bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of PAP smear and liquid based cytology as a screening method for cervical carcinoma
Authors: Khakwani Mehnaz , Parveen Rashida , Azhar Maryam 
Published: August 2022

Objectives: To compare conventional PAP smear (CPS) and liquid-based cytology (LBC) for cervical carcinoma screening at a tertiary care hospital of South Punjab, Pakistan.
Methods: This cross-sectional study was conducted at the Department of Obstetrics and Gynecology, Nishtar Hospital, Multan, Pakistan from January 2021 to June 2021. We included a total of 265 women aged between 20 to 65 years who, presented with complaints related to cervical lesion and unhealthy cervix. The CPS and LBC methods were applied for screening of cervical carcinoma. Findings of both CPS and LBC were compared with histopathological findings to find out sensitivity, specificity, positive predictive value and negative predictive value for both techniques.
Results: In a total of 265 women, mean age was noted to be 45.4±6.8 years. White discharge per vagina was the commonest presenting complaint noted in 12 (46.8%) patients. Satisfactory smears were found in significantly more cases with LBC in comparison to CPS (p<0.001). Sensitivity CPS and LBC for the detection of low-grade squamous intraepithelial lesion (LSIL) were found to be 71.8% and 87.2% while for high-grade squamous intraepithelial lesion (HSIL), sensitivity of CPS and LBC were 61.9% and 76.2% respectively. Specificity of CPS and LBC for the detection of LSIL was found to be 97.9% and 98.7% while for HSIL, specificity of CPS and LBC was 98.7% and 99.2% respectively.
Conclusion: In comparison to conventional CPS, LBC was found to be better in terms of adequacy of smear and identification of LSIL and HSIL.
doi: https://doi.org/10.12669/pjms.38.7.5742
How to cite this:Khakwani M, Parveen R, Azhar M. Comparison of PAP smear and liquid based cytology as a screening method for cervical carcinoma. Pak J Med Sci. 2022;38(7):---------. doi: https://doi.org/10.12669/pjms.38.7.5742
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.
Adverse COVID-19 vaccination effects in Finnish patients with Ménière’s disease: a cross-sectional study
Authors: Beukes Eldre , Manchaiah Vinaya , Pyykkö Nora , Pyykkö Ilmari 
Published: August 2022

Background: The association between reporting adverse coronavirus disease 2019 (COVID-19) vaccination effects and those with a history of audiovestibular difficulties is unknown. The aim of this research is therefore to investigate adverse vaccination effects in adults with a history of Ménière’s disease. Specifically, the incidence of adverse effects, the factors associated with those reporting adverse effects and the relationship between the reporting of audiovestibular and other adverse effects. Methods: A mixed-methods exploratory cross-sectional survey study design was used. Data were collected from 333 members of the Finnish Ménière Association. The survey was designed to obtain demographic information that may be associated with having adverse effects or not, vaccination-specific information and adverse vaccination effects. Both health and audiovestibular adverse events were identified. Data analysis included comparing those reporting and not reporting adverse vaccination effects. Results: The mean age was 63 years with 81% being female. Of the 327 respondents who had one of the COVID-19 vaccinations (Comirnatry/ Pfizer, Astra Zeneca, or Moderna), 203 (62%) reported no adverse effects. The type of or number of vaccinations were not related to the reporting of adverse effects. The most frequently reported adverse effects were injection site tenderness (38%), arm pain (21%), fever (15%) and headaches (15%). Post-vaccination tinnitus and vertigo (both 7%) were the most frequently reported audiovestibular-related symptoms, followed by aural fullness (6%) and hearing loss (4%). Those reporting previous pre-vaccination vertigo were more likely to have post-vaccination vertigo. The presence of post-vaccination tinnitus, hearing loss, and aural fullness, predicted the presence of post-vaccination vertigo. Conclusions: A small proportion of patients with a history of Ménière’s disease may experience adverse post-vaccination effects. Further research is required to explore whether adverse post-vaccination audiovestibular effects are more prevalent in those with a history of otological disorders compared with the general population.
Next-generation sequencing (NGS) reveals low-abundance HIV-1 drug resistance mutations among patients experiencing virological failure at the time of therapy switching in Uganda
Authors: Namaganda Maria Magdalene , Sendagire Hakim , Kateete David Patrick , Kigozi Edgar , Luutu Nsubuga Moses , Ashaba Katabazi Fred , Kabahita Jupiter Marina , Kakembo Fredrick Elishama , Kanyerezi Stephen , Castelnuovo Barbara , Kambugu Andrew , Ssewanyana Isaac , Okirya Chris , Nabadda Susan , Joloba Moses , Mboowa Gerald 
Published: August 2022

Background: The emergence and spread of antiretroviral drug resistant HIV-1 variants is one of the major factors associated with therapeutic failure in persons living with HIV (PLWH) as it jeopardizes the efforts to reduce the progression to AIDS. Whereas Sanger sequencing is the most appropriate conventional method for HIV drug resistance testing, it has limited capacity to detect low-abundance variants. This study assessed the suitability of next generation sequencing (NGS) to reveal low-abundance HIV-1 drug resistance mutations amongst patients experiencing virological failure at the time of therapy switching in Uganda. Methods: Archived blood samples previously collected from 60 PLWH were used in this study. Briefly HIV viral RNA was extracted and performed targeted NGS of portions of both the HIV protease and reverse transcriptase genes on the illumina MiSeq. For performance comparison, Sanger sequencing was also performed for all the samples targeting the highlighted genes. The sequence data generated was analyzed using HyDRA bioinformatics pipeline, accompanied by the Stanford HIV drug resistance database, to annotate and report drug resistance mutations/variants. Results: Out of the 60 samples, 58 passed preliminary quality control and were considered for subsequent analysis—of which 38/58 (65.5%) registered low-abundance HIV drug resistance variants. Overall, 757 variants from the NGS data and 90 variants from the Sanger data were identified. The most prevalent minority variants included; K65R (65.5%), K14R (63.8%), K45R (63.8%), L63P (63.8%), I15V (63.8%), K70R (60.3%), V77I (60.3%), L283I (60.3%), G16E (58.6%) and L282C (58.6%). Conclusion: An estimated 65.5% of the sampled population harbors low-abundance HIV-1 variants, most of which are associated with virological failure, and consequently antiviral drug resistance. NGS suitably detects drug resistance mutations even at frequencies below 20% of the viral quasi species that are occasionally missed by Sanger sequencing.
The effect of ingestion of red dragon fruit extract on levels of malondialdehyde and superoxide dismutase after strenuous exercise in rats (Rattus norvegicus)
Authors: Rusip Gusbakti , Ilyas Syafrudin , Lister I. Nyoman Ehrich , Ginting Chrismis N. , Mukti Indra 
Published: August 2022

Background: Prolonged activation of skeletal muscles causes a decrease in the production of fatigue. Exercise with strenuous intensity causes an increase in Reactive Oxygen Species (ROS). An increase in free radicals causes oxidative stress resulting in damage to cell function to mitochondrial dysfunction, and fatigue. This study aimed to determine the antioxidant potential of red dragon fruit (RDF) to delay fatigue due to oxidative stress, which improves cell function in mitochondria. Methods: 25 male rats (Rattus norvegicus) aged three months were divided into five groups: Group K1 was N.A. (No Activity) but drinking and eating; Group K2 performed strenuous exercise without RDF treatment; Groups 3, 4, and 5 (P1, P2 and P3, respectively) performed strenuous exercise and were treated with 75 mg kg-1.bw, 150 mg kg-1.bw, and 300 mg kg-1.bw of RDF extract, respectively. The exercise for the rats involved intense swimming for 20 minutes a day three time a week for fouweeks. Malondialdehyde (MDA) dan SOD was measured with the ELISA and histopathology for muscle soleus and lung tissue. Results: Strenuous exercise followed by RDF extract ingestion was compared for fatigue in terms of duration and time; before (24.55±1.38 minute) and after (95.31±7.82 minute) and led to a significant difference of 39% (p<0.01). The study also compared MDA before and after RDF extract ingestion in the K2 vs. the P1 group (p<0.05). At the same time, P2 differed more significantly (p<0.01). This indicated a spread of free radicals and featured histopathological damage of muscle cells. However, ingestion of RDF extract leads to improvement of soleus muscle cells; thus, repairs cell function, delaying fatigue. Conclusion: This study confirmed that strenuous exercise, which causes an increase in ROS, intensifies free radicals with RDF extract ingestion and declines oxidative stress, repairing cell function and delaying fatigue.
Physico-chemical properties of waste derived biochar from community scale faecal sludge treatment plants
Authors: Nicholas Hannah Larissa , Mabbett Ian , Apsey Henry , Robertson Iain 
Published: August 2022

Background: The dumping of untreated faecal sludge from non-sewered onsite sanitation facilities causes environmental pollution and exacerbates poor public health outcomes across developing nations. Long-term mechanisms to treat faecal sludge generated from these facilities are needed to resolve the global sanitation crisis and realize the Sustainable Development Goal (SDG) 6 “ensure availability and sustainable management of water and sanitation for all” by 2030. Pyrolysis of faecal sludge removes pathogens and generates biochar, which can be used as a soil enhancer. Methods: The properties of faecal sludge biochars from three full-scale treatment plants in India were determined via Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), energy dispersive x-ray (EDX) spectroscopy, crystal x-ray diffraction (XRD), proximate analyses, and BET surface area porosimetry. Results: Results showed that all three biochars had low specific surface area, high alkaline pH values, high ash content, and negative surface charge. Fourier transform infrared spectra showed the same surface functional groups present in each biochar. X-ray diffraction analysis showed the mineral composition of each biochar differed slightly. Scanning electron microscopy analysis indicated a porous structure of each biochar with ash particles evident. Conclusions: Slight differences in the ash content, surface area, pH and mineral content was observed between the three biochars.
LEISH2b - A phase 2b study to assess the safety, efficacy, and immunogenicity of the Leishmania vaccine ChAd63-KH in post-kala azar dermal leishmaniasis
Authors: Lacey Charles , Musa Ahmed , Khalil El Tahir , Younis Brima , Osman Mohamed , Wiggins Rebecca , Keding Ada , Kaye Paul 
Published: August 2022

Background: The leishmaniases are neglected tropical diseases caused by various Leishmania parasite species transmitted by sand flies. They comprise a number of systemic and cutaneous syndromes including kala-azar (visceral leishmaniasis, VL), cutaneous leishmaniasis (CL), and post-kala-azar dermal leishmaniasis (PKDL). The leishmaniases cause significant mortality (estimated 20 - 50,000 deaths annually), morbidity, psychological sequelae, and healthcare and societal costs. Treatment modalities remain difficult. E.g., East African PKDL requires 20 days of intravenous therapy, and frequently relapsing VL is seen in the setting of HIV and immunodeficiency. We developed a new therapeutic vaccine, ChAd63-KH for VL / CL / PKDL and showed it to be safe and immunogenic in a phase 1 trial in the UK, and in a phase 2a trial in PKDL patients in Sudan. Methods: This is a randomised double-blind placebo-controlled phase 2b trial to assess the therapeutic efficacy and safety of ChAd63-KH in patients with persistent PKDL in Sudan. 100 participants will be randomly assigned 1:1 to receive placebo or ChAd63-KH (7.5 x1010vp i.m.) at a single time point. Follow up is for 120 days after dosing and we will compare the clinical evolution of PKDL, as well as the humoral and cellular immune responses between the two arms. Discussion: Successful development of a therapeutic vaccine for leishmaniasis would have wide-ranging direct and indirect healthcare benefits that could be realized rapidly. For PKDL patients, an effective therapeutic vaccination used alone would have very significant clinical value, reducing the need for extensive hospitalization and chemotherapy. Combining vaccine with drug (immuno-chemotherapy) might significantly increase the effective life of new drugs, with lower dose / abbreviated regimens helping to limit the emergence of drug resistance. If therapeutic benefit of ChAd63-KH can be shown in PKDL further evaluation of the vaccine in other forms of leishmaniasis should be considered. Clinicaltrials.gov registration: NCT03969134.
Settings for non-household transmission of SARS-CoV-2 during the second lockdown in England and Wales – analysis of the Virus Watch household community cohort study
Authors: Hoskins Susan , Beale Sarah , Nguyen Vincent , Fragaszy Ellen , Navaratnam Annalan M.D. , Smith Colette , French Clare , Kovar Jana , Byrne Thomas , Fong Wing Lam Erica , Geismar Cyril , Patel Parth , Yavlinksy Alexei , Johnson Anne M. , Aldridge Robert W. , Hayward Andrew ,   Virus Watch Collaborative
Published: August 2022

Background: “Lockdowns” to control serious respiratory virus pandemics were widely used during the coronavirus disease 2019 (COVID-19) pandemic. However, there is limited information to understand the settings in which most transmission occurs during lockdowns, to support refinement of similar policies for future pandemics. Methods: Among Virus Watch household cohort participants we identified those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outside the household. Using survey activity data, we undertook multivariable logistic regressions assessing the contribution of activities on non-household infection risk. We calculated adjusted population attributable fractions (APAF) to estimate which activity accounted for the greatest proportion of non-household infections during the pandemic’s second wave. Results: Among 10,858 adults, 18% of cases were likely due to household transmission. Among 10,475 participants (household-acquired cases excluded), including 874 non-household-acquired infections, infection was associated with: leaving home for work or education (AOR 1.20 (1.02 – 1.42), APAF 6.9%); public transport (more than once per week AOR 1.82 (1.49 – 2.23), public transport APAF 12.42%); and shopping (more than once per week AOR 1.69 (1.29 – 2.21), shopping APAF 34.56%). Other non-household activities were rare and not significantly associated with infection. Conclusions: During lockdown, going to work and using public or shared transport independently increased infection risk, however only a minority did these activities. Most participants visited shops, accounting for one-third of non-household transmission. Transmission in restricted hospitality and leisure settings was minimal suggesting these restrictions were effective. If future respiratory infection pandemics emerge these findings highlight the value of working from home, using forms of transport that minimise exposure to others, minimising exposure to shops and restricting non-essential activities.
A systematic review protocol for identifying the effectiveness of greenhouse gas mitigation interventions for health care systems in low- and middle-income countries
Authors: Blom Iris Martine , Asfura Javier Shafick , Eissa Mohamed , Mattijsen Juliette Claudine , Sana Hamaiyal , Haines Andrew , Whitmee Sarah 
Published: August 2022

Background: Climate change is predicted to be our century's most significant health threat. In 2021, 46 countries committed to environmentally sustainable low carbon health care systems. Of those, 34 were from low- and middle-income countries (LMICs). Currently, health systems are responsible for 4.4% of global greenhouse gas (GHG) emissions, with health systems in high-income countries (HICs) contributing the largest proportion to the sector's GHG emissions. However, future increases are predicted in LMICs in the absence of robust GHG mitigation. This systematic review aims to identify evidence-based GHG mitigation interventions to guide the transformation of health care systems towards net zero, specifically in LMICs. Additionally, potential synergies between interventions that aid adaption to climate change and mitigate GHG emissions will be investigated. Methods: This protocol will follow the 'Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) checklist of recommended items to address in a systematic review protocol'. A comprehensive search will be conducted on electronic databases identified as relevant. Search terms were identified to capture all relevant peer-reviewed, primary research published between 1990 and 2022. The risk of bias will be assessed, and the quality of evidence graded. The eventual narrative synthesis will feed into a theory of change framework on GHG mitigation of health care systems in LMICs. Discussion: This systematic review will synthesise the existing evidence around GHG mitigation interventions across all scopes of emissions, including scope 1 (health care operations), scope 2 (energy), and scope 3 (supply chains). It can be used to inform recommendations on how health care systems in LMICs can reduce emissions while prioritising which actions to take to gain the most significant reductions in GHG emissions, considering ease of implementation, scope and cost. Finally, this can catalyse further research in this area which is urgently needed.
Combined influence of the gain and dispersion of a mode-locked fiber laser on a time-stretching analog-to-digital conversion link
Authors: Chen Bowen , Wei Zihan , Zhao Ranyou , Xiao Lin , Deng Gang , Ma Wanzhuo , Wang Tianshu 
Published: August 2022

Using theory and experiments, we demonstrated the combined influence of the spectral gain and dispersion of a dissipative soliton mode-locked fiber laser on a time-stretching analog-to-digital conversion link without an optical amplifier. The theoretical and experimental results indicate the following: first, the amplitude and envelope shape of the stretched signal are mainly affected by the spectral gain of the dissipative soliton at different central wavelengths under a radio frequency signal of 10 GHz. Second, at the higher frequency of 25 GHz, the influence of the phase shift induced by the dispersion of different spectral ranges on the amplitude of the stretched signal becomes clearer. The amplitude of the stretched signal across all spectral ranges decrease, and the envelope shape differs from that at 10 GHz. Moreover, the wavelength at the maximum amplitude of the stretched signal changes, for which the influence of the spectral dispersion is greater than that of the spectral gain. Finally, the ratio of the amplitude at 25 GHz to that at 10 GHz at different spectral ranges are different, which indicates that the amplitude of the stretched signal at different spectral ranges is affected by the phase shift by different degrees.
Neural networks for self-adjusting mutation rate estimation when the recombination rate is unknown
Authors: Burger Klara Elisabeth , Pfaffelhuber Peter , Baumdicker Franz 
Published: August 2022

Estimating the mutation rate, or equivalently effective population size, is a common task in population genetics. If recombination is low or high, optimal linear estimation methods are known and well understood. For intermediate recombination rates, the calculation of optimal estimators is more challenging. As an alternative to model-based estimation, neural networks and other machine learning tools could help to develop good estimators in these involved scenarios. However, if no benchmark is available it is difficult to assess how well suited these tools are for different applications in population genetics.
Here we investigate feedforward neural networks for the estimation of the mutation rate based on the site frequency spectrum and compare their performance with model-based estimators. For this we use the model-based estimators introduced by Fu, Futschik et al., and Watterson that minimize the variance or mean squared error for no and free recombination. We find that neural networks reproduce these estimators if provided with the appropriate features and training sets. Remarkably, using the model-based estimators to adjust the weights of the training data, only one hidden layer is necessary to obtain a single estimator that performs almost as well as model-based estimators for low and high recombination rates, and at the same time provides a superior estimation method for intermediate recombination rates. We apply the method to simulated data based on the human chromosome 2 recombination map, highlighting its robustness in a realistic setting where local recombination rates vary and/or are unknown.
Occurrence of Lymphatic Filariasis infection after 15 years of mass drug administration in two hotspot districts in the Upper East Region of Ghana
Authors: Adu Mensah Derrick , Debrah Linda Batsa , Gyamfi Peter Akosah , Rahamani Abu Abudu , Opoku Vera Serwaa , Boateng John , Obeng Prince , Osei-Mensah Jubin , Kroidl Inge , Klarmann-Schulz Ute , Hoerauf Achim , Debrah Alexander Yaw 
Published: August 2022

Background
Lymphatic filariasis (LF) causes chronic morbidity, which usually manifests as lymphedema or hydrocele. Mass drug administration (MDA) began in Kassena Nankana East Municipal (KNEM) and Nabdam, two hotspot districts in the Upper East Region in Ghana, in 2000 and 2005, respectively. This cross-sectional study evaluated the impact of 15 years of MDA on the control of LF as determined by circulating filarial antigen (CFA) and microfilariae assessment in the KNEM and the Nabdam districts.

Methodology/Principal findings
A total of 7,453 participants from eight sub-districts in the two hotspot districts (KNEM: N = 4604; Nabdam: N = 2849) were recruited into the study. The overall CFA prevalence as determined by the FTS was 19.6% and 12.8% in the KNEM and Nabdam districts, respectively. Manyoro, a sub-district on the border with Burkina Faso, recorded the highest CFA prevalence of 26% in the KNEM. Assessment of microfilariae and Og4C3 antigen was done from 1009 (KNEM: N = 799 (79.2%); Nabdam: N = 210 (20.8%)) randomly selected FTS-positive (N = 885) and FTS-negative (N = 124) individuals. The Og4C3 antigen was found in 22.6%/23.0% of the selected individuals (KNEM/Nabdam), whereas the night blood revealed microfilariae in only 0.7%/0.5%.

Conclusions/Significance
Using the WHO endorsed FTS, CFA prevalence exceeded the long-standing <2% threshold—which may need revision and validation. Surprisingly, the Og4C3 ELISA showed positive results in only about one-fifth of the FTS positive samples. However, even this result would not have met the <2% CFA criteria for LF elimination. In contrast, projections from the microfilariae results revealed a halt in LF transmission. The global elimination target was due in 2020 but has been extended to 2030 since this could not be met. Focused MDA intervention intensification on seasonal migrants and non-compliers, and implementation of alternative treatment strategies may suffice for the elimination of the disease.