bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of the Educational Scholar Program as a longitudinal faculty development program on the capability of educators as scholars
Authors: Keshmiri Fatemeh
Published: September 2023

Introduction

The Educational Scholar Program (ESP) is designed and implemented as a longitudinal and institution-based faculty development program. The present study aimed to assess the effect of the ESP on educators’ capabilities to undertake SoTL activities associated with their scholar role.

Methods

This study was conducted from 2017 to 2022. The participants (n = 64) were educators in six schools of Shahid Sadoughi University of Medical Sciences. The ESP was a faculty development program that consisted of training and project-based stages. The educators experienced small-group learning, self-directed learning, and reflective assignments in the training stage. In the second stage, the educators completed a SoTL (Scholarship of Teaching and Learning) project. Learner-related outcomes based on Kirkpatrick model was assessed. The reaction of educators (satisfaction, active participation in the ESP, and the perception of mentoring sessions) was assessed by three questionnaires (Reaction level). The educators’ learning was evaluated by modified essay questions and their project reports (Learning and Behavior levels). Outputs of the ESP including journal publications, abstracts presented at meetings or congresses, grant funding, awards in educational festivals, promotions, projects with ongoing implementation following the ESP, and conducting further SoTL projects after ESP were assessed quantitatively over two years after participating in the ESP (Results level). Data were summarized by descriptive statistics (mean, percentage, SD, 95% Confidence Interval (CI)). Cut-off scores of the instruments was calculated with a standard setting method which introduced by Cohen-Schotanus and Van DerVleuten. Data analyzed by One-sample t-test.

Results

Sixty-four of 72 (89%) educators completed the ESP. The mean (CI) satisfaction score of educators was 42 (CI: 26.92–58.28), the active participation was 92 (CI: 80.24-103.76). The scores of the mentoring assessment from the perspective of the educators were reported at 90 (CI: 78.24- 101.76). The mean (95%CI) learning scores in the essay examination were 88 (CI: 70.36- 105.64), and project assessment were 90 (CI: 78.24- 101.76). The results showed the educators’ scores in reaction and learning significantly higher than the cut-off scores. (P < 0.05). Most projects were conducted in curriculum development and assessment/evaluation domains. The number of projects with ongoing implementation over the two years following the ESP and the acquisition of grants was higher than other outputs in the results level.

Conclusion

The ESP, as an institute-based longitudinal program, enhanced the learner-related outcomes (in four levels of reaction, learning, behavior, and results). The creation of practical learning and supportive mechanisms influenced on the results. The outcomes of ESP indicated that the educators prepared to conduct SoTL activities in their educational community.
Benefit of an action camera in endoscopy education for medical students under COVID-19
Authors: Uchiyama Akira , Yamashina Shunhei , Sato Toshifumi , Sakuma Satoshi , Tomiki Yuichi , Isayama Hiroyuki , Nagahara Akihito , Ikejima Kenichi
Published: September 2023

Background

Endoscopy is an important form of clinical gastroenterology education because it gives students the opportunity to learn about diagnosis procedures and even treatment. During the COVID-19 pandemic, medical students were observed from outside the endoscopy room due to the risk of airborne infection. In this study, we investigated the efficacy of combining endoscopy education with doctor’s-eye-view videos of the procedure obtained using live-action cameras (GoPro®).

Methods

From February to May 2021, endoscopists wore GoPro Hero8 cameras on their heads to display a doctor’s-eye view video outside the room. The efficacy of the GoPro videos in combination with endoscopic monitoring was evaluated by 15 participating medical students. The participants rated the efficacy on a 5-point scale and commented on the positive and negative points.

Results

A total of 78.6% of participants evaluated the GoPro as good; 57.2% answered that it increased their understanding, with 71.4% stating that it increased their understanding of procedures in particular. A total of 85.7% of the students answered that their interest in endoscopy had increased, and 85.7% evaluated the benefit of the GoPro videos as good. In addition, 64.3% answered that the method was effective in preventing COVID-19 infection. Education using GoPro videos enabled students to feel as if they were conducting the endoscopy themselves and enabled them to concentrate on learning.

Conclusions

Practical endoscopic education using a GoPro is an effective educational tool that not only increases understanding of endoscopic practice but also stimulates students’ interest and awareness of their future as doctors.
Staphylococcus aureus enterotoxin A- and B-specific IgE in chronic obstructive pulmonary disease
Authors: Karakioulaki Meropi , Berkemeier Caroline Maria , Heijnen Ingmar , Grize Leticia , Papakonstantinou Eleni , Goulas Antonis , Tamm Michael , Stolz Daiana
Published: September 2023

Sensitization to Staphylococcus aureus enterotoxins A (SEA) and B (SEB) has been associated with asthma severity, exacerbations, and disease control. Our study aimed to investigate if there are differences in serum SEA-IgE and SEB-IgE levels between patients with chronic obstructive pulmonary disease (COPD), asthma, and controls, and to assess the association between SE sensitization and COPD clinical parameters and Th2 inflammation biomarkers in two well-defined COPD cohorts. Our findings suggest that COPD patients do not exhibit higher SEA and SEB sensitization compared to asthma patients and controls. However, in COPD patients, the presence of atopy and allergy is associated with positivity for SEA-IgE and SEB-IgE. Consequently, these allergens may aid in identifying atopic or allergic subgroups within the COPD population, but they are not directly associated with the diagnosis of COPD, elevated circulating blood eosinophils, or fractional exhaled nitric oxide (FENO) levels.
“One Health” perspective on prevalence of co-existing extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae: a comprehensive systematic review and meta-analysis
Authors: Ramatla Tsepo , Mafokwane Tshepo , Lekota Kgaugelo , Monyama Maropeng , Khasapane George , Serage Naledi , Nkhebenyane Jane , Bezuidenhout Carlos , Thekisoe Oriel
Published: September 2023

Background

The Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) bacterial isolates that produce extended-spectrum β-lactamases (ESBLs) contribute to global life-threatening infections. This study conducted a systematic review and meta-analysis on the global prevalence of ESBLs in co-existing E. coli and K. pneumoniae isolated from humans, animals and the environment.

Methods

The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) [ID no: CRD42023394360]. This study was carried out following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. One hundred and twenty-six eligible studies published on co-existing antibiotic resistance in E. coli and K. pneumoniae between 1990 and 2022 were included.

Results

The pooled prevalence of ESBL-producing E. coli and K. pneumoniae was 33.0% and 32.7% for humans, 33.5% and 19.4% for animals, 56.9% and 24.2% for environment, 26.8% and 6.7% for animals/environment, respectively. Furthermore, the three types of resistance genes that encode ESBLs, namely blaSHVblaCTX−M,blaOXA, and blaTEM, were all detected in humans, animals and the environment.

Conclusions

The concept of “One-Health” surveillance is critical to tracking the source of antimicrobial resistance and preventing its spread. The emerging state and national surveillance systems should include bacteria containing ESBLs. A well-planned, -implemented, and -researched alternative treatment for antimicrobial drug resistance needs to be formulated.
Heterogeneity in defining multiple trauma: a systematic review of randomized controlled trials
Authors: Jeanmougin Thomas , Cole Elaine , Duceau Baptiste , Raux Mathieu , James Arthur
Published: September 2023

Introduction

While numerous randomized controlled trials (RCTs) have been conducted in the field of trauma, a substantial portion of them are yielding negative results. One potential contributing factor to this trend could be the lack of agreement regarding the chosen definitions across different trials. The primary objective was to identify the terminology and definitions utilized for the characterization of multiple trauma patients within randomized controlled trials (RCTs).

Methods

A systematic review of the literature was performed in MEDLINE, EMBASE and clinicaltrials.gov between January 1, 2002, and July 31, 2022. RCTs or RTCs protocols were eligible if they included multiple trauma patients. The terms employed to characterize patient populations were identified, and the corresponding definitions for these terms were extracted. The subsequent impact on the population recruited was then documented to expose clinical heterogeneity.

Results

Fifty RCTs were included, and 12 different terms identified. Among these terms, the most frequently used were “multiple trauma” (n = 21, 42%), "severe trauma" (n = 8, 16%), "major trauma" (n = 4, 8%), and trauma with hemorrhagic shock" (n = 4, 8%). Only 62% of RCTs (n = 31) provided a definition for the terms used, resulting a total of 21 different definitions. These definitions primarily relied on the injury severity score (ISS) (n = 15, 30%), displaying an important underlying heterogeneity. The choice of the terms had an impact on the study population, affecting both the ISS and in-hospital mortality. Eleven protocols were included, featuring five different terms, with "severe trauma" being the most frequent, occurring six times (55%).

Conclusion

This systematic review uncovers an important heterogeneity both in the terms and in the definitions employed to recruit trauma patients within RCTs. These findings underscore the imperative of promoting the use of a unique and consistent definition.
An automated ash dispersion forecast system: case study Popocatépetl volcano, Mexico
Authors: García Agustin R. , Zavala-Hidalgo J. , Delgado-Granados H. , Garcia-Escalante J. , Gómez-Ramos O. , Herrera-Moro D.
Published: September 2023

An operational volcanic ash dispersion forecast system was developed for Popocatépetl. It runs automatically every day developing 108 possible scenarios of ash dispersion for the following 36 h. Scenarios are simulated for three eruption column heights: 3 km, 5 km, and 10 km above the volcano’s crater level, every hour for eruptions lasting 1 h. For each hypothetical eruption that starts every hour, the dispersion during the following 8 h is modelled. The system uses the Weather Research and Forecasting (WRF) model for weather data and the Fall3D model. It includes a visualization website that displays, among other products: ground accumulation, deposit load, and concentration at relevant flight levels. Popocatépetl volcano, located ~ 60 km from Mexico Megacity was selected as a case study. A comparison from ash forecast system results and satellite observations is presented. The system developed and tested here can be adapted to be operative at any volcano.
Forward invariant set preservation in discrete dynamical systems and numerical schemes for ODEs: application in biosciences
Authors: Anguelov Roumen , Lubuma Jean M.-S.
Published: September 2023

We present two results on the analysis of discrete dynamical systems and finite difference discretizations of continuous dynamical systems, which preserve their dynamics and essential properties. The first result provides a sufficient condition for forward invariance of a set under discrete dynamical systems of specific type, namely time-reversible ones. The condition involves only the boundary of the set. It is a discrete analog of the widely used tangent condition for continuous systems (viz. the vector field points either inwards or is tangent to the boundary of the set). The second result is nonstandard finite difference (NSFD) scheme for dynamical systems defined by systems of ordinary differential equations. The NSFD scheme preserves the hyperbolic equilibria of the continuous system as well as their stability. Further, the scheme is time reversible and, through the first result, inherits from the continuous model the forward invariance of the domain. We show that the scheme is of second order, thereby solving a pending problem on the construction of higher-order nonstandard schemes without spurious solutions. It is shown that the new scheme applies directly for mass action-based models of biological and chemical processes. The application of these results, including some numerical simulations for invariant sets, is exemplified on a general Susceptible-Infective-Recovered/Removed (SIR)-type epidemiological model, which may have arbitrary large number of infective or recovered/removed compartments.
Intelligent intrusion detection framework for multi-clouds – IoT environment using swarm-based deep learning classifier
Authors: Nizamudeen Syed Mohamed Thameem
Published: September 2023

In the current era, a tremendous volume of data has been generated by using web technologies. The association between different devices and services have also been explored to wisely and widely use recent technologies. Due to the restriction in the available resources, the chance of security violation is increasing highly on the constrained devices. IoT backend with the multi-cloud infrastructure to extend the public services in terms of better scalability and reliability. Several users might access the multi-cloud resources that lead to data threats while handling user requests for IoT services. It poses a new challenge in proposing new functional elements and security schemes. This paper introduces an intelligent Intrusion Detection Framework (IDF) to detect network and application-based attacks. The proposed framework has three phases: data pre-processing, feature selection and classification. Initially, the collected datasets are pre-processed using Integer- Grading Normalization (I-GN) technique that ensures a fair-scaled data transformation process. Secondly, Opposition-based Learning- Rat Inspired Optimizer (OBL-RIO) is designed for the feature selection phase. The progressive nature of rats chooses the significant features. The fittest value ensures the stability of the features from OBL-RIO. Finally, a 2D-Array-based Convolutional Neural Network (2D-ACNN) is proposed as the binary class classifier. The input features are preserved in a 2D-array model to perform on the complex layers. It detects normal (or) abnormal traffic. The proposed framework is trained and tested on the Netflow-based datasets. The proposed framework yields 95.20% accuracy, 2.5% false positive rate and 97.24% detection rate.
A novel CAR-T cell product targeting CD74 is an effective therapeutic approach in preclinical mantle cell lymphoma models
Authors: Chan Wing Keung , Williams Jessica , Sorathia Kinnari , Pray Betsy , Abusaleh Kaled , Bian Zehua , Sharma Archisha , Hout Ian , Nishat Shamama , Hanel Walter , Sloan Shelby L. , Yasin Aneeq , Denlinger Nathan , Zhang Xiaoli , Muthusamy Natarajan , Vasu Sumithira , de Lima Marcos , Yang Yiping , Baiocchi Robert , Alinari Lapo
Published: September 2023

Background

Mantle cell lymphoma (MCL) is a rare B-cell non-Hodgkin lymphoma subtype which remains incurable despite multimodal approach including chemoimmunotherapy followed by stem cell transplant, targeted approaches such as the BTK inhibitor ibrutinib, and CD19 chimeric antigen receptor (CAR) T cells. CD74 is a nonpolymorphic type II integral membrane glycoprotein identified as an MHC class II chaperone and a receptor for macrophage migration inhibitory factor. Our group previously reported on CD74's abundant expression in MCL and its ability to increase via pharmacological inhibition of autophagosomal degradation. Milatuzumab, a fully humanized anti-CD74 monoclonal antibody, demonstrated significant activity in preclinical lymphoma models but failed to provide meaningful benefits in clinical trials mainly due to its short half-life. We hypothesized that targeting CD74 using a CAR-T cell would provide potent and durable anti-MCL activity.

Methods

We engineered a second generation anti-CD74 CAR with 4-1BB and CD3ζ signaling domains (74bbz). Through in silico and rational mutagenesis on the scFV domain, the 74bbz CAR was functionally optimized for superior antigen binding affinity, proliferative signaling, and cytotoxic activity against MCL cells in vitro and in vivo.

Results

Functionally optimized 74bbz CAR-T cells (clone 42105) induced significant killing of MCL cell lines, and primary MCL patient samples including one relapse after commercial CD19 CAR-T cell therapy with direct correlation between antigen density and cytotoxicity. It significantly prolonged the survival of an animal model established in NOD-SCIDγc−/− (NSG) mice engrafted with a human MCL cell line Mino subcutaneously compared to controls. Finally, while CD74 is also expressed on normal immune cell subsets, treatment with 74bbz CAR-T cells resulted in minimal cytotoxicity against these cells both in vitro and in vivo.

Conclusions

Targeting CD74 with 74bbz CAR-T cells represents a new cell therapy to provide a potent and durable and anti-MCL activity.
Assessing food security performance from the One Health concept: an evaluation tool based on the Global One Health Index
Authors: Gu Si-Yu , Chen Fu-Min , Zhang Chen-Sheng , Zhou Yi-Bin , Li Tian-Yun , Qiang Ne , Zhang Xiao-Xi , Liu Jing-Shu , Wang Shu-Xun , Yang Xue-Chen , Guo Xiao-Kui , Hu Qin-Qin , Deng Xiao-Bei , Han Le-Fei
Published: September 2023

Background

Food systems instantiate the complex interdependencies across humans, physical environments, and other organisms. Applying One Health approaches for agri-food system transformation, which adopts integrated and unifying approaches to optimize the overall health of humans, animals, plants, and environments, is crucial to enhance the sustainability of food systems. This study develops a potential assessment tool, named the global One Health index-Food Security (GOHI-FS), aiming to evaluate food security performance across countries/territories from One Health perspective and identify relevant gaps that need to be improved for sustainable food systems.

Methods

We comprehensively reviewed existing frameworks and elements of food security. The indicator framework of GOHI-FS was conceptualized following the structure-process-outcome model and confirmed by expert advisory. Publicly available data in 2020 was collected for each indicator. The weighting strategy was determined by the Fuzzy Analytical Hierarchy Process. The data for each indicator was normalized and aggregated by weighted arithmetic mean. Linear regressions were performed to evaluate the associations of GOHI-FS with health and social-economic indicators.

Results

The GOHI-FS includes 5 first-level indicators, 19 second-level indicators and 45 third-level indicators. There were 146 countries/territories enrolled for evaluation. The highest average score of first-level indicators was Nutrition (69.8) and the lowest was Government Support and Response (31.3). There was regional heterogeneity of GOHI-FS scores. Higher median scores with interquartile range (IQR) were shown in North America (median: 76.1, IQR: 75.5–76.7), followed by Europe and Central Asia (median: 66.9, IQR: 60.1–74.3), East Asia and the Pacific (median: 60.6, IQR: 55.5–68.7), Latin America and the Caribbean (median: 60.2, IQR: 57.8–65.0), Middle East and North Africa (median: 56.6, IQR: 52.0–62.8), South Asia (median: 51.1, IQR: 46.7–53.8), and sub-Saharan Africa (median: 41.4, IQR: 37.2–46.5). We also found significant associations between GOHI-FS and GDP per capita, socio-demographic index, health expenditure and life expectancy.

Conclusions

GOHI-FS is a potential assessment tool to understand the gaps in food security across countries/territories under the One Health concept. The pilot findings suggest notable gaps for sub-Saharan Africa in numerous aspects. Broad actions are needed globally to promote government support and response for food security.
Mentalizing in a movie for the assessment of social cognition (MASC): the validation in a taiwanese sample
Authors: Huang Yu-Lien , Chen Tzu-Ting , Dziobek Isabel , Tseng Huai-Hsuan
Published: September 2023

Background

The present study evaluated the psychometrics properties of a sensitive video-based test used in the evaluation of mentalizing skills, that is, the Movie for the Assessment of Social Cognition-Taiwanese version (MASC-TW).

Methods

We recruited two independent samples of nonclinical participants (N = 167) and adult patients with schizophrenia (N = 41). The MASC-TW and two other social cognition measures, namely the Chinese version of Theory of Mind task (ToM) and the Taiwanese version of the Diagnostic Analysis of Nonverbal Accuracy-2 (DANAV-TW-2), and an executive function measure of the Wisconsin Card Sorting Test (WCST), were administered to both groups.

Results

The MASC proved to be a reliable measure of mentalizing capacity, high Cronbach’s α value of 0.87. The intraclass correlation coefficient for the MASC-TW total correct scores was 0.85 across three waves of data collection. Across the entire sample, the scores on the MASC-TW were significantly correlated with verbal and nonverbal scores for the ToM task and recognition of facial and prosodic emotion on the DANAV-TW-2. Both executive function and emotion recognition emerged as noteworthy predictors of mentalizing, indicating that these two variables might play crucial roles in the development of mentalizing capacities. Finally, a receiver operating characteristic analysis revealed that in patients with schizophrenia, the MASC was the most accurate discriminator of diagnostic groups, highlighting the validity of the MASC.

Conclusions

Overall, the MASC-TW is an ecologically valid and useful tool for assessing mentalizing abilities in a Taiwanese population.
TDP43 pathology in chronic traumatic encephalopathy retinas
Authors: Phansalkar Ragini , Goodwill Vanessa S. , Nirschl Jeffrey J. , De Lillo Chiara , Choi Jihee , Spurlock Elizabeth , Coughlin David G. , Pizzo Donald , Sigurdson Christina J. , Hiniker Annie , Alvarez Victor E. , Mckee Ann C. , Lin Jonathan H.
Published: September 2023

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease associated with repetitive head trauma. Brain pathology in CTE is characterized by neuronal loss, gliosis, and a distinctive pattern of neuronal accumulation of hyper-phosphorylated tau (p-tau) and phospho-TDP43 (p-TDP43). Visual anomalies have been reported by patients with CTE, but the ocular pathology underlying these symptoms is unknown. We evaluated retinal pathology in post-mortem eyes collected from 8 contact sport athletes with brain autopsy-confirmed stage IV CTE and compared their findings to retinas from 8 control patients without CTE and with no known history of head injury. Pupil-optic nerve cross sections were prepared and stained with hematoxylin and eosin (H&E), p-tau, p-TDP43, and total TDP43 by immunohistochemistry. No significant retinal degeneration was observed in CTE eyes compared to control eyes by H&E. Strong cytoplasmic p-TDP43 and total TDP43 staining was found in 6/8 CTE eyes in a subset of inner nuclear layer interneurons (INL) of the retina, while only 1/8 control eyes showed similar p-TDP43 pathology. The morphology and location of these inner nuclear layer interneurons were most compatible with retinal horizontal cells, although other retinal cell types present in INL could not be ruled out. No p-tau pathology was observed in CTE or control retinas. These findings identify novel retinal TDP43 pathology in CTE retinas and support further investigation into the role of p-TDP43 in producing visual deficits in patients with CTE.
Overcoming delamination in two-photon lithography for improving fabrication of 3D microstructures
Authors: Ha Cheol Woo
Published: September 2023

Two-photon lithography has emerged as a highly effective method for fabricating intricate three-dimensional (3D) microstructures. It enables the rapid fabrication of 3D microstructures, unlike conventional two-dimensional nanopatterning. Researchers have extensively investigated two-photon polymerization (TPP) for the fabrication of diverse 3D micro/nanodevices with high resolution. TPP can be applied in cell cultures, metamaterials, optical materials, electrical devices, and fluidic devices, to name a few. In this study, we investigate the applications and innovative research pertaining to TPP, which is an effective fabrication technique with significant advancement in various fields. In particular, we attempt to determine the reasons that cause the detachment or delamination of 3D microstructures during the development process and propose some solutions. A step-by-step fabrication process for a glass substrate, from photoresist deposition to laser scanning and the dissolution of the uncured photoresist, is presented. Defects such as pattern delamination are discussed, with emphasis on the cell scaffold structure and microlens array. Understanding and addressing these defects are vital to the success of 3D microstructure fabrication via TPP.
The influence of contralateral circulation on computational fluid dynamics of intracranial arteries: simulated versus measured flow velocities
Authors: Oh SuJeong , Song YunSun , Lim HyunKyung , Ko YoungBae , Park SungTae
Published: September 2023

Background

This study aimed to retrospectively evaluate the influence of contralateral anterior circulation on computational fluid dynamics (CFD) of intracranial arteries, by comparing the CFD values of flow velocities in unilateral anterior circulation with the measured values from phase-contrast magnetic resonance angiography (PC-MRA).

Methods

We analyzed 21 unilateral anterior circulation models without proximal stenosis from 15 patients who performed both time-of-flight MRA (TOF-MRA) and PC-MRA. CFD was performed with the inflow boundary condition of a pulsatile flow of the internal carotid artery (ICA) obtained from PC-MRA. The outflow boundary condition was given as atmospheric pressure. Simulated flow velocities of the middle cerebral artery (MCA) and anterior cerebral artery (ACA) from CFD were compared with the measured values from PC-MRA.

Results

The velocities of MCA were shown to be more accurately simulated on CFD than those of ACA (Spearman correlation coefficient 0.773 and 0.282, respectively). In four models with severe stenosis or occlusion of the contralateral ICA, the CFD values of ACA velocities were significantly lower (< 50%) than those measured with PC-MRA. ACA velocities were relatively accurately simulated in the models including similar diameters of both ACAs.

Conclusion

It may be necessary to consider the flow condition of the contralateral anterior circulation in CFD of intracranial arteries, especially in the ACA.

Relevance statement

Incorporating the flow conditions of the contralateral circulation is of clinical importance for an accurate prediction of a rupture risk in Acom aneurysms as the bidirectional flow and accurate velocity of both ACAs can significantly impact the CFD results.

Key points

• CFD simulations using unilateral vascular models were relatively accurate for MCA.

• Contralateral ICA steno-occlusion resulted in an underestimation of CFD velocity in ACA.

• Contralateral flow may need to be considered in CFD simulations of ACA.

Graphical Abstract
Renal resistive index as a marker of histopathological damage in diabetic and non-diabetic chronic kidney disease
Authors: Kuttancheri Theertha , Das Sudha Kiran , Shetty Manjunath Sanjeeva , Satish Suchitha , Bathrenathh B.
Published: September 2023

Background

Chronic kidney disease is a worldwide public health problem with diabetes being the leading cause. Renal resistive index derived by Duplex Doppler sonography, has been in use clinically to examine intrarenal hemodynamic abnormalities. However, renal biopsy remains the gold standard for the evaluation of intrarenal damage. In this study we correlated the renal resistive index in diabetic and non-diabetic kidney disease patients with the established parameters of renal dysfunction i.e. histopathological changes.

Results

The conducted study was a cross-sectional comparative study on 114 patients (58 diabetic and 56 non-diabetic patients) over a period of 18 months. Evaluated histopathological indices and renal resistive index had a statistically significant positive correlation (glomerulosclerosis, arterial damage and tubulo-interstitial damage scores) in both diabetic and non-diabetic patients. The highest correlation was observed with tubulo-interstitial score in our study.

Conclusions

Renal resistive index could be considered a marker of histological damage in both diabetic and non-diabetic kidney disease. Inclusion of resistive index in the routine diagnostic protocol of chronic kidney disease can help in the accurate assessment of intrarenal damage. Hence, it is of utmost importance as a radiologist to determine resistive index in chronic kidney disease patients and guide the clinicians for efficient management.
Imaging findings of juvenile nasopharyngeal angiofibroma invading orbital apex and middle cranial fossa: a case report
Authors: Castellana Roberto , Fanelli Gianluca , Lunardi Gianmarco , Rosset Massimo , Piccolo Stefano , Ariozzi Irene , Oggero Mara , Castellana Roberto , Petti Pierpaolo , Alessi Monica , Natrella Massimiliano
Published: September 2023

Background

Juvenile nasopharyngeal angiofibroma (JNA) is an infrequent, highly vascular tumor that predominantly affects male adolescents. Although benign, it rarely may exhibit invasive growth, leading to significant morbidity, as in our case presentation. Diagnosis relies on clinical evaluation and imaging, with MR and CT playing vital roles in confirming the tumor's presence, determining its extent, and aiding in treatment planning. MR shows a mass with signal voids at T2-weighted images and intense contrast enhancement at T1-weighted images, while CT shows bone remodeling and destruction. A biopsy is usually avoided due to bleeding risks.

Case presentation

We present a case of a 16-year-old male with nasal obstruction and recurrent epistaxis from the right nostril, headache, and mucopurulent rhinorrhea. Furthermore, he had vision impairment in the right eye for one week associated with proptosis and periorbital swelling. MR and CT imaging evidenced the presence of JNA with extensive involvement in the nasal cavity, nasopharynx, pterygopalatine fossa, and infratemporal fossa. Moreover, the mass invaded the orbital apex and middle cranial fossa contacting the cavernous sinus and internal carotid artery. Preoperative embolization and complete surgical resection were performed. No complications occurred in the postoperative period and histopathological analysis confirmed the diagnosis of JNA. No recurrences were found at 12 months MR follow-up.

Conclusions

Early detection and accurate imaging evaluation are essential for the effective management of JNA. Regular post-treatment MR follow-ups are crucial to detect recurrences or assess fibrosis stability. MR and CT continue to be indispensable tools in the diagnosis and follow-up of JNA.
Eikonal-equation-based characteristic reflection traveltime tomography
Authors: Zhang Jianming , Dong Liangguo , Wang Jianhua , Wang Jianhua , Wang Yilin , Huang Chao
Published: September 2023

Automatically picking reflection traveltimes from the prestack shot gathers and positioning and updating the reflector depths during inversion are challenging in conventional eikonal-equation-based adjoint-state reflection traveltime tomography methods. To solve these problems, we develop an eikonal-equation-based adjoint-state characteristic reflection traveltime tomography (ASCRT) method. This method automatically extracts the reflection traveltimes by sequentially applying characteristic reflector picking in the depth migration section, followed by eikonal-equation-based traveltime calculation and an event-tracking algorithm. We also develop an efficient eikonal-equation-based kinematic imaging method to rapidly position and update the reflector depths. With our ASCRT method, the characteristic reflector positions and the velocity above the reflector are alternately updated. Our ASCRT method is performed with a layer-stripping strategy that sequentially uses selected characteristic reflectors to update the velocity model from shallow to deep. Compared with the wave equation-based reflection traveltime inversion methods, the efficiency of the ASCRT method is improved by several orders of magnitude, and the memory consumption is remarkably reduced. Synthetic and field data examples are presented to demonstrate the effectiveness and efficiency of our method.
Germline Pathogenic Variants and Genetic Counseling by Ancestry in Patients With Epithelial Ovarian Cancer
Authors: Sia Tiffany Y. , Maio Anna , Kemel Yelena M. , Arora Kanika S. , Gordhandas Sushmita B. , Kahn Ryan M. , Salo-Mullen Erin E. , Sheehan Margaret A. , Tejada Prince Rainier , Bandlamudi Chaitanya , Zhou Qin , Iasonos Alexia , Grisham Rachel N. , O'Cearbhaill Roisin E. , Tew William P. , Long Roche Kara , Zivanovic Oliver , Sonoda Yukio , Gardner Ginger J. , Chi Dennis S. , Latham Alicia J. , Carlo Maria I. , Murciano-Goroff Yonina R. , Will Marie , Walsh Michael F. , Robson Mark E. , Mandelker Diana L. , Berger Michael F. , Abu-Rustum Nadeem R. , Brown Carol L. , Offit Kenneth , Hamilton Jada G. , Aghajanian Carol , Weigelt Britta , Stadler Zsofia K. , Liu Ying L.
Published: September 2023

Mutations in ovarian cancer risk genes are found in women of diverse ancestries, supporting genetic testing for ALL
Adipocyte Glucocorticoid Receptor Inhibits Immune Regulatory Genes to Maintain Immune Cell Homeostasis in Adipose Tissue
Authors: Amatya Shripa , Tietje-Mckinney Dylan , Mueller Schaefer , Petrillo Maria G , Woolard Matthew D , Bharrhan Sushma , Orr Anthony Wayne , Kevil Christopher G , Cidlowski John A , Cruz-Topete Diana
Published: September 2023

Glucocorticoids acting via the glucocorticoid receptors (GR) are key regulators of metabolism and the stress response. However, uncontrolled or excessive GR signaling adversely affects adipose tissue, including endocrine, immune, and metabolic functions. Inflammation of the adipose tissue promotes systemic metabolic dysfunction; however, the molecular mechanisms underlying the role of adipocyte GR in regulating genes associated with adipose tissue inflammation are poorly understood. We performed in vivo studies using adipocyte-specific GR knockout mice in conjunction with in vitro studies to understand the contribution of adipocyte GR in regulating adipose tissue immune homeostasis. Our findings show that adipocyte-specific GR signaling regulates adipokines at both mRNA and plasma levels and immune regulatory (Coch, Pdcd1, Cemip, and Cxcr2) mRNA gene expression, which affects myeloid immune cell presence in white adipose tissue. We found that, in adipocytes, GR directly influences Cxcr2. This chemokine receptor promotes immune cell migration, indirectly affecting Pdcd1 and Cemip gene expression in nonadipocyte or stromal cells. Our findings suggest that GR adipocyte signaling suppresses inflammatory signals, maintaining immune homeostasis. We also found that GR signaling in adipose tissue in response to stress is sexually dimorphic. Understanding the molecular relationship between GR signaling and adipose tissue inflammation could help develop potential targets to improve local and systemic inflammation, insulin sensitivity, and metabolic health.
Markers of Glucagon Resistance Improve With Reductions in Hepatic Steatosis and Body Weight in Type 2 Diabetes
Authors: Kjeldsen Sasha A S , Thomsen Mads N , Skytte Mads J , Samkani Amirsalar , Richter Michael M , Frystyk Jan , Magkos Faidon , Hansen Elizaveta , Thomsen Henrik S , Holst Jens J , Madsbad Sten , Haugaard Steen B , Krarup Thure , Wewer Albrechtsen Nicolai J
Published: September 2023

Context

Hyperglucagonemia may develop in type 2 diabetes due to obesity-prone hepatic steatosis (glucagon resistance). Markers of glucagon resistance (including the glucagon-alanine index) improve following diet-induced weight loss, but the partial contribution of lowering hepatic steatosis vs body weight is unknown.

Objective

This work aimed to investigate the dependency of body weight loss following a reduction in hepatic steatosis on markers of glucagon resistance in type 2 diabetes.

Methods

A post hoc analysis was conducted from 2 previously published randomized controlled trials. We investigated the effect of weight maintenance (study 1: isocaloric feeding) or weight loss (study 2: hypocaloric feeding), both of which induced reductions in hepatic steatosis, on markers of glucagon sensitivity, including the glucagon-alanine index measured using a validated enzyme-linked immunosorbent assay and metabolomics in 94 individuals (n = 28 in study 1; n = 66 in study 2). Individuals with overweight or obesity with type 2 diabetes were randomly assigned to a 6-week conventional diabetes (CD) or carbohydrate-reduced high-protein (CRHP) diet within both isocaloric and hypocaloric feeding-interventions.

Results

By design, weight loss was greater after hypocaloric compared to isocaloric feeding, but both diets caused similar reductions in hepatic steatosis, allowing us to investigate the effect of reducing hepatic steatosis with or without a clinically relevant weight loss on markers of glucagon resistance. The glucagon-alanine index improved following hypocaloric, but not isocaloric, feeding, independently of macronutrient composition.

Conclusion

Improvements in glucagon resistance may depend on body weight loss in patients with type 2 diabetes.
Metaphysical Horror in Samuel Beckett
Authors: Conti Christopher
Published: September 2023

Efforts to unravel the strands of philosophy and literature in Samuel Beckett’s work have marked each phase of its critical reception. While the archival turn in scholarship has shed valuable light on Beckett’s debts to philosophy, it has also exposed the rift between the epistemological assumptions of scholars and Beckett’s philosophy of ignorance. I argue that Beckett’s tragic view of philosophy took literary shape as a species of metaphysical horror, Leszek Kolakowski’s term for the failed quest for the absolute in Western thought. Beckett’s legacy is then viewed in a postsecular context as negative theodicy, the struggle to come to grips with the ethical and anthropological consequences of metaphysical horror.
Key role for Rac in the early transcriptional response to extracellular matrix stiffness and stiffness-dependent repression of ATF3
Authors: Dang Irène , Brazzo Joseph A. , Bae Yongho , Assoian Richard K.
Published: September 2023

The Rho family GTPases Rac and Rho play critical roles in transmitting mechanical information contained within the extracellular matrix (ECM) to the cell. Rac and Rho have well-described roles in regulating stiffness-dependent actin remodeling, proliferation and motility. However, much less is known about the relative roles of these GTPases in stiffness-dependent transcription, particularly at the genome-wide level. Here, we selectively inhibited Rac and Rho in mouse embryonic fibroblasts cultured on deformable substrata and used RNA sequencing to elucidate and compare the contribution of these GTPases to the early transcriptional response to ECM stiffness. Surprisingly, we found that the stiffness-dependent activation of Rac was dominant over Rho in the initial transcriptional response to ECM stiffness. We also identified activating transcription factor 3 (ATF3) as a major target of stiffness- and Rac-mediated signaling and show that ATF3 repression by ECM stiffness helps to explain how the stiffness-dependent activation of Rac results in the induction of cyclin D1.
Observations on neurophysiological pattern and behavioural traits as death-feigning mechanism in Eucryptorrhynchus scrobiculatus (Coleoptera: Curculionidae)
Authors: Li Huijuan , Wang Lu , Wen Junbao
Published: September 2023

In adaptation to surrounding environmental stimuli, most insects exhibit defense behaviour (death feigning) to improve survival rates in the wild. However, the underlying mechanism of death feigning remains largely unknown. Here, we tested the neurophysiological pattern and behavioural traits of the death-feigning mechanism in the forestry pest Eucryptorrhynchus scrobiculatus. Using neuroanatomy, LC-MS/MS target metabolomics detection technology and qRT-PCR, we investigated the effects of neurochemicals and metabolic pathways in experimental weevils. Excision and drug tests were conducted to verify the key regulatory body parts involved in regulating the central nervous system in death feigning. Our results reconstructed the death-feigning mechanism of E. scrobiculatus: when the effective stimuli point of arousal weevils received mechanical stimulation, the thoracoabdominal ganglion transmitted signals into the brain through the ventral nerve cord, and then the brain regulated dopamine (DA) and serotonin (5-HT) metabolic pathways, reducing the expression of dopamine (dar2) and octopamine (oar1, oab2) receptor genes, finally inducing death feigning. Our study suggests that the variation of neurotransmitters in the brain is an important indicator of the physiological response of death feigning, and the results provide ecological and theoretical information for future investigations to reveal key behaviour and target genes for pest control.
Impact of Blood Flow Restriction Exercise on Central Hemodynamics and Fluid Regulating Hormones
Authors: THOMPSON KYLE M.A. , GAMBLE ALEXANDER S.D. , COATES ALEXANDRA M. , BURR JAMIE F.
Published: September 2023

Purpose

The purpose of this study is to characterize both the efficacy of altered restriction pressures and consequences of optimized blood flow restriction (BFR) for altering the cardiovascular and fluid regulating response in humans.

Methods

This work comprised a series of related trials. Phase 1: during semi-recumbent cycling (5 min, 60 W) with BFR at 0%, 50%, 75%, 100%, and 125% of participants’ lowest arterial occlusion pressure (LOP) echocardiographic images were collected alongside continuous heart rate (HR) and blood pressure (BP). In phase 2, 24 h fluid balance (intake-output) and fluid-regulating hormone responses were measured after a practical BFR exercise session (treadmill walking: 5·3 min, 1 min rest, 5 km·h−1, 5% incline, 100% LOP). Phase 3 examined the magnitude and effect of blood volume distribution following BFR treadmill walking using a modified CO-rebreathe technique.

Results

Cardiac ejection fraction remained stable irrespective of cuff pressure and despite a reduction in end-diastolic volume (Δ of 11 ± 9 mL, P = 0.02). HR and BP were highest at 100% LOP (ΔHR = 18 ± 19 bpm, ΔSBP = 51 ± 30 mm Hg, ΔDBP = 33 ± 15 mm Hg, ΔRate Pressure Product = 76 ± 32 bpm·mm Hg·100−1). BFR treadmill walking stimulated a greater release of fluid-regulating hormones than normal walking (Δrenin = BFR: 25.3 ± 24.2 vs CON: 9.1 ± 11.8 ng·L−1; Δcopeptin = BFR: 50.1 ± 97.9 vs. CON: 0.43 ± 0.8 pmol·L−1), but no difference in fluid retention was observed (P = 0.2). Approximately 27% of total blood volume was confined to the legs during BFR, but the relative volume trapped in the legs was not related to fluid-regulating hormone release (renin r = −0.04, P = 0.9; copeptin r = 0.27, P = 0.3).

Conclusions

BFR exercise elicits the largest cardiovascular effect using 100% LOP, with evidence of appreciable fluid regulating hormonal response during a typical BFR exercise session. The relative volume of blood sequestered in the limb does not appear to drive this response.
Clinical and genetic attributes of congenital anomalies ascertained at a tertiary care hospital in Rawalpindi, Pakistan
Authors: Shaheen Fatima , Qaisar Shehzad Humayoon  , Sajid Malik  , Mumtaz Sara
Published: September 2023

Objective: Congenital anomalies (CA) or birth defects cause substantial healthcare burden in developing countries. There are few studies from Pakistan on the prevalence-pattern of CA. The purpose of this study was to determine the prevalence-pattern and genetic attributes of CA at a tertiary care facility in Rawalpindi, Pakistan.

Methods: In a cross-sectional study design, patients with CA were ascertained from Pediatric and Neonatal Section of Holy Family Hospital, Rawalpindi from March-2022 to June-2022. International Classification of Diseases (ICD-10) and Online Mendelian Inheritance in Man (OMIM) databases were utilized for uniformity in classification. The pattern of CA as well as familial/sporadic nature, syndromic/isolated presentations, and prenatal consanguinity were estimated. Descriptive summaries were generated.

Results: A total of 517 independent cases with certain types of CA were recruited. There were eight major and 70 minor categories. Among the major categories, neurological disorders (39.1%) were predominating followed by neuromuscular disorders (21.1%), limb defects (13.5%), musculoskeletal defects (7.4%), blood disorders (4.3%), orofacial defects (3.9%), metabolic disorders (3.7%), and Others (7.1%). The sporadic cases were in majority (72.5%) compared to familial cases (27.5%). Further, 63% patients had syndromic presentations and there were 37% cases with isolated appearances. A total of 70% cases had parental consanguinity.

Conclusion: The majority of anomalies were of preventable nature and certain healthcare measures including antinatal care and counseling can be adopted to minimize their burden. Additionally, there is an urgent need to raise awareness of the negative consequences of consanguineous marriages, which constitute a significant risk factor in cases with inherited CA.

doi: https://doi.org/10.12669/pjms.39.6.7408

How to cite this: Shaheen F, Humayoon QS, Malik S, Mumtaz S. Clinical and genetic attributes of congenital anomalies ascertained at a tertiary care hospital in Rawalpindi, Pakistan. Pak J Med Sci. 2023;39(6):1673-1679. doi: https://doi.org/10.12669/pjms.39.6.7408

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.