bluuebunny/crossref_metadata_2025 huggingface dataset:
Manual therapeutic plasma exchange for treatment of a dog with suspected acute canine polyradiculoneuritis
Authors: Czerwik Adriana , Jarešová Tereza , Olszewska Agnieszka , Farke Daniela , Schmidt Martin Jürgen , Lehmann Hendrik
Published: March 2023

Background

Acute canine polyradiculoneuritis is one of the most common polyneuropathies occurring in dogs. The disease is very similar to the Guillain–Barré syndrome in humans. In veterinary medicine, there is no established treatment for this disease, while in human medicine, therapeutic plasma exchange and intravenous immunoglobulin administration are two main immunotherapy treatments of this syndrome.

Case presentation

A 12-year-old male Jack Russel Terrier was presented with a history of acute weakness of the pelvic limbs progressing to flaccid tetraplegia with respiratory compromise. Complete diagnostic workup was performed including blood work, diagnostic imaging (radiographs of the thorax as well as ultrasound of the abdomen) and echocardiography. Based on the clinical course, neurological localisation and the results of electrodiagnostic examination acute canine polyradiculoneuritis was suspected. During the hospitalization, the dog deteriorated and was admitted to the intensive care unit for respiratory support via tracheostomy tube. In addition to symptomatic treatment, immunotherapy via single treatment of manual therapeutic plasma exchange was administered. This procedure was safe, and the dog showed improvement of clinical signs 3 days after therapy was initiated, as well as improvement of neurological signs (from grade 4 tetraplegia to grade 3) within 5 days. However, the dog was euthanized 3 weeks later due to complications related to the tracheostomy.

Conclusions

This is the first case report of a manual therapeutic plasma exchange in a dog with suspected acute canine polyradiculoneuritis suggesting that this method is safe and well tolerated in dogs with this disease. It may be a reasonable adjunctive treatment to supportive therapy in severe cases.
Ageing as a software design flaw
Authors: de Magalhães João Pedro
Published: March 2023

Ageing is inherent to all human beings, yet why we age remains a hotly contested topic. Most mechanistic explanations of ageing posit that ageing is caused by the accumulation of one or more forms of molecular damage. Here, I propose that we age not because of inevitable damage to the hardware but rather because of intrinsic design flaws in the software, defined as the DNA code that orchestrates how a single cell develops into an adult organism. As the developmental software runs, its sequence of events is reflected in shifting cellular epigenetic states. Overall, I suggest that to understand ageing we need to decode our software and the flow of epigenetic information throughout the life course.
The genetic liability to rheumatoid arthritis may decrease hepatocellular carcinoma risk in East Asian population: a Mendelian randomization study
Authors: Zhang Yuzhuo , Zhang Yudong , He Peng , Ge Fan , Huo Zhenyu , Qiao Guibin
Published: March 2023

Background

Patients with rheumatoid arthritis (RA) have a rising possibility of acquiring certain kinds of cancers than the general public. The causal risk association between RA and hepatocellular carcinoma (HCC) remains unknown.

Methods

Genetic summary data from genome-wide association study (GWAS), including RA (n = 19,190) and HCC (n = 197,611), was analyzed. The inverse-variance weighted (IVW) approach was used as the principal analysis, complemented with weighted median, weighted mode, simple median method, and MR-Egger analyses. The genetic data of RA (n = 212,453) was used to verify the results in eastern Asia populations.

Results

The results from the IVW methods indicated that genetically predicted RA was significantly linked with a declined possibility of HCC for East Asians (OR = 0.86; 95% CI: 0.78, 0.95; p = 0.003). The weighted median and the weighted mode also supported similar results (all p < 0.05). Additionally, neither the funnel plots nor the MR-Egger intercepts revealed any directional pleiotropic effects between RA and HCC. Moreover, the other set of RA data validated the results.

Conclusion

The RA may decrease the risk of being susceptible to the HCC in eastern Asia populations, which was beyond expectation. In the future, additional investigations should be made into potential biomedical mechanisms.
Acquired hemophilia A following COVID-19 vaccine: a case report
Authors: Emna Bouselama , Kmira Zahra , Hajer Ben Ismail , Nadia Sassi , Yossra Dhaha , Amina Bouatay , Yosra Ben Youssef , Haifa Regaieg , Abderrahim Khelif
Published: March 2023

Background

In the literature, reported cases of Acquired hemophilia A (AHA) induced by COVID-19 vaccination occurred after Adenoviral Vector Deoxyribonucleic Acid (DNA)- and SARS-CoV-2 Messenger Ribonucleic acid (mRNA)-Based vaccines. Here, and to the best of our knowledge, we report the first case of AHA occurring after an inactivated Sinovac-coronavac COVID-19 vaccine.

Case presentation

A 69-year-old Tunisian male patient consulted for severe left leg pain limiting physical mobility due to a 5*6 cm large ecchymosis located at the left inner thigh, having spontaneously appeared 5 days prior consultation and without notion of trauma. The patient had no known personal medical history. He had received the second dose of CoronaVac-SinoVac vaccine 30 days prior to consultation. Further physical examination revealed the presence of two other ecchymoses: one at the inner face of the right forearm, starting at the wrist reaching the elbow and the other at the left flank of the abdomen. Diagnosis of AHA was based on clinical presentation and confirmed with prolonged a PTT, Factor VIII deficiency and the presence of an FVIII inhibitor. The patient was successfully treated with corticosteroids and low dose Rituximab.

Conclusion

Clinicians should consider AHA in front of prolonged aPTT with or without spontaneous bleedings even after inactivated virus COVID-19.
Multiple distant metastases arising from a single, low-grade rectal neuroendocrine tumor: an autopsy case report
Authors: Goh Keng Wee , Yoshida Hiroshi , Miura Ichiro , Miura Chisako , Norita Kazuaki , Ii Takayuki , Yamanami Hideaki , Kobayashi Koju
Published: March 2023

Background

Rectal neuroendocrine neoplasms are rare epithelial neoplasms of the rectum. The incidence of these tumors has increased over the past decades. However, many questions remain unanswered regarding their clinicopathology, including the possible mechanisms in which these tumors may grow and metastasize.

Case presentation

In this case report, we report the findings of an autopsy of a 65-year-old Japanese woman diagnosed with multiple liver metastases from a single, low-grade rectal neuroendocrine tumor. The diagnosis was made in late 2018 to early 2019, and subsequently the patient underwent several rounds of standard chemotherapy. However, due to unfavorable side effects, she opted for palliative care at our hospital instead from December 2020. The patient’s condition was generally stable for the next 17 months, but in May 2022, she was hospitalized for increased abdominal pain. Despite enhanced pain control therapy, she eventually passed away. An autopsy was conducted to determine the exact cause of death. The primary rectal tumor was found to be small, but showed strong histological evidence of venous invasion. Metastases in the liver, pancreas, thyroid gland, adrenal glands, and vertebrae were also present. On the basis of the histological evidence obtained, we deduced that the tumor cells may have mutated and gained multiclonality as they spread vascularly to the liver, contributing to the distant metastases.

Conclusions

The results from this autopsy may provide an explanation for the possible mechanism by which small, low-grade rectal neuroendocrine tumors metastasize.
Multiple accessory pathways coexisting with a persistent left superior vena cava: a case report
Authors: Uemura Tetsuya , Kondo Hidekazu , Shinohara Tetsuji , Takahashi Masaki , Akamine Koshiro , Ogawa Naoko , Hirota Kei , Fukui Akira , Akioka Hidefumi , Yufu Kunio , Takahashi Naohiko
Published: March 2023

Background

Wolff–Parkinson–White syndrome is characterized by a short PR interval (delta-wave), long QRS complex, and the appearance of paroxysmal supraventricular tachycardia. Patients with Wolff–Parkinson–White syndrome usually have one accessory pathway, whereas cases with multiple accessory pathways are rare. Persistent left superior vena cava is a vascular anomaly in which the vein drains into the right atrium through the coronary sinus at the junction of the left internal jugular and subclavian veins due to abnormal development of the left cardinal vein. The simultaneous presence of multiple accessory pathways and persistent left superior vena cava has not been reported before.

Case presentation

A 56-year-old Japanese man with a 5-year history of palpitations was referred for radiofrequency catheter ablation due to increased frequency of tachycardia episodes in the previous 2 months. Persistent left superior vena cava was confirmed by transthoracic echocardiography and computed tomography. An electrophysiological study revealed that the accessory pathways were located in the left lateral wall, anterolateral wall, and posteroseptal region. They were completely ablated with radiofrequency energy application.

Conclusions

We reported an extremely rare case of a patient with multiple accessory pathways and persistent left superior vena cava. Our case may suggest a potential embryological relationship between the multiple accessory pathways and persistent left superior vena cava.
Structural Performance of Ferrocement Beams Incorporating Longitudinal Hole Filled with Lightweight Concrete
Authors: Shaheen Yousry B. , Eltaly Boshra A. , Yousef Shaimaa G. , Fayed Sabry
Published: March 2023

In this study, 10 ferroconcrete concrete (FC) beams with lightweight cores reinforced with welded steel mesh as a shear reinforcement were evaluated under three-point bending tests along with two conventionally normal-weight concrete (NWC) beams. Expanded polystyrene and lightweight aerated autoclaved brick wastes were used to create lightweight core concrete. The main factors include the type of lightweight concrete used for the core, beam concrete type, the form and number of holes, the existing steel mesh fabric, the hollow, and the hole placement. This study was done on the tested beams' ductility index, failure modes, first cracking loads and associated deflections, and ultimate loads besides corresponding deflections. Experimental results showed that the use of FC, various filling materials, and welded steel meshes in place of traditional stirrups enhanced the ultimate load by 36.6–107.3%, the ultimate deflection by 6–272%, and the ductility by 89–1155% when referenced to a control NWC beam. When the holing ratio increased from 10 to 20%, the ductility of FC beams was enhanced by 307.7%. Proposed equations were developed to predict the ultimate load and bending moment capacity of FC beams while taking into account the compressive strength of the beam body and filling material, the holing ratio, the tensile reinforcement ratio, and the volume fraction of the steel mesh.
Prevalence and associated factors of symptoms of pica among adolescent schoolchildren in northern Sudan: a cross-sectional study
Authors: Ahmed Mohamed A. , Al-Nafeesah Abdullah , AlEed Ashwaq , Adam Ishag
Published: March 2023

Background

Pica, the craving for and purposive eating of non-food items, is a common worldwide problem, especially among children and pregnant women. There are few published data on pica among adolescents in sub-Saharan Africa, and no study has been carried- out in Sudan. This study was conducted to determine the prevalence and associated factors of symptoms of pica among adolescent schoolchildren in northern Sudan.

Methods

A school‑based cross‑sectional study was conducted from July to September 2022 among adolescent students (aged 10–19 years) in four public primary and secondary schools in Almatamah locality in north Sudan. Sociodemographic information (age, sex, mother’s education, mother’s occupation, and father’s education) was collected through a questionnaire. Weight and height were measured using a standard procedure, and the body mass index Z-score was computed using the World Health Organization’s reference values. Logistic regression analysis was performed.

Results

Of the 384 enrolled adolescents, 180 (46.9%) were male and 204 (53.1%) were female. Their median (interquartile range) age was 15.1 (13.1‒16.3) years. The prevalence of symptoms of pica was found to be 30.7%, accounting for 118 adolescents. The most common type of pica was geophagia (eating clay and sand; 102 adolescents, 86.4%), followed by pagophagia (eating ice; 14 adolescents, 11.8%) and flour (starch; two adolescents, 1.6%). In the logistic regression analysis, females (adjusted odds ratio = 3.52, 95% confidence interval (CI) = 2.15‒5.78) and a lower level of father’s education (adjusted odds ratio = 2.05, 95% CI = 1.26‒3.34) were associated with symptoms of pica.

Conclusion

In Sudan, symptoms of pica are common among adolescents, especially females. Caregivers need to assess pica in adolescents. Further research is needed to develop guidelines, medical training, and practice.
Improved quality control of [177Lu]Lu-PSMA I&T
Authors: Kraihammer Martin , Garnuszek Piotr , Bauman Andreas , Maurin Michael , Alejandre Lafont Manuel , Haubner Roland , von Guggenberg Elisabeth , Gabriel Michael , Decristoforo Clemens
Published: March 2023

Background

Targeted radionuclide therapy with [177Lu]Lu-PSMA I&T (zadavotide guraxetan) has proven high efficacy and safety in treating patients with advanced prostate cancer worldwide. Several methods to determine the radiochemical purity have been reported but also limitations in the HPLC analysis due to retention of the sample and tailing effects when using standard gradients containing trifluoroacetic acid (TFA). We here report on the validation of a method for quality control of [177Lu]Lu-PSMA I&T including determination of radiochemical purity, identity testing and limit test for PSMA I&T by HPLC using a Phosphate buffer /Acetonitrile gradient system, complemented with a TLC system with 0.1N Citrate buffer pH 5 as mobile phase including validation of the methods, batch and stability data as well as identification of the main radiochemical impurity by mass spectrometry.

Results

The described HPLC method met the defined acceptance criteria in terms of accuracy, specificity, robustness, linearity, range and LOQ. HPLC analysis revealed symmetrical peaks and quantitative recovery from the column. Batch data showed a radiochemical purity > 95% as determined by HPLC, stability data a pronounced degradation due to radiolysis, which could be limited by addition of ascorbic acid, dilution and storage at low temperatures. The main radiochemical impurity was found to be the de-iodinated form of [177Lu]Lu-PSMA I&T. TLC analysis allowed to determine the amount of free Lu-177 even in the presence of DTPA in the final formulation.

Conclusion

Overall the described combination of HPLC and TLC provides a reliable tool for quality control of [177Lu]Lu-PSMA I&T.
NIHSS is deficient in acute stroke presenting with cortical deafness; clinical skills remain the backbone: a case report
Authors: Roushdy Tamer , Mikhail Narges W. , Abdelaziz Shaimaa Ramadan
Published: March 2023

Background

National institutes of health stroke scale (NIHSS) is used, since its appearance in analysis of stroke in any national or international single center or multicenter study. It is also the golden standard assessment scale for stroke patients whether by emergency medical services on the way to hospital or by emergency room staff and by neurologists whether juniors or senior consultants. Yet, it is not capable of identifying all stroke cases. Along the current case report a relatively rare case of cortical deafness is presented highlighting its rarity and its vascular mechanism as well as how defective is NIHSS in recognizing it.

Case presentation

72-year-old female patient presented with sudden episodic less than 60 min duration of bilateral deafness; initial imaging showed right hemispheric encephalomalacia of old stroke. Patient was initially managed as psychogenic case especially that her NIHSS was zero. On returning again to emergency room she was administered thrombolysis and regained full hearing power. Follow-up imaging revealed a new ischemic stroke along her left auditory cortex explaining her cortical deafness.

Conclusion

Cortical deafness might be missed especially that NIHSS does not detect it. NIHSS role as the only golden standard scale for diagnosing and following up stroke cases ought to be revised.
Bronchiectasis as co morbidity with COPD or ILD: complex interactions and severe consequences
Authors: Elhussini Manal SH. , Mohammed Asmaa Mahmoud , Eid Hoda Assad , Gharib Ahmed
Published: March 2023

Background

Bronchiectasis is a chronic pulmonary disease characterized by widened, malformed bronchi, with profuse expectoration and impaired quality of life. COPD and ILD are common co-morbidities with bronchiectasis.

Methods

The present study evaluated the clinical, laboratory& radiological characteristics of COPD and ILD with/without bronchiectasis. A hospital-based, retrospective study was conducted for 1 year.

Results

A total of 101 patients were analyzed, 60 patients had COPD, 34 had ILD and 7 patients had bronchiectasis without COPD or ILD. It was noticed that, out of the analyzed 60 COPD patients, 10 patients developed bronchiectasis (16.7%) versus10 patients of 34 ILD patients (29.4%). In COPD and ILD accompanied by bronchiectasis, the incidence of hemoptysis was significantly higher in comparison to those without bronchiectasis. Moreover, they showed a significant increase in partial pressure of carbon dioxide (PCO2) in comparison to those without bronchiectasis, as well as in comparison to bronchiectasis only. Sputum culture revealed that COPD with bronchiectasis were significantly associated with Staphlococcus aureus (77.8%), more than ILD with Bronchiectasis (33.3%). While S. pneumoniae were more evident in cases of ILD with bronchiectasis (22.2%). The bilateral, peripheral bronchiectasis was more common than the unilateral, central bronchiectasis among cases of COPD with bronchiectasis followed by ILD with bronchiectasis more than bronchiectasis only.

Conclusion

Patients with COPD /ILD with bronchiectasis can be associated with serious clinical manifestations as hemoptysis. Their sputum cultures detected more positive organisms than negative in comparison to cases of bronchiectasis only. Screening of COPD and ILD patients using HRCT Scanning is a recommended preventive measure for early detection of bronchiectasis.
Implementing Digital Scribes to Reduce Electronic Health Record Documentation Burden Among Cancer Care Clinicians: A Mixed-Methods Pilot Study
Authors: Nguyen Oliver T. , Turner Kea , Charles Dannelle , Sprow Olivia , Perkins Randa , Hong Young-Rock , Islam Jessica Y. , Khanna Neel , Alishahi Tabriz Amir , Hallanger-Johnson Julie , Bickel Young Jennifer , Moore Colin E.
Published: March 2023

PURPOSE

To address shortcomings of human scribes (eg, turnover), clinicians are considering digital scribes (DSs). To our knowledge, to date, no study has assessed DS implementation or clinician user experience in cancer centers. We assessed the DS's feasibility, acceptability, appropriateness, usability and its preliminary association on clinician well-being in a cancer center. We also identified implementation facilitators and barriers to DS use.

METHODS

Using a mixed-methods longitudinal pilot study design, we implemented a DS at a cancer center. Data collection included surveys at baseline and 1 month after DS use and a semistructured interview with clinicians. The survey assessed demographics, Mini Z (workplace stress and burnout), sleep quality, and implementation outcomes (feasibility, acceptability, appropriateness, and usability). The interview assessed how the DS was used and its impacts on workflows and recommendations for future implementations of the DS. We used paired t tests to assess differences in Mini Z and sleep quality measures over time.

RESULTS

Across nine survey responses and eight interviews, we found that although feasibility scores were slightly lower than our cutoff point (15.2 v 16.0), clinicians rated the DS as marginally acceptable (16.0) and appropriate (16.3). Usability was considered marginally usable (68.6 v 68.0). Although the DS did not significantly improve burnout (3.6 v 3.9, P = .081), it improved perceptions of having sufficient documentation time (2.1 v 3.6, P = .005). Clinicians identified suggestions for future implementations, including training needs and usability improvements.

CONCLUSION

Our preliminary findings suggest that DS implementation is marginally acceptable, appropriate, and usable among cancer care clinicians. Individualized training and on-site support may improve implementation.
Differential Efficacy From the Addition of Bortezomib to R-CHOP in Diffuse Large B-Cell Lymphoma According to the Molecular Subgroup in the REMoDL-B Study With a 5-Year Follow-Up
Authors: Davies Andrew J. , Barrans Sharon , Stanton Louise , Caddy Josh , Wilding Sam , Saunders Geoff , Mamot Christoph , Novak Urban , McMillan Andrew , Fields Paul , Collins Graham P. , Stephens Richard , Cucco Francesco , Sha Chulin , van Hoppe Moniek , Tooze Reuben , Davies John R. , Griffiths Gareth , Schuh Anna , Burton Catherine , Westhead David R. , Du Ming-Qing , Johnson Peter W.M.
Published: March 2023

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.

The REMoDL-B phase III adaptive trial compared rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) versus R-CHOP + bortezomib (RB-CHOP) in patients with diffuse large B-cell lymphoma (DLBCL), stratified by molecular subtype. Primary analysis at a median follow-up of 30 months found no effect of bortezomib on progression-free survival (PFS) or overall survival (OS). Retrospective analysis using a gene expression–based classifier identified a molecular high-grade (MHG) group with worse outcomes. We present an updated analysis for patients successfully classified by the gene expression profile (GEP). Eligible patients were age older than 18 years with untreated DLBCL, fit enough for full-dose chemotherapy, and with adequate biopsies for GEP. Of 1,077 patients registered, 801 were identified with Activated B-Cell (ABC), Germinal Center B-cell, or MHG lymphoma. At a median follow-up of 64 months, there was no overall benefit of bortezomib on PFS or OS (5-year PFS hazard ratio [HR], 0.81; P = .085; OS HR, 0.86; P = .32). However, improved PFS and OS were seen in ABC lymphomas after RB-CHOP: 5-year OS 67% with R-CHOP versus 80% with RB-CHOP (HR, 0.58; 95% CI, 0.35 to 0.95; P = .032). Five-year PFS was higher in MHG lymphomas: 29% versus 55% (HR, 0.46; 95% CI, 0.26 to 0.84). Patients with ABC and MHG DLBCL may benefit from the addition of bortezomib to R-CHOP in initial therapy.
Thermal transport imaging in the quantum Hall edge channel
Authors: Moore J. N. , Kamiyama A. , Mano T. , Yusa G.
Published: March 2023

Research focused on heat transport in the quantum Hall (QH) edge channel has successfully addressed fundamental theoretical questions surrounding the QH physics. However, the picture of the edge channel is complicated by the phenomenon of energy dissipation out of the edge, and theories treating this dissipation are lacking. More experimental data is also needed to determine the coupling mechanism by which energy leaves the edge channel. We developed a method to map the heat transport in the QH edge to study the dissipation of heat. We locally heated the QH edge and locally detected the temperature increase while continuously varying the distance between heater and thermometer. We thereby obtained the thermal decay length of the edge state.
Activist Affordances
Authors: Dokumaci Arseli
Published: March 2023

For people who are living with disability, including various forms of chronic diseases and chronic pain, daily tasks like lifting a glass of water or taking off clothes can be difficult if not impossible. In Activist Affordances, Arseli Dokumacı draws on ethnographic work with differently disabled people whose ingenuity, labor, and artfulness allow them to achieve these seemingly simple tasks. Dokumacı shows how they use improvisation to imagine and bring into being more habitable worlds through the smallest of actions and the most fleeting of movements---what she calls “activist affordances.” Even as an environment shrinks to a set of constraints rather than opportunities, the improvisatory space of performance opens up to allow disabled people to imagine that same environment otherwise. Dokumacı shows how disabled people’s activist affordances present the potential for a more liveable and accessible world for all of us.
MERISTEM-DEFECTIVE regulates the balance between stemness and differentiation in the root meristem through RNA splicing control
Authors: Thompson Helen L. , Shen Weiran , Matus Rodrigo , Kakkar Medhavi , Jones Carl , Dolan David , Grellscheid Sushma , Yang Xiyan , Zhang Na , Mozaffari-Jovin Sina , Chen Chunli , Zhang Xianlong , Topping Jennifer F. , Lindsey Keith
Published: March 2023

Plants respond to environmental stresses through controlled stem cell maintenance and meristem activity. One level of gene regulation is RNA alternative splicing. However, the mechanistic link between stress, meristem function and RNA splicing is poorly understood. The MERISTEM-DEFECTIVE (MDF) Arabidopsis gene encodes an SR-related family protein, required for meristem function and leaf vascularization, and is the likely orthologue of the human SART1 and yeast Snu66 splicing factors. MDF is required for the correct splicing and expression of key transcripts associated with root meristem function. We identified RSZ33 and ACC1, both known to regulate cell patterning, as splicing targets required for MDF function in the meristem. MDF expression is modulated by osmotic and cold stress, associated with differential splicing and specific isoform accumulation and shuttling between nucleus and cytosol, and acts in part via a splicing target SR34. We propose a model in which MDF controls splicing in the root meristem to promote stemness and to repress stress response, cell differentiation and cell death pathways.
A hypothesis for robust polarization vision: an example from the Australian imperial blue butterfly,Jalmenus evagoras
Authors: Childers Richard A. Rabideau , Bernard Gary D. , Huang Heqing , Tsai Cheng-Chia , Stoddard Mary Caswell , Hogan Benedict G. , Greenwood Joel S. F. , Soucy Edward R. , Cornwall Mark , Lim Matthew Lek Min , Liénard Marjorie A. , Yu Nanfang , Pierce Naomi E.
Published: March 2023

The Australian lycaenid butterfly Jalmenus evagoras has iridescent wings that are sexually dimorphic, spectrally and in their degree of polarization, suggesting that these properties are likely to be important in mate recognition. We first describe the results of a field experiment showing that free-flying individuals of J. evagoras discriminate between visual stimuli that vary in polarization content in blue wavelengths but not in others. We then present detailed reflectance spectrophotometry measurements of the polarization content of male and female wings, showing that female wings exhibit blue-shifted reflectance, with a lower degree of polarization relative to male wings. Finally, we describe a novel method for measuring alignment of ommatidial arrays: by measuring variation of depolarized eyeshine intensity from patches of ommatidia as a function of eye rotation, we show that (a) individual rhabdoms contain mutually perpendicular microvilli; (b) many rhabdoms in the array have their microvilli misaligned with respect to neighboring rhabdoms by as much as 45 deg; and (c) the misaligned ommatidia are useful for robust polarization detection. By mapping the distribution of the ommatidial misalignments in eye patches of J. evagoras, we show that males and females exhibit differences in the extent to which ommatidia are aligned. Both the number of misaligned ommatidia suitable for robust polarization detection and the number of aligned ommatidia suitable for edge detection vary with respect to both sex and eye patch elevation. Thus, J. evagoras exhibits finely tuned ommatidial arrays suitable for perception of polarized signals, likely to match sex-specific life history differences in the utility of polarized signals.
The roles of brain lipids and polar metabolites in the hypoxia tolerance of deep-diving pinnipeds
Authors: Martens Gerrit A. , Geßner Cornelia , Folkow Lars P. , Creydt Marina , Fischer Markus , Burmester Thorsten
Published: March 2023

Lipids make up more than half of the human brain's dry weight, yet the composition and function of the brain lipidome is not well characterized. Lipids not only provide the structural basis of cell membranes, but also take part in a wide variety of biochemical processes. In neurodegenerative diseases, lipids can facilitate neuroprotection and serve as diagnostic biomarkers. The study of organisms adapted to extreme environments may prove particularly valuable in understanding mechanisms that protect against stressful conditions and prevent neurodegeneration. The brain of the hooded seal (Cystophora cristata) exhibits a remarkable tolerance to low tissue oxygen levels (hypoxia). While neurons of most terrestrial mammals suffer irreversible damage after only short periods of hypoxia, in vitro experiments show that neurons of the hooded seal display prolonged functional integrity even in severe hypoxia. How the brain lipidome contributes to the hypoxia tolerance of marine mammals has been poorly studied. We performed an untargeted lipidomics analysis, which revealed that lipid species are significantly modulated in marine mammals compared with non-diving mammals. Increased levels of sphingomyelin species may have important implications for efficient signal transduction in the seal brain. Substrate assays also revealed elevated normoxic tissue levels of glucose and lactate, which suggests an enhanced glycolytic capacity. Additionally, concentrations of the neurotransmitters glutamate and glutamine were decreased, which may indicate reduced excitatory synaptic signaling in marine mammals. Analysis of hypoxia-exposed brain tissue suggests that these represent constitutive mechanisms rather than an induced response towards hypoxic conditions.
Data drift in medical machine learning: implications and potential remedies
Authors: Sahiner Berkman , Chen Weijie , Samala Ravi K , Petrick Nicholas
Published: March 2023

Data drift refers to differences between the data used in training a machine learning (ML) model and that applied to the model in real-world operation. Medical ML systems can be exposed to various forms of data drift, including differences between the data sampled for training and used in clinical operation, differences between medical practices or context of use between training and clinical use, and time-related changes in patient populations, disease patterns, and data acquisition, to name a few. In this article, we first review the terminology used in ML literature related to data drift, define distinct types of drift, and discuss in detail potential causes within the context of medical applications with an emphasis on medical imaging. We then review the recent literature regarding the effects of data drift on medical ML systems, which overwhelmingly show that data drift can be a major cause for performance deterioration. We then discuss methods for monitoring data drift and mitigating its effects with an emphasis on pre- and post-deployment techniques. Some of the potential methods for drift detection and issues around model retraining when drift is detected are included. Based on our review, we find that data drift is a major concern in medical ML deployment and that more research is needed so that ML models can identify drift early, incorporate effective mitigation strategies and resist performance decay.
Endocrine disorders in Beta-Thalassemia major patients at a Tertiary Care Hospital
Authors: Malik Suleman Elahi , Kanwal Shaista , Javed Javeria , Hidayat Wagma , Ghaffar Tahir , Aamir Azizul Hasan
Published: March 2023

Objectives: To determine the frequency of endocrine disorders in Beta-Thalassemia Major (BTM) patients presenting for Endocrine Evaluation to the Department of Diabetes, Endocrinology and Metabolic Diseases, Hayatabad Medical Complex, Peshawar, Pakistan, a tertiary care hospital.

Method: This descriptive study was conducted in the Department of Diabetes, Endocrinology and Metabolic Diseases, Hayatabad Medical Complex, Peshawar from October 2019 to August 2021. All patients with BTM presenting for endocrine evaluation were included in the study. Height and weight were assessed and plotted on the standard charts. For secondary sexual characteristics tanner staging was used. Blood samples for hormonal profile were taken according to standard protocol and sent for endocrine assessment.

Results: A Total of 135 patients BTM were enrolled in the study comprising of 70 (51.9%) males and 65 (48.1%) females. Their mean age was 14.8±3.9 years, mean height 138.5±13.01 cm, mean weight 35.9±8.4 kg, mean BMI 18.6±2.8 kg/m2, mean age of transfusion started was 6.7±3.99 months, mean duration of transfusion 13.6±4.03 years and mean duration of chelation therapy received 6.1±4.5 years. Regarding endocrine complications, out of 135 patients assessed, one hundred (74.1%) had height less than 5th centile and fifteen (11.1%) had diabetes mellitus. For thyroid and parathyroid function, 58 and 13 were tested respectively, out of which 16 (27.6%) and 6 (46.2%) had thyroid dysfunction and hypoparathyroidism. Out of 91 patients assessed for pubertal delay, 61 (67.03%) had delayed puberty.

Conclusions: High percentage of endocrine complications were found in patients with BTM. Severity and multiplicity of endocrine organs involvement was dependent on duration of the disease and lack of compliance with chelation therapy.

doi: https://doi.org/10.12669/pjms.39.3.6837

How to cite this: Malik SE, Kanwal S, Javed J, Hidayat W, Ghaffar T, Aamir AH. Endocrine disorders in Beta-Thalassemia major patients at a Tertiary Care Hospital. Pak J Med Sci. 2023;39(3):726-731. doi: https://doi.org/10.12669/pjms.39.3.6837

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Comparative Statics of Disclosure Statements
Authors: Burkovskaya Anastasia , Li Jian
Published: March 2023

Financial companies often use disclosure statements (DSs) to categorize uncertain contingencies into different sections (e.g., a health insurance plan includes sections such as “hospital coverage” and “dental coverage”). We model DSs as information partitions of the state space, which influence how a consumer perceives her choice problem and how she makes her demand decisions. We study a consumer with weakly separable preferences, which allows us to define event-risk attitude to the DS’s categories. Our main results show that aggregating the more expensive events into a coarser DS decreases a firm’s profit if and only if the consumer is event-risk averse. The opposite result holds for event-risk loving. Our findings can be extended to a more general class of consumer preferences and provide insights into the optimal design of DSs.

This paper was accepted by Ilia Tsetlin, behavioral economics and decision analysis.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/mnsc.2023.4742 .
Identification and Resistance Testing of Bacteria Causing Nosocomial Infections in Surgery Inpatient Rooms
Authors: Escool Tarigan Grandiano , Nawan Nawan , Immanuela Toemon Agnes
Published: March 2023

Background: Nosocomial infections are the most common infections that occur when patients are under medical care in hospitals. The most common pathogenic bacteria that cause nosocomial infections are Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Enterobacter spp, and Klebsiella pneumonia. One of the factors causing a nosocomial infection is the environment. The spread of nosocomial infections in dr. Doris Sylvanus can occur in the surgical ward environment. Therefore, it is necessary to study and know the identification of bacteria and knowing the pattern of antibiotic resistance of bacteria that cause nosocomial infections in the surgical inpatient ward of dr. Doris Sylvanus Hospital. Methods: This type of research used an observational method with a descriptive approach. The research at dr Doris Sylvanus Hospital. The population is dahlia room which consisted of floors, sheets, patient beds, tables, and door handles. Results: Bacterial identification was Staphylococcus aureus at 13.4% and Staphylococcus non-coagulase at 10%, also found Gram-negative bacteria suspected Salmonella sp. 3.3% and other bacteria at 73.3% The results of the Trimethoprim-sulfamethoxazole antibiotic resistance test on S. aureus bacteria had a sensitivity of 50% and Oxacillin had a sensitivity of 75%, while the Trimethoprim-sulfamethoxazole resistance test results on S. non-coagulase bacteria had a sensitivity of 66.7% and Oxacillin had a sensitivity of 100%. Conclusion: The Trimethoprim-sulfamethoxazole antibiotic resistance test on S. aureus bacteria has moderate sensitivity and the Oxacillin antibiotic has a fairly high sensitivity while on S. non-coagulase bacteria have a fairly high sensitivity and oxacillin antibiotics have high sensitivity.
Literature Review: K-Beauty Effect on Health Behavior and Korean Cosmetics Purchasing in Indonesia
Authors: Widyaningrum Rachmawati , Ramadhani Khairunisa , Lestari Budi
Published: March 2023

Background: The K-wave popularity led to increased Korean fans in Indonesia, including other sectors of Korean products. Further, the styles of the stars, look, and culture became Indonesian people's references in fashion, ideal body shape, and food consumption patterns. However, a concern was also raised about the halal status of Korean beauty products and Indonesian health behavior to meet the ideal body shape of Korean celebrities. This study aims to understand the general perspective of the K-beauty popularity effect on Indonesian people's health behavior and cosmetics purchasing intention, including its halal issues. Method: This study was conducted by reviewing relevant research articles between 2012 to 2022 on the topic through a google scholar search engine. In total, 14 articles that meet the inclusion criteria were reviewed. Results: This study found that some adolescents that worshiped Korean idols had a negative body image and did a strict diet, heavy exercise, took weight loss pills, or did plastic surgery to meet their body goals. Further, South Korean dramas significantly affect the brand image of Korean cosmetics and further increase its purchasing intention. People's knowledge of halal cosmetics, religion, and the halal label will affect their purchasing level and preference for halal cosmetics. Conclusions: This study concludes that the emerging K-beauty trend should be balanced with the knowledge about a healthy way to gain beauty and the understanding of halal cosmetics. The stakeholder should enhance the intervention to improve youngsters' knowledge and attitude toward halal cosmetics and a healthy diet.
Digital mental health platforms
Authors: Gournay Kevin , Haddad Mark , Clough Isobel
Published: March 2023

With the widespread prevalence of mental health problems, digital platforms for mental healthcare are increasingly commonly used. This article explores what this means for services.
Synchronous and Asynchronous Modalities for Mathematics Instruction during the Covid-19 Pandemic
Authors: Cabrera Freddie R.
Published: March 2023

The purpose of this study was to evaluate synchronous and asynchronous mathematics teaching modalities at Isabela State University. The qualitative research method was used to collect information, opinions, and experiences of Isabela State University mathematics faculty in employing synchronous and asynchronous modes in teaching mathematical courses in terms of strengths, weaknesses, possibilities, and problems. The study's subjects were 15 Mathematics Instructors chosen at random from Isabela State University's nine campuses. A structured interview was created and distributed to participants using Google Form. The limitations on face-to-face encounters prompted the use of such data-gathering technique. The researcher followed up with another video call interview to validate the participants' responses. The data was transcribed and processed using thematic analysis. The findings demonstrated that the synchronous and asynchronous learning modalities both have strengths and disadvantages that influence the quality of the teaching-learning process throughout the epidemic. Given this, distant learning is thought to be more effective when both modalities are used rather to just one of the aforementioned. This is because the strengths of one of the two modalities can solve the flaws highlighted in the other. As a result, mathematics instructors may receive more in-depth training in both asynchronous and synchronous teaching approaches, as well as strategies for becoming more successful teachers during the present school closures.
Importancia de las actitudes hacia las personas con discapacidad en Educación Infantil y Primaria. Revisión sistemática
Authors: Hernández-Beltrán Víctor , González-Coto Victor A. , Gámez-Calvo Luisa , Suárez-Arévalo Elsa , Gamonales José M.
Published: March 2023

INTRODUCCIÓN. Las actitudes que presentan los docentes hacia las personas con discapacidad, y, en especial, hacia el fomento de la educación inclusiva, determinan las oportunidades de aprendizaje de los estudiantes, y aumenta el sentimiento de pertenencia y de participación en las actividades. OBJETIVO. Conocer los documentos científicos relacionados con las actitudes hacia las personas con discapacidad en los niveles de Educación Infantil y Educación Primaria. MÉTODO. Para ello, se ha llevado a cabo una búsqueda de documentos en las siguientes bases de datos: Web of Science, Scopus y PubMed. Para la búsqueda de los documentos, se han utilizado las siguientes palabras clave: “preschool”, “inclusive education”, “attitudes” y “disability”, obteniendo un número final de 13 documentos válidos, identificados hasta el mes de junio de 2022, fecha en la cual se realizó la búsqueda de los documentos. Para la inclusión de los diferentes manuscritos en la revisión, debían cumplir una serie de criterios de inclusión y exclusión elaborados por los investigadores. RESULTADOS. Se muestra que la mayoría de los integrantes de la comunidad educativa presenta actitudes positivas hacia las personas con discapacidad. DISCUSIÓN. A través de la inclusión en las aulas de Educación Infantil y Educación Primaria, los estudiantes desarrollan su sentimiento de pertenencia al grupo. Además, permite fomentar valores de respeto, tolerancia y empatía hacia el colectivo de personas con discapacidad. Por tanto, fomentar la inclusión en los centros educativos desde la Educación Infantil es uno de los principales objetivos de la educación actual.
Germany’s Never-Ending Guilt Trip
Authors: Abed-Rabbo Samir
Published: March 2023

Nazi Germany and the Jewish Agency for Palestine, the future government of Israel and the official representative of the Zionist Organization (ZO), entered a contractual transactional relationship from 1933 to 1939. In 1952 the Federal Republic of Germany (FRG) and the State of Israel, on behalf of all Jews, signed an agreement that paved the way for Germany’s unconditional support for Israel. No suggestion is being made here that Nazi Germany and the FRG are the same; the FRG assumed responsibilities for the crimes of the Holocaust.

However, both contractual transactional relationships between both countries from 1933 to the present have initiated policies and programs that contributed significantly to the deterioration of German Jewish living conditions in Germany, the transfer of thousands of German Jewish citizens and their assets out of Germany to colonize Palestine, the establishment of Israel in historic Palestine, the ethnic cleansing of the Palestinian people, the allocation of a significant portion of German reparation money for the benefit of Israel instead of the victims of the Holocaust, the strengthening of the Israeli economy and industrial base, and providing Israel with German military technology and equipment to wage wars in the region.

In this article, I will examine and analyze the special, often secret, relationship between Germany and the Zionist mechanization to colonize Palestine, the establishment of Israel in 1948, and the arming of the state with modern weapon platforms that can carry and deliver nuclear weapons. This secret relationship is in clear violation of German law, made possible by creating a universal guilt feeling among Germans for the crime of the Holocaust, and associated with a deliberate lack of public debate and accountability.
Low-noise φ-OTDR employing nonlinear optical preamplification for distributed acoustic sensing
Authors: Rossi L. , Cheng L. K. , de Jong W. , Jansen R. , Bolognini G.
Published: March 2023

A phase sensitive optical time domain reflectometry sensing scheme employing a
two-stage nonlinear optical preamplification system is proposed to
reduce the blind spot effect in Rayleigh scattering by improving the
optical power distribution and to enhance the resolution at locations
of low-backscatter intensity measurements, providing a higher
signal-to-noise ratio for distributed acoustic measurements; the
developed system has been tested in-laboratory and on in-field
monitoring of a survey well in Cottessen, The Netherlands. The
characterization shows strain noise levels below 1 nɛ for a
10 kHz sampling rate.
Security-enhanced electro-optic chaotic communication system based on the logistic map feedback and dynamic key
Authors: Lu Yuantong , Wang Hongxiang , Ji Yuefeng , Zhang Yu
Published: March 2023

In this paper, a novel electro-optic chaotic system based on the logistic map feedback (EOLM) is proposed. The logistic map is used to introduce additional nonlinear effects into the electro-optic feedback loop. The simulation results show that, with the increase of logistic map iterations N, the bandwidth and permutation entropy of the chaotic output can be significantly increased, and the spectrum is flatter. The time-delay signature (TDS) of the system can be concealed within the appropriate range of values of parameters, which ensures the security of the key. Synchronization results show that the system is not only sensitive to time delay T but is also sensitive to the feedback intensity β, so β is also the key of the system. Utilizing the sensitivity to β, a dynamic EOLM communication system with changing key (DEOLM) is designed. Based on chaotic self-control, the chaotic optical signal is transformed nonlinearly to generate the control signal, which drives the gain coefficient of the amplifier to change dynamically, so as to realize the changing of β. Simulation of communication performance shows that the DEOLM system greatly raises the difficulty for the eavesdropper to crack the message and improves the confidentiality of communication.