bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of patients’ complaints in primary healthcare centres through the Mawid application in Riyadh, Saudi Arabia; a cross-sectional study
Authors: Almusawi Mona Ahmed , Radwan Nashwa , Mahmoud Nagla , Alfaifi Amal , Alabdulkareem Khaled
Published: March 2023

Introduction: The Saudi Ministry of Health launched a central appointment mobile application system (Mawid) that is linked to all primary healthcare (PHC) centres in the kingdom. The application allows patients to evaluate the healthcare services they receive. This study aimed to determine the frequency and nature of the complaints of patients visiting PHC centres through the Mawid application.
Methods: This cross-sectional study was conducted using 3-month secondary data from the Mawid application. The study included 3134 comments from 380,493 patients who visited 38 PHC centres in Riyadh and responded to the Mawid application evaluation questionnaire. Data were analysed using SPSS version 21.
Results: Approximately 59.1% of the patients’ comments were negative (patients’ complaints); only 19%, positive; 8.40%, mixed; and 13.6%, unrelated. The patients’ complaints (n=2969) were obtained from 380,493 patients within 3 months, yielding a complaint rate of 2.6 per 1000 attendances per month. The majority of the complaints (79.3%) were from patients visiting nonspecialised PHC centres. Approximately 59.1% of the complaints fell under the management domain; 23.6%, patient–staff relationship domain; and only 17.2%, clinical domain.
Conclusion: Management and interpersonal problems constituted the main patients’ complaints in the PHC centres in Saudi Arabia. Therefore, future studies must clarify the reasons contributing to these complaints. Increasing the number of physicians, providing staff training and continuous auditing are mandatory to improve patients’ experiences in PHC centres.
Monkeypox: A review of data essential in primary care
Authors: Ng Ying Ying , Abdul Kadir Azidah
Published: March 2023

Monkeypox is known to be endemic in Africa, but recently, the unusually increasing number of cases of monkeypox in non-endemic countries has caught the attention of the world. The World Health Organization has declared the monkeypox outbreak a public health emergency. The spread pattern is unlikely associated with the previous outbreak outside of Africa, which is related to travelling or contact with exotic animals. The current outbreak is linked to sexual history and presents with atypical localised genital eruptions with an unpredictable onset of viral prodromal symptoms. Although the monkeypox virus is not easily transmittable compared with severe acute respiratory syndrome coronavirus 2, anyone who has been in close contact with a patient with monkeypox is at risk. Most patients will present to a primary care centre for assessment and treatment; therefore, it is important to increase awareness of the infection among primary care providers for early recognition of monkeypox, containment of the outbreak and prevention of healthcare-associated infection. A physician who suspects any patient with monkeypox should notify local or state health authorities immediately.
HSR-GEE: A 1-m GEE Automated Land Surface Temperature Downscaling System over CONUS
Authors: Mhawej Mario , Abunnasr Yaser
Published: March 2023

Abstract. Downscaling remote sensing-based Land Surface Temperature (LST) datasets is of paramount importance for multiple research fields including urban heating, irrigation scheduling, volcanic monitoring, to name a few. Even with the constant development in technology, especially improvements in spatial, temporal and spectral resolutions of satellite sensors, global satellites are limited to a 60-m LST datasets at best. In this study, we use the massive computation power and large dataset directory found in the Google Earth Engine (GEE) platform to design a 1-m fully-automated, open-source and user-friendly LST downscaling system, named High Spatial Resolution-GEE or HSR-GEE. It has the ability to downscale Landsat-8 LST, combined with the National Agriculture Imagery Program (NAIP) images, into 1-m HSR LSTs over the CONUS and at Landsat-8 overpass time. Using only red, green, blue and near infrared bands, HSR-GEE implements multiple machine learning approaches, including, Robust Least Square (RLS), Random Forests (RF), and Support Vector Machine (SVM), along with comparison to two commonly-known and classical methods: the disaggregation procedure for radiometric surface temperature (DisTrad) and thermal sharpening (TsHARP). We validate HSR-GEE outputs against multiple airborne thermal images over the USA. We obtained a MAE of 1.92 °C, 2.53 °C, 1.33 °C, 3.42 °C and 3.4 °C for the RLS, RF, SVM, DisTrad and TsHARP, respectively. With RF showing visually salt and pepper effect and SVM a Land Cover/Use form, the RLS appears to be most suited for 1-m LST downscaling. HSR-GEE is proposed as a high-potential system aiding researchers from different backgrounds to advance their research. HSR-GEE remains the only available 1-m GEE-based downscaling system that is able to derive the needed high resolution LST information in a matter of seconds and in five different approaches (i.e., RLS, RF, SVM, DisTrad and TsHARP). The research community is invited to implement this dynamic system over CONUS and enhance it if deemed necessary.
Historical variation in normalized difference vegetation index compared with soil moisture at a taiga forest ecosystem in northeastern Siberia
Authors: Nogovitcyn Aleksandr , Shakhmatov Ruslan , Morozumi Tomoki , Tei Shunsuke , Miyamoto Yumiko , Shin Nagai , Maximov Trofim C. , Sugimoto Atsuko
Published: March 2023

Abstract. The taiga ecosystem in northeastern Siberia, a nitrogen-limited ecosystem on permafrost with a dry climate, changed during the extreme wet event in 2007. We investigated the normalized difference vegetation index (NDVI) as a satellite-derived proxy of needle production and compared it with ecosystem parameters such as soil moisture water equivalent (SWE), foliar C/N ratio, δ13C and δ15N, and ring width index (RWI) at the Spasskaya Pad Experimental Forest Station in Russia for the period from 1999 to 2019. Historical variations in NDVI showed a large difference between typical larch forest (unaffected) and the sites affected by the extreme wet event in 2007 because of high tree mortality at affected sites under extremely high SWE and waterlogging, resulting in a decrease in NDVI. Before 2007, the NDVI in a typical larch forest showed a positive correlation with SWE and a negative correlation with foliar C/N. These results indicate that not only the water availability (high SWE) in the previous summer and current June but also the soil N availability increased needle production. NDVI was also positively correlated with RWI, resulting from similar factors controlling them. However, after the wet event, NDVI was negatively correlated with SWE, while NDVI showed a negative correlation with foliar C/N. These results indicate that after the wet event, high soil moisture availability decreased needle production, which may have resulted from lower N availability. Needle δ15N was positively correlated with NDVI before 2007, but after the wet event, needle δ15N decreased. This result suggests damage to roots and/or changes in soil N dynamics due to extremely high soil moisture.
The Clam Before the Storm: A Meta Analysis Showing the Effect of Combined Climate Change Stressors on Bivalves
Authors: Kruft Welton Rachel A. , Hoppit George , Schmidt Daniela N. , Witts James D. , Moon Benjamin C.
Published: March 2023

Abstract. Impacts of a range of climate change on marine organisms have been analysed in laboratory and experimental studies. The use of different taxonomic groupings, and assessment of different processes, though, makes identifying overall trends challenging, and may mask phylogenetically different responses. Bivalve molluscs are an ecologically and economically important data-rich clade, allowing for assessment of individual vulnerability and across developmental stages. We use meta-analysis of 203 unique experimental setups to examine how bivalve growth rates respond to increased water temperature, acidity, deoxygenation, changes to salinity, and combinations of these drivers. Results show that anthropogenic climate change will affect different families of bivalves disproportionally but almost unanimously negatively. Almost all drivers and their combinations have significant negative effects on growth. Combined deoxygenation, acidification, and temperature shows the largest negative effect size. Eggs/larval bivalves are more vulnerable overall than either juveniles or adults. Infaunal taxa, including Tellinidae and Veneridae, appear more resistant to warming and oxygen reduction than epifaunal or free-swimming taxa but this assessment is based on a small number of datapoints. The current focus of experimental set-ups on commercially important taxa and families within a small range of habitats creates gaps in understanding of global impacts on these economically important foundation organisms.
The contribution of Total Variometric Approachto the 2023 Türkiye earthquake sequences
Authors: Ravanelli Michela , Fuso Federica , Astafyeva Elvira , Crespi Mattia
Published: March 2023

The 2023 Türkiye earthquake sequences are among the most devastating events of recent years. The earthquake occurred on February 6th, 2023 and was characterized by several foreshocks starting from 1:17UT. The Mw 7.8 shock was the strongest and was caused by a shallow strike-slip faulting.We applied the Total Variometric Approach (TVA) methodology to fully characterize the 2023 Turkey earthquake sequences from ground to the ionosphere [1].The TVA technique simultaneously employs two variometric algorithms, VADASE (Variometric Approach for Displacement Analysis Stand-alone Engine) and VARION (Variometric Approach for Real-Time Ionosphere Observation), to retrieve earthquake ground shaking, co-seismic displacements and ionospheric Total Electron Content (TEC) variations in real-time. TVA was already successfully applied to the 2015 Mw 8.3 Illapel earthquake and tsunami.In this case, we used IGS observations from 6 GNSS located in Turkey, Greece and Israeli and data from 60 GNSS receivers belonging to the Turkish network TUSAGA-Akitf [2].Our first results show very strong ground shaking up to 10 cm/s in the East direction and up to 25 cm in the North direction. We notice great displacements especially in the horizontal plane (up to 30 cm). This is coherent with a strike-slip earthquake. Nonetheless, we also observe great displacements in the Up component (up to 1m). This could be the reason why we see this earthquake signature also in the ionosphere, although it is a strike-slip shock.Indeed, preliminary ionospheric analyses reveal the signature of acoustic-gravity waves epicenter (AGWepi) especially for satellites G03, G04, G31 and E09.A 30cm tsunami wave was also registered in Erdemil, along the Turkish coastline.This study shows how the TVA can contribute to the complete understanding and rapid characterization of the seismic event, from ground to the atmosphere, and to manage and real-time earthquake hazard assessment.[1] Ravanelli, M., Occhipinti, G., Savastano, G., Komjathy, A., Shume, E. B., & Crespi, M. (2021). GNSS total variometric approach: first demonstration of a tool for real-time tsunami genesis estimation. Scientific Reports, 11(1), 1-12.[2] https://www.tusaga-aktif.gov.tr/
Réflexions sur l’attribution à Étienne-Simon (de) Gamaches des Lettres Persanes de Montesquieu
Authors: Saleh Rania
Published: March 2023

Nous pouvons considérer l’étude de Gamaches comme une modalité pour analyser et comprendre les impulsions de l’amour et du désir dans les Lettres Persanes, afin d’évaluer ce qui aurait permis l’attribution du roman de Montesquieu à l’auteur du Système du cœur.
Todos los caminos llevan a Chipre
Authors: Ruiz-Gálvez Priego Marisa
Published: March 2023

El texto desarrolla el modelo de las diásporas comerciales como alternativa a la precolonización en el Bronce Final y plantea la existencia de agentes foráneos conviviendo entre indígenas en el Centro y Oeste del Mediterráneo antes de la implantación de las colonias históricas.
Rastreamento ocular e a educação especial inclusiva: uma revisão sistemática
Authors: Batista Leonardo dos Santos , Kumada Kate Mamhy Oliveira , Benitez Priscila
Published: March 2023

A presente pesquisa teve como objetivo a investigação do uso do rastreio ocular na educação inclusiva, visto que essa ferramenta é uma maneira de medida implícita e não invasiva da medida do olhar. Tais dados podem atuar como avaliadores do processo atencional durante a realização de atividade pedagógica por estudantes pertencentes ou não da Educação Especial e Inclusiva. Nos questionamos então “Como o rastreamento ocular está sendo utilizado na educação matemática sob a perspectiva do desenho universal para aprendizagem?”. Para responder, realizamos uma revisão sistemática nos bancos de dados nacionais e internacionais. Identificamos uma lacuna quanto a um público diverso, com trabalhos anteriores sempre mantendo um perfil comportamental pouco detalhado ou muito homogêneo, bem como recursos visuais não muito elaborados. Ao fim, propomos um protocolo que compilou todas as especificações dos métodos utilizados, contendo as informações frequentemente registradas pela literatura, o detalhamento de perfil e de métricas do ramo. Contribuindo para a área de rastreio ocular no contexto da Educação Especial e Inclusiva.
Impact of Religious Orientation on Prosocial Behavior of Undergraduate University Students: Emotional Expressivity as Moderator
Authors: Kausar Asia , Binti Alis Norzaliza , Binti Ismail Suzila
Published: March 2023

The purpose of the current study is to find out the impact of religious orientation on the prosocial behavior of undergraduate university students. The sample consisted of 528 undergraduate students (279 female, 249 male), who were purposefully selected with an age range of 17 to 24 years. Three scales were employed: the Religious Orientation Scale (Urdu) developed by Khan, Ghous, and Malik (2016), the Prosocial Tendency Measure (PTM-R) by Carlo and Randall (2002), and the emotional expressivity scale (Urdu) developed by Fahd and Hanif (2019). SPSS (22.0) is used to draw the results. This study provides important insights into the relationship between religious orientation and prosocial behavior and highlights the role of emotional expressivity as a moderator in this relationship. The results suggest that individuals who are more religious and also score highly on emotional expressivity may be more likely to engage in prosocial behaviors. This has implications for understanding the mechanisms underlying the relationship between religious orientation and prosocial behavior and may inform interventions aimed at promoting prosocial behavior.
O discurso militar
Authors: Soares Thiago Barbosa , Ramos Ghiraldelli Paula
Published: March 2023

A presente investigação constitui uma análise do discurso da propaganda de recrutamento do exército russo de 2021, organizada por veículos do governo. O referido objeto foi investigado por meio de dois conceitos baseados na Análise do Discurso, a cena da enunciação e o ethos discursivo. A partir disso, verificou-se como esses elementos coincidem com uma determinada posição ideológica governamental. No delineamento da cena, no objeto, verificou-se que o enquadramento cênico corresponde a uma propaganda militar e que o cenário possui elementos cinematográficos, promovendo o surgimento da figura principal do herói militar.
The (mis)alignment of health insurers' efficiency measures from different perspectives and Their (un)linkage with financial ratios and asset allocation
Authors: Cole Cassandra , Yang Charles , Lin Hong-Jen
Published: March 2023

This research uses Data Envelopment Analysis (DEA) models to examine the alignment of health insurers’ efficiency measures from different perspectives. It also analyzes the linkage between efficiency measures and asset allocation, as well as traditional financial ratios including medical loss ratio (MLR). The DEA results indicate that the operating efficiency and the medical services efficiency are positively (but not highly) correlated with each other, and financial ratios are not effective indicators of the efficiency of health insurers. The composite efficiency is much higher than the operating or medical services efficiency. The correlation between the composite efficiency and the operating efficiency or the medical services efficiency is moderate. Neither the operating efficiency nor the medical services efficiency is an appropriate measure of the overall efficiency of health insurers. Therefore, innovative regulatory measures, such as a combination of efficiency measures and financial ratios, should be adopted to satisfy all the stakeholders. This research provides significant insights to policymakers, regulators, the health insurance industry and consumers.
Emerging issues within the assignment of benefits clause
Authors: Anderson-Parson Jamie , Epermanis Karen
Published: March 2023

The Assignment of Benefits (AOB) clause under an insurance contract has been recognized for quite some time and until recently has been of little consequence to homeowner's insurance. Over the past decade, however, the clause in homeowner's coverage is coming under fire. Attorneys and water remediation contractors are using Florida's attorney fee-shifting statute in conjunction with an AOB under the Insurance Services Office (ISO) (1999) Homeowners 3 (HO3) -- Special Form policy in filing claims for reimbursement of services rendered subsequent to the insured's executed AOB. As a result, insurer claims costs in Florida are escalating to a crisis point. This paper discusses the challenges within the homeowner's assignment of benefits clause as applied to water mitigation claims in the state of Florida since 2005. We analyze legal and regulatory arguments used to curtail rising litigation in this area. We draw specific attention to Florida's Homestead Exemption as an insurer defense to deflect mounting litigation efforts to pay these increasingly significant claim costs.
The Florida insurance market: an analysis of vulnerabilities to future hurricane losses
Authors: Nicholson Jack , Clark Karen
Published: March 2023

Florida is the peak zone for hurricane risk. The authors evaluate the current vulnerabilities and risks associated with the residential property insurance system in Florida and its financial capability to respond to future hurricane events. The state's residential property insurance system is composed of private insurers and Florida's three public risk financing entities: Citizens Property Insurance Corp. (Citizens), the Florida Hurricane Catastrophe Fund (FHCF) and the Florida Insurance Guaranty Association (FIGA). The Florida residential insurance market has been transformed since the last Category 5 hurricane--Andrew--made landfall, and the current system has not been tested with a major hurricane loss. The authors used the characteristic event (CE) methodology to analyze the impacts of 20-, 50- and 100-year hurricanes on the Florida market from both a micro and a macro perspective. Using a set of realistic assumptions, the analysis illustrates and quantifies Florida's vulnerabilities to hurricane losses by estimating the numbers of private insurer insolvencies and resulting impacts on Florida's public risk financing entities for each of the hurricane scenarios.
Toxicity Test of Strong Drug Using the BSLT
(Brine Shrimp Lethality Test) Method
Authors: Pohan Dame Joyce , Marantuan Randolph Serep , Djojosaputro Mulyadi
Published: March 2023

One of the methods to test cytotoxic materials is to test the toxicity of Artemia salina leach shrimp larvae (Brine Shrimp Lethality Test). This method is often used for pre-screening the active compounds contained in plant extracts because it is cheap, fast, easy (no need for aseptic conditions), and trustworthy. This study aims to determine the acute toxic effects of the powerful drugs used by the public. This research was experimental research using Post Test Only Control Group Design. It used 120 larvae as test animals which were divided into four groups. Each group contains ten larvae. Each group is done by the replication of research two times. As the test component, the cause of bitter melon is given through the media, which contains larvae as the animal test. The final extract concentration in the media, which contains larvae consecutively as the group of 1, is 4000 ppm, 2000 ppm, and 0 ppm for negative control. The result is against larvae that died 24 hours after the component test was given. Through the data, the LC50 value of strong herb was analyzed by probit analysis using Excel for windows. This study shows the load concentration extract in a medium can kill the larvae in a row with a concentration of 4000 ppm and 2000 ppm. The results of probit analysis showed that there is no toxicity to Artemia salina leach larvae. Then it is concluded that there is no potential for acute toxicity according to Artemia salina leach when it was tested using BLST.

Key words: brine shrimp lethality test, herbal, strong medicine, acute toxicity, Artemia salina leach. .
Dynamique sémiotique, ethnométhodologie… et après ? Confrontations, synthèses et ouvertures
Authors: Nicolaï Robert
Published: March 2023

Adossée à la prise en considération de l’activité et de l’activisme des acteurs de la communication, ce que je retiens sous le vocable de "dynamique sémiotique" ambitionne de s’intéresser aux procès de mise en signification, d’élaboration de sens, mais aussi de transformation de forme(s) aux marges (en regard) des approches linguistiques et langagières. Ses concepts ayant déjà été largement présentés par ailleurs, je propose ici, après les avoir synthétiquement repris, de les confronter à ceux qui sont propres à la perspective ethnométhodologique (née aux marges de la recherche sociologique) dans la mesure où un certain parallélisme conceptuel semble lier les deux approches. Dans un deuxième temps, je noterai quelques orientations d’une sémiotique post-greimassienne qui, sur certains points, semble être susceptible de croiser cette problématique de la dynamique sémiotique.
The mechanisms of surface charge formation on polymers - Toward Triboelectric Generators
Authors: Šutka Andris
Published: March 2023

The triboelectrification (TE) of polymers has gained a vast attention
in field of mechanical energy harvesting and related application for
powering microdevices and portable electronics. Numerous concepts of
triboelectric generator (TG) devices have been demonstrated which
exploits TE for harvesting mechanical energy. There are various sources
of mechanical energy which can be harvested by TG including
biomechanical movement, water drops, ambient noise, wind, and water
waves. The performance of TG devices is governed by magnitude of surface
charge, thus it is highly important to understand the mechanism of TE
to develop materials which are tending to gain strong surface charge.
Active control of compressible supersonic wall-bounded flow using direct numerical simulations with spanwise velocity modulation at the walls using PyFR
Authors: Foysi Holger
Published: March 2023

Active turbulence control has been pursued continuously for quite some time already. In this talk, our focus is on a promising method inducing a spanwise wall movement in order to reduce turbulence intensity and hence friction drag, investigated by means of direct numerical simulation. Most procedures related to turbulence control including the present one have been overwhelmingly applied to incompressible flow. This work is different and novel to the effect, that this control method is applied to compressible, supersonic channel flow up to a bulk Mach number of Ma = 3. Due to substantial variations of viscosity, density, and temperature within the near-wall region in supersonic flow, the impact of the control method is altered compared to solenoidal flow conditions. By creating a data
set of different Mach-/Reynolds numbers and control parameters, knowledge is gained in which way the effectiveness of oscillatory techniques and physical
mechanisms can change under the influence of compressibility. It is shown that the control method is able to effectively reduce turbulence levels and lead to large drag reduction levels in compressible supersonic flow. Variable property effects even enhance this behaviour for the whole set of investigated parameters. Overall, the higher Mach number cases show a larger net power saving compared to the incompressible ones. Furthermore, we observe an increase of the optimum wavelength with increasing Mach number, which helps in guiding optimal implementations of such a control method.
Chronic Kidney Disease and Metabolic Disease
Authors: Lalayiannis Alex D. , Dassanayake Thushara , Dilloway Tina
Published: March 2023

CKD MBD in Dialysis Patients: A Growing Understanding

The talk will cover a brief overview of CKD-MBD in young people, the severity and extent of bone disease, the effects of vascular calcification and the interplay between the two.

Dietary Phosphate – hidden in plain sight

This session will focus on dietary phosphate absorption, availability and individual variation addressed in a socio-economic and cultural context.
Childhood growth, current age, and waist circumference predict biological reserve capacity, physical performance, and rapid aging in Bangladeshi women
Authors: Bogin Barry
Published: March 2023

Background: The UK Bangladeshi community is socially disadvantaged, and many adults suffer from obesity, diabetes, and other chronic illnesses. Rapid aging has been noted.

Objectives: Analyse biosocial trade-offs in growth, adult body composition, and reproduction, which are risk factors for age-related decline in physical performance, more rapid aging, frailty, and death.

Methods: Sample: 40 Bangladeshi mothers (40-70 years old), one of their adult daughters (N=37, 18-36 years old) in the United Kingdom (UK), and 22 mother-daughter pairs of the same age range in Bangladesh (BD). Measurements: anthropometry, including knee height, migration, demographic history, education level, current menstruation (yes/no), and a 7-component lower body physical function score (PFS). Analysis: ridge regression and St Nikolas House Analysis (SNHA).

Results: All the women are of short stature (x̄=150cm), with especially low knee height. Daughters who migrated to the UK have shorter knee height than daughters born in the UK. Marriage age was 16-18 years and total pregnancies of ~6 per mother, ~3 per daughter. UK mothers have higher fatness and lower PFS than BD women. Greater knee height predicts greater PFS, and that greater waist circumference and older age predict a lower PFS. SNHA finds that knee height is the most direct predictor of PFS.

Conclusion: Adult knee height may serve as a sensitive indicator of early life physical and emotional well-being and predict physical performance, a risk factor for frailty and death. International migration of daughters is associated with poorer health status and physical performance at later ages.
With Friends like These: Dale Carnegie and the Speech Communication Professoriate
Authors: White William J.
Published: March 2023

This article examines the reaction to Dale Carnegie’s seminal self-help book How to Win Friends and Influence People by the field of speech communication in the context of Carnegie’s prior connection to that field and as the field developed over the course of the twentieth century. It identifies four general categories of response: immediate rejection, cautious and partial incorporation, rhetorical sublimation, and metacommunicative reflexivity. It locates these responses within a historical trajectory that outlines the changing nature of the field and, to a lesser extent, the evolution of the Dale Carnegie organization and shows how this account invites attention to the relationship between self-help and speech education.
The Africana Womanist Rhetoric of Frances Ellen Watkins Harper
Authors: Arnold-Patti Abby
Published: March 2023

To read Frances Ellen Watkins Harper’s corpus of poetry, oratory, and political activism through the lens of feminism is to erase the Afrocentric logics of her rhetoric, but examining her work through the lens of Afrocentricity broadly obscures her radical views on the role of women in society. Africana womanism offers a paradigm through which one can analyze her rhetoric in a way that honors her Blackness and her womanhood—an ethic she insisted on throughout her life. This article elucidates the theory of Africana womanism and highlights evidence of Africana womanist thought in the rhetoric of Watkins Harper, deepening our understanding of women’s contributions to the organizing work and activism of nineteenth-century Black Americans.
Centennial Reflections on Suffrage Scholarship: Feminist Intersectional Assessments
Authors: Enoch Jessica , Glenn Cheryl
Published: March 2023

In this essay, we assess feminist rhetorical scholarship that focuses on the suffrage movement, prioritizing intersectional research in which the analytic frame brings together considerations of gender, race, and power. Here, we trace scholarly lines of conversation among feminist scholars that (1) trouble dominant White suffrage narratives and historiography, (2) amplify the rhetorics of suffragists of color, (3) interrogate the racist rhetorics that inflected and shaped the suffrage movement, and (4) imagine possibilities for and the challenges of cross-racial coalitions and alliances, all in the hope that more scholars will join these ongoing discussions.
Effects of Mulligan's Bent Leg Raise Technique on Hamstring Flexibility and Lumbar Spine Mobility in Healthy Females
Authors: Irfan Afia , Mannan Rafia , . Aleena, , Riaz Saima , Rashid Sajid , Khan Rehan Ramzan
Published: March 2023

Objective: To assess the effects of Mulligan's bent leg raise technique on hamstring flexibility and lumbar spine mobility in healthy females. Methodology: A randomized controlled trial with ClinicalTrials.gov ID: NCT04716205 was conducted. The 48 participants were split into two groups. Mulligan's bent leg raise (BLR) technique and static stretching were given to the experimental group, while only static stretching was given to the control group. The outcome variables were modified Schober's (MST) and active knee extension tests (AKET). The assessment was completed at the outset, and post-treatment values were obtained after the first and second weeks of therapy. Results: Mean value of MST in the Control group pre-treatment was 3.27±0.33 and 4.11±0.37 at 1st-week post-treatment and 4.81±0.32 at the 2nd-week post-treatment, which was less significant than the experimental group. The findings revealed that the experimental group had significantly higher mean values for both the active knee extension test and the modified Schober's test than did the control group. Conclusion: This research concluded that Mulligan's bent leg raise technique combined with static stretching is more effective than static stretching alone in treating hamstring flexibility and spinal mobility. Keywords: Hamstring tightness, Mulligan BLR, Static stretching, flexibility
Compare the Mean Duration of Healing with Sodium Carboxylic Methyl- Cellulose Silver Dressing Versus Standard Petroleum Gauze Dressing for Management of Second-Degree Burns
Authors: Din Ekramud , Jailani Umama , Fayyaz Hamza , Khan Zarak , Shehbazi Hamza Khan , Haider Sayed Rafaiuddin , . Shazma
Published: March 2023

Introduction: Burn injury is one of the most devastating and serous form of trauma that man sustains. Millions of people all over the world are hospitalized each year for treatment of burns and thousands die. It is estimated that in UK alone 10000 burn victims are hospitalized each year and 700 die. Objective: To compare the mean duration of healing with sodium Carboxylic methyl- cellulose silver dressing versus standard petroleum gauze dressing for management of second-degree burns. Material and methods: A total of 100 patients of second-degree burns were selected for this study. Clinical examination of patients was done to find out the degree of burns. In group A, Aquacel Ag dressing was applied. In group B, petroleum gauze dressing was applied. Patients were evaluated on each visit when dressing was changed for complete healing. Results: The mean age of the patients was 33.4±19.2 years. Duration of healing when compared in both the groups its showed that average time of healing in group A was 10.38+2.71 while in Group B it was 13.48+5.26SD and it showed significant difference with p-value=0.000. Practical Implications: This study will help to find the best method used for healing in second-degree burns. Conclusion: Mean duration of healing with sodium Carboxylic methyl-cellulose silver dressing was less than petroleum gauze dressing for management of second-degree burns. Keywords: Burn, Injury, Tissue, Wound, Healing, Management, Dressing
Utility of HS-CRP as an add on to Lipid Profile for Cardiovascular Risk Stratification in Adults with Type II Diabetes Mellitus
Authors: Din Iqtidar-Ud- , Batool Tayyaba , Raza Syed Hyder , Yasir Alard , Salam Rizwan Abdul , Akhtar Nasreen
Published: March 2023

Background: Diabetes mellitus (DM), which has a significant mortality and morbidity percentage, has emerged as a major health hazard. The aim of this study to evaluate the effects of hs-CRP with lipid profile effects on CVS risk in type II diabetic patients. Study design: It was a cross-sectional study conducted in the People’s University of Medical and Health Sciences for Women, Nawabshah, for six month duration from March 2022 to August 2022. Methodology: The total participants were 250 which included 180 diabetic participants and other remaining 70 were non-diabetic participants. These participants were divided into two groups, one group was non-diabetic participants serve as control group and other was diabetic group. The data analyses were done by SPSS 21 version. Results: The mean age of the male and female participant was 50.5±9.9 and 49.48±10.5. There was no significance change in the demographic variables like BMI, weight, systolic pressure and diastolic pressure p>0.005 in diabetic and control group. The participants were 31% and 72% raised CVS risk due to increase of LDL and hsCRP levels. The LDL, TC and TG were statistically significant in the participants having >4 mg/dl of hs-CRP. The HDL and ratio of HDL/LDL level were reduced significantly having >4 hs-CRP mg/dl. Conclusion: According to our observations, patients who are diabetic participants commonly have raised hs-CRP levels along with dyslipidemia. Continuous monitoring of these indicators can sometimes support in reducing the CVS risk among patients. Keywords: lipid profile, dyslipidemia, significant mortality and morbidity.
Frequency of Age-Appropriate Vaccination in Children Till 15 Months of Age Admitted at the Aga Khan Hospital, Karachi, Pakistan
Authors: Mustafa Aiza , Mustafa Anum , Kumar Manoj , Iqbal Rozina , Saleem Ali Faisal , Mustafa Alina
Published: March 2023

Objective: To determine the frequency of age-appropriate vaccination till 15 months of age at Aga Khan Hospital, Karachi Pakistan. Study design: Cross-sectional study Place and Duration: Inpatient department of the Aga Khan University Hospital from Nov 2019 to Nov 2020 Methodology: All children admitted to the pediatric ward and fulfilling the inclusion criteria were enrolled. A predesigned proforma was used to collect data on the basic demographics of children and parents, their socioeconomic status, parental education, occupation, and vaccination status. The age-appropriate vaccination was defined as children who had received the vaccination, according to their age as per the expanded program of immunization (EPI) schedule of Pakistan. All collected data were analyzed using SPSS version 23. Results: Out of 350 admitted children, 222 (63.4%) were males and 128 (36.6%) were females. Most of the children were vaccinated (95.7%), while 4.3% were not vaccinated. Among vaccinated children, 63.7% had not received age-appropriate vaccination, and only 127 (36.3%) had age-appropriate vaccination. Statistically, the employment status of mothers (p=0.001) and educational level of mothers (p=0.001) and fathers (p=0.001) were significantly associated with age-appropriate vaccination in children of age up to 15 months. Conclusion: Despite having a high vaccination coverage rate, the proportion of age-appropriate vaccination was lower. The factors associated with age-appropriate vaccination were the employment status of the mother and the educational status of the parents. Vaccination programmes should work on identified risk factors in order to improve age-appropriate vaccination coverage. Keywords: Age appropriate vaccination, immunization, vaccination card
Endoscopic Retrograde Cholangiopancreatography in Patients with Choledochal Cyst, A Tertiary Care Experience
Authors: Kazim Erum , Taj Muhammad Ali , Leghari Aftab Ahmed , Feroz Rabia , Ahmed Raheel , Ghazanfar Shahriyar
Published: March 2023

Objective: Our aim of this analysis was to evaluate the clinical features, laboratory values, radiological findings, endoscopic management, and technical success in patients with Choledochal cyst (CC). Materials & Methods: This retrospective study was carried out at our Endoscopy suite, between January 2010 to January 2022. All patients of choledochal cyst who underwent ERCPs in last 12 years were analyzed. Technical success was defined as achieving a biliary cannulation and successfully acquiring the desired goal. Descriptive and Frequency analysis were incorporated in Statistical analysis with SPSS. Results: Procedures performed in 100 patients with suspected choledochal cyst either for a diagnostic or therapeutic purpose were evaluated. 48 ERCPs (48%) were performed for therapeutic purpose and 52 (52%) for diagnostic purpose. Diagnostic findings after successful ERCP were CC in 67 (67%), CC with stone in 28 (28%), CC with cholangiocarcinoma in four (4%) and CC with biliary stricture in one (1%). No mortality was documented in our patients who underwent Procedure. Patients referred for surgery were 92 (92%) and ERCP affected management in 100% (100/100 procedures). Practical Implications: This study will determine the clinical features, laboratory values, radiological findings, endoscopic management, and technical success in patients with Choledochal cyst. Conclusion: ERCP is a contemporary procedure, its utility in cases with CCs in a developing country with scarce resources and limited availability of gold standard modality (MRCP), is astounding and safe. Keywords: Endoscopic retrograde cholangiopancreatography; Choledochal cyst; Classification; Endoscopic management.
Pediatric Injury Patterns Presenting at a Tertiary Care Hospital Emergency Department
Authors: Yaseen Tahir Muhammad , Hussain Shabbir , Fazal Aisha , Zulfiqar Atif
Published: March 2023

Introduction: Injuries in the pediatric population relate to significant liability, especially in low- and middle-income countries.1 The aim of this study is to decipher the patterns of pediatric injury in Pakistan. This may give the data on the pattern of pediatric injuries, thereby strategies could be made to deal such patients and eventually reduce the mortalities and morbidities. Objective: To evaluate pediatric injury patterns presenting in emergency department of Liaquat National Hospital, Karachi. Methodology: The study was held at the Emergency department of LNH for six months from 11th may 2018 to 11th November 2018. It was a cross sectional study. Ninety children suffering from trauma as per their history were included in this study. Demographics were noted of all the patients enrolled in the study. An approved Performa was used for recording the outcome variables . Results: - The median age of the children was 4.81±3.12 years. Out of 90 children, 71(79%) were boys and 19(21%) were girls. Pattern of injury were included road traffic injuries (54.4%),falls from height (31.1%), poisoning (9%) ,burns (3.3%) and electrocution (2.2%) Conclusion: We conclude that the patterns of pediatric injuries in children presenting in accident and emergency department shows road traffic accidents as the leading cause followed by fall from height, poisoning and burns. The study emphasizes the need to build an injury surveillance in the emergency dept that would be a building block for a national injury surveillance database. Along with it, study highlights necessary injury prevention measures that would assist in addressing preventable childhood injuries in Pakistan . Keywords: Pediatric injuries, Road traffic injuries, Poisoning
Risk Factors of Computer Vision Syndrome and its Prevention
Authors: Imran Khadeeja , Khan Maha Izzat , Zaib Hafiz Muhammad Jahan , Nazir Fahmina , Khan Nida Armoghan , Khalid Amina
Published: March 2023

Background: The 21st century is thought to need these gadgets. They are employed in households, as well as in recreational settings and educational organizations, in addition to workplaces and businesses. The term "video display terminal" is used to refer to a computer screen (VDT). It includes computers, tablets, e-readers, smartphones, and other electronic gadgets. According to estimates, 45 million employees use computers directly by gazing at VDTs nonstop for long periods. Aim: The goal of this study was to count how many CMT (college of Medical Technology) students have computer vision syndrome and to identify the risk factors that go along with it. Methods: This cross-sectional research was conducted on 198 CMT students at Pakistan institute of Medical Sciences, Islamabad, Pakistan, from 1st April 2022, to 30th September, 2022. The research covered all students between the ages of 17 and 25 who had used a computer in the month before the programs start date. Those students who were using eye medications, those with underlying systemic conditions like diabetes or hypertension, those with pre-existing eye problems, and those who did not provide informed written permission were excluded from the study. To demonstrate relationships between categorical data, the chi-square test was performed. The SPSS version 23 was used to analyze the data. Results: Age of 20.16 ± 3.81 years on average. Out of 198 respondents, 133 (67.2%) said they had at least one of the following symptoms of computer vision syndrome: headache, eye tiredness, burning, eye irritation, neck discomfort, and shoulder pain. Computer users' eye complaints included eye irritability (48%), burning (33%), and eye weariness (15%). Extraocular symptoms range from headaches (38%) to neck and shoulder discomfort (21.8%). Computer use time (240 minutes/four hours) was substantially correlated with eye tiredness and headache. Practical Implication: The benefit of this study is to identify the risk variables linked with computer vision syndrome and its incidence among undergraduate medical students. It will aid in raising public awareness of the health risks associated with computers and other digital electronic devices, as well as assisting public health experts and other stakeholders in taking action to address this public health problem Conclusions: The ailment known as "Computer Vision Syndrome" affects a lot of young students who use computer regularly Keywords: Computer Vision Syndrome, Risk, Prevention, households, irritability, pain, eye tiredness, .
Effectiveness of Calcium Channel Blockers and Nitrates in Inhibition of Spasm of Radial Artery during Coronary Angiography
Authors: Arfat Yasir , Faraz Noor , Nazim Muhammad , Soomroo Imran Ellahi , Qasim Afzal , Sharfi Masroor Hussain
Published: March 2023

Background: The most common issue with transradial cardiac catheterization is radial artery vasospasm. The patient experiences pain and discomfort as a result, the procedure is prolonged, and the interventionist may even be unable to continue. Aim: The aim of the study is to determine the effectiveness of Verapamil, a calcium channel blocker and nitrate, when used together to prevent radial artery spasm during coronary angiographies. Methods: This case control study was held in the Cardiology department of Qazi Hussain Ahmed Medical Complex, Nowshera and Peoples University of Medical and Health Sciences for Women PUMHSW (SBA) Nawabshah for six-months duration from July 2021 to December 2021 including 120 cardiac patients undergoing coronary angiography. The patients were selected by non-probability sampling technique. Patients who were enrolled in the study provided written informed consent. Two groups of patients—control (60) and experimental—were formed (60). Heparin/nitrate was administered to one group and labelled as a control group, while heparin/nitrates/verapamil (a calcium channel blocker) was administered to the other group considered as an experimental group. During the angiography procedure, the radial spasm, discomfort, and catheter resistance were assessed in both groups. A predesigned questionnaire was used to collect all other demographic data and patient’s history. SPSS version 23.0 was used to collect and analyse the data. Results: It was found that 68.3% of cardiac patients were over 50 years old, 41.7% of patients were female, and 58.3% of patients were male. Verapamil, a calcium channel blocker, and nitrate did not significantly affect radial spasm, according to this study with a p value of 0.762. According to the study, there was no obvious difference noted in radial spasm, outcome, discomfort, catheter resistance, or procedure time when cases and controls were compared for various variables. However, the test group have a 100% success rate of the procedure compared to the control group's 95%. Conclusion: Verapamil, a calcium channel blocker when combined with nitrate did not significantly reduce radial spasm during coronary angiography. The theory that calcium channel blockers could prevent radial artery spasm during angiography was nullified. It is best to avoid the financial burden that comes with using calcium channel blockers and nitrate during coronary angiography. Combining nitrate and calcium channel blocker (Verapamil) has no additional advantages. Keywords: Angiography, catheterization, calcium channel blocker, radial spasm, nitrate, and verapamil are some of the related terms.
Assessment of Incidence of Aspiration Pneumonia in Infants with Cleft Palate
Authors: Muhammad Taj , Ullah Farman , Naz Rida
Published: March 2023

Background: A cleft lip (CP) is characterized by a split in upper lip, which may extend into the nose. These abnormal fissures can cause difficulties with nutrition, hearing, speaking and recurrent respiratory and ear infections. Objectives: The study assessed the complications associated with the cleft palate in infants and the incidence of aspiration pneumonia. Methods: The study was conducted in tertiary care hospitals and pediatric clinics at District Dera Ismail Khan, from February 2021 to September 2022, comprising 141 CP patients. Results: The incidence of CP was seen 7.90% in District Dera Ismail Khan, which was higher in males (68.08%) than in females (31.91%). The mean age of the study group was 4.35+3.12, with birth weight and weight at the time of assessment being 3.85+1.78 and 23.78+15.19, respectively. Their mean maternal age and weight at the time of delivery were 32.91+9.07 and 61.65+21.56, respectively. A significant proportion (p<0.05) suffered from aspiration pneumonia (64.53%), while 19.85% of the patients had complained of recurrent pneumonia due to CP. Other complications included chest infection (43.26%), ear infection (8.51%), nasal obstruction (31.91%), vomiting during feeding (26.95%) and regurgitation of milk and other food materials (12.05%). Ten CP patients died (7.09%) due to the complications associated with this disorder. Practical implications: For infants with orofacial clefts, the incidence of LRTIs is potentially high, thus accumulated breastfeeding length might mediate the connections of CP. Conclusion: It was concluded that CP was significantly associated with pulmonary defects and caused fatal LRTIs in the affected population, especially in breastfeeding infants. Keywords: Cleft palate; Ear infections; Fetal defects; Genetic Disorders; Pulmonary infections.