bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical study of vitiligo with assessment of quality of life and comparison with Vitiligo Area Severity Index score in a tertiary care center in northern India
Authors: Geetha K. , Upadhyaya Amrita , Singh Shrada
Published: August 2024

Introduction: Vitiligo is a common, chronic, and idiopathic pigmentary disorder of the skin, characterized by well-defined depigmented macules. It has a significant negative impact on psychological health of patients. Patients report having low self-esteem and a negative body image, which may result in a reduced quality of life for them. Vitiligo also has considerable potential for social stigma and cosmetic impairment, which are aspects of the disease that are often overlooked. Aims and Objective: The aim of this study was to describe the demographic characteristics of the rural population of Uttar Pradesh, India, diagnosed with vitiligo, and to study the association of the Vitiligo Area Scoring Index (VASI) score with the quality of life in patients having vitiligo. Material and Methods: An observational study was conducted on 121 patients diagnosed with vitiligo at a tertiary care hospital for 6 months after receiving ethical approval. The patients’ demographic details were recorded, and the severity of their condition was assessed using the VASI. This information was then compared with the Dermatology Life Quality Index (DLQI) using a standard questionnaire. Statistical analysis was performed using SPSS software. Results: The study included a total of 121 patients, with 67 (55.4%) females and 54 (44.6%) males. Their ages ranged from 15 to 65 years, with a mean age of 32.28 years. The DLQI scores ranged from 3 to 21, with a mean of 11.49. There was no statistically significant difference in scores between males and females. Out of the total, 21 patients (12 males and 9 females) reported a small effect of the disease on their life, while 29 patients (comprising 9 males and 20 females) revealed a moderate effect. Additionally, 32 (59.3%) males and 35 (52.2%) females showed a very large effect on their life. Significant variations were observed between the DLQI score grades in relation to the VASI score. There was a statistically significant positive correlation between the VASI score and the DLQI score (P < 0.001). The DLQI score also showed a statistically significant association with increased body surface area. Conclusion: The severity of vitiligo should be evaluated not only based on the disease itself but also on its impact on the patients’ quality of life.
Reticulate acropigmentation of Kitamura in a case of Gorlin-Goltz syndrome − coincidence or association?
Authors: Laishram Roda , Bhatia Riti , Hazarika Neirita , Vathulya Madhubari , Baishya Pakesh , Saroha Amit
Published: August 2024

Gorlin-Goltz syndrome also known as nevoid basal cell carcinoma syndrome (NBCCS) is a rare, complex hereditary disorder characterized by phenotypic developmental anomalies and postnatal tumors especially basal cell carcinomas (BCCs) and medulloblastomas. It is inherited as autosomal dominant disorder with inactivating mutation in PTCH 1 gene. Reticulate acropigmentation of Kitamura, a rare pigmented genodermatosis has not been described in the literature in association with NBCCS and may be a new finding. Considering the rarity of the disease and its wide clinical spectrum and complications, it is of paramount importance to identity these atypical presentations of the syndrome at an early stage for holistic approach, early intervention, monitoring of basal cell carcinoma, and genetic counselling.
On irreducible representations of Fuchsian groups
Authors: Balaji Vikraman , Pandey Yashonidhi
Published: August 2024

Let
${\mathcal {R}} \subset \mathbb {P}^1_{\mathbb {C}}$
be a finite subset of markings. Let G be an almost simple simply-connected algebraic group over
$\mathbb {C}$
. Let
$K_G$
denote the compact real form of G. Suppose for each lasso l around the marked point, a conjugacy class
$C_l$
in
$K_G$
is prescribed. The aim of this paper is to give verifiable criteria for the existence of an irreducible homomorphism of
$\pi _{1}(\mathbb P^1_{\mathbb {C}} \,{\backslash}\, {\mathcal {R}})$
into
$K_G$
such that the image of l lies in
$C_l$
.
The von Neumann extension theory for abstract Friedrichs operators
Authors: Erceg Marko , Soni Sandeep Kumar
Published: August 2024

The theory of abstract Friedrichs operators was introduced some fifteen years ago with the aim of providing a more comprehensive framework for the study of positive symmetric systems of first-order partial differential equations, nowadays better known as (classical) Friedrichs systems. Since then, the theory has not only been frequently applied in numerical and analytical research of Friedrichs systems, but has continued to evolve as well. In this paper, we provide an explicit characterisation and a classification of abstract Friedrichs operators. More precisely, we show that every abstract Friedrichs operator can be written as the sum of a skew-symmetric operator and a bounded self-adjoint strictly positive operator. Furthermore, we develop a classification of realisations of abstract Friedrichs operators in the spirit of the von Neumann extension theory, which, when applied to the symmetric case, extends the classical theory.
Data profile: the Korean Workers’ Compensation-National Health Insurance Service (KoWorC-NHIS) cohort
Authors: Min Jeehee , Kim Eun Mi , Kim Jaiyong , Jang Jungwon , Choi Youngjin , Kim Inah
Published: August 2024

The Korean Workers’ Compensation-National Health Insurance Service (KoWorC-NHIS) cohort was established to investigate the longitudinal health outcomes of Korean workers who have been compensated for occupational injuries or diseases. This cohort study, which utilized data spanning from 2004 to 2015, merged workers’ compensation insurance claim data with the National Health Insurance Database (NHID), encompassing 858,793 participants. The data included socio-demographic factors such as age, sex, income, address, insurance type, and disability grade. It also covered the types of occupational accidents, International Classification of Diseases, 10th revision codes for diseases or accidents, work tenure, industry, occupation code, and company size. Additional details such as the occupational hire date, date of claim, date of recognition, and affected body parts were recorded. The cohort predominantly consisted of male workers (80.0%), with the majority experiencing their first occupational accident in their 40s (27.6%) or 50s (25.3%). Notably, 93.1% of the cases were classified as occupational injuries. By integrating this data with that from the NHID, updates on health utilization, employment status, and income changes were made annually. The follow-up period for this study is set to conclude in 2045.
Резисторное расстояние и индекс Кирхгофа для двух видов операций двойного соединения графов
Authors: Wang Wei Zhong , Ma Ting Yan
Published: August 2024

Пусть $G$ - связный граф. Резисторное расстояние между любыми двумя вершинами $G$ определяется как эффективное сопротивление сети между ними, если каждое ребро $G$ заменить единичным резистором. Индекс Кирхгофа $G$ - это сумма резисторных расстояний между всеми парами вершин $G$. В этой статье найдены резисторное расстояние и индекс Кирхгофа двойного соединения подразбиением $G^{S}\vee\{G_{1},G_{2}\}$ и двойного $R$-графового соединения $G^{R}\vee\{G_{1},G_{2}\}$ для регулярного графа $G$ и двух произвольных графов $G_1$, $G_2$ соответственно.
О радиоизящных графах Хэмминга любого диаметра
Authors: Niedzialomski Amanda , Niedzialomski Robert
Published: August 2024

Показано, что графы Хэмминга диаметра $D$ радиоизящны, если каждая компонента графа Хэмминга является полным графом с не менее чем $D$ вершинами. Это обобщает аналогичные утверждения для диаметров $D=2$ и $D=3$, а также для случая произвольного $D$ при условии, что числа вершин компонент графа Хэмминга одинаковы или попарно взаимно просты.
Асимптотика числа $A$-отображений с остаточным членом
Authors: Yakymiv Arsen Lubomirovich
Published: August 2024

Пусть $\mathfrak{S}_{n}$ - полугруппа отображений множества $X$ из $n$ элементов в себя и $V_{n}(A)$ - совокупность отображений из $\mathfrak{S}_{n}$, размеры контуров которых принадлежат множеству $A$. Такие объекты называются $A$-отображениями. Как было показано ранее, последовательность $|V_{n}(A)|n^{-n}$ правильно меняется на бесконечности, если множество $A$ имеет положительную асимптотическую плотность в множестве натуральных чисел. В настоящей заметке для более узкого класса множеств $A$ дано уточнение этого утверждения со степенным понижением остатка.
Нижние большие уклонения ветвящегося процесса в случайной среде
Authors: Shklyaev Alexander Viktorovich
Published: August 2024

Изучаются вероятности нижних больших уклонений ветвящегося процесса в случайной среде, представляющей собой независимые одинаково распределенные величины. Доказано, что при ограничениях на моменты распределений чисел непосредственных потомков одной частицы и выполнении левостороннего условия Крамера для шага сопровождающего блуждания вероятности нижних больших уклонений имеют асимптотику, с точностью до константы совпадающую с асимптотикой аналогичных вероятностей для сопровождающего блуждания. В работе рассматривается первая зона нижних больших уклонений.
Toward Explainability in Urban Motion Prediction—Survey and
Outlook
Authors: Okanovic Ilma , Stolz Michael , Hillbrand Bernhard
Published: August 2024

With the influx of artificial intelligence (AI) models aiding the development of
autonomous driving (AD), it has become increasingly important to analyze and
categorize aspects of their operation. In conjunction with the high predictive
power innate to AI solutions, due to the safety requirements inherent to
automotive systems and the demands for transparency imposed by legislature,
there is a natural demand for explainable and predictable models. In this work,
we explore the various strategies that reveal the inner workings of these models
at various component levels, focusing on those adapted at the modeling stage.
Specifically, we highlight and review the use of explainability in
state-of-the-art AI-based scenario understanding and motion prediction methods,
which represent an integral part of any AD system. We break the discussion down
across three key axes that are inherent to any AI solution: the data, the model
architecture, and the loss optimization. For each of the axes, we outline the
general methodologies for introducing explainability, and reference and review
some practical realizations for each methodology. We conclude the article by
identifying several strategies that we believe are yet to be fully explored,
such as physics-inspired machine learning methods, neural network pretraining,
graph neural networks designed using domain-specific priors, and end-to-end
trainable networks based on differentiable kinematic models.
Real-Time Implementable Reduced-Order Energy Model for an Electric
Vehicle
Authors: Goyal Vasu , Dudekula Ahammad Basha , Stutenberg Kevin , Robinette Darrell , Ovist Grant , Naber Jeffery
Published: August 2024

Accurate estimation of vehicle energy consumption plays an important role in
developing advanced energy-saving connected automated vehicle technologies such
as Eco Approach and Departure, PHEV mode blending, and Eco-route planning. The
present study developed a reduced-order energy model with second-order response
surfaces and torque estimation to estimate the energy consumption while just
relying on the drive cycle information. The model is developed for fully
electric Chevrolet Bolt using chassis dynamometer data. The dyno test data
encompasses the various EPA test cycles, real-world, and aggressive maneuvers to
capture most powertrain operating conditions. The developed model predicts
energy consumption using vehicle speed and road-grade inputs for a drive cycle.
The accuracy of the model is validated by comparing the prediction results
against track and road test data. The developed model was able to accurately
predict the energy consumption for track drive cycles within the error of ±4.0%
of that measured from the experimental data. Finally, the model has been tested
and verified for real-time implementation using the dSPACE MicroAutoBox II HIL
test bench.
Gender-fair language usage among Kalinga State University faculty, correlational with gender stereotype impressions
Authors: Quimosing-Ocay Abigail , Pannogan Odette C. , Banggawan Lailani C.
Published: August 2024

This study assessed the relationship between gender-fair language usage and the extent of gender stereotype impressions among the faculty of Kalinga State University. Specifically, it determined the extent of gender-fair language usage and the extent of gender stereotype impressions among the respondents, and it also identified if there is a significant relationship between the extent of gender-fair language usage and the extent of gender stereotype impressions among the respondents. Significantly, the study revealed that the faculty are very sensitive to gender-fair language usage and very sensitive to their level of gender-stereotype impressions. It also revealed that there is a significant relationship between the extent of gender-fair language usage and the extent of gender stereotype impressions among the Kalinga State University faculty. Thus, it was concluded that there is a high regard for gender sensitivity among the faculty of Kalinga State University as a result of their very sensitive level of gender-fair language usage and very sensitive level of gender-stereotype impressions. Consequently, one’s perception of gender-fair language usage also affects one’s impression of gender stereotyping.
Financial education: the challenges of training educators of young learners
Authors: Ditta Aline Wanderley Camisassa , Ramirez Rodrigo Avella , Roberto Junior Francisco de Sousa
Published: August 2024

This paper aims to investigate the current scenario of how Financial Education is taught by teachers at an institution that trains young learners, in order to propose a continuing education program in Financial Education. It is considered essential that teachers have knowledge acquired from both training and practical experience. The methodology employed was applied research, with a qualitative approach, using data collection and analysis, as well as thematic analysis. The study presents a scenario in which the importance of Financial Education in the lives of young learners is recognized, but identifies that the lack of teacher training is an obstacle. This challenge can be overcome through continuing education and communities of practice to train them in Financial Education.
A Study on Experimental Analysis of Strength of Concrete incorporating Ultrafine Slag Mineral
Authors: Srivastava Sahil
Published: August 2024

The cement concrete has attained the status of a major building material in the modern construction because of its various advantages such as its adequate plasticity, remolding characteristics. It is used extensively all over world. But, environmental concerns both in terms of damage caused by the extraction of raw material and the emission of carbon dioxide during the manufacturing of cement have brought pressures to reduce consumption of cement by the use of relatively effective substitute materials. The substitute materials can be mineral admixtures such as fly ash, rich husk, etc. or ultra-fine material such as steatite powder, ultra-fine slag. This paper is based on the compilation of the experimental analysis done by various researchers and scientists. This paper reviews the results of an experimental study, conducted by various authors and researchers to evaluate the strengths and strength efficiency factors of hardened concrete, by partially replacing the cement by various ultrafine materials such as blast furnace slag, fly ash, alccofine, steatite powder, ultra fine calcium carbonate. This reports on the study conducted on the effect of ultrafine slag on the strength of concrete and in order to make an approach to reduce the content of Ordinary Portland Cement which ultimately results in the less carbon emission and less carbon footprints to achieve same or relatively better strength and workability.
EPR STUDY OF THE EFFECT OF γ-IRRADIATION ON POLYPROPYLENE/(CdS+ZnS) COMPOSITES
Authors: Gurbanov M.A. , Hajieva Y.G. , Gasimov R.J. , Bayramov M.A. , Mustafayev I.I.
Published: August 2024

A composite materials with various fillers prepared by adding cadmium sulfide (CdS) and zinc sulfide (ZnS) particles to a polypropylene (PP) matrix and irradiated with different doses of γ-rays were studied by the electron paramagnetic resonance method (EPR). The EPR spectra were investigated, and the nature of the free radicals generated from irradiation was identified. It has been shown that the concentration of radicals in the composites is much lower than in pure PP. The presence of the filler counteracts the effect of γ-rays on the formation of radicals. This result shows that the radiation resistance of the composites is higher.
REMOVAL OF RESIDUAL CONCENTRATIONS OF CESIUM IONS FROM LOW-LEVEL RADIOACTIVE SOLUTIONS
Authors: Guzii Sergii , Lukianova Vitalina , Pugach Olexsandr , Tutskyi Danulo
Published: August 2024

Because of mathematical modelling, the region of existence of the component composition of a complex inorganic sorbent designed to remove residual concentrations of cesium ions from low-level radioactive aqueous solutions was determined. The olay they limited by x1 – the number of nanoparticles of the iron oxide component from 18 to 19.5 ml, by x2 - the amount of copper ferrocyanide from 0.9 to 1.05 g, by x3 – the amount of Portland cement from 0.88 to 0.95 g. The determined concentrations of the complex inorganic sorbent provide for the removal of cesium ions from 98 to 100% and the capacity of the complex inorganic sorbent from 9 to 9.5 mg/g. According to the data on the frequencies of occurrence of the variation factors and their products in terms of their influence on the degree of cesium ion extraction from solution and the sorption capacity of the complex inorganic sorbent, they ranked in the following sequence, namely: х1х2х3>х1х2>х2х3>х1х3>х3>х2>х1. The influence of variation factors on other properties of the initial parameters is less relevant.
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Published: August 2024

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Prison overcrowding in Poland and Hungary
Authors: Wszołek Roksana , Nagy Anita
Published: August 2024

The aim of the article is to describe and discuss current problem in prisons’ system - overcrowding
in prisons in Hungary and Poland. It is an essential problem which deserves an attention, prisons' overcrowding
has been especially visible in these two countries, so it is eminently important to rise this problem in the
dispute of doctrine and to try to solve it. This study contains both previous and present information, statistics,
and position of international bodies on currently overcrowding of prison facilities. The legal regulations of
these two countries are pretty similar, but there are still far away from perfection, that is why this article
shows their advantages and drawbacks. The authors try to emphasize that overcrowding is a significant problem,
they also offer some de lege ferenda ideas to resolve this alarming situation.
Internal investigations and the principle nemo tenetur se ipsum accusare – The Austrian perspective
Authors: Soyer Richard
Published: August 2024

There is no general one but there are limited specific obligations in Austria to carry out Internal Investigations. The Austrian Constitutional Court clarified in a ruling 2016 inter alia that the principles of Article 6 of the European Convention on Human Rights concerning procedural guarantees apply to corporations as well. Yet, it has been accepted also before that the nemo tenetur principle also applies to legal persons. However, disputed questions still exist.
The interference of fiscal regulations with those in the criminal field. The right to silence and the right not to self-incriminate of a legal person in Romania
Authors: Mihes Christian , Cirmaciu Diana
Published: August 2024

In our approach, some aspects must be clarifies from the beginning, regarding a prerogative of the financial (fiscal) authority, but also of the tax system, respectively the control function. The Tax Procedure Code regulates the procedures by which the tax bodies verify the fulfilment by the persons subject to the tax law of the legal obligations. These procedures are the followings i.e. tax inspection, unexpected control, verification of the personal tax situation by the central tax body, anti-fraud control, and documentary verification. Each procedure is governed by specific rules and objectives. Also, the issues of taxpayer’s right to present his point of view on the relevant facts and circumstances are going to be addressed, and of course, the taxpayer’s obligation to cooperate versus the right to silence and plea-agreement.
Assessing geographical variation in economic disadvantage and dermatological care access in Florida
Authors: Khadka Monica , Sayre William , Schwartz Zachary , Reid Devaun , Albers Sharon
Published: August 2024

This study aims to quantify the relationship between economic disadvantage and access to dermatological care in Florida in order to advocate for tailored healthcare policies. Identifying underserved geographic communities can guide policymakers in implementing strategies to enhance accessibility to care in these areas. Using data from the Centers for Medicare & Medicaid Services (CMS) and the US Census, this study analyzed dermatologist density across 920 Florida zip codes. Economic disadvantage was assessed using the distressed community index (DCI), a metric that stratifies zip codes into 5 levels of economic well-being. Statistical analyses, including the Kruskal-Wallis test, were conducted to assess disparities. Findings revealed significant differences in the number of providers by DCI quintile (p<.001) and urban/rural designation (p<.001). Lower deprivation areas were more likely to have providers, with 33.2% of the least deprived quintile having at least one provider compared to 11.8% in the most deprived quintile. Urban areas were more likely to have at least one provider (p<.001), with 36.6% of urban zip codes having providers versus 1.1% of rural ones. Zip codes with at least one provider had significantly higher total population (p<.001). These findings highlight the need for targeted interventions to address geographic disparities in the provision of dermatologic care, particularly in economically disadvantaged and rural areas of Florida. Considering the state’s high sun exposure rates and associated skin cancer risks, ensuring accessible dermatology services across all zip codes, regardless of socioeconomic status, is imperative for public health.
Improving Customer Engagement of Food and Beverage Small and Medium Enterprises (MSMEs) Through E-Commerce and Content Marketing Training
Authors:   Digital Business, Universitas Negeri Surabaya, Indonesia, Kharisma Fresha
Published: August 2024

Over the past five years, the rapid growth of MSMEs in Indonesia has also resulted in many MSMEs going bankrupt. However, this rapid growth of MSMEs is also accompanied by many MSMEs going bankrupt due to mismanagement and low competitiveness caused by the lack of adaptability to business digitalization through e-commerce and product promotion strategies through digital media. Similar problems are also experienced by Food and Beverage MSMEs in Ketintang Village, Surabaya. This drives the importance of increasing competitiveness with more effective business management and digital marketing strategies through community service programs in this area. This community service-based research consists of online store design training activities in e-commerce marketplaces and content marketing with outputs in the form of scientific publications in indexed international journals, publications in the mass media, increasing community understanding and skills, and YouTube videos aimed at improving customer engagement in e-commerce marketplaces. Using the experimental method, this study concluded that SMEs showed a positive perception of the importance of e-commerce in increasing market reach and sales and insight into digital marketing in compiling content marketing that can increase customer engagement for food and beverage products.
Ligation of intersphincteric fistula tract – a retrospective, single centre, individual surgeons’ experience for the management of complex fistula in ano
Authors: Virji Safna Naozer , Khan Sadaf
Published: August 2024

Objective: To identify early treatment outcomes among patients having undergone ligation of intersphincteric fistula tract for complex fistula-in-ano in a tertiary care setting.
Method: The single-centre retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data from January 2016 to January 2021 of adult complex fistula-in-ano patients who underwent ligation of intersphincteric fistula tract procedure. All surgeries were done by a single surgeon. Pre- and post-operative Wexner continence scores were measured, and various factors, including change in continence, complete wound healing, postoperative infection and recurrence, were assessed. Data was analysed using SPSS 23.
Results: Of the 20 patients, 15(75%) were females and 5(25.0%) were males. The overall mean age was 38.4±13.8 years. The median duration of surgery was 65 minutes (interquartile range: 57-99 minutes). There were 2(10%) patients who showed a change in continence after surgery to flatus alone. Complete healing was noted in 11(55%) patients. Recurrence was noted in 8(40%) patients; trans-sphincteric fistula-in-ano in 2(10%) patients, and inter-sphincteric fistula in 6(30%). Body mass index had a significant association with the change in continence (p=0.028).
Conclusion: There was a comparable risk of recurrence after ligation of intersphincteric fistula tract surgery, but among those without recurrence, the post-operative outcomes were optimal and no faecal incontinence was noted.
Key Words: Rectal fistula, Recurrence, Faecal incontinence, Surgical wound infection.
Dietary interventions for Alzheimer's in Pakistan: The MIND diet perspective
Authors: Arif Fariha
Published: August 2024

Dear Editor,
Alzheimer’s disease (AD) stands as the prevalent type of dementia, making up 50–75% of total cases, and showing a higher incidence among elderly patients. (1). Pakistan is a lower-middle-income country with an estimated 150,000–200,000 patients affected by dementia (2). Nevertheless, the patient population faces inadequate healthcare resources, with only one neurosurgeon for every 1,000,000 patients (3). The Alzheimer's Association Facts and Figures Guidelines (2014) have highlighted diet as a modifiable risk factor in progression of AD (4). Thus, investigating lifestyle modifications in the early stages of AD to potentially alleviate the disease progression becomes imperative, considering the significant burden the disease imposes on the healthcare system.
The MIND diet is a composite dietary approach, derived from both the Mediterranean and DASH diets. It underscores the consumption of leafy greens, berries, nuts, whole grains, fish, legumes, and poultry while advocating for the use of olive oil. Conversely, it discourages the intake of red meat, butter, cheese, pastries, and fried or fast-food items (5). Agarwal et al. investigated the impact of the MIND diet on AD pathology in 581 autopsied participants from the Rush Memory and Aging Project. Their research demonstrated a significant correlation between adherence to the MIND diet and a decline in overall disease pathology, particularly in the reduction of Beta-amyloid plaques (6). Furthermore, another study illustrated that increased compliance with the MIND diet was associated with a reduced risk of hippocampal sclerosis (HS), a neurodegenerative condition linked to AD, even after accounting for other factors, such as APOE-4 status and AD pathology (7). Moreover, Morris et al.'s longitudinal study on US participants found a 53% lower risk for AD among individuals who adhered closely to the MIND diet and a 35% lower risk for those with moderate adherence after a follow-up of approximately 4.5 years (8). These findings indicate a potential role for the MIND diet in reducing the risk of AD and slowing cognitive decline.
A comprehensive literature search on PubMed and PakMediNet revealed a lack of research, evaluating the efficacy of the MIND diet in the management of AD in Pakistan. This underscores the inadequacy in the implementation of the MIND diet among the patients. Consequently, it is recommended that researchers submit research grant proposals about the efficacy of the MIND diet in AD to different funding organizations.
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Neurofibromatosis type 1 (NF1) presenting with dichotomous pubertal presentation: a case series
Authors: Rai Versha Rani , Heeranand Rathore  , Manisha Kumari  , Mohsina Noor Ibrahim  , Maira Riaz  , Roshia Parveen
Published: August 2024

Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder that is caused by a mutation in the NF1 gene, which is located on chromosome 17q11.2, which encodes for a protein known as “Neurofibromin”, which acts as an inhibitor of oncogene RAS. This gene mutation causes tumours to grow on nerves which results in other systemic abnormalities such as skin changes, bone and eye abnormalities, hormonal imbalances, and diversity in achievement of puberty with neurologic complications. NF1 has a wide variety of associations in context with puberty. It is important to determine the cause of precocious and delayed puberty in order to establish an early treatment plan, to lead a successful prognosis, and decrease complications. The case reports of two patients presenting with dichotomous pubertal variation in association with NF1 are presented.
Keywords: Neurofibromatosis, Delayed puberty, Early puberty, Genetics.
Domperidone and sudden cardiac death in the elderly due to ventricular arrhythmias in developing countries
Authors: Azeen Razzaq  , Shafaq Saleem  , Hassan Javed
Published: August 2024

To the Editor,
Domperidone is a prokinetic drug used to treat many gastrointestinal conditions including delayed gastric emptying and gastroesophageal reflux disease due to its promotility effects by antagonism on dopamine-2 receptors in the gut. It has also been used as an over-the-counter drug for nausea and vomiting due to its direct action on the chemoreceptor trigger zone involved in vomiting. The drug has gained a lot of popularity as it is more effective than other prokinetic drugs like mosapride and metoclopramide. In addition, it causes less drowsiness than metoclopramide and mosapride because it does not readily cross the blood-brain barrier(1). However, this drug has many side effects including dry mouth, headache and weight gain(2). Despite this, domperidone has been used as a prokinetic in many countries for a long time.
However, the more critical concern about the use of domperidone is QT interval prolongation and its association with sudden cardiac death due to ventricular arrhythmias in patients aged 50 years and older and in those taking more than 30mg/day. A meta-analysis conducted in November 2018 by Bor et al. compared the odds of developing cardiovascular events like sudden cardiac death in patients aged >50 taking domperidone more than 30mg/day to patients not taking domperidone or any other drugs was consistent with statistically significant increased risk of sudden cardiac deaths due to ventricular arrhythmias (OR: 2.09, 95% CI, 1.59 to 2.75, p<0.001)(3).
These are not the only studies to show these results. Many other studies have been done so far which showed an association between domperidone usage and sudden cardiac deaths in the elderly. A systematic review published in 2021 pooled data across multiple studies and showed that domperidone was significantly associated with an increased risk of sudden cardiac death and ventricular arrhythmias in older patients when taken more than 30mg/day. In this meta-analysis when data were pooled across nonoverlapping multiple studies, domperidone was associated with an increased risk of sudden cardiac death in the elderly compared to non-use (adjusted odds ratio: 1.69(1.46-1.95)(4). As far as the young population is concerned, there are very few studies done, so more research needs to be done to find out if domperidone causes sudden cardiac death in young patients.
Despite all these concerns, this drug is still being prescribed in many developing countries, especially in Pakistan.
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Role of Proton Beam Therapy in Spinal Chordomas: A Narrative Review of The Literature
Authors: Syed Faisal Nadeem  , Ahsan Ali Khan  , Muhammad Shahzad Shamim
Published: August 2024

Chordomas are rare malignant neoplasms arising fromvestigial remnants of the embryonic notochord.Approximately 55-70% of chordomas develop within thevertebral column. Their affinity to develop within the bonesof the axial skeleton and propensity to locally invade andrecur makes them challenging candidates for completesurgical excision. Adjuvant therapies are hence necessaryto improve outcomes; for which chemotherapy has beenobserved to be largely ineffective, owing to the tumourbeing resistant to it. Radiotherapy is the current adjuvanttherapy of choice for chordoma management. Over theyears, proton beam therapy (PBT) has been the subject ofmedical attention, given the dosimetric benefits it confersover traditional radiotherapy, allowing more concentratedradiation to be given to the target of interest and reducingdamage to surrounding normal tissue. A review of thecurrent literature reveals PBT offers significantly betteroutcomes when used as an adjuvant to maximal surgicalresection rather than as a definitive therapy.Keywords: Chordoma, Proton Beam Therapy, Outcome,Recurrence, Spinal, Adjuvant Therapy
The accuracy and precision of plain CT chest for diagnosis of anaemia
Authors: Mahnoor Hafeez  , Sattar Amjad , Naz Nasreen
Published: August 2024

Objective: To determine the accuracy and precision of anaemia diagnosis with plain computed tomography of chest by keeping complete blood count as the gold standard.
Method: The cohort study was conducted from January 1 to December 31, 2020, at Dow University of Health Sciences, Karachi, and comprised patients attending the hospital regardless of gender or age. The subjects underwent complete blood count and high-resolution computed tomography scan of chest with 7-day interval. On the basis of haematology, the subjects were divided into anaemic group A and control group B. Blood attenuation measurements and visual perception of the inter-ventricular septum was done blinded to haemoglobin values. Region of interest attenuation cursor was placed within the right ventricular chamber and left ventricular chamber. Quantitative diagnosis of anaemia on computed tomography was done with Hounsfield unit <35 in a chamber. Qualitative computed tomography diagnosis of anaemia was equivalent to inter-ventricular septum visualisation. Accuracy and precision was calculated. Data was analysed using SPSS 17.
Results: Of the 124 subjects, n=62(50%) were males and n=62(50%) were females. The overall mean age was 51.45±17.3 years (range: 8-96 years). On the basis of haematology, n=74(59.6%) subjects were in group A and n=50(40.3%) were in group B. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of chest computed tomography for quantitative diagnosis of anaemia were 48.6%, 76.5%, 76.5%, 50.6% and 60.5% respectively. The corresponding values for qualitative diagnosis of anaemia were 55.4%, 88.0%, 87.2%, 57.1%, and 68.5%.
Conclusion: There was a high positive predictive value for quantitative diagnosis of anaemia on chest computed tomography with low diagnostic accuracy and moderate reliability.
Key Words: Computed tomography, Plain CT, Haemoglobin, Anaemia.
Perfil epidemiológico das leucemias no estado do Maranhão, Brasil
Authors: Figueiredo Suzanne Pinheiro , Da Silva Luanessa Damares de Farias , Cardoso Thaissa Rhandara Campos , Dos Santos Daisy Maria Conceição , Almeida Joelson dos Santos , Miranda Maria do Rosário Costa
Published: August 2024

Introdução: As leucemias são neoplasias do sangue que afetam todos os indivíduos independentemente da idade e sexo, que causam impactos na saúde pública devido à especificidade de tratamento e ao quantitativo dos casos na população. Objetivos: Caracterizar os casos de leucemias atendidos em um hospital oncológico no Maranhão, Brasil. Métodos: Trata-se de um estudo transversal com abordagem quantitativa. Os dados foram extraídos do Sistema de Registro Hospitalar do Câncer de um hospital oncológico no período de 2014 a 2019 e analisados por estatística descritiva. Resultados: Foram registrados 111 casos de leucemias no período do estudo. O sexo masculino foi predominante (60,4%). Na faixa etária de 40 a 59 anos (35,1%). Os pardos representaram a maioria (55,9%). Os casados eram 46,8% dos casos. Quanto à escolaridade, 31,5% possuíam até o ensino fundamental. Em relação à ocupação, diversas profissões predominaram (38,7%) e 58,6% dos pacientes procediam de áreas rurais. Quanto aos dados clínicos, o tipo histológico diversos representou 44,2%; o estadiamento clínico não classificado esteve em 88,5% dos casos; em relação ao consumo de álcool e tabaco nos pacientes 43,2% e 45% nunca consumiram, respectivamente. No tocante às variáveis do tratamento, 39,6% dos pacientes realizaram múltiplos exames, 45% receberam quimioterapia e 14,4% tiveram remissão completa. Conclusão: As leucemias são consideradas um desafio à saúde pública devido ao diagnóstico na população adulto-idosa pelos fatores da baixa escolaridade que influenciam no autocuidado dificultando o reconhecimento dos sintomas nos pacientes. É necessário ampliar a atenção oncológica para melhorar o acesso e qualidade da assistência.
Interprofissionalidade na formação acadêmica
Authors: Margoto Paula , Galavote Heletícia Scabelo , Resse Larissa , Souza Luna Oliveira , Cola João Paulo
Published: August 2024

Introdução: A interprofissionalidade em saúde e a prática da Educação Interprofissional (EIP) têm oferecido uma nova perspectiva para as práticas de reorientação da formação e do trabalho em saúde. Objetivo: Compreender o conhecimento dos docentes dos cursos de graduação em Ciências Biológicas, Enfermagem e Farmácia, de uma Universidade Federal do estado do Espírito Santo, sobre o tema da interprofissionalidade no contexto da formação em saúde. Método: Trata-se de uma pesquisa exploratória e descritiva de natureza qualitativa. Participaram da pesquisa vinte e nove docentes, sendo oito do curso de Ciências Biológicas, doze do curso de Enfermagem e nove do curso de Farmácia, todos integrantes do Colegiado de Curso e do Núcleo Docente Estruturante. Os dados foram analisados através da Análise de Conteúdo na modalidade de Análise Temática. Resultados: Os resultados indicaram que os docentes dos três cursos reconhecem a relevância da interprofissionalidade para a formação em saúde, mas apontam muitos desafios para a efetivação dessa abordagem, como a falta de capacitação sobre o tema, dificuldades no vínculo entre ensino e serviço, carga horária extensa e ausência de momentos que permitam a interação entre discentes de diferentes cursos. Conclusão: Na perspectiva dos docentes, os principais desafios para a prática interprofissional no contexto da formação em saúde decorrem da ausência de conhecimento sobre o tema durante suas formações educacionais e profissionais, sendo explorado apenas de forma empírica. Entretanto, reconhecem que a interprofissionalidade é um fator importante para o desenvolvimento profissional dos discentes.
Gazdasági globalizáció és globális értékláncok
Authors: Ábel István , Gerlaki Bence , Lóga Máté , Nagy Gyula
Published: August 2024

E tanulmány középpontjában a gazdasági globalizáció és a globális értékláncok fejlődésének hatótényezőiben az utóbbi években tapasztalható kedvezőtlen változások elemzése áll. Számos jelenség utal a globalizáció lassulására, irányváltására, miközben a geopolitikai bizonytalanság növekedése miatt fokozódtak a világgazdaság legkülönfélébb térségeit, iparágait és vállalatait összekapcsoló ellátási láncok működési zavarai. Az ebből fakadó kockázatok mérséklése egyrészt gazdaságpolitikai szintű reagálást váltott ki – decoupling, de-risking, reshoring, near-shoring és friend-shoring –, másrészt felértékelte a vállalati alkalmazkodást, a rugalmas ellenálló képességet (reziliencia). Mindezek nyomán várhatóan a globalizációs és deglobalizációs folyamatok új egyensúlya alakul majd ki, amelyben a fokozódó feszültségek ellenére a nemzetközi termelési hálózatok továbbra is központi szerepet töltenek be. A változások bemutatása és a fejlődési dinamika érzékeltetése egyfajta keretet nyújthat a folyamatok változására adható gazdaságpolitikai válaszok megvitatásához.
A francia hadiipar helyzete az orosz-ukrán háború árnyékában
Authors: Fejérdy Gergely
Published: August 2024

Franciaország közismerten a hadiipari nagyhatalmak közé tartozik, mi több, az elmúlt öt év összesítésében az Egyesült Államok és Oroszország után a harmadik legnagyobb hadiipari exportőr a világon. Átfogó hadseregmodellt működtet, amelynek fenntartásához és fejlesztéséhez kellően széleskörű vállalati kapacitással rendelkezik: jelenleg képes a francia fegyveres erők által igényelt szinte valamennyi felszerelés megtervezésére és gyártására. A francia védelmi ipar hosszú évszázadokra visszanyúló hagyománnyal rendelkezik, és szoros kapcsolatban van az állammal és a mindenkori politikai hatalommal. Az orosz–ukrán háború árnyékában egyre nagyobb katonai kiadásokkal számol Franciaország, francia fegyverek modernizálására, a technológiák fejlesztésére jelentős figyelmet fordít a párizsi kormány. Emmanuel Macron elnök az európai védelem megerősítésére törekszik, miközben az Európai Unió nagyobb szuverenitását szeretné elérni, amihez a védelmi iparra is támaszkodni kíván. Párizs egyelőre a hangsúlyt a nemzeti hadiipar megőrzésére helyezi, de ezzel párhuzamosan az uniós szintű kezdeményezésekből sem akar kimaradni, mert ez utóbbiak hátrányaik ellenére számos lehetőséget is kínálnak.
Innovation in Distribution of Wealth Through Zakat: Building Shared Prosperity by Applying Tafsir Qs. At-Taubah Verse 60
Authors: Hasanah Uswatun , Harisah Harisah , Al Humaidy Mohammad Ali
Published: August 2024

Whether it is recognized or not, there are many things in society problems related to the economy,especially not equal distribution of income between one group and another others that cause social and economic disparities.To overcome this problem, zakat is the obligation of every Muslim for those who have fulfilled the requirements to accomplish this, become an alternative solution for overcome this problem. In this case distribution Zakat funds are the most important part of building shared prosperity. But in this era of globalization of course. The distribution of zakat requires new innovations through application of QS interpretation. at-taubah verse 60 effectively, efficiently and relevant to the development of the times by doing various collaborations and modern distribution models. Tree The discussion in this article is the application of QS interpretation. At-Taubah verse 60 which emphasizes the concept of caring, justice and economic equality by combining new innovations to create a more effective system in building economic prosperity, of course can be realized by applying eight groups mustahiq who has the right to receive and utilize funds zakat.
Effectiveness of Recruitment and Selection in Improving Employee Performance at PNM Mekaar Unit Kadur 2
Authors: Iman Nurul , Hidayati Nurul
Published: August 2024

Recruitment is to provide qualified prospective employees in line with the company’s strategy, insight and values to help reduce the possibility of employee turnover. The recruitment process at PMN Mekaar Unit Kadur 2 pays more attention to the quantity aspect. This can be seen from the fact that prospective employees who register there are accepted easily, because the conditions are easy and the process is short. The focus of this research is the recruitment and selection process in improving employee performance at PNM Mekaar Unit Kadur 2. The objective of this research are to 1) determnine the employee recruitment and selection process, 2) identify obstacles in the recruitment adn selection process, and 3) determine the effectiveness recruitment and selection in improving employee performance at PNM Mekaar Unit Kadur 2. The methot use in this research is qualitative descriptive analysis technique with basic research. For data collection, interview techniques, focus groups, documentation were used. The result of the research show that 1) The stages of the recruitment process include employee request, publication of job vacancies, application process, job interviews and psychological tests, employee selection and field test, and employment contracts. 2) The obstacle faced by the company is that employees easily get discouraged, due to the toxic environment and non compliance with work contracts, and 3) Through the five effectiveness criteria, recruitment and selection are found to be ineffective. Meanwhile, through the six employee perfomance criteriam the recruitment and selection process has a very positive effect on employee performance in the quality, quantity and cost effectiveness indicators and has a negative effect on employee performance in the timelines, need for supervision and interpersonal impact indicators.
Verification of Kastner Visibility of Hilal Observation Results at Condrodipo Rukyat Center in 1444 H
Authors: Faizah Nur , Dzulikrom Muhammad Muadz
Published: August 2024

The Kastner Hilal visibility method is one of numerous contemporary observation techniques developed with the objective of monitoring the appearance of Hilal with greater precision. This paper presents a discussion of Hilal observations conducted at the Condrodipo Rukyat Center. The visibility results are analyzed using curve graphs, facilitating the assessment and validation of the observations. The findings demonstrate that employing the Kastner mathematical model can corroborate visibility with a substantial degree of concurrence, regardless of atmospheric constraints and sky conditions. However, the results of observer reports in the field are often inconsistent with model predictions, especially in conditions of low Hilal altitude and naked eye observations. Therefore, more rigorous scientific verification and reliable methodologies are needed to confirm observations for the integrity of the determination of the beginning of the lunar month.
Uji Akurasi Hasil Pengukuran Arah Kiblat Pegawai Kemasjidan Kua Menggunakan Aplikasi Google Earth
Authors: Hasjun Iyan , Kasim Andi Jusran , Putra Nur Astaman
Published: August 2024

This research aims to analyze the accuracy of qibla direction measurements conducted by mosque employees in the Limboro District, Polewali Mandar Regency, using the Google Earth application. The research method employed is descriptive field research with sociological, normative Islamic, and astronomical approaches. Data was collected through direct measurements by mosque employees using qibla compass tools combined with smartphone compass applications. Subsequently, the qibla direction of mosques and musala was evaluated using the Google Earth application. The research findings indicate that out of 12 mosques and 1 musala sampled, only 3 mosques have accurate qibla directions consistent with the measurements. Meanwhile, the other 9 mosques and 1 musala show significant deviations in qibla direction. These deviations point toward countries such as Yemen, Nigeria, Tanzania, Kenya, and Egypt, with variations ranging from 2° to 27°. The implications of this research can be used to enhance qibla direction measurement methods to align with Islamic Sharia regulations.