bluuebunny/crossref_metadata_2025 huggingface dataset:
Exercise and Physical Activity Diversity
Authors: Sanjay Kalra  , Madhur Verma  , Nitin Kapoor
Published: September 2023

In this reflective opinion piece, we introduce the concepts of exercise diversity and physical activity diversity. Similar to dietary diversity and dietary variety, exercise/physical activity diversity represents part of a comprehensive target of ideal health, an objective parameter to audit one’s progress towards such a goal, and a means of accomplishing this aim. We define this concept as the number of types of exercise, the number of limbs and body parts exercised or muscle groups involved, the variety of intensity, or the number of variations in methods of exercise used. A non-weighted score may be allocated to each exercise, limb, and muscle group to get a raw idea of diversity.
Keywords: Activity, exercise, fitness, obesity, overweight, physical fitness.
Lytic bony lesions on 18F-FDG PET-CT versus 99mTc MDP bone scan
Authors: Nida Rasheed  , Mairah Razi
Published: September 2023

With rising incidence of breast carcinoma in Asian population, staging workup remains a crucial entity in diseasemanagement and outcome. Bone scintigraphy for detection of osteoblastic metastasis has remained a convenient choice.However, in the presence of underlying lytic bony lesions sensitivity of 99mTc-MDP bone scan is questionable when comparedto 18F-FDG PET-CT scan. We present a case that showed better sensitivity of 18F-FDG PET-CT for picking up early lytic lesionsfor staging breast cancer.Keywords: breast carcinoma, bone scan, 18F-FDG PET-CT.
Bladder drainage options for people with spinal cord injury: A Mini-Review
Authors: Julia Patrick Engkasan  , Chua Li Shun  , Farooq Azam Rathore
Published: September 2023

Neurogenic bladder is one of the negative consequences following a spinal cord injury (SCI). SCI patients who have neurogenic bladder depend on alternative methods to drain urine from their bladder. These include indwelling catheters, reflex voiding , suprapubic tapping and intermittent catheterisation. This review summarizes evidence from the literature of five selected complications (renal failure, urinary tract infections, calculi, urethral stricture, and bladder cancer) that could result from use of the different bladder drainage methods. There is inconsistent evidence to support the superiority of intermittent over indwelling catheterisation on risk of renal impairment, urethral stricture, and renal calculi. Indwelling catheterisations are associated with higher risk of bladder calculi and cancer. Caution needs to be taken when interpreting this review, as many of its findings are from retrospective studies, and more than a decade old. Clinicians need to communicate the evidence to their patients when making the decision on method of bladder drainage.
Keywords: Rehabilitation Catheterisation Incontinence Urology Paraplegia Renal failure.
Mutation of TBC1 Domain containing kinase (TBCK) with associated intellectual disability and hypotonia
Authors: Prem Chand  , Sulaiman Asna , Kirmani Salman
Published: September 2023

Infantile Hypotonia with Psychomotor Retardation and Characteristic Facies-3 (IHPRF-3) Syndrome is a rare pathology occurring due to mutations in the TBC1 domain containing kinase (TBCK). This is a neurodevelopmental disorder presenting with a neurological and dysmorphic feature including intellectual disability, limb and craniofacial abnormalities. We present a case of TBCK mutation of the variant (p.Gln164*), present on Exon 6; this sequence change creates a premature translational stop signal (p.Gln164*) in TBCK, creating a disrupted protein leading to a loss of function. This variant has not yet been reported in genetic databases. We need to establish a better understanding of this disorder by reporting these novel genetic mutations so that these complex patients can be successfully managed by multidisciplinary teams.
Keywords: Infantile hypotonia, Intellectual disability, Gene mutation.
Is there a difference between disease-free survival of oral squamous cell carcinoma referred by dentists versus other physicians? -A systematic review
Authors: Ghauri Kanza , Siddiqui Humayun Kaleem , Khan Farhan Raza
Published: September 2023

Objectives: To compare disease-free survival rates in oral squamous cell carcinoma patients initially attended to and referred by dentists versus other physicians.
Methods: The systematic review was conducted after registration with the International prospective register of systematic reviews at the University of York, the United Kingdom, and comprised search on Medline, PubMed, Cochrane and CINAHAL Plus databases for studies published up to December 2021.  The Population-Intervention-Comparison-Outcomes-Study criteria was used to search for studies involving patients diagnosed with oral squamous cell carcinoma receiving referrals by dentist or by other healthcare providers. Disease-free survival of patients was taken as the main outcome. Customized data collection proforma was used to record data in line with the Preferred Reporting Items in Systematic Reviews and Meta-Analysis guidelines. Data was subjected to systematic, qualitative review.
Results: Of the 344 studies found, 8(2.3%) were analysed in detail. Patients referred by dentists ranged from 22.6% to 54%. Males comprised 53% to 70.3% of the sample. The highest number of referrals was made by primary physicians, ranging from 27.4% to 71.6%. Upto 67.6% cases were diagnosed with stage 1 and 2 oral cancer. The highest 5-year survival rate was 75% in a study where 59% patients were diagnosed at an early stage of disease.
Conclusion: The relative scarcity of studies makes it impossible to draw an association between oral cancer survival rate and type of referral.
Key Words: Oral squamous cell carcinoma, Cancer-free survival, Early detection, Referrals.
Diagnostic accuracy of fine needle aspiration cytology in comparison to open biopsy for lesions of oral cavity in Covid-19 era
Authors: Syed Shumail Ahmad  , Gulraiz Zulfiqar  , Muhammad Imran
Published: September 2023

Objective: To compare the diagnostic accuracy and uses of fine needle aspiration cytology with histopathology in the diagnosis of lesions of oral cavity.
Method: The single-centre, prospective, non-randomised controlled trial was conducted at the departments of Oral and Maxillofacial Surgery and Pathology of Allama Iqbal Medical College/Jinnah Hospital, Lahore, Pakistan, from January 10 to August 10, 2021, and comprised patients of either gender aged >10 years having superficial or deep well-established mass, palpable, nodular, ulcerative lesions, swellings of the oral cavity or of major or minor salivary glands having intraoral presence or manifestation with size >1cm. Data was analysed using SPSS 20.
Results: Of the 43 patients, 22(51.2%) were males and 21(48.8%) were females. The overall mean age was 40.5+/-15 years (rang: 13-70 years). On cytological examination, 6(14%) samples were excluded for being insufficient aspirate. Of the remaining 37(86%) samples, 20(51.4%) were detected with malignancy on histopathology. The accuracy of fine needle aspiration cytology was 33(89.19%).
Conclusion: Fine needle aspiration was found to be a reliable and cost-effective technique in the diagnosis of oral cavity lesions.
Key Words: Carcinoma, Squamous cell, Fine-needle, COVID-19, Minimally invasive surgical procedures, Mouth neoplasms.
Effects of excessive screen time during online teaching on the physical and mental health of medical and dental students
Authors: Rehman Sadia , Ali Hasan , Sami Zara , Sarfaraz Raza , Ata Madiha
Published: September 2023

To assess the effects of excessive screen time on the health of medical and dental students due to online teaching during the Covid-19 pandemic.
It was a descriptive cross-sectional study, conducted in Bahria University of Health Sciences from June 2022 to September 2022 after getting ethical approval. A total of 200 students who attended online teaching modules for at least one year through online teaching Apps, were included. A structured questionnaire was distributed using google forms. The results revealed that factors including strain on the eyes, restlessness, declined academic performance and exercise during lockdown, along with feeling connected as a group had a significant association with increased screen time. Excessive screen time has various adverse effects on the physical and mental health of medical and dental students. For improving students’ physical and mental health during online teaching we need to change teaching strategies and support the introduction of flipped classroom.
Changes in caloric consumption, physical activity, body mass index and sleeping pattern during holy month of Ramadan among doctors of a public sector University
Authors: Parkash Arit , Maheswari Greesh , Shaikh Shiraz , Anwer Rabia
Published: September 2023

Objective: To determine the change in caloric intake, physical activity, body mass index and sleeping pattern during Ramadan among doctors.
Method: The longitudinal study was conducted at a public-sector medical university in Karachi from April to May 2020, and comprised healthy doctors of either gender who planned to fast during Ramadan. Data was collected using a multitude of validated structured tools by trained data collectors. Data was analysed using SPSS 20.
Results: Of the 193 subjects, 103(53.4%) were females and 90(46.6%) were males. The overall mean age was 30.05±9.4 years. Caloric intake in the month before Ramadan was significantly higher 2288±495kcal/day than during Ramadan 2089±491kcal/day (p<0.001). Calories from proteins decreased and those from fats increased (p<0.001). Metabolic equivalent of task per minute per week increased significantly during Ramadan (p<0.001). Overall sleep per day decreased significantly, and there was an increase in daytime sleep and a decrease in night-time sleep (p<0.05). Body mass index also dropped significantly (p=0.005).
Conclusion: Fasting during Ramadan had a positive effect on body mass index and physical activity levels of doctors, while the quality of diet and sleep was affected negatively.
Key Words: Caloric consumption, Physical activity, Body mass index, Sleeping pattern, Ramadan.
Ultra-low dose multi-drug quadruple single-pill combination for hypertension
Authors: Muhammad Ismail Ibrahim  , Abbasi Zaeem Ahmed , Anusha Naseem
Published: September 2023

Respected Madam,
Patients with hypertension require a multi-drug regimen to manage hypertension. But, multi-drug management may lead to patients’ lower cohesion to drugs and multiple adverse effects. (1) On the contrary a single pill containing four drugs (calcium channel blockers, beta-blockers, angiotensin II receptor blockers, and thiazide diuretics) of low dosages may deliver the same outcomes with lesser inauspicious effects.
Current hypertension guidelines of the American Heart Association categorically recommend using a combination of four drugs in to manage and control hypertension, preferably in single-pill preparations. (2) Most patients remain on a single-drug therapy with insubordinate control, despite the recommendations that most require single-pill combination therapy of four drugs for blood pressure management (3) A recent randomized control trial demonstrated that a combination of four blood pressure-reducing agents in a single-pill at lower doses provided a simple, safe and potent treatment that improved the patient’s cohesion to the drug. The quadruple combination consists of four drugs: calcium channel blockers, beta-blockers, angiotensin II receptor blockers, and thiazide diuretics.
Quadruple therapy is proven to have many benefits, namely higher efficacy, fewer adverse effects, and fast acting. It is found to be cost-effective as compared to monotherapy of multi-drugs. It is also known that patients taking high doses of multiple drugs to control blood pressure would be at higher risk of facing adverse effects such as bradycardia, hypokalemia, metabolic alkalosis, and constipation being the most common ones. In contrast, quadruple therapy consists of low dosages and it’s a combination of drugs to be taken together which helps the patient to surpass the adverse effects and effectively lower the blood pressure. It is also noted that quadruple therapy has proved effective in primary hypertension as a trial on a quadruple single-pill combination showed that the single-pill combination effectively reduced blood pressure in patients with stage 1 hypertension (4).
In light of the above evidence, healthcare professionals should know the benefits of using a single-pill quadruple therapy for managing hypertension instead of traditional monotherapy. Moreover, additional studies should be performed on the effectiveness of using quadruple therapy.
Stem cells on YouTube: National vs international content
Authors: Arif Fizzah , Fazlur Rahman Mohammad , Khozema Safri Mohammad
Published: September 2023

YouTube is one of the most popular video-based social media sites across the globe. The role of stem cell transplant has not been deeply explored on YouTube. The current narrative review was planned to assess the viewership of content available on YouTube related to stem cells. The videos were classified based on type of content, duration, number of views, comments and number of likes. A total of 40 videos were downloaded under the search terms “stem cells in Pakistan” and “stem cells”. Of them, 6(15%) were repeat videos, and 34(85%) were unique. The findings revealed that in 10(25%) most viewed videos from Pakistan, 6(60%) contained opinions from non-expert physicians. Among the 10(25%) most viewed international videos, the information providers were science educators in 4(40%) videos and researchers in 2 (20%). Notably, no content from Pakistan was present among the top relevant international videos.
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Spectrum of HBB gene variants and major endocrine complications in thalassemia patients of Pakistan
Authors: Muhammad Bilal Ghafoor  , Ikram Din Ujjan  , Ali Muhammad Waryah  , Faheem Ahmed Memon
Published: September 2023

Objectives: To determine the molecular characterisation of beta-thalassemia major patients, pattern of major endocrine complications and its association with haemoglobin subunit beta gene variants.
Method: The cross-sectional study was conducted from November 2021 to November 2022 after approval from the ethics review committee of Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan, and comprised of 88 patients with beta thalassemia major aged >8 years and having serum ferritin level >1000µg/L. The subjects were analysed for haemoglobin subunit beta gene variants and major endocrine complications, like growth retardation, hypogonadism,  hypothyroidism, hypoparathyroidism and diabetic abnormalities using an automatic chemistry analyser, fully automatic chemiluminescence immunoassay analyser, enzyme-linked immunosorbent assay and real-time polymerase chain reaction. Data was analysed using SPSS 25.
Results: Of the 88 subjects, 40(45.4%) were girls and 48(54.5%) were boys. The overall mean age was 12±2.81 years. Of the total, 55(62.5%) had growth retardation, 41(46.6%) were cases of hypogonadism, 16(18.1%) hypothyroidism, 5(5.7%) hypoparathyroidism, 3(3.4%) diabetes mellitus and 8 (9.1%) had impaired glucose tolerance. Also, 65(73.9%) patients confronted at least one endocrine complication. Endocrine complications were strongly associated with serum ferritin levels (p=0.000). The most common haemoglobin subunit beta gene variant identified was IVSI-5 (G>C) in 36(40.9%), and the least identified variant was cluster of differenctiation-26 (G>A) 1(1.1%). The association between haemoglobin subunit beta gene variants with endocrine complications was statistically non-significant (p>0.05).
Conclusion: IVSI-5 (G>C) was found to be the most frequent haemoglobin subunit beta gene variant among beta-thalassemia major patients.
Key Words: Beta-thalassemia major, Endocrine complications, Growth retardation, Hypothyroidism, Parathyroidism, Diabetes mellitus.
Introducing Pediatric Radiology as a subspecialty in Pakistan: Bridging the Gap in Healthcare
Authors: Hameed Marya , Siddiqui Fatima , Shaikh Fahad Hassan
Published: September 2023

Madam,
Radiology is a rapidly progressing field that significantly contributes to disease diagnosis and treatment monitoring. Recent advancements in the field have improved evidence-based medicine for patient care. Despite substantial growth in Pakistan, limited opportunities for sub-specialisation training in radiology are available in Pakistan. Just a few institutions offer training in sub-specialties such as women's imaging, neurologic radiology, interventional radiology, and body imaging.
There has been significant evolution in pediatric radiology, which has now emerged as a distinct field requiring solid foundations. Unfortunately, due to undefined training opportunities, pediatric radiology is being neglected in Pakistan. Pediatric radiology requires specialized training due to anatomical variations and unique disease presentations in children. Even senior general radiologists may lack confidence when reporting pediatric cases. Radiology demands updated knowledge and expertise in diagnostic tools, making it challenging to keep up. Reporting pitfalls in pediatrics differ from adults due to varying growth patterns and myelination making expert knowledge essential for accurate reporting in multiple conditions. The acceptable radiation doses and protocols for imaging studies are also different, considering children’s susceptibility to ionizing radiation3. The European Society of Radiology highlighted the importance of integrating pediatric radiology training4. Many other countries, including the USA and Europe, have sub-specializations and accreditations despite having lower proportions of children in their populations compared to Pakistan. Advocacy movements for pediatric radiology have also emerged in other developing nations like Nigeria5.
Pakistan is a largely populated country, with approximately 35% being pediatric population and multiple radiological cases being reported daily. It seems a gross neglect not to cater specifically to such a large proportion of the people. Therefore, there is a dire need to recognize pediatric radiology as a formal subspeciality that requires redrafting of the curriculum. The subspecialty should focus on a particular area and offer comprehensive and consistent training to interested individuals.
Current trends in complete denture education in undergraduate dental colleges of Pakistan
Authors: Lone Muneeb Ahmed , Kumar Dr. Bharat , Musharraf Dr. Hira , Lone Maham Muneeb , Lone Mohid Abrar , Shaikh Muhammad Saad , Inayat Ahsan , Abbas Muhammad
Published: September 2023

Objective: To determine the current trends in complete denture education in undergraduate dental colleges.
Method: The survey-based study was conducted in April and May 2020 at undergraduate dental colleges of Pakistan, and comprised heads of the Prosthodontics Department at all dental colleges across Pakistan having at least one batch of final year dental students. Data was collected using an online predesigned questionnaire that explored theoretical and practical teaching patterns of complete denture prosthodontics in the undergraduate years, and the materials and practices of students when constructing complete dentures in the clinics. The participants were given the option of choosing more than one option where needed. Data was analysed using SPSS 23.
Results: Of the 49 subjects approached, 40(81.6%) returned the forms duly filled; 11(27.5%) from public-sector institutions and 29(72.5%) from the private sector. There were 26(65%) institutions which required that their undergraduate students fabricate 2-4 conventional complete dentures. In all 40(100%) colleges, faculty gave live clinical demonstrations before students fabricated conventional complete dentures in the outpatient departments. Teaching strategy included small group discussions in 25(62.5%) institutions. Green stick 40(100%), zinc oxide eugenol 40(100%) and impression compound 39(97.2%) were the materials of choice for various steps of impression making. In all the 40(100%) institutions, students fabricated conventional complete dentures during their prosthodontics rotation. Immediate, copy and overdentures were constructed by students in 8(20%), 3(7.5%) and 8(20%) institutions, respectively.
Conclusions: Majority of the dental schools used similar impression materials and techniques for fabricating conventional complete dentures. Didactic teaching of conventional and unconventional complete dentures was being carried out at a huge majority of the dental institutions studied.
Key Words: Current trends, Complete dentures, Undergraduate dental education.
ધીરુબેન પટેલના બાળનાટકોમાં વિષય વૈવિધ્ય
Authors: ચાવડા શકુંતલાબેન , પટેલ પ્રશાંત
Published: September 2023

ગુજરાતી સાહિત્યને મધ્યકાલીન અને અર્વાચીન એમ બે વિભાગમાં વહેંચવામાં આવે છે. મધ્યકાલીનયુગમાં સાહિત્ય મોટેભાગે ધર્મકેન્દ્રી જોવા મળતું હતું. નરસિંહ મહેતાથી માંડી દયારામ સુધીનું સાહિત્ય આપણને પદ્ય સ્વરૂપે અને ધર્મકેન્દ્રી જોવા મળે છે. એ સમયે પદ, રાસ, ફાગુ, આખ્યાન, ગરબી, કાફીઓ જેવા સાહિત્યસ્વરૂપો જોવા મળતાં હતાં. આ યુગમાં માત્ર પદ્યમાં જ રચનાઓ જોવા મળે છે.
અર્વાચીનકાળને સાહિત્ય પ્રમાણે જુદા-જુદા યુગવિભાજનમાં મુકવામાં આવેલ છે. સુધારકયુગ, પંડિતયુગ, ગાંધીયુગ, અનુગાંધીયુગ, આધુનિકયુગ અને અનુઆધુનિકયુગ. ગુજરાતી સાહિત્યમાં દરેક યુગમાં તત્કાલીન પરિસ્થિતિ પ્રમાણે સાહિત્યમાં તેની છાપ જોવા મળે છે. અર્વાચીનયુગમાં ગદ્યમાં સાહિત્ય લખવાની શરૂઆત  સુધારકયુગથી થઈ ગઈ હતી. આ યુગમાં વાર્તા, આત્મકથા, નિબંધ, ચરિત્રલેખન, નવલકથા, નાટક વગેરે સાહિત્ય સ્વરૂપો ખેડાયા. આ સાથે બાળસાહિત્ય પણ લખવાની શરૂઆત ધીમે ધીમે થવા લાગી. જેમાં જુદાં જુદાં સ્વરૂપો ખેડાવા લાગ્યા.
ગુજરાતી બાળસાહિત્યને  શિશુસાહિત્ય અને બાળસાહિત્ય એમ બે વિભાગ પાડવામાં આવેલ છે. જેમાં બાળકની વયને આધારિત સાહિત્ય લખવામાં આવે છે. તેમાં બાળવાર્તા, બાળકવિતા, બાળચરિત્ર, બાળનિબંધ અને બાળનાટક જેવાં સ્વરૂપો જોવા મળે છે.
નાટકનું એક સ્વરૂપ તે બાળનાટક. નાટક અને બાળ એકમેક સાથે બિંબ-પ્રતિબિંબ સમાન છે. બાળને જોતાં જ એના પ્રત્યેક વર્તનમાં હાવભાવ, ચેષ્ટા અર્થાત અભિનય જણાય છે. બાળક કંઈ વાત કરે છે તો એકલા મોં વડે જ નથી કરતું, તે કંઈ ગીત ગાય છે તો એકલા કંઠ વડે જ નથી ગાતું, તે આઠે અંગ વડે ગાય છે. હાથના વિવિધ હાવભાવથી વાતનો ભાવ પ્રગટ કર્યા વિના એને સંતોષ થતો નથી. ઘટના મુજબ પોતાના કહેવાનો પૂરો ભાવ સમજાવવા તે દોડી બતાવે છે, કુદી બતાવે છે, કંઈક કંઈક ક્રિયાઓને અભિનય કરીને બતાવે છે, આંખોના મચકારા અને ચહેરાના હસવાના ભાવ પણ ઘટના પ્રમાણે ઉમેરતું રહે છે. જાણે કોઈ તાલીમ પામેલ નટ હોય તેમ તેની આંગિક ચેષ્ટાઓ ચાલે છે. આ ચેષ્ટાઓમાં કળા, સૌષ્ઠવ અને સુડોળપણું સારા પ્રમાણમાં આવી જતું હોય છે. નાટ્યાભિનયની રૂઢિઓ અને મુદ્રાઓ તે પોતાના અભિનયમાં ઉતારી ન શકે પરંતુ  સ્વકલ્પનાનુસારના કળા-કૌશલ એના અભિનયોમાં આવ્યા વિના રહેતાં નથી. ઘટનાની સાથે અને પાત્રની સાથે તે એટલું એકરૂપ બની જાય છે  કે નાટ્યકળા તેના વર્તનમાં કુદરતી રીતે આવી બેસે છે.
નાટકનો વિચાર હંમેશા રંગભૂમિના સંદર્ભે થતો હોય છે. નાટકો ભજવાય છે, ભજવવા માટે હોય છે. તેથી તે રીતે વિચાર થાય એ પણ સ્વાભાવિક છે. પરંતુ તેથી કરીને નાટકો એ સાહિત્ય નથી એવું થોડું છે? ‘કાવ્યેષુ નાટક રમ્ય’ એમ કહીને સાહિત્યમાં રમ્ય તો નાટક જ છે એવી સ્થાપના થઈ છે. વળી, બાળકોના શિક્ષણની દ્રષ્ટીએ પણ બાળનાટકો અત્યંત મહત્વનાં છે.
INNOVATIVE DATA COLLECTION METHODS FOR RESEARCH IN THE DIGITAL ERA
Authors: Rubeena  , Maseeh Minhajullah
Published: September 2023

Data collection is a very important stage in social science research. In social science research, the data collection stage is very patient and challenging. The data collection methods are an important part of the research. During the collection of data, a researcher should identify the appropriate method of data collection based on the type and source of the data. If the researcher does not use the proper data collection method, they will encounter many difficulties while gathering the data, which may have an impact on their research. Therefore, the selection of data collection methods should be done with the utmost care. Before the COVID-19 pandemic, collecting face-to-face primary data from the research population was better. But when the social distancing era started, data collection in the traditional way in the field of teacher education became a challenging task for researchers. The researchers used several online data collection methods to deal with these challenges. Therefore, in this paper, researchers tried to identify online data collection methods for conducting the study or investigation in teacher education during the COVID-19 era.
Qualidade de vida de pessoas vivendo com HIV em um grupo de apoio no município de Vitória, no Espírito Santo
Authors: Miye de Souza Kihara Fernanda , Pinto Ferreira Gabriel , da Silva Kerollen Cristina , Dos Santos Silva Daleprani Larissa , Gomes Teresa , Sales Carolina Maia Martins , Regina Guandalini Valdete
Published: September 2023

Introdução: Ainda é possível observar o reflexo que a pandemia da síndrome da imunodeficiência adquirida (aids) representa desde meados de 1980. Esse fenômeno global trouxe consigo diversas formas de precon­ceitos, estigmas, mudanças nas relações sociais, mentais e físicas do indivíduo, modificando sua quali­dade de vida (QV). Objetivo: Analisar a QV das pessoas que vivem com HIV (PVHIV). Métodos: Estudo descritivo de corte transversal, com 19 participantes, realizado com um grupo de PVHIV atendidos em um ambulatório de Doenças Infecciosas e Parasitárias (DIP) em Vitória/ES. Utilizou-se o questionário validado WHOQOL-HIV-bref, que tem por objetivo avaliar a QV das PVHIV, de acordo com suas particularidades. Tal questionário analisa aspectos físicos, psicológicos, níveis de independência, relações sociais, ambientais e aspectos religiosos/crenças. Resultados: Houve maior proporção de pessoas do sexo feminino (52,6%), com idade entre 41 e 60 anos (42,0%), raça parda (42,1%), escolaridade de segundo grau (36,8%), solteiros (52,6%) e residentes da Grande Vitória (94,7%). Quanto ao WHOQOL-HIV-bref, as melhores médias obtidas foram espiritualidade (15,8), psicológico (14,3), nível de independência (13,9), físico (13,7), relações sociais (13,6) e ambiente (13,3), respectivamente. A QV das PVHIV pode impactar diretamente a adesão terapêu­tica, as interações sociais, a autopercepção e diversas áreas fundamentais de vida do indivíduo. Conclusão: Neste estudo conclui-se que a QV se apresentou satisfatória, indicando que as PVHIV demonstraram um bom enfrentamento da doença. Diante dos desafios enfrentados pelas PVHIV, é de extrema importância analisarmos a QV dessa população para assegurar um melhor enfrentamento à doença.
Notificações de violência física contra pessoas com deficiência no Espírito Santo, Brasil, no período de 2011 a 2018
Authors: Da Silva Brandão Kátia , Portes Ribeiro Luíza Eduarda , Miguel Teixeira Santana Nathália , Rabello Laignier Mariana , Marabotti Costa Leite Franciéle
Published: September 2023

Introdução: As pessoas com deficiência são consideradas grupo de risco para diversas formas de violência, incluindo a violência física, que é caracterizada como o uso intencional da força física com o objetivo de causar sofrimento e dor à vítima, deixando ou não marcas evidentes pelo corpo. Objetivos: Identificar a frequência de violência física notificada contra pessoas com deficiência e sua associação com as características da vítima, do agressor e do evento. Métodos: Estudo transversal, realizado no estado do Espírito Santo, de 2011 a 2018, a partir do banco de dados do Sistema de Informação de Agravos de Notificação. A análise descritiva foi feita por meio do teste qui-quadrado de Pearsone multivariada pelo teste de Regressão de Poisson. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa. Resultados: A frequência de violência física foi de 36,9%, destacando-se vítimas do sexo masculino (RP = 1,17; IC95%: 1,02-1,34), adultos (RP= 1,59; IC95%: 0,99-2,56), de raça/cor preta/parda, (RP= IC95%: 1,08-1,45) e que residiam em zona rural. Os agressores eram em sua maio­ria homens, com suspeita de uso de álcool, e ocorrendo em via pública. Conclusão: A violência física se mostrou prevalente entre as pessoas com deficiência, trazendo importância de seu estudo e fatores associados para maior visibilidade ao agravo e às vítimas.
O trauma no período noturno sob a ótica do Serviço de Atendimento Móvel de Urgência do Espírito Santo: uma análise epidemiológica
Authors: Barbosa de Azevedo Marlon , Duarte Neto Caio
Published: September 2023

Introdução: O trauma é considerado um importante problema de saúde pública mundial, em vir­tude de óbitos, sequelas e suas avassaladoras consequências socioeconômicas. Objetivos: Analisar as ocorrências traumáticas e os fatores associados ao trauma no período noturno ocorrido com as vítimas assistidas pelo Serviço de Atendimento Móvel de Urgência do Espírito Santo, nos anos de 2020 e 2021. Métodos: Estudo observacional transversal de 23.445 ocorrências de trauma, divididas em dois grupos: trauma no período diurno e trauma no período noturno. As variáveis sobre o perfil social, demográfico e clínico foram coletadas a partir dos dados do Sistema de Regulação Médica das Urgências e analisadas de forma uni e multivariada. Resultados: 64,2% dos traumas ocorreram no período diurno, e 35,8% no noturno. Os fatores associados à ocorrência do trauma noturno foram: sexo masculino, faixa etária de 25 a 34 anos, fim de semana, origem domiciliar, Região Serra, vítimas não críticas, envio da Unidade de Suporte Avançado, agressão, arma branca, queda da própria altura, queda de veículo em movimento, óbito na cena e transporte das vítimas para hospitais públicos. Conclusão: O perfil das vítimas de trauma assistidas pelo Serviço de Atendimento Móvel de Urgência do Espírito Santo corresponde ao encontrado no Brasil, entretanto, difere de acordo com os períodos diurno e noturno. Espera-se aprimorar as políticas públicas de saúde visando à prevenção do trauma e à integração dos componentes da Rede do Trauma.
The Moderating Role of Treasury Bills and Bonds Allocations on the Relationship between Systematic Risk and Investment Portfolio Performance of Pension Schemes in Kenya
Authors: Kandie Karen , Macheru Joseph , Osoro Cliff
Published: September 2023

Purpose: This study investigated the moderating role of Treasury Bills and Bonds allocation on the relationship between systematic risk and investment portfolio performance of pension schemes in Kenya. Assets under management by pension schemes make up 14.6% of the GDP in Kenya, making pension schemes significant players in the financial industry and the economy. As of December 2021, the pension industry had mobilised   Kshs. 1,547.43 billion in managed pension assets from Kshs. 44.7 billion in 2000, a significant annual average growth rate of 21%.

 Methodology: The study used secondary data from 1,172 registered pension schemes for seven years between 2015 and 2021. Pension scheme data was collected from the database of the Retirement Benefits Authority. Systematic risk data was collected from the databases of the Central Bank of Kenya, Nairobi Securities Exchange and Kenya National Bureau of Statistics. Panel Regression analysis, fixed effect, random effect, and Hausman test were used to analyse the relationship between the dependent and independent variables. The study applied the Whisman and Maclleland two-step model to evaluate the impact of asset allocation on the investment portfolio performance of pension schemes as moderating variables.

Findings: The study results showed that asset allocation to Treasury Bills and Bonds did not significantly moderate the effect of systematic risk on the investment portfolio performance of pension schemes. 

Unique Contribution to Theory, Practice and Policy: The study contributed to academia by challenging the usefulness of Modern Portfolio Theory. Policymakers should consider reviewing the limits on investment in Treasury Bills and Bonds to less than 100% to encourage diversification to more asset classes. Practitioners are recommended to invest in diverse asset classes.
Assessment of Factors Influencing the Effective Implementation of Public Projects: The Case of Selected Public Projects Financed by Botor Tolay Woreda Administration, Oromia Regional State, Ethiopia
Authors: Susi Elias
Published: September 2023

Purpose: The main purpose of the study was to assess the factors that influence the effective Implementation of public projects: The Case of Botor Tolay Woreda, Oromia Regional State, Ethiopia.

Methodology: The study was both descriptive and explanatory research design and applied Quantitative and qualitative research approach. The primary and secondary data was used, the primary data was collected by using questionnaires and observation while the secondary data was through analysis the documents. Purposively select 26 expertise and experienced employee from the government office and Contractors. The collected data was analyzed by using descriptive and inferential statistics. To ensure the relationship between independent and dependent variables the Pearson correlation and multiple linear regression was applied. The data was analyzed by using Statistical package for Social Science (SPSS) version 25. The study Result was presented through the using of table and figures.

Finding: The study focuses on the four major factors that affecting the success of public project implementation those planning and scope cause of delays, Client related, Contractor related and external factor related delays of the public project implementation. The findings of correlation and regression show that there was a positive and significant relationship between Project implementation and, Planning and scope of the project, Client, Contractor and external factor related delays.

Unique Contribution to Theory, Practice and Policy: The researcher recommended that the government body open consulting and supervising office of construction at woreda level for delays of payment approval to successful implementation of the public project, The woreda also practice by improving the delays of client, and planning and scope level delays, the contractor practice their work as schedule, cost and quality.Both government body and contractor develop the methods of resisting the external factors to compact the problemsystems, stakeholder, agency, institutional, and resource dependency theories.
Diabetische ketoacidose: nog steeds een levensbedreigende ziekte
Authors: Janssens B. , Mathieu C. , Lambert J. , Meersseman P.
Published: September 2023

Diabetic ketoacidosis: still a life-threatening disease.

This report details a rare occurrence of cerebral edema as a complication of diabetic ketoacidosis (DKA) in an 18-year old male. The patient presented with headache, and on further inquiry typical symptoms of DKA (polyuria, polydipsia and weight loss). During treatment his condition rapidly deteriorated resulting in neurological collapse and coma. A CT-scan revealed signs of cerebral edema.

Although the exact pathophysiology is not fully understood, it is believed that both DKA-related (cytotoxic and vasogenic) and treatment-related factors play a role. Cerebral edema caused by DKA can be fatal, or result in persisting neurologic deficits. Proper use of intravenous (IV) resuscitation fluids and avoidance of IV bicarbonate and IV insulin bolus is necessary to avoid exacerbation of pre-existing cerebral edema, as described in this case report. Neurological monitoring, before and during treatment, is essential, as early detection and treatment of cerebral edema improves outcome. If clinical signs of cerebral edema, mannitol 20% or hypertonic salt IV should be administered immediately.

This case emphasizes the importance of careful metabolic and neurological monitoring and adherence to appropriate treatment principles in DKA to reduce the risk of cerebral edema. Increasing awareness of this complication among healthcare providers can help intervene in a timely manner and improve outcome for the patient.
Gender Issues and Electoral Security in Nigeria (1999- 2023)
Authors: Atim Grace , Adeoye Angela Olofu , Nkanta Jennifer
Published: September 2023

The participation of women in electoral politics and security has become an important issue in the global arena. This is because women bear the brunt of conflicts and insecurity in most societies. Since the return of democracy in 1999 in Nigeria, there is a growing concern on the prevalence of sexual and gender-based violence against women especially during electoral processes. Thus, the primary focus of this paper is to establish the link between gender-based electoral violence and low level of women participation in politics, it also seeks to examine the extent to which women have been excluded and violated in security and political related electoral processes. The paper reveals that women’s participation in electoral processes appear to be minimal, while electoral violence issues targeting women during elections in Nigeria appear to be alarmingly high. It further analyses the plethora of factors that are responsible for the continuous exclusion, violation, and discrimination of women in electoral processes. Thus, the paper explores measures that are required to promote and ensure sustained women inclusion in electoral processes, noting that leadership, decision-making, policy analyses, and policy actions should include men and women. From the research, the paper shows a glaring gap between gender participation in issues relating to electoral processes in Nigeria. It therefore recommends the need for interventions/initiatives by governments, political actors, Civil Society Organizations through development of legal frameworks and policies that will promote the inclusion and full participation of women in electoral processes towards a peaceful and sustainable Nigeria.
A Study of Psychotherapy Through Ethical Communication Methods of Nursing Mothers’ Donations by Buddhist Religious in Sri Lanka
Authors: Rathnayaka Sandunika
Published: September 2023

The worship of the goddess Paththini 1, who is considered as the patron goddess of fertility and health, and the almsgiving associated with Nursing mothers called Kiri-ammāwarungè dānaya (or Milk mothers’ alms-giving) was a blessed offering of Sri Lankan society based on Buddhist and Hindu religious communities and folk beliefs. Sinhalese Buddhist believe that the goddess Paththini, who took refuge in Tisarana2, helps those who come to her, thereby aspiring to acquire a masculine self for her. Thus, the devotees who perform this puja with “milk” (milk treatments in rituals) to seek the blessings of Goddess Paththini, who wish to become a Buddha, expect good health and prosperity from it. Sinhalese Buddhist pray to goddess Paththini and seek protection from mental anxiety, cure diseases and relieve troubles; some people also give alms to nursing mothers to seek the blessings of goddess Paththini. One of the main treatment methods used here is psycho-acting / primary forms of therapy. This psychological performance by explaining the meaning of Prayer, so called Yatika can be recognized as a dramatic or theatrical therapy. The use of sound, voice control, intonation and rhythm are also used in the psychological therapy of the person. This is simply a positive treatment or positive mental attitude is created in the minds of those who seek God’s help.
Оптимизация методики определения жирнокислотного состава молочной продукции
Authors: Аухадиева Э. А. , Зеленковская Е. Е. , Даукаев Р. А. , Афонькина С. Р. , Аллаярова Г. Р. , Мусабиров Д. Э.
Published: September 2023

Хроматографический анализ метиловых эфиров жирных кислот используется для определения характеристик липидной фракции пищевых продуктов и является эффективным методом выявления фальсификации и одной из наиболее важных прикладных задач в анализе пищевых продуктов. В статье приводится оптимизированный способ пробоподготовки при определении жирнокислотного состава молочной продукции для сокращения энергозатрат и времени анализа. Вся процедура, начиная от пробоподготовки до получения МЭЖК, занимает около 2 часов. При упрощенном способе время пробоподготовки сократилось в 4-5 раз и составило: для продуктов нежидкой консистенции (творог, сыр, мороженое и пр.) – 20, для молока и жидких кисломолочных продуктов (кефир, ряженка, катык и пр.) – 30 минут. Проведенная оценка показателей качества результатов анализа с применением рабочей пробы при реализации методики показала, что ее метрологические характеристики ниже, чем в базовом нормативном документе, что позволяет рекомендовать ее к применению.
La perspectiva de género en la interpretación de las leyes penales, sustantivas y procesales
Authors: Subijana Zunzunegui Ignacio José
Published: September 2023

La presente reﬂexión entiende que la perspectiva de género equivale a una protección reforzada de las mujeres en el orden penal, tanto sustantivo como procesal, a partir del especial desvalor predicable de una violencia del hombre que ratiﬁca un modelo social de discriminación de la mujer. A la luz de esta premisa, que encuentra cabida en los espacios normativo y jurisdiccional, analiza cómo cabe implementar el enfoque de género en cada uno de los tres ámbitos afectados por la interpretación y aplicación de las leyes penales: la delimitación del hecho, la ﬁjación de la signiﬁcación jurídica del hecho en los delitos contra la vida y los delitos sexuales y la determinación del efecto que se anuda al hecho conforme a la signiﬁcación jurídica conferida.
Teoría de la luz en Francisco Suárez
Authors: Pintado Diego
Published: September 2023

En este conciso estudio se explicará la concepción de la luz que encontramos en Francisco Suárez. Si bien distinta, y por cierto distante, de las teorías modernas (corpuscular y ondulatoria), encontramos en Suárez un corpus de principios, de base y raigambre aristotélica, que dan cuenta de una mecánica del todo exótica para nuestra men- talidad, pero abundante y enriquecida en contenido lógico y filosófico: la filosofía natural de Francisco Suárez está basada, en términos generales, en los conceptos de virtud, necesidad, esfera de acción y energía en el sentido originario de esta palabra. Para sorpresa del lector mínimamente aficionado a estos temas, encontraremos en la física de Suárez explicaciones por momentos mucho más naturales, más claras y más satisfactorias sobre la propagación de la luz y sobre la acción a distancia de lo que han propuesto hasta hoy las teorías en vigencia. Francisco Suárez, desde ya, queda excluido del proyecto de Galileo y de Francis Bacon; no ofrece ni persigue resultados mate- máticos, sino un conocimiento ontológico del Universo y una interesante mecánica esencialista.
A Review on Data Lake
Authors: Shravan R Poojary  , Pradeep Nayak  , Shravitha  , Shreya Rai  , Shrujan Kumar  , Chandana N M
Published: September 2023

One of the contentious ideas to emerge in the big data era. The original concept for Data Lake originated in the business sphere rather than the academic one. Due to its revolutionary features and recent development, Data Lake faces a variety of adoption problems. However, Because data lakes have the ability to alter the data environment, it is worthwhile to conduct research on them
Teaching with Integrity: English Teachers’ Awareness on the Ethical Practices on the Use of Online Materials
Authors: Carmelin P. Mosa  , Carmela D. Resare
Published: September 2023

This study focused on determining the awareness of English teachers on the ethical guidelines on the use of online materials. Specifically, the study sought to look into information on the demographic profile of the respondents as to sex, age, highest educational attainment, number of years in teaching, grade level taught and the number of hours spent using the internet per day. Significant relationship between the demographic profile and the level of awareness on the three components were also looked into. Further, crafting of intervention program that can serve as guide for teachers and students into safe and responsible use of online materials was also made possible.
The study made use of descriptive-quantitative research design wherein the researcher utilizes a researcher-made survey questionnaire consisting of two parts: (1) demographic profile, (2) statements to determine awareness of teachers on the ethical guidelines on the use of online materials.
The data collected were analyzed and interpreted using the following statistical tools; Frequency Count and Percentage, Mean and Standard Deviation, Pearson r, Spearman Rank Correlation, and Point Biserial Correlation. The study revealed the following findings; majority of the English teachers in San Jose, Dinagat Islands are young female who have finished only with their bachelor’s degree, and spent a minimal time online. It was also noted that the respondents are “very much aware” on the ethical practices in using online materials in terms of authenticity, textual resource, and audio-visual resource. Moreover, data of the study also revealed that the educational attainment has significant impact on the level of awareness on ethical guidelines in using online materials. Hence, an intervention program needs to be crafted and to be implemented to sustain their awareness.
The Influence of Technology on English Language Communication: Implications for Language Education
Authors: Carmelin P. Mosa
Published: September 2023

In an interconnected and technologically driven world, the role of technology in reshaping language communication and education assumes paramount importance. This paper delves into the multifaceted influence of technology on English language communication, unveiling its transformative potential in language education. The proliferation of digital devices and internet connectivity has ushered in an era of enhanced accessibility to English language resources, empowering learners to engage in self-paced, personalized language learning experiences. Interactive learning environments, characterized by gamified language lessons and real-time communication tools, redefine language education, fostering learner engagement and motivation. Furthermore, technology facilitates global connectivity, enabling cross-cultural communication and preparing learners for international interactions. However, alongside these opportunities, challenges in digital literacy emerge, emphasizing the need for learners to navigate the digital landscape discerningly. This paper provides an in-depth exploration of these findings and their implications. Recommendations for language educators emphasize the holistic integration of technology, the empowerment of learners with digital literacy skills, and the development of global communication competencies. Policymakers are encouraged to prioritize global competence, support professional development, and foster adaptability in language education. As technology continues to evolve, this study guides the ongoing dialogue within the field of language education, illuminating the path towards effective language instruction in the digital age. It underscores the need for adaptability, innovation, and a keen focus on equipping learners with the skills and knowledge needed to thrive in a digitally connected and globalized society.
The Office of the Dead in Christian Liturgy
Authors: Schell Sarah
Published: September 2023

This chapter provides an overview of developments that gave rise to the two foundational subjects of this book, the Office of the Dead and the Book of Hours. The development of the Office of the Dead is traced through the establishment of an early Christian funeral rite, its formalization in the monastic context, and its later use in the secular community including its regular presence in the Book of Hours. The shape, use, and forms of engagement with the Book of Hours is also discussed.
Introduction
Authors: Schell Sarah
Published: September 2023

This book examines images at the Office of the Dead in Books of Hours. It approaches the topic through three conceptualizations of death which dominate the imagery of the Office: social death, bodily death, and non-death. The social engaged the reader in contemplation of death’s connotations for and in the community. Bodily death considers images responding to the physical consequences of death, such as dissolution and identity loss, as well as engaging with the rhetorical power of the visible corpse. Images of non-death provided visual evidence of the Christian promise of redemption through death and the reunification of body and soul. These images are contributors to, as well as reflections of, the socially and culturally constructed idea of medieval death.