bluuebunny/crossref_metadata_2025 huggingface dataset:
Frequency of undiagnosed hypertension among diabetic patients with micro vascular complications
Authors: Qureshi Sarah Shoaib , Wasim Amer  , Maryam Mueez  , Mehrin Farok  , Syed Khurram Shehzad
Published: December 2024

Objectives: To determine the frequency of undiagnosed hypertension among the diabetic patients with micro vascular complications.
Method: This is a descriptive case series conducted at Department of Medicine, Ghurki Trust Teaching Hospital, in this six month stud which enrolled 213 patients between 18-60 years from March 28, 2021 to September 28, 2021, having diabetes with microvascular complications. These patients were not previously diagnosed as hypertensives. Patient was diagnosed as hypertensive if SBP or DBP was ≥140 or ≥90 mmHg respectively. The frequency of undiagnosed hypertension was noted and compared across various subgroups of patients.
Results: The mean age of the patients was 49.3±9.7 years. The mean BMI of these patients was 28.3±3.5 Kg/m2 and 67 (31.5%) patients were obese. The mean duration of disease was 8.2±3.9 years. Majority (62.4%) of the patients had diabetic retinopathy while 37.6% patients had diabetic nephropathy. Undiagnosed hypertension was observed in 42 (19.7%) patients with diabetic micro vascular complications. The frequency of undiagnosed hypertension was significantly higher among obese as compared to non-obese patients (28.4% vs. 15.8%; p-value=0.032). There was no statistically significant difference in the frequency of undiagnosed hypertension across various subgroups based on patient’s age (p-value=0.750), gender (p-value=0.902), type of micro vascular complication (p value=0.783) and duration of diabetes (p-value=0.763).
Conclusion: In the present study, a substantial proportion of patients with diabetic micro vascular complications suffered undiagnosed hypertension which is alarming and advocates routine blood pressure monitoring of such patients so that timely identification and anticipated management of underlying hypertension may improve the outcome of such cases in future clinical practice.
doi: https://doi.org/10.12669/pjms.41.1.9715
How to cite this: Qureshi SS, Amer W, Mueez M, Farok M, Shehzad SK. Frequency of undiagnosed hypertension among diabetic patients with micro vascular complications. Pak J Med Sci. 2025;41(1):210-213. doi: https://doi.org/10.12669/pjms.41.1.9715
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 Shengyang Yiwei Decoction combined with selective serotonin reuptake inhibitor antidepressants on HAMD-17 score and somatic symptoms in patients with depression
Authors: Li Lin , Wan Aihua , Zhao Mingkun , Yu Liyan , Han Yanchao , Mi Kun
Published: December 2024

Objective: To investigate the efficacy of Shengyang Yiwei Decoction (SYD) combined with selective serotonin reuptake inhibitor (SSRI) antidepressants on the total score and scores of factors of the Hamilton Rating Scale for Depression (HAMD-17) and somatic symptoms in patients with depression.
Methods: This was a retrospective study. One hundred and twenty patients with depression were treated in Hebei Provincial Mental Health Center between December 2020 and May 2022 and randomly divided into the experimental group and the control group, with 60 patients in each group. Patients in the control group were treated with selective serotonin reuptake inhibitor (SSRI) antidepressants and those in the experimental group were treated with modified SYD in addition to SSRIs for eight weeks. Explored the efficacy and adverse drug reactions of the two treatment options.
Results: After eight weeks of treatment, there was no statistically significant difference in the total efficacy between the two groups (p>0.05); the total score of HAMD-17 and scores of factors except body weight were decreased in the experimental group compared with those in the control group, and the differences were statistically significant (p<0.05). The SSI score of the experimental group was decreased compared with that of the control group, and the difference was statistically significant (p<0.05).
Conclusion: SYD combined with SSRI antidepressants in the treatment of depression can reduce the total score and the scores of factors of HAMD-17 without increasing the incidence of adverse drug reactions. This combination can be used as an integrated traditional Chinese and Western medicine treatment for depression.
doi: https://doi.org/10.12669/pjms.41.1.9835
How to cite this: Li L, Wan A, Zhao M, Yu L, Han Y, Mi K. Effect of Shengyang Yiwei Decoction combined with selective serotonin reuptake inhibitor antidepressants on HAMD-17 score and somatic symptoms in patients with depression. Pak J Med Sci. 2025;41(1):205-209. doi: https://doi.org/10.12669/pjms.41.1.9835
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 effect of Hydrogen-rich „Truskavetska” bottled water on the swimming stress test in female rats
Authors: Zukow Walery , Popovych Igor
Published: December 2024

Background and aim. Despite the use of drinking hydrogen rich water both in clinical and sports medicine, further research into the mechanisms of its beneficial effect remains relevant. We found that both Naftussya bioactive water per se and combined balneotherapy have an ambiguous effect on physical performance. It was also found that the preventive use of “Truskavetska” bottled water, the chemical composition of which is somewhat similar to that of Naftussya bioactive water, has both similar and different effects on the post-stress parameters of rats. We set ourselves the goal of finding out the possibility of correcting the effect of "Truskavetska" bottled water on the post-stressor state of the neuro-endocrine-immune complex, as well as the endurance of rats by enriching it with hydrogen.
Material and methods. The experiment is at 26 female Wistar rats purposefully divided into three homogeneous (according to the swimming test and HRV parameters) groups. 5 animals remained intact with free access to regular daily water. Rats of the control group (n=4) for 7 days loaded through a tube with “Truskavetska” bottled table water (2 mL once), while the animals of main group (n=17) received the same water, but enriched with Hydrogen. After completing the preconditioning course, a repeated swimming stress test was performed. The next day after stressing, a number of parameters of the neuro-endocrine-immune complex and metabolism were recorded. 
Results. Hydrogen rich water (HRW) minimizes the post-stressor increase in sympathetic tone and adrenal mass, and prevents the increase in catecholamines and corticosterone as well as plasma cells in the blood and rod-shaped neutrophils in the spleen. On the other hand, HRW prevents a post-stressor decrease in the intensity of macrophage phagocytosis and the bactericidal capacity of blood microphages, the content of lymphoblasts in the thymus, the activity of both antioxidant enzymes and vagal tone, and also minimizes the decrease in the content of eosinophils in the blood, non-alpha-lipoprotein cholesterol in the serum, and the mass of the spleen, in addition, the reduced content of plasma cells in the spleen reverses to an excess. Finally, the non-stress-responsive parameters of the control animals: the activity of AlT, CPhK, AsT and diene conjugates of the serum, the content of reticulocytes and Hassal’s bodies in the thymus - under the influence of HRW increase to one degree or another. Importantly, this also applies to the duration of swimming until exhaustion. A strong canonical correlation was found between the activity of antioxidant enzymes, on the one hand, and metabolic-endocrine (R=0.959) and immune (R=0.959) sets, on the other hand.
Conclusion. Enrichment of "Truskavetska" bottled table water with hydrogen generally has a favorable effect on its stress-limiting and actotropic capacity, associated with antioxidant activity.
Carmen Conde, palabras para contener un destierro. Leading article: Carmen Conde: words to contain a banishment.
Authors: Díez de Revenga Francisco Javier
Published: December 2024

Carmen Conde vivió en sí misma la intensidad de un destierro interior que
coincidió con su propia aventura vital en los años inmediatos al final de la Guerra de España. Su
poesía se manifiesta en intensidades expresivas de indudable originalidad y se caracteriza por su
particular vehemencia porque registró ansiedades vitales y sensaciones que surgían desde su
voluntario confinamiento necesario por razones políticas. La escritora exiliada, perseguida y buscada,
trasladó a su palabra poética sentimientos que fructificaron en una etapa de su poesía muy concreta y
desde luego propia y personal.
Laissez-Faire vs. Government Intervention: Implications of Regulation Preventing Nonauthorized Remanufacturing
Authors: Esenduran Gökçe , Jin Minyue , Zhou Yu
Published: December 2024

Problem definition: In this paper, we compare laissez-faire and mandatory authorization policy regimes for third-party remanufacturing. Under a laissez-faire policy, an independent remanufacturer (IR) chooses whether to get the original equipment manufacturer (OEM) authorization. Under a mandatory authorization policy, the IR is required to get OEM authorization and to pay the OEM a fee for every item remanufactured. Motivated by China’s regulatory journey that first mandated authorized remanufacturing and then moved to a laissez-faire policy, our goal is to understand which policy is better from the perspectives of different stakeholders. Methodology/results: We use a game-theoretic approach and consider a supply chain consisting of a supplier, an OEM, and an IR under the two policy regimes. Conventional wisdom suggests that the IR would be better off under the laissez-faire policy, but the OEM and the supplier would be better off under the mandatory authorization policy. However, we show that this conventional wisdom may not hold. For products with a low remanufacturing cost, all firms benefit from the mandatory authorization policy, whereas for products with a moderately high remanufacturing cost, all firms are better off under the laissez-faire policy. Further, mandatory authorization may outperform the laissez-faire policy in both economic and environmental dimensions. Managerial implications: Our findings reveal that seemingly advantageous policy regimes may backfire for firms. Therefore, before supporting such policies, the firms need to assess the strategic reactions of other firms and the potential impacts on their profits. Furthermore, a mandatory authorization policy can be beneficial in fostering the development of the remanufacturing sector for products with low remanufacturing costs. Nevertheless, it may also lead to an increase in the total environmental impact.

Funding: The work of M. Jin was supported by the National Natural Science Foundation of China [Grants 72071020 and 72471038]. The work of Y. Zhou was supported by the National Natural Science Foundation of China [Grants 71971033 and 72371040] and the Fundamental Research Funds for the Central Universities [Grant 2024CDJSKPT14].

Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2023.0128 .
Parameter optimization of femtosecond laser pulses for implant cavity preparation
Authors: Chen Wanqiang , Yuan Fusong , Liang Shanshan , Qu Chen , Lin Shuting , Li Xiang , Yan Lei , Shi Xuesong , Yi Wei
Published: December 2024

Femtosecond laser pulses are employed in the preparation of implant cavities during dental implant surgeries in the field of digital dentistry, specifically focusing on optimizing laser pulse parameters to enhance precision and control thermal injury. In this study, ex vivo experiments were conducted on sheep tibiae, where thermocouple sensors monitored the temperature variations during ablation. This approach aims to optimize the laser pulse parameters and control the temperature, ensuring smoother cavity margins and better preservation of the bone microarchitecture. Scanning electron microscopy (SEM) confirmed significant improvements in the quality of the implant cavities prepared using the femtosecond laser pulses.
Efficient, broadly tunable, hollow-fiber source of megawatt pulses for multiphoton microscopy
Authors: Eisenberg Yishai , Wang Wenchao , Zhao Shitong , Hebert Eric S. , Chen Yi-Hao , Ouzounov Dimitre G. , Takahashi Hazuki , Gruzdeva Anna , LaViolette Aaron K. , Labaz Moshe , Sidorenko Pavel , Antonio-Lopez Enrique , Amezcua-Correa Rodrigo , Yapici Nilay , Xu Chris , Wise Frank
Published: December 2024

Three-photon fluorescence microscopy (3PM) has driven rapid progress in deep-tissue imaging beyond the depth limit of two-photon microscopy, with impacts in neuroscience, immunology, and cancer biology. Three-photon excitation places a premium on ultrashort pulses with high peak power in the 1300- and 1700-nm wavelength bands, which allow deepest imaging. The inefficiency and cost of current sources of these pulses present major barriers to the use of 3PM in biomedical research labs. Fiber sources of such pulses could potentially alleviate these problems, but the peak-power limitations of optical fibers have limited their use in 3PM. Here, we describe a fiber-based source of femtosecond pulses with multi-megawatt peak power. Femtosecond pulses at 1030 nm are launched into an antiresonant hollow-core fiber filled with argon. By varying only the gas pressure, pulses with hundreds of nanojoules of energy and sub-100 fs duration are obtained at wavelengths between 850 and 1700 nm. This approach is a new route to an efficient and potentially low-cost source for deep-tissue imaging. In particular, 960-nJ and 50-fs pulses are generated at 1300 nm with a conversion efficiency of 10%. The nearly 20-MW peak power is an order of magnitude higher than the previous best from a femtosecond solid-core fiber source at 1300 nm. As an example of the capabilities of the source, these pulses are used to image structure and neuronal activity in a mouse brain as deep as 1.1 mm below the dura.
Point spread function modeling and engineering in black-box lens systems
Authors: Xiao Dafei , Orange Kedem Reut , Shechtman Yoav
Published: December 2024

Point spread function (PSF) engineering in an imaging system involves the introduction of additional optical components to efficiently encode object information. It typically relies on a well-established mapping relation between object space, PSF engineering plane, and image plane. However, this reliance can limit its application in imaging systems with unknown (“black box”) attributes, e. g. commercial photographic lenses, where a theoretical imaging model is not readily available. To address this limitation, we conduct wave-optics analysis of general lens systems, explicitly derive a general imaging model based on scaled Fourier transform, and develop an overall pipeline for automatic parameter determination of the model. When applied to a photographic lens, this pipeline demonstrates high PSF modeling accuracy, showcasing the capability of “seeing what you design”. We then implemented PSF engineering in this lens to find its optimal PSF for 3D localization. This work improves computational imaging by enabling accurate wavefront shaping design in arbitrary imaging systems.
Tunable bound states in the continuum with loss compatibility
Authors: Luo Haoqi , Liu Liangliang , Zhang Junyu , Ye Qing , Hu Yihua , Lu Fengya
Published: December 2024

Dynamic control of bound states in the continuum (BICs) is usually achieved by engineering structural geometries of lossless optical systems, leading to a passive nature for most current BIC devices. Introducing materials with tunable permittivity, i.e., refractive index and loss, may offer a new degree of freedom in designing reconfigurable BIC metadevices with active functionalities. However, achieving loss-accompanied or loss-driven BIC manipulation while preserving its ultrahigh Q factor is extremely challenging. Here, we report a loss-compatible BIC manipulation mechanism based on far-field interference in a mirror-assisted photonic crystal slab, wherein the loss of tunable material not only harmoniously coexists with ultrahigh Q factor, but also serves as a pivotal joystick of BIC dynamics in momentum space. By modulating loss and refractive index of tunable material through the amorphous-crystalline phase transition, simulation results show the active switching of topological charge for BICs, as well as the multidimensional control of chiroptical effect for quasi-BICs, including steerable response/emission direction and chirality continuum with far-field ellipticity ranging from −0.944 to +0.943. Our findings suggest a distinct route to construct BIC metadevices with active functionalities and foster deeper exploration of intrinsic loss applications within the ultrahigh-Q photonic system.
Tunable all-fiber all-normal-dispersion mode-locked laser of cylindrical vector beams covering the range of 69 nm
Authors: Liu Xiangzhong , Luo Jing , Lv Jialiang , Yao Peijun , Xu Lixin , Zhan Qiwen
Published: December 2024

We propose and demonstrate an ultra-wide tunable mode-locked all-fiber laser based on nonlinear amplifying loop mirror (NALM) with the output of cylindrical vector beams (CVBs). The tuning range covers from 1029 nm to 1098 nm through the intracavity nonlinear polarization evolution (NPE) filter effect. The switchable CVBs between radially and azimuthally polarized beams with mode purity above 90% are generated by incorporating a broadband few-mode long-period fiber grating (LPFG). It is the first time to realize mode-locked CVBs near 1100 nm and the widest spectral tuning range in all-fiber laser is achieved to our knowledge. The pulsed CVBs at 1098 nm have 3 dB bandwidth of 0.31 nm with a pulse duration of 358ps.The narrow-bandwidth pulse of less than 1 nm is obtained among the whole tuning process which is of high flexibility and high tuning precision by introducing what we believe to be novel tuning mechanisms of NPE into the NALM cavity. The wide-range tunable CVBs all-fiber mode-locked laser has potential applications in high-capacity optical communication, laser imaging, and fiber optic sensing fields.
The effect of KUS121, a novel VCP modulator, against ischemic injury in random pattern flaps
Authors: Yoshimoto Koichi , Ikeguchi Ryosuke , Noguchi Takashi , Ando Maki , Sakamoto Daichi , Iwai Terunobu , Nishitani Kohei , Ikeda Hanako Ohashi , Kakizuka Akira , Matsuda Shuichi
Published: December 2024

Surgery using skin flaps is essential for soft tissue reconstruction. However, postoperative ischemic injury of the skin flap is a major complication and a top concern after the surgery. Currently, evidence-based drugs to fully prevent ischemic injury are not available. The purpose of this study was to evaluate the effect of KUS121, a VCP modulator, on flap ischemia using a rodent model. 26 Sprague-Dawley rats were randomly divided into two groups. The experimental group was intraperitoneally administered with 100 mg/kg KUS121 dissolved in 5% glucose solution 1 hour before surgery and once per day after surgery. The control group received the same amount of glucose solution on the same schedule. On day 7, 33.6 ± 3.7% of skin flaps in the control group had developed black necrosis compared with 26.4 ± 3.6% in the KUS121 group (p < 0.01). Immunohistochemistry showed that the KUS121 treatment reduced the number of apoptotic cells in the distal third of the flap (p < 0.01); moreover, in the KUS121-treated rats, the number of cells expressing CHOP, an endoplasmic reticulum (ER) stress marker, in the middle third of the flap was significantly lower than in the controls (p < 0.01). We examined the mRNA expression of Ddit3 (CHOP) and Casp3 (caspase-3) on day one after the surgery; mRNA expression of both genes appeared to decrease in the KUS121 group, as compared with the control group, although differences between groups were not significant. Thus, in a random pattern flap, KUS121 reduces ER stress and the number of apoptotic cells, thereby reducing ischemic damage of the flap.
Development of a molecular genetics and cell biology toolbox for the filamentous fungus Diplodia sapinea
Authors: Oostlander Anne Geertje , Brodde Laura , von Bargen Miriam , Slippers Bernard , Becker Yvonne , Brandt Ulrike , Klawonn Frank , Grobler Christiaan , Well Lucas , Stenlid Jan , Oliva Jonas , Elfstrand Malin , Fleissner Andre
Published: December 2024

Diplodia sapinea (Fr.) Fuckel is a widespread fungal pathogen affecting conifers worldwide. Infections can lead to severe symptoms, such as shoot blight, canker, tree death, or blue stain in harvested wood, especially in Pinus species. Its impact on forest health is currently intensified, likely due to climate change, posing an increasing threat to global ecosystems and forestry. Despite extensive and successful research on this pathogen system, fundamental questions about its biology and plant-associated lifestyle remain unanswered. Addressing these questions will necessitate the development of additional experimental tools, including protocols for molecular genetics and cell biology approaches. In this study, we continue to address this need by establishing an Agrobacterium-mediated genetic transformation protocol for D. sapinea, enabling targeted mutagenesis and heterologous gene expression. We utilized this methodology to localize the histone H2B by tagging it with the fluorescent protein mCherry. Additionally, we established a time- and space-efficient laboratory-scale infection assay using two-week-old Pinus sylvestris seedlings. Integrating these tools in a proof-of-concept study enabled the visualization of D. sapinea in planta growth through the fluorescently labeled reporter strain.
Identifying metaphors towards physiotherapists
Authors: Durdubas Rabia Tugba , Yildirim Yildiz , Yosmaoglu Hayri Baran
Published: December 2024

The aim of this study was to identify mental images that physiotherapists and student physiotherapists have regarding the concept of physiotherapist through metaphors. The study was a mixed-methods research that combined latent content analysis and categorical data analysis. Data were collected from 207 physiotherapists or physiotherapy students. Content analysis, a qualitative method, was performed on the raw data, which was composed of each participant’s statement completing the following sentence “Physiotherapist is like… because…”. Metaphors for physiotherapists were centered around 12 concepts. Most cited metaphor by student physiotherapists was “healer” (29.4%) and it was “guiding” (17.2%) for in-service physiotherapists. The rate of the "negative connotation" category in in-service physiotherapists (7.1%) was 2% higher than that of the student physiotherapists. Women mostly emphasized the "healer" (21.9%) category, while men mostly emphasized the "healer" and "supporter" (17.8%) categories. Participants aged under 25 and 26–35 age group were mostly in the "healer" category (26.4% and 18.8%, respectively) but the participants aged 36 years and over mostly opted for "guiding" and "supporter" (20.0%). There were fundamental differences between student physiotherapists and in-service physiotherapists in terms viewpoint regarding physiotherapy as a profession, and that these differences vary by gender and especially by age. During the undergraduate period, it will be beneficial to ensure that students have a realistic perspective with versatile training programs.
Phenotypic and molecular characterization of the largest worldwide cluster of hereditary angioedema type 1
Authors: Arias-Flórez Juan Sebastian , Ramirez Sandra Ximena , Bayona-Gomez Bibiana , Castro-Castillo Lina , Correa-Martinez Valeria , Sanchez-Gomez Yasmín , Usaquén-Martínez William , Casas-Vargas Lilian Andrea , Olmos Olmos Carlos Eduardo , Contreras Bravo Nora , Velandia-Piedrahita Camilo Andres , Morel Adrien , Cabrera-Perez Rodrigo , Santiago-Tovar Natalia , Gaviria-Sabogal Cristian Camilo , Bernal Ingrid Tatyana , Fonseca-Mendoza Dora Janeth , Restrepo Carlos M.
Published: December 2024

Hereditary angioedema type 1 (HAE1) is a rare, genetically heterogeneous, and autosomal dominant disease. It is a highly variable, insidious, and potentially life-threatening condition, characterized by sudden local, often asymmetric, and episodic subcutaneous and submucosal swelling, caused by pathogenic molecular variants in the SERPING1 gene, which codes for C1-Inhibitor protein. This study performed the phenotypic and molecular characterization of a HAE1 cluster that includes the largest number of affected worldwide. A geographically HAE1 cluster was found in the northeast Colombian department of Boyaca, which accounts for four unrelated families, with 79 suspected to be affected members. Next-Generation Sequencing (NGS) was performed in 2 out of 4 families (Family 1 and Family 4), identifying the variants c.1420C>T and c.1238T>G, respectively. The latter corresponds to a novel mutation. For Families 2 and 3, the c.1417G>A variant was confirmed by Sanger sequencing. This variant had been previously reported to the patient prior to the beginning of this study. Using deep-learning methods, the structure of the C1-Inhibitor protein, p.Gln474* and p.Met413Arg was predicted, and we propose the molecular mechanism related to the etiology of the disease. Using Sanger sequencing, family segregation analysis was performed on 44 individuals belonging to the families analyzed. The identification of this cluster and its molecular analysis will allow the timely identification of new cases and the establishment of adequate treatment strategies. Our results establish the importance of performing population genetic studies in a multi-cluster region for genetic diseases.
Ten-year trends in clinical characteristics and outcome of children hospitalized with severe wasting or nutritional edema in Malawi (2011–2021): Declining admissions but worsened clinical profiles
Authors: Chisala Mphatso Nancy , Bourdon Celine , Chimwezi Emmanuel , Daniel Allison I. , Makwinja Chikondi , Wang Dominic , Weise Linnea , Potani Isabel , Mbale Emmie , Bandsma Robert J. H. , Voskuijl Wieger P.
Published: December 2024

Background

Severe acute malnutrition (SAM) constitutes a substantial burden in African hospitals. Despite adhering to international guidelines, high inpatient mortality rates persist and the underlying contributing factors remain poorly understood.

Objective

We evaluated the 10-year trend (2011–2021) in clinical factors and outcomes among children with severe wasting and/or nutritional edema at Malawi’s largest nutritional rehabilitation unit (NRU).

Methods

This retrospective study analyzed trends in presentation and outcomes using generalized additive models. The association between clinical characteristics and mortality or readmission was examined and key features were also related to time to either mortality or discharge.

Results

1497 children (53%, females) were included. Median age at admission (23 months, IQR 14, 34) or anthropometry (i.e., weight-for-age, height-for-age and weight-for-height) did not change over the 10-years. But the prevalence of edema decreased by 40% whereas dehydration, difficulty breathing, and pallor became more common. Yearly HIV testing increased but positive-detection remained around 11%. Reporting of complete vaccination dropped by 49%, and no reduction in ‘watch’ antibiotic usage was detected. Overall admissions declined but mortality remained around 23% [95%CI; 21, 25], and deaths occurred earlier (5.6 days [95%CI; 4.6, 6.9] in 2011 vs. 3.5 days [95%CI; 2.5, 4.7] in 2021; p<0.001). Duration of hospitalization was shortened and readmissions surged from 4.9% [95%CI; 3.3, 7.4] in 2011 to 25% [95%CI; 18, 33] in 2021 (p<0.001). Age, wasting, having both dehydration and diarrhea, or having vomiting, cough, or difficulty breathing were associated with mortality but these associations did not show any interaction over time.

Conclusion

Over 10 years, mortality risk remained high among hospitalized children with SAM and coincided with worsened clinical presentation at admission and increased readmission. Longitudinal data from major NRUs can identify shifts in clinical profiles or outcomes, and this information can be leveraged to promote earlier care-seeking, improved risk stratification, and implementation of more patient-centered treatments.
Correlation between individual thigh muscle volume and grip strength in relation to sarcopenia with automated muscle segmentation
Authors: Kim Hyeon Su , Kim Shinjune , Kim Hyunbin , Cha Yonghan , Kim Jung-Taek , Kim Jin-Woo , Ha Yong-Chan , Yoo Jun-Il
Published: December 2024

Introduction

Grip strength serves as a significant marker for diagnosing and assessing sarcopenia, particularly in elderly populations. The study aims to explore the relationship between individual thigh muscle volumes and grip strength, leveraging advanced AI-based UNETR segmentation techniques for accurate muscle volume assessment.

Methods

The study included 49 participants from a cohort of 478 patients diagnosed with hip fractures at Gyeongsang National University Hospital. We recorded Grip strength and height and utilized UNETR-based segmentation techniques on CT scans, to calculate individual thigh muscle volumes. Point-biserial correlation was employed to explore the relationship between sarcopenia and thigh muscle volumes. The research also included a quantile analysis of grip strength.

Results

Our findings revealed a strong statistical significance in specific thigh muscles like Rectus femoris, Vastus lateralis, and Vastus intermedius, particularly in males, in relation to sarcopenia. The male cohort displayed a trend where higher thigh muscle volumes correlated with better grip strengths. Meanwhile no such relationship was found within the female group.

Conclusion

The findings indicate that stronger grip strength correlates with larger thigh muscles in males but not in females, with specific muscles like the Rectus femoris and Vastus lateralis linked to sarcopenia in men only. The study’s small sample size calls for further research with more diverse and gender-balanced groups to verify these results.
Optimizing RNA extraction methods for high-throughput transcriptome sequencing of formalin-fixed paraffin-embedded cardiac tissue specimens
Authors: Odogwu Nkechi Martina , Jang Jin Sung , Albertson Sabrina , Hagen Clinton , Rasmussen Boyd , Saji Oommen , Nelson Timothy J. ,   the Wanek Program Preclinical Pipeline
Published: December 2024

Archived FFPE cardiac tissue specimens are valuable for molecular studies aimed at identifying biomarkers linked to mortality in cardiovascular disease. Establishing a reliable and reproducible RNA extraction method is critical for generating high-quality transcriptome sequences for molecular assays. Here, the efficiency of four RNA extraction methods: Qiagen AllPrep DNA/RNA method (Method QP); Qiagen AllPrep DNA/RNA method with protocol modification on the ethanol wash step after deparaffinization (Method QE); CELLDATA RNA extraction (Method BP) and CELLDATA RNA extraction with protocol modifications on the lysis step (Method BL) was compared on 23 matching FFPE cardiac tissue specimens (n = 92).In comparing RNA quality metrics across FFPE RNA extract, nucleic acids extracted deploying Method QE and QP produced the highest RNA yield. However, Method QE outperformed Method QP as more extract from Method QE had DV 200 values above 30%. Both method BL and BP produced similar range of RNA purity and yield but more extract from Method BL had DV 200 values above 30% compared to Method BP. When accessing distribution value, Method BL outperformed Methods BP, QE, and QP as more extracts from Method BL had DV 200 values above 30% compared to other methods (PDV200<0.001; Kruskal-Wallis). Method QE outperformed other methods in terms of RNA yield. RNA extracts from Method QE, characterized by high RNA yield, achieved sequencing results comparable to those from Method BL, characterized by high DV200 values. Our findings reveal that optimizing protocols can yield higher-quality RNA, facilitating the exploration of more disease conditions with high-resolution transcriptome profiling.
Evaluation of antibiotic treatment initiation and duration practices in primary care. Cross-sectional study in two French multi-professional health centers
Authors: Ferme Simon , Piednoir Emmanuel , Delestre Marianne , Fiaux Elise , Masik Johann , Verdon Renaud , Thibon Pascal
Published: December 2024

Antibiotic resistance poses a significant human and economic burden. In France, which ranks among the highest consumers of antibiotics in Europe, 93% of prescriptions are issued in primary care, primarily for respiratory tract infections. It is crucial to limit both the indications and the duration of antibiotic prescriptions, with recently updated recommendations in France aimed at achieving this goal. Our main objective was to evaluate whether general practitioners’ antibiotic initiation and prescription durations for respiratory infections align with these recommendations. In this prospective cross-sectional study conducted over six weeks in two multi-professional health centers, all consultations for respiratory infections (in both adults and children) documented in patients’ medical records were reviewed. Overall, 46.8% (N = 334/714) of consultations resulted in an antibiotic prescription (15.8% for nasopharyngitis and 83.5% for acute cough and bronchitis). Compliance with recommended antibiotic durations was observed in 66.7% (N = 476/714) [95% CI: 63.1%-70.0%] of consultations, with adherence rates exceeding 80% for nasopharyngitis and pharyngitis but falling below 20% for community-acquired pneumonia and acute cough and bronchitis. In total, 1,194 excess days of antibiotic therapy were identified, with an average excess of 1.7 days per prescription [95% CI: 1.4–1.9]. There remains significant room for improvement in both reducing the initiation of antibiotic treatments and shortening their prescribed durations. Managing acute coughs and bronchitis continues to be one of the key challenges in primary care. For nasopharyngitis, the high frequency of this condition translates into potentially large prescribing volumes on a collective scale. Efforts to promote the new paradigm of "shorter is better" for antibiotic prescription durations need to be intensified.
Association between food insecurity and overweight: Protocol for a systematic review based on intersectionality of gender and race/color
Authors: Brito Renatha Celiana da Silva , Palmeira Poliana de Araújo , Laurentino Jackson Silva Lima , Silva Rônisson Thomas de Oliveira , Santos Ana Beatriz Macêdo Venâncio dos , Oliveira Angelo Giuseppe Roncalli da Costa
Published: December 2024

Food insecurity violates the right to regular access to quality food, affecting population groups unequally. In Brazil, FI is associated with both malnutrition and increased obesity and is intertwined with racial and gender inequalities, perpetuating cycles of poverty and social exclusion. This protocol aims to select observational studies that evaluate the association between food insecurity and overweight and their intersectional discussions (gender and race/color). The PRISMA checklist guidelines will be applied, and the PROSPERO platform will be used for registration. Searched in the Virtual Health Library (Lilacs-BVS), Medline PubMed, Web of Science, and Embase Elsevier databases. The stages of article selection and information extraction will be carried out by independent researchers who will identify articles that meet the established inclusion criteria, removing duplicate publications and excluding those that do not meet the requirements. The quality of eligible articles will be assessed using the Quality Assessment Tool For Quantitative Studies (QATFQS), which is recommended for observational studies. This study is not needed for ethical approval, as it is a systematic review based on secondary data. They will disseminate their conclusions from the original articles.

PROSPERO registration number: CRD42023427239.
Estuarine dispersal of an invasive Holarctic predator (Esox lucius) confirmed in North America
Authors: Wooller Matthew J. , Bradley Parker , Spaleta Karen J. , Massengill Robert L. , Dunker Kristine , Westley Peter A. H.
Published: December 2024

The capacity for a non-native species to become invasive largely hinges on existing dispersal capacity or adaptation of dispersal in new environments. Here we provide early evidence that invasive Northern Pike (Esox lucius), a Holarctic freshwater top predator, illegally introduced in the late 1950s into Southcentral Alaska, are now dispersing through estuarine corridors. This finding represents the first known documentation of estuary use and dispersal by Northern Pike in North America, exacerbating conservation concerns for already depressed populations of culturally and economically important species such as salmonids. To reconstruct the migratory pathway of individual Northern Pike captured at locations known to be recently invaded, we analyzed the strontium isotope composition (87Sr/86Sr) in otoliths. In Vogel Lake, where Northern Pike were first observed in 2019, the smallest (youngest) Northern Pike collected had relatively constant 87Sr/86Sr values consistent with 87Sr/86Sr values of freshwater samples from the region and indicating a wholly freshwater existence. However, the largest Northern Pike (95.5 cm) in Vogel Lake had isotopic signatures indicating its early life had been in an estuarine habitat before moving into Vogel Lake through a short 4.8 km creek connecting it to the ocean. We subsequently analyzed otoliths from two other Northern Pike, from two additional separate locations in Southcentral Alaska, revealing signatures consistent with colonization through an estuarine corridor. It is unclear whether estuarine dispersal ability has evolved de novo in these Northern Pike populations or was retained by plasticity. Regardless, this early evidence is of considerable concern in Alaska and other regions of North America confronting Northern Pike introductions and underscores the urgency to monitor connected freshwater systems most vulnerable to invasion via adjoining estuarine habitats.
The impact of Cochrane Reviews that apply network meta-analysis in clinical guidelines: A systematic review
Authors: Donegan Sarah , Connor James , Alfirevic Zarko , Tudur-Smith Catrin
Published: December 2024

Background

Systematic reviews, such as those prepared by Cochrane, are the strongest evidence on which to base recommendations in clinical guidelines. Network meta-analysis (NMA) can be used to combine the results of studies to compare multiple treatments, which is advantageous over pair-wise meta-analysis (PW-MA) that compares two treatments. We aimed to summarise which, when, where, who, and why Cochrane Reviews that applied NMA were cited in guidelines; and to compare the citation of NMA reviews in guidelines with PW-MA reviews.

Methods and findings

We carried out a systematic review of Cochrane reviews that applied NMA and we summarised their citation in guidelines. The Cochrane Database of Systematic Reviews was searched (15th January 2024). Additionally, a cohort of Cochrane reviews that applied PW-MA was matched to the NMA reviews. Two authors assessed eligibility and extracted data. We summarised review and guideline characteristics, and the use of the review in guidelines.

Results

Of the 60 included NMA reviews, 26 reviews (43%) were cited in 89 guidelines (1–13 per review). 15 NMA reviews (58%) were first cited within two years of publication, with the remaining 11 reviews (42%) cited 2–6 years later. 52 guideline developers authored the guidelines. The number of citations was higher for NMA than PW-MA reviews (rate ratio 1.53 (1.08 to 2.19), p = 0.02). The number of times reviews were commissioned or cited alongside a recommendation was also higher for NMA than PW-MA reviews (rate ratio 4.40 (1.80 to 13.14), p = 0.003). NMA reviews were more likely to be cited in the text surrounding a recommendation or used for NICE guideline development (1.94 (1.08 to 3.63), p = 0.03).

Conclusions

Cochrane NMA reviews appear to have more impact than PW-MA reviews, but many are not cited in guidelines. Further work is needed to explore the barriers to use of NMAs and promote their use.
DeBo: Contrast enhancement for image registration using binary differential evolution and bat optimization
Authors: Akram Muhammad Adeel , Akram Tallha , Javed Umer , Rafiq Muhammad , Naz Mehvish , He Di
Published: December 2024

Image registration has demonstrated its significance as an essential tool for target recognition, classification, tracking, and damage assessment during natural catastrophes. The image registration process relies on the identification of numerous reliable features; thus, low resolutions, poor lighting conditions, and low image contrast substantially diminish the number of dependable features available for registration. Contrast stretching enhances image quality, facilitating the object detection process. In this study, we proposed a hybrid binary differential evolution and BAT optimization model to enhance contrast stretching by optimizing a decision variables in the transformation function. To validate its efficiency, the proposed approach is utilized as a preprocessor before feature extraction in image registration. Cross-comparison of detected features of enhanced images verses the original images during image registration validate the improvements in the image registration process.
Machine learning-based pipeline for automated intracerebral hemorrhage and drain detection, quantification, and classification in non-enhanced CT images (NeuroDrAIn)
Authors: Elsheikh Samer , Elbaz Ahmed , Rau Alexander , Demerath Theo , Kellner Elias , Watzlawick Ralf , Würtemberger Urs , Urbach Horst , Reisert Marco
Published: December 2024

Background and purpose

External drainage represents a well-established treatment option for acute intracerebral hemorrhage. The current standard of practice includes post-operative computer tomography imaging, which is subjectively evaluated. The implementation of an objective, automated evaluation of postoperative studies may enhance diagnostic accuracy and facilitate the scaling of research projects. The objective is to develop and validate a fully automated pipeline for intracerebral hemorrhage and drain detection, quantification of intracerebral hemorrhage coverage, and detection of malpositioned drains.

Materials and methods

In this retrospective study, we selected patients (n = 68) suffering from supratentorial intracerebral hemorrhage treated by minimally invasive surgery, from years 2010–2018. These were divided into training (n = 21), validation (n = 3) and testing (n = 44) datasets. Mean age (SD) was 70 (±13.56) years, 32 female. Intracerebral hemorrhage and drains were automatically segmented using a previously published artificial intelligence-based approach. From this, we calculated coverage profiles of the correctly detected drains to quantify the drains’ coverage by the intracerebral hemorrhage and classify malpositioning. We used accuracy measures to assess detection and classification results and intraclass correlation coefficient to assess the quantification of the drain coverage by the intracerebral hemorrhage.

Results

In the test dataset, the pipeline showed a drain detection accuracy of 0.97 (95% CI: 0.92 to 0.99), an agreement between predicted and ground truth coverage profiles of 0.86 (95% CI: 0.85 to 0.87) and a drain position classification accuracy of 0.88 (95% CI: 0.77 to 0.95) resulting in area under the receiver operating characteristic curve of 0.92 (95% CI: 0.85 to 0.99).

Conclusion

We developed and statistically validated an automated pipeline for evaluating computed tomography scans after minimally invasive surgery for intracerebral hemorrhage. The algorithm reliably detects drains, quantifies drain coverage by the hemorrhage, and uses machine learning to detect malpositioned drains. This pipeline has the potential to impact the daily clinical workload, as well as to facilitate the scaling of data collection for future research into intracerebral hemorrhage and other diseases.
Effect of glyceryl trinitrate and clevidipine administration on CT angiogram findings in dogs undergoing prostatic artery embolization for prostatic carcinoma
Authors: Griffin Maureen A. , Culp William T. N. , Chohan Amandeep S. , Johnson Eric G. , Giuffrida Michelle A. , Palm Carrie A. , Rebhun Robert B. , Kent Michael S.
Published: December 2024

Objectives

The primary aim of this study was to evaluate the effects of vasodilator administration on CT angiography (CTA) prostatic artery diameter and peak opacification in dogs with prostatic carcinoma prior to prostatic artery embolization (PAE).

Materials and methods

A prospective clinical trial was performed. Ten dogs with naturally occurring prostatic carcinoma and no evidence of cardiovascular disease were enrolled. Each dog underwent multiphase CTA of the prostate before and after IV vasodilator (glyceryl trinitrate [GTN] or clevidipine butyrate [clevidipine]) administration, and cardiovascular parameters were monitored. PAE was performed the following day. Prostatic arterial anatomy was characterized by CTA. Prostatic artery lumen diameter and peak opacification were measured on pre- and post-vasodilator CTA by a blinded radiologist. The percent change of these measurements was calculated and assessed for significance.

Results

Glyceryl trinitrate and clevidipine were administered in 5 dogs each with subsequent blood pressure reduction documented in all dogs. No significant difference was detected in prostatic artery diameter or peak opacification between pre- vs. post-vasodilator CTA. Good agreement in prostatic arterial branch number, origin, and course was documented between pre- and post-vasodilator CTA images.

Clinical significance

Study findings do not support the routine use of vasodilator administration during pre-PAE CTA in dogs, though larger sample sizes and protocol alterations may be needed to detect a clinically relevant utility.