Coronary CTA With AI-QCT Interpretation: Comparison With Myocardial Perfusion Imaging for Detection of Obstructive Stenosis Using Invasive Angiography as Reference Standard.

BACKGROUND. Deep learning frameworks have been applied to interpretation of coronary CTA performed for coronary artery disease (CAD) evaluation. OBJECTIVE. The purpose of our study was to compare the diagnostic performance of myocardial perfusion imaging (MPI) and coronary CTA with artificial intelligence quantitative CT (AI-QCT) interpretation for detection of obstructive CAD on invasive angiography and to assess the downstream impact of including coronary CTA with AI-QCT in diagnostic algorithms. METHODS. This study entailed a retrospective post hoc analysis of the derivation cohort of the prospective 23-center Computed Tomographic Evaluation of Atherosclerotic Determinants of Myocardial Ischemia (CREDENCE) trial. The study included 301 patients (88 women and 213 men; mean age, 64.4 ± 10.2 [SD] years) recruited from May 2014 to May 2017 with stable symptoms of myocardial ischemia referred for nonemergent invasive angiography. Patients underwent coronary CTA and MPI before angiography with quantitative coronary angiography (QCA) measurements and fractional flow reserve (FFR). CTA examinations were analyzed using an FDA-cleared cloud-based software platform that performs AI-QCT for stenosis determination. Diagnostic performance was evaluated. Diagnostic algorithms were compared. RESULTS. Among 102 patients with no ischemia on MPI, AI-QCT identified obstructive (≥ 50%) stenosis in 54% of patients, including severe (≥ 70%) stenosis in 20%. Among 199 patients with ischemia on MPI, AI-QCT identified nonobstructive (1-49%) stenosis in 23%. AI-QCT had significantly higher AUC (all p < .001) than MPI for predicting ≥ 50% stenosis by QCA (0.88 vs 0.66), ≥ 70% stenosis by QCA (0.92 vs 0.81), and FFR < 0.80 (0.90 vs 0.71). An AI-QCT result of ≥ 50% stenosis and ischemia on stress MPI had sensitivity of 95% versus 74% and specificity of 63% versus 43% for detecting ≥ 50% stenosis by QCA measurement. Compared with performing MPI in all patients and those showing ischemia undergoing invasive angiography, a scenario of performing coronary CTA with AIQCT in all patients and those showing ≥ 70% stenosis undergoing invasive angiography would reduce invasive angiography utilization by 39%; a scenario of performing MPI in all patients and those showing ischemia undergoing coronary CTA with AI-QCT and those with ≥ 70% stenosis on AI-QCT undergoing invasive angiography would reduce invasive angiography utilization by 49%. CONCLUSION. Coronary CTA with AI-QCT had higher diagnostic performance than MPI for detecting obstructive CAD. CLINICAL IMPACT. A diagnostic algorithm incorporating AI-QCT could substantially reduce unnecessary downstream invasive testing and costs. TRIAL REGISTRATION. Clinicaltrials.gov NCT02173275.

An analysis of the gender and social determinants of health in urban poor areas of the most populated cities of Pakistan.

BACKGROUND: Recent surveys, studies and reviews in urban areas of Pakistan have highlighted the impacts of social inequities on access of women and children to health services for women and children in Pakistan. OBJECTIVES: The Urban Slum Profiles and coverage surveys were conducted between 2017 and 2019. The objective of the profiles was to obtain an updated listing of slums and other underserved areas, and to better understand current vaccination and health service coverage in these areas. Utilising findings from these studies, this paper aims to better understand the gender and social determinants of health that are giving rise to health inequalities in the slums. METHODS: The Urban Slum Profiles adopted a mixed methods approach combining both qualitative and quantitative methods. The study was comprised of two main survey approaches of Urban Slum Profiles and Immunisation Coverage Survey in 4431 urban poor areas of the 10 most highly populated cities of Pakistan. RESULTS: Findings are classified into six analytic categories of (1) access to health services, (2) female workforce participation, (3) gender-friendly health services, (4) access to schools and literacy, (5) social connections, and (6) autonomy of decision making. Out of a national sample of 14,531 children in urban poor areas of 10 cities, the studies found that just over half of the children are fully immunised (54%) and 14% of children had received zero doses of vaccine. There are large shortages of health facilities and female health workforce in the slums, with significant gaps in the quality of health infrastructure, which all serve to limit both demand for, and supply of, health services for women and children. Results demonstrate low availability of schools, low levels of female literacy and autonomy over decision making, limited knowledge of the benefits of vaccination, and few social connections outside the home. All these factors interact and reinforce existing gender norms and low levels of health literacy and service access. CONCLUSION: The Urban Slum profiles and coverage studies provide an opportunity to introduce gender transformative strategies that include expansion of a female health workforce, development of costed urban health action plans, and an enabling policy environment to support community organisation and more equitable health service delivery access.

Advances in genome editing: the technology of choice for precise and efficient ß-thalassemia treatment.

Beta (ß)-thalassemia is one of the most significant hemoglobinopathy worldwide. The high prevalence of the ß-thalassemia carriers aggravates the disease burden for patients and national economies in the developing world. The survival of ß-thalassemia patients solely relies on repeated transfusions, which eventually results into multi-organ damage. The fetal γ-globin genes are ordinarily silenced at birth and replaced by the adult ß-globin genes. However, mutations that cause lifelong persistence of fetal γ-globin, ameliorate the debilitating effects of ß-globin mutations. Therefore, therapeutically reactivating the fetal γ-globin gene is a prime focus of researchers. CRISPR/Cas9 is the most common approach to correct disease causative mutations or to enhance or disrupt the expression of proteins to mitigate the effects of the disease. CRISPR/cas9 and prime gene editing to correct mutations in hematopoietic stem cells of ß-thalassemia patients has been considered a novel therapeutic approach for effective hemoglobin production. However, genome-editing technologies, along with all advantages, have shown some disadvantages due to either random insertions or deletions at the target site of edition or non-specific targeting in genome. Therefore, the focus of this review is to compare pros and cons of these editing technologies and to elaborate the retrospective scope of gene therapy for ß-thalassemia patients.

Wolfram-like syndrome with bicuspid aortic valve due to a homozygous missense variant in CDK13.

BACKGROUND: Wolfram syndrome (WFS) is characterized by deafness, diabetes mellitus, and diabetes insipidus along with optic atrophy. WFS has an autosomal recessive mode of inheritance and is due to variants in WFS1 and CISD2. METHODS: We evaluated the underlying molecular etiology of three affected members of a consanguineous family with hearing impairment, bicuspid aortic valve, diabetes mellitus and insipidus, clinodactyly, and gastrointestinal tract abnormalities via exome sequencing approach. We correlated clinical and imaging data with the genetic findings and their associated phenotypes. RESULTS: We identified a homozygous missense variant p.(Asn1097Lys) in CDK13, a gene previously associated with autosomal dominant congenital heart defects, dysmorphic facial features, clinodactyly, gastrointestinal tract abnormalities, intellectual developmental disorder, and seizures with variable phenotypic features. CONCLUSION: We report a homozygous variant in CDK13 and suggest that this gene causes an autosomal recessive disorder with hearing impairment, bicuspid aortic valve, diabetes mellitus and insipidus, clinodactyly, and gastrointestinal tract abnormalities.

The risk stratification of coronary vascular disease as linked to homocysteine, its modulating genes, genetic polymorphisms, conventional predictors, and with antihypertensive medicaments.

Cardiovascular disease (CVD) have multifactorial nature, and owing to their disparate etiological roots, it is difficult to ascertain exact determinants of CVD. In the current study, primary objective was to determine association of single nucleotide polymorphisms (SNP) in folate pathway genes, homocysteine, antihypertensive medication, and of known risk factors in relation to CVD outcomes. The participants numbered 477 (controls, n = 201, ischemic heart disease patients, n = 95, and myocardial infarction cases, n = 181, respectively). SNPs that were queried for homocysteine pathway genes included, "methylene tetrahydrofolate reductase (MTHFR)" gene SNPs rs1801133 and rs1801131, "methyltransferase (MTR)" SNP rs1805087, "paraoxonase 1 (PON1)" SNP rs662, and angiotensin-converting enzyme (ACE) gene polymorphisms rs4646994. Medication data were collected through questionnaire, and serum-based parameters were analyzed through commercial kits. The analysis of variance and multiple comparison scrutiny revealed that age, gender, family history, cholesterol, creatinine, triglyceride, high density lipoproteins (HDL), homocysteine, beta-blocker, ACE inhibitors, MTHFR and PON1 SNPs related to coronary artery disease (CAD). On regression, rs662 SNPs and C-reactive protein had nonsignificant odds ratio, whereas age, gender, creatinine, and HDL were nonsignificant. Family history, cholesterol, homocysteine, beta blocker, and ACE inhibitors, homocysteine, rs1801133 and rs1801131 SNP maintained significance/significant odds for CAD. The current study indicates an intricate relationship between genetic variants, traditional factors, and drug usage in etiogenesis of arterial disease. Differences in SNPs, their modulated effects in consensus with medicinal usage may be related to ailment outcomes affecting coronary vasculature.

Effects of Different Sample Pulverisation Methods on the Extraction of Metabolites from the Fermented Cottonseed Meal Based on UPLC-Q-TOF-MS.

The precondition of studying biological sample is to extract sample metabolites by the best pretreatment methods. There is already limited information about pretreatments of fermented feed metabolites. The study compared the extraction effects of different pulverisation methods used in the sample pretreatment process for the extraction of metabolites from cottonseed meal fermented by Lactobacillus acidophilus based on UPLC-Q-TOF-MS. The extraction effects of three pretreatments (non-pulverisation (WF), pulverisation (F), and high-speed homogenisation methods (YJ)) were compared with the numbers of metabolites and the normalised peak areas of the metabolites. The results showed that the number of metabolites extracted with three pulverisation methods were 1745, 1896, 2132 (ESI+ mode) and 1447, 1675, 2073 (ESI- mode), respectively. The number of variable importance plot (VIP) metabolites and the relative peak areas of metabolites showed that the trend was YJ > F > WF. The extraction effect of high-speed homogenisation method was the best way to extract metabolites from the fermented cottonseed meal. This study built a foundation work for the further research of the fermented feed metabolomics.

Association of body mass index, cardiorespiratory fitness, and their correlates among female physiotherapy students in Nawabshah.

OBJECTIVE: To explore the association of body mass index with cardiorespiratory fitness and other health correlates among physiotherapy students. METHODS: This cross-sectional study was conducted from February to July 2018 at the Peoples University of Medical and Health Sciences for Women, Nawabshah, Pakistan, comprising female undergraduate physiotherapy students aged 17-25 years. All the eligible participants were assessed using a self-report questionnaire, body mass index, and standardised cardiorespiratory fitness criteria. SPSS 20 was used for data analysis. RESULTS: There were 228 subjects with a mean age of 20.89±1.66 years. Of the total, 77(33.8%) students were overweight/obese and 52(22.8%) were underweight. Overall, 212(93%) reported good quality of life, and 189(82.9%) were satisfied with their general health. Also, 180(79%) subjects had a post-exercise heart rate below average. There was a significant negative correlation for body mass index and maximum oxygen uptake, body mass index and age, and maximum oxygen uptake and subjective quality of life (p<0.05 each). CONCLUSIONS: The frequency of both overweight/obesity and underweight physiotherapy undergraduates was high.

Comparison of microRNAs in the intramuscular adipose tissue from Jinhua and Landrace pigs.

MicroRNA (miRNA) is critically involved in lipogenesis occurring in various body parts of humans and animals. In this study, to further investigate the role and distribution of miRNA in porcine intramuscular adipose tissue, small RNAs were extracted from Jinhua and Landrace pigs to identify the expression profiles of miRNAs. miRNA expression profiles revealed that 558 miRNAs including 287 known and 271 novel miRNAs were identified, and 220 of them showed differential expression in the pigs. Gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis suggested that the target genes of the differentially expressed miRNAs were involved in fatty metabolism. In conclusion, the current study reveals the active participation of miRNAs in the regulation of adipogenesis in the intramuscular adipose tissue of Jinhua and Landrace pigs.

Exploiting Layered Multi-Path Routing Protocols to Avoid Void Hole Regions for Reliable Data Delivery and Efficient Energy Management for IoT-Enabled Underwater WSNs.

The key concerns to enhance the lifetime of IoT-enabled Underwater Wireless Sensor Networks (IoT-UWSNs) are energy-efficiency and reliable data delivery under constrained resource. Traditional transmission approaches increase the communication overhead, which results in congestion and affect the reliable data delivery. Currently, many routing protocols have been proposed for UWSNs to ensure reliable data delivery and to conserve the node's battery with minimum communication overhead (by avoiding void holes in the network). In this paper, adaptive energy-efficient routing protocols are proposed to tackle the aforementioned problems using the Shortest Path First (SPF) with least number of active nodes strategy. These novel protocols have been developed by integrating the prominent features of Forward Layered Multi-path Power Control One (FLMPC-One) routing protocol, which uses 2-hop neighbor information, Forward Layered Multi-path Power Control Two (FLMPC-Two) routing protocol, which uses 3-hop neighbor information and 'Dijkstra' algorithm (for shortest path selection). Different Packet Sizes (PSs) with different Data Rates (DRs) are also taken into consideration to check the dynamicity of the proposed protocols. The achieved outcomes clearly validate the proposed protocols, namely: Shortest Path First using 3-hop neighbors information (SPF-Three) and Breadth First Search with Shortest Path First using 3-hop neighbors information (BFS-SPF-Three). Simulation results show the effectiveness of the proposed protocols in terms of minimum Energy Consumption (EC) and Required Packet Error Rate (RPER) with a minimum number of active nodes at the cost of affordable delay.

Psycho-social predictors of acculturative stress and adjustment in Pakistani Institutions.

OBJECTIVES: The main objective of study was to investigate the effect of psycho-social predictors on acculturative stress and adjustment in Pakistani institutions. METHODS: The study was carried out from November 15, 2016 to January 18, 2019. For this purpose data was collected from 450 international students who were studying in public and private sector universities of Pakistan and who experienced acculturative stress. The instruments include Relationship Assessment Scale, Acculturative Stress Scale for International, Psychological Adaptation Scale, and Revised Socio Cultural Adaptation Scale. The proposed model was tested by using SPSS (Version-23) and AMOS (Version-9). RESULTS: Findings of the study revealed that relationship satisfaction (p<0.05), length of stay (p<0.05), and financial support (p<0.05) significantly negatively predicted acculturative stress. Financial support significantly positively predicted psychological adjustment (p<0.05). Employment status did not predict acculturative stress, psychological and socio-cultural adjustment (p>0.05). Moreover, all psycho-social predictors did not show effect on socio-cultural adjustment among international students (p>0.05). CONCLUSION: It can be concluded that general relationship satisfaction, more length of stay in host country, and financial support are very important for international students to manage their acculturative stress and to adjust better in a new cultural environment.

Molecular mechanism and therapy application of necrosis during myocardial injury.

Necrosis is an ancient topic which gains new attraction in the research area these years. There is no doubt that some necrosis can be regulated by genetic manipulation other than an accidental cell death resulting from physical or chemical stimuli. Recent advances in the molecular mechanism underlying the programmed necrosis show a fine regulation network which indicates new therapy targets in human diseases. Heart diseases seriously endanger our health and have high fatality rates in the patients. Cell death of cardiac myocytes is believed to be critical in the pathogenesis of heart diseases. Although necrosis is likely to play a more important role in cardiac cell death than apoptosis, apoptosis has been paid much attention in the past 30 years because it used to be considered as the only form of programmed cell death. However, recent findings of programmed necrosis and the related signalling pathways have broadened our horizon in the field of programmed cell death and promote new pharmacological application in the treatment of heart diseases. In this review, we summarize the advanced progress in these signalling pathways and discuss the pathos-physiological relevance and therapeutic implication of targeting necrosis in heart diseases treatment.

Outcomes of anatomical versus functional testing for coronary artery disease.

BACKGROUND: Many patients have symptoms suggestive of coronary artery disease (CAD) and are often evaluated with the use of diagnostic testing, although there are limited data from randomized trials to guide care. METHODS: We randomly assigned 10,003 symptomatic patients to a strategy of initial anatomical testing with the use of coronary computed tomographic angiography (CTA) or to functional testing (exercise electrocardiography, nuclear stress testing, or stress echocardiography). The composite primary end point was death, myocardial infarction, hospitalization for unstable angina, or major procedural complication. Secondary end points included invasive cardiac catheterization that did not show obstructive CAD and radiation exposure. RESULTS: The mean age of the patients was 60.8±8.3 years, 52.7% were women, and 87.7% had chest pain or dyspnea on exertion. The mean pretest likelihood of obstructive CAD was 53.3±21.4%. Over a median follow-up period of 25 months, a primary end-point event occurred in 164 of 4996 patients in the CTA group (3.3%) and in 151 of 5007 (3.0%) in the functional-testing group (adjusted hazard ratio, 1.04; 95% confidence interval, 0.83 to 1.29; P=0.75). CTA was associated with fewer catheterizations showing no obstructive CAD than was functional testing (3.4% vs. 4.3%, P=0.02), although more patients in the CTA group underwent catheterization within 90 days after randomization (12.2% vs. 8.1%). The median cumulative radiation exposure per patient was lower in the CTA group than in the functional-testing group (10.0 mSv vs. 11.3 mSv), but 32.6% of the patients in the functional-testing group had no exposure, so the overall exposure was higher in the CTA group (mean, 12.0 mSv vs. 10.1 mSv; P<0.001). CONCLUSIONS: In symptomatic patients with suspected CAD who required noninvasive testing, a strategy of initial CTA, as compared with functional testing, did not improve clinical outcomes over a median follow-up of 2 years. (Funded by the National Heart, Lung, and Blood Institute; PROMISE ClinicalTrials.gov number, NCT01174550.).

Nine-month results of the BIOHELIX-I clinical trial study: Evaluation of the PRO-Kinetic Energy cobalt chromium bare-metal stent system.

OBJECTIVES: To evaluate the safety and efficacy of the PRO-Kinetic Energy (PKE) Cobalt Chromium Coronary Stent System (BIOTRONIK AG, Switzerland). BACKGROUND: Percutaneous coronary intervention is a mainstay treatment for symptomatic coronary artery disease (CAD). While drug-eluting stents constitute a majority of implants, bare-metal stents (BMS) remain important for a subset of patients. Newer generation BMS offer advantages due to stent design improvements. METHODS: The BIOHELIX-I study was a prospective, multicenter, non-randomized, single arm clinical trial designed to evaluate the safety and efficacy of the PKE bare metal stent. Thirty-three study centers (US, Columbia, Europe) enrolled 329 patients for treatment of one target lesion (≤31 mm). Eligible patients received a PKE stent(s), at least one month of dual antiplatelet therapy and were followed for 36-months. The primary endpoint was the 9-month rate of target vessel failure (TVF) compared with a prespecified performance goal of 18.7% derived from prior BMS trials. RESULTS: The mean patient age was 69 years, 28.6% with diabetes. The mean lesion length was 13.7 ± 6.0 mm. The 9-month TVF rate was 9.06% and met the primary endpoint (P < 0.001). The TVF component rates were 0.95% cardiac death, 1.58% myocardial infarction, and 7.26% ischemia-driven target vessel revascularization (TVR). The ischemia-driven target lesion revascularization rate at 9-months was 6.62%. CONCLUSIONS: The 9-month TVF rate of the PKE stent was comparable to other BMS and is a viable option for treating CAD. The low observed rate of ischemia-driven TVR supports the safety and efficacy of the novel BMS design.

The basic route of the nuclear translocation porcine growth hormone (GH)-growth hormone receptor (GHR) complex (pGH/GHR) in porcine hepatocytes.

Traditional views suggest that growth hormone and the growth hormone receptor (GH/GHR complex) exert their functions only on the plasma membrane. This paradigm, however, has been challenged by recent new findings that the GH/GHR complex could translocate into cell nuclei where they could still exhibit important physiological functions. We also reported the nuclear localization of porcine GH/GHR and their potential functions in porcine hepatocytes. However, the basic path of pGH/GHR's nuclear translocation remains unclear. Combining previous research results and our current findings, we proposed two basic routes of pGH/GHR's nuclear transportation as follows: 1) after pGH binding to GHR, pGH/GHR enters into the cytoplasm though clathrin- or caveolin-mediated endocytosis, then the pGH/GHR complex enters into early endosomes (Rab5-positive), and the endosome carries the GH/GHR complex to the endoplasmic reticulum (ER). After endosome docking on the ER, the endosome starts fission, and the pGH/GHR complex enters into the ER lumen. Then the pGH/GHR complex transports into the cytoplasm, possibly by the ERAD pathway. Subsequently, the pGH/GHR complex interacts with IMPα/ß, which, in turn, mediates GH/GHR nuclear localization; 2) pGH binds with the GHR on the cell membrane and, subsequently, pGH/GHR internalizes into the cell and enters into the endosome (this endosome may belong to a class of endosomes called envelope-associated endosomes (NAE)). Then, the endosome carries the pGH/GHR to the nuclear membrane. After docking on the nuclear membrane, the pGH/GHR complex fuses with the nuclear membrane and then enters into the cell nucleus.

Social support and health related quality of life among pregnant women.

OBJECTIVE: To explore the relationship between social support and health-related quality of life among pregnant women. METHODS: This cross-sectional study was conducted at City Hospital, Kashrote, and District Headquarters Hospital in the city of Gilgit, Pakistan, from January to March2017.Pregnant women presenting to the two hospitals were approached for data collection. The chronological age range of the sample was 15-35 years and age of pregnancy in months were included. Social support of pregnant women was measured through multidimensional scale of perceived social support and health-related quality of life was measured through medical outcomes study questionnaire.. RESULTS: Of the 120 participants, 66(55%) were from the City Hospital, Kashrote, and 54(45%) from the District Headquarters Hospital. Subjects who were in their first trimester of pregnancy were 72(60%), while 25(20.8%) were in their second trimester and 23 (19.2%) in the third. Of the total, 80(66.66%) were educated women and 40 (33.34%) were illiterate. Subjects with a history of physical illness were 76 (63.30%) while 60 (50%) suffered from psychological illness too. There was a significantly positive relationship between social support and health-related quality of life among the pregnant subjects (p<0.05). CONCLUSIONS: More social support, can increase the health-related quality of life of pregnant women.

Single-cell analyses of transcriptional heterogeneity during drug tolerance transition in cancer cells by RNA sequencing.

The acute cellular response to stress generates a subpopulation of reversibly stress-tolerant cells under conditions that are lethal to the majority of the population. Stress tolerance is attributed to heterogeneity of gene expression within the population to ensure survival of a minority. We performed whole transcriptome sequencing analyses of metastatic human breast cancer cells subjected to the chemotherapeutic agent paclitaxel at the single-cell and population levels. Here we show that specific transcriptional programs are enacted within untreated, stressed, and drug-tolerant cell groups while generating high heterogeneity between single cells within and between groups. We further demonstrate that drug-tolerant cells contain specific RNA variants residing in genes involved in microtubule organization and stabilization, as well as cell adhesion and cell surface signaling. In addition, the gene expression profile of drug-tolerant cells is similar to that of untreated cells within a few doublings. Thus, single-cell analyses reveal the dynamics of the stress response in terms of cell-specific RNA variants driving heterogeneity, the survival of a minority population through generation of specific RNA variants, and the efficient reconversion of stress-tolerant cells back to normalcy.

The Role of MicroRNAs in Myocardial Infarction: From Molecular Mechanism to Clinical Application.

MicroRNAs (miRNAs) are a class of small single-stranded and highly conserved non-coding RNAs, which are closely linked to cardiac disorders such as myocardial infarction (MI), cardiomyocyte hypertrophy, and heart failure. A growing number of studies have demonstrated that miRNAs determine the fate of the heart by regulating cardiac cell death and regeneration after MI. A deep understanding of the pathophysiology of miRNA dependent regulatory pathways in these processes is required. The role of miRNAs as diagnostic, prognostic, and therapeutic targets also needs to be explored in order to utilize them in clinical settings. This review summarizes the role of miRNAs in myocardial infarction and focuses mainly on their influence on cardiomyocyte regeneration and cell death including apoptosis, necrosis, and autophagy. In addition, the targets of pro- and anti-MI miRNAs are comparatively described. In particular, the possibilities of miRNA-based diagnostic and therapeutic strategies for myocardial infarction are discussed in this review.

Self-related factors and decision making styles among early adults.

OBJECTIVE: To examine the effect of self-related factors, including self-regulation, self-esteem and self-efficacy, on decision-making styles of early adults. METHODS: The cross-sectional study was conducted from February to August, 2014 at four universities of Islamabad, Pakistan, and comprised adult students of both Social and Natural sciences. Data was collected through Self-Regulation Questionnaire, Self-Esteem Scale, Self-Efficacy Scale and the General Decision Making Styles Questionnaire. Data was subjected to multivariate regression analysis. RESULTS: Of the 300 participants, 160(53%) were men and 140(47%) were women. The overall mean age was 22.68±5.96 years. Besides, 170(56%) were studying Social sciences and 130(44%) Natural sciences. Self-regulation, self-esteem and self-efficacy positively predicted rational and intuitive style and negatively predicted avoidant and spontaneous style. Self-efficacy and self-regulation negatively predicted dependent style. CONCLUSIONS: Ensuring positive self-related factors affected adults' effective decision-making choices.

Paternal malparenting and offspring personality disorders: Mediating effect of early maladaptive schemas.

OBJECTIVE: To examine the mediating role of maladaptive schemas between permissive/authoritarian parenting by fathers and personality disorders, including histrionic, antisocial, narcissistic and depressive attitudes among adults. METHODS: This cross-sectional study was conducted at the University of Sargodha, Sargodha, Pakistan, and comprised university students. Data was collected by administering the parental authority questionnaire, the young schema questionnaire and the personality diagnostic questionnaire. SPSS 23 was used for data analysis. The study was completed in one year. It was started from June 2014 and ended in June 2015. RESULTS: Of the 200 participants who were handed the questionnaires, 100(50%) returned it fully filled up. Of them, 87(87%) were women and 13(13%) were men. All scales had greater than 0.70 alpha reliability coefficients. The values of skewness for all scales ranged from 0.10 to 0.86.Permissive parenting style had positive correlation with histrionic (p<0.05), narcissistic (p<0.05) and antisocial personality disorders (p<0.01). Authoritarian parenting had positive correlation with early maladaptive schemas (p<0.01) and depressive personality disorder (p<0.05). CONCLUSIONS: Both permissive and authoritarian parenting styles led to personality disorders among offspring in the adult phase of their lives.