bluuebunny/crossref_metadata_2025_split huggingface dataset:
A review on marine collagen: sources, extraction methods, colloids properties, and food applications
Authors: Farooq Shahzad , Ahmad Muhammad Ijaz , Zheng Shijie , Ali Usman , Li Yang , Shixiu Cui , Zhang Hui 
Published: March 2024

AbstractThe growing interest in valorizing industrial by-products has led researchers to focus on exploring different sources and optimizing collagen extraction conditions over the past decade. While bovine hide, cattle bones, pork, and pig skins remain the most abundant collagen sources, there is a growing trend in the industrial utilization of collagen from non-mammalian species. This review explores alternative marine collagen sources and summarizes emerging trends in collagen recovery from marine sources, with a particular focus on environmentally friendly methods. Additionally, this review covers the colloidal structure-forming properties of marine collagens, including foam, film, gel, and emulsion formation. It also highlights the potential and important applications of marine collagen in various food products. Based on the currently reported marine sources, collagens extracted from fish, jellyfish, and sea cucumbers were found to have the highest yield and mostly comprised type-I collagen, while crustaceans and mollusks yielded lower percentages of collagen. Traditional extraction techniques isolate collagen based on acetic acid and pepsin treatment, but they come with drawbacks such as being time-consuming, causing sample destruction, and using solvents. Conversely, marine collagen extracted using conventional methods assisted with ultrasonication resulted in higher yields and strengthened the triple-stranded helical structures. Recently, an increasing number of new applications have been found in the food industry for marine collagens, such as biodegradable film-forming materials, colloid stabilizers, foaming agents, and micro-encapsulating agents. Furthermore, collagen is a modern foodstuff and is extensively used in the beverage, dairy, and meat industries to increase the stability, consistency, and elasticity of products.
Graphical abstract
Design optimization for microstrip antennas based on polymethyl methacrylate (PMMA) substrate and carbon nanotube (CNT) conductive material in sub-6 Ghz band
Authors: Ziani Djamila , Belkheir Mohammed , Rouissat Mehdi , Mokaddem Allel 
Published: March 2024

Abstract
Background
The rapid expansion of modern smart applications, demanding faster data transfer and extensive bandwidth, has prompted the development of new-generation networks like 5G and 6G. These networks encompass additional frequency bands such as sub-6 GHz, millimeter waves, and terahertz bands to meet the growing bandwidth requirements. However, despite the substantial bandwidth available in these bands, several challenges must be addressed to overcome unfavorable propagation characteristics. Moreover, numerous applications necessitate wireless devices with antennas that exhibit high flexibility and exceptional radiation responses, particularly when subjected to bending effects. This requirement highlights the importance of polymers-based antennas that can adapt to changing conditions while maintaining optimal performance. The present comprehensive study delves into the performance evaluation of rectangular and circular microstrip antennas utilizing PMMA (polymethyl methacrylate) polymer substrate with varying thicknesses.

Results
Notably, CNTs (Carbon Nanotubes) are employed as an alternative to traditional copper for the conductive part and ground plane. Both PMMA-based antennas, integrated with CNTs, exhibit a compact footprint of 27.8 × 47.8 × 1.5 mm3 for the circular antenna and 22.8 × 39.5 × 1.5 mm3 for the rectangular antenna. Impressively, the realized gain of both antennas surpasses 5 dBi, demonstrating robust performance in both flat and bending scenarios across different substrate thicknesses.

Conclusions
The rectangular antenna achieves a bandwidth of approximately 200 MHz, while the circular microstrip antenna showcase annotable bandwidth of 500 MHz. These exceptional outcomes position the two microstrip antennas as highly suitable for a diverse range of emerging applications within the sub-6 GHz band (the frequency range below 6 GHz in the radio spectrum). Thus, the combination of PMMA substrate, CNTs and the compact form factor of the antennas presents a compelling solution for meeting the demands of modern applications requiring efficient wireless communication with enhanced performance and bandwidth.
The differential impact of distracted auditors in managing portfolio of financially distressed audit clients on audit quality: the role of professional skepticism
Authors: Bedeir Reem Essam 
Published: March 2024

AbstractThis study hypothesizes that distracted auditors affect audit quality. As a result of resources scarcity, auditors pay more attention to financially distressed audit clients rather than non-financially distressed audit clients at the same audit client portfolio which eventually leads to differences in audit quality. In this context, earnings restatement of audit clients is used as a distraction event of auditors. Distracted auditor is measured by the percentage of the audit fees of financially distressed audit clients to total audit fees and audit quality is proxied by total accruals. The data is obtained from firms listed on the US stock market over eleven years between 2010 and 2020. The results indicate that financially distressed audit clients of distracted auditors receive higher audit quality than non-financially distressed audit clients of the same audit client portfolio. Further analysis suggests that this difference in audit quality between financially distressed audit clients and non-financially distressed audit clients decreases with skeptical auditors. This study introduces a new comprehensive approach to measure professional skepticism using KAMs disclosure. The results are robust to different measurements of distracted auditors, audit quality and professional skepticism. Overall, the empirical analyses suggest that distracted auditors have a decreasing differential impact on audit quality by professional skepticism.
Microsurgical Resection of a Medulla Oblongata Cavernoma: 3-Dimensional Operative Video
Authors: Baldoncini Matías , Forlizzi Valeria , Villalonga Juan F. , Castillo Rangel Carlos , Pipolo Derek O. , Campero Alvaro 
Published: March 2024

Cavernous malformations occur in approximately 0.5% of the population. When it comes to the medulla oblongata, the incidence rate is around 5%.
1,2
Patients with these conditions face potential risks such as hemorrhaging, substantial mortality, and morbidity. The symptoms experienced by the patient vary depending on the extent of hemorrhaging and the location of the lesion. Surgery stands as the primary and essential form of treatment in these cases.
1-4

The aim of this operative video was to present the removal of a medulla oblongata cavernoma. The patient consented to the procedure and to the publication of her images and surgical video. We describe the case of a 53-year-old woman presenting with headaches and with swallowing difficulties, being tracheostomized on hospital admission. Magnetic resonance imaging showed a lesion located at the medulla oblongata. Owing to the patient's symptoms and cavernoma bleeding, surgical resection was determined.
There were no adverse outcomes after surgery, and the patient evolved favorably. Postoperative imaging displayed complete removal of the cavernoma.
Microsurgical resection of cavernomas in this location with neurophysiological monitoring and selection of the safe entry zone is an effective option.
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Early response and outcomes of bone marrow to chemotherapy in T-Cell Acute Lymphoblastic Leukemia
Authors: AlMoshary May , Mahmoud Altahan Shatha , Fayez Alswayyed Aziza 
Published: March 2024

Objectives: To evaluate the outcomes (relapse and mortality rate) and response of the bone marrow in early stages after combination chemotherapy in patients with T-cell Acute Lymphoblastic Leukemia (T-ALL).
Methods: A descriptive cross-sectional study was conducted at King Fahad Medical City, from January 2021 to December 2022, to evaluate bone marrow findings at the time of diagnosis and post-chemotherapy in 26 patients diagnosed with T-ALL. The study included all patients diagnosed with T-ALL of any age group during the study period. The patients’ bone marrows were examined at 0 days of treatment (diagnosis work-up), followed by examination at day 15 post induction therapy, and day 30 after treatment.
Results: In this study, 26 cases of T-lymphoblastic leukemia were analyzed. The mean age at diagnosis was 15.69±14.28 years, and eight cases had central nervous system involvement. The majority of cases (88.5%) were positive for Cytoplasmic-CD3 and CD7. Positive findings by fluorescence in situ hybridization (FISH) were: T cell receptor (TCR) α/δ in 6 (23.1%) of the patients, CDNK2A/CEP9 in five (19.2%), and TRCB in one (3.8%). Examination of the bone marrow on day 15 revealed a decrease in blasts to ≤1% in nine patients, and to ≤1% in 19 patients on day 30 post-therapy. Relapse was recorded in five (19.23%) patients. Three (11.53%) patients did not survive during treatment, of which two were <10 years old. The relapse rate for T-ALL was 19.23%, with an overall survival rate of about 64%. The overall mortality rate was 11.53%.
Conclusion: The relapse rate for T-ALL in our study was approximately 19%, but the mortality rate was 11.5%. A substantial decrease in blast percentages was observed, suggesting a favorable initial reaction of the bone marrow to the combined chemotherapy. This suggests that the use of aggressive and more effective chemotherapy has led to better outcomes.
doi: https://doi.org/10.12669/pjms.40.5.7584
How to cite this: AlMoshary M, Altahan SM, Alswayyed AF. Early response and outcomes of bone marrow to chemotherapy in T-Cell Acute Lymphoblastic Leukemia. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.7584
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.
Needs analysis for an undergraduate dental curriculum in KPK, Pakistan: Gap identification and general needs assessment
Authors: Mehboob Bushra , Mahboob Usman , Jamil Brekhna , Shaheen Neelofar 
Published: March 2024

Objective: Dental institutes continue to face challenges in making the transition from a discipline-based to an integrated curriculum. The need analysis is often the first step in the development and implementation of any curriculum. This study intends to carry out a needs analysis for a contemporary dental curriculum in private and public sector dental colleges of Peshawar, KPK, Pakistan.
Methods: The mixed method study was carried out at public and private dental institutes in Peshawar from April to July 2022. To guarantee triangulation, data were gathered from three sources. The first source was an analysis of the Pakistan Medical and Dental Council’s dental curriculum accreditation standards. The second source was gathering the experts’ perspectives, and the final source was a systematic literature search to explore the necessity for an integrated undergraduate dental curriculum from the experiences and expertise of contemporary curricula.
Results: Thematic analysis identified the need for the dental curriculum to be a five-year BDS program, involvement of students, and inclusion of digital dentistry and environmental sustainability in the dental curriculum. PMDC accreditation standards focus on alignment in mission, vision, curricular outcomes, an integrated curriculum, and a quality assurance system for assessment. Experts identified the need for a patient-centered curriculum focusing on integrated patient care. They also identified that the current educational environment should be improved to sustain a contemporary dental curriculum in Pakistan. For the literature review, nine articles were included in the final review.
Conclusion: The current dental curriculum is not accommodating to the needs of the students in Peshawar. The current dental education environment lacks the infrastructure, logistics, and teacher training to sustain the standards set by PMDC.
doi: https://doi.org/10.12669/pjms.40.5.8364
How to cite this: Mehboob B, Mahboob U, Jamil B, Shaheen N. Needs analysis for an undergraduate dental curriculum in KPK, Pakistan: Gap identification and general needs assessment. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.8364
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.
Analysis of factors affecting the clinical efficacy and quality of life in the treatment of pediatric acute lymphoblastic leukemia
Authors: Liu Dan , Zhang Yi-fei 
Published: March 2024

Objective: To analyze the factors affecting the long-term clinical efficacy and quality of life in the treatment of pediatric acute lymphoblastic leukemia (ALL).
Methods: This is a retrospective study. One hundred children with ALL were collected before June, 2018 at The First Affiliated Hospital of Yangtze University and followed up for five years. Not only were their five-years survival rates analyzed, but univariate and multivariate analyses were also performed for factors that might affect their five-year survival rates. The MOS 36-Item Short Form of Health Survey (SF-36) was utilized to investigate the surviving children after five years in order to analyze the factors that may affect the quality of life of the children.
Results: The five-years survival rate of one hundred children with ALL after treatment was 91.00% (91/100). Univariate and multivariate Logistic regression analyses were performed on the factors that may affect the long-term efficacy of pediatric ALL. The results showed that white blood cell count at first diagnosis, prednisone response test, treatment compliance and recurrence were independent risk factors for the long-term efficacy of pediatric ALL(p<0.05). The SF-36 survey of 91 surviving children after five years showed that prednisone response test and treatment compliance were independent risk factors affecting the quality of life of pediatric ALL (p<0.05).
Conclusion: In the initial diagnosis of pediatric ALL, sufficient attention and control should be given to the factors that may affect the long-term clinical efficacy and quality of life, and appropriate treatment plans should be adopted. Meanwhile, the treatment compliance of children should be improved during treatment to improve the survival rate and quality of life of pediatric ALL.
doi: https://doi.org/10.12669/pjms.40.5.8619
How to cite this: Liu D, Zhang Y. Analysis of factors affecting the clinical efficacy and quality of life in the treatment of pediatric acute lymphoblastic leukemia. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.8619
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.
Demographic characteristics and short-term outcomes of laparoscopic colon cancer surgeries at a newly developed cancer center in Peshawar, Pakistan
Authors: Ahmad Riaz , Jan Abbasi Hussain , Ul Islam Nasir Irfan , Shah Muhammad Fahd 
Published: March 2024

Objective: In Pakistan, colon cancer ranks fourth in incidence, exhibiting survival rates of 90% to 14%, contingent on TNM staging and early detection. This research focuses on the demographic involvement and short-term outcomes of elective colon cancer resections at a newly established tertiary care cancer center utilizing laparoscopic procedures.
Method: A retrospective analysis of elective laparoscopic colorectal resections at Shaukat Khanum Memorial Cancer Institute and Research Centre, Peshawar, from April 2021 to February 2022 was conducted. Out of 157 cases, 79 had colon cancer. Criteria included patients >18 years old with positive biopsies; consent non-providers were excluded. Statistical analysis employed descriptive statistics and cross-tabulations using SPSS-22.
Results: The study encompassed biopsy-confirmed colon cancers in patients >18 years. 157 colorectal cases were performed, including 79 colon cancers. The sample comprised 61 males (77.2%) and 18 females (22.7%), mean age 42 years. Most patients (33%) were in the 36-45 age group. Majority were from KPK (69.6%), followed by Afghanistan (24%). Tumors were predominantly in the ascending colon (30.3%). Most were moderately differentiated (70.8%). Mean lymph node yield was 19.0, with 1.2% requiring open laparotomy. Post-discharge, one readmission occurred within 30 days. Mortality within 90 days was 2%, attributed to aspiration pneumonia and chemotherapy-related effects.
Conclusions: Elective laparoscopic colonic surgery exhibits safety and efficacy in treating colon cancer. The study provides evidence of minimal morbidity and mortality, low readmission rates, and absence of anastomotic leaks. Hence, elective laparoscopic colonic surgery should be favored due to fewer post-operative complications and superior short-term outcomes. Larger studies on colon cancer are imperative for enhanced healthcare delivery.
doi: https://doi.org/10.12669/pjms.40.5.8732
How to cite this: Ahmad R, Abbasi HJ, Nasir II, Shah MF. Demographic characteristics and short-term outcomes of laparoscopic colon cancer surgeries at a newly developed cancer center in Peshawar, Pakistan. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.8732
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.
Exploring drivers of unsafe disposal of child stool in India using hierarchical regression model
Authors: Rahaman Margubur , Roy Avijit , Chouhan Pradip , Rana Md. Juel 
Published: March 2024

Background
Disposal of children’s stools is often neglected in Indian sanitation programs, putting them at higher risk of diseases transmitted through the fecal-oral route. Therefore, the current study aims to identify the socioeconomic and demographic factors associated with the unsafe disposal of child stool in India and to estimate the geographical variation in unsafe disposal.

Methods
The study used 78,074 births under two years from the fifth round of the National Family Health Survey (2019–21). Descriptive statistics, bivariate analysis with the chi-square test, and a four-level hierarchical logistic regression model were applied to accomplish the study objectives.

Results
Findings revealed a 61.3% prevalence of unsafe stool disposal nationwide, significantly varying between rural (45%) and urban (67%) areas. Multilevel logistic regression highlighted that mother’s education, wealth quintile, and sanitation facility were significant predictors of unsafe disposal of child stools. Random intercept statistics revealed a substantial geographical unit-level variance in unsafe stool practice in India.

Conclusion
The study emphasizes the widespread unsafe disposal of child stool among Indian mothers with young children below two years, and the study underscores a range of contributing factors, including education, media exposure, prosperity, water availability, and sanitation. It also accentuates the significance of the geographical variance in the unsafe disposal of child stool in India, particularly at the household level, followed by the community level. Hence, the findings underscore the importance of focused interventions, including targeted household-level poverty alleviation programs, initiatives to enhance sanitation and water facilities, and community-level public health awareness programs.
Glycated albumin in the detection of diabetes during COVID-19 hospitalization
Authors: Chume Fernando Chimela , Freitas Priscila Aparecida Correa , Schiavenin Luisa Gazzi , Sgarioni Eduarda , Leitao Cristiane Bauermann , Camargo Joíza Lins 
Published: March 2024

Background
Diabetes has emerged as an important risk factor for COVID-19 adverse outcomes during hospitalization. We investigated whether the measurement of glycated albumin (GA) may be useful in detecting newly diagnosed diabetes during COVID-19 hospitalization.

Methods
In this cross-sectional test accuracy study we evaluated HCPA Biobank data and samples from consecutive in-patients, from 30 March 2020 to 20 December 2020. ROC curves were used to analyse the performance of GA to detect newly diagnosed diabetes (patients without a previous diagnosis of diabetes and admission HbA1c ≥6.5%).

Results
A total of 184 adults (age 58.6 ± 16.6years) were enrolled, including 31 with newly diagnosed diabetes. GA presented AUCs of 0.739 (95% CI 0.642–0.948) to detect newly diagnosed diabetes. The GA cut-offs of 19.0% was adequate to identify newly diagnosed diabetes with high specificity (85.0%) but low sensitivity (48.4%).

Conclusions
GA showed good performance to identify newly diagnosed diabetes and may be useful for identifying adults with the condition in COVID-19-related hospitalization.
Examining how goals of care communication are conducted between doctors and patients with severe acute illness in hospital settings: A realist systematic review
Authors: Gross Jamie , Koffman Jonathan 
Published: March 2024

Background
Patient involvement in goals of care decision-making has shown to enhance satisfaction, affective-cognitive outcomes, allocative efficiency, and reduce unwarranted clinical variation. However, the involvement of patients in goals of care planning within hospitals remains limited, particularly where mismatches in shared understanding between doctors and patients are present.

Aim
To identify and critically examine factors influencing goals of care conversations between doctors and patients during acute hospital illness.

Design
Realist systematic review following the RAMESES standards. A protocol has been published in PROSPERO (CRD42021297410). The review utilised realist synthesis methodology, including a scoping literature search to generate initial theories, theory refinement through stakeholder consultation, and a systematic literature search to support program theory.

Data sources
Data were collected from Medline, PubMed, Embase, CINAHL, PsychINFO, Scopus databases (1946 to 14 July 2023), citation tracking, and Google Scholar. Open-Grey was utilized to identify relevant grey literature. Studies were selected based on relevance and rigor to support theory development.

Results
Our analysis included 52 papers, supporting seven context-mechanism-output (CMO) hypotheses. Findings suggest that shared doctor-patient understanding relies on doctors being confident, competent, and personable to foster trusting relationships with patients. Low doctor confidence often leads to avoidance of discussions. Moreover, information provided to patients is often inconsistent, biased, procedure-focused, and lacks personalisation. Acute illness, medical jargon, poor health literacy, and high emotional states further hinder patient understanding.

Conclusions
Goals of care conversations in hospitals are nuanced and often suboptimal. To improve patient experiences and outcome of care interventions should be personalised and tailored to individual needs, emphasizing effective communication and trusting relationships among patients, families, doctors, and healthcare teams. Inclusion of caregivers and acknowledgment at the service level are crucial for achieving desired outcomes. Implications for policy, research, and clinical practice, including further training and skills development for doctors, are discussed.