bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of perioperative remimazolam in preventing postoperative delirium: a systematic review and meta-analysis
Authors: Wang Mingzhen , Liu Jinhui , Liu Wenjie , Zhang Xin , Zhang Gaofeng , Sun Lixin , Bi Yanlin , Wang Hong , Dong Rui 
Published: February 2025

Abstract

Background
To compare the POD rates in patients undergoing non-cardiac surgery who received remimazolam perioperatively versus placebo or other sedatives.

Methods
We systematically searched four major databases (Cochrane Central Register of Controlled Trials, Web of Science, Embase, and PubMed) for relevant randomized controlled trials (RCTs) up to July 11, 2024. Literature quality evaluation was used the bias risk table in Review Manager 5.4. The primary outcome of interest was POD, and secondary outcomes were the hypotension risk, bradycardia and, nausea and vomiting.

Results
Across 11 trials involving 1985 participants, we recorded 309 cases of POD during follow-up. In trials where the control group received saline, remimazolam decrease the risk of POD significantly by 70% (RR 0.30, 95% CI [0.19, 0.46]; p < 0.00001). Statistical analysis did not show significant difference in the risk of POD between the remimazolam group and the groups receiving either dexmedetomidine (RR 1.23 [0.64, 2.37]; p = 0.53) or propofol (RR 0.83 [0.60, 1.16]; p = 0.28). Regarding adverse events, remimazolam significantly reduces the morbidity of hypotension compared to dexmedetomidine (RR 0.25 [0.10, 0.65]; p = 0.004) and propofol (RR 0.45 [0.33, 0.60]; p < 0.00001). In addition, there were no significant differences in the incidence of bradycardia (RR 0.85; 95% CI [0.34–2.12], p = 0.72) and nausea and vomiting (RR 1.06; 95% CI [0.74–1.51], p = 0.77) between remimazolam and the control group.

Conclusions
During the perioperative period, using remimazolam can lower POD risk after surgery for patients who had non-cardiac surgery, but remimazolam does not work better than dexmedetomidine or propofol. Compared with the dexmedetomidine and propofol, remimazolam also has apparent advantages in preventing intraoperative hypotension.
Secular Trends in Hip Fracture Mortality and Predictors of Mortality from the NSQIP Database
Authors: Rhayem Caline , Ghosn Aya , Issa Zeinab Ali , Alwan Joudie Sahar , Dimassi Hani , Haidar Rachid , Fuleihan Ghada El-Hajj 
Published: February 2025

Abstract

Context
Hip fractures incur high morbidity and mortality. Data on secular trends in mortality from hip fractures and risk predictive models are scarce.

Objective
We aim to describe secular trends in 30-day mortality post-hip fracture surgery from the 2011-2017 National Surgical Quality Improvement Program (NSQIP) database, identify preoperative and on-discharge predictors of 30-day mortality and develop risk calculators.

Methods
We calculated yearly proportions of deaths and examined survival using Kaplan Meier curves. We implemented logistic regressions models, using SPSS and created calculators using Excel.

Results
In 84,824 cases of hip fracture surgery, the overall 30-day mortality was 6.8%. It decreased from 8.1% to 6.5% between 2011 and 2017 (p&lt;0.001). Significant preoperative predictors of 30-day mortality on admission were male gender, age, lower BMI, white race, poorer functional health status, higher creatinine, lower hematocrit, &gt;10% weight loss in the past 6 months, congestive heart failure within 30 days before surgery, and chronic obstructive pulmonary disease. Predictors on discharge included preoperative predictors with the exception of white race, hematocrit and &gt; 10% weight loss in the past 6 months, and the addition of unplanned intubation, cerebrovascular accident, myocardial infarction, and pneumonia. The parsimonious preoperative risk calculator for mortality had 10 variables, an area under the curve (AUC) of 0.739, and a model fit R2 of 0.9716. The on-discharge calculator had 11 variables, an AUC of 0.800, and an R2 of 0.9924.

Conclusion
30-day mortality post-hip fracture surgery decreased significantly from 2011 to 2017. Readily available clinical risk factors predict mortality, preoperatively and on discharge. While most predictors are non-modifiable, the calculators may better inform clinical decision-making.
Spatio-temporal reconstruction of gene expression patterns in developing mice
Authors: Aviñó-Esteban Laura , Cardona-Blaya Heura , Sharpe James 
Published: February 2025

ABSTRACT
Understanding gene regulation in organism development is crucial in biology. Techniques like whole-mount in situ hybridization can reveal spatial gene expression in organs and tissues. However, capturing time-lapse movies of gene expression dynamics in embryos developing in utero, such as mice, remains technically challenging beyond the early stages. To address this, we present a method to integrate static snapshots of gene expression patterns across limb developmental stages, creating a continuous 2D reconstruction of gene expression patterns over time. This method interpolates small tissue regions over time to create smooth temporal trajectories of gene expression. We successfully applied it to a number of key genes in limb development, including Sox9, Hand2, and Bmp2. This approach enables a detailed spatio-temporal mapping of gene expression, providing insights into developmental mechanisms. By estimating gene expression patterns at previously unobserved time points, it facilitates the comparison of these patterns across samples. The reconstructed trajectories offer high-quality data that will be useful to guide computational modeling and machine learning, advancing the study of developmental biology in systems where real-time imaging is technically difficult or impossible.
Unraveling the etiology of primary amenorrhea: Insights from a tertiary care center in Peshawar, Pakistan
Authors: Ambareen Samad  , Bangash Arzoo Gul , Talat Naz  
Published: February 2025

Background & Objectives: The onset of menstruation heralds the beginning of feminism and fecundity. Primary amenorrhea is a distressing symptom and is often associated with late diagnosis and appropriate management. Our study aimed to find the frequency of primary amenorrhea along with its causes and subsequent management by a multidisciplinary team.
Methods: In our descriptive case series patients presenting with primary amenorrhea to the Department of Gynaecology, Khyber Teaching Hospital Peshawar from January 2018 to December 2022, were included. Gynecologist initially analyzed the cases based on history, clinical examination (secondary sexual characteristics, Body mass index) and relevant investigations including hormonal profile, pelvic ultrasound, MRI and karyotype. After final diagnosis, a multidisciplinary team comprising of plastic surgeon, endocrinologist and psychiatrist advised treatment based on cause. Relevant information was recorded on predesigned proforma. Data was analyzed using SPSS 23.
Results: The frequency of primary amenorrhea was 0.3% out of 18,504 patients seen in Gynaecology clinic. Forty-six (82%) patients were in the age group of 14-20 years. The mean body mass index was 22.8±2.4. Mullerian agenesis was seen in 22(39%) of patients, 20(35.7%) had outflow tract abnormality which were treated by vaginoplasty or hymenectomy/ resection of vaginal septum depending on cause. Ten (17.8%) patients diagnosed with gonadal dysgenesis. Four (7.1%) patients with constitutionally delayed menarche had spontaneous onset of menstruation.
Conclusions: Disorders related to Mullerian agenesis are the most common cause of primary amenorrhea. Timely diagnosis by attending gynecologist and subsequent multi-modal approach, including psychological counseling, hormonal therapy, and tailored surgical interventions like neovagina creation by vaginoplasty, hymenectomy and laparoscopic gonadectomy can ensure appropriate management of this distressing condition in young girls.
doi: https://doi.org/10.12669/pjms.41.3.11199
How to cite this: Samad A, Bangash AG, Naz T. Unraveling the etiology of primary amenorrhea: Insights from a tertiary care center in Peshawar, Pakistan. Pak J Med Sci. 2025;41(3):872-875. doi: https://doi.org/10.12669/pjms.41.3.11199
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.
Correlation between social media addiction and academic procrastination in medical students at public and private medical colleges at Peshawar
Authors: Naushad Khurram , Jamil Brekhna , Naveed Afzal Khan  , Maidha Jadoon  
Published: February 2025

Objective: The study aim was to assess correlation between social media addiction and academic procrastination among medical students at public and private medical colleges in Peshawar.
Methods: A correlational research design was employed with research protocols approved by the Advance Studies and Research Board of Khyber Medical University. Data were collected from two public and five private medical colleges. Universal sampling was then performed. Of 4716 medical students, 3366 participated in the study, with a response rate of 71.4%. This study was conducted between June and December 2023. Data were collected using the structured social media addiction scale (SMAS) and academic procrastination scale (APS).
Results: Male participants were (1775) 52.7%, and the rest (1591) 47.3% were female. Among the responders (1591) 61% resided in hostels. The mean academic achievement was 74.14%, ranging from 30% to 85%. Most medical students (63%) showed moderate and 34% showed high academic procrastination. Majority of the medical students (81%) were social media addicts and male reported higher scores. Social media addiction was highly correlated with academic procrastination (r=0.539), which was regressed and found that 29% (R2=0.289) of social media addiction contributed to academic procrastination. Medical students from the public sector, Android users, third-year students, male students, and hostel residents were more prone to social media addiction and academic procrastination.
Conclusion: Social media addiction prevails among medical students and is highly correlated with academic procrastination. Hostel residents, males, and android users were more addicted to social media than their counterparts.
doi: https://doi.org/10.12669/pjms.41.3.9276
How to cite this: Naushad K, Jamil B, Khan NA, Jadoon M. Correlation between social media addiction and academic procrastination in medical students at public and private medical colleges at Peshawar. Pak J Med Sci. 2025;41(3):837-842. doi: https://doi.org/10.12669/pjms.41.3.9276
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.
On Greedy-Like Policies in Online Matching with Reusable Network Resources and Decaying Rewards
Authors: Simchi-Levi David , Zheng Zeyu , Zhu Feng 
Published: February 2025

We build a unified modeling framework for classical online matching problems and emerging online matching problems with three additional practical features: reusable resources, network resources, and decaying rewards. For online matching problems in the unified framework, we provide a unified performance analysis tool for the greedy policy and its simple variants, which we refer to as greedy-like policies. We prove that greedy-like policies can achieve near-optimal performances for online matching problems in the unified framework, where the policy performance is measured by competitive ratios under adversarial environments. We then analyze several representative special classes of online matching problems, which incorporate additional realistic structural assumptions on top of the unified framework. Specifically, we consider online matching problems with each of the following three additional structures: (i) singleton resources with time-decaying rewards; (ii) network resources with accept/reject decisions; and (iii) network resources with interval-type bundles. We show that for these special classes of online matching problems, slight modifications to greedy-like policies can successfully utilize additional structural information to further enhance policy performances. This work may suggest that the greedy policy and its variants, despite its simplicity, can achieve reliable performances for a number of emerging online matching problems. This paper was accepted by J. George Shanthikumar, data science. Funding: The work of D. Simchi-Levi and F. Zhu is partially supported by the Massachusetts Institute of Technology Data Science Laboratory. Supplemental Material: The online appendix is available at https://doi.org/10.1287/mnsc.2023.02588 .
Environmental Harm Resulting from Israeli Bombing of Gaza: Legal Aspects
Authors: Aasi Joni 
Published: February 2025

Abstract
Israel’s unprecedented bombardment of the Gaza Strip has caused more than 100,000 casualties and the forced displacement of most of Gaza’s 2.3 million inhabitants, but there is a “silent victim”: the environment, which includes the natural and built environment. This bombing is part of a strategy adopted by the occupying power toward the Palestinians since 1967, a strategy of conflict management. The high intensity and scale of the bombing is aimed at achieving a period of calm, as was the case after the invasion of the OPT (Operation Defensive Fence, 2002). According to this strategy, the continuation of the occupation of the Gaza Strip requires a radical “mowing” operation, which in legal terms amounts to genocide. This article attempts to present a broad concept of genocide that includes ecocide, and discusses the consideration of “military necessity” in populated areas when we know that the casualty rate in bombing these areas exceeds 90 percent, and that Israel justifies any objective on this principle. It also raises the question of responsibility for ecocide in light of developments in international criminal law and the contradiction between individual and collective responsibility.
Neural network based clinical decision support system for the calculation the initial continuous subcutaneous insulin infusion settings
Authors: Laptev D. N. , Sorokin D. Y. 
Published: February 2025

BACKGROUND: Despite existing recommendations for the initial calculation of insulin pump settings, the process is largely subjective and depends on the physician’s personal experience.AIM: Development of a clinical decision support system (CDSS) that determines the initial settings of the insulin pump, which would have satisfactory agreement with the expert opinion of physicians.MATERIALS AND METHODS: Neural network model developed using data (continuous subcutaneous insulin infusion (CSII) settings, age, weight, total daily dose, and HbA1c) from 2850 children with T1D who were switched to CSII and achieved optimal glycemic control according to glucose levels. CDSS utilizing the model implemented as a computer program in Python.A prospective assessment of the agreement between the recommendations of the CDSS and the physician conducted on 35 data sets of children with T1D (median age 9.3 years [6.4, 11.5]), and 840 points for decisions were analyzed. 4 degrees of agreement were used: complete consistency, when the physicians agreed with the CDSS recommendations; partial consistency, when the physicians didn’t agree with the CDSS recommendations, but the difference was in the range of ±15%; complete inconsistency — the difference more than ±15%; acceptable consistency is the sum of full and partial consistency (± 15% error is clinically acceptable). The null hypothesis of the study was the absence of difference in consistency/inconsistency between physicians and the CDSS.RESULTS: The frequency of full consistency between CDSS and physician recommendations for initiating insulin pump therapy is 29.8-43.8%, and inconsistency is 33.7-41.1%. Acceptable consistency is 58.9–66.3%. There were no significant differences in mean insulin pump parameters between CDSS and physicians.CONCLUSION: The results obtained are consistent with previous studies. Proposed model demonstrates acceptable performance regarding initial CSII settings, without significant deviations between various parameters.
Clinical, bio­chemical and genetic characteristics of familial forms of type 1 diabetes
Authors: Zufarova I. M. , Laptev D. N. , Minniahmetov I. R. , Khusainova R. I. , Popov S. V. , Titovich E. V. , Eremina I. A. , Peterkova V. A. 
Published: February 2025

BACKGROUND: Familial clustering of type 1 diabetes (T1D) highlights the importance of genetic and environmental factors in the pathophysiology of diabetes mellitus (DM). It could be the key to understanding of new immunological and genetic characteristics of T1D.AIM: To study the clinical, biochemical, immunological and genetic characteristics of children with familial forms of T1D.MATERIALS AND METHODS: A single-center cross-sectional study included 267 patients with familial T1D and 681 patients with sporadic T1D. Clinical and metabolic characteristics, beta cell autoantibodies and HLA class II genetics from patients with T1D hospitalized to Endocrinology Research Centre Moscow between 2016 and 2023 were analyzed.RESULTS: The median age of onset of DM was significantly lower in children with familial T1D (5,2 [3,0; 8,0] vs 6,4 [3,6; 9,2], p<0,001). Children with sporadic T1D had diabetic ketosis or diabetic ketoacidosis (DKA) at presentation more frequently (90,3% vs 74%, p<0,001). Among the sib-pair groups 50,5% of first-affected siblings and 19,5% of second- and third-affected siblings had DKA at presentation, while in children from parent-offspring subgroup DKA episodes were observed in 21% of patients (p<0,001). IAA and GAD antibodies were more frequent in familial cases (p<0,013, p<0,003). In our groups, no significant differences in metabolic compensation of the T1D were found. HLA haplotypes associated with an increased disease risk DRB1*04-DQA1*03:03-DQB1*03:02 and DRB1*07-DQA1*02:01-DQB1*02:02 were more common in children with familial T1D (p<0.001 and p<0.001), while the protective haplotype DRB1*08-DQA1*04:01-DQB1*04:02 was more frequent in sporadic forms.CONCLUSION: Due to our study familial forms of T1D are characterized by an earlier age of onset, a smaller risk of DKA at presentation, as well as features of the immunological profile and predisposing and protective HLA haplotypes presentation. We believe more studies are required in the future to look for risk factors and pathogenesis unserstanding.
Postprandial secretion of insulin and peptide YY when taking erythritol and sucrose
Authors: Silina N. V. , Mazurina N. V. , Ershova E. V. , Komshilova K. A. , Nikankina L. V. , Pershina-Milutina A. P. , Antonova K. V. , Troshina E. A. 
Published: February 2025

AIM. To study the effect of the non-calorie sweetener erythritol and the combination of erythritol and sucrose on postprandial secretion of insulin and peptide-YY (PYY).MATERIALS AND METHODS. A comparative study was conducted to assess the effect of erythritol, sucrose and a combination of erythritol and sucrose on postprandial glucose, IRI and PYY levels. The participants were selected from among healthy volunteers, aged 18 to 35 years. If the participants met the selection criteria, further stages of the study were carried out. During the study, each participant took a solution of sucrose 75 g, erythritol 75 g or a mixture of sucrose and erythritol (75 g and 25 g, respectively). Further determination of glucose and insulin was carried out every 30 minutes, so glucose, insulin and PYY values were determined initially and at the 30th, 60th, 90th and 120th minutes.RESULTS. Data were obtained confirming the absence of the effect of erythritol on postprandial secretion of insulin and glucose. In our work, we also demonstrated a decrease in postprandial glycemia when taking sucrose and erythritol together. Sucrose and erythritol equally stimulated PYY secretion.CONCLUSION. Our data show that erythritol can be considered as an optimal sugar substitute in people with impaired carbohydrate metabolism and obesity.
“Além do olhar petrificante"
Authors: Zukoski Ana Maria Soares , Esteves Natacha dos Santos , Coqueiro Wilma dos Santos 
Published: February 2025

O presente estudo, partindo do romance O olhar petrificante: a história de Medusa (2023), de Nathalie Haynes, apresenta uma revisitação ao mito da Antiguidade Clássica e uma perscrutação sobre como foi criado o monstro Medusa. Tendo como corpus de análise uma obra contemporânea, cuja premissa básica é humanizar e evidenciar como a personagem foi vítima de diversas violências, o corrente estudo desnuda a influência do patriarcalismo na criação do arquétipo de monstro e, assim, convida ao questionamento sobre quem são, de fato, os monstros.
A method for MRI‐guided bronchoscopy to identify obstructed airway segments
Authors: Mummy David G. , McIntosh Marrissa J. , Carey Katherine J. , Kehoe Shannon , Esnault Stephane , Johansson Mats W. , Evans Michael D. , Sorkness Ronald L. , Schiebler Mark , Jarjour Nizar N. , Denlinger Loren C. , Fain Sean B. 
Published: February 2025

AbstractBronchoscopy is not conventionally guided by prior knowledge of segmental airway obstruction. Hyperpolarized gas magnetic resonance imaging (MRI) ventilation abnormalities and computed tomography (CT) air trapping are related to lung function and asthma severity but have not been used to target segmental inflammation and remodeling. We evaluate the feasibility of using bronchoscopy guided by 3He MRI and CT to reveal differences in inflammatory response, morphology, and cellular activity in poorly‐ (defect) versus well‐ventilated (control) lung regions. Eleven participants (5 female; age, 22.8 ± 3.4 years; 9 asthma) who experienced a cold with increased lower airway symptoms underwent 3He MRI and/or CT at least 6 weeks after recovery. Differences between defect and control regions were compared. In defect as compared to control sites, bronchoalveolar lavage neutrophils (p = 0.06) and granulocytes (p = 0.08) trended towards an increase; inflammatory mediators (i.e., 15‐epi‐LXA4, LXA4) were also significantly different (p < 0.05) between sites. Correlations were observed between macrophages, neutrophils, and eosinophils with inflammatory mediators (i.e., 15‐epi‐LXA4, LXA4, LTB4). Correlations were observed for macrophages and neutrophils with 15‐epi‐LXA4, and eosinophils with LXA4 and leukotriene B4. Basement membrane wall thickness was similar for defect versus control sites (p = 0.9). These results support the feasibility of image‐guided methods to identify airway obstruction phenotypes.
A corpus-based behavioral profile analysis of polysemy and antonymy: the case of the ancient Greek size adjectives mikrós and mégas
Authors: Georgakopoulos Thanasis , Lavda Marialena 
Published: February 2025

Abstract
This article explores the semantic relationships between the antonymous adjectives mikrós (‘small’/‘little’) and mégas (‘big’/‘large’) in Classical Greek. Adopting a cognitive and usage-based perspective, the study applies the Behavioral Profile approach to investigate the polysemy of these adjectives and to assess the strength of their antonymic relationship. Specifically, it aims to determine whether the functional similarity among antonymous words is greater or lesser than that found within the senses of polysemous words. By focusing on how antonymous senses of different lexemes cluster together in a joint network, the study examines the extent to which antonymy, rather than polysemy, governs the organization of these senses. The analysis points to an upgraded role of antonymy in semantic structure.