bluuebunny/crossref_metadata_2025 huggingface dataset:
Emerging role of macrophage polarization in disease
Authors: Xu Yice
Published: November 2024

Abstract. Macrophages, present in many human cells and play an essential duty in human body, Triggered macrophages are usually separated into 2 phenotypes, depending on a range of aspects. M1 produces a pro-inflammatory feedback, while M2 is anti-inflammatory and fixings cells. In infection, macrophages polarize to M1 to eliminate virus and then to M2 to fix tissues. Excitement of macrophage polarization regulates immune function. Macrophage polarity plays a significant role in infections, inflammatory conditions, and hatreds; its monitoring is crucial for the prevention and therapy of condition. Consequently, this evaluation summarizes the governing mechanisms of macrophage polarization, suggesting that macrophages are a heterogeneous course of cells that can rapidly change their phenotype in feedback to exterior signals. Among them, TLR4 receptor sets off pro-inflammatory actions with MyD88 and TRIF signaling pathways.Notch signaling pathway controls mobile features and may contribute in macrophage apoptosis and M1/M2 polarization.JAK/STAT signaling path manages macrophage inflammatory feedbacks and advertises M1-type pro-inflammatory feedbacks and M2-type anti-inflammatory differentiation. Exhibits the function of macrophage polarization in inflammatory conditions such as sensitive bronchial asthma, atherosclerosis, and excessive weight. The crucial duty of macrophages in illness pathogenesis and inflammatory guideline is explored.
Advancing the frontiers of oncology: The promising horizon of CAR-T cell therapy for colon cancer
Authors: Shi Nuo
Published: November 2024

Abstract. In the changing field of cancer treatment, cancer immunotherapy shines as a promising method that uses the body's own immune system to fight against cancer. This review investigates how this therapy works and its possibilities, with special attention given to CAR-T cell therapy for colon cancer. We investigate why immune checkpoint inhibitors work, what happens when we use cancer vaccines and especially CAR-T cell therapy - showing their victories as well as difficulties encountered along the way particularly within solid tumor treatments. The future of CAR-T cell therapy in colon cancer and the current clinical trials to tackle these hurdles are explained thoroughly.
Penggunaan Standar Metode Work Breakdown Structure (WBS) Pada Proyek Pembangunan Gudang BPBD dan Rumah Jabatan Dandim
Authors: Soeparyanto Try Sugiyarto , Nuhun Ridwan Syah , Ismayana Ismayana , Apriani Meri , Hado Hado
Published: November 2024

In today's modern era, the construction of buildings stands as a crucial element in the development of infrastructure. Among the various methods utilized for managing such construction projects, the Work Breakdown Structure (WBS) has emerged as an effective tool. WBS serves as a project management technique, breaking down complex tasks into smaller, manageable components, thereby facilitating efficient planning, execution, and monitoring throughout the project lifecycle.This research employs the Earned Value Method (EVM) approach, chosen for its adeptness in quantifying project cost and time performance. By integrating three key dimensions - scope, schedule, and budget - EVM offers a comprehensive framework for evaluating project performance.The findings of this study reveal subpar cost and time performance in the construction of the BPBD Warehouse and Military District Commander's office building. Conversely, the construction of the Veterans Building demonstrates stable performance in both cost and time aspects.The observed impact of implementing WBS standards, particularly in the construction of the Veterans Building, proves instrumental in enhancing project control. The detailed breakdown of work items and the clearer identification of required resources streamline the planning of Purchasing Orders (PO), thereby facilitating cost management efforts.
Environmental Impact of Overtreatment of Distal Radius Buckle Fractures
Authors: Zainab Mosufa , Sandefur Evan P. , Peterman Nicholas J. , Kilinc Mehmet E. , Yu-Shan Andrea A. , Apel Peter J.
Published: November 2024

Introduction:

Pediatric buckle fractures are common. Current literature supports a single provider visit with education and removable wrist brace/bandage, without additional follow-up visits. Potential overtreatment through casting and follow-up visits may impose a substantial environmental burden through waste generated from casts and vehicular CO2 emission. This study seeks to estimate the national environmental impact of buckle fracture overtreatment through geospatial analysis extrapolated from a review of buckle fracture treatment at our institution.

Methods:

A retrospective chart review was performed to determine incidence and treatment of buckle fractures at our institution between 2018 and 2022. All radiographs were reviewed to confirm appropriateness for inclusion. Data were collected for treatment, follow-up frequency, cast utilization, and patient home ZIP code. Buckle fracture incidence was computed using the total pediatric population served by our institution, derived from United States (US) Census data. Treatment was assumed to occur at the office of the nearest orthopedic surgeon, identified through the National Provider Identifier Registry. For cast waste estimation, we collected and weighed discarded short-arm casts from our institution and used the number of patients treated in a cast to estimate total waste. CO2 emissions were estimated to be 411 g of CO2 per mile, and mileage was calculated for round-trip distance to the nearest orthopedic surgeon and multiplied by the estimated number of unnecessary visits. Travel for the initial visit was not considered overtreatment and was not included.

Results:

Annually, the United States sees an estimated 66,495 buckle fractures, with 62.5% overtreated with casting. The average short-arm cast weighed 0.498 lbs ± 0.133. When additional visits occurred, there were an average of 1.2 additional visits. Each year, overtreatment of pediatric buckle fractures in the United States generates an estimated 9.4 tons of cast waste and 405.4 tons of CO2.

Conclusion:

Overtreatment of buckle fractures has a significant measurable environmental impact.
MULTIMEDIA TECHNOLOGIES AND INNOVATIONS IN TEACHING READING IN ENGLISH
Authors:   Chechen State Pedagogical University, Zekieva P. M. ,   Kadyrov Chechen State University, Arsahanova M. A.-H.
Published: November 2024

Abstract. The relevance of the problem of using multimedia technologies in teaching a foreign language is due to the rapid changes in the educational environment caused by digitalization and globalization. In the modern world, where communication in various languages is becoming an integral part of professional and personal life, the need for effective and accessible learning of foreign languages is of particular importance. Traditional teaching methods no longer fully meet the needs of today's students, who expect more interactive, engaging and flexible forms of learning. The article discusses modern multimedia technologies and their impact on innovative approaches in teaching a foreign language. Particular attention is paid to the use of interactive tools, such as virtual and augmented realities, multimedia textbooks, as well as online platforms for language learning. The role of multimedia technologies in increasing students' motivation, improving the perception of educational material and developing communication skills is analyzed. Examples of successful implementation of multimedia in the educational process are considered, and possible prospects and challenges associated with their use are discussed.
THE USE OF EXPERIMENTAL METHODS IN THE STUDY OF THE SEMANTICS OF PROPER NAMES
Authors:   Chechen State Pedagogical University, Navrazova Kh. B , Makhayev M. R. ,   Kh. Ibragimov Complex Institute of the Russian Academy of Sciences,,   3Moscow International University
Published: November 2024

The article presents the results of experimental studies of the semantics of toponyms, conducted by a group of linguists in the period from 2018 to 2023. The relevance of the study of this problem is due to the growing interest of linguists in a living, functioning language within the framework of the anthropocentric paradigm, in which language is studied not as a system autonomous from humans, but as a phenomenon of psychological nature. Therefore, in modern anthropocentric linguistics, experimental methods are actively used in studies of the semantics of language units. One of them is a linguistic associative experiment that allows identifying such semes, sememes and semantemes that actually function in the minds of native speakers. This article presents the results of an experimental study of the semantics of toponymic vocabulary, conducted by a group of scientists from the Voronezh State University, Moscow International University and the Complex Research Institute of the Russian Academy of Sciences under the supervision of Professor I. Sternin. The sample of the experimental study included 730 students of both sexes – students of different courses and specialties of the Chechen State Pedagogical University, Chechen State University, Voronezh State University, Social and Pedagogical Institute of the city of Derbent. The experiment was conducted in written form. The list of presented stimuli included 10 toponyms of the Russian language, selected by random sampling and arranged in alphabetical order on the form. The subjects completed three tasks. The results were processed manually. Associative fields were built, the semantic interpretation of which made it possible to formulate psycholinguistic meanings of the studied toponyms. The article proves that the semantic structure of toponyms is congruent with the structure and content of linguistic consciousness (the congruence hypothesis).
DEVELOPMENT OF COGNITIVE ACTIVITY OF STUDENTS IN RUSSIAN LANGUAGE LESSONS USING SEARCH TASKS BASED ON POETIC TEXTS (FROM WORK EXPERIENCE)
Authors:   Chechen State Pedagogical University, Bamatgireeva М. V. , Selmurzayeva H. R. ,   Kadyrov Chechen State University
Published: November 2024

Abstract. This article describes the experience of working on the development of cognitive activity of fifth grade students in Russian lessons using search tasks based on examples of analysis of poetic texts. Various search tasks are designed to create fundamentally new, but different situations (intellectual tension, search, analysis, comprehension of deep meaning). The creative process itself becomes the main incentive for solving search tasks, and the highest level of this process is the discovery of truth, which can happen gradually or suddenly – with the help of insight (insight). The topic of studying poetic works through search tasks is relevant, since students learn to pay attention not only to the content of the text, but also to its stylistics and other characteristic features (expressiveness, imagery). By performing and solving search tasks, students learn to analyze, perform sequential actions, developing logic and thinking.
THE GAME AS A MEANS OF TEACHING PROFESSIONAL COMMUNICATION TO STUDENTS OF A TECHNICAL UNIVERSITY (USING THE EXAMPLE OF ENGLISH)
Authors:   Moscow Technical University of Communications and Informatics (MTUCI), Vvedenskaya V. G. , Sosunova G. A. ,   National Research Technological University (NUST MISIS)
Published: November 2024

Abstract. The article discusses the issue of using role-playing games in teaching English at a technical university. Modern definitions of the authors of the concepts game, role-playing game are analyzed. The importance of conducting role-playing games is noted in the possibility of modernizing the educational process. The game is a way to increase students' intrinsic motivation and their involvement in the learning process. Attention is focused on the functioning of the concept of gamification in modern works of researchers, and examples of its various interpretations by different authors are given. The practical significance of game-based learning in solving problems related to professional activities, careers, and personal relationships is highlighted. The article analyzes the classification of games using the example of the English language, which are often used by teachers in the classroom. It is noted that an important role in role-playing games is given to lexical and grammatical aspects, but at the same time, great priority is given to speech practice, the active activity of the game participants, and the interlocutor’s remarks. It is important that role-playing games directly interact with creative ones, since a successful role-playing game scenario certainly involves elements of creativity and the development of speech skills. The article provides the specific examples of conducting role-playing games in English classes at a technical university. The presented scenarios are considered as examples of professional communications on certain topics within various fields of activity.
PEDAGOGICAL CONDITIONS ENSURING THE FORMATION OF THE SUBJECT POSITION OF STUDENTS IN THE CONDITIONS OF THE EDUCATIONAL ENVIRONMENT OF A MILITARY UNIVERSITY
Authors:   Novosibirsk Military Institute of the Order of Zhukov named after the General of the Army I. K. Yakovlev National Guard Troops of the Russian Federation, Vilisov D. V.
Published: November 2024

Abstract. The article is devoted to the formation of the subjective position of students in the educational environment of a military university using the example of cadets mastering automotive equipment. In the modern conditions of the development of troops, constant modernization of weapons and equipment, a difficult situation in the world, not only the acquired knowledge, skills and abilities are fundamental, but also the ability of a modern officer to make the right decision, a developed level of independence and responsibility for the decisions made by him and the actions committed, since the formed subjective position plays an important role in the successful fulfillment of the assigned service and combat tasks by the unit. The author of the article provides pedagogical conditions that contribute to the formation of the subjective position of cadets using the example of successful mastering of automotive equipment in the educational environment of a military university. An analysis of approaches to the terminology of pedagogical conditions is carried out, her own concept of the term pedagogical conditions is presented. The work provides approaches, forms and means used in the training and education of cadets. As an example, a successful experience of mastering automotive equipment by cadets in the process of studying the discipline of automotive training is given.
Pengaruh Praktik Pengalaman Lapangan (Ppl) Terhadap Kesiapan Menjadi Guru Mahasiswa Prodi Ekonomi/Akuntansi Institut Pendidikan Tapanuli Selatan
Authors: Samakmur Samakmur , Rambey Mara Judan , Vebrina Dinda
Published: November 2024

Penelitian ini bertujuan untuk mengetahui 1) Gambaran Praktik Pengalaman Lapangan (PPL), 2) Gambaran Kesiapan Menjadi Guru 3) Pengaruh Praktik Pengalaman Lapangan (PPL) terhadap Kesiapan Menjadi Guru Mahasiswa Prodi Ekonomi/Akuntansi Institut Pendidikan Tapanuli Selatan. Penelitian ini menggunakan metode kuantitatif deskriptif dengan populasi seluruh Mahasiswa Prodi Ekonomi/Akuntansi Institut Pendidikan Tapanuli Selatan yang berjumlah 253 orang. Teknik pengambilan sampel yang digunakan adalah purposive sampling. Sehingga sampel dalam penelitian ini yaitu sebanyak 45 orang. Berdasarkan analisis data diketahui bahwa gambaran Praktik Pengalaman Lapangan (PPL) Mahasiswa Prodi Ekonomi/Akuntansi Institut Pendidikan Tapanuli Selatan memperoleh nilai rata-rata yaitu 66,31. Apabila dikonsultasikan pada kriteria penilaian yang terdapat pada Bab III tabel 3.5, berada pada posisi “Baik”, sedangkan nilai rata-rata Kesiapan Menjadi Guru yaitu 66,18. Apabila dikonsultasikan pada kriteria penilaian pada Bab III tabel 3.5, maka berada pada posisi “Baik”. Berdasarkan pengujian hipotesis yang dilakukan dapat diketahui bahwa nilai thitung 8,446 > ttabel 2,016 dan signifikan 0,001<0,05, artinya Ha diterima dan Ho ditolak. Oleh karena itu dapat disimpulkan bahwa terdapat pengaruh yang signifikan antara Praktik Pengalaman Lapangan (PPL) Terhadap Kesiapan Menjadi Guru Mahasiswa Prodi Ekonomi/Akuntansi Institut Pendidikan Tapanuli Selatan.
Assessment of the knowledge on nutrology among medical course students: an observational cross-sectional study
Authors: Salomone Paloma , Viaro Maurício Schneider , Machado Michely , Leão Silvana , Pereira Liliane Alves
Published: November 2024

Introduction: An unbalanced diet is responsible for more deaths than any other risk factor, including smoking. By definition, Nutrology is the medical specialty whose function is to prevent, diagnose and treat nutroneurometabolic diseases. As it is a relatively new specialty, it has not yet become part of the basic curriculum as a mandatory subject in most medical schools. This fact means that students have little or no contact with the specialty during their academic training. Objective: The objective of this study was to evaluate the knowledge on Nutrology among medical students. Methods: An observational and cross-sectional study was conducted to assess the knowledge of students enrolled in the Ugraft Journey of the Plastic Surgery Leagues of Rio Grande do Sul. Data collection took place through the application of an online questionnaire comprising 14 questions. Results: A total of 170 participants spanning across all semesters of the course, representing 7 universities (UFSM, UFCSPA, UFN, UFAL, Unoeste, Univates, and Unijuí). The participants were aged between 18 and 43 years old, 114 were female and 56 were male. In regard to the question of which course Nutrology is a part of, 84.1% answered Medicine, 14.7% answered Nutrition, and 1.2% answered another course. Additionally, 67.6% stated that they do not know or are not sure about the area of activity of Nutrology, while only 17.6% have already consulted a Nutrologist. Concerning the significance of dietary guidance and supplementation during the pre- and post-operative phases of surgery, 98.2% deemed it advantageous for the patient. When it came to distinguishing between the various indications for oral dietary supplementation, enteral, or parenteral therapy, 74.7% did not know how to differentiate them. Regarding the safety of prescribing a food supplement, 90% do not feel able to do so. As for the meaning of the acronym MNTT, 93% are unaware. Regarding obesity being a chronic disease, 92.4% agreed. Regarding the desire to undertake a residency in Nutrology, 12.9% expressed interest. Finally, regarding the importance of the subject of Nutrology in the curriculum, 94% considered it important. Conclusion: Despite the increasing prevalence of nutrition-related diseases and the evidence showing that poor diet is responsible for more deaths than any other risk factor, studies have observed that the majority of medical students feel unprepared regarding the subject. The findings of this study could serve as motivation for institutions to reconsider the significance of incorporating the discipline of Nutrology into the medical curriculum.
Squid (Loligo sp) Export Marketing Strategy in Tegal City
Authors: . Saheri , Elfitasari Tita , Mudzakir Abdul Kohar
Published: November 2024

Squid is one of the leading fishery commodities in Tegal City with quite large export potential which has an important role in contributing to the Indonesian economy. This study aims to analyze the development of squid exports in Tegal City and analyze the marketing strategies carried out by squid export companies in Tegal City. This study was conducted in May-December 2023 at the squid export company in Tegal City. Respondents in this study were 10 people using purposive sampling. Data collection methods using interviews, observations and questionnaires. Data analysis using SWOT analysis and QSPM analysis. SWOT analysis to formulate marketing strategies and QSPM analysis to produce priority strategies in squid export marketing. The results of this study show that the volume of squid exports in Tegal City from 2018 to 2022 tends to fluctuate. This fluctuation is influenced by the squid fishing season, market needs and government policies regarding the prohibition of cantrang fishing gear in Tegal City. The SWOT Analysis Cartesian diagram shows that the position of the diagram is in the second quadrant or diversification strategy (positive-positive) meaning that the strategy used is the Strengths-Opportunities (S-O) strategy also known as an aggressive strategy, where this position is a profitable situation.
O USO DE PAINÉIS ESTRUTURAIS DE CONCRETO E PVC EM UM EDÍFICIO MULTIFAMILIAR LOCALIZADO NA CIDADE DE MANAUS/AMAZONAS: ESTUDO DE CASO
Authors: Farias Maria Caroline Conceição , Pinheiro Érika Cristina Nogueira Marques
Published: November 2024

Os sistemas construtivos que caracterizam os vistos de obras e serviços de engenharia, estão em constante aprimoramentos a cada avanço da tecnologia e pesquisas científicas, seja com a descoberta de novos materiais ou com a possibilidade de outras aplicações na maneira de executar as construções. Um dos principais pontos na escolha sistemas diferentes aos tradicionais construtivos, é a aprimoração de etapas, redução do tempo de entrega e viabilidade de minorar orçamentos. No estado do Amazonas a execução desse sistema tende a mudar o cenário do setor da construção a cada ano, ao considerar o crescimento de investimentos na área e empresas especializadas nos serviços de engenharia no uso de paredes estruturais de concreto, motivo pelo qual o tema torna-se relevante para entender tais perspectivas.Dessa forma, este estudo tem o intuito principal de descrever o processo executivo da construção de paredes com o uso do sistema de painéis pré-fabricados de concreto e pvc de um edifício multifamiliar da cidade de Manaus/Amazonas. Assim, verificou-se a eficácia da obra bem como uma aplicação alternativa ao uso de modelos tradicionais na engenharia, produzindo competividade no mercado e fomento às pesquisas e estudo de procedimentos.
CIRURGIAS MINIMAMENTE INVASIVAS NA PERIODONTIA: REVISÃO INTEGRATIVA
Authors: Lima Beatriz Maia , Nicoletti Enáira Oliveira Cidrão , Dias Karina Sarno Paes Alves
Published: November 2024

O presente trabalho de conclusão de curso, visa contribuir com as discussões existentes a respeito das cirurgias minimamente invasivas na periodontia, e analisar às abordagens odontológicas utilizadas na contemporaneidade. Para tanto, objetivo deste estudo é apresentar as Técnicas minimamente invasivas utilizadas na periodontia, demonstrando o impacto desses procedimentos cirúrgicos nos resultados clínicos para a regeneração de defeitos intraósseos e estéticos. Este trabalho será uma revisão integrativa da literatura conduzida de acordo com o Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Para isso, foram seguidas as seguintes etapas: construção da questão norteadora; busca bibliográfica nas bases de dados; seleção dos estudos primários; extração dos dados; avaliação metodológica dos estudos incluídos; síntese, apresentação e análise dos resultados da revisão. As buscas por literaturas científicas foram feitas através das principais bases de dados em periódicos da área da saúde: Pubmed, Google Acadêmico e Scielo. A pesquisa indicou que após às inovações das técnicas minimamente invasivas, tornou-se possível realizar procedimentos periodontais com menor morbidade do paciente e maior estética, proporcionando melhor aceitação entre os pacientes.
Desenvolvimento econômico e a transformação digital
Authors: Falcón Maria Lucia de Oliveira
Published: November 2024

Atualizando o debate sobre o processo de desenvolvimento diante da transformação digital, esse artigo trata de: 1) conceito de Economia de Dados, que se estabelece como novo regime de acumulação e seu modo de regulação correspondente, além da sua trajetória tecnológica; 2) principais características de seu sistema produtivo e inovativo; 3) o mercado de múltiplos lados e seus monopólios e oligopólios tecnológicos-financeiros; 4) desafios para o desenvolvimento, especialmente os  direitos digitais e o papel do Estado. O referencial teórico se apoia em quatro pilares no campo da economia e dois pilares no campo da sociologia da ciência e tecnologia.
Uji SPF formulasi krim ekstrak etanol dari biji kopi lanang robusta (Coffea Canephora)
Authors: Meinisasti Resva , Krisyanella Krisyanella , Utami Mardhah Sastri
Published: November 2024

Paparan sinar UV dalam kondisi yang berlebihan pada kulit akan menyebabkan kerusakaan kulit, kulit terbakar, peradangan, penuaan dini, hiperpigmentasi hingga pembentukan melanoma. Salah satu cara untuk melindungi kulit dari paparan sinar UV adalah dengan penggunaan tabir surya dengan SPF. Bahan alam dapat dimanfaatkan karena mengandung senyawa antioksidan (flavonoid, dan fenolik), senyawa ini dapat meningkatkan nilai SPF dan menyerap panjang gelombang maksimum sinar UV. Biji kopi robusta (Coffea canephora) memiliki kandungan senyawa fenolik yang berpotensi sebagai bahan aktif tabir surya. Biji kopi lanang merupakan kopi dengan biji bulat utuh atau buah berbiji tunggal. Krim adalah salah satu sediaan yang dapat di gunakan sebagai tabir surya karena memiliki keuntungan lebih mudah diaplikasikan, dan lebih nyaman digunakan pada kulit. Penelitian ini bertujuan untuk mengetahui nilai SPF pada sediaan krim dari ekstrak etanol biji kopi lanang robusta (Coffea canephora) dengan konsentrasi ekstrak 1%, 2% dan 3%. Penelitian ini menggunakan metode eksperimental. Berdasarkan pengujian yang telah dilakukan pada masing-masing formula di dapatkan hasil yaitu sediaan krim ekstrak etanol dari biji kopi lanang robusta memenuhi kriteria pengujian tetapi pada formula II memiliki homogenitas yang kurang baik karena masih adanya butiran pada saat pengujian. Nilai SPF pada formula I sebesar 6,049, formula II sebesar 6,164, dan pada formula III sebesar 6,791. Dari hasil penelitian yang telah dilakukan formula yang memiliki nilai SPF paling tinggi yaitu pada formula III dengan konsentrasi ekstrak 3% dan nilai SPF sebesar 6,791 yang memberikan perlindungan terhadap sinar matahari dengan proteksi ekstra.
Tasks with parameters: a digitized approach
Authors: Horoshko Yurii , Pidhorna Tetiana , Samusenko Petro , Tsybko Hanna , Tverdokhlib Ihor
Published: November 2024

Technological and methodological aspects of using freeware software, such as GeoGebra, Wolfram|Alpha, Maxima, SageMath and GRAN1, for solving tasks with parameters, are presented in the article. Criteria were defined for selection of computer mathematics system (CMS) to solve tasks with parameters, including plotting a graph of a function given in explicit and implicit forms, using a parameter in a function’s analytical definition, and automatically changing the graph of a function depending on the parameter value; ability to changing the parameter step change; plotting of a tangent and a normal to a curve at a point; ability to change the scale; determination of the coordinates of the intersection of graphs of functions; obtaining an analytical solution. In the article, some examples were presented for graphic and analytical tasks that used CMS parameters. GRAN1 and GeoGebra are recommended to use for plotting and analyzing of the graphs
Relación entre estructura de capital y rentabilidad de las microempresas del sector construcción de Loja-Ecuador
Authors: Enríquez Díaz Lenin Raúl , Hernández Ocampo Silvana Elizabeth
Published: November 2024

La estabilidad financiera de las empresas ecuatorianas depende de la estructura de capital y rentabilidad, requiriendo una gestión eficaz de deuda y capital. Esta investigación busca analizar la relación entre estructura de capital y rentabilidad de las microempresas del sector construcción de Loja - Ecuador, utilizando razones de endeudamiento que ayudan a controlar las empresas. La metodología tiene un enfoque cuantitativo y utiliza el método de regresión lineal múltiple, en el cual se analizaron 37 microempresas de construcción del cantón Loja con información de la Superintendencia de Compañías, Valores y Seguros de los periodos comprendidos entre 2020-2022. Los resultados demuestran que la rentabilidad ROE se vio influenciada por la razón de Deuda Sobre El Patrimonio (DEUP) el cual ejerce un impacto significativo sobre la rentabilidad. Mientras que la rentabilidad ROA no tuvo un efecto significativo por las variables independientes de las razones de endeudamiento. Dando como conclusiones que los hallazgos alientan al sector micro empresarial de la construcción a realizar un análisis a la estructura de capital con el fin de reducir y pronosticar modelos relevantes que influyan en la toma de decisiones, y que permita dar un uso adecuado a los recursos obtenidos.
Palabras Clave: Estructura de capital, endeudamiento, rentabilidad, sector construcción, regresión lineal múltiple.
Examination of fecal electrolyte on pediatric patient with intestinal stoma
Authors: Haliza Wilda , Ranuh Reza Gunadi , Athiyyah Alpha Fardah , Novi Theresia , Darma Andy , Sumitro Khadijah Rizky , Sudarmo Subijanto Marto
Published: November 2024

Intestinal stomas are increasingly performed in pediatric patients to manage various gastrointestinal conditions, such as congenital malformation of intestinal, necrotizing enterocolitis and intestinal obstruction, which are frequently occured in developing countries with Low-Middle Income Country (LMIC). However, the presence of a stoma has possibility of morbidity such as can significantly affect the body’s fluid and electrolyte balance, particularly in infant and under five years old children. This risk is increased due to the immature renal system in pediatric patients, increased loss of fluids and electrolytes through stoma output, especially small intestinal stoma. In addition to being a challenge in the management of infants and children with stomas and intestinal resections, electrolyte imbalances are one of the factors contributing to morbidity and mortality in these group. Early detection of abnormalities can guide timely interventions such as fluid replacement therapy and dietary modifications, prevent complications like dehydration, metabolic acidosis or electrolyte disturbances. Measuring fecal electrolyte provide valuable insights into the patient’s hydration status and potential electrolyte imbalances. Since the fecal sample measuring is the simplest, harmless and noninvasive than the other electrolyte tests, so it can be considered for pediatric patients.
Insurance coverage in unstable region: Managing insurance claim risk amid Kashmir's political landscape
Authors: Punoo Aamir Altaf , Ota Mahadev , Mohammed Shariq , Azad Imran , Khan Mohammad Shahfaraz , Dar Amir Ahmad
Published: November 2024

This study investigates the impact of prolonged political unrest on insurance claim amounts in Kashmir. It examines the behavior and coverage provided by insurance companies in high-risk areas, focusing on the hazards and perils associated with terrorism and political uncertainty. By analyzing historical data on political violence and terrorism in Kashmir, the study reveals significant patterns and relationships through descriptive statistics. The findings demonstrate that higher levels of political violence and terrorism lead to increased losses for insurers. Moreover, the study underscores the necessity of tailoring insurance coverage to the specific risks in unstable regions. It suggests employing time series analysis for more accurate pricing of insurance policies during periods of political instability. These insights offer practical implications for insurance companies, policymakers, and stakeholders, facilitating more effective risk assessment, pricing, and risk management strategies in volatile areas. In addition to outlining general customer requirements, the study discusses the measures and regulations needed for commercial insurers to provide economical services in such contexts. This comprehensive analysis enhances the understanding of the effects of abnormal situations like prolonged political unrest in Kashmir. Ultimately, the study proposes the integration of time series analysis into insurance pricing models to better navigate periods of political instability.
CHRONIC INFLAMMATORY SCORE IN PATIENTS WITH DACRYOCYSTORHINOSTOMY AND CORRELATION WITH SURGICAL OUTCOME
Authors: Shahid Erum , Shahid Ruqaiya , Fasih Uzma , Jafri Asad Raza
Published: November 2024

Background: Dacryocystorhinostomy (DCR) is an ophthalmic surgical procedure for relieving obstruction from chronically inflamed nasolacrimal duct (chronic dacryocystitis). This study was performed to observe the surgical outcome of DCR in patients with chronic dacryocystitis; to grade the inflammation in lacrimal sac biopsies, using the chronic inflammatory score (CIS); and to correlate the CIS with the surgical outcome. Methods: Twenty-five patients with chronic dacryocystitis underwent DCR with lacrimal sac biopsies. The biopsies were examined microscopically, and a CIS score was assigned and graded into mild, moderate and severe. The patients were followed up. The success of DCR was evaluated at 6 months post-surgery, by syringing of the lacrimal tract. Results: The mean age of the patients was 37.76 years±12.32 SD. The mean duration of watering of the eye was 2.9 years±3.18 years. The right eye was involved in 60% and 80% of the patients were females. Severe inflammation was reported in 72%, moderate angiogenesis in 76% and moderate fibrosis in 72%, squamous metaplasia in 40%, and a reduced number of goblet cells in 72% of the biopsies. CIS was severe in 72% of the patients. At 6 months follow-up, 96% of the patients had a successful DCR. Conclusion: Although the chronic inflammatory score was severe, the DCR was successful in most of the patients, suggesting that the success of the surgical procedure is not related to the degree of inflammation. Large-scale studies are recommended for confirmation of our findings
EFFICACY AND SAFETY OF PNEUMATIC LITHOTRIPSY WITH LASER LITHOTRIPSY IN THE TREATMENT OF URETERAL STONES <20 MILLIMETERS IN CHILDREN: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Irsayanto Danang , Yatindra Ida Bagus Gde Tirta Yoga , Setiawan Muhammad Rifki , Salsabila Sirin , Renaldo Johan , Wirjopranoto Soetojo
Published: November 2024

Background: Ureterorenoscopy (URS) in treating ureteral stones in children is preferred for >10 mm-sized stones. Pneumatic lithotripsy is often used, but laser lithotripsy is gaining more popularity over the years, as it is considered better in terms of safety and efficacy. However, no previous meta-analysis has discussed the comparison of these two modalities. This meta-analysis compared pneumatic and laser lithotripsy in children with ureteral stones. Methods: This meta-analytic study followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Inclusion studies were retrieved by thoroughly searching Pubmed, Scopus, ScienceDirect, Web of Science, and Embase databases, focusing on the comparative intervention of pneumatic and laser lithotripsy in the paediatric population. Result: Study analysis showed that laser lithotripsy had a significantly higher stone-free rate (OR: 2.06; 95% CI: 1.06 – 4.00; p=0.03) and lower stone retropulsion (OR: 0.37; 95% CI: 0.16–0.87; p=0.02) compared to pneumatic lithotripsy. However, mean operative time (MD: 2.33; 95% CI: -4.09–8.74; p=0.48), length of stay (MD: -0.17; 95% CI: -0.36–0.02; p=0.08), post-operative fever (OR: 1.50; 95% CI: 0.48–4.66; p=0.48), and ureteral injury (OR: 0.43; 95% CI: 0.08–2.48; p=0.35) was not different between the two groups. Conclusion: A higher stone-free rate (SFR) and a lower incidence of stone retropulsion can be achieved using laser lithotripsy instead of pneumatic lithotripsy for treating ureteral stones in children.
COMPARISON OF THE OUTCOMES OF ENHANCED RECOVERY AFTER SURGERY (ERAS) VS CONVENTIONAL CARE IN ELECTIVE COLORECTAL SURGERY
Authors: Iqbal Muhammad Tariq , Jatt Atta Ullah , Arbi Fawad Mueen
Published: November 2024

Background: Uncontrolled cell development in the colon, rectum, or appendix is the cause of colorectal cancer, sometimes referred to as colon cancer, rectal cancer, or bowel cancer. Its incidence is higher in developed countries than in developing ones. About 75–95% of cases occur in individuals without significant genetic risk. The aim of Enhanced Recovery After Surgery (ERAS) or fast-track surgery involves the use of several perioperative strategies to facilitate better surgical conditions to achieve faster recovery of the patients which has shown better outcomes in different surgery types. This study aims to compare the outcome of ERAS vs conventional care in elective colorectal surgery. Methods: In this randomized controlled trial, 60 patients undergoing elective colorectal surgery were assessed by dividing them into two groups. Group A patients followed ERAS protocols, while Group B patients followed conventional care techniques. Time for bowel sounds and first flatus were noted. Mean hospital stay was recorded for each patient from operation to discharge. Patients were followed for 4 weeks for surgical site infection assessment. Results: The mean time to return bowel sounds in Group A was 20.63±2.66 hours while in Group B was 27.0±2.07 hours (p-value =0.0001). The mean time to passage of the first flatus in Group A was 18.67±2.38 hours while in Group B was 25.93±2.88 hours (p-value =0.0001). The mean hospital stay in Group A was 3.37±1.75 days while in Group B was 8.30±1.68 days (p-value =0.0001). Surgical site infection was found in 04 (13.33%) patients in group A while in group B, it was found in 09 (30.0%) patients with a p-value of 0.1172. Conclusion: This study concludes that the outcome of enhanced recovery after surgery (ERAS) is better than conventional care in elective colorectal surgery.
THE EFFECT OF SUBCUTANEOUS EPINEPHRINE DOSAGE ON BLOOD LOSS IN SURGICAL INCISION
Authors: Naz Erum , Ali Khan Faisal Akhlaq , Zulfiqar Bushra , Farrukh Rabeeaa , Naseem Aiman , Isamail Sarosh
Published: November 2024

Background: Vasoconstrictive drugs are increasingly frequently used to stop bleeding during cosmetic and reconstructive surgeries, especially subcutaneous epinephrine7. As far as we are aware, no studies have been conducted on how adrenaline affects bleeding in patients having supraventricular flap surgery so we planned this study to find out the impact of various epinephrine dosages on the amount of bleeding in surgical incisions among participants undergoing supraclavicular flap surgery. Methods: This single-blinded randomized controlled trial was performed at the Department of Plastic Surgery, Ruth Pfau Civil Hospital, from September 2022 to September 2023. Group 1 was given 0.9% saline with an epinephrine concentration of 1:200,000. Group 2 was administered a 0.9 % saline solution containing a 1:400,000 epinephrine concentration. Group 3 was given just 10 ml of 0.9 % saline (control group). Bleeding was measured for 5 minutes by volumetric method. Results: Patients’ age (p=0.221), gender (p=1.000) and surgery site (p=0.265) were not significantly different among the three study groups. Mean blood loss volume for group 1, group 2 and group 3 was 15.8 0±5.37mL, 19.80±8.44mL and 57.20±14.14mL respectively. On post-hoc analysis for total blood loss volume, significant differences were seen between Group 1 and Group 3 (p<0.001), and Group 2 and Group 3 (p<0.001). Conclusion: The present study showed that blood loss was significantly lower among both of the groups of adrenaline but blood loss from the two doses of epinephrine did not differ significantly.
UNVEILING A RARE CASE OF KIKUCHI-FUJIMOTO IN SINDH, PAKISTAN
Authors: Bano Saira , Jawed Inshal , Fatima Fasiha Bakhtawar , Alam Mohammad Omer , Feroze Ahsan
Published: November 2024

Kikuchi-Fujimoto disease (KFD) commonly manifests with symptoms of fever, tender cervical adenopathy, and systemic symptoms like night sweats, rashes, headache, weight loss, nausea, vomiting, and sore throat. In this case study, a 27-year-old patient's main complaints included fever, neck oedema, and weight loss that started one month ago. Following preliminary inquiries, ultrasonography, and CT scans, a multidisciplinary team has been overseeing the case. After a biopsy of axillary and cervical lymph nodes, it has been diagnosed as a case of Kikuchi-Fujimoto disease overlapping with Systemic Lupus Erythematous. Symptomatic and specific treatment started which showed improvement in 4 weeks. The treatment is symptomatic because of the benign characteristic and typical resolution within several weeks to months. The prognosis is usually excellent without an increased risk of malignancy or mortality.
A RARE CASE OF NON-CLASSICAL TYPE OF CONGENITAL ADRENAL HYPERPLASIA IN A 27-YEAR-OLD FEMALE
Authors: Ali Masab , Ahmad Muhammad Husnain , Mirza Zaid Ashraf
Published: November 2024

This case report presents the case of a 27-year-old female patient with a complex clinical presentation, diagnosed with nonclassical congenital adrenal hyperplasia (NCCAH). The patient presented with a constellation of symptoms including hirsutism, acne, hyperpigmentation, amenorrhea, frontal baldness, and renal stones, posing diagnostic challenges. Comprehensive evaluation revealed NCCAH, emphasizing the importance of considering this condition in cases of hyperandrogenism. Treatment with oral dexamethasone and oral contraceptive pills resulted in gradual symptom improvement. This case underscores the necessity for thorough clinical assessment and awareness of NCCAH as a differential diagnosis in patients with hyperandrogenic symptoms.
PERINATAL OUTCOME IN WOMEN PRESENTING WITH REDUCED FOETAL MOVEMENT AT TERM
Authors: Ghani Seema , Hasan Shabnam , Ali Fauzia , Nadeem Shabnum
Published: November 2024

Background: foetal movements are one straightforward indicator of foetal health. The evidence, however, is still insufficient to warrant the inclusion of reduced foetal movements in national recommendations as part of a more comprehensive evaluation. The study objective was to determine perinatal outcome in women presenting with reduced foetal movement at term gestation. Methods: A prospective, observational study was conducted in Hamdard University Hospital Karachi during January 2021 to June 2021, 216 pregnant women with reduced foetal movement at term were recruited from outpatient clinics, wards and labour room triage. Data was collected regarding demographic and clinical features of mothers. Neonatal outcomes were also investigated. Results: Findings of the study revealed that 60.6% women had one episode and 39.4% women had two episodes of reduced foetal movements. 1/4th of the neonates were low birth weight, 1/5th of the babies had Apgar score less than 7 in five minutes, 9.3% neonates had cord around the neck and 1/3rd of the neonates were admitted to the NICU. Chi square test of association revealed that maternal factors such as maternal age, BMI, gravidity were significantly associated with reduced foetal movements. foetal outcomes such as NICU admission and presence of meconium were significantly associated. Conclusion: The present study analyzed that Episodes of RFM were significantly associated with age, BMI, gravidity of mother. RFM episodes was associated with increased risk of cord around neck among neonates of mother with repeated RFM episodes whereas NICU likelihood was higher among neonates of mother with single RFM episode.
ECTHYMA GANGRENOSUM: CASE REPORT OF 5-MONTH-OLD FEMALE
Authors: Anwar Tayyaba , Safdar Saba , Qaisarani Salik , Shafique Ramna , Kanwal Maria , Haider Saleha
Published: November 2024

Ecthyma gangrenosum is a rare and severe skin disease that is typically accompanied by a systemic infection caused by Pseudomonas aeruginosa bacteria. It manifests as painful, necrotic lesions surrounded by redness and including a noticeable black eschar in the centre. The majority of ecthyma gangrenosum instances occur in immunocompromised individuals, such as those with significant underlying medical conditions or those who are neutropenic. We present a case of 5-month-old vaccinated female child, treated for dengue fever 2 weeks back presented to the ER at our facility in a critical state with complaints of pus draining from the right ear, right thigh discoloration and swelling, and swelling of the left cheek, along with difficulty in feeding. On examination, she was afebrile, capillary refill test of more than 4 seconds and random blood sugar of 192 mg/dL. On physical examination, her GCS was 8/15, her pupils were reactive to light, and she was responsive to pain, she appeared pale, and her skin and peripheries were cold. Following the detailed history and physical examination findings, a provisional diagnosis of septic shock and Ecthyma Gangrenosum was established.
EFFICACY OF TRANSEPITHELIAL ACCELERATED COLLAGEN CROSS LINKING IN STOPPING THE PROGRESSION OF KERATOCONUS
Authors: Ahmad Imran , Gul Nazli , Khan Bilal , Khan Jahandad , Rasheed Mutasim , Khan Fahad
Published: November 2024

Background: Keratoconus is a progressive ectatic disease of the cornea leading to central corneal thinning, protrusion and permanent visual impairment in untreated cases. It is affecting young children with strong association to vernal keratoconjunctivitis a common disease of Asian countries. Corneal collagen cross linkage (CXL) is standard procedure to stop progression of keratoconus. In this research article we used trans-epithelial accelerated corneal cross-linking to check its efficacy in stopping the progression of disease as quick and safe procedure with less chances of complication than standard CXL protocol. Methods: The study was carried out in Khyber Teaching Hospital from November 2022–October 2023. The sample size calculated was 36 with sampling technique of non-probability consecutive convenience sampling method. Results: The mean age of the patients was 19.157±3.53 years. Post corneal cross-linking, at 6 months follow-up showed that in 94.44% of the patients, no progression of keratoconus was noted. Improvement in vision was recorded in 44.44% of patients. A positive correlation was detected between pre- and post-treatment patients in visual acuity, keratometry and pachymetry. Conclusion: The trans-epithelial accelerated corneal collagen crosslinking is a safe and quick procedure for stopping the progression of keratoconus associated with less morbidity and complications.
SYNERGISTIC ANTIBIOIFLM ACTIVITY OF PROBIOTIC LACTOBACILLUS ACIDOPHILUS AND PUNICA GRANATUM L., AGAINST PSEUDOMONAS AERUGINOSA BIOFILM
Authors: Khursheed Hadia , Qasim Rimsha
Published: November 2024

Background: Antibiotic resistance is one of the most urgent public health concerns. Biofilm formation is well linked with chronic wounds, chronic obstructive pulmonary disease, urinary tract infections, and cystic fibrosis. Our goal was to assess the biofilm activity of P. aeruginosa and the individual and combined anti-biofilm forming activity of probiotic Lactobacillus acidophilus and Pomegranate peel extract Punica granatum L., against P. aeruginosa. Methods: A total of 150 swabs of urine, blood, pus, and CSF were collected from PNS Shifa Hospital Karachi, and P. aeruginosa was isolated and identified according to standard bacteriological methods. The ability of P. aeruginosa to form biofilms was assessed using a microtiter plate assay. Results: The anti-biofilm forming activity of pomegranate peels extract against P. aeruginosa was 29.26±19.09 whereas the anti-biofilm forming activity of Lactobacillus acidophilus against P. aeruginosa was 0.5×106. When used in combination, there was significant synergistic activity between Punica granatum L. (pomegranate peel extract) and Lactobacillus acidophilus. Conclusion: The unique synergistic mixture of natural product extracts and probiotics has demonstrated more efficiency against rapidly evolving pathogens, serving as promising candidates for developing biofilm inhibitors and perhaps proving as possible environmentally friendly agents against bacteria that produce antibiotic-resistant biofilms.