bluuebunny/crossref_metadata_2025 huggingface dataset:
RNA profiles differ between small and large extracellular vesicle subsets isolated from porcine seminal plasma
Authors: Barranco Isabel , Almiñana Carmen , Parra Ana , Martínez-Diaz Pablo , Lucas Xiomara , Bauersachs Stefan , Roca Jordi
Published: December 2024

Background

Extracellular vesicles (EVs) are essential for cell-to-cell communication because they transport functionally active molecules, including proteins, RNA, and lipids, from secretory cells to nearby or distant target cells. Seminal plasma contains a large number of EVs (sEVs) that are phenotypically heterogeneous. The aim of the present study was to identify the RNA species contained in two subsets of porcine sEVs of different sizes, namely small sEVs (S-sEVs) and large sEVs (L-sEVs). The two subsets of sEVs were isolated from 54 seminal plasma samples by a method combining serial centrifugations, size exclusion chromatography, and ultrafiltration. The sEVs were characterized using an orthogonal approach. Analysis of RNA content and quantification were performed using RNA-seq analysis.

Results

The two subsets of sEVs had different size distributions (P < 0.001). They also showed differences in concentration, morphology, and specific protein markers (P < 0.05). A total of 735 RNAs were identified and quantified, which included: (1) mRNAs, rRNAs, snoRNAs, snRNAs, tRNAs, other ncRNAs (termed as “all RNAs”), (2) miRNAs and (3) piRNAs. The distribution pattern of these RNA classes differed between S-sEVs and L-sEVs (P < 0.05). More than half of “all RNAs”, miRNAs and piRNAs were found to be differentially abundant between S- and L-sEVs (FDR < 0.1%). Among the differentially abundant RNAs, “all RNAs” were more abundant in L- than in S-sEVs, whereas the most of the miRNAs were more abundant in S- than in L-sEVs. Differentially abundant piRNAs were equally distributed between S- and L-sEVs. Some of the all RNAs and miRNAs found to be differentially abundant between S- and L-sEVs were associated with sperm quality and functionality and male fertility success.

Conclusions

Small and large sEVs isolated from porcine seminal plasma show quantitative differences in RNA content. These differences would suggest that each sEV subtype exerts different functional activities in the targeted cells, namely spermatozoa and functional cells of the female reproductive tract.
Toward value-based care using cost mining: cost aggregation and visualization across the entire colorectal cancer patient pathway
Authors: Leusder Maura , Relijveld Sven , Demirtas Derya , Emery Jon , Tew Michelle , Gibbs Peter , Millar Jeremy , White Victoria , Jefford Michael , Franchini Fanny , IJzerman Maarten
Published: December 2024

Background

The aim of this study is to develop a method we call “cost mining” to unravel cost variation and identify cost drivers by modelling integrated patient pathways from primary care to the palliative care setting. This approach fills an urgent need to quantify financial strains on healthcare systems, particularly for colorectal cancer, which is the most expensive cancer in Australia, and the second most expensive cancer globally.

Methods

We developed and published a customized algorithm that dynamically estimates and visualizes the mean, minimum, and total costs of care at the patient level, by aggregating activity-based healthcare system costs (e.g. DRGs) across integrated pathways. This extends traditional process mining approaches by making the resulting process maps actionable and informative and by displaying cost estimates. We demonstrate the method by constructing a unique dataset of colorectal cancer pathways in Victoria, Australia, using records of primary care, diagnosis, hospital admission and chemotherapy, medication, health system costs, and life events to create integrated colorectal cancer patient pathways from 2012 to 2020.

Results

Cost mining with the algorithm enabled exploration of costly integrated pathways, i.e. drilling down in high-cost pathways to discover cost drivers, for 4246 cases covering approx. 4 million care activities. Per-patient CRC pathway costs ranged from $10,379 AUD to $41,643 AUD, and varied significantly per cancer stage such that e.g. chemotherapy costs in one cancer stage are different to the same chemotherapy regimen in a different stage. Admitted episodes were most costly, representing 93.34% or $56.6 M AUD of the total healthcare system costs covered in the sample.

Conclusions

Cost mining can supplement other health economic methods by providing contextual, sequence and timing-related information depicting how patients flow through complex care pathways. This approach can also facilitate health economic studies informing decision-makers on where to target care improvement or to evaluate the consequences of new treatments or care delivery interventions. Through this study we provide an approach for hospitals and policymakers to leverage their health data infrastructure and to enable real time patient level cost mining.
Early detection of bacterial pneumonia by characteristic induced odor signatures
Authors: Arnold Kim , Gómez-Mejia Alejandro , de Figueiredo Miguel , Boccard Julien , Singh Kapil Dev , Rudaz Serge , Sinues Pablo , Zinkernagel Annelies S.
Published: December 2024

Introduction

The ability to detect pathogenic bacteria before the onsets of severe respiratory symptoms and to differentiate bacterial infection allows to improve patient-tailored treatment leading to a significant reduction in illness severity, comorbidity as well as antibiotic resistance. As such, this study refines the application of the non-invasive Secondary Electrospray Ionization-High Resolution Mass Spectrometry (SESI-HRMS) methodology for real-time and early detection of human respiratory bacterial pathogens in the respiratory tract of a mouse infection model.

Methods

A real-time analysis of changes in volatile metabolites excreted by mice undergoing a lung infection by Staphylococcus aureus or Streptococcus pneumoniae were evaluated using a SESI-HRMS instrument. The infection status was confirmed using classical CFU enumeration and tissue histology. The detected VOCs were analyzed using a pre- and post-processing algorithm along with ANOVA and RASCA statistical evaluation methods.

Results

Characteristic changes in the VOCs emitted from the mice were detected as early as 4–6 h post-inoculation. Additionally, by using each mouse as its own baseline, we mimicked the inherent variation within biological organism and reported significant variations in 25 volatile organic compounds (VOCs) during the course of a lung bacterial infection.

Conclusion

the non-invasive SESI-HRMS enables real-time detection of infection specific VOCs. However, further refinement of this technology is necessary to improve clinical patient management, treatment, and facilitate decisions regarding antibiotic use due to early infection detection.
Association between the EHBP1 SNPs and dyslipidemia in the end-stage renal disease patients with dialysis in Chinese Han population
Authors: Lai Yan-Fei , Liang Zhong-E , Wu Chun-Xiang , Zhang Min , Shi Zong-Hu , Meng Xiao-Yan , Liu Chun-Xiao
Published: December 2024

Background

Lipid metabolism is influenced by mutations in the EH domain binding protein 1 gene (EHBP1). This study investigated the link between the EHBP1 single-nucleotide polymorphisms (SNPs) and dyslipidemia risks in maintenance dialysis patients with end-stage renal disease in Chinese Han population.

Methods

A total of 539 patients were divided into dyslipidemia (379) and control (160) groups. The patients with dyslipidemia were divided into four subgroups: high low-density lipoprotein cholesterol, low high-density lipoprotein cholesterol (HDLC), high triglyceride (TG) and high total cholesterol groups. The genotype distributions of three EHBP1 SNPs (rs2710642, rs10496099 and rs1168816) were determined by high-throughput sequencing technology and were analyzed via generalized multifactor dimension reduction and binary logistic regression analysis.

Results

The high-TG and control groups differed in terms of the genotype frequency of the rs2710642. One haplotype was detected in both the dyslipidemia and high-TG groups. The risk of dyslipidemia was 2.72-fold higher in participants with rs2710642GG compared with those of rs2710642AA and 2.62-fold higher compared with those with rs2710642AA + GA. Subjects who carried rs2710642GG had a 2.94 times greater risk of high TG levels than those who carried rs2710642AA and a 2.89 times greater risk than those who carried rs2710642AA + GA. Compared with those who carried rs2710642AA + GA, those who carried rs2710642GG were 2.53 times more likely to have low HDLC levels. The rs2710642–body mass index (BMI) (≥ 24 kg/m2) and rs11688816A–rs2710642G haplotype interactions increased the risk of dyslipidemia, and the rs2710642–BMI (≥ 24 kg/m2) interaction increased the risk of high TG levels. The rs10496099–rs2710642 and rs10496099–rs2710642–rs11688816 interactions increased the risk of low HDLC levels.

Conclusions

These results suggest that the EHBP1 rs2710642G and rs2710642GG and interactions with rs11688816A or BMI (≥ 24 kg/m2) were linked to higher dyslipidemia risks in end-stage renal disease patients in Chinese Han population.
Contraceptive use, prevalence and incidence of pregnancy and associated factors among women participating in a vaccine preparedness cohort study in Masaka, Uganda, a retrospective secondary analysis
Authors: Kusemererwa Sylvia , Kansiime Sheila , Nakamanya Sarah , Mbabazi Elizabeth , Fox Julie , McCormack Sheena , Kaleebu Pontiano , Ruzagira Eugene
Published: December 2024

Background

HIV prevention trials usually require that women of childbearing potential use an effective method of contraception. This is because the effect of most investigational products on unborn babies is unknown. We assessed contraceptive use, prevalence and incidence of pregnancy and associated factors among women in a HIV vaccine preparedness study in Masaka, Uganda.

Methods

HIV sero-negative women (18–45 years) at high risk of HIV infection identified through HIV counselling and testing (HCT) were recruited between July 2018 and October 2022. Study procedures included collection of baseline socio-demographics and contraceptive use data, quarterly HCT, counselling on and provision of contraceptive methods onsite/through referral, and 6-monthly urine pregnancy tests. Multivariable Logistic and Poisson regression analyses were conducted to determine factors associated with contraceptive use, prevalence, and incidence of pregnancy.

Results

652 (73%) of 891 women reported contraceptive use at baseline. Contraceptive use was higher in women who were in a relationship/married/cohabiting [adjusted odds ratio (aOR) = 1.60; 95% confidence interval (CI) 1.07–2.40] or divorced/separated/widowed [aOR = 1.86; 95% CI 1.24–2.79] versus those that were single, and among women reporting transactional sex [aOR = 2.10; 95% CI 1.16–3.80] versus those who did not. Baseline pregnancy prevalence was 4% (95% CI 3–6%) and lower in women who reported using long-acting contraceptive methods (aOR = 0.17; 95% CI 0.07–0.39) versus women who did not use these methods. A total of 65 pregnancies over 301.3 person-years of observation (PYO), an incidence rate of 21.6/100 (95% CI 16.9–27.5) PYO, higher among younger women (≤ 24 versus 25 + years, adjusted incidence rate ratio = 1.97; 95% CI 1.15–3.40).

Conclusion

We observed a high pregnancy incidence in this cohort. Innovative strategies that promote sustained and consistent use of highly effective contraceptive methods especially for young women will be critical to the success of HIV prevention trials in this and similar populations.
Impact of enzyme replacement therapy on clinical manifestations in females with Fabry disease
Authors: Lenders Malte , Nowak Albina , Cybulla Markus , Kaufeld Jessica , Köhn Anja Friederike , Muschol Nicole Maria , Kurschat Christine , Brand Eva
Published: December 2024

Background

The aim of our multicenter study was to investigate the implementation of the European Fabry guidelines on therapeutic recommendations in female patients with Fabry disease (FD) and to analyze the impact of enzyme replacement therapy (ERT) in treated and untreated females.

Results

Data from 3 consecutive visits of 159 female FD patients from 6 Fabry centers were retrospectively analyzed. According to their treatment, patients were separated in 3 groups (untreated, n = 71; newly ERT-treated, n = 47; long-term ERT-treated, n = 41). Clinical presentation and laboratory data, including plasma globotriaosylsphingosine (lyso-Gb3) levels were assessed. The observation time ranged from 49 to 62 months. ∼90% of female patients treated with ERT presented with at least one organ manifestation justifying treatment according to current European guidelines. Untreated females showed a less severe disease load with less FD-typical organ damage. All groups presented with a stable cardiac status (all p > 0.05) over time. ERT-treated females presented with a slight yearly loss of estimated glomerular filtration (eGFR) over time (both p < 0.05), which was comparable to the natural decline for this age. Plasma lyso-Gb3 levels were higher in ERT-treated females and decreased by 0.95 [-4.44 to 4.08] ng/ml/year (p = 0.0002) in those who were newly ERT-treated.

Conclusions

Severely affected females with FD who were treated with ERT, and less severely affected untreated females, showed a broadly stable disease course over 5 years. The treatment decisions were largely based on the European guidelines for FD. In untreated females, it is crucial to explore if organ involvement is FD-related in order to make the correct treatment decision.
The relationship between callous-unemotional traits and internalizing psychopathology in adolescent psychiatric inpatients: a network analysis
Authors: Derks Laura Maria , Becker Eni Sabine , Lange Wolf-Gero , Rinck Mike , Dapprich Anna Lena , Holtmann Martin , Legenbauer Tanja
Published: December 2024

Background

Numerous studies have investigated the relevance of callous-unemotional traits in relation to externalizing psychopathology among children and adolescents. However, less research has examined the connections between callous-unemotional traits and internalizing psychopathology and findings were inconsistent. Consequently, the present study aimed to elucidate the role of callous-unemotional traits in the context of depression and anxiety while controlling for conduct problems, age, and gender.

Methods

The study utilized self-report questionnaire data from 978 adolescent psychiatric inpatients (Mage = 15.18, SD = 1.44) presenting a range of psychopathological conditions. A network analysis was conducted, incorporating callous-unemotional traits, depressive symptoms, anxiety symptoms, conduct problems, and covariates (age, gender). Additionally, comparisons were made between the networks of inpatients diagnosed with conduct disorders and those with internalizing disorders.

Results

The findings indicated that callous-unemotional traits were relevant within the general network, as well as in both the conduct disorder and internalizing networks. In both contexts, callous-unemotional traits were predominately positively associated with depression and conduct problems. Within the conduct disorder network, callous-unemotional traits exhibited primarily negative associations with anxiety, whereas the relationships within the internalizing network were more varied.

Conclusions

Our findings suggest that callous-unemotional traits hold substantial relevance for internalizing symptoms, supporting the notion that these traits should be considered potentially transdiagnostic factors.
Cationized albumin conjugated solid lipid nanoparticles as vectors for delivery of albendazole against cystic echinococcosis
Authors: Faizi Fariba , Mahjub Reza , Torabi Negin , Motavallihaghi Seyedmousa , Fallah Mohammad
Published: December 2024

Background

Cystic echinococcosis (CE) is a common neglected parasitic disease. Nanoparticles containing drugs have been widely utilized in various formulations for several purposes, including improving the bioavailability of drugs by increasing the solubility and dissolution rate of the nanoparticles. The purpose of this study was to evaluate the effects of solid lipid nanoparticles containing albendazole and conjugated to albumin (B-SLN + ABZ) as a novel treatment approach for hydatid cysts in vivo.

Methods

Albendazole-loaded solid lipid nanoparticles were prepared by emulsification and solvent evaporation method. The experimental mice were assessed for prophylactic and therapeutic effects of the drugs. Ultrastructural changes were observed by transmission electron microscopy.

Results

The variance analysis of the fitted model indicated that the Glyceryl monostearate (GMS)/soy lecithin concentration ratio and the amount of albendazole had a significant effect on nanoparticle size. The GMS/soy lecithin concentration ratio and the amount of albendazole had a notable effect on nanoparticle polydispersity index (PdI) and entrapment efficiency (EE%), respectively. During chemoprophylaxis, the B-SLN + ABZ group showed a lower number and weight of cysts (0.90 ± 0.73 and 15.01 ± 10.46, respectively) compared with the ABZ + SLN group (1.4 ± 0.51 and 26.73 ± 9.92, respectively). In addition, therapeutic efficacy analysis showed a significant reduction in wet weights of metacestodes in mice treated with both B-SLN + ABZ (29.37 ± 13.82 mg) and SLN + ABZ (35.88 ± 7.49 mg) compared with the control group (59.78 ± 3.80 mg).

Conclusions

The results showed that B-SLN + ABZ nanoparticles were more effective against E. granulosus cysts compared with free ABZ. The cysts in the animals receiving B-SLN + ABZ every 24 h showed more ultrastructural changes.

Graphical abstract
An opportunity to sleep well in hospital: development of a multi-level intervention to improve inpatient sleep (ASLEEP) using behaviour change theories
Authors: Hurley-Wallace Anna Louise , Bertram Wendy , Johnson Emma , Wylde Vikki , Whale Katie
Published: December 2024

Background

Sleep is substantial issue for hospital inpatients and can negatively affect healing and recovery. There is a good evidence-base for interventions which can improve sleep, however currently they are not being implemented into NHS practice. To address the evidence-practice gap, we have conducted early-phase development for an inpatient sleep intervention (ASLEEP); a multi-level intervention to improve inpatient sleep in UK hospital wards.

Methods

We used an iterative development process incorporating Patient and Public Involvement and Engagement, ward staff surveys and stakeholder consultations (orthopaedic and acute medicine), and theoretical mapping using behaviour change theories. Development took place in four stages: identification of existing patient-level intervention components to improve sleep in hospital; identification of environmental barriers and facilitators to sleep in hospital; consultation with health professional stakeholders; and final theoretical mapping using the COM-B model and Theoretical Domains Framework, also considering who holds ‘change power’ for each change construct.

Results

We identified 18 variables contributing to inpatient sleep, which are malleable to change universally across hospital wards. Central domains for change were identified as the ward environment context and resources; to reduce noise from equipment (material resources), and social influence; to modulate staff and patient noise awareness and behaviours (group norms). Change power mapping identified key stakeholders as patients, ward staff, procurement/estates, and NHS management.

Conclusions

Improving sleep in hospital requires a whole-systems approach which targets environmental factors, staff behaviour, and patient behaviour. We have provided recommendations for a multi-level intervention, highlighting core areas for change and essential stakeholders who must be involved to progress implementation. The next stage of development will involve operationalising recommendations and piloting, including evaluating mechanisms of change. It will be important to continue working with a broad range of stakeholders to bridge the evidence-practice gap and support sustainable practice adoption.
Density-dependent distributions of hosts and parasitoids resulting from density-independent dispersal rules: implications for host–parasitoid interactions and population dynamics
Authors: Okuyama Toshinori
Published: December 2024

Background

The distribution of hosts and parasitoids across patches is a key factor determining the dynamics of host-parasitoid populations. To connect behavioral rules with population dynamics, it is essential to comprehend how individual-level dispersal behavior influences the distribution of individuals. Typically, a simple deterministic model has been used to describe this connection. This study explicitly derived the relationship between individual-level dispersal behavior and the distribution of individuals across patches, contrasting it with the conventional deterministic model.

Methods

A stochastic individual-based model was developed from a widely used deterministic host–parasitoid population model. Individual-level dispersal rules were simulated in the stochastic model without assuming the resulting distributions. The models assume that the dispersal of hosts and parasitoids is independent of conspecific density. The deterministic model can be seen as an approximation of the stochastic model, describing the outcomes of stochastic processes as their expected patterns. In addition to describing the relationship between dispersal behavior and distribution across patches, its consequences for population dynamics were also examined.

Results

The stochastic model revealed that the distribution of individuals among patches varies with the number of dispersing conspecifics, whereas the deterministic model assumes independence from conspecific density, indicating that the deterministic model fails to capture the outcomes of stochastic dispersal. The resulting density-dependent distributions of hosts and parasitoids lead to other density-dependent interactions between them, such as density-dependent parasitism risk for hosts and density-dependent searching efficiency for parasitoids, ultimately affecting population dynamics. For instance, while aggregation of parasitoids is stabilizing in the deterministic model, it can be both stabilizing and destabilizing in the stochastic model.

Conclusions

The stochastic model revealed that density-dependent distributions of hosts and parasitoids emerge when individuals disperse in a density-independent manner, significantly impacting existing host-parasitoid theory, which assumes density-independent distributions. To address this, the implications of emerging density dependencies for well-known results, such as the pseudointerference of parasitoids and the CV2 > 1 rule, were discussed. Explicitly considering individual-level dispersal behavior is essential for understanding host–parasitoid interactions and population dynamics.
A remote motion analysis of mass casualty incident simulations
Authors: Tolg Boris
Published: December 2024

Background

Regular training for mass casualty incidents at physical simulation events is vital for emergency services. The preparation and execution of these simulations consume huge amounts of time, personnel, and money. It is therefore important to gather as much information as possible from each simulation while minimizing any influence on the participants, so as to keep the simulation as realistic as possible. In this paper, an analysis of GPS-based remote motion measurements of participants in a mass casualty incident simulation is presented. A combination of different evaluation methods is used to analyze the data. This could reduce the potential bias of the measurement methods.

Methods

Movement patterns of participants of mass casualty incident simulations, measured by GPS loggers, were analyzed. The timeline of the simulation was segmented into event sections, based on movement patterns of participants entering or leaving defined areas. Movement patterns of participants working closely together were correlated to analyze their cooperation. Written logs created by observers on the ground were used to reconstruct the events of the simulation, to provide a comparative reference to validate the motion analysis.

Results

Recorded motion patterns of the participants were found to be qualitatively related to observer logs and triage allocations, allowing a partial reconstruction of the behavior of the participants during the simulation. By analyzing the times the simulation patients left the site of events some possible misjudgments in the triage decisions were indicated.

Conclusions

Analysis of movement patterns from GPS loggers and comparison with observations made on the ground showed that accurate information about the events during the simulation can be automatically delivered. Although the records of observers on the ground are vital to assess details, delegation of the automated analysis of individual and group motion could perhaps allow observers to concentrate on more specific tasks. The partially automated motion analysis methods presented should simplify the process of analyzing mass casualty incident simulations.
A survey on the application of blockchain in cryptographic protocols
Authors: Luo Xiangyang , Chen Xingxing , Chen Xiaofeng , Cheng Qingfeng
Published: December 2024

With the continuous development of network technology, cryptographic protocols are facing diverse and complex security challenges. Blockchain technology, as a solution incorporating decentralization, traceability, programmability, and immutability, effectively enhances the security, trustworthiness, operational efficiency, and ensures the security and integrity of data storage in traditional cryptographic protocols. Consequently, it has gradually emerged as a focal point of research in cryptographic protocols. This manuscript delves into the ongoing research concerning the application of blockchain technology in cryptographic protocols. First, this manuscript introduces the background of blockchain research in cryptographic protocols and the corresponding basic knowledge. Secondly, we delve into the main concerns of traditional cryptographic protocols, with a particular focus on security and performance. Thirdly, according to the main classification of cryptographic protocols, the latest research results of blockchain in authentication protocols, authentication and key agreement protocols, and e-commerce protocols are presented. Finally, the research directions of blockchain technology in cryptographic protocols are summarized based on the existing research, and the future development trend is also prospected.
Design of CCM boost converter using fractional-order PID and neural-network techniques for power factor correction
Authors: Liu Wanci , Liu Yapeng , Wang Aibing
Published: December 2024

The most important factors that guarantee good operation are power quality (PQ) criteria such as the following: power factor (PF), total harmonic distortion (THD), and proper output regulation. This paper shows that the conventional uncontrolled diode bridge rectifier introduces a pulsed current on the input side. It proposes an active wave-shaping control system approach to deal with the problem straightforwardly and effectively. Shifting it closer to unity improves the PF, and the parameters of THD remain within their limits. Additionally, it regulates the generated voltage. The control system implemented here will cascade with a fractional-order proportional-integral-derivative (PID) controller optimized using Antlion optimization (ALO) as its outer loop. This PID controller takes the output voltage as input and adjusts the amplitude of the reference current for the inductor. Conversely, the inner loop is based on the neural networks (NN) adaptive approach to track the reference current to the inductor accurately. A cascade controller in the suggested scheme tends to assure the desired performance and results in satisfactory PQ. Ultimately, the analysis of the simulation results attests to significant robustness and a gain in dynamics across a wide range of challenging cases.
Performance of hump slab track in sandstorms using simulation and a wind tunnel experiment
Authors: Fathali Masoud , Nasrabad Mohammad Mohsen Kabiri , Moghadasnejad Fereidoon
Published: December 2024

Sandstorms have destructive effects on railway infrastructures due to the movement and erosion of sand. One of the proposed solutions to reduce the impact of windblown sand on desert railways is the hump slab track superstructure. This system entails removing the ballast layer and elevating the rails using concrete foundations called humps, which create sand movement channels beneath the rails. The hump’s geometry must not only meet optimal aerodynamic conditions but also ensure ample clearance for sand passage, maintaining structural stability and efficient railway performance. In this study, the aerodynamic evaluation of various hump geometry is examined considering the elliptical (EL) and semicircular-rectangular (CR) shapes. Simulations are carried out using 3D computational fluid dynamics in ANSYS Fluent software. A gas–solid two-phase model, comprising a distinct phase for sand particles and another for air, is developed to assess the sand movement capacity through the selected hump geometries. A wind tunnel experiment is then performed on a prototype of a hump slab track to validate the software model. The findings highlighted that the CR shape, with a height of 25 cm, resulted in the most favorable outputs.
Abridging the Human Activity Profile (HAP): Item Reduction for Ambulatory Outpatient Populations
Authors: Price Jillian Kallman , Stepanova Maria , Weinstein Ali , Gerber Lynn , Younossi Zobair M.
Published: December 2024

Introduction

The purpose of this study was to develop an abridged Human Activity Profile (HAP-A) for ambulatory patients.

Methods

Classical test theory item reduction model and exploratory factor analysis (EFA) were used, including maximum likelihood factor extraction with Kaiser varimax rotation, eigenvalues >1 retained, and item loading cutoff of 0.4, followed by confirmatory factor analysis (CFA) and internal consistency reliability analyses. Data were originally collected from an outpatient ambulatory tertiary care clinic and research site of a large nonprofit health system hospital medical campus located in a metropolitan area of the northeastern United States. Four hundred and fifty-five de-identified healthy controls and people with chronic liver diseases or autoimmune or metabolic conditions with basic demographic information and completed HAP were collected across one retrospective and four prospective studies with institutional review board approval over 15 years (2006–2021). Main analyses included maximum and adjusted activity scores (MAS and AAS), EFA and CFA, internal consistency reliability (Cronbach’s α, McDonald’s ω), and convergent validity.

Results

HAP and HAP-A MAS and AAS measures were statistically indistinguishable (P = 1.00, paired t-tests). HAP-A Cronbach’s α was 0.892, and McDonald’s ω was 0.902. CFA revealed three factors (domains) in 29 questions: factor 1, high activity/sport (5.7–10.3 metabolic equivalents (METs)); factor 2, light mobility/leisure (0.9–7.1 METs); and factor 3, chores/activities of daily living (<0.9–6.6 METs). Using CFA, 28 of 29 items loaded as expected; Tucker–Lewis Index, comparative fit index, and root mean square error of approximation were modest (0.716, 0.738, and 0.110, respectively), likely due to cohort composition shifts. Controlling for age, sex, body mass index, hypertension, hyperlipidemia, and diabetes, HAP-A’s AAS score retained its significant correlation with the Fatigue Severity Scale (FSS) (analysis of covariance sum of squares, 6.097; 1 degree of freedom; mean square, 6.097; P = 0.03).

Conclusions

HAP and HAP-A scores were statistically indistinguishable and preserved a significant correlative relationship with a validated fatigue measure (FSS). HAP-A is a reasonable HAP alternative in ambulatory patients.
PDA-associated infective endocarditis with pulmonary artery perforation
Authors: Munawar Fatina , Ikram Ahmed Rana  , Muhammad Ali Mumtaz
Published: December 2024

Infective endocarditis used to frequently cause mortality in subjects having PDA before the advent of antibiotics and surgical ligation. It has been documented that clinically silent PDAs may cause infective complications of heart valves. We present case of an 18-years-old male who presented with palpitations and fever to our emergency department. The fever was sudden in onset, associated with rigors, high-grade and with a continuous pattern for 12 days. The patient was previously managed as a case of dengue fever based on serology. Eight days after the onset of fever, the patient developed left-sided chest pain. Past medical record showed documentation of a patent ductus arteriosus.
A two-dimensional echocardiography showed circumferential pericardial effusion and a small-sized PDA; the left ventricular function was normal. Nevertheless, the definitive cause of the pericardial effusion was not known. The patient became haemodynamically unstable during the hospital stay and it was planned to ligate the PDA with cardiac surgical consultation. A left thoracotomy approach was chosen for the PDA ligation that unveiled rupture of the main pulmonary artery, so the pulmonary artery repair alongside the PDA ligation was planned with median sternotomy approach and cardiopulmonary bypass immediately. The patient had a 14-days course of antibiotics during the ICU stay. In conclusion, infective endocarditis remains a rare yet life-threatening complication of PDA irrespective of the size; a timely PDA-ligation could prevent the life-threatening sequels.
doi: https://doi.org/10.12669/pjms.41.1.10200
How to cite this: Munawar F, Rana IA, Mumtaz MA. PDA-associated infective endocarditis with pulmonary artery perforation. Pak J Med Sci. 2025;41(1):344-346. doi: https://doi.org/10.12669/pjms.41.1.10200
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.
Prevalence and predictors of obstructive sleep apnea in patients with bipolar disorder: A systematic review and meta-analysis
Authors: Zhu Fangyan , Cui Chenmin , Gu Kailong
Published: December 2024

Background & Objective: Obstructive sleep apnea (OSA) has been increasingly recognized as a comorbidity in many psychiatric disorders, including bipolar disorder (BD). This study aimed to synthesize existing evidence to determine the frequency of OSA in patients diagnosed with BD and identify potential predictors of its occurrence.
Methods: PubMed, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials), and Google Scholar databases were searched for English-language papers published up from 1st January 1960 to 31st October 2023 that reported incidences of OSA in patients with BP and provided sufficient data for quantitative analysis. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane Handbook (version 5.1.0) guidelines were followed. Meta-regression analyses were done to identify predictors that correlate with the prevalence of obstructive sleep apnea.
Results: The systematic review identified a total of 14 eligible studies. The pooled prevalence of OSA in individuals with BD was determined to be [24.55%] (95% confidence interval (CI): [17.25 to 32.63%, I2=99.57%]). Meta-regression analyses showed that male gender was associated with a higher prevalence of OSA, while body mass index (BMI) and mean age showed no significance in predicting OSA prevalence.
Conclusion: Our results demonstrated higher incidence of OSA in patients with BD. Male BD patients had higher rate of OSA.
doi: https://doi.org/10.12669/pjms.41.1.10567
How to cite this: Zhu F, Cui C, Gu K. Prevalence and predictors of obstructive sleep apnea in patients with bipolar disorder: A systematic review and meta-analysis. Pak J Med Sci. 2025;41(1):302-311. doi: https://doi.org/10.12669/pjms.41.1.10567
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.
The Harm reduction associated with heated tobacco products: A systematic review and meta-analysis
Authors: Akram Javed , J. Akram Shehla , Naseem Nadia , Shehzad Sheeraz , Rana Arslan , Ashraf Verda , Akram Ansa , E. Sheikh Usman , Joshi Miland , S. Khan Khalid
Published: December 2024

Objective: We conducted a systematic review and meta-analysis of randomised studies in humans comparing the outcomes of switching to heated tobacco products (HTPs) versus continuing conventional tobacco smoking by burning.
Methods: We searched the electronic databases which included PubMed, Web of Science, Cochrane Controlled Trials Register, and Google Scholar from inception to May 2023. Randomised Controlled Trials (RCTs) in humans comparing HTPs with conventional burnt tobacco products were selected. Our search yielded 4817 search results, of which six RCTs (number of participants 1362, all from high-income countries) were selected. Five of the six included RCTs had low risk in four of five domains of bias; only one study had a high risk of bias in one domain. PRISMA guidelines were followed.
Results: There were 40 biomarkers of harm reduction reported categorised into six categories. One cancer biomarker (nitrosamine) and two cardiovascular biomarkers (eosinophils and total bilirubin) showed statistically significant harm reduction (total NNAL SMD=0·82, 95% CI 0·67-0·98, eosinophils SMD=0·38, 95% CI 0·12-0·65, total bilirubin SMD=0·71, 95% CI 0·28-1·31). The remaining biomarkers of harm in cardiovascular, inflammatory, metabolic, pulmonary, and renal categories showed imprecise findings.
Conclusions: In RCTs of moderate quality, some biomarkers show harm reduction associated with switching from burnt tobacco smoking to HTPs. The majority of the findings are imprecise due to the small sample sizes of the included studies. Sufficiently powered, robust RCTs targeting key harm reduction biomarkers within both upper and low-middle income country settings are required in the future.
doi: https://doi.org/10.12669/pjms.41.1.10820
How to cite this: Akram J, Akram SJ, Naseem N, Shehzad S, Rana A, Ashraf V, et al. Harm reduction associated with heated tobacco products: A systematic review and meta-analysis. Pak J Med Sci. 2025;41(1):295-301. doi: https://doi.org/10.12669/pjms.41.1.10820
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Association of hip dysplasia in newborns with ethnicity using graf method ultrasound
Authors: Marvi Nasim , Khokhar Samia Khalid , Qamar Aisha , Ashfaq Muhammad
Published: December 2024

Objectives: To determine gender and ethnic distribution of developmental dysplasia of hip in newborns using Graf method for ultrasound. To determine the significance of association between developmental dysplasia of hip with ethnicity in newborns using Graf’s method ultrasound.
Method: This analytical cross-sectional observational study was conducted in Karachi from January through June 2022. A total of 115 healthy newborns (both male and female) aged under 28 days were included in the study after parental informed consent. Hip dislocation was assessed clinically using Barlow and Ortolani maneuvers. The gender, ethnicity and hip angles were recorded in the proforma. Graf’s method ultrasound was used to measure the hip angles. Acetabular roof, head of femur, triradiate cartilage and acetabular labrum were used as landmarks for angle measurements. The hip joint was classified based on Graf method criteria.
Results: The incidence of hip dysplasia was higher in male (16.08%) as compared to female infants (14.78%). The difference between gender distributions was not significant. The predominant ethnicities with pathological hip were Sindhi (9.13%), Punjabi (7.39%) and Pathan (6.08%). The association between ethnicity and pathological hips was statistically significant (p=0.021).
Conclusion: There is no significant difference in incidence of DDH with gender. However, there is a significant association between ethnicity and incidence of developmental dysplasia of hip in neonates of 28 days age. Incidence of DDH is high in the Sindhi, Punjabi and Pathan populations.
doi: https://doi.org/10.12669/pjms.41.1.8600
How to cite this: Marvi N, Khokhar SK, Qamar A, Ashfaq M. Association of hip dysplasia in newborns with ethnicity using graf method ultrasound. Pak J Med Sci. 2025;41(1):247-250. doi: https://doi.org/10.12669/pjms.41.1.8600
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.
Diagnostic accuracy and safety of ultrasound-guided percutaneous core needle biopsy among children with extra cranial solid masses at a tertiary care hospital in Karachi, Pakistan
Authors: Imran Fatima Ambreen , Razaque Abdul , Mehwish Qureshi Aisha , Rafie Raza Muhammad
Published: December 2024

Objective: To determine the diagnostic accuracy and procedure safety of ultrasound-guided core needle biopsy of extra cranial solid masses in the pediatric population.
Method: A cross-sectional survey was conducted by the Department of Pediatric Hematology /Oncology and Radiology at Indus Hospital and Health Network Karachi from August 2022 to April 2023. A total of 118 pediatric patients, from age one month to 18 years, with extra cranial solid masses were studied. Data was analyzed using SPSS version 24.
Results: The median age of study participants was six years with IQR = 7.2 years. Among all study participants 62.7% (n=74) were male while 37.3% (44) were female. Out of all biopsies 94.07% (n=111) were conclusive and provided an accurate diagnosis of the tumor while only 5.63% (n=07) biopsies remained inconclusive. No serious post-procedure complication was reported. Pain on the site of biopsy was the most post-procedure complain reported by 34.7% (n=41) of all the study participants. Forty-two percent of the study participants never reported any post-procedure complaints after ultrasound-guided biopsy. The diagnostic accuracy was significantly higher for malignant lesions as compared to non-malignant lesions.
Conclusion: Ultrasound-guided percutaneous core needle biopsy had high diagnostic accuracy and a good safety profile among children with extra cranial solid masses in private tertiary care hospital in Karachi Pakistan.
doi: https://doi.org/10.12669/pjms.41.1.9777
How to cite this: Imran FA, Razaque A, Qureshi AM, Raza MR. Diagnostic accuracy and safety of ultrasound-guided percutaneous core needle biopsy among children with extra cranial solid masses at a tertiary care hospital in Karachi, Pakistan. Pak J Med Sci. 2025;41(1):219-224.  doi: https://doi.org/10.12669/pjms.41.1.9777
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.
Dates fruit effects on dyslipidemia among patients with Type-2 diabetes mellitus: A systematic review and meta-analysis of randomized trials
Authors: Mirghani Hyder Osman , Alhowiti Amira
Published: December 2024

Objectives: Dyslipidemias are major risk factors for cardiovascular disease, and other comorbidities. The focus on food and nutrition to prevent and treat cardiovascular risk factors including dyslipidemia is a paradigm shift. This is the first meta-analysis to assess the association of dates fruit and dyslipidemia in Type-2 diabetes. The study aimed to assess the same among patients with Type-2 diabetes.
Methods: Six databases were searched for relevant articles from inception to March 2024. We included randomized trials, studies with other methods, and those conducted among healthy people were excluded. A structured checklist including the author’s name, country, year of publication, study type, duration of the study, lipid profile at baseline and after-dates fruit consumption, age, and gender of participants, type of dates, and the amount consumed.
Results: Out of the 448 studies retrieved, fourteen cohorts from four studies (298 participants with Type-2 diabetes) were included. Dates fruit reduced cholesterol, odd ratio, -0.87, 95% CI, -1.39--0.35, P-value, 0.001, and I2 for heterogeneity=90%. No significant changes were observed on low-density lipoprotein (odd ratio, -0.31, 95% CI, -0.65-0.03, and P-value, 0.08), triglycerides (odd ratio, -0.77, 95% CI, -2.17--0.63, P-value 0.28), and high-density lipoproteins (odd ratio, 0.03, 95% CI, -0.13-0.19, P-value, 0.69). The I2 for heterogeneity were=99%, 95%, and 65% respectively.
Conclusion: Dates fruit could reduce total cholesterol, with a non-significant reduction in low-density lipoproteins. No significant effect was evident regarding triglycerides and high-density lipoproteins. Further larger studies with a high selection of controls and dates are needed.
doi: https://doi.org/10.12669/pjms.41.1.9928
How to cite this: Mirghani HO, Alhowiti A. Dates fruit effects on dyslipidemia among patients with Type-2 diabetes mellitus: A systematic review and meta-analysis of randomized trials. Pak J Med Sci. 2025;41(1):331-337. doi: https://doi.org/10.12669/pjms.41.1.9928
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.
Miniatury portretowe Wincentego Lesseura na kości słoniowej
Authors: Maniakowska-Jazownik Zofia , Ryguła Anna , Matosz Marta
Published: December 2024

W ramach przygotowań do nowej ekspozycji Muzeum Książąt Czartoryskich – Oddziału Muzeum Narodowego w Krakowie konieczne było przeprowadzenie konserwacji części należących do muzealnej kolekcji miniatur Wincentego Lesseura, co wykorzystano jako sposobność do rozpoznania i analizy warsztatu artysty. W tym celu grupę portretów poddano badaniom specjalistycznym: wykonano pomiary za pomocą spektroskopii fluoroscencji rentgenowskiej (makro-XRF) i spektroskopii Ramana (RS) oraz fotografie w światłach analitycznych, prowadzono obserwacje mikroskopowe. W wyniku badań zidentyfikowano kilkanaście pigmentów i ziarna skrobi na powierzchni obiektów. Szczególnie interesujące jest odkrycie, że artysta stosował błękit kobaltowy już w 1796 r., zanim pigment ten zdobył szerszą popularność w pierwszej połowie XIX wieku. Na podstawie ujawnionych sposobów nanoszenia i łączenia poszczególnych pigmentów opracowano technologię malarską Lesseura. Należy podkreślić, że badania zespołu miniatur, które wyszły spod jednej i tak znakomitej ręki to okoliczność wyjątkowa, zwłaszcza jeśli chodzi o warsztat miniaturzysty tworzącego na terenie Polski.