bluuebunny/crossref_metadata_2025 huggingface dataset:
O-GlcNAcylated FTO promotes m6A modification of SOX4 to enhance MDS/AML cell proliferation
Authors: Gou Junjie , Bi Jingjing , Wang Kexin , Lei Lei , Feng Yanli , Tan Zengqi , Gao Jiaojiao , Song Yanan , Kang Enci , Guan Feng , Li Xiang
Published: January 2025

Fat mass and obesity-associated protein (FTO) was the first m6A demethylase identified, which is responsible for eliminating m6A modifications in target RNAs. While it is well-established that numerous cytosolic and nuclear proteins undergo O-GlcNAcylation, the possibility of FTO being O-GlcNAcylated and its functional implications remain unclear. This study found that a negative correlation between FTO expression and O-GlcNAcylation in patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). The decreased O-GlcNAcylation on FTO can result in diminished m6A modification of SRY-related high mobility group box 4 (SOX4). This led to the promotion of cell apoptosis and inhibition of cell proliferation in MDS/AML. The O-GlcNAcylation of FTO stabilized SOX4 transcripts in an m6A-dependent manner, resulting in increased AKT and MAPK phosphorylation and decreased cell apoptosis. Inhibiting FTO O-GlcNAcylation significantly slowed AML progression in vitro, a finding supported by clinical data in MDS/AML patients. In conclusion, our study highlights the crucial role of FTO O-GlcNAcylation in RNA m6A methylation and the progression of MDS/AML, thereby providing a potential therapeutic avenue for these formidable diseases.
Risk factors for mechanical complications in degenerative lumbar scoliosis with concomitant thoracolumbar kyphosis: does the selection of the upper instrumented vertebra matter?
Authors: Qiu Weipeng , Sun Zhuoran , Chen Ze , Zhou Siyu , Qi Qiang , Li Weishi
Published: January 2025

Background

Degenerative lumbar scoliosis (DLS) represents a distinct subset of adult spinal deformity, frequently co-occurring with thoracolumbar kyphosis (TLK) in the sagittal plane. TLK is typically viewed as detrimental in degenerative spinal conditions and has been linked to increased pain severity and a higher prevalence of mechanical complications (MC) as previously reported. The present study aimed to identify the risk factors associated with the development of MC in patients with DLS and concomitant TLK.

Methods

This study retrospectively included 65 DLS patients with a TLK > 20°. During follow-up, MC events were recorded, and patients were categorized into MC and non-MC groups. Spinopelvic parameters were assessed pre- and post-surgery. The locations of the kyphotic apex (KA) and the upper instrumented vertebra (UIV) were documented. Clinical and radiographic data were compared between the two groups. A multivariate logistic regression model was employed to analyze the independent risk factors for MC.

Results

Twenty-nine (44.6%) patients developed at least one MC at final follow-up. At baseline, patients in the MC group exhibited lower bone mineral density (P = 0.002), lower distal lumbar lordosis (DLL, P = 0.025), and higher sagittal vertical axis (SVA, P = 0.005). Post-surgery, the KA shifted cranially with an average vertebral displacement of 2.6 ± 1.8. The proportion of UIV located in the postoperative KA area significantly increased (P < 0.001). The MC group had a higher incidence of Roussouly type mismatch (P = 0.023) and UIV located in the KA area (P = 0.003). Multivariate logistic regression analysis revealed that UIV located in the KA area (OR = 3.798, P = 0.043), increased preoperative SVA (OR = 1.017, P = 0.016) and osteoporosis (OR = 6.713, P = 0.007) were independent risk factors for MC.

Conclusions

The presence of UIV in the KA area, preoperative sagittal imbalance, and osteoporosis were identified as significant risk factors for MC in patients with DLS and concomitant TLK. The spinal morphological characteristics of TLK must be taken into account during surgical planning to prevent placing the UIV within the kyphotic region.
Pulse oximetry at two sensor placement sites in conscious foals
Authors: Rossi Heini Sofia , Mykkänen Anna Kristina , Junnila Jouni Juho Tapio , Hyytiäinen Heli Katariina
Published: January 2025

Background

Pulse oximetry has not been thoroughly evaluated for assessment of oxygenation in conscious foals. Compared with invasive arterial blood sampling, it is a painless and non-invasive method for real-time monitoring of blood oxygen saturation. The aim of this prospective clinical study was to evaluate the usability, validity, and reliability of pulse oximetry at two measuring sites (lip and caudal abdominal skin fold) for blood oxygen saturation measurement in conscious foals with and without respiratory compromise. Thirty-two foals under one month of age were used. Nineteen foals had normal respiratory and cardiovascular function, and 13 had pneumonia. Pulse oximetry with a transmittance sensor was performed in triplicate on each foal’s lip (n = 196 measurements) and/or skin fold (n = 338 measurements), and arterial blood sample was collected. The oxygen saturation values measured by pulse oximetry from the lip and skin fold were compared with each other (n = 58 measurement pairs) and with the calculated arterial oxygen saturation based on arterial blood samples (n = 93 measurement pairs). Furthermore, repeatability of the pulse oximetry measurements was assessed.

Results

Measured blood oxygen saturation was clearly associated with the calculated saturation, but on average (± SD) it was 1.8 (± 3.3) percentage units higher from the lip and 5.7 (± 4.3) percentage units higher from the skin fold than the calculated saturation. In concurrent lip and skin fold measurements within a foal, the skin fold measurements were 2.4 (± 2.4) percentage units higher than the lip measurements. The repeatability of three pulse oximetry saturation measurement results was moderate to good and significantly improved when the measurement furthest from the middle-measured value was excluded. The most deviating measurement was often obtained first. Pulse oximetry in general was well tolerated and easy to perform, but as expected in conscious foals, movement and contact problems generated occasional technical difficulties in some individuals.

Conclusions

In conscious foals, pulse oximetry with a transmittance sensor attached to the lip (but not to the skin fold) is a clinically applicable and valid method for arterial blood oxygen saturation determination. Several measurements should be obtained and outliers discarded to obtain a reliable result.
The causal relationship between steroid hormones and risk of stroke: evidence from a two-sample Mendelian randomization study
Authors: Zhang Yang , Jiang Miaowen , Wu Di , Li Ming , Ji Xunming
Published: January 2025

It is unclear how steroid hormones contribute to stroke, and conducting randomized controlled trials to obtain related evidence is challenging. Therefore, Mendelian randomization (MR) technique was employed in this study to examine this association. Through genome-wide association meta-analysis, the genetic variants of steroid hormones, including testosterone/17β-estradiol (T/E2) ratio, aldosterone, androstenedione, progesterone, and hydroxyprogesterone, were acquired as instrumental variables. Analysis was done on the impact of these steroid hormones on the risk of stroke subtypes. The T/E2 ratio was associated to an elevated risk of small vessel stroke (SVS) according to the inverse variance weighted approach which was the main MR analytic technique (OR, 1.23, 95% CI: 1.05–1.44, p = 0.009). These findings were solid since no heterogeneity nor horizontal pleiotropy were found. The causal association between T/E2 and SVS was also confirmed in the replication study (p = 0.009). Nevertheless, there was no proof that other steroid hormones increased the risk of stroke. According to this study, T/E2 ratio and SVS are causally related. However, strong evidence for the impact of other steroid hormones on stroke subtypes is still lacking. These findings may be beneficial for developing stroke prevention strategies from steroid hormones levels.
Determinants of prolonged exclusive breastfeeding among children aged 6–23 months in 21 sub-saharan African countries: evidence from nationally representative data
Authors: Mekonen Enyew Getaneh
Published: January 2025

Background

Under-five mortality and malnutrition are more common in many low- and middle-income countries, highlighting the grave consequences of improper nutrition for children. Infants that continue to be exclusively breastfed after six months are considered to be engaging in prolonged exclusive breastfeeding. Children with prolonged exclusive breastfeeding are more susceptible to anemia, atopic dermatitis, and food allergies. There is no evidence on the pooled prevalence and determinants of prolonged exclusive breastfeeding in sub-Saharan Africa. Therefore, this study is intended to determine the prevalence and associated factors of prolonged exclusive breastfeeding among children aged 6 to 23 months in sub-Saharan African countries.

Methods

Data from the recent demographic and health surveys of 21 countries in sub-Saharan Africa conducted between 2015 and 2022 were used. A total weighted sample of 63,172 mother-child pairs was included in the current study. Multilevel mixed-effects logistic regression was used to determine the factors associated with the outcome variable. Intra-class correlation coefficient, likelihood ratio test, median odds ratio, and deviance (-2LLR) values were used for model comparison and fitness. Finally, variables with a p-value < 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant.

Results

The pooled prevalence of prolonged exclusive breastfeeding among children aged 6–23 months in sub-Saharan Africa was 17.32% (95% CI: 17.03%, 17.62%). Factors like child age [AOR = 4.39; 95% CI (4.17, 4.62)], wealth index [AOR = 1.15; 95% CI (1.07, 1.23)], maternal educational level [AOR = 1.56; 95% CI (1.36, 1.78)], marital status of the mother [AOR = 1.11; 95% CI (1.04, 1.19)], media exposure [AOR = 1.11; 95% CI (1.06, 1.17)], place of delivery [AOR = 0.82; 95% CI (0.78, 0.87)], postnatal checkup [AOR = 1.43; 95% CI (1.36, 1.51)], drinking water source [AOR = 1.06; 95% CI (1.01, 1.11)], sanitation facility [AOR = 1.15; 95% CI (1.10, 1.21)], antenatal care attendance [AOR = 1.27; 95% CI (1.16, 1.39)], community literacy [AOR = 1.08; 95% CI (1.02, 1.15)], and community media exposure [AOR = 1.06; 95% CI (1.01, 1.13)] were significantly associated with prolonged exclusive breastfeeding.

Conclusions

Nearly one out of five children aged 6–23 months in sub-Saharan Africa had prolonged exclusive breastfeeding. Both individual- and community-level factors were significantly associated with prolonged exclusive breastfeeding. Policymakers could find it very important to support maternal education, poverty reduction, media exposure, maternal healthcare services, and complementary feeding hygiene practices in order to encourage the timely initiation of complementary feeding.
Functional differentiation of human dental pulp stem cells into neuron-like cells exhibiting electrophysiological activity
Authors: Pardo-Rodríguez B. , Baraibar A. M. , Manero-Roig I. , Luzuriaga J. , Salvador-Moya J. , Polo Y. , Basanta-Torres R. , Unda F. , Mato S. , Ibarretxe Gaskon , Pineda Jose Ramon
Published: January 2025

Background and aim

Human dental pulp stem cells (hDPSCs) constitute a promising alternative for central nervous system (CNS) cell therapy. Unlike other human stem cells, hDPSCs can be differentiated, without genetic modification, to neural cells that secrete neuroprotective factors. However, a better understanding of their real capacity to give rise to functional neurons and integrate into synaptic networks is still needed. For that, ex vivo differentiation protocols must be refined, especially to avoid the use of fetal animal serum. The aim of our study is to improve existing differentiation protocols of hDPSCs into neuron-like cells.

Methods

We compared the effects of the (1) absence or presence of fetal serum during the initial expansion phase as a step prior to switching cultures to neurodifferentiation media. We (2) improved hDPSC neurodifferentiation by adding retinoic acid (RA) and potassium chloride (KCl) pulses for 21 or 60 days and characterized the results by immunofluorescence, digital morphometric analysis, RT-qPCR and electrophysiology.

Results

We found that neural markers like Nestin, GFAP, S100β and p75NTR were expressed differently in neurodifferentiated hDPSC cultures depending on the presence or absence of serum during the initial cell expansion phase. In addition, hDPSCs previously grown as spheroids in serum-free medium exhibited in vitro expression of neuronal markers such as doublecortin (DCX), neuronal nuclear antigen (NeuN), Ankyrin-G and MAP2 after neurodifferentiation. Presynaptic vGLUT2, Synapsin-I, and excitatory glutamatergic and inhibitory GABAergic postsynaptic scaffold proteins and receptor subunits were also present in these neurodifferentiated hDPSCs. Treatment with KCl and RA increased the amount of both voltage-gated Na+ and K+ channel subunits in neurodifferentiated hDPSCs at the transcript level. Consistently, these cells displayed voltage-dependent K+ and TTX-sensitive Na+ currents as well as spontaneous electrophysiological activity and repetitive neuronal action potentials with a full baseline potential recovery.

Conclusion

Our study demonstrates that hDPSCs can be differentiated to neuronal-like cells that display functional excitability and thus evidence the potential of these easily accessible human stem cells for nerve tissue engineering. These results highlight the importance of choosing an appropriate culture protocol to successfully neurodifferentiate hDPSCs.
The effect of continuous positive airway pressure (CPAP) application on airway problems in pediatric patients with subglottic stenosis who undergo balloon dilatation
Authors: Tuncel Zeliha , Göksu Şenay , Deligöz Özlem , Saracoglu Kemal Tolga , Albasha Abdulatif , Abdallah Bushra M. , Saracoglu Ayten
Published: January 2025

Background

Subglottic stenosis is a significant clinical challenge in pediatric anesthesia, often necessitating interventions that can lead to various postoperative complications. The aim of this study was to determine the effect of prophylactic continuous positive airway pressure (CPAP) application on recovery time and airway complications in pediatric patients with subglottic stenosis undergoing balloon dilatation.

Methods

A prospective, double-blinded, parallel-group, randomized controlled study was conducted at Health Sciences University Ümraniye Training and Research Hospital on pediatric patients with subglottic stenosis, aged from 0 to 12 years and who underwent elective balloon dilatation under general anesthesia. Patients were randomized in a 1:1 ratio into the CPAP or non-CPAP group. The primary outcome was the duration of recovery time. Secondary outcomes included bronchospasm, the number of desaturation episodes, intubation, tracheostomy, and the need for intensive care.

Results

A total of 84 patients were enrolled in this randomized controlled trial, 81 of which received the allocated treatment and were analyzed (non-CPAP n = 41, CPAP n = 40). Compared to controls, the proportions of bronchospasm, tracheal secretion, need for intensive care, and tracheostomy were consistently lower in the CPAP group, whereas the requirement of intubation was higher. Further, the mean recovery time was significantly shorter in the CPAP group compared to the non-CPAP group (mean difference − 3.3 min, 95%CI − 5.16 to − 1.44, p = 0.0007). Despite lacking statistical significance, the CPAP group had reduced odds of developing bronchospasm, tracheal secretion, need for intensive care, and tracheostomy, but higher odds of requiring intubation when compared to the controls.

Conclusion

Prophylactic CPAP application following therapeutic balloon dilatation in pediatric patients who have developed subglottic stenosis due to acquired or congenital causes appears to effectively shorten recovery time and may have a role in decreasing postoperative pulmonary complications; however, more research is recommended to further confirm these findings.

Trial registration

The protocol for this clinical trial was retrospectively registered on clinicaltrials.gov with registration ID NCT06183515 on 30 November 2023.
Aberrant c-AMP signalling in richter syndrome revealed by single-cell transcriptome and 3D chromatin analysis
Authors: Li Heng , Xing Cheng , Li Ji , Zhan Yihao , Luo Ming , Wang Peilong , Sheng Yue , Peng Hongling
Published: January 2025

Richter syndrome (RS), characterized by aggressive lymphoma arising from chronic lymphocytic leukaemia (CLL), presents a poor response to treatment and grim prognosis. To elucidate RS mechanisms, paired samples from a patient with DLBCL-RS were subjected to single-cell RNA sequencing (scRNA-seq) and high-throughput chromosome conformation capture (Hi-C) sequencing. Over 10,000 cells were profiled via scRNA-seq, revealing the comprehensive B cell transformation in RS. Hi-C sequencing exposed a unique chromatin architecture in RS, with increased proximal and decreased distal interactions. At the compartment scale, the interaction between B compartments was strengthened in DLBCL cells, while topologically associating domains (TADs) in DLBCL had elevated intra-TAD and reduced inter-TAD contacts. Differentially expressed genes at TAD borders between CLL and DLBCL cells highlighted an enrichment of cAMP-mediated signalling. To substantiate the functional relevance of ATF1 and CAP1, the genes involve in cAMP-mediated signalling, in the context of cell proliferation, we have performed gain- and loss-of-function experiments in relevant cell lines. Collectively, integrated scRNA-seq and Hi-C data suggest that chromatin reorganization and altered cAMP signalling drive RS transformation.
The Development and Content of Movement Quality Assessments in Athletic Populations: A Systematic Review and Multilevel Meta-Analysis
Authors: Wijekulasuriya Gyan A. , Woods Carl T. , Kittel Aden , Larkin Paul
Published: January 2025

Background

Despite their prominence in the sport and human movement sciences, to date, there is no systematic insight about the development and content of movement quality assessments in athletic populations. This is an important gap to address, as it could yield both practical and scientific implications related to the continued screening of movement quality in athletic contexts. Hence, this study aimed to systematically review the (i) developmental approach, (ii) movements included, (iii) scoring system utilised, and (iv) the reliability of movement competency assessments used in athletic populations.

Methods

Electronic databases (SPORTDiscus, MEDLINE, CINAHL, Web of Science, Scopus) were searched for relevant articles up to 12 May 2023. Studies were included if they reported data about the developmental approach, movements included, scoring system utilised and reliability of assessment in an athletic population. A modified Downs and Black checklist was used to measure study quality.

Results

From a total of 131 identified studies: (i) 26 (20%) described the developmental approach of an assessment; (ii) 113 (86%) included descriptions of the movements included; (iii) 106 (81%) included a description of scoring system and criteria; and (iv) 77 (59%) studies included reliability statistics. There were 36 assessments identified within these studies, comprising 59 movements in total. Each assessment scored movement quality through a Likert or binary classification system.

Conclusion

First, the results demonstrate that choosing an appropriate movement quality assessment in an athletic population may be a complex process for practitioners as the development approach, movements included and scoring criteria vary substantially between assessments. Second, academics could use these results to help design new assessments for novel applications that meet rigour and reliability requirements. Third, these results have the potential to foster guidelines of use for the reliable assessment of movement quality in athletic populations.
Development and biomechanical evaluation of a 3D printed analogue of the human lumbar spine
Authors: Dukkipati Siril Teja , Driscoll Mark
Published: January 2025

Background

There exists a need for validated lumbar spine models in spine biomechanics research. Although cadaveric testing is the current gold standard for spinal implant development, it poses significant issues related to reliability and repeatability due to the wide variability in cadaveric physiologies. Moreover, there are increasing ethical concerns with human dissection practices. Analogue models can act as cost saving alternatives to human tissue with better repeatability. The current study proposes a new methodology of spinal biomechanics testing using 3D printable surrogates and characterized its multi-dimensional stiffness in displacement-controlled loading scenarios.

Methods

The model consisted of L1 to S1 vertebrae, intervertebral discs (IVD), intertransverse, interspinous, anterior and posterior longitudinal ligaments. The vertebrae and the IVDs were derived from an open-source 3D MRI anatomography database, while the ligaments were modeled based on literature incorporating mounting points on the spinous and transverse processes. Stereolithography 3D printing along with a combination of stiff and soft photopolymer resins were used to manufacture the vertebrae and the soft tissues in the model. Thereafter, displacement-controlled pure moments were applied in the range of ± 15° at 0.5°/sec in all bending modes using a torsion testing machine and a custom pure bending jig. Model rotation and resisting moment under loading were recorded to quantify the rotational stiffness and hysteresis in the model.

Results

The model reached a maximum of 5.66Nm and 3.53Nm at 15° flexion-extension, 3.84Nm and 3.93Nm at 15° right and left lateral bending, and 2.45Nm and 2.59Nm at 15° right and left axial rotation respectively. Model RMS error against ex vivo human response was estimated to be 1.57°, 1.64°, 0.82° in flexion-extension, lateral bending and axial rotation respectively. Bilateral symmetry in model stiffness was observed in lateral bending and axial rotation directions.

Conclusions

This study presents a reproducible 3D printable L1-S1 lumbar spine and validated it in all three orthogonal bending modes in the range of ± 15° against ex vivo and in silico data. The 3D printed analogue spine model described herein shows promising results, suggesting this model, with further validation, could have potential as a human cadaveric tissue substitute within the explored contexts of use.
Combination therapy of intravitreal ranibizumab and sub-tenon triamcinolone for treatment of resistant diabetic macular edema: a clinical study in Egypt
Authors: Khalil Hossam Eldin M. A. , Haroun Hazem E. , Shalan Alaa A. I. , Mahran Waleed M.
Published: January 2025

Background

Among those aged 20–74 in industrialized countries, diabetic retinopathy (DR) is the main cause of visual impairment. Diabetic macular edema (DME) is the leading cause of blindness in people with DR. DME that is resistant to therapy is now being treated with a number of different management strategies. This research was to examine the efficacy of sub-tenon steroid and anti- vascular endothelial growth factor (VEGF) injections as a combination therapy for the treatment of resistant DME, owing to the synergistic effect of this combination.

Methods

This is a two-arm, randomized, prospective clinical trial that included 100 eyes of patients with refractory DME divided into 2 equal groups: group 1 received posterior subtenon triamcinolone (STTA) and anti-VEGF injections (0.5 mg ranibizumab), and group 2 received anti-VEGF injections (0.5 mg ranibizumab) only, in the same session. The 2 groups were followed up for a period of 6 months.

Results

Group 1 showed significant improvements in best corrected visual acuity (BCVA) (from 0.20 ± 0.11 to 0.32 ± 0.12, p = 0.04) and central macular thickness (CMT) (from 393.2 ± 35.29 to 260.2 ± 11.43 µm, p = 0.001), with fewer injections required compared to Group 2. Recurrence rates were significantly higher in Group 2 (42% vs. 12%, p = 0.026). After injections, there was a noticeable rise in intraocular pressure (IOP) (16.02 ± 1.56 Vs 16.26 ± 1.24 in both groups respectively). However, this elevation is usually just transitory lasting for short periods of time and is within the safe, insignificant rise ranges.

Conclusion

The use of combined therapy with anti-VEGF treatment and STTA has been found to be an effective and safe approach to managing resistant DME. The lower number of injections needed help to reduce the economic burden, especially under constrained financial circumstances.
Optimal transport-based full-waveform inversion for shallow seismic data
Authors: Borisov Dmitry , Miller Richard D. , Sloan Steven D.
Published: January 2025

Full-waveform inversion (FWI) is widely used to reconstruct subsurface properties at different geological scales. For shallow land applications using surface waves, a lack of information on the source wavelet, dispersion, and presence of higher modes increases the nonlinearity of the inverse problem. Moreover, the inversion can become more challenging with the presence of near-surface (NS) complexities associated with scattering, attenuation, and high-contrast variations in the elastic parameters. To address those challenges, we exploit the potential of graph-space optimal transport-based waveform inversion (GSOT). Compared to least-squares (LS) formulation, GSOT provides a more convex misfit function and reduces dependence on accuracy of the initial model. While a few field-data applications have shown the potential and benefits of using GSOT-based FWI with body waves, there are limited real applications of inversion with GSOT misfit function for NS characterization. Moreover, despite a considerable effort with blind benchmark tests in exploration seismology, typically synthetic FWI examples for NS applications are demonstrated through an inverse crime approach, where the same forward modeling engine is used to generate observed and simulated data. Synthetic FWI examples performed here compare performance of LS- and GSOT-based FWI with more realistic scenarios. Those scenarios include using different wavefield propagators, inaccurate source wavelets, elastic inversion of anelastic data, and use of a coarse grid for the inversion of shallow seismic modeled and field data collected over a man-made elongated cavity located at about 10 m below ground surface. We demonstrate that the GSOT misfit function improves the initial 1D velocity models and guides the updates toward the actual subsurface properties. This enables the recovery of higher-mode Rayleigh waves and reconstruction of the cavity with better precision.
Impact of short rotation coppice of Populus ×canadensis on vegetation and soil fauna diversity
Authors: Slabejová Denisa , Čiampor Jr Fedor , Čiamporová-Zaťovičová Zuzana , Jarolímek Ivan , Šibíková Mária , Michalková Michaela
Published: January 2025

Sustainable forest management aims to preserve biodiversity while simultaneously meeting wood production demands. One of the ways to achieve this aim is by using short-rotation plantations of non-native trees. The cultivation of hybrid Populus ×canadensis (Canadian poplar) presents a unique case study in forest management due to its potential impact on biodiversity. This study investigates the influence of the short rotation coppice of Canadian poplar on vegetation and soil fauna, filling the knowledge gap by evaluating the multitaxa biodiversity data. The data were sampled in the Western Slovakia region. Nine vegetation plots (plot × reference plots selected and based on the forest potential vegetation in the study area) and four twin soil eDNA samples (plot × neighboring reference plot) were investigated. For vegetation data neophytes, archaeophytes, and apophytes were distinguished. The percentage number and percentage coverage were calculated for each category. In the plantation of Canadian poplar, a high number and cover of non-native species and apophytes were recorded. Metabarcoding analysis of soil fauna biodiversity using eDNA revealed a diverse community composed mainly of invertebrates, suggesting that the cultivation of Canadian poplar affects species diversity less than the composition of the soil fauna community. Overall, the findings underscore the complexity of managing Canadian poplar plantations and the importance of considering both ecological and economic factors. Different groups of organisms react differently to the replacement of alien tree species – in the vegetation, both the overall diversity and the species composition of plant communities have changed, in the soil fauna only the species composition has changed. Sustainable forest management practices must be tailored to specific local contexts to minimize negative impacts on biodiversity while maximizing economic benefits.
Effect of professional commitment on the career plans of intern doctors
Authors: Turan Sema , Hayme Serhat
Published: January 2025

Objective: The career choices of medical school graduates are extremely important because of their impact on a country’s medical workforce planning. This study aimed to investigate the impact of medical students’ level of professional commitment (PC) on their career plans.
Method: This cross-sectional study was conducted between April 15th and November 15th 2023, in a medical faculty in Erzincan Province in eastern Turkiye. A 16-question questionnaire and the medical students’ PC scale were used. A total of 129 intern doctors (93.5%) participated in the study. The t test, Mann-Whitney U test, and Kruskal-Wallis test were used in the statistical analyses.
Results: Students who voluntarily chose medical school, aimed to become specialist doctors, selected specialties with higher occupational risks, and intended to work in Turkiye after obligatory service exhibited higher levels of PC. Notably, those inclined towards family practice specialty demonstrated lower levels of PC, whereas public health specialty, basic sciences, and certain clinical sciences were not preferred by any of the students.
Conclusion: The results obtained suggest that PC levels may influence the career plans of medical students. Further research into factors affecting changes in PC throughout medical education and their impact on future career goals will enhance understanding in this area.
doi: https://doi.org/10.12669/pjms.41.2.10253
How to cite this: Turan S, Hayme S. Effect of professional commitment on the career plans of intern doctors. Pak J Med Sci. 2025;41(2):525-530. doi: https://doi.org/10.12669/pjms.41.2.10253
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.
Does the use of protective face masks affect temporomandibular joint function?
Authors: Özdemir Görgü Sena , Yasin Yildirim  , Pınar Kaya  , Gizem Ergezen  , Eda Uzuner
Published: January 2025

Objective: Long-term mask use can trigger or exacerbate various health issues. This prospective experimental study evaluated the impact of protective face masks on masseter muscle activity and temporomandibular joint (TMJ) function reported by participants.
Methods: This prospective, experimental tudy was conducted to investigate the effect of face masks on TMJ function, we used surface electromyography to assess masseter muscle activity at rest, during maximum contraction of the masseter muscle, and while reading a text. We also evaluated the intensity of the masseter muscle pain using an algometer. The participants underwent these evaluations at the Istanbul Medipol University between July and October 2022.
Results: The study included 24 female participants with an average age of 28.5±5.40 years. After at least five hours of daily N95 mask use, a significant increase in masseter muscle activity was observed at rest and during speech (p=0.01; p=0.04, respectively). However, no significant changes in the maximum contraction of masseter muscle or pain threshold were observed (p>0.05).
Conclusion: This study found that the use of N95 mask is associated with restricted TMJ movements and discomfort, and an increase in its use is associated with restricted TMJ movements, discomfort, and increased masseter muscle activity. Questions regarding mask-wearing-related habits should be included in the routine lifestyle assessment of patients who report TMJ complaints.
doi: https://doi.org/10.12669/pjms.41.2.10588
How to cite this: Gorgu SO, Yildirim Y, Kaya P, Ergezen G, Uzuner E. Does the use of protective face masks affect temporomandibular joint function?. Pak J Med Sci. 2025;41(2):432-436. doi: https://doi.org/10.12669/pjms.41.2.10588
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.
Clinical and epidemiological characteristics of multiple sclerosis in the southern region of the Republic of Azerbaijan
Authors: Aliyev Rahim , Mehtiyeva Shahla , Shiraliyeva Rana
Published: January 2025

Objectives: To investigate the clinico-epidemiological characteristics of multiple sclerosis (MS) in the southern region of the Republic of Azerbaijan, which has a population of 930,601.
Methods: This prospective, single-center, longitudinal study was conducted from January 1, 2013, to December 31, 2022. MS patients in this region underwent examination and treatment under a State Program. During this period, 123 individuals visited the Neurological Center, and 104 confirmed MS cases were included in a digital database. Age-standardized incidence and prevalence rates per 100,000 were calculated using world and European population standards. Data analysis was performed using IBM SPSS Statistics 27.
Results: The mean diagnostic age was 36.31±6.93 years, higher than the countrywide average of 34.9 years. The average diagnostic delay was 7.01 years, significantly longer than the national average of 5.2 years. Regional MS prevalence was 10.96/100,000, with higher urban rates but no significant sex difference. The average 10-years incidence of MS was 0.94±0.32/100,000. Compared to neighboring regions, such as Iran’s East Azerbaijan Province and Turkiye, the MS prevalence in this area is lower. Although MS prevalence and incidence in Azerbaijan are below European levels, they exceed those in some Asian countries.
Conclusion: This is the first study on MS epidemiology in Southern Azerbaijan. The findings underscore the need for public awareness campaigns and enhanced diagnostic training for healthcare professionals, particularly in primary care, to facilitate early symptom detection and reduce diagnostic delays. Further research is recommended to investigate regional factors affecting MS diagnosis and to improve timely healthcare access.
doi: https://doi.org/10.12669/pjms.41.2.11373
How to cite this: Aliyev RR, Mehtiyeva ShN, Shiraliyeva RK. Clinical and epidemiological characteristics of multiple sclerosis in the southern region of the Republic of Azerbaijan. Pak J Med Sci. 2025;41(2):437-442. doi: https://doi.org/10.12669/pjms.41.2.11373
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.
Analysis of risk factors for death during treatment of hemodynamically unstable pelvic fractures
Authors: Wang Dazhi , Xiao Jungang , Zheng Kaifu
Published: January 2025

Objective: To analyze the risk factors associated with the occurrence of death during the treatment of patients with hemodynamically unstable pelvic fractures.
Methods: The present study is a retrospective research design, which selected 136 patients with hemodynamically unstable pelvic fractures admitted to China Resource & WISCO General Hospital from March 2020 to March 2022 as the subjects of the study. They were divided into a survival group (113 cases) and a death group (23 cases) according to whether the patients died during treatment. The general clinical data and laboratory test indexes of the two groups were compared to analyze the risk factors affecting the death of pelvic fracture patients. Receiver operator characteristic (ROC) curves were plotted, and the area under the curve was calculated.
Results: The two groups were significantly different in aspects of age, systolic blood pressure, rapid emergency medicine score, injury severity score (ISS), sequential organ failure assessment (SOFA) score, prothrombin time, activated partial thromboplastin time, and percentages of patients with bleeding volume > 2,000 mL, shock index > 2, and minimum oxygenation index < 200 (P<0.05). Logistic regression analysis suggested that shock index > 2, ISS, SOFA score, and bleeding volume > 2,000 mL were independent risk factors for patient death. ROC analysis showed that the area under the curve for shock index > 2, ISS, SOFA score, and bleeding volume > 2,000 mL was 0.656, 0.732, 0.907, and 0.798, respectively.
Conclusions: Severe shock, increased ISS and SOFA score, and bleeding are independent risk factors for death in patients with hemodynamically unstable pelvic fractures. Implementation of rapid and efficient targeted management during treatment of high-risk patients with these factors is key to reducing their risk of death.
doi: https://doi.org/10.12669/pjms.41.2.9808
How to cite this: Wang D, Xiao J, Zheng K. Analysis of risk factors for death during treatment of hemodynamically unstable pelvic fractures. Pak J Med Sci. 2025;41(2):559-563. doi: https://doi.org/10.12669/pjms.41.2.9808
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.
Ο Γιάννης Χρήστου ως Μύστης
Authors: Ηλιάδου Ηλιάνα
Published: January 2025

Η παρούσα μελέτη πραγματεύεται μία ολική ανασύσταση του έργου Μυστήριον του Γιάννη Χρήστου (1926-1970), ένα έργο που δημιουργήθηκε το 1966 αλλά η οριστική έκδοσή του από τον συνθέτη δεν ολοκληρώθηκε εξαιτίας του πρόωρου θανάτου του. Η μελέτη κινείται σε δύο άξονες: α) μια ενδελεχή θεώρηση του ίδιου του έργου και των συνθηκών μέσα στις οποίες εξελίχθηκε και β) την δημιουργία μιας ολοκληρωμένης έκδοσης με προορισμό την εκτέλεσή του, που συμπεριλαμβάνει αφενός τη συλλογή και αποκατάσταση των γραμμένων στοιχείων που αποτελούν την παρτιτούρα και αφετέρου την ανασύσταση του ηχητικού υλικού της συνοδευτικής μαγνητοταινίας. Η διατριβή περιλαμβάνει μια μελέτη της ζωής και του έργου του ΓΧ μέσα από μια επιλογή κειμένων του συνθέτη, εξετάζοντας την θέση του Μυστήριον μέσα στο έργο του. Αφηγείται την περιπέτεια της έκδοσης των τελευταίων έργων στα οποία περιλαμβάνεται και το Μυστήριον καθώς και της προσπάθειας του ΓΧ για την εκτέλεση του έργου, από την αναβολή της παράστασης στο Φεστιβάλ Αθηνών το 1966 μέχρι την επίσης αναβληθείσα τηλεοπτική παραγωγή της Δανικής Ραδιοτηλεόρασης τον Ιούνιο του 1969. Με αφορμή την τελευταία παραγωγή, ο ΓΧ προχώρησε σε κάποιες τροποποιήσεις της αρχικής εκδοχής του έργου. Αυτές, γράφτηκαν επάνω στην αρχική παρτιτούρα και σε γραπτά που συγκέντρωσε σε ένα φάκελο που προετοίμαζε την τελική εκδοχή της η οποία δεν ολοκληρώθηκε ποτέ. Στη μελέτη υποστηρίζεται ότι το φάκελος περιέχει πολύτιμες πληροφορίες σχετικά με τις τροποποιήσεις, το ηχητικό υλικό και τη χρήση του. Επιπλέον, η διατριβή εξετάζει το προσωπικό σημειογραφικό σύστημα του ΓΧ που εφαρμόζεται για πρώτη φορά στο Μυστήριον και που η εξελικτική του πορεία είναι εμφανής ανάμεσα στις δύο γραφές του έργου. Οι τροποποιήσεις του έργου αφορούν κυρίως στην χρήση μαγνητοταινίας. Έτσι, η διατριβή διερευνά τον τρόπο σημείωσης της μαγνητοταινίας και της λειτουργικής της σημασίας από τον Προμηθέα Δεσμώτη (1963) μέχρι και τα τελευταία έργα που η χρήση της γίνεται όλο και πιο συστηματική. Το Μυστήριον αποτελεί την μοναδική περίπτωση έργου της ύστερης δημιουργικής περιόδου του συνθέτη που δεν έχει παρουσιαστεί, τουλάχιστον σε μια πλήρη μορφή. Η διατριβή καταλήγει σε μια δυνητικά εκτελέσιμη εκδοχή που έχει ως στόχο να καλύψει το κενό που αφήνει η έλλειψη μιας τελικής παρτιτούρας. Αυτή η εκδοχή συγκεντρώνει το σύνολο της πληροφορίας για το έργο που είναι σήμερα διαθέσιμη μαζί με το ηχητικό υλικό που συνοδεύει το έργο και σημειώνεται στην παρτιτούρα του.
SDLE- Development of a system dynamics model for the prediction of acute noncontact lower extremity injuries in team sports
Authors: Λιβέρης Νικόλαος
Published: January 2025

Εισαγωγή: Πρόσφατες θεωρητικές μελέτες έχουν προτείνει την υιοθέτηση μεθοδολογιών συστημικής σκέψης για την εξέταση του κινδύνου τραυματισμού. Ωστόσο, η εφαρμογή παρόμοιων μεθοδολογικών προσεγγίσεων στον τομέα των αθλητικών τραυματισμών παραμένει περιορισμένη. Στόχοι: Σκοπός αυτής της μελέτης είναι να εφαρμόσει μεθοδολογίες συστημικής σκέψης για να εξετάσει τις πολύπλοκες αλληλεπιδράσεις των διαφόρων παραγόντων κινδύνου που επιδρούν στην εκδήλωση οξέων μη-επαφής τραυματισμών στα κάτω άκρα και τραυματισμών των οπίσθιων μηριαίων. Για τον παραπάνω σκοπό χρησιμοποιήθηκαν ποιοτικές και ποσοτικές μεθοδολογικές προσεγγίσεις. Μεθοδολογία: Στο ποιοτικό μεθοδολογικό στάδιο, διεξήχθησαν μια σειρά από εις βάθος συζητήσεις της βασικής ομάδας μοντελοποίησης και των ενδιαφερομένων μελών (n = 8) σε εργαστήρια δομημένης ομαδικής μοντελοποίησης (group model building workshops), σε συνδυασμό με μια εκτενή βιβλιογραφική ανασκόπηση. Το αποτέλεσμα αυτού του σταδίου ήταν ένα λεπτομερές μοντέλο αιτιώδους βρόχου (Causal loop diagram) που απεικονίζει την πολυπλοκότητα των παραγόντων κινδύνου που οδηγούν σε τραυματισμό των Οπισθιών Μηριαίων (ΟΜ) [Hamstring Injury Causal Loop Diagram (HI-CLD)]. Στο ποσοτικό στάδιο της μελέτης, συλλέχθηκαν δεδομένα ενδογενών παραγόντων κινδύνου από 99 επαγγελματίες και ημιεπαγγελματίες αθλητές ποδοσφαίρου χρησιμοποιώντας ένα ολιστικό πρωτόκολλο προ-αγωνιστικού ελέγχου που εφαρμόστηκε στις αθλητικές εγκαταστάσεις των ομάδων. Επιπλέον κατά τη διάρκεια της αγωνιστικής περιόδου συλλέχθηκαν στοιχεία σχετικά με τους τραυματισμούς που εκδηλώθηκαν. Οι αλληλεπιδράσεις των παραγόντων κινδύνου και οι άμεσες, έμμεσες και διαμεσολαβητικές επιδράσεις τους στον τραυματισμό αξιολογήθηκαν με τη μέθοδο των μοντέλων δομικών εξισώσεων [Partial Least Square Structural Equation Modeling (PLS-SEM)]. Δύο μοντέλα PLS-SEM διαμορφώθηκαν έχοντας ως εξαρτημένη μεταβλητή στο ένα τους τραυματισμούς των ΟΜ και στο άλλο τη συχνότητα των οξέων μη επαφής τραυματισμών στα κάτω άκρα. Αποτελέσματα: Το HI-CLD καθορίζει τις αλληλεπιδράσεις των παραγόντων κινδύνου για τραυματισμό, δείχνοντας τις πιθανές μη γραμμικές επιδράσεις των διαφόρων παραγόντων. Τα αποτελέσματα του PLS-SEM υποδεικνύουν ότι η ηλικία > 24 ετών και οι αυξημένες ασυμμετρίες δύναμης των ΟΜ έχουν στατιστικά σημαντική συσχέτιση με τους τραυματισμούς των ΟΜ. Επιπλέον, οι προηγούμενοι τραυματισμοί και οι ασυμμετρίες δύναμης των κάτω άκρων αποδείχτηκε ότι έχουν άμεση στατιστικά σημαντική συσχέτιση με τους οξείς μη επαφής τραυματισμούς των κάτω άκρων. Επιπλέον, οι παράγοντες της αντοχής των οπίσθιων μηριαίων και των μυών του κορμού έδειξαν σημαντικές έμμεσες επιδράσεις και στα δύο μοντέλα. Τέλος, οι προηγούμενοι τραυματισμοί και η ηλικία έδειξαν σημαντική διαμεσολαβητική επίδραση και στα δύο PLS-SEM μοντέλα.
A digital twin enabled wearable device for customized healthcare
Authors: Zhu Zhengxu , Zhong Ray Y
Published: January 2025

Background The traditional healthcare process centers on the hospital rather than the individual patient. The demand for continuous monitoring is increasing with the increasing proportion of patients with chronic diseases and the elderly. Wearable medical devices have brought medical monitoring into the Internet age. To improve the devices' adaptability, this research proposes a combination between digital twin (DT) and wearable medical devices is proposed to provide personalized wearable medical devices and personalized healthcare efficiently. Methods A DT-enabled smart system is proposed for personalization in the design, manufacturing, and data tracking of a healthcare device prototype. DTES is a proposed DT-based personalized service system framework. Through the digital mapping of user physical data, manufacturers and third-party service providers can quickly respond to user needs and complete the design process quickly in the digital space, thereby supporting manufacturing in the physical space. A case study is made for three healthcare monitoring scenarios: rehabilitation training, wheelchair, and human fall. Based on computer-aided design and additive print, a triaxial vibration collection bracelet with a simple Internet of things mode is designed and manufactured in personalization. Results The bracelet shows great application ability in this case study, including design, manufacturing, and remote connection. 10 groups of data were recorded in each scenario. In rehabilitation training and wheelchair experiments, the average values of correlation coefficient between models and the actual data are 0.991 and 0.749 respectively. In human fall experiment, the motion signal parameters of the user and movement pattern were clearly identified. These results provide the basis for applications in different scenarios. Conclusions The device is representative, with good personalization and health monitoring performance, and has excellent potential for large-scale application. DT will provide a new feasible solution for the realization of personalized medicine.
'It’s become a theatre’: relational experiences of family carers and persons living with Amyotrophic lateral sclerosis (ALS) after cognitive impairment emerges
Authors: Oseland Marit Sofie , Sveen Unni , Taule Tina
Published: January 2025

Background Amyotrophic lateral sclerosis (ALS) can lead to emotional and psychological distress between persons with ALS and their family carers. Many persons with ALS develop cognitive impairment, which limits their ability to process complex information, interact, and communicate. This cognitive decline adds to caregiver burden. Few studies have explored interpersonal relations between persons with ALS and their family carers. Aim To better understand how ALS-associated cognitive impairment influences close relations. Methods Individual semi-structured in-depth, interviews were conducted once, with four persons with ALS and four family carers. Reflexive thematic analysis was used. Results Increased distance of close relations was identified as the overarching theme. Differences and similarities within the data were identified according to the two main themes. The first main theme, Everyday life together but apart: a demanding role to play, was structured according to three subthemes: Keeping the façade of civility, Demanding daily interaction and communication, and Taken for granted changes in everyday roles. The second main theme, Coping with a lost future, was structured according to the two subthemes, Striving to live in the normal present, and Holding on to self. Conclusions and significance Cognitive impairment following ALS can lead to increased relational distance between persons with ALS and their family carers. To ease their burden, professionals should recognize person with ALS’ and family carers’ relational issues and grief at an early stage. Focusing on their occupational identity and valued occupations that are still-accessible may help persons with ALS and family carers regain meaning in everyday life.