bluuebunny/crossref_metadata_2025 huggingface dataset:
Endotoxin-induced alterations of adipose tissue function: a pathway to bovine metabolic stress
Authors: Chirivi Miguel , Contreras G. Andres
Published: April 2024

During the periparturient period, dairy cows exhibit negative energy balance due to limited appetite and increased energy requirements for lactogenesis. The delicate equilibrium between energy availability and expenditure puts cows in a state of metabolic stress characterized by excessive lipolysis in white adipose tissues (AT), increased production of reactive oxygen species, and immune cell dysfunction. Metabolic stress, especially in AT, increases the risk for metabolic and inflammatory diseases. Around parturition, cows are also susceptible to endotoxemia. Bacterial-derived toxins cause endotoxemia by promoting inflammatory processes and immune cell infiltration in different organs and systems while impacting metabolic function by altering lipolysis, mitochondrial activity, and insulin sensitivity. In dairy cows, endotoxins enter the bloodstream after overcoming the defense mechanisms of the epithelial barriers, particularly during common periparturient conditions such as mastitis, metritis, and pneumonia, or after abrupt changes in the gut microbiome. In the bovine AT, endotoxins induce a pro-inflammatory response and stimulate lipolysis in AT, leading to the release of free fatty acids into the bloodstream. When excessive and protracted, endotoxin-induced lipolysis can impair adipocyte’s insulin signaling pathways and lipid synthesis. Endotoxin exposure can also induce oxidative stress in AT through the production of reactive oxygen species by inflammatory cells and other cellular components. This review provides insights into endotoxins’ impact on AT function, highlighting the gaps in our knowledge of the mechanisms underlying AT dysfunction, its connection with periparturient cows’ disease risk, and the need to develop effective interventions to prevent and treat endotoxemia-related inflammatory conditions in dairy cattle.
Social media addiction and academic engagement as serial mediators between social anxiety and academic performance among college students
Authors: Mou Qiaoxing , Zhuang Jie , Wu Qunhong , Zhong Yaqin , Dai Qianqian , Cao Xin , Gao Yuexia , Lu Qingyun , Zhao Miaomiao
Published: April 2024

Background

Social anxiety has been shown to affect college students’ academic performance. However, the role of social media addiction and academic engagement in this association is unclear.

Methods

A total 2661 college students completed a self-report questionnaire including Liebowitz Social Anxiety Scale, the Bergen Social Media Addiction Scale, the Utrecht Student Work Engagement Scale for Students, and the grade point average. Hayes’ PROCESS macro for SPSS was employed to test the serial mediation effect.

Results

Results indicated that social anxiety was negatively related to academic performance, only academic engagement played a single mediating role in the relationship between social anxiety and academic performance, meanwhile social media addiction and academic engagement acted as serial mediators between social anxiety on academic performance.

Conclusions

Social media addiction and academic engagement can explain the potential mechanisms of the association between social anxiety and academic performance, which have implications for devising intervention strategies to enhance the mental health and academic outcomes of college students.
The longitudinal relations between mental state talk and theory of mind
Authors: Sehlstedt Isac , Hansson Isabelle , Hjelmquist Erland
Published: April 2024

Background

Previous investigations of associations between children’s Theory of Mind (ToM) and parents’ use of words relating to mental states (or mental state talk; MST) have predominantly been performed using cross-sectional designs and false belief tasks as indicators of ToM.

Methods

We here report a longitudinal study of 3–5 year-olds (n = 80) investigating ToM development using the ToM scale and three different parental MST types: the absolute frequency of words, the proportions of words, and the vocabulary size.

Results

Our results revealed significant relations between all parental MST types and later child ToM. Proportions of parental MST were most often related to the children’s ToM at 4 years of age. However, the rate at which the children developed ToM from 3 to 5 years of age was associated with the other two parental MST type measures, namely, absolute frequency and vocabulary size. Additionally, our analyses revealed that parents’ use of cognitive MST words (e.g., think, or know) were most frequently associated with children’s ToM at 4 years of age compared to emotion and desire-related MST words.

Conclusions

We conclude that the parental ability to capture the thoughts, beliefs, and knowledge present in different scenarios is associated with children’s ability to understand other minds. Moreover, parents’ way of talking about the mental states of others is associated with their children’s ability to understand and further develop ToM.
Gamma camera imaging characteristics of 166Ho and 99mTc used in Selective Internal Radiation Therapy
Authors: Kästner David , Braune Anja , Brogsitter Claudia , Freudenberg Robert , Kotzerke Jörg , Michler Enrico
Published: April 2024

Background

The administration of a 166Ho scout dose is available as an alternative to 99mTc particles for pre-treatment imaging in Selective Internal Radiation Therapy (SIRT). It has been reported that the 166Ho scout dose may be more accurate for the prediction of microsphere distribution and the associated therapy planning. The aim of the current study is to compare the scintigraphic imaging characteristics of both isotopes, considering the objectives of the pre-treatment imaging using clinically geared phantoms.

Methods

Planar and SPECT/CT images were obtained using a NEMA image quality phantom in different phantom setups and another body-shaped phantom with several inserts. The influence of collimator type, count statistics, dead time effects, isotope properties and patient obesity on spatial resolution, contrast recovery and the detectability of small activity accumulations was investigated. Furthermore, the effects of the imaging characteristics on personalized dosimetry are discussed.

Results

The images with 99mTc showed up to 3 mm better spatial resolution, up to two times higher contrast recovery and significantly lower image noise than those with 166Ho. The contrast-to-noise ratio was up to five times higher for 99mTc than for 166Ho. Only when using 99mTc all activity-filled spheres could be distinguished from the activity-filled background. The measurements mimicking an obese patient resulted in a degraded image quality for both isotopes.

Conclusions

Our measurements demonstrate better scintigraphic imaging properties for 99mTc compared to 166Ho in terms of spatial resolution, contrast recovery, image noise, and lesion detectability. While the 166Ho scout dose promises better prediction of the microsphere distribution, it is important to consider the inferior imaging characteristics of 166Ho, which may affect individualized treatment planning in SIRT.
Extended MRI-based PET motion correction for cardiac PET/MRI
Authors: Aizaz Mueez , van der Pol Jochem A. J. , Schneider Alina , Munoz Camila , Holtackers Robert J. , van Cauteren Yvonne , van Langen Herman , Meeder Joan G. , Rahel Braim M. , Wierts Roel , Botnar René M. , Prieto Claudia , Moonen Rik P. M. , Kooi M. Eline
Published: April 2024

Purpose

A 2D image navigator (iNAV) based 3D whole-heart sequence has been used to perform MRI and PET non-rigid respiratory motion correction for hybrid PET/MRI. However, only the PET data acquired during the acquisition of the 3D whole-heart MRI is corrected for respiratory motion. This study introduces and evaluates an MRI-based respiratory motion correction method of the complete PET data.

Methods

Twelve oncology patients scheduled for an additional cardiac18F-Fluorodeoxyglucose (18F-FDG) PET/MRI and 15 patients with coronary artery disease (CAD) scheduled for cardiac18F-Choline (18F-FCH) PET/MRI were included. A 2D iNAV recorded the respiratory motion of the myocardium during the 3D whole-heart coronary MR angiography (CMRA) acquisition (~ 10 min). A respiratory belt was used to record the respiratory motion throughout the entire PET/MRI examination (~ 30–90 min). The simultaneously acquired iNAV and respiratory belt signal were used to divide the acquired PET data into 4 bins. The binning was then extended for the complete respiratory belt signal. Data acquired at each bin was reconstructed and combined using iNAV-based motion fields to create a respiratory motion-corrected PET image. Motion-corrected (MC) and non-motion-corrected (NMC) datasets were compared. Gating was also performed to correct cardiac motion. The SUVmaxand TBRmaxvalues were calculated for the myocardial wall or a vulnerable coronary plaque for the18F-FDG and18F-FCH datasets, respectively.

Results

A pair-wise comparison showed that the SUVmaxand TBRmaxvalues of the motion corrected (MC) datasets were significantly higher than those for the non-motion-corrected (NMC) datasets (8.2 ± 1.0 vs 7.5 ± 1.0,p < 0.01 and 1.9 ± 0.2 vs 1.2 ± 0.2,p < 0.01, respectively). In addition, the SUVmaxand TBRmaxof the motion corrected and gated (MC_G) reconstructions were also higher than that of the non-motion-corrected but gated (NMC_G) datasets, although for the TBRmaxthis difference was not statistically significant (9.6 ± 1.3 vs 9.1 ± 1.2,p = 0.02 and 2.6 ± 0.3 vs 2.4 ± 0.3,p = 0.16, respectively). The respiratory motion-correction did not lead to a change in the signal to noise ratio.

Conclusion

The proposed respiratory motion correction method for hybrid PET/MRI improved the image quality of cardiovascular PET scans by increased SUVmaxand TBRmaxvalues while maintaining the signal-to-noise ratio.

Trial registrationMETC162043 registered 01/03/2017.
Utilization of modern contraceptives among female health care workers at Gulu university teaching hospitals in Northern Uganda
Authors: Opiro Keneth , Opee Jimmy , Sikoti Margret , Pebalo Pebolo Francis , Ayikoru Jackline Hope , Akello Harriet , Manano Priscilla , Bongomin Felix
Published: April 2024

Background

The global high rate of unintended pregnancy is a direct result of underutilization of contraceptives methods. Healthcare workers (HCWs) play a pivotal role in promoting and facilitating access to modern family planning services. By examining the extent to which healthcare providers practice what they preach, this research aimed to shed light on the prevalence and factors associated with modern contraceptive use among female HCW at two university teaching hospitals in northern Uganda.

Methods

A cross-sectional survey was conducted among qualified female healthcare workers (FHCWs) at Gulu Regional Referral Hospital (GRRH) and St. Mary’s Hospital-Lacor in Gulu, Uganda. Convenient consecutive sampling was used to enroll study participants. Linear regression analysis was employed to determine factors independently associated with modern contraceptive use. P < 0.005 was considered statistically significant.

Results

We enrolled 201 female HCWs, with a median age 31 (interquartile range: 27–38) years. Overall, 15 (7.5%, 95% Confidence Interval [CI]: 4.4 —11.1) participants utilized modern methods of family planning in the last 3 months while lifetime use was at 73.6% (n = 148, 95%CI: 67.3 — 79.4%). Most common method utilized was intra-uterine devices [IUDs] (51%, n = 76), followed by sub-dermal implants (15.4%, n = 23). Eighty-five (42.3%, n = 85) participants had desire to get pregnant. Factors independently associated with utilization of modern methods contraceptives were working at GRRH (adjusted odds ratio (aOR): 5.0, 95% CI: 1.59 — 10.0, p = 0.003), and being single (aOR: 3.3, 9%CI: 1.02 —10.57, p = 0.046).

Conclusions

Utilization of modern methods of contraceptive among female HCWs in this study is lower than the Uganda national estimates for the general female population. Most utilized method is IUDs followed by sub-dermal implants. More studies are recommended to see if this finding is similar among FHCWs in other regions of Uganda and the rest of Africa while also considering Male Healthcare Workers.
Skill the low-skilled: the knowledge-driven stepwise migration of Vietnamese workers in South China
Authors: Huang Kejie , You Tianlong
Published: April 2024

This article investigates the interplay between knowledge acquisition and the stepwise migration trajectories of low-skilled Vietnamese workers in China. Utilizing a rich array of data garnered from face-to-face interviews, customized surveys, on-site observations, media narratives, and an archival review of government regulations in Guangxi—a province bordering Vietnam—and in Guangdong, a non-adjacent province, this study proposes an analytical framework, skill-driven migration, to highlight the synergy between the pre-migratory socio-demographic attributes of migrants and the circumstances prevailing in both the places of origin and destination which orchestrates distinct job allocations and skill augmentation avenues. Notably, our study underscores that the competencies acquired in manufacturing employments potentially broaden the horizon of destinations for migrants in their subsequent stepwise migration endeavors. This phenomenon, in turn, poses intricate immigration management quandaries for newly emerged destination nations like China, spotlighting a nuanced dimension of labor mobility and policy frameworks in the evolving regional economic integration. Last, our findings challenge the conventional dichotomy of high-skilled and low-skilled categories of labor migration, as well as the dichotomy of explicit-tacit knowledge.
Histopathological and clinical analysis of COVID-19-infected placentas
Authors: Nascimento Aline C. M. , Avvad-Portari Elyzabeth , Meuser-Batista Marcelo , Conde Thayana Camara , de Sá Renato Augusto Moreira , Salomao Natalia , Rabelo Kissila , Ciasca Erica Stein , de Oliveira Brendolin Michelle , Vasconcelos Zilton , Brasil Patricia , Moreira Maria Elisabeth
Published: April 2024

Background

The impact of COVID-19 pandemic in pregnant patients is an important emerging topic. Evidence of transplacental transmission and typical histopathological alterations in the placenta are controversial in the literature.

Methods

This was a prospective observational cohort multicenter study in which we selected 23 placentas of 21 patients that showed detection of SARS-CoV-2 RNA by RT-PCR in the placenta tissue and described both morphological and clinical characteristics. Immunohistochemistry was performed to localize the virus in the specimens.

Results

Most of the patients were asymptomatic (61.9%) and preterm delivery was observed in 8 patients (34.7%). In relation to histopathological features, all the placentas showed evidence of maternal vascular malperfusion, as well as some degree of villitis with a high frequency of high grade placentitis (73.9%) and chronic and/or acute intervillositis (82.6%). We observed immunopositivity for SARS-CoV-2 antibody in 69.5% of the cases, notably in the syncytiotrophoblast.

Conclusions

We reported histopathological features of placentas with viral detection in the tissue, thus providing evidence that SARS-CoV-2 can affect the placenta, although maternal and neonatal clinical outcome is usually mild.
Endovascular retrieval of a migrated contraceptive implant into the pulmonary artery : case report and review of literature
Authors: Grange Rémi , Magand Nicolas , Grand Nathalie , Leroy Stéphanie , Corsini Thomas , Azarnoush Kasra , Grange Sylvain
Published: April 2024

Background

The migration of contraceptive devices into pulmonary arteries is extremely rare, reported to be 1 in 100,000.

Case presentation

A 19-year-old female presented no sensation of a contraceptive implant in her arm which had been placed one year prior. A CT scan confirmed that the implant had migrated into the left lower segmentary pulmonary artery. After a multidisciplinary meeting, an endovascular approach was attempted. Following right femoral venous access, a 8F NeuronMax® introducer was placed into the left pulmonary artery under fluoroscopic guidance. The contraceptive device was removed using a 25-mm loop snare, with a proximal capture technique. The patient was discharged the following day, with no reported complications.

Conclusion

In cases of contraceptive device migration, the first medical decision involves deciding between removal or 'watching and waiting'. Previous reports describe two removal options: endovascular or surgical approaches. Fourteen reports have been published, with high technical success and low rates of complications. The loop snare technique is described as the optimal technique for an endovascular approach. Due to their invasive nature, surgical approaches should be reserved for cases of endovascular removal failure, after evaluating risks and benefits.

Graphical Abstract
Trend of using cementless total knee arthroplasty: a nationwide analysis from 2015 to 2021
Authors: Agarwal Amil R. , Kuyl Emile-Victor , Gu Alex , Golladay Gregory J. , Thakkar Savyasachi C. , Siram Gautam , Unger Anthony , Rao Sandesh
Published: April 2024

Background

Modern cementless total knee arthroplasty (TKA) fixation has shown comparable long-term outcomes to cemented TKA, but the trend of using cementless TKA remains unclear. This study aimed to investigate the trend of using cementless TKA based on a national database.

Methods

The patients undergoing cementless TKA between 2015 and 2021 were retrospectively extracted from the PearlDiver (Mariner dataset) Database. The annual percentage of cementless TKA was calculated using the following formula: annual number of cementless TKA/annual number of TKA. The trend of the number of patients undergoing cementless TKA was created according to a compounded annual growth rate (CAGR) calculation of annual percentages. Patient age, comorbidity, region, insurance type, etc., were also investigated. Differences were considered statistically significant at P < 0.05.

Results

Of the 574,848 patients who received TKA, 546,731 (95%) underwent cemented fixation and 28,117 (5%) underwent cementless fixation. From 2015 to 2021, the use of cementless TKA significantly increased by 242% from 3 to 9% (compounded annual growth rate (CAGR): + 20%; P < 0.05). From 2015 to 2021, we observed a CAGR greater than 15% for all age groups (< 50, 50–59, 60–69, 70–74, 75 +), insurance types (cash, commercial, government, Medicare, Medicaid), regions (Midwest, Northeast, South, West), sex (male and female), and certain comorbidities (osteoporosis, diabetes mellitus, tobacco use, underweight (BMI < 18.5), rheumatoid arthritis) (P < 0.05 for all). Patients undergoing TKA with chronic kidney disease, prior fragility fractures, and dementia demonstrated a CAGR of + 9%–13% from 2015 to 2021 (P < 0.05).

Conclusion

From 2015 to 2021, the use of cementless TKA saw a dramatic increase in all patient populations. However, there is still no consensus on when to cement and in whom. Clinical practice guidelines are needed to ensure safe and effective use of cementless fixation.
Apiospora arundinis, a panoply of carbohydrate-active enzymes and secondary metabolites
Authors: Sørensen Trine , Petersen Celine , Muurmann Asmus T. , Christiansen Johan V. , Brundtø Mathias L. , Overgaard Christina K. , Boysen Anders T. , Wollenberg Rasmus D. , Larsen Thomas O. , Sørensen Jens L. , Nielsen Kåre L. , Sondergaard Teis E.
Published: April 2024

The Apiospora genus comprises filamentous fungi with promising potential, though its full capabilities remain undiscovered. In this study, we present the first genome assembly of an Apiospora arundinis isolate, demonstrating a highly complete and contiguous assembly estimated to 48.8 Mb, with an N99 of 3.0 Mb. Our analysis predicted a total of 15,725 genes, with functional annotations for 13,619 of them, revealing a fungus capable of producing very high amounts of carbohydrate-active enzymes (CAZymes) and secondary metabolites. Through transcriptomic analysis, we observed differential gene expression in response to varying growth media, with several genes related to carbohydrate metabolism showing significant upregulation when the fungus was cultivated on a hay-based medium. Finally, our metabolomic analysis unveiled a fungus capable of producing a diverse array of metabolites.
Congenital cardiac surgery and diaphragmatic paralysis: efficacy of diaphragm plication
Authors: Arslanoğlu Ergin , Bakhshaliyev Shiraslan , Kara Kenan Abdurrahman , Yiğit Fatih , Yeşiltaş Mehmet Ali , Altunyuva Kaan , Özalp Zeynep Gülben Kük , Karaci Ali Rıza
Published: April 2024

Background

Diaphragmatic paralysis due to phrenic nerve injury is a rare but potentially serious complication following congenital cardiac surgery, with reported incidences ranging from 0.28 to 5.6%. Early plication has been recommended for children diagnosed with diaphragmatic paralysis, especially those requiring prolonged respiratory support after cardiopulmonary bypass. It is important to note that late plication may jeopardize the results of successful surgical plication due to diaphragm atrophy.

Results

This retrospective study was performed between May 2020 and June 2023. Patients who could not be weaned from the ventilator and underwent diaphragmatic plication in symptomatic patients after phrenic nerve injury were included in the study. During the study period, 22 (3.5%) of 624 pediatric patients operated for congenital heart disease required diaphragm plication. The mean age of the patients ranged from 1 month to 13 years with a mean of 23.88 ± 37.99 months. Fourteen (63.6%) of the patients were female, and 8 (36.4%) were male. Two of the patients (9%) were exited due to ventilator-associated pneumonia and sepsis.

Conclusions

In conclusion, diaphragmatic paralysis after congenital heart surgery is a rare but important complication that can lead to serious respiratory and cardiac problems. Diaphragmatic plication has been shown to be an effective intervention for pediatric patients with the potential to improve pulmonary function, reduce dyspnea, and minimize complications associated with diaphragmatic paralysis. Careful consideration of patient selection, timing, and potential complications is crucial in optimizing the outcomes of this surgical intervention.
Association Between Hypotension During Pancreatectomy and Development of Postoperative Diabetes
Authors: Moon Seoil , Lee Mirang , Lee Jun Suh , Lee Jooyeop , Oh Tae Jung , Jang Myoung-jin , Yoon Yoo-Seok , Han Youngmin , Kwon Wooil , Jang Jin-Young , Jung Hye Seung
Published: April 2024

Context

With advancements in long-term survival after pancreatectomy, postpancreatectomy diabetes has become a concern, and the risk factors are not yet established. Pancreatic islets are susceptible to ischemic damage, though there is a lack of clinical evidence regarding glycemic deterioration.

Objective

To investigate association between hypotension during pancreatectomy and development of postpancreatectomy diabetes.

Design

In this retrospective, longitudinal cohort study, we enrolled patients without diabetes who underwent distal pancreatectomy or pancreaticoduodenectomy between January 2005 and December 2018 from 2 referral hospitals in Korea.

Main outcome measures

Intraoperative hypotension (IOH) was defined as a 20% or greater reduction in systolic blood pressure. The primary and secondary outcomes were incident diabetes and postoperative Homeostatic Model Assessment (HOMA) indices.

Results

We enrolled 1129 patients (average age, 59 years; 49% men; 35% distal pancreatectomy). IOH occurred in 83% (median duration, 25 minutes; interquartile range, 5-65). During a median follow-up of 3.9 years, diabetes developed in 284 patients (25%). The cumulative incidence of diabetes was proportional to increases in the duration and depth of IOH (P < .001). For the median duration in IOH compared with a reference time of 0 minutes, the hazard ratio was 1.48 (95% CI, 1.14-1.92). The effect of IOH was pronounced with distal pancreatectomy. Furthermore, the duration of IOH was inversely correlated with 1-year HOMA β-cell function (P < .002), but not with HOMA insulin resistance.

Conclusion

These results support the hypothesis that IOH during pancreatectomy may elevate risk of diabetes by inducing β-cell insufficiency.
Safety of high-risk diabetic patients during Ramadan at a tertiary care hospital in Pakistan, practicing updated IDF DAR guidelines
Authors: Farooq Qaisar , Ghaffar Tahir , Malik Suleman Elahi , Aamir Azizul Hasan
Published: April 2024

Objective: To determine trend of following medical advice and safety of high-risk diabetic patients during Ramadan practicing updated IDF DAR guidelines.

Methods: The cross-sectional study was conducted at Outpatient Department of Diabetes, Endocrinology and Metabolic Disorders Hayatabad Medical Complex Peshawar, Pakistan from April to June 2022, and comprised of high-risk diabetic patients (>6.0) based on updated IDF-DAR guidelines 2022 intending to fast. A questionnaire was designed to document patient risk factors score, type and duration of diabetes, HbA1c, comorbidities and complications developed during Ramadan. Data was analyzed using SPSS 20.

Results: Among all 130 participants, 78(60%) followed medical advice and did not fast and 52(40%) patients fasted against medical advice during month of Ramadan. Out of 130 participants, 89.2% were having type-2 diabetes Mellitus, 55.4% were female and mean age of participants was 52+14.6.40%. In fasting group, 57.7% were in the age range of 16 to 50 years while in non-fasting group 69.2% participants were more than 50 years old (P-value 0.031). There were 80.8% female participants in fasting group versus 38.5% in non-fasting group (P-value 0.001). Hypoglycemia occurred in 58.3% patients in fasting group and 29.3% non-fasting group. (P-value 0.021). On the other hand, 27.8% patients in fasting group and 55.2% of non-fasting group had hyperglycemia (P-value 0.025).

Conclusion: Despite advised against fasting in these high-risk patients as per IDF DAR guidelines, almost half of patients fasted considering fasting a religious obligation. Those who fasted had significant hypoglycemia despite adjustment of medications as in guidelines. There is need of more intensive education before fasting, especially in high-risk diabetic patients.

doi: https://doi.org/10.12669/pjms.40.5.8007

How to cite this: Farooq Q, Ghaffar T, Malik SE, Aamir AH. Safety of high-risk diabetic patients during Ramadan at a tertiary care hospital in Pakistan, practicing updated IDF DAR guidelines. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.8007

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.
Effectiveness of early pharmaceutical interventions in symptomatic COVID-19 patients: A randomized clinical trial
Authors: Azhar Shehnoor , Akram Javed , Latif Waqas , Cano Ibanez Naomi , Mumtaz Samiullah , Rafi Ali , Aftab Usman , Iqtadar Somia , Shahzad Muhammad , Syed Fibhaa , Zafar Bilal , Fatima Nighat , Saadat Afridi Saleh , Javed Akram Shehla , Afzal Chaudhary Muhammad , Sadiq Farah , Goraya Saifullah , Haneef Muhammad , Ashraf Verda , Ashraf Saadia , Akrma Humaira , Khaliq Tanwir
Published: April 2024

Objective: We assessed the effectiveness of oral Hydroxychloroquine (HC), Azithromycin (AZ) and Oseltamivir (OS), alone or combined, among patients hospitalized with mildly symptomatic coronavirus infectious disease (COVID-19).

Methods: Following the approval of the National Bioethics Committee and prospective registration (clinicaltrials.gov NCT04338698), a multicenter randomized clinical trial of adaptive design was conducted at 10 multispecialty hospitals in Pakistan. Patients were randomized into seven treatment groups. Starting April 15, 2020, consenting, eligible, otherwise healthy adult patients or those with co-morbidities under control, were recruited if they presented with mildly symptomatic COVID-19 (scored 3 on a 7-point ordinal scale anchored between 1 = not hospitalized, able to undertake normal activities, to 7 = death) confirmed by quantitative Real-Time Polymerase Chain Reaction (qRT-PCR). Two primary outcomes were assessed by day seven: Turning qRT-PCR negative; and clinical improvement of two points from the baseline. Outcome rates were compared using a chi-square test. Multiple imputations were applied to handle missing data. An interim data analysis was carried out on July 19, 2020, following which the study continued without treatment group changes. Data Safety and Monitoring Board advised to stop recruitment due to its futility on January 18, 2021.

Results: Of 471 patients randomized, a total of 426 (90.4%) completed the follow-up for primary outcomes. Based on imputed data analyses at day seven: Total qRT-PCR negative cases were 137/471 (29%, 95% CI 25.0 - 33.4). By day seven, a total of 111/471 (23.5%, 95% CI 19.8 - 27.6) showed clinical improvement. No serious or non-serious adverse event was reported.

Conclusions: Among patients with mild COVID-19, there was no statistically significant difference in the effectiveness of oral antimalarial, antiviral, or antibiotic treatments.

Clinicaltrials.gov ID: NCT04338698.

doi: https://doi.org/10.12669/pjms.40.5.8757

How to cite this: Azhar S, Akram J, Latif W, Ibanez NC, Mumtaz S, Rafi A, et al. Effectiveness of early pharmaceutical interventions in symptomatic COVID-19 patients: A randomized clinical trial. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.8757

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.
Ethical leadership behaviors of senior managers perceived by the junior managers working in public hospitals in Hail, Saudi Arabia
Authors: Badr K. Aldhmadi  , Kumar Rakesh , Bilesha Perera  , Mohammad A. Algarni  , Sage Mesias Raguindin  , Ammar A. Attar  , Guidoume Ahmed
Published: April 2024

Objective: To examine junior managers experiences of ethical leadership behaviors exhibited by their senior managers.

Methods: In this cross-sectional study, 263 junior health care managers working in public hospitals in Hail, Saudi Arabia were surveyed using a self-administered questionnaire between 20 November, 2022 and 15 February, 2023. Descriptive statistics and regression analysis were employed in the analysis. Statistical Package for Social Sciences (SPSS) version 25 (IBM, Armonk, NY, USA) was used to conduct statistical analyses.

Results: The sample consisted of 118 men (44.9%) and the majority (66.6%) of the respondents were below the age of 36 years. In case of working environment, nearly 84% of the participants were satisfied with the relationships that they have had with their supervisors. Regression analysis indicate that women were more likely than men to experience healthy ethical leadership behaviors of their seniors (β = -0.163, p < 0.05). Ethical leadership behaviors of senior health care managers would not influence by the age or work experience of their juniors.

Conclusion: Ethical leadership behavior of senior health care managers was satisfactory. Longitudinal research is needed to investigate how cultural and environmental factors affect the ethical leadership behavior of healthcare managers in Saudi Arabia.

doi: https://doi.org/10.12669/pjms.40.5.8996

How to cite this: Aldhmadi BK, Kumar R, Perera B, Algarni MA, Raguindin SM, Attar AA, et al. Ethical leadership behaviors of senior managers perceived by the junior managers working in public hospitals in Hail, Saudi Arabia. Pak J Med Sci. 2024;40(5):---------.  doi: https://doi.org/10.12669/pjms.40.5.8996

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.
Wars, Conflicts & Mental Health
Authors: Javed Afzal
Published: April 2024

doi: https://doi.org/10.12669/pjms.40.5.9505

How to cite this: Javed A. Wars, Conflicts & Mental Health. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.9505

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 dynamic of changes of pNFH levels in the CSF compared with the motor scales’ scores during three years of nusinersen treatment in children with spinal muscular atrophy types 2 and 3
Authors: Badina Mihaela , Sporea Corina , Bejan Gabriel Cristian , Mirea Andrada , Ion Daniela Adriana
Published: April 2024

Abstract: Neurofilaments are crucial in neuronal cytoskeleton formation, influencing axonal growth and impulse modulation. This study focuses on understanding the dynamics of the phos-phorylated neurofilament heavy subunit (pNFH) in pediatric spinal muscular atrophy (SMA) pa-tients undergoing Nusinersen treatment. The presence of five neurofilament types, particularly pNFH, is explored as a potential biomarker. SMA, an autosomal recessive disease impacting motor neurons, is characterized by disease severity linked to the number of SMN2 gene copies. Approved drugs, including Nusinersen, have demonstrated efficacy in enhancing motor activity. Methods: A retrospective analysis was conducted on 18 pediatric SMA patients treated with Nusinersen from October 2018 to July 2023. Cerebrospinal fluid (CSF) samples were utilized to assess pNFH levels. Motor scales were employed to evaluate performance, focusing on patients with varying SMN2 gene copies. Results: Following the initiation of Nusinersen treatment, a substantial decrease in pNFH levels was observed in CSF samples. Motor scales indicated improved performance, partic-ularly in patients with more SMN2 copies. However, the correlation between pNFH levels and motor improvement was not strongly evident, suggesting a limited role as a prognostic indicator within this timeframe. Conclusion: Nusinersen effectively reduced pNFH levels in pediatric SMA patients, showcasing promising outcomes in motor function. However, the predictive value of pNFH remains inconclusive, emphasizing the need for further research. Study limitations, including the rarity of SMA, the absence of a control group, and the disease's dynamic nature over time, should be considered when interpreting these findings.
Evaluation of the bioclimate of the Piatra-Neamț tourist resort
Authors: Roșu Constantin , Mihăilă Dumitru , Bistricean Petruț-Ionel , Boiciuc Carmen , Silișteanu Sînziana – Călina
Published: April 2024

Abstract: Background: The study responds to real needs of knowing the bioclimate of some tourist resorts in order to develop different types of tourism, in which the bioclimate plays a significant role. In Romania, a similar study was carried out for the resort towns of Vatra Dornei and Tg. Ocna. Methods: The research is based on time series of weather elements from 1961-2021. These series were used for the calculation of the bioclimatic index of the physiological equivalent temperature (PET) which allows the analysis of the temporal peculiarities of the bioclimate. In order to highlight in a new perspective the relationship between biocli-mate and tourism in the Piatra Neamț resort, we created climate-tourism schemes (CTIS). Results: PET values ranged between a maximum of 35.7°C (severe thermal stress due to heating) and a minimum of - 29.3°C (extreme thermal stress due to cooling). The mean PET value was 8.8°C (indicating moderate cold stress). The period of the year with biocli-matic comfort, for hiking, visiting, outdoor sports, climatotherapy, balneotherapy cor-re-sponds to the interval April (3rd decade) - October (1st decade). Conclusions: Tourists who want to plan their vacation in Piatra Neamț will benefit from non-restrictive bioclimatic conditions from the end of April to the beginning of October. During the cold season, with a layer of snow, winter sports can be practiced.
Effect of HIIT on Motor Performance in Female Handball
Players
Authors: Demirman Ragip , Bilge Murat , Tuncer Damla Selin , Eler Nebahat
Published: April 2024

Abstract: The aim of this study was to investigate the effects of interval training at four different intensities in addition to handball training for 8 weeks on aerobic-anaerobic, speed and agility pa-rameters in female handball players. Twenty female handball players (experimental group: 10; control group: 10) voluntarily participated in the studyThe experimental group trained in high-intensity interval training (HIIT) 3 days a week for 8 weeks in addition to handball training, while the control group was allowed to continue their standard training program. The anaerobic capacity, speed, and agility of the experimental and control groups were measured twice before and after an 8-week training program. The HIIT training program for the experimental group was adapted to the movements most commonly used in handball. The values of the data obtained from the handball players were analyzed. ANOVA for mixed measures was applied to determine the difference between the pre-test and post-test values of the experimental and control groups. There was a statistically significant difference (p < 0.05) between the pre and post-test values of the 20-m sprint test of the experimental and control groups of HIIT training for handball players, while there was no statistically significant difference between the pre and post-test values of the anaerobic capacity and agility test of HIIT training. In conclusion, it is recommended to include HIIT training in the training periodization of handball players during the season, and it is believed that it will have a positive effect on players' speed performance.
Long-term case management and outcomes in a young male patient with complete paraplegia post T4-T5 vertebral osteomyelitis and a previous documented thalamo-mesencephalic hemorrhage – case presentation
Authors: Bistriceanu Roxana , Spînu Aura , Daia Cristina , Andone Ioana , Popescu Cristina , Băilă Mihai , Postoiu Ruxandra , Onose Gelu
Published: April 2024

Abstract: (1) Background: Vertebral osteomyelitis is an infection affecting the vertebrae, with a potentially devastating impact, which requires a prompt diagnosis established as quickly as possible to avoid complications such as neurological impairment, fractures, and chronic pain; (2) Methods: We reported a case of a 47-year-old male patient with multiple risk factors (high blood pressure, smoking, dyslipidemia, type II diabetes) and a history of right hemiplegia post a thalamo- mesencephalic hemorrhage, admitted to the Neuromuscular Clinic Division of The Teaching Emergency Hospital “Bagdasar- Arseni” (TEHBA) Bucharest, for complete paraplegia following a surgically treated vertebral osteomyelitis at T4-T5 level with spinal epidural abscess; (3) Results: The patient had an oscillating and long evolution, due to long-term antibiotherapy and the imperative of minimal mobilization periods, which eventually led to favorable results, with the recovery of motor function and the ability to perform his previous daily activities; (4) Conclusions: Proper management in vertebral osteomyelitis cases has a great impact on the evolution of the patient, increasing the quality of life, and preventing future complications. A multidisciplinary approach is essential for this type of complex case in order to achieve significant improvements.
The effect of mofettes and natural carbonated mineral water on accelerating bone healing in a femoral defect model in rats
Authors: Dogaru Gabriela , Oltean-Dan Daniel , Rus Vasile , Gherman Luciana Mădălina , Ciubean Alina Deniza , Dindelegan Maximilian George , Pop Bianca , Pașca Gabriel , Ciumărnean Lorena
Published: April 2024

Abstract: (1) Background: The aim of the study was to investigate the effecs of mofettes and car-bonated mineral water baths on bone healing using a rat femoral defect model; (2) Methods: A 2mm diameter unicortical defect in the left femoral diaphysis in 40 Wistar Rats was surgically created. Furthermore, the subjects were divided into 4 treatment-groups: control, mofette therapy, mofette therapy and carbonated mineral water bath, and carbonated mineral water bath. At the end of the 2-week treatment and at 4 and 6 weeks, the animals were evaluated through Micro-CT analysis of the bone defect and histological analysis of bone tissue and skin; (3) Results: The pro-cesses of bone consolidation and repair are not completed at 6 weeks in all groups. However, comparing the proliferated bone tissue in the created orifice and the degree of thickening of the femoral wall, it can be affirmed that at 6 weeks, the best results are present in Group 4, treated with carbonated mineral water baths, followed by the combination of mofettes and carbonated water. (4) The use of these treatments could open a new possibility for shortening the healing time in patients with bone defects, as it is non-invasive and accessible.
Sentiment Analysis: a Comparative Study of Online Booking Platforms Used for Spa Tourism in Northern Oltenia, Romania
Authors: Truțescu Marius-Nicolae , Nicolaie Daniela
Published: April 2024

Abstract: Purchasing a tourist package for a specific tourist destination has become extremely easy and transparent through the diversity and continuously upgraded online booking platforms. Their content provides information through the reviews among tourists and hospitality managers, being, at the same time, opened Big Data for researchers or policymakers. Mining the reviews of two global platforms (Booking and TripAdvisor) and a national one (Turistinfo) the study aims to an-alyze the tourists’ sentiments and emotions experienced in a balneary destination such as Northern Oltenia, Romania. The research addresses the overarching question of whether positive sentiments dominate in destinations led by spa tourism, and consequently, which emotions are definers? For this purpose, 10,945 online reviews, from 2018 to 2020 for 248 accommodation units of the studied area were collected and processed in Statistical Package for the Social Sciences (SPSS 17.0) and Geographical Information System (GIS). The key findings indicate that most travelers are satisfied with tourist destinations, sustained by the dominance of positive sentiments (82%) asso-ciated with a high rating score (8.9) and ‘joy’ and ‘trust’ emotions. Mostly positive sentiments are linked to the quality of five- and four-star accommodation units, but also to the intimacy of the small family’s business, the spatial framing in the landscape, and the friendship of the hosts. At the same time, the repulsive aspects draw attention to some problems of the state of the indoor or outdoor environment and the price-quality ratio. The research demonstrates the effectiveness of leveraging electronic word of mouth as a valuable resource for stakeholders in the tourism in-dustry. This approach enables a swift and sustainable assessment of tourist satisfaction, providing valuable insights for accommodation service providers to make informed decisions.
Cognitive mechanism of worldview models: structure and principles of functioning
Authors: Podshibyakina T. , Pupykin R. , Semenko I.
Published: April 2024

The work is devoted to the little-studied problem of cognitive elements of worldview. The subject of analysis is the cognitive mechanism of functioning of worldview models. A theoretical and methodological construct for studying the dynamic states of various worldview models was developed, which was based on the functional directions of the philosophy of cognitive science and cognitive science. The goal is to identify predictors of dynamics (prognostic parameters of variables) that make it possible to predict trends in changes in worldview models. The structure of the cognitive mechanism of worldview models is described, the elements of which are cognitions - cognitive elements of consciousness, or mental processes of information processing. The empirical part of the study, devoted to testing the hypothesis about the principles of functioning of the cognitive mechanism of worldview models, made it possible to conduct a quantitative analysis of some parameters that are most susceptible to external influence. The result was the conceptualization of the cognitive mechanism of worldview models and the identification of criteria for its dynamics. It has been established that the functional cognitive-value mechanism is represented by a set of processes of perception, reception, representation and memory. It has been proven that parameters such as assessment of the surrounding world, assessment of threats and risks, personal control, and memory can become objects of influence on the worldview in order to change it. The results obtained made it possible to formulate the principles of cognitive technologies of consciousness control necessary to control destructive forms of behavior. The study was conducted with the financial support of the Ministry of Science and Higher Education of the Russian Federation within the framework of the project “Cognitive and value structure of worldview models of modern Russians: generational and regional differences.”
The kinds of value conflicts during the changing of state policy paradigm and governance
Authors: Rakhmanov Sergey
Published: April 2024

The purpose of the article is to study the types of value conflicts during the period of political transformation of the modern Russian state. Decree of the President of the Russian Federation No. 809 dated 11/19/2022 "On Approval of the Foundations of State Policy for the Preservation and Strengthening of Traditional Russian spiritual and Moral Values" defines a priority direction for the development of public administration, which should be based on traditional values. At the same time, the transition from the existing situation to the new one will inevitably lead to a clash of liberal and neoliberal ideas with national values and traditional ideas. The author consistently studies the processes of changing the value paradigm in political and managerial decisions of the previous and modern era, namely the period from the collapse of the USSR in 1991 to the present. There is a tendency to repeat the value conflict of the early 90s in the Russian Federation, when socialist values in public administration were replaced by liberal values, and part of society was not ready for such a development. The hypothesis of this study is to search for the possibility of avoiding a value conflict similar to the conflicts of previous historical eras when carrying out evolutionary changes in public policy and management in the Russian Federation in the near future. Institutional and neo-institutional approaches are used, which are associated with value-rational and goal-oriented approaches in public administration. The SWOT analysis methodology is used to determine systemic changes in public administration. The theoretical and practical significance of the work lies in expanding knowledge about the role of values in the field of public policy and management and in solving the applied task of introducing traditional national values into political and managerial decisions, outlined in the decree of the President of the Russian Federation. The conclusions are the value aspect is a basis and root cause of the political process. The results include the characteristic of the Russian society from the value relation view and the description of the core trend of the public administration development in modern Russia.