bluuebunny/crossref_metadata_2025 huggingface dataset:
Managing uncertainty in forecasting health workforce demand using the Robust Workforce Planning Framework: the example of midwives in Belgium
Authors: Benahmed Nadia , Lefèvre Mélanie , Stordeur Sabine
Published: September 2023

Background

In Belgium, the Planning Commission for Medical Supply is responsible for monitoring human resources for health (HRH) and ultimately proposing workforce quotas. It is supported by the Planning Unit for the Supply of the Health Professions. This Unit quantifies and forecasts the workforce in the healthcare professions on the basis of a stock and flow model, based on trends observed in the past. In 2019, the Planning Unit asked the KCE (Belgian Health Care Knowledge Centre) to develop additional forecasting scenarios for the midwifery workforce, to complement the standard historical trend approach. The aim of this paper is to present the development of such forecasting scenarios.

Methods

The Robust Workforce Planning Framework, developed by the Centre for Workforce Intelligence in the UK was used to develop alternative midwifery workforce scenarios. The framework consists of four steps (Horizon scanning, Scenario generation, Workforce modelling, and Policy analysis), the first two of which were undertaken by KCE, using two online surveys and five workshops with stakeholders.

Results

Three alternative scenarios are proposed. The first scenario (close to the current situation) envisages pregnancy and maternity care centred on gynaecologists working either in a hospital or in private practice. The second scenario describes an organisation of midwife-led care in hospitals. In the third scenario, care is primarily organised by primary care practitioners (midwives and general practitioners) in outpatient settings.

Conclusions

The Robust Workforce Planning Framework provides an opportunity to adjust the modelling of the health workforce and inform decision-makers about the impact of their future decisions on the health workforce.
The effect of letrozole overlapped with gonadotropin on IVF outcomes in women with DOR or aged over 40 years old with repeated cycles
Authors: Li Xiaojia , Chen Jingbo , Zhao Yang , He Fengyi , Zeng Meijun , Guan Guijun , Zhao Xiaomiao
Published: September 2023

Background

Evaluating the efficacy of letrozole overlapped with gonadotropin-modified letrozole protocol (mLP) for diminished ovarian reserve (DOR) or advanced-age women with repeated cycles.

Methods

This is a retrospectively registered, paired-match study including 243 women with DOR and 249 women aged over 40 years old who received in vitro fertilization (IVF) treatment. 123 women received stimulation with mLP (mLP group). GnRH agonist (GnRH-a) long, GnRH antagonist (GnRH-anta), and mild stimulation protocol were used as controls with 123 women in each group. We further analyzed 50 of 123 patients in the mLP group who have experienced more than one failed cycles with other ovarian stimulation protocols (non-mLP group). Clinical pregnancy rate (CPR), cumulative clinical pregnancy rate (CCPR), and live birth rate (LBR) were main outcomes.

Results

The CPR in the mLP group (38.46%) was significantly higher than mild stimulation (17.11%), but not significantly different from GnRH-a long (26.13%) and GnRH-anta (29.17%) group. The CCPR showed an increasing trend in the mLP group (33.33%) although without significance when compared with controls. The CCRP of GnRH-a long, GnRH-anta, mild stimulation group were 21.68%, 29.03%, and 13.04%, respectively. In women with repeated cycles, mLP achieved the higher available embryo rate (P < 0.05), the top-quality embryo rate, the CPR (P < 0.001), and the LBR (P < 0.001). Further study showed a positive correlation between testosterone and the number of oocytes retrieved in the mLP group (r = 0.395, P < 0.01).

Conclusion

The mLP may be effective for aged or DOR women who have experienced previous cycle failure by improving the quality of embryos, the CPR, and the LBR. An increasing serum testosterone level may reflect follicular growth during ovarian stimulation.
Salmonella meningitis in a young child from Pakistan: a case report
Authors: Majeed Imad , Khan Sami Ullah , Khan Zaraq Rashid , Hayat Sabawoon , Ullah Ihtisham , Ali Asim
Published: September 2023

Background

Salmonella meningitis is a rare but serious complication of Salmonella infection, primarily affecting infants, children, and immunocompromised individuals.

Case presentation

We present a case of a two-and-a-half-year-old Asian boy who developed Salmonella meningitis along with pneumonia and respiratory failure. Initially, he experienced symptoms of loose motions, fever, and irritability, which progressed to neck stiffness and brisk reflexes. Cerebrospinal fluid (CSF) analysis confirmed Salmonella typhi in the CSF. Due to the worsening condition, the patient was admitted to the intensive care unit, intubated, and switched to meropenem as the antibiotic of choice after an initial empiric therapy with ceftriaxone and vancomycin. With appropriate treatment, the patient showed significant improvement, including resolution of fever and respiratory symptoms.

Conclusion

Management of Salmonella meningitis is often challenging primarily because of the fact that the empiric therapy for meningitis may not always provide coverage to the multi-drug resistant Salmonella species found in South Asia. Prompt administration of appropriate antibiotics based on sensitivity testing is crucial for successful management. This case emphasizes the importance of early recognition and effective management of this uncommon yet severe complication of Salmonella infection.
Astaxanthin attenuates cognitive deficits in Alzheimer’s disease models by reducing oxidative stress via the SIRT1/PGC-1α signaling pathway
Authors: Liu Ning , Lyu Xiaohong , Zhang Xianglin , Zhang Fan , Chen Yiming , Li Gang
Published: September 2023

Objective

Oxidative stress plays a pivotal role in neurodegenerative diseases. Astaxanthin (AST) can play a neuroprotective role owing to its long-chain conjugated unsaturated double bond, which imparts potent antioxidant, anti-neuroinflammatory, and anti-apoptotic properties. However, the biological mechanisms underlying these effects remain unknown. Therefore, this study aimed to investigate and validate the protective effect of AST on neuronal senescence and apoptosis caused by oxidative stress induced by Aβ25–35 peptide, with the goal of preventing the onset of cognitive dysfunction.

Methods

Alzheimer's disease models comprising ICR mice and PC12 cells were established using Aβ25–35. The Morris water maze test was used to assess mouse behavior. Nissl staining revealed morphological changes in the mouse hippocampal neurons. To elucidate the mechanism of action of AST, ICR mice and PC12 cells were treated with the silent information regulator 1 (SIRT1) inhibitor nicotinamide (NAM). Additionally, immunofluorescence, western blotting, and reverse transcription polymerase chain reaction were used to evaluate changes in the expression of Bcl-2 and Bax in the mouse hippocampus, and SIRT1/PGC-1α signaling pathway proteins were detected. Moreover, the oxidative stress markers in ICR mice and PC12 cells were evaluated. Further, CCK-8 assays, Annexin V/PI double staining, and β-galactosidase activity assays were performed in PC12 cells to evaluate the anti-senescence and apoptotic effects of AST.

Results

In vivo experiments showed that Aβ25–35 impaired cognitive function, promoted morphological changes in hippocampal neurons, decreased Bcl-2 expression, increased Bax expression, decreased superoxide dismutase and GSH-px levels, and increased reactive oxygen species and malondialdehyde levels. Conversely, AST alleviated the impact of Aβ25–35 in mice, with reversed outcomes. NAM administration reduced SIRT1 and PGC-1α expression in the hippocampus. This decrease was accompanied by cognitive dysfunction and hippocampal neuron atrophy, which were also evident in the mice. Additionally, in vitro experiments showed that Aβ25–35 could promote oxidative stress and induce the senescence and apoptosis of PC12 cells. Nonetheless, AST treatment counteracted this effect by inhibiting oxidative stress and altering the state of PC12 cells. Notably, the Aβ + NAM group exhibited the most significant rates of senescence and apoptosis in PC12 cells following NAM treatment.

Conclusion

AST can improve cellular senescence and apoptosis mediated by oxidative stress via the SIRT1/PGC-1α signaling pathway and plays a vital role in inhibiting neuronal senescence and apoptosis and enhancing cognitive ability.
The Commercial Determinants of Health and Evidence Synthesis (CODES): methodological guidance for systematic reviews and other evidence syntheses
Authors: Petticrew Mark , Glover Rebecca E. , Volmink Jimmy , Blanchard Laurence , Cott Éadaoin , Knai Cécile , Maani Nason , Thomas James , Tompson Alice , van Schalkwyk May C. I. , Welch Vivian
Published: September 2023

Background

The field of the commercial determinants of health (CDOH) refers to the commercial products, pathways and practices that may affect health. The field is growing rapidly, as evidenced by the WHO programme on the economic and commercial determinants of health and a rise in researcher and funder interest. Systematic reviews (SRs) and evidence synthesis more generally will be crucial tools in the evolution of CDOH as a field. Such reviews can draw on existing methodological guidance, though there are areas where existing methods are likely to differ, and there is no overarching guidance on the conduct of CDOH-focussed systematic reviews, or guidance on the specific methodological and conceptual challenges.

Methods/results

CODES provides guidance on the conduct of systematic reviews focussed on CDOH, from shaping the review question with input from stakeholders, to disseminating the review. Existing guidance was used to identify key stages and to provide a structure for the guidance. The writing group included experience in systematic reviews and other forms of evidence synthesis, and in equity and CDOH research (both primary research and systematic reviews).

Conclusions

This guidance highlights the special methodological and other considerations for CDOH reviews, including equity considerations, and pointers to areas for future methodological and guideline development. It should contribute to the reliability and utility of CDOH reviews and help stimulate the production of reviews in this growing field.
Enhanced recovery after surgery (ERAS) for vascular surgery: an evidence map and scoping review
Authors: Apaydin Eric A. , Woo Karen , Rollison Julia , Baxi Sangita , Motala Aneesa , Hempel Susanne
Published: September 2023

Background

Enhanced recovery after surgery (ERAS) interventions aim to improve patient outcomes. Vascular surgery patients have unique requirements and it is unclear which ERAS interventions are supported by an evidence base.

Methods

We conducted a scoping review to identify ERAS randomized controlled trials (RCTs) published in the biomedical or nursing literature. We assessed interventions for applicability to vascular surgery and differentiated interventions given at preadmission, preoperative, intraoperative, and postoperative surgery stages. We documented the research in an evidence map.

Results

We identified 76 relevant RCTs. Interventions were mostly administered in preoperative (23 RCTs; 30%) or intraoperative surgery stages (35 RCTs; 46%). The majority of studies reported mortality outcomes (44 RCTs; 58%), but hospital (27 RCTs; 35%) and intensive care unit (9 RCTs; 12%) length of stay outcomes were less consistently described.

Conclusion

The ERAS evidence base is growing but contains gaps. Research on preadmission interventions and more consistent reporting of key outcomes is needed.
Establishing a health-based recommended occupational exposure limit for isoflurane using experimental animal data: a systematic review protocol
Authors: Struijs Fréderique , Hooijmans Carlijn R. , Buijs Marije , Dahan Albert , Hoffmann Sebastian , Kiffen Romy , Mandrioli Daniele , Menon Julia , Ritskes-Hoitinga Merel , Roeleveld Nel , de Ruijter Anne , Scheffer Gert Jan , Schlünssen Vivi , Scheepers Paul T. J.
Published: September 2023

Background

Isoflurane is used as an inhalation anesthetic in medical, paramedical, and veterinary practice. Epidemiological studies suggest an increased risk of miscarriages and malformations at birth related to maternal exposure to isoflurane and other inhalation anesthetics. However, these studies cannot be used to derive an occupational exposure level (OEL), because exposure was not determined quantitatively and other risk factors such as co-exposures to other inhalation anesthetics and other work-related factors may also have contributed to the observed adverse outcomes. The aim of this systematic review project is to assess all available evidence on the effects of isoflurane in studies of controlled exposures in laboratory animals to derive a health-based recommended OEL.

Methods

A comprehensive search strategy was developed to retrieve all animal studies addressing isoflurane exposure from PubMed, EMBASE, and Web of Science. Title-abstract screening will be performed by machine learning, and full-text screening by one reviewer. Discrepancies will be resolved by discussion. We will include primary research in healthy, sexually mature (non human) vertebrates of single exposure to isoflurane. Studies describing combined exposure and treatments with >  = 1 vol% isoflurane will be excluded. Subsequently, details regarding study identification, study design, animal model, and intervention will be summarized. All relevant exposure characteristics and outcomes will be extracted. The risk of bias will be assessed by two independent reviewers using an adapted version of the SYRCLE’s risk of bias tool and an addition of the OHAT tool. For all outcomes for which dose–response curves can be derived, the benchmark dose (BMD) approach will be used to establish a point of departure for deriving a recommended health-based recommended OEL for 8 h (workshift exposure) and for 15 min (short-term exposure).

Discussion

Included studies should be sufficiently sensitive to detect the adverse health outcomes of interest. Uncertainties in the extrapolation from animals to humans will be addressed using assessment factor. These factors are justified in accordance with current practice in chemical risk assessment. A panel of experts will be involved to reach consensus decisions regarding significant steps in this project, such as determination of the critical effects and how to extrapolate from animals to humans.

Systematic review registration

PROSPERO CRD42022308978
The role of intraoperative ultrasound in management of spinal intradural mass lesions and outcome
Authors: Elmesallamy Wael Abd Elrahman Ali , Yakout Hesham , Hassanen Sami , Elshekh Magdy
Published: September 2023

Background

The spinal intradural mass lesions represent a challenge in microsurgical practices. The intraoperative precise localization and characterization of these lesions must be achieved to avoid excessive exposure and neural tissue damage. This study aims to evaluate the role of intraoperative ultrasound during surgical dealing with spinal intradural mass lesions starting before bony work exposure.

Results

This prospective study had been done during the period from January 2022 to January 2023 with follow-up at least 6 months on 36 patients, suffered intradural spinal mass lesions and underwent microsurgical interventions aided with intraoperative ultrasound. MRI spine and Klekamp score were used as preoperative and postoperative parameters for assessment of the patients. Intraoperative ultrasound features were analyzed to evaluate its values. All lesions were visualized and characterized by intraoperative ultrasound beside spinal anatomical identification. Laminoplasty, laminectomy, durotomy and myelotomy were determined by IOUS. Gross total eradication was achieved in 28/36 (78%). Intraoperative ultrasonography definition of cystic component, well-defined borders and smooth shape of the masses were associated with significant Klekamp outcome improvement.

Conclusion

Intraoperative ultrasound can be used safely to detect the spinal intradural mass lesions even before bony work for exposure with anatomical and pathological definition and has the ability to predict the outcome.
808s and Heartbreak
Authors: Weheliye Alexander Ghedi , McKittrick Katherine
Published: September 2023

Taking on heartbreak, one of the principal themes of R&B music, Track 9.0 threads quotations from R&B songs about heartbreak throughout with the aim of enfleshing the supposedly abstract mechanical technology of the 808 drum machine through the conceptual lens of the generalized heartbreak of Black life. As a result, heartbreak does not function in the frequential key of individuated and privatized neoliberal affect but as a far-reaching condition of Black life in an anti-Black world that nevertheless acts on different groups and individuals gathered under in this umbrella unevenly.
The Sagittal Angle of the Trigeminal Nerve at the Porus Trigeminus is a Radiologic Predictor of Surgical Outcome in Microvascular Decompression for Classical Trigeminal Neuralgia
Authors: Branstetter Barton F. , Sekula Raymond F.
Published: September 2023

BACKGROUND AND OBJECTIVES:

Classical trigeminal neuralgia (cTN) is a painful disease. Microvascular decompression (MVD) provides immediate and durable relief in many patients. A variety of positive and negative prognostic biomarkers for MVD have been identified. The sagittal angle of the trigeminal nerve at the porus trigeminus (SATNaPT) is an MRI biomarker that can identify a subset of patients with cTN whose trigeminal nerve anatomy is different from normal controls. The purpose of this case-control study was to determine whether an abnormally hyperacute SATNaPT is a negative prognostic biomarker in patients with cTN undergoing MVD.

METHODS:

Preoperative MRIs from 300 patients with cTN who underwent MVD were analyzed to identify patients with a hyperacute SATNaPT (defined as less than 3 SDs below the mean). The rate of surgical success (pain-free after at least 12 months) was compared between patients with a hyperacute SATNaPT and all other patients.

RESULTS:

Patients without a hyperacute SATNaPT had an 82% likelihood of surgical success, whereas patients with a hyperacute SATNaPT had a 58% likelihood of surgical success (P < .05). Patients with a hyperacute SATNaPT who also had no evidence of vascular compression on preoperative MRI had an even lower likelihood of success (29%, P < .05).

CONCLUSION:

In patients with cTN being considered for MVD, a hyperacute SATNaPT is a negative prognostic biomarker that predicts a higher likelihood of surgical failure. Patients with a hyperacute SATNaPT, particularly those without MRI evidence of vascular compression, may benefit from other surgical treatments or a modification of MVD to adequately address the underlying cause of cTN.
Lateral Displacement of the Phrenic Nerve in C5 Tumors
Authors: Lakomkin Nikita , Wu Kitty Y. , Hébert-Blouin Marie-Noëlle , Spinner Robert J.
Published: September 2023

BACKGROUND AND OBJECTIVES:

Nerve sheath tumors of the brachial plexus frequently distort the local anatomy, increasing the difficulty of safe exposure and resection. However, lateral displacement of the phrenic nerve has not been previously described. The purpose of this study was thus to illustrate the abnormal lateral displacement of the phrenic nerve in 2 cases of patients undergoing brachial plexus tumor resection and provide a possible mechanism for this observation.

METHODS:

Two patients underwent surgical resection of clinically progressing C5 schwannomas. During exposure, the phrenic nerve was found to be significantly more superficial and lateral than typical. This structural relationship persisted even after complete resection of the lesion. Both patients did well postoperatively.

RESULTS:

The phrenic nerve traverses along the anterolateral aspect of the anterior scalene. However, in these 2 cases of C5 nerve sheath tumors, the phrenic was found to be significantly more lateral and superficial than usual, draping across the medial aspect of the tumor. We believe that the C5-phrenic communicating branch may act as a functional tether that mobilizes the phrenic nerve laterally as the tumor grows. The mass effect on the anterior scalene by the underlying C5 tumor may further contribute to the anterolateral and superficial displacement of the nerve.

CONCLUSION:

The phrenic nerve may be seen markedly more laterally and superficially displaced in cases of C5 nerve sheath tumors. It is important for surgeons who operate on lesions of the brachial plexus to be aware of this phenomenon.
Microenvironment-dependent growth of Sezary cells in humanized IL-15 mice
Authors: Gao Jie , Ren Shumei , Choonoo Gabrielle , Chen Guoying , Frleta Davor , Zhong Jun , Gupta Namita , Sharma Prachi , Oyejide Adelekan , Atwal Gurinder S. , Macdonald Lynn , Murphy Andrew , Kuhnert Frank
Published: September 2023

Sezary syndrome (SS) is a rare, aggressive leukemic variant of cutaneous T-cell lymphoma (CTCL) that lacks adequate therapeutic options and representative small-animal models. Here, we demonstrate that IL-15 is a critical CTCL growth factor. Importantly, an immunodeficient knock-in mouse model genetically engineered to express human IL-15 uniquely supported the growth of SS patient samples relative to conventional immunodeficient mouse strains. SS patient-derived xenograft (PDX) models recapacitated key pathological features of the human disease, including skin infiltration and spread of leukemic cells to the periphery, and maintained the dependence on human IL-15 upon serial in vivo passaging. Detailed molecular characterization of the engrafted cells by single-cell transcriptomic analysis revealed congruent neoplastic gene expression signatures but distinct clonal engraftment patterns. Overall, we document an important dependence of Sezary cell survival and proliferation on IL-15 signaling and the utility of immunodeficient humanized IL-15 mice as hosts for SS – and potentially other T and NK cell-derived hematologic malignancies – PDX model generation. Furthermore, these studies advocate the thorough molecular understanding of the resultant PDX models to maximize their translational impact.
Caffeine Improves Simulated 800-m Run Performance without Affecting Severe Exercise-Induced Arterial Hypoxemia
Authors: DOBASHI KOHEI , FUKAZAWA YUKI , KATAGIRI AKIRA , ENOMOTO YASUSHI , NISHIYASU TAKESHI , FUJII NAOTO
Published: September 2023

Purpose

Although caffeine is known to possess ergogenic effects, previous studies demonstrated no effect of caffeine on 800-m run performance outdoors, which might be due to several uncontrolled factors including pacing strategies. We hypothesized that caffeine ingestion improves a pace-controlled simulated 800-m run performance. We also hypothesized that exercise-induced arterial hypoxemia occurs during the simulated 800-m run, and this response is mitigated by caffeine-induced increases in exercise ventilation.

Methods

In a randomized, double-blind, placebo-controlled and crossover design, 16 (3 females) college middle-distance runners who have 800-m seasonal best of 119.97 ± 7.64 s ingested either 1) placebo (6 mg of glucose per kilogram of body weight) or caffeine (6 mg of caffeine per kilogram of body weight). Then they performed an 800-m run consisting of 30-s running at 103% of their 800-m seasonal best, followed by running at 98% of seasonal best until exhaustion, which mimics actual 800-m run pacing pattern.

Results

Running time to exhaustion was extended by 7.3% ± 6.2% in the caffeine-ingested relative to placebo trial (123 ± 12 vs 114 ± 9 s, P = 0.04). Arterial oxygen saturation markedly decreased during the simulating running, but this response was similar (76.6% ± 5.7% vs 81.1% ± 5.2%, at 113 s of the simulating running) between the caffeine and placebo trials (P ≥ 0.23 for time–supplement interaction and main effect of supplement). Minute ventilation, oxygen uptake (all P ≥ 0.36 for time–supplement interaction and main effect of supplement), and rate of perceived exertion (all P ≥ 0.11) did not differ between the trials throughout the simulating running. Heart rate was higher in the caffeine-ingested trial throughout the simulated running (P < 0.01 for main effect of supplement). Postexercise blood lactate concentration was higher in the caffeine trial (P = 0.02).

Conclusions

Caffeine ingestion improves simulated 800-m run performance without affecting exercise ventilation and severe exercise-induced arterial hypoxemia.
A Device Agnostic Approach to Predict Children’s Activity from Consumer Wearable Accelerometer Data: A Proof-of-Concept Study
Authors: WEAVER R. GLENN , WHITE JAMES , FINNEGAN OLIVIA , NELAKUDITI SRIHARI , ZHU XUANXUAN , BURKART SARAH , BEETS MICHAEL , BROWN TREY , PATE RUSS , WELK GREGORY J. , DE ZAMBOTTI MASSIMILIANO , GHOSAL RAHUL , WANG YUAN , ARMSTRONG BRIDGET , ADAMS ELIZABETH L. , REESOR-OYER LAYTON , PFLEDDERER CHRISTOPHER D. , BASTYR MEGHAN , VON KLINGGRAEFF LAUREN , PARKER HANNAH
Published: September 2023

Introduction

This study examined the potential of a device agnostic approach for predicting physical activity from consumer wearable accelerometry compared with a research-grade accelerometry.

Methods

Seventy-five 5- to 12-year-olds (58% male, 63% White) participated in a 60-min protocol. Children wore wrist-placed consumer wearables (Apple Watch Series 7 and Garmin Vivoactive 4) and a research-grade device (ActiGraph GT9X) concurrently with an indirect calorimeter (COSMED K5). Activity intensities (i.e., inactive, light, moderate-to-vigorous physical activity) were estimated via indirect calorimetry (criterion), and the Hildebrand thresholds were applied to the raw accelerometer data from the consumer wearables and research-grade device. Epoch-by-epoch (e.g., weighted sensitivity, specificity) and discrepancy (e.g., mean bias, absolute error) analyses evaluated agreement between accelerometry-derived and criterion estimates. Equivalence testing evaluated the equivalence of estimates produced by the consumer wearables and ActiGraph.

Results

Estimates produced by the raw accelerometry data from ActiGraph, Apple, and Garmin produced similar criterion agreement with weighted sensitivity = 68.2% (95% confidence interval (CI), 67.1%–69.3%), 73.0% (95% CI, 71.8%–74.3%), and 66.6% (95% CI, 65.7%–67.5%), respectively, and weighted specificity = 84.4% (95% CI, 83.6%–85.2%), 82.0% (95% CI, 80.6%–83.4%), and 75.3% (95% CI, 74.7%–75.9%), respectively. Apple Watch produced the lowest mean bias (inactive, −4.0 ± 4.5; light activity, 2.1 ± 4.0) and absolute error (inactive, 4.9 ± 3.4; light activity, 3.6 ± 2.7) for inactive and light physical activity minutes. For moderate-to-vigorous physical activity, ActiGraph produced the lowest mean bias (1.0 ± 2.9) and absolute error (2.8 ± 2.4). No ActiGraph and consumer wearable device estimates were statistically significantly equivalent.

Conclusions

Raw accelerometry estimated inactive and light activity from wrist-placed consumer wearables performed similarly to, if not better than, a research-grade device, when compared with indirect calorimetry. This proof-of-concept study highlights the potential of device-agnostic methods for quantifying physical activity intensity via consumer wearables.
Responses of β-thalassemia and compound heterozygote of Sickle/βthalassemia of BCL11A Gene Polymorphism in Pakistani Patients
Authors: Soomro Nayab , Wahid Mohsin , Mehmood Mehreen , Danish Syed Hasan
Published: September 2023

Background and Objective: Beta-thalassemia major (β-Thal) and compound heterozygote of Sickle β-thalassemia (S-β Thal) are hereditary autosomal recessive disorders resulting from mutations or deletion in β-globin gene cluster. Patients with increased HbF levels having polymorphism at BCL11A site loci have shown clinical significance. The present study aimed to assess the frequency of BCL11A gene polymorphism in a study population of β-Thal, S-β Thal & Controls using Sanger sequencing leading to plot the HbF response of polymorphism with reference to wild type.

Methods: The sample size of the study is n=180, groups were divided in Controls, β-thal & S-β thal. One ml blood was drawn from patients and controls to extract DNA for PCR amplification and BCL11A locus genotyping using Sanger sequencing. This study was carried out at Dow Research Institute of Biotechnology and Biomedical Sciences, for one year from March 2021 to February 2022.

Results: The HbF response of three groups is hyperbolic with 83 for β-Thal, 16 for S-β Thal and close to zero for controls. The frequency of heterozygous variant GA of BCL11A gene polymorphism is 51%. The frequency of homozygous variant GG is 49%. Complete absence of wild type AA in patient group. The frequency of BCL11A polymorphism in control group was 43% (with male 18% and female 21%) showing wild type status of 57%.

Conclusions: The patient groups of SCD and Beta thalassemia are devoid of wild type status. The wild type status of BCL11A is 57% even in control population. Higher level of HbF in B-thalassemia and SCD and B Thalassemia is a cost-effective screening marker before switching to an expensive genotyping testing.

doi: https://doi.org/10.12669/pjms.39.6.7183

How to cite this: Soomro N, Wahid M, Mehmood M, Danish SH. Responses of β-thalassemia and compound heterozygote of Sickle/βthalassemia of BCL11A Gene Polymorphism in Pakistani Patients. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.7183

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.
Μελέτη της εξέλιξης των παραμέτρων φυσικής κατάστασης κατά τη διάρκεια της βιολογικής γήρανσης
Authors: Πατερόπουλος Κωνσταντίνος
Published: September 2023

Τα τελευταία 50 χρόνια, ο αριθμός των ατόμων ηλικίας 60 ετών και άνω έχει διπλασιαστεί σε περίπου 810 εκατομμύρια παγκοσμίως, ενώ ο ηλικιωμένος πληθυσμός θα αυξηθεί σε περίπου 2 δισεκατομμύρια έως το 2050. Επίσης, η αύξηση της ηλικίας του πληθυσμού φαίνεται ότι θα αυξήσει και τα ελλείματα της φυσικής απόδοσης. Η παρούσα μελέτη αποσκοπεί στην αξιολόγηση των φυσιολογικών μεταβολών του οργανισμού σε επίπεδο φυσικής κατάστασης και στην ανάδειξη της σχέσης της εξέλιξης των δεικτών φυσικής κατάστασης με την γήρανση. Ειδικότερα οι σκοποί της παρούσας μελέτης ήταν: Να αξιολογηθεί η επίδραση του φύλου και της ηλικίας στις παραμέτρους της φυσικής κατάστασης και να δημιουργηθούν τιμές αναφοράς και νόρμες αξιολόγησης για δοκιμασίες φυσικής κατάστασης στον ελληνικό πληθυσμό. Συνολικά 237 Έλληνες συμμετέχοντες (άνδρες και γυναίκες) συμμετείχαν στην παρούσα μελέτη. Μετά την εισδοχή τους στη μελέτη, οι άνδρες και γυναίκες συμμετέχοντες κατανεμήθηκαν σε τρεις ομάδες ανάλογα με την χρονολογική τους ηλικία (ηλικιακή ομάδα 20-40 ετών, N=82, ηλικιακή ομάδα 40-65 ετών, N=78, ηλικιακή ομάδα >65 ετών, N=77). Στη συνέχεια, οι συμμετέχοντες επισκέφτηκαν το εργαστήριο 5 φορές (πρωινές ώρες) όπου υποβλήθηκαν σε αξιολόγηση των σωματομετρικών τους χαρακτηριστικών και της φυσικής τους κατάστασης. Η ικανότητα της ισορροπίας φαίνεται να επηρεάζεται από την ηλικία των 40 ετών σε άνδρες και γυναίκες ενώ η μέγιστη πρόσληψη οξυγόνου μειώνεται και αυτή εκθετικά με σημαντικές διαφορές ανάμεσα στα δύο φύλα. Η μέγιστη δύναμη των άνω και κάτω άκρων μειώνεται προοδευτικά με την ηλικία ενώ οι άνδρες παρουσιάζουν υψηλότερες τιμές από τις γυναίκες. Τα επίπεδα δύναμης μειώνονται σημαντικά ακόμα και από τα 40 έτη ενώ η μυϊκή αντοχή μειώνεται και αυτή προοδευτικά με τη πρόοδο της ηλικίας. Η ευλυγισία μειώνεται από τα 40 έτη και μετά και στα δύο φύλα και παραμένει μειωμένη και μετά τα 65 έτη. Η μυϊκή ισχύς, μειώνεται κατά >50% από την ηλικία των 40 ετών και στα δύο φύλα και παραμένει σε μειωμένα επίπεδα μετά τα 65 έτη. Η δύναμη χειρολαβής παραμένει αμετάβλητη και στα δύο φύλα έως τα 65 έτη και μετά μειώνεται ενώ οι γυναίκες παρουσιάζουν σημαντικά χαμηλότερα επίπεδα δύναμης σε σχέση με τους άνδρες. Συμπερασματικά, οι γνώση της εξέλιξης των παραμέτρων φυσικής κατάστασης κατά τη διάρκεια της βιολογικής γήρανσης και οι προτεινόμενες τιμές αναφοράς που προκύπτουν από τη παρούσα μελέτη μπορούν να βοηθήσουν στην αξιολόγηση της φυσικής κατάστασης του ελληνικού πληθυσμού με σκοπό την βελτίωση της φυσικής κατάστασης και της ποιότητας ζωής.
Case Series: Severe meibomian gland loss in polycystic ovarian syndrome patients on estrogen-progesterone therapy
Authors: Sandhu Japmehr Kaur , Singh Swati , Basu Sayan
Published: September 2023

Purpose: To report the ocular surface and meibomian gland changes in polycystic ovarian syndrome (PCOS) women taking hormone supplementation.

Methods: Case series.

Results: Three women (27 ± 11 years) already diagnosed with PCOS presented with dry eye symptoms (mean OSDI, 37.5) for a mean duration of 13 months and were taking hormonal supplements for a mean duration of 60 ± 11 months. The hormonal supplements included oral estrogen (n=3), oral progesterone (n=3), antiandrogen cyproterone (n=1) and isotretinoin (n=1). Ocular surface evaluation revealed mean NIBUT of 9.9 ± 1.6 seconds and mean TMH of 0.27 ± 0.05 mm assessed non-invasively using Oculus keratograph 5M (K5M). Meibography (K5M) showed near total loss of all meibomian glands (n=8/12 eyelids) with residual ghost glands in all four eyelids of two patients, and gland shortening alone in one eyelid. The gland morphology did not change following intense thermal pulsation treatment or cessation of hormonal therapy.

Conclusions: Near-total irreversible meibomian gland loss was seen in two young PCOS women taking hormonal supplements. Collaboration between ophthalmologists and gynecologists is advisable for early detection and better understanding of dry eye disease (DED) progression in these patients.
Green Tea and Decaffeinated Light Roasted Green Coffee Extract Combination Improved Cardiac Insulin Resistance through Free Fatty Acids and Adiponectin/FAS Pathways Amelioration in Metabolic Syndrome Rat Model
Authors: Lukitasari Mifetika , Rohman Mohammad Saifur , Nugroho Dwi Adi , Nur Kholis Mukhamad , Wahyuni Nila Aisyah , Widodo Nashi
Published: September 2023

Background: Insulin resistance has been independently associated with cardiac diseases. Free fatty acids are recently known to induce cardiac insulin resistance due to low-grade inflammation. Therefore, the improvement of free fatty acid levels can also improve cardiac insulin resistance. This study investigated the combination of green tea and decaffeinated-light roasted green coffee extract in the improvement of free fatty acid-induced cardiac insulin resistance by improving the adiponectin/FAS pathways.

Methods: This study used 25 males Sprague-Dawley rats induced by a high-fat high sucrose diet and injection of low dose streptozotocin to make a metabolic syndrome (MS) rat model and standard chow as healthy control rats. The MS rats were treated with green tea (200 mg/ b. w.), decaffeinated-light roasted green coffee (300 mg/ b. w.), and the combination of both extracts in 9 weeks. Experimental groups in this study were divided into 5 groups: 1) MS (HFHS diet + STZ) group, 2) NC (normal chow) group, 3) GT (green tea extract) group, 4) GC (decaffeinated-light roasted green coffee extract), 5) CM (combination of both extracts) group. Adiponectin and HOMA-IR level was analysed using ELISA, and the gene expression of Adipo-R1, FAS, PI3K, PDK1, Akt, GLUT4 was measured by RT-PCR.

Results: The combination of green tea and decaffeinated-light roasted green coffee showed synergistic effects in improving FFA levels. The adiponectin/FAS pathways was attenuated in the CM group. Moreover, the combination also showed improvement in cardiac insulin resistance markers such as IRS1/2, PI3K, PDK1, Akt, and GLUT4.

Conclusions:  The combination of green tea and decaffeinated-light roasted green coffee extract improved cardiac insulin resistance better than green tea and green coffee extract administration alone by reducing free fatty acids levels through adiponectin/FAS pathways modulation.
FEATURES OF THE AUSTRIAN VARIETY OF GERMAN IN ACADEMIC DISCOURSE
Authors: Kostina Daria M. , Sidorova Elizaveta N. , Shirlina Elena N.
Published: September 2023

The article deals with the main approaches to the study of the Austrian variant of the German language as a means of oral and written communication in the academic discourse. The authors focus on the lexical and pragmatic features of the Austrian variant of the German language that distinguish it from the language of the academic communication in Germany.

Background. Though today much attention is given to the German variants, their functioning in institutional discourse haven’t been explored enough yet, which can lead to errors in cross-lingual communication and translation.

Purpose. The aims of this paper are to analyze the main approaches and methods used in the study of the Austrian version of the German language in the academic discourse and to identify its main features on the lexical and pragmatic levels based on the results of the author’s research and the works of Austrian linguists.

Materials and methods. The methods of continuous sampling and lexicographic analysis were used to describe the lexical and pragmatic features of the written academic discourse.

Results. The paper describes the main methods for studying the Austrian variant of the German language in the academic discourse (lexicographic method, corpus analysis and sociolinguistic method) and identifies such features of the Austrian variant as terminological austriacisms, Latin words, gender-fair language, peculiarities of address and use of academic titles as well as internal multilingualism.

Practical implications. The results of the study can be used for further, deeper study of academic discourse and other institutional discourses, for further analysis of the specific features of the Austrian variant of the German language, and will also be useful for translators and participants in international academic events and academic exchange.
Bell: A Symbol of Wholeness
Authors: Cho Eunjin
Published: September 2023

This study explores the bell’s attributes as a representation of wholeness, analyzed through the lens of analytical psychology. Encompassing its production, religious significance, and literary references, our aim is to uncover the profound meaning behind the bell. The bell’s transformative journey parallels the internal struggles of individuals grappling with emerging energies while bringing unconscious thoughts into awareness. As a potent symbol, the bell possesses the unique power to bridge and harmonize opposing elements. It plays a dual role as both a religious emblem and a literary motif, embodying spirituality as a conduit for divine communication, while also safeguarding against malevolent spirits and natural perils. Additionally, it symbolizes the intricate balance between feminine and masculine forces. The resonating sound of the bell serves to awaken consciousness, initiating a cyclical process alternating between awareness and the unconscious, facilitating the experience of death and rebirth. Operating as an alarm, it illuminates existence, stirring the psyche toward an altered state of awareness and eventual conscious realization. Therefore, the bell acts as a catalyst, facilitating creative transformation that integrates disparate aspects into unity, embodying the essence of wholeness within an individual’s psyche. Through this exploration, we shed light on the bell’s pivotal role in profound psychological transformation.
Snowman: A Symbol of Self-Realization and Unity of Opposites
Authors: Ma Kyunghee , Sin Jihyun
Published: September 2023

This literature review delves into the symbolic aspects associated with snowman. The study examines the symbolism connected to both the process of constructing snowman and the eventual melting of snow. Furthermore, it explores how snowman can be seen as representations of life's patterns and natural processes. Particularly, the analysis scrutinizes snowman as integrative symbols within a broader dramatic context. The research also reveals how the cyclical processes of nature parallel the concept of individualization, leading to self-understanding and Self-realization. Through a comprehensive analysis of existing literature, this study investigates the symbolism of snowman, shedding light on their relevance in enhancing our understanding of human nature.
Time to invest in nutritional care for patients with inflammatory bowel disease
Authors: Patience Sara
Published: September 2023

Data suggest that the NHS lacks capacity to provide adequate nutritional care to patients with inflammatory bowel disease. Registered nutritionist and health visitor Sara Patience highlights the importance of nutritional care, alongside the human and financial costs of malnutrition in this patient group.
Handle with Care
Authors: Doyle Wesley
Published: September 2023

While airlines strive to clean up their act, greater savings in CO2 emissions could come from electrifying the vehicles that get us and our luggage to and from the runway, rather than in the air
EV First
Authors: Stone Tom
Published: September 2023

For the newly unveiled second-generation Kona, Hyundai has switched its priorities, developing it first and foremost as an electric vehicle before adding hybrid and ICE versions afterwards
Vegas Goes Electric
Authors: Gooding Richard
Published: September 2023

Electric vehicles have gradually become more prominent at the annual Consumer Electronics Show in Las Vegas, and the 2023 event was no different. EHVTI looks at the electric vehicles and associated technology that were on show in January at the Las Vegas Convention Center
Missing Piece of the Jigsaw
Authors: Rickatson Martin
Published: September 2023

AGCO’S VALTRA BRAND HAS A HEALTHY REPRESENTATION IN THE 150-250HP TRACTOR SECTOR WITH ITS T SERIES AND THE 300-400HP BRACKET WITH ITS S MODELS. THE RECENT LAUNCH OF ITS Q RANGE MEETS DEMAND FOR THE BURGEONING SECTOR IN BETWEEN
The Rescue?
Authors: James Anthony
Published: September 2023

LIEBHERR’S AWARD-WINNING 50-TONNE CRAWLER EXCAVATOR POWERED BY HYDROGEN COMBUSTION CAUSED A STIR AT BAUMA – BUT IS IT THE FUTURE?
Yunus Nüzhet Unat’ın Haydi Suna Piyesi Üzerine Zaman Okumaları
Authors: ALVER Tolga
Published: September 2023

Yunus Nüzhet Unat’ın 1936 senesinde kaleme aldığı Haydi Suna piyesi, Erken Cumhuriyet Dönemi edebiyatının özelliklerini gösteren bir metindir. Yeni kurulan devletin yöneticileri halkın arasında inkılâpların yaygınlaşması için kültürel yoldan propagandalar yapmışlardır. Bu propaganda unsurlarının en önemlilerinden birisi de tiyatro oyunlarıdır. Dönemin yazarları yeni devletin siyasetine uygun biçimde piyesler kaleme almışlardır. Yazılan bu piyesler özellikle Halkevleri ve Halkodaları başta olmak üzere yurdun dört bir yanında halka sergilenmiştir. Piyeslerdeki propaganda aracılığı ile, ideal bir bireyin ve toplumun nasıl olması gerekliliğine ilişkin söylemlerde bulunulmuştur. Yunus Nüzhet Unat’ın Haydi Suna piyesi de bu özelliklere sahip bir piyestir. Piyesin kurgusu 2023 yılında geçmektedir. Yazar, 1936 senesinin bakış açısıyla Türkiye’nin 100. yılındaki manzarasından izlenimler vermeye çalışmıştır. Bunu yaparken zaman zaman şimdicilik sorunu ile karşılaştığı ve tersine bir anakronizme düştüğü görülmektedir. Bu çalışmada 2023 yılında geçen metnin günümüz zamanıyla mukayesesi yapılacak ve bunun üzerine zaman okumaları gerçekleştirilecektir. Metnin yazıldığı zaman ile (1936 yılı), 2023 yılı arasındaki benzerlikleri ve farklılıkları ortaya koymak bu çalışmanın amacıdır.
Geçici Koruma Kapsamında Bulunanların Suç Oranlarına Dair Algı Araştırması: Çankırı İli Örneği
Authors: GÖÇ Eray
Published: September 2023

Bu çalışmanın amacı, ülkemizde geçici koruma kapsamında bulunan ve Türkiye’ye 2011 yılından itibaren kitleler halinde geçiş yapmak mecburiyetinde kalan Suriye vatandaşlarının Türkiye’de suç oranlarında etkisinin algı bakımından araştırılmasıdır. Bu maksatla örnek il olarak Çankırı ili seçilmiş olup, öncelikle vatandaşın suç oranlarına etkisi bakımından geçici koruma kapsamında bulunanlar hakkında algısı araştırılmıştır. Çalışmada rastgele anket yöntemi uygulanarak veriler toplanmış, bu veriler değerlendirilerek toplumsal algı anlaşılmaya çalışılmıştır, böylece yerleşik durumda olanların göç ile gelenler (Geçici korum kapsamında olanlar) hakkında algısı, önyargı, bilinçli önyargı ve ayrımcılık kavramları bakış açısı ile anlamlandırılmaya çalışılmıştır. Bu çalışma aynı zamanda suç kavramının da irdelenmesine, suçluluk ile göç arasında nasıl bir ilişki olduğuna da dikkat çekmeye çalışmıştır. Suç kavramı genel mantığı üzerinde durularak kriminoloji biliminin de yargı oluşmasında etken bir faktör olduğu üzerinde durulmaya çalışılmıştır. Suriye savaşı sonucu Türkiye’de belli bir statü ile kabul edilen Suriye vatandaşları, savaşın neden olduğu, mecbur kalma durumu ile göç etmek durumunda kaldığı için toplumsal algıda olumsuz bir takım yargıların ortaya çıkması kaçınılmaz olmuştur. Gönüllü zorunlu göç ayrımında gönüllü göç ile başka toplumlara gidenlerin görece daha olumlu bir bakış açısı ile karşılandıkları ve gittikleri toplumlara artı değer kattıkları kabul edilir bir değerlendirmedir. Bu çalışma göç etmek durumunda kalanlarla ilgili nasıl bir yargının olduğunun araştırılmasıdır.
Correlation analysis of serum thyroglobulin, thyroid-stimulating hormone levels, and thyroid-cancer risk in thyroid nodule surgery
Authors: Shuai Jin-Hao , Leng Zhao-Fang , Wang Peng , Ji Yi-Chi
Published: September 2023

In recent years, metabolomics research has become a hot spot in the screening and treatment of cancer. It is a popular technique for the quantitative characterization of small molecular compounds in biological cells, tissues, organs or organisms. Further study of the tumor revealed that amino acid changes may occur early in the tumor. The rapid growth and metabolism required for survival result in tumors exhibiting an increased demand for amino acids. An abundant supply of amino acids is important for cancer to maintain its proliferative driving force. Changes in amino acid metabolism can be used to screen malignant tumors and improve therapeutic outcomes. Therefore, it is particularly important to study the characteristics of amino acid metabolism in colorectal cancer. This article reviews several specific amino acid metabolism characteristics in colorectal cancer.
Laparoscopic vs open radical resection in management of gallbladder carcinoma: A systematic review and meta-analysis
Authors: He Shiin , Yu Tu-Nan , Cao Jia-Sheng , Zhou Xue-Yin , Chen Zhe-Han , Jiang Wen-Bin , Cai Liu-Xin , Liang Xiao
Published: September 2023

In recent years, metabolomics research has become a hot spot in the screening and treatment of cancer. It is a popular technique for the quantitative characterization of small molecular compounds in biological cells, tissues, organs or organisms. Further study of the tumor revealed that amino acid changes may occur early in the tumor. The rapid growth and metabolism required for survival result in tumors exhibiting an increased demand for amino acids. An abundant supply of amino acids is important for cancer to maintain its proliferative driving force. Changes in amino acid metabolism can be used to screen malignant tumors and improve therapeutic outcomes. Therefore, it is particularly important to study the characteristics of amino acid metabolism in colorectal cancer. This article reviews several specific amino acid metabolism characteristics in colorectal cancer.