bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Product Quality and E-Service Quality on Repurchase Intention Kopi Kenangan (Study on Consumer Kopi Kenangan in City Jakarta)
Authors: Haryanti Febri Hikmah , Ariyanti Maya
Published: November 2022

This study aims to see how much influence product quality, e-service quality and customer satisfaction have on the intention to repurchase Kopi Memories simultaneously and partially in terms of product quality variables (food presentation, taste, variety of choices, healthy choices, freshness, and product quality, temperature), e-service quality (efficiency, responsiveness, compliance, privacy, compensation, contacts and system availability). The method used in this research is a quantitative approach. The sampling technique used in this study is non-probability sampling with purposive sampling method. The samples taken in this study were 385 respondents who had ordered coffee through the Kopi Kenangan application who were domiciled in the city of Jakarta. The data analysis used is descriptive analysis and Structural Equation Model (SEM) analysis with the help of SmartPLS 3.0. The results of this study indicate that there is a positive and significant effect on the quality of e-service products and services on customer satisfaction and customer satisfaction has a positive and significant effect on repurchase intentions based on the hypothesis (T test). Based on the Structural Equation Model Analysis using smartPLS tools, it shows that the most dominant influence is on the product quality variable on consumer satisfaction with a path coefficient value of 0.314 and the largest T-Statistic with a value of 6.177. While the smallest effect is on e-service quality in the efficiency variable on consumer satisfaction with a path coefficient value of -0.016 and the smallest T-Statistic with a value of 0.297, meaning that memory coffee management must pay attention to these aspects and make improvements so that consumers can access the application properly. search for the desired product and information related to that product, and leave the site in question with minimal effort.
Effect of infant formula enriched with long-chain fatty acids and lutein on the formation of the central nervous system and vision from the standpoint of nutritional programming
Authors: Холодова И.Н. , Киселева Е.С. , Нечаева В.В.
Published: November 2022

Характер питания с момента зачатия и до возраста 24 месяцев (первая тысяча дней жизни) имеет решающее значение для развития центральной нервной системы и зрения ребенка. Поэтому детям на искусственном вскармливании необходимо не только получать питание, богатое макро- и микроэлементами, но и компенсировать возможный дефицит эссенциальных нутриентов, содержащихся в грудном молоке. Хотя большинство детских смесей содержит все необходимые нутриенты, этого может быть недостаточно для правильного развития мозга и зрения. Дефицит длинноцепочечных полиненасыщенных жирных кислот и лютеина, возникший в период, когда высока потребность в определенных питательных веществах, необходимых для развития центральной нервной системы, может снизить интенсивность развития структур мозга, зрительного анализатора и повлиять на когнитивное развитие ребенка. Поэтому оба нутриента включены в нормативные документы в качестве обязательных компонентов смеси для детского питания. Из-за ограниченной биодоступности длинноцепочечных полиненасыщенных жирных кислот и лютеина смеси на основе козьего молока являются доказанно эффективным детским молочным питанием с рождения, которое решает проблему ограниченной биодоступности ключевых эссенциальных нутриентов.

The nature of nutrition from the moment of conception to the age of 24 months (the first 1000 days of life) is crucial for the development of the central nervous system and vision of the child. Therefore, formula-fed children need to receive nutrition that is not only rich in macro- and microelements, but also compensate for the possible deficiency of essential nutrients contained in breast milk. Although most infant formula contains all the necessary nutrients, this may not be enough for proper brain and vision development. Deficiency of long-chain polyunsaturated fatty acids and lutein, if it occurs during a period when there is a high need for certain nutrients necessary for the development of the central nervous system, can reduce the intensity of development of brain structures, the visual analyzer and affect the cognitive development of the child. Therefore, both nutrients are included in the regulatory documents as mandatory components of infant milk formula. Due to the limited bioavailability of ong-chain polyunsaturated fatty acids and lutein from cow's milk, goat's milk-based formulas are a proven effective infant nutrition from birth that solves the problem of limited bioavailability of key essential nutrients.
A RESPONSABILIDADE DO ESTADO CHINÊS NO CASO DA COVID-19 PERANTE A COMUNIDADE INTERNACIONAL
Authors: Santiago Beatriz Calíope de Souza , Santana Neto Hamilton Gomes de
Published: November 2022

A legislação internacional traz direcionamento para os Estados prevenirem problemas, aqui em destaque os sanitários, dentro de seus territórios e para além deles, na intenção de manter a harmonia e o interesse coletivo das nações. Por isto, foi proposta neste trabalho a discussão da responsabilidade internacional do Estado chinês no contexto pandêmico gerado pela COVID-19, com verificação das literaturas do direito internacional já existentes e a identificação de opiniões de especialistas da área do direito sobre a responsabilidade da China na pandemia vigente. Para a viabilização do estudo, utilizou-se como metodologia a pesquisa bibliográfica com abordagem qualitativa, utilizando produções científicas como revistas, livros e artigos publicados com referência à temática em estudo. O acesso aos dados referentes às opiniões dos especialistas por meio dos noticiários formais e dos raros artigos já publicados com esta temática possibilitaram o entendimento de que a China tem responsabilidade, pelo menos parcial, no desenvolvimento da pandemia devido ao descumprimento da legislação internacional, mas, com o debate ainda inconcluso, talvez haja possibilidade de adoção de excludente de ilicitude na acusação ao país.
PRÉ-INDUÇÃO HORMONAL COM PROGESTERONA INJETÁVEL EM NOVILHAS
Authors: Amaral Igor , Junior Jair Sabio de
Published: November 2022

A puberdade precoce em vacas, avaliada pela puberdade ou idade ao primeiro parto, constitui um dos parâmetros mais fiáveis quando é necessário medir e melhorar a eficiência reprodutiva de um rebanho e, como geralmente se expressa, índice ótimo de fertilidade. A referida pesquisa visa responder a seguinte problemática: Quais os benefícios da pré-indução hormonal com progesterona em novilhas? O objetivo geral deste estudo foi ressaltar os benefícios da pré-indução hormonal com progesterona injetável em novilhas. A pesquisa consistiu em uma análise documental qualiquantitativa, no qual foram primeiramente selecionados artigos que abordam sobre a temática, tais artigos serão retirados das referidas bases de dados: Lilacs, Scielo e Periódicos Capes. Os artigos foram aqueles publicados nos últimos 10 anos, compreendendo o período de 2013 a 2022. Na primeira etapa da pesquisa, após colhida a autorização para pesquisa na referida fazenda, foi preciso selecionar as duas planilhas do desempenho da taxa de indução de ovulação de 55 novilhas e também de 55 outras novilhas que não receberam a pré-indução de progesterona injetável. Para a realização da análise estatística foi utilizado o programa Excel para que fosse possível o estabelecimento da tabela e posteriormente a análise em forma de gráfico para melhor compreender os resultados e compilar com a ideia de outros autores. Conclui-se que a indução de puberdade com progesterona injetável é uma estratégia eficiente para antecipação da ciclicidade e redução da idade ao primeiro parto (IPP), pois 56% das novilhas se tornaram gestantes em comparação a outras 41% de novilhas de igual porte e número. O tratamento proporcionou taxa de gestação ao final da estação de monta elevada e influenciou a eficiência reprodutiva. Sendo assim, os resultados do referido estudo de caso mostraram que a indução da puberdade em novilhas pré-púberes é eficaz e com isso pode contribuir para diminuição dos custos e maior eficiência.
Smart Communication Interpreter for Mute and Deaf People
Authors: Majid Baba Samiya , Bala Indu
Published: November 2022

As a consequence of birth anomalies and accidents, the number of hearing impaired and speech challenged sufferers has increased dramatically in recent years. When a deaf-dumb person speaks to a normal person, the normal person struggles to understand and demands that the deaf-dumb person display gestures to meet his or her needs. Dumb individuals speak to us in their own language. The only need is that we need to understand their language. Sign language is a communication capacity used by deaf and dumb people that uses hand signs, orientations, and movement of the hands, arms, or body, as well as facial expressions, to transmit the thoughts of a speaker fluently. However, most people struggle to understand this sign language. People who are unable to speak or have lost their ability to speak as a result of an injury find it difficult to transmit their message in society. We created an electronic speaking glove for this project. Dumb individuals may easily converse with normal people by merely wearing the glove. The system’s circuitry translates some activities, such as receiving a speech for each chosen button, making it easier for deaf/dumb people to converse with normal people. In this system, an LCD display is also employed; normal people’s voice is detected word by word and shown as text on the LCD display, making it easier for normal people to converse with deaf/mute people. As a result, this initiative will assist to bridge the communication gap between mute, deaf, and hearing persons.
Observer Based Single-Phase Active Current Harmonic Filter for Distributed Industrial Loads
Authors: Patel Hanuman , Mathur Sanjay Kumar , Rajpurohit Vikram Singh
Published: November 2022

Harmonic currents are introduced into power system as use of nonlinear electrical loads increases. Extra losses are caused by harmonic current stream into effective supply lines. A dynamic power filter engenders harmonic compensating current using a switching inverter. Single-phase current into the harmonic filter connects in parallel to load end and inject current harmonic required by the load feeder to avoid harmonic current in the direction of power system. This report discusses harmonic problem, available harmonic mitigation techniques, basic design of filter, control strategy, design steps of major hardware blocks, modelling and simulation of current harmonic filter in MATLAB SIMULINK setting, component selection, hardware implementation and final results. This filter will eliminate harmonic up to 45th order. The control circuit consists of a peak filter, all-pass filter, low pass filter and adders which are used to produce error signal by comparing harmonic current demand of load and injected harmonic current through switching inductor.
From Macau to the United States and Canada
Authors: Tavares Vander
Published: November 2022

Framed as a narrative inquiry, this investigation focuses on the lived experiences of Seth, a 24-year-old international student from Macau at a university in Ontario prior to the pandemic. Semi-structured interviews were employed to explore the participant’s experiences of belonging and identity formation over the course of his transnational journey. Seth’s story highlights the importance of social interaction for the sociocultural adjustment and academic performance of international students. As universities in Canada prepare to welcome international students for face-to-face instruction in the fall of 2021, this investigation becomes a timely reminder of the importance of adequate socio-academic support for international students.
Another university is possible?
Authors: Chatterjee Soma , Shahrokni Shirin , Gomez Bianca , Poojary Monisha
Published: November 2022

The aspirational postsecondary strategies of Indigenizing and internationalization claim to address pressing political questions such as racism and systemic inequities in the university. Through close examination of these initiatives in two key postsecondary institutions in Toronto, Canada, we show how these priorities instead betray strategic investment in diversity in three specific ways: First, universities are positioned as a horizontal ‘community of changemakers’ that are themselves disarticulated from global relations of inequities. Next, international and Indigenous students’ welcome is made conditional and contingent on their becoming ‘diversity informants’ for the university and its normative membership. Related to that, the claims of curricular diversity remain ‘performative’ and thereby reify established epistemic hierarchies. Finally, while the university is cast as a ‘fraternal community’ these various strategic priorities are managed and executed separately, thereby foreclosing opportunities for robust conversations across the university communities.
Sintaxis matemática del cielo precopernicano
Authors: Llamas Roig Vicente
Published: November 2022

Examen crítico de la sintaxis matemática del etéreo mundo celeste en el que los arquetipos noéticos quedan plasmados en réplicas de rol dinámico superior a las del mundo sublunar por μέθεξις más ajustada. Área de convergencia de pensamientos islámico y cristiano por su nexo aristotélico, la astronomía despunta en el Medievo como scientia media (inter scientiam naturalem et mathematicam). El sistema ptolemaico de epiciclos y deferentes es testado en su irrefutabilidad formal como modelo descriptivo solvente con la solución positivista del ecuante como temprana petición de excentricidad orbital (foco vacío de la futura elíptica kepleriana).
ՊԱՇՏՊԱՆՎԱԾ ԳՐՈՒՆՏՈՒՄ ԿՈՆՖԻԴՈՐԻ ԵՎ ՊԵԳԱՍԻ ԹՈՒՆԱԶԵՐԾՄԱՆ ԱՌԱՆՁՆԱՀԱՏԿՈՒԹՅՈՒՆՆԵՐԸ ԼՈԼԻԿԻ ՊՏՈՒՂՆԵՐՈՒՄ
Authors: Atshemyan L.H. , Mirzoyan V.S. , Petrosyan N.K.
Published: November 2022

The total residual amount of Confidor in tomato fruits was lower than the maximum allowable level 3 days after experimental treatment (0.5 mg/kg). Detoxification of Pegas was rather long-lasting. Thus, to ensure safety, it is required to set up more than 7 days of “waiting period”.
Guide Extension Catheter-assisted Interventions -
A Single-Centre Experience
Authors: Polavarapu Raghava Sarma , Ravella Keerthika Chowdary , Siripuram Yudhistar
Published: November 2022

Objective: To evaluate the technical and procedural success and safety of guide extension catheter-assisted percutaneous coronary intervention (PCI) in challenging and complex coronary lesions.
Methods: A physician-initiated, observational study conducted at a tertiary care centre in India between July 2021 and July 2022. The patients who underwent guide extension catheter-assisted PCI with the indication of facilitating stent delivery and deployment were consecutively enrolled in the study. Complete medical records including history, demographics and clinical characteristics, and angiographic data of patients who underwent guide extension catheter-assisted PCI were reviewed and noted.
Results: Total 19 patients were included in the study of which 18 underwent guide extension catheter-assisted PCI, and one patient internal carotid artery angioplasty. The mean of patients was 62.74±10.38 years ranging from 42 years to 82 years. Total 9 (47.3%) patients were presented with chronic stable angina, 8 (42.1%) with unstable angina and only one patient represented acute myocardial infarction. The right coronary artery (RCA) was the most common target vessel involved in (63.2%). Total 31.6% lesions were distally located, 57.9% were heavily calcified, and 10.5% lesions were chronic totally occluded. A 100% procedural success was noted with the use of guide extension catheter. No case of stent disruption, vessel dissection or ventricular arrythmias and in-hospital death or myocardial infarction were noted during hospital-stay. Only one case of small access site hematoma was reported.
Conclusion: The study concluded that the use of guide extension catheter facilitates easy advancement of stents or other devices through tortuous, heavily calcified, distal, bifurcations and CTOs coronary as well as carotid lesions. However, larger studies on wide range of patient population are required to validate our findings.

Keywords: percutaneous coronary intervention, coronary artery, carotid artery, guide catheters
Erythropoietin-Resistant Therapy in Routine Hemodialysis Patients: A Case Report
Authors: Sri Ariani Putri I Gusti Ayu Nyoman , Kandarini Yenny , Rena Renny Anggreni
Published: November 2022

Background: Anemia in chronic kidney disease can be caused by erythropoietin deficiency. Erythropoietin stimulating agent (ESA) is the treatment of choice for anemia in patients with chronic kidney disease. Some patients for some reason fail to reach target hemoglobin levels despite maximal ESA doses.
Case illustration: We reported a 58-year-old man suffering from CKD with recurrent anemia despite the maximum dose of ESA. The investigations showed secondary hyperparathyroidism due to complications of chronic kidney disorders.
Discussion: Our patient's resistance to erythropoietin therapy was caused by inadequate dialysis and secondary hyperparathyroidism. The management is focused on the adequacy of hemodialysis and the management of secondary hyperparathyroidism with nutrition and medication.

Keywords: anemia, kidney failure, hemodialysis, hyperparathyroidism.
Effects of Regional Financial Independence, Total Assets, Intergovernmental Revenue and Inspection Findings on Financial Performance with Capital Expenditure as Moderating Variable in Provincial Government of North Sumatera
Authors: Lubis Windy Syafira , . Erlina , Hasyim Sirojuzilam
Published: November 2022

This study aims to determine and analyze how the effect of regional financial independence, total assets, intergovernmental revenue, and audit findings on the financial performance of local governments in North Sumatra Province. In addition, this study also aims to determine whether capital expenditure can be used as a moderating variable in the research model.
This type of research is causal associative research that uses a quantitative approach. The population in this study were all district/city governments in the Province of North Sumatra, consisting of 25 regencies and eight cities. The number of observation samples in this study was 165 data. Meanwhile, the data analysis technique used in this research is panel data regression and moderating test carried out with the help of Eviews software.
The results of this study indicate that regional financial independence and intergovernmental revenue have a positive and significant effect on the financial performance of local governments. Meanwhile, the audit findings have a negative and significant impact on the financial performance of local governments. Other results in this study indicate that capital expenditure can moderate the effect of regional financial independence and total assets on the financial performance of local governments in North Sumatra Province.

Keywords: Regional Financial Independence, Total Assets, Intergovernmental Revenue, Audit Findings, Local Government Financial Performance, Capital Expenditure.
Measurement of Air Pollutant levels and the Occurrence of Environmental Lung Diseases in Umuahia Metropolis, Southeastern Nigeria
Authors: A.U. Offiah, , A.N. Amadi, , Y.C. Azuamah,
Published: November 2022

Exposure to air pollutants can result to environmental lung diseases. This study was a cross-sectional study carried out at Umuahia metropolis, South-Eastern Nigeria to measure the level of outdoor air pollutants and assess the occurrence of environmental lung diseases among residents. An informed consent was obtained from all the participants in the study. Gas meters were used to measure the level of air pollutants at various outdoor locations and a well-structured questionnaire was used to obtain information from the residents. Results showed that the CO level in ppm was 182 at GPS location 5.52491N and 7.49460E; 181 at 5.52480N and 7.49226E; 183 at 5.52071N and 7.49603E; 186 at 5.52466N and 7.49711E; 190 at 5.52413N and 7.49488E; 185 at 5.52164N and 7.49491E. The SO2 level in μg/m3 was 470 at GPS location 5.52491N and 7.49460E; 512 at 5.52480N and 7.49226E; 492 at 5.52071N and 7.49603E; 480 at 5.52466N and 7.49711E; 504 at 5.52413N and 7.49488E; 552 at 5.52164N and 7.49491E. SPM levels in μg/m3 was 1948 at GPS location 5.52491N and 7.49460E; 1915 at 5.52480N and 7.49226E; 1939 at 5.52071N and 7.49603E; 1955 at 5.52466N and 7.49711E; 1920 at 5.52413N and 7.49488E; 1963 at 5.52164N and 7.49491E. The mean CO value was 184.44±3.27; mean SO2 was 501.62±29.02; mean SPM was 1940±19.20. The CO, SO2 and SPM levels were significantly higher (P<0.05) than normal levels. The distribution of the respiratory complaints by the residents were coughing, 74(50.68%); sneezing, 83(56.85%); catarrh, 46(31.51%); asthma, 28(19.18%); short breath, 36(24.66%); pneumonia, 19(13.01%); wheezing, 67(45.89%); dizziness, 49(33.56%); breathing difficulty, 62(42.47%). Public enlightenment on the gaseous pollutants present at work places and possible health effects was recommended.

Keywords: Pollutants, Carbon Monoxide, Sulphur dioxide, Suspended Particulate Matter, Asthma, Pneumonia
Autopsy Pathology of Hypertensive Cardiovascular Disease: Case Reports
Authors: A.U Offiah, , A.N. Amadi, , Y.C. Azuamah,
Published: November 2022

An Autopsy is performed on a dead body primarily to determine the cause of death. Two autopsies of death from hypertensive cardiovascular disease were performed at Abia State University Teaching Hospital, Aba, Nigeria. The first autopsy was on a 51 year old man diagnosed about 12 years before his death with hypertension. Autopsy report after his death revealed pan-valvular dilatation, benign nephrosclerosis, chronic pyelonephritis, hepatomegaly with chronic passive congestion of the liver, splenomegaly, pleural effusion, pulmonary edema, ascites and moderate cerebral edema. The cause of death was ruled as congestive cardiac failure and hypertensive cardiovascular disease. The second autopsy was on a 60 year old woman who died after a 5 day history of headache and a day history of loss of consciousness. Autopsy report after her death revealed massive intracerebral and intraventricular haemorrhage, pontine haemorrhage, laryngotracheobronchitis, pulmonary edema, and congested liver and spleen. The cause of death was ruled as hypertensive cardiovascular disease with massive intracranial haemorrhage. A thorough autopsy of deaths from hypertensive cardiovascular disease to reveal other associated pathologies was recommended.

Keywords: Autopsy, Hypertensive cardiovascular disease, Intracranial haemorrhage, Congestive cardiac failure, Hypertension
Cardiocytoprotection with metabolic drugs - study of the effectiveness of meldonium in ischemic heart disease
Authors:   Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova, Chetruș Olga
Published: November 2022

Introduction. Ischemic heart disease is one of the most widespread cardiovascular diseases. In Republic of Moldova the total number of patients with ischemic heart disease is 30-40 thousand per 1 million population and is observed more of working age with important social value. Materials and method. An open randomized clinical trial involving 139 patients with chronic heart failure (107 men and 32 women) aged 37 to 81 years: 111 patients had angina pectoris of stable effort from different functional classes, and 28 – unstable angina pectoris, which include: basic treatment n = 43; basic treatment + meldonium (non-infarct) n = 52; basic treatment + meldonium (post-infarct) n = 35; basic treatment + meldonium, (aggravated) n = 9. Study groups were compared according to the frequency of using background (basic) drugs and meldonium. Statistical processing of the results was carried out in Statistics Software Package 9.0. Results. During the treatment, the increase of the nitric oxide level was registered even from the discharge stage, and in the second group being approximately at the same level as the initial stage. At the 3-month, nitric oxide level reached the normal level. There is an improvement of the endothelial dysfunction by the significant increase of the nitric oxide under the treatment at 6 months (in group I – 87.26±4.3 µM/L (p = 0.01), in group II – 95.33±10.85 µM/L). Conclusions. The inclusion of meldonium in the complex treatment of patients with stable angina increases the clinical efficacy of basic pharmacotherapy when prescribing meldonium, mainly due to increased antianginal actions.
Recovery of patients with gout
Authors:   Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova, Rotaru Larisa , Groppa Liliana ,   Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova, Popa Serghei ,   Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova, Nurseitova Tamilla ,   Dunarea de Jos University of Galati, Romania, Cornea Cornelia ,   Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova
Published: November 2022

Introduction. The incidence and prevalence of gout have increased worldwide in recent decades. Scientists at the Rochester Epidemiology Project (MN, USA) have seen a two-fold increase in the incidence of primary gout (patients without diuretic exposure) over a 20-year period, which ended in 1996. The increase of incidence may be related due to the difficulty and often unsatisfactory treatment options. The aim of the study was to systematize the recommendations on dietary treatment, and medication for patients with gout. Materials and methods. An analytical, qualitative, and secondary study was performed in the form of a synthesis article. 115 sources were identified and analyzed; from this list, 44 sources were selected according to the impact score during the publication period and according to the level of recommendations. Results. 44 articles were included. Most studies were small, retrospective analyses performed in single centers, with concerns for bias. Eleven studies (including five randomized controlled trials) reported improved patient outcomes following pharmacological interventions with known efficacy in gout, including allopurinol, prednisolone, NSAIDs and anakinra. Eight studies reported improved outcomes associated with non-pharmacological interventions: inpatient rheumatology consultation and a hospital gout management protocol. No studies to date have prospectively evaluated strategies designed to prevent re-admissions of patients hospitalized for gout flares. Conclusions. Urate crystals is completely soluble when we can lower the serum level of uric acid to normal values, but this often requires long-term treatment. The early onset of rehabilitation of affected joints helps to reduce the articular inflammatory process, the pain syndrome and it delays the progression of the underlying pathology while improving the quality of life in patients with gout. Further research is needed to enable healthcare providers to individualize and optimize gout treatment strategies, ensuring that patients with gout receive effective, safe, and high-quality care.
Assessing the factors for humanitarian logistics digital business ecosystem (HLDBE) using a novel integrated correlation coefficient and standard deviation - combined compromise solution (CCSD-CoCoSo) method
Authors: Baffoe Benjamin Ohene Kwapong , Luo Wenping , Pan Qiao Hong , Zhou Sheng Hong , Wu Mei Ju , Atimu Louis Kofi Desire , Darko Peter Adjei , Opoku-Mensah Evans
Published: November 2022

This study updates Humanitarian Logistics Digital Business Ecosystem framework coupled with the development of a proposed integrated CCSD-CoCoSo MCDM method to rank factors used in assessing humanitarian and business logistics actor’s propensity to use, diffuse, and adopt a collaborative digital business ecosystem platform for their future operational use. Employing nine criteria derived from technology innovation theories and institutional theory, and 28 experts comprising our decision matrix. The findings report perceived relative advantage, perceived safety and security, and infrastructure and expertise as the top three vital criteria that experts believe when addressed in an ecosystem platform for humanitarian and business logistics actors it would encourage a collaboration for their sustainable future operations. With organisational culture and structure as the least prioritised criteria. The study concludes that the CCSD-CoCoSo obtained results are objective, validating, and that this model is useful and suitable for MCDM analysis and policy making.
Management of periprosthetic knee joint infections: focus on the role of Nuclear Medicine (v2)
Authors: Boero Michele , Allocca Michela , Pisu Nicola , Sanna Silvia , Ruggiero Alessia , Pung Bi Llie Joy , Margotti Simone , Dessì Giuseppe
Published: November 2022

Background

When faced with a painful knee replacement, ruling out infection is mandatory to set the correct therapeutic approach. However, it is not always easy, especially in subclinical/chronic infections. A multidisciplinary approach is necessary to assess in the most correct way each case of suspected periprosthetic knee joint infection. This review explores the role of nuclear medicine investigations in the management of periprosthetic knee infections and their proper use within a multidisciplinary pathway.

Methods

A PubMed search was conducted selecting studies from the past 10 years.

Results

Triphasic bone scintigraphy has high sensitivity (93%) but poor specificity (56%) for periprosthetic joint infections of the knee, with a high negative predictive value (NPV), ranging from 96% to 100%. Consequently, a negative bone scan is useful in ruling out infection. In contrast, radiolabeled leukocyte scintigraphy is characterized by a sensitivity of 85.7-93%, specificity of 93.6-100%, diagnostic accuracy of 92.6-98%, NPV of 93-97.8%, and positive predictive value (PPV) of 66.7-100%. By adding a tomographic acquisition with hybrid single-photon emission computed tomography combined with computed tomography technique (SPECT/CT), the diagnostic accuracy increases. Because 18F-fluorodeoxyglucose (FDG) accumulates at both sites of inflammation and infection, FDG positron emission tomography (PET/CT) shows low specificity.

Conclusions

A common decision-making process in the diagnosis of periprosthetic joint infection is not yet validated and multidisciplinary integration is mandatory. In this context, nuclear medicine can contribute decisively.
A Survey on the Choice of Spinal Cord Stimulation Parameters and Implantable Pulse Generators and on Reasons for Explantation
Authors: Gill Jatinder S , Kohan Lynn R , Hasoon Jamal , Urits Ivan , Viswanath Omar , Cai Viet L , Yazdi Cyrus , Aner Musa M , Kaye Alan D , Simopoulos Thomas T
Published: November 2022

Objective

Spinal Cord Stimulation (SCS) is a vital treatment for chronic intractable pain. In the last few years, the field has undergone dramatic changes in new waveform and frequency introduction as well as device miniaturization. It is important to understand contemporary practice patterns regarding these parameters.

Methods

We surveyed the active membership of Spine Intervention Society (SIS), and American Society of Regional Anesthesia (ASRA) on their practices regarding various aspects of Spinal Cord Stimulation therapy. Here we report on SCS waveform usage, battery types, and causes of explant in this cohort of providers.

Results

There was similar degree of usage of tonic, burst, and 10 kHz usage at 71.5%, 74.1% and 61.7% respectively. Dorsal root ganglion stimulation was used by 32.6% and other modes of stimulation by 13.5%. Rechargeable systems were often or always used by 67.2% whereas 10% never used a rechargeable system. Most common cause of explant was loss of effectiveness, reported by 53.7%.

Conclusion

There has been significant adoption of new waveforms in daily practice of spinal cord stimulation therapy and there is robust mixed usage of new waveforms and frequencies. Rechargeable systems are the most commonly used but primary cell is also used in significant numbers. Loss of efficacy remains the most common cause of explant for the majority of practitioners. This survey establishes practice patterns of SCS usage regarding these important variables against which future changes can be gauged.
El asentimiento como vínculo entre la razón y la fe
Authors: Romero Baró José M.
Published: November 2022

Esta comunicación intenta exponer algunas de las actividades del pensamiento humano que muestran el vínculo que mantiene unida la razón con la fe, concluyendo que la fe es algo necesario para la razón. En efecto, siguiendo algunas de las enseñanzas de Aristóteles, san Agustín y santo Tomás de Aquino, se muestra cómo la razón lleva necesariamente hasta el entendimiento, cómo el entendimiento se da necesariamente con la voluntad y, finalmente, cómo la voluntad asiente libremente en el acto de fe.
Fascism, Vulnerability, and the Escape from Freedom
Authors: Delogu C. Jon
Published: November 2022

A worldwide struggle between democracy and authoritarianism set against a backdrop of global surveillance capitalism is unmistakable. Examples range from Myanmar, China, and the Philippines to Hungary, Turkey, Russia, and the United States. Fascism, Vulnerability, and the Escape from Freedom offers a multidisciplinary analysis drawing on psychology and literature to provide readers with a deeper understanding of the mechanisms that drive people to abandon democracy in favor of vertically organized authoritarianism and even fascism.

In a comparative study of texts selected for their insights and occasional blind spots regarding fascist experiments of the past 100 years, Delogu examines fascism’s exploitation of fear (of change, loss, and death), disruption, and extreme inequality. The book offers an accessible and persuasive argument linking fascist authoritarianism, also called “right-wing populism,” to certain underlying conditions, such as a rise in us-versus-them thinking; distrust or simple apathy regarding democratic institutions, norms, and results; the vulnerabilities that result from extreme inequality (economic, social, racial); and addictions and codependency. Stressful events, such as a pandemic, an environmental disaster, or deep recession aggravate these harmful factors and make the fascist temptation, including the use of violence, almost irresistible. Delogu’s distinctive examination of texts that plumb the unconscious reveal linkages between actions and unavowable motives that purely historical and theoretical studies of fascism leave out.

Erich Fromm’s neglected 1941 classic Escape from Freedom serves as a key reference in Delogu’s study, as does Robert Paxton’s authoritative history, The Anatomy of Fascism (2004). After underscoring the argument and urgent context around these two studies (Hitler’s Germany and George W. Bush’s post-9/11 America), Delogu examines novels, a diary, memoirs, and manifestos to show how vulnerability forces individuals to choose between exclusionary fascist authoritarianism and inclusive, collaborative democracy.
The Discourging Behavour of Seniors Effects the Personality of Junior Doctors A Cross Sectional Study
Authors: Nawaz Sobia , Ashraf Asma , Haleema Sadia , Sharif Kanwal , Arshad Asma , Ashraf Nargis
Published: November 2022

Purpose: Insulting and discouraging conduct of the senior could be very common in fitness professionals. My goal was to explore the emotions, behaviors and reactions of the junior doctors closer to this form of discouraging mindset at their painting’s region (In NSSH). (Ahmer, Yousafzai et al. 2008) Study Design: Cross sectional study Place and Duration: Nawaz Sharif social safety hospital. June 2018 Methods: A convenient sampling length consists of one hundred and fifteen which include both males and female, most of them were in age group (21-45). A data become amassed by a predesigned, pretested questionnaire survey which changed into advanced after big literature evaluation and allotted to scientific specialists of their hospitals. Verbal knowledgeable consent was taken and confidentiality changed into ensured. Results: An average reaction price is a hundred%, 75%of responses suggested enjoy the insulting and discouraging behavior at their paintings region from the senior college participants. The maximum not unusual insulting behavior became unjustified grievance. Junior docs experience multiple episodes of insult and discouraging conduct in past six months. Junior docs have observed the humiliating conduct of their seniors with their colleagues. Conclusion: Bullying or Insulting conduct is confronted with the aid of massive population of junior docs in Pakistan. The maximum common perpetrators of this bullying are specialists. fundamental changes are required at countrywide and character stage in Pakistan to resolve this problem. To save you its unwanted results in fitness care gadget. (Hicks 2000) Keywords: Discouraging Behavior, Doctors, Senior, Junior
Correlation of Vitamin D with Monocytes and Lymphocytes in Care Takers of Tuberculosis Patients
Authors: Namoos Kiran , Jaleel Anila , Uppal Sadaf Saleem , Asim Samar , Khursheed Rukhshan , Chughtai Arsalan Saleem
Published: November 2022

Background: Close relatives of tuberculosis patients may be at increased risk of developing the disease as they are in close contact with them Objectives: A cross-sectional research was conducted to determine correlation of Vitamin D with monocytes and lymphocytes in individuals with active tuberculosis as well as their care takers. Material and Methods: Total of 83 subjects was divided into three groups. Of the 83 participants, 31 had active tuberculosis, while 31 were adult family members who lived with and looked after the patients. 21 healthy age matched individuals were chosen to form the control group. SWISS Max analyzer was used to evaluate the levels of lymphocytes and monocytes in the blood and Vitamin D was measured by ELISA. Results: Vitamin D levels and monocyte lymphocyte count in the three groups showed substantial variation. The patient's monocyte and lymphocyte count showed a statistically significant correlation. However there was non-significant correlation of vitamin D with both monocyte and lymphocyte. Conclusion: Caretakers of active tuberculosis patients showed increased levels of circulating monocytes, lymphocytes as well as lower vitamin D levels with increased risk of developing tuberculosis. Keywords: care taker, tuberculosis, vitamin D, monocyte and lymphocyte
Association of Elevated ASO Titer with Plaque and Guttate Psoriasis
Authors: Kumari Rakhi , Sohail Sorath , Dost Samrin , Tirmizi Syeda Shahmoona , Siddiqui Sana , Shaikh Fozia
Published: November 2022

Objectives: To determine the association of elevated ASO titer with plaque and guttate psoriasis. Study Design: Case control study. Place and Duration: Department of Dermatology, Shaheed Mohtrama Benazir Bhutto Medical University (SMBBMU), Larkana during from 22nd January 2018 to 21st July 2018 Materials & Methods: A total of 30 patients with plaque or guttate psoriasis and 30 controls, 20 to 60 years of age of either gender were included. Patients taking systemic anti-psoriatic drugs, CRF and erythroderma were excluded. After this throat swabs were taken and pathogenic organism was identified by gross colony morphology and types of hemolysis on culture media. β-hemolysis indicated growth of Streptococcus pyogens. Antistreptolysin O titer (ASO titer) was measured and titer >200 IU/ml was taken as elevated. Results: Mean age was 40.92 ± 10.62 years. Out of 60 patients, 40 (66.67%) were males and 20 (33.33%) were females with male to female ratio of 2:1. Frequency of elevated ASO titer in patients with plaque and guttate psoriasis was found in 13 (43.33%) and in 04 (13.33%) controls with p-value of 0.014 and odds ratio of 2.97. Conclusion: This study concluded that concluded that there is positive association of elevated ASO titer with plaque and guttate psoriasis. Keywords: Psoriasis, Throat Infection, ASO Titer
Do Non Alcoholic Fatty Liver Disease Patients Have more Severe Metabolic Syndrome
Authors: Basit Abdul , Ali Muhammad , Batool Muazma , Jakhrani Hafiz Abdul Salam , Atiya Aamer Atiya x , Naz Maryam
Published: November 2022

Background and goal: Alcohol-unrelated fatty liver disease (NAFLD) is a frequent type of chronic liver disease (CLD) that is rapidly spreading around the world. The study's primary goal is to evaluate the severity of metabolic syndrome in people with nonalcoholic fatty liver disease. Materials and methods: From January to July 2019, Shalimar Medical and Dental College in Lahore, Pakistan, conducted this cross-sectional study. Through the use of non-probability sampling, the data was gathered. 100 patients with hepatic cirrhosis provided the data. The participants in this study ranged in age from 20 to 60. For the serum examination of liver enzymes, blood was drawn. Results: A correlation between the severity of the metabolic syndrome and NAFLD was found in this study, which included data from 100 individuals with biopsy-proven NAFLD. The patients were 45.67 3.56 years old on average. Compared to the normal control (11,3.42), the ALT levels in the patients were 258.291.73, 79.6628.63, and 50.73 8.4 correspondingly. Patients with cirrhosis, alcoholic liver disease, and viral hepatitis all had considerably higher aspartate aminotransferase levels. The significant frequency elevated aminotransferases and of NAFLD in IR-obese adolescents, as well as the potential consequences for their health, are concluded. The strong connections between NAFLD and MetS encourage the screening for additional MetS co-morbidities.
Association Between Hormonal Contraceptives and Cervical Neoplasia in Local Population of Khyber Pakhtunkhwa
Authors: Gul Sara , Ali Tabassum , Bibi Razia , Hanif Sadia , Gul Sanila , Farooqi Komal
Published: November 2022

Background: Hormonal contraception and the risk of developing cervical cancer is a contentious topic. These debates may reduce the popularity of hormonal birth control. Objectives: The goal of this study is to assess the prevalence of Cervical Smear abnormalities among Peshawar's multiethnic population in relation to the usage of hormonal contraceptives. Methods: This was a Case Control Study conducted on the females visiting DHQ Teaching Hospital Swabi, RHSC (A) KTH, HMC, LRH and FWC’s in district Peshawar who were persistent long-term users for more than 5 years of any type of hormonal contraception. The study was conducted during the period from 1st August, 2021 to 30th January, 2022. We made two groups, one who had never used any method of contraception and the other persistent users of hormonal contraception. After approval from ethical committee and an informed consent of the client, enrollment in the study was made. Results: A total of 300 patients were included in this study. 150 were cases whereas 150 were controls. Mean and SDs For Age 30+4.6 28+4.92. In the hormonal group, for type of contraceptives used, 98 (65.33%) patients used injectable, 40 (26.66%) patients used OCP whereas 12 (8%) patients used implants. As per frequencies and percentages for duration of use of contraceptives in the hormonal group, 120 (80%) were using different types of contraceptives for less than or equal to seven years whereas 30 (20%) were found using contraceptives for more than seven years As per frequencies and percentages for smear results in both groups, only 3 (2%) patients were found having atypical smear results who using injectable contraceptives for more than seven years however in the control group only 02 (1.33%) patient were having atypical smear results. Conclusion: Our research did not identify any correlation between using birth control and having an abnormal Pap smear. Additional prospective research is needed. Keywords: Pap smear, Abnormal, and Oral Contraceptive Pill (OCP).
A Retrospective Study on Outcome of Hemodialysis in Elderly Diabetic Patients
Authors: Noor Sana , Noor Hajra , Ishaque Aishah , Waheed Shahid , Hussain Syed Imad , Naeem Nadeem
Published: November 2022

Background and Aim: Hemodialysis is a valuable treatment for elderly individuals progressing to chronic kidney disease (CKD). Globally, hemodialysis demand is increasing for elderly individuals as a life-sustaining therapy which might lead to prolonged suffering in geriatric patients. Therefore, the current study aimed to evaluate the outcomes of hemodialysis in elderly diabetic patients. Methodology: This retrospective study was carried out on 64 type 2 diabetic patients admitted to the Dialysis Unit at Social Security Hospital, Multan Road Lahore from January 2021 to April 2022. Ethical approval was taken from the institution research and ethical committee. All the type 2 diabetic patients above 65 years age having CKD on dialysis were included. Patients having disease that require immunosuppressive treatment, history of malignancy, and those who died within three months of initial treatment were excluded. Patient’s survival data and comorbidities such as cognitive, vascular, and autonomy were studied. Other comorbid conditions such as cerebrovascular disease, peripheral vascular disease (PVD), and coronary artery disease (CAD) were reviewed. SPSS version 25 was used for data analysis. Results: Of the total 64 diabetes patients, there were 34 (53.1%) males and 30 (46.9%) females. The overall mean age was 68.9±3.1 years whereas dialysis mean duration was 28±22 months. Cognitive impairment, lost autonomy, and prior cerebrovascular accident had significant association with mortality rate reported as 7.8% per year. The incidence of fistula or graft, depression, dementia, died, and bedridden cases were 39% (n=25), 18.8% (n=12), 15.6% (n=10), 12.5% (n=8), and 14.1% (n=9) respectively. Of the 25 cases of fistula or graft, about 9.5% used catheter. Conclusion: The present study found that mortality rate was 7.8% in elderly (>65 years) diabetes patients. The high mortality risk was substantially related with cognitive disorder, cerebral vascular accident, and lost autonomy. Generally, hemodialysis practice varies with the region’s clinical pattern due to age variation in elderly patients. Keywords: Hemodialysis, Chronic kidney disease, Elderly, Diabetes