Mean Age Of Participants Research Articles

Smartphone Application‐Based Addiction Scale: Psychometric Evidence Across Nine Asian Regions Using Advanced Analytic Methods

ABSTRACTIntroductionA smartphone is a device with various functions, including wifi, application functions, mobile networks, ease of mobility, and the capability of using mobile data. Because of the aforementioned functions, people may use smartphones frequently. The Smartphone Application‐Based Addiction Scale (SABAS) is a six‐item questionnaire assessing smartphone addiction with promising psychometric properties. However, it is unclear if the SABAS possesses the strong psychometric properties across Asian regions. The present study aimed to examine the factor structure of the SABAS across nine Asian regions.MethodsUsing datasets collected from Asian regions of Bangladesh, China, Indonesia, Iran, Malaysia, Pakistan, Taiwan, Thailand, and Vietnam, data from 10,397 participants (mean age = 22.40 years; 44.8% men) were used for analyses. All participants completed the SABAS using an online survey or paper‐and‐pencil mode.ResultsFindings from confirmatory factor analysis, Rasch analysis, and network analysis all indicate a one‐factor structure for the SABAS. Moreover, the one‐factor structure of the SABAS was measurement invariant across age (21 years or less vs. above 21 years) and gender (men vs. women) in metric, scalar, and strict invariance. The one‐factor structure was invariant across regions in metric but not scalar or strict invariance.ConclusionThe present study findings showed that the SABAS possesses a one‐factor structure across nine Asian regions; however, noninvariant findings in scalar and strict levels indicate that people in the nine Asian regions may interpret the importance of each SABAS item differently. Age group and gender group comparisons are comparable because of the invariance evidence for the SABAS found in the present study. However, cautions should be made when comparing SABAS scores across Asian regions.

Association of kinesiophobia with pain, disability and functional limitation in adults with knee osteoarthritis: A systematic review and meta-analysis

Knee osteoarthritis (KOA) is a prevalent degenerative joint disease associated with pain, disability, and functional limitations. Kinesiophobia, the fear of movement, has been linked to disability and pain in KOA patients. This study aimed to analyze the relationship between kinesiophobia and symptoms of KOA. A comprehensive literature search was conducted in four electronic databases (PubMed/Medline, Web of Science, Scopus and Science Direct) with the following inclusion criteria: 1) recruited participants with diagnostic of knee osteoarthritis; 2) measures of pain, disability and/or functional limitation through questionnaires or physical tests; 3) articles exploring the correlation between kinesiophobia, and pain, disability, and/or functional limitation as principal or secondary outcome; 4) primary data studies (observational and experimental). A total of 17 studies involving 1,574 participants (mean age 61.04 ± 5.79 years) were included in the corresponding meta-analyses. Results showed a moderate correlation between kinesiophobia and disability (r = 0.519; p-value=0.004), and fair correlations of kinesiophobia with pain (r = 0.362; p-value<0.001), and functional limitation (r = 0.270; p-value<0.001). Despite high heterogeneity (I2: 89.4% for pain, 94.6% for disability, and 90.4% for functional limitation), 52% of studies displayed low risk of bias. In conclusion, kinesiophobia positively correlates with pain, disability, and functional limitation in KOA patients.

Sociodemographic predictors and cross-cultural comparisons in tests performance from the Cambridge Neuropsychological Testing Automated Battery (CANTAB) among children aged 6-8 years from Montevideo, Uruguay.

Cross-culturally comparative data on measures of executive function (EF) are essential, but the 6-8-year group remains insufficiently described. This study examined the sociodemographic predictors of EF test performance employing the Cambridge Neuropsychological Testing Automated Battery (CANTAB). It also compared developmental trends in EF among children from Uruguay, the United States, and Mexico. EFs were assessed with the Intra-dimensional/Extra-dimensional shift, Spatial Span (SSP), and Stockings of Cambridge (SOC) tests from the CANTAB. The study sample consisted of 6-8-year-old children from the Salud Ambiental Montevideo (SAM) cohort in Uruguay. Differences between cohorts were examined, and we performed generalized linear regressions to assess the association between sociodemographic factors, and each EF domain. The final sample consisted of 525 participants (mean age in months 82.5 ± 6.0). Across all ages, SAM children had significantly lower performance in the SSP and SOC tasks compared to U.S. and Mexican children. On the Intra-dimensional/Extra-dimensional shift task, SAM children had similar scores to U.S. and Mexican children. Mother's intelligence quotient (IQ; β = 0.01; 95% CI [0.005, 0.02]), child's IQ (0.02 [0.02, 0.03]), the HOME total score (0.02 [0.01, 0.03]), as well as HOME subscales of accompaniment (0.13 [0.07, 0.20]), enrichment (0.11 [0.06,0.16]), and physical environment (0.07 [0.03, 0.10]) were positively associated with the span length (SSP task). Child's IQ (0.02 [0.01,0.03]) was positively associated with the number of problems solved on the SOC test. Uruguayan children perform lower in working memory and planning tests than U.S. children but similarly to Mexican children, while cognitive flexibility is consistent across all groups. Further, mother and child IQ, as well as the home environment, are important predictors of EF. These differences should be examined in the context of diverse cultural values and sociodemographic factors affecting CANTAB construct validity in this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cognitive impact of anticholinergic and sedative burden in people with HIV.

This study aims to estimate the extent to which anticholinergic and sedative burden is associated with cognitive ability and self-reported cognitive difficulties (SCD) in middle-aged and older adults living with HIV. This cross-sectional analysis examined data from the inaugural visit of participants enrolled in the Positive Brain Health Now (BHN) study. Cognitive ability was measured using the Brief Cognitive Ability Measure (B-CAM; higher is better) and SCD using the Perceived Deficits Questionnaire (PDQ; higher is worse). Medication burden was quantified using several scoring systems, including the Anticholinergic Cognitive Burden (ACB), Anticholinergic and Sedative Burden Catalog (ACSBC), Anticholinergic Drug Scale (ADS), Anticholinergic Risk Scale (ARS), and the Sedative Load Model (SLM). Multivariable Ordinary Least Squares and quantile regression were utilized to estimate average effects and distribution-specific impacts, respectively. Of 824 participants (mean age 53 years, 84.7% men), 41.4% used anticholinergics (ACSBC) and 39% used sedatives (SLM). High anticholinergic burden was linked to worse cognitive ability [ β = -3.81; 95% confidence interval (CI): -7.16, -0.46] and SCD ( β = 3.89; 95% CI: 1.08, 6.71). Using three or more anticholinergics worsened cognitive ability ( β = -4.45; 95% CI: -8.54, -0.35), and using three or more sedatives increased SCD ( β = 4.35; 95% CI: 0.92-7.78). Stronger negative associations were observed in participants with lower cognitive ability and more difficulties. These results suggest that anticholinergic and sedative burden may contribute to cognitive impairment in people with HIV. Personalized medication management and regular cognitive assessments could mitigate these adverse effects.

Sex-dependent interplay of phosphate and inflammation on muscle strength irrespective of muscle mass in middle-aged and older adults

BackgroundElevated circulatory phosphate levels are linked to age-related muscle dysfunction, yet the mechanisms remain unclear. This study investigated the hypothesis that inflammation plays a role in connecting elevated phosphate levels to muscular dysfunction in middle-aged and older individuals and explored potential sex-based differences in these associations. MethodsThe study, based on the I-Lan Longitudinal Aging Study Cohort, analyzed individuals' serum phosphate and hsCRP levels. Sex-specific analyses explored links between circulatory phosphate, inflammation, and muscle profiles (mass, handgrip strength, and walking speed). The study also examined potential mediation or synergistic effects of inflammation in the circulatory phosphate-muscle relationship. ResultsThe study included 2006 participants (mean age: 65.5 ± 6.5 years; 49.8 % men). Women exhibited higher circulatory phosphate levels than men. Linear analyses revealed that higher phosphate levels were significantly associated with weaker handgrip strength but not with reduced muscle mass in both men and women. In women, circulatory phosphate was not associated with inflammation (hsCRP levels), while in men, higher phosphate levels were significantly associated with higher hsCRP levels. In men, a synergistic effect was observed, where the combination of high hsCRP and elevated phosphate levels had a more pronounced impact on reducing handgrip strength than either factor alone. ConclusionsThis study highlights a sex-specific association of inflammation in the mechanisms of hyperphosphatemia-related muscle weakness. The findings emphasize the importance of managing both hyperphosphatemia and chronic inflammation to mitigate their collective impact on muscle function, particularly in older men. Addressing these factors is crucial for promoting muscle health in later life.

Factors associated with mental health outcomes in a Muslim community following the Christchurch terrorist attack.

On 15 March 2019, a white supremacist terrorist attacked two mosques in Christchurch, New Zealand. Fifty-one people were killed and another 40 sustained non-fatal gunshot injuries. To examine the mental health of the Muslim community, and individual and exposure-related factors associated with mental health outcomes. This is the baseline analysis of a longitudinal study of adults from the Muslim community interviewed 11-32 months after the shootings. It included a diagnostic interview (MINI), measures of sociodemographic factors, prior mental health, prior traumatic events, exposure in the attacks, discrimination, life stressors, social support and religious coping. Logistic regression models examined associations with mental health outcomes. The sample comprised 189 participants (mean age 41 (s.d. = 13); 60% female), and included: bereaved, 17% (n = 32); injured survivors 12% (n = 22); non-injured survivors, 19% (n = 36); family members of survivors, 35% (n = 67); and community members without the above exposures, 39% (n = 74). Overall, 61% had at least one mental disorder since the attacks. Those bereaved (P < 0.01, odds ratio 4.28, 95% CI 1.75-10.49) and survivors, whether injured (P < 0.001, odds ratio 18.08, 95% CI 4.70-69.60) or not (P < 0.01, odds ratio 5.26, 95% CI 1.99-13.89), had greater odds of post-traumatic stress disorder. Those bereaved (P < 0.001, odds ratio 5.79, 95% CI 2.49-13.46) or injured (P = 0.04, odds ratio 4.43, 95% CI 1.07-18.28) had greater odds of depression. Despite unique features of this attack on a Muslim population, findings accord with previous studies. They suggest generalisability of psychopathology after terror attacks, and that being bereaved or directly experiencing such events is associated with adverse mental health outcomes. The study is registered on the Australian NZ Clinical Trials Registry (ACTRN12620000909921).

Sleep Bad, Feel Bad: Unpacking the Role of Exercise and Socializing

This study investigates the daily associations between sleep disturbances and emotional well-being, focusing on exercise and social interaction as potential moderating factors. Using a longitudinal daily diary approach, we analyzed data from 455 participants (mean age = 41.98 years, 382 females) who reported daily diaries over 20 days. Multilevel modeling was employed to analyze both within- and between-person relations between sleep variables (duration, efficiency, difficulty falling asleep) and next day positive/negative affect. The analysis also explored the moderating roles of exercise and socializing, adjusting for age, sex, and COVID-related variables. Our findings indicate that at both within- and between-person levels, higher sleep efficiency predicted increased positive affect and reduced negative affect; conversely, difficulty falling asleep predicted diminished positive affect and heightened negative affect. Sleep duration had a nonlinear relationship with positive and negative affect, with both longer and shorter than usual sleep duration predicting less positive and more negative affect. Exercise and socializing showed different moderating roles in the relationship between sleep and negative affect. Exercise was found to mitigate the negative impact of poor sleep on negative affect, whereas extended socializing amplified the salutary impact of good sleep on reducing negative affect. Our findings underscore the importance of sleep health in daily emotional well-being, suggesting associations between sleep efficiency, difficulty falling asleep, and next-day affect at both within- and between-person levels. Furthermore, the distinct moderation patterns of exercise and socializing provide unique insights into the interplay of sleep, exercise, and social interaction, allowing more targeted interventions.

Dissociation of White Matter Bundles in Different Recovery Measures in Poststroke Aphasia.

Poststroke aphasia (PSA) recovery shows high variability across individuals and at different time points. Although diffusion biomarkers from the ventral and dorsal streams have demonstrated strong predictive power for language outcomes, it is still unclear how these biomarkers relate to the various stages of PSA recovery. In this study, we aim to compare diffusion metrics and language measures as predictors of language recovery in a longitudinal cohort of participants with PSA. Participants were recruited at a stroke unit at the emergency room, and underwent diffusion magnetic resonance imaging scanning and language assessment within 3 days (acute phase) after stroke, with behavioral follow-ups at subacute (10±3 days) and chronic phases (>6 months). We conducted regression analyses on language performance (cross-sectional), Δscores between all time points (acute-subacute, subacute-chronic, acute-chronic), and relative Δscores between all time points (Δscore/language baseline score), with acute diffusion metrics from language-related white matter tracts, lesion size, language baseline scores, and demographic data as predictors. Thirty-nine participants presenting PSA were recruited, and 24 participants (mean age, 73 years; 8 women) completed the 3-time point assessment in total. The best prediction model of performance scores used axial diffusivity from the left arcuate fasciculus in both the subacute (R2=0.785) and chronic stages (R2=0.626). Moreover, the prediction of ∆scores depended on axial diffusivity from the left inferior frontal-occipital fasciculus in the subacute stage (R2=0.5) and depended additionally on axial diffusivity from the right inferior frontal-occipital fasciculus in the chronic stage (R2=0.68). The prediction of mediation analyses showed that the lesion load of the left arcuate fasciculus mediated the relationship between axial diffusivity from the left arcuate fasciculus and chronic language performance. Language performance at subacute and chronic time points could be predicted by the integrity of the left arcuate fasciculus, whereas Δscores in the subacute and chronic phases depended on the left inferior frontal-occipital fasciculus, showing a dissociation of the white matter pathways about language outcomes. These results suggest a functional differentiation of the dual-stream components in PSA recovery.

When noise becomes signal: a study of blink rate using an eye tracker

PurposeAlthough blink rate is considered important for digital eye strain and dry eye conditions, its assessment has been mostly manual. This study aimed at quantifying blink rate automatically using the Eyelink 1000 Plus eye tracker and comparing it with manual counting. Additionally, blink rate was correlated with reading eye movements and reading speed. MethodsThirty participants (mean age 26.8±3.5 years; 19 females) were enrolled. An on-screen reading task for 3 minutes duration, was repeated 3 times with a 2-minute break between the repetitions. During this task, eye movements and blinks were measured through the Eyelink 1000 Plus eye tracker. The blink was also counted manually by the examiner in real time from a video feed. ResultsThe blink rate obtained by the eye tracker (median [Q1, Q3]:11.7 [6.8,15.5] blinks/min) and manual counting (11.6 [7.1, 15.4] blinks/min) were comparable (p>0.5). No significant correlations were observed between the blink rate and any of the reading eye movement parameters except saccadic amplitude (Spearman's rho, rs =0.506). No statistically significant correlation was found between the blink rate and reading speed. ConclusionThe Eyelink 1000 Plus eye tracker gives a comparable blink rate compared to that obtained through manual counting. A positive correlation between the blink rate and saccade amplitude could indicate a coupled interaction between the two mechanisms to minimize visual loss during reading. The option of using this tracker to investigate blinks in dry eye and binocular vision disorders can be further explored.

School environment and adolescent health: Results from the HPTN 068 cohort

PurposeTo assess the relationship between school environment and health and behavior outcomes. MethodsData are from baseline and first follow-up of the HIV Prevention Trials Network (HPTN) 068 longitudinal trial established in 2012 of adolescent girls and young women in rural Mpumalanga Province, South Africa. Data from 2212 participants are included. We measured the association between four school environment domains: school resources, school safety, negative personal experiences, and school connectedness, and several health and behavior outcomes: depressive symptoms, low attendance, recent pregnancy, recent unprotected sex, transactional sex, and having an older romantic partner. We used a g-computation approach to estimate risk differences (RD) for the longitudinal relationship between the school environment (measured at the individual and school level) on individual health and behavior outcomes, controlling for baseline covariates. ResultsThe mean age of participants at baseline was 15.4; mean age at first follow-up was 16.6. Individual baseline perceptions of an unsafe school environment (RD = 3.1 %, 95 % CI: 1.3–5.2 %) and more frequent negative experiences (RD = 4.0 %, 95 % CI: 2.0–5.9 %) were associated with higher absolute risk of depressive symptoms at follow-up. There was an overall trend toward higher risk of pregnancy, unprotected sex, and having an older partner among those who reported fewer school resources, lack of school safety, more negative personal experiences, and lack of school connectedness. ConclusionsOur findings provide evidence of an overall trend toward higher risk of depression, pregnancy, unprotected sex, and having an older partner among those reporting a worse school environment across four school environment domains.

Clinical and Biochemical Profiles of Hospitalized Patients with Hypercalcaemia from a Tertiary Care Centre in North India.

Background and aims: The profile of hypercalcaemia in hospitalized patients in India seems to be changing. However, studies evaluating the profile of hypercalcaemia in hospitalized settings in India are extremely limited. This prospective study aims to evaluate the clinical and biochemical profile of hospitalized patients with hypercalcaemia from a tertiary care centre in north India. Materials and methods: Clinical and biochemical profiles of subjects with hypercalcaemia detected during hospitalization/hospitalized with hypercalcaemia were assessed. A total of 91 subjects with sustained hypercalcaemia, who were eligible, underwent further investigation as per the institutional protocol and the data collected were analyzed. Results: The mean age of participants was 57.88 ± 14.23 years, with 62.64% of participants being females. The most common symptoms were nausea and anorexia, which were observed in all patients. The most common clinical sign was dehydration, which was observed in 32.97% of subjects. Primary hyperparathyroidism was the most common cause (41.76%), followed by suspected or confirmed malignancy/solid tumours in 15.38% of subjects. Other causes were advanced chronic liver disease (10.99%), multiple myeloma (9.89%), vitamin D toxicity (8.79%), granulomatous disorders (2.20%) and drug-i nduced disorders (1.10%). Forty-one subjects (45.05%) developed acute kidney injury and 14 subjects (15.38%) developed acute pancreatitis as a complication. Six subjects (6.59%) died during the course of hospitalization because of either primary disease or other secondary complications. Conclusions: Clinicians should be aware of changing patterns of hypercalcaemia in a hospital setting. Hypercalcaemia in hospitalized patients is associated with significant complications and mortality. Further large-scale prospective studies are needed to understand the changing pattern of hypercalcaemia in hospitalized patients from India.

Iron Deficiency Anemia Among Women in Skardu, Gilgit-Baltistan

ABSTRACT Objective: To determine the frequency of iron deficiency anemia among women in Skardu, Gligit-Baltistan. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital, Skardu, Pakistan, from Dec 2021 to May 2022. Methodology: A total of 202 women were selected through consecutive sampling from General Medical OPD of Combined Military Hospital, Skardu, Pakistan. Hemoglobin globin levels (Hb gram/deciliter), mean corpuscular volume (MCV fL) and red cell distribution width (RDW%) were determined for all enrolled patients. Results: Mean age of participants in this study was 34.46±10.93 years. Reduced Hb was observed in 62(30.69%) women with a mean hemoglobin level of 9.48±1.59 gl/deciliter and mean corpuscular volume of 79.97±10.7d fL. Among these women, 5(2.47%) were severely anemic (6.56±0.39 gl/deciliter), 28(13.86%) moderately anemic (8.51±0.83 gl/deciliter) while 29(14.35%) were mildly anemic (10.92±0.48 gl/deciliter). Women of younger age group, between18-35 years, were found to suffer more from iron deficiency anemia (39.14%) with mean hemoglobin levels of 11.31±1.80 and mean corpuscular volume of 79.34±10.86 fL. Conclusion: Iron Deficiency Anemia is present in female population of Gilgit-Baltistan in general and woman of childbearing age in particular. Emergency measures for awareness and fortification of basic food items with iron should be undertaken at large scale.

Visual and Surgical Outcomes of Outreach Cataract Surgeries in Ilam District of Nepal: An Observational Study

Introduction: Cataracts are the leading cause of preventable blindness worldwide. Although cataract blindness is reversible, its service coverage remains poor, particularly in rural and hilly areas of Nepal. The study aimed to evaluate visual outcomes of outreach cataract surgeries and associated intraoperative and post-operative complications. Methods: This cross-sectional study was conducted at a district of Eastern Nepal after ethical clearance was taken from the Institutional Review Committee (Reference number: 88). Total 131 subjects had cataract surgeries at the surgical camp, and their pre-operative, one-day and one-month post-operative visual acuities were compared, and intraoperative and post-operative surgical complications were recorded. Visual acuity ≥ 6/12 was considered normal. Data was collected in excel and analyzed in SPSS. Results: The mean age of participants was 71.8±9.51 years, with 70 (53.43%) male. A total of 156 eyes from 131 subjects underwent cataract surgeries and among them 25 (19.08%) cases underwent bilateral cataract surgeries. At the day one of surgery, visual acuity improved to normal in 137 (87.82%) of cases, while after one-month, visual acuity improved to normal in 150 (96.15%) of cases with best-corrected glasses. There were 4 (2.56%) intraoperative complications, which included surgery-induced subluxated bag, premature entry, iris trauma, and posterior capsule rent. Conclusions: The visual and surgical outcomes of cataract surgeries performed at an outreach surgical camp were excellent with minimal surgical complications.

Immuno-hematological parameters among adult HIV patients before and after initiation of Dolutegravir based antiretroviral therapy, Addis Ababa, Ethiopia.

Immuno-hematological abnormalities are common among HIV infected individuals as well as patients with highly active antiretroviral therapy (HAART). However, the immuno-hematological outcome of Dolutegravir based antiretroviral therapy (ART) usage is not well investigated. To assess hematological and immunological parameters among adult HIV patients before and after initiation of Dolutegravir based ART regimen at St. Peter Specialized Hospital, Addis Ababa, Ethiopia. A cross-sectional study was conducted from May to July 2021 at St. Peter Specialized Hospital among adult HIV patients. A total of 422 HIV patients on Dolutegravir based ART (combination of Dolutegravir/lamivudine/tenofovir disoproxil fumarate (DTG/3TC/TDF)) for a minimum of 3 months were selected using convenient sampling methods. Socio-demographic as well as clinical data of the participants was obtained using pre-tested structured questionnaires and a review of medical records. Hematological parameters such as CBC was obtained using Beckman coulter automated hematology analyzer and immunological parameters such as CD4 count were determined using BD FACS presto. Statistical analysis of the data was done using SPSS version 21. Paired t-test was used to compare dependent variables before and after initiation of the new HAART and binary logistic regression was used to determine predictors of immuno-hematological abnormalities. P-value < 0.05 was considered as statistically significant. Of 422 adult HIV patients, about 273(64.7%) were females. The mean age of study participants was 42.2 years (±10.4SD). The mean white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin (Hb), platelet distribution width (PDW), CD4 count, as well as lymphocyte percentage, neutrophil percentage, and platelet counts (PLT) were increased significantly(P<0.05) after 3 months of the Dolutegravir based therapy. While, red cell distribution width (RDW) and mean cell hemoglobin (MCH) were decreased (P<0.05) after the treatment. Other hematological parameters such as mean cell volume (MCV), hematocrit (HCT), mean cell hemoglobin concentration (MCHC), mean platelet volume (MPV) and platelet distribution width (PDW) showed no significant change. On the other hand, the most common hematological abnormalities identified after the new HAART were anemia (12.1%); followed by Leucopenia (11.3%), neutropenia (6%), and thrombocytopenia (4%). Anemia was associated with female sex (AOR = 7.8, 95% CI: 1.9-32.2, P<0.005) and WHO clinical stage III/IV (AOR = 16, 95% CI: 10.63-66.46, P<0.01). There was a significant change in certain immuno-hematological parameters such as WBC count, RBC count, PLT count, Hb, PDW, CD4 count, lymphocyte and neutrophil percentage after initiation of the Dolutegravir based therapy. Anemia was the most common hematological abnormality. Further studies are required to fully comprehend the outcome of the new treatment regimen on immuno-hematological parameters.

Comparison of Disease Severity in Established Rheumatoid Arthritis by DAS28-ESR and Clinical Disease Activity Index

Objective: To compare disease severity in established rheumatoid arthritis by Disease Activity Score-28 for Rheumatoid Arthritis with Erythrocyte sedimentation rate (DAS28-ESR) and Clinical Disease Activity Index. Study Design: Cross-sectional study. Place and Duration of Study: Rheumatology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jul 2021 to Feb 2022. Methodology: Patients diagnosed with active Rheumatoid Arthritis were clinically evaluated in detail by consultant rheumatologist. Disease activity and severity was assessed by using DAS-28 and Clinical Disease Activity Index. Association of disease severity on DAS-28 was established with severity on Clinical Disease Activity Index and other socio-demographic factors. Results: Mean age of the study participants was 35.81±8.45 years. In our sample, 303(75.75%) patients were female while 97(24.25%) were male. As per DAS-28 scoring, 175(43.75%) had mild, 142(35.5%) had moderate while 83(20.75%) had severe Rheumatoid Arthritis while as per Clinical Disease Activity Index scoring, 176(44%) had mild, 145(36.25%) had moderate while 79(19.75%) had severe Rheumatoid Arthritis. Disease severity on DAS-28 was strongly associated with disease severity on Clinical Disease Activity Index (p-value &lt;0.001). Conclusion: Severity of illness with DAS28-ESR had significant association with severity on Clinical Disease Activity Index, thus, both scales can be used interchangeably depending upon choice of clinician and availability of resources.

Comparison of Awake Craniotomy with Craniotomy Under General Anesthesia for Resection of Tumors in Eloquent Areas of Brain

Objective: To compare awake craniotomy with craniotomy under general anesthesia for early post-operative parameters in patients undergoing resection of tumors in eloquent areas of brain. Study Design: Quasi experimental study. Place and Duration of Study: Department of Anesthesia, Combined Military Hospital, Rawalpindi Pakistan Apr 2021 to May 2022. Methodology: All the patients who underwent resection surgeries for brain tumors in eloquent areas of brain were included in the study. They were divided into two Groups via lottery method. Group A underwent awake craniotomy while Group B underwent craniotomy under general anesthesia. Relevant intraoperative and early post-operative parameters were compared in both the Groups. Results: A total of 60 patients who underwent resection of eloquent area brain tumors in our hospital during the study period were included in the final analysis. Out of these 40(66.7%) underwent craniotomy under general anesthesia while 20(33.3%) underwent awake craniotomies. Mean age of the study participants was 45.61±7.889 years. Frontal lobe tumors were the most encountered brain tumors in our study participants. Patients who underwent awake craniotomy had statistically significantly lower KORNAFSKY score, lesser days of post-operative admission days and lesser neurological deficits (p-value &lt;0.005) as compared to those who underwent craniotomy under general anesthesia. Conclusion: Awake craniotomy emerged as superior option as compared to craniotomy under general anesthesia in terms of early post-operative parameters. Lower KORNAFSKY score, lesser days of post-operative admission days and lesser neurological deficits were seen in patients undergoing awake craniotomy.

Exploring the Relationship Between Visceral Fat and Coronary Artery Calcification Risk Using Metabolic Score for Visceral Fat (METS-VF)

Background: Metabolic Score for Visceral Fat (METS-VF) is a novel indicator for estimating intra-abdominal fat, yet its connection with coronary artery calcification (CAC) remains uncharted. Our research aims to explore the novel METS-VF indicator’s link to CAC while comparing its performance against relevant anthropometric indices. Methods: This study enrolled participants who underwent health checkups and computed tomography scans for categorizing severity of CAC using the coronary artery calcium score. The METS-VF was calculated and compared with anthropometric indices in estimating the presence of CAC and different CAC severity using receiver operating characteristic curves. Results: Overall, 1217 participants (mean age 50.7 ± 9.9, 53.8% male) were included. METS-VF (odds ratio [OR], 1.506; 95% confidence interval [CI], 1.181–1.921; p = 0.001) was positively associated with the presence of CAC, even after accounting for cardiometabolic factors. Notably, METS-VF was positively associated with mild (OR, 1.450; 95% CI, 1.115–1.886; p = 0.006), moderate (OR, 1.865; 95% CI, 1.137–3.062; p = 0.014), and severe (OR, 2.316; 95% CI, 1.090–4.923; p = 0.029) CAC. Moreover, METS-VF yielded the highest area under curve (AUC) value in the estimation of the CAC presence (AUC = 0.710), mild (AUC = 0.682), moderate (AUC = 0.757), and severe (AUC = 0.807) CAC when compared with body mass index, waist circumference, visceral adiposity index, triglyceride–glucose index, and metabolic score for insulin resistance. The optimal METS-VF cut-off value was 6.4 for predicting CAC. Conclusions: METS-VF emerged as a strong independent marker for detecting CAC presence across mild, moderate, and severe CAC categories, outperforming major anthropometric indices in accurately estimating the presence of CAC and different severity of CAC.

Social Media As An Online Public Sphere: A Study among the First-Time Malay Voters

In a developing democracy like Malaysia, social media is pervasive in its influence on politics and democratic processes, particularly among the youth. Social media promotes the expression of opinions among groups, thereby opening up the realm of the public sphere in a semi-democratic country like Malaysia. Unlike the original conception of the public sphere, social media consists of spaces where citizens belonging to different groups and cultures, speak in different registers or languages, finding meaningful participation. Based on online interviews with 44 first-time voters among the Malay youth group, this article investigates the aspects of the interaction between young voters and the social media “public sphere.” It examines the platforms they use to communicate about politics, how they make sense of politics, and how they interact with other citizens through social media. The findings reveal four prevalent themes. First, young people have a keen interest in accessing political information on social media, albeit passively. Secondly, Twitter and Facebook were found to be the most influential social media channels for first-time voters seeking political information. Thirdly, out of concern about the surveillance practices on social media, private WhatsApp groups have emerged as the primary platform for first-time voters to engage in political discussions and debates. This leads us to the fourth theme, where the stories that feature on WhatsApp and Instagram are gaining prominence as the dominant platform for sharing political information. This trend highlights the potential for the incidental and ephemeral consumption of political content through these platforms. This trend may have significant implications for how political messages are communicated and received on these social media platforms.

The effect of Vagus nerve stimulation (VNS) on seizure control, cognitive function, and quality of life in individuals with drug-resistant epilepsy: A systematic review article.

To evaluate the effect of vagus nerve stimulation (VNS) on seizure control, cognitive functions, and quality of life in individuals with drug-resistant epilepsy. An extensive search of electronic databases was carried out in order to carry out this systematic review. The databases Google Scholar, Embase, PubMed, and the Cochrane Library were searched first to carryout gray literature. To reduce the quantity of pointless studies in the advanced search, the search is limited to "human studies" and "English language" publications only. Combining keywords and Medical Subject Headings (MeSH) terms like ("Vagus Nerve Stimulation" OR "VNS") AND ("Epilepsy" OR "Seizure Control") AND ("Cognitive Function" OR "Quality of Life"). Studies that have been published up to November 30/2023 were included. The search strategy yielded a total of 392 relevant studies. The mean age of participant's ranges from 11 years to 33 years. The duration of follow-up ranging from 6 to 36 months. Eleven studies were included in the review. The mean≥50% response rate after VNS therapy was 56.94% ranged from 48.90% to 83.00%. Four and three studies provided information about Quality of Life in Epilepsy Inventory (QOLIE-31) and The Liverpool Seizure Severity Scale (LSSS) questionnaires respectively. Epilepsy is a chronic disease characterized by sudden abnormal discharge of brain neurons, which leads to transient brain dysfunction and the presence of spontaneous recurrent seizures. Vagus nerve stimulation has recently been proposed as a potential tool in the treatment of seizure, depressive symptoms, and cognitive impairments. There has been variation in the effects of VNS treatment on seizure control, cognitive functions, and quality of life among patients with drug-resistant epilepsy. So, a comprehensive review of exciting literature is important to see the pooled effect. Previous systematic review and meta-analysis papers were mostly randomized control trial type with specific diseases. The use of a wider variety of study designs than only randomized controlled trials is important. So, we included retrospective and prospective cohort studies in addition to randomized control trials. This enables a more thorough assessment of the connection between quality of life, cognitive function, and vagus nerve stimulation. In addition, the paper looks at a wide range of disease kinds and patterns. We have established a uniform and comprehensive approach throughout the selected studies by mandating the inclusion of all three crucial parameters: vagus nerve stimulation, cognitive function, and quality of life. This systematic review examined 392 relevant studies on vagus nerve stimulation (VNS) therapy, with participants ranging from 11 to 33 years old and follow-up durations of 6-36 months. Eleven studies were included, and the mean response rate after VNS therapy was 56.94%, ranging from 48.90% to 83.00%. The review also reported on quality of life and cognitive function, and seizure severity frequency result from several studies.

Intravesical Tranexamic Acid for Patients Requiring Continuous Bladder Irrigation in the ED: A Non-Randomized Feasibility Study

Objectives Tranexamic Acid (TXA) is a well studied clot stabilizer that may have benefit when used intravesically prior to continuous bladder irrigation (CBI). This study determined the feasibility of conducting a randomized controlled trial using TXA intravesically in patients who present to the emergency department (ED). The study goals were to recruit 20 participants within a six-month time frame and have an 80% recruitment rate. Methods Potential participants were identified at triage if they presented with a complaint of hematuria or urinary retention and were over the age of eighteen. Informed consent was obtained if the patient needed CBI and met inclusion/exclusion criteria. If consented, TXA was instilled intravesically at the start of CBI treatment and the patient was followed until their CBI treatment was complete. Results A total of 14 (out of 18) participants were recruited over eight months. The mean age of participants was 74.5 +/- 7.4 years with only one of the 14 participants identifying as female. For resource management, the study was designed to include support from an on-call nurse. The on-call nurse was called seven out of fourteen times and came into hospital one time. Eight participants did not require hospital admission after the TXA intervention. The mean length of hospital stay for participants was 4.6+/-2.7 days. The mean ED length of stay was 8.1+/-4.9 hours. There were no reported adverse events. Conclusion The recruitment rate of 78% indicated that the study was acceptable to participants, but we were unable to meet our goal of recruiting 20 participants over six months. Study protocol was followed, and no adverse events were found.