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Growth hormone deficiency (GHD) requires long-term hormone replacement therapy, most commonly through daily injections of recombinant human growth hormone (rhGH). Although effective, this daily regimen may lead to poor adherence, particularly in children. Somapacitan, a long-acting growth hormone analog administered once weekly, has emerged as a potential alternative. This systematic review and meta-analysis compares the efficacy, safety, and biochemical outcomes of once-weekly somapacitan with daily Norditropin in patients with GHD. Following PRISMA guidelines (PROSPERO: CRD420251118208), PubMed and CENTRAL were systematically searched up to August 2025. Randomized controlled trials comparing somapacitan with Norditropin in patients with GHD were included. Data were pooled using a random-effects meta-analysis in Review Manager 5.4, and risk of bias was assessed using the Cochrane RoB 2 tool. Ten randomized controlled trials involving 920 participants were included. Somapacitan and Norditropin demonstrated comparable outcomes in height velocity (MD = 0.12; 95
This study examines contemporary Pashto poetry as a critical cultural site where collective trauma, identity, and resistance are articulated under conditions of prolonged militarization and political marginalization in Pakistan. Drawing on Cultural Trauma Theory, the study conceptualizes poetry not merely as an aesthetic form but as a mode of cultural knowledge through which communities narrate suffering, contest dominant power structures, and preserve collective memory. Focusing on the Pashtun regions of Khyber Pakhtunkhwa and the former Federally Administered Tribal Areas (FATA), the analysis explores how poetic discourse represents state violence, surveillance, displacement, and the transformation of Pashtun identity into a securitized and suspect category. Using qualitative textual and thematic analysis, the study examines a corpus of nineteen contemporary Pashto poems produced in the post-2001 conflict context. The findings demonstrate that Pashtun poetry functions simultaneously as testimony, critique, and resistance by exposing the normalization of violence, the marginalization of Pashtun voices, and the unequal valuation of life and death within dominant national narratives. Through metaphor, imagery, silence, and symbolic inversion, poets reclaim narrative agency and challenge imposed representations of Pashtun identity and history. The study further shows how poetry operates as a cultural counter-archive that preserves alternative memories and perspectives often absent from official narratives of war and security. By foregrounding poetic expression as a site where cultural trauma is articulated and contested, this research contributes to trauma studies, postcolonial literary scholarship, and South Asian cultural studies, demonstrating how marginalized communities employ poetry to resist erasure and articulate alternative moral and political imaginaries beyond securitized frameworks.
Insulation is critical to reliable power system performance, including medium voltage cut-out fuse insulators that are crucial to protecting outdoor distribution lines, transformers, and equipment. In case of medium-voltage networks, these insulators are primary protection from voltage flashover and breakdown that might result from impurities like dust, salt, industrial discharge, organic elements, and desert conductive pollutants. Damage to these insulators, however, can result in equipment damage, safety hazards, and blackouts. Recently, polymeric materials have been studied to replace the conventional porcelain insulators. The porcelain and polymer performance of soft relining materials is compared in the article. the work examines the dry FRP porcelain and polymeric cut-out insulators in 11 kV overhead lines to evaluate their performance under different types of lightning impulse tests, including clean and heavily polluted conditions. The study discusses positive polarity and critical flashover voltage (CFO), as well as the parameters of voltage-time waves, with the direct Strike using 1.2/50 µs and the Side Strike using non-standard 5/100 µs impulse shapes (with standard values). The laboratory experiments, carried out when heavy pollution was simulated, showed that the loss in mechanical strength reached 43.29% for porcelain and 14.39% for polymer under standard conditions and 51.82% for porcelain and 22.17% for polymer under non-standard conditions. This goes to show that polymer cut-out insulators have better performance than porcelain insulators. The dielectric properties of an insulator profile are heavily dominated by the effect of the lightning impulse voltage, and non-standard impulses expose them to more over-voltage stress than standard ones. This paper suggests that prototype testing should introduce non-standard impulses. The results set a baseline for future experimental work in this area.
