The Increasing Dine-out Trend: Investigation from Karachiites

This paper analyzes the increasing preference of people in regard to dining out more in the recent years as compared with eating at home. The trend of dining out is often not to fulf il hunger instead it is more often because of socializing and just for the sake of trying out new places. The present study further elaborates the impact and consequences of the increased dining out on the changing lifestyle of people. Particularly in Pakistan, the trend of dining out is increasing and is being taken as a leisure trip or a social gathering, which is very different than as it was perceived once when eating out was restricted to occasions and celebrations. This trend is multi-faceted as it is not restricted to a particular segment or class that is being affected by the change in dining out trends. The focus in this study has been on exploring how the trend is increasing amongst the youth as well as a family event, and more importantly, how it is signif icant despite the increase varies in different social classes. This paper also emphasizes on literature that includes the various strategies used by restaurateurs to encourage increasing dine out behaviour. For primary data collection, a questionnaire, containing both open-ended and close-ended questions, was floated and responses of consumers belonging to different areas of Karachi were recorded. The f indings of the study highlighted that male customers are more signif icant contributors to the dine out trend than that of the female customer

Knowledge and Practices of Nurses Regarding the Management of Elderly Patient with Dysphagia at Tertiary Care Hospital Lahore

Introduction: Dysphagia is the subjective sensation of difficulty swallowing and there are many potential etiologies. It also negatively impacts quality of life and decreases work productivity, and it is the 10th leading cause of ambulatory care visits in the United States among gastrointestinal (GI) symptoms, with more than 600,000 visits annually. Method: Quantitative cross-sectional study design was used to determine the knowledge and practices of nurses regarding the management of elderly patient with dysphagia at tertiary care hospital. 111 nurses working at gastro, medical and surgical wards were selected as sample. Data was collected through the standardized well adopted 14 item questionnaires. Results: Results revealed that only (52) 47 % nurses have good knowledge and majority (59) 53% nurses have poor knowledge. Further the practices of nurses regarding dysphagia management analysis revealed that 41 % nurses have adequate practices and majority 59% nurses have inadequate practices. Conclusions: The results of the present study showed that the participants had a moderate/low knowledge practice of the definition, diagnosis, and clinical management of liquid dysphagia and inadequate. So necessary tools must be provided for their training in this field. This training must be multidisciplinary and should be directed to all professionals who provide healthcare to patients with liquid dysphagia. Keywords: knowledge, practices, dysphagia, management, elderly DOI: 10.7176/JHMN/100-04 Publication date:May 31st 202

Cubic bipolar fuzzy VIKOR and ELECTRE-II algorithms for efficient freight transportation in Industry 4.0

The theory of cubic bipolar fuzzy sets (CBFSs) is a robust approach for dealing with vagueness and bipolarity in real-life circumstances. This theory provides a hybrid machine learning paradigm that can accurately describe two-sided contrasting features for medical diagnosis. The ELECTRE-II model, which is extensively used, is expanded in this article to include the cubic bipolar fuzzy (CBF) context. In order to produce a comprehensive preference ordering of actions, ELECTRE-II establishes two different forms of embedded outranking relations while taking into account the subjective human judgments. A huge number of applications have been created by its variations under various models, considering the CBF model's greater capacity to deal. For opinions in the adaptive CBF structure with unknown information, the CBF-ELECTRE-II group decision support method is described. With the use of proper CBF aggregation operations, the expert CBF views on each alternative and criterion are compiled in the first step. The approach then constructs weak and strong outranking relations and offers three distinct CBF outranking set kinds ("concordance", "indifferent" and "discordance" sets). Strong and weak outranking graphs serve as a visual depiction of the latter, which is finally studied by a rigorous iterative procedure that yields a preferred system. For these objectives, integrated CBF-VIKOR and CBF-ELECTRE-II techniques are developed for multi-criteria group decision making (MCDGM). Finally, suggested techniques are recommended to determine ranking index of efficient road freight transportation (FRT) in Industry 4.0. The ranking index and optimal decision are also computed with other techniques to demonstrate robustness of proposed MCDGM approach

Papillary Renal Cell Carcinoma: Demographics, Survival Analysis, Racial Disparities, and Genomic Landscape

Papillary renal cell carcinoma (PRCC) is the second most common histological subtype of renal cell cancer. This research aims to present a large database study highlighting the demographic, clinical, and pathological factors, racial disparities, prognosis, and survival of PRCC. The clinical and demographic data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database, and molecular data was cured from the Catalogue Of Somatic Mutations in Cancer (COSMIC) database. PRCC had a median age of diagnosis at 64 years, with a higher incidence in men (77%), and Whites (68%). 70.3% of cases were Grades I–IV (13, 53, 31, and 3%, respectively). In patients with known data, 85% were localized to the kidney, and 84% of cases were 7 cm in size. No metastasis occurred in 97% of the known data. The most common treatment offered was surgical resection (9%). The 5-year overall survival was 79%, with patients undergoing surgery having a 90.6% 5-year survival. Multivariable analysis revealed age > 60 years, Black race, poor histologic differentiation, distant metastases, and tumor size > 10 cm as independent risk factors for mortality. The most common mutations identified from the COSMIC database were MET, KMT2D, KMT2C, ARID1A, and SPEN. PRCC affects male individuals in the sixth decade of life. Increased age, Black race, distant metastases, and tumors > 10 cm are associated with a worse prognosis. Surgical resection offers a favorable survival outcome. Next-generation sequencing (NGS) could identify potentially targetable alterations and future personalized therapeutic approaches

A decision-making strategy to combat CO2 _2 emissions using sine trigonometric aggregation operators with cubic bipolar fuzzy input

A cubic bipolar fuzzy set (CBFS) is by far the most efficient model for handling bipolar fuzziness because it carries both single-valued (SV) and interval-valued (Ⅳ) bipolar fuzzy numbers at the same time. The sine trigonometric function possesses two consequential qualities, namely, periodicity and symmetry, both of which are helpful tools for matching decision makers' conjectures. This article aims to integrate the sine function and cubic bipolar fuzzy data. As a result, sine trigonometric operational laws (STOLs) for cubic bipolar fuzzy numbers (CBFNs) are defined in this article. Premised on these laws, a substantial range of aggregation operators (AOs) are introduced. Certain features of these operators, including monotonicity, idempotency, and boundedness, are explored as well. Using the proffered AOs, a novel multi-criteria group decision-making (MCGDM) strategy is developed. An extensive case study of carbon capture and storage (CCS) technology has been provided to show the viability of the suggested method. A numerical example is provided to manifest the feasibility of the developed approach. Finally, a comparison study is executed to discuss the efficacy of the novel MCGDM framework

INTERDEPENDENCE OF CANDIDA GROWTH AMONG MALES AND FEMALES IN THE PERSPECTIVE OF USE OF COMPLETE DENTURES ALL DAY LONG AND NIGHT

Background: The factors associated with infection in oral candida are countless. This infection is mainly caused by bad prosthetic cleanliness. Objective: The goal of current research study was to assess that how oral candida growth is influenced by wearing false teeth all over night and gender. Patients and Methods: The present research was organized at Sir Ganga Ram Hospital, Lahore (October 2017 to August 2019). Total patients enrolled for this research were forty. The males and females were in equal number i.e. 20. These patients were between fifty to sixty-five years of age and complete denture wearer for first time. Those patients were not selected for the study who were found with smoking habit, diabetes and with the record of treatment with radiotherapy and chemotherapy in the previous six months. For the assemblage of sample, the method used was oral rinse on some time in a day. In this method, each patient was given ten milliliter of sterile saline in a sterile container that was disposable. They were asked to rinse for the time period of sixty seconds. Quantitative and qualitative growth of candida was examined and Gram stain, microscopy and colony count were measured after sending the sample to Microbiology section of pathology department of the hospital. Results: It is concluded by the results that candida growth is increased by overnight denture wearing. It was also observed that after one month of wearing complete denture, the dissimilarity in candida growth in females was valuable. Conclusion: It is concluded that dentures should be removed during night, as in case of eyeglasses. In this way, denture stomatitis will be avoided. Moreover, information should be provided about oral cleanliness to common people, especially to females. Keywords: Denture, Candida and Sterile Container

PD-L1 Over-Expression Varies in Different Subtypes of Lung Cancer: Will This Affect Future Therapies?

Programmed death-ligand (PD-L) 1 and 2 are ligands of programmed cell death 1 (PD-1) receptor. They are members of the B7/CD28 ligand-receptor family and the most investigated inhibitory immune checkpoints at present. PD-L1 is the main effector in PD-1-reliant immunosuppression, as the PD-1/PD-L pathway is a key regulator for T-cell activation. Activation of T-cells warrants the upregulation of PD-1 and production of cytokines which also upregulate PD-L1 expression, creating a positive feedback mechanism that has an important role in the prevention of tissue destruction and development of autoimmunity. In the context of inadequate immune response, the prolonged antigen stimulation leads to chronic PD-1 upregulation and T-cell exhaustion. In lung cancer patients, PD-L1 expression levels have been of special interest since patients with non-small cell lung cancer (NSCLC) demonstrate higher levels of expression and tend to respond more favorably to the evolving PD-1 and PD-L1 inhibitors. The Food and Drug Administration (FDA) has approved the PD-1 inhibitor, pembrolizumab, alone as front-line single-agent therapy instead of chemotherapy in patients with NSCLC and PD-L1 ≥1% expression and chemoimmunotherapy regimens are available for lower stage disease. The National Comprehensive Cancer Network (NCCN) guidelines also delineate treatment by low and high expression of PD-L1 in NSCLC. Thus, studying PD-L1 overexpression levels in the different histological subtypes of lung cancer can affect our approach to treating these patients. There is an evolving role of immunotherapy in the other sub-types of lung cancer, especially small cell lung cancer (SCLC). In addition, within the NSCLC category, squamous cell carcinomas and non-G12C KRAS mutant NSCLC have no specific targetable therapies to date. Therefore, assessment of the PD-L1 expression level among these subtypes of lung cancer is required, since lung cancer is one of the few malignances wherein PD-L1 expression levels is so crucial in determining the role of immunotherapy. In this study, we compared PD-L1 expression in lung cancer according to the histological subtype of the tumor