bluuebunny/crossref_metadata_2025 huggingface dataset:
Failure to follow up abnormal test results associated with cervical cancer in primary and ambulatory care: a systematic review
Authors: Martinez-Gutierrez Javiera , Chima Sophie , Boyd Lucy , Sherwani Asma , Drosdowsky Allison , Karnchanachari Napin , Luong Vivien , Reece Jeanette C. , Emery Jon
Published: July 2023

Background

Cervical cancer is a preventable and treatable form of cancer yet continues to be the fourth most common cancer among women globally. Primary care is the first point of contact most patients have with health services and is where most cancer prevention and early detection occur. Inadequate follow-up of abnormal test results for cervical abnormalities in primary care can lead to suboptimal patient outcomes including higher mortality and decreased quality of life.

Aims

To explore the magnitude of and factors associated with, inadequate follow-up of test results for cervical abnormalities in primary and ambulatory care.

Methods

MEDLINE, Embase, Cochrane Library and CINAHL were searched for peer-reviewed literature from 2000–2022, excluding case-studies, grey literature, and systematic reviews. Studies were included if they reported on patients aged ≥ 18 years with no previous cancer diagnosis, in a primary care/ambulatory setting. Risk of bias was assessed using the Joanna Briggs Institute Critical appraisal checklists, appropriate to the study design. A segregated methodology was used to perform a narrative synthesis, maintaining the distinction between quantitative and qualitative research.

Results

We included 27 publications reporting on 26 studies in our review; all were conducted in high-income countries. They included 265,041 participants from a variety of ambulatory settings such as family medicine, primary care, women’s services, and colposcopy clinics. Rates of inadequate follow-up ranged from 4 to 75%. Studies reported 41 different factors associated with inadequate follow-up. Personal factors associated with inadequate follow-up included younger age, lower education, and socioeconomic status. Psychological factors were reported by only 3/26 studies and 2/3 found no significant association. System protective factors included the presence of a regular primary care provider and direct notification of abnormal test results.

Discussion

This review describes inadequate follow-up of abnormal cervical abnormalities in primary care. Prevalence varied and the evidence about causal factors is unclear. Most interventions evaluated were effective in decreasing inadequate follow-up. Examples of effective interventions were appointment reminders via telephone, direct notification of laboratory results, and HPV self-sampling. Even though rates of cervical cancer have decreased over the years, there is a lack of information on factors affecting follow-up in primary care and ambulatory settings, particularly in low and middle-income countries. This information is crucial if we are to achieve WHO’s interim targets by 2030, and hope to avert 62 million cervical cancer deaths by 2120.

Trial registration

PROSPERO ID CRD42021250136.
Valero’s host index is useful in predicting radiation-induced trismus and osteoradionecrosis of the jaw risks in locally advanced nasopharyngeal carcinoma patients
Authors: Topkan Erkan , Somay Efsun , Yilmaz Busra , Pehlivan Berrin , Selek Ugur
Published: July 2023

Background

In the absence of previous research, we sought to assess the H-Index’s predictive significance for radiation-induced trismus (RIT) and osteoradionecrosis of the jaw (ORNJ) in patients with locally advanced nasopharyngeal carcinoma (LA-NPC) receiving concurrent chemoradiotherapy (C-CRT).

Patients and methods

The research comprised 295 LA-NPC patients who had C-CRT and pre- and post-C-CRT oral exams between June 2010 and December 2021. The H-Index was calculated using neutrophils, monocytes, lymphocytes, hemoglobin, and albumin measurements obtained on the first day of C-CRT. Patients were divided into three and two H-index groups, respectively, based on previously established cutoff values (1.5 and 3.5) and the cutoff value determined by our receiver operating characteristic (ROC) curve analysis. The primary objective was the presence of any significant connections between pretreatment H-Index groups and post-C-CRT RIT and ORNJ rates.

Results

RIT and ORNJ was diagnosed in 46 (15.6%) and 13 (7.8%) patients, respectively. The original H-Index grouping could only categorize RIT and ORNJ risks at a cutoff value of 3.5, with no significant differences in RIT and ORNJ rates between groups with H-Index 1.5 and 1.5 to 3.5 (P < 0.05 for each). The ideal H-Index cutoff for both RIT and ORNJ rates was found to be 5.5 in ROC curve analysis, which divided the entire research population into two groups: H-Index ≤ 5.5 (N = 195) and H-Index > 5.5 (N = 110). Intergroup comparisons revealed that patients in the H-Index > 5.5 group had significantly higher rates of either RIT (31.8% vs. 5.9%; P < 0.001) or ORNJ (17.3% vs. 2.2%; P < 0.001) than their H-Index ≤ 5.5 counterparts. The results of the multivariate analysis showed that H-Index > 5.5 was independently linked to significantly higher RIT (P < 0.001) and ORNJ (P < 0.001) rates.

Conclusion

Pre-C-CRT H-Index > 5.5 is associated with significantly increased RIT and ORNJ rates in LA-NPC patients receiving definitive C-CRT.
Worsening of alcohol abuse disorder in a Spanish population during the first twelve months of the COVID-19 pandemic and associated factors: retrospective, ecological and community study
Authors: Oliván-Blázquez Bárbara , Lear-Claveras Ana , Samper-Pardo Mario , León-Herrera Sandra , Magallón-Botaya Rosa
Published: July 2023

Purpose

To analyse: (1) Changes in clinical parameters and in the use of social healthcare resources by patients with alcohol abuse disorder between the six months prior to the start of the pandemic and the first year of the pandemic. (2) The factors related to a worsening of clinical parameters among patients with alcohol abuse disorder.

Methods

A retrospective and observational study of a population who have been diagnosed with alcohol abuse disorders according to their primary health care (PHC) electronic medical records was performed. The total sample was made up of 11,384 patients. The variables (sociodemographic variables, chronic comorbidities, analytical parameters related to alcohol abuse disorder, COVID-19 infection, and use of healthcare resources) were collected in three different time periods: (i) six months before the onset of the strict lockdown, (ii) six months following the end of lockdown and (iii) from six to twelve months after the end of lockdown. Paired Student’s T-test and a multivariate logistic regression were performed.

Results

Along the first year after the onset of the pandemic, between 44% and 54% of the patients suffered a decline in every clinical parameter. The number of PHC nursing, GP visits and social worker visits reduced significantly. As regards the associated factors related to deterioration of alcohol abuse disorder, being younger than 40 years old, having an income of over 18,000 euros/year and not having visited the social worker were associated with a worsening of the disorder.

Conclusions

These results suggest that the impact of COVID-19 on this group has been high, and the social care offered to these patients plays a significant role in minimising the repercussions of the pandemic.
Staff perceptions of factors affecting the use of RAS-DS to support collaborative mental health practice
Authors: Honey Anne , Hancock Nicola , Scanlan Justin Newton
Published: July 2023

Background

The Recovery Assessment Scale: Domains and Stages (RAS-DS) was designed to be both a recovery outcome measure and a tool to enhance service-user control over their recovery journey. While extensively and globally used in mental health services for the former purpose, routine use for the latter purpose is yet to be realised. The aim of this study was to identify barriers, facilitators and additional supports needed for RAS-DS to be used to support service user participation, goal setting and recovery action planning.

Methods

An online survey was conducted of mental health workers who had engaged with RAS-DS, including fixed choice and open-ended questions. Data were analysed using descriptive statistics and interpretive content analysis respectively.

Results

The 65 respondents reported more frequent use of RAS-DS as an outcome measure than as a collaboration tool and more than half reported difficulties in using it in this way. Factors that they described as influencing the use of RAS-DS as a tool for collaboration and support included: previous experiences with RAS-DS; organisational supports and policies; awareness of the RAS-DS amongst colleagues; RAS-DS related training and support; staff time and capacity; the format of RAS-DS; service user population or context; and respondents’ own active efforts.

Conclusions

Extending the use of RAS-DS, an already widely used tool, to routinely support recovery-oriented practice has both efficiency and service user empowerment benefits. However further work is needed to enable this including: provision of co-designed, accessible training resources; a user platform including built in guidance; and strategies to promote management understanding and valuing of the enhanced recovery-orientation opportunities inherent in RAS-DS use.
Global burden of type 2 diabetes attributable to non-high body mass index from 1990 to 2019
Authors: Wu Jingjing , Feng Zeying , Duan Jingwen , Li Yalan , Deng Peizhi , Wang Jie , Yang Yiping , Meng Changjiang , Wang Wei , Wang Anli , Wang Jiangang
Published: July 2023

Background

The prevalence of type 2 diabetes mellitus (T2DM) currently was increased in some countries of the world like China. However, the epidemiological trends of T2DM attributable to non-high body mass index (BMI) remain unclear. Thus, we aimed to describe the burden of T2DM attributable to non-high BMI.

Methods

To estimate the burden of T2DM attributable to non-high BMI, data from the Global Burden of Disease Study 2019 were used to calculate the deaths and disability-adjusted life years (DALYs) by age, sex, year, and location. The estimated annual percentage change (EAPC) was applied in the analysis of temporal trends in T2DM from 1990 to 2019.

Results

Globally in 2019, the number of death cases and DALYs of T2DM attributable to non-high BMI accounted for 57.9% and 48.1% of T2DM-death from all risks, respectively. Asia accounted for 59.5% and 63.6% of the global non-high-BMI-related death cases and DALYs of T2DM in 2019, respectively. From 1990 to 2019, regions in the low-income experienced a rise in DALYs attributable to non-high BMI. As compared to other age groups, older participants had higher deaths and DALYs of T2DM attributable to non-high BMI. The death and DALY rates of T2DM due to non-high BMI were higher in males and people in regions with low socio-demographic index (SDI) countries.

Conclusions

The burden of T2DM attributable to non-high BMI is higher in the elderly and in people in regions with low- and middle-SDI, resulting in a substantial burden on human health and the social cost of healthcare.
Study Protocol: Adolescents of Ukraine During the Russian Invasion (AUDRI) Cohort
Authors: Goto Ryunosuke , Pinchuk Irina , Kolodezhny Oleksiy , Pimenova Nataliia , Skokauskas Norbert
Published: July 2023

Background

Since February 14, 2022, Ukraine has once again been under attack by the Russian forces, putting the nation in one of the biggest emergencies in Europe since World War II. This puts Ukrainians at high risk of psychiatric disorders, amidst unseen attacks on infrastructure that have put massive strain on Ukraine’s mental health services. Despite this, the prevalence of psychiatric disorders among adolescents and their changes over time have not yet been documented in Ukraine during the invasion. More generally, there is a need to more comprehensively uncover the long-term consequences of war on youth, especially their risks and protective factors.

Methods

The Adolescents of Ukraine During the Russian Invasion (AUDRI) Cohort is the largest cohort of war-affected Ukrainian adolescents. We will recruit adolescents aged 15 to 18 years attending any school in Ukraine. Data collection will start early 2023, and will be held via online questionnaires every six months during the war as well as after the war has terminated. We will use several well-validated tools to screen for PTSD, depression, anxiety, substance use disorder, and eating disorders. In addition, we will ask participants about possible risks and protective factors of their mental health including resilience and social capital. Using the cohort, we will evaluate the trends in psychiatric disorder prevalence among adolescents in Ukraine over time and evaluate risks and protective factors of adolescents’ mental health.

Discussion

The AUDRI Cohort will provide a unique opportunity to learn more about trauma and resilience among youth in conflict settings, in addition to aiding international efforts to save the mental health of youth in Ukraine. At-risk adolescents identified from our study can directly become beneficiaries of targeted intervention themselves. Building evidence on the mental health of adolescents is especially valuable, as protecting the mental health of war-affected adolescents could help rebuild society and have positive consequences for generations to come.
Dentistry responding in domestic violence and abuse (DRiDVA) feasibility study: a qualitative evaluation of the implementation experiences of dental professionals
Authors: Femi-Ajao Omolade , Doughty Janine , Evans Maggie A. , Johnson Medina , Howell Annie , Robinson Peter G. , Armitage Christopher J. , Feder Gene , Coulthard Paul
Published: July 2023

Background

Domestic Violence and Abuse (DVA) is a persistent public health problem in the UK. Healthcare settings offer an opportunity to ask patients about DVA, either opportunistically or in response to the presence of injuries. However, it has been suggested that dental practices and dental teams have not been actively involved supporting adult patients when presenting with injuries that might have resulted from DVA. This qualitative study was conducted to satisfy the evaluative component of the Dentistry Responding in Domestic Violence and Abuse (DRiDVA) feasibility study.

Methods

In total, 30 participants took part in the study; nine associate dentists and practice principals/owners took part in one-to-one interviews and 21 auxiliary staff took part across two focus group discussion sessions. Data were analysed using the seven step Framework Analysis process.

Result

Three key themes were identified from the data, focusing on barriers to enquiring about domestic violence and abuse, Facilitators of identification and referral of DVA in dental settings, and recommendations for further adaptation of intervention to dental settings.

Conclusion

DVA training coupled with robust referral pathways to a named specialist DVA advocate increases knowledge and awareness of the signs of DVA and confidence in making onward referrals. Further research is needed to understand how to increase dental professional willingness to ask patients about DVA.
Efficacy of recombinant human interleukin-11 in preventing and treating oral mucositis after chemotherapy for patients with acute leukemia
Authors: Zhang Yilin , Li Yuxin , He Aili , Wang Jin , Zhang Pengyu , Lei Bo , Huang Zhuan , Zhang Lin , Zhao Wei , Ma Xiaorong
Published: July 2023

Objective

This study aimed to investigate the clinical effects of recombinant human interleukin-11 (rhIL-11) gargle on preventing and treating oral mucositis (OM) after chemotherapy for acute leukemia.

Methods

This single-site, prospective, observer-blinded, nonrandomized controlled trial was conducted on 74 patients with acute leukemia, who were divided into the experimental and control groups. The patients in the experimental group were treated with IL-11 gargle, and those in the control group were treated with sodium bicarbonate gargle. We examined the time and severity of oral mucositis, severity and duration of associated pain, healing time of mucositis, effects of OM on eating, and levels of T-cell subset indicators before and after treatment to evaluate the effects of IL-11 treatment.

Results

The proportion of patients with severe OM was significantly lower in the experimental group than in the control group. Mucositis occurred later in the experimental group compared with the control group. The degree and duration of pain, ulcer healing time, and effects on eating were lower in the experimental group compared with the control group. Following treatment, the levels of all T-cell subset indicators improved in each of the two groups. However, the rate of improvement was significantly higher in the experimental group than in the control group. These differences were statistically significant (P < 0.05).

Conclusions

IL-11 gargle reduced the severity of OM after chemotherapy for acute leukemia. Treatment with IL-11 relieved pain, promoted healing, and improved the curative effect of the condition, making it worthy of clinical promotion.
Three-dimensional spatial analysis of the temporomandibular joint in adult patients with Class II division 2 malocclusion before and after orthodontic treatment: a retrospective study
Authors: Zheng Jiajing , Zhang Yueying , Wu Qiuyue , Xiao Hua , Li Feifei
Published: July 2023

Background

To investigate changes in the three-dimensional (3D) spatial morphology of the temporomandibular joint (TMJ) and condyle position in adult patients with Class II division 2 malocclusion using a 3D spatial measurement method and to investigate the similarities and differences in the effects of fixed appliance and clear aligner treatments on the TMJ.

Methods

Cone-beam computed tomography (CBCT) data of 47 adult patients with Class II division 2 malocclusion (25, fixed appliance group; 22, clear aligner group) were collected before and after treatment. Mimics 21.0 was used to reconstruct the TMJ 3D model. Fourteen measurement items, such as the anterior, upper, and posterior joint spaces, were measured directly on the 3D model and compared.

Results

Post-orthodontic treatment, the shape and position of the condyle changed in adult patients with Class II division 2 malocclusion. Reduction in the anterior joint space and increase in the posterior joint space after orthodontic treatment were significant in both fixed appliance and clear aligner treatments; the condyle moved forward to the center of the fossa. The superior joint space and depth of the glenoid fossa increased after clear aligner treatment, but there was no significant change after fixed appliance treatment.

Conclusions

The condylar shape and position in patients with Class II division 2 malocclusion changed significantly post-treatment, indicating that the condyle undergoes adaptive reconstruction during orthodontic treatment in these patients. These results provide a reference for diagnosis, design of treatment plan, and monitoring of treatment in orthodontic clinics.
Third delay and associated factors among women who gave birth at public health facilities of Gurage zone, southern Ethiopia
Authors: Berihun Ayenew , Abebo Teshome Abuka , Aseffa Bethelhem Mezgebe , Simachew Yilkal , Jisso Meskerem , Shiferaw Yemisrach
Published: July 2023

Background

The third delay is a delay in accessing emergency obstetric care timely and appropriately once a woman reaches a health facility. The third delay plays a crucial role as an indicator to assess the quality of obstetrics services and is often the leading contributing factor to maternal mortality in developing countries. Although considerable research has been conducted on pre-facility delays in healthcare access, there is a lack of focus on delays experienced upon arrival at health facilities, particularly in Ethiopia and the specific study areas of Gurage zone. This study aimed to assess the magnitude of the third delay and associated factors among women who gave birth at Public Health Facilities of Gurage Zone, Southern Ethiopia.

Method

A facility-based cross-sectional study was conducted with 558 women who gave birth at public health facilities of Gurage Zone from January 01/2020 to March 30/2020. Multi-stage stratified sampling technique was used to select the nine facilities. The data was collected using a structured interviewer administer questionnaire and an observational checklist. Women who waited more than an hour to receive delivery services after arriving at the health facility were classified as experiencing the third delay. The data were entered and analyzed using Epi Data version 3.1 and SPSS version 20.0 software, respectively. Binary logistic regression was employed to identify the determinant factors for the third delay. Variables having a P-value < 0.25 in the binary analysis were a candidate for multivariable analysis. Variables with P < 0.05 were considered statistically significant.

Result

The magnitude of the third delay was 193 [(34.8%; 95% CI; (30.8%, 38.8%)]. Complication during labor [AOR = 2.0; 95% CI, (1.4, 3.0)], Presence of functional generator in a health facility [AOR = 2.8; 95% CI, (1.3, 6.3)], level of health institution [AOR = 2.8; 95% CI, (1.04, 7.8)] and BEMONC training in the last two years [AOR = 1.6; 95% CI, (2.0, 6.5)] were significantly associated with third delay.

Conclusion

The magnitude of third delay was high compared to some low income countries, which shows most of mothers were not getting the service timely after they arrived at the health facility. Equipping health facilities with trained manpower and with necessary materials and infrastructure will contribute to hastening the provision of obstetric care.
A pilot study of the use of human amniotic membrane as subcutaneous implants in a mouse model: a potential for temporary substitutes in two-stage breast reconstructions
Authors: Alipour Sadaf , Omranipour Ramesh , Eslami Bita , Khalighfard Solmaz , Saberi Azin , Shabestari Azar , Alizadeh Ali Mohammad
Published: July 2023

Introduction

Breast reconstruction by prosthesis is frequently performed in breast cancer treatments, and a temporary substitute is used in the first step of two-stage operations.

Aim

Due to the advantageous biological features of the human amniotic membrane, we aimed to evaluate its use for temporary implants.

Method

We prepared small spherical implants from human amniotic membranes and inserted them into BALB/c mice’s subcutaneous flanks. Then, we compared the bulging they produced, the durability, and the host reaction with implants made from the chorionic membrane, folded membrane patches, and sterile plastic beads.

Results

All amionitic cases were healthy throughout the study and only mild inflammation occurred in them. Furthermore, the bulging of the implants was acceptable and faded gradually. However, moderate inflammation was observed in chorionic implant mice, and the bulging disappeared very soon. Finally, the control group had severe inflammation and the beads implant was rejected.

Conclusion

Our study showed that the human amniotic membrane could represent a safe and valid tool for breast reconstruction, however, further studies on larger animals and more implants are suggested.
Community centred co-design methodology for designing and implementing socio-behavioural interventions to counter COVID-19 related misinformation among marginalized population living in the squatter settlements of Karachi, Pakistan: a methodology paper
Authors: Qasim Rubina , Farooqui Waqas Ahmed , Rahman Atiya , Haroon Rukhsana , Saleem Madiha , Rafique Muhammad , Noor Fiza , Ghani Afifa , Yaqoob Muhammad , Yadav Uday Narayan , Yousafzai Mohammad T.
Published: July 2023

Background

Misinformation regarding COVID-19 pandemic and vaccination is damaging COVID-19 vaccine trust and acceptance in Low- and Middle-Income Countries (LMIC). Identification of misinformation and designing locally acceptable solutions are needed to improve COVID-19 vaccine acceptance. This study aimed to utilize community-led co-design methodology to evaluate misinformation regarding COVID-19 and develop contextual interventions to address misinformation in a marginalized peri urban slum communities of Landhi town Karachi, Pakistan.

Methods

This study was conducted between January and December 2021, in marginalized peri-urban slum dwellers of Muslimabad Colony, Landhi Town Karachi, Pakistan. We used a community-centred co-design methodology embedded within mixed study design to identify misinformation, co-design, test and implement locally acceptable solutions. The co-design methodology involved five stages of the design thinking model: (1) Empathize, (2) Define, (3) Ideate, (4) Prototype, and (5) Test. The project involved active engagement and participation of wide range of stakeholders and community beneficiaries (end users) including local EPI vaccinators, informal healthcare workers, religious leaders (male and female), schoolteachers (male and female), local government representatives, community leaders, housewives, youth, and general population. To develop a trusting relationship, and understand local culture, values, practices, and traditions, we allowed one month of observation period (observe, engage, watch, and listen) in the beginning, followed by door-to-door survey along with focus group discussions (FGD) and in-depth interviews (IDI) at baseline. Co-design workshops (separate for male and female) were conducted at each stage of co-design methodology to design and test locally acceptable solutions.

Conclusion

Community-centred co-design methodology was not only successful in designing, testing, and evaluating locally acceptable solutions but it also actively engaged and empowered the marginalized population living in peri urban slum communities of Karachi, Pakistan.
Oral bacterial composition associated with lung function and lung inflammation in a community-based Norwegian population
Authors: Shigdel Rajesh , Johannessen Ane , Lin Huang , Peddada Shyamal , Gómez Real Francisco , Ringel-Kulka Tamar , Svanes Cecilie , Bertelsen Randi Jacobsen
Published: July 2023

Background

The oral cavity is the gateway to the bacteria community in the lung. Disruption of the symbiotic balance of the oral microbiota has been associated with respiratory diseases. However, little is known about the relationship between oral bacteria and respiratory outcomes in the general population. We aimed to describe the associations between oral bacteria, lung function, and lung inflammation in a community-based population.

Methods

Oral (gingival) samples were collected concurrently with spirometry tests in 477 adults (47% males, median age 28 years) from the RHINESSA study in Bergen, Norway. Bacterial DNA from the 16S rRNA gene from gingival fluid were sequenced by Illumina®MiSeq. Lung function was measured using spirometry and measurement of fractional exhaled nitric oxide (FeNO) were performed to examine airway inflammation. Differential abundance analysis was performed using ANCOM-BC, adjusting for weight, education, and smoking.

Results

The abundance of the genera Clostridiales, Achromobacter, Moraxella, Flavitalea and Helicobacter were significantly different among those with low FEV1 (< lower limit of normal (LLN)) as compared to normal FEV1 i.e. ≥ LLN. Twenty-three genera differed in abundance between among those with low FVC < LLN as compared to normal FEV1 ≥ LLN. The abundance of 27 genera from phyla Actinobacteria, Bacteroidetes, Firmicutes, Proteobacteria and Sacchribacteria differed significantly between elevated FeNO levels (≥ 50 ppb) compared to FeNO ≤ 25 ppb.

Conclusion

Oral bacterial composition was significantly different for those with low FEV or FVC as compared to those with normal lung function equal to or higher than LLN. Differential bacterial composition was also observed for elevated FeNO levels.
The efficacy of L-carnitine in patients with nonalcoholic steatohepatitis and concomitant obesity
Authors: Zakharova Natalia , Luo Chenguang , Aringazina Raisa , Samusenkov Vadim
Published: July 2023

Background

In light of the high prevalence of nonalcoholic fatty liver disease and obesity, treatment options for nonalcoholic steatohepatitis are of particular interest. The purpose of the study is to assess the efficacy of L-carnitine and its effects on the functional state of the liver, as well as on lipid and carbohydrate metabolism in patients with nonalcoholic steatohepatitis and concomitant obesity.

Methods

People in the control group followed a hypocaloric diet and received 1 tablet of simvastatin 20 mg once a day and 2 capsules of essential phospholipids 600 mg three times a day for 90 days. People in the experimental group followed a hypocaloric diet and received 1 tablet of simvastatin 20 mg once a day and L-carnitine 10 mL orally two times a day for 90 days.

Results

L-carnitine normalized the blood lipid profile of subjects, as demonstrated by a significant decrease in the blood levels of total cholesterol, triglycerides, low-density lipoproteins, atherogenic index, and insulin resistance. The use of L-carnitine in patients with nonalcoholic steatohepatitis and concomitant obesity contributes to the steady reduction of the main clinical and biochemical symptoms of nonalcoholic steatohepatitis.

Conclusions

L-carnitine produces positive effects on the blood lipid profile and carbohydrate metabolism.
Cefoperazone rapidly and sensitive quantitative assessment via a validated RP-HPLC method for different dosage forms, in-use stability, and antimicrobial activities
Authors: Al-Hakkani Mostafa F. , Ahmed Nourhan , Abbas Alaa A. , Hassan Mohammad H. A.
Published: July 2023

Cefoperazone (Cfz) is a member of the third generation of parenteral cephalosporin antibiotics. It is used on a wide scale in prescribed antibiotic drugs as anti-infection, especially for Gram-negative and also against Gram-positive microorganisms. The current study aimed to find a rapid RP-HPLC method of Cfz analysis with high linearity, repeatability, sensitivity, selectivity, and inexpensive. In our developed method, there is no need to use special chemical reagents, a high percentage of organic solvent, a high flow rate, further guard column. The chromatographic system comprises an ODS column (150 mm × 4.6 mm × 5 μm). The mobile phase was prepared by mixing KH2PO4 solution: acetonitrile (80:20) with a flow rate of 1.0 mL/min at detection wavelength 230 nm, at room temperature using injection volume 20 μL. The method manifested a satisfied linearity regression R2 (0.9993) with a good repeatability range (0.34–0.92%) with LOD and LOQ; 4.04 μg/mL and 12.24 μg/mL respectively. The method proved its efficiency via system suitability achievement in the robustness and ruggedness conduction according to the validation guidelines. The shorter analysis time makes the method very valuable in quality control to quantify the commercial Cfz in pharmaceutical preparations. This improved HPLC method has been successfully applied for Cfz analysis for Peracef and Peractam vials in our routine finished and stability studies testing laboratories. Additionally, the detection limit of Cfz has been tested in our quality control lab to detect the smallest amount of traces that may be present after the cleaning process of the production machines for cephalosporins preparations. In a precedent for the first time, we were able to use the current analysis method to determine the minimum inhibitory concentration (MIC) and minimum bacteriostatic concentration (MBC). The conventional broth micro-dilution tube method was used to determine MIC at 250 µg/mL and MBC at 125 µg/mL of Cfz against the standard strain of Burkholderia cepacia (B. cepacia) ATCC 25416 as Gram-negative bacteria in vitro.
Kinetic characterization of annotated glycolytic enzymes present in cellulose-fermenting Clostridium thermocellum suggests different metabolic roles
Authors: Daley Steve R. , Gallanosa Patricia Mae , Sparling Richard
Published: July 2023

Background

The efficient production of sustainable biofuels is important for the reduction of greenhouse gas emissions.Clostridium thermocellumATCC 27405 is a candidate for ethanol production from lignocellulosic biomass using consolidated bioprocessing. Fermentation of cellulosic biomass goes through an atypical glycolytic pathway in this thermophilic bacterium, with various glycolytic enzymes capable of utilizing different phosphate donors, including GTP and inorganic pyrophosphate (PPi), in addition to or in place of the usual ATP.C.thermocellum contains three annotated phosphofructokinases (PFK) genes, the expression of which have all been detected through proteomics and transcriptomics. Pfp (Cthe_0347) was previously characterized as pyrophosphate dependent with fructose-6-phosphate (F6P) as its substrate.

Results

We now demonstrate that this enzyme can also phosphorylate sedoheptulose-7-phosphate (an intermediate in the pentose phosphate pathway), with theVmaxandKmof F6P being approximately 15 folds higher and 43 folds lower, respectively, in comparison to sedoheptulose-7-phosphate. Purified PfkA shows preference for GTP as the phosphate donor as opposed to ATP with a 12.5-fold difference inKmvalues while phosphorylating F6P. Allosteric regulation is a factor at play in PfkA activity, with F6P exhibiting positive cooperativity, and an apparent requirement for ammonium ions to attain maximal activity. Phosphoenolpyruvate and PPiwere the only inhibitors for PfkA determined from the study, which corroborates what is known about enzymes from this subfamily. The activation or inhibition by these ligands lends support to the argument that glycolysis is regulated by metabolites such as PPiand NH4+in the organism. PfkB, showed no activity with F6P, but had significant activity with fructose, while utilizing either ATP or GTP, making it a fructokinase. Rounding out the upper glycolysis pathway, the identity of the fructose-1,6-bisphosphate aldolase in the genome was verified and reported to have substantial activity with fructose-1,6-bisphosphate, in the presence of the divalent ion, Zn2+.

Conclusion

These findings along with previous proteomic data suggest that Pfp, plays a role in both glycolysis and the pentose phosphate pathway, while PfkA and PfkB may phosphorylate sugars in glycolysis but is responsible for sugar metabolism elsewhere under conditions outside of growth on sufficient cellobiose.
Investigation on birth weight outcomes in schistosomiasis and praziquantel research: a correspondence
Authors: Holtfreter Martha C. , Mischlinger Johannes , Davi Saskia Dede , Schleenvoigt Benjamin T.
Published: July 2023

Infection with Schistosoma sp. during pregnancy can cause low birth weight of the newborn. To allow a better differentiation between newborns with low birth weight and those with normal weight, the terms of intrauterine growth restriction (IUGR), small for gestational age (SGA) or fetal growth restriction (FGR) should be used. FGR describes the relationship between birth weight and gestational age and is defined as the incapability of a fetus to achieve expected growth with birth weight below the 10th percentile for gestational age. Additional investigations of the proportion of newborns with FGR should obtain more certainty about the effect of praziquantel and schistosomiasis on fetal growth.
Development of a Pichia pastoris cell factory for efficient production of germacrene A: a precursor of β-elemene
Authors: Cheng Jintao , Zuo Yimeng , Liu Gaofei , Li Dongfang , Gao Jucan , Xiao Feng , Huang Lei , Xu Zhinan , Lian Jiazhang
Published: July 2023

β-Elemene, an active ingredient found in medicinal plants like turmeric and zedoary, is a sesquiterpene compound with antitumor activity against various cancers. However, its current mode of production through plant extraction suffers from low efficiency and limited natural resources. Recently, there has been an increased interest in establishing microbial cell factories to produce germacrene A, which can be converted to β-elemene by a one-step reaction in vitro. In this study, we constructed an engineeredPichia pastoriscell factory for producing germacrene A. We rerouted the fluxes towards germacrene A biosynthesis through the optimization of the linker sequences between germacrene A synthase (GAS) and farnesyl pyrophosphate synthase (ERG20), overexpression of important pathway genes (i.e.,IDI1, tHMG1, andACS), and multi-copy integration of related expression cassettes. In combination with medium optimization and bioprocess engineering, the final titer of germacrene A in a 1 L fermenter reached 1.9 g/L through fed-batch fermentation. This represents the first report on the production of germacrene A inP. pastorisand demonstrates its advantage in producing terpenoids and other value-added natural products.

Graphical Abstract
Beyond energy provider: multifunction of lipid droplets in embryonic development
Authors: Li Tai , Jin Yi , Wu Jian , Ren Zhuqing
Published: July 2023

Since the discovery, lipid droplets (LDs) have been recognized to be sites of cellular energy reserves, providing energy when necessary to sustain cellular life activities. Many studies have reported large numbers of LDs in eggs and early embryos from insects to mammals. The questions of how LDs are formed, what role they play, and what their significance is for embryonic development have been attracting the attention of researchers. Studies in recent years have revealed that in addition to providing energy for embryonic development, LDs in eggs and embryos also function to resist lipotoxicity, resist oxidative stress, inhibit bacterial infection, and provide lipid and membrane components for embryonic development. Removal of LDs from fertilized eggs or early embryos artificially leads to embryonic developmental arrest and defects. This paper reviews recent studies to explain the role and effect mechanisms of LDs in the embryonic development of several species and the genes involved in the regulation. The review contributes to understanding the embryonic development mechanism and provides new insight for the diagnosis and treatment of diseases related to embryonic developmental abnormalities.
The influence of intellectual capital on organizational performance
Authors: Mukaro Charlie Tatenda , Deka Abraham , Rukani Sylvester
Published: July 2023

Intellectual capital is by far the most important factor in enhancing organizational performance. Companies require skilled workers who have the know-how, skills, experience, as well as the ability to bring new ideas for the success of the business. The contemporary economy is a knowledge-based economy, which means that information, knowledge, and other intangible assets are considered to be more valuable than physical commodities. The present research is aimed at investigating the connection between intellectual capital and organizational performance among the business sectors of Turkiye. The current research uses the current dataset of the business sectors of Turkey from 2009 to 2021. The Autoregressive Distributive Lag technique, which provides robust results on short-time period dataset, is employed to investigate this association. The present research differs from past studies in that it uses secondary data in analyzing the effect of human capital component of IC on firm performance, hence the originality of this research. Past research has widely examined the association of intellectual capital (IC) and firm performance with primary data. The major results of the present research show the importance of debt and equity finance in raising organizational performance. The results also show that long-term liability and intellectual capital reduce firm profitability. The present research gives crucial policy recommendations that are vital for policy making.
Cancer Cachexia: ASCO Guideline Rapid Recommendation Update
Authors: Roeland Eric J. , Bohlke Kari , Baracos Vickie E. , Smith Thomas J. , Loprinzi Charles L. ,   for the Cancer Cachexia Expert Panel, Bruera Eduardo , Fabbro Egidio del , Dixon Suzanne , Fallon Marie , Herrstedt Jørn , Lau Harold , Platek Mary , Rugo Hope S. , Tan Winston
Published: July 2023

ASCO Rapid Recommendations Updates highlight revisions to select ASCO guideline recommendations as a response to the emergence of new and practice-changing data. The rapid updates are supported by an evidence review and follow the guideline development processes outlined in the ASCO Guideline Methodology Manual . The goal of these articles is to disseminate updated recommendations, in a timely manner, to better inform health practitioners and the public on the best available cancer care options. See the Appendix for disclaimers and other important information ( Appendix 1 and Appendix 2 , online only).
Integrated Radiology, Pathology, and Pharmacy Program to Accelerate Access to Osimertinib
Authors: Dagogo-Jack Ibiayi , Manoogian Amanda , Jessop Nicholas , Georgantas N. Zeke , Fintelmann Florian J. , Farahani Alexander , Digumarthy Subba R. , Price Melissa C. , Folch Erik E. , Keyes Colleen M. , Do Andrew , Peterson Jennifer L. , Mino-Kenudson Mari , Pitman Martha , Rivera Miguel , Nardi Valentina , Dias-Santagata Dora , Le Long P. , Iafrate Anthony John , Heist Rebecca S. , Ritterhouse Lauren R. , Lennerz Jochen K.
Published: July 2023

A workflow involving radiology, pathology, pharmacy, and oncology reduced time between biopsy and osimertinib.
Comparison of the effect of Dapagliflozin and Pioglitazone on the risk of osteoporosis in postmenopausal women with Type-2 diabetes
Authors: SON Osman
Published: July 2023

Objective: Type 2 Diabetes mellitus (T2DM) and osteoporosis, which increase with age, are two common diseases with different complications. The risk of fractures due to osteoporosis is 2 to 6 times higher in patients with diabetes mellitus (DM). Medications used in the treatment of DM in addition to the disease itself are associated with the risk of osteoporosis and osteoporotic fractures. This study was planned to examine the effects of pioglitazone and dapagliflozin, used in the treatment of T2DM, on the development of osteoporosis in postmenopausal women.

Methods: This single-centre comparative study was conducted at Endocrine and Metabolic Diseases Polyclinic of a Hospital between April 15, 2019 and April 15, 2020, with a total of 80 postmenopausal female patients with a diagnosis of T2DM and 20 in the control group, aged between 50 and 70. The participants were evaluated under four groups: “Control” without diabetes mellitus (n=20), “Pioglitazone” using (n=30), “Dapagliflozin” using (n=30), and “Other Oral Antidiabetic” using (n=20).

Results: The mean age of the participants was 61.32±6.27 years. There was no statistically significant difference between the groups in the hip and waist T-score values of participants with T2DM in the study (p>0.05). There was no significant difference in waist and hip t-score values between the intervention groups. Pioglitazone and dapagliflozin used in postmenopausal T2DM patients were determined not to make a significant difference in waist and hip bone mineral density values.

Conclusion: Our study revealed that pioglitazone and dapagliflozin can be used in postmenopausal T2DM individuals without known osteoporosis and other osteoporosis risk factors.

doi: https://doi.org/10.12669/pjms.39.5.7580

How to cite this: Son O. Comparison of the effect of Dapagliflozin and Pioglitazone on the risk of osteoporosis in postmenopausal women with Type-2 diabetes. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.7580

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.
Game on: Can gamification enhance productivity?
Authors: Rahiman Habeeb Ur , Kodikal Rashmi , Suresh Sucharitha
Published: July 2023

Background: Research suggests that gamification can increase work engagement by providing employees with a sense of autonomy, competence, and relatedness, and by creating a fun and engaging work environment. Gamification is designed to increase consumer and employee engagement and see that they holistically collaborate to achieve a shared vision. The concept of gamification is as old as learning itself, just that the use of the terminology “Gamification” is of a recent origin.

Methods: This article focuses on the impact of gamification in various organizations and simultaneously sees its relationship with job engagement and productivity. A primary investigation was done to determine the nexus between the various variables and data collection from 400 respondents working in various fraternities of the economy from both public and private domains from countries in the Gulf region. The structural equation model and SPSS has been inferred to analyse the results.

Results: The study results show that variable such as perceived adoption and usefulness in the gamified system is significantly associated with job engagement. Similarly, employee’s recognition and perceived motivation have a positive impact on productivity. The study identified job engagement mediating factor to enhance organisational productivity in a gamified system.

Conclusion: The effectiveness of gamification in enhancing work engagement may depend on factors such as the design of the gamification system, the preferences and motivations of individual employees, and the organizational culture and goals. The findings have significant implications for insight into how employees in the service sector are aware of the gamified working environment and react to the system through work engagement and productivity.
FINANCIAL LITERACY AS A FACTOR IN IMPROVING THE WELL–BEING OF THE POPULATION - A REGIONAL ASPECT
Authors: Paladova Tatyana A , Mamiyok Lyudmila A
Published: July 2023

The article is devoted to the study of the population's financial literacy as the basis of family well-being. In modern conditions of the expansion of the use of financial services, the complexity, and the emergence of new and difficult-to-understand financial instruments, the issues of financial literacy of the population have become extremely relevant for most countries of the world. Ensuring personal financial security is becoming an important factor in people's economic well-being. The paper studies and summarizes the essence of the concept of financial literacy, highlights the main features of a financially literate person and identifies and considers the main components of financial literacy. It is shown that the role of financial literacy in Russia is sufficiently large and raising its level among citizens is an important task facing the state, the solution of which is very important both for the state and for the economy and citizens. Indicators of the level of financial literacy of the population of the Russian Federation, the dynamics of changes in the level of financial literacy of the population, and the dependence of the level of financial literacy on age have been examined and analyzed in the research.