Search Results (16)

Background/Objectives: In this study, we review the diagnostic accuracy of magnetic resonance imaging (MRI) in detecting orbital and intracranial invasion of sinonasal malignancies (SNMs) using histopathological and surgical evidence as the reference standard. Methods: A systematic search of studies in English was conducted in MEDLINE and Embase, limited to articles published since 1990. We included studies using preoperative MRI to detect the intracranial and orbital invasion of SNMs, with histological or surgical confirmation as the reference standard, and reported patient numbers in each class as required to assess diagnostic accuracy. The outcome measures were sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Heterogeneity was assessed with the Higgins inconsistency test (I²). Results: Seven original articles with 546 subjects were included in the review, with six included in the meta-analysis. The pooled overall accuracy for orbital invasion was higher at 0.88 (95% CI, 0.75–0.94) than that for intracranial invasion at 0.80 (95% CI, 0.76–0.83). The meta-analytic estimates and their 95% confidence intervals were as follows for intracranial/orbital invasion: sensitivity 0.77 (0.69–0.83)/0.71 (0.40–0.90); specificity 0.79 (0.74–0.83)/0.91 (0.78–0.97); PPV 0.76 (0.64–0.85)/0.78 (0.61–0.88); and NPV 0.82 (0.72–0.89)/0.90 (0.63–0.98). Substantial heterogeneity was observed in the Higgins inconsistency test (I²) for orbital invasion (84%, 83%, and 93% for sensitivity, specificity, and NPV, respectively). Conclusions: MRI yielded moderate-to-high diagnostic accuracy for intracranial and orbital invasion, despite some limitations leading to false diagnoses. Loss of the hypointense zone on postcontrast MRI was found to predict dural invasion. Infiltration of the extraconal fat beyond the periorbita was found to be an MRI feature of orbital invasion. Full article

Islamic finance (IF) holds significant potential for economic development and the enhancement of financial inclusion in Uzbekistan. Sukuk, as a key Islamic capital market instrument and Shari’ah-compliant investment alternative, plays an important role in this context. However, the demand for sukuk and its determinants are not well understood by policymakers and industry practitioners in Uzbekistan. This study aims to address this research gap by utilizing an ordinal logit model on primary data collected through a survey of 196 individuals from diverse demographic and professional backgrounds, with varying levels of IF and capital market knowledge and experience. The regression results indicate that factors such as prior investment experience, knowledge of sukuk, and a strong inclination toward Shari’ah-compliant investments positively influence an individual’s intent to buy sukuk. Conversely, we found that residents of Tashkent (the capital city) are less likely to invest in sukuk compared to residents of other regions in Uzbekistan or those residing abroad. Based on this study’s findings, several essential policy and practical recommendations are provided to relevant stakeholders. Full article

Simple low-cost, nontoxic, environmentally friendly plant-extract-based polymer films play an important role in their application in medicine, the food industry, and agriculture. The addition of silver nanoparticles to the composition of these films enhances their antimicrobial capabilities and makes them suitable for the treatment and prevention of infections. In this study, polymer-based gels and films (AgRonPVA) containing silver nanoparticles (AgNPs) were produced at room temperature from fresh red onion peel extract (“Ron”), silver nitrate, and polyvinyl alcohol (PVA). Silver nanoparticles were synthesized directly in a polymer matrix, which was irradiated by UV light. The presence of nanoparticles was approved by analyzing characteristic local surface plasmon resonance peaks occurring in UV-Vis absorbance spectra of irradiated experimental samples. The proof of evidence was supported by the results of XRD and EDX measurements. The diffusion-based method was applied to investigate the antimicrobial activity of several types of microbes located in the environment of the produced samples. Bacteria Staphylococcus aureus ATCC 29213, Acinetobacter baumannii ATCC BAA 747, and Pseudomonas aeruginosa ATCC 15442; yeasts Candida parapsilosis CBS 8836 and Candida albicans ATCC 90028; and microscopic fungi assays Aspergillus flavus BTL G-33 and Aspergillus fumigatus BTL G-38 were used in this investigation. The greatest effect was observed on Staphylococcus aureus, Acinetobacter baumannii, and Pseudomonas aeruginosa bacteria, defining these films as potential candidates for antimicrobial applications. The antimicrobial features of the films were less effective against fungi and the weakest against yeasts. Full article

Ionizing radiation covers a broad spectrum of applications. Since radioactive/radiation pollution is directly related to radiation risk, radiation levels should be strictly controlled. Different detection methods can be applied for radiation registration and monitoring. In this paper, radiation-induced variations in the optical properties of silver-enriched PVA-based hydrogel films with and without azo dye (Toluidine blue O, TBO, and Methyl red, MR) additives were investigated, and the feasibility of these free-standing films to serve as radiation detectors/exposure indicators was assessed. AgNO₃ admixed with PVA gel was used as a source for the radiation-induced synthesis of silver nanoparticles (AgNPs) in irradiated gel films. Three types of sensors were prepared: silver-enriched PVA films containing a small amount of glycerol (AgPVAGly); silver-enriched PVA films with toluidine blue adducts (AgPVAGlyTBO); and silver-enriched PVA films with methyl red additives (AgPVAGlyMR). The selection of TBO and MR was based on their sensitivity to irradiation. The irradiation of the samples was performed in TrueBeam2.1 (VARIAN) using 6 MeV photons. Different doses up to 10 Gy were delivered to the films. The sensitivity of the films was assessed by analyzing the characteristic UV-Vis absorbance peaks on the same day as irradiation and 7, 30, 45, 90, and 180 days after irradiation. It was found that the addition of azo dyes led to an enhanced radiation sensitivity of the AgNPs containing films (0.6 Gy⁻¹ for AgPVAGlyTBO and 0.4 Gy⁻¹ for AgPVAGlyMR) irradiated with <2 Gy doses, indicating their applicability as low-dose exposure indicators. The irradiated films were less sensitive to higher doses. Almost no dose fading was detected between the 7th and 45th day after irradiation. Based on the obtained results, competing AgNP formation and color-bleaching effects in the AgPVAGly films with dye additives are discussed. Full article

The purpose of this study was to review the diagnostic accuracy of MRI in detecting perineural spreading (PNS) of head and neck tumors using histopathological or surgical evidence from the afflicted nerve as the reference standard. Previous studies in the English language published in the last 30 years were searched from PubMed and Embase databases. We included studies that used magnetic resonance imaging (MRI) (with and without contrast enhancement) to detect PNS, as well as the histological or surgical confirmation of PNS, and that reported the exact numbers of patients required for assessing diagnostic accuracy. The outcome measures were sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Heterogeneity was assessed with the Higgins inconsistency test (I²). P-values smaller than 0.05 were considered statistically significant. A total of 11 retrospective studies were found, reporting 319 nerve samples from 245 patients. Meta-analytic estimates and their 95% confidence intervals were as follows: sensitivity 0.85 (0.70–0.95), specificity 0.85 (0.80–0.89), PPV 0.86 (0.70–0.94), and NPV 0.85 (0.71–0.93). We found statistically significant heterogeneity for sensitivity (I² = 72%, p = 0.003) and PPV (I² = 70%, p = 0.038), but not for NPV (I² = 65%, p = 0.119) or specificity (I² = 12%, p = 0.842). The most frequent MRI features of PNS were nerve enlargement and enhancement. Squamous cell carcinoma and adenoid cystic carcinoma were the most common tumor types, and the facial and trigeminal nerves were the most commonly affected nerves in PNS. Only a few studies provided examples of false MRI diagnoses. MRI demonstrated high diagnostic accuracy in depicting PNS of cranial nerves, yet this statement was based on scarce and heterogeneous evidence. Full article

Country of origin (COO) is one of the key extrinsic factors to consumers in their decision-making process. This research evaluates the effects of COO image on food purchase intentions in terms of Chinese processed foods among Uzbekistani customers, and there are four dimensions of COO image: product, economic, people, and international relationships. A questionnaire was distributed to consumers in the city of Tashkent, and a total of 287 valid samples were collected. The collated data were analyzed using frequency distribution and charts in addition to Cronbach’s alpha, which was utilized to determine the reliability of the variables. In addition, definitions and explanations were provided with the aid of means and standard deviations, percentages, correlation, and regression. The results showed that product image and people’s perception of COO image influence customers’ food purchase intentions, but there is no significant correlation between economic image or international relationship image and customer purchase intentions inclined towards foods manufactured in China based on the view of Uzbekistani consumers. Furthermore, the outcomes indicated that the effect of COO image would vary based on the nationality of the consumer. Full article

Impervious surface area (ISA) has been recognized as a significant indicator for evaluating levels of urbanization and the quality of urban ecological environments. ISA extraction methods based on supervised classification usually rely on a large number of manually labeled samples, the production of which is a time-consuming and labor-intensive task. Furthermore, in arid areas, man-made objects are easily confused with bare land due to similar spectral responses. To tackle these issues, a self-trained deep-forest (STDF)-based ISA extraction method is proposed which exploits the complementary information contained in multispectral and polarimetric synthetic aperture radar (PolSAR) images using limited numbers of samples. In detail, this method consists of three major steps. First, multi-features, including spectral, spatial and polarimetric features, are extracted from Sentinel-2 multispectral and Chinese GaoFen-3 (GF-3) PolSAR images; secondly, a deep forest (DF) model is trained in a self-training manner using a limited number of samples for ISA extraction; finally, ISAs (in this case, in three major cities located in Central Asia) are extracted and comparatively evaluated. The experimental results from the study areas of Bishkek, Tashkent and Nursultan demonstrate the effectiveness of the proposed method, with an overall accuracy (OA) above 95% and a Kappa coefficient above 0.90. Full article

The Belt and Road Initiative (BRI) has revealed that it is necessary to strengthen research on land use and land cover change (LUCC) and ecological risk in key regions of countries around the world. In this study, the spatiotemporal characteristics of LUCC in the five capitals of Central Asian countries within the BRI were analyzed. Based on the grid scale, a landscape pattern index was introduced to quantitatively evaluate the landscape ecological risk levels of the five capitals. The results showed the following: first, the components of land use types in the five capitals have different structural characteristics, which are mainly grassland, unused land, and cultivated land. The landscape types that changed significantly were water and unused land, while the construction land area showed a trend of continuous increase. Second, different capitals have different land-use transfer patterns. Akmola State is mainly converted from cultivated land to grassland; Chuy State is mainly converted from forest land to grassland; Dushanbe and Tashkent City are mainly converted from grassland to forestland; and Ahal State is mainly converted from grassland to unused land. Third, the overall landscape ecological risks of the five capitals were low. Akmola State had the largest proportion of lowest ecological risk areas, whereas Chuy State and Dushanbe City had an increasing trend of highest ecological risk areas. The level of ecological risk in Tashkent remained stable during the study period, and the highest ecological risk areas in Ahal State decreased to 49,227.86 km². This study has enriched the research results of land use change and landscape ecological risk assessment of countries within the BRI and can provide a research reference for these countries and regions to achieve ecological sustainable development and strengthen ecosystem management. Full article

The treatment of childhood tuberculosis can be challenging due to the lack of pediatric drug formulations and monitoring of drug-toxicity in routine settings. There are no published studies from Uzbekistan on the adverse drug reactions (ADR) associated with anti-tuberculosis treatment in children. In this study, we aimed to investigate the ADR associated with anti-tuberculosis treatment in children. This was a cohort study using secondary program data of children treated at the city and regional tuberculosis clinics in Tashkent, Uzbekistan. Of the 302 patients evaluated, 135 (44.7%) reported ADR. New tuberculosis was registered in 277 (92%) patients and 262 (87%) had extrapulmonary tuberculosis. Factors associated with ADR included treatment at a regional hospital (adjusted odds ratio, aOR = 1.75; p = 0.026), female sex (aOR = 2.2; p = 0.004), and treatment with second-line drugs (aOR = 8.82; p < 0.001). The most common ADRs were gastrointestinal disorders (28.5%) followed by hepatitis (8.9%) and dermatologic reactions (8.6%). Most of the ADRs were mild (55.6%) or moderate (43.7%), only one child had severe ADR. Patients with the identified risk factors should be closely monitored during the treatment. We also recommend expansion of ADR surveillance throughout the country for more representative data in the future. Full article

Surgical interventions are performed as an adjunct to pharmacological treatment in Uzbekistan in 10–12% of diagnosed tuberculosis (TB) patients. In this study among patients with respiratory TB who had surgical interventions in Republican Specialized Scientific-Practical Medical Centre of Phthisiology and Pulmonology of Uzbekistan (RSSPMCPP) from January to May 2017, we describe (i) reasons and types of surgical intervention, (ii) post-surgical complications, (iii) histological diagnosis before and after surgery, and (iv) treatment outcomes. There were 101 patients included in the analysis (mean age 36 years; 51% male; 71% lived in rural areas). The main indications for surgical intervention included pulmonary tuberculoma (40%), fibrocavitary, or cavernous pulmonary TB (23%) and massive hemoptysis (20%). Pulmonary resections were the most frequent surgical procedures: segmentectomy (41%), lobectomy or bilobectomy (19%), and combined resection (17%). Ten patients (9%) suffered post-surgery complications. According to histological examination after surgery, TB was confirmed in 81 (80%) patients. For the other 20 patients, the confirmed diagnoses were: lung cancer (n = 6), echinococcosis (n = 5), post-TB fibrosis (n = 5), non-tuberculous pleurisy (n = 2), hamartoma (n = 1), and pneumonia (n = 1). The majority of patients (94%), who underwent surgery, were considered successfully treated. In conclusion, adjunctive surgical therapy can be an option for TB treatment, especially in cases of complicated TB. Full article

There is growing concern about the consequences of future urban expansion on carbon storage as our planet experiences rapid urbanization. While an increasing body of literature was focused on quantifying the carbon storage impact of future urban expansion across the globe, rare attempts were made from the comparative perspective on the same scale, particularly in Central Asia. In this study, Central Asian capitals, namely Ashkhabad, Bishkek, Dushanbe, Nur Sultan, and Tashkent, were used as cases. According to the potential impacts of BRI (Belt and Road Initiative) on urban expansion, baseline development scenario (BDS), cropland protection scenario (CPS), and ecological protection scenario (EPS) were defined. We then simulated the carbon storage impacts of urban expansion from 2019 to 2029 by using Google Earth Engine, the Future Land Use Simulation model, and the Integrated Valuation of Environmental Services and Tradeoffs model. We further explored the drivers for carbon storage impacts of future urban expansion in five capitals. The results reveal that Nur Sultan will experience carbon storage growth from 2019 to 2029 under all scenarios, while Ashkhabad, Bishkek, Dushanbe, and Tashkent will show a decreasing tendency. EPS and CPS will preserve the most carbon storage for Nur Sultan and the other four cities, respectively. The negative impact of future urban expansion on carbon storage will be evident in Ashkhabad, Bishkek, Dushanbe, and Tashkent, which will be relatively inapparent in Nur Sultan. The potential drivers for carbon storage consequences of future urban expansion include agricultural development in Bishkek, Dushanbe, and Tashkent, desert city development in Ashkhabad, and prioritized development of the central city and green development in Nur Sultan. We suggest that future urban development strategies for five capitals should be on the basis of differentiated characteristics and drivers for the carbon storage impacts of future urban expansion. Full article

People living with the human immunodeficiency virus (PLHIV) have a higher risk of developing active tuberculosis (TB) disease, and TB remains a major cause of death in PLHIV. Uzbekistan is facing a substantial TB epidemic, which increases the risk of PLHIV developing active TB. Our retrospective cohort study aimed to evaluate the incidence rate and assess the risk factors for developing active TB among PLHIV. We collected secondary data extracted from medical charts of all patients, newly diagnosed at the AIDS Center in Tashkent, during the period of 2015–2017. The incidence rate of TB among PLHIV was 5.1 (95% CI: 4.5–6.0) per 1000 person/month. Adjusted regression analysis showed three major risk factors for TB, namely, being less than 15 years old (hazard ratio (HR) 5.83; 95% CI: 3.24–10.50, p value = 0.001),low CD4 count (adjusted hazard ratio(aHR) 21.0; 95% CI: 9.25–47.7, p value < 0.001), and antiretroviral therapy (ART) interruption/not receiving ART (aHR 5.57; 95% CI: 3.46–8.97 and aHR 6.2; 95% CI: 3.75–10.24, p value < 0.001, respectively) were significantly associated with developing active TB among PLHIV. Our findings indicate that taking prescribed ART without interruptions and maintaining CD4cell counts higher than 320 cells/μL are essential to prevent the development of active TB among PLHIV. Full article

Uzbekistan has a high burden of drug-resistant tuberculosis (TB). Although conventional treatment for multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) has been available since 2013, there has been no systematic documentation about its use and effectiveness. We therefore documented at national level the trends, characteristics, and outcomes of patients with drug-resistant TB enrolled for treatment from 2013–2018 and assessed risk factors for unfavorable treatment outcomes (death, failure, loss to follow-up, treatment continuation, change to XDR-TB regimen) in patients treated in Tashkent city from 2016–2017. This was a cohort study using secondary aggregate and individual patient data. Between 2013 and 2018, MDR-TB numbers were stable between 2347 and 2653 per annum, while XDR-TB numbers increased from 33 to 433 per annum. At national level, treatment success (cured and treatment completed) for MDR-TB decreased annually from 63% to 57%, while treatment success for XDR-TB increased annually from 24% to 57%. On multivariable analysis, risk factors for unfavorable outcomes, death, and loss to follow-up in drug-resistant TB patients treated in Tashkent city included XDR-TB, male sex, increasing age, previous TB treatment, alcohol abuse, and associated comorbidities (cardiovascular and liver disease, diabetes, and HIV/AIDS). Reasons for these findings and programmatic implications are discussed. Full article

Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection poses a growing clinical challenge. People living with HIV have a higher chance of developing TB, and once the disease has progressed, are at greater risk of having unfavorable TB treatment outcomes. Data on TB treatment outcomes among the HIV-associated TB population in Uzbekistan are limited. Thus, we conducted a cohort study among 808 adult patients with HIV-associated TB registered at the Tashkent TB referral hospital from 2013–2017 to document baseline characteristics and evaluate risk factors for unfavorable TB treatment outcomes. The data were collected from medical records and ambulatory cards. About 79.8% of the study population had favorable treatment outcomes. Antiretroviral therapy (ART) coverage at the admission was 26.9%. Information on CD4-cell counts and viral loads were largely missing. Having extrapulmonary TB (aOR 2.21, 95% CI: 1.38–3.53, p = 0.001), positive sputum smear laboratory results on admission (aOR 1.62, 95% CI: 1.07–2.40), diabetes (aOR 5.16, 95% CI: 1.77–14.98), and hepatitis C (aOR 1.68, 95% CI: 1.14–2.46) were independent risk factors for developing unfavorable TB treatment outcomes. The study findings provide evidence for targeted clinical management in co-infected patients with risk factors. Strengthening the integration of TB/HIV services may improve availability of key data to improve co-infection management. Full article

Treatment of drug-resistant tuberculosis is lengthy, insufficiently effective, and toxic. Since 2016, the World Health Organization has recommended shorter treatment regimens (STR). We assessed effectiveness and predictors of drug adverse events (DAE) among patients treated with STR. There were 95 consecutive rifampicin-resistant patients enrolled in STR in Tashkent between June 2018 and September 2019. Of these, 66.3% were successfully treated, 17.9% suffered failed treatment, 7.4% died, 5.3% were lost to follow-up and 3.2% were not evaluated. No recurrence was identified in 54 patients after 12 months of successful treatment completion. There were 47 reported DAE: the incidence rate was 6.15 DAE per 100 person-months-of-treatment. Any DAE was reported in 38 (40%) patients and grade 3/4 DAE were recorded in 21 (22.1%) patients. Median time to DAE was 101 (interquartile range 64–139) days. The most frequently encountered DAE were gastro-intestinal disorders, followed by hepatotoxicity and ototoxicity. The most commonly offending drug inducing DAE was protionamide. The dose was temporarily interrupted in 55.3% of DAE, reduced in 8.5% of DAE and permanently withdrawn in another 8.5% of DAE. HIV status was the only predictor associated with increased hazard of DAE. In Uzbekistan STR showed moderate effectiveness and safety, although treatment failure was high. Full article