bluuebunny/crossref_metadata_2025 huggingface dataset:
Health-related quality of life among patients with knee osteoarthritis in Guangzhou, China: a multicenter cross-sectional study
Authors: Chang Jinghui , Yuan Yuxin , Fu Manru , Wang Dong
Published: May 2023

Purposes

To investigate health-related quality of life (HRQoL) of patients with knee osteoarthritis (KOA) in Guangzhou, China, and examine its association with selected sociodemographic characteristics as well as knee function.

Methods

This multicenter cross-sectional study included 519 patients with KOA in Guangzhou from April 1 to December 30, 2019. Data on sociodemographic characteristics were obtained using the General Information Questionnaire. The disability was measured using the KOOS-PS, resting pain using the Pain-VAS, and HRQoL using the EQ-5D-5L. The association of selected sociodemographic factors, KOOS-PS and Pain-VAS scores with HRQoL (EQ-5D-5L utility and EQ-VAS scores) were analyzed using linear regression analyses.

Results

The median (interquartile range [IQR]) of EQ-5D-5L utility and EQ-VAS scores were 0.744 (0.571–0.841) and 70 (60–80) respectively, lower than the average HRQoL in the general population. Only 3.661% of KOA patients reported no problems in all EQ-5D-5L dimensions, with Pain/Discomfort being the most frequently affected dimension (78.805%). The correlation analysis showed that the KOOS-PS score, Pain-VAS score and HRQoL were moderately or strongly correlated. Patients with cardiovascular disease, no daily exercise, and high KOOS-PS or Pain-VAS scores had lower EQ-5D-5L utility scores; and patients with body mass index (BMI) > 28 ,high KOOS-PS or Pain-VAS scores had lower EQ-VAS scores.

Conclusions

Patients with KOA had relatively low HRQoL. Various sociodemographic characteristics as well as knee function were associated with HRQoL in regression analyses. Providing social support and improving their knee function through methods such as total knee arthroplasty might be crucial to improve their HRQoL.
Comparison of three-dimensional reconstruction and CT-guided Hook-wire segmental resection for pulmonary nodules: a propensity score matching study
Authors: Hong Ziqiang , Lu Yingjie , Sheng Yannan , Cui Baiqiang , Bai Xiangdou , Cheng Tao , Wu Xusheng , Jin Dacheng , Gou Yunjiu
Published: May 2023

Objective

To analyze and compare the clinical application value of three-dimensional reconstruction and computed tomography (CT)-guided Hook-wire localization for row lung segment resection of pulmonary nodules.

Methods

Retrospective analysis of the clinical data of 204 patients suffering from pulmonary nodules admitted to the Department of Thoracic Surgery of Gansu Provincial People’s Hospital from June 2016 to December 2022. According to the preoperative positioning method, the group was divided into a 3D reconstruction group (98 cases) and a Hook-wire group (106 cases), respectively. The two groups of patients were propensity score matching (PSM) to compare their perioperative outcomes.

Results

All patients in both groups underwent successful surgeries without perioperative deaths. After PSM, 79 patients were successfully matched in each group. Two cases of pneumothorax, three cases of hemothorax, and four cases of decoupling occurred in the Hook-wire group; no complications of pneumothorax, hemothorax, and decoupling occurred in the 3D reconstruction group. Compared to the Hook-wire group, the 3D reconstruction group has shorter operative time (P = 0.001), less intraoperative bleeding (P < 0.001), less total postoperative chest drainage (P = 0.003), shorter postoperative tube placement time (P = 0.001), shorter postoperative hospital stay (P = 0.026), and postoperative complications (P = 0.035). There was no statistically significant difference between the two groups in terms of pathological type, TNM staging, and number of lymph node dissection.

Conclusion

Three-dimensional reconstruction and localization of pulmonary nodules enables safe and effective individualized thoracoscopic anatomical lung segment resection with a low complication rate, which has good clinical application value.
Lung infection by Pseudomonas aeruginosa induces neuroinflammation and blood–brain barrier dysfunction in mice
Authors: Villalba Nuria , Ma Yonggang , Gahan Sarah A. , Joly-Amado Aurelie , Spence Sam , Yang Xiaoyuan , Nash Kevin R. , Yuan Sarah Y.
Published: May 2023

Background

Severe lung infection can lead to brain dysfunction and neurobehavioral disorders. The mechanisms that regulate the lung-brain axis of inflammatory response to respiratory infection are incompletely understood. This study examined the effects of lung infection causing systemic and neuroinflammation as a potential mechanism contributing to blood–brain barrier (BBB) leakage and behavioral impairment.

Methods

Lung infection in mice was induced by instillingPseudomonas aeruginosa(PA) intratracheally. We determined bacterial colonization in tissue, microvascular leakage, expression of cytokines and leukocyte infiltration into the brain.

Results

Lung infection caused alveolar-capillary barrier injury as indicated by leakage of plasma proteins across pulmonary microvessels and histopathological characteristics of pulmonary edema (alveolar wall thickening, microvessel congestion, and neutrophil infiltration). PA also caused significant BBB dysfunction characterized by leakage of different sized molecules across cerebral microvessels and a decreased expression of cell–cell junctions (VE-cadherin, claudin-5) in the brain. BBB leakage peaked at 24 h and lasted for 7 days post-inoculation. Additionally, mice with lung infection displayed hyperlocomotion and anxiety-like behaviors. To test whether cerebral dysfunction was caused by PA directly or indirectly, we measured bacterial load in multiple organs. While PA loads were detected in the lungs up to 7 days post-inoculation, bacteria were not detected in the brain as evidenced by negative cerebral spinal fluid (CSF) cultures and lack of distribution in different brain regions or isolated cerebral microvessels. However, mice with PA lung infection demonstrated increased mRNA expression in the brain of pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α), chemokines (CXCL-1, CXCL-2) and adhesion molecules (VCAM-1 and ICAM-1) along with CD11b + CD45+ cell recruitment, corresponding to their increased blood levels of white cells (polymorphonuclear cells) and cytokines. To confirm the direct effect of cytokines on endothelial permeability, we measured cell–cell adhesive barrier resistance and junction morphology in mouse brain microvascular endothelial cell monolayers, where administration of IL-1β induced a significant reduction of barrier function coupled with tight junction (TJ) and adherens junction (AJ) diffusion and disorganization. Combined treatment with IL-1β and TNFα augmented the barrier injury.

Conclusions

Lung bacterial infection is associated with BBB disruption and behavioral changes, which are mediated by systemic cytokine release.
Comparison of lipid accumulation product and visceral adiposity index with traditional obesity indices in early-onset type 2 diabetes prediction: a cross-sectional study
Authors: Lin Chen-Ying , Li Jing-Bo , Wu Fan , Wang Jun-Jia , An Hao-Hua , Qiu Hui-Na , Xia Long-Fei , Li Yao-Shuang , Zhai Ya-Jie , Li Chun-Jun , Lin Jing-Na
Published: May 2023

Background

The purpose of the study was to compare the efficacy of two novel obesity indices, lipid accumulation product (LAP) and visceral adiposity index (VAI), with traditional obesity indices in predicting early-onset type 2 diabetes (T2DM).

Methods

In this cross-sectional study, a total of 744 participants, including 605 patients newly diagnosed with T2DM and 139 non-diabetic control subjects, were enrolled from a tertiary care hospital in Tianjin, China. Participants with T2DM were divided into two groups based on their age at diagnosis, namely early-onset T2DM (age less than 40 years, n = 154) and late-onset T2DM (age 40 years or older, n = 451). The predictive power of each obesity index was evaluated using receiver operating characteristic (ROC) curve analysis. Furthermore, binary logistic regression analysis was conducted to examine the independent relationship between LAP and VAI with early-onset T2DM risk. The relationship between novel obesity indices and the age of T2DM onset was also evaluated through correlation and multiple linear regression analysis.

Results

In males, LAP had the highest predictive power for early-onset T2DM with an area under the ROC curve (AUC) of 0.742 (95% CI 0.684–0.799, P < 0.001). In females, VAI had the highest AUC for early-onset T2DM with a value of 0.748 (95% CI 0.657–0.839, P < 0.001), which was superior to traditional indices. Patients in the 4th quartile of LAP and VAI had 2.257 (95% CI 1.116–4.563, P = 0.023) and 4.705 (95% CI 2.132–10.384, P < 0.001) times higher risk of T2DM before age 40, compared to those in the 1st quartile, respectively. A tenfold increase in LAP was associated with a decrease in T2DM onset age of 12.862 years in males (β = −12.862, P < 0.001) and 6.507 years in females (β = −6.507, P = 0.013). A similar decrease in T2DM onset age was observed for each tenfold increase in VAI in both male (β = −15.222, P < 0.001) and female (β = −12.511, P < 0.001) participants.

Conclusions

In young Chinese individuals, LAP and VAI are recommended over traditional obesity indices for improved prediction of early-onset T2DM risk.
Genome-wide DNA methylation profiling of HPV-negative leukoplakia and gingivobuccal complex cancers
Authors: Inchanalkar Mayuri , Srivatsa Sumana , Ambatipudi Srikant , Bhosale Priyanka G. , Patil Asawari , Schäffer Alejandro A. , Beerenwinkel Niko , Mahimkar Manoj B.
Published: May 2023

Background

Gingivobuccal complex oral squamous cell carcinoma (GBC-OSCC) is an aggressive malignancy with high mortality often preceded by premalignant lesions, including leukoplakia. Previous studies have reported genomic drivers in OSCC, but much remains to be elucidated about DNA methylation patterns across different stages of oral carcinogenesis.

Results

There is a serious lack of biomarkers and clinical application of biomarkers for early detection and prognosis of gingivobuccal complex cancers. Hence, in search of novel biomarkers, we measured genome-wide DNA methylation in 22 normal oral tissues, 22 leukoplakia, and 74 GBC-OSCC tissue samples. Both leukoplakia and GBC-OSCC had distinct methylation profiles as compared to normal oral tissue samples. Aberrant DNA methylation increases during the different stages of oral carcinogenesis, from premalignant lesions to carcinoma. We identified 846 and 5111 differentially methylated promoters in leukoplakia and GBC-OSCC, respectively, with a sizable fraction shared between the two sets. Further, we identified potential biomarkers from integrative analysis in gingivobuccal complex cancers and validated them in an independent cohort. Integration of genome, epigenome, and transcriptome data revealed candidate genes with gene expression synergistically regulated by copy number and DNA methylation changes. Regularised Cox regression identified 32 genes associated with patient survival. In an independent set of samples, we validated eight genes (FAT1, GLDC, HOXB13, CST7, CYB5A, MLLT11, GHR, LY75) from the integrative analysis and 30 genes from previously published reports. Bisulfite pyrosequencing validated GLDC (P = 0.036), HOXB13 (P < 0.0001) promoter hypermethylation, and FAT1 (P < 0.0001) hypomethylation in GBC-OSCC compared to normal controls.

Conclusions

Our findings identified methylation signatures associated with leukoplakia and gingivobuccal complex cancers. The integrative analysis in GBC-OSCC identified putative biomarkers that enhance existing knowledge of oral carcinogenesis and may potentially help in risk stratification and prognosis of GBC-OSCC.

Graphical abstract
Validation of a primary care electronic medical records case definition for eczema: retrospective cross-sectional study
Authors: Stirton Hannah , Kosowan Leanne , Abrams Elissa M , Protudjer Jennifer LP , Queenan John , Singer Alexander
Published: May 2023

Background

To validate case definitions for eczema using primary care Electronic Medical Record (EMR) data from the Canadian Primary Care Sentential Surveillance Network (CPCSSN).

Methods

This study used EMR data from 1,574 primary care providers in seven Canadian provinces, representing 689,301 patients. Using a subset of patient records seven medical students or family medicine residents created a reference set of 1,772 patients. A total of 23 clinician-informed case definitions were validated against the reference. We assessed agreement using sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) and overall accuracy. The case definitions with the best agreement statistics were deployed to estimate the prevalence of eczema in the CPCSSN.

Results

Case definition 1 had the highest SE (92.1%,85.0-96.5) but a lower SP (88.5%,86.7–90.1) and PPV (36.6%,33.1–40.3). Case definition 7 was the most specific case definition with a SP (99.8%, 99.4–100) and PPV (84.2%,61.2–94.7) but low SE (15.8%,9.3–24.5). Case definition 17 had a SE (75.3%, 65.7–83.3), SP (93.8%, 91.5–94.3) and PPV 43.7% (38.3–49.2). When we applied the most specific and most sensitive case definitions, we estimate the prevalence of eczema to be between 0.8 and 15.1%. Case definition 17 suggests an eczema prevalence estimate of 8.2% (8.08–8.21%).

Conclusions

We validated EMR-based eczema case definitions to estimate the prevalence of clinician-documented eczema. Future studies may choose to apply one or more of these definitions’ dependent on their studies objectives to inform disease surveillance as well as explore burden of illness or interventions related to eczema care in Canada.
A lightweight YOLOX-based model for detection of metallic gaskets on High-speed EMU wheelset
Authors: Wang Tengfei , Zhu Chongfei , Wang Xiaoning , Li Shuxia , Hu Yanchen
Published: May 2023

In order to solve the requirements of real-time detection on metallic gaskets of wheelset assembly under the condition of limited hardware resources, here we propose an improved lightweight YOLOX-like network that can be deployed on mobile devices with low computing resource consumption. Firstly, the basic components of ShuffleNetV2 network structure are trimmed to reduce the computation intensity and the number of training parameters. Thus the lightweight ShuffleNetV2 is used as the backbone structure of YOLOX. The prediction layer for $$20\times 20$$

20
×
20

size large targets is also removed from the head of this structure to further reduce the calculation time and improve the inference speed. Besides, the channel-attention enhancement module efficient channel attention is added into the network to improve the capability of feature extraction and the accuracy of target detection. Finally, the verification of inference for the proposed model is carried out on mobile terminal devices.The results show that the improved lightweight algorithm proposed in this paper not only ensures the detection accuracy, but also greatly reduces training parameters and computing resources, and it particularly can be run rapidly on mobile terminal devices with low-cost of computation.
Simultaneous quantification of ferrous gluconate and calcium gluconate in foods using liquid chromatography–tandem mass spectrometry (LC–MS/MS)
Authors: Park Yeong-Ju , Sim Sol , Jung Soyeon , Seo Hyunji , Lee Yejin , Lee Jihyun , Lee Chan , Suh Hee-Jae
Published: May 2023

Ferrous gluconate and calcium gluconate are used as food acidity regulators in South Korea, Japan, the European Union (EU), and other countries. A simultaneous analytical method was developed to quantify ferrous gluconate and calcium gluconate in food using ultra-performance liquid chromatography–tandem mass spectrometry. The limits of detection and quantification of ferrous gluconate were 1.1 and 3.5 mg/kg, respectively, while those of calcium gluconate were 1.4 and 4.8 mg/kg, respectively. The recoveries of ferrous gluconate from processed olives were in the range of 97.7–109.7%, while those of calcium gluconate from beverages were in the range of 94.3–110.8%. The developed simultaneous analytical method was applied to real samples from South Korea, which found ferrous gluconate concentrations of 0.031–0.065 g/kg in processed olives and calcium gluconate concentrations of 3.8–7.8 g/kg in beverages.
Water mass age structures the auxiliary metabolic gene content of free-living and particle-attached deep ocean viral communities
Authors: Coutinho Felipe H. , Silveira Cynthia B. , Sebastián Marta , Sánchez Pablo , Duarte Carlos M. , Vaqué Dolors , Gasol Josep M. , Acinas Silvia G.
Published: May 2023

Background

Viruses play important roles in the ocean’s biogeochemical cycles. Yet, deep ocean viruses are one of the most under-explored fractions of the global biosphere. Little is known about the environmental factors that control the composition and functioning of their communities or how they interact with their free-living or particle-attached microbial hosts.

Results

We analysed 58 viral communities associated with size-fractionated free-living (0.2–0.8 μm) and particle-attached (0.8–20 μm) cellular metagenomes from bathypelagic (2150–4018 m deep) microbiomes obtained during the Malaspina expedition. These metagenomes yielded 6631 viral sequences, 91% of which were novel, and 67 represented high-quality genomes. Taxonomic classification assigned 53% of the viral sequences to families of tailed viruses from the order Caudovirales. Computational host prediction associated 886 viral sequences to dominant members of the deep ocean microbiome, such as Alphaproteobacteria (284), Gammaproteobacteria (241), SAR324 (23), Marinisomatota (39), and Chloroflexota (61). Free-living and particle-attached viral communities had markedly distinct taxonomic composition, host prevalence, and auxiliary metabolic gene content, which led to the discovery of novel viral-encoded metabolic genes involved in the folate and nucleotide metabolisms. Water mass age emerged as an important factor driving viral community composition. We postulated this was due to changes in quality and concentration of dissolved organic matter acting on the host communities, leading to an increase of viral auxiliary metabolic genes associated with energy metabolism among older water masses.

Conclusions

These results shed light on the mechanisms by which environmental gradients of deep ocean ecosystems structure the composition and functioning of free-living and particle-attached viral communities.
Clinicians’ preferences and attitudes towards the use of lithium in the maintenance treatment of bipolar disorders around the world: a survey from the ISBD Lithium task force
Authors: Hidalgo-Mazzei Diego , Mantingh Tim , Pérez de Mendiola Xavier , Samalin Ludovic , Undurraga Juan , Strejilevich Sergio , Severus Emanuel , Bauer Michael , González-Pinto Ana , Nolen Willem A. , Young Allan H. , Vieta Eduard
Published: May 2023

Background

Lithium has long been considered the gold-standard pharmacological treatment for the maintenance treatment of bipolar disorders (BD) which is supported by a wide body of evidence. Prior research has shown a steady decline in lithium prescriptions during the last two decades. We aim to identify potential factors explaining this decline across the world with an anonymous worldwide survey developed by the International Society for Bipolar Disorders (ISBD) Task Force “Role of Lithium in Bipolar Disorders” and distributed by diverse academic and professional international channels.

Results

A total of 886 responses were received of which 606 completed the entire questionnaire while 206 completed it partially. Respondents were from 43 different countries comprising all continents. Lithium was the most preferred treatment option for the maintenance of BD patients (59%). The most relevant clinical circumstances in which lithium was the preferred option were in patients with BD I (53%), a family history of response (18%), and a prior response during acute treatment (17%). In contrast, Lithium was not the preferred option in case of patients´ negative beliefs and/or attitudes towards lithium (13%), acute side-effects or tolerability problems (10%) and intoxication risk (8%). Clinicians were less likely to prefer lithium as a first option in BD maintenance phase when practising in developing economy countries [X2 (1, N = 430) = 9465, p = 0.002) ] and private sectors [X2 (1, N = 434) = 8191, p = 0.004)].

Conclusions

Clinicians’ preferences and attitudes towards the use of lithium in the maintenance treatment of bipolar disorders appear to be affected by both the patients’ beliefs and the professional contexts where clinicians provide their services. More research involving patients is needed for identifying their attitudes toward lithium and factors affecting its use, particularly in developing economies.
Gaussian transformation enhanced semi-supervised learning for sleep stage classification
Authors: Guo Yifan , Mao Helen X. , Yin Jijun , Mao Zhi-Hong
Published: May 2023

Sleep disorders are significant health concerns affecting a large population. Related clinical studies face the deficiency in sleep data and challenges in data analysis, which requires enormous human expertise and labor. Moreover, in current clinical practice, sleep data acquisition processes usually cover only one night’s sleep history, which is too short to recognize long-term sleep patterns. To address these challenges, we propose a semi-supervised learning (cluster-then-label) approach for sleep stage classification, integrating clustering algorithms into the supervised learning pipeline. We test the effectiveness of the proposed semi-supervised learning approach on two architectures: an advanced architecture using deep learning for classification and k-means for clustering, and a relatively naive Gaussian-based architecture. Also, we introduce two novel Gaussian transformations to improve the robustness and accuracy of the Gaussian-based architecture: assembled-fixed transformation and neural network based transformation. We reveal the effectiveness of the proposed algorithm via experiments on whole-night electroencephalogram (EEG) data. The experiments demonstrate that the proposed learning strategy improves the accuracy and F1 score over the state-of-the-art baseline on out-of-distribution human subjects. The experiments also confirm that the proposed Gaussian transformations can significantly gain normality to EEG band-power features and in turn facilitate the semi-supervised learning process. This cluster-then-label learning approach, combined with novel Gaussian transformations, can significantly improve the accuracy and efficiency of sleep stage classification, enabling more effective diagnosis of sleep disorders.
Sex hormone binding globulin (SHBG) as a predictor of liver fibrosis in subjects with nonalcoholic fatty liver disease (NAFLD)
Authors: Abdel-latif Abeer , Al-Jarhi Ula Mabid , Hesham Dina , khozam Mona , Fathy Shaimaa A.
Published: May 2023

Background

Nonalcoholic fatty liver disease (NAFLD) is the fastest growing cause of chronic liver disease worldwide. The prevalence of NAFLD increases in parallel with the increasing prevalence in obesity, metabolic syndrome and type 2 diabetes (T2DM). Recently, more evidence indicates the important role of sex hormone binding globulin (SHBG) on metabolic health.

Methods

A controlled cross-sectional cohort study was conducted upon 60 patients (NAFLD and control group). Patients were categorized according to the NAFLD fibrosis score. All patients subjected to routine labs and SHBG measurement.

Results

BMI was 35.80 ± 6.56 SD and 23.23 ± 2.5 SD in the NAFLD group and control group respectively. The NAFLD fibrosis score was 2.12 ± 1.47 SD. Fifty patients were categorized as advanced liver fibrosis: F3–F4 (> 0.675). No patients scored to exclude advanced liver fibrosis: F0–F2 (< − 1.455). The remaining 10 patients were categorized as indeterminate (in-between). There was a significant correlation between age, mid-arm circumference, waist circumference, BMI, serum albumin level, lipid profile components, as well as the NAFLD fibrosis score and SHBG levels using univariable regression analysis. There was also a significant correlation between mid-arm circumference, waist circumference, lipid profile components as well as SHBG levels and the NAFLD fibrosis score using univariable regression analysis. SHBG can predict severe liver fibrosis (F3–F4) in our NAFLD female cohort at a cut-off level of > 10 ng/mL, with 34% sensitivity and 90% specificity, area under the ROC curve (AUC) = 0.548, with 95% Confidence interval 0.414 to 0.677.

Conclusion

SHBG is positively correlated to severe fibrosis in female NAFLD patients. It is an efficient positive predictor of severe fibrosis in female NAFLD patients at a cut-off level > 10 ng/ml, with a high specificity and modest sensitivity.
Complications of Therapeutic Plasma Exchange in pediatric patients: An experience at a tertiary care hospital
Authors: Dr Tooba Fateen  , Dr Nighat Sultana  , Dr Muhammad Sarwar  , Dr Nazish Saqlain
Published: May 2023

Objective: To find the incidence of various complications of therapeutic plasma exchange (TPE) in ICU admitted children and to determine their association with age, gender, blood group and diagnosis of the patients.

Methods: In this observational study, data of 24 patients who underwent 125 sessions of TPE was collected from the Pediatric Intensive care unit (PICU) and Hematology department of The Children’s Hospital, Lahore from December 2020 to November 2021. Age, gender, blood group, indications and complications observed during and after the TPE procedure were documented on a pre-designed proforma. The data was analyzed by using SPSS version 23. Quantitative variables were presented in the form of mean and standard deviation. Qualitative variables like gender, blood groups, indications and complications of plasmapheresis were presented as frequency and percentage. Chi square test was applied for comparison of variables.

Results: Among the 24 patients, 45.8% were of age group five to ten years with mean age of 7.58 years± 2.04 years and male to female ratio of 0.84:1. Guillain-Barré syndrome (GBS) and Neuromyelitis Optica spectrum disorder (NMO-SD) were the most prevalent among the patients who underwent TPE. Most common complication was hypotension (44.9%), others were febrile reactions (11.6%), unstable vital signs (14.5%) and allergic reactions (24.6%). Blood group, clinical condition and diagnosis of the patient showed significant association with the incidence of TPE related complications.

Conclusion: The majority of problems caused by TPE are considered to be minor. Sudden fall in blood pressure, pruritus, urticarial rash and fever are the common adverse consequences among pediatric patients. Blood group and diagnosis of the patient can determine the development of such complications during plasmapheresis procedure.

doi: https://doi.org/10.12669/pjms.39.4.7002

How to cite this: Fateen T, Sultana N, Sarwar M, Saqlain N. Complications of Therapeutic Plasma Exchange in pediatric patients: An experience at a tertiary care hospital. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.7002

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.
Brain drain of healthcare professionals from Pakistan from 1971 to 2022: Evidence-based analysis
Authors: Meo Sultan Ayoub , Sultan Tehreem
Published: May 2023

Since the creation of Pakistan in August 1947, political instability has been a persistent issue in the country, causing a migration of highly qualified, skilled people, and healthcare professionals. From 1971 to 2022 the total number of highly qualified and skilled people including healthcare professionals who migrated from the country is 60,19,888. Among them, 251677 (4.18%), were highly qualified, 455097 (7.55%) were highly skilled, and 5313114 (88.27%) were skilled professionals. Moreover, 50110 (0.83%) were healthcare professionals including doctors 31418 (62.69%), nurses 12853 (25.64%), and pharmacists 5839 (11.65%). The unsustainable political environment, lack of advanced technology-based institutes, poor healthcare infrastructure, low job opportunities and salary benefits in Pakistan caused the brain drain of highly qualified people including healthcare professionals. It adversely affected the academic institutes, the healthcare system, socio-economic growth, research productivity, and the development of the nation. The government of Pakistan must establish sustainable policies to minimize the brain drain of highly qualified people, and healthcare professionals, and recuperate the prosperity of their academic institutes and healthcare system for better healthcare services, and the advancement and sustainable development of the nation.

doi: https://doi.org/10.12669/pjms.39.4.7853

How to cite this: Meo SA, Sultan T. Brain drain of healthcare professionals from Pakistan from 1971 to 2022: Evidence-based analysis. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.7853

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.
Approaches to the Methodology of Human Potential Assessment in the Conditions of Crisis Phenomena in Russia
Authors: Kulikov V. , Mel'nichuk I.
Published: May 2023

Empirical approaches to solving the problems of increasing human potential are investigated. The central place in the study is given to the activities of the Russian authorities in the conditions of crisis phenomena over the past 6–8 years. The authors proceeded from the need to use different approaches, even in times of crisis, as one of the main indicators for assessing the country and regions. The main arguments in favor of the methodology for achieving the main goal of improving human well–being are presented.
On the Main Factors of Socio-Economic and Economic Development of Modern Russia
Authors: Basovskiy Leonid , Basovskaya Elena
Published: May 2023

The paper attempts to identify the main hidden socio-economic and economic factors in the development of modern Russia in recent years. At the first stage of the study, data from the Federal State Statistics Service of Russia (Rosstat) on the main socio-economic indicators for the period 2000–2021 were used. At the second stage of the study, to clarify the factors that determined the development of the economy in recent years, we used data from the Federal State Statistics Service of Russia (Rosstat) for the period 2019–2021 on employment, as well as data on gross value add-ed indices and the value of fixed assets for the main sectors of the economy. To identify the main hidden factors, factor analysis is used based on the method (mod-el) of principal components. The obtained research results indicate that the most im-portant role in the socio-economic development of modern Russia is played by the growth of national production and the well-being of the population in the conditions of natural decline and migration growth of the population. Changes in the sectoral structure of employment, the dynamics of gross value added, the value of fixed assets by industry indicate the inconsistency of development that combines industrial and post-industrial trends. The nature of the inconsistency may be related to the transitional processes taking place in the economy of modern Russia and requires additional research.
The impact of virtual marketing tools on the communication activities of a modern enterprise
Authors: Aleshin Evgeniy , Yakubenko E.
Published: May 2023

In this article, we will analyze the communication activities of an enterprise in a digital environment in order to find out which theoretical and practical provisions most deeply and fully reflect the digital tools of modern digital means of enterprise communication activities.
Causes of runner’s diarrhea and dietary recommendations to avoid it - systematic review
Authors: Jedlina Klaudia , Pacek Katarzyna , Makowska Karolina , Kamińska Izabela , Pikulicka Agata , Szulc Izabela , Swacha Weronika , Piekarska Małgorzata , Kasperski Radosław , Rusin Klaudia
Published: May 2023

Complaints of diarrhea and other gastrointestinal symptoms are common among endurance runners. These problems may interfere with athletic activities and be the main cause of underperformance during sports events. It is estimated that this difficulty affects 30 to 90 percent of long-distance runners. The most important pathophysiological factors affecting the occurrence of gastrointestinal symptoms are ischemia and mechanical damage to the intestines, as well as the secretion of neuroendocrine substances. The diet before physical exercise is also one of the most significant factors related to the appearance of gastrointestinal symptoms. Avoiding the intake of fat, caffeine, protein, fiber, non-steroidal anti-inflammatory drugs and dehydration before performance is one of the suggestions for preventing runner’s diarrhea. There are new recommendations for athletes, such as avoidance of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) and the intake of multiple transportable carbohydrates. It seems that a short-term gluten free diet has no effect on the performance of athletes but further research is needed. Mechanisms of runner’s diarrhea are still poorly understood, so more research needs to be conducted to improve the recommendations to runners.
Groundnut Shells and Toddy Palm Shells Recycling Through Vermicomposting Technology and its Efficacy on Growth and Yield Attributes of Cluster Bean (Cyamopsis Tetragonoloba L.) Taub
Authors: .V Karthiya , A Vijayalakshmi
Published: May 2023

Farming generates numerous types of agricultural wastes to the environment such as crop residues, animal waste, poultry waste etc,. those are landfilled or burning creates environmental pollutions. The aim of the study was
to determining the growth and yield performance of cluster bean (Cyamopsis tetragonoloba L.) Taub on groundnut shells and toddy palm shells based vermicompost with Trichoderma asperelloides, microbial consortium and Eisenia fetida assistance. Pot experiments of plants were grown on six different combination of groundnut shells and toddy palm shells composts and one control treatment. During 25, 50 and 75 DAS (Days After Sowing) growth parameters and 90 DAS yield characters of cluster bean was carried out under pot culture respectively. The combined application of toddy palm shells composted with consortium of microorganisms and earthworm (T6) achieved the maximum growth parameters such as root length (21.9cm), shoot length (84.8cm), number of leaves (46.3), number of nodules (4.6), number of flowers (24.6), number of pods (6.6), fresh weight (17.912g) and dry weight (2.684g) of plant on 75 DAS of cluster bean (Cyamopsis tetragonoloba L.) Taub. During the 90th day the same treatment achieved the yield characters like number of pods (8.0), length of pod (16.6cm), number of seeds/pod (10.3), yield/plant (45.384g), fresh weight (5.673g) and dry weight (1.496g) of pod compared to the control. Based on the results T6 more suitable for growth and yield characters of cluster bean followed by T3 respectively. The study suggested that, the organic fertilizer prepared from groundnut shells and toddy palm shells with microbial consortium and Eisenia fetida assistance promotes the plant development and yield attributes of Cyamopsis tetragonoloba (L.) Taub. simultaneously,
reduce the usage of chemical fertilizers.
Isolation Improvement Using the Field-Circuit Combined Method for In-Band Full-Duplex MIMO Antenna Arrays
Authors: Da Yiran , Yi Jianjia , Li Jianxing , Chen Xiaoming
Published: May 2023

This paper proposes a field-circuit combined decoupling method for co-polarized in-band full-duplex multiple-input multiple-output (MIMO) antenna arrays. The proposed field-circuit combined method is composed of decoupling network and neutralization-based decoupling. An in-band full-duplex antenna with high isolation and low cross-polarization level is designed and extended to a 1 × 4 linear array. The decoupling network and ADS are applied for the array to alleviate the mutual coupling by rebuilding the neutralization wave paths in the circuit and field domains. Thus, low coupling (< −25 dB) among the transmitting/receiving antennas and high isolation (> 47 dB) between the transmitting and receiving antennas are achieved at 2.6 GHz, exhibiting a superior decoupling performance.
Metalens Enhanced Ray Optics: An End-to-End Wave-Ray Co-Optimization Framework
Authors: Zhu Ziwei , Liu Zhaocheng , Zheng Changxi
Published: May 2023

We present a fully differentiable framework for seamlessly integrating wave optical components with geometrical lenses, offering an approach to enhance the performance of large-scale end-to-end optical systems. In this study, we focus on the integration of a metalens, a geometrical lens, and image data. Through the use of gradient-based optimization techniques, we demonstrate the design of nonparaxial imaging systems and the correction of aberrations inherent in geometrical optics. Our framework enables efficient and effective optimization of the entire optical system, leading to improved overall performance.
Green Fabrication of Titanium Dioxide Nanoparticles and
their Antimcrobial and Anticancer Activities
Authors: Parveen Shama , Kandwal Anuj , Rao C. Narasimha , Kumar D. Veera Nagendra
Published: May 2023

In this study, a plant-mediated method for the synthesis of titanium dioxide (TiO2) nanoparticles is
reported. Using the titanium oxide and a plant extract of medicinal herb Leucas cephalotes, the TiO2
nanoparticles were effectively synthesized. The reaction temperature was kept between 75 ºC and 80
ºC, while 1 M of TiO2 and the plant extract were being processed. The absorption peak for titanium
dioxide nanoparticles in the UV-Vis spectrometer was observed at 212 and 345 nm. The typical
dimension of the nanoparticles was determined to be 38.99 nm from the XRD pattern. According to
the findings, titanium and oxygen were composed with high energy signals of 61.27% and 23.16%,
respectively. According to FT-IR spectrum, the Ti-O bonding absorption peak is appeared at 586 cm-1.
The scanning electron microscopy (SEM) was employed to confirm the spherical shape of the
synthesized TiO2 nanoparticles. The green synthesized TiO2 nanoparticles could be used to treat a
variety of malignancies. The MTS and MTT assays were used to assess the anticancer activity of
biogenic TiO2 nanoparticles. The IC50 values were 1.89, 2.00, 1.98 and 4.00 μM, respectively, against
the MCF-7, HeLa, PC-3 and A549 nanoparticles cancer cell lines. Additionally, this study has also
shown that synthesized TiO2 nanoparticles are highly active against Staphylococcus aureus, Bacillus
subtilis, Pseudomonas aeruginosa and Escherichia coli as well as against yeast (Candida albicans).
Synthesis, Biological Evaluation and Molecular Modeling of Novel Ethyl 2′-Amino-5′-oxo-1′-
(4-phenylthiazol-2-yl)-2-(phenylthio)-1′,4′,5′,6′,7′,8′-hexahydro-[3,4′-biquinoline]-3′-
carboxylate Derivatives and their Computational Quantum Mechanical Modelling
Authors: Sharma Puja , Patel Rajat , Koshti Rohit R. , Vyas Akshay , Sangani Chetan B.
Published: May 2023

A new series of biquinoline-phenylthiazole hybrids were designed and synthesized by a base-catalyzed
cyclocondensation through one-pot multicomponent reaction. All compounds were tested for in vitro
antimicrobial and anticancer activities. Enzyme inhibitory activities of all compounds were carried
out against FabH and EGFR. Majority of the synthesized compounds displayed promising antimicrobial
as well as anticancer activity against used strains and cancer cell lines, respectively. All the compounds
were tested for in vitro anticancer activities against two cancer cell lines A549 and Hep G2. Compound
9n (IC50 = 0.09 μM) against EGFR and (IC50 = 1.03 μM) against A549 kinase displayed the most
potent inhibitory activity as compared to other member of the series. In the molecular modelling
study, compound 9p was bound in to the active pocket of EGFR with two hydrogen bonds and one
π-cation interactions having minimum binding energy ΔGb = -8.5626 kcal/mol. For FabH molecule 9u
was found to be binding in the active pocket with minimum binding energy of -8.4033 kcal/mol.
Adsorption of Heavy Metals by Chopped Human Hair: An Equilibrium and Kinetic Study
Authors: Mir M. Amin
Published: May 2023

In this work, heavy metal adsorption by hair particles as adsorbents was studied and analyzed. The
kinetic and isothermal studies were performed by optimizing the initial concentration and the pH. The
adsorption isotherms of the majority of the metals are more suited to either the Langmuir or Freundlich
models. The uptake capacity of hair material to absorb metals was found to be in the order of Pb2+ >
Cu2+ > Zn2+. According to the adsorption data, metal ions adhere to hair particles as confirmed through
a pseudo-second-order process. The kinetic study demonstrated that metal adsorption on hair particles
involves both intraparticle diffusion and surface adsorption. According to the column studies, hair
particles are more effective adsorbent for removing the heavy metals from aqueous solutions.
Effects of Axial Ligands on the Redox Properties of Manganese(III) meso-tetrakis(p-Hydroxyphenyl) Porphyrin
Authors: Thandiayyakone V. , Murugan A. , Ravikumar C.R. , Rajkumar T. , Kulandaisamy A. , Muzaddadi Ijaz Ullah , Manohar A. , Arasu P. Thillai , Chakrabarty Mithun
Published: May 2023

In this work, meso-tetrakis(p-Hydroxyphenyl) porphyrin [T(p-OH)PP] and manganese(III) meso-tetrakis(p-hydroxyphenyl) porphyrin Mn[T(p-OH)PP] were synthesized and characterized. The UV-visible and cyclic voltammetry were used to evaluate the axial ligand and redox behaviour of Mn[T(p-OH)PP]. The addition of ethylamine, diethylamine and tertiary amines to Mn(III) meso-porphyrins distinguishes their axial ligand characteristics. The presence of ethylamine causes the octahedral geometry to transform into a square pyramidal structure. Cyclic voltammetry shows that Mn(III) converts to Mn(II) porphyrins. Additionally, the UV-visible spectrophotometry and cyclic voltammetry were also used to investigate the oxidation process.
Studying of 2,2′-Bipyrimidine Based Dyes Properties as Photo-Sensitizer for Dye Sensitized Solar Cells (DSSCs)
Authors: Krishnaveni S. , Josephine X. Mary , Sathyanarayanamoorthi V.
Published: May 2023

In this investigation, five novel π-new organic donor-π-acceptor dyes (D-π-A) based on 2,2′-bipyrimidines were used. For optimization and DFT research, respectively, the 6-311+G(d,p) basis set and B3LYP density functional theory were applied. In all the systems, diphenyl amine moiety acts as the electron-donor component, whereas the nitro/cyano moiety as electron acceptor (anchoring) group. In the conjugated spacer, a methyl/ethyl substituent was used to examine the impact of the auxiliary donor group. The computed HOMO-LUMO gap and the spectral data matched well. The oscillator strength (f), electron injection free energy (ΔGinject) and light-harvesting efficiency (LHE) were also computed and explained. The calculated values for the examined dye-sensitizers open-circuit photo voltage (Voc) and electron coupling constant (VRP) were also included in this research. This study demonstrates that every synthetic dye has promising potential as a dye sensitized solar cells (DSSCs) sensitizer.
Synthesis and Characterization of SnO2/BNNTs Nanocomposite for
Ethanol Vapour Sensing at Room Temperature
Authors: Sharma H. , Rawat P.S. , Rawat B.S. , Kumar N. , Verma S.
Published: May 2023

Ethanol vapour sensors based on tin oxide (SnO2) nanoparticles onto boron nitride nanotubes (BNNTs)
have been synthesized as a promising solution for detecting ethanol vapour in air. The existence of
encapsulation of BNNTs over SnO2 i.e. SnO2/BNNT was confirmed by AFM, FTIR and current-voltage
characteristics. Activation energy of sensor has been investigated to study the nature of synthesized
material. Ethanol sensitivity, responsiveness and response-recovery durations of the SnO2-BNNTs
sensor, as well as other sensing features, was examined by exposure to various ethanol vapour
concentrations starting from 70 to 500 mL/min at room temperature with increasing rate of pressure
value at room temperature. The SnO2 nanoparticles have a high sensitivity to ethanol vapour, while
BNNTs enhance the sensing performance and stability of the sensor. This is achieved by combining
BNNT (large surface area) and SnO2 (good electrical conductivity). The ethanol vapour sensor based
on SnO2-BNNTs has been shown to have a good response and recovery time around 1 min and 2 s,
respectively. With its high sensitivity of ~110 and stability, it is an excellent option for practical
applications.
Virtual Screening, DNA Strapping and Antimicrobial
Investigation of Mixed Ligand Transition Metal Complexes
Authors: Nasar Nazeer Mohamed , Samuel Michael , Jayaraman Porkodi , Sheela Freeda Selva , Raman Natarajan
Published: May 2023

To obtain the highest level of biological effectiveness, four transition metal viz., Cu(II), Zn(II), Co(II)
and Ni(II) complexes viz. were synthesized using Schiff base obtained by the condensation reaction of
o-phenylene diamine, 4-chlorobenzaldehyde and a co-ligand (malonic acid). Elemental analysis and
other spectroscopic methods were used to identify them. All the synthesized metal(II) complexes have
a square planar geometry, according to the physico-chemical analyses. The antibacterial properties of
the ligand and its metal(II) complexes on various microorganisms were also studied. SWISS-ADME
online freeware was used to screen these compounds for drug-like action and pharmacokinetic research.
Furthermore, UV absorption analyses and viscosity titrations were employed to test the efficacy of the
synthesised metal complexes as DNA nucleases, and the results are consistent with an intercalative
binding mechanism. The outcomes of molecular docking research on the COVID-19 virus and cancer
DNA are fascinating.
One Pot Synthesis and Antimicrobial Evaluation of 8-Substituted-2,5-dihydro-
2-(2-nitrophenyl/4-nitrophenyl)-4-(2-thienyl)-1,5-benzothiazepines
Authors: Kandalkar Madhuri , Sharma Priyanka
Published: May 2023

The reaction of an α,β-unsaturated heterocyclic ketone, 3-(2-nitrophenyl/4-nitrophenyl)-1-(2-thienyl)-
2-propenone (3a-b) with 5-substituted-2-aminobenzenethiols (4a-d) with substituent -CH3, -Cl, -F and
-Br was carried out in dry methanol containing trifluoroacetic acid (TFA) in catalytic amount as well
as by swirling for 20 min in diethyl ether at room temperature. The yields of the products, 8-substituted-
2,5-dihydro-2-(2-nitrophenyl/4-nitrophenyl)-4-(2-thienyl)-1,5-benzothiazepines (5a-h), ranged from
60% to 75% by first method and 65% to 85% by second method. The synthesized compounds have
been characterized by micro-estimation of C, H, N and 1H NMR, 13C NMR as well as mass spectral
studies. All the synthesized compounds are tested for biological efficacy against, Gram-positive bacteria,
Staphylococcus aureus, Gram-negative bacteria Escherichia coli and fungi, Candida albicans. All of
the compounds demonstrated effective antibacterial and antifungal activities.