bluuebunny/crossref_metadata_2025 huggingface dataset:
Ovarian hyperstimulation syndrome and pregnancy luteoma mimicking malignant ascites: a rare case report
Authors: Chen Jing , Sun Qian , Zhu Tao , Li Kezhen
Published: May 2023

Background

During pregnancy, both ovarian hyperstimulation syndrome (OHSS) and pregnancy luteoma could manifest as massive ascites, enlarged ovaries, or elevated serum levels of cancer antigen 125 (CA125), and atypical cells may be found in the ascitic fluid of OHSS patients. Whether this should be treated aggressively as peritoneal carcinomatosis is controversial.

Case presentation

A 35-year-old G2P1A1 woman with secondary infertility had a successful pregnancy after one cycle of assisted reproductive technology. The patient complained of lower abdominal distension, oliguria, and poor appetite 19 days after embryo transplantation. She was diagnosed with late-onset OHSS. Although the size of the ovaries decreased bilaterally to the normal range at 12 weeks of gestation after prompt medical care, the ascites increased again after an initial decreasing trend. Elevated serum levels of CA125 (191.1 IU/mL), and suspected adenocarcinoma cells were observed in the ascitic fluid. Although further magnetic resonance imaging examination or diagnostic laparoscopy was recommended, the patient was provided with supportive treatment and closely monitored upon her request. Surprisingly, her ascites diminished, and serum level of CA125 started to decline at 19 weeks of gestation. During cesarean section, pathological examination of the solid mass in the right ovary revealed pregnancy luteoma, which was presumably the other cause of the intractable ascites.

Conclusions

Caution should be exercised in cases of suspicious malignant ascites during pregnancy. This may due to OHSS or pregnancy luteoma, in which abnormalities usually regress spontaneously.
Percutaneous pedicle screw fixation was effective for bone regeneration after a huge vertebral defect due to intractable pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus: a case report
Authors: Tatsumura Masaki , Eto Fumihiko , Kato Mikiro , Nagashima Katsuya , Takeuchi Yosuke , Funayama Toru , Yamazaki Masashi
Published: May 2023

Background

Pyogenic spondylitis by methicillin-resistant Staphylococcus aureus (MRSA) is known to be intractable. In the past, the insertion of an implant into infected vertebra was considered contraindicated in affected patients because it may exacerbate the infection, but there are increasing numbers of reports indicating the usefulness of posterior fixation to correct instability and alleviate infection. Bone grafting is often required to repair large bone defect due to infection, but free grafts can exacerbate infection and are controversial.

Case presentation

We present the case of a 58-year-old Asian man with intractable pyogenic spondylitis who had repeated septic shocks due to MRSA. Back pain from repeated pyogenic spondylitis caused by a huge bone defect in L1–2 rendered him unable to sit. Posterior fixation by percutaneous pedicle screws (PPSs) without bone transplantation improved spinal stability and regenerated bone in the huge vertebral defect. He regained his activities of daily living, had no reoccurrence of pyogenic spondylitis nor bacteremia, and was completely cured of the infection without antibiotics after removal of all screws.

Conclusions

For intractable MRSA pyogenic spondylitis with instability accompanied by a huge bone defect, posterior fixation using PPSs and administration of antibacterial agents stopped the infection, allowed the bone to regenerate, and recovered the patient’s activities of daily living.
Modulating AHR function offers exciting therapeutic potential in gut immunity and inflammation
Authors: Chen Yue , Wang Yadong , Fu Yawei , Yin Yulong , Xu Kang
Published: May 2023

Aryl hydrocarbon receptor (AHR) is a ligand-dependent transcription factor. 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is a classical exogenous synthetic ligand of AHR that has significant immunotoxic effects. Activation of AHR has beneficial effects on intestinal immune responses, but inactivation or overactivation of AHR can lead to intestinal immune dysregulation and even intestinal diseases. Sustained potent activation of AHR by TCDD results in impairment of the intestinal epithelial barrier. However, currently, AHR research has been more focused on elucidating physiologic AHR function than on dioxin toxicity. The appropriate level of AHR activation plays a role in maintaining gut health and protecting against intestinal inflammation. Therefore, AHR offers a crucial target to modulate intestinal immunity and inflammation. Herein, we summarize our current understanding of the relationship between AHR and intestinal immunity, the ways in which AHR affects intestinal immunity and inflammation, the effects of AHR activity on intestinal immunity and inflammation, and the effect of dietary habits on intestinal health through AHR. Finally, we discuss the therapeutic role of AHR in maintaining gut homeostasis and relieving inflammation.

Graphical Abstract
Sharp bounds on moments of random variables
Authors: Caraballo David
Published: May 2023

We give new inequalities involving the expectation and variance of a random variable defined on a finite interval and having an essentially bounded probability density function. Our inequalities sharpen previous inequalities by N.S. Barnett and S.S. Dragomir. We prove our bounds are optimal, and we explicitly give the cases in which equality occurs.
Association of intraoperative hypotension and postoperative acute kidney injury after adrenalectomy for pheochromocytoma: a retrospective cohort analysis
Authors: Ruan Xia , Li Mohan , Pei Lijian , Lan Ling , Chen Weiyun , Zhang Yuelun , Yu Xuerong , Yu Chunhua , Yi Jie , Zhang Xiuhua , Huang Yuguang
Published: May 2023

Background

Perioperative acute kidney injury (AKI) has been one of the leading causes of morbidity and mortality for surgical patients. Pheochromocytoma is a rare, catecholamine-secreting neuroendocrine neoplasm characterized by typical long-term hypertension that needs surgical resection. Our objective was to determine whether intraoperative mean arterial pressures (MAPs) less than 65 mmHg are associated with postoperative AKI after elective adrenalectomy in patients with pheochromocytoma.

Methods

We performed a retrospective review of patients undergoing adrenalectomy for pheochromocytoma between 1991 and 2019 at Peking Union Medical College Hospital, Beijing, China. Two intraoperative phases, before and after tumor resection, were recognized based on distinctly different hemodynamic characteristics. The authors evaluated the association between AKI and each blood pressure exposure in these two phases. The association between the time spent under different absolute and relative MAP thresholds and AKI was then evaluated adjusting for potential confounding variables.

Results

We enrolled 560 cases with 48 patients who developed AKI postoperatively. The baseline and intraoperative characteristics were similar in both groups. Though time-weighted average MAP was not associated with postoperative AKI during the whole operation (OR 1.38; 95% CI, 0.95–2.00; P = 0.087) and before tumor resection phase (OR 0.83; 95% CI, 0.65–1.05; P = 0.12), both time-weighted MAP and time-weighted percentage changes from baseline were strongly associated with postoperative AKI after tumor resection, with OR 3.50, 95% CI (2.25, 5.46) and 2.03, 95% CI (1.56, 2.66) in the univariable logistic analysis respectively, and with OR 2.36, 95% CI (1.46, 3.80) and 1.63, 95% CI (1.23, 2.17) after adjusting sex, surgical type (open vs. laparoscopic) and estimated blood loss in the multiple logistic analysis. At any thresholds of MAP less than 85, 80, 75, 70, and 65 mmHg, prolonged exposure was associated with increased odds of AKI.

Conclusions

We found a significant association between hypotension and postoperative AKI in patients with pheochromocytoma undergoing adrenalectomy in the period after tumor resection. Optimizing hemodynamics, especially blood pressure after the adrenal vessel ligation and tumor is resected, is crucial for the prevention of postoperative AKI in patient with pheochromocytoma, which could be different from general populations.
Tumor immune microenvironment (TIME) to enhance antitumor immunity
Authors: Rajbhandary Sajin , Dhakal Hari , Shrestha Sudip
Published: May 2023

The tumor microenvironment is a result of dynamic interaction between different cellular and non-cellular components. In its essence it is not a solo performer, but an ensemble of performers that includes cancer cells, fibroblasts, myo-fibroblasts, endothelial cells and immune cells. The short review highlights important immune infiltrates within the tumor microenvironment that shape cytotoxic t lymphocyte (CTL)-rich immune hot and CTL-deficient immune cold tumors and novel strategies that have potential role in enhancing our immune responses in both immune hot and immune cold tumors.
Suicidal ideation of people living with HIV and its relations to depression, anxiety and social support
Authors: Yu Yong , Luo Bangan , Qin Lulu , Gong Hongjie , Chen Yijia
Published: May 2023

Background

The HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome) remains a global threat to health. Suicidal ideation has been a serious public health problem among people living with HIV (PLWH). However, the suicide prevention mechanism among PLWH still unclear. This study aims to analyze the suicidal ideation and its related factors in PLWH, and further explore the relationships between suicidal ideation and depression, anxiety and perceived social support.

Methods

This is a cross-sectional study. A total of 1146 PLWH were investigated by the general information questionnaire, the perceived social support scale (PSSS), the Beck scale for suicide ideation of Chinese version (BSI-CV), the generalized anxiety disorder scale-2 (GAD-2) and the patient health questionnaire-2 (PHQ-2) though the WeChat in China in 2018. By using statistical description and the binary unconditional logistic regression, we assessed the incidence of suicidal ideation and its related factors in PLWH. Besides, the intermediary effect of social support between anxiety, depression and suicidal ideation were explored by the stepwise test and Bootstrap method.

Results

The incidence of suicide ideation was 54.0% (619/1146) among the PLWH in the last week or during the most serious depression. Binary logistic regression analysis results showed that the PLWH who with short time for HIV positive diagnosis (aOR (adjusted odd ratio) = 1.754, 95% CI (confidence interval):1.338–2.299), low monthly income (aOR = 1.515, 95%CI:1.098–2.092), other chronic diseases except HIV (aOR = 1.555, 95%CI:1.134–2.132), irregular lovers (aOR = 1.369, 95%CI:1.021–1.837), anxiety (aOR = 2.711, 95%CI:1.767–4.161), depression (aOR = 1.614, 95%CI:1.078–2.417), low PSSS (aOR = 2.139, 95%CI:1.345–3.399) had high risk of suicide ideation.The social support played a mediating role between the anxiety (the mediating effect accounted for 30.43% of the total effect), depression (the mediating effect accounted for 23.76% of the total effect) and the suicide ideation among PLWH.

Conclusion

The incidence of suicide ideation of PLWH was high. Anxiety, depression, and social support are the key factors of suicide ideation of PLWH. Social support plays a partial mediating role between anxiety, depression and suicidal ideation, which provides a new approach for prevention of suicidal ideation in PLWH and should be known widely for people to prevent suicide.
A blood-based composite panel that screens Alzheimer’s disease
Authors: Wang Yan , Li Ying , Li Yan , Li Tingting , Wang Qi , Wang Qigeng , Cao Shuman , Li Fangyu , Jia Jianping
Published: May 2023

Background

Blood tests would be much easier to implement in the clinical diagnosis of Alzheimer’s disease (AD) as minimally invasive measurements. Multiple inspection technologies promoted AD-associated blood biomarkers’ exploration. However, there was a lack of further screening and validation for these explored blood-based biomarkers. We selected four potential biomarkers to explore their plasma levels in AD and amnestic mild cognitive impairment (aMCI) and developed a composite panel for AD and aMCI screening.

Method

The plasma concentrations of soluble low-density lipoprotein receptor-associated protein 1 (sLRP1), Gelsolin (GSN), Kallikrein 4 (KLK4) and Caspase 3 were measured in the discovery and validation cohort. The receiver operating characteristic (ROC) curve was generated to assess the classification panel with the area under the curve (AUC).

Results

A total of 233 participants (26 CN, 27 aMCI, and 26 AD in the discovery cohort, and 51 CN, 50 aMCI, and 53 AD in the validation cohort) with complete data were included in the study. The plasma concentrations of sLRP1 and Caspase 3 were significantly decreased in AD and aMCI when compared with those in the CN group. Compared with the CN group, the concentrations of KLK4 and GSN were increased in AD, but not in MCI. Interestingly, one of four proteins, sLRP1 in plasma level was higher in Apolipoprotein E (APOE) ε4 non-carriers than that in APOE ε4 carriers, especially among CN and MCI. No significant difference was found between females and males in the plasma levels of four proteins. The composite panel is based on four blood biomarkers accurately classifying AD from CN (AUC = 0.903–0.928), and MCI from CN (AUC = 0.846–0.865). Moreover, dynamic changes in the plasma levels of four proteins exhibited a significant correlation with cognitive assessment.

Conclusions

Altogether, these findings indicate that the plasma levels of sLRP1, KLK4, GSN and Caspase 3 changed with the progression of AD. And their combination could be used to develop a panel for classifying AD and aMCI with high accuracy, which would provide an alternative approach for developing a blood-based test for AD and aMCI screening.
Mapping of stones and their deterioration forms: the Clock Tower, Venice (Italy)
Authors: Piovesan Rebecca , Tesser Elena , Maritan Lara , Zaccariello Gloria , Mazzoli Claudio , Antonelli Fabrizio
Published: May 2023

The HYPERION EU project aims to develop a Decision Support System to improve resilience and sustainable reconstruction of historic areas faced with climate change and extreme events. In this context, Venice presents an outstanding example of urban and architectural complexity and richness. The mapping of the ornamental stones of the façade of the Venice Clock Tower (Torre dell’Orologio) and their deterioration patterns acts as a milestone on which to build the knowledge-acquisition process of the system as regards stone artefacts and their decay products. The Clock Tower is an early Renaissance building (1499) in Lombardesque style and stands over the entrance to the Mercerie on the northern side of St. Mark’s Square. Detailed surveys and mapping of both building materials (mainly stones) and deterioration patterns were carried out, the latter following the glossary of weathering forms, coupled with an easy-to-use scale of evaluation of their intensity. The data output consists of several monothematic maps which can be handled separately, each one focusing on precise lithological or specific deterioration aspects. This study also proposes a simple approach to summarizing the total state of deterioration of the building in the form of a Total Deterioration Rank (TDR) and its representation. The stones used in the façade are regional (Ammonitico Rosso and Scaglia Rossa) and extra-regional limestones (Istrian Stone), as well as Mediterranean white and coloured marbles and stones already used in antiquity (i.e., Fior di Pesco or marmor chalcidicum, lapis porphyrites, a volcanic rock from the Egyptian Eastern Desert, Proconnesian marble from the Island of Marmara, Pavonazzetto toscano and white Carrara marble from the Italian Apuan Alps). The most frequent forms of deterioration detected are black crusts, patinas, discoloration and patterns linked to erosion processes. The interrelation of different mappings led to a number of useful considerations concerning differences in the effectiveness of maintenance procedures between public and private management of the monument.
Evaluation of quality of life after septorhinoplasty using Rhinoplasty Outcome Evaluation questionnaire
Authors: Saraf Aditiya , Gupta Nitika , Manhas Monica , Kalsotra Parmod
Published: May 2023

Background

To assess satisfaction level of patients undergoing septorhinoplasty pre- and post-operatively using Rhinoplasty Outcome Evaluation (ROE) questionnaire.

Methods

The present prospective study, after approval by Institutional Ethics Committee, was conducted in the Department of ENT, SMGS Hospital, from March 2021 to November 2022 on 83 patients who underwent septorhinoplasty. Demographic and clinical characteristics (age, gender, education, technique of surgery) of all participants were recorded. All patients were asked to answer the Rhinoplasty Outcome Evaluation (ROE) questionnaire 1 day prior to surgery. Postoperative ROE questionnaire was asked at the 6th month in ENT OPD by the same researcher.

Results

In our study, the mean preoperative total ROE score was 32.17 ± 5.38, and the mean postoperative total ROE score was 87.11 ± 5.39, the difference being statistically significant (p = 0.0039). Higher post-operative satisfaction score (89.7 ± 5.64) was seen in patients aged more than 35 years, as compared to younger patients (78.4 ± 5.8). In our study, upon gender-wise comparison, there was more statistically significant satisfaction in male patients than female patients postoperatively (p = 0.0022). Better postoperative ROE score was seen in lower literacy group (88.9 ± 6.73) than higher literacy group (83.3 ± 5.63). However, both open and closed techniques showed statistically insignificant difference in postoperative ROE score (p = 0.388).

Conclusion

Based on the Rhinoplasty Outcome Evaluation (ROE) questionnaire, our study showed that septorhinoplasty significantly improved quality of life in majority of our study subjects in terms of both aesthetic as well as functional parameters.
Development of safety method for a 3-DOF industrial robot based on recurrent neural network
Authors: Mahmoud Khaled H. , Sharkawy Abdel-Nasser , Abdel-Jaber G. T.
Published: May 2023

In this paper, a safety method for a 3-DOF industrial robot is developed based on recurrent neural network (RNN). Safety standards for human robot interaction (HRI) are taken into accounts. The main objective is to detect the undesired collisions on any of robot links. Since most of industrial robots are not collaborative, the dependence of the method on torque sensors to detect collisions makes its ability to use very restricted. Therefore, only the position data of joints are collected to be the data inputs of the proposed method in order to detect the undesired collisions. These data are aggregated from KUKA LWR IV robot while no collisions and in another time when applying collisions. These data are used to train the proposed RNN using Levenberg-Marquardt LM algorithm. KUKA robot is configured to act as a 3-DOF manipulator that moves in space and under the effect of gravity.

The results show that the modelled and trained RNN is sensitive and efficient in detecting collisions on each link of robot separately. Studying the resulted error from the developed model reveals clearly that the method is reliable.
Profile of the Postoperative Care Provided for Patients With Pancreatic and Periampullary Cancers by Family and Unpaid Caregivers
Authors: Fong Zhi Ven , Teinor Jonathan , Yeo Theresa P. , Rinaldi Dee , Greer Jonathan B. , Lavu Harish , Qadan Motaz , Johnston Fabian M. , Ferrone Cristina R. , Chang David C. , Yeo Charles J. , Wolfgang Christopher L. , Warshaw Andrew L. , Lillemoe Keith D. , Fernandez-del Castillo Carlos , Wolff Jennifer L. , Wu Albert W. , Weiss Matthew J.
Published: May 2023

PURPOSE

Patients with pancreatic and periampullary cancers may experience significant reduction in their quality of life and often rely on family and unpaid caregivers for assistance after surgery. However, as caregivers are not systematically identified, little is known about the nature, difficulty, and personal demands of assistance they provide. We aim to assess the frequency and difficulty of specific assistance caregivers provide and identify potential interventions that could alleviate the caregiving demands.

METHODS

This was a prospective, multi-institutional study of caregivers accompanying patients with periampullary and pancreatic cancer at their 1-month postpancreatectomy office visit. An instrument that drew heavily on the National Study of Caregiving was administered to caregivers.

RESULTS

Of 240 caregivers, more than half (58.3%) of caregivers were the patients' spouse, a quarter (25.8%) were daughters or sons, 12.9% other relatives, and 2.9% nonrelatives. Caregivers least frequently provided assistance with transportation (14.6% every day) and most frequently provided assistance with housework (65.0% every day, P = .003) and diet (56.5% every day, P = .004). Caregivers reported the least difficulty helping patients with exercise (1.5% somewhat difficult). Caregivers reported significantly more difficulty with assisting with housework (14.5% somewhat difficult, P < .001) and diet (14.9% somewhat difficult, P < .001). Caregivers identified the immediate postpancreatectomy and early discharge periods as the most stressful phases. They also reported having received very little information about available services that could have supported their efforts.

CONCLUSION

Caregivers of patients with periampullary or pancreatic cancer provide considerable assistance in the postoperative period and many reported difficulty in assisting with housework and diet. Work is needed to better prepare and support caregivers to better enable them to adequately care for patients with pancreas and periampullary cancer.
The role of CT in arrhythmia management—treatment planning and post-procedural imaging surveillance
Authors: Cundari Giulia , Alkadhi Hatem , Eberhard Matthias
Published: May 2023

Several interventional treatment options exist in patients with atrial and ventricular arrhythmia. Cardiac CT is routinely performed prior to occlusion of the left atrial appendage, pulmonary vein isolation, and cardiac device implantation. Besides the evaluation of coronary artery disease, cardiac CT provides isotropic, high-resolution CT images of the cardiac anatomy with the possibility of multiplanar reformations and three-dimensional reconstructions which are helpful to guide interventional treatment. In addition, cardiac CT is increasingly used to rapidly evaluate periprocedural complications and for the routine post-procedural imaging surveillance in patients after interventions. This review article will discuss current applications of pre- and post-interventional CT imaging in patients with arrhythmia.
Two-year follow-up of participants in the BreastScreen Victoria pilot trial of tomosynthesis versus mammography: breast density-stratified screening outcomes
Authors: Houssami Nehmat , Lockie Darren , Giles Michelle , Noguchi Naomi , Marr Georgina , Marinovich M Luke
Published: May 2023

Objective:

This follow-up study of BreastScreen Victoria’s pilot trial of digital breast tomosynthesis aimed to report interval cancer rates, screening sensitivity, and density-stratified outcomes for tomosynthesis vs mammography screening.

Methods:

Prospective pilot trial [ACTRN-12617000947303] in Maroondah BreastScreen recruited females ≥ 40 years presenting for screening (August 2017–November 2018) to DBT; concurrent screening participants who received mammography formed a comparison group. Follow-up of 24 months from screen date was used to ascertain interval cancers; automated breast density was measured.

Results:

There were 48 screen-detected and 9 interval cancers amongst 4908 tomosynthesis screens, and 34 screen-detected and 16 interval cancers amongst 5153 mammography screens. Interval cancer rate was 1.8/1000 (95%CI 0.8–3.5) for tomosynthesis vs 3.1/1000 (95%CI 1.8–5.0) for mammography (p = 0.20). Sensitivity of tomosynthesis (86.0%; 95% CI 74.2–93.7) was significantly higher than mammography (68.0%; 95% CI 53.3–80.5), p = 0.03. Cancer detection rate (CDR) of 9.8/1000 (95%CI 7.2–12.9) for tomosynthesis was higher than that of 6.6/1000 (95%CI 4.6–9.2) for mammography (p = 0.08); density-stratified analyses showed CDR was significantly higher for tomosynthesis than mammography (10.6/1000 vs 3.5/1000, p = 0.03) in high-density screens. Recall rate for tomosynthesis was significantly higher than for mammography (4.2% vs  3.0%, p < 0.001), and this increase in recall for tomosynthesis was evident only in high-density screens (5.6% vs  2.9%, p < 0.001).

Conclusion:

Although interval cancer rates did not significantly differ between screened groups, sensitivity was significantly higher for tomosynthesis than mammography screening.

Advances in knowledge:

In a program-embedded pilot trial, both increased cancer detection and recall rates from tomosynthesis were predominantly observed in high-density screens.
Development of deep learning model and evaluation in real clinical practice of lingual mandibular bone depression (Stafne cyst) on panoramic radiographs
Authors: Ha Eun-Gyu , Jeon Kug Jin , Lee Chena , Kim Hak-Sun , Han Sang-Sun
Published: May 2023

Objectives:

Lingual mandibular bone depression (LMBD) is a developmental bony defect in the lingual aspect of the mandible that does not require any surgical treatment. It is sometimes confused with a cyst or another radiolucent pathologic lesion on panoramic radiography. Thus, it is important to differentiate LMBD from true pathological radiolucent lesions requiring treatment. This study aimed to develop a deep learning model for the fully automatic differential diagnosis of LMBD from true pathological radiolucent cysts or tumors on panoramic radiographs without a manual process and evaluate the model’s performance using a test dataset that reflected real clinical practice.

Methods:

A deep learning model using the EfficientDet algorithm was developed with training and validation data sets (443 images) consisting of 83 LMBD patients and 360 patients with true pathological radiolucent lesions. The test data set (1500 images) consisted of 8 LMBD patients, 53 patients with pathological radiolucent lesions, and 1439 healthy patients based on the clinical prevalence of these conditions in order to simulate real-world conditions, and the model was evaluated in terms of accuracy, sensitivity, and specificity using this test data set.

Results:

The model’s accuracy, sensitivity, and specificity were more than 99.8%, and only 10 out of 1500 test images were erroneously predicted.

Conclusion:

Excellent performance was found for the proposed model, in which the number of patients in each group was composed to reflect the prevalence in real-world clinical practice. The model can help dental clinicians make accurate diagnoses and avoid unnecessary examinations in real clinical settings.
Comparison of Uterine manipulators types in total Laparoscopic Hysterectomy: A retrospective study
Authors: Sengul Mustafa , Selim Halime Sen
Published: May 2023

Objective: To compare the results of operations of commercial uterine manipulators. Considering that the optimal uterine manipulator is still not found, our goal was to give an idea for gynecologists to choose the most suitable uterine manipulator for their purposes and expectations.

Methods: Between January 2016 and September 2021, 294 laparoscopic hysterectomy cases met the inclusion criteria and were operated in İzmir Katip Çelebi University Atatürk Training and Research Hospital Gynecology and Obstetrics Clinic. They were divided into four groups according to the type of manipulator used. Group-1 (RUMI-I), Group-2 (Clermont-Ferrand), Group-3 (sharp intrauterine curette-tenaculum), and Group-4 (without uterine manipulator). All four groups were compared with operation time, hospital stay, absolute change in hemoglobin (g/dl), and per-op complications.

Results: Considering the operation times in all groups, the mean operation time in the first Group-was 180 minutes (98-349); in Group-2 was 159 minutes (96-564); in the 3rd Group was 178 minutes (141-540); in the 4th Group was 189 minutes (115-453). The group with the shortest operation time was Group-2; the difference was statistically significant (p=0.015). In general terms, the effect of all manipulators on patient parameters wasn’t very different. Clermont-Ferrand seems more advantageous than others in making the surgeon’s work more straightforward regarding operation time only.

Conclusions: In our study, the choice of uterine manipulator did not affect the surgical results except for the duration of the operation. The personalization of uterine manipulators according to the needs of the surgery and the easiness of use of the surgeon should be at the forefront.

doi: https://doi.org/10.12669/pjms.39.4.6728

How to cite this: Sengul M, Selim HS. Comparison of Uterine manipulators types in total Laparoscopic Hysterectomy: A retrospective study. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.6728

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 of HbA1c with Serum Iron & Transferrin Saturation in Non-Diabetic Patients with Iron Deficiency
Authors: Darshan Kumar  , Rasheed Tazeen , Bader Faiyaz Zuberi  , Rabiah Sadaf  , Faiza Sadaqat Ali
Published: May 2023

Objective: To determine correlation of HbA1c with serum iron and transferrin saturation in non-diabetic patients with iron deficiency.

Methods: This cross-sectional comparative study was conducted at Dr Ruth KM Pfau Civil Hospital Karachi from 15th September 2021 to 14th March 2022, on non-diabetic patients based on fasting blood sugar (FBS) of <100 mg/dl. Patients were divided into two groups. Group one included patients having iron deficiency anemia (ID), whereas group two included same number of age and sex matched healthy subjects taken as controls, without ID. Blood sample was taken for HbA1c, CBC, serum iron and total iron binding capacity. Transferrin saturation (TSAT) was calculated. Comparison of quantitative variables with ID and non-ID group was done by Student’s t-test. Correlation of HbA1c with iron &TSAT was done in both groups using Kendal tau-b test, as data was not normally distributed.

Results: Out of 230 patients, 83 (36.1%) were males while 147(63.9%) were females. Mean age of patients was 43.7±13.28 years. Mean HbA1c level was significantly high in ID group (5.89±0.43) as compared to non-ID group (5.52±0.50) with a p-value <.001. The HbA1c levels correlated negatively with hemoglobin, serum iron levels and transferrin saturation with a p-value <.001.

Conclusion: Low serum Iron and TSAT was related to elevation in HbA1c value. Iron deficiency needs to be corrected before HbA1c interpretation.

doi: https://doi.org/10.12669/pjms.39.4.6964

How to cite this: Kumar D, Rasheed T, Zuberi BF, Sadaf R, Ali FS. Correlation of HbA1c with Serum Iron & Transferrin Saturation in Non-Diabetic Patients with Iron Deficiency. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.6964

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinical effect and safety of targeted therapy combined with chemotherapy in the treatment of patients with advanced colon cancer
Authors: Zhang Tao , Liu Zhi , Lin Qian
Published: May 2023

Objective: To evaluate the clinical effect and safety of immunotherapy combined with chemotherapy in patients with advanced colon cancer.

Methods: This is a retrospective study. The subjects of this study were 120 patients with advanced colon cancer who were admitted to The No.2 Hospital of Baoding from November 30, 2019 to November 30, 2021. The enrolled patients were randomly divided into two groups, with 60 cases in each group. Patients in the control group were given F0LF0X4 regimen, while those in the study group were provided with Bevacizumab therapy on the basis of the method in the control group. All patients were evaluated after two cycles of treatment. The comparison of outcome measures included the curative effects, adverse drug reactions, improvement of quality-of-life scores and changes in tumor markers between the two groups.

Results: The total effective rate of the study group was significantly better than that of the control group. There was no significant difference in the incidence of adverse drug reactions between the two groups. After treatment, the study group had a significantly higher rate of improved quality of life score, while the obviously lower rate of the aggravated score than those in the control group. The levels of CEA, CA19-9 and CA125 in the study group were significantly lower than those in the control group after treatment.

Conclusion: Targeted therapy combined with chemotherapy is a safe and effective therapeutic option that has a definite curative effect in the treatment of patients with advanced colon cancer.

doi: https://doi.org/10.12669/pjms.39.4.7105

How to cite this: Zhang T, Liu Z, Lin Q. Clinical effect and safety of targeted therapy combined with chemotherapy in the treatment of patients with advanced colon cancer. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.7105

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.
Assessing trait emotional intelligence and its relationship with stress and health behaviour in the education sector: An empirical study from Uttarakhand, India
Authors: Pandey Mamta , Sharma Deepti , Kamboj NK
Published: May 2023

Background: Emotional intelligence of teachers can affect their mental and physical health as well their performance in school. Both emotional intelligence and health behavior can have an impact on stress. The majority of Indian studies have examined only one type of teacher, have used indigenous scales which are not internationally valid, and have not studied health behaviour. The role of age and gender on emotional intelligence is also a debatable subject which requires larger studies 

The present study was undertaken to evaluate the trait emotional intelligence, stress and health behaviour of teachers and to determine their inter-relationship and to assess the role of demographic and professional attributes on emotional intelligence. 

Methods: Teachers from different schools, colleges and professional institutes situated in Dehradun and nearby towns in the state of Uttarakhand, India were evaluated by internationally valid tools for the three parameters.  

Results:  Emotional Intelligence of teachers has no relation with age, gender, educational qualification, level of teaching or type of institute. It has a negative correlation with stress and a positive correlation with health behaviour. Further, health behaviour is inversely related to stress. 

Conclusions: Assessment of emotional intelligence and health behaviour of teachers should be a part of their routine evaluation and training so that specific interventions to reduce stress and to improve their overall health and performance can be appropriately planned.
Mental health issues during pregnancy - overview of the current knowledge
Authors: Majcher Monika , Majcher Magdalena , Świercz Kamila , Górska Dominika , Karwańska Aleksandra , Kulbat Mateusz , Brzychczy Piotr , Sierpień Małgorzata , Pikulicka Agata , Kulbat Aleksandra
Published: May 2023

Depressive disorders of antenatal and postnatal period are diagnostic challenge, as well as increasingly frequent social problem. Incidence of antenatal depression varies from 10% to 16%. Around one third of all postpartum depression cases has its beginning during the antenatal period. From the beginning of 2019, Ministry of Health’s regulations specified for the first time the recommendation to perform screening of depressive symptoms - twice during the pregnancy and once during the perinatal period, defined as the first six weeks after the delivery. Therefore the review of current studies in the subject of mental health issues during pregnancy was conducted in order to establish possible risk factors.
Knowledge and eating habits of CrossFit trainees
Authors: Oleksiuk Klaudia , Grot Martina , Greń Maria , Grajek Mateusz , Krupa-Kotara Karolina
Published: May 2023

Introduction. Achieving high performance in sports is the result of many factors, both exo and endogenous. Proper nutrition is the basis of the so-called healthy lifestyle, health care and prevention of diet-related diseases. Physical activity is an extremely important component and carries a number of benefits that affect mental, physical and social well-being. Failure to provide sufficient energy, can lead to decreased performance, delayed recovery processes or loss of muscle mass. The purpose of the study was to assess the knowledge and nutritional habits of CrossFit trainees.

Material and methods. 131 people were surveyed; the questionnaire was posted on the CrossFit Poland forum. The survey was voluntary and anonymous. The results were collected in a database in Microsoft Excel 2010 MS Office Package and statistically analyzed using Statistica 12. In the statistical evaluation of the relationship between characteristics, a significance level of p ≤ 0.05 was adopted. Results. In a survey of the knowledge and eating habits of CrossFit trainees, about 50% of respondents declare that they eat regularly. In addition, 50.5% state a moderate level of knowledge about healthy eating, while 33% state a high level. There is a high incidence of dietary supplement intake, accounting for 78.5%. As the frequency of training increases, the amount of supplements consumed increases. Conclusions. A significant part of the study group declares a very good or moderate level of knowledge of rational nutrition, which influences the choice of and regularity of the meals consumed in this group of Crossfit trainers.
Evaluation of physical activity of women in the second and third trimester of pregnancy using the standardized PPAQ questionnaire-a pilot study
Authors: Plachetka Aleksandra , Głowacka Magdalena , Grajek Mateusz , Krupa-Kotara Karolina
Published: May 2023

Pregnancy is a unique period in a woman's life, so every pregnant woman should be aware of the importance of physical exercise during pregnancy. The purpose of this study was to compare the physical activity of women in the second and third trimesters of pregnancy. The standardized Physical Activity Questionnaire for Pregnant Women (PPAQ-PL) was used to achieve the purpose of the study. Thirty women in the age range of 18-35 years (28 years±3.54) participated in the study. Analysis of the results showed that higher values of total weekly energy expenditure were obtained by the group of women in the third trimester of pregnancy (206.37 MET/h/week) compared to pregnant women in the second trimester (140.42MET/h/week). The women differed in terms of energy expenditure in activities such as housework (in women in the second trimester 49.1% of total activity, in the third trimester 56.7%), passive rest (24.1% and 14.5%), professional work (12.9% and 7.7%), sports and exercise (2.8% and 6.6%), and moving around (10.6% and 14.5%). In both women in the second and third trimesters of pregnancy, a low level of activity intensity prevailed (58.08% and 55.64%). Energy expenditure on sports and exercise consistent with the recommended for the second trimester (≥28 MET/h/week) was declared by only 6% of the women surveyed, while in the third trimester the recommended energy expenditure on physical activity (≥16 MET/h/week) was fulfilled by 29% of pregnant women. There is an ongoing need to educate women about the benefits of systematic prenatal activity.
Primary Membranous Nephropathy - what do we know today?
Authors: Wais Marcin , Warchoł Konrad , Jasiura Adam , Wójcik Aleksandra , Giżewska Kamila
Published: May 2023

Introduction: Primary membranous nephropathy (PMN) is a common cause of nephrotic syndrome in adults, characterized by the deposition of immune complexes in the glomerular basement membrane.

Aim of this study: evaluate the features of PMN such as incidence, pathology, clinical features and assess the effectiveness of immunosuppressive therapy.

Materials and Methods: The review was based on articles found in PubMed database, using keyword „primary membranous nephropathy” with appropriate sufixes.

Results: PMN is a challenging disease that requires a multidisciplinary approach to diagnosis and management. Laboratory tests, including assessment of autoantibodies and complement levels, are essential for the diagnosis of PMN. Immunosuppressive therapy can be effective in inducing remission in a significant proportion of patients.

Conclusions: Further research is needed to optimize the duration and intensity of immunosuppressive therapy, and to evaluate the role of newer therapies such as rituximab and belimumab.
Libertarianism and Original Appropriation Homesteading: Response to Dominiak
Authors: Block Walter E.
Published: May 2023

What is the ultimate justification for private property rights? How do they first legitimately come into being? Both Dominiak and I reject the usual explanation: they come into existence based upon a grant of executive privilege, based upon the will of the king or the democratic legislature. For this leaves open the issue of why either of them have the right to grant private property rights in the first place. Dominiak claims this is based upon first or prior possession. In the present paper I will criticize that alternative, and defend the John Lockean notion of “mixing labor” with land and natural resources as a means of coming to own them via homesteading.
Umieranie i śmierć w polskojęzycznych drukach prawosławnych z kręgu Akademii Mohylańskiej
Authors: Klimek-Grądzka Jolanta
Published: May 2023

DYING AND DEATH IN POLISH LANGUAGE ORTHODOX PRINTED TEXTS AUTHORED BY THE MEMBERS OF KIYV-MOHYLA ACADEMY
This article deals with the Polish lexis in the semantic field of DEATH and conceptualizations of death as represented in Orthodox hagiographies and miracula collections. The analysis includes the following three text collections: H. Denisowicz’s Parergon cudów świętych [Parergon of the Miracles of the Saints] (1638), A. Kalnofojski’s Teratourgēma lubo cuda... [Teratourgēma, that is Miracles...] (1638) and S. Kossow’s Paterikon abo zywoty… [Patericon, that is the lives...] (1635). The lexical field under analysis was further divided in to subcategories addressing e.g. the cause of death (zabić [kill], zamordować [murder], obwiesić się [hang oneself]), the killer (bratomorderca [fratricide]), or the relationship between the killer and the victim (oycozaboystwo [patricide]). The article concentrates predominantly on conceptualizations of death, such as death as a road, farewell, crossing the borderline, salvation / condemnation, a dream. These are presented against the background of the Old Polish literary tradition.
Słownictwo religijne a reformacja. Głos w dyskusji nad konfesyjnym zróżnicowaniem polskiej leksyki w XVI w.
Authors: Gozdek Magdalena , Woźniak Ewa
Published: May 2023

RELIGIOUS VOCABULARY AND THE REFORMATION: A CONTRIBUTION TO THE DISCUSSION ON THE CONFESSIONAL DIVERSITY OF THE SIXTEENTH-CENTURY POLISH LEXICON
The article addresses the problem of the confessional diversity of sixteenth-century Polish religious vocabulary. It revises the arguments put forward by other academics and formulates new research recommendations. Focusing on the lexicon of Polish Lutheranism, which has so far received little scholarly attention, the article examines the vocabulary used in the polemical texts by one of the main representatives of the Polish Reformation: the Lutheran Erazm Gliczner. Based on the analysis of two groups of confessional terms: 1. repentance [pokajanie] – reflection [upamiętanie], 2. the Catholic church [Kościół] – the Protestant church [Zbór], we claim that the author does not avoid words that belong to the Catholic lexicon, but distances himself from the terminology used by representatives of radical, anti-Trinitarian denominations. Our findings help to revise certain popular ideas, conclusions drawn from the analysis of Polish translations of the Bible, as well as linguistic commentaries of the translators. It is thus essential that the research in the field of the sixteenth-century Polish religious vocabulary should be continued and should include texts other than Bible translations, i.e., texts whose authors’ word choice was determined by different factors.
Time Is Not Money! Temporal Preferences for Time Investments and Entry into Entrepreneurship
Authors: Gutierrez Cédric , Sloof Randolph , Crilly Donal
Published: May 2023

Starting a business requires investing both money and time in the hope of future financial benefits. Because investments and potential gains happen over time, the way in which individuals value the future relative to the present—that is, their temporal preferences—may be an important driver behind the decision to become an entrepreneur. Whereas existing research examines temporal preferences for financial gains, we advance this research by theorizing about temporal preferences not only for money, but also for the future time commitments that entrepreneurship entails. Results from a laboratory-in-the-field study show that individuals who heavily discount future time investments are more likely to become entrepreneurs. In two follow-up studies, we confirm that recent start-up founders discount future time investments more than salaried workers. We also provide suggestive evidence of the mechanisms at play: recent start-up founders perceive the future differently than salaried workers, both viewing themselves as more agentic vis-à-vis the future and perceiving the future as more distant. We discuss the implications of temporal preferences—not only for money, but also for time—for understanding the behavioral drivers of entrepreneurship.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/orsc.2023.1681 .
Percursos de pesquisas no contexto do desastre de mineração ocorrido em Mariana, no Rio Doce e na costa do Brasil
Authors: Lopes Diego Kern
Published: May 2023

Apresentamos uma problematização do fazer científico e artístico no contexto do desastre gerado pelo rompimento da barragem de mineração em Fundão, Minas Gerais, Brasil. Damos ênfase neste artigo à interação entre os campos disciplinares da arte contemporânea e das ciências sociais apresentando algumas experiências concretas resultantes dessa investigação.
O homem venoso-zodiacal entre arte, ciência e religião / The zodiacal vein-man between art, science and religion
Authors: Mendes Jefferson de Albuquerque , Lemos Maya Suemi
Published: May 2023

O artigo retraça o percurso da interpretação da iconografia astrológica contida nas Très Riches Heures, analisando o vínculo entre astrologia, ciência e religião nela representado. Assim, busca-se evidenciar a tentativa de ordenação e orientação cósmica da qual a arte participou, fornecendo soluções plásticas capazes de representar relações entre o observável e o incognoscível.The article retraces the path of interpretation of astrological iconography contained in Les très riches heures, analyzing the link between astrology, science and religion represented in it. Thus, it seeks to highlight the attempt at cosmic ordering and orientation of which art was a part, providing plastic solutions capable of representing relations between the observable and the unknowable.