bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Information Leakage and Conserving Digital Privacy
Authors: Senapati Kishore Kumar , Kumar Abhishek , Sinha Kunal
Published: September 2023

The rise of globally integrated technology with a pace in technical intervention in diversified fields of social, financial, governmental, and defense services the world today is transforming into data age. This scientific development of storing and processing tasks within software territory had invaded the privacy of the users and individuals through technical attacks of existing and innovated technical solutions to discover and mine related information that may use for illegal and legal activities as per demand. Such a data, if extracted from a secured system, may harm a user or an individual in various ways depending on culprit's intention. It therefore becomes important to learn and understand the technical art of safeguarding their data while going digital. Privacy conserved data publishing should be an essential precondition for all data driven technologies. Keeping data safe and legal is another aspect. Existing protection mechanisms may not help in privacy mechanism due to unbalanced research in legal and illegal related technical innovations.
MC-YOLO-Based Lightweight Detection Method for Nighttime Vehicle Images in a Semantic Web-Based Video Surveillance System
Authors: Wang Xiaofeng , Hao Xiao , Wang Kun
Published: September 2023

Semantic web-based video surveillance systems can provide strong decision-making support for managers, and they have high requirements for real-time and precision of vehicle detection models in complex night scenes. To address this issue, a lightweight nighttime vehicle detection method (MC-YOLO) integrating MobileNetV2 and YOLOV3 is proposed. Firstly, in the preprocessing stage, image enhancement is performed on nighttime images to facilitate model feature extraction. Then, the lightweight network MobileNetV2 is used to extract feature by replacing the backbone network DarkNet53 in YOLOv3, thus accelerating the speed of target detection. Finally, after the convolution operation of the backbone network, a convolution block attention module is added to enhance the important feature information and suppress the secondary features, thereby improving the detection precision. The experimental results on the BDD100K dataset show that the proposed MC-YOLO model has a precision of up to 92.75%, which is superior to several other advanced comparative models.
Dyslipidemia in Patients with Chronic Kidney Disease: An Updated Overview
Authors: Suh Sang Heon , Kim Soo Wan
Published: September 2023

Dyslipidemia is a potentially modifiable cardiovascular risk factor. Whereas the recommendations for the treatment target of dyslipidemia in the general population are being more and more rigorous, the 2013 Kidney Disease: Improving Global Outcomes clinical practice guideline for lipid management in chronic kidney disease (CKD) presented a relatively conservative approach with respect to the indication of lipid lowering therapy and therapeutic monitoring among the patients with CKD. This may be largely attributed to the lack of high-quality evidence derived from CKD population, among whom the overall feature of dyslipidemia is considerably distinctive to that of general population. In this review article, we cover the characteristic features of dyslipidemia and impact of dyslipidemia on cardiovascular outcomes in patients with CKD. We also review the current evidence on lipid lowering therapy to modify the risk of cardiovascular events in this population. We finally discuss the association between dyslipidemia and CKD progression and the potential strategy to delay the progression of CKD in relation to lipid lowering therapy.
From rodents to humans: Rodent behavioral paradigms for social behavioral disorders
Authors: Guo Mingyue , Sun Le
Published: September 2023

Social cognition guides social behavior. Subjects with proper social cognition should be able to: (1) have reasonable social motivation, (2) recognize other people and infer their intentions, and (3) weigh social hierarchies and other values. The choice of appropriate behavioral paradigms enables the use of rodents to study social behavior disorders in humans, thus enabling research to go deeper into neural mechanisms. This paper reviews commonly used rodent behavioral paradigms in studies of social behavior disorders. We focused specifically on sorting out ways to transfer the study of human social behavior to rodents through behavioral paradigms.
Parainfectious cerebral vasculopathy complicating bacterial meningitis: Acute-short lived vasospasm followed by delayed-long lasting vasculitis
Authors: Kumar Vivig Shantha
Published: September 2023

Bacterial meningitis is a serious, life-threatening infection of the meninges. Several radiological studies highlight prominent structural alterations occurring in the cerebral vasculature, leading to significant cerebrovascular consequences during bacterial meningitis. Beginning with reflexive arterial vasospasm , cerebrovascular disease during bacterial meningitis proceeds through a orderly sequence of arterial vasculitis with inflammatory cell infiltration, medial smooth muscle migration and proliferation, medial necrosis, adventitial fibrosis and eventual intimal stenosis. As such, this review focuses on changes occurring within cerebral arteries during disease progression, highlighting the various structural modifications occurring in the arterial vessels that contribute to disturbances in cerebral hemodynamics and, ultimately, cerebrovascular consequences during bacterial meningitis.
Cardiac Rehabilitation after Percutaneous Coronary Intervention – Evidence and Barriers
Authors: Pothineni Naga Venkata , Gondi Suhas , Kovelamudi Swathi
Published: September 2023

Cardiac rehabilitation (CR) represents a spectrum of interventions that influence physical, mental, and social well-being of an individual. These interventions can range from dietary counseling to intense physical activity. The role of CR in various cardiac disorders, particularly ischemic heart disease, has been well established across multiple studies. However, real-world utilization of CR still seems to lag behind. As coronary intervention modalities keep evolving with increasing number of patients receiving percutaneous coronary intervention, there is a need for reappraisal of the role of CR in this population. In this review, we discuss data behind the benefit of CR in patients with ischemic heart disease and highlight the barriers encountered in implementing CR in real-world practice.
Heart Rate Variability
Authors: Low Adrian , McCraty Rollin
Published: September 2023

Introduction:

Cardiovascular diseases are the highest cause of death in the world. Many of these deaths may be workplace related. Long hours at work seem to be influencing the increased risks of heart diseases. Workplace stress can be defined as the “discrepancies between the physiological demands within a workplace and the inability of employees to either manage or cope with such work demands.” The varied nature and perception of stress are exemplified from literature that shows stress being either a stimulus, or a response, or a stimulus–response combination, also known as a transactional relationship between one or more individuals and the environment, leading to an initiative toward a physiological standpoint.

Methods:

This research opted for a correlational study which involves 85 full-time employees who were working at least 40 h per week in a large corporation participated in this study. The Personal and Organizational Quality Assessment and Perceived Stress Scale were used to correlate with heart rate variability (HRV).

Objectives:

The primary objective of this study is to introduce a new quantitative assessment tool emWave Pro Plus (Institute of HeartMath) and compare heart rate variability (HRV) results with the Personal and Organizational Quality Assessment (POQA) and the Perceived Stress Scale (PSS).

Results:

Astonishing findings emerged. Significant positive correlations were found between emotional stress and HRV and between intention to quit and HRV. In other words, the researcher has to make sense the following surprising findings: (1) The higher the emotional stress an employee faces, the healthier they are. (2) Healthier employees may have higher intentions of quitting their jobs.

Conclusion:

The surprising results may be attributed to personality, culture, emotional regulation, and age among others.
Modifying Effect of Diabetes on the Short-term Effect of Clopidogrel in Patients with Myocardial Infarction
Authors: Xie Wuxiang , Feng Lin , Li Xian , Gao Runlin , Wu Yangfeng
Published: September 2023

Background:

Patients with diabetes are reported having inadequate response to clopidogrel treatment compared with patients without diabetes. The present study aims to investigate the effect of clopidogrel treatment in lowering in-hospital major adverse cardiovascular events (MACEs) among hospitalized myocardial infarction (MI) patients with and without diabetes.

Materials and Methods:

This is a post hoc analysis of the third phase of Clinical Pathways in Acute Coronary Syndromes program study. Between October 2011 and November 2014, a total of 14,997 patients with MI were consecutively recruited from 101 county hospitals without the capacity to perform onsite percutaneous coronary intervention (PCI).

Results:

The mean age of the 14,997 patients with MI was 64.8 ± 12.2 years, and 67.5% of the participants were male. Of these patients, 1920 (12.8%) were classified as diabetes when presenting at the hospital, and 12,875 (85.9%) patients received in-hospital clopidogrel treatment. In total, 167 patients (8.7%) with and 955 patients (7.3%) without diabetes experienced an in-hospital MACE. Multivariable-adjusted relative risk (RR) associated with clopidogrel treatment for in-hospital MACEs was 0.79 (95% confidence interval [CI]: 0.68–0.93) among all MI patients, and it was also consistent between patients with (RR = 0.79, 95% CI: 0.54–1.16) and without diabetes (RR = 0.79, 95% CI: 0.65–0.95; P for interaction = 0.970). Propensity score-matched subgroup analyses yielded similar results.

Conclusion:

Our large-scale study of real-world data from non-PCI-capable hospitals in China demonstrated that clopidogrel treatment was associated with a lower risk of in-hospital MACEs in MI patients, and this effect was not modified by diabetes.
Heart or Mind? Unexplained Chest Pain in Patients with and Without Coronary Disease
Authors: Garroni Dina , Fragasso Gabriele
Published: September 2023

Patients with unexplained chest pain continue to present a difficult challenge for clinicians, especially for cardiologists. Approximately 20% of patients undergoing diagnostic coronary arteriography for acute or chronic cardiac ischemia have angiographically normal coronary arteries. In these cases, patients with chest pain are usually reassured by their physician and other causes of substernal chest pain are searched. However, apart from a sizeable proportion of patients with gastroesophageal disorders, the remaining patients remain symptomatic without apparent reasons. The mechanism behind this phenomenon is likely to be the result of a combination of functional or anatomical abnormalities in the coronary microcirculation, a metabolic disorder which affects the handling of energy substrates by the heart, insulin resistance and neuropsychological components affecting pain perception. These patients often exhibit an increase in sympathetic outflow to the cardiovascular system, which might account for the reduction in coronary flow reserve, changes in metabolic utilization and development of insulin resistance that are seen in some of these patients. Therapeutically, beta-blockers appear to be most effective in controlling the symptoms associated with this condition, although those calcium antagonists which do not affect the neurohormonal system may be of some utility in patients with primary microvascular angina, in which microvascular spasm is operating or in whom excessive constriction of the distal component of the coronary circulation limits the vasodilatory reserve. This article reviews the clinical presentation, differential diagnosis, and approach to evaluation and therapy of this complex group of patients.
Greater N-Acetylaspartate to Creatine Ratio within Left Anterior Insula Predicts Sympathetic Imbalance in Postmenopausal Women Living with Hypertension and/or HIV
Authors: McIntosh Roger C. , Lobo Judith D. , Fajolu Olumide , Reyes Elizabet , Pattany Pradip M. , Kolber Michael A.
Published: September 2023

Context:

Brain metabolite ratios derived from magnetic resonance spectroscopy (MRS) has been used to document changes in neuronal viability, glial activation and inflammation associated with Human Immunodeficiency Virus (HIV) infection and cardiovascular disease.

Aims:

To determine whether brain metabolite ratios in the left anterioar insula predicts cardio-autonomic regulation indexed by the ratio of low- to high-frequency heart rate varaibility (LF:HF) after accounting for post-menopausal age, HIV and hypertensive (HTN) status.

Design:

Thirty women, (n=14 HIV+ and n=16 HTN+) with an average age of 54.5 (SD=6.4) years and no history of neurological disease were recruited for the study.

Methods:

After conventional MR imaging, single-voxel 1H-MRS (TR = 1500 msec; TE = 35 msec) was performed by using a PROBE-SV system implemented on a 3T GE Discovery MR750 scanner. Shift-selective imaging pulses for water suppression were acquired from a voxel placed in the midline of the left anterior insula with an average voxel size of 15×15×15 mm. Heart rate variability was estimated over a 7 minutes resting state scan using an MR-compatible photoplethysmogram.

Statistics:

A stepwise regression analysis controlling for (1) age, disease status (HIV+ and HTN+) was modelled separately for the ratio of N-acetylaspartate (NAA), Myo-inostol (mI), and Choline (Ch) to Creatine (Cr) ratios to predict LF:HF.

Results:

Higher ratios of NAA/Cr were associated with lower LF:HF (β= -.393, t(29)= -2.26, p= .033). Ratios of mI:Cr and Cho:Cr did not predict LF:HF.

Conclusions:

Decreased neuronal viability in the left anterior insula, indexed by lower NAA/Cr metabolite ratios explain a significant proportion of the variance in the skew towards sympathetic overarusal in postmenopausal women at risk for cerebrovacular disease.
Depression Assessment
Authors: Toukhsati Samia R , Yau Lewis , Yates Rosemary , Catrice Isabelle , Wasser Cory , Young Lynette , Greening Kimberley , Flaks Gabriella , Miller Jenna , Hare David L
Published: September 2023

Background:

Patients are frequently assisted by proxies, usually a spouse, to complete health and medical surveys, including depression assessments.

Objective:

The objective of this study was to examine whether spousal assessments of patient depression concord with those of the patient.

Materials and Methods:

Consecutive adult cardiac patients attending an outpatient cardiovascular disease clinic accompanied by an adult were enrolled. Patient–spousal pairs independently completed the Cardiac Depression Scale (CDS) on behalf of the patient. Proxies provided demographic and medical history information and also completed the Physical Health Questionnaire.

Results:

A total of 72 patients (males 75%; mean age = 67.18 ± 11.35 years) and 72 spouses (mean age = 65.19 ± 11.49 years) met enrollment and analysis criteria. Most spouses were female (75%). Proxies rated patients significantly higher on the CDS (mean = 93.14 ± 29.33) than did patients of themselves (mean = 87.93 ± 26.79), t(71) = –2.05, P < 0.05. Patient–spousal concordance was low to moderate on the total CDS (concordance correlation coefficient [CCC] = 0.69) and CDS symptoms including mood (CCC = 0.35), anhedonia (CCC = 0.63), anxiety (CCC = 0.71), irritability (CCC = 0.55), hopelessness (CCC = 0.50), cognitive dysfunction (CCC = 0.41), and sleep disturbance (CCC = 0.64).

Conclusions:

These results suggest that spouses have limited insight into patient's psychological status, as self-reported by patients. Proxy assessments should be interpreted with caution and, wherever possible, patients should be encouraged to complete depression assessments on their own.
Cardiac Preconditioning and Cardiovascular Diseases
Authors: Li William A , Ding Yuchuan
Published: September 2023

Cardiovascular disease is the leading cause of mortality and morbidity in the United States. Cardiac preconditioning, an endogenous phenomenon, has been shown to protect the heart from acute myocardial infarction by subjecting it to brief cycles of ischemia and reperfusion. The concept of ischemic preconditioning has led to a group of cardiac conditioning strategies that include preconditioning, postconditioning, and remote conditioning. Other than complete reperfusion, cardiac conditioning is considered the most powerful intervention available for reducing infarct size in animal models and in clinical trials. A comprehensive investigation into the mechanisms underlying cardiac conditioning has led to the identification of several therapeutic targets for pharmacological intervention, including the ATP-dependent potassium channel. Remote cardiac conditioning has garnered a great deal of attention as a noninvasive method to deliver conditioning. Several signaling mechanisms have been investigated, including humoral communication and neuronal stimulation. Although the cardioprotective pathways of remote conditioning are widely studied, the translation to clinical practice has been controversial. Two recent, large, and well-designed clinical trials highlight the challenges of implementing remote conditioning. However, a number of cardioprotective therapies involving conditioning have shown promising results. Future research should continue to explore the potential of remote conditioning.
Heart and Mind
Authors: Liu Meiyan
Published: September 2023

Although it has been proposed in scholarly works for centuries that psychological factors play a role in the pathophysiology of somatic disease, this belief has not been validated mechanistically until relatively recently. This article discusses one specific instance of this general phenomenon: psycho-cardiology. Combining insights from epidemiological research, which has been prolific in showing associations between cardiovascular and psychological diseases, and the basic science research that has recently begun elucidating the biological mechanisms that may underlie those associations, the aim of this article is to provide a broad overview of the field of psycho-cardiology as it is presently understood. Beginning with a history of the development of psycho-cardiology, the article proceeds through separate sections that discuss contemporary research in the field under the following categories: epidemiology, clinical manifestations, structural and functional derangements, induction mechanisms, the impact of technological and diagnostic changes, and the practical implications for treatment. Taken together, the body of work that this article surveys points clearly to the need to integrate the evaluation for and treatment of psychological disease into the scope of clinical cardiology.
Analgesic Efficacy and Outcomes of Ultrasound-guided Erector Spinae Plane Block in Patients Undergoing Bariatric and Metabolic Surgeries: A Systematic Review
Authors: Nair Abhijit Sukumaran , Rangaiah Manamohan , Dudhedia Ujjwalraj , Borkar Nitinkumar Bhajandas
Published: September 2023

Erector spinae plane block (ESPB) has been used as an intervention for providing postoperative analgesia in patients undergoing bariatric and metabolic surgeries. After registering the protocol in PROSPERO, randomized controlled trials and nonrandomized observational studies were searched in various databases till July 2022. The primary outcome was 24-h opioid consumption; the secondary outcomes were intraoperative opioid use, pain scores, time to rescue analgesia, and complications. The risk of bias and Newcastle-Ottawa scale were used to assess the quality of evidence. From the 695 studies identified, 6 studies were selected for analysis. The 24-h opioid consumption was significantly lesser in ESPB group when compared to control (mean difference [MD]: −10.67; 95% confidence interval [CI]: −21.03, −0.31, I² = 99%). The intraoperative opioid consumption was significantly less in the ESPB group (MD: −17.75; 95% CI: −20.36, −15.13, I² = 31%). The time to rescue analgesia was significantly more in the ESPB group (MD: 114.36; CI: 90.42, 138.30, I² = 99%). Although pain scores were significantly less at 6 and 24 h in ESPB group (MD: −2.00, 95% CI: −2.49, −1.51; I² = 0% and MD: −0.48; 95% CI: −0.72, −0.24; I² = 48%), at zero and 12 h, the pain scores were comparable (MD: −1.53, 95% CI: −3.06, −0.00, I² = 97% and MD: −0.80; 95% CI: −1.80, 0.20, I² = 88%). Bilateral ESPB provides opioid-sparing analgesia and better pain scores when compared to control. These results should be interpreted with caution due to high heterogeneity among the included studies.
An Unusual Antenatal Presentation of a Mature Pericardial Teratoma Masquerading as Congenital Pulmonary Airway Malformation
Authors: Krishnan Vivek , Abraham Mohan K , Abraham Ajay , Nair Indu Ramachandran , Mathews Basil
Published: September 2023

We report an antenatal presentation of a huge pericardial mature teratoma that was referred as congenital pulmonary airway malformation (CPAM) in the late third trimester of pregnancy. Initial ultrasound evaluation revealed a huge predominantly cystic lesion with mixed echogenicity in the left hemithorax. A provisional diagnosis of pleural tumor was considered in view of previous scans at 20‒28 weeks being normal and associated pleural effusion. Magnetic resonance imaging of the fetus reported the lesion to be CPAM which was supported by postnatal computed tomographic imaging done on day 2 of life. However, intraoperatively, the lesion was found to be of pericardial origin which on subsequent histopathological examination was confirmed to be mature teratoma. We recommend considering potential differential diagnosis other than CPAM, especially when the lesion is found for the first time in the late third trimester.
An in vitro Model for Experimental Evaluation of Sonothrombolysis under Tissue-mimicking Material Conditions
Authors: Drakos Theocharis , Evripidou Georgios , Damianou Christakis
Published: September 2023

Background:

The mechanical properties of therapeutic ultrasound (US) have attracted scientific interest for thrombolysis enhancement in combination with thrombolytic agents and microbubbles (MBs). The aim of the study was to develop an in vitro model to observe how the effects of sonothrombolysis change in the case where a tissue-mimicking material (TMM) is placed in the path of the US beam before the clot.

Methods:

Fully retracted blood clots were prepared and pulse sonicated for 1 h under various conditions. The system was in a state of real circulating flow with a branch of an open bypass and an occluded tube containing a blood clot, thus mimicking the case of ischemic stroke. The effectiveness of thrombolysis was quantified in milligrams of clots removed. An agar-based TMM was developed around the occluded tube.

Results:

The clot breakdown in a TMM was found to be more pronounced than in water, presumably due to the retention of the acoustic field. A higher level of acoustic power was required to initiate clot lysis (>76 W acoustic power) using only focused US (FUS). The greatest thrombolysis enhancement was observed with the largest chosen pulse duration (PD) and the use of MBs (150 mg clot mass lysis). The synergistic effect of FUS in combination with MBs on the enzymatic fibrinolysis enhanced thrombolysis efficacy by 260% compared to thrombolysis induced using only FUS. A reduction in the degree of clot lysis was detected due to the attenuation factor of the intervening material (30 mg at 1 and 4 ms PD).

Conclusion:

In vitro thrombolytic models including a TMM can provide a more realistic evaluation of new thrombolytic protocols. However, higher acoustic power should be considered to compensate for the attenuation factor. The rate of clot lysis is slow and the clinical use of this method will be challenging.
Ultrasound Assessment of the Fetal Optic Chiasm
Authors: Wang Jo-Ting , Chang Tung-Yao
Published: September 2023

This article reviews the literature on different methods of prenatal ultrasound visualization of the optic chiasm (OC) and its applications. Prenatal imaging of the OC is feasible from 19 to 37 weeks of gestation. Evaluation of the OC has been shown crucial in differentiating isolated agenesis of the septum pellucidum from septo-optic dysplasia. Multiple methods can be applied for imaging of the OC, including three-dimensional and two-dimensional ultrasounds in different views, as well as color Doppler. According to the literature, both transabdominal and transvaginal routes produce equally acceptable images. OC visualization might be challenging but can be achieved by developing a standard scanning protocol and raising awareness.
An Online Educational Module to Improve General Internal Medicine Trainees’ Knowledge and Comfort in Managing Acute Complications of Sickle Cell Disease
Authors: Bhella Sita , Radwi Mansoor , Ward Richard
Published: September 2023

BACKGROUND:

Sickle cell disease (SCD) is a genetic disorder characterized by hemolytic anemia and vaso-occlusive episodes. Many adults with SCD require hospitalization for the management of acute manifestations. There appears to be a gap in the level of knowledge that general internal medicine (GIM) trainees possess regarding the treatment and management of SCD.

METHODS:

We created an online module that helps medical residents improve their knowledge about SCD. Participants were exposed to different scenarios related to SCD. A pre-and posttests were administered to detect improvement in knowledge and comfort when managing SCD and its acute complications.

RESULTS:

Thirty consecutive GIM residents participated. Of these, 20 completed the demographic survey, 17 completed the pretest, and 10 completed the posttest and usability survey. The median time to complete the module was 68 min. Fifty percent of participants were 1st-year postgraduation from medical school. Forty-five percent stated that they were uncomfortable managing patients with SCD 80% had cared for at least 1–5 patients with SCD. All reported having no SCD lectures in residency. The median pretest score was 12/20 (range, 8–15) and posttest score was 20.5/25 (range, 13–24).

CONCLUSIONS:

Residents agreed that the module was useful, helps understanding about SCD and its complication, and aids with clinical duties. This module demonstrated to be an effective educational tool that can support resident education during their internal medicine. Further strategies will be needed to improve the delivery of online modules to keep residents engaged with the module and attaint full benefit from these activities.
Venous Thromboembolism Risk Assessment among Beta-thalassemia Patients
Authors: Abo-Elwafa Hasnaa A. , Youseff Laila M. , Mahmoud Ramadan A. , Elbadry Mahmoud I. , Tawfeek Ahmed , Aziz Shereen P.
Published: September 2023

BACKGROUND:

Thromboembolic (TE) disorders are among the most common complications of beta-thalassemia. We designed this cross-sectional study to investigate the state of hypercoagulability and platelet activation in patients with beta-thalassemia.

PATIENTS AND METHODS:

Seventy-five patients diagnosed with beta-thalassemia by hemoglobin electrophoresis were divided into three groups of 25 patients each: Group I (thalassemia trait), Group II (thalassemia intermedia [TI]), and Group III (thalassemia major). In addition, 50 healthy individuals were included as controls. Both patients and control groups were subjected to clinical and laboratory assessment, which included measurement of protein C, anti-thrombin III, D-dimer, CD41, CD42, CD61, and CD62P, and detection of beta-chain mutations.

RESULTS:

Levels of the platelet activation marker CD62P were significantly higher in beta-thalassemia patients (26.28 ± 18.01%) than in controls (4.78 ± 2.27%) (P < 0.001). The D-dimer level was significantly higher in beta-thalassemia patients (348.41 ± 571.01 ng/mL) than in controls (71.6 ± 39.61 ng/mL) (P < 0.001). Protein-C and AT-III levels were significantly lower in beta-thalassemia patients (71.45 ± 13.26%, 78.38 ± 15.32%) in comparison with controls (94.9 ± 13.03%, 96.52 ± 11.01%) (P < 0.001 and P < 0.001, respectively). TE disorders were found in 7/25 (9%) beta-thalassemia patients, especially in older and postsplenectomy patients. TE was most commonly found in beta-TI. Beta-chain mutations were found in all patients with TE disorders, especially compound heterozygous intervening sequence (IVS) (IVS1.6 [T > C]/IVS1.110 [G > A]).

CONCLUSION:

Postsplenectomy teenagers and adults with beta-thalassemia with lower levels of natural anticoagulant in the blood, an increased level of D-dimer, and platelet activator factor had a significantly higher risk for TE than those with childhood beta-thalassemia and the control group. In comparison with other beta-thalassemia patients, TI with beta-chain mutations is more likely to develop TE.
Incidence and Prevalence of Acute Stroke and its Clinical Implications and Outcomes in Patients with Sickle Cell Disease: A Systematic Review
Authors: Pitliya Aakanksha , Khatri Kanishka , Elapolu Anjana Chowdary , Ahmed Rabia , Kancherla Neeraj , Jonnala Ramya Reddy , Ibrahim Abdulgafar Dare , Muppidi Harshini , Ashiq Amir , Pitliya Anmol
Published: September 2023

This systematic review aims to determine the incidence and prevalence of acute stroke in patients with sickle cell disease (SCD) and explore its clinical implications and outcomes. A comprehensive search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines to identify relevant studies published between 2013 and 2023. Databases including PubMed, Google Scholar, ResearchGate, ScienceDirect, and Wiley Online Library are searched. Inclusion criteria are applied to select studies involving human subjects, written in English, and reporting the association between acute stroke and confirmed cases of SCD. Study quality assessment and data extraction are performed by two independent reviewers using study-specific tools. A total of 9 studies met the inclusion criteria including 7 cohort studies, and two meta-analyses are included in the systematic review with a total of 24,480 participants. The prevalence of stroke in SCD patients varied across studies, ranging from 1.24% to 27.3%. The incidence rates of stroke showed significant variability, ranging from 0.31% to 31%. Long-term disabilities, recurrence, and reduced quality of life characterized the clinical outcomes of stroke in SCD patients. Mortality rates varied among studies, emphasizing the need for early detection and comprehensive care. The review provides valuable insights for health-care professionals, researchers, and policymakers involved in SCD care, emphasizing the importance of early detection, intervention, and comprehensive management to improve patient outcomes. Further research is needed to address knowledge gaps and understand the underlying mechanisms of stroke in SCD.
Incidence of Lymphoma Among Adult Patients in the Eastern Province of Saudi Arabia – A Single-center Study
Authors: Al-Ansari Rehab Yusuf , Aljarah Nasser Mohammed , Alofi Ghufran Moaid , Shaigah Faisal Ahmed Abu , Al-Qahtany Faisal Hani , Jebakumar Arulanantham Zechariah , Alsubaie Saad Mohammed , Al-Almaie Saad Mohammed , Qureshi Arifa Jamaluddin
Published: September 2023

BACKGROUND:

Lymphoma is a cancer of the lymphatic system with two main types, namely Hodgkin lymphoma (HL) and non-HL (NHL). Within these, there are many subtypes. Based on data from the National Cancer Institute, NHL accounts for 4.2% whereas HL accounts for 0.5% of all cancers in the United States. The treatment strategy depends on the type and the stage of the lymphoma. In this study, we are studying the incidence rate of lymphoma in a military-nononcology center for better understanding and recording of the condition.

METHODS:

We conducted an observational, analytical, retrospective study in a tertiary care hospital on 56 patients admitted to the hospital between January 2016 and the end of December 2021, with lymphadenopathy or body mass, who were diagnosed with lymphoma. The modality of diagnosis was tissue histopathology. All data including demographics, details of lymphoma lesions, and laboratory and histopathology results were obtained from health informatics or manual records.

RESULTS:

In this study, we found that 67.9% of the cases were male, with a significantly higher rate among Saudi patients in comparison to non-Saudi (94.6% and 5.3%, respectively). Among Saudi cases, we found that a significantly higher percentage of lymphoma cases were originally from the Eastern and the Southern provinces (47.1% and 35.8%, respectively), and 46.5% of them were living in Dammam at the time of diagnosis. The percentage of NHL was significantly higher than Hodgkin type (80.3% and 19.6%, respectively). The majority of the cases belonged to B-cell NHL (73.2%). Moreover, the incidence rate increased from 2016 to 2021 with an accumulative rate of 25.14 / 100,000 person-years.

CONCLUSION:

Our data indicate that the incidence rate of lymphoma increased in the last 5 years at a tertiary care center. We found evidence for associations between the original province and the rate of the lymphoma. Moreover, the rate of B-cell NHL was significantly higher with superior mortality rate in comparison to other types of lymphoma in our cohort, which supported previous studies in the Kingdom of Saudi Arabia. There was no increase in incidence of lymphoma in our study cohort of military personnel, and it matches the incidence data of other local studies. Further national studies and initiation of lymphoma registry may add a value for future researches.
Myxedema crisis in an adolescent girl, successfully treated by oral thyroxine: A case report
Authors: Tandon Rahul , Kumar Amit , Patel Shradha , Mori Sandip , Thakkar Fenil , Tandon Krutika
Published: September 2023

Myxedema crisis is a condition with high mortality. It affects adults more often than children. Patients present with low blood pressure, low pulse, low body temperature, hypoventilation, and gastrointestinal dysfunction. Here, we present a case report of a teenage girl who was diagnosed with acquired hypothyroidism at the age of 7 years and was effectively treated with oral thyroxine in myxedema crisis.
Coronavirus disease 2019 pneumonia with acute respiratory distress syndrome in a child requiring prolonged mechanical ventilation: A case report
Authors: Sunthwal Shraddha , Lad Sagar , Bafna Sanjay , Kulkarni Rajesh , Lad Preeti , Ahmadi Salma , Ganacharya Raj
Published: September 2023

Coronavirus disease 2019 (COVID-19) infection in children predominantly presents with milder symptoms and is apparently less severe. However, 2% of acute pediatric COVID-19 cases possessed severe manifestations. Here, we describe a case study of a 4-year-old boy suffering from acute COVID-19 infection that presented like an adult ARDS requiring prolonged ventilation and medical course complicated with hospital-acquired infection and thrombosis which is very rarely seen. After 45 days of mechanical ventilation, the child was successfully weaned off from ventilatory support. Notably, analysis of the current literature revealed that this represents the longest reported hospitalization and ventilation period for a child presenting with COVID-19 pneumonia with potential complications. It highlights the importance of allowing sufficient time for clinical interventions to take effect, even when the prognosis appears poor. Hence, treating physicians should be aware of this atypical presentation.
Simplified scoring system to predict outcome in pediatric patients admitted through emergency department from a tertiary care teaching hospital of North India
Authors: Gupta Prakhar , Kumari Anita , Bhatnagar Ruchika , Aggarwal Kanika , Ruby
Published: September 2023

Background:

Estimating the morbidity and mortality in the emergency department (ED) only allows the pediatricians to assess the prognosis of the patient and plan therapies accordingly. This study was conducted to develop and validate a simple scoring system and establish a correlation between clinical parameters and the outcome of the patient.

Subjects and Methods:

Nine parameters, i.e., body temperature, respiratory rate, heart rate, blood pressure (BP), pulse oxygen saturation (SpO2), capillary refill time, level of sensorium, presence of seizure, and random blood sugar level, were documented, at the time of admission. Parameters were assigned a score of “0” if it is normal. An abnormality in the above parameters were indicated by a score ranging from 1 to 3. The primary outcome was assessed in terms of death/survival.

Results:

Out of the total, 57.2% required critical care, and mortality was reported in 14.75% of cases. On univariate analysis, seven clinical parameters were significantly associated with mortality. In multivariate logistic regression analysis, abnormalities in BP, SpO2, and temperature were independent predictors of mortality (P < 0.05). The receiver operating characteristic was 0.798 (95% confidence interval, 0.755–0.836; P < 0.0001) for the outcome of mortality (the predictive ability of score of 79.8%). The patients with scores 1–5, 6–10, and >10 had 4.923, 23.143, and 112.0 higher odds of mortality, respectively.

Conclusions:

This scoring system predicts the severity of illness and outcome with a sensitivity of 71.19% and specificity of 72.14%, respectively, in the ED. Higher scores predict unfavorable outcomes in these children.
Application of Subjective and Objective Empowerment in Evaluation of ideological and political Distance Learning Online Teaching
Authors: Cui Yu , Wang Lijuan , Li Lemin
Published: September 2023

INTRODUCTION: Distance network teaching has been widely used in today's informationization era, and it also provides a new teaching mode for ideological and political education. However, evaluating the quality of ideological and political distance network teaching still needs to be solved.
OBJECTIVES: To solve the problem of subjective solid dependence in its evaluation, the hierarchical analysis method and entropy weighting method are used to calculate the subjective and objective weights, and the principle of minimum information identification is used to determine the optimal comprehensive consequences of the indicators, taking into account the absolute subjectivity and absolute objectivity brought about by the calculation method of the weights of the hands.
METHODS: Considering the incompatibility of grade determination in the evaluation results, the evaluation grade determination of Civics remote network teaching is completed through the table evaluation model, and the table evaluation model of Civics remote network teaching based on the principle of minimum information discrimination with combined weights is finally established, and the application of the model is carried out.
RESULTS: The evaluation model is simple and practical and improves the efficiency and operability of comprehensive evaluation.
CONCLUSION: Civics remote network teaching will further broaden the sharing and dissemination channels of educational resources and needs to improve the quality and effect of education continuously, and the study has a good application prospect for the evaluation of Civics remote network teaching.
DINAMIKA KEBIJAKAN SERTA IMPLEMENTASI KELEMBAGAAN ANTARA PEMKO DAN BP BATAM
Authors: 16 Gusnia nia
Published: September 2023

Kota Batam merupakan salah satu kota yang letaknya strategis yaitu berdekatan dengan Malaysia maupun singapura dan tidak lupa pula dengan keberadaan kota batam itu sendiri berada di jalur pelayaran internasional sehingga sebagai jalur keluar masuknya pelabuhan dan perdagangan bebas , di kota ini mempunyai dua kepemimpinan yang saling berpengaruh bagi kota batam dari dua kepemimpinan ini menimbulkan yang namanya ketimpangan akan jabatan ataupun kekuasaan terkait dengan masalah roda kepemerintahan dalam artikel ini saya menjelaskan upaya yang dilakukan baik pemerintah maupun badan pengusaha batam yakni dalam membentuk suatu zona atau yang dikenal dengan FTZ Batam yang sebenarnya ada beberapa hambatan akan tetapi solusi dari pengembangan dari FTZ batam itu sendiri ialah tidak lepas dari pedoman akan asas asas dalam pemerintahan yang baik dan bersih.
IMPLEMENTATION OF E-GOVERNMENT ON THE E-ORDER SYSTEM TO INCREASE MICRO, SMALL, AND MEDIUM ENTERPRISES IN SOUTH JAKARTA
Authors: Asmiyanti Reny
Published: September 2023

Study this aims for identify and understand urgency management application e-Order or online market for goods and services public for speed up SMEs growth in DKI Jakarta Province. The program aims to increase growth economy and opportunity work for SMESs DKI Jakarta Province with provide marketing online. Website development is one of the political str(web and development strategy e-government national , that is implementation systematic development _ through realistic and measurable steps _ Government website development area is the first from four layers ( web presence , interaction , transaction and transformation / integration ) within stages development Indonesian e-government for possible Indonesian people with easy access information government area and participate  in development Indonesian democracy through online media. This study use approach qualitative through interviews and studies library, this showing several thing that is first System application e-Order this is breakthrough innovative BPPBJ (Service Agency Procurement Goods and Services) Government DKI Jakarta Province Second, System Application e-Order is connecting application _ activity purchase SMES products (as supplier) with agency government province in DKI Jakarta.System building e-Order this is form cooperation Among Provincial government DKI Jakarta with citizen. DKI Jakarta residents can participate direct in the development process Technology Industry 4.0 DKI citizens must be IT -based care with IT progress, SMEs can develop marketing and owning quality more product _ fine, however permanent notice factor effective and efficient from use system   e-government.
ANALISIS KINERJA PELAYANAN ADMINISTRASI PENDUDUK DALAM PERSPEKTIF NEW PUBLIC SERVICE DI KELURAHAN PAKIS SURABAYA
Authors: Viranda Elis
Published: September 2023

Konsep New Public Service adalah suatu konsep manajemen publik yang memperhatikan pengembangan layanan publik yang responsif, transparan, partisipatif, dan berkaitan dengan kebutuhan masyarakat. Dalam konteks ini, administrasi kependudukan yang terkait dengan New Public Service harus memperhatikan pentingnya partisipasi masyarakat dalam pengambilan keputusan, serta memberikan layanan yang berkualitas dan merata kepada seluruh masyarakat. Penelitian ini bertujuan untuk mengetahui kinerja pelayanan administrasi kependudukan di Kelurahan Pakis, Kecamatan Sawahan, Kota Surabaya. Metode yang digunakan dalam penelitian ini mengunakan pendekatan kualitatif dengan jenis penelitian deskriptif. pengumpulan data dilakukan dengan observasi, wawancara dan studi litelatur. Hasil penelitian menunjukan bahwa pelayanan administrasi kependudukan di Kelurahan Pakis terlaksana dengan baik, hal ini didukung dengan adanya tekonologi informasi yang memadahi dan layanan berbasis elektronik government.
POLITISASI KEPOLISIAN DALAM KONTEKS PEMILIHAN UMUM
Authors: Sarjito Aris
Published: September 2023

Abstrak: Penelitian ini mengkaji fenomena politisasi kepolisian dalam konteks pemilihan umum, dengan fokus pada faktor-faktor yang melatarbelakangi terjadinya politisasi tersebut dan dampaknya terhadap keadilan, kredibilitas, dan transparansi proses pemilu.Tujuan dari studi ini adalah untuk mengatasi dan mencegah politisasi kepolisian selama pemilihan umum, serta mengeksplorasi konsekuensi dari kegagalan untuk mengatasi masalah ini terhadap supremasi hukum dan demokrasi.Rancangan penelitian yang digunakan adalah kualitatif, dengan memanfaatkan data sekunder dari jurnal akademik, laporan, dan sumber lain yang relevan.Temuan penelitian ini menyoroti beberapa faktor kunci yang berkontribusi terhadap politisasi kepolisian selama pemilihan umum. Faktor-faktor ini berkisar dari campur tangan dan manipulasi politik oleh partai-partai yang berkuasa hingga subversi mekanisme akuntabilitas dalam sistem kepolisian. Dampak politisasi kepolisian terhadap proses pemilu sangat merugikan, karena merusak keadilan, kredibilitas, dan transparansi pemilu dengan memungkinkan penegakan hukum yang bias, intimidasi pemilih, dan favoritisme partisan. Mengatasi dan mencegah politisasi kepolisian memerlukan reformasi sistemik yang bertujuan untuk mendepolitisasi kepolisian. Reformasi ini harus mencakup penguatan kemandirian kepolisian, peningkatan mekanisme akuntabilitas internal, dan peningkatan standar dan etika profesional. Kegagalan untuk menangani politisasi kepolisian dapat memiliki konsekuensi yang luas bagi supremasi hukum dan demokrasi, termasuk erosi kepercayaan publik, integritas elektoral yang dikompromikan, dan meningkatnya polarisasi sosial dan politik.Kata kunci: pemilihan umum, politisasi kepolisian, proses pemilu
TINGKAT KEBERHASILAN IMPLEMENTASI PROGRAM PENGUNGKAPAN SUKARELA WAJIB PAJAK PADA KANTOR PELAYANAN PAJAK MADYA PEKANBARU
Authors: Fitrinisa Deswinda
Published: September 2023

Berdasarkan Undang-Undang Nomor 7 Tahun 2021 tentang Harmonisasi Peraturan Perpajakan. Pihak berwenang mengeluarkan sebuah program yang dinamakan Program Pengungkapan Sukarela Wajib Pajak. Program ini diharapkan mampu meningkatkan penerimaan negara dari sektor perpajakan. Implementasi program berjalan baik, namun di Kantor Pelayanan Pajak Madya Pekanbaru terdapat 723 wajib pajak yang tidak mengikuti program ini. Penelitian ini secara komprehensif akan mendeskripsikan dan menganalisis Tingkat Keberhasilan Implementasi Program Pengungkapan Sukarela Wajib Pajak pada Kantor Pelayanan Pajak Madya Pekanbaru. Penelitian ini dirancang menggunakan metode campuran, yaitu menggabungkan metode penelitian kualitatif dan kuantitatif. Data yang dikumpulkan meliputi data primer dan data sekunder, kemudian data dianalisis menggunakan analisis deskriptif dan uji kuantitatif. Penelitian ini menggunakan kombinasi teori Keberhasilan Implementasi dari Ripley dan Frankin dalam Masriani (2017) dengan teori Keberhasilan Implementasi dari Van Meter dan Van Horn dalam Heriyanto, dkk (2019) dengan enam variabel, yaitu: Tingkat Kepatuhan, Standar dan Tujuan Kebijakan, Sumber Daya Kebijakan, Aktivitas Pengamatan dan Komunikasi Interorganisasional, Kondisi Ekonomi, Sosial dan Politik, dan Disposisi atau Sikap Pelaksana. Penelitian ini menemukan bahwa implementasi Program Pengungkapan Sukarela Wajib Pajak pada Kantor Pelayanan Pajak Madya Pekanbaru sudah sesuai dengan peraturan perundang-undangan yang berlaku dan terkait 723 wajib pajak yang tidak mengikuti Program Pengungkapan Sukarela Wajib Pajak pada Kantor Pelayanan Pajak Madya Pekanbaru telah patuh dalam pelaporan Surat Pemberitahuan Tahunan dan kinerja para pegawai sudah bagus. Oleh karena itu, wajib pajak tidak perlu mengungkapkan kewajiban perpajakannya dalam Program Pengungkapan Sukarela Wajib Pajak.