bluuebunny/crossref_metadata_2025 huggingface dataset:
Weight Loss in Parkinson’s Disease: No Evidence for Role of Small Intestinal Bacterial Overgrowth
Authors: DiBaise John K. , Crowell Michael D. , Driver-Dunckley Erika , Mehta Shyamal H. , Hoffman-Snyder Charlene , Lin Tanya , Adler Charles H.
Published: November 2024

Background and Objective:

Weight loss and small intestinal bacterial overgrowth (SIBO) are common in Parkinson’s disease (PD). We aimed to study the relationship between weight loss and SIBO in PD.

Methods:

This was a cross-sectional study with a prospective, interventional component. Consecutive patients seen in the PD clinic who agreed to participate underwent extensive history, movement exam, SIBO breath testing and answered questionnaires. A subset of those in the weight loss group were treated with rifaximin for 14 days and returned 3 months later for an assessment of their weight, GI symptoms, quality of life and SIBO status. All analyses were adjusted for age and disease duration.

Results:

Fifty-one patients participated in the study; 37 without weight loss and 14 with weight loss. Total energy intake including the distribution of macronutrient intake was similar between groups while physical activity was less in those with weight loss. PD severity scores did not differ between groups; however, PD-specific quality of life scores were significantly worse for the summary index and the subscales of emotional well-being, social support and communication. The prevalence of constipation, dyspepsia and abdominal pain/discomfort was higher in those with weight loss. The prevalence of SIBO was 14% in the weight loss group and was not different between groups. Eight PD patients with weight loss were treated with rifaximin; no significant change in GI symptoms, quality of life or weight was seen 3 months later.

Conclusion:

Although a number of differences were identified in quality of life and gastrointestinal symptoms between groups with and without weight loss, SIBO was not associated with weight loss in patients with PD. Given the exploratory nature and small number of patients with weight loss, however, further study is suggested.
The Role of TMEM230 Gene in Parkinson’s Disease
Authors: Deng Hao , Fan Kuan , Jankovic Joseph
Published: November 2024

Parkinson’s disease (PD) is a common neurodegenerative disease whose pathogenesis remains unknown. TMEM230 gene, encoding a transmembrane protein in secretory and recycling vesicle, has been recently identified as a novel disease-causing gene of autosomal dominant PD with Lewy pathology and typical clinical symptoms. Although its mutation and variants seem to be rare in PD patients, functional studies have indicated that TMEM230 protein probably plays an important role in secretory and recycling pathway and may be involved in Lewy pathological mechanism. Here we summarize current genetic and functional reports about TMEM230 and focus on its relation with PD.
Structurally targeted mutagenesis identifies key residues supporting α-synuclein misfolding in multiple system atrophy
Authors: Reis Patricia M , Holec Sara AM , Ezeiruaku Chimere , Frost Matthew P , Brown Christine K , Liu Samantha L , Olson Steven H , Woerman Amanda L.
Published: November 2024

Background

Multiple system atrophy (MSA) and Parkinson's disease (PD) are caused by misfolded α-synuclein spreading throughout the central nervous system. While familial PD is linked to several α-synuclein mutations, no mutations are associated with MSA. We previously showed that the familial PD mutation E46K inhibits replication of MSA prions both in vitro and in vivo, providing key evidence to support the hypothesis that α-synuclein adopts unique strains in patients.

Objective

Here we sought to further interrogate α-synuclein misfolding to identify the structural determinants that contribute to MSA strain biology.

Methods

We engineered a panel of cell lines harbouring both PD-linked and novel mutations designed to identify key residues that facilitate α-synuclein misfolding in MSA. We also used Maestro in silico analyses to predict the effect of each mutation on α-synuclein misfolding into one of the reported MSA cryo-electron microscopy conformations.

Results

In many cases, our modelling accurately identified mutations that facilitated or inhibited MSA replication. However, Maestro was occasionally unable to predict the effect of a mutation, demonstrating the challenge of using computational tools to investigate intrinsically disordered proteins. Finally, we used our cellular models to determine the mechanism underlying the E46K-driven inhibition of MSA replication, finding that the E46/K80 salt bridge is necessary to support α-synuclein misfolding.

Conclusions

Our studies used a structure-based approach to investigate α-synuclein misfolding, resulting in the creation of a powerful panel of cell lines that can be used to interrogate MSA strain biology.
Numerical Prediction of the Steady-State Distribution Under Stochastic Resetting from Measurements
Authors: Roichman Yael
Published: November 2024

A common and effective method for calculating the steady-state distribution of a process under stochastic resetting is the renewal approach that requires only the knowledge of the reset-free propagator of the underlying process and the resetting time distribution. The renewal approach is widely used for simple model systems such as a freely diffusing particle with exponentially distributed resetting times. However, in many real-world physical systems, the propagator, the resetting time distribution, or both are not always known beforehand. In this study, we develop a numerical renewal method to determine the steady-state probability distribution of particle positions based on the measured system propagator in the absence of resetting combined with the known or measured resetting time distribution. We apply and validate our method in two distinct systems: one involving interacting particles and the other featuring strong environmental memory. Thus, the renewal approach can be used to predict the steady state under stochastic resetting of any system, provided that the free propagator can be measured and that it undergoes complete resetting.
AVID: Adapting Video Diffusion Models to World Models
Authors: Rigter Marc , Gupta Tarun , Hilmkil Agrin , Ma Chao
Published: November 2024

Large-scale generative models have achieved remarkable success in a number of domains. However, for sequential decision-making problems, such as robotics, action-labelled data is often scarce and therefore scaling-up foundation models for decision-making remains a challenge. A potential solution lies in leveraging widely-available unlabelled videos to train world models that simulate the consequences of actions. If the world model is accurate, it can be used to optimize decision-making in downstream tasks. Image-to-video diffusion models are already capable of generating highly realistic synthetic videos. However, these models are not action-conditioned, and the most powerful models are closed-source which means they cannot be finetuned. In this work, we propose to adapt pretrained video diffusion models to action-conditioned world models, without access to the parameters of the pretrained model. Our approach, AVID, trains an adapter on a small domain-specific dataset of action-labelled videos. AVID uses a learned mask to modify the intermediate outputs of the pretrained model and generate accurate action-conditioned videos. We evaluate AVID on video game and real-world robotics data, and show that it outperforms existing baselines for diffusion model adaptation.1 Our results demonstrate that if utilized correctly, pretrained video models have the potential to be powerful tools for embodied AI.
signwriting-evaluation: Effective Sign Language Evaluation via SignWriting
Authors: Moryossef Amit , Zilberman Rotem , Langer Ohad
Published: November 2024

The lack of automatic evaluation metrics tailored for SignWriting presents a significant obstacle in developing effective transcription and translation models for signed languages. This paper introduces a comprehensive suite of evaluation metrics specifically designed for SignWriting, including adaptations of standard metrics such as BLEU and chrF, the application of CLIPScore to SignWriting images, and a novel symbol distance metric unique to our approach. We address the distinct challenges of evaluating single signs versus continuous signing and provide qualitative demonstrations of metric efficacy through score distribution analyses and nearest-neighbor searches within the SignBank corpus. Our findings reveal the strengths and limitations of each metric, offering valuable insights for future advancements using SignWriting. This work contributes essential tools for evaluating SignWriting models, facilitating progress in the field of sign language processing. Our code is available at https://github.com/sign-language-processing/signwriting-evaluation.
Association of Franciscana (Pontoporia blainvillei) Occurrence with the Doce River Plume
Authors: Barreto Jonathas , Vianna Ana Júlia , Di Giacomo Amanda , Ribeiro Camila , Xavier César , Venturini Daniel , Teixeira João Batista , Freire Jordana Borini , Hoffmann Lilian Sander , Rocha Marcos Eduardo , Barcelos Nelson , Bride Thamires , Tagliacarne Victoria , Martins Agnaldo
Published: November 2024

_Pontoporia blainvillei_, known as the franciscana, is a small dolphin endemic to the Southwestern Atlantic. The collapse of the mining tailings dam in Mariana in 2015 altered the ecosystem dynamics near the mouth of the Doce River, an ecologically crucial area for the species that is both genetically and geographically isolated. Using drone monitoring of an isolated and threatened population of franciscan dolphins, we analyzed the relationship between the Rio Doce sediment plume and the occurrence of this species in the region. Franciscana sightings outside the plume were significantly higher compared to those inside the plume. With the arrival of the tailings plume, there was a considerable increase in sediment load, potentially causing acoustic attenuation.
Pemberdayaan Usaha Kecil Puding Kelengkeng Berbasis Digitalisasi Di Desa Simoketawang
Authors: Natasya Fathya Jihan , Eko Pujianto Wahyu
Published: November 2024

Sektor Industri perlu meningkatkan keterampilan pemasaran mereka agar dapat unggul serta bersaing dengan UMKM lainnya dengan meningkatkan keterampilan pemasaran melalui digital. Lokasi pengabdian masyarakat terletak di Desa Simoketawang, kelurahan Tawangsari. Desa Simoketawang Kecamatan Wonoayu Kabupaten Sidoarjo merupakan salah satu desa dengan destinasi wisata yaitu Kampung Kelengkeng. Salah satu masyarakat desa memanfaatkan kelengkeng tersebut untuk membuka usaha dimana buah kelengkeng ini dijadikan puding di mana usaha ini didirikan pada tahun 2019 dan sampai sekarang telah berjalan 4 tahun lamanya, pelaku UMKM bernama “Altdeev Kitchen” adalah Ibu Elif. Penelitian yang digunakan adalah penelitian Kualitatif dengan metode observasi, wawancara, praktik pelatihan kemudian ada dokumentasi pelatihan dengan membuat akun Instagram dan Facebook untuk usaha, desain logo kemasan, Tujuan dari pengabdian masyarakat ini adalah membantu UMKM puding kelengkeng ini agar dapat bersaing dengan UMKM lain yang sudah maju dengan digitalisasinya
Literasi Kesehatan dengan Pemantauan Glukosa Darah Mandiri Penderita Diabetes Mellitus Tipe 2
Authors: Adhania Fiona , Hasneli N Yesi , Damanik Siti Rahmalia Hairani
Published: November 2024

Latar Belakang: Literasi kesehatan adalah kemampuan seseorang untuk mengakses, memahami, dan menggunakan informasi kesehatan untuk mengambil keputusan yang tepat. Pada pasien DM tipe 2, literasi kesehatan membantu dalam praktik pemantauan glukosa darah mandiri (SMBG), yang memungkinkan pasien untuk memantau kadar glukosa dan menyesuaikan perawatan mereka sesuai kebutuhan.
Metode: Penelitian kuantitatif ini menggunakan desain deskriptif korelasi dengan pendekatan cross-sectional. Populasi penelitian ini adalah seluruh pasien diabetes melitus tipe 2 yang berkunjung ke poli penyakit dalam RSUD Arifin Achmad, Provinsi Riau. Dengan menggunakan teknik consecutive sampling, terpilih 111 responden. Alat ukur yang digunakan adalah kuesioner literasi kesehatan dan SMBG-Q (Self-Monitoring Blood Glucose Questionnaire). Data dianalisis dengan menggunakan uji Chi-square.
Hasil: Berdasarkan 111 responden, mayoritas responden memiliki literasi kesehatan yang tinggi yaitu 69 orang (62,2%), dan responden dengan literasi rendah sebanyak 42 orang (37,8%). Mayoritas responden memiliki SMBG yang baik yaitu 79 orang (71,2%), dan memiliki SMBG yang kurang baik yaitu 32 orang (28,8%). Terdapat hubungan yang signifikan antara literasi kesehatan dengan self monitoring glukosa darah pada pasien diabetes melitus tipe 2 dengan nilai p-value (0,000) < alpha (0,05).
Kesimpulan: Literasi kesehatan yang memadai akan meningkatkan kemampuan pasien dalam menerima informasi terkait perawatan DM, sehingga menghasilkan pemahaman yang baik. Pemahaman yang baik akan menghasilkan SMBG yang baik. Penelitian ini dapat menjadi dasar bagi perawat untuk menilai tingkat literasi kesehatan pasien sebelum menentukan rencana intervensi keperawatan.
АСИМІЛЯЦІЯ ТРУДОВИХ МІГРАНТІВ ТА ІНСТРУМЕНТИ ЇХ ПІДТРИМКИ
Authors: Зайченко Катерина
Published: November 2024

У статті розглянуто основні аспекти асиміляції трудових мігрантів та інструменти їх підтримки. Визначено фактори, що мають суттєвий вплив на сталість підвищення кількості міжнародних мігрантів у світі. Відзначено причини збільшення кількості трудових мігрантів та частки трудових мігрантів у загальній кількості мігрантів працездатного віку, в той час як кількість працездатного віку навпаки зменшується. Висвітлено підходи до визначення поняття «асиміляція» вітчизняними та зарубіжними науковцями та її особливості. Вітчизняні вчені переважно розглядають її сутність у контексті соціології, етнології та культурних студій як процес інтеграції; зарубіжні – як процес інтеграції з повною або частковою втратою певних національних особливостей. Розглянуто складові асиміляції та визначено її інструменти підтримки трудових мігрантів відповідно до них.
ВЕРИФІКАЦІЯ ПРОГНОЗНОЇ ІНФОРМАЦІЇ В КОРПОРАТИВНИХ ЗВІТАХ КОМПАНІЙ
Authors: Коцупал Олександр , Уманців Галина
Published: November 2024

Стаття присвячена питанням достовірності прогнозної інформації, наведеної в корпоративних звітах компаній. Одним із ключових структурних елементів корпоративної (інтегрованої) звітності, визначених Міжнародною концептуальною основою інтегрованої звітності є інформація про перспективи на майбутнє, тобто інтегрований звіт повинен відповідати на питання, які перешкоди та невизначеності можуть виникнути в компанії при реалізації її стратегії, потенціальні наслідки її бізнес-моделі та майбутньої діяльності. Оприлюднення компаніями корпоративної звітності може викликати сумніви щодо правдивості задекларованих намірів і правильності формування наданої інформації, в тому числі прогнозної. Це стосується як фінансових, так і нефінансових відомостей. Враховуючи, що звіт використовується переважно зацікавленими групами користувачів, факти та судження, що містяться у звіті, будуть проаналізовані у контексті інформації, доступної цим групам. Перевірка достовірності інформації стає важливим фактором, враховуючи швидкість поширення інформації та пов’язані з нею репутаційні ризики.
ПРОБЛЕМНІ АСПЕКТИ ДЕРЖАВНОГО РЕГУЛЮВАННЯ ЗАЙНЯТОСТІ В КОНТЕКСТІ ГЛОБАЛІЗАЦІЇ
Authors: Арістаров Євген , Квятковська Любов , Кришан Олексій
Published: November 2024

У статті досліджуються основні проблемні питання, які виникають у процесі реалізації політики державного регулювання зайнятості в умовах глобалізації. В умовах швидких змін на ринку праці, зумовлених технологічними інноваціями, автоматизацією та цифровізацією, уряди стикаються з новими викликами. Основна увага приділяється оцінці ефективності існуючих програм регулювання зайнятості, зокрема програм перекваліфікації, їх здатності відповідати потребам сучасного ринку. Дослідження також розглядає соціальні аспекти зайнятості, виявляючи найуразливіші групи населення та програми підтримки для їх адаптації. Важливим є вивчення співпраці між державою, бізнесом і навчальними закладами, а також вплив міжнародних угод на локальні ринки праці. Екологічні фактори також враховуються в контексті сталого розвитку. Результати можуть стати основою для розробки практичних рекомендацій щодо підвищення ефективності державного регулювання зайнятості, включаючи залучення громадськості до цього процесу.
Exclusive Breastfeeding in Lesotho: Influences, Barriers, and The Role of Informal Networks
Authors:   UNICEF, UNICEF Lesotho Country Office, Ferreira Sonia Mairos , Mathule Lineo ,   UNICEF, UNICEF Lesotho Country Office, Muthengi Kimanzi ,   UNICEF, UNICEF Lesotho Country Office
Published: November 2024

Abstract: This research investigated maternal and infant care in Lesotho, with an emphasis on exclusive breastfeeding practices during the first year of life. A quantitative, descriptive survey included 97 mothers attending healthcare facilities. The findings highlighted a prevalent preference for exclusive breastfeeding in the initial three months, which decreases during the following 3 months. Yet around 7% introduced complementary foods or fluids early on and many did not breastfeed exclusively until the 6-month recommended period. The majority began breastfeeding within the recommended one-hour post-delivery window. Distinct decision-making dynamics emerged: nearly half of the mothers made autonomous feeding decisions, around a quarter collaborated with the child’s father or partner, and 11.3% involved extended family in these choices. Colostrum's recognized value as a newborn's first nutrient source aligned with global health recommendations. However, the early introduction of other foods indicates a need to explore mothers’ beliefs and knowledge about feeding practices further. Common breastfeeding challenges encompassed issues like sore nipples and perceived milk insufficiency, underlining the importance of educational support. Healthcare professionals, especially nurses, played a key role in offering guidance and support on breastfeeding. The frequent practice of immediate skin-to-skin contact post-birth emphasized the trend toward promoting early bonding and breastfeeding initiation. Furthermore, the community’s positive reception to public breastfeeding signaled societal acceptance. In conclusion, this study illuminates the nuances of breastfeeding practices and decision-making in Lesotho, providing insights into interventions and policies to enhance maternal and child health in the country.

Keywords: Decision-making, Exclusive Breastfeeding, Parental Autonomy, Support Systems
What is Jesus’ Definition of a Disciple Embedded in the Great Commission?
Authors: Ogden Greg
Published: November 2024

Any conference on discipleship must be rooted in the biblical definition of a disciple. When Jesus commands us to “make disciples,” who or what exactly are we making? What does a disciple look like? We need to look no further than the definition embedded in Jesus’ original mandate known as the Great Commission (Matt 28:16-20). There is a precise structure to this text which gives us the basic characteristics of a disciple. We find here a singular imperative, “make disciples.” What is often overlooked is that this central command is modified by three participles, “going,” “baptizing,” and “teaching.” Participles are verbal adjectives (descriptive images) ending in “ing” that describe the nature of a disciple. In this presentation, I will contrast the popular definition of a Christian with the biblical definition of a disciple. Christians, as commonly understood, are those who have trusted Christ for their salvation and believe that they will be with Jesus when they die. In other words, we have, perhaps unwittingly said, “You can be Christian without being a disciple.” The “gospel” we have been proclaiming has led directly to a non-discipleship or “forgiveness only” gospel. Bill Hull and Ben Sobels assert two truths: 1. You cannot make a Christlike disciple from a non-discipleship gospel. 2. The gospel you preach determines the disciples you make. In contrast, I will note that the three descriptive participles of “going,” “baptizing,” and “teaching,” when fleshed out, contain within them Jesus’ definition of a disciple. This is further underscored by the gospel Jesus proclaimed as recorded in Mark’s gospel at the inception of Jesus’ ministry: “Now after John was arrested, Jesus came into Galilee, proclaiming the gospel of God, and saying, ‘The time is fulfilled, and the kingdom of God is at hand, repent and believe in the gospel’” (Mk 1:14-15).
“Tüm” (Kull) Kavramı ve Geçmişe Matuf Varlıklar Zincirine Dair Hükme Etkisi: İbn Teymiyye Metinleri Üzerinden Bir Okuma
Authors: Özaykan Cihan
Published: November 2024

Bu çalışmada, İbn Teymiyye’nin (ö. 728/1328) evrene matuf varlıklar zincirine verdiği hükmün, benimsediği “tüm” (kull) kavramıyla ilişkisi ele alınmıştır. Daha önce yapılan İbn Teymiyye araştırmalarında işlenmediği anlaşılan bu konu temelinde İbn Teymiyye, “Ortak nitelik/ler taşıyan fertlerden oluşan her bütün (cümle) veya toplam (mecmūʿ), tümel (kullī) olarak tümü vermek zorunda mıdır?” sorusuna muhatap kılınmaktadır. İbn Teymiyye’nin bu soruya verebileceği muhtemel yanıta, metinleri üzerinden ulaşılmaya çalışılmaktadır. Böylece evrenin kıdemi yahut hudûsuna yönelik İbn Teymiyye’nin verdiği hükmün mantıksal bir yönünü irdeleyen çalışma, öncelikle bütün ve tümel kavramlarını ele almakta ve aralarındaki farkları vazetmektedir. Çalışma, tek bir tümün farklı itibarlarla hem bütün hem de tümel olarak değerlendirilebileceğini fakat bu iki tüm türü arasında kategorik bir geçişliliğin ve indirgemenin olamayacağını belirtmektedir. Çalışmada son olarak, İbn Teymiyye’nin geçmişe dönük evrene matuf varlıklar zincirine, tümün bir türü açısından kadim hükmünü verdiği, diğer bir tüm türü açısından ise hâdis hükmünü verdiği ortaya konulmakta ve meselenin salt akledilir kavramların dışsal entiteler olarak görülmesiyle ilgili yönüne ve bu yönün evrene dair hüküm ile ilişkisine işaret edilmektedir.
Ok-Dinî Tutum Ölçeği-G: Genişletilmiş Versiyon
Authors: Ok Üzeyir
Published: November 2024

Dindarlık kuramsal olarak çok boyutlu bir kavramdır. Dindarlığın bu çok boyutluluğu nedeniyle ölçümünü gerçekleştiren veri toplama araçlarının güçlü psikometrik özelliklere sahip olması bir zorunluluktur. Bu çalışmanın amacı 2011 yılında yayımlanmış olan her biri iki madde ile ölçülen dört boyutlu Ok-Dinî Tutum Ölçeğini genişletmektir. Bu amaçla mevcut dinî tutum ölçeğine dindarlığın farklı boyutlarını ölçebileceği düşünülen 66 madde (toplam 74) eklenmiştir. Taslak ölçek formu çevrim içi ve yüz yüze veri toplama yöntemiyle ulaşılan 358 gönüllü (91 Erkek ve 259 kadın, 8 cinsiyet belirtmeyen) tarafından doldurulmuştur. Yürütülen açımlayıcı faktör analizi, madde analizi ve doğrulayıcı faktör analizi sonuçlarına göre dinî tutumu her biri 4 maddeden oluşan (biri 6 madde) en iyi 6 boyutun temsil ettiği belirlenmiştir. Bu boyutlar sırayla itikat, grup aidiyeti (dinî sosyal kimlik), bağlanma, kutsallık, deneyim (duygu) ve pratikler olarak isimlendirilmiştir. Söz konusu ölçeğin kriter geçerliliği onun önceki ölçekte kullanılan maddelerle ilişkisine bakılarak belirlenmiştir. Gerek güvenirlik göstergeleri gerek alt boyutların kendi aralarındaki ilişkilerine bakıldığında geliştirilen Ok-Dinî Tutum Ölçeğinin genişletilmiş formunun bilimsel olarak güçlü veya iyi ölçütlere sahip kapsamlı bir ölçüm aracı olduğu ileri sürülebilir.
Clinical Profile of COVID-19 Patients Admitted in a COVID Designated Hospital
Authors: Ghimire Pukar , Pokharel Anuradha , Aryal Prakash , Bhandari Rajan , Bhandari Bibek
Published: November 2024

Background: Pandemic of COVID-19 has engulfed Nepal as well. In this paper, we studied the demographic, clinical, laboratory findings as well as the treatment modalities, prognostic factors and outcome of patients admitted with COVID-19.Methods: This was an observational cross-sectional study that included all patients admitted to the General Medicine Department of College of Medical Sciences, Bharatpur, during the first wave of COVID-19 from April 2020 to February 2021 after obtaining the ethical clearance. Data analysis was done using statistical packages for social sciences version 16.Results: A total of 119 patients with mean age of 61.5 years were admitted. They had a mean duration of onset of symptoms of 7.1 days. Commonest symptoms were fever (70.6%), cough (67.2%) and dyspnea (64.7%). Severe COVID-19 at admission with a median CT severity score of 15 was found in 49.7% of them. Total 83.2% patients required ICU care and 10.9% required mechanical ventilation. ARDS and secondary infection occurred in 17.6% each. Median length of hospital stay was 6 days. In total, 56.3% recovered 27.7% left against medical advice and 16.0% expired. Severity of COVID at admission, CT severity score at presentation and D-dimer at admission were found to be significantly associated with mortality (P<0.05).Neither of the age, duration of illness, CRP at admission nor the use of remdesivir or convalescent plasma had significant relation with the mortality (P>0.05).Conclusions: Severity of illness at presentation, CT severity score and D-dimer level at admission are significantly associated with mortality of the patients admitted with COVID-19.Keywords: COVID-19; prognosis; SARS-CoV-2
Internet Gaming Disorder and Aggression among Students on School Closure during COVID-19 Pandemic
Authors: Joshi Alisha , Sharma Kalpana , Sigdel Dipa , Thapa Taniya , Mehta Rajkumar
Published: November 2024

Background: The Corona Virus Disease (COVID-19) pandemic has significantly disrupted the regular school-going activities of the students, predominantly increasing internet gaming activities to endure significant stress. Excessive involvement in internet gaming brings deviant behaviour, especially aggression among the students. Hence, this study aimed to assess the internet gaming disorder and aggression among the students on school closure during COVID-19 pandemic in Chitwan, Nepal.Methods: A web-based cross-sectional survey was conducted among 417 students from secondary and higher secondary level who studied in two private schools of Chitwan district. Sample were selected using simple random sampling technique and structured questionnaire, i.e. Internet gaming disorder scale- short form (IGDS9-SF) and Aggression questionnaire (Buss & Perry, 1992) were used to collect the data via web-based through Google Form. Obtained data were analysed using descriptive and inferential statistics. Results: Out of 417 students, the mean age was 17 (±1.411) years, 278 (66.7%) were male and 150 (36.0%) were studying in twelve standard. Majority of students 405 (97.1%) were non-disordered gamers whereas only 12 (2.9%) students were disordered gamers. Students’ overall aggression score was 57.79% where the verbal aggression score was higher (66.33%) followed by hostility (61.41%) and anger (56.80%). Further significant positive relationship was found between scores on online gaming disorders and aggression (r=0.239, p<0.001). Conclusions: Internet gaming disorder and aggression are common among the students during COVID-19 pandemic. Therefore, educational institutions and concern authorities need to organize awareness programs and effective psychosocial intervention approaches for students to enhance the knowledge regarding harmful use of internet game, IGD, to cope with stress and aggression as well as to enhance the adoptive behaviour.Keywords: Aggression; COVID-19 pandemic; internet gaming disorder.
Significance of Hematological Biomarkers in Association to Syphilitic Patients
Authors: Chand Arun Bahadur , Basnet Ajaya , Shrestha Lok Bahadur , Sen Bindu , Priyadarshinee Anamika , Amatya Isha , Rajbanshi Bijendra Raj
Published: November 2024

Background: Venereal syphilis is a sexually transmitted disease, involving pathological activities mediating tissue destruction by extensive tissue necrosis. As such, the goal amongst researchers has been set to the identification of effective laboratory biomarkers that can reflect the broad spectrum of disease and ultimately aid in timely diagnosis and effective treatment of syphilis. This research aimed to study the applications of hematological biomarkers associated with syphilitic patients visiting a tertiary care hospital. Methods: A retrospective cross-sectional study was conducted in the syphilitic patients attending KIST Medical College and Teaching Hospital, Lalitpur, Nepal. A total of 25 syphilitic patients and 41 non-syphilitic participants were included. The rapid plasma reagin test and Treponema pallidum hemagglutination assay were used for the screening and confirmation of syphilis respectively. The hematological investigation was performed using a hematology analyzer. Statistical Package for Social Science version 17.0 was used for data analysis. A P value <0.05 was considered significant.Results: Syphilitic patients showed significantly elevated levels of lymphocytes (39.8±11.5) (p=0.025), monocyte (1.9±0.8) (p=0.002), mean corpuscular volume (MCV) (92.6±12.9) (p=0.005), and mean corpuscular hemoglobin (MCH) (31.9±4.6) (p=0.008) and lowered levels of red blood cell (RBC) (4.2±0.3) (p=0.005) and platelets (237.2±628.6) (p=0.048) as compared to the lymphocytes (32.9±11.9), monocyte (0.6±1.2), MCV (83.9±8.8), MCH (34.3±1.5), RBC (4.6±0.7), and platelets (280.9±113.3) of the non-syphilitic participants. Conclusions: The results showed that the elevated levels of lymphocyte, monocyte, MCV, and MCH and lowered levels of RBC and platelets are highly specific hematological biomarkers for the diagnosis of patients with syphilis.Keywords: Hematological biomarkers; sexually transmitted disease; syphilis
Overuse of Intravenous Proton Pump Inhibitors in General Medicine and Surgery Wards
Authors: Shah Jay N , Shah Jenifei , Sharma Pawan , Shah Jesifei , Pandey Ashim , Joshi Chunauti , Adhikari Devesh , Gurung Grisha , Khatri Kalpashri , Basnet Lisa , Shah Shailendra , Dahal Romi , Lamichhane Deep
Published: November 2024

Background: Overuse of stress ulcer prophylaxis is prevalent globally despite guidelines leading to the added cost, especially the intravenous proton pump inhibitor (IVPPI). This study aims to analyze the prevalence of such overuse and be aware of rational use which may help develop local guidelines.Methods: This study analyzed the prospectively collected data on IVPPI use in adult patients in general wards of medicine and surgery at Patan Hospital, Patan Academy of Health Sciences, Nepal, from April-Jun 2022. Ethical approval was obtained. Variables analyzed were the patient's age, gender, history of peptic ulcer disease, risk for stress ulcer and gastrointestinal bleeding, the status of nil per os (NPO ?12 hours), appropriate use of IVPPI, and cost. Results: Prevalence of IVPPI use was 36.24% (274/756 admissions), surgery 39.45(189/479), medicine ward 30.68% (85/277). The mean age was 43.1 ±18.6 years, males 113(41.2%), surgery 189 (69%). Inappropriate overuse in 253(92.3%, significantly more in surgery-182 than medicine-7, p=0.001. Appropriate use was in 21 (7.7%, i.e., NPO-15, NPO + gastrointestinal bleed, and NPO + non steroid anti-inflammatory drugs each 3).Conclusions: Prevalence of IVPPI use was 36.24%. Inappropriate overuse of IVPPI was high (92.2%, 253/274), more in surgery. The nil per os status was the main reason for appropriate use of IVPPI. Keywords: Acid suppression therapy; cost; general medical surgical ward; intravenous proton pump inhibitor; stress ulcer prophylaxis guideline.
Prostatic Urethral Length as a Predictor for Surgery in Benign Prostatic Hyperplasia
Authors: Basnet Surendra , Shrestha Parash Mani , Shrestha Anil , Basnet Robin Bahadur , Regmi Probodh , Shah Chitaranjan , Shah Arvind Kumar , Mishra Udita , Adhikari Baikuntha
Published: November 2024

Background: Benign prostatic hyperplasia is associated with structural and morphological changes including elongation of prostatic urethral length. The aim of our study was to assess whether prostatic urethral length could predict need of surgery in patients with benign prostatic hyperplasia.Methods: This prospective observational study was conducted over a 12-months duration. All the patients who presented with lower urinary tract symptoms secondary to benign prostatic hyperplasia were evaluated with International Prostate Severity Score, serum Prostate Specific Antigen, Transrectal Ultrasound was done to measure prostatic urethral length, prostate volume, Intravesical prostatic protusion and Post-void Residual Urine. Patients not responding to medical treatment and complications secondary to benign prostatic hyperplasia underwent surgery. Logistic regression analysis was performed to identify risk factors associated with surgery. Results: A total of 153 patients were included in the study. Eighty-three (54.2%) patients underwent surgery during the study period. Prostate volume, intravesical prostatic protrusion, post-void residual volume, serum prostate specific antigen, and prostatic urethral length were significantly higher in the surgical group. The mean prostatic urethral length in the surgical group was 39.47 + 10.2 mm and in the nonsurgical group was 26.20 + 6.72 mm (p <0.0001). According to the ROC curve-based prediction of surgery, the area under the curve for PUL was 0.866 and the best cutoff value was 31.5mm (81% sensitivity and 84.3% specificity).Conclusions: BPH patients with longer PUL may require surgical management. PUL measured by TRUS may be a predicting factor for the need of surgery in BPHKeywords: Benign prostatic hyperplasia; lower urinary tract symptoms; prostatic urethral length.
Perceived Communication Barriers by Caregivers of Psychiatric Patients
Authors: Khatri Sushila , Samson Priscilla
Published: November 2024

Background: Caregivers have significant role in effective treatment and recovery during hospitalization. Communication barriers in health care lead to poor treatment outcome of patients and caregiver’s dissatisfaction. The aim of study was to find out perceived communication barriers by caregivers of psychiatric patients.Methods: A cross-sectional study was conducted among 120 caregivers of psychiatric patients admitted in psychiatric ward of Patan Hospital who were selected by purposive sampling and interviewed using self-developed structured questionnaire. Data was analyzed with SPSS version 16 using descriptive statistics and Chi- square test was used to find out association between personal characteristics of caregivers and extent of perceived communication barriers.Results: Low extent of communication barrier was perceived by 29.17%, great extent by 25.83%, moderate extent by 24.17% and no barriers were perceived by 20.83% caregivers. There was association between duration of hospital stay (p= .006) and extent of perceived communication barrier. Most barriers were due to caregiver’s related factors (31.2%) and least perceived barriers were due to environment related factors (17.1%).Conclusions: More than one fourth caregiver’s perceived low extent of communication barrier, almost one fourth perceived great extent and less than one fourth perceived moderate extent. There was association between duration of hospital stay and extent of perceived communication barrier. Effective communication may help to minimize perceived barriers resulting in better treatment outcome of patients and caregiver’s satisfaction. Most perceived barriers were due to caregiver’s related factors like feeling of not being educated, not knowing what to ask with health personnel, unaware of whom to approach and so on for which it is crucial to develop awareness among health personnel while delivering healthcare services. Nurses and doctors need to be effectively trained in communication skills to minimize various perceived barriers resulting in better treatment outcome and satisfaction.Keywords: Caregivers; communication barriers; therapeutic communication
Effects of COVID-19 Virus Infection on Pregnancy Outcomes: a Systematic Review and Meta-analysis
Authors: Pandit Upendra , Shrestha Niki , Khanal Gayatri
Published: November 2024

Background: Pregnant mothers are more susceptible to Corona Virus Diseases 2019 (COVID-19) during pandemic. Our aim was to find out the effects of the COVID-19 infection on pregnancy outcomes compared to mothers without COVID-19 diseases.Methods: The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) and obtained number of the Centre for review and Dissemination (CRD42021272321). The observational studies from September 1st to October 31, 2021 were searched with Medical Subject Heading (MeSH) term in the databases. A Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was followed. Certainty of the evidence were assessed using Grading of Recommendations Assessment Development and Evaluation (GRADEpro) approach.Results: Pregnant women with Polymerase Chain Reaction (PCR) positive group for COVID-19 were likely to have preeclampsia/eclampsia of Relative Risk (RR) and Confidence Interval (CI) (RR, 1.52; 95% CI, 1.14-2.02) respectively. Likewise, foetal distress (RR, 1.56; 95% CI, 1.31- 1.85, caesarean section (RR, 1.25; 95% CI, 1.10-1.42), postpartum haemorrhage (RR, 1.37; 95%CI, 1.00-1.88), moderate certainty of the evidence in ICU/high-dependency unit admission (RR, 4.92; 95% CI, 3.28- 7.38), preterm births (RR, 2.12; 95% CI, 1.10-4.08) and perinatal death (RR, 2.55; 95% CI, 1.64-3.95). Very wide CI on maternal death rate (RR 9.87; 95% CI, 3.10- 31.45) was observed compared to COVID-19 negative group.Conclusions: Pregnant mothers with COVID-19 positive diseases have a moderate certainty of the effect of admission to ICU/high-dependency unit, Preterm birth and perinatal death.Keywords: Childbirth; complications; COVID-19; maternal; neonates
Incidence and Predictors of Delirium After Cardiac Surgery
Authors: Bajracharya Smriti Mahaju , Baidya Rabin , Bhandari Sandip , Amatya Ashish G
Published: November 2024

Background: The overall purpose of this study was to determine the incidence and perioperative factors that predispose to cause delirium in postoperative cardiac surgery patients in our Intensive Care Unit.Methods: We performed a prospective, observational study. Following institutional review board approval, this study included 234 patients above the age of 18 years meeting the inclusion criteria for cardiac surgery in Shahid Gangalal National Heart Center from July 2018 to December 2018. Preoperative, intraoperative and postoperative data for possible risk factors were obtained. Daily assessment of delirium was done during Intensive Care Unit stay of the patient. Collected data were analysed by means of statistical software SPSS-21.Results: The incidence of delirium was 15.6% (35/224) in our study. Delirium was seen in 14 out of 58 (24.1%) patients with age >60 years which was found to be statistically significant. Preoperative risk factor for developing delirium were carotid artery disease and Hemoglobin level <10gm/dl. Intraoperative risk factor for developing delirium were blood transfusion, longer cardiopulmonary bypass time. Post-operative factors for developing delirium included longer Intensive Care Unit stay, mechanical ventilation time ,duration on inotropes , blood transfusion, use of non-invasive ventilation, sleep deprivation, use of intra-aortic balloon pump, Pao2<70.Conclusions: As shown in our study, delirium is a frequent occurrence in the cardiac surgical population. The incidence of delirium after cardiac surgery was 15.6%. Several risk factors pre-operatively like age>60 years, carotid artery disease, Hb<10gm/dl, intra-operative factors like longer cardiopulmonary bypass time, blood transfusion and post-operatively longer duration of Mechanical ventilation, Intensive Care Unit stay, blood transfusion, use of intra-aortic balloon pump and Non-invasive ventilation were found to be predictors of delirium.Keywords: Keywords: Cardiac surgery; delirium; risk factors
Primary Ovarian Pregnancy after Bilateral Tubal Sterilization
Authors: Lama Poonam , Jha Gautam , Amatya Indra Prasad
Published: November 2024

Tubal sterilization is considered a permanent method of contraception because it is highly effective. However, pregnancy can still occur following a successful procedure and such pregnancies are likely to be ectopic. Primary ovarian pregnancy is one of the rarest forms of ectopic pregnancy having incidence of 1/7000-1/40,000 in live births and 0.5-3% of all ectopic gestations. In this paper, we report a rare case of ovarian pregnancy after tubal sterilization.All women who are offered this procedure should always be educated about its failure rate. And in women presenting with acute abdomen, a prior history of tubal sterilization doesn’t preclude the possibility of ectopic pregnancy.Keywords: Contraception; ovarian pregnancy; tubal sterilization
Prediction of Hamstring Autograft sizes for Anterior Cruciate Ligament Reconstruction using Preoperative Magnetic Resonance Imaging
Authors: Shrestha Prakash , Singh Thapa Sunil , Mahara Deepak Prakash , Paudel Sharma , Lamichhane Arjun , Saud Tejendra
Published: November 2024

Background: The purpose of this study is to determine whether preoperative magnetic resonance image measurements can predict the hamstring tendon autograft diameter during anterior cruciate ligament reconstruction.
Methods: We prospectively evaluated Forty-two patients with anterior cruciate ligament injury who underwent reconstruction using hamstring tendon autograft. Preoperative diameters and cross-sectional areas of the hamstring tendons were estimated using magnetic resonance imaging of the knee. Intraoperative diameters of the hamstring tendon graft were measured using a cylindrical graft sizer. We used Pearson's correlation test to compare the Preoperative and intraoperative graft size measurements. A possible cutoff value for the hamstring graft size was determined using Receiver operating characteristic analysis.
Results: The mean age of the patient in the study was 27.5 ± 8.5 years. There were statistically significant correlations between preoperative and intraoperative hamstring tendon graft measurements (P < 0.001). Our study found 13.3 mm² cross-sectional area as the cutoff for predicting 7mm of quadrupled hamstring graft size with both sensitivity and specificity of 85.7 %, respectively.
Conclusions: We can conclude that preoperative magnetic resonance imaging measurements can predict the intraoperative graft size. This study can help in preoperatively planning for the graft choice.
Keywords: Anterior cruciate ligament (ACL), Hamstring graft, Magnetic resonance imaging (MRI), Prediction
Faculty Development Program in Nepalese Medical Schools: Past, Present, and Future Perspectives
Authors: Dhakal Ajaya Kumar , Adhikari Ramesh Kant
Published: November 2024

Teaching medical students is an art that requires expertise in the core content of the subject and specialized teaching techniques. Learning to teach medical students and teachers learning from those teachings themselves is a lifelong process. Short medical teacher training courses in various specialized teaching techniques lay the foundation for a positive teaching experience that can substantially impact medical education. The Faculty Development Program is one such training course for medical teachers, designed to be an essential step toward becoming a student-centered facilitator. This article sheds light on the current status and significance of the faculty development program in Nepalese medical education. It also offers suggestions and critical strategies to improve the program in the future with available resources and to integrate it further into medical education.Keywords: Faculty development program; medical education; Nepal; teacher training
Attitude towards Spirituality and Spiritual Care among Nurses of Bharatpur Hospital
Authors: Malla Shubhekshya , Ghimire Anita
Published: November 2024

Background: Understanding spirituality and spiritual care is a prerequisite for holistic care in nursing. Spirituality is an important dimension of human existence with a crucial role in health promotion. The objective of this study was to assess the level of attitude towards spirituality and spiritual care among nurses.Methods: A cross-sectional analytical study design was used among 208 nurses to assess attitude toward spirituality and spiritual care among nurses of Bharatpur Hospital. A pretested semi-structured, self-administered questionnaire was used to collect data from the respondents. The instrument spirituality and spiritual care rating scales were used. Collected data were coded and entered in Microsoft office excel and SPSS version 22 was used for analysis.Results: The finding of the study revealed that, out of 208 respondents, the majority (74.0%) of respondents were of age 20-29 years with a mean and SD of 28.2±5.510. Among all, 125(60.1%) respondents had a moderate attitude score of 32-62, 83(39.9%) had a high level of attitude score of 63-92, whereas 0.5% had a low level of attitude towards spirituality and spiritual care score (0-31).There is no statistically significant relationship between the level of attitude and socio-demographic variables.Conclusions: It is concluded that most of the respondents had a moderate level of attitude. In-service education and awareness on providing spiritual care among nurses needs to be focused.Keywords: Attitude; holistic nursing; nurses; spirituality.
Experience of Mindfulness Meditations Based on Stress Reduction among Undergraduate Nursing Students, Chitwan, Nepal
Authors: Pandey Bista Archana , Adhikari Jamuna , Shah Bimala Kumari , Poudel Kalpana , KC Bhagwati , Pandey Apsara
Published: November 2024

Background: Undergraduate nursing students are frequently vulnerable to stress during their education with a high rate of attrition. Mindfulness Mediations based on Stress Reductions have been found to promote psychological well-being and mental health among nursing students. Therefore, the objective of the study was to explore the experiences of Mindfulness among undergraduate nursing students. Methods: Qualitative Hermeneutic Phenomenology research design was adopted. Data were collected from under graduate nursing students from Chitwan Medical College, Institute of Medicine who had been practicing Mindfulness Meditation for 6 weeks. The duration of data collection was January to June 2022. Data were collected after obtaining ethical approval from Nepal Health Research Council. Focused Group Discussions were conducted to collect data by the researcher using the Focused Group Discussion guide in Nepali language. A total of three Focused Group Discussions was carried out among 12 participants in each Focused Group Discussion with a total of 36 participants. Data were analyzed by thematic analysis technique based on Giorgi’s qualitative data analysis technique.Results: Five developed themes were stress managed well in daily life and during examination time, present moment awareness and positivity, self-realization of inner peace and more self-acceptance, and feeling of developed future role for advocating mindfulness meditations.Conclusions: Mindfulness-based mediations have been found effective strategies among undergraduate nursing for the management of stress during daily living and during examinations, development of self-realization, increase inner peace, self-acceptance and developed skills for future role for advocating mindfulness meditations. Keywords: Mindfulness meditations; nursing students; stress.