of inflammation in the fascia. One showed inflammation of the fascia without signs of inflammation of the muscle.

Conclusions: This small study introduces the idea that intrinsic myositis may contribute to, or be responsible for some cases of plantar heel pain and plantar fasciitis. This may be important in changing the way we deal with plantar heel pain in the future.
Postprocedural Opioid-Prescribing Practice in Nail Surgery
Authors: Brooks Brandon M. , Li Qiyang , Fleischer Adam E. , Anderson Natalie A. , Handa Aaron Z. , Shih Chia-Ding
Published: July 2023

Background: Ingrown toenails are a common condition requiring outpatient procedures in podiatric medical clinics. To prevent recurrence, chemical matrixectomy is often recommended. Postprocedural pain management is largely based on preferences rather than on a formal guideline. This study aims to explore the postprocedural prescribing behavior among practicing podiatric physicians to foster future guideline and policy development.

Methods: We administered an open, voluntary, anonymous questionnaire via an online survey platform that included a common nail procedure scenario (chemical matrixectomy) and a prescribed demographics section. Podiatric physicians were asked what they would prescribe to manage postprocedural pain. Opioid and nonopioid options were provided. We developed two multiple logistic regression models to identify associations between prescriber characteristics and prescribing opioids after “standard” chemical matrixectomy.

Results: Of the 860 podiatrists who completed the survey, 8.7% opted to prescribe an opioid. Hydrocodone was most commonly chosen. A median of 18 opioid pills were prescribed. No prescriber characteristics were associated with prescribing opioids after chemical matrixectomy scenario. There is a large discrepancy and knowledge gap in the literature on the optimal postprocedural pain management for outpatient procedures, including procedures in specialties such as dentistry and dermatology. The median number of opioids prescribed by podiatrists is higher than that by dentists for management of third molar extraction. In contrast, opioid-prescribing behavior among the 8.7% of respondents is similar to dermatologic management of postprocedural pain in Mohs surgery.

Conclusions: Podiatric physicians cannot assume that their prescribing of opioids does not affect the opioid abuse problem in the United States. The presented study serves to be an initiation for procedure-specific opioid prescription benchmarking to foster future guideline and policy development. After nail procedures, opioids should not be routinely prescribed.
Effectiveness of Quiz-Enhanced Videocasts for the Review of Foundational Sciences in the Podiatry Curriculum
Authors: Schmidt Martin , Wilson Wayne A.
Published: July 2023

Background: Integrated medical curricula commonly require the review of foundational science concepts in the context of clinical applications. A detailed analysis of the Des Moines University second-year medical curricula revealed that such reviews, conducted as hours-long basic science lectures in second-year clinical systems courses, often create undesirable redundancy and can load the curriculum with excessively detailed content. We hypothesized that short, quiz-enhanced videocasts (QEVs) would allow a more focused and efficient review of foundational sciences than traditional lectures.

Methods: Five biochemistry lectures in the second year Des Moines University Doctor of Podiatric Medicine curriculum were reviewed for relevance and redundancy, shortened to 8- to 12-min QEVs and offered to students as an alternative to the respective hours-long lecture.

Results: Download data show that students chose content delivery by QEV as frequently as delivery of lectures, with QEV use peaking in the days immediately preceding the exam. Survey comments show that students appreciate the efficiency and flexibility of content delivery by QEV, particularly for focused exam preparation.

Conclusions: We conclude that the review of foundational concepts by means of short, interactive videocasts can reduce redundant and excessively detailed content from integrated curricula. Although the faculty effort for context review, content selection, and videocast production is higher than for the design of a traditional lecture, the end product offers students a much-appreciated opportunity for efficient, focused, and individualized learning.
An Appraisal of Using Opioids in Patients with Opioid Use Disorder
Authors: Smith Robert G.
Published: July 2023

Podiatric physicians have come to realize that opioid use disorder (OUD) is a public health crisis causing morbidity, mortality, lost productivity, and legal cost in the United States. Opioid analgesics are efficient first-line pain relievers for acute and chronic lower-extremity pain syndrome. Perioperative pain management strategies have been proposed using opioid stewardship, but there are few standardized protocols to guide podiatric medical providers treating patients with OUD. First, we describe the pharmacology of therapeutic agents used as medications for addiction treatment for OUD and substance use disorder (SUD). Second, we offer criteria for selecting acute pain and perioperative management in patients with OUD and SUD per current medical literature. Finally, we review the literature applying opioid stewardship in the context of prescribing opioid analgesics in the presence of OUD and SUD.

Three hypothetical clinical scenarios grounded in clinical-based literature are described with congruent data and founded guidelines. The first and second scenarios describe acute pain and perioperative management in patients with OUD receiving methadone and buprenorphine-naloxone, respectively. The third scenario describes acute pain and perioperative management in a patient with SUD receiving intravenous naltrexone. We hope that the lower-extremity specialist will appreciate that thoughtful management of acute perioperative pain among patients who receive medications for addiction treatment for OUD is critically important given the risks of destabilization during the perioperative period. The literature reveals the lack of rigorous evidence on acute pain management in patients who receive medication for OUD; however, some clinical evidence supports the practice of continuing methadone or buprenorphine for most patients during acute pain episodes.
An allocentric human odometer for perceiving distances on the ground plane
Authors: Zhou Liu , Wei Wei , Ooi Teng Leng , He Zijiang J.
Published: July 2023

We reliably judge locations of static objects when we walk despite the retinal images of these objects moving with every step we take. Here, we showed our brains solve this optical illusion by adopting an allocentric spatial reference frame. We measured perceived target location after the observer walked a short distance from the home base. Supporting the allocentric coding scheme, we found the intrinsic bias
1, 2
, which acts as a spatial reference frame for perceiving location of a dimly lit target in the dark, remained grounded at the home base rather than traveled along with the observer. The path-integration mechanism responsible for this can utilize both active and passive (vestibular) translational motion signals, but only along the horizontal direction. This anisotropic path-integration finding in human visual space perception is reminiscent of the anisotropic spatial memory finding in desert ants
3
, pointing to nature’s wondrous and logically simple design for terrestrial creatures.
EphrinB2 knockdown in spinal cord astrocytes preserves diaphragm innervation in a mutant SOD1 mouse model of ALS
Authors: Urban Mark W. , Charsar Brittany A. , Heinsinger Nicolette M. , Markandaiah Shashirekha S. , Sprimont Lindsay , Zhou Wei , Henderson Nathan T. , Ghosh Biswarup , Cain Rachel E. , Trotti Davide , Pasinelli Piera , Wright Megan C. , Dalva Matthew B. , Lepore Angelo C.
Published: July 2023

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by motor neuron loss. Importantly, non-neuronal cell types such as astrocytes also play significant roles in disease pathogenesis. However, mechanisms of astrocyte contribution to ALS remain incompletely understood. Astrocyte involvement suggests that transcellular signaling may play a role in disease. We examined contribution of transmembrane signaling molecule ephrinB2 to ALS pathogenesis, in particular its role in driving motor neuron damage by spinal cord astrocytes. In symptomatic SOD1
G93A
mice (a well-established ALS model), ephrinB2 expression was dramatically increased in ventral horn astrocytes. Reducing ephrinB2 selectively in these cervical spinal cord astrocytes via viral-mediated shRNA delivery reduced motor neuron loss and preserved respiratory function by maintaining phrenic motor neuron innervation of diaphragm. EphrinB2 expression was also elevated in human ALS spinal cord. These findings implicate ephrinB2 upregulation as both a transcellular signaling mechanism underlying astrocyte pathogenicity in mutant SOD1-associated ALS and a promising therapeutic target.
Diagnostic efficiency of multi-modal MRI based deep learning with Sobel operator in differentiating benign and malignant breast mass lesions—a retrospective study
Authors: Tang Weixia , Zhang Ming , Xu Changyan , Shao Yeqin , Tang Jiahuan , Gong Shenchu , Dong Hao , Sheng Meihong
Published: July 2023

Purpose

To compare the diagnostic efficiencies of deep learning single-modal and multi-modal for the classification of benign and malignant breast mass lesions.

Methods

We retrospectively collected data from 203 patients (207 lesions, 101 benign and 106 malignant) with breast tumors who underwent breast magnetic resonance imaging (MRI) before surgery or biopsy between January 2014 and October 2020. Mass segmentation was performed based on the three dimensions-region of interest (3D-ROI) minimum bounding cube at the edge of the lesion. We established single-modal models based on a convolutional neural network (CNN) including T2WI and non-fs T1WI, the dynamic contrast-enhanced (DCE-MRI) first phase was pre-contrast T1WI (d1), and Phases 2, 4, and 6 were post-contrast T1WI (d2, d4, d6); and Multi-modal fusion models with a Sobel operator (four_mods:T2WI, non-fs-T1WI, d1, d2). Training set (n = 145), validation set (n = 22), and test set (n = 40). Five-fold cross validation was performed. Accuracy, sensitivity, specificity, negative predictive value, positive predictive value, and area under the ROC curve (AUC) were used as evaluation indicators. Delong’s test compared the diagnostic performance of the multi-modal and single-modal models.

Results

All models showed good performance, and the AUC values were all greater than 0.750. Among the single-modal models, T2WI, non-fs-T1WI, d1, and d2 had specificities of 77.1%, 77.2%, 80.2%, and 78.2%, respectively. d2 had the highest accuracy of 78.5% and showed the best diagnostic performance with an AUC of 0.827. The multi-modal model with the Sobel operator performed better than single-modal models, with an AUC of 0.887, sensitivity of 79.8%, specificity of 86.1%, and positive prediction value of 85.6%. Delong’s test showed that the diagnostic performance of the multi-modal fusion models was higher than that of the six single-modal models (T2WI, non-fs-T1WI, d1, d2, d4, d6); the difference was statistically significant (p = 0.043, 0.017, 0.006, 0.017, 0.020, 0.004, all were greater than 0.05).

Conclusions

Multi-modal fusion deep learning models with a Sobel operator had excellent diagnostic value in the classification of breast masses, and further increase the efficiency of diagnosis.