bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extended MRI-based PET motion correction for cardiac PET/MRI
Authors: Aizaz Mueez , van der Pol Jochem A. J. , Schneider Alina , Munoz Camila , Holtackers Robert J. , van Cauteren Yvonne , van Langen Herman , Meeder Joan G. , Rahel Braim M. , Wierts Roel , Botnar René M. , Prieto Claudia , Moonen Rik P. M. , Kooi M. Eline 
Published: April 2024

AbstractPurposeA 2D image navigator (iNAV) based 3D whole-heart sequence has been used to perform MRI and PET non-rigid respiratory motion correction for hybrid PET/MRI. However, only the PET data acquired during the acquisition of the 3D whole-heart MRI is corrected for respiratory motion. This study introduces and evaluates an MRI-based respiratory motion correction method of the complete PET data.MethodsTwelve oncology patients scheduled for an additional cardiac18F-Fluorodeoxyglucose (18F-FDG) PET/MRI and 15 patients with coronary artery disease (CAD) scheduled for cardiac18F-Choline (18F-FCH) PET/MRI were included. A 2D iNAV recorded the respiratory motion of the myocardium during the 3D whole-heart coronary MR angiography (CMRA) acquisition (~ 10 min). A respiratory belt was used to record the respiratory motion throughout the entire PET/MRI examination (~ 30–90 min). The simultaneously acquired iNAV and respiratory belt signal were used to divide the acquired PET data into 4 bins. The binning was then extended for the complete respiratory belt signal. Data acquired at each bin was reconstructed and combined using iNAV-based motion fields to create a respiratory motion-corrected PET image. Motion-corrected (MC) and non-motion-corrected (NMC) datasets were compared. Gating was also performed to correct cardiac motion. The SUVmaxand TBRmaxvalues were calculated for the myocardial wall or a vulnerable coronary plaque for the18F-FDG and18F-FCH datasets, respectively.ResultsA pair-wise comparison showed that the SUVmaxand TBRmaxvalues of the motion corrected (MC) datasets were significantly higher than those for the non-motion-corrected (NMC) datasets (8.2 ± 1.0 vs 7.5 ± 1.0,p < 0.01 and 1.9 ± 0.2 vs 1.2 ± 0.2,p < 0.01, respectively). In addition, the SUVmaxand TBRmaxof the motion corrected and gated (MC_G) reconstructions were also higher than that of the non-motion-corrected but gated (NMC_G) datasets, although for the TBRmaxthis difference was not statistically significant (9.6 ± 1.3 vs 9.1 ± 1.2,p = 0.02 and 2.6 ± 0.3 vs 2.4 ± 0.3,p = 0.16, respectively). The respiratory motion-correction did not lead to a change in the signal to noise ratio.ConclusionThe proposed respiratory motion correction method for hybrid PET/MRI improved the image quality of cardiovascular PET scans by increased SUVmaxand TBRmaxvalues while maintaining the signal-to-noise ratio.Trial registrationMETC162043 registered 01/03/2017.
Utilization of modern contraceptives among female health care workers at Gulu university teaching hospitals in Northern Uganda
Authors: Opiro Keneth , Opee Jimmy , Sikoti Margret , Pebalo Pebolo Francis , Ayikoru Jackline Hope , Akello Harriet , Manano Priscilla , Bongomin Felix 
Published: April 2024

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Abstract

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

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

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

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

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

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

Objective: To determine trend of following medical advice and safety of high-risk diabetic patients during Ramadan practicing updated IDF DAR guidelines.
Methods: The cross-sectional study was conducted at Outpatient Department of Diabetes, Endocrinology and Metabolic Disorders Hayatabad Medical Complex Peshawar, Pakistan from April to June 2022, and comprised of high-risk diabetic patients (>6.0) based on updated IDF-DAR guidelines 2022 intending to fast. A questionnaire was designed to document patient risk factors score, type and duration of diabetes, HbA1c, comorbidities and complications developed during Ramadan. Data was analyzed using SPSS 20.
Results: Among all 130 participants, 78(60%) followed medical advice and did not fast and 52(40%) patients fasted against medical advice during month of Ramadan. Out of 130 participants, 89.2% were having type-2 diabetes Mellitus, 55.4% were female and mean age of participants was 52+14.6.40%. In fasting group, 57.7% were in the age range of 16 to 50 years while in non-fasting group 69.2% participants were more than 50 years old (P-value 0.031). There were 80.8% female participants in fasting group versus 38.5% in non-fasting group (P-value 0.001). Hypoglycemia occurred in 58.3% patients in fasting group and 29.3% non-fasting group. (P-value 0.021). On the other hand, 27.8% patients in fasting group and 55.2% of non-fasting group had hyperglycemia (P-value 0.025).
Conclusion: Despite advised against fasting in these high-risk patients as per IDF DAR guidelines, almost half of patients fasted considering fasting a religious obligation. Those who fasted had significant hypoglycemia despite adjustment of medications as in guidelines. There is need of more intensive education before fasting, especially in high-risk diabetic patients.
doi: https://doi.org/10.12669/pjms.40.5.8007
How to cite this: Farooq Q, Ghaffar T, Malik SE, Aamir AH. Safety of high-risk diabetic patients during Ramadan at a tertiary care hospital in Pakistan, practicing updated IDF DAR guidelines. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.8007
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effectiveness of early pharmaceutical interventions in symptomatic COVID-19 patients: A randomized clinical trial
Authors: Azhar Shehnoor , Akram Javed , Latif Waqas , Cano Ibanez Naomi , Mumtaz Samiullah , Rafi Ali , Aftab Usman , Iqtadar Somia , Shahzad Muhammad , Syed Fibhaa , Zafar Bilal , Fatima Nighat , Saadat Afridi Saleh , Javed Akram Shehla , Afzal Chaudhary Muhammad , Sadiq Farah , Goraya Saifullah , Haneef Muhammad , Ashraf Verda , Ashraf Saadia , Akrma Humaira , Khaliq Tanwir 
Published: April 2024

Objective: We assessed the effectiveness of oral Hydroxychloroquine (HC), Azithromycin (AZ) and Oseltamivir (OS), alone or combined, among patients hospitalized with mildly symptomatic coronavirus infectious disease (COVID-19).
Methods: Following the approval of the National Bioethics Committee and prospective registration (clinicaltrials.gov NCT04338698), a multicenter randomized clinical trial of adaptive design was conducted at 10 multispecialty hospitals in Pakistan. Patients were randomized into seven treatment groups. Starting April 15, 2020, consenting, eligible, otherwise healthy adult patients or those with co-morbidities under control, were recruited if they presented with mildly symptomatic COVID-19 (scored 3 on a 7-point ordinal scale anchored between 1 = not hospitalized, able to undertake normal activities, to 7 = death) confirmed by quantitative Real-Time Polymerase Chain Reaction (qRT-PCR). Two primary outcomes were assessed by day seven: Turning qRT-PCR negative; and clinical improvement of two points from the baseline. Outcome rates were compared using a chi-square test. Multiple imputations were applied to handle missing data. An interim data analysis was carried out on July 19, 2020, following which the study continued without treatment group changes. Data Safety and Monitoring Board advised to stop recruitment due to its futility on January 18, 2021.
Results: Of 471 patients randomized, a total of 426 (90.4%) completed the follow-up for primary outcomes. Based on imputed data analyses at day seven: Total qRT-PCR negative cases were 137/471 (29%, 95% CI 25.0 - 33.4). By day seven, a total of 111/471 (23.5%, 95% CI 19.8 - 27.6) showed clinical improvement. No serious or non-serious adverse event was reported.
Conclusions: Among patients with mild COVID-19, there was no statistically significant difference in the effectiveness of oral antimalarial, antiviral, or antibiotic treatments.
Clinicaltrials.gov ID: NCT04338698.
doi: https://doi.org/10.12669/pjms.40.5.8757
How to cite this: Azhar S, Akram J, Latif W, Ibanez NC, Mumtaz S, Rafi A, et al. Effectiveness of early pharmaceutical interventions in symptomatic COVID-19 patients: A randomized clinical trial. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.8757
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.