| 1. |
- Asif, Sana, M.D, PhD student, et al.
(författare)
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Immuno-Modulatory Effects of Dexamethasone in Severe COVID-19 : A Swedish Cohort Study
- 2023
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Ingår i: Biomedicines. - : MDPI. - 2227-9059. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Dexamethasone (Dex) has been shown to decrease mortality in severe coronavirus disease 2019 (COVID-19), but the mechanism is not fully elucidated. We aimed to investigate the physiological and immunological effects associated with Dex administration in patients admitted to intensive care with severe COVID-19. A total of 216 adult COVID-19 patients were included-102 (47%) received Dex, 6 mg/day for 10 days, and 114 (53%) did not. Standard laboratory parameters, plasma expression of cytokines, endothelial markers, immunoglobulin (Ig) IgA, IgM, and IgG against SARS-CoV-2 were analyzed post-admission to intensive care. Patients treated with Dex had higher blood glucose but lower blood lactate, plasma cortisol, IgA, IgM, IgG, D-dimer, cytokines, syndecan-1, and E-selectin and received less organ support than those who did not receive Dex (Without-Dex). There was an association between Dex treatment and IL-17A, macrophage inflammatory protein 1 alpha, syndecan-1 as well as E-selectin in predicting 30-day mortality. Among a subgroup of patients who received Dex early, within 14 days of COVID-19 debut, the adjusted mortality risk was 0.4 (95% CI 0.2-0.8), i.e., 40% compared with Without-Dex. Dex administration in a cohort of critically ill COVID-19 patients resulted in altered immunological and physiologic responses, some of which were associated with mortality.
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| 2. |
- Asif, Sana, M.D, PhD student, et al.
(författare)
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Plasma endostatin correlates with hypoxia and mortality in COVID-19-associated acute respiratory failure
- 2021
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Ingår i: Biomarkers in Medicine. - : Future Medicine. - 1752-0363 .- 1752-0371. ; 15:16, s. 1509-1517
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Tidskriftsartikel (refereegranskat)abstract
- Background: The contribution of endothelial injury in the pathogenesis of COVID-19-associated acute respiratory distress syndrome (ARDS) and resulting respiratory failure remains unclear. Plasma endostatin, an endogenous inhibitor of angiogenesis and endothelial dysfunction is upregulated during hypoxia, inflammation and progress of pulmonary disease.Aim: To investigate if plasma endostatin is associated to hypoxia, inflammation and 30-day mortality in patients with severe COVID-19 infection.Method: Samples for blood analysis and plasma endostatin quantification were collected from adult patients with ongoing COVID-19 (n = 109) on admission to intensive care unit (day 1). Demographic characteristics and 30-day mortality data were extracted from medical records. The ability of endostatin to predict mortality was analyzed using receiving operating characteristics and Kaplan-Meier analysis with a cutoff at 46.2 ng/ml was used to analyze the association to survival.Results: Plasma endostatin levels correlated with; PaO2/FiO2 (r = -0.3, p < 0.001), arterial oxygen tension (r = -0.2, p = 0.01), lactate (r = 0.2, p = 0.04), C-reactive protein (r = 0.2, p = 0.04), ferritin (r = 0.2, p = 0.09), D-dimer (r = 0.2, p = 0.08) and IL-6 (r = 0.4, p < 0.001). Nonsurvivors at 30 days had higher plasma endostatin levels than survivors (72 ± 26 vs 56 ± 16 ng/ml, p = 0.01). Receiving operating characteristic curve (area under the curve 0.7) showed that plasma endostatin >46.2 ng/ml predicts mortality with a sensitivity of 92% and specificity of 71%. In patients with plasma endostatin >46.2 ng/ml probability of survival was lower (p = 0.02) in comparison to those with endostatin <46.2 ng/ml.Conclusion: Our results suggest that plasma endostatin is an early biomarker for disease severity in COVID-19.
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| 3. |
- Asif, Sana, M.D, PhD student, et al.
(författare)
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Severe obstetric lacerations associated with postpartum depression among women with low resilience : a Swedish birth cohort study
- 2020
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 127:11, s. 1382-1390
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Women's levels of resilience and attitudes towards perineal lacerations vary greatly. Some women see them as part of the birthing process, while others react with anger, depressed mood or even self-harm thoughts. A previous study has reported increased risk of postpartum depressive (PPD) symptoms in women with severe perineal lacerations. The aim of this study was to assess the association between severe obstetric perineal lacerations and PPD. A secondary objective was to assess this association among women with low resilience.DESIGN: Nested cohort study.SETTING: Uppsala, Sweden.SAMPLE: Vaginally delivered women with singleton pregnancies (n = 2,990).METHODS: The main exposure was obstetric perineal lacerations. Resilience was assessed in gestational week 32 using the Swedish version of the Sense of Coherence Scale (SOC-29). A digital acyclic graph (DAG) was used to identify possible confounders and mediators. Logistic regression was used to estimate odds ratios and 95% confidence intervals. A sub-analysis was run after excluding women with normal or high resilience.MAIN OUTCOME MEASURES: Postpartum depression, assessed with the Depression Self-Reporting Scale (DSRS), completed at six weeks postpartum.RESULTS: There was no significant association between severe obstetric perineal lacerations and PPD at six weeks postpartum. However, a significant association was found between severe lacerations and PPD in women with low resilience (OR =4.8 95% CI = 1.2-20), persisting even after adjusting for confounding factors.CONCLUSION: Health care professionals might need to identify women with low resilience, as they are at increased risk for PPD after a severe perineal laceration.
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| 4. |
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| 5. |
- Batool, Sana, et al.
(författare)
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Effects of visual scanning exercises in addition to task specific approach on balance and activities of daily livings in post stroke patients with eye movement disorders : a randomized controlled trial
- 2022
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Ingår i: BMC Neurology. - : BioMed Central. - 1471-2377. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Impaired vision is one of the commonest and most disabling consequence following stroke. Among all visual impairments, eye movement disorders are found in 70% of stroke patients which include nystagmus, strabismus, gaze palsies, disconjugate eye movements and cranial nerve palsies. They have a wide ranging impact on balance and activities of daily livings by creating difficulties in maintaining normal alignment and appropriate movement of eyes. The purpose of this study was to examine the effects of visual scanning exercises in addition to task specific approach on balance and activities of daily livings in post stroke patients with eye movement disorders.METHODS: This study is a randomized controlled trial and was conducted in the University of Lahore Teaching Hospital from May 2019 to October 2020. A sample of 64 patients was recruited and randomly allocated into experimental and control group. 32 patients in experimental group were treated with visual scanning exercises along with task specific approach and 32 patients in control group were treated with task specific approach alone. Pre and post assessment of balance and activities of daily livings was assessed on BERG BALANCE SCALE and BARTHEL INDEX SCALE at baseline and at 4th week.RESULTS: Intra-group analysis of BERG BALANCE SCALE in experimental group showed statistically significant result (p < 0.05) in all items except in items 4, 13 and 14 respectively. Intra-group analysis of BERG BALANCE SCALE in control group showed statistically significant result (p < 0.05) in items 3, 5, 8 and 12 respectively, whereas remaining all items showed statistically insignificant result. Intra-group analysis of BARTHEL INDEX SCALE in experimental group showed statistically significant result in all items (p < 0.05) except in items 9 and 10 respectively. Intra-group analysis of BARTHEL INDEX in control group showed statistically significant result (p < 0.05) in items 1, 3, 4 and 8 respectively whereas remaining all items showed statistically insignificant result. Inter-group analysis showed statistically significant result in total scores of BERG BALANCE SCALE (p = 0.000) and BARTHEL INEX SCALE (p = 0.033).CONCLUSION: Visual scanning exercises along with task specific approach were found to be more effective in comparison to task specific approach alone.TRIAL REGISTRATION: Trial registration number: [IRCT20190717044237N1], trial registration date: 10/11/2019.
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| 6. |
- Batool, Sana, et al.
(författare)
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Intrarater and interrater reliability of the dynamic gait index in post stroke patients with eye movement disorders
- 2023
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Ingår i: Journal of Bodywork & Movement Therapies. - : Elsevier. - 1360-8592 .- 1532-9283. ; 35, s. 38-42
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Dynamic Gait Index (DGI) is a useful tool that has been evaluated for its reliability in patients with vestibular disorders, elderly people and, in chronic stroke population. Present study was aimed to evaluate the intrarater and interrater reliability of the DGI to measure dynamic balance and gait performance in stroke patients with eye movement disorders. Methods: A sample of 30 stroke patients suffering from eye movement disorders were recruited. Two Physical therapists assessed the intrarater and interrater reliability of the DGI in two testing sessions three days apart. In the later session, two raters assessed the patients' performance simultaneously on the DGI. The reliability was calculated using the intra-class correlation coefficient (ICC2, 1). Standard error of measurement (SEM) and minimal detectable change (MDC95) at 95% confidence interval were also calculated. A significance level was set at p-value <0.05. Results: The (ICC2, 1) for intrarater and interrater reliability of total DGI scores was 0.86 and 0.91 respectively. While (ICC2, 1) for intrarater and interrater reliability of individual items ranged from 0.73 to 0.91 to 0.73–0.93, respectively. The (SEM) and (MDC95) for intrarater reliability of total DGI scores were 0.76 and 2.10, respectively. Corresponding values for interrater reliability were 0.62 and 1.71, respectively. Conclusions: The DGI is a reliable tool for evaluating the dynamic balance and gait performance in stroke patients with eye movement disorders. This tool showed good to excellent intrarater and interrater reliability of total DGI scores and moderate to good intrarater and interrater reliability of individual items of the DGI.
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| 7. |
- Javed, Sana, et al.
(författare)
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Biophysics and the nonlinear dynamics instigated by a special hormone
- 2020
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Ingår i: Progress in Biophysics and Molecular Biology. - : Elsevier BV. - 0079-6107 .- 1873-1732. ; 150, s. 62-66
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Forskningsöversikt (refereegranskat)abstract
- Calcitonin, a potent hypocalcemic hormone, plays a vital role in inhibiting osteoclastic activities and suppressing bone removal. The physiological characteristics of calcitonin have long been discussed, along a few recommending calcitonin as a vestigial hormone. The basis for this article is to discuss the role of low and high levels of calcitonin in normal and osteoprotic bone turnover. The effect of calcitonin on the receptor activator of nuclear factor kappa-ligand and osteoclasts has been demonstrated using numerical simulations. This behavior recommends that treatment of osteoporosis via calcitonin does not provide the required upshots. For effectiveness calcitonin must be advised along with a combined therapy like aspirin which agrees with the experimental results available in the literature.
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| 8. |
- Khan, Arslan, et al.
(författare)
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Comprehensive investigation of almond shells pyrolysis using advance predictive models
- 2024
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Ingår i: Renewable energy. - : Elsevier. - 0960-1481 .- 1879-0682. ; 227
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Tidskriftsartikel (refereegranskat)abstract
- This research focused on comprehensive characterization and assessment of almond shells pyrolysis for bioenergy potential through thermogravimetric analysis from ambient temperature to 900 °C at different heating rates of 10, 15, and 20 °C/min in inert environment. Iso-conversional model-free methods like Friedman, Ozawa-Flynn-Wall (OFW), and Kissinger-Akahira-Sunose (KAS) were used for kinetic analysis. Average activation energies (Ea) evaluated using Friedman, OFW, and KAS methods were 198.45 kJ mol−1, 204.43 kJ mol−1, and 204.97 kJ mol−1, respectively. The evaluation of thermodynamic parameters, including ΔH‡, ΔG‡, and ΔS‡, was also assessed. The average values of ΔH‡, ΔG‡, and ΔS‡, were found to be 199.4 kJ mol−1, 172.17 kJ mol−1 and 42.60 kJ mol−1 respectively. The reaction mechanism was obtained from combined kinetics. A high R2 value of 0.9933 demonstrates strong agreement between the combined kinetic analysis results and the experimental data. The distribution activation energy model was assessed employing four pseudo elements identified as PC1, PC2, PC3, and PC4. Artificial Neural Network (ANN) and Boosting regression trees (BRT) were used for the prediction of Ea of almond shells pyrolysis. The detailed understanding of thermokinetics and creating customized predictive and innovative modelling techniques like ANN and BRT sets a new benchmark for developing customized models for thermochemical conversion of varieties of almond shells.
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| 9. |
- Micah, Angela E., et al.
(författare)
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Tracking development assistance for health and for COVID-19 : a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050
- 2021
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Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 398:10308, s. 1317-1343
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Forskningsöversikt (refereegranskat)abstract
- Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached $8. 8 trillion (95% uncertainty interval [UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this, $13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and $1.4 billion was repurposed from existing health projects. $3.1 billion (22.4%) of the funds focused on country-level coordination and $2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34.3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.
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| 10. |
- Welander, Nike Zoe, et al.
(författare)
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Migraine as a risk factor for mixed symptoms of peripartum depression and anxiety in late pregnancy : A prospective cohort study.
- 2021
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Ingår i: Journal of Affective Disorders. - : Elsevier. - 0165-0327 .- 1573-2517. ; 295, s. 733-739
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Migraine has been identified as a risk factor for peripartum depression. However, little is known about the contribution of anxiety to this association or potential changes throughout the peripartum period.METHODS: In a sample of 4,831 women from the Biology, Affect, Stress, Imaging and Cognition cohort in Sweden, participants were asked about history of migraine prior to pregnancy. The participants completed the Edinburgh Postnatal Depression Scale (EPDS) at gestational weeks 17 and 32 and postpartum week 6. Multinomial logistic regression analyses were used to assess associations between migraine and symptoms of depression, anxiety or mixed depression and anxiety, while adjusting for potential confounders.RESULTS: In crude estimates, migraine was associated with separate and mixed symptoms of depression and anxiety at most time points. After adjustments, migraine was associated with anxiety at week 17 (adjusted odds ratio: 1.69; 95% confidence interval: 1.11-2.54) and with mixed depression and anxiety at week 32 (adjusted odds ratio: 1.45; 95% confidence interval: 1.06-1.99). None of the other associations remained statistically significant after adjustments.LIMITATIONS: Migraine history was self-reported. Symptoms of depression and anxiety were based on the screening tool EPDS and not on clinical diagnoses.CONCLUSIONS: The results demonstrate that migraine may be a risk factor for anxiety in mid- pregnancy and mixed symptoms of peripartum depression and anxiety in late pregnancy. Inflammatory and hormonal factors may underlie the association between migraine, depression and anxiety across the peripartum period.
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