bluuebunny/crossref_metadata_2025 huggingface dataset:
Extrinsic factors influencing gut microbes, the immediate consequences and restoring eubiosis
Authors: Bajinka Ousman , Tan Yurong , Abdelhalim Khalid A. , Özdemir Güven , Qiu Xiangjie
Published: July 2020

From the emerging studies, the more diverse the microbial population in the gut, the healthier the gut. Health benefits are associated with the functional characteristics of these diverse microbial genes. Extrinsic factors causing dysbiosis are extensively studied however, linking the varying degree of consequences to the respective factors and therapeutic possibilities are not explored at length. This review aims to examine from previous studies and put forward the types of dysbiosis, the immediate consequences and the scientific approaches to restore disrupted microbiota. Dietary supplements are found to be one of the factors contributing profoundly to the alteration of gut microbiota. While diet rich in fibre and fermented food established a diverse microbiome and produce vital metabolites, high fat, animal proteins and high caloric carbohydrate are as well relative to dysbiosis among infants, adult or diseases individuals. The intermittent fasting, feeding methods, the pH and water quality are among the factors associated with dysbiosis. Prebiotics and Probiotics maintain and restore gut homeostasis. Antibiotic-induced dysbiosis are relatively on the spectrum of activity, the pharmacokinetics properties, the dose taken during the treatment route of administration and the duration of drug therapy. The higher the altitude, the lesser the diversity. Extreme temperatures as well are related to reduced microbial activity and metabolism. Delivery through caserium-section deprived the newborn from restoring valuable vaginal bacterial species and the baby will instead assumed intestinal microbiota-like. While exercise and oxidative stress contribute even though moderately, fecal microbial transfer (FMT) also influence gut microbiota.
Volcanic unrest scenarios and impact assessment at Campi Flegrei caldera, Southern Italy
Authors: Charlton Danielle , Kilburn Christopher , Edwards Stephen
Published: July 2020

At Campi Flegrei caldera, volcanic unrest hazards during 1982–1984 caused significant building damage and led to the evacuation of over 40,000 residents in the central town of Pozzuoli. Past hazard assessments in this region have focused on eruption hazards rather than on hazards from volcanic unrest. In this study, we developed a hypothetical unrest hazard scenario applied to three locations within Campi Flegrei caldera: Pozzuoli, Agnano and Baia. We also collated GIS exposure datasets and used vulnerability models of building and road damage to carry out an impact assessment for future volcanic unrest at these three test locations. The resulting impact maps provide useful insight into the effects future unrest could have on businesses, buildings and livelihoods within Campi Flegrei.

The impact maps show that, depending on the location of unrest, evacuations associated with future unrest may involve displacement of large numbers of residents, and significant damage to buildings and infrastructure. The Agnano scenario is associated with the greatest impact and involves the potential evacuation of 136,000 people and damage to about 2400 buildings, with up to 200 km of roads and 17 km of high-voltage electricity network also exposed. Agnano also lies between Naples and the rest of Campi Flegrei, so that damage to infrastructure may trigger a cascade of obstacles to managing evacuations and repairs during an emergency. The results highlight how a simple impact assessment can be used to explore the possible effects of future unrest hazard, and the importance of considering scenarios in which renewed ground uplift is not necessarily focused beneath Pozzuoli.
New quantum estimates in the setting of fractional calculus theory
Authors: Rashid Saima , Hammouch Zakia , Ashraf Rehana , Baleanu Dumitru , Nisar Kottakkaran Sooppy
Published: July 2020

In this article, the investigation is centered around the quantum estimates by utilizing quantum Hahn integral operator via the quantum shift operator${}_{\eta}\psi_{\mathfrak{q}}(\zeta)=\mathfrak{q}\zeta+(1-\mathfrak{q})\eta$ψqη(ζ)=qζ+(1−q)η,$\zeta\in[\mu,\nu]$ζ∈[μ,ν],$\eta=\mu+\frac{\omega}{(1-\mathfrak{q})}$η=μ+ω(1−q),$0<\mathfrak{q}<1$0<q<1,$\omega\geq0$ω≥0. Our strategy includes fractional calculus, Jackson’s$\mathfrak{q}$q-integral, the main ideas of quantum calculus, and a generalization used in the frame of convex functions. We presented, in general, three types of fractional quantum integral inequalities that can be utilized to explain orthogonal polynomials, and exploring some estimation problems with shifting estimations of fractional order$\varrho_{1}$ϱ1and the$\mathfrak{q}$q-numbers have yielded fascinating outcomes. As an application viewpoint, an illustrative example shows the effectiveness of$\mathfrak{q}$q,ω-derivative for boundary value problem.
Existence of solution and stability for the fractional order novel coronavirus (nCoV-2019) model
Authors: Hussain Azhar , Baleanu Dumitru , Adeel Muhammad
Published: July 2020

The aim of this work is to present a new fractional order model of novel coronavirus (nCoV-2019) under Caputo–Fabrizio derivative. We make use of fixed point theory and Picard–Lindelöf technique to explore the existence and uniqueness of solution for the proposed model. Moreover, we explore the generalized Hyers–Ulam stability of the model using Gronwall’s inequality.
Microbiota from alginate oligosaccharide-dosed mice successfully mitigated small intestinal mucositis
Authors: Zhang Pengfei , Liu Jing , Xiong Bohui , Zhang Cong , Kang Beining , Gao Yishan , Li Zengkuan , Ge Wei , Cheng Shunfeng , Hao Yanan , Shen Wei , Yu Shuai , Chen Liang , Tang Xiangfang , Zhao Yong , Zhang Hongfu
Published: July 2020

Background

The increasing incidence of cancer and intestinal mucositis induced by chemotherapeutics are causing worldwide concern. Many approaches such as fecal microbiota transplantation (FMT) have been used to minimize mucositis. However, it is still unknown whether FMT from a donor with beneficial gut microbiota results in more effective intestinal function in the recipient. Recently, we found that alginate oligosaccharides (AOS) benefit murine gut microbiota through increasing “beneficial” microbes to rescue busulfan induced mucositis.

Results

In the current investigation, FMT from AOS-dosed mice improved small intestine function over FMT from control mice through the recovery of gene expression and an increase in the levels of cell junction proteins. FMT from AOS-dosed mice showed superior benefits over FMT from control mice on recipient gut microbiotas through an increase in “beneficial” microbes such asLeuconostocaceaeand recovery in blood metabolome. Furthermore, the correlation of gut microbiota and blood metabolites suggested that the “beneficial” microbeLactobacillaleshelped with the recovery of blood metabolites, while the “harmful” microbeMycoplasmatalesdid not.

Conclusion

The data confirm our hypothesis that FMT from a donor with superior microbes leads to a more profound recovery of small intestinal function. We propose that gut microbiota from naturally produced AOS-treated donor may be used to prevent small intestinal mucositis induced by chemotherapeutics or other factors in recipients.
Predictive big data analytics for supply chain demand forecasting: methods, applications, and research opportunities
Authors: Seyedan Mahya , Mafakheri Fereshteh
Published: July 2020

Big data analytics (BDA) in supply chain management (SCM) is receiving a growing attention. This is due to the fact that BDA has a wide range of applications in SCM, including customer behavior analysis, trend analysis, and demand prediction. In this survey, we investigate the predictive BDA applications in supply chain demand forecasting to propose a classification of these applications, identify the gaps, and provide insights for future research. We classify these algorithms and their applications in supply chain management into time-series forecasting, clustering, K-nearest-neighbors, neural networks, regression analysis, support vector machines, and support vector regression. This survey also points to the fact that the literature is particularly lacking on the applications of BDA for demand forecasting in the case of closed-loop supply chains (CLSCs) and accordingly highlights avenues for future research.
Mining frequent itemsets from streaming transaction data using genetic algorithms
Authors: Bagui Sikha , Stanley Patrick
Published: July 2020

This paper presents a study of mining frequent itemsets from streaming data in the presence of concept drift. Streaming data, being volatile in nature, is particularly challenging to mine. An approach using genetic algorithms is presented, and various relationships between concept drift, sliding window size, and genetic algorithm constraints are explored. Concept drift is identified by changes in frequent itemsets. The novelty of this work lies in determining concept drift using frequent itemsets for mining streaming data, using the genetic algorithm framework. Formulas have been presented for calculating minimum support counts in streaming data using sliding windows. Testing highlighted that the ratio of the window size to transactions per drift was a key to good performance. Getting good results when the sliding window size was too small was a challenge since normal fluctuations in the data could appear to be a concept drift. Window size must be managed in conjunction with support and confidence values in order to achieve reasonable results. This method of detecting concept drift performed well when larger window sizes were used.
Meniscal substitution, a developing and long-awaited demand
Authors: Winkler Philipp W. , Rothrauff Benjamin B. , Buerba Rafael A. , Shah Neha , Zaffagnini Stefano , Alexander Peter , Musahl Volker
Published: July 2020

The menisci represent indispensable intraarticular components of a well-functioning knee joint. Sports activities, traumatic incidents, or simply degenerative conditions can cause meniscal injuries, which often require surgical intervention. Efforts in biomechanical and clinical research have led to the recommendation of a meniscus-preserving rather than a meniscus-resecting treatment approach. Nevertheless, partial or even total meniscal resection is sometimes inevitable. In such circumstances, techniques of meniscal substitution are required. Autologous, allogenic, and artificial meniscal substitutes are available which have evolved in recent years. Basic anatomical and biomechanical knowledge, clinical application, radiological and clinical outcomes as well as future perspectives of meniscal substitutes are presented in this article. A comprehensive knowledge of the different approaches to meniscal substitution is required in order to integrate these evolving techniques in daily clinical practice to prevent the devastating effects of lost meniscal tissue.
Delayed ankle muscle reaction time in female amateur footballers after the first 15 min of a simulated prolonged football protocol
Authors: Fong Daniel T. P. , Leung Wing-Ching , Mok Kam-Ming , Yung Patrick S. H.
Published: July 2020

Purpose

Ankle sprain injury rate is reported to be higher towards the end of a football match. Muscle fatigue may contribute to the delayed muscle reaction and subsequent injury. This study investigated the ankle muscle reaction time during a simulated, prolonged football protocol.

Methods

Seven amateur female football players participated in a 105-min simulated, prolonged football protocol. An ankle muscle reaction test was conducted with a pair of ankle sprain simulators at a scheduled interval every 15-min. The reaction times of peroneus longus, tibialis anterior, and lateral gastrocnemius were collected using an electromyography system sampling at 1000 Hz. Repeated measures one-way multivariate analysis of variance with post-hoc paired t-tests were conducted to evaluate if the reaction time at each time point significantly differed from baseline. Statistical significance was set at p < 0.05 level.

Results

Reaction times started from 40.5–47.7 ms at baseline and increased to 48.6–55.7 ms at the end. Reaction times significantly increased in all muscles after the first 15 min except for the dominant lateral gastrocnemius. Increased reaction times were seen in the non-dominant limb after 60 min for tibialis anterior, after 75 min for peroneus longus, and after 90 min for the lateral gastrocnemius.

Conclusions

Delayed reaction time of the ankle muscles were found after the first 15 min and in the final 45 min of a simulated prolonged football protocol. Strategies for injury prevention should also focus on tackling the delayed ankle muscle reaction time in the acute phase (the first 15 min), in addition to the latter minutes in the second half.

Level of evidence

Controlled laboratory study, Level V.
The effect of positive end-expiratory pressure on cardiac output and oxygen delivery during cardiopulmonary resuscitation
Authors: Levenbrown Yosef , Hossain Md Jobayer , Keith James P. , Burr Katlyn , Hesek Anne , Shaffer Thomas
Published: July 2020

Background

Positive end-expiratory pressure (PEEP) is used to optimize oxygenation by preventing alveolar collapse. However, PEEP can potentially decrease cardiac output through cardiopulmonary interactions. The effect of PEEP on cardiac output during cardiopulmonary resuscitation (CPR) is not known.

Methods

This was a preclinical randomized, controlled, animal study conducted in an animal research facility on 25 Landrace-Yorkshire pigs. After inducing cardiac arrest, CPR was performed with LUCAS 3. During CPR, pigs were ventilated at a PEEP of 0, 5, 10, 15, 20 cmH2O (randomly determined via lottery) for 9 min. Cardiac output, obtained via ultrasound dilution, and PaO2 were measured, and oxygen delivery calculated for each PEEP.

Results

A mixed-effects repeated-measures analysis of variance was used to compare the baseline value adjusted mean cardiac output, PaO2, and oxygen delivery between PEEP groups. Least significant difference test was used to conduct pairwise comparisons between PEEP groups. To determine optimum PEEP, Gaussian mixture model was applied to the adjusted means of cardiac output and oxygen delivery. Increasing PEEP to 10 and higher resulted in significant declines in cardiac output. A PEEP of 15 and higher resulted in significant declines in oxygen delivery. As PEEP was increased from 0 to 20, PaO2 increased significantly. Gaussian mixture model identified the 0–5 PEEP group as providing optimal cardiac output and oxygen delivery, with PEEP of 5 providing the highest oxygen delivery.

Conclusions

A PEEP of 0–5 resulted in the optimal oxygen delivery and cardiac output during CPR, with PEEP of 5 resulting in higher oxygen delivery, and a slightly lower, statistically insignificant cardiac output than PEEP of 0.
First record of Columbus crab Planes minutus (Crustacea: Decapoda: Brachyura: Grapsidae) Linnaeus, 1758 for the northwestern Indian Ocean
Authors: Yaghmour Fadi , Al Naqbi Halima
Published: July 2020

Planes minutus Linnaeus, 1758 is a species of grapsid crab that is known to be symbiotically associated with various species that include but are not limited to sea turtles. This specie is known to occur in tropical and subtropical oceans. In this study, we report a P.minutus specimen from a stranded loggerhead sea turtle from the Sea of Oman coast of the United Arab Emirates, signifying the first record of this specie from the Northwestern Indian Ocean.
Spatial anxiety mediates the sex difference in adult mental rotation test performance
Authors: Alvarez-Vargas Daniela , Abad Carla , Pruden Shannon M.
Published: July 2020

Mental rotation ability is associated with successful advances in STEM (science, technology, engineering, and mathematics) education and occupations. Meta-analyses have shown consistent sex disparities in mental rotation, where men outperform women on one measure of mental rotation ability, theMental Rotations Test(MRT). Spatial anxiety, or the fear and apprehension felt when completing a task that requires spatial thinking, was proposed as a mechanism explaining the relation between sex and mental rotation test performance. This study modified theSpatial Anxiety Scale(SAS) to include questions about how anxious individuals feel when they must mentally rotate items to accomplish a task (e.g., playing Tetris). An exploratory factor analysis was conducted to assess the factorial structure of the modified spatial anxiety scale. Three factor loadings were extracted representing the ability to navigate, mentally rotate objects, and visualize objects. Furthermore, we analyzed the role of spatial anxiety and trait anxiety as potential mediators of the relation between participant sex and mental rotation performance. Spatial anxiety partially mediated the link between the sex of the participants and the MRT performance controlling for trait anxiety. Only navigation and mental rotation anxiety significantly mediated the relation between participant sex and mental rotation performance. We posit spatial anxiety as a barrier to efficient and accurate spatial thinking, and suggest that reducing spatial anxiety has the potential to improve spatial skills and reduce sex differences in mental rotation test performance. To ascertain this, an experimental design can determine whether a reduction in spatial anxiety causes changes in mental rotation test scores.
Research on the reform of county-level Fangguanfu in ethnic regions in China —a case study of the Fangguanfu Reformation at Ongniud Banner
Authors: Fang Yong , Zhou Jinghong , Zhang Shaochun , WuRigexiletu  , Shao Lei , Liang Xin
Published: July 2020

Ongniud Banner, as a mixed agricultural and pastoral county-level administrative region within the Inner Mongolia Autonomous Region, actively promotes an improved level of government services, especially the Fangguanfu Reform promoted by the central government of China. The banner government actively sought to overcome difficulties related to the foundation, technical conditions, and institutional constraints, and thus solidly promoted the Fangguanfu Reform in the county, achieving significant results in “decentralization”, increased awareness of “supervision”, and “service”. The initial creation of the service system and the positive impact of significantly improved efficiency have enabled government services to increasingly reflect the political concept of governing for the people, effectively optimizing the environment for local development.
Adductor canal block versus femoral nerve block in unicompartmental knee arthroplasty: a randomized, double blind, prospective, comparative study
Authors: Armanious Simon H. , Botros Joseph M. , EL Ganzoury Ibrahim M. , Abdelhameed Gamal A.
Published: July 2020

Background

Minimally invasive knee replacement surgery has grown in early twenty-first century to join international trend of ambulatory joint surgery. Both ultrasound-guided femoral nerve block (FNB) and adductor canal block (ACB) have excellent postoperative analgesia following uni-knee replacement. Minimal motor power affection facilitates early patient ambulation and rehabilitation. Therefore, the objective of this study is to evaluate and compare the functional recovery and analgesic efficacy of both techniques in uni-knee arthroplasty.

Methods

After University Review Board approval, informed written consent to participate in the study was obtained. Patients scheduled for unicompartmental knee arthroplasty (UKA) with combined spinal-epidural anesthesia were eligible for enrollment in this double blind, randomized trial. Patients received either FNB or ACB with a 20 cc of 0.5% of bupivacaine with 5 μg/ml epinephrine. Quadriceps muscle strength was measured as primary outcome using Medical Research Council scale (MRC). Postoperative pain with visual analog scale (VAS) and total morphine consumption was considered as secondary outcome, all recorded for 48 h post-anesthesia administration.

Results

Eighty patients were analyzed; quadriceps strength was significantly lower in the FNB group compared with ACB group especially at 12 postoperative hour (2 versus 4), respectively, p value < 0.05. There was no difference between the groups regarding postoperative. VAS at rest except at 24 h was significantly lower in FNB group with p value 0.003. The gate disturbance and the number of falls were significantly lower in the ACB group than the FNB group (2 compared to 9), respectively. There was no difference between groups regarding postoperative nausea, vomiting, and itching.

Conclusion

ACB preserved quadriceps muscle strength more than FNB, with reduced number of falls and without significant difference in pain relief. Therefore, ACB considered an alternative to FNB when given as supplemental postoperative pain control after unicompartmental knee arthroplasty.

Trial registration

This clinical trial was registered in the Pan African Clinical Trial Registry (PACTR) http://www.pactr.org/ as a prospective trial with the identification number PACTR201907788767332.
Botany, pharmacology and conservation status of wonder flower: Neelakurinji (Strobilanthes kunthiana (Nees) T. Anderson ex Benth)
Authors: Bera Soumen , Das Sibsankar , Kalindi Dharmadas
Published: July 2020

Strobilanthes kunthiana (Nees) T. Anderson ex Benth locally known as Neelakurinji is an endemic to Western Ghat, India and belongs to the Acanthaceae family. It has a unique flowering pattern to bloom every 12 years. The objective of this review is to highlight the taxonomy, distribution, ecology, biology, pharmacological properties, and conservation status of Strobilanthes kunthiana. The plant S. kunthiana is a rich source of pharmacological constituents and can act as herbal alternatives for various disorders. This review discusses the unique botany specifically the flowering pattern for in-depth study to conserve not only for tourism but also for exploring its pharmacological properties and usefulness in apiary. Finally, this review highlights the potential research areas that should be interlinked with promotion of tourism with Neelakurinji attraction as well as its potential use in apiary.
Short- and long-term outcomes following percutaneous coronary intervention in hepatitis C virus seropositive patients
Authors: Hussein Ahmed , Abdel Ghany Mohamed , Mahmoud Hossam Eldin M.
Published: July 2020

Background

Hepatitis C virus (HCV) infection is progressively recognized as a potential atherogenic condition that is associated with coronary artery disease (CAD). Factors that affect the cardiovascular system as diabetes mellitus and dyslipidemia also may affect the outcomes following PCI. So, HCV infection may have an impact on the outcomes following PCI. We aimed to investigate the impact of HCV seropositivity on the outcomes following percutaneous coronary intervention (PCI).

Results

We conducted a multi-center prospective cohort study on 400 patients candidate for elective PCI using drug-eluting stents; 200 patients were HCV seropositive and did not received antiviral treatment, and 200 patients were HCV seronegative. The patients were followed up for 1 year for the development of major adverse cardiovascular events (MACEs) and clinical in-stent restenosis. Multivariate Cox hazard regression analyses for MACEs and clinical in-stent restenosis at 12 months after adjustment for confounding factors showed that HCV seropositivity did not present a higher hazard upon MACEs (adjusted hazard ratio (HR) 0.74; 95% CI 0.41–1.32; p value 0.302), the individual cardiovascular outcomes (target lesion revascularization (TLR), target vessel revascularization (TVR), myocardial infarction (MI), cerebrovascular stroke (CVS), stent thrombosis, major bleeding, coronary artery bypass graft (CABG), cardiac death, and non-cardiac death), or the incidence of clinical in-stent restenosis (adjusted HR was 1.70; 95% CI 0.64–4.51; p value 0.28) compared to seronegative patients.

Conclusion

HCV seropositivity had no impact on MACEs, individual cardiovascular outcomes, or clinical in-stent restenosis following PCI for a 1 year follow-up period.
Assessment of the role of fractional exhaled nitric oxide as a predictor of airway eosinophilia and corticosteroid responsiveness in patients with chronic cough
Authors: Shebl Eman , Abdel-moety Hanaa
Published: July 2020

Background

Fractional exhaled nitric oxide (FeNO) can be used as a rapid indicator of eosinophilic airway inflammation and steroid responsiveness in patients with bronchial asthma, but this role in chronic cough is still questionable. So, this study was carried out to assess the role FeNO as a predictor of airway eosinophilia and inhaled steroids responsiveness in patients with chronic cough. This prospective study included 70 patients with undiagnosed chronic cough and 20 healthy non-smoker control group. Sputum eosinophils % and FeNO were measured before and after a 4-week treatment trial with high dose inhaled corticosteroids. The optimal cut-off value of FeNO to predict sputum eosinophilia and the responsiveness of cough for corticosteroids were determined.

Results

Forty-five patients (64.3%) of the studied 70 patients with chronic cough responded to the 4-week trial of inhaled steroids. In the steroid responder group, FeNO and sputum eosinophils % were significantly higher than in the non-responder group. There was a significant positive correlation between FeNO and sputum eosinophils %. The optimal cut-off value of FeNO to detect airway eosinophilia was 33 ppb (with 65% sensitivity and 80% specificity) The ROC AUC was 0.757 and the optimal cut-off value of FeNO to predict corticosteroids responsiveness was 34.5 ppb (with 85% sensitivity and 90% specificity). The ROC AUC was 0.835.

Conclusion

FeNO can be used as a rapid and non-invasive diagnostic tool of airway eosinophilic inflammation and as a predictor for steroid responsiveness in patients with chronic cough.
Efficacy of Levamisole in children with Frequent Relapsing and Steroid Dependent Nephrotic Syndrome at Tertiary Care Center-Karachi
Authors: Moorani Khemchand Netaram , Zubair Aasia Mohammad , Veerwani Nanga Ram , Hotchandani Harnam Jaichand
Published: July 2020

Objectives: To determine the effectiveness of levamisole in maintaining remission of proteinuria in children with frequent relapsing and steroid dependent nephrotic syndrome (FR/SDNS).

Methods: This observational study on 81 children with FR /SDNS was carried out from June 2007 - June 2017 at The Kidney Center-Postgraduate Training Institute, Karachi-Pakistan. Levamisole (leva) along with low dose prednisolone on alternate day (AD) was used after induction of remission with daily oral prednisolone in children with FR/ SDNS for 6-36 months. Patients with steroid resistance were excluded. Data was analyzed using descriptive statistics.

Results: Eighty-one patients with FR (66) or SD (15) received levamisole treatment. Mean age at diagnosis was 3.72 ±2.33 years. Levamisole was used on AD in 59.25% and daily in 40.74% of cases. Twenty-four could not complete six months and were excluded, 57 patients completed treatment duration of 15.68±9.93 months and 51 post-leva follow-up of 11.70±11.23 months. Mean cumulative prednisolone dose per patient before, on-leva and post-leva was 3389.81±2785.22, 2471.97±2024.98 and 661.37± 905.37 mg respectively. Mean relapse rate per year before leva, on -leva and post -leva was 3.30 ±0.50,0.98± 1.1and 0.79±1.27 respectively. Levamisole was effective in 90% of patients. During post-leva follow up, 76.4% patients, maintained remission, whereas 23.5% behaved as FR/SD and require further immunosuppressive therapy.

Conclusions: Levamisole was effective in maintaining remission in 90% while on treatment, whereas it maintained remission after discontinuation in 76.4% cases. Levamisole may be used as first steroid sparing agent before other immunosuppressive therapies in children with FR/SDNS. Further studies are required for optimal duration and dosage schedule.

doi: https://doi.org/10.12669/pjms.36.6.2337

How to cite this:Moorani KN, Zubair AM, Veerwani NR, Hotchandani HJ. Efficacy of Levamisole in Children with Frequent Relapsing and Steroid Dependent Nephrotic Syndrome at Tertiary Care Center-Karachi. Pak J Med Sci. 2020;36(6):1193-1198.  doi: https://doi.org/10.12669/pjms.36.6.2337

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.
Talipes equinovarus or Clubfoot: A review of study approaches, management and trends in Pakistan
Authors: Murtaza Khadija , Saleem Zahra , Malik Sajid
Published: July 2020

This paper aims to assess the status of scientific literature on talipes equinovarus (TEV) published from Pakistan, to get an insight into the trend in knowledge over the years, and to highlight study gaps in this area. A detailed review of published literature was conducted from November 2019 to January 2020. ‘Talipes/congenital talipes’, ‘clubfoot/congenital clubfoot’, ‘talipes equinovarus /congenital talipes equinovarus’ AND ‘Pakistan’ were used as key terms. Different search engines, PubMed, PakMediNet, ScienceDirect, Embase and Google Scholar were utilized to retrieve articles. A total of 63 articles were retrieved. The hotspot of TEV research in Pakistan has been its treatment and management. Over the years, treatment trend has shifted from operative to conservative; Ponseti method is predominantly employed. Hospital-based studies focusing on pediatric patients are common while population-based studies are devoid. In majority of cohorts, there is preponderance of male patients, idiopathic and unilateral cases. There is, however, scarcity of basic research on the prevalence, etiology, risk factors, clinical heterogeneity, associated anomalies, genetics, and molecular diagnostics of TEV. In conclusion, prudent scientific evidence is required for any policy-making and relevant public health action. Hence, large scale population-based studies are required for a broader overview and understanding the clinical spectrum of TEV.
doi: https://doi.org/10.12669/pjms.36.6.2514
How to cite this:Murtaza K, Saleem Z, Malik S. Talipes equinovarus or Clubfoot: A review of study approaches, management and trends in Pakistan. Pak J Med Sci. 2020;36(6):1414-1420. doi: https://doi.org/10.12669/pjms.36.6.2514
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.
Alcohol withdrawal
Authors: Sarangi Ashish
Published: July 2020

Objective: This case review discusses the current recommended protocol for the diagnosis and treatment of delirium tremens using a review of a patient managed both in an inpatient psychiatry unit and in an intensive care unit. This review and case study are intended to help guide patient care with co-morbid conditions confounding diagnosis and in facilities lacking sophisticated monitoring equipment.
Data Sources: PubMed was searched using keywords and phrases, including delirium tremens, alcohol withdrawal, chronic alcoholism, CIWA, alcohol effect on CNS, treatment of delirium tremens, and treatment of alcohol withdrawal.
Study Selection: The case discussed provided the basis for this report based on its complexity due to comorbid conditions and the initial subacute presentation.
Data Extraction: Data were gathered from charting notes written concurrently with patient management. Vital signs and laboratory values were regularly measured, and healthcare faculty documented each clinical encounter with findings and updates to treatment.
Results: Delirium tremens was identified before progression to seizures and severe autonomic instability. Appropriate treatment and transfer to an intensive care unit were secured once a significant index of suspicion was reached.
Conclusions: Close and frequent patient evaluation despite the lack of continuous monitoring technology allowed detection of decompensation as it began insidiously. The gradual development of cognitive symptoms and the presence of abnormal laboratory results helped identify his deterioration. The current guidelines for the treatment of delirium tremens provide the basis for the management of this highly dangerous disorder.
Key Words: Delirium tremens, alcohol withdrawal biomarkers, geriatric delirium
Extrapulmonary Mycobacterium avium complex infections in immunocompetent patients
Authors: Yim Vivian , Sotello David , Nugent Kenneth
Published: July 2020

The Mycobacterium avium complex (MAC) includes ubiquitous bacteria that typically cause infection in immunocompromised patients. This paper reviews the presentation, diagnosis, pathogenesis, and treatment of extrapulmonary MAC infections in immunocompetent patients by compiling information from case reports identified by a PubMed search. Mycobacterium avium complex infections in immunocompetent patients can present primarily with extrapulmonary symptoms, and this makes the diagnosis of MAC infection in these patients more difficult. The American Thoracic Society has not established criteria for the diagnosis of extrapulmonary MAC infections; testing for MAC should be based on clinical suspicion or after the exclusion of all other causative agents. Methods of testing should include molecular and biochemical tests, since these tests provide more definitive identification than routine cultures. Extrapulmonary presentations usually respond well to macrolide based multi-drug regimens started as soon as a MAC infection is identified. 
Key words: Mycobacterium avium, infection, diagnosis, treatment
Susceptibility/manifestations of different age groups with various comorbidities to COVID-19 infection
Authors: John Albin , Ha Freedom , Zumwalt Mimi
Published: July 2020

The COVID-19 pandemic has taken a great toll on many families. From its rapid spread to debilitating outcomes, the virus has wreaked havoc on healthcare systems around the world. As researchers study this novel virus, the public continues to seek more information on who is the most susceptible and which population will be affected by the more severe manifestations of the disease. As a result, scientists have started analyzing the variable effects of COVID-19 infection in different age groups. While the information is still nascent, these studies demonstrate that no one is immune, that all are susceptible to infection by this virus, and that certain demographics of the general population have more severe disease than others. This literature review examines how COVID-19 has affected different age groups, from neonates to older adults, by exploring statistics, mechanisms, and possible risk factors. This article will also investigate the role of comorbidities in increasing the severity of this viral infection.
Key words: COVID-19, SARS-CoV-2, coronavirus, age, neonates, pregnancy, older adults, mechanism, comorbidities, angiotensin converting enzyme 2
Electroencephalographic abnormalities in COVID-19-related encephalopathies: A systematic review
Authors: Pan Jie , Khan Shazma , Thakolwiboon Smathorn , Chi Dargelis
Published: July 2020

Background: Acute encephalopathy is a common neurological manifestation in coronavirus disease 2019 (COVID-19) patients and presents with confusion, delirium, or poor responsiveness. Non-convulsive status epilepticus (NCSE) is an important differential diagnosis in this situation. The electroencephalography (EEG) patterns in COVID-19 patients remain largely unknown.
Method: A literature search was conducted on MEDLINE, EMBASE, and Cochrane database. Eligibility criteria included case series and case reports of COVID-19 patients with neurological complication who underwent EEG. Two authors screened all resulting studies and extracted the data independently.
Results: Four retrospective case control studies and eleven case reports were identified. Background diffuse slow activity were seen in most of the COVID-19 patients. Other EEG patterns reported included status epilepticus, focal slow activity, rhythmic periodic discharges, and interictal epileptiform discharges. Imaging and CSF studies were available in only a few patients.
Conclusions: Acute encephalopathy is common in the context of COVID-19. There is no specific EEG pattern found in these patients.
Keywords: COVID-19, coronavirus, SAR-CoV-2, electroencephalogram, EEG
CFD Assisted Steady-State Modelling of Restrictive Counterbalance Valves
Authors: Jakobsen Jannik H. , Hansen Michael R.
Published: July 2020

The counterbalance valve is an important component in many hydraulic applications and its behaviour hugely impacts system stability and performance. Despite that, CBVs are rarely modelled accurately due to the effort required to obtain basic model parameters and the complexity involved in identifying expressions for flow forces and friction. This paper presents a CFD assisted approach to steady-state modelling of CBVs. It is applied to a 3-port restrictive commercially available counterbalance valve. The model obtained is based on detailed measurements of the valve geometry, a single data set and CFD modelling and includes flow forces and friction. The CFD assisted model is compared to experimental data at three temperatures and two versions of more classical steady-state model based on the orifice equation, uniform pressure distribution and experimental results. The results support the CFD assisted approach as a way to increase modelling accuracy. The load pressure corrected coulomb friction model used manages to capture the changes to hysteresis with temperature but not the changes with pilot pressure.
Load Passenger Forecasting Towards Future Bus Transportation Network
Authors: Vial Clément , Gazeau Vivien
Published: July 2020

Knowing the load of a transport system is one of the critical information of the operators and allows them to take strategic moves to optimize the line, involving more buses or changing the missions of the buses. Having this information in real-time and in the near future opens a new dimension in the management possibilities of the line. The paper describes a prototype that demonstrates this possibility and exposes the methodology used and some examples of the results. The study here presented was possible thanks to a new kind of data: the counting of passengers boarding and dropping out at each stop provide by sensors installed above the doors.
The Business Case for Automating Data Management
Authors: Hobart Mark
Published: July 2020

Back in 2016, IDC forecast a ten-fold increase on business data processed globally by 2025. Combine this with increasing regulatory compliance and demand for quality data, then it is perhaps not a surprise to find that many businesses are feeling somewhat over-whelmed by the enormity of the data management and governance task they face. But, don’t despair, there is a compelling business case, both in terms of efficiency gains and tangible financial savings in adopting a strategy for centralising information governance and automating the management of your data.

This paper will explore the emerging problem domain of data and look at the business case for use of automated data management tools to better prepare your organisation for the tsunami of data coming its way.
Design, Development and Performance Evaluation of Nano Robot in Traditional Siddha Medicines for Cancer Treatment
Authors: Balakrishnan Kaviarasu , Arumugam Sivabalan , Magesan Guna
Published: July 2020

This paper reports a design and fabrication of a functional nano robot “Sootha Vennai Parpamcutâvanai – Parpam – SVP” of 150-200 nm size which behaves more or less like a human physician in nano form inside the body. This nanorobot is a medicine which has artificial intelligence i.e. the distinguishing ability, decision making ability and some basic behavioral properties such as target detection ability, self-propelling capability and handling the infection in the case of breast cancer. This nanorobot can also aid in cancer therapy, site-specific or target drug delivery, and tissue repair.
Satellite Communication in the Age of 5G
Authors: Hofmann Marc
Published: July 2020

The next generation of mobile networks (5G) aims to revolutionize the world of communication. New technologies and use cases spawn new opportunities. Many of the promised performance characteristics of 5G require that terrestrial networks are augmented by communication satellites. This paper describes where an integration of satellite and 5G will benefit both technologies.
A Context-Aware Personalized Hybrid Book Recommender System
Authors: Arabi Hossein , Balakrishnan Vimala , Mohd Shuib Nor Liyana
Published: July 2020

Contextual information such as emotion, location and time can effectively improve product or service recommendations, however, studies incorporating them are lacking. This paper presents a context-aware recommender system, personalized based on several user characteristics and product features. The recommender system which was customized to recommend books, was aptly named as a Context-Aware Personalized Hybrid Book Recommender System, which utilized users’ personality traits, demographic details, location, review sentiments and purchase reasons to generate personalized recommendations. Users’ personality traits were determined using the Ten Item Personality Inventory. The results show an improved recommendation accuracy compared to the existing algorithms, and thus indicating that the integration of several filtering techniques along with specific contextual information greatly improves recommendations.
Exploiting optical nonlinearities for group delay dispersion compensation in femtosecond optical parametric oscillators
Authors: Stasevičius Ignas , Vengris Mikas
Published: July 2020

A wavelength tunable femtosecond optical parametric oscillator pumped by the second harmonic of a Yb: KGW solid state oscillator was investigated. The intracavity group delay dispersion was positive, and soliton condition was satisfied by introducing negative nonlinearity from cascaded quadratic nonlinearity (CQN). Two different approaches were investigated – CQN induced by the same amplifying nonlinear crystal or CQN induced by an additional second harmonic generating nonlinear crystal inside the same resonator. The second crystal was shown to correct the resonator misalignment induced by the rotation of the amplifying crystal as the wavelength was tuned in the range of 770-970 nm. It simultaneously compensated positive resonator GDD offsets of +/- 1000 fs2 with +/- 5% SHG power losses, simulating a method for compensation of GDD ripples in a broadband mirror.
Buildup dynamics in an all-polarization-maintaining Yb-doped fiber laser mode-locked by nonlinear polarization evolution
Authors: Zhao Heng , Ma Gai-Ming , Li Xiang-Yue , Li Ti-Jian , Cui Hu , Liu Meng , Luo Ai-Ping , Luo Zhi-Chao , Xu Wen-Cheng
Published: July 2020

Soliton buildup dynamics in ultrafast fiber lasers are one of the most significant topics in both the fundamental and industrial fields. In this work, by using the dispersive Fourier transformation technique, the real-time spectral evolution of soliton buildup dynamics were investigated in the all-polarization-maintaining Yb-doped fiber laser, which is mode-locked by nonlinear polarization evolution technique through the cross splicing method. It was experimentally confirmed that the same stable soliton state could be achieved through different soliton starting processes because of the initial random noises. In one case, the maximum pulse energy during the soliton starting process could reach ∼15 times the stable pulse energy, which results in the spectral chaotic state and temporal shift. We also provide another soliton buildup case with the same cavity parameters, which illustrates more moderate evolution. It involves smaller energy variation and no complex transition state. These results would deepen our understanding of soliton buildup dynamics and be beneficial for the applications of ultrafast fiber lasers.
Ultrafast electro-optical disk modulators for logic, communications, optical repeaters, and wavelength converters
Authors: Gostimirovic Dusan , De Leonardis Francesco , Soref Richard , Passaro Vittorio M. N. , Ye Winnie N.
Published: July 2020

We propose a U-shaped pn junction in a silicon-on-insulator microdisk resonator to effectively double the junction–mode overlap in the state-of-the-art, vertical pn junction microdisk electro-optical (EO) modulators. The U-shaped pn junction promotes the maximum overlap between the junction depletion zone and the whispering gallery optical mode in the microdisk. By fully depleting the p region of the npn-sequenced U-junction, the capacitance is reduced below 3 fF, which significantly improves the speed and power performance. In this work, we implement the high-efficiency, depleted U-junction design to maximize the operating bandwidth of EO modulators, EO logic elements, EO 2 × 2 switches for wavelength-division cross-connects, 2 × 2 reconfigurable optical add–drop multiplexers, optical-to-electrical-to-optical (OEO) repeaters-with-gain, OEO wavelength converters, and 2 × 2 optical–optical logic gates. These devices all operate in the 7.6-to-50 GHz bandwidth range with ultralow energy consumption between 0.4 and 9.8 fJ/bit. By using CMOS-compatible materials and fabrication-feasible design dimensions, our proposed high-performance devices offer a promising potential in next-generation, high-volume electro-optical communications and computing circuits.
Use of recombinant Brucella outer membrane proteins 19, 25, and 31 for serodiagnosis of bovine brucellosis
Authors: Bulashev Aitbay , Akibekov Orken , Syzdykova Alfiya , Suranshiyev Zhanbolat , Ingirbay Bakytkali
Published: July 2020

Background and Aim: Brucellosis remains one of the most common zoonoses. The current anti-brucellosis measures are largely deemed ineffective due to a lack of specificity of conventional serological tests. This study evaluated the use of Brucella outer membrane protein (Omp)19 for serodiagnostic testing. Materials and Methods: The antigenicity of recombinant Brucella Omp19, Omp25, and Omp31 was examined in serum samples from mice and rabbits immunized with Omp19 or Brucella abortus 19 whole cell (WC) and 12 and 152 cows experimentally or naturally infected with brucellosis, respectively. Serum samples were collected from 151 cows that were vaccinated with B. abortus 19 and 12 unvaccinated heifers that were maintained on a brucellosis-free farm. Results: Immunization with Omp19 resulted in antibody production in mice after a single injection without the use of adjuvant. Serum antibodies obtained from rabbits immunized with inactivated B. abortus strain 19 WC targeted Omps by enzyme-linked immunosorbent assay (ELISA) and Western blot. Antibodies targeting Omp19 were identified in all B. abortus strain 544 experimentally infected cows at day 14 post-inoculation (p.i.); Omp25 was detected by ELISA at day 28 p.i., while an ELISA targeting Omp31 was negative for 25% of cows at this time point. Omp19 and Omp25 were readily detected by sera from cows from a new epizootic focus. Antibodies recognizing Omps were also detected in >50% of the animals maintained in a brucellosis-free herd at 10 months after vaccination. Conclusion: Brucella Omp19 in combination with Omp25 and Omp31 may be utilized as target antigens in an ELISA designed for serological testing of unvaccinated cattle.