bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers and facilitators to medication-assisted treatment for cocaine use disorder among men who have sex with men: a qualitative study
Authors: Hsiang Elaine , Patel Kishan , Wilson Erin C. , Dunham Alexandrea , Ikeda Janet , Matheson Tim , Santos Glenn-Milo
Published: November 2024

Background

Rates of cocaine use disorder (CUD) among men who have sex with men (MSM) are high and rising. Among MSM, cocaine use is associated with negative socioeconomic, medical, and psychological outcomes. There are no FDA-approved pharmacotherapy options to treat CUD, and psychosocial interventions demonstrate limited efficacy. While there have been numerous trials evaluating possible medications for CUD, there is a scarcity of qualitative data on the barriers and facilitators of medication-assisted treatment.

Methods

Semi-structured interviews were conducted with 16 participants enrolled in a phase II randomized control trial evaluating extended-release lorcaserin among MSM with CUD. Participants were asked about their motivations for enrolling in the study, attitudes towards taking a medication for CUD, barriers and facilitators of study pill adherence, and their general study experience. Interviews were analyzed using an inductive and exploratory approach to thematic analysis.

Results

Participants were highly motivated to reduce cocaine use and viewed pharmacotherapy as a viable and desirable treatment option. Pharmacotherapy was seen as having fewer access and adherence structural barriers compared to existing psychosocial therapies. Medication reminders facilitated pill taking, while side effects, travel, and active substance use presented barriers to study pill adherence. Disclosure of study participation within social networks was variable pointing to anticipated substance use and treatment stigma.

Conclusions

Our study highlights important factors affecting the acceptability and uptake of medication-assisted treatment for CUD among a diverse sample of MSM. These findings can help guide the development and implementation of future pharmacotherapy options for CUD and other substance use disorders in this key population.
Cellular senescence in Alzheimer’s disease: from physiology to pathology
Authors: Zhu Jing , Wu Chongyun , Yang Luodan
Published: November 2024

Alzheimer’s disease (AD) is one of the most common neurodegenerative disorders, characterized by the accumulation of Aβ and abnormal tau hyperphosphorylation. Despite substantial efforts in development of drugs targeting Aβ and tau pathologies, effective therapeutic strategies for AD remain elusive. Recent attention has been paid to the significant role of cellular senescence in AD progression. Mounting evidence suggests that interventions targeting cellular senescence hold promise in improving cognitive function and ameliorating hallmark pathologies in AD. This narrative review provides a comprehensive summary and discussion of the physiological roles, characteristics, biomarkers, and commonly employed in vivo and in vitro models of cellular senescence, with a particular focus on various cell types in the brain, including astrocytes, microglia, oligodendrocyte precursor cells, neurons, and endothelial cells. The review further delves into factors influencing cellular senescence in AD and emphasizes the significance of targeting cellular senescence as a promising approach for AD treatment, which includes the utilization of senolytics and senomorphics.
The contribution of agricultural inputs in reducing child stunting
Authors: Rogna Marco
Published: November 2024

While the impact of agricultural inputs on crop yields has received considerable attention, their influence on nutritional outcomes has been somewhat neglected. This study aims to fill this gap by examining the role of agricultural inputs in mitigating child stunting through linear dynamic panel regressions conducted at the country level. By analysing data from approximately half of the world’s countries over a 20-years period, our findings reveal that mineral fertilizers make significant positive contributions to reducing child stunting. Other agricultural inputs, such as per-capita agricultural land and manure exhibit a positive contribution in reducing child stunting, but their statistical significance is obtained only in few models. Surprisingly, irrigation appears to have no impact on alleviating child stunting.
The generation method of orthophoto expansion map of arched dome mural based on three-dimensional fine color model
Authors: Hu Chunmei , Wang Yang , Xia Guofang , Han Yang , Ma Xinjian , Jing Guofeng
Published: November 2024

Murals carry cultural significance and historical information, and are an important channel for understanding ancient social norms, artistic styles, and religious beliefs. At present, the digitization of murals is an important technical means for the protection of cultural heritage. Orthogonal images of murals play a vital role in high-precision recording, preservation, academic research, educational expansion, mural protection, digital exhibition and dissemination. At present, orthogonal images of murals are mostly realized by plane projection, but this method is not suitable for making orthogonal images of arched and dome-shaped murals. To address this problem, this paper proposes a method for generating orthogonal expansion images of arched and dome-shaped murals. This method combines a three-dimensional virtual space simulation model with an RTT virtual camera and adopts a spatial reference orthogonal ray scanning model. First, the detailed three-dimensional color model is fitted to the geometric reference of cylindrical and spherical objects to determine its parameters. Next, for the cylindrical murals on the arch, the orientation of the model is initialized using quaternions, and the viewport matrix is adjusted to obtain the required resolution. Then, the RTT camera is used to perform line orthogonal projection in the viewport, and the fringe projection image is generated by rotating around the cylinder axis according to the inversely calculated rotation angle. For the murals on the dome ceiling, this method is used to segment them according to a certain longitude, and the circumscribed cylinder of the fitted sphere is rotated to perform cylindrical orthogonal line scanning in the segmented area. These individual orthogonal line scan images are carefully spliced together to form a complete orthogonal unfolded image. Finally, a fringe projection image is generated with the central meridian of the unfolded part as the center line, and the fringe projection images are spliced together to obtain the final orthogonal unfolded image. Experiments show that compared with existing methods, this method can generate two-dimensional orthogonal unfolded images with high texture fidelity, minimal texture deformation, and uniform deformation distribution. This study provides a novel perspective on the orthogonal unfolding of quasi-cylindrical and quasi-spherical painted objects, and provides an accurate and diverse data basis for the digitization of murals.
Increased kinematic changes in ascending compared with descending biplanar cut in open wedge high tibial osteotomy—a multibody simulation
Authors: Jörgens Maximilian , Ehreiser Sonja , Schroeder Lennart , Watrinet Julius , Böcker Wolfgang , Holzapfel Boris Michael , Radermacher Klaus , Fürmetz Julian
Published: November 2024

Background

The ascending or descending extended biplanar tibial cut in open wedge high tibial osteotomy (owHTO) not only changes the lower limb anatomy in the coronal plane but also leads to different three-dimensional (3D) changes in the patellofemoral joint. This study aimed to perform a comprehensive analysis of the dynamic biomechanical changes in the knee joint using a multibody simulation model.

Methods

Thirteen 3D computer models derived from lower limb computer tomography scans were used for owHTO. Osteotomies with ascending or descending biplanar cut were simulated for each wedge height from 6 to 12 mm (in 1-mm intervals). Multibody simulation was used to analyze differences in patellar shift, patellar tilt, mediolateral patellar rotation, and tibiofemoral rotation during a squat simulation from 5° to 100° knee flexion.

Results

The main effects of an ascending compared with a descending extended biplanar cut in owHTO were characterized by an increase in lateralization of the patella and rotation, along with reduced tilt. Linear mixed models revealed statistically significant effects of both wedge height and cut variant on knee kinematics at 100° knee flexion, with the influence of the cut variant (ascending/descending) being higher on all analyzed kinematic parameters.

Conclusions

Significant differences in the changes in patellofemoral shift, tilt, rotation, and tibiofemoral rotation were observed when performing owHTO with an ascending versus a descending biplanar cut. Apart from tibiofemoral rotation, the resulting kinematic changes were greater with an ascending cut.
Analysis of Concordance Between Next-Generation Sequencing Assessment of Microsatellite Instability and Immunohistochemistry-Mismatch Repair From Solid Tumors
Authors: Ali-Fehmi Rouba , Krause Harris Benjamin , Morris Robert T. , Wallbillich John J. , Corey Logan , Bandyopadhyay Sudeshna , Kheil Mira , Elbashir Leana , Zaiem Fadi , Quddus M. Ruhul , Abada Evi , Herzog Thomas , Karnezis Anthony N. , Antonarakis Emmanuel S. , Kasi Pashtoon Murtaza , Wei Shuanzeng , Swensen Jeffrey , Elliott Andrew , Xiu Joanne , Hechtman Jaclyn , Spetzler David , Abraham Jim , Radovich Milan , Sledge George , Oberley Matthew J. , Bryant David
Published: November 2024

PURPOSE

The new CAP guideline published in August 2022 recommends using immunohistochemistry (IHC) to test for mismatch repair defects in gastroesophageal (GE), small bowel (SB), or endometrial carcinoma (EC) cancers over next-generation sequencing assessment of microsatellite instability (NGS-MSI) for immune checkpoint inhibitor (ICI) therapy eligibility and states there is a preference to use IHC over NGS-MSI in colorectal carcinoma (CRC).

METHODS

We assessed the concordance of NGS-MSI and IHC-MMR from a very large cohort across the spectrum of solid tumors.

RESULTS

Of the over 190,000 samples with both NGS-MSI and IHC-MMR about 1,160 were initially flagged as discordant. Of those samples initially flagged as discordant, 50.9% remained discordant after being reviewed by an additional pathologist. This resulted in a final discordance rate of 0.31% (590/191,767). Among CRC, GE, SB and EC, 55.4% of mismatch repair proficient/MSI high (MMRp/MSI-H) tumors had at least one somatic pathogenic mutation in an MMR gene or
POLE
. Mismatch repair deficient/microsatellite stable (MMRd/MSS) tumors had a significantly lower rate of high tumor mutational burden than MMRp/MSI-H tumors. Across all solid tumors, MMRd/MSI-H tumors had significantly longer overall survival (OS; hazard ratio [HR], 1.47,
P
< .001) and post-ICI survival (HR, 1.82,
P
< .001) as compared with MMRp/MSS tumors. The OS for the MMRd/MSS group was slightly worse compared to the MMRp/MSI-H tumors, but this difference was not statistically significant (HR, 0.73,
P
= .058), with a similar pattern when looking at post-ICI survival (HR, 0.43,
P
= .155).

CONCLUSION

This study demonstrates that NGS-MSI is noninferior to IHC-MMR and can identify MSI-H tumors that IHC-MMR is unable to detect and conversely IHC-MMR can identify MMRd tumors that NGS-MSI misses.
Analysis of influencing factors and construction of nomogram prediction model of postoperative kinesiophobia in patients undergoing total knee arthroplasty
Authors: Xie Jian , Cai Haoliang , Chen Wenting , Wu Xiaohui , Chen Xi , Guo Jun
Published: November 2024

Objective: To explore the influencing factors of kinesiophobia and to establish a nomogram prediction model.
Methods: A retrospective observational study was conducted in 354 patients who underwent TKA in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from December 2019 to December 2022. Sociodemographic characteristics, anesthesia methods, Tampa Scale for Kinesiophobia (TSK), numeric rating scale (NRS), hospital for special surgery (HSS), activities of daily living (ADL), and self-rating anxiety scale (SAS) were reviewed and analyzed. Logistic regression analysis was used to identify the influencing factors of kinesiophobia, and a nomogram model was established based on the identified influencing factors and verified by consistency index (C-index), calibration curve, and receiver operating characteristic (ROC) curve.
Results: Incidence of kinesiophobia in patients who received TEAS combined with western medicine (dexmedetomidine and remifentanil) was significantly lower than that in patients who received western medicine alone. The logistic regression analysis showed that family monthly income level, HSS, ADL, and combined TEAS and western medicine approach were independent protective factors for kinesiophobia (all P<0.05). The degree of pain and anxiety were independent risk factors for kinesiophobia (both P<0.05). A nomogram model was constructed with C-index of 0.721 (0.658, 0.784), and the area under curve (AUC) was 0.748 (95 %CI: 0.685-0.807). The calibration curve also showed good consistency between actual observations and nomogram model predictions.
Conclusions: Family monthly income level, anesthesia methods, NRS, HSS, ADL, and SAS scores are influencing factors of kinesiophobia, and the nomogram model can be useful for predicting postoperative kinesiophobia.
doi: https://doi.org/10.12669/pjms.40.11.10306
How to cite this: Xie J, Cai H, Chen W, Wu X, Chen X, Guo J. Analysis of influencing factors and construction of nomogram prediction model of postoperative kinesiophobia in patients undergoing total knee arthroplasty. Pak J Med Sci. 2024;40(11):2550-2557.  doi: https://doi.org/10.12669/pjms.40.11.10306
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.
Revisiting the need for intellectual and moral virtues in making ethical decisions in Healthcare
Authors: Naeem Noor-i-Kiran
Published: November 2024

Patient-physician interaction is an essential factor influencing the patient’s health management decisions. This communication allows the patients to develop trust in the treating physicians and facilitates them in deciding what’s best for themselves. The physicians, on the other hand, may interact with the patients based on three moral philosophies i.e. as a part of their duty (deontology), as a part of anticipating consequences (consequentialism) and as a part of being a virtuous doctor (virtue ethics). In this communication, we aim to debate the need and utility of having moral virtues for ethical decision-making. We will also evaluate the role of intellectual virtues in patient-doctor interaction for decisions taken on clinical grounds.
doi: https://doi.org/10.12669/pjms.40.11.10602
How to cite this: Naeem NK. Revisiting the need for intellectual and moral virtues in making ethical decisions in Healthcare Pak J Med Sci. 2024;40(11):2455-2457. doi: https://doi.org/10.12669/pjms.40.11.10602
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The paradox of healing
Authors: Khan Sheraz Jamal , Iftikhar Mehwash
Published: November 2024

doi: https://doi.org/10.12669/pjms.40.11.11015
How to cite this: Khan SJ, Iftikhar M. The paradox of healing. Pak J Med Sci. 2024;40(11):2453-2454.  doi: https://doi.org/10.12669/pjms.40.11.11015
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.
Blood stream infections in Stevens Johnson Syndrome and Toxic Epidermal Necrolysis: Risk factors and association with poor outcome
Authors: Amber Tazein , Tabassum Saadia , Mehmood Saad Bin Zafar , Ali Syed Ahsan , Javed Umair , Mushtaq Muhammad Zain
Published: November 2024

Background & Objective:  Blood Stream Infections (BSI) are considered a significant cause of morbidity and mortality in patients with Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). We aimed to identify risk factors for BSI upon admission, highlight clinical and microbiological findings and ascertain the frequency of mortality in patients with BSI in SJS/TEN.
Methods: A retrospective cross-sectional study over 12 years (2011-2022) was performed in the department of medicine at a tertiary care hospital in Pakistan. All patients admitted with the diagnosis of SJS or TEN were included from the health information management system. We included clinical and microbiological details, reviewed medical charts, and filled out a predesigned proforma.
Results: A total of 100 patients were admitted with SJS or TEN. The majority (55%) were of age greater than 40 years and had female preponderance (57%). Sixty five patients had a prior history of using a precipitating drug. BSI was seen in 19 patients; 68.4% had a mono-microbial infection, while 31.5% had a poly-microbial infection. In total, 10 organisms were identified, Staphylococcus aureus being the most common isolate followed by Enterococcus. Twelve patients required intensive care monitoring while 33 patients had hospital stays of equal or more than seven days. The overall mortality rate was 15% while it was 60% in those with BSI. SCORTEN score of ≥4 had a significant impact on mortality (60% deaths).
Conclusion: Vigilant monitoring and early detection of BSI in SJS/TEN patients, especially those presenting with high SCORTEN scores can enhance clinical outcomes.
doi: https://doi.org/10.12669/pjms.40.11.9360
How to cite this: Amber T, Tabassum S, Mahmood SBZ, Ali SA, Javed U, Mushtaq MZ. Blood stream infections in Stevens Johnson Syndrome and Toxic Epidermal Necrolysis: Risk factors and association with poor outcome. Pak J Med Sci. 2024;40(11):2495-2501.  doi: https://doi.org/10.12669/pjms.40.11.9360
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.
Retrospective analysis of hip arthroplasty in patients younger than 50 years in a single center
Authors: Naeem Ullah  , Babur Farid  , Saleem Ullah  , Bukhari Syed Imran
Published: November 2024

Objective: To report on causes and treatment options of hip arthroplasty in younger population in a single center.
Methods: Data was accessed retrospectively from hospital information system (HIS) and charts were reviewed. All patients younger than 50 years, who had hip arthroplasty for any indication during January 2020 to July 2023 time period at Lady Reading Hospital, Peshawar, were included in this study.
Results: We identified 61 patients, comprising of 33 male and 28 female patients. Mean age was 36.98±7.792 years. Non-cemented hip arthroplasty was performed in 88.5% of patients. Avascular necrosis (49.2%) was the leading indication for hip arthroplasty in younger patients, followed by neglected fracture neck of femur (24.6%), inflammatory arthritis (3.2%), and other causes (23%). Metal on highly cross-linked polyethylene was the commonest bearing surface.
Conclusion: Non-cemented hip arthroplasty was the commonest treatment method in younger population in this study.
doi: https://doi.org/10.12669/pjms.40.11.9453
How to cite this: Ullah N, Farid B, Ullah S, Bukhari SI. Retrospective analysis of hip arthroplasty in patients younger than 50 years in a single center. Pak J Med Sci. 2024;40(11):2508-2512. doi: https://doi.org/10.12669/pjms.40.11.9453
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.
Academic excellence: A comprehensive investigation of medical students′ study habits, strategies, and sources in medical colleges of Peshawar, Pakistan
Authors: Muhammad Osama  , Saeed Afaq , Muhammad Raza Ul Haq  , Mallahat Abdul Baseer
Published: November 2024

Background & objective: It’s no secret that medical students have access to a plethora of medical literature, which can make it challenging to determine the right sources and how to cover them effectively using various study habits and strategies. Our objective was to determine the association of study habits (time and location), study duration, study strategies, and study sources with academic performance.
Methods: It was a cross-sectional study conducted in six Medical Colleges in Peshawar, Pakistan between 13th April 2023 to 13th Jun 2023. Total 138 students were selected for the study. A well-structured questionnaire was used for data collection. Participants were from both genders and in both public and private sector medical colleges. First-year students and students from medical colleges outside of Peshawar were excluded from the study. SPSS (Version 20.0) was used for data analysis.
Results: The study revealed that daily study hours (during normal days), residence status, library study, morning study timings, active recall, MCQS solving, and watching online videos made a significant association with academic performance (P < 0.05). Pearson’s correlation showed a positive and statistically significant association between daily study hours (during normal days), study strategies, and academic performance (p < 0.05). The multiple regression model explained 30.5% of the variance in academic performance.
Conclusion: This study established a noteworthy link between academic performance and various factors, including daily study hours, strategies, and specific study sources. Notably, morning study sessions, active recall, MCQs-based strategies, and online video resources showed significant associations with enhanced academic performance.
doi: https://doi.org/10.12669/pjms.40.11.9502
How to cite this: Osama M, Saeed A, Raza ul Haq M, Baseer MA. Academic excellence: A comprehensive investigation of medical students′ study habits, strategies, and sources in medical colleges of Peshawar, Pakistan. Pak J Med Sci. 2024;40(11):2594-2599.  doi: https://doi.org/10.12669/pjms.40.11.9502
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.
Correlation analysis of the risk of ischemic stroke with related risk factors in a health examination population
Authors: Bai Xue , Wang Hui , Li Jiangzhe , Xu Jinjin , Cai Pan
Published: November 2024

Objective: To explore the correlation between the risk of ischemic stroke and related risk factors in a health examination population.
Methods: This was a retrospective study. A total of 300 subjects undergoing health examination in the physical examination center of Baoding NO.1 Central Hospital were selected from January 2023 to December 2023, and divided into the normal group (Group-N) and the risk group according to the criteria of cerebral hemodynamic integral value(CVHI). The risk group was further subdivided into three groups, including the high-risk group(Group-H), the medium-risk population(Group-M), and the low-risk group(Group-L), with 75 subjects in each group. The general data, including BMI, smoking, and the incidence of hypertension, diabetes, and hyperlipidemia, were analyzed and compared between the two groups.
Results: Multivariable logistic regression analysis was conducted using stroke risk factors as the dependent variables after assignment, and it was found that BMI, smoking, hypertension, diabetes, hyperlipidemia, and hyperuricemia were independent risk factors for ischemic stroke (P<0.05); the incidence of obesity and overweight, smoking, hypertension, hyperlipidemia, and hyperuricemia were significantly increased in Group-H compared with those in groups M, L, and N, with statistically significant differences(P<0.05). The chi square test showed statistically significant differences in the stroke risk factors among different age groups (P<0.05).
Conclusion: The incidence of ischemic stroke risk factors varies among different age groups in the health examination population, and is related to poor lifestyle and underlying diseases.
doi: https://doi.org/10.12669/pjms.40.11.9563
How to cite this: Bai X, Wang H, Li J, Xu J, Cai P. Correlation analysis of the risk of ischemic stroke with related risk factors in a health examination population. Pak J Med Sci. 2024;40(11):2533-2537. doi: https://doi.org/10.12669/pjms.40.11.9563
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.
Are congenital malformations associated with maternal sociodemographic and risk factors? A multicenter ultrasound-based study
Authors: Aslam Awan Jawaria , Qamar Aisha , Surti Ambreen , Anwar Eman
Published: November 2024

Objective: Congenital malformations (CM) are structural defects of the human body that arise during development. They significantly impact neonatal outcomes such as morbidity and mortality, hence identification of risk factors and their reduction is vital to improve materno-fetal outcomes. In Karachi, Pakistan, there is insufficient data on the incidence of congenital malformations. Therefore, it is necessary to initiate a prospective case control study. The desired objective was to determine the association of congenital malformations with sociodemographic and maternal risk factors in different ethnicities.
Methods: This multi-center case control study spanned over a duration of six months (December 2022 – May 2023) and included women ranging from 18–45 years using purposive sampling technique. It was conducted at Jinnah Postgraduate Medical Center and Tanveer Ultrasound Clinic. Sample of 120 participants fulfilling the inclusion criteria were included in this study after purposive sampling. Sonoscape S22 ultrasound system and Toshiba Aplio 500 ultrasound system were used to detect congenital malformations.
Results: Participants were divided into five groups based on ethnicity. Most of the congenital anomalies of the central nervous system were seen in Urdu-speaking group with a p-value = 0.016. An association between maternal age, education level, family income and medications with congenital malformations in fetuses was observed with p-values of 0.003, 0.000, 0.024 and 0.000 respectively.
Conclusion: It was evident that various maternal sociodemographic and risk factors play a significant role in the development of congenital anomalies.
doi: https://doi.org/10.12669/pjms.40.11.9792
How to cite this: Awan JA, Qamar A, Surti A, Anwar E. Are congenital malformations associated with maternal sociodemographic and risk factors? A multicenter ultrasound-based study. Pak J Med Sci. 2024;40(11):2538-2543. doi: https://doi.org/10.12669/pjms.40.11.9792
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.
Importance of scattered white spots detected in the duodenum and their relationship with zonulin
Authors: Sezer Semih , Demirci Selim
Published: November 2024

Objective: Scattered white spots (SWS) seen in the duodenum during esophagogastroduodenoscopy are rare lesions. The histopathologic examination of SWS lesions reveals normal duodenal mucosa (ND), chronic nonspecific duodenitis, and intestinal lymphangiectasia (IL). The intestinal epithelium, through its barrier function, is responsible for tightly controlling antigen traffic from the intestinal lumen to the submucosa. Zonulin plays a crucial role in intestinal barrier function. In this study, we aimed to determine whether there is a relationship between zonulin, the most important marker of leaky gut syndrome, and SWS lesions associated with lymphatic stasis and inflammation in the duodenum.
Methods: This cross-sectional study at Dr. Abdurrahman Yurtaslan Oncology Hospital in Turkey, conducted from September to December 2023, included 63 patients with SWS and 30 control patients with ND. SWS lesions were categorized into two groups, Grade-1 and Grade-2, based on the degree of density and endoscopic appearance. Biopsies were taken from the duodenum, antrum, and corpus. Blood samples were taken for serum zonulin levels.
Results: The difference between zonulin values was not significant in the control and patient groups (p>0.05). Metaplasia in the antrum was significantly higher in the SWS group than in the control group (p<0.05). There was no relationship between duodenal biopsy results and zonulin values (p>0.05).
Conclusions: Patients with identified SWS more frequently exhibit IL and gastric metaplasia. There is no relationship between SWS and serum zonulin levels.
doi: https://doi.org/10.12669/pjms.40.11.9800
How to cite this: Sezer S, Demirci S. Importance of scattered white spots detected in the duodenum and their relationship with zonulin. Pak J Med Sci. 2024;40(11):2544-2549. doi: https://doi.org/10.12669/pjms.40.11.9800
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.
¿Élites rurales tumultuosas? Economía política del paramilitarismo en las sabanas de Bolívar (1980-2006)
Authors: Aponte González Andrés Felipe
Published: November 2024

El capítulo se divide en cuatro secciones. La primera trabaja las categorías que encuadran el fenómeno en cuestión. Los conceptos clave son hacienda y paramilitarismo. La segunda, de corte histórico y sociológico, expone cómo el proceso de configuración regional estuvo íntimamente ligado a la hacienda ganadera y cómo en ella se configuró una experiencia de privatización de la seguridad y violencia. La tercera versa alrededor de las dinámicas y el desarrollo del paramilitarismo en las sabanas, abordando, primero, la experiencia de Córdoba y, luego, la de Sucre. La última reflexiona a manera de epílogo sobre algunos de los aportes y las vetas de investigación.
Entre el mundo legal e ilegal: narcotráfico, élites agrarias y violencia en el Magdalena (1972-1992)
Authors: Lévy Benjamin , Castillo Rojas Luis David
Published: November 2024

Este capítulo analiza la relación entre narcotráfico, tierra y violencia en el Magdalena. Nos enfocamos en el periodo de la bonanza marimbera, como se le conoce al auge de la producción y el tráfico de marihuana que comenzó en la década de 1970 en la región caribe, y la forma en que la participación de los sectores sociales dominantes en el narcotráfico transformó profundamente los conflictos del mundo rural e interactuó con la escalada de violencia.
Improved Guarantees for the A Priori TSP
Authors: Blauth Jannis , Neuwohner Meike , Puhlmann Luise , Vygen Jens
Published: November 2024

We revisit the a priori TSP (with independent activation) and prove stronger approximation guarantees than were previously known. In the a priori TSP, we are given a metric space (V, c) and an activation probability p(v) for each customer [Formula: see text]. We ask for a TSP tour T for V that minimizes the expected length after cutting T short by skipping the inactive customers. All known approximation algorithms select a nonempty subset S of the customers and construct a master route solution, consisting of a TSP tour for S and two edges connecting every customer [Formula: see text] to a nearest customer in S. We address the following questions. If we randomly sample the subset S, what should be the sampling probabilities? How much worse than the optimum can the best master route solution be? The answers to these questions (we provide almost matching lower and upper bounds) lead to improved approximation guarantees: less than 3.1 with randomized sampling and less than 5.9 with a deterministic polynomial-time algorithm.
Gaps in public support for young carers: policies and young people’s experiences in Austria
Authors: Pot Mirjam , Kadi Selma , Staflinger Heidemarie
Published: November 2024

Austria has been classified as ‘preliminary’ in terms of policies for young carers. Against this backdrop, we ask how young carers experience their situation, to what extent existing support measures meet their needs and what gaps remain. We demonstrate that the few measures addressing young carers specifically have mainly focused on providing information and counselling. In contrast, young carers underline the need for recognition of the diverse forms and particularities of young caring across various institutions and fields of practice and the implementation of policies that address the long-term implications and social risks associated with young caring.
Protein phosphatase 1 catalytic subunit gamma is a causative gene for meat lightness and redness
Authors: Sun Jiahong , Yang Xinting , Zhao Guiping , He Zhengxiao , Xing Wenhao , Chen Yanru , Tan Xiaodong , Wang Mengjie , Li Wei , An Bingxing , Pan Zhangyuan , Zhou Zhengkui , Wen Jie , Liu Ranran
Published: November 2024

The quality of meat is important to the consumer. Color is a primary indicator of meat quality and is characterized mainly into lightness, redness, and yellowness. Here, we used the genome-wide association study (GWAS) and gene-based association analysis with whole-genome resequencing of 230 fast-growing white-feathered chickens to map genes related to meat lightness and redness to a 6.24 kb QTL region (GGA15: 6298.34–6304.58 kb). This analysis revealed that only the protein phosphatase 1 catalytic subunit gamma (PPP1CC) was associated with meat color (P = 8.65E-08). The causal relationships between PPP1CC expression and meat lightness/redness were further validated through Mendelian randomization analyses (P < 2.9E-12). Inducible skeletal muscle-specific PPP1CC knockout (PPP1CC-SSKO) mice were generated and these mice showed increased lightness and decreased myoglobin content in the limb muscles. In addition, the predominant myofiber shifted from slow-twitch to fast-twitch myofibers. Through transcriptome and targeted metabolome evidence, we found that inhibition of PPP1CC decreased the expression of typical slow-twitch myofiber and myofiber-type specification genes and enhanced the glycolysis pathway. Functional validation through a plasmid reporter assay revealed that a SNP (rs315520807, C > T) located in the intron of PPP1CC could regulate the gene transcription activity. The differences in meat color phenotypes, myoglobin content, frequency of rs315520807 variant, expression of PPP1CC and fast-twitch fiber marker genes were detected between fast-growing white-feathered chickens and local chickens. In this study, PPP1CC was identified as the causative gene for meat color, and the novel target gene and variant that can aid in the innovation of meat improvement technology were detected.
Sex trafficking vulnerabilities in context: An analysis of 1,264 case files of adult survivors of commercial sexual exploitation
Authors: Furlong Courtney , Hinnant Ben
Published: November 2024

Purpose

Commercial sexual exploitation occurs when anything of value is given in exchange for a sex act. Sex trafficking involves the commercial sexual exploitation of individuals by means of force, fraud, or coercion. Due to the illegal nature of commercial sexual exploitation, there is a profound dearth in the literature. To develop a deeper understanding of the experiences of adult survivors of commercial sexual exploitation, investigators analyzed 1,264 unique case files collected between 2011 and 2021.

Methods

Key predictors included mental health diagnoses, childhood sexual abuse, and educational achievement, while relevant outcomes included age of entry into sexual exploitation, length of exploitation, number of arrests, cycling into and out of commercial sexual exploitation, and program placement outcomes. Regression analyses (e.g., linear, binomial, or zero-inflated Poisson) were conducted.

Results

Results suggest that educational achievement is a potential protective factor against exploitation. Higher number of arrest and higher number of children had a bidirectional relationship with longer experiences of exploitation. Further, diagnoses of bipolar disorder and neurodevelopmental disorders were related to higher rates of cycling (i.e., repeated attempts to exit exploitation), and neurodevelopmental disorders and schizophrenia spectrum disorders were related to poorer placement outcomes.

Conclusions

The findings provide a more authentic portrait of contextual influences on commercial sexual exploitation across a lifespan, informing services, interventions, and policy and supporting survivors in their promising futures.
Enhancing growth, antioxidant capacity, and immune response in tilapia (Oreochromis niloticus) through curcumin supplementation across varied stocking density paradigms
Authors: Komal Wajeeha , Fatima Shafaq , Minahal Qandeel , Liaqat Razia
Published: November 2024

The present study evaluated the effects of curcumin on growth, immune and antioxidant response in tilapia (Oreochromis niloticus). An optimum dose of curcumin was investigated by feeding four different levels of this compound in combination with three different regimes of stocking density (12 treatments). Fish were reared at three densities; low density (LD = 1.50 kg/m3), medium density (MD = 3.00 kg/m3), and high density (HD = 4.50 kg/m3). Each treatment was fed with four different levels of dietary supplementation of curcumin (C0 = 0 mg/kg, C1 = 50 mg/kg, C2 = 100 mg/kg, and C3 = 150 mg/kg) for 60 days. Each treatment has three replicates (n = 50/replicate in LD, 100/replicate in MD, 150/ replicate in HD). Although better growth was observed in MD, however treatments at all densities fed with C1 diet showed improved growth as compared to other diets. Chemical composition of fish and activity of amylase, lipase and protease in all treatments were noted to be similar. Levels of antioxidant enzymes (catalase, superoxide dismutase and glutathione peroxidase) and cortisol in MD and HD treatments were similar to those in LD treatment. However, fish fed with C1 diet in each density treatment showed the lowest values of antioxidant enzymes. Similarly, the levels of malondialdehyde were noted to be similar in MD and HD treatments as compared to that in LD. Its levels were lower in fish fed with C1 and C3 diets in all density treatments. Expression of pro-opiomelanocortin-α (POMC-α), Somatostatins-1 (SST-1) and Interleukin 1-β (IL-1β) did not increase in MD and HD treatments in response to high stocking density when compared with LD treatment. The lowest levels of these genes were noted in fish fed with C2 and C3 diets in all treatments. In conclusion, supplementation of curcumin in diet of tilapia improved growth and antioxidant response in tilapia. optimum dose of curcumin for tilapia culture is 50 mg/kg at the density of 3.00 kg/m3which might be further investigated for intensive culture.
Historical ecology reveals the “surprising” direction and extent of shifting baselines for the Florida manatee (Trichechus manatus latirostis)
Authors: Pluckhahn Thomas J. , Thulman David K.
Published: November 2024

Historical data are often overlooked in risk assessments and recovery plans for marine animals, resulting in the “shifting baselines.” Historical ecological studies demonstrate the “surprising” extent to which contemporary assumptions misrepresent premodern baselines. The Florida manatee, a subspecies of the West Indian manatee found primarily in Florida, USA, faces several existential threats, but risk assessments and recovery targets for the species are hindered by poor understanding of historical baselines. We conducted systematic and opportunistic reviews of archaeological and historical records of manatee occurrence in Florida, USA. Our data reveal that manatee populations in Florida were very small in the Precolonial and Colonial Periods, possibly representing infrequent in-migration from the Caribbean during favorable climate conditions. Manatees expanded in number and range across the Florida peninsula during the Territorial/Early Statehood and Early Modern Periods, first northward on the Atlantic Coast and later along the coast of the Gulf of Mexico. These expansions track increasing human populations, associated anthropogenic landscape alterations, and social and policy changes. Historical ecology is critical for “shaping a better Anthropocene” for humans and manatees in Florida.
Quantifying redundancies and synergies with measures of inequality
Authors: Mages Tobias , Rohner Christian
Published: November 2024

Inequality measures provide a valuable tool for the analysis, comparison, and optimization based on system models. This work studies the relation between attributes or features of an individual to understand how redundant, unique, and synergetic interactions between attributes construct inequality. For this purpose, we define a family of inequality measures (f-inequality) from f-divergences. Special cases of this family are, among others, the Pietra index and the Generalized Entropy index. We present a decomposition for any f-inequality with intuitive set-theoretic behavior that enables studying the dynamics between attributes. Moreover, we use the Atkinson index as an example to demonstrate how the decomposition can be transformed to measures beyond f-inequality. The presented decomposition provides practical insights for system analyses and complements subgroup decompositions. Additionally, the results present an interesting interpretation of Shapley values and demonstrate the close relation between decomposing measures of inequality and information.
Riesgo cardiovascular luego de una intervención de estilo de vida: estudio prospectivo
Authors: Pintos Faustino José , Illesca Paola Guadalupe , Cuneo Florencia , Eusebi Ma. Emilia , Ezcurra Tomás Andrés , Benítez Lucas Ignacio , Martinelli Marcela Inés
Published: November 2024

Las enfermedades cardiovasculares (ECV) están asociadas a numerosos factores de riesgo - hipertensión arterial (HTA), hipercolesterolemia, entre otros.  Para prevenir las ECV es importante fomentar un estilo de vida (EV) saludable. El objetivo de este trabajo fue evaluar la evolución del riesgo cardiovascular (RCV), los factores de riesgo y el EV en pacientes adultos de un sanatorio privado luego de una estrategia de promoción de EV saludable. Se realizó un estudio prospectivo. Los pacientes concurrieron espontáneamente a consulta médica y 15 meses después fueron citados a reevaluación. Durante ese período se enviaron mensajes de promoción de EV saludable. Se observó una tendencia a disminuir la proporción de pacientes con RCV alto y muy alto. No se registraron cambios en la proporción de pacientes incluidos en las categorías HTA y Presión Arterial (PA) limítrofe, sin embargo, disminuyó significativamente la PA sistólica media. El número de pacientes con glucemia en ayuno alterada permaneció constante al igual que la proporción de sujetos con hipertrigliceridemia, hipercolesterolemia, col-LDL aumentados y con bajos niveles de col-HDL. La cantidad de individuos que no alcanzaron la meta para col-noHDL disminuyó. La proporción de pacientes con exceso de peso y obesidad abdominal fue elevada y permaneció constante. No se registraron cambios en el número de nuevos fumadores. Se evidenció bajo consumo de frutas y verduras, escasa actividad física, sueño alterado y presencia de algunos factores de riesgo psicosociales. Se destaca la importancia de la promoción de hábitos de EV saludable debido a su rol protector cardiovascular y metabólico.
Informe de casos Oxiuriasis: una causa a tener en cuenta de apendicitis aguda
Authors: Ramirez Debora Mariana , Visentin Florencia , Rabellino Alejandro , Brosutti Oscar
Published: November 2024

La apendicitis aguda (ApA) es una causa frecuente de abdomen agudo (AA) en nuestro medio y una de las indicaciones más comunes de cirugía de urgencia. La presencia de oxiuros en piezas resecadas de apéndices va desde el 0,6 al 13%. Reportamos 10 casos desde diciembre de 2022 a febrero de 2024 en el Hospital J. B. Iturraspe, a los cuales se les realizó apendicectomía videolaparoscópica por cuadros compatibles con apendicitis aguda y se detectó la presencia de oxiuros durante el acto intraoperatorio y en anatomía patológica. Luego de la cirugía, se les instauró tratamiento antihelmíntico. La apendicectomía no completaría el tratamiento, sería necesario establecer un tratamiento antihelmíntico para tratar la infección parasitaria.
El fanzine: una propuesta de expresión crítica desde el arte
Authors: Acevedo Tarazona Álvaro , Correa Lugos Andrés David
Published: November 2024

El fanzine es una producción artística, independiente y transgresora que replantea desde su estética la función social y crítica del arte como medio de liberación y de expresión. Este artículo discute las implicaciones del fanzine como una estrategia divulgativa, a partir de la pregunta: ¿cual ha sido el rol del fanzine como propuesta de transformación social desde el arte? Para dar respuesta a este interrogante, se examinan fuentes documentales editadas entre los años de 1985 y 2000, las cuales abordan problemáticas como la violencia, el conflicto armado y la relación de las personas con las políticas gubernamentales en Colombia. Se concluye que el fanzine es una producción artística y cultural cuya independencia y naturaleza la convierte en una estrategia de expresión crítica y se constituye en respuesta histórica a coyunturas sociales y culturales transgresoras de la sociedad.
Los cuerpos de la danza escénica: La dualidad entre el “cuerpo-sensible” y el “cuerpo- aséptico” como herramienta de análisis
Authors: Gómez de la Hoz Iker
Published: November 2024

Términos como bailarín, performer, mover, intérprete, bailaor, butohka o danzante reflejan la diversidad de enfoques para la identificación del cuerpo en la danza escénica en la actualidad. A pesar de esta multiplicidad de perspectivas, la falta de un consenso generalizado para analizar dicha complejidad es evidente. Este artículo propone un enfoque para examinar la multiplicidad de cuerpos a través del binomio “cuerpo-sensible” y “cuerpo- aséptico”, abordando las subcategorías de “emoción”, “sentimiento”, “neutralidad” y “materia”. La propuesta de este binomio considera la distinción entre danza expresionista y expresivista, así como la confrontación de dos frases emblemáticas: “Motion, not emotion”, resumiendo los ideales de la danza posmoderna y “No me interesa cómo se mueve el ser humano, sino aquello que lo mueve”, de la coreógrafa Pina Bausch.