bluuebunny/crossref_metadata_2025 huggingface dataset:
ASUHAN KEBIDANAN PADA IBU BERSALIN NY P DENGAN PEMBERIAN KELAPA UNTUK MENINGKATKAN TENAGA PERSALINAN DI PUSKESMAS TANJUNG BALAI KARIMUN
Authors: Menda Maria , Franshisca Sihombing Sarmauli , Juni Ekasari Dian
Published: May 2024

Childbirth is influenced by three main elements, namely energy (his power of straining), the condition of the birth canal, and the size of the fetus. Foods and drinks that are scientifically proven to be used to facilitate labor are dates, young coconut water, honey and soy milk. Objective To provide comprehensive and continuous midwifery care for mothers giving birth, with management of midwifery care in accordance with midwifery service standards. The midwifery care that is applied is Midwifery Care for Mrs. P. Giving Birth Coconuts to Increase Labor Force. The practice report preparation method is descriptive research using the case study method. The research was conducted at the Tanjung Balai Karimun Health Center in March 2023. The subject used in this case study with midwifery care management was Mrs. P. Results and Conclusions Evaluation of the care provided related to the implementation Midwifery Care for Maternity Mrs. P By Giving Coconuts to Increase Labor Force, there is an Increase in Labor Force for Mothers
PERAWATAN LUKA UNTUK PENCEGAHAN INFEKSI PADA TALI PUSAT BAYI DI BPM BIDAN ANOVA SARAGIH, S.KEB
Authors: Marsela Yenny , Dwi Anjani Arum
Published: May 2024

Carrying out umbilical cord care is very important to prevent infection. The aim of umbilical cord care is to prevent tetanus in newborn babies, so that the umbilical cord remains clean, germs do not enter so that infection does not occur in the baby's umbilical cord. Tetanus is caused by clostridium tetani, which is a germ that releases toxins (poison), which enters through the umbilical cord wound, due to unclean care or procedures. Providing midwifery care in the form of education to mothers about how to properly care for the umbilical cord to prevent infection in newborns in accordance with service standards for independent practicing midwives. The method used in this research method was written based on a case study report of midwifery care for newborns using a descriptive observational method with a midwifery care approach. Umbilical cord wound care is intended as an act of caring for and cleaning the umbilical cord, as well as to prevent infection in the baby's umbilical cord and speed up healing of wounds left by cutting the umbilical cord. Improper care for umbilical cord wounds in babies will result in infections that can result in death. This disease is caused by the entry of tetanus germ spores into the body through the umbilical cord, either from unsterile instruments, use of drugs, powders or leaves sprinkled on the umbilical cord which can cause infection.
Lipid Variability Induces Endothelial Dysfunction by Increasing Inflammation and Oxidative Stress
Authors: Rhee Marie , Lee Joonyub , Lee Eun Young , Yoon Kun-Ho , Lee Seung-Hwan
Published: May 2024

Background: This study investigates the impact of fluctuating lipid levels on endothelial dysfunction.Methods: Human aortic and umbilical vein endothelial cells were cultured under varying palmitic acid (PA) concentrations: 0, 50, and 100 μM, and in a variability group alternating between 0 and 100 μM PA every 8 hours for 48 hours. In the lipid variability group, cells were exposed to 100 μM PA during the final 8 hours before analysis. We assessed inflammation using real-time polymerase chain reaction, Western blot, and cytokine enzyme-linked immunosorbent assay (ELISA); reactive oxygen species (ROS) levels with dichlorofluorescin diacetate assay; mitochondrial function through oxygen consumption rates via XF24 flux analyzer; and endothelial cell functionality via wound healing and cell adhesion assays. Cell viability was evaluated using the MTT assay.Results: Variable PA levels significantly upregulated inflammatory genes and adhesion molecules (Il6, Mcp1, Icam, Vcam, E-selectin, iNos) at both transcriptomic and protein levels in human endothelial cells. Oscillating lipid levels reduced basal respiration, adenosine triphosphate synthesis, and maximal respiration, indicating mitochondrial dysfunction. This lipid variability also elevated ROS levels, contributing to a chronic inflammatory state. Functionally, these changes impaired cell migration and increased monocyte adhesion, and induced endothelial apoptosis, evidenced by reduced cell viability, increased BAX, and decreased BCL2 expression.Conclusion: Lipid variability induce endothelial dysfunction by elevating inflammation and oxidative stress, providing mechanistic insights into how lipid variability increases cardiovascular risk.
PENGALAMAN PASIEN TERPASANG KATETER URIN URETHRAL JENIS INDWELLING DAN INTERMITTEN: QUALITATIVE REVIEW
Authors: Agustiani Sirli , Dewi Arlina
Published: May 2024

The use of urinary catheter affect the patient’s life in holistic. There is one review article that explores about experiences of urinary catheter patient’s inserted. But the article only discusses about psychosocial aspect and not discusses patient in holistic. The aim of this research to explore about experiences of urethral catheter patients insertedwith indwelling and intermitten. This research is qualitative review. The researcher searched data from PubMed, SAGE Journals, and Mendeley. The search was restricted to English language articles and limited to last 2001-2020. The main keywords use experience and “urinary catheter*”. There were 23 articles included in the inclusion criteria. Holistically, several experiences were reviewed including physical aspects such as sleep, comfort, pain, physical activity, urinary tract infections, muscle spasm, and bleeding. In psychological aspect, include anxiety, self-adaptation or self-acceptance, self-identity, self-image, self-ideal and self-esteem. In social aspects such as social activity and social interaction. In environmental aspects include size of toilets, toilet cleanliness, material from catheter which affect the environment. In other aspects include patient knowledge, role of health professionals (nurse), and economy crisis. Negative and positive experiences were felt for urethral catheter patients inserted with indwelling and intermitten. Nurses are expected to provide holistic nursing care for patients with urinary catheters.
Grievance Management System in PHP
Authors: Shivaji Devkule Rutuja , M. Palkar Prashant , V. Shetage Sagar
Published: May 2024

The college grievance system project outlined in these abstract aims to streamlined and improve the process through the student can raise concerns and complaint within the academic community. Recognizing the importance of addressing student grievance promptly and fairly. Project seeks to design and implement effective an accessibility system that enhance the overall student experience.
Groundwater Exploration and Assessment in Arid and Semi-Arid Regions of Basaltic Terrain of Solapur: Lessons Learned and Future Prospects
Authors: Birajdar Farjana , Shaikh Mustaq
Published: May 2024

This research delves into the intricate dynamics of groundwater exploration and assessment in the arid and semi-arid basaltic terrain of Solapur, India. The study investigates the hydrogeological complexities of the region, emphasizing the importance of community involvement and sustainable practices in groundwater management. Employing advanced geophysical surveys, borehole logging, and hydrogeological modeling, the research uncovers the challenges and successes encountered during the study, providing valuable insights for future exploration strategies. Key findings highlight the heterogeneity of basaltic formations, the significance of local community engagement, and the need for adaptive approaches in groundwater exploration. Lessons learned from successes in geophysical surveys and challenges faced in borehole logging contribute to the knowledge base for effective exploration techniques in similar geological settings. The research's significance for Solapur lies in its potential to guide sustainable water management practices, empower local communities, and inform policy formulation. The emphasis on community involvement, awareness, and regulatory measures serves as a foundation for addressing water scarcity challenges in the region. Beyond Solapur, the study holds broader implications for arid and semi-arid regions globally. It contributes to scientific knowledge, informing policy frameworks, and promoting community-centric approaches to groundwater management. The research provides a blueprint for addressing water resource challenges in diverse geographical contexts, ensuring the resilience of communities and the preservation of vital groundwater resources.
Creating Patterns for Handicrafts and Embroidery
Authors: Lokhande Jaydeep , Idathe Seema
Published: May 2024

In this era of design and fashion , matching technology with aesthetics , selecting colors plays a major role in enhancing the beauty of designs .colors are a vital part of design artists to realm the designs , emotions , and make the paintings appear real .The color combination generator in this abstract deals with the enhancing of colors with the computational algorithms and make it simple for artisans compute the color for their use . The colors they use play a vital role in developing paintings and all other delusions such as combinations of arts , and creativity.This paper deals with the enhancing of handicrafts with the modern cultures trends such as coding , developing codes for several patterns in handicrafts to reduce the efforts of craftsmen engaged in the crafting , and framing of crafts such as ceramic crafts , pottery crafts , textile crafts , decorative and jewelry crafts.
Variations in Line Profiles of Atomic Transitions in RR Lyrae Stars
Authors: Sneden Christopher , Preston George W.
Published: May 2024

We have investigated the absorption shapes of atomic lines and Hα in RR Lyrae stars. We used the database of high-resolution spectra gathered with the Las Campanas Observatory du Pont Telescope, analyzing a set of about 2700 short exposure spectra of 17 RRab and 5 RRc variables. To increase the signal-to-noise ratio of the spectra for each star, we first coadded spectra in small photometric phase bins, and then coadded metallic line profiles in velocity space. The resulting line absorption shapes vary with photometric phase in a consistent manner for all RRab stars, while exhibiting no obvious phase-related variations for the RRc stars. We interpret these line profile variations in terms of velocity gradients in the photospheric layers that produce absorption line profiles. The Hα profiles are much broader, indicative of shock temperatures of order 100,000 K.
The Intrinsic Sizes of Odd Radio Circles
Authors: Rupke David S. N. , Coil Alison L. , Whalen Kelly E. , Moustakas John , Tremonti Christy A. , Perrotta Serena
Published: May 2024

A new class of sources, the so-called odd radio circles (ORCs), have been discovered by recent sensitive, large-area radio continuum surveys. The distances of these sources have so far relied on photometric redshifts of optical galaxies found at the centers of or near ORCs. Here we present Gemini rest-frame optical spectroscopy of six galaxies at the centers of, or potentially associated with, the first five ORC discoveries. We supplement this with Legacy Survey imaging and Prospector fits to their griz+W1/W2 photometry. Of the three ORCs with central galaxies, all lie at distances (z = 0.27–0.55) that confirm the large intrinsic diameters of the radio circles (300–500 kpc). The central galaxies are massive (M
* ∼ 1011
M
☉), red, unobscured ellipticals with old (≳1 Gyr) stellar populations. They have LINER spectral types that are shock-powered or active galactic nucleus (AGN)-powered. All three host low-luminosity, radio-quiet AGN. The similarity of their central galaxies is consistent with a common origin, perhaps as a blast wave from an ancient starburst. The other two ORCs are adjacent and have no prominent central galaxies. However, the z = 0.25 disk galaxy that lies between them hosts a Type 2, moderate-luminosity AGN. They may instead be the lobes of a radio jet from this AGN.
Stellar Escape from Globular Clusters. II. Clusters May Eat Their Own Tails
Authors: Weatherford Newlin C. , Rasio Frederic A. , Chatterjee Sourav , Fragione Giacomo , Kıroğlu Fulya , Kremer Kyle
Published: May 2024

We apply for the first time orbit-averaged Monte Carlo star cluster simulations to study tidal tail and stellar stream formation from globular clusters (GCs), assuming a circular orbit in a time-independent spherical Galactic potential. Treating energetically unbound bodies—potential escapers (PEs)—as collisionless enables this fast but spherically symmetric method to capture asymmetric extratidal phenomena with exquisite detail. Reproducing stream features such as epicyclic overdensities, we show how returning tidal tails can form after the stream fully circumnavigates the Galaxy, enhancing the stream's velocity dispersion by several kilometers per second in our ideal case. While a truly clumpy, asymmetric, and evolving Galactic potential would greatly diffuse such tails, they warrant scrutiny as potentially excellent constraints on the Galaxy’s history and substructure. Reexamining the escape timescale Δt of PEs, we find new behavior related to chaotic scattering in the three-body problem; the Δt distribution features sharp plateaus corresponding to distinct locally smooth patches of the chaotic saddle separating the phase-space basins of escape. We study for the first time Δt in an evolving cluster, finding that

Δ
t
∼
(

E

J

−
0.1

,

E

J

−
0.4

)

for PEs with (low, high) Jacobi energy E
J, flatter than for a static cluster (

E

J

−
2

). Accounting for cluster mass loss and internal evolution lowers the median Δt from ∼10 Gyr to ≲100 Myr. We finally outline potential improvements to escape in the Monte Carlo method intended to enable the first large grids of tidal tail/stellar stream models from full GC simulations and detailed comparison to stream observations.
Age Determination of LAMOST Red Giant Branch Stars Based on the Gradient Boosting Decision Tree Method
Authors: Wang Hai-Feng , Carraro Giovanni , Li Xin , Li Qi-Da , Spina Lorenzo , Chen Li , Wang Guan-Yu , Deng Li-Cai
Published: May 2024

In this study, we estimate the stellar ages of LAMOST DR8 red giant branch (RGB) stars based on the gradient boosting decision tree (GBDT) algorithm. We used 2643 RGB stars extracted from the APOKASC-2 asteroseismological catalog as the training data set. After selecting the parameters ([α/Fe], [C/Fe], T
eff, [N/Fe], [C/H], log g) highly correlated with age using GBDT, we apply the same GBDT method to the new catalog of more than 590,000 stars classified as RGB stars. The test data set shows that the median relative error is around 11.6% for the method. We also compare the predicted ages of RGB stars with other studies (e.g., based on APOGEE) and find some systematic differences. The final uncertainty is about 15%–30% compared to the ages of open clusters. Then, we present the spatial distribution of the RGB sample with an age determination, which could recreate the expected result, and discuss systematic biases. All these diagnostics show that one can apply the GBDT method to other stellar samples to estimate atmospheric parameters and age.
Intrinsic Emission of PSR B1937+21 at 327 MHz
Authors: Mahajan Nikhil , van Kerkwijk Marten H.
Published: May 2024

At 327 MHz, the observed emission of PSR B1937+21 is greatly affected by scattering in the interstellar medium, on a timescale of order the pulse period. We use the bright impulsive giant pulses emitted by the pulsar to measure the impulse response of the interstellar medium and then recover the intrinsic emission of the pulsar by deconvolution—revealing fine structure on timescales not normally observable. We find that the intrinsic widths of the main pulse and interpulse in the pulse profile are similar to those measured at higher frequencies. We detect 60,270 giant pulses, which typically appear as narrow, ∼100 ns bursts consisting of one to a few nanoshots with widths ≲ 10 ns. However, about 10% of the giant pulses exhibit multiple bursts that seem to be causally related to each other. We also report the first detection of giant micropulses in PSR B1937+21, primarily associated with the regular main pulse emission. These are distinct from giant pulses not only in the phases at which they occur, but also in their larger widths, of order a microsecond, and steeper energy distribution. These measurements place useful observational constraints on emission mechanisms for giant pulses as well as the regular radio emission of millisecond pulsars.
Mass Flows in Expanding Coronal Loops
Authors: Reep Jeffrey W. , Scott Roger B. , Chhabra Sherry , Unverferth John , Knizhnik Kalman J.
Published: May 2024

An expansion of the cross-sectional area directly impacts the mass flow along a coronal loop and significantly alters the radiative and hydrodynamic evolution of that loop as a result. Previous studies have found that an area expansion from the chromosphere to the corona significantly lengthens the cooling time of the corona and appears to suppress draining from the corona. In this work, we examine the fluid dynamics to understand how the mass flow rate, the energy balance, and the cooling and draining timescales are affected by a nonuniform area. We find that in loops with moderate or large expansion (cross-sectional area expansion factors of 2, 3, 10, 30, 100 from the photosphere to the apex), impulsive heating, for either direct thermal heating or electron beam heating, induces a steady flow into the corona, so that the coronal density continues to rise during the cooling phase, whereas a uniform loop drains during the cooling phase. The induced upflow carries energy into the corona, balancing the losses from thermal conduction, and continues until thermal conduction weakens enough so that it can no longer support the radiative losses of the transition region. As a result, the plasma cools primarily radiatively until the onset of catastrophic collapse. The speed and duration of the induced upflow both increase in proportion to the rate of area expansion. We argue that observations of blueshifted spectral lines, therefore, could place a constraint on a loop’s area expansion.
A 1 bit Raw Voltage-recording System for Dedicated Observations of Transients at Low Radio Frequencies
Authors: Bane Kshitij S. , Barve Indrajit V. , Gireesh G. V. S. , Kathiravan C. , Ramesh R.
Published: May 2024

Recently we had reported commissioning of a prototype for pulsar observations at low radio frequencies (<100 MHz) using log-periodic dipole antennas in the Gauribidanur Radio Observatory (≈77°E, 14°N) near Bangalore in India (https://www.iiap.res.in/?q=centers/radio). The aforementioned system (the Gauribidanur Pulsar System) is currently being augmented to directly digitize the radio-frequency signals from the individual antennas in the array. Our initial results using a 1 bit raw voltage-recording system indicate that such a back-end receiver offers distinct advantages like (i) simultaneous observations of any set of desired directions in the sky with multiple offline beams and smaller data rate/volume, and (ii) archival of the observed data with minimal resources for reanalysis in the future, either in the same or a different set of directions in the sky.
Law and order: what can we expect from an incoming Labour government?
Authors: Forkert Kirsten , Blowe Kevin
Published: May 2024

Kirsten Forkert talks to Kevin Blowe, campaigns coordinator of Netpol A Starmer-led government is unlikely to deviate from the mainstream-constructed consensus on policing Netpol - the Network for Police Monitoring ‐ is a coalition of organisations that liaise together
on monitoring police activities. Cases it has been involved in include those of Ian Tomlinson and Jean Charles de Menezes. As DPP, Keir Starmer confirmed CPS decisions not to prosecute the police officers concerned in these deaths. Such actions, together with other positions he has adopted,
tell us that Starmer doesn’t understand the massive imbalance in power between the individual and the state: when he was in a position to adjudicate on where that balance lies, he always came down on the side of the state. He has little understanding of social movements, seeing change
as happening within committee meetings ‐ as involving discussions amongst people with real power. Labour’s criticisms of the Police, Crime, Sentencing, and Courts Act, and the Public Order Act have also been tepid. All this means that a Starmer-led government is unlikely to deviate
from the mainstream-constructed consensus on policing. It is likely to continue to give the police whatever they say they need to deal with a given situation. There may be noises made about the importance of human rights, and, possibly, there will be fewer attacks on judges when there are
legal challenges, and less resort to culture-war rhetoric; and at least Labour won’t abolish the Human Rights Act, which means that there will still be a basis for challenging actions that contravene it. But an incoming Labour government is unlikely to provide a greater degree of protection
to people who are vulnerable to overreaching state power. Dealing with policing in communities over many years has not been about asking grand questions about what happens during elections: it has been about finding processes for survival ‐ helping people to develop a sense of power,
the confidence to complain and to organise, to push back against local councillors who are not prepared to challenge the police commander in their area. This often stops people in particular areas from experiencing the same level of oppressive policing as they would without local opposition.
This is why local Copwatch groups are so important. After the election, regardless of who wins, there is still going to be an absolutely essential role for people who do this grassroots work: that???s where you are going to be able to make a difference.
Spontaneous Resolution of a Combined Hamartoma in a One-Year-Old Child
Authors: Firlie Marissa , Scarboro Shannon , Harper C. Armitage
Published: May 2024

The combined hamartoma of the retina and the retinal pigment epithelium (CHR-RPE) is a rare but histologically benign tumor of which no clear consensus exists regarding its appropriate management. Most commonly CHR-RPE presents unilaterally in children as an elevated, pigmented lesion associated with vascular tortuosity and an epiretinal membrane (ERM). Patients may have decreased visual acuity (VA) in the affected eye, notably if the overlying ERM extends into the macula. For this reason, surgical intervention in the form of ERM removal has been pursued with notable success. Still, those who pursue observation cite the interwoven nature of the overlying glial membrane within the dysplastic retina, complicating surgery and accounting for variability in post-operative VA success. Given the rarity of the tumor coupled with the scarcity of data on its natural evolution, clinicians who pursue observation cannot know for sure whether withholding surgical management is predisposing their patients to worse visual outcomes as compared to those patients who undergo ERM peel as first-line therapy. This case report will discuss an infant with clinically diagnosed CHR-RPE whose lesion showed significant regression after 6 months of observation. This success story should cause ophthalmologists to reconsider the management options at their disposal when faced with a case of CHR-RPE, and to call for further research to better define the risks of observation over surgical intervention.

[
Ophthalmic Surg Lasers Imaging Retina
2024;55:471–473.]
Efficient defective cocoon recognition based on vision data for intelligent picking
Authors: Chen Jun , Guo Xueqiang , Zhang Taohong , Zheng Han
Published: May 2024

Cocoons have a direct impact on the quality of raw silk. Mulberry cocoons must be screened before silk reeling can begin in order to improve the quality of raw silk. For the silk product sector, the cocoons' level of categorization and sorting is crucial. Nonetheless, the majority of mulberry cocoon production facilities in use today choose the cocoons by hand. The accuracy and efficiency of mulberry cocoon plucking can be significantly improved by automatic methods. To increase efficiency, mulberry cocoons must be sorted automatically and intelligently using machine vision. We proposed an effective detection technique based on vision and terahertz spectrum characteristics data for distinguishing defective cocoons, including common and thin shelled defective cocoons. Each mulberry cocoon with a defect had its spatial coordinate and deflection angle computed so that grippers could grasp it. With 3762 photos in our dataset, our approach could detect mAP values up to 99.25% of the time. Furthermore, the GFLOPS of our suggested model was only 8.9 G, and its Parameters were only 5.3 M, making it appropriate for use in real-world application scenarios.
New drugs, old problems: immune checkpoint inhibitors and cancer-associated thrombosis
Authors: Patel Mehrie H. , Khorana Alok A.
Published: May 2024

A frequent side effect of cancer treatment is venous thromboembolism (VTE), which is made more likely by systemic anticancer medication. Immune checkpoint inhibitors (ICIs) have emerged as a paradigm-shifting treatment for many cancers. Early trials investigating the efficacy of ICIs did not identify thrombosis as a significant adverse event of concern. An initial meta-analysis reported a 1.1% [95% confidence interval (CI) 0.5-2.1] risk of arterial thromboembolism (ATE) and a 2.7% (95% CI 1.8-4.0) rate of vein thrombosis. ICIs have, however, been linked to ATE and VTE in an increasing number of post-marketing investigations. The reported incidence rates of cumulative VTE range from 5-8% at 6 months to 10-12% at 12 months, while the rates of ATE vary from 1-2% at 6 months to 17 months. Furthermore, a number of studies show a correlation between reduced survival and ICI-related thromboembolism. In order to provide a compiled and thorough narrative on the mechanisms, incidence, risk factors, and survival related to ICI-associated VTE and ATE, this narrative review summarizes the literature.
Cancer-associated ischemic stroke: current knowledge and future directions
Authors: Lun Ronda , Siegal Deborah M.
Published: May 2024

Because cancer is a strong prothrombotic, there is an increased risk of thromboembolism, which includes ischemic stroke, especially in the first six to twelve months following a cancer diagnosis. The risk of ischemic stroke differs according to the location and stage of cancer. Given that the risk increases prior to a cancer diagnosis, stroke may be the initial sign of occult cancer. Although data on the risk, treatment, and outcomes of cancer-associated stroke are more limited than those on cancer-associated venous thromboembolism, the condition is still recognized as a thrombotic complication of cancer. Up to 10% of ischemic stroke patients also have a concurrent cancer diagnosis, and these patients seem to have higher short-term mortality and morbidity rates. With more people expected to survive longer after cancer treatment and an increasing number of cancer survivors, the burden of stroke among cancer patients is predicted to rise. This narrative review aims to provide an overview of the pathophysiologic mechanisms, treatment options, and epidemiology of ischemic stroke, including cancer screening for those who have cryptogenic (unexplained) stroke.
Venous thromboembolism and mortality in patients with hematological malignancies
Authors: Sanfilippo Kristen M. , Wang Tzu-Fei
Published: May 2024

Mortality and venous thromboembolism (VTE) are major risks for patients with hematological malignancies. However, they are commonly underrepresented in major clinical trials of VTE. Treatment decisions are further complicated by the unique characteristics they frequently exhibit, such as thrombocytopenia. In addition to discussing treatment challenges, knowledge gaps, and future directions, our goal in this narrative review is to provide an overview of the epidemiology and risk factors of mortality in patients with hematological malignancies and VTE.
Identifying novel biomarkers using proteomics to predict cancer-associated thrombosis
Authors: Fernandez Turizo Maria J. , Patell Rushad , Zwicker Jeffrey I.
Published: May 2024

Comprehensive protein analyses of plasma are made possible by high-throughput proteomic screens, which may help find new therapeutic targets and diagnostic biomarkers. Patients with cancer are frequently affected by venous thromboembolism (VTE). The limited predictive accuracy of current VTE risk assessment tools highlights the need for new, more targeted biomarkers. Although coagulation biomarkers for the diagnosis, prognosis, and treatment of VTE have been investigated, none of them have the necessary clinical validation or diagnostic accuracy. Proteomics holds the potential to uncover new biomarkers and thrombotic pathways that impact the risk of thrombosis. This review explores the fundamental methods used in proteomics and focuses on particular biomarkers found in VTE and cancer-associated thrombosis.
Patient and public involvement in cancer-associated thrombosis research: necessary or glorified tokenism?
Authors: Noble Simon
Published: May 2024

The advantages of patient and public involvement (PPI) in research are becoming more widely known, however different research organizations have different rates of adoption. Comparably, some groups provide tokenistic participation in the research process, which is inconsistent with the extent to which PPI partners are truly involved. Recent developments in the field of cancer-associated thrombosis (CAT) research have shown how crucial PPI is to the foundation of the entire research process, from formulating the research question to disseminating the findings. This manuscript aims to present an overview of PPI within the framework of CAT research and demonstrate how, when used appropriately, PPI can improve a project’s overall success, rigor, and relevance.
Knowledge and Attitudes Toward Pressure Ulcer Prevention Evidence-based Guidelines among Nursing Students at Jazan University, Saudi Arabia
Authors: Alyahyawi Khalid O. , Alshekh Fatmah O. , Madkhali Abdullah Y. , Mosleh Amani A. , Alfaifi Ibrahim A. , Omar Rawan N. , Baiti Maisa A. , Hakami Abdulrahman
Published: May 2024

Background:

Pressure ulcers (PUs) are a common global problem. They affect health-care costs and patient health because of increased morbidity and mortality rates. Critically ill patients are more prone to acquiring PUs than other patients. As the prevalence of PUs is high in Saudi Arabia, more attention is required for PU prevention. Nurses’ knowledge and attitudes toward PU prevention are crucial.

Aims:

This study aimed to assess the knowledge and attitudes of nursing students regarding PU prevention evidence-based guidelines.

Setting and Design:

This descriptive, cross-sectional study was conducted among nursing students at Jazan University.

Materials and Methods:

Data were collected using an electronic questionnaire.

Statistical Analysis Used:

Data were entered, coded, and analyzed using the SPSS version 23.

Results:

A total of 378 participants were included. The mean age was 22.4 ± 3.4 years, and the mean knowledge score was 7.6 ± 2.64 (range = 0–16). Of the participants, 365 (96.6%) and 13 (3.4%) were considered to have poor and good knowledge about PUs, respectively. Only 72 (19%) correctly identified a lack of oxygen as the cause of PUs; other participants answered malnutrition and moisture. Conversely, 200 (52.9%) participants indicated that recent weight loss below patients’ ideal weight increases the risk for PUs. Concerning knowledge about preventive measures, 64 (16.9%) participants correctly answered that a backward sitting position, with both legs resting on a footrest, can reduce the amount of pressure. Meanwhile, 169 (44.7%) participants correctly selected thick air cushion as a means to reduce the magnitude of pressure when patients are sliding down on a chair. Some participants answered that PUs can be reduced if patients are mobilized. Seventy-two (19%) participants indicated that patients laying on a visco-elastic foam mattress should be repositioned every 2 h to reduce the duration of pressure. Age, year of education, training experience, and department were not significantly associated with knowledge about PUs (P = 0.333, P = 0.370, P = 0.700, and P = 0.810, respectively).

Conclusions:

The general knowledge and attitudes toward PUs of the nursing students at Jazan University were poor. Nevertheless, they had an average knowledge level regarding PU prevention. Age and training experience were not significantly associated with knowledge about PUs.
Functional movement disorders during the COVID-19 pandemic
Authors: Kamath Sneha Dayanand , Kamble Nitish , D. M. Sindhu , Sakhardande Kasturi A. , Basavarajappa Chethan , Pal Pramod Kumar
Published: May 2024

Functional movement disorders (FMDs) are a heterogenous group of movement abnormalities that greatly affect the quality of life of patients. They usually manifest as a result of underlying psychological or psychiatric illnesses without any known structural or neurochemical diseases. Various neurological disorders such as encephalitis, stroke, demyelination, seizures, and neuropathy have been reported by otherwise healthy individuals during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Here, we describe the case of a 27-year-old woman who presented to our outpatient department with episodes of deviation of angle of mouth with variability and distractibility. Following thorough clinical evaluation and appropriate investigation, the underlying etiology was identified as FMD secondary to the restrictions imposed during the COVID-19 pandemic to contain the transmission of the virus. The lockdown, isolation, financial strain, and other pandemic-related issues are stressors that may contribute to psychogenic disorders in people.
Tacrolimus-induced generalized tremor with excellent response to primidone
Authors: Lenka Abhishek , King Caroline , Soni Monica , Hu Nancy , Motamedi Gholam K.
Published: May 2024

Tacrolimus treatment is associated with a range of neurological adverse effects. Neurotoxicity caused by tacrolimus may result in subacute onset of tremor in a subset of patients. The commonly reported tremor phenomenology associated with tacrolimus neurotoxicity is the action tremor of bilateral upper limbs with or without rest tremor. Tremor may occur even if the plasma concentration of tacrolimus is within the therapeutic range. In this report, we highlight a case of tacrolimus-induced tremor, in which, in addition to having action and rest tremor of the upper limbs, the patient had vocal, lingual, and lower limb tremor. We demonstrate how drug cessation and temporary administration of primidone remarkably improved the tremor.
Resting-state functional connectivity in patients with minimally disabled Parkinson’s disease: A case-control study
Authors: Singh Mohit , Dev Rahul , Khokhar Sunil Kumar , Kumar Niraj , Saini Jitender , Saxena Sudhir
Published: May 2024

OBJECTIVE:

To assess the resting-state functional connectivity within the default mode network (DMN) and the whole brain in minimally disabled Parkinson’s disease (MiPD) patients and compare it with age- and gender-matched healthy controls (HCs).

METHODS:

Twenty-seven MiPD patients (Hoehn and Yahr score, H–Y = 1–3) and 21 HCs underwent resting-state functional magnetic resonance imaging. The data collected included demographic profiles of both groups along with duration of illness, age of PD onset, and the H–Y score in PD patients. The Fazekas scores were calculated in all PD patients and HCs. The region of interest (ROI) functional connectivity method was used to assess resting-state functional connectivity within DMN and whole brain using the CONN toolbox. A total of 132 ROIs were selected in the whole brain using the Harvard Atlas.

RESULTS:

The mean age, gender, and median Fazekas scores in both groups were comparable. Mean (±SD) age of PD onset in patients was 52.92 ± 8.32 years. The median (range) H–Y score was 2 (1–3). Regions of increased functional connectivity were observed in the whole-brain analysis in the MiPD group. Four ROI pairs showed increased functional connectivity in the MiPD group compared to HCs (p < 0.001), prominently involving the frontoparietal, cerebellar, and basal ganglia region. Functional connectivity within DMN was comparable between the two groups.

CONCLUSION:

Compared to age- and gender-matched healthy controls, MiPD patients showed increased functional connectivity in selected regions, in particular, those involving the precuneus, thalamus, pallidum, and vermis, which may be related to initial compensation in PD.
Adverse effects of medications used to treat motor symptoms of Parkinson's disease: A narrative review
Authors: Mishal Bhushan , Shetty Akash , Wadia Pettarusp
Published: May 2024

BACKGROUND:

In the 1960s, levodopa was first administered to treat the symptoms of Parkinson’s disease (PD), and it has since become the “gold standard” in its treatment. Since then, many classes of drugs have been made available to treat PD; however, these drugs are associated with considerable adverse effects.

OBJECTIVE:

The objective of this review is to highlight the most important and clinically relevant side effects of the medications used to treat the motor symptoms of PD.

MATERIAL AND METHODS:

We used PubMed and Google scholar to search for articles from January 1975 to January 2021.

RESULTS:

The medications used to treat PD vary in their mechanisms of action. The major classes of drugs that are used include levodopa and dopamine agonists. Nausea, vomiting, sleepiness, and neuropsychiatric and cardiovascular problems are some of the most common adverse effects observed. In addition, class-specific adverse effects of various drugs are observed and are important.

CONCLUSIONS:

The drugs used to treat PD are associated with considerable adverse effects, which may be mild, severe, or even life threatening. Most adverse effects are reversible and disappear with drug withdrawal. However, discontinuation of the drugs may not always be possible. Education of the patient and caregiver and awareness among clinicians is essential for early recognition and to prevent impairment of the quality of life. In addition, the development of new drugs with a favorable side effect profile should be prioritized.
Vascular Parkinsonism and Parkinson’s disease
Authors: Rath Shivani , Kumar Anand , Pathak Abhishek , Verma Ashish , Singh Varun K. , Chaurasia Rameshwar N. , Mishra Vijay N. , Joshi Deepika
Published: May 2024

BACKGROUND:

Vascular parkinsonism (VP) is an atypical Parkinsonian syndrome that is believed to have a temporal association with cerebrovascular disease. However, now it is evolving as a heterogeneous entity with no clear consensus on the definition and diagnostic criteria.

AIM AND OBJECTIVES:

This study aimed at evaluating the clinico-radiological profile of patients with VP and Parkinson’s disease (PD).

MATERIALS AND METHODS:

The present study was conducted at a tertiary care university hospital. A total of 80 patients, with a diagnosis of probable VP (40) and PD (40), were evaluated and compared with Unified Parkinson’s Disease Rating Scale (UPDRS) part III, gait scale, Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), and MRI brain.

RESULTS:

Significantly older age of onset (P = 0.005), higher vascular risk factors (P < 0.001), and motor scores in UPDRS part III (P < 0.001), gait scale (P < 0.001), and modified Hoehn and Yahr (P < 0.001) were seen in the VP as compared with the PD. On the cognitive scales, patients with VP scored significantly lower in MMSE (19.92 ± 6.0 vs. 24.90 ± 3.34; P < 0.001) and FAB (7.75 ± 4.27 vs. 11.22 ± 2.75; P < 0.001); on the modified Hachinski scale (7.77 ± 3.19 vs. 3.30 ± 1.97; P < 0.001), they scored higher compared with patients with PD. Periventricular ischemic changes, generalized brain atrophy, and multiple lacunar infarcts were the most common radiological abnormality found significantly more in patients with VP.

CONCLUSION:

An older age, worse cognitive scores and motor scores, and more profound periventricular and subcortical lesions on MRI favored VP.
Ondansetron for the treatment of Parkinson’s disease psychosis: Rationale and literature review
Authors: Kaur Jaslovleen , Lenka Abhishek , Isaacson Jonathan R , Isaacson Stuart H
Published: May 2024

Psychosis is a debilitating non-motor symptom of Parkinson’s disease that commonly manifests with illusions, presence/passage hallucinations, and well-formed visual hallucinations. Parkinson’s disease psychosis (PDP) is associated with several negative repercussions such as increased caregiver distress and high rates of nursing home placement, healthcare expenditure, and mortality. Several neurotransmitters have been implicated in the pathogenesis of PDP; these include dopamine, acetylcholine, and serotonin. Most antipsychotics have a variable degree of dopamine-blocking property that may worsen parkinsonism or result in the emergence of other drug-induced movement disorders. Therefore, atypical antipsychotics with minimal dopamine-blocking property (quetiapine, clozapine) are commonly prescribed to treat PDP. Pimavanserin, which modulates serotonergic transmission (5-HT2A inverse agonist), is the only drug approved by the US Food and Drug Administration to treat PDP; however, it is not globally available. Therefore, it is crucial to continue the search for effective pharmacotherapy of PDP. Other serotonergic targets of interest include selective 5-HT3 receptor antagonist ondansetron. Licensed for use as an antiemetic, open-label studies on ondansetron in the 1990s have shown encouraging results in the treatment of hallucinations in PD. However, ondansetron was not further studied in PDP as it was cost-prohibitive. In this article, we highlight the role of abnormal serotonergic transmission in the pathogenesis of PDP, revisit the studies that investigated the role of ondansetron in treating PDP, and discuss its potential as an effective therapeutic option for PDP.
Impact of the COVID-19 pandemic on patients with Parkinson's disease and other movement disorders
Authors: Rakesh Kempaiah , Bhattacharya Amitabh , Ganaraja Valakkunja Harikrishna , Kamble Nitish , Holla Vikram V. , Yadav Ravi , Pal Pramod Kumar
Published: May 2024

INTRODUCTION:

The coronavirus disease-19 (COVID-19) pandemic is a global health crisis that has directly and indirectly impacted almost all populations globally. In this study, we aimed to study the impact of the COVID-19 pandemic on motor and nonmotor symptoms in patients with various movement disorders who visited our outpatient department.

MATERIALS AND METHODS:

We conducted a prospective study using a structured questionnaire involving patients who visited our outpatient department during the COVID-19 pandemic from May 2020 to April 2021. The study was conducted at the Department of Neurology at the National Institute of Mental Health and Neuro Sciences, Bangalore.

RESULTS:

A total of 208 patients with the following disorders were assessed: Parkinson's disease (n = 141), atypical parkinsonism (n = 31), dystonia (n = 15), Wilson's disease (n = 5), and other disorders (n = 16). Approximately, 3.5% of the patients had acquired the COVID-19 infection. Almost 80% of the patients had missed scheduled appointments with their physicians during this study period due to travel restrictions or the fear of traveling. Approximately, 50% of the patients experienced worsening of their motor and nonmotor symptoms. Approximately, 25% of patients availed teleconsultation facilities, and majority of them found it to be equivalent to or better than in-person consultation. Almost 80% of the patients were eager to receive the COVID-19 vaccination.

CONCLUSION:

The COVID-19 pandemic resulted in worsening of both motor and nonmotor symptoms in patients with movement disorders. Teleconsultation is a helpful option in managing the patients’ symptoms during the pandemic.
Diabetic striatopathy
Authors: Ranjan Abhay , Mudassir Sanaullah , Sinha Neetu , Kumar Abhishek
Published: May 2024

OBJECTIVE:

Diabetic striatopathy (DS) is characterized by a hyperglycemic state associated with chorea/ballism, and/or striatal hyperdensity on computed tomography, or hyperintensity on T1-weighted magnetic resonance imaging. To date, there have been only a few case series reported in the literature on this topic. In the present study, we report four cases of DS associated with movement disorders.

METHODS:

The patients were recruited based on the presence of hyperglycemia associated with chorea/ballism or striatal hyperintensity on T1-weighted magnetic resonance imaging.

RESULTS:

Four patients with DS (two men and two women), with a mean age of 61 years, were included in our study. Three out of the four patients had a previous diagnosis of type 2 diabetes mellitus. The mean blood glucose level on admission and glycated hemoglobin were 390.25 mg/dl and 12.45%, respectively. Hemiballism was present in two patients: one patient had dystonia and the other had choreiform movement at presentation. The putamen was affected in all patients, with involvement of the globus pallidus and caudate nucleus in one patient. All patients had resolution of their abnormal movements after glucose-lowering therapy, with additional use of anti-chorea medication in three patients.

CONCLUSION:

DS should be considered in elderly patients who present with chorea/ballism/dystonia and should be accordingly managed with resolution of abnormal movements. In addition, dystonia can be a presenting symptom in DS.
Study of Impact of Stereotactic parameters on Microelectrode recording in Parkinson’s disease patients who underwent Subthalamic nucleus Deep brain stimulation
Authors: Kola Sruthi , Kandadai Rukmini Mridula , Alugolu Rajesh , Jabeen S Afshan , Borgohain Rupam
Published: May 2024

AIM:

To study the impact of trajectory parameters on Microelectrode recording during Subthalamic nucleus deep brain stimulation surgery in PD patients

MATERIALS AND METHODS:

This is a retrospective study. On the day of surgery MRI was taken with frame on which planning was done using stereocalc and navigation systems and final coordinates of X, Y, Z, mid sagittal angle, axial angles were obtained. During surgery Microelectrode recording (MER) was done and with bed side examination final lead placement decided. Impact of trajectory angles on MER was studied using appropriate statistical analysis.

RESULTS:

Among 40 patients studied,mean age of patients and duration of disease were 55.65years and 7.95 years. Mean UPDRS OFF and ON scores were 60.7 and 15.4 respectively and mean MOCA score was 26.6. Distribution of type of recording differs significantly across mid sagittal angles among <15o vs >15o (P <0.05). Group of <15o for midsagittal angle and >75o for axial angle had highest percentage (60%) showing no recording when compared to others. Significantly higher proportion of cases with higher duration of PD had higher incidence of no recording and vice-versa (P <0.05).

CONCLUSION:

The study found a correlation between approach angle and the quality of MER. Results showed that a midsagittal angle > 15o and an axial angle < 75o produced better MERs. Although not statistically significant, this could suggest approach angles may have a role to achieve good microelectrode recordings. Larger prospective studies may be helpful to understand this further.