bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFECT OF SPACE CHARGE ON THE FREQUENCY OF OSCILLATION IN POSITIVE-GRID OSCILLATORS
Authors: Chai Yeh  ,   Radio Research Institute National Tsing Hua University,Kunming.
Published: January 2022

In estimating the frequency of oscillation of a positive-grid oscillator, it isusually assumed that the space charge effect is negligible. Under this assumption, the potential distribution in the space between the plane-parallel electrodes is linear. Thus the electric field in the space is uniform and the average velocity of electrpn flight can be used to evaluate the frequency of oscillation. The presence of space charge affects the potential distribution in space so that the electric field in this region is no more constant. Hence more exact formula must be used to compute the frequency of oscillation. The calculation is further complicated by the fact that the anode potential is usually made slightly negative with respect to the cathode. In this case, the location of the virtual cathode at which the electrons turn back does not coincide with that if a straight line potential distribution were assumed. The predicated trequency of oscillation is about 10-20 percent lower than that if space charge were neglected.
Lipid kinases VPS34 and PIKfyve coordinate a phosphoinositide cascade to regulate retriever-mediated recycling on endosomes
Authors: Giridharan Sai Srinivas Panapakkam , Luo Guangming , Rivero-Rios Pilar , Steinfeld Noah , Tronchere Helene , Singla Amika , Burstein Ezra , Billadeau Daniel D , Sutton Michael A , Weisman Lois S
Published: January 2022

Cell surface receptors control how cells respond to their environment. Many cell surface receptors recycle from endosomes to the plasma membrane via a recently discovered pathway, which includes sorting-nexin SNX17, Retriever, WASH, and CCC complexes. Here, using mammalian cells, we discover that PIKfyve and its upstream PI3-kinase VPS34 positively regulate this pathway. VPS34 produces phosphatidylinositol 3-phosphate (PI3P), which is the substrate for PIKfyve to generate PI3,5P2. We show that PIKfyve controls recycling of cargoes including integrins, receptors that control cell migration. Furthermore, endogenous PIKfyve colocalizes with SNX17, Retriever, WASH, and CCC complexes on endosomes. Importantly, PIKfyve inhibition results in displacement of Retriever and CCC from endosomes. In addition, we show that recruitment of SNX17 is an early step and requires VPS34. These discoveries suggest that VPS34 and PIKfyve coordinate an ordered pathway to regulate recycling from endosomes and suggest how PIKfyve functions in cell migration.
Personalized computational heart models with T1-mapped fibrotic remodeling predict sudden death risk in patients with hypertrophic cardiomyopathy
Authors: O'Hara Ryan P , Binka Edem , Prakosa Adityo , Zimmerman Stefan L , Cartoski Mark J , Abraham M Roselle , Lu Dai-Yin , Boyle Patrick M , Trayanova Natalia A
Published: January 2022

Hypertrophic cardiomyopathy (HCM) is associated with risk of sudden cardiac death (SCD) due to ventricular arrhythmias (VAs) arising from the proliferation of fibrosis in the heart. Current clinical risk stratification criteria inadequately identify at-risk patients in need of primary prevention of VA. Here, we use mechanistic computational modeling of the heart to analyze how HCM-specific remodeling promotes arrhythmogenesis and to develop a personalized strategy to forecast risk of VAs in these patients. We combine contrast-enhanced cardiac magnetic resonance imaging and T1 mapping data to construct digital replicas of HCM patient hearts that represent the patient-specific distribution of focal and diffuse fibrosis and evaluate the substrate propensity to VA. Our analysis indicates that the presence of diffuse fibrosis, which is rarely assessed in these patients, increases arrhythmogenic propensity. In forecasting future VA events in HCM patients, the imaging-based computational heart approach achieved 84.6%, 76.9%, and 80.1% sensitivity, specificity, and accuracy, respectively, and significantly outperformed current clinical risk predictors. This novel VA risk assessment may have the potential to prevent SCD and help deploy primary prevention appropriately in HCM patients.
Exploring the potential biomarkers for prognosis of glioblastoma via weighted gene co-expression network analysis
Authors: Zhang Mengyuan , Zhou Zhike , Liu Zhouyang , Liu Fangxi , Zhao Chuansheng
Published: January 2022

Background

Glioblastoma (GBM) is the most common malignant tumor in the central system with a poor prognosis. Due to the complexity of its molecular mechanism, the recurrence rate and mortality rate of GBM patients are still high. Therefore, there is an urgent need to screen GBM biomarkers to prove the therapeutic effect and improve the prognosis.

Results

We extracted data from GBM patients from the Gene Expression Integration Database (GEO), analyzed differentially expressed genes in GEO and identified key modules by weighted gene co-expression network analysis (WGCNA). GSE145128 data was obtained from the GEO database, and the darkturquoise module was determined to be the most relevant to the GBM prognosis by WGCNA (r =  − 0.62, p = 0.01). We performed enrichment analysis of Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) to reveal the interaction activity in the selected modules. Then Kaplan-Meier survival curve analysis was used to extract genes closely related to GBM prognosis. We used Kaplan-Meier survival curves to analyze the 139 genes in the darkturquoise module, identified four genes (DARS/GDI2/P4HA2/TRUB1) associated with prognostic GBM. Low expression of DARS/GDI2/TRUB1 and high expression of P4HA2 had a poor prognosis. Finally, we used tumor genome map (TCGA) data, verified the characteristics of hub genes through Co-expression analysis, Drug sensitivity analysis, TIMER database analysis and GSVA analysis. We downloaded the data of GBM from the TCGA database, the results of co-expression analysis showed that DARS/GDI2/P4HA2/TRUB1 could regulate the development of GBM by affecting genes such as CDC73/CDC123/B4GALT1/CUL2. Drug sensitivity analysis showed that genes are involved in many classic Cancer-related pathways including TSC/mTOR, RAS/MAPK.TIMER database analysis showed DARS expression is positively correlated with tumor purity (cor = 0.125, p = 1.07e−02)), P4HA2 expression is negatively correlated with tumor purity (cor =−0.279, p = 6.06e−09). Finally, GSVA analysis found that DARS/GDI2/P4HA2/TRUB1 gene sets are closely related to the occurrence of cancer.

Conclusion

We used two public databases to identify four valuable biomarkers for GBM prognosis, namely DARS/GDI2/P4HA2/TRUB1, which have potential clinical application value and can be used as prognostic markers for GBM.
Association between perceived life stress and subjective well-being among Chinese perimenopausal women: a moderated mediation analysis
Authors: Li Xiangrong , Ren Zheng , Ji Tianliang , Shi Hong , Zhao Hanfang , He Minfu , Fan Xinwen , Guo Xia , Zha Shuang , Qiao Shuyin , Li Yuyu , Pu Yajiao , Liu Hongjian , Zhang Xiumin
Published: January 2022

Background

The impact of perceived life stress on subjective well-being has been well-established; while few studies have explored the mediating and moderating mechanisms of the association between perceived life stress and subjective well-being among perimenopausal women. This study is aimed at exploring the mediating effect of depressive symptoms and the role of interests/hobbies as a moderator in the association between perceived life stress and subjective well-being among perimenopausal women.

Methods

The participants were 1,104 perimenopausal women at the age of 40 to 60, who were asked to complete a paper-based questionnaire. A single item was used to measure self-perceived life stress and interests/hobbies. The Zung Self-rating Depression Scale (SDS) and Subjective Well-being Scale for Chinese Citizens (SWBS-CC) were applied to assess both depressive symptoms and subjective well-being. Multiple linear regression analysis and the PROCESS macro were adopted to analyse not only the mediating effect of depressive symptoms but also the moderating role of interests/hobbies.

Results

Perceived life stress was negatively associated with subjective well-being (B =  − 1.424, β =  − 0.101, P < 0.001). The impact of perceived life stress on subjective well-being was partially mediated by depressive symptoms (mediation effect = −0.760, 95% confidence intervals (CI) [−1.129, −0.415]). In addition, the interaction term between depressive symptoms and interests/hobbies was significantly related to subjective well-being (β =  − 0.060, P < 0.05), indicating moderating effect. Moderated mediation had a significant index (Index = −0.220, SE = 0.099, 95% CI [−0.460, −0.060]).

Conclusions

Perceived life stress was negatively related to subjective well-being. The impact of perceived life stress on subjective well-being was mediated by depressive symptoms. Besides, interests/hobbies moderated the indirect effect of depressive symptoms on the relationship between perceived life stress and subjective well-being.
CONOCIMIENTO DE LOS NIÑOS, NIÑAS Y ADOLESCENTES DEL ACOSO ESCOLAR EN UNA INSTITUCIÓN EDUCATIVA DE LA LOCALIDAD DE CIUDAD BOLÍVAR (COLOMBIA). UN APORTE DESDE ENFERMERÍA PARA LA RECONCILIACIÓN Y RECONSTRUCCIÓN DE LA PAZ
Authors: Alvarado Romero Herly Ruth , Norella Córdoba Diana , López María José , Villarraga Daniela , Ayala Johan , Pinzón Jocelyn , Rodríguez Liliana , Mondragón Edna Camila
Published: January 2022

Objetivo: Describir los conocimientos que tienen los estudiantes entre los 12 y 17 años frente al acoso escolar, en una institución educativa de la localidad de Ciudad Bolívar (Colombia)en el segundo semestre del 2020. Materiales y Método: Se desarrolló un estudio cualitativo con enfoque descriptivo exploratorio, con el fin de comprender experiencias y percepciones de la niñez y adolescencia con respecto al acoso escolar. Se llevó a cabo una encuesta con 134 niños entre los 12 y 17 años y un grupo focal de 12 participantes de distintas edades, pertenecientes a la institución educativa. El análisis y la sistematización de la información y la codificación se realizó utilizando el software Nvivo V.12. Resultados: luego del análisis cualitativo emergieron cuatro categorías: definiciones de acoso escolar, porqué se realiza el Acoso Escolar, reacciones frente al acoso escolar y lugares donde se realiza el acoso escolar. Conclusiones: A pesar de reconocer a través de las categorías cómo se realiza el Acoso Escolar, dónde se realiza y sus principales efectos, se evidenció como la definición de acoso en este estudio al igual que en la literatura no es única, el aspecto común es que es una forma de agresión. Se sigue reconociendo como primera causa del acoso escolar el manejo del poder justificándose desde razones económicas, aspecto físico, el género y su desarrollo durante el colegio. Desde Enfermería es importante liderar programas para la promoción de convivencia en paz, prevención de la aparición de este fenómeno y su reconocimiento temprano, con el fin de disminuir consecuencias graves y aportar a nuestra sociedad en búsqueda de reconciliación que se reflejará en una convivencia pacífica en las aulas; aspecto que se reflejará en futuros ciudadanos respetuosos de las diferencias y tolerantes en búsqueda de un país mejor.
CONOCIMIENTO Y SOBRECARGA DEL CUIDADOR PRINCIPAL DE PERSONA MAYOR DEPENDIENTE
Authors: Olarte Rueda Graciela , Largo Cardenas Yineth Cristina , León Acosta Deisy Lizeth , Sánchez Cubides Linda Sarid Del Rosio , Ríos Gómez Liliana Marcela
Published: January 2022

INTRODUCCIÓN: Los cuidadores son los encargados de brindar apoyo a las necesidades básicas de persona mayor. OBJETIVO: Determinar los conocimientos y sobrecarga en el cuidador principal de persona mayor dependiente del municipio de San Gil Santander. MATERIALES Y MÉTODOS: el estudio fue de tipo descriptivo, transversal, la muestra estuvo conformada por 50 cuidadores informales, la recolección de datos se realizó mediante los instrumentos de antecedentes demográficos, evaluación del conocimiento, índice de Katz para medir el grado de dependencia en el adulto mayor y la escala de Zarit para analizar el nivel de sobrecarga en el cuidador. RESULTADOS: El nivel de conocimiento de los cuidadores principales de persona mayor se encontró que el 66% conocen los beneficios de la alimentación, el 68% tienen una incapacidad severa y los cuidadores presentan una sobrecarga leve en 34%. CONCLUSIÓN: los cuidadores presentaron un déficit de conocimientos en técnicas de mecánica corporal, técnicas para manejo del estrés y en la importancia de la utilización de los elementos de protección personal, por otra parte, a los adultos mayores tenían una dependencia severa y los cuidadores presentaron una sobrecarga leve.
CALIDAD DE VIDA EN CUIDADORES INFORMALES DE PACIENTES CON ALZHEIMER TRAS IMPLEMENTACIÓN DE PROGRAMA MULTICOMPONENTE
Authors: Cerquera Cordoba Ara Mercedes , Tiga Loza Diana Carolina , Álvarez Anaya William Armando , Dugarte Peña Edwin , Plata Osma Leidy Johanna , Jaimes Espíndola Lisseth Rocío
Published: January 2022

INTRODUCCIÓN: el cuidado de un paciente dependiente tiene mayores implicaciones si el diagnóstico es la enfermedad de Alzheimer, su calidad de vida se ve afectada de manera considerable en los aspectos relacionados con la salud. OBJETIVO: evaluar el efecto de una intervención multicomponente y transdisciplinar en la calidad de vida relacionada con la salud en cuidadores informales de pacientes con Trastorno Neurocognitivo Mayor (TNC) tipo Alzheimer. MÉTODOS: participaron 50 cuidadores informales de pacientes con Alzheimer, empleando el cuestionario SF-36, mediante un ensayo aleatorizado con tres grupos de comparación y con evaluación de la calidad al inicio, y a los 5 y 10 meses. Para encontrar el tamaño del efecto de las intervenciones en la calidad de vida, según los grupos estudiados, se usó un modelo de efectos mixtos con covarianza no estructurada. RESULTADOS: se encontró que quienes recibieron la intervención multicomponente más respiro obtuvieron un mejoramiento de la calidad de vida en todas las dimensiones y componentes excepto en la función física, con efectos sostenidos en seguimiento. CONCLUSIÓN: las intervenciones no farmacológicas multicomponente acompañadas de un relevo del cuidado tienen un efecto positivo en la percepción de calidad de vida en cuidadores.
VIVIR CON DOLOR CRÓNICO DESDE LA EXPERIENCIA DE ADULTOS MAYORES CON ENFERMEDADES CRÓNICO DEGENERATIVAS
Authors:   Centro Universitario Siglo XXI, Ruiz-Aguilar Katia , Chan-Castro Vidal ,   Centro Universitario Siglo XXI, Hernández-Gómez Gabriela ,   Centro Universitario Siglo XXI, Cab-López Alan ,   Centro Universitario Siglo XXI, Espadas-Uuh Janet ,   Centro Universitario Siglo XXI, Medina-Fernández Josué ,   Universidad de Quintana Roo
Published: January 2022

INTRODUCCIÓN: Ser adulto mayor conlleva a cambios físicos, psicológicos y sociales que se ven aún más afectados por comorbilidades como las enfermedades crónicas y el dolor. El propósito es interpretar las experiencias de vivir con dolor de los adultos mayores con enfermedades crónico-degenerativas. METODOLOGÍA: Diseño cualitativo de tipo fenomenológico, recolectado mediante un muestreo intencional a través de una entrevista semi estructurada, en la cual se seleccionó a la población adulta mayor con una patología crónico-degenerativa que haya experimentado dolor crónico, se analizó los datos con el proceso cognitivo de Janice Morse, hasta llegar a la saturación de la información. RESULTADOS: participaron 8 personas entre los 66 y 72 años, habiendo siete mujeres y un hombre. Se encontraron cuatro categorías: 1. el desgaste de vivir con dolor, 2. Cotidianidad del vivir con dolor, 3. alternativas para aliviar el dolor y 4. afectación en el entorno social. CONCLUSIÓN: Ser adulto mayor trae muchos cambios en todas las esferas de la vida, sin embargo, el padecer una enfermedad crónica acelera toda esta transición, viéndose afectados la salud mental, físico y social, adaptando esta situación a su cotidianidad, buscando a su vez medios alternos que mitiguen o disminuya el dolor.
CALIDAD DE LAS PRÁCTICAS FORMATIVAS EN LOS ÚLTIMOS SEMESTRES DE ENFERMERÍA DE LA UNIVERSIDAD CATÓLICA DE MANIZALES, COLOMBIA
Authors: Escobar Escobar Maria Beatriz , Álvarez Castaño Nancy , Rendón Caro Stephania , Villegas Quintero Mariana , García Gallego Valentina , Mantilla Sánchez Lina Marcela
Published: January 2022

Introducción: La calidad de las prácticas formativas de enfermería deben ir acompañadas por un sistema de conocimientos genéricos, desarrollo permanente, y apoyo en la práctica clínica. Objetivo: Describir las condiciones de calidad de las prácticas formativas de los últimos semestres del programa de Enfermería de la Universidad Católica de Manizales con relación a los criterios básicos definidos por el Ministerio de Protección Social, el Ministerio de Educación Nacional, y los definidos por el programa de Enfermería en los años 2015 – 2017. Metodología: Investigación descriptiva, retrospectiva, documental. Con la información suministrada por la literatura, el marco de regulación, los factores y las características del modelo de evaluación de las prácticas, entre los años 2015 al 2017, los criterios de inclusión fueron el formato de evaluación de prácticas de la Universidad del caso y exclusión que se emplearon. Resultados: Muestran debilidades y fortalezas como que se descubre que la UCM cumple con todos los criterios de idoneidad como institución educativa, pero hay condiciones para mejorar. Conclusiones: Realizar acompañamiento a las entidades como hospitales y centros de practica, para obtener mejores escenarios de práctica.
ABORDAJE HOLÍSTICO DE LAS LESIONES POR PRESIÓN EN LA PERSONA MAYOR: CASO CLÍNICO
Authors: Valencia Contrera Miguel Andrez
Published: January 2022

Se expone un caso clínico de una paciente de 88 años cursando una hospitalización domiciliaria de larga estadía, por múltiples lesiones por presión, tras su seguimiento presenta una merma en su recuperación, por lo que un profesional de enfermería de hospitalización domiciliaria realiza una visita domiciliaria integral que evidencia múltiples elementos que precisan un abordaje holístico de la situación. Para su abordaje se utilizó el marco teórico de Virginia Henderson, que facilitó la elección del diagnóstico en la cuidadora de Cansancio del rol de cuidador, lo cual permitió que la situación lograra ser abordada satisfactoriamente. Conclusión: se relevó la importancia de un manejo holístico en las lesiones por presión, que debe considerar la dimensión social en la que está inmerso el paciente, junto a un manejo interdisciplinario, preparación profesional y abordaje precoz del probable impacto económico en estos pacientes.
Prognostic Significance of Baseline Serum Calcium Levels in Patients with Acute Coronary Syndrome- An Observational Study
Authors: Raina Rohit , Gupta Puneeta
Published: January 2022

Introduction: The risk stratification is very important for the management of patients with Acute Coronary Syndrome (ACS). Extraskeletal calcium plays a critical role in a range of biological processes. There is an urgent need to accurately identify, the additional factors which are important in the clinical course and outcome of patients of ACS. Aim: To evaluate impact of baseline serum calcium levels in patients with ACS and to determine prognostic significance of baseline serum calcium levels in patients with ACS. Materials and Methods: The present observational study was conducted on 100 patients of ACS, over a period of one year from December 2018 to December 2019 at Acharya Shri Chander College of Medical Sciences, Sidhra, Jammu and Kashmir, India. They were divided into three tertile ranges as: hypocalcaemic (<8.1), normocalcaemic (8.1-10.4), hypercalcaemic (>10.4). The clinical outcome was measured in terms of Left Ventricular Ejection Fraction (LVEF) development of acute pulmonary oedema, rates of emergency revascularisation, development of arrhythmias, recurrence of chest pain, mortality within 7 days of admission, readmission rates with reinfarction or any other cardiovascular complication and finally, mortality within 90 days of follow-up. Quantitative variables were compared using ANOVA/Kruskal Wallis Test between the three groups. Results: The mean age of the study population was 73.29±8.11 years. Baseline calcium on admission was found to be <8.1 mg/dL in ACS patients and more common in males, older age group, patients with higher Body Mass Index (BMI) and was associated with worse prognosis as compared to those with normal serum calcium levels. Mortality within 90 days of follow-up occurred in 42.86%, 20% and 6.25% in unstable angina and 39.29% 11.76% and 13.33% in AMI in hypocalcaemic, normocalcaemic and hypercalcaemic groups, respectively. It is inferred that 64% of the patients in hypocalcaemia tertile (n=14) were males in unstable angina and overwhelming 78.57% in AMI. Conclusion: Hypocalcaemia (corrected calcium <8.1 mg/dL) is common in patients of ACS and a predictor of adverse outcomes.
In vitro Effects of the Methanolic Leaf Extract of Otholobium fruticans in Murine B16 Melanoma Cells: Implications for the Treatment of Skin Hyperpigmentation
Authors: Oyekunle Olubunmi , Meyer Mervin , Madiehe Abram , Hussein Ahmed , Ekpo Okobi
Published: January 2022

Hyperpigmentation is a cosmetically important skin disorder which commonly affects the face and neck regions and impacts negatively on the self-esteem of affected persons. Most of the current treatment agents for hyperpigmentation are cosmetic additives and prescription medications which generally act to suppress melanogenesis. However, many of these products are known to have limited effectiveness, deleterious side effects, and induce adverse reactions especially after prolonged use, hence safe and efficacious treatments are required. Herbal formulations are a putative alternative, considering their use for generations in traditional medicine for treating many diseases, including skin-related conditions. In this study, the methanolic leaf extract of Otholobium fruticans, a gardening and ornamental plant common to the South African Cape provinces, was evaluated for its possible anti-melanogenic effects based on evidence from its traditional use. The 50 µg/mL extract concentration was found to be non-toxic to murine B16 melanoma cells, to significantly reduce tyrosinase activity, increase intracellular reactive oxygen species (iROS) levels and down-regulate some melanogenesis-related genes (TYR, TRP-1, TRP-2, MITF and MC1R), except the β-catenin gene which was upregulated. These findings tend to suggest that the depigmentation potential of the methanolic extract of O. fruticans could be mediated through an interplay of mechanisms that inhibit tyrosinase activity and the cAMP-dependent pathway, as well as increased iROS levels. Further studies involving the chemical isolation, characterization and testing of the activities of the constituent compounds in O. fruticans are recommended to fully understand the basis for the current traditional uses of Otholobium plants for the treatment of skin conditions.
An Algorithmic Approach of Evidence-based Dentistry-review
Authors: Sheefaa M. I. , Sinduja Palati , Priyadharshini R.
Published: January 2022

Evidence-based practice is mainly based on scientific evidence, nowadays there is an increasing approach towards research-based studies, there are various steps in choosing the criteria, steps in writing, level of grading, and various search engines have been mentioned, such as google scholar, PubMed, etc. finally we have various other criteria for selecting and writing the final article, it is very important to choose a proper website for publishing our article. In recent years, practice of dentistry has become more complex and challenging, because of its advancement on a daily basis, so it is very important to analyse and update the current. iSeek is also a particular type of search engine for students, teachers, and administrators alike. The main aim is to provide a balanced mix of knowledge with science for the clinical expertise, and at same time which helps to know the needs of the patient so that optimizing patient care in a practice would not be underestimated.
Assessing the Roadblocks to Organ Donation
Authors: Sherawat Tithi , Dhande Nikhil
Published: January 2022

There has been a significant propulsion in the growth rate of organ failure across the globe in the recent times and major contributor for the same is rising graph of non-communicable diseases, especially diabetes and hypertension in developing countries like India. For patients with end- stage organ disease, organ transplantation is the most desired therapeutic option but according to the current estimates, there is a substantial discrepancy between the organ supply and demand ratio as organ transplantation serves only to less than 10% of the global need of organ donations. These figures thereby necessitates the action towards the promotion of organ donation at various levels. Despite massive advancements in the intricate procedure that occurs between organ donor identification and transplantation and overcoming challenges such as a lack of knowledge, financial restraints, and insufficient transplant facilities, there is still a perennial inability to meet the needs of donors across the country. Varying beliefs and cultures reflect different regulations and donation practices among different groups, posing a challenge to the standardized processes. The purpose of this article is to set out the close link between shortage of organ supply, its relation to the various factors contributing to it along with the certain suggestions in which we can counter these challenges. This article also provides a brief overview of the origin and evolution of India's Transplantation of Human Organ Act, in the hope that our experience in drafting legislation governing organ transplantation may be useful to ones who are considering or overseeing this life-saving procedure.
Case Report on Ebstein Anomaly
Authors: Ansari Saleha Shahid , Sharma Ranjana
Published: January 2022

Introduction: Ebstein anomaly, also known as Ebstein malformation, is a congenital (existing at birth) heart defect that affects a small percentage of people. The tricuspid valve (the valve that connects the chambers on the right side of the heart) does not close properly in people with Ebstein abnormality [1].

Patient History:  A 25-years female patient was admitted in Acharya Vinoba Bhave Rural Hospital in medicine ward. She was admitted with the complaint of breathlessness on exertion, and weakness since 2 months. patient is a known case of severe ASD since birth. After coming to the ward all investigations done like blood test, ECG, 2D Echo, chest x-ray etc. then final diagnosis is conformed as severe ASD with Ebstein anomaly.

Past History: Patient is a known case of ASD. And not having any other history of communicable disease, asthma, tuberculosis.

Management: Tablet- Lasilactone (20/60)) A diuretic, Tablet- Neurobion Fort, Tablet- Pan 40mg a antacid are prescribed the doctor .

Nursing Management: vital sign checked and documented, comfortable position given as patient having breathing difficulty. Fowlers position given. intake and output of patient recorded. Assessed the patient for anxiety, depression.

Conclusion: Patient was admitted to the hospital with the major complaints of trouble breathing and generalised weakness, and her situation was critical. Immediate treatment was initiated by a member of the health team, and all available treatments were administered, and the patient's condition has improved.
Case Report on Nursing Management of a Client with Peripheral Arterial Disease
Authors: Meshram Vishakha , Tembhare Vaishali , Sawarkar Achita , Shambharkar Madhuri , Raut Arati , Sakharwade Prerana
Published: January 2022

Peripheral artery disease is a frequent cardiovascular ailment in which constricted arteries restrict blood flow to our limbs. When we have Peripheral Artery Disease in our limbs, our legs haven't had enough flow of blood to increase production. The capillaries that nourish the lower legs narrow and stiffen in peripheral vascular disease, making walking harder. Reduced blood flow can cause cartilage and necrosis in the limbs. Peripheral arterial disease (PAD) is usually caused by multilevel atherosclerotic disease, typically in patients with a history of cigarette smoking, diabetes mellitus, or both. Intermittent claudication (IC), an early manifestation of PAD, commonly leads to reduced quality of life for patients who are limited in their ambulation. Percutaneous intervention for peripheral artery disease has evolved from balloon angioplasty for single lesions. To achieve good long-term efficacy, a close follow-up including objective tests of both the arterial lesion and hemodynamic status, surveillance of secondary preventive measures, and risk factor control.

A 65-year-old man was admitted to the hospital with the following symptoms: worsening left severe calf pain, fatigue, cramping, aching, pain in the legs or arms that worsens when walking or using the arms, tightness in the muscles of the legs that worsens with exercise and improves with rest. He has a diabetes mellitus history. The lower extremity pulse was diminished or absent on physical examination, but all other vital signs were typical. Pulses in the left dorsalispedis and posterior tibialis could not be felt. The results of the cardiac examination were average. The patient has numbness in one leg, pain in both legs, decreased energy in both upper and lower limbs, ulceration, gangrene in the lower extremities, Hair loss, weakness, and dependent rubor (redness caused by swelling) present. He had audible bruits, a nonhealing lower extremity wound, and a delayed capillary refill, so he started treatment as soon as possible.

The primary focus of this study is on professional management and outstanding nursing care, which may provide the holistic care that peripheral arterial disease necessitates while also effectively managing the challenging case.
Comparison of Effect of Phyllanthus emblica (Indian Gooseberry) with and without Honey on Hemoglobin, RBC and PCV among Adolescents
Authors: Kamalli M. , Priyadharshini R. , Sinduja Palati
Published: January 2022

Introduction: Phyllanthus emblica commonly known by names such as Indian gooseberry, amla belongs to the Phyllanthaceae. The plant is used as a medicine and tonic which is highly nutritious and forms an important dietary source of vitamin C and amino acids. Honey is rich in iron which helps in boosting the hemoglobin content in blood by increasing their synthesis. Complete blood count (CBC) is an array of tests to evaluate the cells in the blood which are the red blood cells, white blood cells, platelets. 

Aim: The aim of the study is to compare the effect of Phyllanthus emblica (Indian Gooseberry) with and without honey on hemoglobin, RBC (Red Blood Cell) and PCV (Packed cell volume) among adolescents. 

Materials and Methods: Ten adolescents including both male and female were selected as subjects for the study. The first group of subjects were categorised to consume gooseberry alone and the second group of subjects were categorised to consume gooseberry along with honey. After 15 days, CBC was taken for the subjects of both groups to analyse the results. Independent ‘t’ test was applied to evaluate the significance of clinical trials performed in two groups. 

Results and Discussion: The participant history included fatigueness, pallor, menstrual history, blood pressure, pulse. There is an increase in the mean value of Hb (Hemoglobin), RBC (Red Blood Cell), HCT (Hematocrit), MCV (Mean corpuscular volume), MCH (Mean corpuscular hemoglobin) and RDW (Red cell distribution width). Independent statistical analysis showed that p value is not significant as all the values are not <0.05.

Conclusion: The present study concludes that gooseberry with honey supplementation has shown better results than gooseberry supplementation but it is not statistically significant. It is evident that gooseberry has nutritive and restorative properties. Daily use of gooseberries is safe and can show more significant increase in counts of RBC, Hb in longer duration.
Comparison of Haemoglobin, RDW, RBC Values among Diabetes Mellitus and Normal Individuals
Authors: Baskar Sharwini , Priyadharshini R. , Sinduja Palati
Published: January 2022

Introduction: Diabetes mellitus is a disorder characterized by hyperglycemia. It has been reported that 75% of the primary cause for mortality in diabetes mellitus patients is cardiovascular disease which is caused by hyperglycemia. Erythrocytes of diabetes mellitus patients have a shorter life span than normal. Red cell distribution width (RDW) is a measure of the heterogeneity of the volume of red blood cells (Red Blood Cells). High RDW has various adverse outcomes. The study aims to compare Haemoglobin, RDW and RBC values among diabetes mellitus and normal individuals.

Materials and Methods: Blood samples of 20 patients with and without diabetes were collected from outpatients visiting Saveetha dental college and hospitals. The results of the following parameters Haemoglobin, RDW, RBC were analyzed using Independent t Test in SPSS software. The statistical significance (P value) was set at 0.05.

Results: It is evident that there is a higher incidence of diabetes among the male population compared to females which result in higher RBC and Haemoglobin values. The RDW value is also reported to be higher in diabetic patients than non-diabetic patients. For Haemoglobin  p value was 0.984 (>0.05), RDW p value was 0.180 (>0.05), RBC p value was 0.680 (>0.05). The p values  were >0.05 which is statistically not significant.

Conclusion: The Hemoglobin, RBC and RDW values are higher for diabetic patients than non-diabetic. Higher RDW has various adverse effects such as cardiovascular disease which may cause mortality in diabetes mellitus patients.
Obesity in Children: Symptoms and Complications
Authors: Agrawal Tanya , Hiwale Keshav
Published: January 2022

We aim to review the causes, symptoms, and treatment for obese children. And what does an obese children problems the effect and problem? We can say complicated condition in which our body weight is more than desired weight according to height, weight, and age. Obesity is characterized differently for children and teenagers than it is for adults. Male child and Female children develop at various rates, and children are still growing. This condition leads to a a higher risk of getting other dangerous diseases like DM, HTN, etc. Childhood is the right time to pay attention; otherwise it will lead to obese adolescents and adults. Facts from different articles was amalgamated and shown in a simplified fashion, with the year of publication, the age of the children, sample size, study design, and study conclusions all taken into account. The key finding of this review was obesity is a major topic of concern today, especially in childhood. The lifestyle we have adapted in the present generation is more luxurious and physically less active. Obesity is the primary cause of a lot of diseases like diabetes mellitus, hypertension, thyroidism, even in younger children

This review article thoroughly covers a lot of ground, with references provided. It is a collection of various case studies that have been completed. As a result, this essay will only include essential information if anyone reads it. Childhood Obesity is a word used to describe a youngster who is considerably overweight for their age and height. Childhood obesity can lead to diabetes, high blood pressure, and high cholesterol.
Knowledge of Cleft Lip and Cleft Palate among Medical Students of a Tertiary Care Hospital in South India
Authors: Mohan Sajitha , Mahipathy Surya Rao Rao Venkata , Ganesh Praveen , Durairaj Alagar Raja , Sundaramurthy Narayanamurthy , Jayachandiran Anand Prasath , Rajendran Suresh
Published: January 2022

Background: Sufficient knowledge and awareness of cleft lip and palate deformity is required to identify and manage at the condition at the earliest.

Objectives: This study was conducted to assess the awareness and knowledge of medical students on cleft lip and palate. To assess the understanding of the possible causative factors of cleft lip and palate among the same population.

Materials and Methods: A cross sectional study was carried out among 128 medical students attending a tertiary care hospital in south India. This was performed through a researcher administered questionnaire which contained queries regarding risk factors and management.

Results: A total of 89.1% of the subjects were aware of the term cleft lip and palate with the majority being females. Though they were not well informed regarding the treatment procedures, and timings. The results were then interpreted in table formats for better understanding of the level of education on the topic.

Conclusion: There is a general lacking of experience in the diagnosis and management of cleft lip and palate among medical students which should be addressed to ensure timely cure and quality of life of the patients.
Adherence to Pharmacological Treatment and Factors Affecting the Adherence among Hypertensive Patients Attending Primary Health Care Centers in Jazan, Saudi Arabia
Authors: Khalafalla Husameldin Elsawi , Shugairi Ahmad A. , Othathi Faisal A. , Alhuraysi Abdulrahman M. , Albrraq Abdulaziz Y. , Rayani Ahmad Y. , Shami Mohammed O. , Jareebi Mohammad , Doweri Abrar A.
Published: January 2022

Background: Hypertension (HTN) is a major health problem globally because it can result in significant morbidity and a reduction in life expectancy, HTN is responsible for 9.4 million deaths annually, either due to heart attack or stroke with a contribution of 45% and 51%, respectively

Objective: Evaluate the level of adherence to anti-HTN medications and which factors affect this adherence in the Jazan area

Methodology: The researcher investigated the adherence to anti-hypertension (anti-HTN) medication of participants aged more than 18 in the Jazan region of Saudi Arabia, they conducted interviews with patients who attend primary health care centers and focused on their socio-demographics, such as age, education, and topographical location of their home. The data from the interviews were analyzed using the Hill-Bone scale to determine perfect and imperfect adherence to anti-HTN medication 

Results: 82.7% of the participants show imperfect adherence to medication which is a significantly higher percentage than that found in other areas of Saudi Arabia and the Middle East. The researchers further analyzed the data for correlations between sociodemographic characteristics and adherence to anti-HTN medication. This showed that patients living in the mountainous areas of Jazan have a stronger adherence to their medication than those living in the plains or on the coast (OR = 10.77, P value = 0.011). Also, those patients with an income of 5,000 RS or less are more likely to adhere to their medication than those with higher income (OR = 0.18, P value = 0.035). Other socio-demographic characteristics showed no strong correlation with medication adherence. 

Conclusion: Overall, anti-HTN medication adherence in the Jazan region is poor and researchers recommend the implementation of an educational program to highlight the importance of adhering to anti-HTN medication.
Characterizing the amino acid activation center of the naturally editing‐deficient aminoacyl‐tRNA synthetase PheRS in Mycoplasma mobile
Authors: Han Nien‐Ching , Kavoor Arundhati , Ibba Michael
Published: January 2022

To ensure that correct amino acids are incorporated during protein synthesis, aminoacyl‐tRNA synthetases (aaRSs) use proofreading mechanisms collectively referred to as editing. Although editing is important for viability, editing‐deficient aaRSs have been identified in host‐dependent organisms. In Mycoplasma mobile, editing‐deficient PheRS and LeuRS have been identified. We characterized the amino acid activation site of MmPheRS and identified a previously unknown hyperaccurate mutation, L287F. Additionally, we report that m‐Tyr, an oxidation byproduct of Phe which is toxic to editing‐deficient cells, is poorly discriminated by MmPheRS activation and is not subjected to editing. Furthermore, expressing MmPheRS and the hyperaccurate variants renders Escherichia coli susceptible to m‐Tyr stress, indicating that active site discrimination is insufficient in tolerating excess m‐Tyr.
Assessing the state of New Zealand's garden birds from national to local scales
Authors: MacLeod Catriona J. , Green Peter , Howard Simon , Gormley Andrew M. , Brandt Angela J. , Spurr Eric B.
Published: January 2022

Better biodiversity indicators are needed to address information gaps, describe trends accurately and robustly and be useful for decisionmakers. Citizen science's potential to help address these challenges often goes unrealized, despite promises by organizers to deliver such information.

This paper addresses these challenges by demonstrating the powerful utility of citizen science results for improving our knowledge of the state of New Zealand's garden birds, from the national to the local scale. For 14 species and three annual assessments, we: (a) calculate changes in bird counts over the medium to short term (over 10 and 5 years, respectively); (b) use an alert system to identify trends of interest or concern and collate the assessments in an online interactive tool; and (c) apply the results to address management questions.

Seven species have declined nationally in gardens in the medium term, but the population trends of six of these have improved in the short term (the declines of three have been reversed). For Otago, as a regional example, a wider range of medium‐term alerts was initially raised, and positive short‐term changes were also more evident. Performance differed across Otago's districts: positive increases were muted in Dunedin City, while Waitaki had the highest number of increasing species and Central Otago more species rapidly increasing.

For 54 neighbourhoods managed by Predator Free Dunedin, as a local example, the baseline medium‐term assessment detected rapid declines in two species, moderate to shallow declines in five species and increases in three species.

Based on these findings, managers could improve benefits for biodiversity by using: (a) trends, to direct and evaluate policy investments; (b) benchmarks, to provide social incentives; and (c) targets, to give management purpose and direction.

Our case study highlights how citizen science can address biodiversity information gaps and make powerful management contributions at scale by delivering metrics that are robust and comparable across time and space, showing decisionmakers how to readily access and interpret information of interest, building trust and value and highlighting how spatially hierarchical assessments can facilitate multiple end‐user benefits.
Sirolimus for epileptic seizures associated with focal cortical dysplasia type II
Authors: Kato Mitsuhiro , Kada Akiko , Shiraishi Hideaki , Tohyama Jun , Nakagawa Eiji , Takahashi Yukitoshi , Akiyama Tomoyuki , Kakita Akiyoshi , Miyake Noriko , Fujita Atsushi , Saito Akiko M. , Inoue Yushi
Published: January 2022

Objective

To determine whether sirolimus, a mechanistic target of rapamycin (mTOR) inhibitor, reduces epileptic seizures associated with focal cortical dysplasia (FCD) type II.

Methods

Sixteen patients (aged 6–57 years) with FCD type II received sirolimus at an initial dose of 1 or 2 mg/day based on body weight (FCDS‐01). In 15 patients, the dose was adjusted to achieve target trough ranges of 5–15 ng/mL, followed by a 12‐week maintenance therapy period. The primary endpoint was a lower focal seizure frequency during the maintenance therapy period. Further, we also conducted a prospective cohort study (RES‐FCD) in which 60 patients with FCD type II were included as an external control group.

Results

The focal seizure frequency reduced by 25% in all patients during the maintenance therapy period and by a median value of 17%, 28%, and 23% during the 1–4‐, 5–8‐, and 9–12‐week periods. The response rate was 33%. The focal seizure frequency in the external control group reduced by 0.5%. However, the background characteristics of external and sirolimus‐treated groups differed. Adverse events were consistent with those of mTOR inhibitors reported previously. The blood KL‐6 level was elevated over time.

Interpretation

The reduction of focal seizures did not meet the predetermined level of statistical significance. The safety profile of the drug was tolerable. The potential for a reduction of focal seizures over time merit further investigations.
Dosing Variation at Initiation of Adalimumab and Etanercept and Clinical Outcomes in Juvenile Idiopathic Arthritis: A Childhood Arthritis and Rheumatology Research Alliance Registry Study
Authors: Verstegen Ruud H. J. , Shrader Peter , Balevic Stephen J. , Beukelman Timothy , Correll Colleen , Dennos Anne , Phillips Thomas , Feldman Brian M. ,   for the CARRA Registry Investigators
Published: January 2022

Objective

To determine the dose–response relationship of tumor necrosis factor (TNF) inhibition in the treatment of juvenile idiopathic arthritis (JIA).

Methods

Participants of the Childhood Arthritis and Rheumatology Research Alliance Registry were eligible for inclusion in the analyses if they started TNF inhibition treatment for JIA. The primary treatment response was determined 3 to 7 months after the start of treatment, based on the JIA American College of Rheumatology Pediatric criteria for improvement, clinical Juvenile Arthritis Disease Activity Score, and persistence of treatment after 6 months. Subsequently, pooled logistic regression models were performed to include long‐term follow‐up data. The models were adjusted for risk factors associated with poor treatment response. Dosing was expressed by body weight, body surface area, ideal body weight, fat free mass, and lean body mass.

Results

Participants treated with adalimumab (n = 328) and etanercept (n = 437) were included in the analyses (median dose 0.82 mg/kg body weight [interquartile range (IQR) 0.66–1.04] and 0.83 mg/kg body weight [IQR 0.75–0.95], respectively). The majority of analyses did not show a relationship between dose and outcome. Where associations were found, results were conflicting. Alternative dosing characteristics based on ideal body weight, fat free mass, and lean body mass did not result in stronger or more consistent associations.

Conclusion

This study was not able to confirm our hypothesis that increased dosing of TNF inhibitors results in improved treatment outcomes. Although adjustment was performed for risk factors of impaired treatment response, residual confounding by indication likely explains the negative associations found in this study.