bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmaceutical nanotechnology: from the bench to the market
Authors: Mazayen Zaed M. , Ghoneim Amira M. , Elbatanony Rasha S. , Basalious Emad B. , Bendas Ehab R. 
Published: January 2022

Abstract
Background
Nanotechnology is considered a new and rapidly emerging area in the pharmaceutical and medicinal field. Nanoparticles, as drug delivery systems, impart several advantages concerning improved efficacy as well as reduced adverse drug reactions.

Main body
Different types of nanosystems have been fabricated including carbon nanotubes, paramagnetic nanoparticles, dendrimers, nanoemulsions, etc. Physicochemical properties of the starting materials and the selected method of preparation play a significant aspect in determining the shape and characteristics of the developed nanoparticles. Dispersion of preformed polymers, coacervation, polymerization, nano-spray drying and supercritical fluid technology are among the most extensively used techniques for the preparation of nanocarriers. Particle size, surface charge, surface hydrophobicity and drug release are the main factors affecting nanoparticles physical stability and biological performance of the incorporated drug. In clinical practice, many nanodrugs have been used for both diagnostic and therapeutic applications and are being investigated for various indications in clinical trials. Nanoparticles are used for the cure of kidney diseases, tuberculosis, skin conditions, Alzheimer’s disease, different types of cancer as well as preparation of COVID-19 vaccines.

Conclusion
In this review, we will confer the advantages, types, methods of preparation, characterization methods and some of the applications of nano-systems.
Breeding for disease resilience: opportunities to manage polymicrobial challenge and improve commercial performance in the pig industry
Authors: Bai Xuechun , Plastow Graham S. 
Published: January 2022

AbstractDisease resilience, defined as an animal’s ability to maintain productive performance in the face of infection, provides opportunities to manage the polymicrobial challenge common in pig production. Disease resilience can deliver a number of benefits, including more sustainable production as well as improved animal health and the potential for reduced antimicrobial use. However, little progress has been made to date in the application of disease resilience in breeding programs due to a number of factors, including (1) confusion around definitions of disease resilience and its component traits disease resistance and tolerance, and (2) the difficulty in characterizing such a complex trait consisting of multiple biological functions and dynamic elements of rates of response and recovery from infection. Accordingly, this review refines the definitions of disease resistance, tolerance, and resilience based on previous studies to help improve the understanding and application of these breeding goals and traits under different scenarios. We also describe and summarize results from a “natural disease challenge model” designed to provide inputs for selection of disease resilience. The next steps for managing polymicrobial challenges faced by the pig industry will include the development of large-scale multi-omics data, new phenotyping technologies, and mathematical and statistical methods adapted to these data. Genome editing to produce pigs resistant to major diseases may complement selection for disease resilience along with continued efforts in the more traditional areas of biosecurity, vaccination and treatment. Altogether genomic approaches provide exciting opportunities for the pig industry to overcome the challenges provided by hard-to-manage diseases as well as new environmental challenges associated with climate change.
Machine learning in perioperative medicine: a systematic review
Authors: Bellini Valentina , Valente Marina , Bertorelli Giorgia , Pifferi Barbara , Craca Michelangelo , Mordonini Monica , Lombardo Gianfranco , Bottani Eleonora , Del Rio Paolo , Bignami Elena 
Published: January 2022

Abstract
Background
Risk stratification plays a central role in anesthetic evaluation. The use of Big Data and machine learning (ML) offers considerable advantages for collection and evaluation of large amounts of complex health-care data. We conducted a systematic review to understand the role of ML in the development of predictive post-surgical outcome models and risk stratification.

Methods
Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, we selected the period of the research for studies from 1 January 2015 up to 30 March 2021. A systematic search in Scopus, CINAHL, the Cochrane Library, PubMed, and MeSH databases was performed; the strings of research included different combinations of keywords: “risk prediction,” “surgery,” “machine learning,” “intensive care unit (ICU),” and “anesthesia” “perioperative.” We identified 36 eligible studies. This study evaluates the quality of reporting of prediction models using the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) checklist.

Results
The most considered outcomes were mortality risk, systemic complications (pulmonary, cardiovascular, acute kidney injury (AKI), etc.), ICU admission, anesthesiologic risk and prolonged length of hospital stay. Not all the study completely followed the TRIPOD checklist, but the quality was overall acceptable with 75% of studies (Rev #2, comm #minor issue) showing an adherence rate to TRIPOD more than 60%. The most frequently used algorithms were gradient boosting (n = 13), random forest (n = 10), logistic regression (LR; n = 7), artificial neural networks (ANNs; n = 6), and support vector machines (SVM; n = 6). Models with best performance were random forest and gradient boosting, with AUC > 0.90.

Conclusions
The application of ML in medicine appears to have a great potential. From our analysis, depending on the input features considered and on the specific prediction task, ML algorithms seem effective in outcomes prediction more accurately than validated prognostic scores and traditional statistics. Thus, our review encourages the healthcare domain and artificial intelligence (AI) developers to adopt an interdisciplinary and systemic approach to evaluate the overall impact of AI on perioperative risk assessment and on further health care settings as well.
Impact of long duty hours on education and well-being of diagnostic radiology residents: A national survey in Saudi Arabia
Authors: Alhasan Ayman S , Alahmadi Shahad M , Altayeb Yara A , Daqqaq Tareef S 
Published: January 2022

Objectives: The primary purpose of this study was to assess and report the perceived negative impact of long duty hours on education and personal well-being among medical trainees in the diagnostic radiology residency training program in Saudi Arabia.
Methods: This cross-sectional study used a questionnaire (sent by email) with eight indicators related to the education and well-being of radiology residents in Saudi Arabia during the academic year 2019–2020. Participants were given a five-point Likert response format for each indicator. The relative importance index (RII) was calculated to rank the different indicators.
Results: Our of 337 residents, 116 diagnostic radiology trainees completed the survey, with a response rate of 34.4%. A total of 102 (87.9%) indicated their preference for 16-hour shifts instead of the currently implemented 24-hour duty system. Using the RII, three items related to the post-duty day ranked at the top of the list. The negative impact on sleep rhythm during the post-call day ranked first (mean 4.23 ± 1.02, RII 0.84), followed by the impact on social life, family activities, and exercise during the post-call day (mean 4.09 ± 1.06, RII 0.81). The third highest ranking factor was missing academic activities on the post-call day (mean 3.91 ± 1.15, RII 0.78). There was no relationship between negative perception and gender (P > 0.05).
Conclusion: The 24-hour duty system had a negative impact on radiology residents’ education and personal well-being, especially for items related to the post-call day. Reforming duty hours should be considered to promote residents’ well-being.
doi: https://doi.org/10.12669/pjms.38.3.4440
How to cite this:Alhasan AS, Alahmadi SM, Altayeb YA, Daqqaq TS. Impact of long duty hours on education and well-being of diagnostic radiology residents: A national survey in Saudi Arabia. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4440
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 clinical features of myasthenia gravis complicated with hyperthyroidism
Authors: Wang Yaxuan , Qi Guoyan , Yang Ying 
Published: January 2022

Objectives: To investigate the clinical features of patients with myasthenia gravis complicated with and without hyperthyroidism.
Methods: A total of 2083 patients with myasthenia gravis (MG) admitted in Center of Treatment of Myasthenia Gravis Hebei Province between January 2013 and July 2020 were retrospectively analyzed and divided into two groups: Group-A and Group-B, with 108 MG patients complicated with hyperthyroidism in Group-A and 1975 MG patients without thyroid disease in Group-B. The age of onset, gender, Osserman classification, acetylcholine receptor antibody and thymus status of the two groups were analyzed in the two groups. Independent-sample t test was used for intra-group comparison, and χ2 test was utilized for comparison of enumeration data. P<0.05 indicates a statistically significant difference.
Results: The age of onset in Group-A was significantly lower than that in Group-B (p=0.000), the number of female patients was significantly higher than that in Group-B (p=0.037), and the level of Achrabs titer was significantly lower than that in Group-B (p=0.000). The incidence of thymoma in Group-A was significantly lower than that in Group-B (p=0.012), while the incidence of thymic hyperplasia was significantly higher than that in Group-B (p=0.000).
Conclusion: Patients with MG complicated with hyperthyroidism are mainly female, with a lower age of onset, a lower level of acetylcholine receptor antibody, a lower incidence of thymoma, and a higher incidence of thymic hyperplasia. The clinical features of such patients are remarkably different from those of MG without thyroid disease.
doi: https://doi.org/10.12669/pjms.38.3.4656
How to cite this:Wang Y, Qi G, Yang Y. Analysis of clinical features of myasthenia gravis complicated with hyperthyroidism. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4656
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.
White blood cell differential fluorescence abnormal scattergram: A useful indicator for early detection of malarial parasite
Authors: Rehan Madeeha , Khalid Attika , Nasreen Fariha 
Published: January 2022

Background & Objective: Undiagnosed malarial infectionis associated with significant mortality and morbidity. Laboratory investigations leading to rapid, accurate and timely diagnosis of malaria is still a challenge. This study was done to assess the utility of abnormal White blood cell differential fluorescence (WDF) scattergram for diagnosis of malaria. Our aim was to study the utility of WDF scattergram for early detection of malarial parasite.
Methods: All EDTA anti-coagulated blood samples received in laboratory during a period from Dec 2019 to May 2020 were analyzed on anautomated hematology analyzer, Sysmex XN 1000. All abnormal WDF scattergrams pertaining to plasmodium specie were critically evaluated and recorded. Review of Leishman-stained peripheral smears as well as immune-chromatographic assay by rapid test devices (RTD) was done. Accordingly, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detection of malaria by abnormal scattergram were calculated.
Results: Out of total 1, 26,000of samples analyzed, abnormal WDF scattergrams were detected in 96 cases. Amongst these, 95.8% (92) were positive for MP on Leishman-stained peripheral smear as well as on ICT with a p-value of 0.05. WDF scattergram abnormalities typical of malaria showed a sensitivity of 80% and specificity of 93.26%. Positive predictive value of 95.8% whereas negative predictive value of 99.9% was detected. Significant findings of hemolysis, platelet clumps, nucleated RBCS (NRBCs) and RBC agglutination were noted in cases (n=4) with abnormal WDF scattergram negative for malaria on peripheral smear.
Conclusion: Interpretation of abnormal WDF scattergram not only increases the early detection rate for malarial parasite but isa strong indicator for presence of hemolysis, RBC agglutination, platelet clumps and leucoerythroblastic blood picture as well.
doi: https://doi.org/10.12669/pjms.38.3.4702
How to cite this:Rehan M, Khalid A, Nasreen F. White blood cell differential fluorescence abnormal scattergram: A useful indicator for early detection of malarial parasite. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4702
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 Mobile Health Augmented Cardiac Rehabilitation (MCard) on health-related quality of life among post-acute coronary syndrome patients: A randomized controlled trial
Authors: Hisam Aliya , Haq Zia Ul , Aziz Sohail , Doherty Patrick , Pell Jill 
Published: January 2022

Objectives: To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome (post-ACS) patients.
Methods: At the Armed Forces Institute of Cardiology (AFIC), a tertiary care hospital in Rawalpindi, Pakistan, a two-arm randomised controlled trial was conducted in which mobile health augmented cardiac rehabilitation (MCard) was developed and implemented on post-ACS patients from January 2019 until March 2021. The trial conforms to the CONSORT statement 2010. The post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counselling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three time points (baseline, 12 weeks and 24 weeks).
Results: At baseline, 160 patients (80 in each group; mean age 52.66±8.46 years; 126 male, 78.75%) were recruited, of which 121(75.62%) continued and were analysed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs control 43.87, p<.001) and 24 weeks (53.52 vs 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group.
Conclusion: MCard is an effective and acceptable intervention at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting.
doi: https://doi.org/10.12669/pjms.38.3.4724
How to cite this:Hisam A, Zia-ul-Haq, Aziz S, Doherty P, Pell J. Effectiveness of Mobile Health Augmented Cardiac Rehabilitation (MCard) on health-related quality of life among post-acute coronary syndrome patients: A randomized controlled trial. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4724
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.
Prospective randomized study comparing outcome of myocardial protection with Del-Nido Cardioplegia versus Saint Thomas Cardioplegia in adult cardiac surgical patients
Authors: Rizvi Muhammad Farhan Ali , Yousuf Syed Muhammad Arslan , Younas Attaullah , Baig Mirza Ahmad Raza 
Published: January 2022

Objectives: To compare the effectiveness of Del-Nido cardioplegia as myocardial protective agent with Saint Thomas cardioplegia in adult cardiac surgical patients.
Methods: This prospective randomized study was conducted in cardiac surgery department of Bahawal Victoria hospital Bahawalpur, from October 2020 to March 2021. Eighty adult patients who underwent primary Isolated coronary artery bypass grafting (CABG) or isolated Valve surgery requiring cardiopulmonary bypass were randomly divided into Del Nido (DN, n=40) and Saint Thomas (ST, n=40) groups. Data regarding operative and post-operative variables such as cardiopulmonary bypass (CPB) and aortic cross clamp (AXC) times, inotropic requirements, resumption of sinus rhythm, need for electrical defibrillation, post-operative CKMB, blood requirement and ICU stay were noted.
Results: CPB and AXC times were statistically insignificantly different. Resumption of Sinus rhythm was seen significantly in more patients of DN group (95%) than in ST group (72.5%) [p-value 0.05]. Less patients of DN group (5%) were candidates of electrical defibrillation than ST group (17.5%) [p-value <0.001). Post- operative CKMB values were significantly lower in DN group as compared to ST group (30.5±22.6 IU vs 50.5±50.28 IU, p value.008). Blood transfusion was significantly lower in DN group; 50% versus 80% in ST group (p-value 0.005). Ventilation time was significantly less in DN group than ST group (165.95±48.09 minutes versus 165.95±48.09 minutes respectively, p-value 0.03). While ICU stay was also less in DN group; 5.2±0.8 days versus 6.05±1.6 days in ST group (p-value 0.003).
Conclusion: Del-Nido cardioplegia is a reliable and better myocardial protective agent than Saint Thomas cardioplegia in adult cardiac surgical procedures.
doi: https://doi.org/10.12669/pjms.38.3.4730
How to cite this:Rizvi MFA, Yousuf SMA, Younas A, Baig MAR. Prospective randomized study comparing outcome of myocardial protection with Del-Nido Cardioplegia versus Saint Thomas Cardioplegia in adult cardiac surgical patients. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4730
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.
Gynaecologists’ views on the management of Vaginal Vault Prolapse: A qualitative study
Authors: Al-Baghdadi Omaema , Barnick Christian , Srivastava Garima , Elbiss Hassan 
Published: January 2022

Objective: This study examined gynaecologists’ experience and views on the management of vaginal vault prolapse (VVP) using laproscopic sarcocolpopexy (LSCP) versus open sarcocolpopexy (OSCP).
Methods: In a qualitative study conducted at the University of Surrey and Homerton University Hospital, UK, from 2016 to 2017, semi-structured interviews were conducted with 15 consultants experienced in minimal access surgery or urogynecology. Interviews were recorded and transcripts were analyzed using the qualitative description (QD) approach.
Results: Eight broad themes emerged: VVP management, LSCP for management of VVP, OSCP and vaginal surgery with or without mesh use in VVP management, laparoscopic training and support as well as surgeons’ attitude towards LSCP. All participants acknowledged the importance of LSCP in the management of post-hysterectomy VVP as benefits outweighed risks in their view. OSCP was considered suitable in very specific circumstances. Vaginal surgery could be an excellent alternative to OSCP bearing in mind long-term efficacy and sexual activity in young women. Most participants agreed with national recommendations to avoid use of mesh in vaginal surgery for VVP and expressed the view that it should be done in specialised centres by trained surgeons who do such operations.
Conclusions: This study showed that the acceptability of LSCP was dependent on participants’ experience and consideration of the balance between patient’s goals and potential risks. It provides useful guidance for future large-scale projects.
doi: https://doi.org/10.12669/pjms.38.3.5215
How to cite this:Al-Baghdadi O, Barnick C, Srivastava G, Elbiss HM. Gynaecologists’ views on the management of Vaginal Vault Prolapse: A qualitative study. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.5215
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 association of pre-existing comorbid conditions with COVID-19 severity and post-COVID complications; insights from South Asia
Authors: Saeed Sahrai , Rajani Ronak 
Published: January 2022

doi: https://doi.org/10.12669/pjms.38.3.5719
How to cite this:Saeed S, Rajani R. The association of pre-existing comorbid conditions with COVID-19 severity and post-COVID complications; insights from South Asia. Pak J Med Sci. 2022;38(3):439-441. doi: https://doi.org/10.12669/pjms.38.3.5719
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.
Κρίσιμοι παράγοντες ανάληψης περιβαλλοντικών δράσεων στα σχολεία
Authors: Γκερμπεσιώτη Γραμματία , Τσιρούκης Αχιλλέας , Κύδρος Δημήτριος , Μπλάνας Γεώργιος 
Published: January 2022

Η περιβαλλοντική εκπαίδευση ως αντικείμενο έρευνας της διεθνούς επιστημονικής κοινότητας δεν είναι πρόσφατη. Ωστόσο, οι περισσότερες έρευνες ασχολήθηκαν με τα αποτελέσματα της περιβαλλοντικής εκπαίδευσης ή τις διαφορετικές διδακτικές μεθοδολογίες και ελάχιστα με τη διερεύνηση της επιρροής των μορφών διοίκησης, οργάνωσης και δικτύωσης της σχολικής μονάδας και των εκπαιδευτικών στην αποτελεσματικότητα των προγραμμάτων και έργων περιβαλλοντικής εκπαίδευσης. Η παρούσα ανασκόπηση της διεθνούς βιβλιογραφίας αποτυπώνει με συστηματικό τρόπο τους κρίσιμους παράγοντες που ωθούν ή απωθούν τους εκπαιδευτικούς από το να συμμετάσχουν σε προγράμματα περιβαλλοντικών δράσεων. Η ανασκοπική έρευνα και μετα-ανάλυση αποκαλύπτει ότι οι συχνότερα απαντώμενοι παράγοντες είναι οι ακόλουθοι: κίνητρα των εκπαιδευτικών, η κοινωνική τους δικτύωση, το στυλ ηγεσίας, το σχολικό κλίμα, αλλά και η οργανωσιακή κουλτούρα των σχολείων.