bluuebunny/crossref_metadata_2025 huggingface dataset:
Funeral Company Customer Satisfaction and Loyalty
Authors: SOWIER-KASPRZYK Izabella
Published: March 2024

Purpose: The aim of the paper was to analyse and present the results of the research concerning customers satisfaction and loyalty. The uniqueness of this article is that it concerns funeral services that are associated with the sad event of the death of a loved one. The study examined the issue of customer satisfaction in funeral services and how it affects customer loyalty. Moreover, attention was also focused on the analysis of loyalty. Design/Methodology/Approach: The research methodology is based on customers surveys and a confrontation with the research literature. In addition, a literature analysis of the study of this phenomenon was carried out. Conclusions: The research showed that customers are satisfied with the funeral company they have previously used. They are willing to use this company again should the occasion arise. On this basis, it can be concluded that they are loyal customers. In addition, customers emphasised the understanding of their needs in the event of the death of a loved one. They also indicated calmness in customer service, good communication and keeping their word and the terms of the contract. It can be concluded that customers expect personalised contact with funeral company and a high level of emotional involvement in the relationship between service providers and bereaved family customers. If there are feelings in the relationship, it is trusting and enduring. Funeral homes can use these opportunities to create a relationship of trust and loyalty with the client. Practical implications: The results of the research deepen the understanding of strengthening customer relationships, with a particular focus on loyalty in such a sensitive topic as funeral home customer service. Customer loyalty is built by funeral directors and the relationship with the customer is deepened. With customer satisfaction, this happens naturally and the funeral company should not emphasise the slogan loyalty because, as mentioned earlier, the subject of death and the purchase of a funeral service is sensitive. Originality/value: The application of the solutions proposed in the article influences the development of knowledge in terms of deepening customer relations, customer satisfaction and customer loyalty when it comes to funeral companies. The article may be useful for companies in the funeral industry
Funeral Company Customer Satisfaction and Loyalty
Authors: SOWIER-KASPRZYK Izabella
Published: March 2024

Purpose: The aim of the paper was to analyse and present the results of the research concerning customers satisfaction and loyalty. The uniqueness of this article is that it concerns funeral services that are associated with the sad event of the death of a loved one. The study examined the issue of customer satisfaction in funeral services and how it affects customer loyalty. Moreover, attention was also focused on the analysis of loyalty. Design/Methodology/Approach: The research methodology is based on customers surveys and a confrontation with the research literature. In addition, a literature analysis of the study of this phenomenon was carried out. Conclusions: The research showed that customers are satisfied with the funeral company they have previously used. They are willing to use this company again should the occasion arise. On this basis, it can be concluded that they are loyal customers. In addition, customers emphasised the understanding of their needs in the event of the death of a loved one. They also indicated calmness in customer service, good communication and keeping their word and the terms of the contract. It can be concluded that customers expect personalised contact with funeral company and a high level of emotional involvement in the relationship between service providers and bereaved family customers. If there are feelings in the relationship, it is trusting and enduring. Funeral homes can use these opportunities to create a relationship of trust and loyalty with the client. Practical implications: The results of the research deepen the understanding of strengthening customer relationships, with a particular focus on loyalty in such a sensitive topic as funeral home customer service. Customer loyalty is built by funeral directors and the relationship with the customer is deepened. With customer satisfaction, this happens naturally and the funeral company should not emphasise the slogan loyalty because, as mentioned earlier, the subject of death and the purchase of a funeral service is sensitive. Originality/value: The application of the solutions proposed in the article influences the development of knowledge in terms of deepening customer relations, customer satisfaction and customer loyalty when it comes to funeral companies. The article may be useful for companies in the funeral industry.
Diamond is a scientist’s best friend
Authors: Andringa Sible , Mos Maria , Van Beuningen Catherine , González Paz , Hornikx Jos , Steinkrauss Rasmus
Published: March 2024

The field of applied linguistics is increasingly adopting open science practices. As open access publication gains traction, ethical issues emerge that need to be addressed by the field. This viewpoint paper addresses the concern that open science is not equally open for everyone. This paper describes how open access publication is increasingly being commercialized and explains how open access publication coincides with systemic inequality. We offer the following viewpoints for the field to consider:

We are morally obligated to make our research output accessible.
Hybrid, Gold, and Green open access publishing lead to systemic inequality in open access publishing, benefiting commercial publishers and those working in research-intensive universities and rich countries.
Diamond open access publication removes the systemic inequalities; hence, Diamond open access should be prioritized over Hybrid, Gold, and Green open access publication models.
We should move away from publish-and-read agreements and Green open access publishing, because they prevent system change.
Through our choices in our work as researchers, editors, reviewers, authors and teachers, we can contribute to the transition towards truly equitable open access publishing practices.
Senior researchers are in the position and have the moral obligation to be drivers of these changes.
Utility of Kent's Repertory in the treatment of candidiasis: An open labelled, Single arm, interventional clinical trial
Authors: Saklani Nitin Kumar , Prajapati Ramkripal
Published: March 2024

ABSTRACT

Background: Candidiasis is the most significant opportunistic infection impacting the Quality of life. Objective: This study assess the effectiveness of individualized homoeopathy (IH) in centesimal scale selected from the Kent’s repertory in cases of Candidiasis. Methods: This is open – label, prospective, Single-arm, non-randomized, non-controlled clinical trial of pre-post comparison design was conducted at the Repertory outpatient department (OPD) of National Institute of Homoeopathy, Kolkata, India. Result: Calculated t29 value is 8.04 OR 9.17 by using NRS and MCAQ scoring scale and on referring t-table at degree of freedom 29,  it is found that the t-value is 2.05 at p=0.05. However our calculated value 8.04 or 9.17 is > 2.05 (t at p=0.05). As the calculated t-value is greater than the table value at α  = 0.05 . So the result is significant at p ≤ 0.05. There is statically significant improvement in pre and post intervention status of patients enrolled in this clinical study. Conclusion: This study provides a positive trend to support the effect of IH (Individualized Homoeopathy) selected on the basis of principal of Kent’s repertory  in patients with different variety of candidiasis and warrants further evaluation in RCT (Randomized control trial) with higher sample size.
A novel infrared imager for studies of hydroxyl and oxygen nightglow emissions in the mesopause above northern Scandinavia
Authors: Dalin Peter , Brändström Urban , Kero Johan , Voelger Peter , Nishiyama Takanori , Trondsen Trond , Wyatt Devin , Unick Craig , Perminov Vladimir , Pertsev Nikolay , Hedin Jonas
Published: March 2024

Abstract. The paper describes technical characteristics and presents the first scientific results of a novel infrared imaging system (imager) for studies of nightglow emissions coming from the hydroxyl (OH) and molecular oxygen (O2) layers in the mesopause region (80–100 km) above northern Scandinavia. The OH imager was put into operation in November 2022 at the Swedish Institute of Space Physics in Kiruna (67.86° N, 20.42° E; 400 m altitude). The OH imager records selected emission lines in the OH(3-1) band near 1500 nm to obtain intensity and temperature maps at around 87 km altitude. In addition, the OH imager registers infrared emissions coming from the O2 IR A-band airglow at 1268.7 nm in order to obtain O2 intensity maps at a slightly higher altitude, around 94 km. This technique allows the tracing of wave disturbances in both horizontal and vertical domains in the mesopause region. Validation and comparison of the OH(3-1) rotational temperature with collocated lidar and Aura Microwave Limb Sounder (MLS) satellite temperatures are performed. The first scientific results obtained from the OH imager for the first winter season (2022–2023) are discussed.
Air pollution emission inventory using national high-resolution spatial parameters for the Nordic countries and analysis of PM2.5 spatial distribution for road transport and machinery and off-road sectors
Authors: Paunu Ville-Veikko , Karvosenoja Niko , Segersson David , López-Aparicio Susana , Nielsen Ole-Kenneth , Schmidt Plejdrup Marlene , Thorsteinsson Throstur , Vo Dam Thanh , Kuenen Jeroen , Denier van der Gon Hugo , Jalkanen Jukka-Pekka , Brandt Jørgen , Geels Camilla
Published: March 2024

Abstract. Air pollution is an important cause of adverse health effects, even in the Nordic countries, which have relatively good air quality. Modelling-based air quality assessment of the health impacts relies on reliable model estimates of ambient air pollution concentrations, which furthermore rely on good-quality spatially resolved emission data. While quantitative emission estimates are the cornerstone of good emission data, description of the spatial distribution of the emissions is especially important for local air quality modelling at high resolution. In this paper we present a new air pollution emission inventory for the Nordic countries with high-resolution spatial allocation (1 km × 1 km) covering the years 1990, 1995, 2000, 2005, 2010, 2012, and 2014. The inventory is available at https://doi.org/10.5281/zenodo.10571094 (Paunu et al., 2023). To study the impact of applying national data and methods to the spatial distribution of the emissions, we compared road transport and machinery and off-road sectors to CAMS-REGv4.2, which used a consistent spatial distribution method throughout Europe for each sector. Road transport is a sector with well-established proxies for spatial distribution, while for the machinery and off-road sector, the choice of proxies is not as straightforward as it includes a variety of different type of vehicles and machines operating in various environments. We found that CAMS-REGv4.2 was able to produce similar spatial patterns to our Nordic inventory for the selected sectors. However, the resolution of our Nordic inventory allows for more detailed impact assessment than CAMS-REGv4.2, which had a resolution of 0.1° × 0.05° (longitude–latitude, roughly 5.5 km × 3.5–6.5 km in the Nordic countries). The EMEP/EEA Guidebook chapter on spatial mapping of emissions has recommendations for the sectoral proxies. Based on our analysis we argue that the guidebook should have separate recommendations for proxies for several sub-categories of the machinery and off-road sectors, instead of including them within broader sectors. We suggest that land use data are the best starting point for proxies for many of the subsectors, and they can be combined with other suitable data to enhance the spatial distribution. For road transport, measured traffic flow data should be utilized where possible, to support modelled data in the proxies.
Hull-House y la terapia ocupacional como activismo artístico en la lucha feminista
Authors: Dacuña Vázquez Inés , Álvarez Barrio Carla , Mesías Lema José María
Published: March 2024

Este artículo quiere visibilizar, divulgar y recuperar la historia de la Hull-House, como un referente único en la lucha por los derechos ciudadanos. Es a través de los procesos artísticos vinculados a la Terapia Ocupacional cuando, la feminista Jane Addams, desarrolla el proyecto de la Hull-House como democratización de un modelo político-cultural a través de las artes. Planteamos una reflexión crítica sobre el análisis etnográfico del archivo fotográfico vinculado al proyecto de la Hull House. Esta investigación nos permitió contar una historia invisibilizada debido a la hegemonía colonialista en el campo de la Terapia Ocupacional, muy encorsetada en su aspecto clínico y reduccionista. Así, proponemos un redescubrimiento de los orígenes terapéuticos de la Terapia Ocupacional a través del activismo artístico como uno de los ejes vertebradores de la Hull-House.
A Paloma Hidalgo Goyanes
Authors: Cuadernos de Documentación Multimedia
Published: March 2024

A Paloma Hidalgo Goyanes
REFLEXÕES SOBRE VIOLÊNCIA EM AMBIENTE ESCOLAR
Authors: Aguiar Maycon Silva
Published: March 2024

Nas escolas brasileiras, a violência é um problema multifatorial: reflete tanto desafios sociais quanto desafios educacionais e se enraíza, sobretudo, em relações de desigualdade, na desestruturação familiar, na influência de mídias sociais e na violência comunitária. Varia de bullying psicológico a agressões físicas graves, afetando a segurança dos envolvidos, a consecussão dos objetivos atrelados ao processo de ensino-aprendizagem e o exercício do magistério. Para combatê-la, é necessário um esforço contínuo e conjunto de educadores, de familiares, de políticas públicas e de membros da comunidade escolar, com estratégias que incluam fortalecimento do apoio socioemocional, promoção da segurança física, formação de professores e efetivação de uma cultura de paz. Investimentos em educação, em saúde e em oportunidades de emprego são essenciais para a oferta de um ambiente escolar mais seguro e, portanto, para o desenvolvimento integral de crianças e de adolescentes.
Comparative Thematic Analysis of Social Science Research Articles by Pakistani and British Research Scholars: A Corpus-Based Study
Authors: Munir Sadia , Qasim Hafiz Muhammad , Muhammad Shafqat Nawaz
Published: March 2024

Writers maintain the texture of the text and information with appropriate thematic choices. Previous studies have established that the problem of jumbled information existed in the academic writings of non-native English writers. Considering this, the present study aimed to analyze social science research articles written by Pakistani and British researchers keeping textual metafunction as the focal point. The objectives were to explain the functional interpretation of the thematic structures and figure out the dominant theme type in collected 160 research articles. The data was analyzed through feature coding of UAM corpus software to find out frequencies and percentages of themes and their types. The results revealed that the frequencies of themes in Pak-19 and Pak-20 were 1066 and 1252, while the frequencies in Bri-19 and Bri-20 were 1519 and 1883. Further, the findings suggested that the topical theme was frequently used as compared to textual and interpersonal themes. The second highest ratio was of textual theme as the frequencies of interpersonal theme were less as compared to textual. The topical themes functioned as noun groups, while the textual themes connected new information with previous information. Based on the findings, it was established that unmarked topical themes were prevailing in the research articles. Further, the use of finite, continuatives, and conjunctions was prevalent in textual themes.
The Digitalization in Insurance Broker Industry: How Artificial Intelligence Affect This Industry
Authors: Khalisa Arvidhia
Published: March 2024

This qualitative research explores the impact of digitalization, with a particular focus on artificial intelligence (AI), on the insurance broker industry. In-depth interviews and focus group discussions were conducted with eight senior-level employee and eight younger participants from technology and operations departments, also from client-facing positions. The research aimed to analyze the impact of digitalization, especially artificial intelligence, to the insurance broker industry and to explore whether artificial intelligence is capable to replace an insurance broker role. The findings indicate that digitalization, including the adoption of AI, has brought about significant advancements in the industry. Digitalization efforts have led to streamlined processes, reduced costs, improved data analysis, and enhanced customer experiences. The findings of this research highlight the importance of taking a deliberate and strategic approach to digitalization and AI adoption in the insurance broker industry. Companies should use technology to increase efficiency while maintaining the human-centric elements that are essential for developing strong client relationships and providing tailored insurance solutions.
The Influence of Sustainable Captured Fish Supply Chain Management on the Quality of Sea-Caught Fish Exports
Authors: Ariffien Afferdhy , Sudirman Iman , Juniati Atty Tri
Published: March 2024

A report from the Ministry of Maritime Affairs and Fisheries explains that Indonesia's total fishery exports in September 2023 will reach US$ 4.1 billion (Rp. 64.1 trillion). This figure is still far from the target to be achieved, namely US$ 7.8 billion in 2023. The aim of this research is to accelerate the development of the National Fisheries Industry which is at the forefront. Take the example of the fisheries supply chain in Cilacap Regency which is the largest producer of caught fish on the island of Java. By using the Soft System Research Methodology (SSM), the efforts made are to outline solutions to unstructured problems, understand the actual problem situation and take action to improve it. From the survey results, there are six problems in the supply chain of capture fisheries industry activities in Cilacap Regency, namely lack of facilities and infrastructure, lack of understanding and knowledge of fishermen, limited capital for capture fisheries businesses, excessive fishing, fishing community culture and weak supervision/law. Meanwhile, the research results show that in an ideal marine fisheries industry supply chain system, Cilacap Regency must carry out coordination and communication activities between caught fish supply chain actors, provide facilities and infrastructure, build logistics networks, standardize production, control storage methods, build systems monitoring, quality assurance of fisheries, and building a capture fisheries trading system. The implications include providing education to fishermen regarding marketing, collecting information about consumers and their needs, developing and developing fishermen's competence, government supervision, building local fishermen's cooperatives and maintaining traditional values.
Side Effects of Brand Ambassadors on Brands “s”
Authors: Kuswandi Ignatius Richard , Kurniadi Benedicta Alvina , Hundura Rindina
Published: March 2024

BTS is a Korean boy band that is internationally renowned, with numerous fans across various countries, especially in Indonesia. BTS collaborates with various brands as brand ambassadors, one of them being Brand "S" brand ambassadors. BTS and ARMY (BTS fans) use various media to communicate with each other, and BTS often posts content related to the brands they collaborate with in their social media. The widely discussed phenomenon among BTS fans revolves around the products offered by the brand "S." The research aims to investigate how word of mouth affects the likelihood of purchasing, using the case study of the boy group BTS as brand ambassadors for the "S" brand. The study involved individuals from the Jabodetabek area who were familiar with the BTS band in association with the "S" brand. The research used a non-probability sampling approach, specifically choosing the convenience sampling technique during the sample selection process. The number of samples used in the study was 122 respondents, and data collection was conducted by distributing questionnaires through Google Forms. The data analysis was conducted using the Structural Equation Modelling (SEM) program SmartPLS 4.0. The results of the study indicate that word of mouth has a positive and significant influence on purchase intention.
Optimizing Financial Performance: A Comprehensive Examination of Economic Value Added (EVA) and Market Value Added (MVA) at Telecommunication Companies in Indonesia
Authors: Adiandari Ade Maharini , Anggara I Komang Bayu
Published: March 2024

This research aims to determine the factors that influence the financial performance of telecommunications companies in Indonesia using the Economic Value Added (EVA) and Market Value Added (MVA) approaches. The background to this research arises from the need to understand how operational efficiency, financial policy, innovation, market competition, and economic conditions play a role in creating economic value and the market value of equity. Data collected from telecommunications companies during the 2017-2022 period formed the basis of the analysis, and the research methodology involved measuring EVA and MVA and assessing factors that influence financial performance. The results of this research provide in-depth insight into the complexity of the relationships between variables and their implications for the business strategy of telecommunications companies in Indonesia.
Integrating Banking Fundamental Factors with Financial Technologies in Increasing Banking Performance
Authors: Rakhmat Adrianna Syariefur , Mohammad Hatta Fahamsyah  , Preatmi Nurastuti  , Muhammad Hamdan Ainulyaqin
Published: March 2024

The existence of innovation involving the adoption of technology in banking has boosted financial performance, where banks get sizable benefits. The use of technology in financial services or known as fintech not only produces new products and models in financial services, but has created solutions. This research is a quantitative research with secondary data sourced from the Financial Services Authority and Bank Indonesia from April 2020 to April 2023. The object of this research is all banks in Indonesia whose data has been aggregated. The variables used in the research are fintech as the independent variable, and banking profitability as the dependent variable, then adding banking fundamentals as a control variable . Meanwhile the analysis technique to be used is Ordinary Least Square (OLS). Fintech can optimize its role in supervising customers which can have an impact on minimizing non-performing loans so that it can increase profitability. The next thing is that even though costs increase it can actually increase profitability. The role of fintech in this case is that although the adoption of fintech will increase costs, profitability will also increase. The level of financing represented by LDR can be maximized in percentage in order to increase profitability.
EFFECT OF ORAL VITAMIN D3 ON THYMIC INDEX IN MALNOURISHED CHILDREN
Authors: Bashir Hafsa , Malik Muhammad Omar , Amir Sabahat , Ahmad Habiba , Rehman Syed Kaleem Ur
Published: March 2024

Objectives: To compare the thymic Index, vitamin D3 level, and T cell receptor excision circle (TREC) of healthy and malnourished infants. To evaluate the effect of oral vitamin D3 supplementation on the Thymic Index and TREC in malnourished children.
Material and Methods: This quasi-experimental study (non-equivalent control group design) included 44 infants within the age range of 2 to 6 months. The cases were 22 malnourished infants, and 22 were healthy infants (controls) based on WHO Z scores classification (weight for length). Weight, age, thymic Index (TI), Vitamin D levels, and TRECs were recorded for cases and controls(pre-test). The cases were given Vitamin D supplementation for 8 weeks. The weight for length (z-score), thymic Index (TI), vitamin D levels, and TRECs were checked in these malnourished children on follow-up (post-test). Thymic Index (TI) was checked by ultrasonography (length multiplied by breadth). ELISA was performed to check Vitamin D levels and RT-PCR was done to compare TRECs.
Results: The malnourished infants had a mean thymic index of 8.015 ±3.2192 as compared to controls of 11.667 ±3.2730. Post Vit D supplementation TI increased (8.459 ±3.2191) in cases. Weight, length, and Z scores were found to be directly related to TI values. Pre and Post supplementation TI were strongly correlated to each other (r= 0.985, p= <0.001). The thymic index increased significantly (p= 0.001) after intervention. There was a statistically non-significant rise in TRECS (809 vs 4242) (p= 0.075) after vitamin D supplementation. The Pearson Correlation showed no significant correlation of TRECS to any of the variables including the Thymic index.
Conclusion: TI (thymic size) and vitamin D levels increase with vitamin D supplementation in malnourished children. However, Vitamin D supplementation has no significant effect on TRECS.
Keywords: Malnourished, Vitamin D3, T cell receptor excision circles, Thymic Index, TRECs.
ANALYSIS OF PHYSICOCHEMICAL AND NUTRITIONAL PARAMETERS OF RAW MILK FROM COMMERCIAL DAIRY FARMS – IMPLICATIONS OF ADULTERATION FOR PUBLIC HEALTH
Authors: Azhar Saud , Jamil Wasia , Ali Abdul Hannan , Iftikhar Bushra , Orakzai Mehr , Afaq Yumna , Arshad Aiman , Azhar Anusha , Ali Wajid
Published: March 2024

Objective: Globally, milk adulteration is an important public health issue but more so in developing countries, for small financial gains. This study was designed to assess the physicochemical and nutritional parameters of raw milk from commercial dairy farms from a public health perspective.
Material and Methods: In this study 29 bulk samples of raw cattle milk were selected, one from each dairy farm in Peshawar, using simple random sampling and analyzed using by ultrasonic milk analyser. The main parameters tested for adulteration of milk were urea, starch, hydrogen peroxide, detergent, sorbitol, quaternary ammonium compounds, boric acid, cane sugar, sodium chloride, carbonate, formalin, hypochlorite, freezing point, added water, salt percentages and electrical conductivity (EC). Additionally, nutritional quality was assessed by fats, solids-non-fats (SNF), lactose, and protein. The results were statistically analyzed by t-test using SPSS software.
Results: Results showed that more than 90% of the samples had water adulteration of more than 5% due to which 55% had significantly reduced nutritional parameters but still overall nutritional quality was acceptable in 24% of the samples. 21% of samples had high electrical conductivity reflecting mastitis in animals and consequently considered unsuitable for consumption due to the resultant transmission of either antibiotics or microorganisms into the human body. Furthermore, chemical adulterants were not detected in any sample. t-test showed that most of the parameters were significantly different (p=0.05) than the population standard means.
Conclusion: Milk samples had compromised quality due to water addition in half of them and raised EC values in about a quarter of the samples. Despite water adulteration, nutrients like fat and SNF remained within ranges, indicating a cow-buffalo milk blend. Most tested parameters were lower than national averages but above minimum values. No chemical adulterants were detected. There’s a need for continuous milk testing to maintain public health standards.
key words: mild adulteration, commecial dairy farms
THE CORRELATION BETWEEN BETHESDA SYSTEM AND ULTRASOUND-BASED TIRADS FOR REPORTING THYROID CYTOPATHOLOGY
Authors: Safdar Ayesha , Mehmood Raazia , Khan Maria , Javaid Faryal , Sajjad Ayesha , Khattak Maria Tasneem , Khan Iqbal Muhammad
Published: March 2024

Objectives: To correlate the screening ability of ultrasound-based TIRADS with the FNAC-based Bethesda system when the latter is kept as a gold standard.
Material and Methods: A cross-sectional study was conducted in the Histopathology department, Rehman Medical Institute, Peshawar 15th June 2022- 14th June 2023. A total of 363 patients from any age group of either gender diagnosed with thyroid nodules were included in the trial. All the participants underwent ultrasound followed by ultrasound-guided fine needle aspiration of thyroid nodules. TIRADS and Bethesda grading was done for each participant. Demographics and grading scores were recorded. Keeping Bethesda scoring as gold standard diagnostic performance of TIRADS grading was calculated.
Results: Mean age of the patients was 46.68 ± 12.28 years with a female-to-male ratio of 2.3:1.  TIRADS grading revealed 210 (69.8%) from TIRADS 2 while 70(82.4%), 12(50%), and 09(23.7%) patients were from TIRADS 3, 4 and 5 categories respectively. Bethesda grades were 301(82.9%), 21(5.8%), 09(2.5%), 28(7.7%), and 04(1.1%) from Bethesda 2, 3, 4, 5, and 6 categories respectively. The sensitivity of the TIRADS was 93.8%, specificity 89.1%, positive predictive value 45%, negative predictive value 99.3%, and a diagnostic accuracy of 89.5%.
Conclusion: TIRADS grading has a high diagnostic ability when Bethesda scoring is kept as the gold standard. It can be used effectively in segregating benign from malignant nodules and is recommended for screening patients presenting with thyroid nodules.
Keywords: Biopsy, Fine-Needle, Sensitivity and Specificity, Thyroid Nodule
DELINEATION OF HEMATOLOGICAL CHANGES OCCURRING IN STORED CITRATE PHOSPHATE DEXTROSE ADENINE CPDA-1 BLOOD
Authors: Idrees Muhammad , Waqas Muhammad , Rehman Manzoor Ur , Riaz Huma , Ihtesham Khan Muhammad , Rahman Inayat Ur
Published: March 2024

Objectives: To study the changes in red cell indices and counts over a period of 42 days in blood stored in blood bags.
Materials and Methods: This research was done in Blood Bank, Khyber Teaching Hospital, Peshawar in collaboration with the main laboratory, Khyber Teaching Hospital, Peshawar. About 450 ml of whole blood was taken from 200 donors into Citrate Phosphate Dextrose Adenine blood bags. The storage temperature for the blood bags was maintained between 2–8°C. Blood samples were collected from blood bags. At days 1 and 42, using a haematology analyser, parameters including haemoglobin, RBC count, WBC count, haematocrit, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration and platelet counts were measured. Mean and standard deviation were used for quantitative variables. Frequency and percentages were used for qualitative variables.
Results: Through days 1 to 42, Haemoglobin (Hb) level decreased from 13.4gm/dl to 12.78 gm/dl, white cell count (WBC) decreased from 6.03x109/l to 2.95 x109/l, platelets count fell from 207 x109/l to 121 x109/l, neutrophils decreased from 59.6% to 23.8% while lymphocyte count increased from 28.36% to 66.3%.
Conclusion: There is a decrease in haemoglobin level and white cell count over a period of 42 days of storage of blood bags. Lymphocyte counts increased during the storage duration of blood bags.
MORTALITY AND LENGTH OF HOSPITAL STAY IN PATIENTS WITH LIVER CIRRHOSIS BASED ON THEIR MELD SCORE
Authors: Khan Hamza Ali , Din Nizam Ud , Iqbal Saleem , Abbas Ghulam , Yousaf Muhammad , Shah Badar Mahmood , Umam Shah
Published: March 2024

Objective: This study aimed to find the frequency of mortality and length of hospital stay in patients with liver cirrhosis based on their MELD score at admission. We also aim to study prognostication in cirrhotic patients using MELD scores at admission.
Materials and Methods:         A descriptive cross-sectional study was conducted in the Medical Department of Khyber Teaching Hospital Peshawar from 17/10/2019 to 17/4/2020. A total of 100 patients were observed. Investigations required for the calculation of the MELD score were done from the hospital laboratory. Admitted patients were followed for study outcome in-hospital mortality and length of hospital stay for at least 30 days. All information was noted in the predesigned proforma.
RESULTS: One hundred patients were analyzed among which the mean age was 53 years with SD ± 7.11. Forty-two percent were male and 58% were female. In-hospital mortality was observed in 8(8%) while mean hospital stay was 7 days with a standard deviation ± 4.12 in patients presenting with liver cirrhosis mortality was observed in patients with a MELD score of less than 20. However, mortality was 6.89%  in patients with a MELD score of 20-29 and 42.85 % in those with a MELD score of more than 30.
CONCLUSION: The frequency of in-hospital mortality was 8% and the mean length of hospital stay was 7± 4.12 days in patients with liver cirrhosis. For patients with higher MELD scores, the hospital stay and mortality increased.
Key Words: in-hospital mortality, mean length of hospital stay, MELD score
LAPAROSCOPIC EXPLORATION FOR INFANTILE HYPERTROPHIC PYLORIC STENOSIS: AN EXPERIENCE AT TERTIARY CARE HOSPITAL
Authors: Mohammad Imran  , Ali Sajjad , Fayaz ur Rahman  , Saeed Khawar , Ghayur Mahjabina S.
Published: March 2024

Objectives: This study aims to share our experience of laparoscopic exploration for infantile hypertrophic pyloric stenosis.
Material and methods: This retrospective study was conducted in the Department of Pediatric Surgery, Khyber Teaching Hospital, Peshawar from June 2017 to July 2020. This study includes all patients whose diagnosis of infantile hypertrophic pyloric stenosis (IHPS) was confirmed through ultrasound parameters and laparoscopic pyloromyotomy was performed. Data was retrieved from the laparoscopic surgery record. Retrieved data was tabulated and fed in SPSS 25 for analysis.
Results: This study included 42 patients with a mean age of 50.28 ±18.5days and a mean weight of 3.35±0.76 kg. Male patients were 57 % while females were 43 %. The mean time to resuscitate the patient pre-operatively was 34.6±15.4 hours while the mean postoperative hospital stay was 45±12.47 hours. The mean operative time was 31.6±10.4 min. Operative time decreased with time depicting improvement in our learning curve (p=0.004). The method of working instrument placement had no impact on operative time (p=0.337). Meantime to full oral feed was 9.7±5.1 hours. We did not encounter mucosal perforation or incomplete myotomy. No surgery was converted to open.
Conclusion: Laparoscopic pyloromyotomy is a safe and effective method of treatment for infantile hypertrophic pyloric stenosis.
Keywords:  laparoscopic pyloromyotomy, pyloric stenosis, IHPS
DIAGNOSTIC ACCURACY OF DIFFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING IN THE DIAGNOSIS OF MYOMETRIAL INVASION AMONG PATIENTS WITH ENDOMETRIAL CARCINOMA
Authors: Anjum Humaira , Khattak Muska , Ghayur Mahjabina S. , Rehman Mahnoor , Iftikhar Samia
Published: March 2024

OBJECTIVE: To determine the accuracy of magnetic resonance diffusion-weighted imaging in the diagnosis of myometrial invasion in patients with carcinoma endometrium keeping histopathology as the gold standard.
MATERIALS AND METHODS:  It was a descriptive cross-sectional study carried out from 11 July 2019 to 10 July 2021 at the Radiology Department, Khyber Teaching Hospital, Peshawar. The sample was collected via a Non-probability sampling technique. The sample size was 141 taking the prevalence of myometrial invasion 46% 12 with sensitivity and specificity of DW-MRI 90% and 73%,95% confidence level, and 10% margin of error. All women presenting with biopsy-proven endometrial carcinoma scheduled for hysterectomy, aged between 30 to 70 years were included. The myometrial invasion via MRI pelvis including DWI, with a 1.5 T machine (Philips), was evaluated for all patients. After a hysterectomy, myometrial invasion was confirmed on histopathology.
RESULTS: Among 141 women, 58 (41%) patients were between 30-50 years of age, and 83(59%) patients were in the 51-70 years age group. DW-MRI had 91.11% sensitivity, 66.66% specificity, 98.4% Positive predictive value, 25% Negative predictive value, and 90.07% diagnostic accuracy
CONCLUSION: In carcinoma endometrium, MR-DWI has good diagnostic accuracy in the detection of myometrial invasion.
Keywords: Endometrial cancer, Diffusion-weighted magnetic resonance imaging, Histopathology.
THE EFFECTIVENESS OF JIGSAW COOPERATIVE LEARNING STRATEGY AMONG BACHELOR NURSING STUDENTS AT ZIAUDDIN UNIVERSITY, KARACHI
Authors: Rehman Abdul , Raja Raja , Husain Abbas , Ghouri Aftab
Published: March 2024

Objective: This study aimed to determine the effectiveness of the jigsaw cooperative learning strategy among Bachelor nursing students.
Material and Methods: The quasi-experimental study was conducted from July to December 2021 at Ziauddin University Faculty of Nursing and Midwifery, Karachi, among 60 students of 4th year BSN, approached by non-probability consecutive sampling method.  The willing students of BSN year VI were included. The participants were divided into A and B groups. Group A was interventional, and group B was non-interventional. Independent t-test, Mann-Whitney U test, and Fisher exact test were applied for inferential statistics.
Results: The majority, 80% of the participants, were female, and almost half, 31 (51.67%) study participants were between 23-26 years. The average score of the participants through jigsaw cooperative learning and lecture method was18.73±3.5 and 14.13±2.42, respectively. Moreover, it was also found to be statistically significant (p-value<0.001).
Conclusion: It is concluded that the jigsaw cooperative learning strategy was found effective as compared to the traditional teaching style. To increase the quality of education in the health sectors, the educational system must accept and apply modern interactive technologies.
Keywords: Jigsaw method, lecture method, nursing students
Device for Measuring Forces and Torques in Flexible Connection Joints for Parabolic Trough Collector
Authors: López-Martín Rafael Antonio , Valenzuela Loreto , Amador-Cortés Carmen María
Published: March 2024

Measurement of forces and torques in flexible connection joints for parabolic trough collectors (PTC) during their life time is important to prevent damage or breakage of these elements. Plataforma Solar de Almería (PSA) has developed and patented a device for measuring these forces and torques in flexible connection joints installed in solar power plants. The device consists of three dynamometers and one torque transducer coupled to a rotation assembly that can be externally coupled to a ball joint installed in interconnections of parabolic-troughs, with no interference in the hydraulic circuit. To calibrate the device and perform initial performance checks at lab scale, a test bench was prepared for applying forces and torques on a set-up composed of a multicomponent sensor connected in series to a standard rotary ball joint and measuring simultaneously the forces and torques by mean of the designed device. Calibration tests have been performed applying a range of forces and torques to the multicomponent sensor-ball joint at different rotation positions. Multicomponent sensor and developed device measurements have been compared to obtain a calibration matrix for the last one. Results show good performance of the device once calibrated, but that will be improved measuring angular deviations from reference axes position of each of the dynamometers that compose the device during the operation, to increase the accuracy of the measurements.
優秀女子排球選手雙側膝關節肌群向心肌力與離心肌力之比較分析
Authors: 陳鷹成 陳鷹成 , 馮德字 馮德字 , 宋明律 宋明律 , 蔡俊賢 蔡俊賢
Published: March 2024

目的：本研究目的為探討優秀女子排球選手在雙側膝關節伸展與屈曲動作肌力與肌力平衡特徵之差異。方法：以等速肌力測量儀檢測參與者雙側膝關節之力矩，研究參與者為 16 名大專公開一級女子排球選手。統計分析以成對樣本t-tset比較女子排球選手在雙側膝關節伸屈肌力矩之差異及傳統式腿後肌與四頭肌比值 (hamstring to quadriceps strength ratio, H/Q 比值) 與功能性 H/Q 比值的差異，顯著水準訂為α ＝ .05。結果：排球選手在雙側膝關節的伸屈肌向心最大力矩中，只有在 60 °/s 時的伸肌未達顯著差異，其餘向心最大力矩皆有達顯著差異，且慣用側大於非慣用側；在雙側膝關節肌力之伸屈肌離心最大力矩與傳統式 H/Q 比值皆未達顯著差異，傳統式 H/Q 比值雖未達顯著差異，但都低於理想的安全值；在功能性比值方面，60 °/s 時伸、屈動作皆未達顯著差異，而 180 °/s 時伸展與屈曲動作則皆達到顯著差異，且非慣用側大於慣用側。結論：參與者應加強雙側的腿後肌群向心力矩，以提高傳統式 H/Q 比值，降低受傷的風險。功能性比值在伸展與屈曲動作的爆發力矩皆出現差異，這與排球攻擊動作落地時以非慣用側著地緩衝的特性有關。因此，應重視非慣用側的肌力訓練，以降低受傷的風險，更進一步提升選手攻擊的能力。

 

Purpose: The purpose of this study was to investigate the differences in muscular strength and muscle balance characteristics in bilateral knee joint flexion-extension movements of elite female volleyball players. Methods: The study utilized the isokinetic dynamometer to measure the torque of the knee joint in 16 collegiate division Ⅰ female volleyball players. Statistical analysis was us-ing paired sample t-tests to compare the differences in knee joint flexion-extension torque, tradi-tional H/Q ratio(hamstring to quadriceps strength ratio, H/Q ratio) and functional H/Q ratio be-tween the dominant and non-dominant sides, with a significance level set at α = .05. Results: The study found that in the concentric maximum torque of knee joint flexion-extension muscles, sig-nificant differences were observed at all angular velocities except for the extension muscle at 60°/s. The dominant side exhibited greater torque than the non-dominant side. However, there were no significant differences in eccentric maximum torque and traditional H/Q ratio of knee joint muscles. Although the traditional H/Q ratio did not show significant differences, it remained below the ideal safety value. Regarding functional H/Q ratio, there were no significant differences in both flexion and extension movements at 60°/s, while at 180°/s, significant differences were observed in both flexion and extension movements, with the non-dominant side exhibiting greater values than the dominant side. Conclusion: Participants should enhance the concentric force of the traditional H/Q ratio to reduce the risk of injury. Discrepancies in functional ratios are evident in the torque generated during extension and flexion movements, attributed to the characteristic landing pattern, which involves buffering on the non-dominant side during volleyball attacking actions. Therefore, prioritizing strength training on the non-dominant side is crucial to mitigate injury risks and further enhance athletes’ attacking capabilities.

 
Pulsed lavage in joint arthroplasty: A systematic review and meta-analysis
Authors: Daher Mohammad , Haykal Gaby , Aoun Marven , Moussallem Marc , Ghoul Ali , Tarchichi Jean , Sebaaly Amer
Published: March 2024

BACKGROUND

Knee and hip osteoarthritis affects millions of people around the world and is expected to rise even more in frequency as the population ages. Joint arthroplasty is the surgical management of choice in these articulations. Heterotopic ossification and radiolucent lines formation are two frequent problems faced in hip and knee replacements respectively. Some studies show that the usage of pulsed lavage may prevent their formation.

AIM

To compare pulsed lavage to standard lavage in joint arthroplasty.

METHODS

PubMed, Cochrane, and Google Scholar (page 1-20) were searched till December 2023. Only comparative studies were included. The clinical outcomes evaluated were the heterotopic ossification formation in hip replacements, radiolucent lines formation, and functional knee scores in knee replacements.

RESULTS

Four studies met the inclusion criteria and were included in this meta-analysis. Pulsed lavage was shown to reduce the formation of radiolucent lines (P = 0.001). However, no difference was seen in the remaining outcomes

CONCLUSION

Pulsed lavage reduced the formation of radiolucent lines in knee replacements. No difference was seen in the remaining outcomes. Furthermore, the clinical significance of these radiolucent lines is poorly understood. Better conducted randomized controlled studies and cost-effectivity studies are needed to reinforce these findings.
Un inspirio insolito
Authors: Fracas Daniele
Published: March 2024

The diagnosis of vocal cord dysfunction was eventually made in a 10-year-old boy with repeated self-limited episodes of inspiratory dyspnoea.
Fearing the World Too Much: Another View of Ebenezer Scrooge
Authors: Daly Kari
Published: March 2024

Scholars of Charles Dickens’s A Christmas Carol have traditionally accepted Ebenezer Scrooge’s designation as a “miser” at face value. In this article, the author suggests a somewhat radical reading of Scrooge’s character, which suggests that he has a deep concern for his fellow man, one with which he struggles. Highlighting textual clues from Scrooge’s childhood and his interactions with those closest to him, the article demonstrates that the deeds of the world’s most famous “miser” are grounded in empathy. This empathy, as well as Scrooge’s tendency to view the world through an intensely logical framework, makes him particularly vulnerable to a Utilitarian ideology. Scrooge is not, this article argues, cold-hearted, but rather rooted in indecision as to how he can maximize overall well-being and effect real change. When the reader assembles the pieces of Scrooge’s life in chronological order—as opposed to the order in which the narrator relates them—it becomes clear that he is not transformed at the end so much as unfrozen. This more generous reading of Scrooge demands more than a passive reception, asking us to reflect on our own experiences and assess how these may have negatively influenced our capacities for generosity and kindness.
Just in Time: Calling, Responding, and Making Music from the Soul
Authors: Campbell Kermit
Published: March 2024

Although Kairos in Greek mythology is often depicted as the winged son of Zeus who grants to those who lay hold of his single lock of hair their once-in-a-lifetime opportunity, in traditional African American culture, particularly when it comes to speech, Kairos is essentially family. Given how much African American speakers depend on seizing the moment to invoke spiritual connections, emit laughter, and profess the truth, Kairos, or what we might call CPT (“Colored People’s Time”), can be summoned almost at will. One of the African American discourses this article will use to illustrate this point is Call and Response, a verbal exchange in which speakers and listeners attune to one another and to the timeliness of an event. Martin Luther King Jr.’s “I Have a Dream” speech was such an event, but it wouldn’t have been so were it not for the timely responding of his favorite gospel singer, Mahalia Jackson.
A Rhetoric of Everyday Violence: Embodied Slow Violence
Authors: Walzer Belinda
Published: March 2024

This article builds on the scholarship on violence at the nexus of rhetoric, philosophy, decoloniality, and human rights discourse to theorize what it calls a rhetoric of everyday violence. Moving beyond the focus on the politics of representation in slow violence, it brings a transnational feminist rhetorical analytic and a focus on the politics of recognition to illegible temporal violence, arguing that a rhetoric of everyday violence can help recalibrate human rights discourse to recognize temporal and gendered violence as human rights violations.