bluuebunny/crossref_metadata_2025 huggingface dataset:
Roles of Parathyroid Hormone and Fibroblast Growth Factor 23 in Advanced Chronic Kidney Disease
Authors: Nakagawa Yosuke , Komaba Hirotaka
Published: May 2024

Parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23) each play a central role in the pathogenesis of chronic kidney disease (CKD)-mineral and bone disorder. Levels of both hormones increase progressively in advanced CKD and can lead to damage in multiple organs. Secondary hyperparathyroidism (SHPT), characterized by parathyroid hyperplasia with increased PTH secretion, is associated with fractures and mortality. Emerging evidence suggests that these associations may be partially explained by PTH-induced browning of adipose tissue and increased energy expenditure. Observational studies suggest a survival benefit of PTHlowering therapy, and a recent study comparing parathyroidectomy and calcimimetics further suggests the importance of intensive PTH control. The mechanisms underlying the regulation of FGF23 secretion by osteocytes in response to phosphate load have been unclear, but recent experimental studies have identified glycerol-3-phosphate, a byproduct of glycolysis released by the kidney, as a key regulator of FGF23 production. Elevated FGF23 levels have been shown to be associated with mortality, and experimental data suggest off-target adverse effects of FGF23. However, the causal role of FGF23 in adverse outcomes in CKD patients remains to be established. Further studies are needed to determine whether intensive SHPT control improves clinical outcomes and whether treatment targeting FGF23 can improve patient outcomes.
KECEMASAN LANSIA DENGAN HIPERTENSI TERHADAP KUALITAS HIDUPNYA
Authors: Prianahatin Ari Loga , Retnaningsih Dwi , Kustriyani Menik
Published: May 2024

Hypertension is still a health problem faced by the elderly related to changes in the cardiovascular system, which if left unchecked will interfere with the function of other organs. So that the issue arises where feelings of anxiety and depression are experienced by the elderly. This study aims to determine the level of anxiety on the quality of life of elderly people with hypertension. This type of research is quantitative, with a cross sectional design where data collection for independent and dependent variables is carried out at the same time. The research instrument used was a questionnaire. Research respondents were 40 elderly hypertension. The research was conducted from May to August 2021 in Limbangan District, Kendal, Central Java. The test analysis method used is Rank Spearman. There is a relationship between the level of anxiety and the quality of life of the elderly with hypertension. The results of the analysis obtained p value = 0.000 <0.05, the coefficient value or r value = 0.602 indicates a strong relationship with a negative direction which means that the higher the level of anxiety, the lower the level of quality of life. It can be concluded that there is a relationship between the level of anxiety on the quality of life of elderly people with hypertension in Limbangan Village, Kendal Regency.
IMPLEMENTASI KEBIJAKAN VAKSINASI COVID 19 DI KOTA PEKALONGAN
Authors: Artanti Swasti , Setyowati Ana
Published: May 2024

The Covid-19 pandemic has created a huge burden of morbidity and mortality and has seriously disrupted lives and economies worldwide. Efforts have been made to contain the spread of Covid-19. One of them is to create a vaccine. Countries from all over the world by involving governments, biotechnology companies, scientists and academics are trying to create safe and effective vaccines on a large scale. Several countries have succeeded in creating vaccines that are considered capable of dealing with the spread of Covid-19. The government is intensively conducting vaccination socialization with the aim of achieving the national vaccination target as an effort to break the chain of Covid-19 spread. Vaccination is a specific prevention of a disease. If the vaccination is successful, then the individual is healthy, the family is healthy, the community structure is healthy, then productivity will increase. The results of the research are expected to contribute to the health sector, especially in the implementation of the Covid-19 vaccination implementation. The research to be carried out includes qualitative research with a descriptive study approach. Data collection techniques were carried out by observation and in-depth interviews. The research sample was taken by purposive sampling with the main informant data sources (Health Personnel/Covid 19 Vaccinations), supporting informants (Head of Health Center, Pekalongan City Health Office, Clients who received covid 19 vaccination services).
Apresentação
Authors: Nogueira Mauro Oddo
Published: May 2024

O boletim Radar: tecnologia, produção e comércio exterior está comemorando sua 75a edição! Nela, trazemos o segundo volume da edição temática produção do futuro. Como citado na edição anterior, os desafios socioambientais que hoje se apresentam para toda a humanidade – que se encontram claramente expressos nos objetivos da Agenda 2030, ou Objetivos de Desenvolvimento Sustentável (ODS) – são muito mais do que aqueles para um futuro melhor: são desafios para que a própria humanidade possa ter um futuro. E isso já deixou de ser uma previsão de futuro dos cientistas para se apresentar como ameaça concreta, palpável e presente para todos nós. dando continuidade à apresentação do projeto, trazemos nesta edição mais cinco trabalhos que vêm sendo desenvolvidos na Diretoria de Estudos e Políticas Setoriais, de Inovação, Regulação e Infraestrutura do Instituto de Pesquisa Econômica Aplicada (Diset/Ipea), no âmbito de projeto transversal e estruturante da diretoria que tem como tema produção do futuro.
Impact of Climate Change on Agriculture & Vice Versa: A Review
Authors: Majeed Najma , Sharif Rimsha , Sheeraz Muhammad Noman , Sajjad Sabeen , Maqsood Hafsa , Imran Muhammad , Jamshaid Muhammad Usman , Arif Muhammad , Hussain Muhammad Baqir
Published: May 2024

The article tackles the intricate relationship between agriculture and climate change, shedding light on the sector's vulnerability to the issue and its significant contribution to it. It not only underlines the simultaneity of the problem of climate change adaptation in agriculture but also highlight the need of greenhouse gas reductions. Climate change disrupts agricultural practices through extreme weather events like droughts, flood and unpredictable rainfall patterns.  Climate changes threaten agricultural output and food security, economic hardship and social unrest. Climate change isolates crops production hence resulting in low yields, economic losses, and changing food prices. Cattle, rice growth, fertilizer use and residue burning are principal greenhouse gas contributors of agriculture. When carving virgin forests for agricultural purposes, the ancient carbon is released and climatic patterns are disrupted, greatly exacerbating the problem. These agricultural practices include deforestation, utilization of fossil fuel, and intensive use of water. Mitigation in climate change require sustainable agricultural practices that reduced emission and improve soil health. We need to adapt agricultural practices to be more resilient in the face of climate change while also reducing agricultures contribution to the problem. The complex interplay between climate change and agriculture requires a holistic approach that integrates mitigation and adaptation strategies at local, national and global scale. Efforts to enhance resilience, promote sustainable practices and support equitable adaptation measures are essential to safeguarding the future of agriculture in a changing climate
Tachysurus wuyueensis (Teleostei, Bagridae), a new species of catfish from the Qiantang-Jiang basin, southeast China
Authors: Zhou Jia-Jun , Yuan Le-Yang , Shao Wei-Han
Published: May 2024

Tachysurus wuyueensis, new species, is described from the Qiantang-Jiang Basin, situated in Suichang County, Zhejiang Province and Xiuning County, Anhui Province, southeast China. The coastal basin drains into the East China Sea. The new species belongs to the T. pratti-T. truncatus group within the genus Tachysurus defined by having a smooth anterior margin of the pectoral-fin spine, short maxillary barbels not extending beyond the base of the pectoral-fin spine, short dorsal spine not exceeding two thirds of head length and an emarginated caudal fin. This new species is distinct from all other species of this group, Tachysurus pratti (Gunther, 1892), T. truncatus (Regan 1913), T. gracilis (Li, Chen & Chan, 2005) and T. brachyrhabdion (Cheng, Ishihara & Zhang, 2008), in having a shorter prepelvic body (length 40.0–46.4% of SL vs. 45.8–54.8%). It further differs from T. pratti, T. truncatus and T. gracilis in having more vertebrae (45–47 vs. 37–44) and more anal fin rays (21–25 vs. 14–20), from T. brachyrhabdion in having a more slender body (depth 10.1–13.5% of HL vs. 13.1–17.6%). Molecular phylogeny, based on the mitochondrial cytochrome b (cyt. b) gene confirms the validity of T. wuyueensis and the T. pratti-T. truncatus group. Furthermore, this study addresses the diagnostic traits distinguishing the T. pratti-T. truncatus group from the T. tenuis-T. crassilabris group which have historically been treated as a single species group due to morphological similarities.
Urban communist politics of the everyday in Graz, Austria
Authors: Saltiel Rivka , Naumann Matthias , Strüver Anke
Published: May 2024

The everyday communist politics of local politicians in Graz offers a potential way forward for the left more broadly In September 2021, the Communist Party of Austria (KPÖ) won the municipal elections in Austria’s second-largest city, Graz, and Elke Kahr became the city’s
mayor. Kahr has governed in a coalition with the Green Party and the Social Democrats, replacing the former conservative and far-right coalition that had lasted for eighteen years. A different kind of local politics has since then proved possible, even in conservative Austria. Graz local communists
practise a politics that is sensitive to class injustice and engaged in the local community. Its slogan for the last thirty years has been ‘A party for everyday life’. The party’s success is based on its focus on everyday concerns such as housing, tenants’ rights, public
health, education and mobility issues, as well as its battles against austerity and neoliberal privatisation. Its community-oriented approach, strongly committed to social infrastructure at the scale of people’s everyday experiences is explicitly critical of top-down state solutions
‐ and thus stands in stark contrast both to the previous neoliberal and profit-oriented policies in Graz, and to the centralist ways of governing of the socialist states. KPÖ politicians voluntarily cap their salaries at the level of the average worker, with the surplus going into
a social fund for emergency help for those on low incomes. This has been criticised by some as a charity commitment rather structural change, but it can also be read as an attempt at lived solidarity. Drawing from local media coverage as well as interviews with politicians and local residents,
the article discusses the everyday politics of Graz communists through the lens of relational care ethics, and discusses the potential international movements that could be built on this approach to communist municipal politics. The focus is on alternative social norms in urban cultures of
care: solidarity among all members of society, and a recognition of people’s everyday practices and needs.
Coats-Like Presentation of Familial Exudative Vitreoretinopathy Associated With a Novel
LRP5
Variant
Authors: López-Font Francisco J. , Shah Serena M. , Lin Benjamin R. , Cruz Natasha Ferreira Santos da , Sengillo Jesse D. , Berrocal Audina M.
Published: May 2024

This report describes a unique case of a Coats-like presentation of familial exudative vitreoretinopathy in an 11-year-old girl. The patient was originally referred for evaluation of presumed Coats disease and presented with telangiectatic vessels, perivascular exudates, diffuse peripheral exudation, and intraretinal hemorrhages. Clinical and angiographical findings were consistent with familial exudative vitreoretinopathy, while genetic testing identified variants of uncertain significance in two associated genes,
LRP5
and
ZNF408
. In silico analysis predicts the
LRP5
variant to be pathogenic. Retinal vasculopathies often have phenotypic overlap, warranting angiographic examination of both eyes and genetic testing to uncover the correct diagnosis and guide proper treatment.

[
Ophthalmic Surg Lasers Imaging Retina
2024;55:462–466.]
Investigation of cementitious composites reinforced with metallic nanomaterials, boric acid, and lime for infrastructure enhancement
Authors: Al-Ramthan Ahmed , Al Mezrakchi Ruaa
Published: May 2024

Nanomaterials integration within construction materials could promote the generation of more sophisticated structural materials, as it imbues reinforcement at the nanoscale. This research adopted experimental approaches to assess the influence of metallic nanomaterials on the performance of cementitious composites with various ratios of boric acid (1%, 3%, and 5% by sand's weight) and lime (0.5%, 1.5%, and 2.5% by sand's weight), respectively, for use in construction infrastructure facilities. This research provides valuable insight into the potential of using boric acid and lime as well as metallic nanomaterials to strengthen cement-based composites. Initial curing stages revealed a notable decrease in compressive strength attributed to the inhibitory effects of boric acid and lime on cement hydration. However, the introduction of TiO2 nanoparticles demonstrated significant enhancements in compressive strength and durability. Statistical analysis emphasized the significance of nanomaterials in augmenting compressive strength, with implications for long-term performance. This study has shown that the addition of nano-titanium dioxide TiO2 can significantly enhance the compressive strength of Portland cement mortars, particularly when used in conjunction with appropriate ratios of boric acid and lime. The results of the 7 days test indicated that the inclusion of boric acid and lime in the cement mortars significantly decreased the compressive strength. However, the addition of nano-TiO2 to cement mortars containing 1% boric acid and 0.5% lime resulted in a 31-fold increase in compressive strength compared to cementitious composites without nano-TiO2. In contrast, the compressive strength significantly increased by 1.2 times, 85.3 times, and 65.1 times, respectively, after 56 days for the addition of boric acid (1%, 3%, and 5%) with lime (0.5%, 1.5%, and 2.5%), respectively, in the presence of nano-TiO2, compared to the 7 days strength. The results also illustrated that, in general, the incorporation of various types of nano-TiO2 into cementitious composites containing boric acid and lime increases their compressive strength as the ratios of boric acid and lime increase, as long as sufficient curing time is allowed.
A note on maps preserving products of matrices
Authors: Lu Lan , Wang Yu
Published: May 2024

Let $ D $ be a division ring such that either char$ (D)\neq 2, 3 $ or $ D $ is not a field and char$ (D)\neq 2 $. Let $ R = M_n(D) $ be the matrix ring over $ D $, where $ n > 1 $. Let $ m, k $ be fixed invertible elements in $ R $. The main purpose of the paper is to give a description of a bijective additive map $ f $: $ R\rightarrow R $, satisfying the identity $ f(x)f(y) = m $ for every $ x, y\in R $ with $ xy = k $, which gives a correct version of a result due to Catalano et al. in 2019.
Applications of $ q- $Ultraspherical polynomials to bi-univalent functions defined by $ q- $Saigo's fractional integral operators
Authors: Al-Hawary Tariq , Amourah Ala , Alsoboh Abdullah , Ogilat Osama , Harny Irianto , Darus Maslina
Published: May 2024

This study established upper bounds for the second and third coefficients of analytical and bi-univalent functions belonging to a family of particular classes of analytic functions utilizing $ q- $Ultraspherical polynomials under $ q- $Saigo's fractional integral operator. We also discussed the Fekete-Szegö family function problem. As a result of the specialization of the parameters used in our main results, numerous novel outcomes were demonstrated.
AI in Special Education
Authors: Singh Suyesha , Jain Paridhi
Published: May 2024

With recent technological breakthroughs, AI is developing as a revolution for mankind, and it has obvious potential advantages in a number of areas. The potential to improve the educational outcomes and experiences of children with exceptional needs by incorporating AI in special education is significant. The theoretical foundations of using AI in special education have been examined in this study and how AI technologies could enhance learning outcomes and promote inclusion. This study aims to further the understanding of how AI may successfully help students with special needs while simultaneously addressing the practical difficulties involved with its implementation. In conclusion, integrating AI into special education has enormous potential to enhance the educational results and experiences of kids with exceptional needs. The use of AI-driven technology may help special educators as well as persons with special needs by enabling real-time feedback and evaluation, individualized education and rehabilitation services, and training tailored to each individual's requirements.
Technology and Communication
Authors: Mishra Parul
Published: May 2024

The present chapter is an attempt to revive the ancient communication skills and techniques and its influence on the relationships; it is by no means a suggestion that technology is less significant. The long hours given to mobiles have put a negative impact on the human relationships. The use of AI techniques has now become an everyday thing which certainly shall, at a point of time, be dangerous for the critical and mental growth of humans. Excessive use of technology has a negative impact.
AI Unleashed
Authors: Mukherjee Tanushri , Mishra Pallavi
Published: May 2024

This chapter will delve into the dynamic landscape of event management and how artificial intelligence (AI) is revolutionizing the overall event experience. AI technologies have left no area untouched, and, similarly, event planners and event entrepreneurs have also integrated AI in every phase of seamless event execution. Through a comprehensive exploration of AI-driven tools and technologies in the realm of event management, the chapter aims to shed light on how AI is reshaping the entire process of event design, delivering a personalised touch to its attendees thus influencing the nature of engagement strategies. The chapter aims to provide the readers with a holistic understanding of the transformative potential and responsible use of AI in creating unforgettable event experiences. The researcher also employs qualitative research method and seeks the perception of seasoned event professionals related to the topic to further add to its relevance and significance.
Securing Web Data and Privacy in AIoT Systems
Authors: Mihailescu Marius Iulian , Nita Stefania Loredana
Published: May 2024

The exponential growth of Artificial Intelligence of Things (AIoT) has resulted in an unparalleled fusion of AI with IoT technologies, giving rise to intricate systems that present vast opportunities for automation, productivity, and data-centric decision-making. Nevertheless, this amalgamation also poses substantial obstacles regarding safeguarding online information and upholding confidentiality. The chapter extensively examines the difficulties associated with these issues and the tactics employed to surmount them. The chapter commences by delineating the distinctive susceptibilities inherent in AIoT systems, with a particular emphasis on how the interconnection of AI and IoT technologies gives rise to novel avenues for data breaches and privacy infringements. It then explores the most recent approaches and technologies used to protect data sent over AIoT networks. These include improved encryption methods, secure data transfer protocols, and solutions based on blockchain technology. A substantial chunk of the chapter focuses on privacy-preserving strategies in AIoT. The text examines the equilibrium between data usefulness and privacy protection. It delves into techniques like anonymization, differential privacy, and federated learning as means to safeguard user data while ensuring the effectiveness of AIoT systems. The chapter also examines regulatory and ethical factors, thoroughly examining current and developing legislation and regulations that oversee data security and privacy in AIoT. The content incorporates case studies and real-world examples to demonstrate the pragmatic implementation of theoretical principles. Ultimately, the chapter predicts forthcoming patterns and difficulties in this swiftly progressing domain, providing valuable perspectives on possible AIoT security and privacy protocol advancements. This resource is vital for professionals, researchers, and students engaged in AIoT, cybersecurity, and data privacy. It provides them with the necessary information and tools to protect against the ever-changing threats in this dynamic field.
Emerging Trends in Artificial Intelligence of Things With Machine Learning and Semantic Web Convergence
Authors: Revathi A. , Poonguzhali S.
Published: May 2024

This chapter explores the dynamic convergence of artificial intelligence of things (AIoT), machine learning algorithms, and the semantic web. The fusion of AI and the internet of things (IoT) creates context-aware applications with transformative potential. Machine learning enhances AIoT capabilities, empowering systems to process IoT data effectively. Simultaneously, the semantic web, with its knowledge representation frameworks, augments adaptability. Delving into deep learning, reinforcement learning, and ensemble methods, the chapter elucidates how machine learning drives autonomous decision-making in AIoT. In the semantic web, the integration of machine learning introduces dynamic knowledge adaptation. Case studies in smart environments, predictive maintenance, and recommendation systems highlight practical implementations. The chapter addresses challenges, including scalability, security, and ethical implications. Emerging trends, interdisciplinary approaches, and societal impacts are explored, emphasizing the transformative potential of AIoT and semantic web integration.
Oil and Gas Industry Challenges for the Next Decade
Authors: Cruz Rosario
Published: May 2024

Hydrocarbons are one of the most important sources of energy globally. The processing, use, and commercialization of these resources are the basis of the world economy, even in an era of energy transition like the one experienced today, in which alternative energies are developing rapidly. Activities carried out in the hydrocarbon industry contribute a large amount of energy-related CO2 emissions, in addition to other environmental risks such as hydrocarbon spills, soil and groundwater contamination, and fires. As a result, the importance of the industry has been overshadowed, even though because of these same activities, engineering and scientific advances have been achieved to optimize the production of hydrocarbons to satisfy global demand. Consequently, it is expected that the oil and gas industry will face challenges in the environmental, operational, and social context during the next decade.
Analyzing Fuel Cell Vehicles Through Intelligent Battery Management Systems (BMS)
Authors: Reddy Putchakayala Yanna , Madan Balpreet Singh , Anandaram Harishchander , Rathod Praveen , Vasanthaseelan S. , Boopathi S.
Published: May 2024

Integrating artificial intelligence (AI), internet of things (IoT), and machine learning (ML) technologies into fuel cell systems offers numerous benefits, applications, and opportunities for advancement across various sectors. This chapter explores the synergistic potential of AI, IoT, and ML in fuel cell integration, outlining their advantages, applications, challenges, and potential solutions. By leveraging AI for predictive maintenance, optimizing operating conditions through IoT sensors, and employing ML algorithms for efficiency enhancements, fuel cell systems can achieve higher performance and reliability. Real-world case studies and examples demonstrate successful integration in sectors such as transportation, energy production, and manufacturing. Moreover, this chapter discusses future prospects, including advancements in data analytics, system optimization, and scalability, driving innovation in fuel cell technology integration with AI, IoT, and ML.
Innovative Approaches to Public Safety
Authors: Chaudhary Anita
Published: May 2024

This book chapter examines cutting-edge tactics to improve public safety by using Generative Adversarial Networks (GANs) to improve cyber security in public areas. Conventional security solutions frequently fail to provide adequate protection against cyber-attacks in public settings in an era characterized by growing digital interconnection and changing security risks. Using GANs, a state-of-the-art machine learning method, offers a viable way to strengthen cyber security measures and reduce possible threats. The chapter explores the theoretical underpinnings of GANs and how they are used to identify and neutralize cyber threats in public areas. Through the utilisation of GANs to produce artificial intelligence-generated data and replicate cyber-attack scenarios, entities can anticipate weaknesses and develop resilient protection strategies in advance.
Behavioral Intention of Women to Use E-Learning
Authors: Abbas Hasan A.
Published: May 2024

Behavioral intention research suggests that it can effectively predicts intention to adopt information technology and emphasizes the importance of examining antecedents of such use. However, the literature also highlights that individual behavioral intentions can be affected by external factors and social influences. Current study examines the impacts of different factors (quality, social, behavioral, and innovative) on behavioral intention to use e-learning system. We designed special instruments to examine female students' behavioral intention to adopt e-learning system by extending the TPB as foundational framework. An extension of TPB is used with McLean & Delone and Innovative Theory to enhance the overall theoretical framework. Survey data collected from 699 female e-learning participants to test the study hypotheses. Findings suggested that subjective norms, self-efficacy, environment quality, and perceived innovativeness presented significant associations to behavioral intention of e-learning. Research implications and limitations are also examined and discussed.
Coagulome and tumor microenvironment: impact of oncogenes, cellular heterogeneity and extracellular vesicles
Authors: Tawil Nadim , Adnani Lata , Rak Janusz
Published: May 2024

Cancer-associated thrombosis (CAT) results from the hemostatic system being dysregulated by the progression of cancer. Despite common clinical manifestations, the mechanisms of CAT may vary greatly because cancers develop along distinct biological trajectories that are imposed by the interaction between the tumor cell genome, the epigenome, the surrounding microenvironment, and the tissue of origin. The coagulome, or repertoire of coagulation effectors, expressed by stromal, inflammatory, and cancer cells at the tumor-vascular interface and systemically, reflects this biological variability. Complex landscapes of coagulant and non-coagulant cellular populations are revealed by single-cell RNA sequencing analyses conducted on unperturbed human cancer tissues. Additionally, through mediators of cell-cell interactions, soluble coagulants, and extracellular vesicles containing tissue factor, podoplanin, and other effectors, coagulomes are projected into the pericellular milieu and systemic circulation. As this complexity is currently outside of the clinical paradigm, one could argue that better CAT management could result from a more individualized analysis of coagulomes in cancer patients.
Cancer complicated by thrombosis and thrombocytopenia: still a therapeutic dilemma
Authors: Tan Yishi , Carrier Marc , Curry Nicola , Desborough Michael , Musgrave Kathryn , Scully Marie , Wang Tzu-Fei , Thomas Mari , Stanworth Simon J.
Published: May 2024

Individuals who have thrombocytopenia and cancer-associated thrombosis (CAT) are difficult to manage because they have a high risk of bleeding and recurrent thrombosis. The International Society on Thrombosis and Haemostasis guidelines for the management of thrombocytopenia in patients with CAT suggest two main approaches: either complete anticoagulation with transfusion support if necessary, or dose-modified anticoagulation while the platelet count is <50×109/L. Nevertheless, rather than being based on information from randomized controlled trials (RCTs), these recommendations were based on expert consensus. Recent research from two different countries has shown how this cohort’s management and results vary widely. While the United Kingdom study, Cancer-Associated Venous Thrombosis and Thrombocytopenia, found no significant differences in bleeding or recurrent thrombosis between full dose and modified dose groups, the North American Thrombocytopenia Related Outcomes with Venous thromboembolism study demonstrated a significantly lower risk of bleeding events in those receiving modified dose anticoagulation compared to full dose, without an increased risk of recurrent VTE. Therefore, an RCT is required to assess the best course of action for patients with CAT and thrombocytopenia. To define the standard of care for the management of patients with CAT and thrombocytopenia, a full-scale trial called the START randomized trial (STrategies for Anticoagulation in patients with thRombocytopenia and cancer-associated Thrombosis) is an international, multi-site pilot study that compares the use of platelet transfusions plus higher dose anticoagulation to modified dose anticoagulation in patients with thrombocytopenia and CAT receiving anticoagulation.
Risk of recurrent venous thromboembolism in cancer patients after discontinuation of anticoagulant therapy
Authors: Raskob Gary E.
Published: May 2024

Anticoagulant therapy is recommended for cancer-related venous thromboembolism (VTE). Recurrent VTE prevention is the main goal of this treatment. The majority of evidence-based practice guidelines recommend anticoagulant treatment for at least 6 months. Based on individual assessment of potential benefits and risks, tolerability, drug availability, patient preference, and cancer activity, active cancer patients should continue anticoagulant treatment beyond the 6-month course. When cancer is no longer active or the risk outweighs the benefit, anticoagulant therapy is usually stopped after 3-6 months. Until recently, there was little data on the risk of recurrent VTE in cancer-associated VTE patients after stopping anticoagulants. New results and evidence synthesis have emerged in the last 3 years. Recurring VTE occurs in over 30% in the 5 years after treatment discontinuation. In the first six months, recurrence rates are 10-15%. Recurrences reach 31% at 2 years and stabilize between 2 and 5. Duration of prior anticoagulation does not affect cumulative recurrence. The high risk of recurrent VTE after discontinuing treatment supports guidelines to continue anticoagulant treatment if cancer is active. Stopping anticoagulants after 3-6 months may not be ideal, so randomized clinical trials should be conducted quickly. This review highlights the need to improve cancer patients' primary VTE prevention efforts.
Review of foodborne helicobacteriosis
Authors: Almashhadany Dhary Alewy , Zainel Mustafa Abdulmonam , AbdulRahman Taha Talal
Published: May 2024

Helicobacteriosis is a common bacterial infection caused by Helicobacter pylori. It affects the stomach and small intestines, leading to inflammation. Bacteria can spread through contaminated food or water. This review explores the role of food in the transmission of H. pylori, drawing on research from the past three decades. People commonly acquire the infection during childhood, often from close family members. Crowded living conditions can also contribute to the spread. This review also discusses various risk factors and highlights the challenges of detecting H. pylori, particularly in its dormant form. Techniques like ribotyping and restriction fragment length polymorphism hold promise for tracing transmission routes, but more long-term studies are needed to account for potential confounding factors.
Endovascular Therapy in Large Core Ischemic Strokes: Real-World Indian Experience
Authors: Garg Surabhi , Ramachandran Dileep , Mishra Tanaya , Rangarajan Anush , Dash Gopal Krishna , Manohar Radhika , Philip Vivek Jacob , Shetty Kuldeep , Thomas Pravin , Krishna Shri Harsha , Nalubolu Shivakanth , Huded Vikram
Published: May 2024

Background:

Large core acute ischemic strokes have predominantly been excluded from endovascular therapy (EVT) studies due to perceived higher risks of hemorrhage and poorer functional outcomes. However, recent randomized controlled trials (RCTs) indicate that EVT for large vessel occlusion (LVO) strokes improves functional outcomes compared to medical management alone, despite higher hemorrhagic transformation rates, with no corresponding increase in symptomatic intracerebral hemorrhage (sICH) rates. The real-world outcomes of this intervention in Indian patients remain underexplored.

Objectives:

To evaluate the real-world outcomes of EVT for large core acute ischemic strokes with LVO in an Indian population.

Methods:

We conducted a single-center, retrospective observational study using a 7 years prospective database of EVT in anterior circulation stroke patients. Patients with Alberta Stroke Program Early Computed Tomography Score (ASPECTS) of 3–5 were included. Clinical and radiologic data were analyzed, with the primary endpoint being 90-day modified Rankin scale (mRS) scores. Safety outcomes included rates of sICH and mortality. Descriptive statistical analysis was done using Microsoft Excel.

Results:

The study included 25 patients who met the inclusion criteria. Mean age of patients was 52.9 ± 14.3 years, and there were 13 (52%) males. Median ASPECTS was 5 (interquartile range 4–5). Successful recanalization, classified by modified Thrombolysis in Cerebral Infarction score, was 92%. Good functional recovery, that is, 90-day mRS 0–3, was achieved in nine (36%) patients. Safety outcomes: sICH was seen in four (16%) and mortality was reported in nine (36%) patients.

Conclusions:

Our results reaffirm findings from RCTs, provide updated real-world evidence, and suggest that EVT is a viable option to be considered in selected patients with large core ischemic infarcts.
Chorea associated with infections
Authors: Yadav Rahul , Vijay Shankar , Desai Soaham
Published: May 2024

In tropical countries like India, infections of the central nervous system (CNS) and their varied complications are often encountered. Movement disorders (MDs) are reported to be a complication of infectious diseases, and the spectrum of MDs differs in tropical countries from other developed countries. We screened three electronic databases to search for cases of chorea as a presenting feature of infections, collected cases, and series describing chorea associated with infections. The studies were identified later and data were extracted regarding study design, sample size, neurological assessment, and diagnostic workup including brain imaging and cerebrospinal fluid analysis. After a detailed review of 283 different articles in the selection, a total of 33 articles were included in the final manuscript. In this narrative review, we review the important contributions in the field of chorea related to infections and discuss the salient features of infections of the CNS which can present with chorea. The infections presenting with chorea include streptococcal infections, tuberculosis, neurosyphilis, Japanese encephalitis, herpes simplex encephalitis, and neurocysticercosis. The hypothesized mechanisms of infection-related dystonia are vasculopathy, space-occupying lesions, autoimmune reaction, and inflammation. Although chorea is considered to be a result of heredodegenerative, metabolic, or autoimmune disorders lesions, infections may also present with chorea, especially in tropical and developing countries.
Ifosfamide-induced extrapyramidal neurotoxicity with COVID-19
Authors: Nagpal Chitrakshi , Agarwal Ayush , Venkateswaran Vineeta , Soni Kapil D , Srivastava M V Padma , Trikha Anjan
Published: May 2024

Ifosfamide, an analog of cyclophosphamide, is commonly used as a chemotherapeutic agent to treat sarcomas and solid tumors. However, neurotoxicity is a rare side effect of this drug. When present, the symptoms range from confusion, agitation, and delirium in mild cases to mutism, visual blurring, hallucinations, seizures, stupor, and even coma in extreme cases. Within this spectrum, extrapyramidal symptoms are extremely rare, and when present, may not revert with drug discontinuation. Sequelae may occasionally persist even after discontinuation of the drug.

Our case illustrates a rare occurrence of ifosfamide-induced extrapyramidal neurotoxicity in a patient with metastatic phyllodes tumor of the breast and concomitant COVID-19 illness.

Ifosfamide-induced extrapyramidal neurotoxicity is a clinical diagnosis of exclusion and requires ruling out of other possible causes. The diagnosis is supported by a temporal correlation with drug administration, presence of risk factors, and improvement after infusion cessation, along with normal brain imaging.
MT-ND5 gene mutation-associated mitochondrial complex I cytopathy in Leigh syndrome presenting as writer’s cramp
Authors: Agarwal Vikash , Mushahary Dolly , Venkitachalam Anil , Babu Sachin Suresh , Nayak Dinesh
Published: May 2024

Leigh syndrome is a classical mitochondrial cytopathy with multisystemic presentation that can lead to death in the first few years of life; however, cases in adults have also been reported. In this study, we report the case of an adolescent female presenting with writer’s cramp associated with the MT-ND5 gene mutation, diagnosed after observation of brain abnormalities on magnetic resonance imaging (MRI) and biochemical changes suggestive of mitochondrial cytopathy. The patient responded to botulinum toxin injection. To the best of our knowledge, ours is the first case report on focal dystonic presentation associated with the MT-ND5 gene mutation (with unclear pathogenicity) as a mild form of Leigh syndrome in adolescents.
ADCY5-related dyskinesia with myoclonus-dystonia syndrome
Authors: Saraf Udit , Chandarana Mitesh , Divya K. P. , Krishnan Syam
Published: May 2024

ADCY5-related dyskinesia is a childhood-onset autosomal dominant disorder that is caused by gain-of-function mutations in the ADCY5 gene. The core clinical features include a varying combination of hyperkinetic movement disorders (chorea, athetosis, dystonia, or myoclonus), orofacial dyskinesia, nocturnal exacerbations of dyskinesias while falling asleep, and axial hypotonia. We report two patients diagnosed with ADCY5-related dyskinesia, with myoclonus-dystonia presentation, and elaborate the clinical clues for diagnosis.
Paraneoplastic dystonia and spastic ataxia syndrome as a manifestation of oral carcinoma
Authors: Fatima Saman , Kakkar Aanchal , Tripathi Madhavi , Vibha Deepti , Singh Rajesh K. , Tripathi Manjari , Elavarasi Arunmozhimaran
Published: May 2024

Paraneoplastic syndromes are a heterogeneous group of disorders that present with varied symptoms in the presence of a tumor but are unrelated to the growth of primary malignancies, invasiveness, or metastases. Paraneoplastic neurological syndromes are estimated to affect <1% of the patients with cancer. They are commonly associated with small-cell lung carcinoma and hematologic and gynecologic malignancies and are rarely observed in head and neck malignancies. The diagnosis of paraneoplastic neurological syndromes may precede, be concurrent with, or follow the diagnosis of a malignant tumor. In this report, we present the case of a 55-year-old man who presented with rapidly progressive spastic ataxia and neurobehavioral symptoms with a background of longstanding cervical dystonia, which subacutely progressed to generalized dystonia. The patient was diagnosed with oral squamous cell carcinoma.
Hyperammonemia presenting as opsoclonus–myoclonus–ataxia–tremor syndrome
Authors: Manorenj Sandhya , Verma Govind
Published: May 2024

Opsoclonus myoclonus syndrome (OMS) is a rare autoimmune condition occurring due to Purkinje cell degeneration due to remote aetiology. Most often it occurs as a paraneoplastic syndrome. Here we report a case of opsoclonus-myoclonus–ataxia tremor syndrome in a 60-year-old woman that occurred due to hyperammonemia and she recovered completely with immunotherapy and correction of hyperammonemia. OMS is the first in literature associated with hyperammonemia.
Treatment of sialorrhea in Parkinson’s disease
Authors: Mehta Sahil , Lal Vivek
Published: May 2024

Sialorrhea is a common disabling nonmotor symptom of Parkinson’s disease. It can lead to several ill effects such as poor orodental hygiene, speech and feeding difficulty, depressive symptoms, poor quality of life, and aspiration pneumonia. It most likely occurs secondary to swallowing dysfunction due to a combination of factors such as lingual bradykinesia, oropharyngeal dysphagia, and esophageal dysmotility, leading to impaired salivary clearance. Various tools are available for its objective assessment to assess drooling in patients with Parkinson’s disease. The treatment options include use of anticholinergic medications and optimization of dopaminergic therapy. However, their use is limited due to the occurrence of adverse effects. Botulinum toxin injections into the parotid and submandibular glands is the most effective and safest treatment available at present.
Enhancement and Digitalization in Healthcare with “THE ARTIFICIAL INTELLIGENCE”
Authors: Goel Neha , Saluja Pulin , Dave Aparna , Arora Manpreet
Published: May 2024

The present review aims at understanding artificial intelligence (AI) in general with special emphasis on the enhancement and digitalization it brought in the various fields of healthcare. Not only it help in the diagnosis and treatment of various diseases but also in the prevention of diseases by aiding in early detection and providing prompt treatment to the patient. It also helps in predicting risk for various diseases thus reducing the morbidity rate. Nowadays, even AI-assisted surgery and robot surgery are being carried out. In fact, in the recent SARS-COVID-19 pandemic, vaccines have been stored under optimal temperature with the use of thermoregulated sensors. Undoubtedly, AI can never completely replace clinicians but it can assist the clinician in providing quality and effective treatment to the patient at every stage from scheduling appointments, documenting it, and maintaining records of the patient’s previous medical history till diagnosis, treatment, and follow-ups. This review covers various applications of AI tools in different health-care sectors from drug and vaccine development to even gene detection. Thus, after review of many articles by the authors, we concluded that AI in healthcare helps in imparting both time and cost-effective, patient-friendly, precise, and quality treatment to the patient. With the emerging advancement and technology in the IT sector, AI is soon going to revolutionized the field of healthcare.
Radiographic Diagnostic Dilemma – A Rare Case Report of Secondary Hyperparathyroidism
Authors: Yadav Preetika , Vohra Puneeta , Chaudhry Astha , Malhotra Kajal , Chauhan Pratibha
Published: May 2024

This case report highlights the role of oral physicians in taking a detailed systemic history along with relevant laboratory investigations to rule out some rarer cases of secondary hyperparathyroidism manifesting in the jaw/mandibular bone. Although radographicaly the tumour site was resembling like Central giant cell granuloma but on detiled laboratory investigations alkaline phospahatase levels (401IU/L)were raised and serum calcium levels were (8.5mg/dl) hence final diagnosis of secondary hyperparathyroidisum was made and pateint was managed by giving vitamin d3 and calcium support rather then surgery. Hence, cases like this draw the attention of oral as well as general physicians to not treat the patient based only on histopathological or radiological findings without proper correlation of clinical and other laboratory investigations.
Comparative Evaluation of Gingival Zenith Position in Maxillary Incisors in Males and Females of Uttarakhand Population
Authors: Tomer Pranshu , Sharma Tarun , Prasad P. Narayana , Rawat Anupa , Grover Anu
Published: May 2024

Introduction:

The entire appearance of face can be virtually transformed in an instant with a smile makeover. One of the most important parameters of clinical importance for gingival morphology is the gingival zenith. Therefore, the aim of the study was the evaluation and establishment of the gingival zenith position (GZP) from the vertical bisecting midline (VBM) axis of each maxillary incisor and the influence of gender on these parameters under healthy conditions.

Materials and Methods:

Frontal intraoral photographs of 200 young individuals (100 males and 100 females) 14–17 years old with healthy gingiva were randomly selected from Uttarakhand population. Their intraoral soft-tissue landmarks were digitized for standardization using Digimizer Image Analysis (6.3.0). Statistical analysis was done using Statistical Package for Social Sciences (22.0.0). We used descriptive statistics to find the mean GZPs. Comparison of mean GZP between males and females was done using Mann–Whitney U-test and comparison of GZP of different tooth types was done employing the Chi-squared test. Significance fixed at P < 0.005.

Results:

For central incisors, mean GZP was 0.77 ± 0.39 mm for males and 0.91 ± 0.42 mm for females, for lateral incisors, 0.48 ± 0.25 mm for males and 0.54 ± 0.31 mm for females. No statistically significant differences were seen between the mean GZP of left central and left and right lateral incisors in male and female populations (P > 0.005). However, statistically significant differences were seen in the mean GZP of right central incisors between males and females (P < 0.005). The mean GZP distance of right central incisors in females was more statistically significant than in males.
Correlation of Diabetes, Hypertension, and Obesity with the Stage of Periodontitis
Authors: Sheokand Vidushi , Bhardwaj Amit , Munjal Neha , Chugh Alisha , Bhatnagar Anurag
Published: May 2024

Background:

Systemic diseases such as diabetes and hypertension may affect periodontium. Increased protein glycosylation from poorly controlled diabetes enhanced glycation end-product synthesis, which in turn triggers the release of inflammatory cytokines and increases the risk of periodontal attachment loss and alveolar bone loss. Alterations in the microcirculation can cause ischemia in the periodontium in hypertension, which may make the situation worse. Its pathophysiology has been postulated to involve oxidative stress and endothelial dysfunction.

Aim:

The current study’s objective is to correlate the blood sugar level, blood pressure, and body mass index (BMI) with the stage of periodontitis.

Materials and Methods:

A total number of 245 patients having periodontitis and gingivitis were examined for systemic parameters which included hypertension, diabetes, and BMI. Glucometer kit is used for measuring random blood glucose, sphygmomanometer is used for measuring blood pressure whereas Omron BMI machine is used for calculating BMI.