bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between fair skin and poor serum Vitamin D levels in Pakistani women
Authors: Safa Zakaria  , Haya Kashif
Published: March 2023

Madam, the European beauty standard of fair skin has plagued Pakistan for centuries. Home remedies and formulated products promising white, youthful skin have increasingly infiltrated homes worldwide, particularly affecting women.1 However, regardless of creams and lotions, nothing guarantees white skin as effectively as avoidance of the sun does. Unfortunately, an unhealthy fear of sun exposure is commonplace in Pakistani homes, so much so, that their effects can be measured. As of 2020, 53.5% of Pakistani women are vitamin D deficient.2
Vitamin D deficiency is multifaceted due to poor diet, lack of vitamin D supplementation, and decreased sun exposure.3 It is important to note that society's treatment of women with tan skin is a possible underlying force that causes women to fear the sun. A cross-sectional study conducted in Pakistan explored how low self-esteem in Pakistani women is directly linked to their beliefs about the colour of their skin4. Millions of women face discrimination in their work environments and social circles because of their skin tone, pushing them to remain conscious of their colour, and further promoting their obsession with fair skin. In Pakistan, a fair skin complexion was found to be statistically significant (p=0.041) in contributing to poor serum vitamin D levels5. As Pakistan shows more hostility towards women with deeper complexions, they are forced to suffer vitamin D deficiency's mental and physical consequences. While the lasting stigma of dark skin cannot be undone overnight, Pakistanis must understand the dangers of fair skin. Women should be encouraged to celebrate their skin tone and be able to enjoy the outdoors, without the fear that doing so may change how society perceives them. Federal and local governments should encourage families to spend time in nature and advertise safe sun exposure while pushing for strict legislation against the marketing of whitening products. The Pakistani beauty industry must shift its focus from white skin to healthy skin. An interracial nation like Pakistan should have an equal representation of all skin tones and celebrate the diversity that comes with the vast geography of its country.
Dostarlimab: A light of hope espied amidst an age-long combat against cancer
Authors: Gul Areeba
Published: March 2023

Madam, a recent study investigated if checkpoint blockade would be effectual in patients with mismatch repair-deficient (MMRd), locally advanced rectal cancer.1 Patients with MMRd stage II or III rectal adenocarcinoma- treated conventionally via surgery, radiation therapy and chemotherapy- received the intravenous medicament of single-agent dostarlimab, an anti-PD-1 monoclonal antibody, every three weeks for six months.1, 3 Extraordinarily, complete clinical remission was observed in 100% of the patients.1, 4 Twelve patients have undertaken the complete treatment, with an additional six month period of post-treatment follow up, and exhibited no sign of tumor on physical exam, MRI scans, endoscopy, PET scans, digital rectal examination, or biopsy.1 Hence, they were not required to partake in chemoradiotherapy or surgery.1, 4
Dostarlimab, a checkpoint inhibitor, has been utilized as a form of immunotherapy which worked in MMRd colorectal cancer cells amongst which the absence of a DNA repairing gene is observed.2, 4 Dr. Andrea Cercek, explains that ordinarily immunotherapy demonstrates a success rate of approximately 10% when used in colorectal cancer in advanced disease, as opposed to that of dostarlimab at 100%.2
Commonly, checkpoint inhibitors trigger reactions in 1 in 5 patients, and while the majority are easily handled, 3% to 5% suffer extreme complications that  may cause difficulty in swallowing, masticating and muscle weakness..4 Another game-changer observed by Cercek et al. is the lack of clinical side-effects.1, 4 In rectal cancer, where arduous treatments can have enfeebling sequelae, comprising bowel, bladder and sexual disfunction, in addition to infertility and neural damage, dostarlimab may also be the key to a good quality of life post cancer survival.3,4  
Due to the small sample size, however, there is little data on the efficacy of this treatment. Results, though promising, will require a bigger group of patients to add to their credibility. 3,4 Follow up-s spanning a lengthier period would ensure that there are no relapses or  sideeffects and that the drug has proved remedial. 1, 3, 4 Furthermore, as suggested by Dr. Cercek, this hypothesis should be tested in other MMRd solid tumours such as stomach, pancreatic and bladder cancer, which have similar potential for successful immunotherapy.2  Dostarlimab’s previous success with endometrial cancer adds promise to this vision.5 The National Health Service in the UK, via the Cancer Drugs Fund, is offering dostarlimab to 100 women every year for endometrial cancer treatment, which costs $11,000 per dose.4, 5
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Semaglutide: new dawn for diabetics
Authors: Memon Areeba , Moniba Tehrim  , Beena Kumari
Published: March 2023

Madam, the growing prevalence of diabetes and obesity in Pakistan demands an optimal treatment plan to simultaneously manage the root pathologies. Semaglutide is a novel glucagon-like peptide-1 receptor agonist (GLP-1 RA) that was approved by the Food and Drug Administration (FDA) in 2017 for the treatment of type 2 diabetes and has recently, in 2020, approved for cardiovascular (CV) risk reduction in adults with T2D and known heart disease. Semaglutide has proved beneficial in terms of inducing weight loss while actively reducing blood glucose and blood pressure. It is also the first of its class to be available in an oral form in addition to the standard subcutaneous (SC) therapy.
Results from various research trials indicate a superiority of Semaglutide not only among other GLP-1 RA of its class but also over insulin glargine and Sitagliptin inducing significant weight loss and reducing HbA1c and systolic blood pressure.1 It does this while continuing to offer a favorable CV profile. Studies like Sustain 6 and Pioneer 6, have demonstrated a non-inferiority and safety of SC and oral Semaglutide in CV health. At the same time while we await the completion of the SOUL and SELECT trials to confirm an added potential superiority in improving CV outcomes.2 In conclusion, Semaglutide can safely be used in patients with T2D as a monotherapy or as an add-on to metformin or insulin. The Diabetes Canada guidelines 2018 recommend using incretins like GLP1 RA, and/or Sodium-glucose transport protein 2 inhibitors (SGLT2i) when weight loss and lower risk of hypoglycemia are a targeted patient priority.3 However, Helena et al. have demonstrated more significant reductions in HbA1c and continued weight loss beyond week 26 up to week 52, with Semaglutide signifying its superiority over standard empagliflozin therapy.4
Semaglutide, although well-tolerated, has some side effects, including dizziness, headache, and gastrointestinal upset3,5 that can be reduced by gradually increasing the dose.3 Potential side effects of pancreatitis and diabetic retinopathy, however, require physicians to warrant caution as such side effects may yet have been underreported or understudied.1
Nonetheless, the beneficial effects of Semaglutide, a once-weekly SC dose, and the alternative option of an oral formulation offer ease of use for the patient. However, the lack of research and cost-effectiveness have limited its use and availability in Pakistan. Therefore, ample work must be done to introduce this important drug in our market and routine practice.
Inhumanity, a heinous crime against health personnel in Pakistan: challenges and recommendations
Authors: Raja Sandesh , Ali Azzam , Adarsh raja
Published: March 2023

Respected Sir, Violence is the utilization of actual power that either result in or has high possibilitys of causing injury, death, psychological mischief, or hardship. The World Health Organization estimates that physical violence affects 8–38 percent of healthcare employees at some time in their professional lives(1). An innumerable large number of health personals are verbally abused.
Intolerance and hostility toward doctors are global phenomena. In1996, the Forty-Ninth World Health Assembly proclaimed violence as a significant public health issue(2). Violence is becoming more common in many professions, but it is known to be particularly prevalent in the medical area. Doctors have been the target of violence for a long time, as observed worldwide, and it is nothing new in Pakistan. In fact, because of the already common political violence and a fragile law enforcement system, countries like Pakistan are at a greater risk of violence.
Exposure to violence in the medical fraternity consequences in accelerated tiers of anxiety, stress, insomnia, and depression which has a direct impact on the quality of treatment delivered to patients and can even end in a patient's death. A cross-sectional study was carried out within the emergency departments of nine predominant tertiary hospitals in Pakistan, which revealed a significant problem, with nearly 77 per cent of physicians dealing with verbal or bodily abuse from patients and their attendants(3). According to the Pakistan Medical Association (PMA), An independent organization that addresses the problems of healthcare providers, 54 doctors were killed in Karachi between 2010 and 2014 for various reasons. Most incidents were reported in 2014, when approximately 17 doctors were killed(4). This is the only figure that is reported; many more go unreported.
There are complicated motives in the back of the violence toward Health Care Personnel (HCP); as a result, medical disputes and, at times, violence have increased. However, the primary motives are poor medical service quality and communication between HCPs and patients. Inadequate security and funds can also lead to violence.
Awareness campaigns to improve HCPs' communication skills, better health care facilities, patient satisfaction, and attendants should be kept in the loop at every medical step, and security should be maintained in hospitals to protect the staff are among the preventative measures that can significantly reduce incidents of violence against HCPs.
Hubungan Kepimpinan Teragih Pengetua Terhadap Kompetensi Guru di Sekolah Menengah Kebangsaan
Authors: See See Yong , Mohd Nor Mohamed Yusoff , Alias Bity Salwana
Published: March 2023

Kepimpinan teragih yang berkesan perlu menjadi amalan pentadbir sekolah pada masa kini untuk peningkatan tahap kompetensi guru demi mencapai kecemerlangan sekolah. Kajian ini bertujuan untuk mengkaji hubungan kepimpinan teragih pengetua dengan kompetensi guru di sekolah menengah kebangsaan dengan menggunakan pendekatan reka bentuk tinjauan melalui pengaplikasian kaedah kuantitatif. Kajian ini mengaplikasikan kaedah kuantitatif dengan pendekatan reka bentuk tinjauan. Seramai 403 orang pentadbir dan guru dari sembilan buah sekolah dilibatkan sebagai sampel kajian. Instrumen kajian adalah soal selidik yang dianalisis secara statistik deskriptif dan inferensi menggunakan perisian Statistical Package for Social Sciences (SPSS) Version 26. Setelah dianalisis hasil kajian menunjukkan gaya kepimpinan teragih pengetua dan kompetensi guru berada pada tahap tinggi . Dapatan kajian mendapati wujud korelasi secara signifikan antara hubungan gaya kepimpinan teragih pengetua terhadap kompetensi guru yang turut memberi dampak kepada sistem pengurusan di sekolah demi memenuhi transformasi pendidikan. Oleh itu, dapatan ini boleh memberi kesan kepada dasar kerajaan untuk memperkasa dan memartabatkan profesion perguruan dengan memberi penekanan dan perhatian dalam meningkatkan pembangunan bagi melahirkan warga pendidik yang berkualiti. Kesimpulannya, gaya kepimpinan teragih pengetua boleh menjadi tunjang utama dalam meningkatkan pencapaian kecemerlangan sekolah bergantung kepada kebijaksanaan pihak pentadbir dalam melaksanakan pengurusan pentadbiran yang adil bagi melahirkan guru yang berkualiti dengan kompetensi guru yang sedia ada.
Factors Contributing to Extreme Polarization of the Society in South Africa
Authors: Madjozi Nelson
Published: March 2023

Purpose: The study sought to analyze the factors contributing to extreme polarization of the society in South Africa

Methodology: The study adopted a desktop methodology. Desk research refers to secondary data or that which can be collected without fieldwork. Desk research is basically involved in collecting data from existing resources hence it is often considered a low cost technique as compared to field research, as the main cost is involved in executive’s time, telephone charges and directories. Thus, the study relied on already published studies, reports and statistics. This secondary data was easily accessed through the online journals and library.

Findings: The results show that polarization is strongly path dependent and sensitive to stochastic variation. Second, polarization depends strongly on the initial distribution of opinions in the population. In the absence of extremists, polarization may be mitigated. Noisy communication can drive a population toward more extreme opinions and even cause acute polarization. Finally, the apparent reduction in polarization under increased cultural complexity arises via a particular property of the polarization measurement, under which a population containing a wider diversity of extreme views is deemed less polarized.

Unique Contribution to Theory, Practice and Policy: The social comparison theory and Robert Tallisie theory may be used to anchor future studies in the political sector. The study results will also benefit other stakeholders such as the policy makers as well as researchers and scholars from different parts of the world. The top management of politics in the country will also use the study findings to improve the society and ensure high and stable performance in all their activities and programs. The study recommends that the adoption of effective social protection development policies in the society will help to improve efficiency in their major operations and activities. This work has implications for understanding the population dynamics of beliefs opinions and polarization as well as broader implications for the analysis of agent-based models of social phenomena.
Le principe de réciprocité dans la construction et la gestion de partenariats internationaux dans des universités du Québec : perceptions et pratiques de membres du personnel administratif
Authors: Uzenat Morgane , Kamanzi Pierre Canisius
Published: March 2023

L’objectif de cet article est de comprendre comment les universités québécoises appliquent le principe de réciprocité dans la gestion de leur internationalisation. En prenant comme angle d’analyse le travail de membres du personnel administratif dans la construction et la gestion de partenariats internationaux, nous examinons les pratiques associées aux quatre objectifs du principe de réciprocité (équité, autonomie, participation et solidarité) pour mieux identifier celles qui permettent concrètement de le mettre en application. Une analyse d’entretiens menés auprès de neuf administrateurs de haut rang et coordonnateurs de projets œuvrant dans trois universités francophones et une université anglophone met en évidence la volonté de construire des partenariats transformationnels. Il ressort des propos des répondants une volonté affirmée d’inscrire les partenariats internationaux dans une vision conciliant à la fois des avantages économiques et symboliques et la cohésion sociale.
Lessons from Our Sweetgrass Baskets: A Wholistic Vision of Academic Success for Indigenous Women in Higher Education
Authors: Brant Jennifer
Published: March 2023

This qualitative inquiry documents the lessons gleaned from my journey toward the praxis of Indigenous Maternal Pedagogies, an Indigenous women-centred teaching and learning engagement, to offer insights for supporting Indigenous women in higher education. Specifically, this article offers an express vision for Indigenous women’s educational access and success in higher education by sharing a collective research story offered by Indigenous women participants who completed one or more of three courses related to Indigenous women’s literatures and Indigenous maternal theory. Each course was delivered through a decolonial feminist lens, comprised of Indigenous curricular content and engaged students in culturally relevant assessment. This work connects Maternal Pedagogies with Indigenous epistemologies that embrace the “whole student” within educational contexts to establish a teaching and learning environment that can speak to the hearts and minds of students. In the spirit of reconciliation, I position this environment as a safe space where students can be their whole authentic selves and where their realities and lived experiences are positioned as strengths and key assets to establishing an ethical space for cross-cultural and anti-racist dialogue. Collectively, the participant narratives offer four key lessons that are integral to reconciliation education more broadly, and I map these lessons as final  recommendations that align with Kirkness and Barnhardt’s timeless work on the “Four Rs” of respect, relevance, reciprocity, and responsibility.
A Study on Improvement of Wastewater Disposal System in Jaffna Municipal Council Area, Jaffna Sri Lanka
Authors: Denagama T.D. , P.Gajenthiran  , R.Sivakumar
Published: March 2023

Jaffna Municipal Council is the heart of Jaffna district with a land area of around 20.20 km2 and 27,820 families are living at present. JMC is maintaining the groundwater recharging ponds, wastewater disposal systems and drainages. At present storm water drainage is using as wastewater drainage and using as a wastewater collecting tank. Therefore, wastewater treatment is needed to provide a quality and affordable environment. A detailed literature review was carried out to understand the reasons for this problem and how to overcome them. A survey with a questionnaire and wastewater testing analysis was carried out. According to the analysis majority of the people are using open dug well, therefore, groundwater should be protected and 55.83% of the lands are 10-20 perches and some main parameters were above the standard level. Based on the findings of the feasibility study centralized conventional wastewater treatment plant with tertiary or advanced treatment is very much feasible. The common conventional process with advanced treatment was used and the treatment plant was designed to 17900 m3 /day to accommodate 109,535 people. The total cost of the project is 473 million. With the propose system waste water quality will be well below the required standard levels. A wastewater treatment plant is most important for JMC to reduce environmental pollution and reduce groundwater pollution and maintain the groundwater table.
INTERAÇÃO INTERSETORIAL E A PRODUÇÃO DAS COMMODITIES AGRÍCOLAS NA REGIÃO CENTRO-OESTE: UMA ABORDAGEM ESPACIAL / INTERSETORIAL INTERACTION AND THE PRODUCTION OF AGRICULTURAL COMMODITIES IN THE BRAZILIAN CENTRAL-WEST REGION: A SPACE APPROACH
Authors: Farias do Nascimento Erianne , Justo Wellington Ribeiro
Published: March 2023

Considerando a importância da agropecuária para a região Centro-Oeste, o objetivo deste trabalho é estimar o impacto da produção agropecuária, industrial e do setor de serviços na produção das culturas agrícolas da soja, do milho e do algodão herbáceo na região usando o instrumental da econometria espacial. Os resultados da Análise Exploratória dos Dados Espaciais (AEDE) mostram que há uma concentração do cultivo das três culturas na área central e no nordeste da região que refletem a formação heterogênea da agropecuária no espaço. As estimações para cada cultura revelaram que de forma geral há um efeito transbordamento significativo e cooperação entre os municípios produtores da região e um efeito positivo da agropecuária na produção das três culturas.
 
Considering the importance of agriculture for the Brazilian Central-West region, the aim of this article is to estimate the impact the sectors of the economy in production off soybean, maize and herbaceous cotton crop production in the region on using the instruments of spatial econometrics. The results of the Exploratory Analysis of Spatial Data (EASD) show that there is a concentration of the cultivation of the three crops in the central area and in the northeast of the region that reflect the heterogeneous formation of agriculture in space. Estimates for each crop showed that in general there is a significant spillover effect and cooperation among municipalities producers in the region. There are positive effects of agricultural in production of tree crops.
The relationship between poultry producers and their integrators: a case of West Region of Paraná, Brazil
Authors: Farias Celso José , Schneider Mirian Beatriz , Santoyo Alain Hernández , Darr Dietrich
Published: March 2023

Brazilian poultry sector stands out as the second largest poultry producer in the world and the world's largest exporter of chicken meat, where Paraná State has one of the most important contributions to the sector. Thus, the main objective of this paper consist to discuss the relationship between poultry producers and their integrators in West region of Paraná, capturing poultry producer’s perception and theirs decisions for choosing and staying in an integration contract. A sample of 98 producers were interviewed and non-parametric statistical tests were used, including cross-reference tables, comparison proportions tests and bivariate correlations. Results indicate that producer profiles are mainly constituted by small or medium enterprises with a high dependence degree on agro-industry. An intense competition exists and mostly, producers choose an integrator based on brand trustworthiness and not according to prices offered, explained by the high specificity of production relationship.
A DEPENDÊNCIA DO AGRONEGÓCIO BRASILEIRO EM RELAÇÃO AOS FERTILIZANTES IMPORTADOS / The dependence of Brazilian agribusiness on imported fertilizers
Authors: Arruda de Oliveira Thiago José , Dorner Stefan Hubertus , Munhoz de Almeida Rodrigo Estevam
Published: March 2023

Em vista dos confrontos armados na Ucrânia e as suas consequências negativas para o agronegócio brasileiro, analisou-se o seu nível de dependência com os fertilizantes importados. Justificou-se o estudo devido à elevação nos custos de produção agrícola e às limitações internas no fornecimento de insumos a montante. Para tanto, empregaram-se dados secundários oficiais e análises gráficas e econométricas que identificaram quais os elementos com maior nível de prioridade para os plantadores de soja e milho do Brasil.  Os resultados apontaram que todos os componentes da formulação NPK (nitrogenados, fosfatados e potássios) importados se correlacionam com a produção e produtividade dos grãos em estudo. Nesse contexto, destacou-se a ureia, da qual a Petrobras era um dos fornecedores até 2015. Portanto, a mitigação da subordinação estrangeira no agronegócio brasileiro, passa, a princípio, pela reformulação do setor petroquímico nacional.
Abstract: Recent armed conflicts in Ukraine have caused negative effects on Brazilian agribusiness. Fertilizer supply has been strongly dependent on imported products, focus of this research. Increased costs of national food production due to shortage of national fertilizer production were the main motives for this paper. Data was obtained by governmental institutions and submitted to visual and econometric analysis. It was intended to identify which fertilizer inputs have been crucial for soy and maize producers in Brazil. The results suggested that all elements of NPK (nitrogenous, phosphate, and potassium) were correlated to production and profitability. Furthermore, urea is a core input which Petrobras produced until 2015. In conclusion, the mitigation of external dependence on Brazilian agribusiness requires a reframing of national petrochemical industry.
Primary signet ring cell adenocarcinoma as a rare cause of colonic stenosis in a young patient with Crohn’s disease – the case report
Authors: Pipek Barbora , Prokešová Kateřina , Kotásek Rostislav , Štěpán Michal , Fojtík Petr
Published: March 2023

Summary: Signet ring cell carcinoma (SRCC) is a rare type of highly malignant adenocarcinoma that produces mucin and predominantly affects the stomach, ovaries, and the small intestine. Primary localisation in the colon is rare, and the prognosis of this type of adenocarcinoma is very poor. We present a case report of a 44-year-old woman who suffered from Crohn‘s disease beginning in the year 2000. During the last three years of her treatment, she was treated using bio­logical therapy with ustekinumab. The treatment led to clinical, laboratory, and endoscopic remission. In February 2021, she had widely metastatic primary signet ring cell carcinoma of the colon, which mimicked the IBD activity in the case of her colon obstruction. Because of the extensive infiltration of her liver and peritoneum at the time of the dia­gnosis, in addition to the symptoms of the passage disorders she was experiencing, she proceeded with an end ileostomy and palliative treatment was started. The patient‘s prognosis was unfavourable, and she died within 5 months of the dia­gnosis in hospice care. Key words: primary signet ring cell carcinoma – colon cancer – Crohn‘s disease – colonic stenosis
Out-Of-School Children in Northern Sindh, Pakistan Qualitative Exploration of Push and Pull Factors
Authors: Datoo Al Karim , Haider Hassanain , Nawab Ali
Published: March 2023

Despite its severity in Pakistan, the issue of out-of-school children has surprisingly received very little attention from academics. A couple of studies conducted in other provinces of Pakistan have investigated the views of parents and school principals on out-of-school children, where both parties seem to be blaming each other. How do children themselves feel being out of school, although very significant has remained unattended. It is believed that listening to the voices of the real sufferers is essential, to bring forth insights that would help policy makers and educational reformers in considering the existent issues to be addressed in relation to out-of-school children. The current study explores the perceptions of out-of-school children, factors that force to drop them out of school, and the challenges they face after dropping out of school. Five children who had dropped out of school were identified and interviewed using semi-structured interviews. The results revealed that the push-out factors enforced by the schools included teachers' unprofessional behaviors. Pull-out factors enforced from home included poverty and heavy responsibilities at a very early age and to be an earning member for the family. The study calls for collaborative efforts by schools, parents, community, and civil society to address multi-sectorial issues of out-of-school children. It is also argued that for SDG-4 to be practically effective on grounds in Sindh or elsewhere for that matter, education needs to be re-imagined to make education of out of school children possible.
Emotional Intelligence and Anxiety Handling in Secondary Grade Students by Classroom Managerial Style
Authors: Zafar Jam Muhammad , Akhtar Muhammad Saleem
Published: March 2023

Emotional intelligence means not only controlling emotions, solving inner problems and mental conflicts, but also steaming other people's mental problems and their conflicts. It is also used to assess the emotions of others, their inner conflicts, and their mental anxieties. Understanding Emotional Intelligence (EI) by the teacher can reduce emotional distress and stress in students and guide them to the best of their ability for teamwork, and harmony. The research sample comprised 250 secondary grade students equally distributed under five classroom managerial styles in Rahimyar Khan. A questionnaire was used for data collection, based on ten themes: enthusiasm, self-awareness, motivation, social skills, self-regulation, and collaboration, atmosphere of trust, mutual harmony, enthusiasm, and empathy. Overall, it was clear that students were more enthusiastic, self-aware, motivated, socially skilled, self-regulated, collaborated, trusted, mutually harmonial, coherent, and empathetic in the democratic operational atmosphere. This was visible mostly in an achievement-oriented classroom atmosphere and then in the situational classroom atmosphere, but least in laissez-faire and authoritarian classroom atmosphere. Overall anxiety revealed that students are very anxious in laissez-faire and authoritarian classroom atmospheres. The results will play a dominant role for teachers to think about their overall management style in the classrooms.
Obstacles to Co-Education in Pakistan and Their Impact on Girl’s Education A Critical Analysis of Literature
Authors: Iqbal Shahid , Anjum Tehseen , Ahmed Ishfaq
Published: March 2023

Education is an essential human right. In countries where women and men have equal educational opportunities, are successful in all areas of society today. The focus of this research is the governmental, social, and cultural barriers to bringing harmony in Pakistani culture. To do this, the research critically examined the adaptive political, religious, and social components of Pakistani society. The study's major results were reached after a thorough review of the literature. The study identified a number of socioeconomic and ethical hurdles to co-education in Pakistani culture through literature review. Male dominance, conservatism, rigid customs and traditions, stereotype social codes, acute and chronic poverty, male insularity toward women's roles, complex social structure, religious misconceptions, gender differences, feminine discrimination, home issues, and a lack of women's political liberation are just a few of the barriers to co-education mentioned in the study. The data analysis in this study leads to the conclusion that removing these barriers will aid girls' educational development.
Can Dry Needling Technique Replace Cervical Manipulation Technique for Patients with Migraine
Authors: Dr. Achalkumar Vashi  , Dr. C. K. Senthil Kumar  , Dr. Sanjib Kumar Behera
Published: March 2023

Background of the study: Migraine is a renowned medical condition in 15% of general population. The patients with migraine exhibited active Trigger Points in their neck extensor muscles. Dry needling is a treatment using a thin filament sterile needle to puncture skin and create tiny lesions in a muscle, tendon, to help restore normal physiology function, and reduce pain. Needling has applications for myofascial pain, chronic pain, headache, migraine. Cervical Manipulation Technique has been used to reduce pain and improve range of motion and used in the treatment of patients with head and neck disorders, including neck pain and stiffness, muscle-tension headache, and migraine. The aim of this study is to compare the effectiveness of dry needling technique versus cervical manipulation technique on patients with migraine. Methodology: 30 patients were randomly divided into two groups; fifteen patients in the experimental group-A received cervical manipulation technique (3 times/week) and fifteen patients in the experimental group-B received Dry needling technique. The VAS and NDI were used as outcome measures. Result: Comparing between Group A and Group B showed significant difference in effectiveness on pain and Neck disability with P value >0.0001 among patients with migraine. Group B with Dry needling technique found more effective than Group A with cervical manipulation technique with mean difference of (2.867) and (11.40) over (2.267) and (10.47) respectively. Conclusion: Dry needling technique group is more effective over cervical manipulation technique on enhancing on pain and neck disability. Therefore, this study concludes that Dry needling technique is an effective intervention for migraine patients. Key words: Visual analog scale, Neck disability index, cervical manipulation technique, Dry needling technique, Trigger points.
Desenvolvimento profissional de professores de Educação Física mediados por programas de incentivo à docência em escolas de educação básica
Authors: Paixão Jairo Antônio , Castro Caroline Marques
Published: March 2023

Identificou e analisou possíveis impactos da participação de professores de Educação Física em programas de incentivo à docência no desenvolvimento profissional em escolas de educação básica. Realizou-se uma pesquisa qualitativa, a partir de entrevista semiestruturada com professores licenciados em Educação Física. A análise dos dados mostrou que os impactos das vivências nos programas de incentivo à docência relacionam-se com a percepção do real papel de ser docente, com a tomada de consciência mais crítica e ampliada a partir do caráter colaborativo e coletivo nas discussões temáticas, nos planejamentos de atividades de ensino e pesquisa. Verificou-se ainda que os programas influenciaram no reconhecimento, por parte dos professores, da importância da continuidade do processo formativo, distanciando-se da zona de conforto, rumo ao desenvolvimento de uma série de habilidades profissionais.
Vom Laborblatt zur Industrieanlage
Authors: Gailat Tilo
Published: March 2023

Seit einiger Zeit hat sich unsere Technologie der Trockenzerfaserung in der Papierindustrie und in zahlreichen anderen Anwendungsbereichen etabliert und die Kooperation GoDryToFuture ist eine Erfolgsstory. Im Vortrag auf dem Symposium der Papieringenieure 2022 sollte nun eine erste Bilanz gezogen werden. Dabei werden rückblickend die einzelnen Entwicklungsetappen bewertet, die Herausforderungen und Probleme genannt und Erfolge und Misserfolge in Relation gesetzt. Darüber hinaus wird auch die Gegenwart beschrieben und es werden Ausblicke in die Zukunft und die aktuellsten Vorhaben gegeben.
Rewe tauscht Regionschefs in West und Dortmund aus
Authors: Tewes Werner
Published: March 2023

Die Rewe-Gruppe lässt das Spitzenpersonal in zwei Kerngebieten rotieren. Die Regionen West und Dortmund erhalten neue Chefs. Eine gesellschaftsrechtliche Verschmelzung steht damit aber nicht auf der Agenda.
Griesson stellt die Chefetage neu auf
Authors: Fries Tanja
Published: March 2023

Griesson-de Beukelaer besetzt den vakanten Posten des Finanzchefs aus den eigenen Reihen: Der langjährige Manager Pascal Haegel kommt zum Zug.
Hoher Zuckerpreis belastet Hersteller
Authors: Sachsenröder Delphine
Published: March 2023

Zucker ist auf dem Weltmarkt teuer – in Europa ist er noch teurer. Hersteller klagen über bis zu 140 Prozent Mehrkosten. Die Folgen zeigen sich jetzt schon in Verhandlungen für das Weihnachtsgeschäft.
Yfood baut auf die Vertriebskraft von Nestlé
Authors: Adelhardt Andrea
Published: March 2023

Trinkmahlzeiten-Hersteller Yfood verkauft einen Minderheitsanteil des Unternehmens an Nestlé. Mit dem weltweit größten Lebensmittelkonzern im Rücken will das Startup die internationale Expansion vorantreiben.
Wurstbranche doppelt belastet
Authors: Lenders Dirk
Published: March 2023

Die deutschen Wurst- und Schinkenproduzenten sehen sich mit zwei Herausforderungen konfrontiert. Sie müssen für Aldi bis 2030 den sogenannten Haltungswechsel organisieren und mit den aktuell hohen Preisen für Schweinefleisch klar kommen.
Sieber gegen Bayern
Authors: Falker Gerrit-Milena
Published: March 2023

Der Zweck heiligt nicht alle Mittel: Trotz Sorge um die Gesundheit der Bürger durfte Bayern nicht pauschal vor allen Produkten der Großmetzgerei Sieber warnen. Für sein überstürztes Vorgehen drohen dem Freistaat nun bis zu 8 Millionen Euro Schadenersatz. Gerrit-Milena Falker
„Nicht zu stoppen“
Authors: Mende Jan
Published: March 2023

Professor Marcel Corstjens über harte Preiskämpfe, das schwierige Verhältnis von Industrie und Handel in Zeiten der Verknappung und die ökonomische Effizienz internationaler Einkaufsallianzen.
Weinpreise überschreiten Limits
Authors: Hubert Wolfgang , Murmann Christoph
Published: March 2023

Vermarkter wollen einen Nachfrageschock verhindern. Auch an veränderte Wünsche müssen sie sich anpassen. Christoph Murmann
„Die Vermeidung von CO2 ist das zentrale Thema“
Authors: Roeb Thomas
Published: March 2023

Der Lebensmittelhandel setzt noch zu stark auf das Thema Regionalität und vernachlässigt das Herausstellen von CO2-Armut, erläutert Branchenprofessor Thomas Roeb, der eine empirische Erhebung hierzu vorgelegt hat.
BASED ON THE COGNITIVE AND BEHAVIORAL APPROACH, CAN KNOWING ABOUT SEXUALITY IN THE 21st CENTURY PROMOTE HEALTH?
Authors: Priscila de Souza Fernandes Thaynara
Published: March 2023

This article unites sexuality and the cognitive and behavioral approach to present some of the main beliefs surrounding the theme, which, at the present time, is slowly breaking away from taboos and enigmas within the constant scientific revolutions of the 21st century. By analyzing some discourses of the cognitive and behavioral model, health and sexuality, we can identify the dynamic constructs that involve them and establish a healthier vision for men and women in general, since the importance of disseminating the subject with quality is evident, as surveyed by the World Health Organization (WHO). Thus, giving theoretical support to professionals to work on the theme, which is on a growing trend, has great social importance, since, as the belief and interpretation of events are motivating factors based on the therapeutic approach of cognition and behavior, when contributing to areas of interest such as medicine, psychology and sexology, through the archeology of knowledge about sexuality and the implication of beliefs, one definitely gains more health, because what perpetuates its dysfunctionalities and its prejudices is the lack of knowledge or the inaccessibility of works already produced on the subject.
STRUCTURAL LINGUISTICS IN THE PSYCHOANALYTICAL CLINIC
Authors: Jonas Ribeiro Magno
Published: March 2023

The present work aims to demonstrate the importance of structural linguistics, at the base of the clinical structure of Jacques Lacan’s psychoanalysis. considering that psychoanalysis is a knowledge developed by Sigmund Freud, considered the father of psychoanalysis, it was Lacan who emphasized the structural basis of how we could understand the psychoanalytic theoretical discourse, introducing sciences from other fields of knowledge, in this case, structural linguistics , as a guiding theory to understand such knowledge. finally, the present work has, in its importance, to point out the theoretical need that Lacan had, in making use of structural linguistics to deepen his reflections about the clinical discourse, and its importance in the understanding of the attendances.
CONTRIBUTIONS OF MONITORING IN THE MONITOR’S ACADEMIC TRAINING
Authors: Kercia Trajano Feitosa Ana , Xavier Silva Barbosa Milena , Augusto Arnes dos Santos Ihernes
Published: March 2023

The monitoring program is a modality of extracurricular activity, focused on expanding teaching to undergraduate courses, this constitutes an integrated form in the construction of more in-depth knowledge of a given discipline. The main objective of the project was to present, in the form of an experience report, the contributions of the monitoring program in the academic training of the monitor. To carry out this work, we opted for a descriptive study, of the experience report type, carried out from the experience in voluntary monitoring. During the period in which the monitoring took place, important aspects were noted about the social relationships that are established during that time, relationships that encourage a better personal development of the monitor, a fact that was also observed by TAVARES et al. (2017) in their experience report with the monitoring program. It is emphasized that monitoring is of paramount importance as a support to students for a better quality of teaching, and encompasses disciplines and potential areas, constituting a full activity that helps in the pedagogical knowledge produced during the graduation period.
“IT’S NOT A PROBLEM TO BE GAY, THE PROBLEM IS TO BE GAY AND EMPLOYED” - THE MULTIPACT FORMS OF LGBTQIA+-PHOBIA IN THE WORK MARKET
Authors: Augusto Silva de Castro Hudson , Descovi Schimith Cristiano
Published: March 2023

According to Drydakis (2015), business characteristics negatively affect the performance of LGBTQIA+ in the labor market. These characteristics make it possible for LGBTQIA+-phobia to present itself in different ways, both in the pre-selection, as well as in the hiring, dismissal and post-dismissal of employees (MEDEIROS, 2007). Given these assumptions, the academic and social importance of describing the multifaceted ways in which LGBTQIA+-phobia is presented in the labor market and how LGBTQIA+ is affected by it is seen, which is the objective of this research. In order to carry out the research, we first sought to understand, in the existing literature, the difficulties encountered by LGBTQIA+ in the labor market, as well as the consequences of the prejudice suffered in their lives. To achieve the objective, interviews were made available virtually through a structured questionnaire with objective questions. The sample was selected using the non-statistical convenience method. In total, 54 (fifty-four) interviews were collected and 48 (forty-eight) were validated. In the interviews, it was observed that the LGBTQIA+ suffers from different types of prejudices in the labor market and that such prejudices negatively interfere with their productivity, efficiency and the achievement of their professional goals.
PHYSICIAN’S CIVIL LIABILITY IN PUBLIC HEALTH PRACTICE
Authors: Moreira Barcelos De Souza Elizangela , Villela Florêncio Stella
Published: March 2023

The objective of the present work is to analyze the civil liability of the doctor as a public agent or exercising a function in private law companies that provide public services. Detailing in a detailed way the requirements for the configuration of civil liability: conduct, damage and causal link, as well as the hypotheses of exclusion of liability, their nature, and the species of medical errors, especially medical acts performed in public health. Analyzing the possibilities of solidary legitimacy of the State and of the causative agent under the obstacle of the procedural economy and the institute of the denunciation of the dispute. In this way, the jurisprudential research was the method used to evidence the kind of legitimacy and the consequences of civil liability. Being demonstrated, the applicability of Theme 940 of the Federal Supreme Court, to remove the solidary legitimacy of the public agent causing the damage in the civil liability claim against the State, ensuring the right of return, for analysis of intent or fault. It is noted that the jurisprudential research evidenced the filing of actions with the qualification of the defendant considered illegitimate, since the State objectively responds for the acts of its agents. Thus, it is concluded that the objective civil liability of the doctor in the provision of medical services to public health, removes its legitimacy in the passive pole of the indemnity action; regressive action being applicable to them, after any eventual desire by the State.
Malaria asociada al embarazo: revisión narrativa
Authors: Núñez-Troconis José T. , Carvallo Ruiz Daniel Ernesto , Martínez Núñez Elizabeth Natalia
Published: March 2023

Malaria infections increase the risk of complications in the mother-fetus binomial. In Venezuela, the casuistry of this vulnerable group has not been updated in recent years. The objective of this narrative review was to comprehensively describe what pregnancy-associated malaria is and its maternal, fetal and neonatal effects; trying to answer the following research question. All forms of pregnancy-associated malaria, including gestational, placental and congenital malaria, cause maternal-fetal and neonatal alterations that, if they progress, could lead to the death of this binomial. Physiopathology and immunopathology can explain the symptoms of pregnant women and the fetus, as well as their complications; depending on the parasitic form affecting. There are new updates in the diagnosis, prevention and treatment of this entity.
ĐÁNH GIÁ KẾT QUẢ SAU PHẪU THUẬT THAY KHỚP HÁNG TOÀN PHẦN KHÔNG XI MĂNG Ở BỆNH NHÂN DƯỚI 30 TUỔI
Authors: Lương Toàn Thắng , Nguyễn Mạnh Khánh , Đinh Quốc Nhật , Nguyễn Khánh Triển , Đào Văn Nhật , Nguyễn Xuân Khái
Published: March 2023

Mục tiêu: đánh giá kết quả phẫu thuật thay khớp háng toàn phần không xi măng ở bệnh nhân dưới 30 tuổi tại Bệnh viện Hữu nghị Việt Đức. Đối tượng, phương pháp nghiên cứu: mô tả cắt ngang, hồi cứu kết hợp tiến cứu không đối chứng trên 85 bệnh nhân dưới 30 tuổi được phẫu thuật thay khớp háng toàn phần không xi măng tại bệnh viện Việt Đức từ 2015 đến 2022. Kết quả: 68,2% BN hoại tử chỏm xương đùi, 29,4% thoái hóa thứ phát; chiều dài vết mổ trung bình 9,1 ± 0,5cm; thời gian mổ trung bình 74,88 ± 7,5 phút; máu truyền trung bình 381,5ml. Không có biến chứng xa, 2,4% có biến chứng gần nhiễm khuẩn nông. X-quang sau mổ 83,5% trục chuôi trung gian, 88,2% độ áp khít chuôi ≥80% với góc nghiêng dạng ổ cối 40-45 độ chiếm 89,4%. Điểm VAS trước mổ 7,9 ± 1,5, sau mổ 3,8 ± 1,5; điểm HHS trước mổ 42,6 ± 11,1, sau mổ 81,4± 1,2 với p<0,05. Kết luận: Kỹ thuật thay khớp háng toàn phần không xi măng là phương pháp hiệu quả và an toàn để điều trị một số bệnh lý khớp háng có chỉ định thay khớp ở nhóm bệnh nhân dưới 30 tuổi.
ĐẶC ĐIỂM LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ BỆNH NHÂN SAU NGỪNG TUẦN HOÀN NGOẠI VIỆN TẠI KHOA CẤP CỨU BỆNH VIỆN BẠCH MAI
Authors: Nguyễn Anh Tuấn , Nguyễn Quốc Linh
Published: March 2023

Mục tiêu: Nhận xét một số đặc điểm lâm sàng và kết quả điều trị bệnh nhân sau ngừng tuần hoàn ngoại viện. Đối tượng: 35 bệnh nhân (BN) hôn mê sau ngừng tuần hoàn được điều trị tại khoa cấp cứu Bệnh viện Bạch Mai từ tháng 8/2016 đến tháng 8/2017. Phương pháp nghiên cứu: mô tả tiến cứu. Bệnh nhân được đánh giá lâm sàng thời điểm nhập khoa và ghi nhận kết cục thần kinh thời điểm ra viện. Các biến định lượng được trình bày theo giá trị trung bình và độ lệch chuẩn; sử dụng các test tham số cho biến phân bố chuẩn và test phi tham số cho biến phân bố không chuẩn; sự khác biệt có ý nghĩa thống kê với p < 0,05. Các biến định tính được trình bày theo tỷ lệ phần trăm (%), sự khác biệt có ý nghĩa thống kê với p < 0,05. Kết quả: Tỉ lệ BN được hồi sức tim phổi tại hiện trường là 5.7%; Thời gian gian từ lúc biến cố ngừng tim đến lúc được hồi sức tim phổi trung bình là 10 phút, không có sự khác biệt về khoảng thời gian này giữa nhóm sống và nhóm tử vong; Tỉ lệ tử vong của các BN hôn mê sau ngừng tuần hoàn là 45.7%; Thời gian hồi sức tim phổi ≥ 28 phút là yếu tố tiên lượng tử vong cao với ROC = 0.755, p = 0.01 (CI95% 0.597 – 0.913); Tỷ lệ BN hôn mê Glasgow < 9 điểm tại thời điểm kết thúc điều trị tại khoa là 68.4%; 15.8% BN kết thúc điều trị với điểm Glasgow > 13; 60% BN có điểm Glasgow kết thúc điều trị từ 9 – 15 điểm còn phản xạ giác mạc thời điểm nhập viện.  Kết luận: Tỉ lệ hồi sinh tim phổi tại hiện trường thấp, khoảng thời gian hồi sinh tim phổi cho đến khi có tuần hoàn trở lại dài là yếu tố tiên lượng tử vong cao. Còn phản xạ giác mạc thời điểm nhập viện có tiên lượng kết cục thần kinh tốt.