bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterising fragmentation of compostable bioplastic: releasing microplastics or small bioplastic debris
Authors: Fang Cheng , Zhang Xian , Zhang Zixing , Naidu Ravi
Published: June 2024

Background

Plastic is generating global pollution and the replacement such as bioplastic has been developed to mitigate the pollution. To this end, the fate, transformation and pathway of bioplastics need more research. For example, the fragmentation of bioplastic can release small debris that can be categorised as microplastics, which is tested herein by taking an example of a compostable plastic that is used as a bin bag on our kitchen table to collect the food residues.

Results

First, we employ matrix-assisted laser desorption/ionisation mass spectrometry (MALDI-MS) to identify the main components of the bioplastic bag as polymer and starch. Next, we use Raman imaging to monitor the stability under laser illumination, in an oven at ~ 60 °C for ~ 2 weeks, or in the presence of tap water for half a year. Basically, the compostable plastic is stable under these conditions. Thirdly, however, once used as table-bin bag with involvement of food residues, within ~ 1 week, the bioplastic bag is broken and biodegraded to release debris. The derivate surface groups are effectively monitored and directly visualised via Raman imaging, and cross-checked with scanning electron microscope (SEM). The yielded small molecule such as formic acid is also identified, along with the released debris of microplastics, with the help of on-site extraction of the fragmented sample and imaging analysis algorithm of the hyper spectrum.

Conclusions

After one week, the bag in the waste bin fragments, releasing a significant amount of debris. This could pose a functional issue if users intend to use the bag for at least a week, and could become a potential environmental problem if the waste is dispersed uncontrollably. In general, further research is needed to potentially distinguish the persistent conventional microplastics from the bioplastic fragments, to effectively mitigate the plastic pollution.

Graphical Abstract
Altered pupil light and darkness reflex and eye-blink responses in late-life depression
Authors: Lee Yao-Tung , Chang Yi-Hsuan , Tsai Hsu-Jung , Chao Shu-Ping , Chen David Yen-Ting , Chen Jui-Tai , Cherng Yih‐Giun , Wang Chin-An
Published: June 2024

Background

Late-life depression (LLD) is a prevalent neuropsychiatric disorder in the older population. While LLD exhibits high mortality rates, depressive symptoms in older adults are often masked by physical health conditions. In younger adults, depression is associated with deficits in pupil light reflex and eye blink rate, suggesting the potential use of these responses as biomarkers for LLD.

Methods

We conducted a study using video-based eye-tracking to investigate pupil and blink responses in LLD patients (n = 25), older (OLD) healthy controls (n = 29), and younger (YOUNG) healthy controls (n = 25). The aim was to determine whether there were alterations in pupil and blink responses in LLD compared to both OLD and YOUNG groups.

Results

LLD patients displayed significantly higher blink rates and dampened pupil constriction responses compared to OLD and YOUNG controls. While tonic pupil size in YOUNG differed from that of OLD, LLD patients did not exhibit a significant difference compared to OLD and YOUNG controls. GDS-15 scores in older adults correlated with light and darkness reflex response variability and blink rates. PHQ-15 scores showed a correlation with blink rates, while MoCA scores correlated with tonic pupil sizes.

Conclusions

The findings demonstrate that LLD patients display altered pupil and blink behavior compared to OLD and YOUNG controls. These altered responses correlated differently with the severity of depressive, somatic, and cognitive symptoms, indicating their potential as objective biomarkers for LLD.
Time trends in proximal humeral fractures from 1944 to 2020 – A cohort study in Malmö, Sweden
Authors: Cederwall Anton , Karlsson Magnus K , Rosengren Björn E
Published: June 2024

Background

Most studies infer increasing incidence of proximal humeral fractures (PHF) from the 1950´s until the 1990´s. Recent time trends are less clear.

Objectives

Our primary objective was to identify time trends in the age- and sex-adjusted adult incidence of PHF in Malmö, Sweden, from year 1944 until 2020. Our secondary objectives were to describe the variation in incidence according to age, the monthly distribution, and to compare data from the two most recent decades with earlier.

Study design and methods

Malmö has one emergency hospital where acute fractures are treated. We identified PHF in adult patients (≥ 18 years) by reviewing relevant radiology examinations during 17 sample years from year 1944 to 2020. We used jointpoint analyses to estimate time trends.

Results

We identified 3 031 PHF during the study period (3 231 161 person years), 73% were sustained by women with mean age of 69 years (mean age in men 59). Joinpoint analyses indicated an increase in the age- and sex-adjusted incidence of PHF from year 1944 (52 per 100 000 person years) until 1977 (120 per 100 000) and thereafter a decrease until 2020 (85 per 100 000). A seasonal variation with more fractures during winter months, was apparent in earlier but not recent decades.

Conclusions

The age- and sex-adjusted incidence of PHF increased in Malmö, Sweden, from the 1940´s until year 1977 and thereafter decreased until 2020. More fractures were seen during winter months in earlier but not recent decades.
Expression of epithelial growth factor receptor as a protein marker in oral reticular and erosive lichen planus
Authors: Keshani Forooz , Kargahi Neda , Nikbakht Mohammad Hossein , Najafi Shekufe , Fallah Fateme
Published: June 2024

Background

Oral lichen planus (OLP) is a chronic inflammatory mucosal disease that is classified as a premalignant condition. Epithelial growth factor receptor (EGFR) is associated with tumorigenesis and tumor progression and is overexpressed in several oral malignant disorders. Despite the association of EGFR overexpression with oral potentially malignant lesions, few studies have analyzed its expression in OLP, showing controversial results. This study aimed to compare the expression of EGFR as a protein marker in Reticular and Erosive OLP.

Methods

This descriptive-analytical cross-sectional was conducted on 15 paraffin blocks of reticular lichen planus lesions, 16 paraffin blocks of erosive OLP lesions, and 8 paraffin blocks of inflammatory fibrous hyperplasia lesions as the control group (39 in total). After immunohistochemical staining for EGFR, samples were simultaneously observed by two maxillofacial pathologist, and the percentage of stained cells, intensity of staining, pattern of staining, and the location of stained cells were obtained.

Results

The Mann-Whitney-U test showed that there was no significant difference in the mean percentage of stained cells between erosive OLP and reticular OLP (P-value = 0.213) and between reticular OLP and control group (P-value = 0.137), but there was a significant difference between erosive OLP and control group (P-value = 0.035). Fisher’s exact test showed that there was no significant difference between the frequency distribution of staining patterns in three types of lesions (P-value = 0.90). Kruskal-Wallis test showed that there was no significant difference between the intensity of staining in the three groups (P-value = 0.19) and also there was no significant difference between the location of stained cells in different layers of the epithelium in the three groups (P-value = 0.90).

Conclusions

The results of this study showed that in comparison of reticular OLP, erosive OLP, and the control group there was a significant difference just between erosive OLP and control group in the percentage of stained cells.
Risk factors for residual lesions after total hysterectomy in patients with high-grade cervical intraepithelial neoplasia
Authors: Wang Jing , Wang Chao , Su Tao
Published: June 2024

Background

The purpose of this study was to predict the risk factors for residual lesions in patients with high-grade cervical intraepithelial neoplasia who underwent total hysterectomy.

Methods

This retrospective study included 212 patients with histologically confirmed high-grade cervical intraepithelial neoplasia (CIN2-3) who underwent hysterectomy within 6 months after loop electrosurgical excision procedure (LEEP). Clinical data (e.g., age, menopausal status, HPV type, and Liquid-based cytology test(LCT) type), as well as pathological data affiliated with endocervical curettage (ECC), colposcopy, LEEP and hysterectomy, were retrieved from medical records. A logistic regression model was applied to estimate the relationship between the variables and risk of residual lesions after hysterectomy.

Results

Overall, 75 (35.4%) patients had residual lesions after hysterectomy. Univariate analyses revealed that positive margin (p = 0.003), glandular involvement (p = 0.017), positive ECC (p < 0.01), HPV16/18 infection (p = 0.032) and vaginal intraepithelial neoplasia (VaIN) I-III (p = 0.014) were factors related to the presence of residual lesions after hysterectomy. Conversely, postmenopausal status, age ≥ 50 years, ≤ 30 days from LEEP to hysterectomy, and LCT type were not risk factors for residual lesions. A positive margin (p = 0.025) and positive ECC (HSIL) (p < 0.001) were identified as independent risk factors for residual lesions in multivariate analysis.

Conclusions

Our study revealed that positive incisal margins and ECC (≥ CIN2) were risk factors for residual lesions, while glandular involvement and VaIN were protective factors. In later clinical work, colposcopic pathology revealed that glandular involvement was associated with a reduced risk of residual uterine lesions. 60% of the patients with residual uterine lesions were menopausal patients, and all patients with carcinoma in situ in this study were menopausal patients. Therefore, total hysterectomy may be a better choice for treating CIN in menopausal patients with positive margins and positive ECC.
Development of a quantitative index system for evaluating the quality of electronic medical records in disease risk intelligent prediction
Authors: Zhou Jiayin , Hao Jie , Tang Mingkun , Sun Haixia , Wang Jiayang , Li Jiao , Qian Qing
Published: June 2024

Objective

This study aimed to develop and validate a quantitative index system for evaluating the data quality of Electronic Medical Records (EMR) in disease risk prediction using Machine Learning (ML).

Materials and methods

The index system was developed in four steps: (1) a preliminary index system was outlined based on literature review; (2) we utilized the Delphi method to structure the indicators at all levels; (3) the weights of these indicators were determined using the Analytic Hierarchy Process (AHP) method; and (4) the developed index system was empirically validated using real-world EMR data in a ML-based disease risk prediction task.

Results

The synthesis of review findings and the expert consultations led to the formulation of a three-level index system with four first-level, 11 second-level, and 33 third-level indicators. The weights of these indicators were obtained through the AHP method. Results from the empirical analysis illustrated a positive relationship between the scores assigned by the proposed index system and the predictive performances of the datasets.

Discussion

The proposed index system for evaluating EMR data quality is grounded in extensive literature analysis and expert consultation. Moreover, the system’s high reliability and suitability has been affirmed through empirical validation.

Conclusion

The novel index system offers a robust framework for assessing the quality and suitability of EMR data in ML-based disease risk predictions. It can serve as a guide in building EMR databases, improving EMR data quality control, and generating reliable real-world evidence.
Differences in trajectories of quality of life according to type of dementia: 6-year longitudinal findings from the IDEAL programme
Authors: Martyr Anthony , Gamble Laura D. , Hunt Anna , Quinn Catherine , Morris Robin G. , Henderson Catherine , Allan Louise , Opdebeeck Carol , Charlwood Catherine , Jones Roy W. , Pentecost Claire , Kopelman Michael D. , Thom Jeanette M. , Matthews Fiona E. , Clare Linda
Published: June 2024

Background

People with different types of dementia may have distinct symptoms and experiences that affect their quality of life. This study investigated whether quality of life varied across types of dementia and over time.

Methods

The participants were 1555 people with mild-to-moderate dementia and 1327 carers from the IDEAL longitudinal cohort study, recruited from clinical services. As many as possible were followed for up to 6 years. Diagnoses included were Alzheimer’s disease, vascular dementia, mixed Alzheimer’s and vascular dementia, Parkinson’s disease dementia, dementia with Lewy bodies, and frontotemporal dementia. Self- and informant-rated versions of the Quality of Life in Alzheimer’s Disease scale were used. A joint model, incorporating a mixed effects model with random effects and a survival model to account for dropout, was used to examine whether quality of life varied by dementia type at the time of diagnosis and how trajectories changed over time.

Results

The strongest associations between dementia type and quality of life were seen around the time of diagnosis. For both self-ratings and informant ratings, people with Parkinson’s disease dementia or dementia with Lewy bodies had lower quality of life scores. Over time there was little change in self-rated scores across all dementia types (− 0.15 points per year). Informant-rated scores declined over time (− 1.63 points per year), with the greatest decline seen in ratings by informants for people with dementia with Lewy bodies (− 2.18 points per year).

Conclusions

Self-rated quality of life scores were relatively stable over time whilst informant ratings showed a steeper decline. People with Parkinson’s disease dementia or dementia with Lewy bodies report particularly low levels of quality of life, indicating the importance of greater attention to the needs of these groups.
‘Small volume—big problem’: culturing Yarrowia lipolytica in high-throughput micro-formats
Authors: Celińska Ewelina , Gorczyca Maria
Published: June 2024

With the current progress in the ‘design’ and ‘build’ stages of the ‘design-build-test-learn’ cycle, many synthetic biology projects become ‘test-limited’. Advances in the parallelization of microbes cultivations are of great aid, however, for many species down-scaling leaves a metabolic footprint. Yarrowia lipolytica is one such demanding yeast species, for which scaling-down inevitably leads to perturbations in phenotype development. Strictly aerobic metabolism, propensity for filamentation and adhesion to hydrophobic surfaces, spontaneous flocculation, and high acidification of media are just several characteristics that make the transfer of the micro-scale protocols developed for the other microbial species very challenging in this case. It is well recognized that without additional ‘personalized’ optimization, either MTP-based or single-cell-based protocols are useless for accurate studies of Y. lipolytica phenotypes. This review summarizes the progress in the scaling-down and parallelization of Y. lipolytica cultures, highlighting the challenges that occur most frequently and strategies for their overcoming. The problem of Y. lipolytica cultures down-scaling is illustrated by calculating the costs of micro-cultivations, and determining the unintentionally introduced, thus uncontrolled, variables. The key research into culturing Y. lipolytica in various MTP formats and micro- and pico-bioreactors is discussed. Own recently developed and carefully pre-optimized high-throughput cultivation protocol is presented, alongside the details from the optimization stage. We hope that this work will serve as a practical guide for those working with Y. lipolytica high-throughput screens.
Investigating the impact of training programs on work-life balance of women teachers in secondary schools using PLS-SEM approach
Authors: Dwivedi Prerna , Shrivastava Urvashi , Nair Sindhu J.
Published: June 2024

The primary aim of this study is to investigate the factors influencing work-life balance among women teachers in secondary schools, with a focus on the role of training programs, emotional intelligence, stress management and supportive work environments. A cross-sectional research design was employed, and data were collected from 422 women teachers in Durg district, Chhattisgarh, using an online survey during period July to December 2023. Through Partial Least Squares Structural Equation Modeling (PLS-SEM) analysis, the study found that high-quality training programs play a significant role in enhancing work-life balance, with emotional intelligence and stress management acting as crucial mediating factors. Additionally, a supportive work environment was identified as a key moderator in the relationship between training programs and work-life balance. These findings highlight the importance of holistic approaches that integrate training programs, emotional intelligence development, stress management, and supportive work environments to foster a healthy work-life balance among women educators. The implications of these findings for policy and practice in the education sector highlight the necessity of investing in teacher development programs and organizational initiatives aimed at supporting teacher well-being.
Towards the diagnosis of osteoporosis – contributions from coincidental diagnostic imaging findings in chiropractors' practice
Authors: Uhrenholt Lars , Bakkegaard Jakob Hermannsen , Hansen Kasper , Doktor Klaus Knarberg
Published: June 2024

Background

Osteoporosis is significantly associated with fractures and burdens the health of especially older people. Osteoporotic fractures cause pain, disability, and increased mortality. Early diagnosis of osteoporosis allows earlier initiation of treatment, thereby reducing the risk of osteoporotic fractures. Chiropractors encounter potential osteoporotic patients daily, and perform radiological evaluation of these and other patients, including evaluation of X-rays done for other purposes than osteoporosis. Therefore, chiropractors may identify vertebral fractures, vertebral deformity or osteopenia not otherwise suspected or recorded.

Methods

This study examines procedures available to the chiropractor to describe conventional X-rays with the focus of osteoporosis related findings. We review the indications for radiological examination in chiropractic practice, and in the realm of osteoporosis we describe radiological methods available for examination of conventional radiographs, and the necessity of inter-disciplinary communication.

Results

National guidelines are available regarding referral for X-rays in chiropractic practice. Standardized protocols ensure image acquisition of the highest quality in the chiropractors’ radiological department. Conventional X-ray examination is not indicated on clinical suspicion of osteoporosis alone, as bone mineral density testing is the diagnostic test. Radiological assessment of all available X-rays of patients above the age of 50 years should include evaluation of the bone quality, and hip and vertebral fracture assessment. The Singh index, Genant Semi-Quantitative tool (GSQ), and Algorithm-Based Qualitative method (ABQ) should be used consistently during interpretation. Referral for additional imaging and evaluation should be prompt and systematic when needed.

Conclusions

This article presents an overview of evidence-based radiological procedures for the purpose of promoting early diagnosis of osteoporosis. We present recommendations to the clinicians where we propose an opportunistic evaluation of X-rays, done for any reason, which include systematic evaluation of bone quality, presence of hip and vertebral fractures, and vertebral deformation of all patients above the age of 50 years. Detailed referral to healthcare professionals for further diagnostic evaluation is performed when needed. Consistent, high-quality radiological procedures in chiropractic practices could feasibly contribute to the timely diagnosis of osteoporosis, ultimately minimizing the impact of osteoporosis-related complications on patients’ health.
Tadalafil versus pentoxifylline in the management of diabetic kidney disease: a randomized clinical trial
Authors: Hegazy Sahar Kamal , Amaar Walaa Ahmed , Hegab Wafaa Salah Mohamed
Published: June 2024

Aims

To investigate the efficacy and safety of tadalafil (TAD) versus pentoxifylline (PTX) in the management of diabetic kidney disease (DKD). Some animal studies and clinical trials reported that tadalafil and pentoxifylline have a reducing effect on different blood glucose parameters and lipid profiles which contribute to progress the patients with diabetes mellitus (DM) to DKD.

Methods

From February 2022 to March 2023, 90 patients with type 2 DM and DKD (micro-albuminuria) were enrolled in this randomized-controlled study. The patients were randomized into three equal groups: control group, TAD group, and PTX group. The three groups received traditional blood glucose lowering therapy + ramipril 10 mg PO. The TAD group also received tadalafil 20 mg PO every other day. The PTX group also received pentoxifylline 400 mg PO twice daily.

Results

Both TAD and PTX groups produced statistically significant improvement in the primary outcomes by a significant reduction in Urinary albumin/creatinine ratio (UACR) which was pronounced by a reduction percentage of—47.47%, −53.73% respectively. In addition to a significant decrease in Hemoglobin A1C (HbA1c) (mmol/mol), Fasting blood glucose (FBG), 2-h postprandial blood glucose (2-h PPG) (p < 0.001). Only the PTX group showed a significant increase in Cr Cl and a significant decrease in S. Cr (p < 0.001). Only the TAD group showed a significant increase in high-density lipoprotein—cholesterol (HDL-C) (p < 0.001), while the PTX group showed a significant decrease in low-density lipoprotein—cholesterol (LDL-C) (p-value 0.011), and triglyceride (p-value 0.002). Both TAD and PTX groups showed a decrease in tumor necrosis factor-α (TNF-α) which was significant only in the PTX group (p < 0.001). There was a significant increase in malondialdehyde (MDA) (p < 0.001), and an increase in urinary neutrophil gelatinase-associated Lipocalin (uNGAL) (p-value 0.850, 0.014 respectively) which was significant only in the PTX group.

Conclusions

The use of tadalafil or pentoxifylline may serve as an effective adjuvant therapy for patients with diabetic kidney disease.

Trial Registration: ClinicalTrials.gov identifier NCT05487755, July 25, 2022.
Artificial intelligence for MRI stroke detection: a systematic review and meta-analysis
Authors: Bojsen Jonas Asgaard , Elhakim Mohammad Talal , Graumann Ole , Gaist David , Nielsen Mads , Harbo Frederik Severin Gråe , Krag Christian Hedeager , Sagar Malini Vendela , Kruuse Christina , Boesen Mikael Ploug , Rasmussen Benjamin Schnack Brandt
Published: June 2024

Objectives

This systematic review and meta-analysis aimed to assess the stroke detection performance of artificial intelligence (AI) in magnetic resonance imaging (MRI), and additionally to identify reporting insufficiencies.

Methods

PRISMA guidelines were followed. MEDLINE, Embase, Cochrane Central, and IEEE Xplore were searched for studies utilising MRI and AI for stroke detection. The protocol was prospectively registered with PROSPERO (CRD42021289748). Sensitivity, specificity, accuracy, and area under the receiver operating characteristic (ROC) curve were the primary outcomes. Only studies using MRI in adults were included. The intervention was AI for stroke detection with ischaemic and haemorrhagic stroke in separate categories. Any manual labelling was used as a comparator. A modified QUADAS-2 tool was used for bias assessment. The minimum information about clinical artificial intelligence modelling (MI-CLAIM) checklist was used to assess reporting insufficiencies. Meta-analyses were performed for sensitivity, specificity, and hierarchical summary ROC (HSROC) on low risk of bias studies.

Results

Thirty-three studies were eligible for inclusion. Fifteen studies had a low risk of bias. Low-risk studies were better for reporting MI-CLAIM items. Only one study examined a CE-approved AI algorithm. Forest plots revealed detection sensitivity and specificity of 93% and 93% with identical performance in the HSROC analysis and positive and negative likelihood ratios of 12.6 and 0.079.

Conclusion

Current AI technology can detect ischaemic stroke in MRI. There is a need for further validation of haemorrhagic detection. The clinical usability of AI stroke detection in MRI is yet to be investigated.

Critical relevance statement

This first meta-analysis concludes that AI, utilising diffusion-weighted MRI sequences, can accurately aid the detection of ischaemic brain lesions and its clinical utility is ready to be uncovered in clinical trials.

Key Points

There is a growing interest in AI solutions for detection aid.

The performance is unknown for MRI stroke assessment.

AI detection sensitivity and specificity were 93% and 93% for ischaemic lesions.

There is limited evidence for the detection of patients with haemorrhagic lesions.

AI can accurately detect patients with ischaemic stroke in MRI.

Graphical Abstract
PET/CT deep learning prognosis for treatment decision support in esophageal squamous cell carcinoma
Authors: Song Jiangdian , Zhang Jie , Liu Guichao , Guo Zhexu , Liao Hongxian , Feng Wenhui , Lin Wenxiang , Li Lei , Zhang Yi , Yang Yuxiang , Liu Bin , Luo Ruibang , Chen Hao , Wang Siyun , Liu Jian-Hua
Published: June 2024

Objectives

The clinical decision-making regarding choosing surgery alone (SA) or surgery followed by postoperative adjuvant chemotherapy (SPOCT) in esophageal squamous cell carcinoma (ESCC) remains controversial. We aim to propose a pre-therapy PET/CT image-based deep learning approach to improve the survival benefit and clinical management of ESCC patients.

Methods

This retrospective multicenter study included 837 ESCC patients from three institutions. Prognostic biomarkers integrating six networks were developed to build an ESCC prognosis (ESCCPro) model and predict the survival probability of ESCC patients treated with SA and SPOCT. Patients who did not undergo surgical resection were in a control group. Overall survival (OS) was the primary end-point event. The expected improvement in survival prognosis with the application of ESCCPro to assign treatment protocols was estimated by comparing the survival of patients in each subgroup. Seven clinicians with varying experience evaluated how ESCCPro performed in assisting clinical decision-making.

Results

In this retrospective multicenter study, patients receiving SA had a median OS 9.2 months longer than controls. No significant differences in survival were found between SA patients with predicted poor outcomes and the controls (p > 0.05). It was estimated that if ESCCPro was used to determine SA and SPOCT eligibility, the median OS in the ESCCPro-recommended SA group and SPOCT group would have been 15.3 months and 24.9 months longer, respectively. In addition, ESCCPro also significantly improved prognosis accuracy, certainty, and the efficiency of clinical experts.

Conclusion

ESCCPro assistance improved the survival benefit of ESCC patients and the clinical decision-making among the two treatment approaches.

Critical relevance statement

The ESCCPro model for treatment decision-making is promising to improve overall survival in ESCC patients undergoing surgical resection and patients undergoing surgery followed by postoperative adjuvant chemotherapy.

Key Points

ESCC is associated with a poor prognosis and unclear ideal treatments.

ESCCPro predicts the survival of patients with ESCC and the expected benefit from SA.

ESCCPro improves clinicians’ stratification of patients’ prognoses.

Graphical Abstract
Fomes weberianus, 50 years of taxonomic confusion: lectotypification and taxonomic notes
Authors: Decock Cony , Cabarroi-Hernández Milay , Guzmán-Dávalos Laura , Kirk Paul M. , García-Beltrán José Ángel , Amalfi Mario
Published: June 2024

Fomes weberianus Bres. & Henn. ex Sacc. is currently the basionym of two very distinct polypores (Basidiomycota), Ganoderma weberianum (Polyporales) and Phylloporia weberiana (Hymenochaetales). This fact has led to almost fifty years of taxonomic confusion. Fomes weberianus was first lectotypified by Steyaert, who accepted the species as G. weberianum. However, studies of Weber’s original material in B, duplicate material in S, the protologue, and early interpretations of the name have shown that Steyaert’s choice conflicts with the protologue and early interpretations, and that his interpretation as a species of Ganoderma is erroneous. A new lectotype was designated and the species was re-described under the correct interpretation Phylloporia weberiana.
Sortilin and its potential role in cardiovascular pathology
Authors: Namitokov Alim
Published: June 2024

Background

This comprehensive review explores the multifaceted role of sortilin, a key receptor in lipid metabolism, within the context of cardiovascular diseases (CVDs), the leading cause of global mortality.

Main body

Sortilin, encoded by the SORT1 gene, is implicated in the pathogenesis of atherosclerosis, primarily through its regulation of low-density lipoprotein cholesterol (LDL-C) and very low-density lipoproteins (VLDL). The review delves into the biological functions of sortilin, emphasizing its critical role in lipid and cholesterol homeostasis and its influence on hepatic secretion of lipoproteins and atherogenesis. We highlight sortilin's pathophysiological significance in atherosclerosis, underscoring its involvement in lipid metabolism pathways and vascular inflammation, and its impact on macrophage functions in atherosclerotic plaque formation. The potential of sortilin as a therapeutic target is discussed, considering evidence that suggests its modulation could ameliorate atherosclerosis. The review also acknowledges current inconsistencies and gaps in the evidence, calling for more comprehensive patient studies and in-depth mechanistic research. Finally, the article outlines future research directions, focusing on understanding sortilin's specific cellular mechanisms in cardiovascular health, exploring its genetic variability, therapeutic implications, and its broader relevance to other diseases.

Conclusion

This review underscores the significance of sortilin as a biomarker and a promising target for therapeutic intervention in cardiovascular pathology, while advocating for continued research to fully unravel its complex role.
Artificial intelligent tools: evidence-mapping on the perceived positive effects on patient-care and confidentiality
Authors: Botha Nkosi N. , Ansah Edward W. , Segbedzi Cynthia E. , Dumahasi Victor K. , Maneen Samuel , Kodom Ruby V. , Tsedze Ivy S. , Akoto Lucy A. , Atsu Fortune S.
Published: June 2024

Background

Globally, healthcare systems have always contended with well-known and seemingly intractable challenges like safety, quality, efficient and effective clinical and administrative patient-care services. To firmly confront these and other healthcare challenges, the World Health Organisation proposed a full adoption of artificial intelligence (AI) applications into patient care to stimulate efficiency and guarantee quality in patient management.

Purpose

This review aimed to establish the extent and type of evidence of the positive effects of the use of AI tools in patient care. Thus, the review mapped evidence by using articles published between January 1, 2010, and October 31, 2023.

Methods

Consistent with the protocol by Tricco et al., a comprehensive literature search was executed from Nature, PubMed, Scopus, ScienceDirect, Dimensions, Web of Science, Ebsco Host, ProQuest, JStore, Semantic Scholar, Taylor & Francis, Emeralds, World Health Organisation, and Google Scholar. Upholding the inclusion and exclusion standards, 95 peer-reviewed articles were included in this review.

Findings

We report that the use of AI tools can significantly improve the accuracy of clinical diagnosis to guarantee better patient health outcomes. AI tools also have the ability to mitigate, if not eliminate, most of the factors that currently predict poor patient outcomes. Furthermore, AI tools are far more efficient in generating robust and accurate data in real time and can help ease and accelerate workflow at healthcare facilities.

Conclusion

If properly integrated into the healthcare system, AI will help reduce patients’ waiting time and accelerate the attainment of Sustainable Development Goals 3.4, 3.8, and 3.b. We propose that AI developers collaborate with public health practitioners and healthcare managers to develop AI applications that appreciate socio-cultural dimensions in patient care.
Operator growth and spread complexity in open quantum systems
Authors: Carolan Eoin , Kiely Anthony , Campbell Steve , Deffner Sebastian
Published: June 2024

Commonly, the notion of “quantum chaos” refers to the fast scrambling of information throughout complex quantum systems undergoing unitary evolution. Motivated by the Krylov complexity and the operator growth hypothesis, we demonstrate that the entropy of the population distribution for an operator in time is a useful way to capture the complexity of the internal information dynamics of a system when subject to an environment and is, in principle, agnostic to the specific choice of operator basis. We demonstrate its effectiveness for the Sachdev-Ye-Kitaev (SYK) model, examining the dynamics of the system in both its Krylov basis and the basis of operator strings. We prove that the former basis minimises spread complexity while the latter is an eigenbasis for high dissipation. In both cases, we probe the long-time dynamics of the model and the phenomenological effects of decoherence on the complexity of the dynamics.
Perioperative Care of Patients Using Wearable Diabetes Devices
Authors: Cruz Paulina , McKee Alexis M. , Chiang Hou-Hsien , McGill Janet B. , Hirsch Irl B. , Ringenberg Kyle , Wildes Troy S.
Published: June 2024

The increasing prevalence of diabetes mellitus has been accompanied by a rapid expansion in wearable continuous glucose monitoring (CGM) devices and insulin pumps. Systems combining these components in a “closed loop,” where interstitial glucose measurement guides automated insulin delivery (AID, or closed loop) based on sophisticated algorithms, are increasingly common. While these devices’ efficacy in achieving near-normoglycemia is contributing to increasing usage among patients with diabetes, the management of these patients in operative and procedural environments remains understudied with limited published guidance available, particularly regarding AID systems. With their growing prevalence, practical management advice is needed for their utilization, or for the rational temporary substitution of alternative diabetes monitoring and treatments, during surgical care. CGM devices monitor interstitial glucose in real time; however, there are potential limitations to use and accuracy in the perioperative period, and, at the present time, their use should not replace regular point-of-care glucose monitoring. Avoiding perioperative removal of CGMs when possible is important, as removal of these prescribed devices can result in prolonged interruptions in CGM-informed treatments during and after procedures, particularly AID system use. Standalone insulin pumps provide continuous subcutaneous insulin delivery without automated adjustments for glucose concentrations and can be continued during some procedures. The safe intraoperative use of AID devices in their hybrid closed-loop mode (AID mode) requires the CGM component of the system to continue to communicate valid blood glucose data, and thus introduces the additional need to ensure this portion of the system is functioning appropriately to enable intraprocedural use. AID devices revert to non-AID insulin therapy modes when paired CGMs are disconnected or when the closed-loop mode is intentionally disabled. For patients using insulin pumps, we describe procedural factors that may compromise CGM, insulin pump, and AID use, necessitating a proactive transition to an alternative insulin regimen. Procedure duration and invasiveness is an important factor as longer procedures increase the risk of stress hyperglycemia, tissue malperfusion, and device malfunction. Whether insulin pumps should be continued through procedures, or substituted by alternative insulin delivery methods, is a complex decision that requires all parties to understand potential risks and contingency plans relating to patient and procedural factors. Currently available CGMs and insulin pumps are reviewed, and practical recommendations for safe glycemic management during the phases of perioperative care are provided.
The Public Power Observatory
Authors: Dawson Ashley
Published: June 2024

We are entering a period of abrupt and irreversible environmental change. Currently dominant assumptions about what is politically appropriate and realistic will be obliterated as vast masses of people find the conditions for their collective survival annihilated in coming decades. This article argues that it is imperative we deepen the debate about strategies to provoke revolutionary ruptures within the fossil-capitalist world system. We need viable strategies to generalize mutual aid and disaster communism, and these strategies must provide concrete solutions to the intersecting climate crises on different scales, from the local to the global. The abolition of fossil capital through the building of counterpower—in all senses of that term—should be a key strategic priority of the global movement for ecosocialism. The article discusses the Public Power NY campaign, which has established itself as a potent counterpower within the corporate-dominated US energy system. Constituted on the heels of the campaign's legislative success, the Public Power Observatory is an interdisciplinary formation dedicated to monitoring and building this counterpower and, in so doing, reclaiming the energy commons. The article discusses some of the suite of transmedia tools currently being developed by the Public Power Observatory.
Optimal Timing of Microsurgical Treatment for Ruptured Arteriovenous Malformations: A Systematic Review and Meta-Analysis
Authors: Orscelik Atakan , Musmar Basel , Matsukawa Hidetoshi , Ismail Mustafa , Elawady Sameh Samir , Assad Salman , Cunningham Conor , Sowlat Mohamed Mahdi , Spiotta Alejandro M.
Published: June 2024

BACKGROUND AND OBJECTIVES:

The timing of microsurgical treatment (MST) for ruptured brain arteriovenous malformations (bAVM) is a contentious issue in the literature. This study aimed to investigate the impact of MST timing on outcomes in patients with ruptured bAVMs, considering MST with and without preoperative endovascular treatment (EVT).

METHOD:

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, a comprehensive search was conducted across multiple databases, yielding 15 studies meeting the inclusion criteria. The timing was defined as the duration from the rupture of bAVM to the MST. The patients were divided into 4 different groups based on MST timing: <48 hours, <1 week, <2 weeks, and <1 month. The primary outcome was favorable outcome defined as a modified Rankin Scale score of 0 to 2 or a Glasgow Outcome Scale score of 4 to 5 in the last clinical follow-up. Secondary outcomes included periprocedural mortality and complete excision.

RESULTS:

MST time >48 hours were associated with a significantly higher favorable outcome rate (odds ratio: 9.71, 95% Cl: 3.09-30.57, P < .01) and a lower mortality rate (OR: 0.15, 95% Cl: 0.02-0.88, P = .04) compared with MST timing ≤48 hours. After exclusion of patients who underwent MST with preoperative EVT, MST time >48 hours had a significantly higher rate of favorable outcome (OR: 9.39, 95% CI: 2.53-34.89, P < .01).

CONCLUSION:

This meta-analysis suggests that delayed surgical intervention beyond 48 hours may be associated with improved favorable outcomes in patients who underwent MST with and without preoperative EVT for ruptured bAVMs.
Resilience After High-Grade Subarachnoid Hemorrhage: A Prospective Cohort Study on Quality of Life
Authors: Denneman Nadine , Post René , Coert Bert A. , van den Berg René , Verbaan Dagmar , Vandertop W. Peter
Published: June 2024

BACKGROUND AND OBJECTIVES:

Treatment of patients who present with poor clinical condition is often postponed until neurological improvement is observed. Despite previous studies, it is still unclear how survivors perceive their quality of life (QoL). This study aimed to evaluate self-perceived QoL in patients with aneurysmal subarachnoid hemorrhage who present with poor clinical condition, as defined by World Federation of Neurosurgical Societies (WFNS) grades 4 to 5, compared with those who present in more favorable clinical condition (WFNS 1-3).

METHODS:

Between 2011 and 2021, 1160 patients with aneurysmal subarachnoid hemorrhage were admitted to the Amsterdam UMC. Among the 845 patients who survived, 537 participated in the QoL questionnaires. Patient characteristics, complications, EQ-5D questionnaires, modified Rankin Scale, and Hospital Anxiety and Depression Scale were analyzed using the nonparametric Mann-Whitney U test for continuous variables or the Pearson χ2 test for categorical variables.

RESULTS:

Of the 537 responders, 452 (84%) presented with low grade (WFNS 1-3) and 85 (16%) presented with high grade (WFNS 4-5). The high-grade group reported a self-perceived QoL score of 70 (of 100), while the low-grade group reported a score of 75 (P = .12). The mean EQ-5D index value was 0.74 for the high-grade group and 0.81 for the low-grade group (P < .01). In the high-grade group, 61 patients (72%) had a favorable outcome (modified Rankin Scale 0-3) compared with 419 (94%) in the low-grade group (P < .001).

CONCLUSION:

High-grade WFNS patients rated their QoL as satisfactory, with only a marginal 5-point difference on a 100-point scale compared with low-grade WFNS patients. In addition, almost three-quarters of high-grade WFNS survivors achieved a favorable outcome. Given that a subset of patients, despite presenting with a poor clinical condition, still achieve a favorable outcome, these findings reinforce our perspective advocating for early and comprehensive treatment.
Changes in mitochondrial distribution occur at the axon initial segment in association with neurodegeneration in Drosophila
Authors: Wodrich Andrew P. K. , Harris Brent T. , Giniger Edward
Published: June 2024

Changes in mitochondrial distribution are a feature of numerous age-related neurodegenerative diseases. In Drosophila, reducing the activity of Cdk5 causes a neurodegenerative phenotype and is known to affect several mitochondrial properties. Therefore, we investigated whether alterations of mitochondrial distribution are involved in Cdk5-associated neurodegeneration. We find that reducing Cdk5 activity does not alter the balance of mitochondrial localization to the somatodendritic versus axonal neuronal compartments of the mushroom body, the learning and memory center of the Drosophila brain. We do, however, observe changes in mitochondrial distribution at the axon initial segment (AIS), a neuronal compartment located in the proximal axon involved in neuronal polarization and action potential initiation. Specifically, we observe that mitochondria are partially excluded from the AIS in wild-type neurons, but that this exclusion is lost upon reduction of Cdk5 activity, concomitant with the shrinkage of the AIS domain that is known to occur in this condition. This mitochondrial redistribution into the AIS is not likely due to the shortening of the AIS domain itself but rather due to altered Cdk5 activity. Furthermore, mitochondrial redistribution into the AIS is unlikely to be an early driver of neurodegeneration in the context of reduced Cdk5 activity.
Strength of motivation of 1st year dental students of a dental institution: A cross-sectional study
Authors: Fizzah Ali  , Ehsan Muhammad Tauqeer , Suhaib Fatima , Fatima Mariam
Published: June 2024

Objective: The study aims to evaluate the motivation levels of dental students, with an emphasis on first-year BDS students, by utilizing the Strength of Motivation for Medical School (SMMS) questionnaire.
Methods: It was a descriptive cross-sectional quantitative study targeting 89 first-year BDS students enrolled at Lahore Medical and Dental College from 5th June to 18th August 2023. The Strength of Motivation for Medical School (SMMS) questionnaire was given to the participants after ethical board approval. Data analysis was done through SPSS version 26. The SMMS score was presented as the means standard deviation and an independent t-test was used to find the difference between the groups. The maximum score possible is 80 and the minimum is 16. The higher the score, the greater the strength of motivation.
Results: In this study, a total of 89 first-year BDS students completed motivation questionnaires, with 34.8% males and 65.2% females. The average age was 19.92±3.13. The overall Strength of Motivation Score (SMMS) averaged 45.53±6.82. Results indicated 9% low, 89.9% moderate, and 1.1% strong motivation. Females had a slightly higher mean SMMS (45.93±6.88) than males (44.80±6.76), but the difference was deemed insignificant (p = 0.462) via independent t-test.
Conclusion: Motivation is vital to achieving excellence in academic pursuits. Nevertheless, there isn’t a single criterion that can be utilized to assess success and motivation. Our primary focus must be on every possible outcome of success, not just the scoring criteria.
doi: https://doi.org/10.12669/pjms.40.7.9112
How to cite this: Ali F, Ehsan MT, Suhaib F, Fatima M. Strength of motivation of 1st year dental students of a dental institution: A cross-sectional study. Pak J Med Sci. 2024;40(7):---------. doi: https://doi.org/10.12669/pjms.40.7.9112
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