bluuebunny/crossref_metadata_2025 huggingface dataset:
Fibrosis score 4 index has an independent relationship with coronary artery diseases in patients with metabolic-associated fatty liver disease
Authors: Namakchian Maryam , Rabizadeh Soghra , Seifouri Sara , Asadigandomani Hassan , Bafrani Melika Arab , Seifouri Kiana , Avanaki Foroogh Alborzi , Rajab Armin , Nakhjavani Manouchehr , Esteghamati Alireza
Published: March 2023

Background

Metabolic-associated fatty liver disease (MAFLD), one of the most common liver diseases, is detected in patients with concomitant hepatic steatosis and Type 2 Diabetes (T2D). We looked into the relationship between Fibrosis-4 (FIB-4) index and coronary artery diseases (CAD) in patients with MAFLD, to further look into the efficiency of FIB-4 in screening for CAD among patients with MAFLD.

Method

In this study, we included 1664 patients with MAFLD (T2D, who also had hepatic steatosis) during 2012–2022 and divided them into 2 groups; CAD and non-CAD. Demographic, Anthropometric indices, liver function tests, lipid profile and FIB-4 index of all patients were evaluated and compared.

Result

Among the 1644 patients (all have MAFLD), 364(21.4%) had CAD. Patients with MAFLD and CAD were more probable to be hypertensive, have longer duration of diabetes and be older (with p-values < 0.001). After adjustment for confounding factors, in a multivariable logistic regression model, FIB4 showed a significant independent relationship with concomitant MAFLD and CAD. Upper Tertile FIB-4 had an odds ratio of 3.28 (P-value = 0.002) to predict CAD. Furthermore, in Receiver Operating Characteristic (ROC) Curve analysis with the maximum Youden Index, a FIB-4 cut-off of 0.85 (AUC = 0.656, 95% CI 0.618–0.693, P < 0.001) noted to predict CAD in patients with MAFLD.

Conclusion

This study showed that the FIB-4 score independently correlates with CAD in patients with MAFLD.
Sex differences in the intergenerational link between maternal and neonatal whole blood DNA methylation: a genome-wide analysis in 2 birth cohorts
Authors: Hu Jie , Xu Xin , Li Jun , Jiang Yu , Hong Xiumei , Rexrode Kathryn M. , Wang Guoying , Hu Frank B. , Zhang Hongmei , Karmaus Wilfried J. , Wang Xiaobin , Liang Liming
Published: March 2023

Background

The mother–child inheritance of DNA methylation (DNAm) variations could contribute to the inheritance of disease susceptibility across generations. However, no study has investigated patterns of mother–child associations in DNAm at the genome-wide scale. It remains unknown whether there are sex differences in mother–child DNAm associations.

Results

Using genome-wide DNAm profiling data (721,331 DNAm sites, including 704,552 on autosomes and 16,779 on the X chromosome) of 396 mother–newborn pairs (54.5% male) from the Boston Birth Cohort, we found significant sex differences in mother–newborn correlations in genome-wide DNAm patterns (Spearman’s rho = 0.91–0.98; p = 4.0 × 10–8), with female newborns having stronger correlations. Sex differences in correlations were attenuated but remained significant after excluding X-chromosomal DNAm sites (Spearman’s rho = 0.91–0.98; p = 0.035). Moreover, 89,267 DNAm sites (12.4% of all analyzed, including 88,051 [12.5% of analyzed] autosomal and 1,216 [7.2% of analyzed] X-chromosomal sites) showed significant mother–newborn associations in methylation levels, and the top autosomal DNAm sites had high heritability than the genome-wide background (e.g., the top 100 autosomal DNAm sites had a medium h2 of 0.92). Additionally, significant interactions between newborn sex and methylation levels were observed for 11 X-chromosomal and 4 autosomal DNAm sites that were mapped to genes that have been associated with sex-specific disease/traits or early development (e.g., EFHC2, NXY, ADCYAP1R1, and BMP4). Finally, 18,769 DNAm sites (14,482 [77.2%] on the X chromosome) showed mother–newborn differences in methylation levels that were significantly associated with newborn sex, and the top autosomal DNAm sites had relatively small heritability (e.g., the top 100 autosomal DNAm sites had a medium h2 of 0.23). These DNAm sites were mapped to 2,532 autosomal genes and 978 X-chromosomal genes with significant enrichment in pathways involved in neurodegenerative and psychological diseases, development, neurophysiological process, immune response, and sex-specific cancers. Replication analysis in the Isle of Wight birth cohort yielded consistent results.

Conclusion

In two independent birth cohorts, we demonstrated strong mother–newborn correlations in whole blood DNAm on both autosomes and ChrX, and such correlations vary substantially by sex. Future studies are needed to examine to what extent our findings contribute to developmental origins of pediatric and adult diseases with well-observed sex differences.
Residual unabsorbed midazolam: a case report
Authors: Baboolal Hemanth A. , Gulati A.
Published: March 2023

Background

Oral midazolam is commonly administered to reduce anxiety in children presenting for medical procedures or surgery. It is unclear what volume of medication remains unabsorbed in the stomach when the child presents for anesthetic induction prior to these procedures. The presence of any significant residual medication in the stomach has significant clinical implications in the postoperative period.

Case presentation

A 5-year-old white Caucasian boy presented for upper gastrointestinal endoscopy after receiving oral midazolam liquid. Insertion of the endoscope into the stomach revealed a significant amount of unabsorbed medication remaining within the gastric cavity.

Conclusion

Clinicians should be aware that the sedative effects of midazolam may be present before the medication is fully absorbed. A significant amount of unabsorbed medication may be present in the stomach during medical procedures/surgery. This may continue to be absorbed in the intraoperative and postoperative period, with unwanted clinical effect.
Common clinical blood and urine biomarkers for ischemic stroke: an Estonian Electronic Health Records database study
Authors: Kurvits Siim , Harro Ainika , Reigo Anu , Ott Anne , Laur Sven , Särg Dage , Tampuu Ardi ,   the Estonian Biobank Research Team, Alasoo Kaur , Vilo Jaak , Milani Lili , Haller Toomas ,   the PRECISE4Q consortium
Published: March 2023

Background

Ischemic stroke (IS) is a major health risk without generally usable effective measures of primary prevention. Early warning signals that are easy to detect and widely available can save lives. Estonia has one nation-wide Electronic Health Record (EHR) database for the storage of medical information of patients from hospitals and primary care providers.

Methods

We extracted structured and unstructured data from the EHRs of participants of the Estonian Biobank (EstBB) and evaluated different formats of input data to understand how this continuously growing dataset should be prepared for best prediction. The utility of the EHR database for finding blood- and urine-based biomarkers for IS was demonstrated by applying different analytical and machine learning (ML) methods.

Results

Several early trends in common clinical laboratory parameter changes (set of red blood indices, lymphocyte/neutrophil ratio, etc.) were established for IS prediction. The developed ML models predicted the future occurrence of IS with very high accuracy and Random Forests was proved as the most applicable method to EHR data.

Conclusions

We conclude that the EHR database and the risk factors uncovered are valuable resources in screening the population for risk of IS as well as constructing disease risk scores and refining prediction models for IS by ML.
Mutation screening of SPTLC1 and SPTLC2 in amyotrophic lateral sclerosis
Authors: Li Chunyu , Hou Yanbing , Wei Qianqian , Lin Junyu , Jiang Zheng , Jiang Qirui , Yang Tianmi , Xiao Yi , Huang Jingxuan , Cheng Yangfan , Ou Ruwei , Liu Kuncheng , Chen Xueping , Song Wei , Zhao Bi , Wu Ying , Cao Bei , Chen Yongping , Shang Huifang
Published: March 2023

Background

Recently, several rare variants of SPTLC1 were identified as disease cause for juvenile amyotrophic lateral sclerosis (ALS) by disrupting the normal homeostatic regulation of serine palmitoyltransferase (SPT). However, further exploration of the rare variants in large cohorts was still necessary. Meanwhile, SPTLC2 plays a similar role as SPTLC1 in the SPT function.

Methods

To explore the genetic role of SPTLC1 and SPTLC2 in ALS, we analyzed the rare protein-coding variants in 2011 patients with ALS and 3298 controls from the Chinese population with whole exome sequencing. Fisher’s exact test was performed between each variant and disease risk, while at gene level over-representation of rare variants in patients was examined with optimized sequence kernel association test (SKAT-O).

Results

Totally 33 rare variants with minor allele frequency < 0.01 were identified, including 17 in SPTLC1 and 16 in SPTLC2. One adult-onset patient carried the variant p.E406K (SPTLC1) which was reported in previous study. Additionally, three adult-onset patients carried variants in the same amino acids as the variants identified in previous studies (p.Y509C, p.S331T, and p.R239Q in SPTLC1). At gene level, rare variants of SPTLC1 and STPLC2 were not enriched in patients.

Conclusion

These results broadened the variant spectrum of SPTLC1 and SPTLC2 in ALS, and paved the way for future research. Further replication was still needed to explore the genetic role of SPTLC1 in ALS.
Detecting narwhal foraging behaviour from accelerometer and depth data using mixed-effects logistic regression
Authors: Jensen Frederik H. , Tervo Outi M. , Heide-Jørgensen Mads Peter , Ditlevsen Susanne
Published: March 2023

Background

Due to their Arctic habitat and elusive nature, little is known about the narwhal (Monodon monoceros) and its foraging behaviour. Understanding its ability to catch prey is essential for understanding its ecological role, but also to assess its ability to withstand climate changes and anthropogenic activities. Narwhals produce echolocation clicks and buzzing sounds as part of their foraging behaviour and these can be used as indicators of prey capture attempts. However, acoustic data are expensive to store on the tagging devices and require complicated post-processing. The main goal of this paper is to predict prey capture attempts directly from acceleration and depth data. The aim is to apply broadly used statistical models with interpretable parameters. The ultimate goal is to be able to estimate prey consumption without the more demanding acoustic data.

Results

We predict narwhal buzzing activity using mixed-effects logistic regression models with 83 features extracted from acceleration and depth data as explanatory variables. The features encompass both instantaneous values as well as delayed values to capture behavioural patterns lasting several seconds. The data correlations were not strong enough to predict the exact timing of the buzzes, but were reliably able to detect buzzes within a few seconds. Most of the of the buzz predictions were within 2 s of an observed buzz (68%), increasing to 94% within 30 s. Conversely, 46% of the observed buzzes were within 2 s of a predicted buzz, increasing to 82% within 30 s. Additionally, the model performed well, although with a tendency towards underestimation of the number of buzzes per dive. In total, we predicted 17, 557 buzzes versus 25, 543 observed across data from 10 narwhals. Classifying foraging and non-foraging dives yielded a precision of 86% and a recall of 91%.

Conclusion

We conclude that narwhal foraging estimation through acceleration and depth data is a valid alternative or supplement to buzz recordings, even when using somewhat simple statistical methods, such as logistic regression. The methods in this paper can be extended to foraging detection in similar marine species and can aid instrument development.
A multi-species evaluation of digital wildlife monitoring using the Sigfox IoT network
Authors: Wild Timm A. , van Schalkwyk Louis , Viljoen Pauli , Heine Georg , Richter Nina , Vorneweg Bernd , Koblitz Jens C. , Dechmann Dina K. N. , Rogers Will , Partecke Jesko , Linek Nils , Volkmer Tamara , Gregersen Troels , Havmøller Rasmus W. , Morelle Kevin , Daim Andreas , Wiesner Miriam , Wolter Kerri , Fiedler Wolfgang , Kays Roland , Ezenwa Vanessa O. , Meboldt Mirko , Wikelski Martin
Published: March 2023

Bio-telemetry from small tags attached to animals is one of the principal methods for studying the ecology and behaviour of wildlife. The field has constantly evolved over the last 80 years as technological improvement enabled a diversity of sensors to be integrated into the tags (e.g., GPS, accelerometers, etc.). However, retrieving data from tags on free-ranging animals remains a challenge since satellite and GSM networks are relatively expensive and or power hungry. Recently a new class of low-power communication networks have been developed and deployed worldwide to connect the internet of things (IoT). Here, we evaluated one of these, the Sigfox IoT network, for the potential as a real-time multi-sensor data retrieval and tag commanding system for studying fauna across a diversity of species and ecosystems. We tracked 312 individuals across 30 species (from 25 g bats to 3 t elephants) with seven different device concepts, resulting in more than 177,742 successful transmissions. We found a maximum line of sight communication distance of 280 km (on a flying cape vulture [Gyps coprotheres]), which sets a new documented record for animal-borne digital data transmission using terrestrial infrastructure. The average transmission success rate amounted to 68.3% (SD 22.1) on flying species and 54.1% (SD 27.4) on terrestrial species. In addition to GPS data, we also collected and transmitted data products from accelerometers, barometers, and thermometers. Further, we assessed the performance of Sigfox Atlas Native, a low-power method for positional estimates based on radio signal strengths and found a median accuracy of 12.89 km (MAD 5.17) on animals. We found that robust real-time communication (median message delay of 1.49 s), the extremely small size of the tags (starting at 1.28 g without GPS), and the low power demands (as low as 5.8 µAh per transmitted byte) unlock new possibilities for ecological data collection and global animal observation.
The psychometric properties of Binge Eating Scale among overweight college students in Taiwan
Authors: Yan Huey-Yeu , Lin Fu-Gong , Tseng Mei-Chih Meg , Fang Yue-Lin , Lin Hung-Ru
Published: March 2023

Background

The Binge Eating Scale (BES) is a widely used measuring tool to assess binge eating problems in Western countries. However, the psychometric properties of such scales among cross-cultural youth groups are insufficient, and the factor structure continues to be debated; therefore, further research is needed. The aim of this study was to examine the properties of BES among overweight college students in Taiwan.

Methods

A cross-sectional design and convenience sampling were adopted to recruit 300 overweight students from five universities. A translated Traditional Chinese version of BES was used for the survey, and the validity of the scale was tested using the Confirmatory Factor Analysis (CFA) and Bulimic Investigatory Test, Edinburgh (BITE). The reliability was evaluated using internal consistency and test–retest reliability.

Results

The CFA results showed a reasonable model fit. The first-order two-factor model was consistent with that of the original BES and significantly correlated with the criterion of BITE score. Cronbach’s α value, representing internal consistency reliability, and the intraclass correlation coefficient of repeated measures made one month apart were both 0.83, indicating good reliability and stability. Significant correlations were observed between the BES score and sex and BMI; however, no correlation was observed between BES scores and age.

Conclusion

The BES presents sound psychometric properties, has good cross-cultural applicability, and can be used as a first-line screening tool by mental health professionals to identify the severity of binge eating behavior among overweight college students in Taiwan. It is recommended that participant diversity and obesity indicators be incorporated into the scale in the future to establish a universal psychometric tool.
Emotion regulation in bipolar disorder type-I: multivariate analysis of fMRI data
Authors: Kondo Fumika , Whitehead Jocelyne C. , Corbalán Fernando , Beaulieu Serge , Armony Jorge L.
Published: March 2023

Background

Bipolar disorder type-I (BD-I) patients are known to show emotion regulation abnormalities. In a previous fMRI study using an explicit emotion regulation paradigm, we compared responses from 19 BD-I patients and 17 matched healthy controls (HC). A standard general linear model-based univariate analysis revealed that BD patients showed increased activations in inferior frontal gyrus when instructed to decrease their emotional response as elicited by neutral images. We implemented multivariate pattern recognition analyses on the same data to examine if we could classify conditions within-group as well as HC versus BD.

Methods

We reanalyzed explicit emotion regulation data using a multivariate pattern recognition approach, as implemented in PRONTO software. The original experimental paradigm consisted of a full 2 × 2 factorial design, with valence (Negative/Neutral) and instruction (Look/Decrease) as within subject factors.

Results

The multivariate models were able to accurately classify different task conditions when HC and BD were analyzed separately (63.24%–75.00%, p = 0.001–0.012). In addition, the models were able to correctly classify HC versus BD with significant accuracy in conditions where subjects were instructed to downregulate their felt emotion (59.60%–60.84%, p = 0.014–0.018). The results for HC versus BD classification demonstrated contributions from the salience network, several occipital and frontal regions, inferior parietal lobes, as well as other cortical regions, to achieve above-chance classifications.

Conclusions

Our multivariate analysis successfully reproduced some of the main results obtained in the previous univariate analysis, confirming that these findings are not dependent on the analysis approach. In particular, both types of analyses suggest that there is a significant difference of neural patterns between conditions within each subject group. The multivariate approach also revealed that reappraisal conditions provide the most informative activity for differentiating HC versus BD, irrespective of emotional valence (negative or neutral). The current results illustrate the importance of investigating the cognitive control of emotion in BD. We also propose a set of candidate regions for further study of emotional control in BD.
Cerebellar presence of immune cells in patients with neuro-coeliac disease
Authors: Rouvroye Maxine D. , Bontkes Hetty J. , Bol John G. J. M. , Lissenberg-Witte Birgit , Byrnes Valerie , Bennani Fadel , Jordanova Ekaterina S. , Wilhelmus Micha M. M. , Mulder Chris J. , van der Valk Paul , Rozemuller Annemieke J. M. , Bouma Gerd , Van Dam Anne-Marie
Published: March 2023

Although various neurodegenerative disorders have been associated with coeliac disease (CD), the underlying neuropathological link between these brain and gut diseases remains unclear. We postulated that the neuronal damage sporadically observed in CD patients is immune-mediated. Our aim was to determine if the loss of neurons, especially Purkinje cells, coincides with microglia activation and T- and B-cell infiltration in the cerebellum of patients with CD and a concomitant idiopathic neurological disease affecting the cerebellum (NeuroCD). Post-mortem cerebellar tissue was collected of validated NeuroCD cases. Gender- and age-matched genetic spinocerebellar ataxia (SCA) controls and non-neurological controls (NNC) were selected based on clinical reports and pathological findings. Cerebellar tissue of seventeen patients was included (6 NeuroCD, 5 SCA, 6 NNC). In SCA cases we found that the Purkinje cell layer was 58.6% reduced in comparison with NNC. In NeuroCD cases this reduction was even more prominent with a median reduction of 81.3% compared to NNC. Marked increased numbers of both CD3+ and CD8+ cells were observed in the NeuroCD but not in SCA patients. This coincided with significantly more microglial reactivity in NeuroCD patients. These findings demonstrate that the massive loss of Purkinje cells in the cerebellum of neuro CD patients is accompanied by local innate and T-cell mediated immune responses.
Ganglioglioma deep transcriptomics reveals primitive neuroectoderm neural precursor-like population
Authors: Regal Joshua A. , Guerra García María E. , Jain Vaibhav , Chandramohan Vidyalakshmi , Ashley David M. , Gregory Simon G. , Thompson Eric M. , López Giselle Y. , Reitman Zachary J.
Published: March 2023

Gangliogliomas are brain tumors composed of neuron-like and macroglia-like components that occur in children and young adults. Gangliogliomas are often characterized by a rare population of immature astrocyte-appearing cells expressing CD34, a marker expressed in the neuroectoderm (neural precursor cells) during embryogenesis. New insights are needed to refine tumor classification and to identify therapeutic approaches. We evaluated five gangliogliomas with single nucleus RNA-seq, cellular indexing of transcriptomes and epitopes by sequencing, and/or spatially-resolved RNA-seq. We uncovered a population of CD34+ neoplastic cells with mixed neuroectodermal, immature astrocyte, and neuronal markers. Gene regulatory network interrogation in these neuroectoderm-like cells revealed control of transcriptional programming by TCF7L2/MEIS1-PAX6 and SOX2, similar to that found during neuroectodermal/neural development. Developmental trajectory analyses place neuroectoderm-like tumor cells as precursor cells that give rise to neuron-like and macroglia-like neoplastic cells. Spatially-resolved transcriptomics revealed a neuroectoderm-like tumor cell niche with relative lack of vascular and immune cells. We used these high resolution results to deconvolute clinically-annotated transcriptomic data, confirming that CD34+ cell-associated gene programs associate with gangliogliomas compared to other glial brain tumors. Together, these deep transcriptomic approaches characterized a ganglioglioma cellular hierarchy—confirming CD34+ neuroectoderm-like tumor precursor cells, controlling transcription programs, cell signaling, and associated immune cell states. These findings may guide tumor classification, diagnosis, prognostication, and therapeutic investigations.
The CB1 cannabinoid receptor regulates autophagy in the tibialis anterior skeletal muscle in mice
Authors: Sepúlveda Carlos , Rodríguez Juan Manuel , Monsalves-Álvarez Matías , Donoso-Barraza Camila , Pino-de la Fuente Francisco , Matías Isabelle , Leste-Lasserre Thierry , Zizzari Philippe , Morselli Eugenia , Cota Daniela , Llanos Miguel , Troncoso Rodrigo
Published: March 2023

The endocannabinoid system (ECS) regulates energy metabolism, has been implicated in the pathogenesis of metabolic diseases and exerts its actions mainly through the type 1 cannabinoid receptor (CB1). Likewise, autophagy is involved in several cellular processes. It is required for the normal development of muscle mass and metabolism, and its deregulation is associated with diseases. It is known that the CB1 regulates signaling pathways that control autophagy, however, it is currently unknown whether the ECS could regulate autophagy in the skeletal muscle of obese mice. This study aimed to investigate the role of the CB1 in regulating autophagy in skeletal muscle. We found concomitant deregulation in the ECS and autophagy markers in high-fat diet-induced obesity. In obese CB1-KO mice, the autophagy-associated protein LC3 II does not accumulate when mTOR and AMPK phosphorylation levels do not change. Acute inhibition of the CB1 with JD-5037 decreased LC3 II protein accumulation and autophagic flux. Our results suggest that the CB1 regulates autophagy in the tibialis anterior skeletal muscle in both lean and obese mice.
A latent approach in the fashion retailing context: segmenting co-creator users
Authors: Lorenzo-Romero Carlota , Alarcón-del-Amo María-del-Carmen , Frasquet-Deltoro Marta
Published: March 2023

Co-creation activities have shown dramatic development somewhat recently. The initial step of a productive co-creation technique originates from a comprehension of people’s practices inside of these websites. Based on the limited knowledge of online co-creation behaviour in the retail sector, particularly in fashion retailing, this study develops a latent class segmentation analysis that allows examining the diversity of co-creation behaviours. Thus, the main objective of this paper is to analyse the heterogeneity of co-creators’ behaviours in the online retail environment. This study examines different indicators that determine the co-creation behaviour of users such as co-creation value and activities, engagement with the company/brand, satisfaction with the co-creation process, intention to continue co-creating) in the Spanish fashion sector. Three different segments have been obtained: “full co-creator”, “co-creator oriented to the company/brand” and “co-creator oriented to other people” that show three distinct ways of co-creating with a fashion firm. The findings offer fashion retailers an interesting perspective for attracting customers to co-creation ventures during the fashion online shopping process.
Unearthing the fungal endophyte Aspergillus terreus for chemodiversity and medicinal prospects: a comprehensive review
Authors: Amr Khadiga , Ibrahim Nehal , Elissawy Ahmed M. , Singab Abdel Nasser B.
Published: March 2023

Aspergillus terreus microorganism represents a promising prospective source for drug discovery since it is rich in diverse kinds of bioactive secondary metabolites. It contributed to many biotechnological applications and its metabolites are used in the synthesis of certain pharmaceuticals and food products, in addition to its useful uses in fermentation processes. There are about 346 compounds identified from marine and terrestrial-derived A. terreus from 1987 until 2022, 172 compounds of them proved a vast array of bioactivity. This review aimed to create an up-to-date comprehensive literature data of A. terreus’s secondary metabolites classes supported by its different bioactivity data to be a scientific record for the next work in drug discovery.
Patient and public involvement in research: the need for budgeting PPI staff costs in funding applications
Authors: De Simoni Anna , Jackson Tracy , Inglis Humphrey Wendy , Preston Jennifer , Mah Heather , Wood Helen E. , Kinley Emma , Gonzalez Rienda Laura , Porteous Carol
Published: March 2023

Background

Patient and Public Involvement (PPI) groups are becoming more established as collaborators with academic researchers and institutions to ensure that research is important and relevant to end users, and to identify areas that might have ethical considerations, as well as to advise on solutions. The National Institute for Health and Care Research UK Standards for Public Involvement in Research embody best practice for PPI, including support and learning opportunities that build confidence and skills for members of the public to play an invaluable and mutually productive role in research. However, the pivotal role of research and professional services (management and administrative) staff within academic institutions for sustaining and making this involvement successful is often overlooked.

Main body

It takes significant effort to develop and sustain effective PPI in research. The six UK Standards for Public Involvement highlight the need for consistent, inclusive, well-governed and mutually respectful working relationships to sustain effective PPI contributions in health research. Productivity across a team of lay and academic members requires organisation and experience of implementing these standards by a dedicated PPI team, yet advice on PPI finances is usually focused on costs for patient panel members, and budgets in funding applications rarely consider the wider PPI team behind this involvement. As an exemplar, we reflect on how the Asthma UK Centre for Applied Research (AUKCAR) has developed a dedicated PPI Platform, with guidance for how PPI should be embedded throughout the research lifecycle, and detailed information to support the costing of PPI in funding applications. AUKCAR’s work with established researchers, as well as Early Career Researchers and PhD students, is at the heart of a campaign to raise awareness of the importance of PPI in effective research planning.

Conclusion

Focusing attention on the staff behind best practice involvement in health research may stimulate a much-needed discussion to ensure flourishing PPI capacity, with significant patient and public benefit. With adaptation, the PPI expertise within AUKCAR can be translated more widely.
Developing sustainable patient and public involvement in mesothelioma research: multi-method exploration with researchers, patients, carers, and patient organisations
Authors: Marcu Afrodita , McGregor Fiona , Egan Bernadette , Hill Kate , Cook Tim , Arber Anne
Published: March 2023

Background

Rare diseases where prognosis is poor provide limited scope for patient and public involvement (PPI). One such disease is mesothelioma, a cancer of the lung pleura or of the peritoneum caused by exposure to asbestos, where PPI is poorly documented. We undertook to explore how PPI could be facilitated in mesothelioma research.

Methods

An online survey with mesothelioma researchers (n = 23) assessed the perceived benefits and challenges of PPI in mesothelioma. Six online workshops and thirteen in-depth interviews with patients and the public explored their views on how PPI could be increased in mesothelioma and their motivations to become PPI representatives in the future. The survey data were analysed using descriptive statistics and the interviews, using Thematic Analysis.

Results

In the survey, 26% (n = 6) of the researchers did not include PPI in their research, while 74% (n = 17) did, finding it most beneficial at the stages of applying for funding and dissemination. The main perceived benefits of PPI were clarifying the research question and outcome measures, making research more credible and relevant to patients’ needs, and increasing its impact. The main perceived challenges to PPI were the general poor prognosis in mesothelioma, and funding timescales which hindered timely recruitment of PPI representatives. The analysis of the interviews with the patients and public revealed three main themes: “Motivations to become a PPI representative in the future”, “Understanding the nature of PPI during the project”, and “Perceived challenges to PPI in mesothelioma”. Altruism and the need for hope were the main reasons to wish to become involved in PPI in the future. For many participants, the project proved to be a journey of understanding the nature of PPI, a concept that was not easy to grasp from the start. The participants perceived certain barriers to PPI such as high symptom burden in mesothelioma, the abstract concept of PPI, and the use of scientific language.

Conclusions

The present research provides a detailed picture of the benefits and challenges of PPI in mesothelioma. We recommend long-term engagement with mesothelioma support groups so that researchers achieve meaningful and sustainable PPI in mesothelioma research.
Working together: reflections on how to make public involvement in research work
Authors: McVey Lynn , Frost Tina , Issa Basma , Davison Eva , Abdulkader Jamil , Randell Rebecca , Alvarado Natasha , Zaman Hadar , Hardiker Nicholas , Cheong V.-Lin , Woodcock David
Published: March 2023

Background

The importance of involving members of the public in the development, implementation and dissemination of research is increasingly recognised. There have been calls to share examples of how this can be done, and this paper responds by reporting how professional and lay researchers collaborated on a research study about falls prevention among older patients in English acute hospitals. It focuses on how they worked together in ways that valued all contributions, as envisaged in the UK standards for public involvement for better health and social care research.

Methods

The paper is itself an example of working together, having been written by a team of lay and professional researchers. It draws on empirical evidence from evaluations they carried out about the extent to which the study took patient and public perspectives into account, as well as reflective statements they produced as co-authors, which, in turn, contributed to the end-of-project evaluation.

Results

Lay contributors’ deep involvement in the research had a positive effect on the project and the individuals involved, but there were also difficulties. Positive impacts included lay contributors focusing the project on areas that matter most to patients and their families, improving the quality and relevance of outcomes by contributing to data analysis, and feeling they were ‘honouring’ their personal experience of the subject of study. Negative impacts included the potential for lay people to feel overwhelmed by the challenges involved in achieving the societal or organisational changes necessary to address research issues, which can cause them to question their rationale for public involvement.

Conclusions

The paper concludes with practical recommendations for working together effectively in research. These cover the need to discuss the potential emotional impacts of such work with lay candidates during recruitment and induction and to support lay people with these impacts throughout projects; finding ways to address power imbalances and practical challenges; and tips on facilitating processes within lay groups, especially relational processes like the development of mutual trust.
Healthcare resource utilization and cost of pneumococcal disease in children in Germany, 2014–2019: a retrospective cohort study
Authors: Hu Tianyan , Podmore Bélène , Barnett Rosemarie , Beier Dominik , Galetzka Wolfgang , Qizilbash Nawab , Heckl Dennis , Boellinger Timo , Weaver Jessica
Published: March 2023

Background

Since the introduction of higher valency pneumococcal conjugate vaccines in 2009, recent estimates on the economic burden of pediatric pneumococcal disease (PD) in Germany have been lacking. This study estimates healthcare resource utilization (HCRU) and medical cost associated with PDs in children < 16 years old in Germany from 2014–2019.

Methods

A nationally representative sample from the Institute for Applied Health Research (InGef) German claims database was used, covering approximately 5% of the total German population. Episodes of pneumococcal pneumonia (PP), all-cause pneumonia (ACP), invasive pneumococcal disease (IPD), and acute otitis media (AOM) in children aged < 16 years were identified using ICD-10-GM codes. HCRU was estimated from annual rates of outpatient visits, outpatient antibiotic prescriptions and inpatient admissions, divided by person-years (PY) at-risk. Average direct medical costs per episode were estimated as the total cost of all HCRU, divided by the total number of episodes. The Mann–Kendall test was used to assess monotonic time trends from 2014–2019.

Results

 During 2014–2019, 916,805 children aged < 16 years were followed up for a total of 3,608,716 PY. The average costs per episode for out-versus inpatient care associated with PP and ACP were €67 (95% CI 58–76) versus €2,606 (95% CI 1,338–3,873), and €63 (95% CI 62–63) versus €620 (95% CI 598–641), respectively. For IPD, the average medical cost per episode for out-versus inpatients were €30 (95% CI 19–42) versus €6,051 (95% CI 3,323–8,779), respectively. There were no significant trends in HCRU or costs for IPD or pneumonia over the study period, except for a significant reduction in ACP outpatient visits. A significant decrease in rate of outpatient visits and antibiotic prescribing for recurrent AOM was observed, in addition to an increase in rates of hospital admissions for simple AOM. This was paralleled by a significant increase in inpatient costs per episode for treating AOM overall, and simple AOM, over the study period.

Conclusions

 The HCRU and cost per episode of pneumonia and IPD did not vary significantly from 2014–2019, but increased for AOM. The economic burden of pneumonia, IPD, and AOM remains substantial in Germany.
Designing of robust frequency stabilization using optimized MPC-(1+PIDN) controller for high order interconnected renewable energy based power systems
Authors: Gulzar Muhammad Majid
Published: March 2023

The challenge of controlling frequency becomes greater as the complexity of a power network increases. The stability of a power system is highly dependent upon the robustness of the controller. This paper presents automatic generation control (AGC) of a four-area interconnected power system along with integrated renewable energy sources of PV and wind energy. The designed model is a challenge given the increased penetration levels of PV and wind along with a thermal-hydropower system. The addition of a hydropower system as a fourth type results in the pole of the open loop system of the hydropower system being located at the right half side of the s-plan. This demands a robust control. A novel MPC-(1 + PIDN) is designed for high-order interconnected areas (HOIA) to stabilize the frequency in a robust way. The salp swarm algorithm is adopted to optimize the parameters of the PIDN controller. The performance of the proposed controller under HOIA is tested in a unbalanced load environment with uncertainty in the power system. The proposed controller can effectively handle the frequency disruption by stabilizing it in $$0.86 s$$

0.86
s

for Area-1, $$1.08 s$$

1.08
s

for Area-2, $$0.81 s$$

0.81
s

for Area-3, and $$0.84 s$$

0.84
s

for Area-4 with an average time of $$0.89 s$$

0.89
s

for all the areas, whereas the average time for GWO: PI-PD, MPC/PI and GA-PI is $$3.48 s$$

3.48
s

, $$10.36 s$$

10.36
s

and $$18.47 s$$

18.47
s

, respectively. The results demonstrate the effectiveness of the controller when compared to other controllers.
Efficacy of dexmedetomidine in attenuating pressor response to laryngoscopy and endotracheal intubation under bispectral index controlled anesthesia: a prospective randomized double-blinded study
Authors: Jain Kavita , Sethi Surendra Kumar , K.N. Harsha , Patodi Veena , Jain Neena , Meena Deepika
Published: March 2023

Background

Laryngoscopy and endotracheal intubation may lead to a remarkable hemodynamic pressor response. Dexmedetomidine, an α2-adrenergic receptor agonist, can be effectively used to attenuate this pressor effect. This study was aimed to compare the efficacy of two different doses of dexmedetomidine (0.5 µg/kg and 1.0 µg/kg) in attenuation of hemodynamic pressor response to largyngoscopy and endotracheal intubation under bispectral index (BIS) monitoring. One hundred twenty adult patients with American Society of Anesthesiologists (ASA) physical status I or II posted for various elective surgeries under general anesthesia were enrolled to receive an intravenous (IV) infusion of dexmedetomidine 0.5 μg/kg (group D1; n = 40), 1.0 μg/kg (group D2; n = 40) or normal saline over 15 min (group C; n = 40). The primary outcome measure was to assess the hemodynamic changes while the secondary outcome measures were to assess sedation, dose of propofol required for induction and side effects.

Results

The mean HR, SBP, DBP, and MAP remained significantly lower in both dexmedetomidine groups as compared to control group after study drug infusion, after induction, at and after intubation (P < 0.05). Group D2 also had significantly lower mean HR, SBP, DBP, and MAP in comparison to group D1 (P < 0.05). The induction dose of propofol was significantly less in dexmedetomidine groups as compared to control group (P < 0.05). Ramsay sedation scale (RSS) score was found to be significantly more in both groups D1 and D2 after study drug infusion (P<0.001). No significant difference was noted in incidence of side effects (P = 0.907).

Conclusions

Dexmedetomidine (0.5 µg/kg and 1.0 µg/kg) was found to be effective in attenuating the hemodynamic pressor response to laryngoscopy and endotracheal intubation with BIS monitoring.

Trial registration

CTRI, CTRI/2020/03/024088. Registered 19 March 2020.
Notes on the current status of freshwater snails fauna of the Palestinian territories (West Bank)
Authors: Handal Elias , Adawi Shadi , Gedeon Johann , Amr Zuhair S.
Published: March 2023

A total of 14 species of freshwater snails are recorded from the Palestinian Territories (West Bank). They belong to seven families (Cochliopidae, Melanopsidae, Neritidae, Lymnaeidae, Physidae, Planorbidae, and Thiaridae) in eleven genera (Bulinus, Eupaludestrina, Heleobia, Galba, Melanoides, Melanopsis, Mieniplotia, Physella, Planorbella, Radix, and Theodoxus). Planorbella duryi (Wetherby, 1879) is an invasive alien species recorded for the first time in the West Bank. The most common species were Physella acuta, Melanopsis buccinoidea and Theodoxus jordani. All previous records of Theodoxus macri are now considered as T. jordani. Bulinus truncatus, the intermediate host for schistosomiasis, was found in three localities within the West Bank, representing the first records for this species within the Palestinian Territories.
Female Urinary Incontinence: Frequency, Risk Factors, and Impact on the Quality of Life of Pregnant Pakistani Women
Authors: Abrar Saida , Rizvi Raheela , Samad Anita
Published: March 2023

Objectives: To determine the frequency and associated risk factors of urinary incontinence (UI), and its effect on the quality of life (QOL) of pregnant Pakistani women.

Methods: This was a cross-sectional study of 309 pregnant women, 16-40 weeks gestation, age 18- 45 years, at the Aga Khan University Hospital Karachi, between August 2019 and February 2020. Data were obtained using the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short form (ICIQ-UI-SF).

Results: The frequency of UI was 63.1%. Stress UI was the commonest type (53.0%) followed by urgency (17.5%) and mixed UI (11.7%). In majority of women, it occurred in small amounts, once a week with a very severe impact on QoL in 24.91% of women, affecting sexual relation the most. Risk factors for UI in pregnancy were age > 35 years (p < 0.02), gestation > 37 weeks (p< 0.00), higher body mass index and family history of UI (p< 0.00), previous instrumental vaginal delivery (P < 0.002), cough, constipation and strenuous job (p< 0.00), and lack of pelvic ﬂoor muscle exercises (p <0.03).

Conclusions: UI is a common problem in pregnant women in Pakistan. It affects sexual functions the most, with a severe impact on the QOL, however, it commonly remains unreported. Thus the health care providers need to enquire all pregnant women on this issue, especially those at risk, and educate them on the available management options.

doi: https://doi.org/10.12669/pjms.39.3.6313

How to cite this: Abrar S, Mohsin R, Samad A. Female Urinary Incontinence: Frequency, Risk Factors, and Impact on the Quality of Life of Pregnant Pakistani Women. Pak J Med Sci. 2023;39(3):667-671. doi: https://doi.org/10.12669/pjms.39.3.6313

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.
Effect of high-flow nasal cannula on patients’ recovery after inhalation general anesthesia
Authors: Liu Dong , Jin Teng-yu , Li Wei , Chen Li , Xing Dong
Published: March 2023

Objective: To investigate the effect of high-flow nasal cannula (HFNC) and Oxygen Nebuliser mask (ONM) on patients recovering from inhalation anesthesia.

Methods: A retrospective analysis was performed on 128 patients after inhalation of general anesthesia in the recovery room of the Anesthesiology Department of The Fourth Hospital of Hebei Medical University from September 2019 to September 2021. All patients received the same anesthesia induction and analgesia methods, inhalation anesthesia or intravenous-inhalation anesthesia maintenance, recovered spontaneous breathing and removed endotracheal intubation after surgery, then were divided into HFNC group and ONM group for oxygen therapy. HFNC setting mode: flow rate: 20-60 L/minutes, humidification temperature: 370C, the oxygen concentration was adjusted to maintain finger pulse oxygen saturation SPO2>90%; ONM group, the oxygen flow rate was adjusted to maintain finger pulse oxygen saturation SPO2>90%. All patients in the two groups were compared immediately after they entered the recovery room for 0 minutes,, 10 minutes, and 20 minutes, including tidal volume, blood gas, Richmond Agitation-Sedation Scale (RASS) score and time from sedation to awakening.

Results: The changes in tidal volume, oxygenation index and RASS score over time in the HFNC group were higher than those in the ONM group (p<0.05), and the awakening time in the HFNC group was faster than that in the ONM group (p<0.01), with significant statistical differences.

Conclusions: Compared with ONM, HFNC can shorten postoperative recovery time, reduce the incidence of agitation and improve lung function and oxygenation state during recovery from anesthesia.

doi: https://doi.org/10.12669/pjms.39.3.6638

How to cite this: Liu D, Jin T, Li W, Chen L, Xing D. Effect of high-flow nasal cannula on patients’ recovery after inhalation general anesthesia. Pak J Med Sci. 2023;39(3):687-692. doi: https://doi.org/10.12669/pjms.39.3.6638

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.