bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of post-operative pancreatic fistulas following Longmire–Traverso pylorus-preserving pancreatoduodenectomy by endoscopic vacuum-assisted closure therapy
Authors: Kaczmarek Dominik J. , Heling Dominik J. , Gonzalez-Carmona Maria A. , Strassburg Christian P. , Branchi Vittorio , Matthaei Hanno , Kalff Jörg , Manekeller Steffen , Glowka Tim R. , Weismüller Tobias J.
Published: November 2021

Background

Pylorus-preserving pancreatoduodenectomy (PPPD) with pancreatogastrostomy is a standard surgical procedure for pancreatic head tumors, duodenal tumors and distal cholangiocarcinomas. Post-operative pancreatic fistulas (POPF) are a major complication causing relevant morbidity and mortality. Endoscopic vacuum therapy (EVT) has become a widely used method for the treatment of intestinal perforations and leakages. Here we report on a pilot single center series of 8 POPF cases specifically caused by dehiscences of the pancreatogastric anastomosis (PGD), successfully managed by EVT.

Methods

We included all patients with PGD after PPPD, who were treated with EVT between 07/2017 and 08/2020. For EVT a vacuum drainage film (EVT film) or open-pore polyurethane foam sponge (EVT sponge) was fixed to a 14Fr or 16Fr suction catheter and placed endoscopically within the PGD for intracavitary EVT with continuous suction between − 100 and − 150 mmHg. The EVT film/sponge was exchanged twice per week. EVT was discontinued when the PGD was sufficiently healed.

Results

PGD closure was achieved in 7 of 8 patients after a mean EVT time of 16 days (range 8–38) and 3 EVT film/sponge exchanges (range 1–9). One patient died on day 18 after PPPD from acute hemorrhagic shock, unlikely related to EVT, before effectiveness of EVT could be fully achieved. There were no adverse events directly attributable to EVT.

Conclusions

EVT could be an effective and safe addition to our therapeutic armamentarium in the management of POPF with PGD. Unless prospective comparative studies are available, EVT as minimally invasive therapeutic alternative should be considered individually by an interdisciplinary team involving endoscopists, surgeons and radiologists.
Association between teeth loss and nasogastric tube feeding dependency in older adults from Taiwan: a retrospective cohort study
Authors: Wang Chun-Chieh , Chen Yu-Yen , Hung Kuo-Chuan , Wu Shang-Jung , Yen Yung-Feng , Chen Chu-Chieh , Lai Yun-Ju
Published: November 2021

Background

To examine the association between teeth loss and nasogastric tube feeding dependency in older people.

Methods

The National Health Interview Survey (NHIS) 2005, 2009, and 2013 in Taiwan. Participants were selected by a multistage stratified sampling method and baseline characteristics, including socioeconomic status and health habits, were obtained by well-trained interviewers. The NHIS was linked with the National Health Insurance research database 2000–2016 and the National Deaths Dataset, which contains all the medical information of ambulatory and inpatient care. Cox regression was used to examine the association between the number of teeth lost and nasogastric tube feeding dependency.

Results

There were 6165 adults older than 65 years old enrolled in the analysis, with 2959 male (48%) and the mean (SD) age was 73.95(6.46) years old. The mean follow-up duration was 6.5(3.3) years. Regarding the teeth loss categories, 1660 (26.93%), 2123 (34.44%), and 2382 (38.64%) of participants were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. During 39,962 person-years of follow-up, new-onset nasogastric feeding dependency was recognized in 220(13.25%), 256(12.06%), and 461(19.35%) participants who were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. Kaplan-Meier curves demonstrated significant findings (Log-rank P < 0.01). After potential confounders were adjusted, compared with those without teeth loss, older adults who had lost 10–28 teeth had significantly increased risks of occurrence nasogastric feeding dependency (AHR, 1.31; 95% CI, 1.05–1.62; p-value = 0.02). Furthermore, a significant dose-response relation between the number of teeth lost and increased risk of nasogastric feeding was found (p for trend< 0.01).

Conclusions

Older adults who had lost 10–28 teeth had a significantly increased risk of nasogastric tube feeding dependency. Early identification of the oral disease is crucial for the prevention of the occurrence of teeth loss and the following nutrition problems, which would reduce risk of nasogastric tube feeding dependency.
Facilitating Perinatal Access to Resources and Support (PeARS): a feasibility study with external pilot of a novel intervention
Authors: Slade Pauline , Dembinsky Melanie , Bristow Katie , Garthwaite Kim , Mahdi Amy , James Annette , Rahman Atif , Downe Soo
Published: November 2021

Background

Up to 50% of women in areas of high socio-economic deprivation are at risk of developing depressive symptoms in pregnancy. Feeling well supported, can facilitate good mental health perinatally. A brief, innovative intervention to facilitate access to support and resources was developed and tested. This included one antenatal and one postnatal session, each with three evidence-based components: i) support from a non-professional peer to enable a woman to identify her needs; ii) information about local community services and signposting; and iii) development of a personalised If–Then plan to access that support. The aims were to evaluate the intervention and research methods for feasibility and acceptability for perinatal women, maternity care providers and peers, and provide preliminary effectiveness indications.

Methods

Pregnant women living in an area of high deprivation were recruited from community-based antenatal clinics and randomised to intervention or control condition (a booklet about local resources). Outcome measures included women’s use of community services by 34 + weeks gestation and 6 months postnatally; mental health and wellbeing measures, and plan implementation. Interviews and focus groups were conducted with women participants, providers, and peers. Data were analysed using framework analysis. Recruitment and retention of peers and participants, intervention fidelity, and acceptability of outcome measures were recorded.

Results

Peer facilitators could be recruited, trained, retained and provide the intervention with fidelity. One hundred twenty six women were recruited and randomised, 85% lived in the 1% most deprived UK areas. Recruitment constituted 39% of those eligible, improving to 54% after midwifery liaison. Sixty five percent were retained at 6 months postnatally. Women welcomed the intervention, and found it helpful to plan access to community services. Providers strongly supported the intervention philosophy and integrated this easily into services. The study was not powered to detect significant group differences but there were positive trends in community service use, particularly postnatally. No differences were evident in mental health and wellbeing.

Conclusions

This intervention was well received and easily integrated into existing services. Women living in highly deprived areas could be recruited, randomised and retained. Measures were acceptable. Peer facilitators were successfully trained and retained. Full effectiveness studies are warranted.
Women's experiences of VBAC in Cyprus: a qualitative study
Authors: Hadjigeorgiou Eleni , Katsie Constantina , Papadopoulou Maria , Christofi Maria Dolores , Christoforou Andri
Published: November 2021

Background and aim

In 21st century, there has been an increasing interest in vaginal birth after previous caesarean section (VBAC) in Cyprus, a country with a very high operative birth rate. Research-based evidence of women’s VBAC experiences in Cyprus is non-existent, despite its significance for the well-being of mothers and families. The aim of this study is to gain insight into the women’s lived experience of VBAC in Cyprus. In this study women’s experiences of VBAC are explored for the first time in Cyprus.

Method

The study is qualitative and exploratory in nature. Data were collected through semi-structured interviews with 10 women, who experienced vaginal birth after a previous caesarean section (VBAC) in Cyprus. A descriptive phenomenological approach was employed for the analysis of data.

Results

Analysis of data yielded four major themes: (a) medicalization of childbirth, (b) preparing for a VBAC, (c) birth environment, and (d) healing through VBAC. On the whole, the women interviewed described their previous experience of CS as traumatic, in contrast to vaginal childbirth. VBAC was considered an utterly positive experience that made the women feel empowered and proud of themselves.

Conclusion

This study offers valuable insight into a newly researched subject in Cyprus, which is necessary for advancing perinatal care in Cyprus. The findings indicate that women need evidence-based information, guidelines on birthing options, good preparation with tailored information and personalized care for a successful vaginal birth after a previous caesarean section. Proper, non-biased, consultations are a main factor that affects women’s choice of mode of birth. The introduction of new, women-friendly perinatal strategies that respect and promote childbirth rights is imperative in the case of Cyprus. All women have the right to exercise informed choice and the choice to alternative birthing options.
Telomerase-positive circulating tumor cells are associated with poor prognosis via a neutrophil-mediated inflammatory immune environment in glioma
Authors: Zhang Wen , Qin Tiancheng , Yang Zhenrong , Yin Liyuan , Zhao Changyun , Feng Lin , Lin Song , Liu Binlei , Cheng Shujun , Zhang Kaitai
Published: November 2021

Background

Gliomas are the most common aggressive cancer in the central nervous system. Considering the difficulty in monitoring glioma response and progression, an approach is needed to evaluate the progression or survival of patients with glioma. We propose an application to facilitate clinical detection and treatment monitoring in glioma patients by using telomerase-positive circulating tumor cells (CTCs) and to further evaluate the relationship between the immune microenvironment and CTCs in glioma patients.

Methods

From October 2014 to June 2017, 106 patients newly diagnosed with glioma were enrolled. We used the telomerase reverse transcriptase CTC detection method to detect and analyze the CTC statuses of glioma patients before and after surgery. FlowSight and FISH confirmed the CTCs detected by the telomerase-based method. To verify the correlation between CTCs and the immune response, peripheral white blood cell RNA sequencing was performed.

Results

CTCs were common in the peripheral blood of glioma patients and were not correlated with the pathological classification or grade of patients. The results showed that the presence of postoperative CTCs but not preoperative CTCs in glioma patients was a poor prognostic factor. The level of postoperative CTCs, which predicts a poor prognosis after surgery, may be associated with neutrophils. RNA sequencing suggested that postoperative CTCs were positively correlated with innate immune responses, especially the activation of neutrophils and the generation of neutrophil extracellular traps, but negatively correlated with the cytotoxic response.

Conclusions

Our results showed that telomerase-positive CTCs can predict a poor prognosis of patients with glioma. Our results also showed a correlation between CTCs and the immune macroenvironment, which provides a new perspective for the treatment of glioma.
Efficient hepatic differentiation and regeneration potential under xeno-free conditions using mass-producible amnion-derived mesenchymal stem cells
Authors: Choi Jiwan , Kang Seoon , Kim Bitnara , So Seongjun , Han Jongsuk , Kim Gyeong-Nam , Lee Mi-Young , Roh Seonae , Lee Ji-Yoon , Oh Soo Jin , Sung Young Hoon , Lee Yeonmi , Kim Sung Hoon , Kang Eunju
Published: November 2021

Background

Amnion-derived mesenchymal stem cells (AM-MSCs) are an attractive source of stem cell therapy for patients with irreversible liver disease. However, there are obstacles to their use due to low efficiency and xeno-contamination for hepatic differentiation.

Methods

We established an efficient protocol for differentiating AM-MSCs into hepatic progenitor cells (HPCs) by analyzing transcriptome-sequencing data. Furthermore, to generate the xeno-free conditioned differentiation protocol, we replaced fetal bovine serum (FBS) with polyvinyl alcohol (PVA). We investigated the hepatocyte functions with the expression of mRNA and protein, secretion of albumin, and activity of CYP3A4. Finally, to test the transplantable potential of HPCs, we transferred AM-MSCs along with hepatic progenitors after differentiated days 11, 12, and 13 based on the expression of hepatocyte-related genes and mitochondrial function. Further, we established a mouse model of acute liver failure using a thioacetamide (TAA) and cyclophosphamide monohydrate (CTX) and transplanted AM-HPCs in the mouse model through splenic injection.

Results

We analyzed gene expression from RNA sequencing data in AM-MSCs and detected downregulation of hepatic development-associated genes including GATA6, KIT, AFP, c-MET, FGF2, EGF, and c-JUN, and upregulation of GSK3. Based on this result, we established an efficient hepatic differentiation protocol using the GSK3 inhibitor, CHIR99021. Replacing FBS with PVA resulted in improved differentiation ability, such as upregulation of hepatic maturation markers. The differentiated hepatocyte-like cells (HLCs) not only synthesized and secreted albumin, but also metabolized drugs by the CYP3A4 enzyme. The best time for translation of AM-HPCs was 12 days from the start of differentiation. When the AM-HPCs were transplanted into the liver failure mouse model, they settled in the damaged livers and differentiated into hepatocytes.

Conclusion

This study offers an efficient and xeno-free conditioned hepatic differentiation protocol and shows that AM-HPCs could be used as transplantable therapeutic materials. Thus, we suggest that AM-MSC-derived HPCs are promising cells for treating liver disease.
Evaluation of cerebroprotective effect of Ricinus communis leaves against ischemia reperfusion injury in rats
Authors: Ahmad Nesar , Mishra Anuradha , Ahsan Farogh , Khan Zafar
Published: November 2021

Background

Ricinus communis (RC) has been used for a long time as natural origin medicine in the treatment of central nervous system ailments. This present study was designed to identify the possible role of Ricinus communis leaves extract against ischemia-reperfusion induced-neurobehavioral changes, oxidative stress, histopathological and cellular modifications in the brain.

Methods

Sprague Dawley (SD) rats (200–250 g) were induced to bilateral common carotid artery occlusion (BCCAO) for around 30 min later subjected to reperfusion for 24 h to induce cerebral injury by reperfusion. Ricinus communis leaves extract (250 and 500 mg/kg, p.o) was administered continuously for 14 days and on the 15th-day animals were subjected to ischemia-reperfusion injury. Different behavioral tests and biochemical parameters were assessed subsequently.

Results

Fourteen days Ricinus communis leaves extract (250 and 500 mg/kg, p.o.) treatment very significantly improved neurobehavioral alterations when compared to control ischemia-reperfusion. Ricinus communis leaves extract (250 and 500 mg/kg, p.o.) kg, i.p. treatment significantly attenuated oxidative damage when compared to ischemia-reperfusion (I/R) group animals. In addition, Ricinus communis leaves extract treatment was well supported histopathologically when compared to the ischemia-reperfusion (I/R) group.

Conclusion

The data from this study recommend that treatment with Ricinus communis leaves extract increases the antioxidant protection against BCCAO-induced global cerebral ischemia and demonstrates neuroprotective activity.
Characterization of simulation centers and programs in Latin America according to the ASPIRE and SSH quality criteria
Authors: Armijo-Rivera Soledad , Machuca-Contreras Felipe , Raul Norma , de Oliveira Saionara Nunes , Mendoza Ismael Ballesteros , Miyasato Héctor Shibao , Díaz-Guio Diego Andrés
Published: November 2021

Background

Latin American clinical simulation has had an important development; there are no studies that characterize simulation centers and programs in the entire region. The aims of this work are to characterize the current state of simulation-based education in the health sciences, to determine the structure of Latin American simulation centers in terms of teaching, research, and continuing medical education (CME), as well as to determine the perception of quality based on international standards of simulation practices for the directors of Latin American centers.

Methods

A quantitative, descriptive, cross-sectional study with a demographic questionnaire and a Likert-type survey was conducted to the directors of the simulation centers found in Latin America.

Results

Four hundred eight simulation centers were documented, the survey was answered by 240 directors, and the data from 149 were complete responses on the 42 quality self-perception scale and considered valid on further analyses related to the quality of the programs. Most of the centers that responded correspond to Chile, Brazil, and Mexico (37.5%, 18.1%, 12.7%). 84% of the centers are university-based, and 71% of the centers are medium-sized, with less than 10 instructors (54%). The directors are mostly women (61.7%), medical doctors (50%), and nurses (40%), with clinical specialization (37%), master’s degree (53%), and doctorate (13%). 75% have completed a simulation instructor course, and 6% have developed a fellowship. Most consider the maintenance of international quality standards to be relevant in their centers, mainly in reflective training techniques, ethical aspects, and adequate learning environments.

Conclusions

Simulation-based education in health sciences has had an increasing development in Latin America, within a university environment, in an important academic specialization process that seeks to adhere to high-quality standards to improve training and development of clinical skills, human factors, and critical thinking. We recommend starting accreditation processes in Latin America and studies that measure the quality of simulation-based education in our region, based on objective observations more than in self-reporting.
3D printed customised external cranial plate in a patient with syndrome of trephined: ‘a case report’
Authors: H. Mee , S. Greasley , G. Whiting , C. Harkin , G. Oliver , D. Marsden , R. Andrews , S. Sireau , RD. Price , F. Anwar , IS. Timofeev , PJ. Hutchinson , PA. White , A. Helmy
Published: November 2021

Background

Syndrome of the trephined is a well-recognised phenomenon that occurs in patients following a craniectomy. It is associated with several symptoms, including headaches, motor impairments, cognitive disorders and reduced consciousness. Treatment for the syndrome usually involves replacing the skull defect.

Case Study

A 71-year-old male underwent a left-sided craniectomy after being diagnosed with biopsy-confirmed invasive squamous cell carcinoma with associated skull erosion. Subsequently, he developed a severe case of syndrome of the trephined (SoT,) resulting in having to lie flat to prevent the motor component of the Glasgow Coma Score (GCS) falling from M5/6 (E3/4 Vt M5/6) to M1 (E3/4 Vt M1) on sitting to 30 degrees. Unfortunately, due to ongoing chest sepsis and physical frailty, he was unable to undergo a cranioplasty. Therefore, to aid in clinical stabilisation, the treating physicians and clinical engineering teams designed and manufactured a prosthesis on-site, allowing rapid patient treatment. The prosthesis led to the patient being able to sit up to 30 degrees without the motor component of the GCS falling from M6 to M1 (E4 VT M6).

Conclusion

Clinical improvements were demonstrated with definitive neurological improvement after applying the external cranial plate in clinical outcome measures and radiographically. Furthermore, we have shown that rapid prototyping technology provides a flexible solution to synthesise bespoke medical prostheses with the correct expertise and regulatory framework.
The value of quantitative diffusion tensor imaging indices of spinal cord disorders
Authors: Omar Mohammad Koriem Mahmoud , Abd Allah Abd El-Karem Hasan , Maghrabi Mona Gouda , Mohamed Mohamed Zidan
Published: November 2021

Background

Different lesions affecting the spinal cord can lead to myelopathy. Diffusion tensor imaging (DTI) is widely used to predict the degree of spinal cord microstructure affection and to assess axonal integrity and diffusion directionality. We hypothesized that not all DTI parameters have the same affection with different spinal cord pathologies. The purpose of this study is to assess the value of the quantitative diffusion tensor imaging indices in different spinal cord lesions.

Results

There is highly statistically significant difference of the fractional anisotropy (FA), relative anisotropy (RA), volume ratio (VR) and secondary eigenvector values (E2 and E3) between various studied cord lesions and control levels. There is no statistically significant difference of the apparent diffusion coefficient (ADC) and the primary eigenvector value (E1) (ANOVA test). The ROC curve analysis showed the higher sensitivity and accuracy were ‘88% and 62.5%, respectively,’ with FA cutoff value about 0.380.

Conclusion

The resulted quantitative DTI indices ‘fractional anisotropy, relative anisotropy, volume ratio and secondary eigenvalues’ work as a numerical in vivo marker of overall tissue injury in different pathologies affecting the spinal cord.
Constructing the resistivity-to-sediment-type transform for the interpretation of airborne electromagnetic data
Authors: Dewar Noah , Knight Rosemary
Published: November 2021

A novel Markov chain Monte Carlo (MCMC)-based methodology was developed for the transformation of resistivity, derived from airborne electromagnetic (AEM) data, into sediment type. This methodology was developed and tested using AEM data and well sediment type and resistivity logs from Butte and Glenn Counties in the California Central Valley. Our methodology accounts for the spatially varying sensitivity of the AEM method by constructing different transforms separated based on the sensitivity of the AEM method. The large spatial separation that typically exists between the AEM data and the wells with sediment type logs was avoided by planning the acquisition of AEM data so as to fly as close as possible to the well locations. We had 55 locations with sediment type logs and AEM data separated by 100 m, determined to be the maximum acceptable separation distance. Differences in vertical resolution between the AEM method and the sediment type logs were addressed by modeling the physics of the AEM measurement, allowing for a comparison of field and AEM data generated during the MCMC process. The influence of saturation state was captured by creating one set of transforms for the region above the top of the saturated zone and another for below. Using the set of transforms developed at the 55 locations, an inverse distance weighting scheme that included a well quality ranking was used to construct a set of 12 (six sensitivity bins, and two saturation states) resistivity-to-sediment-type transforms at every AEM data location. These represent a set of transforms that accommodate the variation in AEM sensitivity and are independent of the inversion used to retrieve the resistivity model. Thus, these transforms avoid two of the significant limitations common to resistivity-to-sediment-type transforms used to interpret AEM data.
Incidentalomas at abdominal imaging
Authors: Pickhardt Perry J.
Published: November 2021

As all radiologists are well aware, cross-sectional abdominal imaging tests such as CT, MR, and ultrasound generally include organs and structures that are not directly related to the clinical indication for obtaining the examination. As a result, unsuspected additional findings or “incidentalomas” must be handled in a responsible manner that balances any need for reporting and management against the potential harms that may result from such actions. The majority of abdominal incidentalomas detected at imaging will not cause downstream harm to the patient, unless perhaps the radiologist unleashes an unnecessary work-up cascade that results in patient anxiety, inconvenience, added costs, or complications. Applying the principle of primum non-nocere, an argument can be made for not even reporting incidental imaging findings that have an exceedingly low likelihood of clinical relevance, such as small, simple-appearing sporadic cysts that are commonly seen in many abdominal organs. The situation becomes more challenging, however, when “likely benign” yet indeterminate lesions are encountered. At some threshold, which is difficult to precisely define for all cases, further action may be indicated, be it imaging follow-up to confirm resolution or stability, more definitive imaging characterization, or even tissue sampling. For more concerning or ominous incidentalomas, the need for further work-up will be more clear cut.
Convicção para alcançar o futuro
Authors: Wilner Adriana , Santos Aline Lilian dos
Published: November 2021

Tushar Parikh, country head da Tata Consultancy Services para o Brasil, fala sobre como a empresa atua para ficar no cerne da transformação digital das organizações.
A diplomacia das vacinas
Authors: Casarões Guilherme , Ananda Gomes Leonardo
Published: November 2021

A Índia desponta como força global para ajudar a imunizar populações em países em desenvolvimento contra a Covid-19 e tem sido um dos principais fornecedores de insumos para o Brasil.
Iniciativas promissoras
Authors: Dilip Kumar Mukhi Umesh , Kumar Mishra Amit
Published: November 2021

Ações de colaboração entre a Índia e o Brasil em setores como educação, defesa, aeroespaço, saúde e ayurveda revelam as possibilidades de expansão das relações econômicas entre os dois países.
O lado oculto da diversidade de gênero
Authors: Rezende Julia , Story Joana
Published: November 2021

O sexismo pode ser explicitamente hostil ou implicitamente benevolente e, portanto, organizações que almejam inclusão devem combater vieses, muitas vezes inconscientes, que transparecem em frases como “mulheres são mais sensíveis”.
Open banking: quais são os riscos?
Authors: Yoshinaga Claudia
Published: November 2021

A promessa é um mercado mais competitivo e inovador, mas é importante ter cuidado e atenção na autorização do uso de dados, bem como discutir potenciais problemas como discriminação, transparência e inclusão.
Role of Optical Coherence Tomography Angiography to differentiate Intraretinal microvascular abnormalities and retinal neovascularization in Diabetic Retinopathy
Authors: Memon Abdul Sami , Memon Nasir Ahmed , Mahar Pir Salim
Published: November 2021

Objective: To assess proliferative diabetic retinopathy (PDR) and to describe the difference in angiographic representation of new vessels (NVs) and Intra retinal microvascular abnormalities (IRMA) on optical coherence tomography angiography (OCTA).

Methods: A cross-sectional observational study was performed at ISRA Postgraduate Institute of Ophthalmology, Karachi, from March 2018 to September 2018. Forty-two eyes of 21 patients with history of diabetes mellitus (DM) were examined. Twenty-eight eyes with a clinical diagnosis of severe non proliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) according to early treatment diabetic retinopathy study (ETDRS) were included and evaluated using Swept source optical coherence tomography angiography (SS-OCTA). Then face wide ﬁeld SS-OCTA images and co registered structural optical coherence tomography (OCT) with ﬂow overlay were used to distinguish the features of IRMA and retinal NVs.

Results: Forty-two eyes (21 patients) were examined clinically. Fourteen eyes had moderate NPDR, 15 had severe NPDR and 13 eyes had changes consistent with PDR. After clinical diagnosis, we included 28 eyes in our study based on inclusion criteria. These 28 eyes went through SS-OCTA evaluation and we observed 15 cases with PDR and 13 with severe NPDR changes. The OCTA and clinical diagnosis were similar except in 2 eyes, which is critical but not statically significant showing the importance of this noninvasive technology.

Conclusions: Widefield OCTA can work as an alternative to fundus fluorescein angiography (FFA) in the diagnosis of diabetic retinopathy (DR). As it is a non-invasive and depth encoded technique so can be used frequently to monitor the retinal changes and their progression.

doi: https://doi.org/10.12669/pjms.38.1.3891

How to cite this:Memon AS, Memon NA, Mahar PS. Role of Optical Coherence Tomography Angiography to differentiate Intraretinal microvascular abnormalities and retinal neovascularization in Diabetic Retinopathy. Pak J Med Sci. 2022;38(1):57-61.  doi: https://doi.org/10.12669/pjms.38.1.3891

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.
Pre-morbidity and COVID-19 disease outcomes in Pakistani population: A cross-sectional study
Authors: Toori Kaleem Ullah , Qureshi Muhammad Arsalan , Chaudhry Asma
Published: November 2021

Objectives: To identify association of underlying pre-morbidities with disease severity and mortality in hospitalized patients with Corona virus disease 2019.

Methods: Total 884 COVID RT-PCR positive patients admitted to KRL Hospital Islamabad from April 2020 to August 2020 were included in this cross-sectional study. Pre-morbidities recorded were hypertension, diabetes mellitus, ischemic heart disease, chronic respiratory disease, chronic kidney disease, chronic liver disease, chronic neuro-psychiatric conditions (stroke and depression) and malignancy. Oxygen requirement, requirement of invasive ventilation, and outcome (recovered versus died) was documented. WHO categories for disease severity were used. Demographic profile and symptoms were also noted. SPSS 22 was used for data analysis. Pearson’s Chi square test was used to see association between pre-morbidities and disease severity categories, oxygen requirement, invasive ventilation and outcome. Pearson’s correlation was applied to analyze the correlation between individual pre-morbidities and disease severity categories. P-value < 0.05 was considered statistically significant.

Results: The mean age was 40 ± 12.21 years with 98.5% being males. Majority patients (74.8%) were asymptomatic. Fever was the most common symptom. Diabetes mellitus and hypertension were the most commonly recorded co-morbidity. Significant correlation (p-value < 0.05) was found between the presence of underlying pre-morbidities and disease severity as well as oxygen requirement, requirement of invasive ventilation and mortality.

Conclusion: Results are compatible with worldwide studies and underlying pre-morbidities are convincing risk factors for disease severity and mortality.

doi: https://doi.org/10.12669/pjms.38.1.4235

How to cite this:Toori KU, Qureshi MA, Chaudhry A. Pre-morbidity and COVID-19 disease outcomes in Pakistani population: A cross-sectional study. Pak J Med Sci. 2022;38(1):287-292. doi: https://doi.org/10.12669/pjms.38.1.4235

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.
Immunohistochemical Expression of MMP-9 and E-Cadherin in subtypes of Ameloblastoma
Authors: Farhan Farah , Niazi Zainab , Masood Sana , Abbas Beenish
Published: November 2021

Background & Objective: Ameloblastomas have been analyzed histologically for diagnostics and its sub-classification; however, the analysis carried out so far does not provide any authentic evidence regarding prognosis of Ameloblastoma. Subject categorization is still a topic of debate. The purpose of this study was to determine the immuno-expression of markers such as MMP-9 and E-Cadherin in different sub-types of ameloblastoma and establish their correlation with histological variants.

Methods: Analytical study of 71 cases of ameloblastoma was conducted in AFIP Rawalpindi, between January to June, 2019. Samples were taken from different intraoral sites including the patients with tumor of ameloblast. The tumor was sub classified histologically on the basis of WHO classification. ‘Chi Square’ Test was applied to find the association of MMP-9 and E-Cadherin with histological variants of ameloblastoma. P-value ≤ 0.05 were found statistically significant.

Results: On histopathological sub-classification, 52.1% were diagnosed as follicular type, 23.9% were plexiform type, 14.1% were Acanthomatous type and 9.9% were of unicystic ameloblastoma. 80% of the total Acanthomatous type and 59% of the total plexiform had strong immuno-expression, which was significantly different from follicular type MMP-9 (p ≤ 0.05). All cases of unicystic ameloblastoma and 67.6% of follicular type showed strong immuno-expression significantly different from 20% of Acanthomatous type and 59% of plexiform type E-Cadherin (p ≥ 0.05). On the other hand, when statistical analysis was carried out, an inverse relation between MMP-9 and E-cadherin was observed.

Conclusion: The effect of MMP-9 and E-cadherin in ameloblastoma is aggressive in nature and effectiveness was seen in subtypes of ameloblastoma.

doi: https://doi.org/10.12669/pjms.38.1.4465

How to cite this:Farhan F, Niazi Z, Masood S, Abbas B. Immunohistochemical Expression of MMP-9 and E-Cadherin in subtypes of Ameloblastoma. Pak J Med Sci. 2022;38(1):207-213. doi: https://doi.org/10.12669/pjms.38.1.4465

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.
Time to negative PCR in various disease categories of COVID-19 infection in Pakistani population
Authors: Toori Kaleem Ullah , Chaudhry Asma , Qureshi Muhammad Arsalan
Published: November 2021

Objectives: To identify association of epidemiological characteristics, presence of underlying pre-morbidities and disease severity with time to first negative PCR in Corona virus disease 2019.

Methods: Total 842 Corona Virus Real Time Polymerase-Chain-Reaction positive patients were included in this cross-sectional study. Patients were admitted to Department of Medicine at KRL Hospital Islamabad from April to August 2020. Age, gender, symptoms, pre-morbidities and disease severity were recorded. Outcome (recovered versus died) was documented. World Health Organization categories to classify disease severity (asymptomatic, mild, moderate and severe) were used. Time to negative PCR was documented as time between first positive PCR to first negative PCR.

Results: The mean age of patients was 39.04 ± 11.32 years with 99.8% being males. Majority of patients (78.4%) were asymptomatic. Amongst symptoms, fever was the most common symptom. Diabetes mellitus and hypertension were the most commonly recorded co-morbidity. Mean time to negative PCR was 8.8 ± 3.1 days. A large proportion of patients recovered (99.9%). Significant positive correlation (p value < 0.05) was found between age, gender, presence of underlying pre-morbidities and disease severity categories with time to first negative PCR.

Conclusion: The underlying epidemiological factors, pre-morbidities and disease severity are associated with time to negative PCR and hence affect frequency of recovery samples.

doi: https://doi.org/10.12669/pjms.38.1.4476

How to cite this:Toori KU, Chaudhry A, Qureshi MA. Time to negative PCR in various disease categories of COVID-19 infection in Pakistani population. Pak J Med Sci. 2022;38(1):243-247. doi: https://doi.org/10.12669/pjms.38.1.4476

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.
Use of Rose Bengal, Methylene blue and Curcumin Photosensitizers activated using light emitting diode on post space disinfection bonded to fiber post: An assessment of extrusion bond strength
Authors: Niazi Fayez Hussain , Qamar Zeeshan , Noushad Mohammed , Muhareb Abdullah Khaled Bin
Published: November 2021

Objectives: To evaluate the effect of Rose Bengal (RB), methylene blue (MB) and curcumin used as a canal disinfectant on the extrusion bond strength (EBS) of FRCP (fiber reinforced composite resin) with canal dentin.

Methods: The present invitro study was completed in 90 days approved by Riyadh Elm University. Forty premolars were extracted disinfected and decoronated. Mechanochemical preparation was done of canal space using 10k file widening canals sequentially with a 25K file with constant saline irrigation. Canal was dried condensed with gutta percha and sealer. Post space was prepared using peso reamer. Based on canal disinfection samples were divided into four groups. Group-1 MBP+17% EDTA, Group-2 RBP +17% EDTA, Group-3 Curcumin+17% EDTA and Group-4 5.25% NaOCl +17% EDTA. Following disinfection, the canal space of all specimens was washed with 17% EDTA for 120 sec. Post was cemented in canal space and cured. Specimens were placed on Universal testing machine (UTM) for EBS. The type of bond failure was evaluated using stereomicroscope. ANOVA and Tukey multiple comparison test was used to compare means.

Results: Cervical third of Group-3 in which samples were disinfected with CP+17% EDTA displayed the maximum EBS (8.69±1.32 MPa). Whereas, the lowest EBS (3.30±0.54 MPa) was exhibited by the apical third of Group-4, where 5.25% NaOCl +17% EDTA was used as a canal disinfectant. The intragroup comparison demonstrated a declining trend of EBS from cervical to apical third in all investigated groups.

Conclusion: Root canal dentin treated with different PS (MBP, CP, and RBP) demonstrated better EBS than the conventional disinfecting regime (NaOCl +17% EDTA). CP and RBP displayed better EBS than MBP.

doi: https://doi.org/10.12669/pjms.38.1.4780

How to cite this:Niazi FH, Qamar Z, Noushad M, Khaled Bin Muhareb A. Use of Rose Bengal, Methylene blue and Curcumin Photosensitizers activated using light emitting diode on post space disinfection bonded to fiber post: An assessment of extrusion bond strength. Pak J Med Sci. 2022;38(1):34-39. doi: https://doi.org/10.12669/pjms.38.1.4780

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 role of Emergency Departments for Antimicrobial stewardship in COVID-19 Pandemic; the time is now
Authors: Ismail Madiha , Kapadia Nazir Najeeb , Usman Sara
Published: November 2021

doi: https://doi.org/10.12669/pjms.38.1.5107

How to cite this:Ismail M, Kapadia NN, Usman S. The role of Emergency Departments for Antimicrobial stewardship in COVID-19 Pandemic; the time is now. Pak J Med Sci. 2022;38(1):329. doi: https://doi.org/10.12669/pjms.38.1.5107
Identifying periodontitis risk factors through a retrospective analysis of 80 cases
Authors: Guan Jing , Zhang Dong , Wang Cailing
Published: November 2021

Objectives: To investigate periodontitis risk factors and to establish a reference framework for identifying factors that place individuals at greater risk for periodontitis.

Methods: Clinical data from 80 periodontitis patients admitted in the Department of Stomatology at Hebei Provincial People’s Hospital and treated between March 2020 and March 2021 were retrospectively analyzed.

Results: Univariate analysis showed that lower daily brushing frequencies, decreased tooth brushing duration, decreased scaling frequency, dietary habits, smoking and drinking, genetic factors, diabetes, hypertension, and obesity were more prevalent among periodontitis patients than healthy controls. Multivariate binary logistic analysis showed that daily brushing frequency, routine scaling, smoking, drinking, heredity, diabetes, hypertension, and obesity were all risk factors for periodontitis.

Conclusions: There are many risk factors for periodontitis. Clinicians need to be aware of these factors for early detection and treatment of the disease.

doi: https://doi.org/10.12669/pjms.38.1.5205

How to cite this:Guan J, Zhang D, Wang C. Identifying periodontitis risk factors through a retrospective analysis of 80 cases. Pak J Med Sci. 2022;38(1):293-296. doi: https://doi.org/10.12669/pjms.38.1.5205

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.
Καινοτόμες στρατηγικές μάρκετινγκ
Authors: Κοττίκας Κωνσταντίνος
Published: November 2021

Η συγκεκριμένη διδακτορική διατριβή επικεντρώνεται στο ευρύτερο επιστημονικό πεδίο του στρατηγικού μάρκετινγκ. Γενικότερος στόχος της διατριβής είναι η μελέτη των χαρακτηριστικών των οργανισμών που έχουν υιοθετήσει τη στρατηγική διαμόρφωσης της αγοράς (market-driving strategy). Ειδικότερo ερευνητικό στόχο αποτελεί η διερεύνηση των συσχετίσεων που αναπτύσσονται μεταξύ της στρατηγικής διαμόρφωσης της αγοράς (market-driving strategy), συγκεκριμένων προσδιοριστικών παραγόντων (antecedents) και αποτελεσμάτων (outcomes) της συγκεκριμένης στρατηγικής. Η στρατηγική διαμόρφωσης της αγοράς ορίζεται ως η αλλαγή της σύνθεσης, των ρόλων, ή και της συμπεριφοράς των «παικτών» σε μία αγορά, προς μια κατεύθυνση επωφελή για την υφιστάμενη εταιρία. H μεθοδολογική ερευνητική προσέγγιση που ακολουθήθηκε είναι η διενέργεια τόσο ποιοτικής, όσο και ποσοτικής έρευνας (mixed methods design). Κατά την εκπόνηση της ποιοτικής μελέτης υλοποιήθηκαν 27 συνεντεύξεις-σε-βάθος (in-depth interviews), ενώ η ανάλυση των ποιοτικών δεδομένων πραγματοποιήθηκε με τη μέθοδο της ποιοτικής ανάλυσης περιεχομένου (qualitative content analysis). Κατά την εκπόνηση της ποσοτικής μελέτης, υλοποιήθηκε δημοσκόπηση εκτενούς κλίμακας με επιλογή δείγματος κρίσης (purposive sampling) (241 ερωτηματολόγια που συλλέχθηκαν μέσω διαδικτύου) και ανάλυση ποσοτικών δεδομένων με τη μέθοδο Partial Least Square Structural Equation Modeling (PLS-SEM). Στο πλαίσιο της ποσοτικής μελέτης, προέκυψε ότι οι βασικοί προσδιοριστικοί παράγοντες της στρατηγικής διαμόρφωσης της αγοράς είναι η ριζική καινοτομία, η σταδιακή καινοτομία, η ριζικότητα της τεχνολογίας, τα συστήματα μέτρησης μάρκετινγκ και οι ικανότητες μάρκετινγκ. Επιπρόσθετα, τα βασικά αποτελέσματα της εν λόγω στρατηγικής είναι η οικονομική απόδοση, η απόδοση σε σχέση με πελάτες, το ανταγωνιστικό πλεονέκτημα και η οργανωσιακή φήμη. Τέλος, η οργανωσιακή φήμη σχετίζεται θετικά με την οικονομική απόδοση, κάτι που συνεπάγεται πως παίζει έναν ρόλο διαμεσολαβητή (mediator) στη σχέση μεταξύ στρατηγικής διαμόρφωσης της αγοράς και οικονομικής απόδοσης. Η διατριβή έχει οργανωθεί με τον ακόλουθο τρόπο: Μέρος Α’ – Εισαγωγή, Μέρος Β’ - Βιβλιογραφική Επισκόπηση, Μέρος Γ’ - Συνολική Ερευνητική Μεθοδολογία, Μέρος Δ’ - Ποιοτική Μελέτη, Μέρος Ε’ - Ποσοτική Μελέτη, Παραρτήματα
Καινοτόμοι φωτοκαταλυτικοί οργανικοί μετασχηματισμοί για τη χημική βιομηχανία
Authors: Νικήτας Νικόλαος
Published: November 2021

Η χρήση της Φωτοχημείας στην Οργανική Χημεία και πιο συγκεκριμένα στην κατάλυση έχει εισάγει νέες δραστικότητες, δίνοντας έτσι νέες δυνατότητες στην ανάπτυξη νέων πράσινων και αειφόρων καταλυτικών μεθόδων. Η χρήση μικρών οργανικών μορίων που προάγουν φωτοχημικούς μετασχηματισμούς έχει αξιοποιηθεί ευρέως από την επιστημονική κοινότητα, μέσω του πεδίου της Φωτοοργανοκατάλυσης. Στο πρώτο κεφάλαιο της παρούσας διδακτορικής διατριβής, γίνεται η εισαγωγή στους τρόπους ενεργοποίησης και τους μηχανισμούς στη Φωτοκατάλυση. Στο δεύτερο κεφάλαιο, αναφέρονται οι σημαντικότερες κατηγορίες οργανικών μορίων που χρησιμοποιούνται ως φωτοκαταλύτες, καθώς και σύγχρονα παραδείγματα χρήσης αυτών. Στο τρίτο κεφάλαιο γίνεται γνωστός ο σκοπός της παρούσας διδακτορικής διατριβής. Στο τέταρτο κεφάλαιο παρουσιάζονται μελέτες αντιδράσεων, όπου γίνεται χρήση του μορίου της θειοξανθόνης ως φωτοκαταλύτη. Στο πέμπτο κεφάλαιο, παρουσιάζονται αντιδράσεις που κάνουν χρήση διαφόρων μορίων ως φωτοεκκινητών-φωτοκαταλυτών, από ενεργοποιημένες καρβονυλικές ενώσεις έως σύμπλοκα ρουθηνίου. Στο έκτο κεφάλαιο παρουσιάζονται αντιδράσεις που πραγματοποιούνται παρουσία του φαινυλογλυοξυλικού οξέος ως φωτοεκκινητή. Στο τελευταίο κεφάλαιο παρουσιάζονται τα πειραματικά δεδομένα.
Limitations in the Use of Social Network Analysis Methods in Marketing Project Management
Authors: Akimova E.
Published: November 2021

One of the trends of the labor market is project management skills. In such conditions, the professional education of a project manager becomes especially relevant since it is often impossible to completely replace it with work experience.

One of the most vital areas for project success is communication management. Nevertheless, in this area, unlike many others, tools that allow objectively analyzing the quality of communications are not used. Relatively recently, a method of social network analysis (SNA) has appeared, which enables, among other things, analyzing communications in projects. Researchers wrote about the applicability of this methodology in project management. This article will identify some of the limitations in the use of SNA in project management.
Increasing physical activity by Gamification among Brazilian high school students: a pilot study
Authors: Caputo Eduardo Lucia , Feter Natan , Alt Ricardo , Leite Jayne Santos , Rodrigues Alysson Nogueira , Dumith Samuel Carvalho , Da Silva Marcelo Cozzensa
Published: November 2021

This pilot study aimed to evaluate the effectiveness of a Gamification-based intervention on physical activity levels of High School students. This quasi experimental study was conducted in two federal high schools in Southern Brazil. One class from each school was selected to be either intervention (INT) or control (CON) group. Experiment duration was two weeks, and both groups downloaded My Active Life app. INT group (n = 69) participants received daily app alerts with messages of encouragement to practice physical activity. They also received a score based on the percentage of goal achieved. CON group (n = 35) only had access to total number of steps per day. INT group showed a lower decrease in physical activity at school compared to CON group (p = 0.024). No effect of intervention was observed in physical activity out of school (p = 0.911). Gamification-based intervention prevented a decrease in physical activity at school among male (F = 10.680; p = 0.004), students at first half of high school (F = 12.668; p = 0.002), and adequate body mass index (F = 4.640; p = 0.037), and with lower perception of barriers to physical activity (F = 5.437; p = 0.024). Although we did not observe an increase in physical activity at school, gamification-based intervention may mitigate its decrease among adolescents.