bluuebunny/crossref_metadata_2025 huggingface dataset:
NODAL variants are associated with a continuum of laterality defects from simple D-transposition of the great arteries to heterotaxy
Authors: Dardas Zain , Fatih Jawid M. , Jolly Angad , Dawood Moez , Du Haowei , Grochowski Christopher M. , Jones Edward G. , Jhangiani Shalini N. , Wehrens Xander H. T. , Liu Pengfei , Bi Weimin , Boerwinkle Eric , Posey Jennifer E. , Muzny Donna M. , Gibbs Richard A. , Lupski James R. , Coban-Akdemir Zeynep , Morris Shaine A.
Published: April 2024

Background

NODAL signaling plays a critical role in embryonic patterning and heart development in vertebrates. Genetic variants resulting in perturbations of the TGF-β/NODAL signaling pathway have reproducibly been shown to cause laterality defects in humans. To further explore this association and improve genetic diagnosis, the study aims to identify and characterize a broader range of NODAL variants in a large number of individuals with laterality defects.

Methods

We re-analyzed a cohort of 321 proband-only exomes of individuals with clinically diagnosed laterality congenital heart disease (CHD) using family-based, rare variant genomic analyses. To this cohort we added 12 affected subjects with known NODAL variants and CHD from institutional research and clinical cohorts to investigate an allelic series. For those with candidate contributory variants, variant allele confirmation and segregation analysis were studied by Sanger sequencing in available family members. Array comparative genomic hybridization and droplet digital PCR were utilized for copy number variants (CNV) validation and characterization. We performed Human Phenotype Ontology (HPO)-based quantitative phenotypic analyses to dissect allele-specific phenotypic differences.

Results

Missense, nonsense, splice site, indels, and/or structural variants of NODAL were identified as potential causes of heterotaxy and other laterality defects in 33 CHD cases. We describe a recurrent complex indel variant for which the nucleic acid secondary structure predictions implicate secondary structure mutagenesis as a possible mechanism for formation. We identified two CNV deletion alleles spanning NODAL in two unrelated CHD cases. Furthermore, 17 CHD individuals were found (16/17 with known Hispanic ancestry) to have the c.778G > A:p.G260R NODAL missense variant which we propose reclassification from variant of uncertain significance (VUS) to likely pathogenic. Quantitative HPO-based analyses of the observed clinical phenotype for all cases with p.G260R variation, including heterozygous, homozygous, and compound heterozygous cases, reveal clustering of individuals with biallelic variation. This finding provides evidence for a genotypic-phenotypic correlation and an allele-specific gene dosage model.

Conclusion

Our data further support a role for rare deleterious variants in NODAL as a cause for sporadic human laterality defects, expand the repertoire of observed anatomical complexity of potential cardiovascular anomalies, and implicate an allele specific gene dosage model.
Unicentric Castleman’s disease in the parotid gland associated with psoriasis: a case report
Authors: Zhang Ying , Li Chong-Yang , Li Zhi , Chen Wei
Published: April 2024

Background

Castleman’s disease is a rare lymphoproliferative disorder that is often misdiagnosed because of its untypical clinical or imaging features except for a painless mass. Besides, it is also difficult to cure Castleman’s disease due to its unclear pathogenesis.

Case presentation

We present a Castleman’s disease case with diagnostic significance regarding a 54-year-old Chinese male who has a painless mass in his left parotid gland for 18 months with a 30-years history of autoimmune disease psoriasis. Computed tomography scan showed a high-density nodule with clear boundaries in the left parotid and multiple enlarged lymph nodes in the left submandibular and neck region. General checkup, the extremely elevated serum interleukin-6 and lymph node biopsy in the left submandibular region gave us an initial suspicion of Castleman’s disease. Then the patient underwent a left superficial parotidectomy. Based on histopathologic analysis, we made a certain diagnosis of Castleman’s disease and gave corresponding treatments. In 18 months of follow-up, the patient showed no evidence of recurrence, with the level of serum interleukin-6 decreased.

Conclusions

Clinicians should be aware of the possibility of Castleman’s disease when faced with masses or enlarged lymph nodes in the parotid gland to avoid misdiagnosis, especially in patients with autoimmune diseases and elevated serum interleukin-6.
Receipt of prescription opioid medication is associated with increased mortality in an Israeli population
Authors: Cohen Matan J. , Dressler Reuven L. , Kaliner Ehud
Published: April 2024

Background

Despite Israel’s increased use of prescription opioids, reported deaths resulting or associated with opioids have decreased, in fact dramatically, since 2005. This contrast is unique and difficult to explain. We sought to examine whether higher prescribed opioid dosages among adults without oncologic diagnoses were associated with higher all-cause mortality rates.

Methods

A historical cohort study in Clalit Health Services, using a data repository including all adult patients prescribed opiates between 2010 and 2020, excluding patients with oncologic diagnoses. Patients were classified into three groups according to opioid use: below 50 Morphine milligram equivalents (MME) per day, 50 to 90 MME per day, and above 90 MME per day. Sex, Charlson comorbidity score, age and socioeconomic status were recorded. Mortality rates were compared between the dosage groups and compared to age-standardized mortality rates in the general population.

Results

On multivariate analysis, patients receiving 90 or more MME per day were 2.37 (95%CI 2.1 to 2.68) more likely to have died compared to patients receiving below 50 MME per day. The respective hazard ratio among patients receiving between 50 and 90 MME per day was 2.23 (2.01 to 2.46). Among patients aged 18 to 50, standardized mortality ratios (SMRs) compared to the general population ranged between 5.4 to 8.6 among women, receiving between 50 and 90 MME per day, and between 8.07 and 10.7 among women receiving 90 or more MME per day. The respective SMRs among men were 1.2 to 3.8 and 2.7 to 5.4.

Conclusion

Increased opioid use is independently associated with increased all-cause mortality among non-oncological patients. This result is most notable among young adults with little or no known comorbidities. These findings are consistent with results in other countries and seem more credible than previous Israeli reports. Healthcare regulators and providers should, therefore, act to curtail the increasing opioid prescriptions and devise and enhance controls in the healthcare system, which, until 2020, had very limited mechanisms in place.
Object tracking method based on edge detection and morphology
Authors: Xu Jie , Niu Sijie , Wang Zhifeng
Published: April 2024

With the continuous development of science and technology, intelligent surveillance technology using image processing and computer vision is also progressing. To improve the performance of target detection and tracking, an improved target tracking method is proposed, which uses a combination of the Canny operator and morphology for the detection part, and a Kalman filter extended Kernel Correlation Filter (KCF) tracking algorithm approach for the tracking part. First, a convolution kernel of $$3\times 3$$

3
×
3

is improved to a convolution kernel of $$2\times 2$$

2
×
2

in the traditional Canny algorithm, and the pixel gradient in the diagonal direction is increased. Secondly, a mathematical morphology theory of nonlinear filtering is applied to the Canny edge detection algorithm, and this method effectively improves the clarity of image edges. Finally, the extended kernel correlation filtering algorithm is applied to video surveillance and Online Object Tracking Benckmark2013 (OTB2013) datasets for testing. The experimental results show that the method proposed in this paper can accurately detect moving targets and the algorithm has good accuracy and success rate.
Effects of different types of Ringer’s solution on patients with traumatic haemorrhagic shock: a prospective cohort study
Authors: Li Qing , Yang Qiang , Tian Chao , Guo Yao , Liu Hui , Cheng Yadong , Bi Shu-Zhen , Chen Jin-Hua
Published: April 2024

Objective

To compare the fluid resuscitation effect of sodium acetate Ringer’s solution and sodium bicarbonate Ringer’s solution on patients with traumatic haemorrhagic shock.

Method

We conducted a prospective cohort study in our emergency department on a total of 71 patients with traumatic haemorrhagic shock admitted between 1 December 2020 and 28 February 2022. Based on the time of admission, patients were randomly divided into a sodium bicarbonate Ringer’s solution group and sodium acetate Ringer’s solution group, and a limited rehydration resuscitation strategy was adopted in both groups. General data were collected separately, and the patients’ vital signs (body temperature, respiration, blood pressure and mean arterial pressure (MAP)), blood gas indices (pH, calculated bicarbonate (cHCO3−), partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (pCO2) and clearance of lactate (CLac)), shock indices, peripheral platelet counts, prothrombin times and plasma fibrinogen levels were measured and compared before and 1 h after resuscitation.

Results

The post-resuscitation heart rate of the sodium bicarbonate Ringer’s solution group was significantly lower than that of the sodium acetate Ringer’s solution group (p < 0.05), and the MAP was also significantly lower (p < 0.05). The patients in the sodium bicarbonate Ringer’s solution group had significantly higher pH, cHCO3− and PaO2 values and lower pCO2 and CLac values (p < 0.05) than those in the sodium acetate Ringer’s solution group, and the post-resuscitation peripheral platelet counts and fibrinogen levels were significantly higher, with shorter plasma prothrombin times and smaller shock indices (p < 0.001).

Conclusion

Sodium bicarbonate Ringer’s solution is beneficial for maintaining MAP at a low level after resuscitation. The use of sodium bicarbonate Ringer’s solution in limited fluid resuscitation has positive results and is of high clinical value.
Bone marrow dosimetry in low volume mHSPC patients receiving Lu-177-PSMA therapy using SPECT/CT
Authors: Grob Dagmar , Privé Bastiaan M. , Muselaers Constantijn H. J. , Mehra Niven , Nagarajah James , Konijnenberg Mark W. , Peters Steffie M. B.
Published: April 2024

Background

Bone marrow toxicity in advanced prostate cancer patients who receive [177Lu]Lu-PSMA-617 is a well-known concern. In early stage patients; e.g. low volume metastatic hormone sensitive prostate cancer (mHSPC) patients, prevention of late bone marrow toxicity is even more crucial due to longer life expectancy. To date, bone marrow dosimetry is primarily performed using blood sampling. This method is time consuming and does not account for possible active bone marrow uptake. Therefore other methodologies are investigated. We calculated the bone marrow absorbed dose for [177Lu]Lu-PSMA-617 in mHSPC patients using SPECT/CT imaging and compared it to the blood sampling method as reference.

Methods

Eight mHSPC patients underwent two cycles (3 and 6 GBq) of [177Lu]Lu-PSMA-617 therapy. After each cycle, five time point (1 h, 1 day, 2 days, 3 days, 7 days) SPECT/CT was performed at kidney level. Bone marrow dosimetry was performed using commercial software by drawing ten 1.5 cm diameter spheres in the lowest ten vertebrae to determine the time-integrated activity. Simplified protocols using only 2 imaging time points and 3 vertebrae were also compared. Blood-based dosimetry was based on the blood sampling method according to the EANM guideline.

Results

Mean bone marrow absorbed dose was significantly different (p < 0.01) for the imaging based method (25.4 ± 8.7 mGy/GBq) and the blood based method (17.2 ± 3.4 mGy/GBq), with an increasing absorbed dose ratio between both methods over time. Bland Altman analysis of both simplification steps showed that differences in absorbed dose were all within the 95% limits of agreement.

Conclusion

This study showed that bone marrow absorbed dose after [177Lu]Lu-PSMA-617 can be determined using an imaging-based method of the lower vertebrae, and simplified using 2 time points (1 and 7 days) and 3 vertebrae. An increasing absorbed dose ratio over time between the imaging-based method and blood-based method suggests that there might be specific bone marrow binding of [177Lu]Lu-PSMA-617.
Predictive factors of tinnitus after vestibular schwannoma surgery: a case-control study
Authors: You Na , Zhang Jiashu , Zhang Ding , Zhao Yue , Zhang Jun , Xu Bainan
Published: April 2024

Background

Tinnitus is very common in patients with vestibular schwannoma (VS). We analyzed the related factors of tinnitus after surgery.

Methods

One hundred seventy-three patients diagnosed with unilateral VS operated via the retrosigmoid approach were included in the study. All patients underwent relevant examinations and completed the THI scale before surgery and 6 months after surgery. The prognosis of tinnitus was evaluated according to the changes in THI.

Results

Of the 129 preoperative tinnitus patients, postoperative tinnitus resolved in 12.4%, improved in 29.5%, remained unchanged in 28.6%, and worsened in 29.5%. 18.2% of 44 patients without preoperative tinnitus appeared new-onset tinnitus postoperatively. Thirty-six patients never had tinnitus. Patients with smaller tumor sizes (≤ 3 cm) were more likely to experience preoperative tinnitus. Younger patients and those with serviceable hearing preoperatively were more likely to report their tinnitus unchanged or worsened. A new onset of postoperative tinnitus in the preoperative non-tinnitus group was found in better preoperative hearing function.

Conclusions

In this study, 70% of patients had persistent tinnitus after vestibular schwannoma resection. The prognosis of tinnitus was influenced by age and preoperative hearing function. Tinnitus is a bothersome symptom and is often underestimated by doctors. Assessment of tinnitus is mandatory during the management of vestibular schwannoma.
Modeling time to death for under-five children in Malawi using 2015/16 Demographic and Health Survey: a survival analysis
Authors: Mulagha-Maganga Assa , Kazembe Lawrence , Ndiragu Martin
Published: April 2024

Background

Malawi has one of the highest under-five mortality rates in Sub Sahara Africa. Understanding the factors that contribute to child mortality in Malawi is crucial for the development and implementation of effective interventions to reduce child mortality. The aim of this study is to use survival analysis in modeling time to death for under-five children in Malawi. In turn, identify potential risk factors for child mortality and inform the development of interventions to reduce child mortality in the country.

Method

This study used data from all births that occurred in the five years leading up to the 2015/16 Malawi Demographic and Health Survey. The Frailty hazard model was applied to predict infant survival in Malawi. In this analysis, the outcome of interest was death and it had two possible outcomes: "dead" or "alive". Age at death was regarded as the survival time variable. Infants who were still alive at the time of the study as of the day of the interview were considered as censored observations in the analysis.

Results

A total of 17,286 live births born during the 5 years preceding the survey were analysed. The study found that the risk of death was higher among children born to mothers aged 30–39 and 40 or older compared to teen mothers. Infants whose mothers attended fewer than four antenatal care visits were also found to be at a higher risk of death. On the other hand, the study found that using mosquito nets and early breastfeeding were associated with a lower risk of death, as were being male and coming from a wealthier household.

Conclusion

The study reveals a notable decline in infant mortality rates as under-five children age, underscoring the challenge of ensuring newborn survival. Factors such as maternal age, birth order, socioeconomic status, mosquito net usage, early breastfeeding initiation, geographic location, and child's sex are key predictors of under-five mortality. To address this, public health strategies should prioritize interventions targeting these predictors to reduce under-five mortality rates.
Effects of stigma on the quality of life in patients with epilepsy
Authors: Hu Chunmei , Zhao Yuping , Xiao Zheng
Published: April 2024

Background

This study was aimed to evaluate the stigma and quality of life (QoL) in adult patients with epilepsy (PWEs) and explore the relationship between stigma and QoL.

Methods

Two hundred and ninety-eight PWEs admitted to the Epilepsy Center of the First Affiliated Hospital of Chongqing Medical University during September 2020 and March 2021 were enrolled in this study. All participants completed self-reported questionnaires including the Stigma Scale for Epilepsy and the Quality of Life in Epilepsy Inventory-31 (QOLIE-31).

Results

A total of 146 (49%) PWEs reported an experience of stigma. The total score of QOLIE-31 and the individual scores of seven subscales (worry about new seizures, emotion, well-being, energy and fatigue, cognitive impairment, medication effect, and social function) were significantly decreased in these patients (P < 0.001). Multivariate stepwise linear regression analysis showed that the annual household income per capita, the number of antiseizure medications and stigma had statistically significant effects on QoL (P < 0.05). Among them, stigma had the most significant negative effect.

Conclusions

Nearly half of PWEs have experienced stigma. Stigma, lower household income per capita, and polypharmacy treatment are associated with poorer QoL. Stigma has the most obvious negative impact.
Association of single nucleotide polymorphism at BMP2 gene with iron deficiency status among anaemic patients in Hospital Universiti Sains Malaysia
Authors: Azman Nur Ain , Zulkafli Zefarina , Bakar Nur Salwani , Assyuhada Mat Ghani Siti Nor , Mohammad Siti Nur Nabeela A’ifah
Published: April 2024

Background

Iron deficiency contributes for over half of all anaemia cases, especially among women and children. Iron deficiency anaemia remains a serious public health concern worldwide. The aim of this study is to determine the association between the single nucleotide polymorphism rs235756 in the bone morphogenetic protein 2 (BMP2) gene and iron deficiency status.

Results

104 total anaemic samples were selected from Hospital Universiti Sains Malaysia. ARMS-PCR was performed to genotype the rs235756 SNP in the 104 samples. The genotype distribution of BMP2 rs235756 showed that AG genotypes had the highest frequency 51(86.4%) followed by GG 6(10.2%) and AA 2(3.4%) in IDA group, whereas AG 42(93.3%), AA 2(4.4%) and GG 1(2.2%) were found in the other anaemia group. The minor allele frequency in BMP 2 rs235756 from this study (0.514) was not similar to the East Asian (EAS) population (0.135); however, the allelic frequency showed significant association between these two. The mean of total iron binding capacity level differed significantly between homozygous-dominant AA and AG + GG genotypes (P < 0.05) but no significant difference for the mean of haematological parameter, ferritin and serum iron.

Conclusions

In future clinical settings, this finding can potentially be as a guide in the early prediction for IDA patients through the genetic testing.
Clinical and epidemiological characterization of eosinophilic ascites in Egypt: a single center experience
Authors: Medhat Mohammed Ahmed , Abdelmalek Mohamed O. , Mekky Mohamed A. , Abd-Elsalam Sherief , Abdel-Malek Mohamed Ahmed Yehya , Ahmed Sayed Hassan , Amry Yusuf S. , Hassan Waleed Attia
Published: April 2024

Background & aims

Eosinophilic ascites is non-common and challenging disease. This study aimed to describe the clinical presentation and treatment of eosinophilic ascites.

Methods

This was a prospective single-center study that included cases with eosinophilic ascites who were admitted to Tropical Medicine and Gastroenterology Department, Assiut University Hospital, Assiut, Egypt, during the period between May 2020 to May 2023. The clinical presentation, investigations, treatment, and follow-up data of the included patients were collected and analyzed.

Results

Seventeen cases of eosinophilic ascites were included in the study. The main presenting manifestations were abdominal pain (47.1%), and abdominal pain with distension (29.4%). Two patients presented with a picture of intestinal obstruction. Moderate ascites was found in 10 patients (58.8%) by ultrasound. Eosinophilia in the peripheral hemogram was detected in 76.5% of the study population. Endoscopic examination showed gastro-duodenitis in 9 patients (52.9%) and duodenitis in 4 patients (23.5%). All patients showed complete improvement and disappearance of ascites after starting steroids within two weeks. Eleven patients (64.7%) relapsed after discontinuation of steroids.

Conclusion

Eosinophilic ascites is an uncommon cause of ascites that is often underdiagnosed. The relapse rate after stopping treatment is high but with excellent response to retreatment.
The role of artificial intelligence in Physical Therapy education
Authors: Lowe Scott William
Published: April 2024

Background and purpose

Recently, there has been significant discussion about artificial intelligence (AI) and Large-Language Models (LLMs) as they relate to teaching and learning. To date, literature exists about the role of AI in Physical Therapy treatment, but not Physical Therapy education. This review will identify the benefits of adapting AI into Physical Therapy education to better prepare the healthcare providers of tomorrow.

Rationale

Survey research shows that AI can improve access to information, increase productivity, and reduce errors. However, most also feel ill-informed on the topic. A majority agreed that AI concepts should be included in Physical Therapy education.

While valid concerns exist about AI sources giving false information, as well as the potential to use these services to plagiarize work, tools are already in existence to mitigate these issues.

Potential benefits of AI in Physical Therapy education include the ability to produce examples, provide different explanations, and assist in assessing student learning while providing immediate feedback on performance.

Discussion and conclusion

With the scope of AI rapidly expanding, we believe it is imperative for Physical Therapy educators to have access to current information about its potential benefits, uses, and limitations. While many professionals do not currently possess much knowledge on the topic, there is a growing consensus as to the role it will play in our profession in the future. While discussions of AI can raise more questions than answers, preparation now will reduce the need for urgent adaptations in the future.
Predicting the Stability of Lyophilized Human Serum Albumin Formulations Containing Sucrose and Trehalose Using Solid-State NMR Spectroscopy: Effect of Storage Temperature on 1H T1 Relaxation Times
Authors: Lay-Fortenbery Ashley , Tower Cole W. , Ezeajughi Ernest , Calahan Julie , Duru Chinwe , Matejtschuk Paul , Munson Eric J.
Published: April 2024

In a lyophilized protein/disaccharide system, the ability of the disaccharide to form a homogeneous mixture with the protein and to slow the protein mobility dictates the stabilization potential of the formulation. Human serum albumin was lyophilized with sucrose or trehalose in histidine, phosphate, or citrate buffer. 1H T1 relaxation times were measured by solid-state NMR spectroscopy and were used to assess the homogeneity and mobility of the samples after zero, six, and twelve months at different temperatures. The mobility of the samples decreased after 6 and 12 months storage at elevated temperatures, consistent with structural relaxation of the amorphous disaccharide matrix. Formulations with sucrose had lower mobility and greater stability than formulations with trehalose.
Dexmedetomidine for Preventing Sleep Disturbance after Ambulatory Anesthesia: A Case Report
Authors: Quinn Jacqueline , Krakowski James C.
Published: April 2024

Propofol anesthesia may impact a patient’s sleep quality in the immediate postprocedure timeframe. We describe a 24-year-old man presenting for gastrostomy-jejunostomy tube replacement who reported debilitating sleep-onset disturbances after 3 previous anesthetic exposures for the same procedure. Review of the patient’s records revealed the recurring use of propofol infusion. We proposed using dexmedetomidine infusion to potentially avoid another extended sleep disturbance. Following a dexmedetomidine-centered plan, the patient reported experiencing his usual sleep pattern without side-effects for 5 consecutive days postprocedure. This case highlights the potential for propofol-induced sleep disturbance in the ambulatory setting, which may be avoided with dexmedetomidine administration.
The EU as a Political Determinant of Global Health: The Case of Research and Development Incentives for Orphan Medicines and Biotechnology
Authors: Perehudoff Katrina , Ippel Kaja Anastazja
Published: April 2024

Context: The European Union (EU) governs global health through its constituent laws, institutions, actors, and policies. However, it is unclear whether or how these political factors interact to position the EU as a political determinant of global health.

Methods: The authors conduct a case study of the political factors influencing the adoption of the EU's Biotechnology Directive 98/44/EC and Orphan Medicines Regulation 141/2000.

Findings: The European Commission (EC) generally framed both of its proposals around economical and biomedical paradigms aligned with the needs of the EU's industry and patients, whereas the European Parliament (EP) contested some of these frames and proposed amendments supporting global access to medical products. The political factors influencing the adoption (in the Biotechnology Directive) or rejection (in the Orphan Regulation) of the EP's amendments include the complementarity between the EP and EC proposals, the EP's power in the intra- and interinstitutional negotiating process, the existence and support of civil society, and the alignment with member state priorities in the Council.

Conclusions: In the late 1990s, the EU was an internally fragmented and politicized player concerning global health matters. These political factors should be considered for a coherent post-2022 EU strategy on global health.
Checkmating the Nutri-Score: Will Food Patriotism Prevent the Harmonization of Front-of-Pack Labeling Schemes within the EU?
Authors: Ewert Benjamin
Published: April 2024

Front-of-pack labeling schemes are an effective but contested regulatory approach to nudge consumers toward healthy food choices. The Nutri-Score, being implemented by eight European countries, is one of the most elaborated and evidence-based examples. Therefore, the Nutri-Score has been deemed as the front-runner within the European Commission's attempt to harmonize front-of-pack labeling among European Union (EU) member states under its Farm-to-Fork strategy by the end of 2022. However, the endeavor is on the brink of failure because of massive resistance by Mediterranean member states and parts of the food industry capitalizing on patriotic narratives (e.g., “Made in Italy”). This article investigates the Nutri-Score saga from a political and commercial determinants of health lens. It argues that an EU-wide rollout of the label hinges on the specific interplay between political structures and stakeholder agency. As shown, the EU's weak decision-making power has been exploited by the No-Nutri-Score alliance.
A comparison of the clinical features of molar pregnancy in adolescents and adults
Authors: Özer Mehmet , Özer Pınar Tuğçe , Karaca Ibrahim , Yıldırım Karaca Suna , İleri Alper , Budak Adnan
Published: April 2024

Objective: To compare the age-specific clinical features of molar pregnancy and to describe the risk factors associated with this situation.

Method: This retrospective case-control study was conducted at the Department of Obstetrics and Gynecology. Tepecik Education and Research Hospital, Izmir, Turkey. The participants included both adolescents (≤ 19 years) and adults with histologically confirmed hydatidiform moles in our institution between January 2015 and January 2022. The interventions and main outcome measures of this study involved evaluating the clinical and ultrasonographic features, as well as the risk factors, associated with molar pregnancies in adolescents.

Results: This study of 137 patients with molar pregnancy found that adults had a higher incidence of partial molar pregnancy (20 patients versus seven patients) and lower beta-hCG levels than adolescents (176.890.71 mIU/ml versus 253.734.47 mIU/ml). Adolescents had a higher likelihood of hyperthyroidism (25.4% versus 9.2%). bleeding on admission (4.2% versus 1.51%),. longer hospital stays (5.44 ± 2.73 days versus 3.59 ± 3.08 days). Higher rates of uterine enlargement and postoperative bleeding (15.5% versus 1.5%). Adolescents also required more analgesia (97% versus 89.4%).

Conclusions: Adolescents with Gestational trophoblastic diseases (GTD) may present with more severe symptoms compared to adults, which can lead to delayed diagnosis and treatment. Further research is needed to better understand the underlying mechanisms and risk factors for GTDs in this population. Increased awareness and education can help improve recognition and management of GTDs in adolescents and improve their overall health outcomes.

doi: https://doi.org/10.12669/pjms.40.5.8383

How to cite this: Ozer M, Ozer PT, Karaca I, Karaca S, Ileri A, Budak A. A comparison of the clinical features of molar pregnancy in adolescents and adults. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.8383

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.
Efficient accelaration of complex DSP applications on reconfigurable devices
Authors: Στρατάκος Ιωάννης
Published: April 2024

Τα τελευταία χρόνια έχει σημειωθεί μια αξιοσημείωτη άνοδος στον τομέα των ενσωματωμένων συστημάτων, ιδίως στον τομέα των ηλεκτρονικών ειδών ευρείας κατανάλωσης. Η αυξανόμενη ζήτηση για συστήματα υψηλών επιδόσεων και ενεργειακά αποδοτικά συστήματα έχει παρακινήσει τους ερευνητές να επινοήσουν καινοτόμες τεχνικές σχεδιασμού για να ανταποκριθούν σε αυτές τις δύσκολες απαιτήσεις. Μεταξύ διαφόρων πτυχών, η ψηφιακή επεξεργασία σήματος (DSP) έχει κερδίσει ιδιαίτερη προσοχή, η οποία περιλαμβάνει πολύπλοκους μαθηματικούς υπολογισμούς, όπως αντιστροφές πινάκων, φιλτράρισμα και βασικές αριθμητικές πράξεις.Καθώς η ψηφιακή επεξεργασία σήματος συνεχίζει να αποκτά σημασία σε διάφορες συσκευές, ορισμένοι παράγοντες, όπως ο χρόνος διάθεσης στην αγορά και η ευελιξία για καθυστερημένες αλλαγές στη σχεδίαση, έχουν γίνει κρίσιμοι παράγοντες. Οι λύσεις που βασίζονται σε λογισμικό παρέχουν ευελιξία και δυνατότητα προσαρμογών ακόμη και σε μεταγενέστερα στάδια, αλλά συχνά υστερούν σε απόδοση έναντι του υλικού λόγω των περιορισμών της σειριακής επεξεργασίας. Από την άλλη πλευρά, η ανάπτυξη προσαρμοσμένων ολοκληρωμένων κυκλωμάτων ειδικής εφαρμογής (ASIC) μπορεί να είναι χρονοβόρα διαδικασία και στερείται δυνατότητας αναδιαμόρφωσης μόλις ολοκληρωθεί η κατασκευή. Η παρούσα διατριβή επικεντρώνεται στην επιτάχυνση απαιτητικών και πολύπλοκων εφαρμογών ψηφιακής επεξεργασίας σήματος σε επαναδιαμορφώσιμες συσκευές, με ιδιαίτερη έμφαση στα SoC-FPGAs.Οι εφαρμογές που μελετώνται καλύπτουν δύο τομείς: επεξεργασία εικόνας/βίντεο και τηλεπικοινωνίες. Στον τομέα της επεξεργασίας εικόνας/βίντεο, η κύρια έμφαση δίνεται 1) στην επιτάχυνση εφαρμογών ιατρικής απεικόνισης και 2) αυτόνομης πλοήγησης με βάση την όραση για διαστημικές εφαρμογές. Στον τομέα των τηλεπικοινωνιών, η έρευνα επικεντρώνεται στην επεξεργασία φυσικού επιπέδου, στοχεύοντας ειδικά στα κινητά δίκτυα επόμενης γενιάς 5G/B5G. Αυτές οι εφαρμογές έχουν κοινά χαρακτηριστικά, απαιτώντας αυστηρή τήρηση των απαιτήσεων καθυστέρησης, διατηρώντας παράλληλα την κατανάλωση ενέργειας στο ελάχιστο. Για την επίτευξη αυτών των στόχων, πραγματοποιείται εκτεταμένη εξερεύνηση του χώρου σχεδίασης (Design Space Exploration - DSE) και χρησιμοποιούνται προηγμένες τεχνικές σχεδίασης. Η αξιοποίηση των μοναδικών χαρακτηριστικών της υποκείμενης συσκευής SoC-FPGA ενισχύει περαιτέρω την αποτελεσματικότητα των προτεινόμενων λύσεων.
Towards successful aging classification using machine learning algorithms
Authors: Zaccheus Jesuloluwa , Atogwe Victoria , Oyejide Ayodele , Salau Ayodeji Olalekan
Published: April 2024

Background: Aging is a significant risk factor for a majority of chronic diseases and impairments. Increased medical costs brought about by the increasing aging population in the world increases the strain on families and communities. A positive and qualitative perspective on aging is successful aging (SA). Successful aging refers to the state of being free from diseases or impairments that hinder normal functioning, as observed from a biological perspective. This differs from typical aging, which is associated with a gradual decrease in both physical and cognitive capacities as individuals grow older. Methods: In this study, the geriatric data acquired from the Afe Babalola University Multi-System Hospital, Ado-Ekiti was initially prepared, and three fundamental machine learning (ML) techniques such as artificial neural networks, support vector machines, and Naive Bayes were then constructed using the data from a sample of 2000 individuals. The Rowe and Kahn Model was used to determined that the dataset was SA based on factors such as the absence of fewer than or equivalent to two diseases, quality of life, nutrition, and capacity for everyday activities. Results: According to the experimental findings, the predictive network, Artificial Neural Network (ANN) performed better than other models in predicting SA with a 100% accuracy, 100% sensitivity, and 100% precision. Conclusions: The results show that ML techniques are useful in assisting social and health policymakers in their decisions on SA. The presented ANN-based method surpasses the other ML models when it comes to classifying people into SA and non-SA categories.
Consumer Attitude toward Purchase Intention of Culinary Product’s through Video-Based Social Media: A Deductive Exploratory Studies in Bandung City
Authors:   Faculty of Economics and Business, Jenderal Achmad Yani University, Indonesia, Ahmad Lukni Burhanuddin , Septiarini Eka , Satriawan Dhennies Ariel Aru , Aas Raihan Elian
Published: April 2024

In today's digitalization era, promoting products using social media has become the primary strategy to accelerate business growth, especially promotion. With the emergence of various short video-based social media platforms, information can rapidly spread through a solid and short video duration. For many content creators, a short video can call crowds faster than other types of data transmissions, such as text, pictures, or traditional video. Millions of views can be gained in a matter of days. The video that gains high exposure is not always because of the celebrity or famous person; it is more of the quality of the content itself. One of the most popular themes is related to culinary products. Bandung, recognized as a city of culinary in Indonesia, has many content creators that create food promotional videos. Some of them have millions of followers that advocate for their followers to try and purchase the food. This phenomenon raises questions to be revealed, becoming the background for this research. This study aimed to determine the variables causing interest in purchasing culinary products in Bandung through Short Video-Based Social Media. Thus, this study contributes to theory development, business practice, and digital marketing through short videos posted on various social media platforms. The method used in this research is deductive exploratory research as a methodological approach that investigates the micro-conceptual framework of working hypotheses that have not been studied in-depth with qualitative data collection techniques using data collection techniques with in-depth interviews (IDI) and focus group discussions (FGD) online to specific individuals and groups. As a result, seven of eight factors are considered to independently influence intention to purchase culinary products towards SVBSM by the respondents: perceived ease of use, perceived usefulness, consumer personality characteristics, retail, commercial images, product features, attractiveness, and trustworthiness. The expertise variable is not considered as the factor that can influence the purchase intention. Another result shown short video-based social media that consumers commonly use are Tiktok, Reels by Instagram, and Youtube Short Keywords: Attitude, purchase intention, short video, digital platform, social media
How Firms Cultivate Collaboration During Postmerger Integration of Technology Acquisitions
Authors: Bingham Christopher B. , Heimeriks Koen H. , Meyer-Doyle Philipp
Published: April 2024

Technology acquisitions are increasingly prevalent, but their failure rate is notoriously high. Although extant research suggests that collaboration may improve acquisition success, relatively little is known about how firms cultivate collaboration during postmerger integration (PMI) of technology acquisitions. Using inductive multiple-case methods, we address this gap. Our primary contribution is an emergent framework that sheds needed light on how firms cultivate successful collaboration postacquisition. Our study reveals three key mechanisms that help relieve collaboration bottlenecks stemming from geographic, motivational, cultural, and power-perception-related barriers. More broadly, our findings contribute to the literature on postmerger integration.
A fast-growing myxoma of the left atrium
Authors: Benko Jakub , Péč Martin Jozef , Cingel Marek , Jurica Jakub , Bolek Tomáš , Mokáň Marián , Samoš Matej
Published: April 2024

Introduction: Myxoma of the left atrium is a less typical cause of mitral obstruction. If this develops, a flash pulmonary oedema can be the first manifestation. Case description: We present a case report of a 50-year-old woman who was admitted to our internal department because of dyspnoea. The patient overcame a stroke three years before the index hospitalisation with a negative transthoracic echocardiography. By anamnesis and physical examination, an exacerbation of COPD was assumed, and the patient was treated accordingly. As the patient showed numerous risk factors for heart failure with preserved ejection fraction, transthoracic echocardiography was performed. A large polypoid mass was found in the left atrium, which caused severe mitral obstruction. Subsequent transoesophageal echocardiography confirmed this finding. The patient underwent urgent cardiac surgery, and the tumour was successfully resected. A histological examination revealed a cardiac myxoma. After the cardiac surgery the patient felt well, and no recurrence of the tumour occurred. Conclusions: We provide a case report of a fast-growing myxoma that was incidentally found in a patient with dyspnoea. We highlight the fast growth rate of the tumour and the potential for misdiagnosed signs of pulmonary oedema caused by mitral obstruction.
The importance of prescribing
Authors: Bennett Sharon
Published: April 2024

In this article, Sharon Bennett discusses the ways in which the BACN supports their nurse members through the complex landscape of aesthetics practice and regulation
The transformative power of gender-affirming healthcare: recommendations for effective treatment
Authors: Ramadan Francesca
Published: April 2024

The demographics of aesthetic clinic attendees are changing, and the aesthetic practitioner should be cognisant of the needs and patient-related factors of the growing variety of individuals encountered in their practice. This includes transgender individuals who wish to seek gender-affirming surgical or non-surgical procedures as part of their transition. Francesca Ramadan explores the transformative power of gender-affirming healthcare and the treatment considerations and recommendations for this demographic, so that aesthetic practitioners are well-equipped to help their patients reach their full potential.
Is it possible for a procedure to be just ‘skin deep’?
Authors: Auer Deborah
Published: April 2024

Dr Deborah Auer discusses why practitioners should consider a robust assessment process

This piece discusses the complexities that sometimes underlie a patient's request for procedures, highlighting the importance of practitioners having a robust and ethical assessment process in place. Research that links psychology with requests for procedures, more often than not, will consider how to assess for body dysmorphia in particular. This does have benefits in identifying patients for whom having a procedure may result in a poor outcome. However, often these measures and/or screening tools do not highlight the more nuanced difficulties a patient may have regarding their relationship with their body. Procedures have a twofold impact: firstly, on the external body that is shown to the world, and secondly, the internal part — an individual's psyche, self-esteem, body image and confidence ( Auer, 2018 ). Therefore, it is paramount that practitioners consider both the physical and psychological wellbeing of their patients.
Role of spatial efficiency, layout planning, and sustainability in the success of shopping malls
Authors:   University of Engineering & Technology Lahore, Architectural Engineering and Design Department, Lahore, Pakistan, Riaz Huda , Amina Norheen ,   The University of Lahore, Department of Technology, Lahore, Pakistan, Khan Muhammad Arif ,   University of South Asia, Architectural Design Department, Lahore, Pakistan, Iqbal Amna ,   Superior University, Architectural Design Department, Lahore, Pakistan, Irfan Amina ,   NAVTTAC, Lahore, Pakistan, Ishitaq Hira ,   NAVTTAC, Lahore, Pakistan, Noshin Sadaf ,   The University of Lahore, Department of Technology, Lahore, Pakistan, Mohsin Habiba ,   NAVTTAC, Lahore, Pakistan, Shahbaz Imran ,   NAVTTAC, Lahore, Pakistan
Published: April 2024

Building multi-storey shopping malls has grown to be a very lucrative industry for investors in recent years. As a result, the success of a plaza depends on a variety of elements, including its design, security, appealing façade, and amenities. This study examined the structural systems, services, and architectural designs of a few of Lahore's prosperous plazas. Food courts and hyper malls provide essential functions that boost foot traffic and have the potential to revolutionise the way that entertainment amenities raise a mall's worth. Mixed-use multi-story spaces such as those that combine offices, apartments, and retail stores can also increase the efficiency of a mall in terms of sales and attractiveness. The assessment parameters in case studies include the gross area, circulation, parking area, toilet area, services area, and vertical transportation, with average values of 33,83 %, 22,00 %, 24,30 %,1,10 %, 3,05 %, and 4,60 %, respectively. These will assist future studies to determine the minimum threshold for success, making mall planning easier and more accurate. High-quality malls have higher occupancy because they offer better quality development, facilities, sustainable techniques, and amenities to support the overall development, along with shop sizes that suit international brands. This research defines the emerging trends and provides guidelines for the future architectural planning, structural systems, and services of shopping malls in Lahore to meet sustainable development goals and attract more shoppers.
Tradigital Humanities: Experiences in a context of change.
Authors: PÉREZ GONZÁLEZ Jordi
Published: April 2024

Asumiendo un proverbio de Séneca —mientras enseñamos, aprendemos— debemos entender el oficio del historiador como una profesión en continua renovación, nutriéndonos de nuevos aspectos que mejoren la metodología y las técnicas de la ciencia, descartando aquellos que quedan obsoletos. Desde hace tres décadas, la aportación de metodologías provenientes de otras disciplinas, como la informática y los estudios de Humanidades han ido convergiendo en la disciplina conocida como Humanidades Digitales.

Aunque estas técnicas computacionales han introducido nuevos métodos para la identificación de patrones en los datos y prometen acelerar los procesos de análisis de la creciente masa de datos, divergen de la narrativa tradicional y sus métodos. En este sentido, experiencias recientes permiten discutir los beneficios y límites del vínculo entre métodos y técnicas tradicionales, por un lado, aquellas que son computacionales, por otro, a la hora de preparar resultados científicos. Así, creemos que sin perder de vista la esencia básica del historiador de sumergirse continuamente en la lectura y análisis de las fuentes, los cambios de paradigma de la ciencia pueden asumirse adoptando esta nueva técnica.

Ahora, con perspectiva, miramos los límites que la propia convergencia ofrece y aquí presentamos nuestra experiencia más reciente para mejorar su desempeño.
El pre-orientalisme a Europa: Un estat de la questió.
Authors: GARCÍA MARRASÉ Elisabeth
Published: April 2024

Si a menudo resulta complicado acotar el término “orientalismo”, que es lo que puede ocurrir cuando emprendemos los caminos del pre-orientalismo. Hace unos cincuenta años, en un intento encarnizado de reemprender la relación con el otro desde una mirada occidental limpia de prejuicios, Edward W. Said identificó y codificó los tópicos en torno al islam -aparentemente inseparables a pesar de que se habían generado y difundido durante los siglos XVIII y XIX- para, a continuación, descomponerlos hasta diluirlos. A medida, pero, que retrocedemos hacia centurias anteriores a las mencionadas, nos adentramos en un horizonte todavía más complejo. Más que un diálogo-relación-oposición entre Oriente y Occidente con el elemento religioso impregnado de clichés ideológicos como telón de fondo, el propósito desde el cambio del siglo XV y en adelante era buscar los orígenes occidentales en las civilizaciones pre-clásicas de raíces orientales. Una búsqueda que, de paso, pasaba por aceptar que Occidente se debía a Oriente. De ahí que, en estos momentos, el presente Estado de la Cuestión resulte idóneo no sólo por la permanente contraposición Oriente versus Occidente que, de vez en cuando, aflora con notoria intensidad, incluso en escenarios bélicos; también por el hecho de que aporta una perspectiva diferente de como debe entenderse el “pre-orientalismo”.
A Path Forward: Addressing Current Issues in Campus Racial Climate Research and Practice
Authors: Briscoe Kaleb L. , LePeau Lucy A. , Johnson Dawn R.
Published: April 2024

Abstract: Attacks on diversity, equity, and inclusion threaten to undo much of the work of creating and maintaining diverse learning and working environments for students, faculty, and staff. In honor of ACPA's 100th anniversary, we reflect on the current threats to the campus racial climate, highlight research that informs our scholarship and practice, and offer strategies for resistance. We close with a consideration of critical hope as necessary to the pursuit of equity-centered work during this turbulent period in higher education.