bluuebunny/crossref_metadata_2025 huggingface dataset:
Migration-associated malaria from Africa in southern Spain
Authors: Pousibet-Puerto Joaquín , Lozano-Serrano Ana Belén , Soriano-Pérez Manuel Jesús , Vázquez-Villegas José , Giménez-López María José , Cabeza-Barrera María Isabel , Cuenca-Gómez José Ángel , Palanca-Giménez Matilde , Luzón-García María Pilar , Castillo-Fernández Nerea , Cabezas-Fernández María Teresa , Salas-Coronas Joaquín
Published: May 2021

Background

The western area of the province of Almeria, sited in southern Spain, has one of the highest immigrant population rates in Spain, mainly dedicated to agricultural work. In recent years, there has been a significant increase in the number of cases of imported malaria associated with migrants from countries belonging to sub-Saharan Africa. The objective of our study is to describe the epidemiological, clinical and analytical characteristics of malaria patients treated in a specialized tropical unit, paying special attention to the differences between VFR and non-VFR migrants and also to the peculiarities of microscopic malaria cases compared to submicroscopic ones.

Methods

Retrospective observational study of migrants over 14 years of age with imported malaria treated from October 2004 to May 2019. Characteristics of VFR and non-VFR migrants were compared. Malaria cases were divided into microscopic malaria (MM) and submicroscopic malaria (SMM). SMM was defined as the presence of a positive malaria PCR test together with a negative direct microscopic examination and a negative rapid diagnostic test (RDT). Microscopic malaria was defined as the presence of a positive RDT and/or a positive smear examination.

Results

Three hundred thirty-six cases of malaria were diagnosed, 329 in sub-Saharan immigrants. Of these, 78.1% were VFR migrants, in whom MM predominated (85.2% of cases). In non-VFR migrants, SMM represented 72.2% of the cases. Overall, 239 (72.6%) patients presented MM and 90 (27.4%) SMM. Fever was the most frequent clinical manifestation (64.4%), mainly in the MM group (MM: 81.1% vs SMM: 20.0%; p < 0.01). The most frequent species was P. falciparum. Patients with SMM presented fewer cytopenias and a greater number of coinfections due to soil-transmitted helminths, filarial and intestinal protozoa compared to patients with MM.

Conclusions

Imported malaria in our area is closely related to sub-Saharan migration. VFR migrants are the main risk group, highlighting the need for actions aimed at improving disease prevention measures. On the other hand, almost a third of the cases are due to SMM. This fact could justify its systematic screening, at least for those travelers at greater risk.

Graphical Abstract
First report of Theileria annulata in Nigeria: Findings from cattle ticks in Zamfara and Sokoto States
Authors: Mamman Adamu Haruna , Lorusso Vincenzo , Adam Babagana Mohammed , Dogo Goni Abraham , Bown Kevin J. , Birtles Richard J.
Published: May 2021

Background

Ticks and tick-borne pathogens (TBPs) represent a significant economic burden to cattle farming in sub-Saharan Africa including Nigeria. However, in the northern part of this country, where the largest livestock population resides, little is known about the contemporary diversity of ticks and TBPs. This area is particularly vulnerable to climate change, undergoing marked transformation of habitat and associated flora and fauna that is also likely to include ticks. This study aimed to document the occurrence of tick species and Apicomplexan TBPs in cattle from north-western Nigeria.

Methods

In 2017, ticks were collected from cattle in Zamfara and Sokoto States and identified morphologically. Additionally, a subset of ticks was screened molecularly for the detection of apicomplexan DNA.

Results

A total of 494 adult ticks were collected from 80 cattle in Zamfara and 65 cattle in Sokoto State. Nine tick species were encountered, among which the presence of one,Hyalomma turanicum, had not previously been recorded in Nigeria.Hyalomma rufipeswas the most prevalent tick infesting cattle in Zamfara State (76%), whileHyalomma dromedariiwas the most prevalent in Sokoto State (44%), confirming the widespread transfer of this species from camels onto livestock and its adaptation to cattle in the region. Of 159 ticks screened, 2 out of 54 (3.7%) from Zamfara State and 29 out of 105 (27.6%) from Sokoto State harboured DNA ofTheileria annulata, the agent of tropical theileriosis.

Conclusions

This study confirms the presence of a broad diversity of tick species in cattle from north-western Nigeria, providing the first locality records for Zamfara State. The occurrence ofH. turanicumindicates a distribution of this tick beyond northern Africa. This study provides the first report forT. annulatain Nigerian ticks. Given its enormous burden on livestock farming in north Africa and across Asia, further investigations are needed to better understand its epidemiology, vector transmission and potential clinical significance in cattle from northern Nigeria and neighbouring Sahelian countries.

Graphical abstract
Imported Hyalomma ticks in the Netherlands 2018–2020
Authors: Uiterwijk Mathilde , Ibáñez-Justicia Adolfo , van de Vossenberg Bart , Jacobs Frans , Overgaauw Paul , Nijsse Rolf , Dabekaussen Charlotte , Stroo Arjan , Sprong Hein
Published: May 2021

Background

Ticks of the genus Hyalomma, which are vectors for several tick-borne diseases, are occasionally found in areas outside their endemic range including northern parts of Europe. The objective of this study was to analyse adult Hyalomma ticks that were recently found in the Netherlands.

Methods

Hyalomma ticks were morphologically identified. Cluster analysis, based upon sequence data (cox1 barcoding) for molecular identification, and pathogen detection were performed. Additionally, a cross-sectional survey of horses was conducted to actively search for Hyalomma ticks in summer 2019. Analysis of temperature was done to assess the possibility of (i) introduced engorged nymphs moulting to adults and (ii) establishment of populations in the Netherlands.

Results

Seventeen adult Hyalomma ticks (one in 2018, eleven in 2019, five in 2020) were found by citizens and reported. Fifteen ticks were detected on horses and two on humans. Twelve were identified as H. marginatum, one as H. rufipes and four, of which only photographic images were available, as Hyalomma sp. No Crimean-Congo haemorrhagic fever virus or Babesia/Theileria parasites were detected. One adult tick tested positive for Rickettsia aeschlimannii. In the cross-sectional horse survey, no Hyalomma ticks were found. Analysis of temperatures showed that engorged nymphs arriving on migratory birds in spring were able to moult to adults in 2019 and 2020, and that cumulative daily temperatures in the Netherlands were lower than in areas with established H. marginatum populations.

Conclusions

Our results show that Hyalomma ticks are regularly introduced in the Netherlands as nymphs. Under the Dutch weather conditions, these nymphs are able to develop to the adult stage, which can be sighted by vigilant citizens. Only one human pathogen, Rickettsia aeschlimannii, was found in one of the ticks. The risk of introduction of tick-borne diseases via Hyalomma ticks on migratory birds is considered to be low. Establishment of permanent Hyalomma populations is considered unlikely under the current Dutch climatic conditions.

Graphical Abstract
Using next generation sequencing of alpine plants to improve fecal metabarcoding diet analysis for Dall’s sheep
Authors: Williams Kelly E. , Menning Damian M. , Wald Eric J. , Talbot Sandra L. , Rattenbury Kumi L. , Prugh Laura R.
Published: May 2021

Objectives

Dall’s sheep (Ovis dalli dalli) are important herbivores in the mountainous ecosystems of northwestern North America, and recent declines in some populations have sparked concern. Our aim was to improve capabilities for fecal metabarcoding diet analysis of Dall’s sheep and other herbivores by contributing new sequence data for arctic and alpine plants. This expanded reference library will provide critical reference sequence data that will facilitate metabarcoding diet analysis of Dall’s sheep and thus improve understanding of plant-animal interactions in a region undergoing rapid climate change.

Data description

We provide sequences for the chloroplast rbcL gene of 16 arctic-alpine vascular plant species that are known to comprise the diet of Dall’s sheep. These sequences contribute to a growing reference library that can be used in diet studies of arctic herbivores.
hERG-deficient human embryonic stem cell-derived cardiomyocytes for modelling QT prolongation
Authors: Chang Yun , Li Ya-nan , Bai Rui , Wu Fujian , Ma Shuhong , Saleem Amina , Zhang Siyao , Jiang Youxu , Dong Tao , Guo Tianwei , Hang Chengwen , Lu Wen-jing , Jiang Hongfeng , Lan Feng
Published: May 2021

Background

Long-QT syndrome type 2 (LQT2) is a common malignant hereditary arrhythmia. Due to the lack of suitable animal and human models, the pathogenesis of LQT2 caused by human ether-a-go-go-related gene (hERG) deficiency is still unclear. In this study, we generated an hERG-deficient human cardiomyocyte (CM) model that simulates ‘human homozygous hERG mutations’ to explore the underlying impact of hERG dysfunction and the genotype–phenotype relationship of hERG deficiency.

Methods

The KCNH2 was knocked out in the human embryonic stem cell (hESC) H9 line using the CRISPR/Cas9 system. Using a chemically defined differentiation protocol, we obtained and verified hERG-deficient CMs. Subsequently, high-throughput microelectrode array (MEA) assays and drug interventions were performed to characterise the electrophysiological signatures of hERG-deficient cell lines.

Results

Our results showed that KCNH2 knockout did not affect the pluripotency or differentiation efficiency of H9 cells. Using high-throughput MEA assays, we found that the electric field potential duration and action potential duration of hERG-deficient CMs were significantly longer than those of normal CMs. The hERG-deficient lines also exhibited irregular rhythm and some early afterdepolarisations. Moreover, we used the hERG-deficient human CM model to evaluate the potency of agents (nifedipine and magnesium chloride) that may ameliorate the phenotype.

Conclusions

We established an hERG-deficient human CM model that exhibited QT prolongation, irregular rhythm and sensitivity to other ion channel blockers. This model serves as an important tool that can aid in understanding the fundamental impact of hERG dysfunction, elucidate the genotype–phenotype relationship of hERG deficiency and facilitate drug development.
Response patterns in adventitial layer of Echinococcus granulosus sensu stricto cysts from naturally infected cattle and sheep
Authors: Hidalgo Christian , Stoore Caroll , Baquedano María Soledad , Pereira Ismael , Franco Carmen , Hernández Marcela , Paredes Rodolfo
Published: May 2021

Cystic echinococcosis is a zoonotic disease caused by the metacestode of Echinococcus granulosus sensu lato. The disease is characterized by the development of cystic structures inside viscera of the intermediate host, mainly liver and lungs. These cysts are formed by three layers: germinal, laminated, and adventitial layer, the latter being the local host immune response. Metacestodes that develop protoscoleces, the infective stage to the definitive host, are termed fertile, whereas cysts that do not produce protoscoleces are termed non-fertile. Sheep usually harbor fertile cysts while cattle usually harbor non-fertile cysts. Adventitial layers with fibrotic resolution are associated to fertile cysts, whereas a granulomatous reaction is associated with non-fertile cysts. The aim of this study was to analyze cellular distribution in the adventitial layer of fertile and non-fertile E. granulosus sensu stricto cysts found in liver and lungs of cattle and sheep. A total of 418 cysts were analyzed, 203 from cattle (8 fertile and 195 non-fertile) and 215 from sheep (64 fertile and 151 non-fertile). Fertile cysts from cattle showed mixed patterns of response, with fibrotic resolution and presence of granulomatous response in direct contact with the laminated layer, while sheep fertile cysts always displayed fibrotic resolution next to the laminated layer. Cattle non-fertile cysts display a granulomatous reaction in direct contact with the laminated layer, whereas sheep non-fertile cysts display a granulomatous reaction, but in direct contact with the fibrotic resolution. This shows that cattle and sheep cystic echinococcosis cysts have distinct local immune response patterns, which are associated to metacestode fertility.
Existence theorem for a unique solution to a coupled system of impulsive fractional differential equations in complex-valued fuzzy metric spaces
Authors: Humaira  , Hammad Hasanen A. , Sarwar Muhammad , De la Sen Manuel
Published: May 2021

In this manuscript, the existence theorem for a unique solution to a coupled system of impulsive fractional differential equations in complex-valued fuzzy metric spaces is studied and the fuzzy version of some fixed point results by using the definition and properties of a complex-valued fuzzy metric space is presented. Ultimately, some appropriate examples are constructed to illustrate our theoretical results.
Does change in barometric pressure per given time at high altitude influence symptoms of acute mountain sickness on Mount Fuji? A pilot study
Authors: Horiuchi Masahiro , Watanabe Misato , Mitsui Satomi , Uno Tadashi
Published: May 2021

Background

Acute mountain sickness (AMS) is a common, transient condition characterized primarily by headaches, and it can also be associated with fatigue, dizziness, and nausea with vomiting. The symptoms of AMS are most pronounced after the first night spent at a new altitude. At sea level, changes in barometric pressure per given time have been associated with migraine headaches. We sought to investigate whether changes in barometric pressure, subjective sleep quality index, and other candidates contributed to the risk of developing AMS on Mount Fuji in Japan.

Method

We surveyed 353 trekkers who stayed overnight at a mountain lodge before summitting Mount Fuji. We collected information regarding sex, age, sleeping altitude at the hut, and perceived sleep quality index including sleep time. AMS was assessed with the Lake Louise Scoring system. Barometric pressure and ambient temperature were collected at the 5th station (2305 m) and at the summit (3776 m).

Result

The overall prevalence of AMS in our cohort was 41.4% (Lake Louise Score ≥ 3 with headache, n=146). Using logistic regression, three factors were combined to generate a robust model for determining the risk of AMS (with or without AMS). These included (1) Δ barometric pressure during ascent per hour, (2) sleepiness on rising, and (3) sleep refreshment assessed by perceived sleep quality index.

Conclusion

These results suggest that climbers who stay overnight at the lodge should keep a better physical condition of sleep, and would pay attention to information of barometric pressure condition to decrease their risk of AMS at the summit of Mount Fuji. Our observatory data indicated that an overnight staying in half way up to the summit does not necessarily reduce the AMS risk in both sexes and irrespective of age, at least, until 3776 m elevation.
Specific and conserved patterns of microbiota-structuring by maize benzoxazinoids in the field
Authors: Cadot Selma , Guan Hang , Bigalke Moritz , Walser Jean-Claude , Jander Georg , Erb Matthias , van der Heijden Marcel G. A. , Schlaeppi Klaus
Published: May 2021

Background

Plants influence their root and rhizosphere microbial communities through the secretion of root exudates. However, how specific classes of root exudate compounds impact the assembly of root-associated microbiotas is not well understood, especially not under realistic field conditions. Maize roots secrete benzoxazinoids (BXs), a class of indole-derived defense compounds, and thereby impact the assembly of their microbiota. Here, we investigated the broader impacts of BX exudation on root and rhizosphere microbiotas of adult maize plants grown under natural conditions at different field locations in Europe and the USA. We examined the microbiotas of BX-producing and multiple BX-defective lines in two genetic backgrounds across three soils with different properties.

Results

Our analysis showed that BX secretion affected the community composition of the rhizosphere and root microbiota, with the most pronounced effects observed for root fungi. The impact of BX exudation was at least as strong as the genetic background, suggesting that BX exudation is a key trait by which maize structures its associated microbiota. BX-producing plants were not consistently enriching microbial lineages across the three field experiments. However, BX exudation consistently depletedFlavobacteriaceaeandComamonadaceaeand enriched various potential plant pathogenic fungi in the roots across the different environments.

Conclusions

These findings reveal that BXs have a selective impact on root and rhizosphere microbiota composition across different conditions. Taken together, this study identifies the BX pathway as an interesting breeding target to manipulate plant-microbiome interactions.
Factors affecting the value revitalization of Qajar religious schools in Tehran
Authors: Taher Tolou Del Mohammad Sadegh , Saleh Sedghpour Bahram , Kamali Tabrizi Sina
Published: May 2021

Nowadays, due to natural erosion and urban development, Qajar religious schools in Tehran have undergone adverse physical changes. Moreover, the semantic and intangible values of them have faded over time, such that their position in society has declined. The religious schools need the conservation and revitalization of their values. Various research has been conducted on the philosophy of education, and the spatial evolution history of Tehran’s religious schools. However, since no study has been carried out on the value revitalization of them, the present study, as an exploratory and novel study, mainly aims to experimentally investigate experts’ views to revitalize the value of Qajar religious schools in Tehran. Delphi research method and Q-type factor analysis were used to identify and classify experts’ views, respectively. Participants were selected through the purposive non-probability sampling technique. The sample size was selected to be 25, which was confirmed according to the Kaiser–Meyer–Olkin test used for sampling adequacy. To collect data from experts, a questionnaire was used in three rounds based on the Delphi method. Data obtained from the questionnaires were analyzed using the Q method. Based on the obtained results, up to 73.267% of factors affecting the value revitalization of Qajar religious schools in Tehran were identified and interpreted with certainty based on interviews with the experts. The experts were divided into eight groups or factors based on their views, and seven of which introduced common variables and concepts, named based on their constituent variables. Based on the value of the coefficient of variation, the identified effective factors included climatic architecture (20.51%), resilient architecture (13.45%), spiritual architecture (8.98%), environmental aesthetics (8.12%), educational architecture (6.87%), structural architecture (6.450%), and site visiting (4.566%). It was concluded that in the value revitalization of the religious schools, paying serious attention to these seven effective factors underlies the conservation process.
Intrusion detection systems using long short-term memory (LSTM)
Authors: Laghrissi FatimaEzzahra , Douzi Samira , Douzi Khadija , Hssina Badr
Published: May 2021

An intrusion detection system (IDS) is a device or software application that monitors a network for malicious activity or policy violations. It scans a network or a system for a harmful activity or security breaching. IDS protects networks (Network-based intrusion detection system NIDS) or hosts (Host-based intrusion detection system HIDS), and work by either looking for signatures of known attacks or deviations from normal activity. Deep learning algorithms proved their effectiveness in intrusion detection compared to other machine learning methods. In this paper, we implemented deep learning solutions for detecting attacks based on Long Short-Term Memory (LSTM). PCA (principal component analysis) and Mutual information (MI) are used as dimensionality reduction and feature selection techniques. Our approach was tested on a benchmark data set, KDD99, and the experimental outcomes show that models based on PCA achieve the best accuracy for training and testing, in both binary and multiclass classification.
The dynamics of dual-magma-chamber system during volcanic eruptions inferred from physical modeling
Authors: Kozono Tomofumi
Published: May 2021

A magma plumbing system with dual magma chambers beneath active volcanoes is commonly observed through petrological and geophysical measurements. This paper developed a physical model for the dynamics of a dual-magma-chamber system during volcanic eruptions. The model consists of the plumbing system where two elastically deformable magma chambers are connected in series with non-deformable conduits. Based on this model, we obtained an analytical solution that describes temporal changes in pressures at the two chambers accompanied by the eruption. The analytical solution showed that the feature of the chamber pressure changes is mainly controlled by two non-dimensional numbers $$C'$$

C
′

and $$\Omega '$$

Ω
′

. Here, $$C'$$

C
′

is the ratio of the parameter controlling the magnitude of pressure change in the shallower chamber to that in the deeper chamber, and $$\Omega '$$

Ω
′

is the ratio of conduit’s conductivity (inverse of resistivity to magma flow) between the shallower chamber and the surface to that between the chambers. For smaller $$C'$$

C
′

and $$\Omega '$$

Ω
′

, the shallower chamber’s pressure is kept constant during the decrease in the pressure at the deeper chamber in the initial phase of the eruption. This corresponds to a deformation pattern commonly observed in some eruptions, in which the deflation of the deeper chamber was predominant. The estimation of $$C'$$

C
′

and $$\Omega '$$

Ω
′

based on the parameters related to magma properties and geometries of the chambers and the conduits revealed that the smaller $$C'$$

C
′

and $$\Omega '$$

Ω
′

conditions are satisfied under realistic magmatic and geological parameters. This indicates that the magma dynamics in the dual-chamber system generally cause the dominance of the deeper chamber’s deflation.
Measurement of geomagnetically induced current (GIC) around Tokyo, Japan
Authors: Watari Shinichi , Nakamura Satoko , Ebihara Yusuke
Published: May 2021

We need a typical method of directly measuring geomagnetically induced current (GIC) to compare data for estimating a potential risk of power grids caused by GIC. Here, we overview GIC measurement systems that have appeared in published papers, note necessary requirements, report on our equipment, and show several examples of our measurements in substations around Tokyo, Japan. Although they are located at middle latitudes, GICs associated with various geomagnetic disturbances are observed, such as storm sudden commencements (SSCs) or sudden impulses (SIs) caused by interplanetary shocks, geomagnetic storms including a storm caused by abrupt southward turning of strong interplanetary magnetic field (IMF) associated with a magnetic cloud, bay disturbances caused by high-latitude aurora activities, and geomagnetic variation caused by a solar flare called the solar flare effect (SFE). All these results suggest that GIC at middle latitudes is sensitive to the magnetospheric current (the magnetopause current, the ring current, and the field-aligned current) and also the ionospheric current.
Sepsis: deriving biological meaning and clinical applications from high-dimensional data
Authors: Schuurman Alex R. , Reijnders Tom D. Y. , Kullberg Robert F. J. , Butler Joe M. , van der Poll Tom , Wiersinga W. Joost
Published: May 2021

The pathophysiology of sepsis is multi-facetted and highly complex. As sepsis is a leading cause of global mortality that still lacks targeted therapies, increased understanding of its pathogenesis is vital for improving clinical care and outcomes. An increasing number of investigations seeks to unravel the complexity of sepsis through high-dimensional data analysis, enabled by advances in -omics technologies. Here, we summarize progress in the following major -omics fields: genomics, epigenomics, transcriptomics, proteomics, lipidomics, and microbiomics. We describe what these fields can teach us about sepsis, and highlight current trends and future challenges. Finally, we focus on multi-omics integration, and discuss the challenges in deriving biological meaning and clinical applications from these types of data.
Psychiatric leadership development in postgraduate medical education and training
Authors: Till Alex , Sen Radhika , Crimlisk Helen
Published: May 2021

The value of strong, compassionate medical leadership in the delivery of high-quality care to patients within mental health services is clear. Leadership development, however, is far less well explored. This article is for psychiatric trainees, trainers and mental health organisations. It provides an introduction to the importance of leadership development within postgraduate medical training, the theory that should underpin its delivery, and the opportunities for both informal and formal leadership development within psychiatric training.
Effective Patient Selection for an Oncology-Dedicated Emergency Service: A Retrospective Study
Authors: Turgeman Ilit , Bar-Sela Gil
Published: May 2021

PURPOSE:

Emergency cancer care constitutes a significant health care and patient burden. The purpose of this study was to identify characteristics of patients most fitting for treatment in an oncology-dedicated emergency department (OED).

METHODS:

Electronic files of patients with cancer seeking emergency services between April and June 2017 were retrospectively obtained from the hospital registry. Efficacy parameters were compared between patients treated in the OED and those treated in the general emergency department (GED). Using descriptive statistics and logistic regressions, patient- and treatment-related factors were correlated with effective care in the OED.

RESULTS:

More than half of the total 799 patients presented initially to the OED, of which 10.4% required GED referral. Treatment in the GED was associated with a higher rate of consultations, imaging, and hospitalization ( P < .001), with the cost of imaging alone four times that of the OED ($23,263 US dollars difference). The relative proportion of patients with cancer visiting the GED was reduced after founding the OED. In the OED, patient diagnoses included lung (33%), GI, and breast cancer, of which 85% were metastatic. Frequent chief complaints were pain (45%), GI, malaise, and respiratory symptoms. Referral to the GED was significant in those with genitourinary cancer, back pain ( P < .001), and neurologic symptoms, on biologic therapy, and with suspected oncological emergencies; conversely, disease symptoms (30% admissions) were well-controlled in the OED ( P = .003).

CONCLUSION:

Using minimal resources, the OED provides efficacious, cancer-focused care, suitable for the majority of acute admissions. Careful triage is recommended, as high-risk patients should be referred to the GED, where advanced multidisciplinary management is more readily available.
Dynamical effects of long-range interaction revealed in screened Coulomb interacting ring systems
Authors: Yao Zhenwei
Published: May 2021

Understanding the intriguing physical effects of long-range interactions is a common theme in a host of physical systems. In this work, based on the classical screened Coulomb interacting ring model, we investigate the dynamical effects of the long-range interaction from the unique perspective of analyzing the dynamical response of the system to disturbance. We reveal the featured dynamics brought by the long-range interaction, including the efficient transformation of the disturbance into the uniform global rotation of the system, the suppression of the intrinsic noise, and the fast relaxation of particle speed.
Adrenomedullin Ameliorates Pulmonary Fibrosis by Regulating TGF-ß-Smads Signaling and Myofibroblast Differentiation
Authors: Wei Yangxuan , Tanaka Megumu , Sakurai Takayuki , Kamiyoshi Akiko , Ichikawa-Shindo Yuka , Kawate Hisaka , Cui Nanqi , Kakihara Shinji , Zhao Yunlu , Aruga Kohsuke , Sanjo Hideki , Shindo Takayuki
Published: May 2021

Pulmonary fibrosis is an irreversible, potentially fatal disease. Adrenomedullin (AM) is a multifunctional peptide whose activity is regulated by receptor activity-modifying protein 2 (RAMP2). In the present study, we used the bleomycin (BLM)-induced mouse pulmonary fibrosis model to investigate the pathophysiological significance of the AM-RAMP2 system in the lung. In heterozygous AM knockout mice (AM+/-), hydroxyproline content and Ashcroft scores reflecting the fibrosis severity were significantly higher than in wild-type mice (WT). During the acute phase after BLM administration, FACS analysis showed significant increases in eosinophil, monocyte, and neutrophil infiltration into the lungs of AM+/-. During the chronic phase, fibrosis-related molecules were upregulated in AM+/-. Notably, nearly identical changes were observed in RAMP2+/-. AM administration reduced fibrosis severity. In the lungs of BLM-administered AM+/-, the activation level of Smad3, a receptor-activated Smad, was higher than in WT. In addition, Smad7, an antagonistic Smad, was downregulated and microRNA-21, which targets Smad7, was upregulated compared to WT. Isolated AM+/- lung fibroblasts showed less proliferation and migration capacity than WT fibroblasts. Stimulation with TGF-β increased the numbers of α-SMA-positive myofibroblasts, which were more prominent among AM+/- cells. TGF-β-stimulated AM+/- myofibroblasts were larger and exhibited greater contractility and extracellular matrix production than WT cells. These cells were α-SMA (+), F-actin (+), and Ki-67(-) and appeared to be nonproliferating myofibroblasts (non-p-MyoFbs), which contribute to the severity of fibrosis. Our findings suggest that in addition to suppressing inflammation, the AM-RAMP2 system ameliorates pulmonary fibrosis by suppressing TGF-β-Smad3 signaling, microRNA-21 activity and differentiation into non-p-MyoFbs.
Gaza and the Limits of Metropolitan Solidarity: Affiliation under Duress
Authors: Mattar Karim
Published: May 2021

This article explores what Gaza reveals about the extent, depth, and limits of contemporary metropolitan solidarity with Palestine. Focusing on Israel's recent wars on Gaza, I assess how these most explicit and spectacular manifestations of Israel's long-term policies there have been addressed in solidarity discourses and practices. Despite their apparent galvanizing powers, do such discourses and practices also act as sites of marginalization or occlusion? Where do we locate a Palestinian voice within them? My overarching objective in this inquiry is to reconsider solidarity from the standpoint of its beneficiaries, and to question the political, ethical, and cultural ramifications of such in context of the deep time of the Israel-Palestine conflict. In so doing, I freshly illuminate the limitations of solidarity in attending to Zionism as a schema of enforced ethno-nationalist differentiation that has undergirded and legitimated not just the Gaza wars but also the history of the conflict itself.
Cavafy's Levant: Commerce, Culture, and Mimicry in the Early Life of the Poet
Authors: Jeffreys Peter
Published: May 2021

The bombing of Alexandria by the British in 1882 forced C. P. Cavafy and his family into temporary exile. Traumatic for the young poet, this displacement produced a set of epistolary exchanges between friends and family that sheds much light on his Western orientation, connecting him back to the metropolitan cities—London and Liverpool—where he had previously resided. Cavafy remained firmly oriented toward the West, and his Anglophilic cosmopolitanism is inextricably linked to commerce and culture as they intersect with his family history. The museum ethos that later defines his poetry and his love for the art object is rooted in the cultural world of the Anglo-Greeks from which he found himself exiled—one of many exiles he would experience. Retrieving this lost world and memorializing the pleasure-loving days of his young friends heavily informs Cavafy's poetry, which is saturated with memory, death, and nostalgia.
The Return of the Barbarians and the Colonial Order of the Archive
Authors: Papatheodorou Yiannis
Published: May 2021

Cavafy's barbarians constitute a peculiar metaphor for the (self-)censoring process of revealing and hiding the voices of Others in the colonial order of the archive. The theme recurs in three of his works—an “unwritten” poem, a “hidden” poem, and a poem included in the canon—all of which reflect Cavafy's engagement with British colonialism in Egypt. The novelist and critic Stratis Tsirkas, also a Greek who grew up in Egypt, has argued that Cavafy's rising aversion to the British occupation regime developed alongside the shifting ideological lines of the Hellenic diaspora, as expressed by its dominant segment. Drawing upon Tsirkas's readings of the poems, we can revisit the poet's archive as a kind of “taxonomy in the making” where colonial reality is inscribed. In addition, Cavafy's “recording” of the hidden material allows us to reframe our readings of his canonical poems.
The Ste20-like kinase – a Jack of all trades?
Authors: Garland Brennan , Delisle Samuel , Al-Zahrani Khalid N. , Pryce Benjamin R. , Sabourin Luc A.
Published: May 2021

Over the past 20 years, the Ste20-like kinase (SLK; also known as STK2) has emerged as a central regulator of cytoskeletal dynamics. Reorganization of the cytoskeleton is necessary for a plethora of biological processes including apoptosis, proliferation, migration, tissue repair and signaling. Several studies have also uncovered a role for SLK in disease progression and cancer. Here, we review the recent findings in the SLK field and summarize the various roles of SLK in different animal models and discuss the biochemical mechanisms regulating SLK activity. Together, these studies have revealed multiple roles for SLK in coupling cytoskeletal dynamics to cell growth, in muscle repair and in negative-feedback loops critical for cancer progression. Furthermore, the ability of SLK to regulate some systems appears to be kinase activity independent, suggesting that it may be an important scaffold for signal transduction pathways. These various findings reveal highly complex functions and regulation patterns of SLK in development and disease, making it a potential therapeutic target.
The role of imaging in pelvic exenteration for gynecological cancers
Authors: Causa Andrieu Pamela Ines , Woo Sungmin , Rios-Doria Eric , Sonoda Yukio , Ghafoor Soleen
Published: May 2021

Pelvic exenteration (PE) is one of the most challenging gynecologic oncologic surgeries and is an overriding term for different procedures that entail radical en bloc resection of the female reproductive organs and removal of additional adjacent affected pelvic organs (bladder, rectum, anus, etc.) with concomitant surgical reconstruction to restore bodily functions. Multimodality cross-sectional imaging with MRI, PET/CT, and CT plays an integral part in treatment decision-making, not only for the appropriate patient selection but also for surveillance after surgery. The purpose of this review is to provide a brief background on pelvic exenteration in gynecologic cancers and to familiarize the reader with the critical radiological aspects in the evaluation of patients for this complex procedure. The focus of this review will be on how imaging can aid in treatment planning and guide management.
A Hospital based study on sudden sensorineural Hearing Loss: It’s audiological characteristics and prevalence
Authors: Naz Erum , Saqulain Ghulam , Mumtaz Nazia , Babur Muhammad Naveed
Published: May 2021

Objectives: To analyze the prevalence & characteristics of sudden sensorineural hearing loss.

Methods: This cross sectional study including n=377 cases of sensorineural hearing impairment, using non-probability convenience sampling, who fulfilled the selection criteria was conducted from 1st July 2019 to 31st October 2019. Study was conducted at Audiology section of ENT department, Lahore General Hospital, Pakistan. Sample included both genders, aged 17-70 years. Cases suffering from inflammatory or obstructive conditions of the external or middle ear and those who could not undergo pure tone audiometry were excluded from the study. Following consent for inclusion in study, data was collected using basic demographic and medical history sheet followed by Audiometric evaluation. Statistical Software for Social Sciences Version 20.0 was used for data analysis.

Results: The prevalence rate of sudden sensorineural hearing loss of 14(3.7%) being significantly more common in males 11(78%) than females 3(22%) (p=0.05) & age group 15-35 years (p=0.001). It is commonly of severe or profound degree with downward sloping audiogram (p<0.05), however it is not associated with vertigo (p=0.32), tinnitus (p=0.08) with no side predilection (p = 0.27).

Conclusion: We conclude that the prevalence of SSNHL is 3.7% being significantly more prevalent in males and those aged15-25 years. It is mostly characterized by severe to profound degree of hearing loss with downward sloping audiogram with no associated vertigo, tinnitus and side predilection.

doi: https://doi.org/10.12669/pjms.37.4.3851

How to cite this:Naz E, Saqulain G, Mumtaz N, Babur MN. A Hospital based study on sudden sensorineural Hearing Loss: It’s audiological characteristics and prevalence. Pak J Med Sci. 2021;37(4):1133-1138. doi: https://doi.org/10.12669/pjms.37.4.3851

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.
Mutational Frequencies in Mycobacterial rpoB gene using GeneXpert/MTB Rif Assay in Rifampicin Resistant patients at a tertiary care setting in Urban Sindh, Pakistan: Analysis from a Five-Year Period
Authors: Alamgir Muhammad , Sajjad Mehwish , Baig Mirza Saifullah , Noori Muhammad Yahya
Published: May 2021

Objectives: To assess the mutational frequencies in Mycobacterial rpoB gene using GeneXpert/MTB Rif Assay in rifampicin resistant patients during 2013-2017 at a tertiary care setting in Urban Sindh, Pakistan.

Methods: This Retrospective Descriptive Cross-Sectional Study was conducted at the TB laboratories, Ojha Institute of Chest Diseases, Dow University of Health Sciences. The record of 713 positive cases of Rifampicin Resistant Tuberculosis from January 2013 to December 2017 were analysed. These were diagnosed using GeneXpert® that detects mutations in the 81 base pair region of rpoB gene with the help of five molecular probes A, B, C, D and E. All invalid and extra pulmonary samples were excluded.

Results: In total, 713 cases were found to be rifampicin resistant during the five-year period, among which 374 (52.45%) were males while 339 (47.55%) were females. Among the five standard probes A, B, C, D and E, 97.48% of the cases had a single mutation. Among these, mutations in Probe E (66.48%) were the most common, followed by Probe B (14.3%) and Probe D (11.08%). Only 13 cases (1.82%) of double mutations and five cases (0.7%) of triple mutations were detected.

Conclusion: The rpoB gene Probe E region 529-533 appears the most potent site for a mutation and development of rifampicin resistance in the rpoB gene in Mycobacterium tuberculosis, that encodes the β-subunit of RNA polymerase. The most affected age-group in both males and females is 19-45 Years.

doi: https://doi.org/10.12669/pjms.37.4.3875

How to cite this:Alamgir M, Sajjad M, Baig MS, Noori MY. Mutational Frequencies in Mycobacterial rpoB gene using GeneXpert/MTB Rif Assay in Rifampicin Resistant patients at a tertiary care setting in Urban Sindh, Pakistan: Analysis from a Five-Year Period. Pak J Med Sci. 2021;37(4):1151-1154. doi: https://doi.org/10.12669/pjms.37.4.3875

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.
Study of neutron induced reactions in rare earth isotopes
Authors: Γεωργαλή Ευσταθία
Published: May 2021

Στα πλαίσια της παρούσας εργασίας μελετήθηκε η αντίδραση (n,2n) για τα ισότοπα σπάνιων γαιών: 162Er, 156Dy και 165Ho. Συγκεκριμένα, για το 165Ho οι ενεργές διατομές τροφοδοσίας της βασικής και της ισομερούς κατάστασης του 164Ho μετρήθηκαν ανεξάρτητα. Οι ενεργές διατομές των αντιδράσεων μετρήθηκαν μέσω της τεχνικής της ενεργοποίησης σε σχέση με τις αντιδράσεις αναφοράς 197Au(n,2n)196Au, 27Al(n,α)24Na και 93Nb(n,2n)92mNb. Οι ημι-μονοενεργειακές δέσμες νετρονίων παρήχθησαν μέσω των αντιδράσεων 2H(d,n)3He (DD) και 3H(d,n)4He (DT), όπου οι δέσμες δευτερίων επιταχύνθηκαν από τον 5.5 MV Tandem Van de Graaff επιταχυντή του Ινστιτούτου Πυρηνικής και Σωματιδιακής Φυσικής του Ε.Κ.Ε.Φ.Ε. «Δημόκριτος», Αθήνα, Ελλάδα. Μετά το τέλος των ακτινοβολήσεων, η επαγόμενη ενεργότητα στα δείγματα μετρήθηκε μέσω φασματοσκοπίας ακτίνων-γ χρησιμοποιώντας ανιχνευτές γερμανίου υπερ-υψηλής καθαρότητας (HPGe). Κατά την ανάλυση των πειραματικών δεδομένων, το λογισμικό GEANT4 χρησιμοποιήθηκε εκτενώς για την προσομοίωση των HPGe ανιχνευτών. Οι κώδικες των ανιχνευτών χρησιμοποιήθηκαν για τον προσδιορισμό της απόδοσης των ανιχνευτών, καθώς και για την αναπαραγωγή των πειραματικών φασμάτων. Επιπλέον, ο κώδικας GEANT4 χρησιμοποιήθηκε για τον υπολογισμό της κατανομής της ενέργειας των δεσμών νετρονίων που παράγονται απο τον 5.5 MV Tandem επιταχυντή στο Ε.Κ.Ε.Φ.Ε. «Δημόκριτος» μέσω των αντιδράσεων DD και DT. Τα πειραματικά δεδομένα που προέκυψαν από την παρούσα μελέτη συγκρίθηκαν με προηγούμενες μετρήσεις της βιβλιογραφίας, καθώς και με θεωρητικούς υπολογισμούς με βάση τον κώδικα TALYS (v. 1.95).
Restriction site-associated DNA from Python-implemented Digestion Simulations (RApyDS): a companion tool for RAD sequencing experimental design
Authors: Gabriel Kristianne Arielle , Nepacina Maria Rejane , Tablizo Francis , Lapid Carlo , Mendoza Mark Lenczner , Pamulaklakin Daniella Jean , Domingo Jobeth , Pontiveros Marc Jermaine , Magno Hannah Mae , Dizon Joshua Gregor , Morado El King , Yap Jan Michael
Published: May 2021

Reduced representation sequencing is a practical approach for obtaining genetic variations from a random subsample of the genome. RADseq (Restriction Site-Associated DNA Sequencing), as one of the more popular reduced representation approaches, is currently being used in a wide array of applications including marker development, phylogenetics, and population genomics. A crucial step in designing a RADseq experiment is the selection of one or a pair of restriction enzymes (RE) that will result in sufficient density of loci to meet the objectives of the study, which is not straightforward because of difficulties in obtaining a standard set of REs that can generally be applied to RADseq experimental designs. Here we present RApyDS, a simulation tool that provides users with evaluation metrics to aid in choosing suitable REs based on their target RADseq design. RApyDS can perform simulations for single- or double-digest RADseq, preferably with a supplied reference genome. The tool outputs an overview page, electrophoresis visualization, mapping of restriction cut sites, and RAD loci density across the genome. If supplied with an annotation file, the program can also output evaluation metrics for a specified genomic feature. The tool is currently available at https://github.com/pgcbioinfo/rapyds.
Abdominal tuberculosis misdiagnosed as acute surgical abdomen and carcinomatosis
Authors: Meregildo-Rodriguez Edinson Dante , Tafur-Ramirez Rosita Claudia , Espino-Saavedra Walter Giovanny , Angulo-Prentice Sonia Fiorella
Published: May 2021

Tuberculosis is a major public health problem worldwide. Tuberculosis can be confused with other diseases and its diagnosis is frequently delayed, especially in areas of low prevalence. We report two cases of young patients who presented preoperatively as acute abdomen due to acute appendicitis. During the intra-operatory these cases were misdiagnosed as “carcinomatosis”, and in the postoperative period these cases were complicated with septic shock. In both cases, histopathology showed caseating granulomas which suggested tuberculous peritonitis and enteritis. Subsequently, RT-PCR in peritoneal fluid confirmed Mycobacterium tuberculosis. In one case the clinical response to treatment was excellent, and the other case was fatal.

The aim of this report is to bring attention to the spectrum of tuberculosis, and to serve as a reminder of tuberculosis as the great imitator that can masquerade as cancer. Most tuberculous patients erroneously diagnosed as cancer have extensive “neoplastic” lesions that would suggest an advanced-stage malignancy. Assuming a case as an advanced cancer would reduce the chance of performing more exhaustive studies to get a definitive diagnosis and clinicians would be tempted to offer only palliative treatments.
Programa de educación intrahospitalaria en EPOC: una estrategia para el automanejo
Authors: Vargas-Pinilla Olga-Cecilia , Peña-Córdoba Carolina , Sandoval Lucía , Coronado Diana Carolina
Published: May 2021

Introducción: La Enfermedad Pulmonar Obstructiva Crónica es una enfermedad progresiva que compromete la condición física y la calidad de vida. La educación ha mostrado resultados positivos al mejorar la adherencia al tratamiento, favorecer el automanejo y disminuir el número de exacerbaciones al igual que los costos de hospitalización. El objetivo de este estudio fue establecer el efecto de un programa de educación intrahospitalaria para pacientes con EPOC, en el nivel de conocimiento de la enfermedad. Materiales y métodos: Estudio cuasiexperimental con mediciones antes y después. Se utilizó el cuestionario de necesidad de información pulmonar (LINQ) para medir el nivel de conocimiento de la enfermedad antes y después del programa educativo, desarrollado en tres sesiones durante la hospitalización. Tres meses después se indagó sobre la utilización de servicios de salud y la percepción del estado de salud. Resultados: Participaron un total de 33 pacientes: 19 mujeres (58%), 14 hombres (42%), edad promedio 73,7 (±7,6); 52% con educación básica y 88,8% nivel socioeconómico bajo. En LINQ-pre el promedio fue de 14,55 (±4,25), LINQ post intervención educativa promedio de 4.94 (±1,7). Puntaje total del SGRQ (incluirlo también en los instrumentos) fue 77.7 con mayor compromiso del dominio de limitación de la actividad en 86,37. En el seguimiento a los tres meses, 19 pacientes (79%) refirieron sentirse bien. Conclusión: A través de la intervención educativa, los pacientes mejoraron de manera estadísticamente significativa su conocimiento sobre la enfermedad. Un programa de educación intrahospitalario beneficia la atención del paciente y optimiza los recursos en salud.