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Objectives: To determine the efficacy (achievement of castrate testosterone level at six months) of LHRH agonist therapy with different agonists, i.e., Leuprolide vs. Goserelin. Study Design: Quasi-experimental study. Place and Duration of Study: Radiation Oncology Department, Combined Military Hospital Rawalpindi Pakistan, from Jan to Oct 2020. Methodology: One hundred and seventy-eight patients (n=178) having histopathologically confirmed prostate adenocarcinoma, aged 60 to 80 years, with eastern cooperative oncology group (ECOG) performance status ≤2, men with advanced prostate cancer were randomly assigned to receive different treatment, group 1(89) patients received Goserelin. 3.6mg vs group 2(89) received Leuprolide 7.5mg. The study achieved 100% accrual in the initial 2.5 months from the start of the study. Each agent was injected intramuscularly six times every 28 days for six injections. The percentage of men whose serum testosterone concentrations fell to and remained at or below castrate levels was the primary endpoint. Results: Analysis was made on 178 patients in this study. No statistically significant difference was observed between the two groups in terms of achievement of castration levels of testosterone (Leuprolide 98.9% vs. Goserline 88.7%, respectively: p=0.126) from baseline to 6 months. The chi-square test was applied to the outcome in both groups, and results were found to be insignificant statistically (p=0.126). Conclusion: In this study, no significant difference was determined between groups in attaining and maintaining castration levels of serum testosterone at six months. [ABSTRACT FROM AUTHOR]

Summary: Energy efficiency is a contemporary and challenging issue in geographically distributed data centers. These data centers consume significantly high energy and cast a negative impact on the energy resources and environment. To minimize the energy cost and the environmental impacts, Internet service providers use different approaches such as geographical load balancing (GLB). GLB refers to the placement of data centers in diverse geolocations to exploit variations in electricity prices with the objective to minimize the total energy cost. GLB helps to minimize the overall energy cost, achieve quality of service, and maximize resource utilization in geo‐distributed data centers by employing optimal workload distribution and resource utilization in the real time. In this paper, we summarize various optimization‐based workload distribution strategies and optimization techniques proposed in recent research works based on commonly used optimization factors such as workload type, load balancer, availability of renewable energy, energy storage, and data center server specification in geographically distributed data centers. The survey presents a systemized and a novel taxonomy of workload distribution in data centers. Moreover, we also debate various challenges and open research issues along with their possible solutions. [ABSTRACT FROM AUTHOR]

The use of technology to facilitate communication and care between patients and dental health care providers at different locations is referred as tele dentistry. It utilises different electronic modalities thus increasing the efficacy of dental clinics by converting traditional paper patient's records to Electronic Health Records (EHR). These EHR can help in increasing inter-professional communication between clinicians and multidisciplinary management of complex cases. Tele dentistry is a unique way to overcome the geographical barriers by delivering long distance treatment, providing Continuing Education (CE) and training opportunities for dental and non-dental providers. It also has the potential to reduce or eliminate oral health care disparities between different communities. During current COVID-19 pandemic tele dentistry is an effective way to triage high risk patients needing urgent or emergency care thus mitigating the risk of the spread of the Coronavirus. Tele dentistry is yet to become integral part of Pakistan dental health care service but it is imperative that dental health care providers actively promote and support the use of tele dentistry. [ABSTRACT FROM AUTHOR]

The leaders play a vital role in the decision scenarios in any organization. A qualitative study was conducted using "Beer distribution game" simulation to create an environment of novel and uncertain conditions. Additionally, the study followed the group interviewing technique to explore the underlying patterns in the creative decision-making phenomenon taken by the leaders in complex situations. The findings of the study revealed three categories of factors that contribute to the creative decision making of the leaders. These categories consist of factors related to individuals' personal characteristics, team-level factors, and process related factors. The study revealed during the group discussion that creative decision making occurs through a unique interplay of people, process and technology in the Pakistani context. [ABSTRACT FROM AUTHOR]