bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers and facilitators to uptake and use of oral pre-exposure prophylaxis in pregnant and postpartum women: a qualitative meta-synthesis
Authors: Liu Ying , Zhang Liao , Chen Hong
Published: June 2024

Background

Acute HIV infection during pregnancy and in the postpartum period increases the risk of vertical transmission. The World Health Organization (WHO) has recommended preexposure prophylaxis for pregnant and postpartum women at risk of acquiring HIV. However, there are significant gaps between the actual practice and the ideal goal of preexposure prophylaxis implementation among pregnant and postpartum women. Therefore, it is important to determine what influences women’s implementation of preexposure prophylaxis during pregnancy and in the postpartum period. This review aims to aggregate barriers and facilitators to preexposure prophylaxis implementation among pregnant and postpartum women.

Methods

A range of electronic databases, including PubMed, CINAHL Plus with Full Text, Embase, and Web of Science, were searched for potentially relevant qualitative studies. The search period extended from the establishment of the databases to March 16, 2023. This review used the ENTREQ (Enhancing transparency in reporting of qualitative research synthesis) statement to guide the design and reporting of qualitative synthesis. The methodological quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The JBI meta-aggregation method was applied for guiding the data extraction, and the JBI ConQual method was applied for guiding the evaluation of the level of evidence for the synthesis.

Results

Of retrieved 2042 studies, 12 met the inclusion criteria. The total population sample included 447 participants, including 231 pregnant and postpartum women, 21 male partners, 75 healthcare providers (HCPs)/healthcare workers (HCWs), 18 policymakers, 37 mothers, and 65 women of childbearing age. A total of 149 findings with credibility ratings of “unequivocal” or “equivocal” were included in this meta-synthesis. Barriers and facilitators to preexposure prophylaxis implementation were coded into seven categories, including three facilitator categories: perceived benefits, maintaining relationships with partners, and external support, and four barriers: medication-related barriers, stigma, barriers at the level of providers and facilities, and biases in risk perception.

Conclusion

This systematic review and meta-synthesis aggregated the barriers and facilitators of preexposure prophylaxis implementation among pregnant and postpartum women. We aggregated several barriers to maternal preexposure prophylaxis implementation, including medication-related factors, stigma, barriers at the level of providers and facilities, and risk perception biases. Therefore, intervention measures for improving preexposure prophylaxis services can be developed based on these points.

PROSPERO Number

CRD42023412631.
Magnitude of in-hospital mortality and its associated factors among patients undergone laparotomy at tertiary public hospitals, West Oromia, Ethiopia, 2022
Authors: Daba Aliyi Benti , Beshah Debrework Tesgera , Tekletsadik Esayas Alemshet
Published: June 2024

Introduction

Laparotomy surgery, which involves making an incision in the abdominal cavity to treat serious abdominal disease and save the patient’s life, causes significant deaths in both developed and developing countries, including Ethiopia. The number studies examining in-hospital mortality rates among individuals that undergone laparotomy surgery and associated risk factors is limited.

Objective

To assess the magnitude of in-hospital mortality and its associated factors among patients undergone laparotomy at tertiary hospitals, West Oromia, Ethiopia, 2022.

Methods

An institutional based retrospective cross-sectional study was conducted from January 1, 2017, to December 31, 2021. Data were collected using systematic random sampling and based on structured and pretested abstraction sheets from 548 medical records and patient register log. Data were checked for completeness and consistency, coded, imported using Epi-data version 4.6, cleaned and analyzed using SPSS version 25 software. Variables with p < 0.2 in the Bi-variable logistic regression analysis were included in the multivariate logistic regression analysis. The fit of the model was checked by the Hosmer‒Lemeshow test. Using the odds ratio adjusted to 95% CI and a p value of 0.05, statistical significance was declared.

Results

A total of 512 patient charts were reviewed, and the response rate was 93.43%. The overall magnitude of in-hospital mortality was 7.42% [95% CI: 5.4–9.8]. American society of Anesthesiology physiological status greater than III [AOR = 7.64 (95% CI: 3.12–18.66)], systolic blood pressure less than 90 mmHg [AOR = 6.11 (95% CI: 1.98–18.80)], preoperative sepsis [AOR = 3.54 (95% CI: 1.53–8.19)], ICU admission [AOR = 4.75 (95% CI: 1.50-14.96)], and total hospital stay greater than 14 days [(AOR = 6.76 (95% CI: 2.50-18.26)] were significantly associated with mortality after laparotomy surgery.

Concussion

In this study, overall in- hospital mortality was high. Early identification patient’s American Society of Anesthesiologists physiological status and provision of early appropriate intervention, and pays special attention to patients admitted with low systolic blood pressure, preoperative sepsis, intensive care unit admission and prolonged hospital stay to improve patient outcomes after laparotomy surgery.
Genetically predicted high sex hormone binding globulin was associated with decreased risk of polycystic ovary syndrome
Authors: Guo Xiaofeng , Chen Langlang , He Jianhua , Zhang Xiaozhi , Xu Shui
Published: June 2024

Background

Previous observational studies have indicated an inverse correlation between circulating sex hormone binding globulin (SHBG) levels and the incidence of polycystic ovary syndrome (PCOS). Nevertheless, conventional observational studies may be susceptible to bias. Consequently, we conducted a two-sample Mendelian randomization (MR) investigation to delve deeper into the connection between SHBG levels and the risk of PCOS.

Methods

We employed single-nucleotide polymorphisms (SNPs) linked to serum SHBG levels as instrumental variables (IVs). Genetic associations with PCOS were derived from a meta-analysis of GWAS data. Our primary analytical approach relied on the inverse-variance weighted (IVW) method, complemented by alternative MR techniques, including simple-median, weighted-median, MR-Egger regression, and MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) testing. Additionally, sensitivity analyses were conducted to assess the robustness of the association.

Results

We utilized 289 SNPs associated with serum SHBG levels, achieving genome-wide significance, as instrumental variables (IVs). Our MR analyses revealed that genetically predicted elevated circulating SHBG concentrations were linked to a reduced risk of PCOS (odds ratio (OR) = 0.56, 95% confidence interval (CI): 0.39–0.78, P = 8.30 × 10–4) using the IVW method. MR-Egger regression did not detect any directional pleiotropic effects (P intercept = 0.626). Sensitivity analyses, employing alternative MR methods and IV sets, consistently reaffirmed our results, underscoring the robustness of our findings.

Conclusions

Through a genetic epidemiological approach, we have substantiated prior observational literature, indicating a potential causal inverse relationship between serum SHBG concentrations and PCOS risk. Nevertheless, further research is needed to elucidate the underlying mechanism of SHBG in the development of PCOS.
Psychometric validation of the Chinese versions of the quality of communication questionnaires for cancer patients and their family caregivers
Authors: Chen Zhihan , Li Yanjia , Xie Zhishan , Tang Siyuan , Xiao Jinnan
Published: June 2024

Background

Given the lack of valid and reliable instruments for evaluating the quality of communication between physicians and cancer patients and their family caregivers in China, this study translated and culturally adapted the Quality of Communication questionnaires for cancer patients (QOC-P) and their family caregivers (QOC-F) for use in the Chinese context and evaluated their psychometric properties.

Methods

The QOC-P and QOC-F were translated following an adapted version of Brislin’s translation model and culturally adapted according to a Delphi expert panel. We pretested and refined the Chinese versions of the QOC-P and QOC-F among 16 dyads of patients and their family caregivers. Subsequently, we administered the questionnaires to 228 dyads of patients and their family caregivers who were recruited from six tertiary hospitals. The content validity, construct validity, convergent validity, and reliability of the QOC-P and QOC-F were examined.

Results

Through exploratory factor analysis, The QOC-P and QOC-F were divided into two dimensions: general communication and end-of-life communication. The Cronbach’s coefficients ranged from 0.905 to 0.907 for the two subscales of the QOC-P and from 0.908 to 0.953 for the two subscales of the QOC-F. The two-week test-retest reliability was acceptable for both the QOC-P and QOC-F, with intraclass correlation coefficients of 0.993 and 0.991, respectively. The scale content validity index (QOC-P: 0.857, QOC-F: 1.0) and split-half reliability (QOC-P: 0.833, QOC-F: 0.935) were satisfactory. There was a negative correlation with anxiety and depression for both the QOC-P (r = -0.233 & -0.241, p < 0.001) and QOC-F (r = -0.464 & -0.420, p<0.001). The QOC-P showed a negative correlation with decision regret (r = -0.445, p<0.001) and a positive correlation with shared decision-making (r = 0.525, p<0.001), as hypothesized.

Conclusion

The QOC-P and QOC-F show acceptable psychometric properties for evaluating the quality of communication between physicians and cancer patients and their family caregivers in both clinical and research contexts. Future studies should use more diverse and inclusive samples to test the structure of the Chinese version of the QOC-P and QOC-F with confirmatory factor analysis.
Circulating small extracellular vesicles in Alzheimer’s disease: a case–control study of neuro-inflammation and synaptic dysfunction
Authors: Singh Rishabh , Rai Sanskriti , Bharti Prahalad Singh , Zehra Sadaqa , Gorai Priya Kumari , Modi Gyan Prakash , Rani Neerja , Dev Kapil , Inampudi Krishna Kishore , Y. Vishnu V. , Chatterjee Prasun , Nikolajeff Fredrik , Kumar Saroj
Published: June 2024

Background

Alzheimer’s disease (AD) is a neurodegenerative disease characterized by Aβ plaques and neurofibrillary tangles. Chronic inflammation and synaptic dysfunction lead to disease progression and cognitive decline. Small extracellular vesicles (sEVs) are implicated in AD progression by facilitating the spread of pathological proteins and inflammatory cytokines. This study investigates synaptic dysfunction and neuroinflammation protein markers in plasma-derived sEVs (PsEVs), their association with Amyloid-β and tau pathologies, and their correlation with AD progression.

Methods

A total of 90 [AD = 35, mild cognitive impairment (MCI) = 25, and healthy age-matched controls (AMC) = 30] participants were recruited. PsEVs were isolated using a chemical precipitation method, and their morphology was characterized by transmission electron microscopy. Using nanoparticle tracking analysis, the size and concentration of PsEVs were determined. Antibody-based validation of PsEVs was done using CD63, CD81, TSG101, and L1CAM antibodies. Synaptic dysfunction and neuroinflammation were evaluated with synaptophysin, TNF-α, IL-1β, and GFAP antibodies. AD-specific markers, amyloid-β (1–42), and p-Tau were examined within PsEVs using Western blot and ELISA.

Results

Our findings reveal higher concentrations of PsEVs in AD and MCI compared to AMC (p < 0.0001). Amyloid-β (1–42) expression within PsEVs is significantly elevated in MCI and AD compared to AMC. We could also differentiate between the amyloid-β (1–42) expression in AD and MCI. Similarly, PsEVs-derived p-Tau exhibited elevated expression in MCI compared with AMC, which is further increased in AD. Synaptophysin exhibited downregulated expression in PsEVs from MCI to AD (p = 0.047) compared to AMC, whereas IL-1β, TNF-α, and GFAP showed increased expression in MCI and AD compared to AMC. The correlation between the neuropsychological tests and PsEVs-derived proteins (which included markers for synaptic integrity, neuroinflammation, and disease pathology) was also performed in our study. The increased number of PsEVs correlates with disease pathological markers, synaptic dysfunction, and neuroinflammation.

Conclusions

Elevated PsEVs, upregulated amyloid-β (1–42), and p-Tau expression show high diagnostic accuracy in AD. The downregulated synaptophysin expression and upregulated neuroinflammatory markers in AD and MCI patients suggest potential synaptic degeneration and neuroinflammation. These findings support the potential of PsEV-associated biomarkers for AD diagnosis and highlight synaptic dysfunction and neuroinflammation in disease progression.
CDK4/6 inhibition enhances T-cell immunotherapy on hepatocellular carcinoma cells by rejuvenating immunogenicity
Authors: Cai Xiurong , Yin Guo , Chen Shuai , Tacke Frank , Guillot Adrien , Liu Hanyang
Published: June 2024

Hepatocellular carcinoma (HCC) poses a significant clinical challenge, necessitating the integration of immunotherapeutic approaches. Palbociclib, a selective CDK4/6 inhibitor, has demonstrated promising efficacy in preclinical HCC models and is being evaluated as a novel therapeutic option in clinical trials. Additionally, CDK4/6 inhibition induces cellular senescence, potentially influencing the tumor microenvironment and immunogenicity of cancer cells. In this study, we conducted comprehensive bioinformatic analyses using diverse HCC transcriptome datasets, including bulk and single-cell RNA-sequencing data from public databases. We also utilized human and mouse HCC cells to investigate functional aspects. Primary T cells isolated from mouse blood were employed to assess T cell immunity against HCC cells. Results revealed that CD8+ T-cell infiltration correlates with improved outcomes in HCC patients with suppressed CDK4/6 expression. Moreover, CDK4/6 expression was associated with alterations in the immune landscape and immune checkpoint expression within the liver tumor microenvironment. Furthermore, we found that treatment with Palbociclib and Doxorubicin induces cellular senescence and a senescence-associated secretory phenotype in HCC cells. Notably, pretreatment with Palbociclib augmented T cell-mediated cytotoxicity against HCC cells, despite upregulation of PD-L1, surpassing the effects of Doxorubicin pretreatment. In conclusion, our study elucidates a novel mechanism by which CDK4/6 inhibition enhances T-cell-associated cancer elimination and proposes a potential therapeutic strategy to enhance T-cell immunotherapy on HCC.

Graphical abstract
Electroactive Brevundimonas diminuta consortium mediated selenite bioreduction, biogenesis of selenium nanoparticles and bio-electricity generation
Authors: Sakr Ebtehag A. E. , Khater Dena Z. , El‑khatib Kamel M.
Published: June 2024

In this study, highly selenite-resistant strains belonging to Brevundimonas diminuta (OK287021, OK287022) genus were isolated from previously operated single chamber microbial fuel cell (SCMFC). The central composite design showed that the B. diminuta consortium could reduce selenite. Under optimum conditions, 15.38 Log CFU mL-1 microbial growth, 99.08% Se(IV) reduction, and 89.94% chemical oxygen demand (COD) removal were observed. Moreover, the UV–visible spectroscopy (UV) and Fourier transform infrared spectroscopy (FTIR) analyses confirmed the synthesis of elemental selenium nanoparticles (SeNPs). In addition, transmission electron microscopy (TEM) and scanning electron microscope (SEM) revealed the formation of SeNPs nano-spheres. Besides, the bioelectrochemical performance of B. diminuta in the SCMFC illustrated that the maximum power density was higher in the case of selenite SCMFCs than those of the sterile control SCMFCs. Additionally, the bioelectrochemical impedance spectroscopy and cyclic voltammetry characterization illustrated the production of definite extracellular redox mediators that might be involved in the electron transfer progression during the reduction of selenite. In conclusion, B. diminuta whose electrochemical activity has never previously been reported could be a suitable and robust biocatalyst for selenite bioreduction along with wastewater treatment, bioelectricity generation, and economical synthesis of SeNPs in MFCs.
Progression patterns, resistant mechanisms and subsequent therapy for ALK-positive NSCLC in the era of second-generation ALK-TKIs
Authors: Wu Lige , Zou Zihua , Li Yan , Hao Xuezhi , Ying Jianming , Li Junling , Xing Puyuan
Published: June 2024

Background

In the era of second-generation ALK tyrosine kinase inhibitors (ALK-TKIs), there was a paucity of data regarding the progression patterns, resistant mechanisms, and subsequent therapeutic approaches for ALK-positive (ALK+) non-small cell lung cancer (NSCLC).

Methods

Patients with advanced ALK+ NSCLC were retrospectively selected from our center. Cohort 1 consisted of patients who experienced disease progression after receiving first-line alectinib treatment (n = 20), while Cohort 2 included patients who progressed following sequential treatment with crizotinib and second-generation ALK-TKIs (n = 53). Oligo-progression was defined as the occurrence of disease progression in no more than three lesions. Symptomatic progression was determined when patients developed new symptoms or experienced worsening of pre-existing symptoms during radiological progression.

Results

The incidence of central nervous system (CNS) progression and symptomatic CNS progression was significantly lower in Cohort 1 compared to patients treated with crizotinib, with rates of 15.0% vs. 56.6% (p = 0.002) and 5.0% vs. 32.1% (p = 0.016), respectively. A total of 60.3% (44/73) patients underwent repeated biopsy and next-generation sequencing subsequent to the second-generation ALK-TKI resistance, with secondary mutation in ALK kinase domain emerging as the predominant mechanism of resistance (56.8%). Local therapy was applied to 50% of oligo-progression cases. Subsequent ALK-TKIs demonstrated significantly prolonged progression-free survival (PFS) (8.6 m vs. 2.7 m, p = 0.021, HR = 0.43, 95%CI: 0.15–0.85) and long-term overall survival (OS) (NA vs. 11.9 m, p = 0.132, HR = 0.50, 95%CI: 0.18–1.25) in patients harboring ALK resistance mutations, compared to those without such mutations. For patients without ALK-resistant mutations following progression on second-generation ALK-TKIs, there was no statistically significant difference in survival outcomes between subsequent chemotherapy or alternative ALK-TKI treatments.

Conclusions

First-line alectinib demonstrated superior efficacy in protecting the CNS compared to crizotinib. For patients with ALK-resistant mutations following the resistance to second-generation ALK-TKIs, appropriate sensitive ALK-TKI should be administered; for those without such mutations, the selection of chemotherapy or third-generation ALK-TKI should be based on the patient’s overall physical health and personal preferences.
Changing how the third 95 is counted: suitable indicators for measuring U = U with findings from Taiwan
Authors: Huang Hsun-Yin , Huang Yu-Ching , Lo Hsiu-Yun , Chan Pei-Chun , Lee Chia-Chi
Published: June 2024

Introduction

The World Health Organisation has implemented multiple HIV prevention policies and strived to achieve the 90-90-90 goal by 2020, achieving the 95-95-95 goal by 2030, which refers to 95% of patients living with HIV knowing their HIV status, 95% of patients living with HIV receiving continual care and medication, and 95% of patients living with HIV exhibiting viral suppression. However, how to measure the status of viral suppression varies, and it is hard to indicate the quality of HIV care. The study aimed to examine the long-term viral load suppression in these cases and explore potential factors affecting the control of long-term viral load.

Methods

This study analyzed viral load testing data from HIV patients who are still alive during the period from notification up to 2019–2020. Three indicators were calculated, including durable viral suppression, Viremia copy-years, and Viral load > 1,500 copies/ml, to assess the differences between them.

Results

Among the 27,706 cases included in the study, the proportion of persistent viral load suppression was 87%, with 4% having viral loads exceeding 1,500 copies/ml. The average duration from notification to viral load suppression was 154 days, and the geometric mean of annual viral replication was 90 copies*years/ml. Regarding the last available viral load measurement, 96% of cases had an undetectable viral load. However, we observed that 9.3% of cases, while having an undetectable viral load for their last measurement, did not show consistent long-term viral load suppression. An analysis of factors associated with non-persistent viral load suppression revealed higher risk in younger age groups, individuals with an educational level of high school or below, injection drug users, cases from the eastern region, those seeking care at regional hospitals, cases with drug resistance data, individuals with lower healthcare continuity, and those with an initial CD4 count below 350 during the study period.

Conclusions

The recommendation is to combine it with the indicator of sustained viral load suppression for a more accurate assessment of the risk of HIV transmission within the infected community.
Investigating the correlation between genotype and phenotype in Prader-Willi syndrome: a study of 45 cases from Brazil
Authors: Cintra Hiago Azevedo , Rocha Danielle Nascimento , da Costa Ana Carolina Carioca , Tyszler Latife Salomão , Freitas Silvia , de Araujo Leonardo Abreu , Crozoe Lisanne Incoutto , de Paula Luísa Ribeiro , Correia Patricia Santana , Gomes Leonardo Henrique Ferreira , da Cunha Guida Letícia
Published: June 2024

Background

Prader-Willi syndrome (PWS) is a genetic disorder characterized by abnormalities in the 15q11-q13 region. Understanding the correlation between genotype and phenotype in PWS is crucial for improved genetic counseling and prognosis. In this study, we aimed to investigate the correlation between genotype and phenotype in 45 PWS patients who previously underwent methylation-sensitive high-resolution melting (MS-HRM) for diagnosis.

Results

We employed methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) and Sanger sequencing, along with collecting phenotypic data from the patients for comparison. Among the 45 patients, 29 (64%) exhibited a deletion of 15q11-q13, while the remaining 16 (36%) had uniparental disomy. No statistically significant differences were found in the main signs and symptoms of PWS. However, three clinical features showed significant differences between the groups. Deletion patients had a higher prevalence of myopia than those with uniparental disomy, as well as obstructive sleep apnea and an unusual skill with puzzles.

Conclusions

The diagnostic tests (MS-HRM, MS-MLPA, and Sanger sequencing) yielded positive results, supporting their applicability in PWS diagnosis. The study’s findings indicate a general similarity in the genotype-phenotype correlation across genetic subtypes of PWS.
Attitude to food supplement use: a survey promoted by the Italian Society of Pediatric Allergy and Immunology
Authors: Ciprandi Giorgio , Daglia Maria , Brindisi Giulia , Brunese Francesco Paolo , Dinardo Giulio , Gori Alessandra , Indolfi Cristiana , Naso Matteo , Tondina Enrico , Trincianti Chiara , Varricchio Attilio , Zicari Anna Maria , del Giudice Michele Miraglia , Drago Lorenzo
Published: June 2024

Food supplements are defined as foodstuffs the purpose of which is to supplement the normal diet and which are concentrated sources of nutrients or other substances with a nutritional or physiological effect, often referred to as nutraceuticals, may exert benefit to the human body. Their use is increasing worldwide, including Europe and in Italy. However, some doctors are skeptical about their effectiveness and safety. This reluctance may depend on poor knowledge of the mechanisms of action and clinical evidence in literature. The Italian Society of Pediatric Allergy and Immunology (SIAIP) promoted the institution of an ad hoc Committee. The first initiative performed by this Committee was the administration of a questionnaire to the members of SIAIP.

The results of this survey provided interesting results. Most pediatricians know the food supplement concept but frequently need help understanding the mechanisms of action. Most prescribe food supplements, mainly for preventing infections or enhancing immune defense. In addition, they prefer to use food supplements as cycles or add-on therapy. Finally, most participants like to attend events on this issue and contribute to new evidence through trials.

In conclusion, this survey underscores the relevance of food supplement issues and attests to interest in this topic. However, there is a need to provide information and promote studies on this matter.
A 42-year-old woman with abnormal uterine bleeding—leiomyoma (AUB-L) reporting a hemoglobin of 1.6 g/dL: a case report
Authors: Qaadri Shamsa M. , Luthra Tavsimran S. , Budhu Kumarie , Sagi Or
Published: June 2024

Background

Abnormal uterine bleeding, formerly known as menometrorrhagia, is estimated to occur in up to one-third of women, commonly at menarche or perimenopause. Among many other causes, abnormal uterine bleeding is known to be caused by leiomyomas, and is itself a leading cause of severe iron deficiency and iron deficiency anemia in women. Rarely, abnormal uterine bleeding can lead to critically low hemoglobin values of less than 2 g/dL. We report here a case of a woman with abnormal uterine bleeding caused by leiomyomas presenting with severely low hemoglobin.

Case presentation

We report the case of a 42-year-old Asian American woman who presented to the emergency department with chronic abnormal uterine bleeding and symptoms of anemia, including multiple syncopal episodes and abnormally pale skin but otherwise alert and oriented. Laboratory tests found a record-low hemoglobin of 1.6 g/dL and hematocrit of 6%. Transabdominal pelvic ultrasound revealed a lower uterine segment/cervical fibroid measuring 7.5 × 5 × 7.8 cm (length × depth × width). Patient was diagnosed with abnormal uterine bleeding–leiomyoma and received five units of packed red blood cells, one unit of fresh frozen plasma, Venofer infusions, tranexamic acid, and medroxyprogesterone. She was discharged from the hospital after 4 days.

Conclusion

To date, only a handful of cases have been reported of female patient survival following severely low hemoglobin caused by abnormal uterine bleeding. This case adds to this literature, highlighting the remarkable degree of compensation that can lead to an alert, ambulatory, and oriented patient with abnormal uterine bleeding caused by leiomyoma.
Study of a class of fractional-order evolution hybrid differential equations using a modified Mittag-Leffler-type derivative
Authors: Shah Kamal , Abdeljawad Thabet , Abdalla Bahaaeldin , Hleili Manel
Published: June 2024

This work is devoted to using topological degree theory to establish a mathematical analysis for a class of fractional-order evolution hybrid differential equations using a modified Mittag–Leffler-type derivative. In addition, two kinds of Ulam–Hyers (U–H) stability results are deduced for the mentioned problem. A pertinent example is given to verify the results.
Identification of iron gall inks, logwood inks, and their mixtures using Raman spectroscopy, supplemented by reflection and transmission infrared spectroscopy
Authors: Retko Klara , Legan Lea , Kosel Janez , Ropret Polonca
Published: June 2024

Raman spectral references for various formulations of iron gall inks, logwood inks and mixtures of both types were acquired during this study. The samples, either liquid or dry inks and applied on paper, were analysed using a portable Raman spectrometer, both with 852 and 785 nm excitation lines, and a confocal dispersive Raman microscope with two different excitations, namely 785 and 532 nm. It was found that longer wavelengths are more suitable for the analysis of iron gall inks and that the spectral response of logwood inks is relatively more dependent on the excitation line. For the mixtures, it is suggested analyses be performed with both longer and shorter wavelengths, since with a 785 nm line mainly the characteristic features of the metal-polyphenol complex in iron gall inks are detected, while the spectra collected with a 532 nm excitation contain information on the presence of logwood inks. The study was complemented by non-invasive reflectance infrared spectroscopy, which enabled the detection of tannic acid in iron gall inks and in the mixtures, and by micro-Fourier transform infrared (FTIR) spectroscopy to complement the reference set. The study aims to contribute to the development of non-invasive protocols for identification of inks in historic and artistic works on paper, such as manuscripts and drawings.

Graphical Abstract
Thyrogrit, supplemented with a sub-optimal dose of levothyroxine, restores thyroid function in rat model of propylthiouracil-induced hypothyroidism
Authors: Balkrishna Acharya , Paliwal Ritu , Maity Madhulina , Varshney Yash , Sinha Sandeep , Varshney Anurag
Published: June 2024

Background

Hypothyroidism is a common endocrine ailment, whose current standard of care is hormonal replacement therapy with levothyroxine (LT4). There is a medical need for alternative and safer therapies as LT4 is associated with special treatment considerations and adverse effects. Thyrogrit (THY) is a polyherbal formulation indicated for the treatment of hypothyroidism. The present study, describes the characterization of the phytocompounds present in THY and its in-vivo efficacy in rat model of hypothyroidism, in combination with a sub-optimal dose of LT4.

Methods

Ultra High Performance Liquid chromatography was employed for the identification of the phytocompounds present in THY. For the evaluation of its in-vivo efficacy, female Wistar rats were administered THY orally, 15-days prior to disease induction, and continued throughout the experiment. Subsequently, hypothyroidism was induced by oral administration of propylthiouracil (PTU). From day 45 onwards, animals were administered orally with a sub-optimal dose of LT4 (2 μg/kg) till the end of the study. On day 79, animals were euthanized, blood was collected for measurement of thyroid hormones and other clinical chemistry parameters. Weights of liver, kidney and thyroid were recorded. Finally, the thyroid was subjected to histopathological evaluation through hematoxylin and eosin (H&E staining), immunohistochemistry as well as immunofluorescence.

Results

The principal phyto-components detected in THY by Ultra High Performance Liquid Chromatography included gallic acid, protocatechuic acid, corilagin, ellagic acid, piperine, guggulsterone E and Z, which are documented to exerted beneficial effects on thyroid function. In the in-vivo study, THY when supplemented with a low dose of levothyroxine restored the PTU-induced reduction in the serum levels of T3 and T4 and improved PTU-induced renal impairment. THY treatment ameliorated the hallmark histopathological changes associated with hypothyroidism and C-cell hyperplasia. Further, co-administration of THY and LT4 did not show any major non-clinical safety concerns even after the administration for more than twelve weeks.

Conclusion

This study has demonstrated that co-administration of THY and LT4 improves the PTU-evoked alterations in the thyroid ultrastructure and function, abrogates hypothyroidism-associated renal impairment and exhibits an acceptable basic safety profile.

Graphical abstract
Is conventional magnetic resonance imaging superior to radiography in the functional integrity evaluation of anterior cruciate ligament in patients with knee osteoarthritis?
Authors: Yu Zhenguo , Wang Hongqing , Wang Xiaoyu , Dong Xin , Dong Jie , Liang Qingchen , Sun Fenglong
Published: June 2024

Background

The functional integrity of the anterior cruciate ligament (ACL) influences surgical decision-making in patients with knee osteoarthritis (KOA). This study aimed to compare the diagnostic value of radiography and magnetic resonance imaging (MRI) in determining the functional status of ACL.

Methods

We analyzed 306 knees retrospectively using preoperative hip-to-ankle anteroposterior standing (APS) radiographs, anteroposterior (AP) and lateral knee radiographs, AP valgus stress (VS) force radiographs, and standard orthogonal MRI. Based on the intraoperative visualization, the knees were grouped into ACL functionally-intact and ACL functionally-deficient (ACLD) groups. The diagnostic validity and reliability were calculated based on the radiograph parameters such as hip-knee-ankle angle (HKA), medial proximal tibial angle (MPTA), lateral distal femoral angle (LDFA), posterior tibial slope (PTS), sagittal tibiofemoral subluxation (STFS), coronal tibiofemoral subluxation (CTFS), joint line convergence angle (JLCA), the maximum wear point of the proximal tibia plateau (MWPPT%), and MRI parameters including ACL grades and MWPPT%.

Results

HKA, MPTA, PTS, STFS, JLCA, and CTFS on APS and AP radiographs, and MWPPT% on radiographs and MRI showed a significant diagnostic value (P < 0.05). There were no statistically significant differences in the single parameters from radiographs and MRI. After constructing the logistic regression models, MRI showed higher sensitivity, specificity, and accuracy, reaching 96.8%, 79.9%, and 83.3%, respectively (P < 0.001).

Conclusions

In patients with KOA, the diagnostic value of single radiographic or MRI parameter in assessing the functional integrity of the ACL are equivalent. However, by constructing predictive models, MRI could significantly improve diagnostic validity compared with radiography.
Optional Exam Retakes Reduce Anxiety but may Exacerbate Score Disparities Between Students with Different Social Identities
Authors: Supriya K. , Bang Christofer , Ebie Jessica , Pagliarulo Christopher , Tucker Derek , Villegas Kaela , Wright Christian , Brownell Sara
Published: June 2024

We studied the impact of offering optional exam retake opportunities to students in three large introductory biology courses. While exam retakes improved student exam scores, differences in participation among students with different social identities led to slightly larger inequities in exam scores after retakes.
Toward Culturally Responsive Mentoring of Muslim Research Mentees in the Sciences
Authors: Mohammed Tasneem F. , Aini Rahmi Q. , Barnes M. Elizabeth , Cooper Katelyn M.
Published: June 2024

This essay highlights the need for culturally responsive mentoring of Muslim research mentees. It describes challenges Muslim research mentees may face in scientific research environments and potential accommodations.
Racial Disparities and Strategies for Improving Equity in Diagnostic Follow-Up for Abnormal Screening Mammograms
Authors: Manik Ritika , Grady Connor B. , Ginzberg Sara P. , Edmonds Christine E. , Conant Emily F. , Hubbard Rebecca A. , Fayanju Oluwadamilola M.
Published: June 2024

PURPOSE

Black and White women undergo screening mammography at similar rates, but racial disparities in breast cancer outcomes persist. To assess potential contributors, we investigated delays in follow-up after abnormal imaging by race/ethnicity.

METHODS

Women who underwent screening mammography at our urban academic center from January 2015 to February 2018 and received a Breast Imaging Reporting and Data System 0 assessment were included. Kaplan-Meier estimates described distributions of time between diagnostic events from (1) screening to diagnostic imaging and (2) diagnostic imaging to biopsy. Multivariable logistic regression models estimated the associations between race/ethnicity and receipt of follow-up within 15 and 30 days.

RESULTS

Two thousand five hundred and fifty-four women were included (48.6% non-Hispanic [NH] Black, 38.2% NH White, 13.1% other/unknown). Median time between screening and diagnostic imaging varied by race/ethnicity (White: 7 days [IQR, 2-14]; Black: 12 days [IQR, 7-23]; other/unknown: 9 days [IQR, 5-21]). There were similar disparities in days between diagnostic imaging and biopsy (White: 12 [IQR, 7-24]; Black: 21 [IQR, 13-37]; other/unknown: 16 [IQR, 9-30]) and between screening and biopsy (White: 20 [IQR, 11-41]; Black: 35 [IQR, 22-63]; other/unknown: 27.5 [IQR, 17-42]). After adjustment, odds of diagnostic imaging follow-up within 15 days of screening were lower for Black versus White women (odds ratio, 0.59 [95% CI, 0.44 to 0.80];
P
< .001).

CONCLUSION

In this diverse cohort, disparities in timely diagnostic follow-up after abnormal breast screening were observed, with Black women waiting 1.75 times as long as White women to obtain a tissue diagnosis. National guidelines for time to diagnostic follow-up may facilitate more timely breast cancer care and potentially affect outcomes.
Thin elastic films and membranes under rectangular confinement
Authors: Sprenger A. R. , Reinken H. , Richter T. , Menzel A. M.
Published: June 2024

We address the deformations within a thin elastic film or membrane in a two-dimensional rectangular confinement. To this end, analytical considerations of the Navier-Cauchy equations describing linear elasticity are performed in the presence of a localized force center, that is, a corresponding Green's function is determined, under no-slip conditions at the clamped boundaries. Specifically, we find resulting displacement fields for different positions of the force center. It turns out that clamping regularizes the solution when compared to an infinitely extended system. Increasing compressibility renders the displacement field more homogeneous under the given confinement. Moreover, varying aspect ratios of the rectangular confining frame qualitatively affect the symmetry and appearance of the displacement field. Our results are confirmed by comparison with corresponding finite-element simulations.
Clinical efficacy of vestibular assessment and rehabilitation training in peripheral vestibular vertigo
Authors: Wang Huan , Zheng Jie , Li Fulai , Feng Chenfang , Zhang Nan
Published: June 2024

Objective: To evaluate the clinical efficacy of vestibular assessment and rehabilitation training in patients with peripheral vestibular vertigo.
Method: This was a retrospective study. A total of 169 patients diagnosed with peripheral vestibular vertigo, admitted to Cangzhou People’s Hospital between January 2020 and January 2023 were divided into control group (83 cases) and observation group (86 cases). The control group received medication-based treatment, while the observation group was provided with combined treatment of medication and vestibular rehabilitation training. Assessment of recovery included the Dizziness Handicap Inventory (DHI), Vestibular Symptom Index (VSI), and Activities-specific Balance Confidence (ABC) scale before and at two, four, and eight weeks post-treatment. Psychological status, sleep quality, and life quality were evaluated. Both groups underwent the Fukuda stepping test and timed balance test.
Result: At two, four, and eight weeks post‐treatment, both groups exhibited significantly lower DHI‐P, DHI‐F, DHI‐E, VSI, and ABC scores compared to pre‐treatment (p<0.05). The observation group showed significantly lower DHI‐P, DHI‐F, DHI‐E, VSI, and ABC scores than the control group at two and four weeks post‐treatment (p<0.05). After treatment, both groups demonstrated reduced body deviation angles and increased time without falling in the Fukuda stepping test (p<0.05). Notably, the observation group had significantly better outcomes (p<0.05).
Conclusion: In comparison to medication‐based treatment alone, a combined approach involving medication treatment and vestibular rehabilitation training may demonstrate early improvements in vertigo symptoms, enhance balance capabilities, and ameliorate psychological well‐being, sleep quality, and overall quality of life for patients.
doi: https://doi.org/10.12669/pjms.40.7.8662
How to cite this: Wang H, Zheng J, Li F, Feng C, Zhang N. Clinical efficacy of vestibular assessment and rehabilitation training in peripheral vestibular vertigo. Pak J Med Sci. 2024;40(7):---------. doi: https://doi.org/10.12669/pjms.40.7.8662
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.
Vaccine a promising immunotherapy option for head and neck cancer patients
Authors: Mohsin Syed Fareed
Published: June 2024

Head and neck cancer (HNC) is a diversified group of tumors arising from the upper aerodigestive tract, encompassing the oral cavity, larynx, and pharynx. Globally, this particular cancer ranks sixth in prevalence, resulting in an annual mortality rate above 325,000 individuals. Surgery, radiation, and chemotherapy are the primary therapeutic options for HNC, which are frequently used in combination. Despite their extensive use, these treatments are typically unsuccessful and can significantly impair patient quality of life. Therapeutic vaccinations are administered to cancer patients instead of preventative immunizations administered to a healthy population. The efficacy of this modality has considerably transformed the application and success of cancer management by providing an additional and effective therapeutic option for patients. Cancer treatment has been revolutionized by introducing Immune Checkpoint receptors inhibitors (ICR), such as anti-CTLA4, anti-PD-1, and anti-PD-L1.3. ICR have also established immunity against self-generated cancerous cells. Cancer vaccines have shown extraordinary synergistic potential with checkpoint inhibitors to maximize tumor-specific CD8+ expansion and activity, which detects and destroys tumor cells. Personalized neoantigen vaccination therapies can potentially combat the heterogeneity of each patient’s tumor. The findings of this review suggest that recent advances in cancer immunology and genetics imply that cancer vaccination can be a promising alternative treatment for head and neck cancer patients. This review conducted a comprehensive literature search to identify relevant studies on immunotherapy options for head and neck cancer patients. The search strategy was designed to capture a wide range of peer-reviewed articles, conference proceedings, and grey literature from 2013 to 2023. The databases searched to ensure comprehensive coverage of the literature included PubMed, Web of Science, and Google Scholar; to include grey literature and articles not indexed in traditional databases.
doi: https://doi.org10.12669/pjms.40.7.8791
How to cite this: Mohsin SF. Vaccine a promising immunotherapy option for head and neck cancer patients. Pak J Med Sci. 2024;40(7):---------.  doi: https://doi.org/10.12669/pjms.40.7.8791
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.
Bridging the Gap: A narrative review of osteoporosis disability, adipokines, and the role of AI in postmenopausal women
Authors: Tariq Saba , Jabbar Sohail , Ahmad Awais , Tariq Sundus
Published: June 2024

Osteoporosis is a global health concern characterized by reduced bone density and compromised bone quality, resulting in an increased risk of fractures, particularly in postmenopausal women. The assessment of bone mineral density (BMD) plays a pivotal role in diagnosing osteoporosis, as it accounts for approximately 70% of overall bone strength. The World Health Organization (WHO) has endorsed BMD measurement as a reliable method for diagnosing this condition. In Pakistan, the incidence of bone fractures is on the rise, largely attributable to an aging population and a range of contributing factors. Understanding the global and local prevalence of osteoporosis, its impact on morbidity and mortality, and the contributing factors is vital for developing effective preventive and therapeutic strategies.
The role of adipokines, including chemerin, vaspin, and omentin-1, in bone metabolism is an emerging area of investigation. These adipokines play diverse roles in physiology, ranging from inflammation and metabolic regulation to cardiovascular health. Understanding their potential impact on bone health is a topic of ongoing research. The intricate relationship between bone density, bone quality, and overall bone strength is central to understanding the diagnosis and management of osteoporosis. Current innovation in machine learning and predictive model can bring revolution in the field of bone health and osteoporosis. Early identification of people with osteoporosis or risk of fracture through machine learning can prevent disability and improve the quality of life.
doi: https://doi.org/10.12669/pjms.40.7.9072
How to cite this: Tariq S, Jabbar S, Ahmad A, Tariq S. Bridging the Gap: A narrative review of osteoporosis disability, adipokines, and the role of AI in postmenopausal women. Pak J Med Sci. 2024;40(7):---------. doi: https://doi.org/10.12669/pjms.40.7.9072
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.
CBCT based investigation of frequency of Middle Mesial Canal in Mandibular First Molars of Saudi Sub-population
Authors: Abulhamael Ayman M. , Javed Muhammad Qasim , Hassan Sobia , Atique Sundus , Habib Syed Rashid
Published: June 2024

Objective: One key factor in determining endodontic treatment outcome is the clinicians’ comprehension of tooth anatomy, as missed canals may harbor bacteria ultimately leading to apical periodontitis. The study aimed to investigate the prevalence of middle mesial canal (MMC) in Mandibular first molars (MFMs) of Saudi subpopulation.
Methods: The cross-sectional retrospective study was conducted at Qassim University Dental College from June to August 2023. Overall, 302 CBCT images with 604 bilateral lower first molars were examined by two calibrated assessors. The existence of MMC was noted. The data were coded, and analysis was done in SPPS-24. The reliability of inter-evaluator and intra-evaluator agreement for detecting MMC were estimated using Cohen’s kappa.
Results: The patients’ average age was 30.95±11.61years. The sample’s female to male ratio was 1:1.75. The overall frequency of MMC was 14.2%. The differences in the frequency of MMC on the basis of gender, quadrants and age groups were found to be insignificant. Inter-evaluator and intra-evaluator reliability was noted to be 0.78 and 0.74, depicting acceptable reliability.
Conclusions: The MMC is an uncommon occurrence with rare bilateral presentation in MFMs of Saudi population. Endodontists performing endodontic treatment in such subjects should mindfully investigate inter mesiobuccal- mesiolingual canals area for locating, negotiating, and managing any present MMC’s.
doi: https://doi.org/10.12669/pjms.40.7.9101
How to cite this: Abulhamael AM, Javed MQ, Hassan S, Atique S, Habib SR. CBCT based investigation of frequency of Middle Mesial Canal in Mandibular First Molars of Saudi Sub-population. Pak J Med Sci. 2024;40(7):---------. doi: https://doi.org/10.12669/pjms.40.7.9101
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.