bluuebunny/crossref_metadata_2025_split huggingface dataset:
Repetitive peripheral magnetic stimulation alone or in combination with repetitive transcranial magnetic stimulation in poststroke rehabilitation: a systematic review and meta-analysis
Authors: Wang Yong , Fong Kenneth N. K. , Sui Youxin , Bai Zhongfei , Zhang Jack Jiaqi 
Published: October 2024

Abstract
Objective
This study aimed to comprehensively review the effects of repetitive peripheral magnetic stimulation (rPMS) alone or in combination with repetitive transcranial magnetic stimulation (rTMS) on improving upper limb motor functions and activities of daily living (ADL) in patients with stroke, and to explore possible efficacy-related modulators.

Methods
A literature search from 1st January 2004 to 1st June 2024 was performed to identified studies that investigated the effects of rPMS on upper limb motor functions and ADL in poststroke patients.

Results
Seventeen studies were included. Compared with the control, both rPMS alone or rPMS in combination with rTMS significantly improved upper limb motor function (rPMS: Hedge’s g = 0.703, p = 0.015; rPMS + rTMS: Hedge’s g = 0.892, p < 0.001) and ADL (rPMS: Hedge’s g = 0.923, p = 0.013; rPMS + rTMS: Hedge’s g = 0.923, p < 0.001). However, rPMS combined with rTMS was not superior to rTMS alone on improving poststroke upper limb motor function and ADL (Hedge’s g = 0.273, p = 0.123). Meta-regression revealed that the total pulses (p = 0.003) and the number of pulses per session of rPMS (p < 0.001) correlated with the effect sizes of ADL.

Conclusions
Using rPMS alone or in combination with rTMS appears to effectively improve upper extremity functional recovery and activity independence in patients after stroke. However, a simple combination of these two interventions may not produce additive benefits than the use of rTMS alone. Optimization of rPMS protocols, such as applying appropriate dosage, may lead to a more favourable recovery outcome in poststroke rehabilitation.
PrescDRL: deep reinforcement learning for herbal prescription planning in treatment of chronic diseases
Authors: Yang Kuo , Yu Zecong , Su Xin , Zhang Fengjin , He Xiong , Wang Ning , Zheng Qiguang , Yu Feidie , Wen Tiancai , Zhou Xuezhong 
Published: October 2024

AbstractTreatment planning for chronic diseases is a critical task in medical artificial intelligence, particularly in traditional Chinese medicine (TCM). However, generating optimized sequential treatment strategies for patients with chronic diseases in different clinical encounters remains a challenging issue that requires further exploration. In this study, we proposed a TCM herbal prescription planning framework based on deep reinforcement learning for chronic disease treatment (PrescDRL). PrescDRL is a sequential herbal prescription optimization model that focuses on long-term effectiveness rather than achieving maximum reward at every step, thereby ensuring better patient outcomes. We constructed a high-quality benchmark dataset for sequential diagnosis and treatment of diabetes and evaluated PrescDRL against this benchmark. Our results showed that PrescDRL achieved a higher curative effect, with the single-step reward improving by 117% and 153% compared to doctors. Furthermore, PrescDRL outperformed the benchmark in prescription prediction, with precision improving by 40.5% and recall improving by 63%. Overall, our study demonstrates the potential of using artificial intelligence to improve clinical intelligent diagnosis and treatment in TCM.
Evaluation of global and regional myocardial work by echocardiography in patients with Fabry disease
Authors: Wang Han , Yang Ying , Liu Lin , Zhao Yawen , Li Yang , Zhang Wei , Ma Wei 
Published: October 2024

Abstract
Background
This study aimed to quantitatively evaluate the left ventricular global and regional myocardial work of patients in Fabry disease (FD) by echocardiographic pressure–strain loop (PSL) analysis.

Results
The study included 48 patients with FD and 48 healthy controls matched for age and sex. According to the presence/absence of left ventricular hypertrophy (LVH), the patients with FD were divided into an LVH + group and an LVH– group. Left ventricular blood pressure was estimated noninvasively according to echocardiographic valvular events and systolic pressure in the brachial artery. Left ventricular myocardial work parameters were acquired by echocardiographic pressure–strain loop analysis.
The FD groups had a significantly lower global longitudinal strain (GLS), global work index, global work efficiency (GWE), global constructive work and higher global waste work than the control group (P < .05). Regional analysis showed that all segmental myocardial waste work increased and myocardial work efficiency decreased in the LVH + group than in the LVH– group (P < .05). Segmental longitudinal strain, myocardial work index, and myocardial constructive work were markedly lower in the basal and middle segments (P < .05) and preserved in the apical segments. Multivariate analysis revealed that GWE and GLS were significant related to LVH.

Conclusions
Myocardial work analysis can be used to assess global and regional myocardial work in patients with FD. In this study, GLS and GWE were reduced in patients with FD and associated with the presence of LVH. Basal and middle myocardial work decreased in relation to the LVH, while apical myocardial work remained, which added value to explore the distribution of myocardial impairment.
A comprehensive lifestyle index and its associations with DNA methylation and type 2 diabetes among Ghanaian adults: the rodam study
Authors: Abidha C. A. , Meeks K. A. C. , Chilunga F. P. , Venema A. , Schindlmayr R. , Hayfron-Benjamin C. , Klipstein-Grobusch Kerstin , Mockenhaupt Frank P. , Agyemang C. , Henneman P. , Danquah I. 
Published: October 2024

Abstract
Background
A series of modifiable lifestyle factors, such as diet quality, physical activity, alcohol intake, and smoking, may drive the rising burden of type 2 diabetes (T2DM) among sub-Saharan Africans globally. It is unclear whether epigenetic changes play a mediatory role in the associations between these lifestyle factors and T2DM. We assessed the associations between a comprehensive lifestyle index, DNA methylation and T2DM among Ghanaian adults.

Methods
We used whole-blood Illumina 450 k DNA methylation data from 713 Ghanaians from the Research on Obesity and Diabetes among African Migrants (RODAM) study. We constructed a comprehensive lifestyle index based on established cut-offs for diet quality, physical activity, alcohol intake, and smoking status. In the T2DM-free discovery cohort (n = 457), linear models were fitted to identify differentially methylated positions (DMPs) and differentially methylated regions (DMRs) associated with the lifestyle index after adjustment for age, sex, body mass index (BMI), and technical covariates. Associations between the identified DMPs and the primary outcome (T2DM), as well as secondary outcomes (fasting blood glucose (FBG) and HbA1c), were determined via logistic and linear regression models, respectively.

Results
In the present study population (mean age: 52 ± 10 years; male: 42.6%), the comprehensive lifestyle index showed a significant association with one DMP annotated to an intergenic region on chromosome 7 (false discovery rate (FDR) = 0.024). Others were annotated to ADCY7, SMARCE1, AHRR, LOXL2, and PTBP1 genes. One DMR was identified and annotated to the GFPT2 gene (familywise error rate (FWER) from bumphunter bootstrap = 0.036). None of the DMPs showed significant associations with T2DM; directions of effect were positive for the DMP in the AHRR and inverse for all the other DMPs. Higher methylation of the ADCY7 DMP was associated with higher FBG (p = 0.024); LOXL2 DMP was associated with lower FBG (p = 0.023) and HbA1c (p = 0.049); and PTBP1 DMP was associated with lower HbA1c (p = 0.002).

Conclusions
In this explorative epigenome-wide association study among Ghanaians, we identified one DMP and DMR associated with a comprehensive lifestyle index not previously associated with individual lifestyle factors. Based on our findings, we infer that lifestyle factors in combination, affect DNA methylation, thereby influencing the risk of T2DM among Ghanaian adults living in different contexts.
Octonion quadratic-phase Fourier transform: inequalities, uncertainty principles, and examples
Authors: Kumar Manish , Bhawna  
Published: October 2024

AbstractIn this article, we define the octonion quadratic-phase Fourier transform (OQPFT) and derive its inversion formula, including its fundamental properties such as linearity, parity, modulation, and shifting. We also establish its relationship with the quaternion quadratic-phase Fourier transform (QQPFT). Further, we derive the Parseval formula and the Riemann–Lebesgue lemma using this transform. Furthermore, we formulate two important inequalities (sharp Pitt’s and sharp Hausdorff–Young’s inequalities) and three main uncertainty principles (logarithmic, Donoho–Stark’s, and Heisenberg’s uncertainty principles) for the OQPFT. To complete our investigation, we construct three elementary examples of signal theory with graphical interpretations to illustrate the use of OQPFT and discuss their particular cases.
Preparation of α-zein loaded with baicalincomposites: A study on their in vitro simulated digestive behavior and molecular dynamics simulation
Authors: Zhou RunCheng , Liang QiLin , Lei Han , Liang Tianci , Chen Simin , Chen Xin 
Published: October 2024

AbstractIn order to improve the bioavailability of baicalin, this article prepared for α-zein loaded with baicalin composites (α-zein@BA) by pH driven method and they were characterized using scanning electron microscopy, infrared spectroscopy, and measurement of particle size distribution in water solution phase techniques. The digestive behavior and antioxidant activity of composites before and after simulating gastrointestinal fluid in vitro were studied as well. At the same time, molecular dynamics simulation techniques were used to reveal the molecular mechanism behind the formation of the composite between the two. The results indicated that the composites of α-zein@BA were observed to be approximately spherical under a scanning electron microscope, and their particle size was mainly distributed in the range of 94.55-145.10 μm in aqueous solution, whose encapsulation efficiency of baicalin was (86.61 ± 0.71) %. Infrared spectroscopy analysis indicated that α-zein and baicalin mainly formed complexes through hydrogen bonding, electrostatic and hydrophobic interactions. The measurement results of baicalin residue in simulated digestion of gastric and intestinal fluids in vitro are as follows: α-zein@BA > Baicalin, while both significantly increased in the gastric digestion stage (P < 0.05) and significantly decreased in the intestinal digestion stage (P < 0.05). Molecular dynamics simulation studies have shown that baicalin has a promoting effect on protein structural stability, and protein 158SER and GLN196 were mainly formed hydrogen bonds with it, while hydrophobic interactions were mainly manifested between non-polar amino acids such as PHE201 and PRO200. This study indicates that α-zein and baicalin can form stable composites, improving the bioavailability of baicalin.
Comprehensive atlas of mitochondrial distribution and dynamics during oocyte maturation in mouse models
Authors: Hao Xia , Zhao Jian , Rodriguez-Wallberg Kenny A. 
Published: October 2024

Abstract
Background
Oocytes, the largest cells in mammals, harbor numerous mitochondria within their cytoplasm. These highly dynamic organelles are crucial for providing energy resources and serving as central regulators during oogenesis. Mitochondrial dynamics ensure proper energy distribution for various cellular processes involved in oocyte maturation. Previous studies have used alterations in mitochondrial distribution as a biomarker to assess the oocyte health. However, there are discrepancies between studies regarding mitochondrial distribution profiles in healthy oocytes. Consequently, a comprehensive mitochondrial distribution profile in oocytes during maturation has not been fully characterized. Additionally, there is a lack of objective, quantitative methods to evaluate alterations in mitochondrial distribution profiles in oocytes.

Methods
This study aims to provide an in-depth overview of mitochondrial distribution profiles in mouse oocytes at different maturation stages: germinal vesicle (GV) stage, metaphase I (MI), and mature metaphase II (MII). Freshly collected mouse GV, MI and MII oocytes were stained with MitoTracker Red. Confocal microscopy was used to obtain images of mitochondrial distribution profiles in these oocytes. Using the Imaris software, we reconstructed three-dimensional (3D) surface renderings of each oocyte and quantitatively illustrated the mitochondrial distribution profiles.

Results
At the GV stage, mitochondria in oocytes were evenly distributed throughout the ooplasm. As oocytes progressed to MI and MII stages, mitochondria aggregated and formed clusters, the mean size of mitochondrial clusters and the proportions of clustered mitochondria increased along with the maturation of oocytes.

Conclusions
Our findings reveal that mitochondria in mouse oocytes are highly dynamic, undergoing significant reorganizations during oocyte maturation. We for the first time provided comprehensive mitochondrial distribution profiles in mouse oocytes at the GV, MI and MII stages. These mitochondrial distribution profiles were further quantitatively evaluated. Our methods provide an objective and standardized approach for evaluating alterations in mitochondrial dynamics, which can be used as biomarkers to monitor oocyte conditions during maturation.
Academic psychiatry is everyone's business
Authors: Critchley Hugo D. , Tracy Derek K. , Malhi Gin S. , Alexander Laith , Baldwin David S. , Cavanagh Jonathan , Chamberlain Samuel R. , Cipriani Andrea , Farooq Saeed , Hassiotis Angela , Howes Oliver , Jauhar Sameer , Lawrie Stephen M. , Lagunes-Cordoba Emmeline , Lingford-Hughes Anne , MacCabe James H. , Memon Ismail , Mulholland Ciaran , Sami Musa , Sayal Kapil , Shankar Rohit , Sinclair Lindsey , Sparasci Oliver , Staufenberg Ekkehart F. A. , Stirland Lucy E. , Stokes Paul R. A. , Jones Charlotte Wilson , Woodruff Peter W. R. , Young Allan H. 
Published: October 2024

SummaryThis editorial considers the value and nature of academic psychiatry by asking what defines the specialty and psychiatrists as academics. We frame academic psychiatry as a way of thinking that benefits clinical services and discuss how to inspire the next generation of academics.
Posterior Reduction and Temporary Fixation Through Intermuscular Approach for Odontoid Fracture
Authors: Xu Zhenji , Wu Ji , Wang Haibin , Chen Changhong , Zhang Bangke , Lu Xuhua , Ni Bin , Chen Fei , Guo Qunfeng 
Published: October 2024

BACKGROUND AND OBJECTIVE:
Posterior reduction and temporary fixation (PRTF) through open approach can effectively avoid the loss of C1-C2 motion caused by posterior atlantoaxial fusion in the treatment of odontoid fracture. PRTF through intermuscular approach can preserve the integrity of the paravertebral muscle. However, its contribution to the preservation of C1-C2 rotation remains unassessed in the context of fresh odontoid fractures.

METHODS:
The data of 31 patients with odontoid fractures who underwent PRTF through intermuscular approach were retrospectively reviewed. Operation time, intraoperative blood loss, the time of ambulation and surgery-related complications were recorded. After fracture healing, the instrumentation was removed. The Japanese Orthopedic Association score, Visual Analog Scale score for neck pain, and patient satisfaction were recorded. The range of motion in rotation of C1-C2 was calculated 1 month after removing the instrumentation.

RESULTS:
Fracture healing was observed in all patients, and the instrumentation was removed. After removing the instrumentation, the range of motion of C1-C2 in rotation was returned to 35.6° ± 4.8°. Patient satisfaction was improved (P < .05). There was no significant difference in Japanese Orthopedic Association scores and Visual Analog Scale score for neck pain between 2 values before and after removing the instrumentation (P > .05). No osteoarthritis was observed at the C1-C2 lateral mass joints. There were no perioperative complications.

CONCLUSION:
PRTF through intermuscular approach can be used as a salvage treatment of an odontoid fracture with an intact transverse ligament in cases of failure of, or contraindication to, anterior screw fixation. This minimally invasive technique can effectively preserve the rotational function of the atlantoaxial complex.
Burden of congenital and hereditary anomalies and their epidemiological attributes in the pediatric and adult population of Peshawar valley, Pakistan
Authors: Syeda Farwa Naqvi  , Umi Ameena  , Waheed Uddin Qazi  , Sulman Ahmad  , Anjum Iqbal  , Sajid Malik  
Published: October 2024

Objectives: To elucidate the burden and clinico-epidemiological attributes of congenital and hereditary anomalies (CA) in the extended Peshawar Valley of Pakistan.
Method: This is a multicenter cross sectional study carried out in Buner, Charsadda, Mardan, Nowshera, Peshawar and Swabi districts, during 2017-2021. The pediatric and adult patients with CA were recruited from hospitals, public places and through door-to-door surveys. The anomalies were classified with the help of specialized clinicians. Descriptive statistics was employed.
Results: In this study, 1065 independent subjects with certain types of CA from independent households were included. The index males were 71%; the majority of subjects originated from rural areas (72%), and spoke Pashto (96%). The CA were categorized into 10 major and at least 104 minor categories. There was highest representation of neurological disorders, n=375 (proportion.: 0.352; 95% CI: 0.323-0.381), followed by limb defects (n=281; prop.: 0.264), sensorineural defects (n=128; prop.: 0.120), musculoskeletal defects (n=84; prop.: 0.079), visual impairments (n=67; prop.: 0.063), hemoglobinopathies (n=40; prop.: 0.038), ectodermal disorders (n=34; prop.: 0.032), cardiovascular anomalies (n=19; prop.: 0.018), and orofacial anomalies (n=19; prop). Among the neurological disorder, intellectual disabilities and cerebral palsy were highly prevalent. The majority of the cases had a sporadic presentation (68%), and isolated occurrence (72%), whereas parental consanguinity was witnessed in 58% of cases.
Conclusion: A wide range of CA were witnessed in this cohort with a preponderance of neurological disorders. The majority of the anomalies are of severe nature rendering a high morbidity burden in the population and requiring early detection, intervention and management.
doi: https://doi.org/10.12669/pjms.40.10.9234
How to cite this: Naqvi SF, Ameena U, Qazi W, Ahmad S, Iqbal A, Malik S. Burden of congenital and hereditary anomalies and their epidemiological attributes in the pediatric and adult population of Peshawar valley, Pakistan. Pak J Med Sci. 2024;40(10):2181-2189. doi: https://doi.org/10.12669/pjms.40.10.9234
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 efficacy of acupuncture-assisted blind insertion of bullet nasointestinal tube method in patients with ischemic stroke: A retrospective study
Authors: Zhao Hongyan , Chen Jiayu , Chen Huan , Lv Xiaoxia , Lu Zhenchan , Sun Yanhua 
Published: October 2024

Objective: To explore the efficacy of Traditional Chinese Medicine (TCM) acupuncture-assisted blind insertion of bullet nasointestinal tube method in patients with ischemic stroke.
Methods: This is a retrospective study using clinical records of 180 patients with ischemic stroke, hospitalized in the Department of Neurology of the Zhejiang Province Tertiary Class A Hospital, Huzhou, China from July 2022 to June 2023. The patients were divided into two groups on the basis of the nasogastric tube insertion method. We selected 90 patients for each group from the database of records by using a random list method. Patients in the observation group underwent TCM acupuncture-assisted blind insertion of nasointestinal tube and those in the control group underwent the traditional bedside blind insertion of bullet nasointestinal tube. Success rate of tube insertion, average tube insertion time, intragastric insertion time, stomach time to jejunal insertion, patient comfort, and patient satisfaction in both groups were compared.
Results: The success rate of nasointestinal tube insertion was significantly higher in the observation group compared to the control group (96.6% and 88.9%, p<0.05). There was no statistically significant difference in the time of nasoenteral tube insertion into the stomach (p>0.05). The insertion time from stomach to jejunum in the observation group was significantly shorter than in the control group (p<0.05). The patient comfort and satisfaction levels were significantly higher in the observation group compared to the control group (p<0.05).
Conclusion: TCM acupuncture-assisted blind insertion of bullet nasointestinal tube method improves the success rate of tube insertion, shortens the average catheterization time from the stomach to the jejunum and improves patient’s comfort and satisfaction.
doi: https://doi.org/10.12669/pjms.40.10.9936
How to cite this: Zhao H, Chen J, Chen H, Lv X, Lu Z, Sun Y. The efficacy of acupuncture-assisted blind insertion of bullet nasointestinal tube method in patients with ischemic stroke: A retrospective study. Pak J Med Sci. 2024;40(10):2208-2212. doi: https://doi.org/10.12669/pjms.40.10.9936
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.
Newest “co-members” of the 1000s club: A case of severe transaminitis secondary to Epstein-Barr and dengue virus co-infection in a returning traveler
Authors: Tahvildar Parsa , Atalla Marina , Tahir Rabia , Cheung Andrew 
Published: October 2024

Background: Timely identification of the etiology of transaminitis is critical in informing subsequent management as strategies can vary from supportive care to urgent transplant assessment. This is especially important in returning travelers as there may be multiple causes of injury that need to be addressed. Case report: We present a case of severe transaminitis secondary to non-hepatitis viral co-infections. A 28-year-old south Asian male returning traveler presented with an acute liver injury (aspartate aminotransferase/alanine aminotransaminase levels of >4000 IU/l) and marked jaundice. A thorough and expanded work-up of acute hepatitis was negative aside from positive mononucleosis spot testing and positive dengue fever serologies. This atypical presentation of mononucleosis and dengue fever was managed conservatively, and the patient was discharged with outpatient follow-up after an eight-day admission. Conclusions: Usually, non-hepatitis viruses typically do not present with severe transaminitis or hyperbilirubinemia. These viruses, such as infectious mononucleosis and dengue fever, may work synergistically to cause an elevated inflammatory response, resulting in severe transaminitis in returning travelers. In the absence of a classic clinical presentation, clinicians should be aware of co-infections in returning travelers and test for them based on a thorough history and physical examination.