563 results on '"Paudyal, P."'
Search Results
2. Patterns, circumstances and risk factors associated with non-fatal substance overdose in a cohort of homeless population: an observational study
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Anderson, Jennifer, Kurmi, Om, Lowrie, Richard, Araf, Adnan, and Paudyal, Vibhu
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- 2024
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3. Distribution of microplastic contamination in Sapta-Gandaki river system, Nepal
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Kandel, B., Adhikari, N., Chetri, A. K., Karki, A., Paudyal, H., Sharma, K. R., Giri, B., and Neupane, B. B.
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- 2024
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4. Comprehensive assessment of pain characteristics, quality of life, and pain management in cancer patients: a multi-center cross-sectional study
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Shrestha, Sunil, Sapkota, Simit, Teoh, Siew Li, KC, Bhuvan, Paudyal, Vibhu, Lee, Shaun Wen Huey, and Gan, Siew Hua
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- 2024
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5. Perspectives of pharmacy staff on provision of self-care and minor ailment education in primary schools: a qualitative study
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Osman, Samira, Paudyal, Vibhu, Jalal, Zahraa, and Hirsch, Christine
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- 2024
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6. Comparative Assessment of Energy, Economics, and Emission (3E) of Rice Production in Plain and Hilly Areas in Nepal
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Bashyal, Shubhechchha, Paudyal, Babita, Pandey, Dakshina, Paudel, Padam Prasad, Bhatta, Anjan, Kim, Dae Hyun, and Kafle, Sagar
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- 2024
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7. Clinical pharmacist interventions on pain management in cancer patients (PharmaCAP) in low resource settings: a multicenter feasibility-pilot randomized controlled trial
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Shrestha, Sunil, Sapkota, Simit, Teoh, Siew Li, KC, Bhuvan, Paudyal, Vibhu, Lee, Shaun Wen Huey, and Gan, Siew Hua
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- 2024
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8. Aerosol immunization with influenza matrix, nucleoprotein, or both prevents lung disease in pig
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Vatzia, Eleni, Paudyal, Basudev, Dema, Barbara, Carr, Brigid Veronica, Sedaghat-Rostami, Ehsan, Gubbins, Simon, Sharma, Bhawna, Moorhouse, Elliot, Morris, Susan, Ulaszewska, Marta, MacLoughlin, Ronan, Salguero, Francisco J., Gilbert, Sarah C., and Tchilian, Elma
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- 2024
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9. Impact of a community pharmacy-based medication therapy management program on clinical and humanistic outcomes in patients with uncontrolled diabetes: a randomised controlled trial
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Albabtain, Basmah, Bawazeer, Ghada, Paudyal, Vibhu, Cheema, Ejaz, Alqahtani, Abdulaziz, Bahatheq, Ahmed, Price, Malcolm J., and Hadi, Muhammad Abdul
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- 2024
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10. Views of healthcare professionals on complementary and alternative medicine use by patients with diabetes: a qualitative study
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Alzahrani, Abdulaziz S., Greenfield, Sheila M., Shrestha, Sunil, and Paudyal, Vibhu
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- 2024
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11. Full-bandwidth anisotropic Migdal-Eliashberg theory and its application to superhydrides
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Lucrezi, Roman, Ferreira, Pedro P., Hajinazar, Samad, Mori, Hitoshi, Paudyal, Hari, Margine, Elena R., and Heil, Christoph
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- 2024
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12. Translation, Cultural Adaptation and Validation of the Medication Adherence Report Scale (MARS-5) in Nepalese Cancer Patients Experiencing Pain
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Shrestha S, Sapkota S, Paudyal V, Moon Z, Horne R, and Gan SH
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cancer pain ,cultural adaptation ,mars-5 ,medication adherence ,nepalese patients ,validation ,Medicine (General) ,R5-920 - Abstract
Sunil Shrestha,1 Simit Sapkota,2,3 Vibhu Paudyal,4,5 Zoe Moon,6 Rob Horne,6 Siew Hua Gan1 1School of Pharmacy, Monash University Malaysia, Bandar Sunway, Subang Jaya, Selangor, Malaysia; 2Department of Clinical Oncology, Kathmandu Cancer Center, Tathali, Bhaktapur, Bagmati Province, Nepal; 3Department of Clinical Oncology, Civil Service Hospital, Minbhawan, Kathmandu, Bagmati Province, Nepal; 4Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College, London, UK; 5School of Pharmacy, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham Edgbaston, Birmingham, UK; 6Centre for Behavioural Medicine, Research Department of Practice and Policy, UCL School of Pharmacy, University College London, London, UKCorrespondence: Sunil Shrestha, Email sunilcresta@gmail.comBackground: Adherence to pain medication is crucial for cancer patients, since non-adherence can lead to increased suffering, reduced quality of life and increased healthcare costs. Although the five‐item Medication Adherence Report Scale (MARS-5) is a validated tool for assessing medication adherence, but it has not been translated and validated into the Nepalese language. This study aimed to translate, culturally adapt and validate the MARS-5 in Nepalese language for Nepalese cancer patients who were experiencing pain.Materials and Methods: The cross-sectional validation study utilized a convenience sampling method. Initially, a pre-test was conducted with 25 patients. The MARS-5 was then forward and backward translated following the EORTC QLG translation procedure. The final translated version was reviewed by experts and subjected to a second pre-test. Construct validity was assessed through principal component analysis, and internal consistency was measured using Cronbach’s alpha coefficient. Inter-rater reliability was evaluated using the Intra-Class Correlation coefficient (ICC).Results: The study included 204 cancer patients (ages 18– 86, 55% female). The Nepalese version of the MARS-5 was translated without significant issues and underwent pre-testing with participants. Participants discussed the scale during these pre-tests, providing feedback on its clarity and comprehensibility. While formal assessment tools were not employed, the iterative nature of the pre-testing process allowed for the refinement of the translation based on participant feedback, indicating a robust understanding of the scale among participants. The ICC of test-retest reliability was found to be 0.860. The Kaiser Meyer Olkin’s value was 0.690, and Cronbach’s alpha was 0.72, indicating good construct validity and high internal consistency. The medication non-adherence rate was 11.3%.Conclusion: The MARS-5 was successfully translated, culturally adapted, and validated in Nepalese for use among Nepalese cancer patients experiencing pain. The Nepalese version of MARS-5 is a reliable tool for evaluating medication adherence in this population.Keywords: cancer pain, cultural adaptation, MARS-5, medication adherence, Nepalese patients, validation
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- 2024
13. Full-bandwidth anisotropic Migdal-Eliashberg theory and its application to superhydrides
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Lucrezi, Roman, Ferreira, Pedro P., Hajinazar, Samad, Mori, Hitoshi, Paudyal, Hari, Margine, Elena R., and Heil, Christoph
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Condensed Matter - Superconductivity ,Condensed Matter - Materials Science - Abstract
Migdal-Eliashberg theory is one of the state-of-the-art methods for describing conventional superconductors from first principles. However, widely used implementations assume a constant density of states around the Fermi level, which hinders a proper description of materials with distinct features in its vicinity. Here, we present an implementation of the Migdal-Eliashberg theory within the EPW code that considers the full electronic structure and accommodates scattering processes beyond the Fermi surface. To significantly reduce computational costs, we introduce a non-uniform sampling scheme along the imaginary axis. We demonstrate the power of our implementation by applying it to the sodalite-like clathrates YH$_6$ and CaH$_6$, and to the covalently-bonded H$_3$S and D$_3$S. Furthermore, we investigate the effect of maximizing the density of states at the Fermi level in doped H$_3$S and BaSiH$_8$ within the full-bandwidth treatment compared to the constant-density-of-states approximation. Our findings highlight the importance of this advanced treatment in such complex materials., Comment: 16 pages, 4 figures. Revised manuscript with minor changes. Supplemental Information available on the journal website (open access)
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- 2023
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14. Helicity dependent cross sections for the photoproduction of $\pi^0\pi^{\pm}$ pairs from quasi-free nucleons
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A2 Collaboration, Ghosal, D., Sokhoyan, V., Fix, A., Lutterer, S., Abt, S., Achenbach, P., Afzal, F., Ahmed, Z., Annand, J. R. M., Bashkanov, M., Beck, R., Biroth, M., Borisov, N., Braghieri, A., Briscoe, W. J., Cividini, F., Collicot, C., Costanza, S., Denig, A., Dieterle, M., Dolzhikov, A. S., Downie, E. J., Drexler, P., Fegan, S., Gardner, S., Glazier, D. I., Gorodnov, I., Gradl, W., Günther, M., Gurevich, D., Heijkenskjöld, L., Hornidge, D., Huber, G. M., Jermann, N., Käser, A., Kashevarov, V. L., Korolija, M., Krusche, B., Lazarev, A., Livingston, K., MacGregor, I. J. D., Manley, D. M., Martel, P. P., Meier, Ch., Miskimen, R., Mocanu, M., Mornacchi, E., Mullen, C., Neganov, A., Neiser, A., Ostrick, M., Otte, P., Paudyal, D., Pedroni, P., Powell, A., Reicherz, G., Rostomyan, T., Spieker, K., Steffen, O., Strakovsky, I. I., Thiel, A., Thiel, M., Thomas, A., Unverzagt, M., Usov, Yu. A., Wagner, S., Walford, N. K., Watts, D. P., Werthmüller, D., Wettig, J., Witthauer, L., Wolfes, M., and Zachariou, N.
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Nuclear Experiment - Abstract
Photoproduction of $\pi^0\pi^{\pm}$-pairs from quasifree nucleons bound in the deuteron has been investigated to study the helicity dependence of this reaction. Measurements with a liquid deuterium target were used to extract the unpolarized cross sections for reactions on protons and neutrons. A deuterated, longitudinally polarized solid-butanol target, together with a circularly polarized photon beam, determined the double polarization observable $E$. From these results the spin-dependent cross sections $\sigma_{1/2}$ and $\sigma_{3/2}$, corresponding to the anti-parallel and parallel spin configurations of the beam photon and target nucleon, have been derived. The measurements were performed at the Mainz MAMI accelerator with tagged, circularly-polarized photon beams produced via bremsstrahlung from longitudinally polarized electron beams. The reaction products were detected with an almost $4\pi$ solid-angle covering calorimeter composed of the Crystal Ball and TAPS detectors, supplemented by plastic scintillation detectors for charged particle identification. The results are sensitive to sequential decays of nucleon resonances via intermediate states and also to the decay of nucleon resonances by emission of charged $\rho$ mesons, and are compared to recent model results., Comment: 9 pages, 6 figures
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- 2023
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15. Collaborative approaches to health education: perspectives of parents and teachers on self-care and managing common health issues in UK primary schools
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Samira Osman, Christine Hirsch, Zahraa Jalal, and Vibhu Paudyal
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Health education ,Primary schools ,Self-care ,Health literacy ,Common health issues ,Mental well-being ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Health education in primary schools plays a critical role in equipping children with essential self-care skills, fostering health literacy, and addressing social determinants of health. This study explores the perspectives of parents and teachers on teaching self-care and managing common health issues in UK primary schools. Despite the recognized importance of health education, there is limited research on how self-care education is perceived and implemented in the primary school setting. Methods A qualitative study was conducted using semi-structured interviews with 18 participants, including 9 generalist primary teachers and 9 parents from diverse educational and socioeconomic contexts in the West Midlands, East Midlands, Northwest, and London of England. Participants were recruited via social media and professional networks, and interviews were conducted via video conferencing platforms. Data were thematically analysed using NVivo 12 to identify recurring themes related to the delivery and impact of self-care education in primary schools. Results Teachers and parents highlighted key self-care topics, including hygiene, managing common illnesses like colds and cuts, and mental well-being. There was a consensus on the importance of self-care education, but views diverged on whether the responsibility should lie primarily with schools, parents, or a collaborative approach. Teachers expressed concerns about their preparedness to teach sensitive topics, citing a lack of training and resources. Socioeconomic and religious contexts further influenced perceptions, with participants emphasising further importance of school-led self-care education for children from lower socioeconomic backgrounds. Strengths were identified in current self-care education efforts, particularly in practical lessons that empower children with age-appropriate skills. Conclusions This study highlights the critical need for comprehensive and collaborative health education in primary schools to promote health literacy and reduce health disparities. Enhancing teacher training, integrating self-care topics into the primary curriculum, and fostering stronger partnerships between schools and families are essential to improving the quality and consistency of self-care education. Policymakers should consider implementing mandatory health education training in teacher education programs and providing ongoing professional development to support teachers. By addressing these gaps, schools can play a pivotal role in preparing children for lifelong health management, reducing the burden on healthcare services, and supporting public health objectives.
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- 2024
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16. Aerosol immunization with influenza matrix, nucleoprotein, or both prevents lung disease in pig
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Eleni Vatzia, Basudev Paudyal, Barbara Dema, Brigid Veronica Carr, Ehsan Sedaghat-Rostami, Simon Gubbins, Bhawna Sharma, Elliot Moorhouse, Susan Morris, Marta Ulaszewska, Ronan MacLoughlin, Francisco J. Salguero, Sarah C. Gilbert, and Elma Tchilian
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Immunologic diseases. Allergy ,RC581-607 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Current influenza vaccines are strain-specific and require frequent updates to combat new strains, making a broadly protective influenza vaccine (BPIV) highly desirable. A promising strategy is to induce T-cell responses against internal proteins conserved across influenza strains. In this study, pH1N1 pre-exposed pigs were immunized by aerosol using viral vectored vaccines (ChAdOx2 and MVA) expressing matrix (M1) and nucleoprotein (NP). Following H3N2 challenge, all immunizations (M1, NP or NPM1) reduced lung pathology, but M1 alone offered the greatest protection. NP or NPM1 immunization induced both T-cell and antibody responses. M1 immunization generated no detectable antibodies but elicited M1-specific T-cell responses, suggesting T cell-mediated protection. Additionally, a single aerosol immunization with the ChAdOx vaccine encoding M1, NP and neuraminidase reduced lung pathology. These findings provide insights into BPIV development using a relevant large natural host, the pig.
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- 2024
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17. Enhancing Deep Excavation Optimization: Selection of an Appropriate Constitutive Model
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Bhim Kumar Dahal, Sandip Regmi, Kalyan Paudyal, Diwash Dahal, and Diwakar KC
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deep excavation ,finite element method ,lacustrine soil ,constitutive model ,Engineering (General). Civil engineering (General) ,TA1-2040 - Abstract
To minimize the impact on nearby structures during deep excavations, choosing an appropriate soil constitutive model for analysis holds significant importance. This study aims to conduct a comparative analysis of various constitutive soil models—namely, the Mohr–Coulomb (MC) model, the hardening soil (HS) model, the hardening soil small strain (HSS) model, and the soft soil (SS) model—to identify the most suitable model for the lacustrine deposit. To implement these models, the soil’s index properties and mechanical behavior were evaluated from undisturbed soil samples. The numerical simulation and verification of these properties were carried out by comparing the laboratory test results with the outcome of the finite element method; the most suitable constitutive soil model for the soil was identified as the HSS model. Upon analyzing the wall deflection and ground settlement profiles obtained from respective constitutive models, it was observed that the HS and HSS models exhibit similar characteristics and are well-suited for analyzing typical lacustrine soil. In contrast, the MC and SS models yield overly optimistic results with lower wall deflection and ground settlement and fail to predict realistic soil behavior. As a result, this research highlights the significance of selecting the appropriate constitutive soil model and refining the parameters. This optimization process contributes significantly to the design of support systems, enhancing construction efficiency and ensuring overall safety in deep excavation projects.
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- 2024
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18. Prevalence and Impact of Psychological Disorders on Pharmacotherapy of Diabetic Patients in Low Resource Settings: A Prospective Assessment in Primary Healthcare Settings
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Shahbaz K, Alamgeer, Paudyal V, Zubair M, Safdar MZ, Tahir M, Akram L, and Ali S
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psychological disorders ,diabetes ,pharmacotherapy ,phq-9 ,Medicine (General) ,R5-920 - Abstract
Kiran Shahbaz,1 Alamgeer,1 Vibhu Paudyal,2 Maryam Zubair,3 Maryam Zahra Safdar,4 Momina Tahir,4 Laraib Akram,4 Salamat Ali4 1Department of Pharmacology, University College of Pharmacy, University of the Punjab Lahore, Pakistan; 2Institute of Clinical Sciences, University of Birmingham, Edgbaston Birmingham, UK; 3Faculty of Experimental Medicine Orebro University, Sweden; 4Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, GC University Faisalabad, Faisalabad, PakistanCorrespondence: Salamat Ali, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, GC University Faisalabad, Faisalabad, Pakistan, Tel +00-92-3004189052; +00-92-041-9201036, Email drsalamatali@gcuf.edu.pkBackground: Prevalence of psychological disorders among individuals with diabetes is significantly higher as compared to the general population.Aim: This study aimed to assess the prevalence and impact of psychological disorders on pharmacotherapy of diabetes patients.Methodology: This cross-sectional study was conducted at two primary care hospitals in Pakistan from April to June 2023. The nine-item Patient Health Care Questionnaire (PHQ-9) scale was used to assess depression in the study’s population, and its effects on pharmacotherapy of diabetes. Chi-square test was used to evaluate relationship between ordinal variables/categorical variables and depression whereas; Student’s t-test was used to assess the relationship between numerical variables with depression.Results: A total of 320 patients were assessed, comprising 120 (37.5%) males and 200 (62.5%) females, with a mean age of 52.5 (SD± 11.8) years. The average duration of diabetes is 7.0 (SD± 5.4). The average PHQ-9 score was 8.3 (SD± 5.5). Depression was found to be prevalent in 43.7% of the study population. Gender (female) (p-value 0.002), advanced age (p-value 0.002), lower income (p-value 0.001), education levels (p-value 0.001), longer duration of diabetes (p-value 0.001), poor diabetes control according to BSR value (p-value 0.001), usage of injectable insulin (p-value 0.005), and concomitant diseases (p-value 0.001) were found to be independently linked with depression. Significant association was observed between depression and treatment adherence (p-value 0.0025), number of missed doses (p-value 0.045), and difficulty in diabetes management (p-value 0.0015).Conclusion: Our study highlights significant prevalence of depression in study population and the prevalent depression negatively impacts on treatment adherence. It also revealed that depression complicates diabetes management resulting in poor medication adherence, poor diabetes control and diabetes related complications, making diabetes control more challenging and difficult.Keywords: psychological disorders, diabetes, pharmacotherapy, PHQ-9
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- 2024
19. Current Status of Cannabis Legalization and Decriminalization Efforts in Nepal
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Pathak N, Dhungana S, Basyal B, Jha PK, Shrestha S, Thapa P, and Paudyal V
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cannabis ,legalization ,decriminalization ,nepal ,Public aspects of medicine ,RA1-1270 - Abstract
Nabin Pathak,1,2 Shreya Dhungana,3 Bijaya Basyal,4 Prabhat Kumar Jha,5 Sunil Shrestha,6 Panna Thapa,7,8 Vibhu Paudyal9,10 1Drug Information Unit and Pharmacovigilance Cell, Department of Pharmacy, Hetauda Hospital, Madan Bhandari Academy of Health Sciences, Hetauda, Bagmati Province, Nepal; 2Department of Pharmacy and Clinical Pharmacology, Madan Bhandari Academy of Health Sciences, Hetauda, Bagmati Province, Nepal; 3Department of Pharmacy, National Model College for Advanced Learning, Tribhuvan University, Kathmandu, Nepal; 4Pharmacy Unit, Prithvi Chandra Hospital, Nawalparasi, Nepal; 5Pharmacy Officer, Province Health Logistic Management Center, Dhanusha, Nepal; 6Department of Research and Academics, Kathmandu Cancer Center, Bhaktapur, Province Bagmati, Nepal; 7Department of Pharmacy, Kathmandu University, Dhulikhel, Kavre, Nepal; 8Multidimensional Cannabis Research Centre (MCRC), Kathmandu University, Dhulikhel, Nepal; 9School of Pharmacy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK; 10Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UKCorrespondence: Nabin Pathak, Drug Information Unit and Pharmacovigilance Cell, Department of Pharmacy, Hetauda Hospital, Madan Bhandari Academy of Health Sciences, Makwanpur, Hetauda, Bagmati Province, Nepal, Email nabin.pathak@mbahs.edu.np; pathaknabin89@gmail.comAbstract: The unique historical and cultural background of Nepal has shaped its perspective on cannabis usage. Narcotic Drugs Control Act 1976 of Nepal prohibits the cultivation, production, manufacture, sales, and distribution of narcotic drugs, which also include various forms of cannabis. With proponents for cannabis legalization increasing in the country, it is equally crucial to analyze context and practices in countries already adopting legalization. As such, this article contextualizes the current debates in Nepal with global policies and practices and talks about the possible impacts of changing the laws on society, the economy, and public health. Policymakers in Nepal must make decisions based on evidence and facts when deciding how to regulate cannabis.Keywords: cannabis, legalization, decriminalization, Nepal
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- 2024
20. Impact of a community pharmacy-based medication therapy management program on clinical and humanistic outcomes in patients with uncontrolled diabetes: a randomised controlled trial
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Basmah Albabtain, Ghada Bawazeer, Vibhu Paudyal, Ejaz Cheema, Abdulaziz Alqahtani, Ahmed Bahatheq, Malcolm J. Price, and Muhammad Abdul Hadi
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Medication review program ,Community pharmacy ,Pharmacist ,Randomized controlled trial ,Medicine ,Science - Abstract
Abstract This study was aimed to evaluate the impact of community pharmacy (CP)-based medication therapy management (MTM) program on clinical and humanistic outcomes in patients with uncontrolled diabetes. An open label, parallel-group randomised controlled trial was undertaken at a community pharmacy in Riyadh city, Kingdom of Saudi Arabia. Patients with a diagnosis of uncontrolled diabetes (HbA1c of ≥ 8%) meeting the eligibility criteria were randomised to receive either the MTM programme provided by pharmacists or standard care. The primary outcome was change in HbA1c over 6 months. Secondary outcomes included: changes in clinical parameters (blood pressure (BP), lipid profile, serum creatinine (SCr) and albumin-to- creatinine ratio (ACR)), types of drug-related problems (DRPs), health service utilization (HSU), adherence, diabetes distress and overall patient satisfaction with the service at 6-month. A sufficiently powered sample of 160 participants with a mean age was 50 years (SD ± 11.9) was recruited. The majority of the patients (68.1%) were male and had diabetes for more than eight years [IQR 3, 14]. After adjusting for baseline HbA1c, compared to the control group, the mean HbA1c level was 0.02% (p = 0.929) and 0.2% (p = 0.47) lower in the intervention arm at 3-month and 6-month respectively. However, these differences were not statistically significant. Nonetheless, within each arm, there was a significant improvement in HbA1c from baseline. Furthermore, the intervention arm demonstrated improvement in BP control (SBP lowered by 3.2 mmHg (p = 0.05) and DBP lowered by 3.8 mmHg (p = 0.008)). During the study period, none of the participants in the intervention group reported hospitalization or ER visits compared to 14 patients in the control group [OR 0.069 (95% CI 0.004, 1.3)]. Patient satisfaction as measured by Patient Satisfaction with Pharmacist Services Questionnaire 2.0 (PSPSQ 2.0) was significantly higher among MTM program participants compared to standard care (p = 0.00001). Patients in the MTM program were eight times more likely to be adherent compared to the patients in the standard care [OR 7.89 (95% CI 3.6, 17.4)]. MTM program metrics showed that per patient, the pharmacists spent a median of 35 [IQR 30, 44.5] minutes at the initial visit and 20 [IQR 10, 25] minutes during the 6-month visit. The number of DRPs had significantly dropped in the intervention arm at 3 and 6-month (p = 0.0001). In conclusion, CP-based MTM program can improve health outcomes and prevent hospitalisations in patients with diabetes. These findings support the implementation of CP-based MTM services for patients with diabetes in the Kingdom of Saudi Arabia.
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- 2024
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21. Predicting airway immune responses and protection from immune parameters in blood following immunization in a pig influenza model
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Simon Gubbins, Basudev Paudyal, Barbara Dema, Ashutosh Vats, Marta Ulaszewska, Eleni Vatzia, Elma Tchilian, and Sarah C. Gilbert
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influenza A virus ,pig ,mucosal immunity ,bronchoalveolar lavage ,aerosol ,protection ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Whereas the intranasally delivered influenza vaccines used in children affect transmission of influenza virus in the community as well as reducing illness, inactivated influenza vaccines administered by intramuscular injection do not prevent transmission and have a variable, sometimes low rate of vaccine effectiveness. Although mucosally administered vaccines have the potential to induce more protective immune response at the site of viral infection, quantitating such immune responses in large scale clinical trials and developing correlates of protection is challenging. Here we show that by using mathematical models immune responses measured in the blood after delivery of vaccine to the lungs by aerosol can predict immune responses in the respiratory tract in pigs. Additionally, these models can predict protection from influenza virus challenge despite lower levels of blood responses following aerosol immunization. However, the inclusion of immune responses measured in nasal swab eluates did not improve the predictive power of the model. Our models are an important first step, providing proof of principle that it is feasible to predict immune responses and protection in pigs. This approach now provides a path to develop correlates of protection for mucosally delivered vaccines in samples that are easily accessed in clinical trials.
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- 2024
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22. Drug utilisation study in hospitalised chronic kidney disease patients, using World Health Organisation prescribing indicators: an observational study
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Wadia S. Alruqayb, Vibhu Paudyal, Price Malcolm, Asif Sarwar, Jeff Aston, and Anthony R. Cox
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Chronic kidney disease ,drug utilisation prescribing pattern ,WHO prescribing indicators ,Therapeutics. Pharmacology ,RM1-950 ,Pharmacy and materia medica ,RS1-441 - Abstract
Background Chronic kidney disease (CKD) is associated with comorbidities and altered pharmacokinetics, making appropriate prescribing, and monitoring necessary to minimise drug-related problems (DRPs). Therefore, this study aimed to describe the drug-utilisation pattern in hospitalised CKD patients.Methods An observational study was conducted in hospitalised adult (≥18 years old) CKD patients in the UK using WHO prescribing indicators, from November 2021 to April 2022 in a large teaching hospital in England from admission until discharge. This study used STATA version 16 for analysis.Results The mean number of drugs per prescription was 11.1(±5), the percentage of encounters resulting in the prescription of an antibiotic was 62%, the percentage of drugs prescribed by generic name was 90%, the percentage of encounters resulting in the prescription of an injection was 94%, and the percentage of drugs prescribed from essential drugs list or formulary was 89%. The most frequent drug group prescribed Alimentary Tract and Metabolism was 22%. Longer hospital stays, admission to a renal ward, and the number of comorbidities were independently associated with polypharmacy.Conclusion Not all prescribing indicators evaluated in this study were in full compliance with WHO recommendations. Polypharmacy was found in most participants which might require interventions to avoid DRPs. Further research is needed to evaluate factors associated with prescribing in the CKD population and prescriber perspectives on decision-making in the context of available guidelines and patient factors.
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- 2024
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23. Advancing opioid stewardship in low-middle-income countries: challenges and opportunities
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Rojita Jadhari, Nabin Pathak, Rajeev Shrestha, Sunil Shrestha, Bhuvan KC, Siew Hua Gan, and Vibhu Paudyal
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Opioids ,Opioid stewardship ,Pharmacist ,Low-and middle-income countries ,Therapeutics. Pharmacology ,RM1-950 ,Pharmacy and materia medica ,RS1-441 - Abstract
The increased utilization of opioids in low– and middle-income countries (LMICs) presents a growing threat of opioid-related abuse, misuse and diversion. Pharmacists, as integral members of healthcare teams, are responsible for dispensing and monitoring opioid use and hold a pivotal role in opioid stewardship within LMICs. This commentary describes the potential and multifaceted roles of pharmacists in opioid stewardship in resource-constrained settings and highlights appropriate strategies for promoting responsible opioid utilization.Opioid stewardship involves prioritising evidence-based prescribing, management and practices for pain management. It includes measures such as incorporating prescription drug monitoring programmes for appropriate opioid prescription, implementing safe disposal through drug take-back programmes, promoting non-opioid pain management, addressing the opioid addiction stigma, tapering opioid dose, educating patients and caregivers, establishing drug information centers, providing rehabilitative services and integrating collaboration with communities and experts.The combined difficulties of restricted access to healthcare resources and services coupled with low levels of literacy worsen the susceptibility to opioid abuse, misuse, and diversion in LMICs. Early detection, assessment and implementation of interventions to optimise opioid use are imperative for ensuring safe and effective opioid utilization, thereby mitigating the risks of overdose and addiction. The involvement of pharmacists in promoting safe and effective opioid utilization through education, monitoring, collaboration, and policy advocacy serves as a critical component in bridging existing gaps in opioid stewardship within LMICs.
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- 2024
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24. Misogynist baggage in Nepali fairy tales
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Mahesh Paudyal and Raj K. Baral
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Fairy tales ,gender stereotypes ,misogyny ,discourse ,gender discrimination ,Oliver Nyambi, English, University of the Free State, South Africa ,Fine Arts ,Arts in general ,NX1-820 ,General Works ,History of scholarship and learning. The humanities ,AZ20-999 - Abstract
This article examines four popular Nepali fairy tales—’The Story of Sumnima’, ‘Sunkeshari Maiya’, ‘Raja Mansarko Katha’, and ‘Hai Rani Chandani’, collected from different written sources—and demonstrates how they perpetuate gender stereotypes and limit women to inferior roles and negative conduct. The study is a critical discourse analysis with a special focus on gender relations among characters. It derives its theoretical lens from feminist theorists like Simone de Beauvoir, Helene Cixous and Cora Kaplan, and gender theorists like Judith Butler. Either origin myths or social and familial tales analyzed in this article relegate the female characters to a stock of voiceless individuals without agency, and limit them to minor domestic chores, or portray them as wicked agents that cause tragedies to their close associates, families, or members of the society. The tales reproduce misogynist baggage and represent a social psychology shaped by patriarchal tradition. The study concludes that characterization in these tales is informed by the value system of the patriarchal society where these tales exist and thus recapitulate gender bias.
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- 2024
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25. Effects of Maternal Age on Fetus and Perinatal Outcomes in a Tertiary Care Center: An Observational Study
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Sonam Chaudhary, Narayan Mahotra, and Pooja Paudyal
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maternal age ,perinatal outcome ,Nepalese ,Medicine (General) ,R5-920 - Abstract
Introduction: The early and late pregnancy both can be hazardous for mother and child. The study aims to explore the maternal age group among Nepalese women who delivered in Tribhuvan University Teaching Hospital and its effects on perinatal outcomes. Methods: An observational cross-section study was carried out from February to September, 2023 with the records of maternity cases at a tertiary care hospital after receiving ethical approval from the Institutional Review Committee [Reference number: 130(6-11) E2-2 079/080]. The records of maternity cases of four years duration from April, 2018 onwards were included. Data was entered in Microsoft Excel 2016 and descriptive analysis was done. Results: Out of 13062 maternity cases, the prevalence of pregnancy in normal reproductive age was 12035 (92.13%). A total of 882 (6.67%) maternity cases were in advanced age and 145 (1.11%) were in teen age. The alive newborns which were more in normal reproductive age was 12008 (99.77%) and stillbirth which was more in teen age pregnancy was 4 (2.75%). The low-birth-weight newborns distributed more in teen age pregnancy was 44 (30.34%) and high birth weight newborns distributed more in advanced age pregnancy was 18 (2.04%). Conclusions: The abnormal birth weight and stillbirths were common in teen age and advanced age pregnancy.
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- 2024
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26. Writing a manuscript for publication in a peer-reviewed scientific journal: Guidance from the European Society of Clinical Pharmacy
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Wirth, Francesca, Cadogan, Cathal A., Fialová, Daniela, Hazen, Ankie, Lutters, Monika, Paudyal, Vibhu, Weidmann, Anita E., Okuyan, Betul, and Henman, Martin C.
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- 2024
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27. Identifying seismicity pattern before major earthquakes in the Western Nepal and adjoining region (28.5°N to 31.0°N − 78°E to 82.96°E)
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Tiwari, Ram Krishna, Chaudhary, Shiva, Paudyal, Harihar, and Shanker, Daya
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- 2024
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28. Reduced-distortion diffusion weighted imaging for head and neck radiotherapy
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Eric Aliotta, Ramesh Paudyal, Alex Dresner, Amita Shukla-Dave, Nancy Lee, Laura Cerviño, Ricardo Otazo, and Victoria Y. Yu
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Medical physics. Medical radiology. Nuclear medicine ,R895-920 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background and purpose: Quantitative Diffusion Weighted Imaging (DWI) has potential value in guiding head and neck (HN) cancer radiotherapy. However, clinical translation has been hindered by severe distortions in standard single-shot Echo-Planar-Imaging (ssEPI) and prolonged scan time and low SNR in Turbo-Spin-Echo (ssTSE) sequences. In this study, we evaluate “multi-shot” (ms) msEPI and msTSE acquisitions in the context of HN radiotherapy. Materials and methods: ssEPI, ssTSE, msEPI with 2 and 3 shots (2sEPI, 3sEPI), and msTSE DWI were acquired in a phantom, healthy volunteers (N=10), and patients with HN cancer (N=5) on a 3-Tesla wide-bore MRI in radiotherapy simulation RF coil setup, with matched spatial resolution (2x2x5mm) and b = 0, 200, 800 s/mm2.Geometric distortions measured with deformable vector field (DVF) and contour analysis, apparent diffusion coefficient (ADC) values, and signal-to-noise-ratio efficiency (SNReff) were quantified for all scans. Results: All techniques significantly (P
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- 2024
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29. Comparative pharmacokinetics of porcine and human anti-influenza hemagglutinin monoclonal antibodies in outbred pigs and minipigs
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Basudev Paudyal, Elliot Moorhouse, Bhawna Sharma, Michael Dodds, Victor Nguyen, Mark Milad, and Elma Tchilian
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pharmacokinetic ,anti-influenza monoclonal antibodies ,minipigs ,outbred pigs ,2-12C ,pb27 ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Assessing the pharmacokinetics of monoclonal antibodies (mAbs) in relevant animal models is essential for designing improved formulations and developing mAb delivery platforms. We have established the pig, a large natural host animal for influenza with many similarities to humans, as a robust model for testing the therapeutic efficacy of anti-influenza mAbs and evaluating mAb delivery platforms. Here, we compared the pharmacokinetic characteristics of two anti-influenza hemagglutinin mAbs, human 2-12C and porcine pb27, in Göttingen minipigs and Landrace × Large White outbred pigs. Minipigs offer the advantage of a more stable weight, whereas outbred pigs are more readily available but exhibit rapid growth. Outbred pigs and minipigs showed similar pharmacokinetics and a similar porcine pb27 half-life (half-life of 15.7 days for outbred pigs and 16.6 days for minipigs). In contrast, the half-life of human 2-12C was more rapid in two of the minipigs but not in the outbred pigs, correlating with the development of antidrug antibodies in the two minipigs. Our results demonstrate that both outbred pigs and minipigs are appropriate models for pharmacokinetic studies and the evaluation of mAb delivery platforms, potentially bridging the gap between small animals and human trials.
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- 2024
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30. Patient and Public Involvement in Research Evaluating Integrated Care for People Experiencing Homelessness: Findings From the PHOENIx Community Pharmacy Pilot Randomised‐Controlled Trial
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Andrew McPherson, Vibhu Paudyal, Richard Lowrie, Helena Heath, Jane Moir, Natalie Allen, Nigel Barnes, Hugh Hill, Adnan Araf, Cian Lombard, Steven Ross, Sarah Tearne, Parbir Jagpal, Versha Cheed, Shabana Akhtar, George Provan, Andrea Williamson, and Frances S. Mair
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health inequality ,homelessness ,integrated care ,patient and public involvement ,pharmacist independent prescriber ,third sector organisation ,Medicine (General) ,R5-920 ,Public aspects of medicine ,RA1-1270 - Abstract
ABSTRACT Introduction There is a paucity of research on and a limited understanding of patient and public involvement (PPI) in the context of research in homelessness and, in particular, direct involvement of people with lived and living experience of homelessness (PEH) as expert advisors. We aim to report on outcomes and reflections from lived experience advisory panel (LEAP) meetings and PPI activities, held throughout the study lifecycle of a pilot randomised‐controlled trial (RCT) focused on evaluating integrated health and practical support for PEH. Methods Community Pharmacy Homeless Outreach Engagement Non‐medical Independent prescribing Rx (PHOENIx Community Pharmacy RCT) is an integrated health and social care intervention for people experiencing homelessness who present to community pharmacy. Intervention includes weekly support from a pharmacist prescriber and a third sector support worker for up to 6 months. PPI activities undertaken throughout the study were documented, including outcomes of LEAP meetings. Outcome reporting followed Guidance for Reporting Involvement of Patients and the Public 2 Short Form (GRIPP2‐SF). Results In total, 17 members were recruited into the LEAP; six meetings (three in two study sites) were held. PPI input was also received through representation from homelessness third sector organisation staff as study co‐applicants and core membership in the trial steering committee. Together, the PPI activities helped shape the study proposal, design of study materials, data analysis and dissemination materials. LEAP panel members offered valuable input via their experience and expertise into the delivery and refinement of interventions. Although longitudinal input was received from some LEAP members, ensuring repeat attendance in the pre‐planned meetings was challenging. Conclusion People who face social exclusion and marginalisation can provide highly valuable input as equal partners in co‐design and delivery of interventions seeking to improve their health and well‐being. Fluid membership and flexible methods of seeking and incorporating advice can offer pragmatic approaches to minimising barriers to continued involvement in research. Patient or Public Contribution This study reports findings and learning relevant to involvement of people with lived and living experience of homelessness as advisors in a research study. It is important for researchers to offer fluid memberships and use diverse methods to receive input from lived experience members, as traditional PPI methodology may be insufficient to ensure inclusivity. Staff and volunteers from third sector organisations were important PPI partners who bring their experience based on frontline service provision, often as the first port of call for people experiencing severe and multiple disadvantage. Trial Registration ISRCTN88146807.
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- 2024
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31. Iron-loaded Punica granatum peel: An effective biosorbent for the excision of arsenite from water
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Bishnu Datt Pant, Sangita Adhikari, Nabina Shrestha, Janaki Baral, Hari Paudyal, Kedar Nath Ghimire, Megh Raj Pokhrel, and Bhoj Raj Poudel
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As(III) ,Heavy metals ,Biosorbent ,Fe(III)-SPGP ,Adsorption isotherms ,Kinetics ,Science (General) ,Q1-390 ,Social sciences (General) ,H1-99 - Abstract
The occurrence of arsenic in the surroundings raises apprehension because its detrimental impacts on both human health and the ecology. Since adsorption is an effective, affordable method that can be adjusted to specific environmental circumstances, it is a sustainable solution for the removal of arsenic from the aquatic environment. Utilizing biomass that has been chemically activated may be a viable way to increase the adsorption capacity of the material, reduce arsenic pollution, and protect the environment and human health. In the proposed research, Fe(III) loaded saponified Punica granatum peel (Fe(III)-SPGP) has been synthesized to remove arsenic from aqueous solutions. FTIR and SEM analysis were utilized to carry out the characterization of the biosorbents. Batch experiments were carried out by altering several factors including pH and contact time, in addition to initial concentration and desorption. The most effective pH for As(III) adsorption using Fe(III)-SPGP was discovered to be 9.0. After determining that a pseudo-second-order kinetic model was the one that provided the greatest fit for the results of the experiment, the model developed by Langmuir was applied. It was discovered that the maximum adsorption of As(III) that could be adsorbed by Fe(III)-SPGP was 63.29 mg/g. The spent biosorbent may easily be reused again in subsequent applications. Based on these findings, Fe(III)-SPGP shows promise as a cheap effective sorbent for excising contaminants of As(III).
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- 2024
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32. Synthesis, characterization and As(III) scavenging behaviours of mango peel waste loaded with Zr(IV) ion from contaminated water
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Deepak Gyawali, Samjhana Poudel, Madan Poudel, Kedar Nath Ghimire, Megh Raj Pokhrel, Prabin Basnet, Krishna Bahadur BK, and Hari Paudyal
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Mango peel ,Zr(IV)-Loading ,As(III) scavenging ,Interfering ions ,Desorption ,Science (General) ,Q1-390 ,Social sciences (General) ,H1-99 - Abstract
Raw mango peel (RMP) was first saponified to yield saponified mango peel (SMP), which was then loaded with Zr(IV) ions to form a biosorbent for As(III) scavenging.The biosorption behaviors and mechanisms of As(III) scavenging using RMP and Zr(IV)-loaded saponified mango peel (Zr(IV)-SMP) were investigated batchwise. The As(III) scavenging efficiency of RMP increased from 20.13 % to 87.32 % after Zr(IV) loading. Optimum contact time of 6 h has been investigated for As(III) scavenging by Zr(IV)-SMP, and the data on kinetics is well fitted to the pseudo-second-order (PSO) model. Similarly, isotherm data of Zr(IV)-SMP fitted well to the Langmuir isotherm model with the maximum As(III) scavenging potential of 45.52 mg/g. Chloride (Cl−) and nitrate (NO3−) have negligible influence on As(III) scavenging, but sulphate (SO42−) interferes significantly. The exhausted Zr(IV)-SMP could be easily regenerated by treating with 2MNaOH. A mechanistic study indicates that As(III) scavenging is primarily contributed to electrostatic interaction and ligand exchange, which is confirmed from both instrumental and chemical characterizations techniques. Tubewell underground water polluted with a trace amount of arsenic (98.63 μg/L) could be successfully lowered down to the WHO standard (10 μg/L) by applying a small amount of Zr(IV)-SMP. Therefore, the Zr(IV)-SMP investigated in this work can be a low-cost, environmentally benign, and promising alternative for scavenging trace levels of arsenic from contaminated water.
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- 2024
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33. Views of healthcare professionals on complementary and alternative medicine use by patients with diabetes: a qualitative study
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Abdulaziz S. Alzahrani, Sheila M. Greenfield, Sunil Shrestha, and Vibhu Paudyal
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Complementary and alternative medicine ,Diabetes ,Healthcare professionals ,Other systems of medicine ,RZ201-999 - Abstract
Abstract Background Recent estimates indicate that a significant proportion of diabetic patients globally, up to 51%, are utilizing complementary and alternative medicine (CAM). To improve patient-provider communication and optimize prescribed treatments, healthcare professionals (HCPs) must understand the factors associated with CAM use among diabetic patients. There is a dearth of literature on HCPs perspectives on CAM use by diabetic patients. This study explored HCPs knowledge, perspective, and views on their diabetic patients’ use of CAM. Methods Qualitative study using one-to-one semi-structured interviews conducted with 22 HCPs involved in the care of diabetic patients (6 endocrinologists, 4 general practitioners, 4 nurses and 8 pharmacists). Participants were recruited through general practices, community pharmacies and a diabetic centre in Saudi Arabia. Data were analyzed using thematic analysis. Results Five key themes resulted from the analysis. HCPs generally demonstrated negative perceptions toward CAM, particularly regarding their evidence-based effectiveness and safety. Participants described having limited interactions with diabetic patients regarding CAM use due to HCPs’ lack of knowledge about CAM, limited consultation time and strict consultation protocols. Participants perceived convenience as the reason why patients use CAM. They believed many users lacked patience with prescribed medications to deliver favourable clinical outcomes and resorted to CAM use. Conclusions HCPs have noted inadequate engagement with diabetic patients regarding CAM due to a lack of knowledge and resources. To ensure the safe use of CAM in diabetes and optimize prescribed treatment outcomes, one must address the communication gap by implementing a flexible consultation protocol and duration. Additionally, culturally sensitive, and evidence-based information should be available to HCPs and diabetic patients.
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- 2024
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34. Cryptocurrency price and volatility predictions with machine learning
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Poudel, Samir, Paudyal, Rajendra, Cankaya, Burak, Sterlingsdottir, Naomi, Murphy, Marissa, Pandey, Shital, Vargas, Jorge, and Poudel, Khem
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- 2023
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35. How University Lecturers and Students Interpret Opportunities and Challenges of Online Mode of Learning
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Paudyal, Ganga Ram and Rana, Karna
- Abstract
This paper reports an analysis of university lecturers and students' experience of the online mode of learning in the COVID-19 situation. It as qualitative research employed semi-structured interviews and observation of online classes to gather data. It reports on how online classes enabled university lecturers and students to manage online learning and improve technological skills with the consistent practice of various information and communication technology (ICT) tools. Despite limited technological and pedagogical knowledge, lecturers initiated online learning as an alternative to physical classroom learning in the crisis. Both lecturers and students, thus, were intimidated by new technologies and ways of learning at the beginning. In absence of ICT training, their consistent practices of online learning enabled them to develop some level of confidence in using ICT in teaching and learning activities. Many students from remote rural villages, however, are unable to access online education due to the lack of the internet, smart devices and electricity. The online mode of learning, albeit it is reported a potential strategy to shift from the traditional education system to modern learning, cannot be sustainable in the context where there is limited or no infrastructure for the internet and electricity.
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- 2021
36. A case report on multisystem inflammatory syndrome in children (MIS‐C) associated with COVID‐19 infection
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Roshan Bhandari, Richa Paudyal, Abhigya Paudyal, and Shreya Singh Beniwal
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COVID‐19 ,immunoglobulin therapy ,inflammation ,multisystem inflammatory syndrome in children (MIS‐C) ,pediatric COVID‐19 management ,Medicine ,Medicine (General) ,R5-920 - Abstract
Key Clinical Message Early recognition and treatment of Multisystem Inflammatory Syndrome in Children (MIS‐C) within the context of COVID‐19 infection is crucial for improved outcomes. Prompt intervention with IVIG and steroids leads to significant improvement in a severe case of MIS‐C. Clinicians should be vigilant for MIS‐C symptoms and initiate timely management. Abstract We report a case involving a fourteen‐year‐old male with COVID‐19 infection who developed multisystem inflammatory disease. A previously healthy child presented with a history of 10 days of fever and cough, along with diarrhea, and vomiting for 3 days. His COVID‐19 infection was confirmed through Polymerase Chain Reaction (PCR), and the laboratory values were remarkable for high levels of C‐reactive protein, D‐dimers, B‐type natriuretic peptide (BNP), and troponin I. He developed circulatory shock on the second day of the presentation and needed inotropic support. Steroids and intravenous immunoglobulin (IVIG) were started in light of Multisystem Inflammatory Syndrome in Children (MIS‐C), which improved his condition. Thus, during the management of COVID‐19 infection, early detection and a careful clinical characterization for MIS‐C are essential.
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- 2024
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37. Stroke‐induced excess in capillarization relative to oxidative capacity in rats is muscle specific
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Hans Degens, Arjun Paudyal, Gert Kwakkel, Mark Slevin, and Huub Maas
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atrophy ,muscle morphology ,oxygen consumption ,photothrombotic stroke ,stroke ,Physiology ,QP1-981 - Abstract
Abstract Stroke is not only associated with muscle weakness, but also associated with reduced muscle fatigue resistance and reduced desaturation during exercise that may be caused by a reduced oxidative capacity and/or microvasculature. Therefore, the objective of the present study was to determine the effects of stroke on muscle mass, fiber size and shape, capillarization and oxidative capacity of the rat m. extensor carpi radialis (ECR) and m. flexor carpi ulnaris (FCU) after a photothrombotic stroke in the forelimb region of the primary sensorimotor cortex. The main observation of the present study was that 4 weeks after induction of stroke there were no significant changes in muscle fiber size and shape. Although there was no significant capillary rarefaction, there was some evidence for remodeling of the capillary bed as reflected by a reduced heterogeneity of capillary spacing (p = 0.006) that may result in improved muscle oxygenation. In the ECR, but not in the FCU, this was accompanied by reduction in muscle fiber oxidative capacity as reflected by reduced optical density of sections stained for succinate dehydrogenase (p = 0.013). The reduced oxidative capacity and absence of significant capillary rarefaction resulted in a capillary to fiber ratio per unit of oxidative capacity that was higher after stroke in the ECR (p = 0.01), but not in the FCU. This suggests that at least during the early stages, stroke is not necessarily accompanied by muscle fiber atrophy, and that stroke‐induced reductions in oxidative capacity resulting in relative excess of capillarization are muscle specific.
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- 2024
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38. Single-cell analysis reveals lasting immunological consequences of influenza infection and respiratory immunization in the pig lung.
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Andrew Muir, Basudev Paudyal, Selma Schmidt, Ehsan Sedaghat-Rostami, Soumendu Chakravarti, Sonia Villanueva-Hernández, Katy Moffat, Noemi Polo, Nicos Angelopoulos, Anna Schmidt, Matthias Tenbusch, Graham Freimanis, Wilhelm Gerner, Arianne C Richard, and Elma Tchilian
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Immunologic diseases. Allergy ,RC581-607 ,Biology (General) ,QH301-705.5 - Abstract
The pig is a natural host for influenza viruses and integrally involved in virus evolution through interspecies transmissions between humans and swine. Swine have many physiological, anatomical, and immunological similarities to humans, and are an excellent model for human influenza. Here, we employed single cell RNA-sequencing (scRNA-seq) and flow cytometry to characterize the major leukocyte subsets in bronchoalveolar lavage (BAL), twenty-one days after H1N1pdm09 infection or respiratory immunization with an adenoviral vector vaccine expressing hemagglutinin and nucleoprotein with or without IL-1β. Mapping scRNA-seq clusters from BAL onto those previously described in peripheral blood facilitated annotation and highlighted differences between tissue resident and circulating immune cells. ScRNA-seq data and functional assays revealed lasting impacts of immune challenge on BAL populations. First, mucosal administration of IL-1β reduced the number of functionally active Treg cells. Second, influenza infection upregulated IFI6 in BAL cells and decreased their susceptibility to virus replication in vitro. Our data provide a reference map of porcine BAL cells and reveal lasting immunological consequences of influenza infection and respiratory immunization in a highly relevant large animal model for respiratory virus infection.
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- 2024
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39. Synthesis analysis of hydrogeochemistry of nepal himalayan rivers: Perspective from major ions and trace elements
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Kshitiz Kandel, Chhatra Mani Sharma, Bakhat Rawat, Rukumesh Paudyal, Mingyue Li, Aastha Pandey, and Qianggong Zhang
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Hydro-geochemistry ,Himalayan rivers ,Water quality ,Major ions ,Elements ,Water Quality Index ,Ecology ,QH540-549.5 - Abstract
Rivers originating from the Himalayas play a crucial role as primary water sources for a significant proportion of the population in Asia downstream. This paper presents a comprehensive synthesis of hydrogeochemical data, incorporating major ions and trace elements from 153 papers spanning 2000 to 2023, with a detailed analysis of 20 papers specific to Nepal Himalayan rivers. To bridge the research gap due to sparse data, we aimed to enhance inclusivity by amalgamating both seasonal and one-time datasets, computing mean values for singular instances, and employing grand means for multiple seasonal data points. Our findings highlight varied research attention across different river basins, with the eastern Koshi Basin receiving extensive attention, while the middle Gandaki and Bagmati Basins garner moderate attention, and data scarcity observed in the western Karnali Basin. Predominant ionic composition, notably Ca2+ and HCO3–, reflect lithological influences, primarily driven by rock weathering. Although anthropogenic impacts remain minimal in most basins, certain lowland areas with higher population densities exhibit increasing significance. Trace element contamination, notably Cd, Cu, Sr, and Zn, poses ongoing threats, both from natural and anthropogenic sources. Water quality assessments conducted for agricultural and drinking suitability indicated good status, except in the densely polluted urban Bagmati stem. Health and ecological risks are low, as determined by pollution indices such as Pi, NPI, HI, and CI. The Bagmati River's middle segment, with high population density and moderate agricultural activity, shows pronounced anthropogenic footprints, while downstream areas exhibited greater impacts. Additionally, this article proposes the potential use of a Water Quality Index tool to comprehensively assess water quality across all parameters in Himalayan water bodies, providing a roadmap for future environmental conservation in the Himalayas. This pioneering review represents a significant effort to understand Himalayan rivers geochemistry on a large geographical scale and emphasizes the need for integrated observation and consideration of river water quality across the entire Himalayan region, from high mountains to lowlands.
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- 2024
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40. Full-bandwidth anisotropic Migdal-Eliashberg theory and its application to superhydrides
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Roman Lucrezi, Pedro P. Ferreira, Samad Hajinazar, Hitoshi Mori, Hari Paudyal, Elena R. Margine, and Christoph Heil
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Astrophysics ,QB460-466 ,Physics ,QC1-999 - Abstract
Abstract Migdal-Eliashberg theory is one of the state-of-the-art methods for describing conventional superconductors from first principles. However, widely used implementations assume a constant density of states around the Fermi level, which hinders a proper description of materials with distinct features in its vicinity. Here, we present an implementation of the Migdal-Eliashberg theory within the EPW code that considers the full electronic structure and accommodates scattering processes beyond the Fermi surface. To significantly reduce computational costs, we introduce a non-uniform sampling scheme along the imaginary axis. We demonstrate the power of our implementation by applying it to the sodalite-like clathrates YH6 and CaH6, and to the covalently-bonded H3S and D3S. Furthermore, we investigate the effect of maximizing the density of states at the Fermi level in doped H3S and BaSiH8 within the full-bandwidth treatment compared to the constant-density-of-states approximation. Our findings highlight the importance of this advanced treatment in such complex materials.
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- 2024
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41. A Quantitative Multiparametric MRI Analysis Platform for Estimation of Robust Imaging Biomarkers in Clinical Oncology
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Eve LoCastro, Ramesh Paudyal, Amaresha Shridhar Konar, Peter S. LaViolette, Oguz Akin, Vaios Hatzoglou, Alvin C. Goh, Bernard H. Bochner, Jonathan Rosenberg, Richard J. Wong, Nancy Y. Lee, Lawrence H. Schwartz, and Amita Shukla-Dave
- Subjects
multiparametric MRI ,dynamic contrast-enhanced MRI ,diffusion-weighted MRI ,optimal model mapping ,cancer ,oncology ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
There is a need to develop user-friendly imaging tools estimating robust quantitative biomarkers (QIBs) from multiparametric (mp)MRI for clinical applications in oncology. Quantitative metrics derived from (mp)MRI can monitor and predict early responses to treatment, often prior to anatomical changes. We have developed a vendor-agnostic, flexible, and user-friendly MATLAB-based toolkit, MRI-Quantitative Analysis and Multiparametric Evaluation Routines (“MRI-QAMPER”, current release v3.0), for the estimation of quantitative metrics from dynamic contrast-enhanced (DCE) and multi-b value diffusion-weighted (DW) MR and MR relaxometry. MRI-QAMPER’s functionality includes generating numerical parametric maps from these methods reflecting tumor permeability, cellularity, and tissue morphology. MRI-QAMPER routines were validated using digital reference objects (DROs) for DCE and DW MRI, serving as initial approval stages in the National Cancer Institute Quantitative Imaging Network (NCI/QIN) software benchmark. MRI-QAMPER has participated in DCE and DW MRI Collaborative Challenge Projects (CCPs), which are key technical stages in the NCI/QIN benchmark. In a DCE CCP, QAMPER presented the best repeatability coefficient (RC = 0.56) across test–retest brain metastasis data, out of ten participating DCE software packages. In a DW CCP, QAMPER ranked among the top five (out of fourteen) tools with the highest area under the curve (AUC) for prostate cancer detection. This platform can seamlessly process mpMRI data from brain, head and neck, thyroid, prostate, pancreas, and bladder cancer. MRI-QAMPER prospectively analyzes dose de-escalation trial data for oropharyngeal cancer, which has earned it advanced NCI/QIN approval for expanded usage and applications in wider clinical trials.
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- 2023
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42. Guideline adherence for cardiometabolic monitoring of patients prescribed antipsychotic medications in primary care: a retrospective observational study
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Ali, Ruba Azfr, Jalal, Zahraa, Johal, Jaspal, and Paudyal, Vibhu
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- 2023
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43. Provision of drug and alcohol services amidst COVID-19 pandemic: a qualitative evaluation on the experiences of service providers
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Richards-Jones, Levi, Patel, Priya, Jagpal, Parbir Kaur, Lowrie, Richard, Saunders, Karen, Burwood, Sarah, Shrestha, Sunil, and Paudyal, Vibhu
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- 2023
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44. Fractal Characteristics of the Seismic Swarm Succeeding the 2015 Gorkha Earthquake, Nepal
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Tiwari, Ram Krishna and Paudyal, Harihar
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- 2023
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45. Spatiotemporal Variability Analysis of Rainfall and Water Quality: Insights from Trend Analysis and Wavelet Coherence Approach
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Syeda Zehan Farzana, Dev Raj Paudyal, Sreeni Chadalavada, and Md Jahangir Alam
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rainfall ,water quality ,modified Mann–Kendall test ,innovative trend analysis ,wavelet transform coherence ,Geology ,QE1-996.5 - Abstract
An understanding of the trend and relationship between rainfall patterns and water quality dynamics can provide valuable guidelines for the effective management of water resources. The aim of this study was to reveal the synchronous trends in rainfall and water quality and to explore the potential connection between seasonal variation in rainfall volume and the water quality index. This study scrutinised the seasonal temporal trends of rainfall and water quality parameters of three water supply reservoirs in the Toowoomba region of Australia by applying the modified Mann–Kendall (MMK) test and innovative trend analysis (ITA) methods from data collected over 22 years (2002–2022). The models showed a significant increasing trend of rainfall in two rainfall stations during autumn season. The water quality parameters, such as PO43−, exhibited a significant decreasing trend in all seasons in three reservoirs. On the other hand, the water quality index (WQI) showed a decreasing trend in the Cooby and Cressbrook reservoirs, excepting the Perseverance reservoir, which exhibited an increasing trend. In addition to the detection of trends, this study investigated the potential correlation between seasonal variation of rainfall volume and the water quality index using the wavelet transform coherence (WTC) method. The data of twelve rainfall stations were brought into this analysis. The WTC analysis displayed an apparent correlation between the water quality index and rainfall pattern for 70% of the rainfall stations across 8–16 periods. The highest coherency was noticed in 8–16 periods from 2002–2022, as observed at both the Cooby Creek rainfall station and in the WQI of the Cooby reservoir. This evaluation revealed the intertwined dynamics of rainfall patterns and water quality, providing a deeper understanding of their interdependence and implications, which might be useful for environmental and hydrological management practices.
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- 2024
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46. Prevalence and associated factors of diabetic retinopathy among people with diabetes screened using fundus photography at a community diabetic retinopathy screening program in Nepal
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Raba Thapa, Sanjita Sharma, Eli Pradhan, Sushma Duwal, Manish Poudel, Krishna Gopal Shrestha, and Govinda Prasad Paudyal
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Diabetic retinopathy ,Sight threatening diabetic retinopathy ,Associated factors ,Screening ,Nepal ,Ophthalmology ,RE1-994 - Abstract
Abstract Background This study aimed to assess the prevalence and associated factors of diabetic retinopathy (DR) and vision threatening DR (VTDR) among people with diabetes screened using fundus photography in Nepal. Methods This is a retrospective study among people with diabetes presented for DR screening using fundus photography from 2013 to 2019. Detailed demographics, duration of diabetes, medical history, visual acuity, and grading of DR on fundus photography were analyzed. Fundus camera used in the study were;Topcon digital fundus camera 900 CXR and digital portable fundus cameras (Nidek-10 portable non-mydriatric fundus camera; Versacam & Trade & Alpha, France), and a Zeiss portable fundus camera (Zeiss Visucout 100). Macula centred and disc centred 45 degree two images were taken from each eye. Pupil were dilated in cases where there was media haze in un-dilated cases. DR was graded using early treatment diabetic retinopathy study criteria. The images were graded by fellowship trained retina specialist. DR prevalence included any DR changes in one or both eyes. Results Total of 25,196 patients with diabetes were enrolled. Mean age was 54.2 years with Standard Deviation (S.D):12.9 years, ranging from 6 years to 97 years. Type 1 and type 2 diabetes comprised of 451 people (1.79%) and 24,747 (98.21%) respectively. Overall, 1.8% of the images were un-gradable. DR prevalence was 19.3% (95% Confidence Interval (CI): 18.8 − 19.7%). DR prevalence in type 1 and type 2 diabetes was 15.5% (95% CI: 12.5 − 18.6%) and 19.3% (CI: 18.8 − 19.8%) respectively. Clinically significant macular edema (CSME) was found in 5.9% (95% CI: 5.6-6.2%) and VTDR in 7.9% (95% CI: 7.7-8.3%). In multivariate analysis, our study revealed strong evidence to suggest that there is meaningful association between DR and VTDR with duration of diabetes, diabetic foot, diabetic neuropathy, agriculture occupation, those under oral hypoglycaemic agents or insulin or both as compared to those under diet only, and presenting visual acuity > 0.3LogMAR. Conclusion Prevalence and associated factors for DR and VTDR were similar to other DR screening programs in the region. Emphasis on wider coverage of DR screening could help for timely detection and treatment of STDR to avoid irreversible blindness.
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- 2023
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47. Barriers and facilitators to seeking and accessing mental health support in primary care and the community among female migrants in Europe: a 'feminisms' systematic review
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Patrick Nyikavaranda, Marija Pantelic, Christina J Jones, Priyamvada Paudyal, Alice Tunks, and Carrie D Llewellyn
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Female migrants ,Refugees ,Asylum seekers ,Mental Health ,Access ,Primary care ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Recent years have seen record levels of migration to Europe. Female migrants are at heightened risk of developing mental health disorders, yet they face barriers to accessing mental health services in their host countries. This systematic review aims to summarise the barriers and facilitators to accessing mental health support for female migrants in Europe. Methods The review follows PRISMA guidelines, and the protocol was pre-published on PROSPERO. Six electronic databases were searched: CINAHL, Global Health Database, Medline, PsycARTICLES, PsycINFO and Web of Science. Thematic analysis was undertaken on the identified studies. A feminist quality appraisal tool was applied. Results Eight qualitative, six quantitative and five mixed methods studies were identified. Barriers included a lack of information, stigma, religious and cultural practices and beliefs, and a lack of consideration of gender-specific needs within the health system. Gender-sensitive services, supportive general practitioners and religious leaders facilitated access. Conclusions The design of mental health research, services, policies, and commissioning of support for migrants must consider female migrant needs. Mental health support services must be culturally aware and gender sensitive. Registration The review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO, registration number CRD42021235571.
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- 2023
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48. Economic burden of chronic migraine in OECD countries: a systematic review
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Alyaa Eltrafi, Sunil Shrestha, Ali Ahmed, Hema Mistry, Vibhu Paudyal, and Saval Khanal
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Chronic migraine ,Cost of illness ,Economic burden ,Direct costs ,Indirect costs ,Intangible costs ,Medicine (General) ,R5-920 - Abstract
Abstract Background Chronic migraine (CM) is a significant neurological condition affecting a substantial portion of the global population. The economic burden of CM includes both direct healthcare costs and indirect costs resulting from productivity losses and intangible impacts on patients’ quality of life. However, there is limited research that comprehensively evaluates all cost components associated with CM, highlighting the need for a systematic review. Methods We conducted a systematic literature search in databases including MEDLINE, Embase, and CINAHL to identify studies estimating the cost of illness of chronic migraines. The search was restricted to English language articles published from inception to October 2021, and only findings from Organisation for Economic Co-operation and Development (OECD) countries were included. Methodology features and key findings were extracted from the studies, and reported costs were converted to GBP for cross-country comparisons. Results Thirteen cost-of-illness studies on CM from various OECD countries were included in this review. The studies demonstrated substantial variations in monetary estimates, but consistently highlighted the considerable economic burden of CM. Direct costs, particularly hospitalisation and medication expenses, were identified as the highest contributors. However, indirect costs, such as productivity losses due to absenteeism and presenteeism, were often underexplored in the reviewed studies. Additionally, intangible costs related to emotional and social impacts on patients were largely overlooked. Conclusion Chronic migraine imposes a significant economic burden on individuals, healthcare systems, and society. Policymakers and healthcare stakeholders should consider both direct and indirect cost components, as well as intangible costs, in developing targeted strategies for effective CM management and resource allocation. Further research focusing on comprehensive cost assessments and sensitivity analyses is needed to enhance the understanding of CM’s economic implications and inform evidence-based healthcare policy decisions. Addressing these research gaps can alleviate the economic burden of CM and improve patient outcomes.
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- 2023
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49. Electron–phonon physics from first principles using the EPW code
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Hyungjun Lee, Samuel Poncé, Kyle Bushick, Samad Hajinazar, Jon Lafuente-Bartolome, Joshua Leveillee, Chao Lian, Jae-Mo Lihm, Francesco Macheda, Hitoshi Mori, Hari Paudyal, Weng Hong Sio, Sabyasachi Tiwari, Marios Zacharias, Xiao Zhang, Nicola Bonini, Emmanouil Kioupakis, Elena R. Margine, and Feliciano Giustino
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Materials of engineering and construction. Mechanics of materials ,TA401-492 ,Computer software ,QA76.75-76.765 - Abstract
Abstract EPW is an open-source software for ab initio calculations of electron–phonon interactions and related materials properties. The code combines density functional perturbation theory and maximally localized Wannier functions to efficiently compute electron–phonon coupling matrix elements, and to perform predictive calculations of temperature-dependent properties and phonon-assisted quantum processes in bulk solids and low-dimensional materials. Here, we report on significant developments in the code since 2016, namely: a transport module for the calculation of charge carrier mobility under electric and magnetic fields using the Boltzmann transport equation; a superconductivity module for calculations of phonon-mediated superconductors using the anisotropic multi-band Eliashberg theory; an optics module for calculations of phonon-assisted indirect transitions; a module for the calculation of small and large polarons without supercells; and a module for calculating band structure renormalization and temperature-dependent optical spectra using the special displacement method. For each capability, we outline the methodology and implementation and provide example calculations.
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- 2023
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50. Transition to professional practice: Perspectives of new nursing graduates of Nepal
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Sital Gautam, Anju Poudel, Kalpana Paudyal, and Mangal Maya Prajapati
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New nursing graduates ,Professional practice ,Transition ,Nursing ,RT1-120 - Abstract
Abstract Background Internationally, the transition from student nurse to practicing nurse is recognized as being the most stressful period. Yet very little is known about how new nursing graduates perceive this transition in Nepal. The study aimed to explore new nursing graduates’ perceptions of the transition to professional practice. Methods A qualitative descriptive methodology was used. In-depth semi-structured interviews were conducted with 10 purposively recruited participants from two private hospitals in Nepal. Data were analyzed using inductive thematic analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were used to report the findings of this study. Results New nursing graduates perceived the transition to professional practice as an intense experience. Inductive thematic analysis yielded four intrinsically linked themes that encompassed new nursing graduates’ transition experiences: ‘getting hit by reality’, ‘losing confidence’, ‘feeling unsupported’, and ‘gathering strengths.’ The theme ‘getting hit by reality’ included three sub-themes: ‘gap between theory and practice,’ ‘no protective shield,’ and ‘plethora of responsibilities’, which explains nurses’ initial encounter with real-world practice. The theme ‘losing confidence’ contained three sub-themes: ‘being fearful,’ ‘being ignored,’ and ‘being accused,’ which describes how nurses started losing confidence as they confronted the real side of the profession. The theme ‘feeling unsupported’ included two sub-themes: ‘left without guidance,’ and ‘limited support from seniors,’ which explains how nurses perceived their work environment. The theme ‘gathering strength’ contained two sub-themes: ‘reflecting’ and ‘asking for help,’ which describes how nurses coped with the challenges related to the transition. Conclusion To facilitate the transition to practice, educational institutions must impart to students a realistic understanding of the transition process, address the theory-practice gap, and collaborate with hospitals. Similarly, hospitals should have realistic expectations from new nurses, assign work according to their capabilities, and allow them sufficient time for role integration. Likewise, well-conceived detailed orientation, mentorship or preceptorship programs, and regular professional development programs are vital to easing the transition. Furthermore, establishing and maintaining a supportive work culture, which promotes equity, respect, and safety among employees, is crucial for positive transition experiences.
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- 2023
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