bluuebunny/crossref_metadata_2025 huggingface dataset:
The prevalence of obstructive sleep apnea in Japanese asthma patients
Authors: Yasuda Mina , Tobino Kazunori , Harada Norihiro , Ooi Ryunosuke , Sueyasu Takuto , Nishizawa Saori , Munechika Miyuki , Yoshimine Kohei , Ko Yuki , Yoshimatsu Yuki , Tsuruno Kosuke , Ide Hiromi , Takahashi Kazuhisa
Published: February 2024

Background

Obstructive sleep apnea (OSA) occurs more commonly in asthma patients than in the general population because these conditions share some comorbidities. In Japan, the prevalence of OSA in the general population is reported to be approximately 20%; however, few reports have described the prevalence of OSA in asthma patients. Furthermore, the characteristics of Japanese patients with OSA and asthma are not clear.

Methods

Adult asthma patients were recruited from the outpatient departments of our institution between August 31, 2017, and March 31, 2019. In all included patients, the presence and severity of OSA were evaluated by the Epworth Sleepiness Scale (ESS) and a home sleep test (HST) using portable polysomnography (PSG). The rate of coexisting OSA in asthma patients and the characteristics of those patients according to the severity of OSA were investigated.

Results

Fifty-three patients were included. OSA was detected in 36 (67.9%) patients (mild, n = 15; moderate, n = 14; and severe, n = 7). Patients with OSA had significantly higher body mass index, Brinkman index, apnea-hypopnea index (AHI), and 3% oxygen desaturation index (ODI) values in comparison to those without OSA, while the percentage of the predicted value of forced vital capacity (%FVC) and lowest SpO2 levels were significantly lower. As the severity of OSA increased, age, brain natriuretic peptide level, AHI, and 3%ODI increased, and in contrast, FVC, %FVC, forced expiratory volume in one second (FEV1), percentage of the predicted value of FEV1 (%FEV1), Epworth Sleepiness Scale (ESS), 3%ODI, and lowest SpO2 levels decreased. In particular, the fact that the ESS value was inversely correlated with the severity of OSA in our patients was different from the general characteristics of OSA. Moreover, the AHI value was negatively correlated with FVC, %FVC, FEV1, and %FEV1. BMI was the only independent factor for the presence of OSA, and for asthma severity (FEV1, % of predicted), there was a weak correlation with smoking history.

Conclusions

This is the first report to investigate the prevalence of OSA in Japanese asthma patients, using an HST. This study suggests that an HST should be performed in addition to the sleep interview for asthma patients with refractory disease, a low pulmonary function, advanced age, and high BMI because the more severe the OSA, the lower the ESS value may be.
Successful treatment of severe calcium channel blocker poisoning, new experience with the guidance of invasive hemodynamic monitoring in a 17-year-old girl: a case report
Authors: Saeed Amir , Naghshzan Amir
Published: February 2024

Background

Calcium channel blocker poisoning is one of the most lethal cardiac drugs overdoses. Calcium and high-dose insulin infusion are the first-line therapy for symptomatic patients, and Intralipid emulsion infusion is useful for refractory cases.

Case presentation

In this report, we describe a 17-year-old Iranian girl who took 250 mg of the drug for a suicidal attempt and presented with refractory hypotension and non-cardiogenic pulmonary edema treated successfully with the guidance of invasive hemodynamic parameters.

Conclusion

For complicated cases, in addition to supportive care and adjuvant therapy such as high-dose insulin and Intralipid, it is mandatory to utilize advanced hemodynamic monitoring to treat hypotension in severe calcium channel blocker poisoning to guide the treatment.
Aldo-keto reductase family 1 member A1 (AKR1A1) exerts a protective function in alcohol-associated liver disease by reducing 4-HNE accumulation and p53 activation
Authors: Lan Ying-Wei , Chen Wan-Ru , Chang Gary Ro-Lin , Chen Ying-Cheng , Chong Kowit-Yu , Chuang Kai-Cheng , Kao Yung-Tsung , Chen Ming-Shan , Chen Chuan-Mu
Published: February 2024

Background

The development of alcohol-associated liver disease (ALD) is influenced by the amount and duration of alcohol consumption. The resulting liver damage can range from reversible stages, such as steatosis, steatohepatitis and alcoholic fibrosis, to the advanced and irreversible stage of cirrhosis. Aldo-keto reductase family 1 member A1 (AKR1A1) is a member of the aldo-keto reductase family that catalyzes the reduction of aldehyde groups to their corresponding alcohols in an NADPH-dependent manner. AKR1A1 was found to be downregulated in patients diagnosed with ALD. This study aims to interpret the protective effects of AKR1A1 on the development of ALD.

Methods

A 5% alcohol-fed (AF) Akr1a1 knockout (Akr1a1−/−) mouse model and an AML12 hepatocyte model were used. The effects of AKR1A1 on liver function, inflammation, oxidative stress, lipid accumulation, and fibrosis were assessed by ELISA, western blotting, RT‒PCR, and a variety of histological staining methods in AF-induced wild-type (WT) and Akr1a1−/− mice compared to control liquid diet-fed (PF) WT and Akr1a1−/− mice.

Results

The results demonstrated that AF-WT mice expressed higher levels of AKR1A1 than WT mice fed a control diet, and they did not show any noticeable liver steatosis. However, AF-Akr1a1−/− mice displayed a lower survival rate and more severe liver injury than AF-WT mice, as demonstrated by increased proinflammatory cytokines, oxidative stress, lipid accumulation, fibrosis, and reduced antioxidant enzymes in their livers. Additionally, elevated levels of 4-HNE and p53 phosphorylation were observed in AF-Akr1a1−/− mice, suggesting that the loss of AKR1A1 led to increased 4-HNE accumulation and subsequent activation of p53, which contributed to the progression of ALD. Furthermore, in AML12 hepatocytes, Akr1a1 knockdown aggravated oxidative stress and steatosis induced by palmitic acid/oleic acid (P/O) inflammation induced by lipopolysaccharide (LPS), and fibrosis induced by TGF-β1.

Conclusions

This loss-of-function study suggests that AKR1A1 plays a liver-protective role during chronic alcohol consumption by reducing the accumulation of 4-HNE and inhibiting 4-HNE-mediated p53 activation.
Sub-convolutional U-Net with transformer attention network for end-to-end single-channel speech enhancement
Authors: Yecchuri Sivaramakrishna , Vanambathina Sunny Dayal
Published: February 2024

Recent advancements in deep learning-based speech enhancement models have extensively used attention mechanisms to achieve state-of-the-art methods by demonstrating their effectiveness. This paper proposes a transformer attention network based sub-convolutional U-Net (TANSCUNet) for speech enhancement. Instead of adopting conventional RNNs and temporal convolutional networks for sequence modeling, we employ a novel transformer-based attention network between the sub-convolutional U-Net encoder and decoder for better feature learning. More specifically, it is composed of several adaptive time―frequency attention modules and an adaptive hierarchical attention module, aiming to capture long-term time-frequency dependencies and further aggregate hierarchical contextual information. Additionally, a sub-convolutional encoder-decoder model used different kernel sizes to extract multi-scale local and contextual features from the noisy speech. The experimental results show that the proposed model outperforms several state-of-the-art methods.
A multi-classification detection model for imbalanced data in NIDS based on reconstruction and feature matching
Authors: Yang Yue , Cheng Jieren , Liu Zhaowu , Li Huimin , Xu Ganglou
Published: February 2024

With the exponential growth of various data interactions on network systems, network intrusions are also increasing. The emergence of edge computing technology brings a new solution to network security. However, due to the difficulty of processing massive and unbalanced data at the edge, higher accuracy requirements are necessary for deployed detection models. This paper proposes a multi-classification model for network intrusion detection based on reconstruction and feature matching. This model can be deployed on small-scale edge nodes, effectively identifying various attack behaviors through the utilization of reconstruction errors and adaptive scaling. Furthermore, we proposed a model transfer method based on feature matching to enhance the training and detection efficiency of multi-classification models under different data distribution conditions. The proposed model has been evaluated on the CICIDS2017 dataset in terms of accuracy, recall, precision and F1 score. The model demonstrates high accuracy for normal flows in the network, majority class attacks, and minority class attacks, achieving an overall multi-class accuracy of 99.81%, outperforming similar models. Furthermore, this model demonstrates faster convergence and training speed after feature matching, exhibiting better robustness and outstanding performance at the edge.
Triglyceride-glucose index is capable of identifying metabolically obese, normal-weight older individuals
Authors: Kim Bokun , Taniguchi Keisuke , Isobe Tomonori , Oh Sechang
Published: February 2024

Background

The concept of metabolically obese, normal weight (MONW) has emerged to describe individuals with a normal body mass index (BMI) who are at a relatively high risk of chronic diseases. However, BMI itself is a suboptimal index for the assessment of the health risks associated with visceral fat. The triglyceride-glucose (TyG) index is considered to be a reliable and cost-effective marker of insulin resistance. Therefore, in the present study, we aimed to determine the TyG index cut-off values that could be used to define MONW in older people and to determine the usefulness of these values for the prediction of chronic diseases.

Methods

A total of 4,721 participants in the Korea National Health and Nutritional Examination Survey who were ≥ 60 years of age and did not have underweight or obesity were included. MONW was defined using the criteria for metabolic syndrome (MS), and the TyG index was calculated on the basis of the fasting plasma triglyceride and glucose concentrations. Chronic diseases, including T2DM, hypertension, and non-alcoholic fatty liver disease (NAFLD), were diagnosed.

Results

The prevalence of MS increased from the lowest to the highest TyG index tertile. The cut-off values of the TyG index for MONW were calculated as 8.88 and 8.80 for males and females, respectively. MONW, defined using these cut-off values, was associated with high odds ratios for NAFLD, T2DM, and hypertension in both males and females.

Conclusions

The TyG index cut-off values calculated in the present study can be used to discriminate individuals with MONW from other older individuals without obesity and to predict the risk of chronic diseases. These findings show that the TyG index is an effective and cost-efficient method of assessing the risk of chronic diseases in people with MONW.
Migration timing and marine space use of an anadromous Arctic fish (Arctic Char, Salvelinus alpinus) revealed by local spatial statistics and network analysis
Authors: Smith Rosie , Hitkolok Eric , Loewen Tracey , Dumond Amanda , Swanson Heidi
Published: February 2024

Background

The ice-free season (typically late-June to early-October) is crucial for anadromous species of fish in the Arctic, including Arctic Char (Salvelinus alpinus), which must acquire adequate resources for growth, reproduction, and survival during a brief period of feeding in the marine environment. Arctic Char is an important food fish for Inuit communities across the Arctic. Understanding drivers and patterns of migration in the marine environment is thus essential for conservation and management of the species.

Methods

We used passive acoustic telemetry to characterize migration patterns of 51 individual anadromous Arctic Char during the ice-free season in the marine environment of Coronation Gulf (Nunavut, Canada; 2019–2022). Based on recent genetic evidence, some tagged individuals were likely Dolly Varden (Salvelinus malma malma), a closely related species to Arctic Char. Using local Getis G* and network analysis, we described movement patterns and identified high-use locations in the marine environment. We also related freshwater overwintering location to migration timing and movement pattern.

Results

Comparing groups of fish that overwintered in distinct locations, we found: (i) limited evidence that marine movements were associated with overwintering location; (ii) minor differences in use of marine space; and, (iii) timing of freshwater return differed significantly between overwintering groups, and was related to length and difficulty of the migratory pathway in freshwater. Results from both network analysis and local Getis G* revealed that, regardless of overwintering location, coastal locations were highly used by fish.

Conclusions

Overwintering locations, and the migratory routes to access overwintering locations, affect the timing of freshwater return. Preference of fish for coastal marine locations is likely due to abundance of forage and patterns in break-up of sea ice. Similarities in marine space use and movement patterns present challenges for managing this and other mixed stock fisheries of anadromousSalvelinusspp. Absences or periods of time when fish were not detected prevented comprehensive assessment of movement patterns. Local Getis G*, a local indicator of spatial association, is a helpful tool in identifying locations associated with absences in acoustic telemetry arrays, and is a complementary method to network analysis.
Collagen type II solution extracted from supercritical carbon dioxide decellularized porcine cartilage: regenerative efficacy on post-traumatic osteoarthritis model
Authors: Periasamy Srinivasan , Chen Yun-Ju , Hsu Dur-Zong , Hsieh Dar-Jen
Published: February 2024

Osteoarthritis (OA) of the knee is a common degenerative articular disorder and is one of the main causes of pain and functional disability. Cartilage damage is frequently linked to elevated osteoarthritis incidence. Supercritical carbon dioxide (scCO2) decellularized cartilage graft produced from the porcine cartilage is an ideal candidate for cartilage tissue engineering. In the present study, we derived collagen type II (Col II) solution from the scCO2 decellularized porcine cartilage graft (dPCG) and compared its efficacy with hyaluronic acid (HA) in the surgical medial meniscectomy (MNX) induced post-traumatic osteoarthritis (PTOA) model. Dose-dependent attenuation of the OA (12.3 ± 0.8) progression was observed in the intra‐articular administration of Col II solution (7.3 ± 1.2) which significantly decreased the MNX-induced OA symptoms similar to HA. The pain of the OA group (37.4 ± 2.7) was attenuated dose-dependently by Col II solution (45.9 ± 4.1) similar to HA (43.1 ± 3.5) as evaluated by a capacitance meter. Micro‐CT depicted a dose-dependent attenuation of articular cartilage damage by the Col II solution similar to HA treatment. A significant (p < 0.001) dose-dependent elevation in the bone volume was also observed in Col II solution-treated OA animals. The protective competence of Col II solution on articular cartilage damage is due to its significant (p < 0.001) increase in the expression of type II collagen, aggrecan and SOX‐9 similar to HA. To conclude, intra‐articular administration of type II collagen solution and HA reestablished the injured cartilage and decreased osteoarthritis progression in the experimental PTOA model.

Graphical Abstract
Building MLR, ANN and FL models to predict the strength of problematic clayey soil stabilized with a combination of nano lime and nano pozzolan of natural sources for pavement construction
Authors: Al-Swaidani Aref M. , Meziab Ayman , Khwies Waed T. , Al-Bali Mohamad , Lala Tarek
Published: February 2024

The current study aims at predicting the strength of the problematic clayey soils treated with combinations of pozzolan of natural sources and lime powder when added as soil additives at a nano scale. Multiple linear regression (MLR), artificial neural networks (ANN) and fuzzy logic (FL) tools were employed in the analytical study. The variables of the present study include the following: nano pozzoaln of natural source (NNP) content, nano lime content (NL), median particle size of NNP, active silica content of NNP (SiO2active), Initial liquid limit (ILL) and initial plastic limit (IPL) of the investigated soils. NNP was added at five percentages, i.e. 0%, 0.5%, 1%, 1.5% and 2%, while NL was added at five percentages, i.e. 0%, 0.3%, 0.6%, 0.9% and 1.2%. Three median particle sizes namely 50, 100 and 500 nm size were studied. Based on the different investigated soils and combinations, 120 soil mixtures were prepared and tested. California bearing ratio (CBR) and plasticity index (PI) were particularly examined. CBR tests were conducted at a soaked condition on specimens compacted to a maximum dry density (MDD) at the optimum moisture content (OMC). PI values were obtained following the Atterberg limits test. Based on the results of the performance criteria of the developed predictive models, it can be concluded that the CBR and PI of the expansive clayey soils can be effectively predicted using ANN and FL techniques. The results obtained by MLR were far from those obtained by both ANN & FL. In addition, ANN tool was slightly more accurate than FL as far as prediction of CBR and PI is concerned. The higher capability of ANN & FL models in predicting CBR & PI values, which generally obtained through time-consuming and expensive tests, could be useful for geotechnical engineers to assess or design a new pavement project. Further, it is recommended to do a re-evaluation of the current study in future, particularly when more data is available in the literature.
The association between energy-adjusted dietary inflammatory index and physical activity with sleep quality: a cross-sectional study
Authors: Zare¹ Mohammad Javad , Masoumi Seyed Jalil , Zare Morteza
Published: February 2024

Background

The study aimed to assess the independent and interactive association of energy-adjusted dietary inflammatory index (E-DII) and physical activity (PA) with sleep quality.

Method

A cross-sectional study was conducted on the 2466 participants (60% women). A 116-item food frequency questionnaire (FFQ) was applied to calculate E-DII, the International Physical Activity Questionnaire (IPAQ) long form for PA, and the Pittsburgh sleep quality index (PSQI) to assess sleep quality were collected via interview. Multivariate logistic regression was applied to assess independent and interactive associations of E-DII and PA with sleep quality.

Result

No significant association was observed between E-DII and sleep quality (OR: 0.96, 95% CI: 0.92_1.01). Also, there was no significant association between the levels of PA and sleep quality. Women had 70% increased odds for poor sleep quality (OR: 1.7, 95% CI: 1.39_2.09) compared with men. No interactive association was observed between E-DII and PA levels with sleep quality.

Conclusion

No significant association was observed between E-DII and PA levels with sleep quality. The study indicates a gender difference in sleep quality. Future prospective studies are required to confirm these findings.
Feasibility and acceptability of a contextualized physical activity and diet intervention for the control of hypertension in adults from a rural subdistrict: a study protocol (HYPHEN)
Authors: Sekome Kganetso , Gómez-Olivé Francesc Xavier , Sherar Lauren B. , Esliger Dale W. , Myezwa Hellen
Published: February 2024

Introduction

In rural and remote South Africa, most strokes and ischaemic heart diseases are as a consequence of hypertension, which is a modifiable risk factor. The widely recommended therapeutic approaches to control hypertension are through physical activity and diet modifications. However, there is a lack of culturally sensitive community-based, lifestyle interventions to control hypertension among rural African adult populations. We designed an intervention which recommends adjusting daily routine physical activity and dietary behaviour of adults with hypertension. This study aims to evaluate the feasibility and acceptability of HYPHEN in a rural community setting.

Methods

We aim to recruit 30 adult participants with a self-report hypertension diagnosis. A one-arm, prospective design will be used to assess the feasibility and acceptability of recruitment, uptake, engagement, and completion of the 10-week intervention. Recruitment rates will be assessed at week 0. Intervention uptake, engagement, and adherence to the intervention will be assessed weekly via telephone. Blood pressure, body mass index, waist-hip ratio, urinary sodium, accelerometer-measured physical activity, and 24-h diet recall will be assessed at baseline and at 10 weeks. Qualitative semi-structured interviews will be conducted at 10 weeks to explore feasibility and acceptability.

Discussion

This study offers a person-centred, sociocultural approach to hypertension control through adaptations to physical activity and dietary intake. This study will determine whether HYPHEN is feasible and acceptable and will inform changes to the protocol/focus that could be tested in a full trial.

Trial registration number

PACTR202306662753321.
A circuit area optimization of MK-3 S-box
Authors: Li Yanjun , Zhang Weiguo , Lin Yiping , Zou Jian , Liu Jian
Published: February 2024

In MILCOM 2015, Kelly et al. proposed the authentication encryption algorithm MK-3, which applied the 16-bit S-box. This paper aims to implement the 16-bit S-box with less circuit area. First, we classified the irreducible polynomials over$$\mathbb {F}_{2^n}$$F2ninto three kinds. Then we compared the logic gates required for multiplication over the finite field constructed by the three types of irreducible polynomials. According to the comparison result, we constructed the composite fields,$$\mathbb {F}_{(2^4)^2}$$F(24)2and$$\mathbb {F}_{(2^8)^2}$$F(28)2. Based on the isomorphism of finite fields, the operations over$$\mathbb {F}_{2^{16}}$$F216can be conducted over$$\mathbb {F}_{(2^8)^2}$$F(28)2. Similarly, elements over$$\mathbb {F}_{2^8}$$F28can be mapped to the corresponding elements over$$\mathbb {F}_{(2^4)^2}$$F(24)2. Next, the SAT solver was used to optimize the operations over smaller field$$\mathbb {F}_{2^4}$$F24. At last, the architecture of the optimized MK-3 S-box was worked out. Compared with the implementation proposed by the original designer, the circuit area of the MK-3 S-box in this paper is reduced by at least 55.9%.
Novel subtype of coxitis knee associated with acetabular dysplasia of the hip: a case series
Authors: Dumlao Patricio III , Yukata Kiminori , Suetomi Yutaka , Tokushige Atsunori , Sakai Takashi , Fujii Hiroshi
Published: February 2024

Background

Multiple joint arthritis patterns require a comprehensive understanding to optimize patient management. This study aimed to present a patient cohort that deviated from known definitions of coxitis knee (CK), identifying and characterizing this atypical group.

Methods

Patients undergoing both total hip arthroplasty and total knee arthroplasty between January 2008 and December 2018 were retrospectively reviewed. The patients were classified into a typical coxitis knee group (classic, long leg arthropathy, and windswept deformity) and an atypical coxitis knee group. Leg-length discrepancy, body mass index (BMI), and radiographic parameters of the groups were compared and analyzed.

Results

A total of 31 patients were allocated to the typical coxitis knee group (n = 10), and atypical coxitis knee group (n = 21). In the atypical group, 27 hips were involved, of which 21 had acetabular dysplasia, 5 exhibited subchondral insufficiency fracture-like changes, and only 1 had classic osteoarthritis. Among the 27 knees undergoing total knee arthroplasty, 26 showed varus alignment, 1 was within the normal range, and none was valgus. Acetabular dysplasia involved ipsilateral (n = 1), contralateral (n = 14), and bilateral (n = 6) hips, showing atypical coxitis knee. Patients with acetabular dysplasia were more likely to exhibit atypical CK.

Conclusion

Most patients in the cohort displayed acetabular dysplasia and contralateral varus knees, constituting a pattern referred to as acetabular dysplasia-associated gonarthritis. Identifying this novel subtype may have important clinical implications for regions with high risk factors, where acetabular dysplasia and constitutional genu varum are prevalent.

Graphical Abstract
Production and characterization of bacterial cellulose from kombucha-fermented soy whey
Authors: Feng Xue , Ge Zhiwen , Wang Ying , Xia Xiudong , Zhao Baomin , Dong Mingsheng
Published: February 2024

Bacterial cellulose (BC) is a high-strong cellulose with high-purity produced by bacteria. The aim of this study was to explore the feasibility of using tofu soy whey as a novel and cheap culture medium to produce bacterial cellulose (BC) through the fermentation of kombucha. In this study, the statistical optimization of the culture medium for producing BC from kombucha was carried out by selecting different parameters. A three-level, three-factor Box-Behnken design (BBD) was used to determine the optimal levels for three significant variables (sucrose addition, kombucha inoculation amount and fermentation temperature). According to the results, the optimal fermentation conditions were found as follows: sucrose addition 8.5%, kombucha inoculation amount 10%, fermentation temperature 32℃, the BC yield can be up to 4.20 g/100 mL (D.W) under 11d fermentation. Besides, the BC was determined with strong tensile strength and water absorption capacity. By scanning electron microscopy (SEM) observation, Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD) and differential scanning calorimetry (DSC) determination, BC produced by soy whey and Hestrin-Schramm (HS) medium were compared. The results showed that BC produced from soy whey has a typical cellulose structure, characteristic peaks of typical functional groups of cellulose, and crystal diffraction peaks of type I natural cellulose. In conclusion, this study utilized the nutrients in the soy whey to obtain a high yield of bacterial cellulose, make full use of industrial waste water, which was more environmentally friendly and cheaper.

Graphical Abstract
Risk factors of electrical status epilepticus during sleep in children with benign childhood epilepsy with centro-temporal spikes
Authors: Wang Xiufeng , Zhang Yanling , Sun Ruixue , Kong Na
Published: February 2024

Objective: To explore risk factors of electrical status epilepticus during sleep in children with benign childhood epilepsy with centro-temporal spikes (BECT).

Methods: This is a clinical comparative study. The subjects of study were 67 children with BECT from the Outpatient Department of Pediatric Neurology in Xingtai People’s Hospital from January 2019 to January 2022. According to the occurrence of ESES, the enrolled children were divided into control group which included BECT children without ESES and the observation group which included BECT children with ESES. Compared differences of the two groups in the age of first seizure, the frequency of seizures before treatment, the classification of treatment drugs, cranial MRI, and discharge side of electroencephalogram (EEG).

Results: There was no statistical difference between the two groups in the frequency of seizures before treatment, the classification of treatment drugs, cranial MRI, and the distribution of EEG discharges in the left and right cerebral areas(P>0.05). Statistical differences were observed in the age of the first seizure, whether the seizures occurred after treatment, and EEG discharges in unilateral/bilateral cerebral areas (P<0.05). Furthermore, the collinearity test and Logistic regression analysis showed that the age of the first seizure, the frequency of seizures before treatment, and whether the seizures occurred after treatment were independent risk factors for the occurrence of ESES in BECT (P<0.05).

Conclusion: Clinically, the occurrence of ESES in children with BECT may be related to the younger age of the first seizure, higher frequency of seizures before treatment, and the occurrence of seizures after treatment.

doi: https://doi.org/10.12669/pjms.40.4.7674

How to cite this: Wang X, Zhang Y, Sun R, Kong N. Risk factors of electrical status epilepticus during sleep in children with benign childhood epilepsy with centro-temporal spikes. Pak J Med Sci. 2024;40(4):612-616. doi: https://doi.org/10.12669/pjms.40.4.7674

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Correlation analysis of Type-2 diabetes mellitus with proliferative retinopathy and central macular thickness
Authors: Huang He , Jiang Shuang , Niu Honglei
Published: February 2024

Objective: To investigate the relevant risk factors of proliferative diabetic retinopathy (PDR) in patients with Type-2 diabetes mellitus (T2DM) and their correlations with the central macular thickness (CMT).

Methods: This is a retrospective study. The clinical data of 300 patients with T2DM were collected and divided into a PDR group (observation group) and non-PDR group (control group) according to the occurrence of PDR in Aier Eye Hospital (Taiyuan) from February 2019 to February 2022. The relevant risk factors were screened out through the t test and the χ2 test, and analyzed by logistic regression.

Results: Logistic regression analysis showed that systolic blood pressure, diastolic blood pressure, course of diabetes, fasting blood glucose (FBG), two hours postprandial blood glucose (two hours PBG) and urinary albumin were independent risk factors for T2DM complicated with PDR. ROC curve revealed that systolic blood pressure, course of diabetes and urinary albumin had the highest diagnostic efficiency. Correlation analysis demonstrated that CMT was positively correlated with systolic blood pressure, course of diabetes, HbA1c level and urinary albumin level.

Conclusion: For patients with T2DM, blood pressure, course of diabetes, FBG, 2hPBG and urinary albumin are independent risk factors for PDR, and increased systolic blood pressure, course of diabetes, HbA1c level and urinary albumin level will increase CMT. Combining the above indexes to predict the occurrence of PDR has a synergistic effect, and the increase in systolic blood pressure, course of diabetes, HbA1c level and urinary albumin level will increase the CMT of the patients.

doi: https://doi.org/10.12669/pjms.40.4.7726

How to cite this: Huang H, Jiang S, Niu H. Correlation analysis of Type-2 diabetes mellitus with proliferative retinopathy and central macular thickness. Pak J Med Sci. 2024;40(4):642-647. doi: https://doi.org/10.12669/pjms.40.4.7726

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinical severity and high-resolution CT severity score in COVID-19: Is there an association
Authors: Raja Mobeen Ahmed  , Kaleem Ullah Toori  , Qureshi Muhammad Arsalan
Published: February 2024

Objectives: To identify a correlation between the clinical parameters and CT chest severity score in COVID-19.

Methods: A total of 205 RT-PCR positive patients were included in this descriptive cross-sectional study with convenience sampling from November 2020 to June 2021 in KRL Hospital. The study population was stratified in disease severity as per the WHO’s guidelines. Clinical and radiological characteristics were compared in survivors and non survivors to draw conclusion

Results: The mean age was 57 years and the majority of the patients 57% were male. Overall mortality was 22% and the mean CT severity score was 18. Non survivors were more tachypneic, hypoxic, had a higher CT chest severity score, higher clinical severity, more comorbid condition and higher TLC, D-Dimers, LDH, CRP, NLR. Raised CT severity score showed a conclusive correlation with greater disease severity. One way ANOVA showed a significant difference between mean CT severity score amongst different disease categories.

Conclusion: Higher CT severity score corresponds to a higher clinical severity and higher chances of mortality.

doi: https://doi.org/10.12669/pjms.40.4.7919

How to cite this: Ahmed RM, Toori KU, Qureshi MA. Clinical severity and high-resolution CT severity score in COVID-19: Is there an association. Pak J Med Sci. 2024;40(4):637-641. doi: https://doi.org/10.12669/pjms.40.4.7919

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.
Association of sleep patterns and water intake with cognitive functions in adults in an urban environment
Authors: Qayyum Shazia , Iltaf Samina , Sajjad Madiha , Azam Mashaal
Published: February 2024

Objectives: To explore the behavior patterns of students and working adults regarding the duration and quality of sleep and water intake in an urban environment and to identify the relationship between nighttime sleep extent and water intake with mood and cognitive performance.

Methods: This was a descriptive correlational study conducted at Islamic International Medical College, Riphah University at the Pathology department from March to June 2022. A total of 160 participants with age range of 20 to 50 years completed a self-report questionnaire regarding sleep patterns, water intake, and perceptions of mood, concentration, and memory. Analyzed the relationship between sleep duration, water intake, mood, mindfulness/concentration, and memory using Kendall’s Tau-b correlation coefficient in SPSS 22.

Results: A significant number (28.7%) of participants had a sleep duration of ≤ 6 hours, with 41.3% sleeping after midnight. 82.5% of the participants switch off-screen just before sleeping. 63.7% have a routine water intake of less than 2 L/day. An aberrant statistically significant negative correlation between total sleeping hours and mood (τb = -.313, p = 0.004) was identified, showing a negative effect on mood with a sleeping time of ≥ 9 hours when compared with the other two groups (6-9 hours, τb = - .689, p = 0.001, ≤ 6hours, τb = - .697, p = 0.001). A significant correlation between daily water intake and concentration was found, wherein a decrease in daily water intake showed a negative effect on concentration (τb = .289, p = 0.008).

Conclusions: Sleep duration and water intake patterns may affect mood and cognitive performance. Regular sufficient nighttime sleep and adequate hydration may help improve cognitive functioning and mood.

doi: https://doi.org/10.12669/pjms.40.4.8268

How to cite this: Qayyum S, Iltaf S, Sajjad M, Azam M. Association of sleep patterns and water intake with cognitive functions in adults in an urban environment. Pak J Med Sci. 2024;40(4):606-611. doi: https://doi.org/10.12669/pjms.40.4.8268

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.
Pathophysiological mechanisms of adaptation of muscle tissue of descendants of irradiated animals to altering influence of ionizing radiation
Authors: Stepanov G.
Published: February 2024

Biochemical processes occurring in a living organism take part in the development of radiation-induced structural disorders, realizing primary damage. As a result, morphological manifestations of radiation damage are preceded by chemical shifts determining them. In the descendants of animals irradiated in different doses, a decrease in physical performance is observed, which is due to a violation of the efficiency of the use of the unique biosubstrate of muscle tissue - creatinephosphate, a change in the ratio of the activity of aerobic and anaerobic metabolism, and processes of trans-deamination of amino acids. The purpose of the work is to investigate the the mechanisms of disruption of metabolic processes in the muscle tissue of the descendants of irradiated animals. It was concluded that, unlike skeletal muscle, the activity of the tricarboxylic acid cycle, in particular the NAD-dependent malate dehydrogenase, in the myocardium is quite significant both in the cytoplasm and in the mitochondria of the tissue, as evidenced by the higher level of tricarboxylic acid cycle metabolites acids - malic and oxaloacetic, as well as the activity of NADP-dependent malate dehydrogenase, which performs a connecting role between glycolysis and the cycle of tricarboxylic acids in providing them with metabolites and transferring protons from NADH+H+ to NADP. The author revealed that myocardium is characterized by a larger pool of adenyl nucleotides due to ATP. Tha data obrtained shiowed hyperglycemia which is observed in the blood of the descendants of irradiated animals. Gluconeogenesis is enhanced in the liver of the descendants of irradiated animals and this explains the hyperglycemia and accumulation of glycogen in the liver. At the same time, the penetration of glucose into muscle cells is weakened, which is associated with a decrease in their glycogen content, and this can be explained by the decrease in adaptation to physical exertion in the descendants of irradiated animals. The author made a cionclusion that the pathophysiological mechanisms of radiation-induced energy supply restructuring are aimed at short-term processes of strengthening the supply of energy to vital organs and systems for destroyed biochemical, physiological, functional and regulatory processes restoration and sanogenetic mechanisms activation.
Fast examination and interventional ultrasound in the diagnosis and treatment of combat abdominal trauma
Authors: Kashtalian M. , Herasymenko O. , Haida Ya. , Shkliarevych P. , Atanasov D. , Okolets A.
Published: February 2024

To improve the diagnosis and surgical treatment of wounded patients with combat abdominal trauma by methods of emergency ultrasound diagnostics and minimally invasive surgery under the control of ultrasound. The purpose of the work is to improve the results of diagnosis and surgical treatment of wounded patients with combat abdominal trauma by emergency ultrasound examination techniques and minimally invasive surgical interventions under ultrasound control. A clinical and statistical analysis of the results of the surgical treatment of 293 wounded patients with combat abdominal trauma treated at the Military Medical Clinical Centre of the Southern Region was conducted. In the main group, additional therapeutic and diagnostic measures were performed — focused assessment with sonography in trauma (FAST), puncture rehabilitation and drainage surgery under the control of ultrasound. In the main group, in contrast to the control group, FAST examination was conducted in all wounded patients. The widespread introduction of the FAST examination and diagnostic punctures under ultrasound control into diagnostics reduces the level of more traumatic diagnostic laparocentesis from 24.7 to 2.2% and unreasonable surgical interventions from 3.2 to 0.7 %. An algorithm of diagnostic and therapeutic measures for wounded patients with combat abdominal trauma based on the results of the FAST examination was developed. The data obtained indicate that the widespread implementation of FAST, percutaneous puncture and sanitation interventions under ultrasound control in the diagnosis and treatment of combat abdominal trauma and its complications helps to reduce the number of invasive and more traumatic (often useless) interventions, which leads to faster recovery and shorter treatment time.
Presentación de cámara anestésica de bajo costo como herramienta didáctica para explicar los fundamentos de la anestesia general a estudiantes de medicina veterinaria
Authors: Isea Fernández Gerardo Alberto , Rodríguez Rodríguez Ilsen Emérita , Isea Morillo Ernesto Enrique , Montero Urdaneta Merilio Antonio
Published: February 2024

Se presenta el uso de una cámara anestésica de bajo costo, construida en vidrio, de fácil manejo y limpieza, como recurso didáctico, para explicar, en ratones de laboratorio, los fundamentos de la anestesia general inhalatoria a estudiantes de medicina veterinaria. La cámara permite adecuada dosificación del anestésico, garantiza la vida de los animales y disminuye la exposición de profesores y estudiantes a los gases anestésicos. Así, se pueden abordar didácticamente los aspectos básicos de la anestesia general inhalada, como el efecto de la concentración del anestésico en el aire inspirado y solubilidad.
La inclusión para las personas con discapacidad: entre la igualdad y la diferencia
Authors: García Ruiz Alix Solángel , Fernández Moreno Aleida
Published: February 2024

Este documento presenta un análisis sobre discapacidad, inclusión social, igualdad, diferencia desde distintos paradigmas de aproximación a la realidad social de las personas con discapacidad. A partir de los planteamientos de Díaz (1), se hace una reflexión de la discapacidad desde los puntos de vista especialista, materialista y posmodernista; de la comprensión y aplicación de los conceptos de inclusión y equidad usados cotidianamente por las entidades en sus políticas, planes, programas y proyectos. La postura de diferentes organizaciones, partiendo de los paradigmas liberal, marxista y postestructuralista, permite entender desde cuáles concepciones se construyen las propuestas de acción. Finalmente, se ordenan las respuestas sociales según el planteamiento de Avaría (2) a partir de las matrices culturales de sobreprotección y esfuerzo; las alternativas postuladas por Santos (3) y Díaz (1) quienes destacan la diversidad y el reconocimiento de la diferencia como una forma de inclusión y de libertad recuperando el papel protagónico de los sujetos con discapacidad, su entorno local y el estado.
Pregnant women's perceptions of daily iron supplementation in rural Ghana
Authors: Ferka Listowel , Kumi-Kyereme Akwasi , Yeboa Naomi Kyeremaa , Adu Isaac Kwaku
Published: February 2024

Background/Aims

In Ghana, compliance with daily iron supplementation during pregnancy is low, particularly in the Tain district. This may be related to pregnant women's perceptions of iron supplements. The aim of this study was to explore pregnant women's perceptions of daily iron supplements in the Tain district.

Methods

This descriptive qualitative study used an interpretative approach. Data were gathered from a purposive sample of 20 pregnant mothers, through semi-structured interviews and face-to-face in-depth discussions. Data were analysed thematically.

Results

Women were unwilling to take iron supplements because of their belief that daily iron supplements make a baby too big for vaginal birth, leading to cervical tears, episiotomy or caesarean section. They were also concerned that supplements could cause nausea and vomiting during pregnancy, and excessive bleeding during labour and birth.

Conclusions

It is important to educate pregnant women on the benefits of iron supplementation during pregnancy and encourage them to acquire information from verified sources.
Perinatal outcomes in persistent occiput posterior fetal position: a systematic review and meta-analysis
Authors: Giallongo Elisa , Webster Angela C
Published: February 2024

Background/Aims

Persistent occiput posterior fetal position is the most common fetal malposition during labour. The aim of this study was to measure the magnitude of the effects of this labour dystocia on perinatal outcomes, as compared to anterior position.

Methods

A systematic review of the literature included prospective and retrospective cohort studies of singleton term pregnancies, comparing the effect of occiput posterior fetal position with occiput anterior fetal position. Random-effect meta-analysis was performed.

Results

Overall, eight studies were included, for a total of 140 590 participants. Women with fetuses in occiput posterior position were more likely to give birth via caesarean section (odds ratio: 6.74, P<0.001), based on data from all eight studies. Newborns experienced an increased risk of admission to a neonatal intensive care unit (odds ratio: 1.60, P<0.001), based on data from five of the included studies.

Conclusions

Persistent occiput posterior fetal position negatively affects maternal and neonatal outcomes. Future studies should reduce potential bias, include adjusted analysis and investigate the best clinical management for this labour dystocia.
Risk assessments and ethnicity in maternity care: looking through the wrong end of the telescope?
Authors: Melamed Anna
Published: February 2024

Many Black and brown women are classified as ‘high risk’ and follow obstetric-led pathways. This may be the result of social determinants of health, or over pathologisation as a result of racial bias by healthcare providers and systems. There may be times when social determinants are mistaken for innate physiological differences, leading to iatrogenic harm. There is both over and underdiagnosis resulting from racial bias in midwifery care. Women with intermediate risk factors may benefit from midwifery-led care, especially Black and brown women. Community-based, relational, women-centred midwifery models of care can reduce the problems of pathologisation and redress some social inequalities.
Poverty could be behind rise in infant and child mortality rates
Authors: Lepkowska Dorothy
Published: February 2024

Deaths in children in England are on the rise according to new data from the National Child Mortality Database. Poverty could be one of the major factors behind this increase. Dorothy Lepkowska explains
Culture: A determinant of breastfeeding in SCPHN practice
Authors: Wilde Matt
Published: February 2024

The health benefits of breastfeeding are well researched and are recognised by professional bodies both nationally and globally, yet breastfeeding rates for many countries globally fall short of their respective national targets. Efforts have been made within both maternity services and Specialist Community Public Health Nursing (SCPHN) practice to provide training for professionals to improve breastfeeding rates, yet in many areas there remains a focus on the biological factors more than cultural beliefs, despite culture being widely accepted as an integral aspect of needs assessment in the field of SCPHN practice. This article explores the literature to identify cultural beliefs surrounding breastfeeding from both positive and negative perspectives, which further highlighted how SCPHNs can improve their practice in sensitively approaching this subject with new and expecting mothers. The purpose of this review was to identify the significance of culture as a determinant of breastfeeding and highlight potential methods for improving SCPHN practice in this area.
Improving the health of ethnically diverse children and young people in minority groups
Authors: Day Patricia
Published: February 2024

Health inequalities profoundly affect the outcomes of ethnically diverse children and young people in minority groups. Patterns of morbidity and mortality are examined and related to life outcomes. They reveal severe disparities in preventable ill health throughout their lifespan. School nurses could be pivotal in drawing attention to this and leading community-based health interventions.
Twelve barriers preventing child sexual abuse disclosures
Authors: Henshaw Pete
Published: February 2024

Twelve barriers that prevent young people from disclosing sexual abuse and four factors that help them have been identified by researchers. Pete Henshaw explains