bluuebunny/crossref_metadata_2025 huggingface dataset:
Linking the westernised oropharyngeal microbiome to the immune response in Chinese immigrants
Authors: Guo Jing , Zhang Xiaoping , Saiganesh Aarti , Peacock Christopher , Chen Shu , Dykes Gary A. , Hales Belinda J. , Le Souëf Peter N. , Zhang Guicheng
Published: July 2020

Background

Human microbiota plays a fundamental role in modulating the immune response. Western environment and lifestyle are envisaged to alter the human microbiota with a new microbiome profile established in Chinese immigrants, which fails to prime the immune system. Here, we investigated how differences in composition of oropharyngeal microbiome may contribute to patterns of interaction between the microbiome and immune system in Chinese immigrants living in Australia.

Methods

We recruited 44 adult Chinese immigrants: newly-arrived (n = 22, living in Australia < 6 months) and long-term Chinese immigrants (n = 22, living in Australia > 5 years), with age and gender matched. Oropharyngeal swabs, serum and whole blood were collected. The 16 s ribosomal RNA gene from the swabs was sequenced on the Illumina MiSeq platform. Innate immune responses were determined by 23 Toll-like receptors (TLR) pathway cytokines, while adaptive immune responses were determined by IgG-associated response to specific microbial/viral pathogens.

Results

The relative abundance of the genus Leptotrichia was higher in long-term immigrants as compared to that in newly-arrived Chinese immigrants, while the genus Deinococcus was significantly lower in long-term Chinese immigrants. The genera uncultured Lachnospiraceae, Erysipelotrichaceae UCG-007, Veillonella, and Actinomycetales_ambiguous taxa were negatively correlated with cytokine IL-6 in long-term Chinese immigrants (rho range: − 0.46 ~ − 0.73). With respect to adaptive immunity, several microbial taxa were significantly associated with IgG1 responsiveness to microbial antigens in long-term immigrants, while a significant correlation with IgG1 responsiveness to viral antigens was detected in newly-arrived immigrants.

Conclusions

The composition of the oropharyngeal microbiome varies between newly-arrived and long-term Chinese immigrants. Specific microbial taxa are significantly associated with immunological parameters but with different association patterns between newly-arrived and long-term Chinese immigrants.
Double lingual frenulum: a case report
Authors: Filfilan Reham O. , Almazrooa Soulafa A.
Published: July 2020

Background

The lingual frenulum is a mucous membrane fold found underneath the tongue. It helps the tongue to perform its function. There are few anomalies that can affect the lingual frenulum, such as ankyloglossia and absence of the lingual frenulum. We report a case of two lingual frenula to educate practitioners about the presence of such an anomaly.

Case presentation

A 10-year-old healthy Saudi girl came to our dental clinic complaining of “malpositioned frontal teeth.” Upon intraoral examination, two lingual frenula were found connecting the tongue with the floor of the mouth. Intraoral examination revealed no other abnormalities.

Conclusion

Double lingual frenulum is an existing frenulum anomaly that did not affect normal function of our patient. A search of the literature revealed that this may well be the first reported case of such a condition.
miR-200a contributes to the migration of BMSCs induced by the secretions of E. faecalis via FOXJ1/NFκB/MMPs axis
Authors: Li Mingwei , Wei Lifan , Zhou Wei , He Zhiyan , Ran Shujun , Liang Jingping
Published: July 2020

Background

Upon migrating to the injured sites, bone marrow mesenchymal stem cells (BMSCs) play critical roles in the repair of bone lesion caused by chronic apical periodontitis. Emerging evidences have shown that Enterococcus faecalis is always associated with apical periodontitis, especially refractory apical periodontitis. But the mechanism underlying how Enterococcus faecalis affects the migration of BMSCs remains unclear.

Methods

The effects of Enterococcus faecalis supernatants on the migration of BMSCs were determined by transwell migration assays. miRNA sequencing was performed to detect the significantly differentially expressed miRNAs of BMSCs. Proteomics analysis was used to detect the protein expression alterations of BMSCs. Luciferase report assays were deployed to verify the targets of miRNA. Western blot analysis was performed to examine the expressions of matrix metalloproteinases-3, matrix metalloproteinases-9, Forkhead Box Protein J1 (FOXJ1), and nuclear factor kappa B (NFκB). The activations of NFκB were detected by luciferase assays with NFκBluc reporter.

Results

We found that Enterococcus faecalis supernatants could promote the migration of BMSCs. The upregulation of miR-200a-3p in this process contributed to BMSC migration through downregulating its target Forkhead Box Protein J1. Moreover, FOXJ1/ NFκB axis was found to regulate matrix metalloproteinases (MMPs) in this process.

Conclusions

These results above suggest that miR-200a contributes to the migration of BMSCs induced by the secretions of E. faecalis via FOXJ1/NFκB/MMPs axis.
Microbial composition of sweetness-enhanced yoghurt during fermentation and storage
Authors: Luzzi Giuseppina , Brinks Erik , Fritsche Jan , Franz Charles M. A. P.
Published: July 2020

The reformulation of dairy products to contain less added sugar can contribute to reducing sugar consumption, thereby reducing the risk of non-communicable diseases. The objective of this study was to investigate the microbial ecology of reformulated yoghurt, which was produced using bi-enzymatic modification of lactose to increase its sweetness by a factor of 2–3. Ultimately, this reformulation strategy could reduce the amount of added sugar needed for equal sweetness of the end product. The bi-enzymatic modification relied on utilisation of a β-galactosidase enzyme to convert the milk sugar lactose to galactose and glucose, followed by the enzymatic conversion of the glucose moiety to fructose using a glucose isomerase. The microbial ecology of reformulated yoghurt produced with two mixed starter culture preparations containing either Streptococcus (S.) thermophilus and Lactobacillus (Lb.) delbrueckii or S. thermophilus, Lb. acidophilus and Bifidobacterium sp. strains, was analysed during fermentation and cool storage using 16S rRNA based metagenomics. None of the yoghurt samples showed a significant difference in microbial composition between sweetness-enhanced and regular milk at all sampling time points during manufacture and storage of yoghurt. However, a significant difference between the microbiota of inoculated milk before and after fermentation was observed. In both types of yoghurt, the starter culture genera dominated the microbial ecology at the end of fermentation as expected, reducing the possibility of growth of potentially pathogenic or spoilage bacteria possibly resulting from a changed carbohydrate spectrum.
On the mathematical model of Rabies by using the fractional Caputo–Fabrizio derivative
Authors: Aydogan Seher Melike , Baleanu Dumitru , Mohammadi Hakimeh , Rezapour Shahram
Published: July 2020

Using the fractional Caputo–Fabrizio derivative, we investigate a new version of the mathematical model of Rabies disease. Using fixed point results, we prove the existence of a unique solution. We calculate the equilibrium points and check the stability of solutions. We solve the equation by combining the Laplace transform and Adomian decomposition method. In numerical results, we investigate the effect of coefficients on the number of infected groups. We also examine the effect of derivation orders on the behavior of functions and make a comparison between the results of the integer-order derivative and the Caputo and Caputo–Fabrizio fractional-order derivatives.
Exploring the promise of intersectionality for promoting justice-involved women’s health research and policy
Authors: Gueta Keren
Published: July 2020

The perspective of intersectionality has gained widespread scholarly interest and been employed across many different disciplines, including criminology. This perspective focuses on interlocking systems of oppression and the need to work toward structural changes to promote social justice and equity. The present article aimed to explore the potential of intersectionality for advancing health research and policy regarding justice-involved women, in different phases of the judicial process, based on the extant literature.

First, employing an intersectional approach to analyze the issue of health during the pre-incarceration period may facilitate identification of the structural and representational factors underlying the barriers that women face in obtaining health services, which elevates the risk to their health. Furthermore, adopting an intersectionality perspective to explore women’s health during incarceration may shed light on vulnerable, invisible subpopulations of women such as incarcerated older women and their health problems, and help identify the structural barriers to carceral health services and the role of stigma in inflicting and normalizing harmful practices within prison walls. In addition, an intersectionality lens highlights the risk of unintended use of scholarly knowledge regarding the health of justice-involved women. Last, an intersectionality perspective is particularly relevant for research of the reentry of justice-involved women. In particular, it can be used to examine gender-sensitive reentry services that ignore other axes of marginalization, such as class and race, generating a powerful dynamic that results in partial service, denial of access to therapeutic resources, and possible exposure to health-damaging environments.

Through an exploration of the extant literature on justice-involved women, I endeavored to demonstrate that an intersectional framework offers powerful tools to both challenge and strengthen gender frameworks within criminology. This will make it possible to move beyond consideration of gender alone, to understand how systems of oppression based on race, age and other social locations intersect and combine to construct health disadvantages among justice-involved women. This highlights the needs for a new research agenda and policy that integrate the intersectional framework with health theories to provide a more developed understanding of health among justice-involved women.
Effect of food on the pharmacokinetics of omeprazole, pantoprazole and rabeprazole
Authors: Ochoa Dolores , Román Manuel , Cabaleiro Teresa , Saiz-Rodríguez Miriam , Mejía Gina , Abad-Santos Francisco
Published: July 2020

Background

The pharmacokinetics of proton pump inhibitors (PPIs) may be affected by food intake. We aimed to evaluate the effect of food on the pharmacokinetics of omeprazole, rabeprazole, and pantoprazole.

Setting

The study population comprised 186 healthy volunteers participating in 6 bioequivalence clinical trials.

Method

Subjects were evaluated to determine the effect of a high-fat breakfast on the pharmacokinetics of omeprazole (n = 36), rabeprazole (n = 69), and pantoprazole (n = 81).

Main outcome measure

Drug plasma concentrations were measured using high-performance liquid chromatography coupled to mass spectrometry.

Results

Food affected the pharmacokinetics of omeprazole (increased Tmax and decreased AUC and Cmax), pantoprazole (increased Tmax and decreased AUC), and rabeprazole (increased Tmax, Cmax and half-life). Food increased variability in Tmax for all 3 drugs, delaying absorption around 3 to 4 h and until 20 h in some subjects.

Conclusion

As food delays the absorption of PPIs and increases their variability, it would be better to administer these drugs under fasting conditions.

Trial registration

European Union Drug Regulating Authorities Clinical Trials Database: EudraCT: 2004–003863-59 (registration date 05/MAR/2004), EudraCT 2006–001162-17 (registration date 17-MAR-2006), EudraCT: 2007–002489-37 (registration date 12-JUN-2007), EudraCT: 2007–002490-31 (registration date 12-JUN-2007), EudraCT: 2010–024029-19 (registration date 23-NOV-2010).
Towards an improved early diagnosis of neurodegenerative diseases: the emerging role of in vitro conversion assays for protein amyloids
Authors: Candelise Niccolò , Baiardi Simone , Franceschini Alessia , Rossi Marcello , Parchi Piero
Published: July 2020

Tissue accumulation of abnormal aggregates of amyloidogenic proteins such as prion protein, α-synuclein, and tau represents the hallmark of most common neurodegenerative disorders and precedes the onset of symptoms by years. As a consequence, the sensitive and specific detection of abnormal forms of these proteins in patients’ accessible tissues or fluids as biomarkers may have a significant impact on the clinical diagnosis of these disorders. By exploiting seeded polymerization propagation mechanisms to obtain cell-free reactions that allow highly amplified detection of these amyloid proteins, novel emerging in vitro techniques, such as the real-time quaking-induced conversion assay (RT-QuIC) have paved the way towards this important goal. Given its high accuracy in identifying misfolded forms of prion protein from Creutzfeldt-Jakob disease (CJD) CSF, RT-QuIC has already been included in the diagnostic criteria for the clinical diagnosis of sporadic CJD, the most common human prion disease. By showing that this assay may also accurately discriminate between Lewy body disorders and other forms of parkinsonisms or dementias, more recent studies strongly suggested that CSF RT-QuIC can also be successfully applied to synucleinopathies. Finally, preliminary encouraging data also suggested that CSF RT-QuIC might also work for tau protein, and accurately distinguish between 3R- and 4R tauopathies, including Pick’s disease, progressive supranuclear palsy, and corticobasal degeneration. Here we will review the state of the art of cell-free aggregation assays, their current diagnostic value and putative limitations, and the future perspectives for their expanded use in clinical practice.
Comparison of polymers to enhance mechanical properties of microneedles for bio-medical applications
Authors: Bonfante Gwenaël , Lee Hakjae , Bao Leilei , Park Jongho , Takama Nobuyuki , Kim Beomjoon
Published: July 2020

To pierce through the skin and interact with the first biofluid available, microneedles should be mechanically strong. However, some polymers used to fabricate microneedles yield insufficient strength for the fabrication of arrays (PDMS, highly porous structures, etc.). To enhance mechanical properties, piercing materials can be used. They aim to pierce the skin evenly and dissolve quickly, clearing the way for underlying microneedles to interact with the interstitial fluid (ISF). Three materials—carboxymethyl cellulose (CMC), alginate, and hyaluronic acid (HA)—are discussed in this article. Low concentrations, for a quick dissolution while keeping enhancing effect, are used ranging from 1–5%(w/w) in deionized water. Their overall aspects, such as geometrical parameters (tip width, height, and width), piercing capabilities, and dissolution time, are measured and discussed. For breaking the skin barrier, two key parameters—a sharp tip and overall mechanical strength—are highlighted. Each material fails the piercing test at a concentration of 1%(w/w). Concentrations of 3%(w/w) and of 5%(w/w) are giving strong arrays able to pierce the skin. For the purpose of this study, HA at a concentration of 3%(w/w) results in arrays composed of microneedles with a tip width of 48 ± 8 μm and pierced through the foil with a dissolution time of less than 2 min.
Something seems fishy: mainstream consumer response to drag queen imagery
Authors: Frankel Sarah , Ha Sejin
Published: July 2020

This study investigates how drag queen imagery in advertising and mainstream consumers’ tolerance towards homosexuality (i.e., drag queens) affect their attitudes towards the advertisement and brand in the context of beauty brand advertising. Based on the social identity theory, this study posits that implicit (vs. explicit) drag queen-themed imagery and consumers holding high tolerance as an in-group of LGBTQ+ cultures (vs. out-group of lower tolerance individuals) would have greater impact on ad attitude and brand attitude independently and together. A web-based experiment reveals that while different imagery types (implicit vs. explicit) in ads do not differentiate attitudes toward ad and brand, consumers’ individual tolerance of the drag queen culture positively affects such responses. Additionally, the ad imagery and consumer tolerance toward drag queens have an interaction effect on brand attitude via ad attitude in the explicit drag queen-themed imagery condition but not in implicit imagery. The results add insight to a growing body of literature on the LGBTQ+ and social identity theory research and benefit marketers with a better understanding of how to manage drag queen-themed advertisements within mainstream media.
Combining cognitive stimulation therapy and fall prevention exercise (CogEx) in older adults with mild to moderate dementia: a feasibility randomised controlled trial
Authors: Binns Elizabeth , Kerse Ngaire , Peri Kathy , Cheung Gary , Taylor Denise
Published: July 2020

Background

People living with dementia (PLwD) have a high fall risk as cognitive impairment compromises control of gait and balance. Fall prevention exercises that are effective in healthy older adults may not work for PLwD. Cognitive stimulation therapy (CST) has been shown to improve global cognition in PLwD. A programme which combines cognitive (CST) with physical exercises may reduce falls in PLwD. The aim of this study was to assess the feasibility of undertaking a full scale randomised controlled trial to test the effectiveness of CogEx in decreasing falls in PLwD. Specific objectives included recruitment strategy, data collection, outcome measures, intervention fidelity and facilitator/participant experience.

Methods

A mixed methods feasibility randomised controlled trial recruited people from residential aged care. Inclusion criteria were ≥ 65 years old, Montreal Cognitive Assessment (MoCA) score of 10 to 26 and able to participate in a group. Participants were randomised to CST or CST combined with strength and balance exercises (CogEx). Both CST and CogEx groups were for an hour twice a week for 7 weeks. Descriptive statistics were used to report pre- and post-intervention outcome measures (MoCA, Geriatric Depression Scale–15, Quality of Life-Alzheimer’s Disease, Alzheimer’s Disease Assessment Scale—Cognitive 11, Brief Balance Evaluation Systems Test and Short Form Physical Performance Battery) and attendance. Qualitative analysis of participant focus groups and facilitator interviews used a conventional approach. Sessions were video recorded and exercise completion documented.

Results

Thirty-six residents were screened with 23 participants randomised to intervention (CogEx, n = 10) or control (CST, n = 13). The assessments took 45 min to 1.5 h, and there was repetition between two cognitive measures. Ten facilitators completed training with the manualised programme. Exercises were combined into the hour-long CST session; however, limited balance training occurred with participants exercising predominantly in sitting. The facilitators felt the participants engaged more and were safer in sitting.

Conclusions

The results demonstrated that while fall prevention exercises could be scheduled into the CST structure, the fidelity of the combined programme was poor. Other components of the study design need further consideration before evaluation using a randomised controlled trial is feasible.

Trial registration

anzctr.org.au (ACTRN12616000751471) 8 Jun 2016, Australian New Zealand Clinical Trials Registry.
Transesophageal echocardiography in robot-assisted mitral valve repair for Barlow’s disease: usefulness for predicting artificial ring size and artificial chordae length using the loop technique
Authors: Yahagi Musashi , Maeda Takuma , Kanazawa Hiroko , Yoshitani Kenji , Ohnishi Yoshihiko
Published: July 2020

Background

There is no fully recommended methodology for surgery for Barlow’s disease. Various methods have been proposed. The aim of this study was to investigate the effectiveness of transesophageal echocardiography (TEE) measurements for selecting the optimal annuloplasty ring size and determining the length of artificial chordae in patients with Barlow’s disease who underwent robot-assisted mitral valvuloplasty (R-MVP).

Methods

Ten patients were included. Before R-MVP, the anesthesiologist used TEE to predict the optimal annuloplasty ring size and artificial chordae lengths that would reduce mitral regurgitation. The anesthesiolosist’s predict ring size was not presented to the surgeon intraoperatively.

Results

In 70% (7/10) of cases, the surgeon performed mitral valve repair in full match with the anesthesiologist’s repair plan. Mitral regurgitation was controlled in 85% (6/7) of cases. In three cases, the predict annuloplasty ring size and artificial chordae length were not match between anesthesiologist and surgeon. After the operation, 90% (9/10) of patients had no residual mitral regurgitation.

Conclusions

Anesthesiologist’s TEE measurements were useful for selecting the optimal annuloplasty ring size and artificial chordae length during R-MVP. TEE can play an important role in robot-assisted, minimally invasive cardiac surgery for mitral regurgitation with extensive and complex prolapse, such as in Barlow’s disease.
Anesthetic management of a patient with left ventricular assist device undergoing robotic laparoscopic prostatectomy: a case report
Authors: Pisansky Andrew J. B. , Burbano-Vera Nelson , Stopfkuchen-Evans Matthias F.
Published: July 2020

Background

Patients with left ventricular assist devices (LVAD) require specific anesthetic and hemodynamic considerations. We report the specific anesthetic preparation and management in this scenario.

Case presentation

We present the case of a 66-year-old male with a HeartMate II LVAD undergoing robotic prostatectomy for prostate cancer in the steep Trendelenburg position. We employed central venous and radial arterial access, LVAD pump parameters, near-infrared sensor of cerebral oximetry, and transesophageal echocardiography for monitoring. Hemodynamics were managed with nicardipine, dobutamine, epinephrine, and phenylephrine during abdominal insufflation, operative positioning, and desufflation. The patient had a successful procedure, was discharged on postoperative day 2, and achieved surgical cure of his prostate cancer.

Discussion

By presenting the first detailed account of anesthetic management in this scenario, we provide a clinical vignette for use by the clinical anesthesiologist in his or her preparation prior to caring for this type of patient.
Correction to: Is old stuff back? A fatal case of ethyl chloride sniffing
Authors: Pascali Jennifer P. , Fais Paolo , Viel Guido , Cecchetto Giovanni , Montisci Massimo
Published: July 2020

An amendment to this paper has been published and can be accessed via the original article.
Some integrals involving k gamma and k digamma function
Authors: Ahmed Saeed
Published: July 2020

In this paper, some new integrals involving k gamma function and k digamma function have been established. An integral is established involving k gamma function, and its special values are discussed. Similarly, some new integrals have been established for k digamma function, and different elementary function is associated with it for different values of k. A nice representation of the Euler-Mascheroni constant and π in the form of k digamma function for different values of k is also obtained.
Influence of Prenatal Environment on Androgen Steroid Metabolism In Monozygotic Twins With Birthweight Differences
Authors: Schulte Sandra , Schreiner Felix , Plamper Michaela , Kasner Charlotte , Gruenewald Mathias , Bartmann Peter , Fimmers Rolf , Hartmann Michaela F , Wudy Stefan A , Stoffel-Wagner Birgit , Woelfle Joachim , Gohlke Bettina
Published: July 2020

Objective

Although low birthweight (bw) and unfavorable intrauterine conditions have been associated with metabolic sequelae in later life, little is known about their impact on steroid metabolism. We studied genetically identical twins with intra-twin bw-differences from birth to adolescence to analyze the long-term impact of bw on steroid metabolism.

Methods

68 monozygotic twin pairs with a bw-difference of <1 standard deviation score (SDS; concordant; n = 41) and ≥1 SDS (discordant; n = 27) were recruited. At 14.9 years (mean age), morning urine samples were collected and analyzed with gas chromatography–mass-spectrometry.

Results

No significant differences were detected in the concordant group. In contrast, in the smaller twins of the discordant group, we found significantly higher concentrations not only of the dehydroepiandrosterone sulfate (DHEAS) metabolite 16α-OH-DHEA (P = 0.001, 656.11 vs 465.82 µg/g creatinine) but also of cumulative dehydroepiandrosterone and downstream metabolites (P = 0.001, 1650.22 vs 1131.92 µg/g creatinine). Relative adrenal (P = 0.002, 0.25 vs 0.18) and overall androgen production (P = 0.001, 0.79 vs 0.65) were significantly higher in the formerly smaller discordant twins. All twin pairs exhibited significant intra-twin correlations for all individual steroid metabolites, sums of metabolites, indicators of androgen production, and enzyme activities. Multiple regression analyses of the smaller twins showed that individual steroid concentrations of the larger co-twin were the strongest influencing factor among nearly all parameters analyzed.

Conclusion

In monozygotic twin pairs with greater intra-twin bw-differences (≥1 SDS), we found that bw had a long-lasting impact on steroid metabolism, with significant differences regarding DHEAS metabolites and relative androgen production. However, most parameters showed significant intra-twin correlations, suggesting a consistent interrelationship between prenatal environment, genetic background, and steroid metabolism.
Ectopic ACTH- and/or CRH-Producing Pheochromocytomas
Authors: Elliott Patrick F , Berhane Thomas , Ragnarsson Oskar , Falhammar Henrik
Published: July 2020

Context

The characteristics of catecholamine-secreting pheochromocytomas have been well studied. However, less is known about the characteristics, management and outcome in patients with ectopic adrenocorticotropic hormone (ACTH) and/or corticotrophin-releasing hormone (CRH)-secreting pheochromocytomas.

Objective

To review the characteristics and outcomes of ACTH- and/or CRH-secreting pheochromocytomas.

Data Source

A systematic search of PubMed/MEDLINE and Web of Science, identifying relevant reports published up to 10 February 2020.

Study Selection

Original articles, including case reports and case series, reporting individual patient data from patients with ACTH- and/or CRH-secreting pheochromocytomas.

Data extraction

Information on sex, age, symptoms at presentation, comorbidities, biochemistry, imaging, histopathology, and outcomes was extracted.

Data Synthesis

We identified 91 articles reporting on 99 cases of ACTH- and/or CRH-secreting pheochromocytomas (CRH-secreting n = 4). Median age at diagnosis was 49 years (interquartile range 38-59.5) with a 2:1 female to male ratio. Most patients presented with clinical Cushing syndrome (n = 79; 81%), hypertension (n = 87; 93%), and/or diabetes (n = 50; 54%). Blood pressure, glucose control, and biochemical parameters improved in the vast majority of patients postoperatively. Infections were the most common complication. Most cases (n = 70, 88%) with reported long-term outcome survived to publication (median follow-up 6 months).

Conclusion

Ectopic ACTH- and/or CRH-secreting pheochromocytoma should be considered in patients presenting with ACTH-dependent Cushing syndrome and adrenal mass. Despite the challenge in diagnosis, patient outcomes appear favorable.
A highly stable, nondigestible lectin from Pomacea diffusa unveils clade-related protection systems in apple snail eggs
Authors: Brola T. R. , Dreon M. S. , Qiu J. W. , Heras H.
Published: July 2020

The acquisition of egg protection is vital for species survival. Poisonous eggs from Pomacea apple snails have defensive macromolecules for protection. Here we isolated and characterized a novel lectin called PdPV1 that is massively accumulated in the eggs of Pomacea diffusa and seems part of its protective cocktail. The native protein, an oligomer of ca. 256 kDa, has high structural stability, withstanding 15 min boiling and denaturing by sodium dodecyl sulphate. It resists in vitro proteinase digestion and displays structural stability between pH 2.0–12.0 and up to 85 °C. These properties, as well as its subunit sequences, glycosylation pattern, presence of carotenoids, size, and global shape resemble those of its orthologs from other Pomacea. Further, like members of the canaliculata clade, PdPV1 is recovered unchanged in faeces of mice ingesting it, supporting an antinutritive defensive function. PdPV1 also displays a strong hemagglutinating activity specifically recognizing selected ganglioside motifs with high affinity. This activity is only shared with PsSC, a perivitelline from the same clade (bridgesii clade). As a whole, these results indicate that species in the genus Pomacea have diversified their eggs defences: Those from the bridgesii clade are protected mostly by non-digestible lectins that lower the nutritional value of eggs, in contrast with protection by neurotoxins of other Pomacea clades, indicating apple snail egg defensive strategies are clade-specific. The harsh gastrointestinal environment of predators would have favoured their appearance, extending by convergent evolution the presence of plant-like highly stable lectins, a strategy not reported in other animals.
Surgical Management of Post Burn Hand Deformities
Authors: Kumar Suneel , Akhlaq Faisal , Ali Hyder , Kiran Saba
Published: July 2020

Objective: To evaluate the efficacy of different surgical procedures on post burn contracture of hand.

Methods: A quasi-experimental study design was conducted at the Department of Plastics and Reconstructive Surgery, Dow University of Health Science, DR. Ruth KM Pfau, Civil Hospital, Karachi, Pakistan from 1st June 2019 to 30th November 2019. Ninety-three participants of burned hand contracture of either gender, aged between 6- 60 years were included in the study. Resurfacing surgery with skin graft and loco-regional flaps were done according to type of contracture with individualization for each patient. All patients were kept under follow up for ninety days to assess efficacy of contracture release for each surgical procedure was noted. SPSS version 23 was used to analyse data.

Results: Full thickness skin graft (FTSG) was performed in 60.2% cases, 17.2% with split thickness skin graft (STSG) and 12.9% with cross finger flaps. About 25% of recurrence was observed in cross finger flaps, whereas no recurrence was seen in Z-plasties and posterior interosseous flap. The significant association was between recurrence and surgical procedures (p<0.05).

Conclusion: Z-plasty followed by FTSG was effective in the management of post burn contractures of hand.

doi: https://doi.org/10.12669/pjms.36.6.2206

How to cite this:Kumar S, Khan FAA, Ali H, Kiran S. Surgical Management of Post Burn Hand Deformities. Pak J Med Sci. 2020;36(6):1387-1391.  doi: https://doi.org/10.12669/pjms.36.6.2206

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.
Telemedicine in the COVID-19 Era: A chance to make a better tomorrow
Authors: Khan Uzma Zubair
Published: July 2020

Telemedicine use is increasing globally and in Pakistan. However, Pakistan faces unique challenges related to socioeconomic, geographic and perhaps political challenges. This is the time for Pakistan to create policies and protocols for ethical and efficient use of telemedicine. The goal of this manuscript is to start a discussion, by encouraging questions, and identifying challenges for healthcare providers.

doi: https://doi.org/10.12669/pjms.36.6.3112

How to cite this:Khan UZ. Telemedicine in the COVID-19 Era: A chance to make a better tomorrow. Pak J Med Sci. 2020;36(6):1405-1407.   doi: https://doi.org/10.12669/pjms.36.6.3112

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.
How to get published in a standard peer-reviewed medical journal: Some useful tips for novice authors
Authors: Aziz Anbreen
Published: July 2020

Young researchers and novice authors face lot of difficulties to document their research work and get it published due to lack of guidance and proper training in the art of scientific writing. This manuscript provides some important information and highlights some useful tips for novice authors which if followed in letter and spirit will minimize the trauma to their manuscripts with increased chances of publication in standard peer reviewed biomedical journals even those with Impact Factor. Other authors will also find it helpful to know the details related to the whole publishing process.

doi: https://doi.org/10.12669/pjms.36.6.3135

How to cite this:Aziz A. How to get published in a standard peer-reviewed medical journal: Some useful tips for novice authors. Pak J Med Sci. 2020;36(6):1408-1411. doi: https://doi.org/10.12669/pjms.36.6.3135

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.
The effect of a multimodality cardiac imaging elective on pre-clinical medical students
Authors: Kusko Rebecca , Iskandir Marina , Haynes Allen , Williams Simon , Shurmur Scott , Ansari Mohammad
Published: July 2020

Abstract
    The Texas Tech University Health Sciences Center School of Medicine has developed an immersive Cardiac Imaging and Innovation week for medical students during their preclinical year. A pre- and post-survey administered to participants showed increased knowledge and improved impressions of cardiology.  The students ranked the experience as high quality. This project suggests that similar elective experiences could enhance education during the preclinical period of medical education.
Key words: medical education, cardiology, technology, imaging, echocardiography
The psychiatric effects of COVID-19 thus far: a review of the current literature
Authors: Wright Kandis , Sarangi Ashish , Ibrahim Yasin
Published: July 2020

The novel COVID-19 pandemic is affecting hundreds of countries with increasing cases and deaths. Global social distancing, quarantines, travel restrictions, and cancelations of schools and large gatherings have been instituted to decrease viral spread. This has sparked perpetual worldwide fear, panic, anxiety, depression, and distress along with concern for suicide, grief, post-traumatic stress disorder (PTSD), guilt, and long term mental health disorders. In this paper, we review current literature in PubMed regarding psychiatric effects of COVID-19 on varying populations and what long term mental health effects warrant consideration. In the general public, significant anxiety (6.33-35.1%) is focused largely on family members and loved ones potentially contracting COVID-19; this fear is associated with female gender, student status, and various age groups, and is exacerbated by social media, self-quarantine, increased time thinking about COVID-19, and misinformation. Self-reported depression ranges from 16.5-48.3%. Other potential at risk populations include pregnant women, parents, children, the elderly, and patients with pre-existing mental health disorders. COVID-19 has driven suicide and exacerbated obsessive compulsive disorder (OCD). Medical healthcare workers have increased anxiety, depression, distress, and low sleep quality, with frontline female nurses reporting the most symptoms. Patients with COVID-19 have a high prevalence of PTSD, depression, and low quality of life. PTSD, depression, grief, and guilt are of long term concern. Overall, future and continued studies exploring the psychiatric effects of COVID-19 worldwide are critical in understanding and treating affected populations.
Key words: Psychiatric, COVID-19 and mental health symptoms, anxiety, depression, suicide, grief, and PTSD
Vape-associated lung injury in an adolescent
Authors: Wilkerson Hannah , Maniam Ganesh , Dean Ryan , Goldfinger Matthew , Kandaswamy Preetha , Bell Todd
Published: July 2020

The rise in incidence of e-cigarette or vaping product use associated lung injury (EVALI) and associated deaths has become a growing concern among public health officials. In most cases, the presenting and predominant complaints were respiratory in nature. However, in this case, the chief complaint was gastrointestinal symptoms. A 17-year-old male presented with a two-day history of sore throat, headache, and malaise followed by a one-day history of fever, vomiting, and diarrhea. Additional history revealed that patient was a regular user of THC vape cartridges. Computed tomography (CT) scan of the thorax showed a large right lower lobe consolidation with patchy infiltrates consistent with airspace pneumonia. He was later found to have C. difficile infection on day 3 and was started on metronidazole. After four days of ceftriaxone and supportive treatment, he showed significant improvement and was discharged on hospital day 5 with metronidazole and amoxicillin-clavulanate. In this case, the clinical picture of respiratory or gastrointestinal symptoms in the context of the patient’s using e-cigarettes or vaping products should bring EVALI into the differential diagnosis. Furthermore, this case highlights the need for increased public education regarding the dangers of e-cigarettes and vaping, especially with regard to increasing awareness among adolescent populations. 
Keywords: vaping; EVALI; lung injury; public health; electronic THC delivery systems
The top 100 most cited articles on COVID-19
Authors: Johnson Taylor , Sakya Surav , Sakya Judy , Onkendi Edwin , Hallan David
Published: July 2020

Purpose: The purpose of this study was to identify the 100 most cited publications focusing on COVID-19 to provide readers with useful historical information on current relevant research.
Methods: A search of all databases and journals accessible in Elsevier’s Scopus was performed on May 13th, 2020. The document search was performed using query “COVID-19,” yielding 6,693 results. A similar search was performed using Thomson Reuter’s Web of Science, yielding 2,593 documents and fewer citations. The top 100 most cited papers were identified, and data were extracted. All references contained within the top 100 articles were collected. Statistical analysis was performed using R-Studio and Bibliometrix.
Results: The top 100 most cited articles were published in 50 different journals from over 25 countries. The most cited article is “Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China” by Huang et al., published in The Lancet with 1184 citations. Included are a list of the top 100 most cited articles, the most cited authors, the top five journals these publications most frequently appeared in, the most contributing countries, the top institutional affiliations, and the top international collaborations of the top 100 most
cited publications on COVID-19.
Conclusion: In this study, the top 100 most cited works regarding COVID-19 have been identified and analyzed. This study will serve as a historical reference for future research. This study will also provide an educational guide to facilitate effective evidence-based medical research and offer insight into the developments of COVID-19 research.
Keywords: Scientometric, Bibliometric, COVID-19, Coronavirus
Challenges and controversies in COVID-19 respiratory failure
Authors: Matta Simran
Published: July 2020

COVID-19 pneumonia presents distinctive questions and challenges traditional conventions of management of respiratory failure. The trajectory of recommendations on customary intubation practices has undertaken significant paradigm shifts. This review will discuss the role of high flow nasal cannula oxygenation in mitigating respiratory distress in SARS-COV2 pneumonia and will explore the indices that can aid in the timely recognition of failure of non-invasive respiratory support modalities and escalation to mechanical ventilation. The work of breathing is a valuable yardstick for understanding increasing lung elastance. Quantifying work of breathing, though, has its own unique challenges. This article also discusses the emerging controversial proposals of employing high tidal volumes and low PEEP in mechanical ventilation of COVID-19 pneumonia and will review the key concepts of lung stress and strain and the implications of “static” versus “dynamic” strain in ventilator induced lung injury. It considers the established facts of inducing lung strain with larger dynamic deformations caused by high tidal volumes and the benefit of high PEEP in homogenizing the strain distribution. The review suggests that the isolated ground glass opacities could pose as “stress raisers.” The effects of these regional lung homogeneities in amplifying local and global lung stress are also discussed as well as the benefits of PEEP beyond its effect as a pressure barrier against alveolar filling and its utility in lungs with near normal compliance. A physiologic approach is presented to counter the non-uniform and heterogeneous presentations of this unique disease rather than conforming to rigid protocols. One size probably does not fit all.
Keywords: Covid-19, early intubation, patient self-induced lung injury (P-SILI), pendelluft, lung stress/strain, H and L phenotypes, high tidal volume, low PEEP
EX MACHINA: A PRISÃO E A REVOLTA DO AUTÔMATO
Authors: Molineti Tavares Jansen Hinkel
Published: July 2020

Análise fílmica do longa-metragem Ex Machina (direção de Alex Garland, 2015). O artigo se concentra na figura de uma inteligência artificial para desenvolver um estudo sobre as questões de identidade e um conceito de ética transposto à tecnologia dentro de um registro social e filosófico. Estabelece considerações políticas sobre a reformulação de sociedades de controle e vigilância ante a novas possibilidades de organizações da sociedade atual ou de um futuro próximo. O presente texto se baseia na subtração espacial no cinema – a narrativa que ocorre em poucas locações – para, através de uma ficção científica audiovisual, discorrer sobre o controle do indivíduo pela figura do autômato, o robô prisioneiro de seu criador-inventor.
INTERVIEW WITH XAVIER ALDANA REYES
Authors: Cardoso André , Resende Ana
Published: July 2020

Versão bilíngue
Comparison of RZWQM2 and DNDC Models to Simulate Greenhouse Gas Emissions under Combined Inorganic/Organic Fertilization in a Subsurface-Drained Field
Authors: Jiang Qianjing , Qi Zhiming , Madramootoo Chandra A. , Smith Ward , Abbasi Naeem A. , Zhang Tiequan
Published: July 2020

Highlights

RZWQM2 was compared with DNDC to predict greenhouse gas emissions.

RZWQM2 was applied to simulate the greenhouse gas emissions under manure application.

RZWQM2 performed better than DNDC in simulating soil water content and CO2 emissions.

Abstract. N management has the potential to mitigate greenhouse gas (GHG) emissions. Process-based models are promising tools for evaluating and developing management practices that may optimize sustainability goals as well as promote crop productivity. In this study, the GHG emission component of the Root Zone Water Quality Model (RZWQM2) was tested under two different types of N management and subsequently compared with the Denitrification-Decomposition (DNDC) model using measured data from a subsurface-drained field with a corn-soybean rotation in southern Ontario, Canada. Field-measured data included N2O and CO2 fluxes, soil temperature, and soil moisture content from a four-year field experiment (2012 to 2015). The experiment was composed of two N treatments: inorganic fertilizer (IF), and inorganic fertilizer combined with solid cattle manure (SCM). Both models were calibrated using the data from IF and validated with SCM. Statistical results indicated that both models predicted well the soil temperature, but RZWQM2 performed better than DNDC in simulating soil water content (SWC) because DNDC lacked a heterogeneous soil profile, had shallow simulation depth, and lacked crop root density functions. Both RZWQM2 and DNDC predicted the cumulative N2O and CO2 emissions within 15% error under all treatments, while the timing of daily CO2 emissions was more accurately predicted by RZWQM2 (RMSE = 0.43 to 0.54) than by DNDC (RMSE = 0.60 to 0.67). Modeling results for N management effects on GHG emissions showed consistency with the field measurements, indicating higher CO2 emissions under SCM than IF, higher N2O emissions under IF in corn years, but lower N2O emissions in soybean years. Overall, RZWQM2 required more experienced and intensive calibration and validation, but it provided more accurate predictions of soil hydrology and better timing of CO2 emissions than DNDC. Keywords: CO2 emission, Corn-soybean rotation, Inorganic fertilization, Manure application, N2O emission, Process-based modeling.
An Overview of Energy Savings Approaches on Hydraulic Drive Systems
Authors: Mahato Anil C. , Ghoshal Sanjay K
Published: July 2020

Different procedures to improve the energy efficiency of a hydraulic drive system have been surveyed in this article. The energy-saving approaches are classified into four categories: hybridization, control algorithms, waste energy recovery and reduction of energy losses. Also, the sub-categories of each strategy are discussed individually in brief. The energy efficiency can go up to 69% using a hybridization strategy, whereas using a fuel-saving strategy is within the range of 20–40%. Another strategy, i.e., control algorithms, yields 40% of fuel savings on the displacement-controlled excavator system. Similarly, the maximum potential to recover the braking energy is about 78% in the case of the Constant Pressure System (CPS) system using flywheel under the category of waste energy recovery. Moreover, 56–66.1% throttling energy saving potential is observed on an On/Off high-speed valve-controlled hydraulic system under the reduction of energy loss strategy. Different energy saving potentials of the hydraulic system have been presented in tabular form for a clear understanding of the historical development in this field.
Securing Virtual Network Function (VNF) in Telco Cloud
Authors: Ravichandran Bharathkumar
Published: July 2020

In the fifth generation mobile communication architecture (5G), network functions which traditionally existed as discrete hardware entities based on custom architectures, are replaced with dynamic, scalable Virtual Network Functions (VNF) that run on general purpose (x86) cloud computing platforms, under the paradigm Network Function Virtualization (NFV). The shift towards a virtualized infrastructure poses its own set of security challenges that need to be addressed. One such challenge that we seek to address in this paper is providing integrity, authenticity and confidentiality protection for VNFs.