Effects Of Modalities Research Articles

Comparison of the preconditioning effect of different exercise training modalities on myocardial ischemia-reperfusion injury.

The study of exercise preconditioning can develop strategies to prevent cardiovascular diseases and outline the efficient exercise model. However, the exercise type with the most protective effect against ischemia-reperfusion injury is unknown. In this study, we examined the effects of three kinds of exercise preconditioning on myocardial ischemia-reperfusion in adult rats and explored the possible underlying mechanisms. Male Wistar rats subjected to ten weeks of endurance, resistance, and concurrent training underwent ischemia (30 min) and reperfusion (120 min) induction. Then, infarction size, serum levels of the CK-MB, the redox status, and angiogenesis proteins (VEGF, ANGP-1, and ANGP-2) were measured in the cardiac tissue. Results showed that different exercise training modes have the same reduction effects on infarction size, but ischemia-reperfusion-induced CK-MB was lower in response to endurance training and concurrent training. Furthermore, cardiac VEGF levels increased in all three kinds of exercise preconditioning but ischemia-reperfusion-induced ANGP-1 elevated more in endurance training. The cardiac GPX activity was improved significantly through the resistance and concurrent exercise compared to the endurance exercise. In addition, all three exercise preconditioning models decreased MPO levels, and ischemia reperfusion-induced MDA was lower in endurance and resistance training. Overall, these results indicated that cardioprotection of exercise training against ischemia-reperfusion injury depends on the exercise modality. Cardioprotective effects of aerobic, resistance, and concurrent exercises are due to different mechanisms. The preconditioning effects of endurance training are mediated mainly by pervasive angiogenic responses and resistance training through oxidative stress amelioration. The preconditioning effects of concurrent training rely on both angiogenesis and oxidative stress amelioration.

Visualization of choroidal vasculature in pigmented mouse eyes from experimental models of AMD

A variety of techniques exist to investigate retinal and choroidal vascular changes in experimental mouse models of human ocular diseases. While all have specific advantages, a method for evaluating the choroidal vasculature in pigmented mouse eyes has been more challenging especially for whole mount visualization and morphometric analysis. Here we report a simple, reliable technique involving bleaching pigment prior to immunostaining the vasculature in whole mounts of pigmented mouse choroids. Eyes from healthy adult pigmented C57BL/6J mice were used to establish the methodology. The retina and anterior segment were separated from the choroid. The choroid with retinal pigment epithelial cells (RPE) and sclera was soaked in 1% ethylenediaminetetraacetic acid (EDTA) to remove the RPE. Tissues were fixed in 2% paraformaldehyde (PFA) in phosphate-buffered saline (PBS). Choroids were subjected to melanin bleaching with 10% hydrogen peroxide (H2O2) at 55 °C for 90 min, washed in PBS and then immunostained with anti-podocalyxin antibody to label vascular endothelium followed by Cy3-AffiniPure donkey anti-goat IgG at 4 °C overnight. Images of immunostained bleached choroids were captured using a Zeiss 710 confocal microscope. In addition to control eyes, this method was used to analyze the choroids from subretinal sodium iodate (NaIO3) RPE atrophy and laser-induced choroidal neovascularization (CNV) mouse models. The H2O2 pretreatment effectively bleached the melanin, resulting in a transparent choroid. Immunolabeling with podocalyxin antibody following bleaching provided excellent visualization of choroidal vasculature in the flat perspective. In control choroids, the choriocapillaris (CC) displayed different anatomical patterns in peripapillary (PP), mid peripheral (MP) and far peripheral (FP) choroid. Morphometric analysis of the vascular area (VA) revealed that the CC was most dense in the PP region (87.4 ± 4.3% VA) and least dense in FP (79.9 ± 6.7% VA). CC diameters also varied depending on location from 11.4 ± 1.97 mm in PP to 15.1 ± 3.15 mm in FP. In the NaIO3-injected eyes, CC density was significantly reduced in the RPE atrophic regions (50.7 ± 5.8% VA in PP and 45.8 ± 6.17% VA in MP) compared to the far peripheral non-atrophic regions (82.8 ± 3.8% VA). CC diameters were significantly reduced in atrophic regions (6.35 ± 1.02 mm in PP and 6.5 ± 1.2 mm in MP) compared to non-atrophic regions (14.16 ± 2.12 mm). In the laser-induced CNV model, CNV area was 0.26 ± 0.09 mm2 and luminal diameters of CNV vessels were 4.7 ± 0.9 mm. Immunostaining on bleached choroids with anti-podocalyxin antibody provides a simple and reliable tool for visualizing normal and pathologic choroidal vasculature in pigmented mouse eyes for quantitative morphometric analysis. This method will be beneficial for examining and evaluating the effects of various treatment modalities on the choroidal vasculature in mouse models of ocular diseases such as age-related macular degeneration, and degenerative genetic diseases.

Is Magnetic Resonance Imaging (MRI) Still a Gold Standard to Detect Breast Cancer: A Meta-analysis.

Breast cancer is fatal if it is not diagnosed and treated promptly; consequently, early and precise diagnosis is essential. In comparison to mammography and sonography, the sensitivity of MRI to cellular changes and its ability to differentiate benign from malignant tumors make it the preferred imaging technique. Consequently, the present meta-analysis assessed the effectiveness of different imaging modalities for breast cancer detection and evaluated the diagnostic accuracy of MRI. Pertinent articles were searched in PubMed, MEDLINE, and Central databases using the appropriate keywords as per the PRISMA guidelines. Retrospective and prospective studies were included according to the predefined PICOS criteria. A meta-analysis was performed using RevMan and MedCalc software, and statistical parameters, such as odds ratio, sensitivity, specificity, likelihood ratios, and accuracy, were calculated. Publication bias was evaluated using Egger's and Begg's tests, and diagnostic performance was assessed using Youden's and Bland-Altman's plots. Fourteen clinical trials with 4666 breast cancer patients with perineural spread were included. The included studies used MRI for the detection of breast cancer lesions according to the BI-RADS® (Breast Imaging Reporting and Data System) guidelines and stated that it has high sensitivity and diagnostic accuracy. Similarly, the present meta-analysis found a high sensitivity of 86.12 % and a high diagnostic accuracy of 91.2%. Other than this, we obtained a specificity of 65%, a positive likelihood ratio of 2.7, and a negative likelihood ratio of 0.22. The pooled odds ratio (OR) was reported to be 1.87 (95% CI 1.42-2.46), and the pooled risk ratio value was 1.19 (95% CI 1.11-1.28). Present meta-analysis strongly recommends MRI as an effective imaging method for the detection of breast cancer.

Comprehension of biology texts in bilingual and monolingual university students: Exploring the effect of presentation modality, previous knowledge, and topic enjoyment.

Comprehension of biology texts in bilingual and monolingual university students: Exploring the effect of presentation modality, previous knowledge, and topic enjoyment.

Justiça e redes sociais: modelos comparados de regulamentação da liberdade de expressão dos Magistrados entre tutela dos direitos fundamentais e estado de direito

Digital communication has transformed the traditional ways information is produced and disseminated, including the judicial process and the actions of its protagonists, such as the judge. Starting with a brief consideration of the positive effects of the new communication modalities, in terms of judicial transparency and access to legal information, and in negative terms, taking into account the phenomenon of the “Judgment by the Media” this study seeks to compare some recent and innovative regulations regarding the use of social networks by judges, adopted at regional and national level, study seeks to compare some recent and innovative regulations for judges’ use of social media, adopted at both regional and national levels. In particular, it aims to highlight the relationship and the necessary balance between limiting the magistrate’s freedom of expression and affirming some fundamental principles of the rule of law, such as the independence and impartiality of the judiciary.

Voice Outcomes of Intensive Voice Feminization Therapy for Transgender Women Delivered via Telepractice: Pilot Study

ObjectivesThe aim of this pilot study is to investigate the efficacy of an intensive voice feminization therapy program provided via telepractice. MethodsA total of 10 transgender women participated, with 9 completing the therapy program. All participants received 12 sessions of resonant voice therapy in combination with Vocal Function Exercises and voice hygiene, which were completed within four weeks. Acoustic and aerodynamic measures, auditory-perceptual ratings, Trans Woman Voice Questionnaire (TWVQ) and self-rated voice femininity were conducted before and after treatment. ResultsStatistical analysis showed significant improvements in acoustic measures such as fundamental frequency and semitones, TWVQ scores, auditory-perceptual ratings and self-perception of voice femininity after intensive voice therapy. ConclusionsThis study provides preliminary evidence to suggest that transgender women can benefit from intensive voice therapy when provided via telepractice, with a more feminine voice and better self-perceived voice-related quality of life. The limitations of this study were that the single-group study design lacked a control group for comparison, and the small sample size. Therefore, a randomize controlled and follow-up study with a larger sample size, exploring the effects of different treatment modalities on transgender women's voices is warranted.

Surveillance After Surgical and Endovascular Treatment for Peripheral Artery Disease: a Dutch Survey

At present, there is no clear, optimal approach to surveillance after invasive treatment of peripheral artery disease (PAD) in terms of modality, duration, clinical benefit, and cost effectiveness. The ongoing debate on the clinical benefit and cost effectiveness of standard surveillance creates a clear knowledge gap and may result in overtreatment or undertreatment. In this study, a survey was conducted among vascular surgeons in the Netherlands to assess the currently applied surveillance programmes. All vascular surgeons from the Dutch Society for Vascular Surgery received an online survey on follow up after open and endovascular revascularisation in patients with PAD. Surveillance was defined as at least one follow up visit after intervention with or without additional imaging or ankle brachial index (ABI) measurement. Ten types of PAD interventions were surveyed. Surveys were returned by 97 (46.2%) of 210 vascular surgeons, and 76% reported using a routine follow up protocol after an invasive intervention. Clinical follow up only is most commonly performed after femoral endarterectomy (53%). After peripheral bypass surgery, clinical follow up only is applied rarely (4 - 8%). In 6 of the 10 interventions surveyed, duplex ultrasound (DUS) is the most used imaging modality for follow up. After bypass surgery, 76 - 86% of vascular surgeons perform DUS with or without ABI measurement. After endovascular interventions, 21 - 60% perform DUS surveillance. Lifelong surveillance is most applied after aortobifemoral bypass (57%). Surveillance frequency and duration vary greatly within the same intervention. Frequencies range from every 3 months or 6 months to annually. Duration ranges from one time surveillance to lifelong follow up. There is significant practice variation in surveillance after surgical and endovascular treatment of patients with PAD in the Netherlands. We recommend the initiation of prospective studies to evaluate treatment outcomes and to define the clinical need and cost effectiveness of standardised surveillance programmes for patients with PAD.

The Effect of Different Input Modalities on Alignment in Second Language Oral Retelling

The Effect of Different Input Modalities on Alignment in Second Language Oral Retelling

Vibration behaviors of orthogonally stiffened cylindrical shell coupled with internal circular plates in wavenumber-frequency domain

In this paper, vibration characteristics of orthogonally stiffened cylindrical shell coupled with multiple internal circular plates are discussed using wavenumber analysis. The theoretical model and formulation for the orthogonally stiffened cylindrical shell coupled with internal circular plates are developed by employing a modified variational method. A unified variational modeling procedure is employed to ensure the continuity conditions between each substructure, including cylindrical shell, circular plate, longitudinal stringer, and circumferential ring. The displacement components of the cylindrical shell are described by Fourier series along the circumferential direction and orthogonal polynomials along meridional direction. Thus, the responses of the shell in wavenumber domain can be naturally obtained. Convergence studies for the theoretical model are conducted by finite element method to verify the reliability of the present method. The vibration behaviors of the coupled model under three typical external loads, including single point force, multiple uniformly spaced point forces, and line force, are studied based on the vibration fields in wavenumber domain. The results indicate that the circumferential modal coupling effect and modal contribution to the total vibrations are sensitive to the types of external excitations, which induces the different vibration behaviors.

Retracted: Meta-Analysis of the Application Effect of Different Modalities of Thermal Ablation and Surgical Treatment in Papillary Thyroid Microcarcinoma

Retracted: Meta-Analysis of the Application Effect of Different Modalities of Thermal Ablation and Surgical Treatment in Papillary Thyroid Microcarcinoma

A multimodal screening system for elderly neurological diseases based on deep learning

In this paper, we propose a deep-learning-based algorithm for screening neurological diseases. We proposed various examination protocols for screening neurological diseases and collected data by video-recording persons performing these protocols. We converted video data into human landmarks that capture action information with a much smaller data dimension. We also used voice data which are also effective indicators of neurological disorders. We designed a subnetwork for each protocol to extract features from landmarks or voice and a feature aggregator that combines all the information extracted from the protocols to make a final decision. Multitask learning was applied to screen two neurological diseases. To capture meaningful information about these human landmarks and voices, we applied various pre-trained models to extract preliminary features. The spatiotemporal characteristics of landmarks are extracted using a pre-trained graph neural network, and voice features are extracted using a pre-trained time-delay neural network. These extracted high-level features are then passed onto the subnetworks and an additional feature aggregator that are simultaneously trained. We also used various data augmentation techniques to overcome the shortage of data. Using a frame-length staticizer that considers the characteristics of the data, we can capture momentary tremors without wasting information. Finally, we examine the effectiveness of different protocols and different modalities (different body parts and voice) through extensive experiments. The proposed method achieves AUC scores of 0.802 for stroke and 0.780 for Parkinson’s disease, which is effective for a screening system.

False Alarm Effects in Early Warnings for Emergency Vehicles: Exploring Drivers' Move-Over Behavior.

This study investigated drivers' move-over behavior when receiving an Emergency Vehicle Approaching (EVA) warning. Furthermore, the possible effects of false alarms, driver experience, and modality on move-over behavior were explored. EVA warnings are one solution to encourage drivers to move over for emergency vehicles in a safe and timely manner. EVA warnings are distributed based on the predicted path of the emergency vehicle causing a risk of false alarms. Previous EVA studies have suggested a difference between inexperienced and experienced drivers' move-over behavior. A driving simulator study was conducted with 110 participants, whereof 54 inexperienced and 56 experienced drivers. They were approached by an emergency vehicle three times. A control group received no EVA warnings, whereas the experimental groups received either true or false warnings, auditory or visual, 15seconds before the emergency vehicle overtook them. Drivers who received EVA warnings moved over more quickly for the emergency vehicle compared to the control group. Drivers moved over more quickly for each emergency vehicle interaction. False alarms impaired move-over behavior. No difference in driver behavior based on driver experience or modality was observed. EVA warnings positively affect drivers' move-over behavior. However, false alarms can decrease drivers' future willingness to comply with the warning. The findings regarding measurements of delay can be used to optimize the design of future EVA systems. Moreover, this research should be used to further understand the effect of false alarms in in-car warnings.

CoFeSe2 @DMSA@FA Nanocatalyst for Amplification of Oxidative Stress to Achieve Multimodal Tumor Therapy.

Nanomedicine has significantly advanced precise tumor therapy, providing essential technical blessing for active drug accumulation, targeted consignment, and mitigation of noxious side effects. To enhance anti-tumor efficacy, the integration of multiple therapeutic modalities has garnered significant attention. Here, we designed an innovative CoFeSe2 @DMSA@FA nanocatalyst with Se vacancies (abbreviated as CFSDF), which exhibits synergistic chemodynamic therapy (CDT) and photothermal therapy (PTT), leading to amplified tumor oxidative stress and enhanced photothermal effects. The multifunctional CFSDF nanocatalyst exhibits the remarkable ability to catalyze the Fenton reaction within the acidic tumor microenvironment, efficiently converting hydrogen peroxide (H2 O2 ) into highly harmful hydroxyl radicals (⋅OH). Moreover, the nanocatalyst effectively diminishes GSH levels and ameliorates intracellular oxidative stress. The incorporation of FA modification enables CFSDF to evade immune detection and selectively target tumor tissues. Numerous in vitro and in vivo investigations have consistently demonstrated that CFSDF optimizes its individual advantages and significantly enhances therapeutic efficiency through synergistic effects of multiple therapeutic modalities, offering a valuable and effective approach to cancer treatment.

Mechanical circulatory support in pediatric myocarditis: Support strategies and outcomes in a nationally representative cohort

Myocarditis is a common cause of pediatric heart failure which may require mechanical circulatory support (MCS). The purpose of this study is to describe MCS strategies used in a nationwide cohort of pediatric patients with myocarditis, identify trends over time, and compare outcomes between MCS strategies. This study utilized the Kids' Inpatient Database (KID), a national sample of administrative discharge data. KID admissions from 2003-2016 were queried using ICD-9/10 codes to identify those with a diagnosis of myocarditis. MCS outcomes were compared using logistic regression. Of 5,661 admissions for myocarditis, MCS was used in 424 (7.5%), comprised of extracorporeal membrane oxygenation (ECMO) in 312 (73.6%), including 32 (10.2%) instances of extracorporeal cardiopulmonary resuscitation (ECPR), temporary ventricular assist devices (tVAD) in 28 (6.6%), durable VAD (dVAD) in 42 (9.9%) and combination MCS in 42 (9.9%). MCS use increased over time (p=0.031), but MCS strategies did not significantly change. Mortality was high in the MCS group (28.3%). There was no difference in odds of death in the VAD only or combination MCS group compared to the non-ECPR ECMO group (p=0.07 and p=0.65, respectively). MCS is used in 1 in 13 pediatric myocarditis cases, and MCS use is increasing over time with ECMO remaining the most frequently used modality. Mortality remains high in patients that receive MCS but does not differ between those receiving VAD or combination MCS as compared to non-ECPR ECMO on unadjusted analysis. Further prospective analysis is required to evaluate the relative effectiveness of MCS modalities in this disease.

The modulation effects of the mind-body and physical exercises on the basolateral amygdala-temporal pole pathway on individuals with knee osteoarthritis

Background/ObjectiveTo investigate the modulatory effects of different physical exercise modalities on connectivity of amygdala subregions and its association with pain symptoms in patients with knee osteoarthritis (KOA). Methods140 patients with KOA were randomly allocated either to the Tai Chi, Baduanjin, Stationary cycling, or health education group and conducted a 12 week-long intervention in one of the four groups. The behavioral, magnetic resonance imaging (MRI), and blood data were collected at baseline and the end of the study. ResultsCompared to the control group, all physical exercise modalities lead to significant increases in Knee Injury and Osteoarthritis Outcome Score (KOOS) pain score (pain relief) and serum Programmed Death-1 (PD-1) levels. Additionally, all physical exercise modalities resulted in decreased resting state functional connectivity (rsFC) of the basolateral amygdala (BA)-temporal pole and BA-medial prefrontal cortex (mPFC). The overlapping BA-temporal pole rsFC observed in both Tai Chi and Baduanjin groups was significantly associated with pain relief, while the BA-mPFC rsFC was significantly associated with PD-1 levels. In addition, we found increased fractional anisotropy (FA) values, a measurement of water diffusion anisotropy of tissue that responded to changes in brain microstructure, within the mind-body exercise groups' BA-temporal pole pathway. The average FA value of this pathway was positively correlated with KOOS pain score at baseline across all subjects. ConclusionsOur findings suggest that physical exercise has the potential to modulate both functional and anatomical connectivity of the amygdala subregions, indicating a possible shared pathway for various physical exercise modalities.

In vitro fertilization pregnancy may cause fetal thymic volume involution: A case-control study

Background: The effect of modern infertility treatment modalities on fetal thymic volume has not been well known.
 Objective: 3-dimensional (3D) fetal thymus volumes of 18-24 wk in vitro fertilization (IVF) pregnancies and spontaneous pregnancy cases were compared.
 Materials and Methods: 135 cases were evaluated in this prospective case-control study. The study was conducted between July 2019 and July 2020 at a university hospital in Trabzon, Turkey. Fetal thymus volume was calculated in the pregnant cases included in the study with the help of the virtual organ computer-assisted analysis system included in the advanced ultrasonography system. The fetal thymus volumes were compared between pregnant women with IVF and spontaneous pregnant women.
 Results: The fetal thymus size was significantly lower in the IVF pregnancy group than in spontaneous pregnancy cases (p < 0.001). It was found that the fetal complications, such as non-reassuring fetal health status and requirement for neonatal intensive care, were higher in cases who became pregnant after IVF treatment. It was also found that the rate of any pregnancy complication was significantly higher in IVF pregnancy c group (p = 0.02).
 Conclusion: In light of these results, it may be concluded that small fetal thymus size may be another fetal complication of IVF pregnancies.
 Key words: Fetus, Fertilization in vitro, Prenatal ultrasonography, Thymus.

The Impact of Regular Physical Exercise on Psychopathology, Cognition, and Quality of Life in Patients Diagnosed with Schizophrenia: A Scoping Review.

The presence of less healthy lifestyle habits among individuals diagnosed with schizophrenia which can contribute to the escalation of physical disorders and exacerbation of psychological symptoms is well documented. The present scoping review aims to synthesize and evaluate the available evidence regarding the impact of regular physical exercise on psychopathology, cognition, and quality of life (QoL) in patients diagnosed with schizophrenia. A literature search was performed across Web of Science, SCOPUS, PubMed, and SPORTDiscus for randomized control trials published up to April 2022. Two independent reviewers applied the selection criteria and a third reviewer resolved discrepancies. A total of twelve studies were included, of which nine used endurance training and three used concurrent training (one of these additionally used resistance training). The results reveal benefits of various modalities of supervised regular exercise in the psychopathology of schizophrenia. Furthermore, regular endurance training seems to improve cognitive function in patients with schizophrenia and promote their QoL; however, results are inconclusive with respect to this last variable. The assessment of methodological quality in the reviewed articles indicates a high overall risk of bias, particularly in relation to deviations from intended interventions and the selection of reported results. Furthermore, an assessment of exercise reporting revealed that only 5 out of 19 items were fulfilled in more than 50% of the articles. Future research is needed to evaluate the effects of different training modalities and the optimal dose-response relationship in patients diagnosed with schizophrenia.

Evaluating Web-Based Care for Mental Health and Substance Use Issues for Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, and 2-Spirit Youths in the Context of the COVID-19 Pandemic: Community-Based Participatory Research Study.

Mental health (MH) and substance use (SU) care supports are often difficult to access for the lesbian, gay, bisexual, transgender, queer, questioning, and 2-spirit (LGBTQ2S+) population. There is little known on how the shift to web-based care has affected and changed the experiences of LGBTQ2S+ youths within the MH care system. This study sought to examine how web-based care modalities have affected access to care and quality of care for LGBTQ2S+ youths seeking MH and SU services. Researchers used a web-based co-design method to explore this population's relationship with MH and SU care supports, focusing on the experiences of 33 LGBTQ2S+ youths and their relationship with MH and SU supports during the COVID-19 pandemic. A participatory design research method was used to gain experiential knowledge of LGBTQ2S+ youths' lived experience with accessing MH and SU care. Thematic analysis was used to examine the resulting audio-recorded data transcripts and create themes. Themes related to web-based care included accessibility, web-based communication, provision of choice, and provider relationship and interactions. Barriers to care were identified in particular for disabled youths, rural youths, and other participants with marginalized intersecting identities. Unexpected benefits of web-based care were also found and emphasize the idea that this modality is beneficial for some LGBTQ2S+ youths. During the COVID-19 pandemic, a time where MH- and SU-related problems have increased, programs need to reevaluate current measures so that the negative effects of web-based care modalities can be reduced for this population. Implications for practice encourage service providers to be more empathetic and transparent when providing services for LGBTQ2S+ youths. It is suggested that LGBTQ2S+ care should be provided by LGBTQ2S+ folks or organizations or service providers who are trained by LGBTQ2S+ community members. Additionally, hybrid models of care should be established in the future so that LGBTQ2S+ youths have the option to access in-person services, web-based ones, or both as there can be benefits to web-based care once it has been properly developed. Implications for policy also include moving away from a traditional health care team model and developing free and lower-cost services in remote areas.

Exploring audiovisual speech perception in monolingual and bilingual children in Uzbekistan

This study aimed to investigate the development of audiovisual speech perception in monolingual Uzbek-speaking and bilingual Uzbek–Russian-speaking children, focusing on the impact of language experience on audiovisual speech perception and the role of visual phonetic (i.e., mouth movements corresponding to phonetic/lexical information) and temporal (i.e., timing of speech signals) cues. A total of 321 children aged 4 to 10 years in Tashkent, Uzbekistan, discriminated /ba/ and /da/ syllables across three conditions: auditory-only, audiovisual phonetic (i.e., sound accompanied by mouth movements), and audiovisual temporal (i.e., sound onset/offset accompanied by mouth opening/closing). Effects of modality (audiovisual phonetic, audiovisual temporal, or audio-only cues), age, group (monolingual or bilingual), and their interactions were tested using a Bayesian regression model. Overall, older participants performed better than younger participants. Participants performed better in the audiovisual phonetic modality compared with the auditory modality. However, no significant difference between monolingual and bilingual children was observed across all modalities. This finding stands in contrast to earlier studies. We attribute the contrasting findings of our study and the existing literature to the cross-linguistic similarity of the language pairs involved. When the languages spoken by bilinguals exhibit substantial linguistic similarity, there may be an increased necessity to disambiguate speech signals, leading to a greater reliance on audiovisual cues. The limited phonological similarity between Uzbek and Russian might have minimized bilinguals’ need to rely on visual speech cues, contributing to the lack of group differences in our study.

Development Of Inhibitors In Hemophilia A Patients Receiving Different Treatment Options

Introduction: Hemophilia A is the most common inherited bleeding disorder in Pakistan. Apart from frequent bleeds and joint deformities, the formation of inhibitors is the major complication of hemophilia. Inhibitors are antibodies formed against the coagulation factor. The purpose of this study is to determine the incidence of inhibitor development in hemophilia A patient receiving different treatment modalities namely fresh frozen plasma (FFP)/cryoprecipitate, plasma derived FVIII concentrates and long-acting recombinant FVIII concentrates. Aims & Objectives: To assess the development of inhibitors in hemophilia A patients receiving treatment modalities. Place and Duration of Study: The study was conducted at Chughtai Institute of Pathology from November 2021 to November 2023. Material &Methods: A total of 75 registered patients of the Hemophilia Patient Welfare Society, Lahore and Sundas Foundation were initially screened for FVIII inhibitors. Those who were found negative for these inhibitors were included in the study and then divided into three equal groups of 25 patients each. One group received only FFP/cryoprecipitate for treatment, the other group received plasma derived FVIII concentrates and the last group received recombinant factor VIII concentrates. These patients were observed for two years i.e after 15-20 exposures and following this period their inhibitors screening was done again to establish the effect of different treatment modalities on inhibitor development. The data collected was entered and analyzed by SPSS-21, a p-value of ?0.05 was considered significant. Results: Our study showed that only 3 patients out of 25, receiving FFP as treatment modality developed inhibitors. Whereas, none of the patients receiving plasma derived FVIII concentrates and recombinant factor VIII concentrates developed inhibitors. The P value calculated is 0.044 which is significant. Conclusion: Plasma derived FVIII concentrates and recombinant FVIII concentrates are safer as compared to FFP/Cryoprecipitate and have lesser risk for inhibitor development.