bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuous subcutaneous apomorphine infusion allowing awake deep brain stimulation in a Parkinson’s disease patient
Authors: Spagnolo Francesca , Romeo Francesco , Proto Piermassimo , Rini Augusto Maria , Leopizzi Emanuela , Tedesco Andrea , Frizzi Marco , Passarella Bruno 
Published: December 2021

Abstract
Background
Subthalamic Deep Brain Stimulation (DBS) have demonstrated in the last decades to determine an important clinical improvement in advanced and selected Parkinson’s disease (PD) patients. However, only a minority of parkinsonian patients meet the criteria to undergo DBS, and the surgical procedure itself is often stressful, especially for patients experiencing severe OFF state. Subcutaneous Apomorphine continuous administration is suitable as an adjunctive therapy capable of improving a suboptimal DBS result. Here we hypothesize a possible role for subcutaneous apomorphine infusion to alleviate severe OFF state in parkinsonian patients undergoing DBS, thus allowing intraoperative microrecording and patient’s collaboration during clinical testing.

Case presentation
A 68-year-old man, suffering from a very long PD-history, characterized by a severe akinetic status and dramatic non-motor features while in OFF, underwent Subthalamic-DBS keeping a slight but continuous apomorphine infusion (1.8 mg/hour), able to guarantee the right degree of patient’s collaboration without interfering with microelectrode recordings. There were no intra or perioperative complications and after the procedure he experienced a marked clinical benefit, being able to stop apomorphine administration.

Conclusions
Here we described the first Subthalamic DBS procedure performed with a low and stable dopaminergic stimulation guaranteed by subcutaneous Apomorphine continuous infusion. For its rapidity of action and prompt reversibility, apomorphine could be particularly suitable for use during difficult surgical procedures in PD, allowing more therapeutic opportunities for patients who would otherwise be excluded from the DBS option.
Lactation counseling for maintaining exclusive breastfeeding in adolescent mothers: a trial protocol
Authors: Sabogal Iliana Milena Ulloa , Nariño Claudia Consuelo Domínguez , Monsalve Mary Alejandra Mendoza 
Published: December 2021

Abstract
Background
Adolescent mothers have lower rates of initiation, continuation, and exclusivity of breastfeeding, and even more so in the first pregnancy. Current interventions target adult women, and little evidence is available for breastfeeding promotion among adolescents.

Methods
This is a pilot study protocol with a parallel, single-blind, randomized, and controlled trial design, to evaluate the feasibility of the intervention “Lactation Counseling” in first-time adolescent mothers to maintain exclusive breastfeeding in the first 6 months of life. The control group will receive routine education in prenatal care and prenatal and childbirth classes, the experimental group will receive additionally the intervention “Lactation Counseling”, for 4 weeks, both conducted by trained nurses. Feasibility outcome includes recruitment and dropout rates, and, pilot outcomes will be the exclusive breastfeeding rate and the breastfeeding knowledge. Measurements will be taken at baseline, post-intervention, and 2, 4, and 6 months after childbirth.

Discussion
Exclusive breastfeeding rates could be increased in adolescent mothers through nursing counseling interventions that are previously structured and evaluated from their feasibility. This study will allow the evaluation of the feasibility of an intervention in low-income, Latin American population adolescents.

Trial registration
ClinicalTrials.gov NCT04655846, Registered 7 December 2020.
COVID-19 vaccine hesitancy among the adult population in Ghana: evidence from a pre-vaccination rollout survey
Authors: Alhassan Robert Kaba , Aberese-Ako Matilda , Doegah Phidelia Theresa , Immurana Mustapha , Dalaba Maxwel Ayindenaba , Manyeh Alfred Kwesi , Klu Desmond , Acquah Evelyn , Ansah Evelyn Korkor , Gyapong Margaret 
Published: December 2021

Abstract
Background
Coronavirus disease 2019 (COVID-19) has already claimed over four million lives globally and over 800 deaths in Ghana. The COVID-19 vaccine is a key intervention towards containing the pandemic. Over three billion doses of the vaccine have already been administered globally and over 800,000 doses administered in Ghana, representing less than 5% vaccination coverage. Fear, uncertainty, conspiracy theories and safety concerns remain important threats to, a successful rollout of the vaccine if not managed well.

Objective
Ascertain the predictors of citizens’ probability of participating in a COVID-19 vaccine trial and subsequently accept the vaccine when given the opportunity.

Methodology
The study was an online nation-wide survey among community members (n = 1556) from 18th September to 23rd October, 2020 in the 16 regions in Ghana. Binary probit regression analysis with marginal effect estimations was employed to ascertain the predictors of community members’ willingness to participate in a COVID-19 vaccine trial and uptake the vaccine.

Results
Approximately 60% of respondents said they will not participate in a COVID-19 vaccine trial; 65% will take the vaccine, while 69% will recommend it to others. Willingness to voluntarily participate in COVID-19 vaccine trial, uptake the vaccine and advise others to do same was higher among adults aged 18–48 years, the unmarried and males (p < 0.05). Significant predictors of unwillingness to participate in the COVID-19 vaccine trial and uptake of the vaccine are: married persons, females, Muslims, older persons, residents of less urbanised regions and persons with lower or no formal education (p < 0.05). Predominant reasons cited for unwillingness to participate in a COVID-19 vaccine trial and take the vaccine included fear, safety concerns, lack of trust in state institutions, uncertainty, political connotations, spiritual and religious beliefs.

Conclusion
The probability of accepting COVID-19 vaccine among the adult population in Ghana is high but the country should not get complacent because fear, safety and mistrust are important concerns that have the potential to entrench vaccine hesitancy. COVID-19 vaccine rollout campaigns should be targeted and cognisant of the key predictors of citizens’ perceptions of the vaccine. These lessons when considered will promote Ghana’s efforts towards vaccinating at least 20 million people to attain herd immunity.
Sensory systems processing in children with spastic cerebral palsy: a pilot study
Authors: Barakat Mennatallah Khamis AbdelHafiez , Elmeniawy Gehan Hassan , Abdelazeim Faten Hassan 
Published: December 2021

Abstract
Background
The study of the sensory aspect alongside the motor aspect in children with spastic cerebral palsy is critical. Knowledge may help improve intervention, children’s quality of life, activity, and participation.
The study aims to analyze the sensory systems processing in children with spastic cerebral palsy classified by Gross Motor Function Classification System (GMFCS) as levels I, II, and III using Child Sensory Profile 2 (CSP-2). Caregivers of children with spastic cerebral palsy aged 6–9 years (n = 20) completed the CSP-2. Children with severe comorbidities besides cerebral palsy (i.e., diabetes, myopathy, neuropathy, and uncontrolled epilepsy), autism, burn injuries, hearing or vision loss were excluded.

Results
All twenty participating children showed sensory processing difficulties in at least one of the sensory sections. With 14 out of 20 showing abnormalities in more than one section, the majority showed problems in the body position section, followed by the movement section. There was a significant difference between raw scores means of children with unilateral and bilateral SCP at the “body position” section, unlike the rest of the other sections.

Conclusions
Children with spastic cerebral palsy (GMFCS levels I, II, and III) show sensory systems processing difficulties compared to normative data, especially at vestibular and proprioceptive processing.
Micro RNA-23b as a potential biomarker in rheumatoid arthritis disease activity and severity: clinical, laboratory, and radiological cross-sectional study
Authors: Abdeen Hanaa Maher , Gharbia Ola Mohammad , Bassiouni Sherine Abdel Rahman Abdel Karim , Zaki Maysaa El Sayed , Abdullah Hazem , Morsi Heba Kamal 
Published: December 2021

Abstract
Background
Rheumatoid arthritis (RA) is an autoimmune inflammatory disease. It is characterized by an inflammatory polyarthritis that preferentially affects the small joints leading to joint damage and eventual deformity and disability, and can also present with extra-articular manifestations. Micro RNA (miRNA) is a class of non-coding RNAs which negatively regulate messenger RNA (mRNA) expression. Several studies had shown that miRNA-23b has a close relationship with inflammation and autoimmune diseases. An increasing evidence has suggested that miRNA-23b is closely associated with many inflammatory and autoimmune diseases. The current study aimed to evaluate the plasma expression of miRNA-23b in rheumatoid arthritis (RA) patients and to explore its potential association with diseases activity.

Results
RA patients had a significantly higher plasma miRNA-23b expression than controls (P < 0.001). The miRNA-23b plasma expression was significantly associated with the clinical and laboratory indices of RA activity as well as with the DAS28-ESR score (P = 0.009) and grades (P < 0.001). The miRNA-23b plasma expression was significantly correlated with the radiological severity of RA (P = 0.002).

Conclusions
Plasma expression of miRNA-23b is significantly increased in patients with RA than controls. In RA patients, plasma expression of miRNA-23b was significantly correlated with the activity and radiological severity of RA. miRNA-23b may represent a potential therapeutic target that can retard progression of RA.
Impact of Hematology Electronic Consultations on Utilization of Referrals and Patient Outcomes in an Integrated Health Care System
Authors: Dosani Talib , Xiang Jenny , Wang Kaicheng , Deng Yanhong , Connell Nathan T. , Connery Donna , Levin Forrest , Roy Alicia , Wadia Roxanne J. , Wong Ellice Y. , Rose Michal G. 
Published: December 2021

INTRODUCTION: Electronic consultations (e-consults) may be a valuable tool in the current era of increased demand for hematologists. Despite the increasing use of e-consults in hematology, their optimal utilization and impact on patient outcomes and workload are largely unknown. METHODS: In this retrospective cohort study, we studied the hematology consult experience at Veterans Affairs Connecticut from 2006 to 2018. We included 7,664 hematology consults (3,240 e-consults and 4,424 face-to-face [FTF] consults) requested by 1,089 unique clinicians. RESULTS: We found that e-consults were rapidly adopted and used equally among physicians of different degrees of experience. The number of FTF consults did not decrease after the introduction of e-consult services. E-consults were preferentially used for milder laboratory abnormalities that had been less likely to result in a consult before their availability. Referring clinicians used e-consults preferentially for periprocedural management, anemia, leukopenia, and anticoagulation questions. Eighty-three percent of e-consults were resolved without needing an FTF visit in the year after the consult. Consults for pancytopenia, gammopathy, leukocytosis, and for patients with known malignancy were less likely to be resolved by e-consult. Among patients who were diagnosed with a new hematologic malignancy after their consult, having an e-consult before an FTF visit did not adversely affect survival. CONCLUSION: In summary, e-consults safely expanded delivery of hematology services in our health care system but increased total consult volume. We report novel data on what types of consults may be best suited to the electronic modality, the impact of e-consults on workload, and their optimal use and implementation.
Different Associations Between Inpatient or Outpatient Palliative Care and End-of-Life Outcomes for Hospitalized Patients With Cancer
Authors: Yeh Jonathan C. , Urman Arielle R. , Besaw Robert J. , Dodge Laura E. , Lee Kathleen A. , Buss Mary K. 
Published: December 2021

PURPOSE: Palliative care (PC) improves outcomes in advanced cancer, and guidelines recommend early outpatient referral. However, many PC teams see more inpatient than outpatient consults. We conducted a retrospective study of hospitalized patients with cancer to quantify exposure to inpatient and outpatient PC and describe associations between PC and end-of-life (EOL) quality measures. METHODS: We identified all decedents admitted to an inpatient oncology unit in 1 year (October 1, 2017-September 30, 2018) and abstracted hospitalization statistics, inpatient and outpatient PC visits, and EOL outcomes. Descriptive statistics, univariate tests, and multivariate analysis evaluated associations between PC and patient outcomes. RESULTS: In total, 522 decedents were identified. 50% saw PC; only 21% had an outpatient PC visit. Decedents seen by PC were more likely to enroll in hospice (78% v 44%; P < .001), have do-not-resuscitate status (87% v 55%; P < .001), have advance care planning documents (53% v 31%; P < .001), and die at home or inpatient hospice instead of in hospital (67% v 40%; P < .01). Decedents seen by PC had longer hospital length-of-stay (LOS; 8.4 v 7.0 days; P = .03), but this association reversed for decedents seen by outpatient PC (6.3 v 8.3 days; P < .001), who also had longer hospice LOS (46.5 v 27.1 days; P < .01) and less EOL intensive care (6% v 15%; P < .05). CONCLUSION: PC was associated with significantly more hospice utilization and advance care planning. Patients seen specifically by outpatient PC had shorter hospital LOS and longer hospice LOS. These findings suggest different effects of inpatient and outpatient PC, underscoring the importance of robust outpatient PC.
Time Difference in the Social Transformation of China and Korea: A Case Study of Water-Moon Avalokiteśvara Paintings of the Song and Yuan Dynasties and the Koryŏ Dynasty
Authors: Lee Hyun Joo 
Published: December 2021

Abstract
The Water-Moon form of Avalokiteśvara arose in China during the process of nativization of Buddhism in Tang China. Extant images of Water-Moon Avalokiteśvara tend to have been painted in either China or Korea, but there is an odd dislocation in the changes of style, with the colorful Koryŏ dynasty images paralleling not contemporary Song trends but rather those from hundreds of years earlier. That this effect might simply be a delay caused by geographical distance seems unlikely given the active cultural exchange between the two realms. Dramatic changes occurred in the Tang-Song era, including the rise of plebeian culture and Zen Buddhism. This carried over to a more minimalist style of art in China. Meanwhile, in Koryŏ, Buddhism continued to receive royal sponsorship and remain influential. This article argues that the differences in images and techniques between Koryŏ and Song-Yuan paintings of Water-Moon Avalokiteśvara were caused by the time difference in the social transformations of China and Korea.
ICON 2022 Supplement
Authors: Amanullah Farhana , Ansari Naila Baig 
Published: December 2021

doi: https://doi.org/10.12669/pjms.38.ICON-2022.5770
How to cite this:Amanullah F, Baig-Ansari N. ICON 2022 Supplement. Pak J Med Sci. 2022;38(2):333. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5770
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Congenital Pouch Colon in a Neonate
Authors: Niaz Sana , Naz Sahira , Raziq Rumaissa Abdul 
Published: December 2021

Congenital Pouch Colon (CPC) is a rare anorectal malformation (ARM) in which a part of or the entire colon is replaced by pouch-like dilatation. Males are more likely to be diagnosed with the condition compared to females. The highest incidence of the disease is in South Asia, with a significant number of cases reported from India. Early diagnosis can be made when there are hypoechogenic lesions on antenatal ultrasound scans. We report a case of a neonate with routine antenatal scans who presented with a distended abdomen and inability to pass feces. The diagnosis was made in the early neonatal period, followed by surgical management.
doi: https://doi.org/10.12669/pjms.38.ICON-2022.5771
How to cite this:Niaz S, Naz S, Raziq RA. Congenital Pouch Colon in a Neonate. Pak J Med Sci. 2022;38(2):426-429. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5771
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Wound closure after total knee replacement: Comparison between staples and sutures
Authors: Khan Mansoor Ali , Memon M. Waseem , Chinoy Amin , Javed Salman , Barkat Rahil , Jiwani Ahsun 
Published: December 2021

Background and Objective: Total Knee Arthroplasty is a commonly performed procedure for arthritic knees. Preventing complications is of utmost importance for good functional outcomes and preventing morbidity. Wound closure after the procedure is as important as the replacement aspect of surgery.The objective of this study was to provide subjective and objective evidence of better closure technique and material; we conducted the study so that the outcome of TKA can be further improved.
Methods: We conducted a randomized trial at The Indus Hospital, Karachi, from December 2018 to June 2020. All patients from age 40 to 70 years who underwent total knee arthroplasty were included in the study. The wound of one knee was closed with Polypropylene (Prolene) sutures, and the other with staples. The wound was assessed independently by two assessors using Hollander’s score; lower score means a worse outcome. All data was entered and analyzed using STATA version 16.
Results: Thirty patients who underwent bilateral total knee replacement were included in the analysis, among which 71.8% were female. The average age of participants was 57.3 (± 7.5) years. The mean incision length on the right knee was 17.6 ± 1.1 cm, while on the left the incision length was 18.3 ± 1.2 cm. Overall, the mean Hollander score was significantly different among participants in the sutures and staples group in both the right (p-value=0.001) and left knees (p-value=0.001). The score was significantly higher in knees closed with sutures as compared to staples. Also, the mean Hollander score is significantly higher in females than males in both the right knee (B=0.56, p-value=0.049) and the left knee (B=0.38, p-value=0.044).
Conclusion: The study has shown that Hollander’s score was significantly higher in knees closed with sutures as compared to the patients in whom staples were used for wound closure.
doi: https://doi.org/10.12669/pjms.38.ICON-2022.5782
How to cite this:Khan MA, Memon MW, Chinoy A, Javed S, Barkat R, Jiwani A. Wound closure after total knee replacement: Comparison between staples and sutures. Pak J Med Sci. 2022;38(2):340-344. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5782
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The art of delegation: integration of the veterinary nursing assistant into New Zealand veterinary practice
Authors: Young Angela C 
Published: December 2021

Background: In 2016 veterinary nursing assistants (VNAs) were introduced as an additional tier to New Zealand veterinary practice. Aim: This study explores the utilisation of VNAs in New Zealand veterinary practices to ascertain the impact of an additional staffing layer to patient outcomes, workload management and staff wellness. Method: Through focus groups and semi-structured interviews with 30 participants, three themes emerged allowing evaluation of the Allied Veterinary Professionals Regulatory Council (AVPRC) Scope of Practice (SP) (AVPRC, 2020) and development of delegation guidelines (DG). Results: Analysis identified weak processes in delegation. The practice-based perspectives of VNA staff utilisation supports the AVPRC SP. Conclusion: Effective communication of the SP and DG for veterinary practice utilisation could contribute to reducing workload pressure. Additionally, individual practice staff discussions regarding own and colleague job expectations, along with review of contractual job descriptions, could further evolution of multi-tiered practices leading to improved patient outcomes, team wellness and business success.
Pixel-Based Calibration and Atmospheric Correction of a UAS-Mounted Thermal Camera for Land Surface Temperature Measurements
Authors: Zhu Yan , Cherkauer Keith 
Published: December 2021

HighlightsA novel pixel-based calibration algorithm and an atmospheric correction method are developed.Application of the calibration methods reduces the RMSE of measurements to less than 1.32°C.The calibrations facilitate stitching of images together to form whole-field mosaics.Abstract. Thermal imagery can be used to provide insight into the water stress status and evapotranspiration demand of crops, but satellite-based sensors are generally too coarse spatially and too infrequent temporally to provide information of use for the management of specific fields. Thermal cameras mounted on small unmanned aerial systems (UAS) have potential to provide canopy temperature information at high spatial and temporal resolutions useful for crop management; however, without appropriate camera corrections, the measurement biases of these uncooled thermal cameras can be larger than ±5°C. Such uncertainty can render such camera measurements useless. In this research, a pixel-based (non-uniformity) calibration algorithm and an atmospheric correction method based on in-field approximate blackbody sources (water targets) were developed for a thermal camera. The objective was to improve the temperature measurement accuracy of the thermal camera on various land surfaces including soil and vegetation. With sufficient accuracy, temperature measurements can be used for the estimation of latent heat flux of field crops in the future. The thermal camera was first calibrated in a laboratory setting where the camera and environmental conditions were controlled. The results indicated that in the range between 10°C and 45°C, the calibrated temperatures were accurate, with an average bias of 1.76°C, and had a high linear correlation with reference temperatures (water target temperatures) (R2 &gt; 0.99). Variability of measurements was also better constrained. In-field atmospheric correction is also important for obtaining high-accuracy thermal imagery. By applying both pixel-based calibration and atmospheric corrections, the RMSE (root mean square error) of validation targets from two dates in 2017 was reduced from 4.56°C and 6.36°C before calibration to 1.32°C and 1.24°C after calibration. The calibration process also increased the range of temperatures in the imagery, which enhanced contrast and may help with identification of tie-points and stitching of images together to form whole-field mosaics. Keywords: Atmospheric correction, Pixel-based calibration, Thermal remote sensing, UAS, Water targets.