bluuebunny/crossref_metadata_2025 huggingface dataset:
A promising new predictive factor for detecting bowel resection in childhood intussusception: the lymphocyte-C-reactive protein ratio
Authors: Chen Bailin , Cao Jian , Yan Chengwei , Zheng Chao , Chen Jingyu , Guo Chunbao
Published: December 2021

Background

The most critical concern for the management of childhood intussusception is bowel resection due to intestinal ischemia and necrosis. The early prediction of this problem is of great importance. We investigated the value of various combinations of inflammatory factors to predict intestinal necrosis and resection.

Methods

We retrospectively reviewed the medical records of pediatric patients with intussusception who underwent surgical management. During the research period, 47 patients who underwent intestinal resection due to intestinal necrosis and 68 patients who did not undergo intestinal resection were enrolled. We evaluated the diagnostic value of various combinations of inflammatory markers from preoperative laboratory analyses using the receiver operating characteristic (ROC) method.

Results

In the current cohort, 115 patients underwent operations for intussusception; among them, 47 patients (40.9%) underwent intestinal resections. In the patients with intestinal resection, the neutrophil count(p = 0.013), CRP level(p = 0.002), platelet–lymphocyte ratio (PLR, p = 0.008), NLR (neutrophil–lymphocyte ratio, p = 0.026), and LCR (lymphocyte–CRP ratio, p < 0.001) values were significantly higher than those in the patients without any resection. The receiver operating characteristic (ROC) analysis results showed that the combination of lymphocytic count along with C-reactive protein levels (LCR) demonstrated the highest correlation with intestinal resection due to intussusception compared with other parameters in the patients, with a sensitivity of 0.82 (0.73–0.86) and specificity of 0.80 (0.57–0.94) for the diagnosis of strangulation.

Conclusion

The preoperative LCR level is a useful marker to predict the need for intestinal resection due to intestinal necrosis in patients with intussusception.
Anomalies of the aortic arch in dogs: evaluation with the use of multidetector computed tomography angiography and proposal of an extended classification scheme
Authors: Schorn Christiane , Hildebrandt Nicolai , Schneider Matthias , Schaub Sebastian
Published: December 2021

Background

Congenital anomalies of the aortic arch are important as they may be associated with vascular ring anomalies. The most common vascular ring anomaly in dogs is a persistent right aortic arch. However, published data of the distribution of the different types of vascular ring anomalies and other aortic arch anomalies are lacking. The objective of this retrospective descriptive study was to evaluate both the prevalence and the different types of aortic arch anomalies that can be detected using thoracic computed tomography (CT) examination. Archived thoracic CT examinations acquired between 2008 and 2020 at a single institution were retrospectively evaluated by 2 evaluators for the prevalence and type of aortic arch anomaly. Breed, age, and presenting complaint were obtained from the medical record system.

Results

A total of 213 CT studies were evaluated; 21 dogs (21/213, 9.9%) showed a right aortic arch and a left ligamentum arteriosum with compression of the esophagus. The following incidental additional findings were detected: aberrant left subclavian artery (17/21, 76.2%), branching from the persistent ductus arteriosus (PDA) (1/21, 4.8%), left-sided brachiocephalic trunk (3/21, 14.3%), bicarotid trunk (17/21, 81.0%), double aortic arch (1/21, 4.8%). One hundred ninety two dogs (192/213, 90.1%) showed a left aortic arch without esophageal compression. The following additional abnormalities were obtained in those dogs with left aortic arch: aberrant right subclavian artery (3/192, 1.6%) without clinical signs of esophageal compression, aberrant vessel branching from the aorta into the left caudal lung lobe (2/192, 1.0%), focal dilatation of the left or right subclavian artery (2/192, 1.0%), bicarotid trunk (1/192, 0.5%).

Conclusion

Similar to previous studies an aberrant left subclavian artery is the most common additional finding in dogs with persistent right aortic arch. Newly, a left-sided brachiocephalic trunk was identified in 14.3% of the dogs with a persistent right aortic arch; no additional compression was caused by the left sided brachiocephalic trunk. Similarly, aberrant right subclavian artery can be an incidental CT finding without causing compression of the esophagus.
The value of cell-free circulating tumour DNA profiling in advanced non-small cell lung cancer (NSCLC) management
Authors: Fernandes Maria Gabriela O. , Cruz-Martins Natália , Machado José Carlos , Costa José Luís , Hespanhol Venceslau
Published: December 2021

Liquid biopsy (LB) has boosted a remarkable change in the management of cancer patients by contributing to tumour genomic profiling. Plasma circulating cell-free tumour DNA (ctDNA) is the most widely searched tumour-related element for clinical application. Specifically, for patients with lung cancer, LB has revealed valuable to detect the diversity of targetable genomic alterations and to detect and monitor the emergence of resistance mechanisms. Furthermore, its non-invasive nature helps to overcome the difficulty in obtaining tissue samples, offering a comprehensive view about tumour diversity. However, the use of the LB to support diagnostic and therapeutic decisions still needs further clarification. In this sense, this review aims to provide a critical view of the clinical importance of plasma ctDNA analysis, the most widely applied LB, and its limitations while anticipating concepts that will intersect the present and future of LB in non-small cell lung cancer patients.

Graphical Abstract
Predicting heterogeneity in clone-specific therapeutic vulnerabilities using single-cell transcriptomic signatures
Authors: Suphavilai Chayaporn , Chia Shumei , Sharma Ankur , Tu Lorna , Da Silva Rafael Peres , Mongia Aanchal , DasGupta Ramanuj , Nagarajan Niranjan
Published: December 2021

While understanding molecular heterogeneity across patients underpins precision oncology, there is increasing appreciation for taking intra-tumor heterogeneity into account. Based on large-scale analysis of cancer omics datasets, we highlight the importance of intra-tumor transcriptomic heterogeneity (ITTH) for predicting clinical outcomes. Leveraging single-cell RNA-seq (scRNA-seq) with a recommender system (CaDRReS-Sc), we show that heterogeneous gene-expression signatures can predict drug response with high accuracy (80%). Using patient-proximal cell lines, we established the validity of CaDRReS-Sc’s monotherapy (Pearson r>0.6) and combinatorial predictions targeting clone-specific vulnerabilities (>10% improvement). Applying CaDRReS-Sc to rapidly expanding scRNA-seq compendiums can serve as in silico screen to accelerate drug-repurposing studies. Availability: https://github.com/CSB5/CaDRReS-Sc.
Thymoma may explain the confusion: a case report
Authors: Maaroufi Abdelkhaleq , Assoufi Naoufal , Essaoudi Mohamed Amine , Fatihi Jamal
Published: December 2021

Background

The association of inflammatory myopathy and myasthenia gravis is a rarely described entity whose clinical presentation has always been intriguing because of the great clinical similarity between these two pathologies. The presence of a thymic pathology often explains this combination, whose mechanisms are very complex.

Case presentation

A 56-year-old woman of North African origin, was hospitalized to explore the Raynaud phenomenon associated with proximal muscle weakness, pain, and arthralgia. There was no rash, and neuromuscular examination had revealed proximal tetraparesis and mild neck weakness. Tendon reflexes were normal. There was no abnormal nail fold capillaroscopy. A significant titer of muscle enzymes had been shown on blood tests, and autoimmune screening for myositis-specific and myositis-associated autoantibodies was negative. Electromyography had shown a myopathic pattern, and muscle biopsy confirmed an inflammatory myopathy. Although steroids were introduced, the clinical course was unsatisfactory; ophthalmic and bulbar symptomatology appeared. The association of myasthenia gravis was confirmed by an elevated level of serum acetylcholine receptor. A chest computed tomography scan had identified a thymoma. Treated with prednisone, pyridostigmine, and thymectomy, the patient’s clinical and biological evolution was favorable.

Conclusion

This case illustrates an exceptional association of two entities and the difficulty encountered during their diagnosis and treatment. The management of these two diseases is different, so it is essential to recognize this concomitant presentation.
Prevalence and predictors of self-medication among university students in Ethiopia: a systematic review and meta-analysis
Authors: Fetensa Getahun , Tolossa Tadesse , Etafa Werku , Fekadu Ginenus
Published: December 2021

Background

Self-medication of medicines is a global issue particularly among those with good access and familiarity with medications such as university students. It has a significant impact on drug resistance and medication-related complications. There are limited and inconsistent studies on self-medication practices in Ethiopia. The aim of this systematic review and meta-analysis was to estimate the pooled prevalence of self-medication and its predictors among university students in Ethiopia.

Methods

A systematic review and meta-analysis was conducted to assess the prevalence and predictors of self-medication among university students in Ethiopia. Published articles from various electronic databases such as Medline, Hinari, Pub Med, Cochrane library, and the Web of Science were accessed. In addition, a manual search was performed including Google Scholar. Searching of articles were searched from January 1st to February 1, 2021. All observational studies conducted among university students in English language were included in the review. Two reviewers independently assessed articles before inclusion in the final review using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) instrument for critical appraisal. The I2 test was used to assess heterogeneity. Since the included studies exhibited high heterogeneity, a random-effects model was used to estimate the pooled prevalence of self-medication.

Results

We found of 812 published and unpublished studies in our search. Finally, 31 full-text studies were reviewed, and 13 studies fulfilled the inclusion criteria and were included in the final meta-analysis. A total of 5377 study respondents from 13 studies were included in the study. The results of our study revealed that the pooled prevalence of self-medication among university students was 49.41% (95% CI 38.67%, 60.13%). The included studies had a sample size ranging from 250 to 792 with the lowest prevalence (19.87%) of self-medication from the University of Gondar, whereas the highest prevalence (77.01%) was recorded in a study conducted at Arsi University. From the pooled estimation, there was a significant association between self-medication and income (OR = 0.67: 95% CI 0.55–0.80). However, the association between self-medication and year of study and sex of participants was insignificant.

Conclusion

The pooled prevalence of self-medication among Ethiopian university students was relatively high compared to the current global health problem with an increase in anti-microbial resistance. Health professionals and concerned bodies should pay attention to raising awareness regarding the consequences of using medications without prescription.
Immobilization of transaminase from Bacillus licheniformis on copper phosphate nanoflowers and its potential application in the kinetic resolution of RS-α-methyl benzyl amine
Authors: Lambhiya Shraddha , Patel Gopal , Banerjee Uttam Chand
Published: December 2021

This study reports the isolation and partial purification of transaminase from the wild species of Bacillus licheniformis. Semi-purified transaminase was immobilized on copper nanoflowers (NFs) synthesized through sonochemical method and explored it as a nanobiocatalyst. The conditions for the synthesis of transaminase NFs [TA@Cu3(PO4)2NF] were optimized. Synthesized NFs revealed the protein loading and activity yield—60 ± 5% and 70 ± 5%, respectively. The surface morphology of the synthesized hybrid NFs was examined by scanning electron microscopy (SEM) and transmission electron microscopy (TEM), which revealed the average size to be around 1 ± 0.5 μm. Fourier-transform infrared (FTIR) was used to confirm the presence of the enzyme inside the immobilized matrix. In addition, circular dichroism and florescence spectroscopy were also used to confirm the integrity of the secondary and tertiary structures of the protein in the immobilized material. The transaminase hybrid NFs exhibited enhanced kinetic properties and stability over the free enzyme and revealed high reusability. Furthermore, the potential application of the immobilized transaminase hybrid NFs was demonstrated in the resolution of racemic α-methyl benzylamine.

Graphical Abstract
Building a full-waveform inversion starting model from wells with dynamic time warping and convolutional neural networks
Authors: Yao Jiashun , Wang Yanghua
Published: December 2021

Seismic full-waveform inversion (FWI) needs a feasible starting model because otherwise it might converge to a local minimum and the inversion result might suffer from detrimental artifacts. We have built a feasible starting model from wells by applying dynamic time warping (DTW) localized rewarp and convolutional neural network (CNN) methods alternatively. We use the DTW localized rewarp method to extrapolate the velocities at well locations to the nonwell locations in the model space. Rewarping is conducted based on the local structural coherence, which is extracted from a migration image of an initial infeasible model. The extraction uses the DTW method. The purpose of velocity extrapolation is to provide sufficient training samples to train a CNN, which maps local spatial features on the migration image into the velocity quantities of each layer. Furthermore, we design an interactive workflow to reject inaccurate network predictions and to improve CNN prediction accuracy by incorporating the Monte Carlo dropout method. We have determined that our method is robust against kinematic incorrectness in the migration velocity model, and it is capable of producing a feasible FWI starting model.
Revisiting a low-dimensional model with short range interactions and mean field critical behavior
Authors: Grassberger Peter
Published: December 2021

In all local low-dimensional models, scaling at critical points deviates from mean ﬁeld behavior – with one possible exception. This exceptional model with “ordinary” behavior is an inherently non-equilibrium model studied some time ago by H.-M. Bröker and myself. In simulations, its 2-dimensional version suggested that two critical exponents were mean-ﬁeld, while a third one showed very small deviations. Moreover, the numerics agreed almost perfectly with an explicit mean ﬁeld model. In the present paper we present simulations with much higher statistics, both for 2d and 3d. In both cases we ﬁnd that the deviations of all critical exponents from their mean ﬁeld values are non-leading corrections, and that the scaling is precisely of mean ﬁeld type. As in the original paper, we propose that the mechanism for this is “confusion”, a strong randomization of the phases of feed-backs that can occur in non-equilibrium systems.
The Learning of the Mind as an Ideological Movement: Probing the Historical Origins of the School of Wang Yangming
Authors: Kun Jiao
Published: December 2021

As an influential scholar, the Ming 明 Neo-Confucian master Wang Yangming 王陽明 (1472–1529) was also active in the political world. While showing philosophical ingenuity, Wang launched an ideological movement which reached beyond Neo-Confucian discourse and into the social and political spheres. By promoting his xinxue 心學 teachings, Wang aimed to change Ming political life through fostering a moral retrenchment among future officials. To achieve his goals, Wang Yangming implemented several strategies, such as turning to humble local literati for a following, teaching them as a sitting official, and supporting nonofficial academies with his political power. These strategies succeeded to some extent, in part because the Ming court had relaxed the ideological intolerance of the early Ming. The real-world background of Wang Yangming's success can be further explored by comparing Wang with his two predecessors, Xue Xuan 薛瑄 (1389–1464) and Wu Yubi 吳與弼 (1391–1469).
Neurosurgical Causes of Pulsatile Tinnitus: Contemporary Update
Authors: Pingree Graham M. , Fleming Charles , Reavey-Cantwell John , Coelho Daniel H.
Published: December 2021

Traditionally in the domain of the otolaryngologist, pulsatile tinnitus (PT) has become increasingly relevant to neurosurgeons. PT may prove to be a harbinger of life-threatening pathology; however, often, it is a marker of a more benign process. Irrespectively, the neurosurgeon should be familiar with the many potential etiologies of this unique and challenging patient population. In this review, we discuss the myriad causes of PT, categorized by pulse-phase rhythmicity.
Recurrent Low-Grade Gliomas: Does Reoperation Affect Neurocognitive Functioning?
Authors: Ng Sam , Lemaitre Anne-Laure , Moritz-Gasser Sylvie , Herbet Guillaume , Duffau Hugues
Published: December 2021

BACKGROUND:

Reoperations in patients with recurrent low-grade gliomas (RLGG) were proposed to control tumor residual and delay the risk of malignant transformation over time.

OBJECTIVE:

To investigate neurocognitive outcomes in patients with RLGG who underwent a second surgery with awake monitoring.

METHODS:

In this retrospective study, patients who underwent a second awake surgery for RLGG were included. Patients had presurgical and 3-mo postsurgical neuropsychological assessments. Data were converted into Z-scores and combined by the cognitive domain. Number of patients with cognitive deficits (Z-score <−1.65), variations of Z-scores, and extent of resection (EOR) were analyzed.

RESULTS:

Sixty-two patients were included (mean age: 41.2 ± 10.0 yr). None had permanent neurological deficits postoperatively. Eight patients (12.9%) had a cognitive deficit preoperatively. Four additional patients (6.5%) had a cognitive deficit 3 mo after reoperation. Among other patients, 13 (21.0%) had a mild decline without cognitive deficits while 29 (46.8%) had no change of their performances and 8 (12.9%) improved. Overall, 94.2% of the patients returned to work. There were no correlations between EOR and Z-scores. Total/subtotal resections were achieved in 91.9% of the patients (mean residual: 3.1 cm3). Fifty-eight patients (93.5%) were still alive after an overall follow-up of 8.3 yr.

CONCLUSION:

Reoperation with awake monitoring in patients with RLGG was compatible with an early recovery of neuropsychological abilities. Four patients (6.5%) presented a new cognitive deficit at 3 mo postoperatively. Total/subtotal resections were achieved in most patients. Based on these favorable outcomes, reoperation should be considered in a more systematic way.
Genetic variation in haemoglobin is associated with evolved changes in breathing in high-altitude deer mice
Authors: Ivy Catherine M. , Wearing Oliver H. , Natarajan Chandrasekhar , Schweizer Rena M. , Gutiérrez-Pinto Natalia , Velotta Jonathan P. , Campbell-Staton Shane C. , Petersen Elin E. , Fago Angela , Cheviron Zachary A. , Storz Jay F. , Scott Graham R.
Published: December 2021

Physiological systems often have emergent properties but the effects of genetic variation on physiology are often unknown, which presents a major challenge to understanding the mechanisms of phenotypic evolution. We investigated whether genetic variants in haemoglobin (Hb) that contribute to high-altitude adaptation in deer mice (Peromyscus maniculatus) are associated with evolved changes in the control of breathing. We created F2 inter-population hybrids of highland and lowland deer mice to test for phenotypic associations of α- and β-globin variants on a mixed genetic background. Hb genotype had expected effects on Hb–O2 affinity that were associated with differences in arterial O2 saturation in hypoxia. However, high-altitude genotypes were also associated with breathing phenotypes that should contribute to enhancing O2 uptake in hypoxia. Mice with highland α-globin exhibited a more effective breathing pattern, with highland homozygotes breathing deeper but less frequently across a range of inspired O2, and this difference was comparable to the evolved changes in breathing pattern in deer mouse populations native to high altitude. The ventilatory response to hypoxia was augmented in mice that were homozygous for highland β-globin. The association of globin variants with variation in breathing phenotypes could not be recapitulated by acute manipulation of Hb–O2 affinity, because treatment with efaproxiral (a synthetic drug that acutely reduces Hb–O2 affinity) had no effect on breathing in normoxia or hypoxia. Therefore, adaptive variation in Hb may have unexpected effects on physiology in addition to the canonical function of this protein in circulatory O2 transport.
Contributions to medical literature by Indus Hospital Health Network through Research
Authors: Jawaid Shaukat Ali
Published: December 2021

doi: https://doi.org/10.12669/pjms.38.ICON-2022.5757

How to cite this:Jawaid SA. Contributions to medical literature by Indus Hospital Health Network through Research. Pak J Med Sci. 2022;38(2):331-332. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5757

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.
Rapidly progressive glomerulonephritis in children
Authors: Moorani Khemchand N , Aziz Madiha , Amanullah Farhana
Published: December 2021

Rapidly progressive glomerulonephritis (RPGN), characterized by a rapid development of nephritis with loss of kidney function in days or weeks, is typically associated histologically, with crescents in most glomeruli; and is a challenging problem, particularly in low resource settings. RPGN is a diagnostic and therapeutic emergency requiring prompt evaluation and treatment to prevent poor outcomes. Histopathologically, RPGN consists of four major categories, anti-glomerular basement membrane (GBM) disease, immune complex mediated, pauci-immune disorders and idiopathic /overlap disorders. Clinical manifestations include gross hematuria, proteinuria, oliguria, hypertension and edema. Diagnostic evaluation, including renal function tests, electrolytes, urinalysis/microscopy and serology including (anti GBM antibody, antineutrophil cytoplasmic antibody (ANCA)) starts simultaneously with management. An urgent renal biopsy is required to allow specific pathologic diagnosis as well as to assess disease activity and chronicity to guide specific treatment. The current guidelines for management of pediatric RPGN are adopted from adult experience and consist of induction and maintenance therapy. Aggressive combination immunosuppression has markedly improved outcomes, however, nephrotic syndrome, severe acute kidney injury requiring dialysis, presence of fibrous crescents and chronicity are predictors of poor renal survival. RPGN associated post infectious glomerulonephritis (PIGN) usually has good prognosis in children without immunosuppression whereas immune-complex-mediated GN and lupus nephritis (LN) are associated with poor prognosis with  development of end stage kidney disease (ESKD) in more than 50% and 30% respectively. Given the need for prompt diagnosis and urgent treatment to avoid devastating outcomes, we conducted a review of the latest evidence in RPGN management to help formulate clinical practice guidance for children in our setting.Information sources and search strategy: The search strategy was performed in the digital databases of PubMed, Cochrane Library, google scholar, from their inception dates to December 2020. Three investigators independently performed a systematic search using the following search terms “Rapidly progressive glomerulonephritis” “children” “crescentic glomerulonephritis” “management” at the same time, backtracking search for references of related literature.

doi: https://doi.org/10.12669/pjms.38.ICON-2022.5774

How to cite this:Moorani KN, Aziz M, Amanullah F. Rapidly progressive glomerulonephritis in children. Pak J Med Sci. 2022;38(2):417-425.   doi: https://doi.org/10.12669/pjms.38.ICON-2022.5774

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 Effects of live- in rehabilitation on ARV adherence, abstinence from drugs and lifestyle modification in people who inject drugs (PWID) Living with HIV – A clinic review
Authors: Hussain Aneela , Rahim Anum , Sheikh Anila , Jiwani Ahsun
Published: December 2021

Background & Objective: HIV/AIDS is mostly seen in people who inject recreational drugs (PWID). Adherence has to be optimum for its treatment to be effective. Compliance to HIV medication has been problematic in PWID making HIV control difficult. Many studies in the past have validated educational activities like rehabilitation programs beneficial in maintaining regularity in medication intake. This brought us to the question of looking at such programs and its effects on our population. This study was conducted to assess the impact of other perspectives of abstinence and adherence including family support and employment status on a person’s willingness for treatment continuation and avoidance of drugs.

Methods: A retrospective chart review of 241 PWID was conducted to assess adherence to antiretroviral agents (ARVs) and abstinence from recreational drugs post visit to the rehabilitation center. Associations with family support, marital status, employment, income and back to work status were also assessed.

Results: Adherence to ARVs had significant statistical association with marital status (p=0.025), starting work again (p=0.001), family support (p=0.009), employment status (p=0.009) and monthly income (p=0.025). While family support (p=0.033), employment status (p<0.0001), Going back to work (p<0.0001), mode of travel to Rehabilitation center (p<0.0001) and monthly income (p=0.004) were associated with abstinence from drugs. Duration of rehabilitation or age had no effect on adherence or abstinence in our patient population of PWID.

Conclusion: Family and spousal support and employment promote optimal ARV compliance and should be encouraged when starting ARVs. Enrollment in a long-term complementing educational program would further enhance ARV intake and abstinence.

doi: https://doi.org/10.12669/pjms.38.ICON-2022.5780

How to cite this:Hussain A, Rahim A, Sheikh A, Jiwani A. The Effects of live- in rehabilitation on ARV adherence, abstinence from drugs and lifestyle modification in people who inject drugs (PWID) Living with HIV – A clinic review. Pak J Med Sci. 2022;38(2):411-416.  doi: https://doi.org/10.12669/pjms.38.ICON-2022.5780

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.
Disseminated cryptococcal infection in a lymphoma suspected patient
Authors: Khursheed Nazia , Umer Amna , Adnan Fareeha
Published: December 2021

Cryptococcus neoformans is an opportunistic pathogen, mainly responsible for meningitis in immunodeficient individuals. We report a rare case of dessiminated cryptococcosis in a six years old boy, patient was being evaluated for lymphoma. In the present case the causative agent was Cryptococcus neoformans. It was diagnosed through Bactec, aerobic blood culture bottle. The cause of hospitalization of the patient was fever with abdominal pain. Blood and CSF culture revealed the presence of Cryptococcus neoformans which was further confirmed by urease test and corn meal tween agar (CMT). In the present case fungus was unusually isolated earlier from blood culture rather than cerebrospinal fluid.

doi: https://doi.org/10.12669/pjms.38.ICON-2022.5784

How to cite this:Khursheed N, Umer A, Adnan F. Disseminated cryptococcal infection in a lymphoma suspected patient. Pak J Med Sci. 2022;38(2):430-432. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5784

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.
Patient perception regarding privacy and confidentiality: A study from the emergency department of a tertiary care hospital in Karachi, Pakistan
Authors: Saleem Syed Ghazanfar , Ali Saima , Ghouri Nida , Maroof Quratulain , Jamal Muhammad Imran , Aziz Tariq , Shapiro David , Rybarczyk Megan
Published: December 2021

Background and Objective: Maintaining privacy and ensuring confidentiality with patients is paramount to developing an effective patient-provider relationship. This is often challenging in over-crowded Emergency Departments (EDs). This survey was designed to explore patients’ perceptions on maintenance of privacy and confidentiality and their subsequent interactions with providers in a busy tertiary care hospital in Karachi.

Methods: Trained nursing staff conducted structured interviews with 571 patients who presented to The Indus Hospital (TIH) ED from January to December 2020. All patients were 14 years of age or older, could speak and understand Urdu, and provide informed consent. Patients were asked about their perceptions of privacy and confidentiality in the ED and whether this affected their interactions with providers.

Results: Respondents were primarily men (64%) under the age of 45 (62%) presenting for the first time (49%). The majority of patients felt that privacy and confidentiality were maintained, however 10% of patients reported that they had rejected examination due to privacy concerns and 15% of patients reported that they had changed or omitted information provided to a provider due to confidentiality concerns. There was correlation between privacy and confidentiality concerns and patient-provider interactions (p<0.0001).

Conclusions: Despite the often over-crowded and busy environment of the ED, patients generally felt that privacy and confidentiality were maintained. Given the correlation between perception and behavior and the importance of an effective patient-provider relationship, particularly in the acute setting when morbidity and mortality is high, initiatives that focus on maintaining privacy and confidentiality should be pursued.

doi: https://doi.org/10.12669/pjms.38.ICON-2022.5785

How to cite this:Saleem SG, Ali S, Ghouri N, Maroof Q, Jamal MI, Aziz T, et al. Patient perception regarding privacy and confidentiality: A study from the emergency department of a tertiary care hospital in Karachi, Pakistan. Pak J Med Sci. 2022;38(2):351-355.  doi: https://doi.org/10.12669/pjms.38.ICON-2022.5785

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.
Weak and strong ties and its connection to experts' problem-solving styles in scaffolding students' PBL activities on social media
Authors: Abdullah Aznur Hajar , Neo Tse Kian , Low Jing Hong
Published: December 2021

Background: Studies have acknowledged that social media enables students to connect with and learn from experts from different ties available in the students’ personal learning environment (PLE). Incorporating experts into formal learning activities such as scaffolding problem-solving tasks through social media, allows students to understand how experts solve real-world problems. However, studies that evaluate experts’ problem-solving styles on social media in relation to the tie strength of the experts with the students are scarce in the extant literature. This study aimed to explore the problem-solving styles that the experts portrayed based on their ties with the students in problem-based learning (PBL) on Facebook.

Methods: This study employed a simultaneous within-subject experimental design which was conducted in three closed Facebook groups with 12 final year management students, six business experts, and one instructor as the participants. The experts were invited by the students from the weak and strong ties in their PLE. Hinging on the Strength of Weak Ties Theory (Granovetter, 1973) and problem-solving styles (Selby et al., 2004), this study employed thematic analysis using the ATLAS.ti qualitative data analysis software to map the experts’ comments on Facebook.

Results:  The experts from strong and weak ties who had a prior relationship with the students showed people preference style by being more sensitive to the students' learning needs and demonstrating firmer scaffolding compared to the weak ties' experts who had no prior relationship with the students. Regardless of the types of ties, all experts applied all manner of processing information and orientation to change but the degree of its applications are correlated with the working experience of the experts.

Conclusion: The use of weak or strong ties benefited the students as it expedited their problem-solving tasks since the experts have unique expertise to offer depending on the problem-solving styles that they exhibited.
New and noteworthy lichenicolous and bryophylous fungi from the Ukrainian Carpathians
Authors: Darmostuk Valeriy , Khodosovtsev Alexander , Vondrak Jan , Sira Olha
Published: December 2021

Nine species, Acremonium rhabdosporum, Arthonia digitatae, Bryocentria metzgeriae, Diplolaeviopsis cf. symmictae, Skyttea gregaria, Rhymbocarpus pubescens, Stromatopogon cladoniae, Tremella cetrariicola and Xenonectriella subimperspicua, are newly reported for Ukraine. Sphinctrina anglica is recollected for the first time since 1955. Parmelia saxatilis and Parmelina pastillifera are new host species for X. subimperspicua.
Two new synonyms of Pertusaria coccodes (Pertusariales, Ascomycota)
Authors: Oset Magdalena
Published: December 2021

Pertusaria atropallida and P. uralensis are found to represent synonyms of the lichenized fungus P. coccodes. Lectotypes are selected for P. atropallida and P. uralensis.
Crocodia Link. (Peltigeraceae, Lobarioideae) in northern Argentinean rainforests
Authors: Rodríguez Mariá Pía , Michlig Andrea
Published: December 2021

A revision of the lichen genus Crocodia Link. in northern Argentinean rainforests is presented. Three species were identified for the region: C. arvidssonii (D.J. Galloway) D.J. Galloway & Elix, C. aurata (Ach.) Link., and C. clathrata (De Not.) Trevis. The distribution range known for these species is extended: C. arvidssonii is recorded for the first time for the country; C. aurata for Corrientes, Misiones, and Salta provinces; and C. clathrata for Corrientes and Jujuy provinces. The morphology of each species is described and illustrated. A distribution map and a key to known species of the genus are also presented.
Elitist Democracy as the Root of Populist Counter-Revolution: A Theoretical Approach
Authors: Lewandowski Arkadiusz
Published: December 2021

The article aims to critically discuss elitist democracy as one of the possible causes of the contemporary crisis of liberal democracy. The research problem is the question about the essential elements of the concept of elitist democracy, which potentially account for the populist counter-revolution aimed at changing the political systems formed after 1989.

The theoretical background of this paper is provided by the studies on the crisis of democracy, which have been conducted in recent years and presented by Jan Zielonka, or the duets of Ivan Krastev and Stephen Holmes as well as Roger Eatwell and Matthew Goodwin.

The analysis makes it possible to state that relations between elites and non-elites are crucial for elitist democracy, and they include the process of elites distancing themselves from non-elites, depreciating the needs of non-elites and their importance within the political system, and privileging the position of the elites. In turn, the indicated features of elitist democracy constitute the areas of populist criticism of liberal democracy.
The dynamics of the party system in the Czech Republic
Authors: Czyżniewski Marcin
Published: December 2021

The article examines the changes that took place in the Czech party system from the moment of the political transformation of 1989/1990 to the last parliamentary elections in 2017. It is based on a survey of data on the results of the elections to the Czech National Council and the Chamber of Deputies. The interpretation of the data allows answering several research questions: is the Czech party system stable, and if so, is it possible to determine it model? Are the inevitable model changes sudden or evolutionary as a consequence of an observable trend? Is it possible to distinguish and define the stages of functioning of the Czech party system? To what extent does the party system of the Czech Republic have roots in the party system of Czechoslovakia and did the disintegration of the federal republic significantly affect its change?
The Constitutionalization of International Law After Liberalism
Authors: Uhma Piotr
Published: December 2021

Many political changes that have taken place across the world in the last decade have been connected with the spill-over of a new narrative in the public dimension. Among other things, this narrative has emphasized returning control over the public space to the people once again, revitalization of the democratic community, restraint on an expansion of judicial power over representational politics, and in many instances, a specific national approach to the questions of governance. These trends have gained the name “illiberal democracy”, a description which Viktor Orban introduced into the language of political practice a few years later. Indeed, in many countries worldwide, from the United States of America (USA) during the presidency of Donald Trump, Central and Eastern Europe, to Turkey and Venezuela, it has been possible to observe changes which had the principal leitmotif to negate liberal democracy as the only possibility of organizing public space within the state. These trends are continuing, and there are no signs of them disappearing in the near future. The new dispensation in the USA under President Biden also does not guarantee an immediate return to the liberal internationalism of the 1990s. Political changes directed toward the constitutional space of the State have inspired researchers to consider the issues of new constitutionalism, new forms of democracy, and the rule of law beyond liberalism. This article is an attempt to transfer these considerations to the international level. The text aims to consider whether withdrawal from the liberal doctrine could also be observed on an international level and what these facts could mean for the intellectual project of constitutionalization of international law. Building upon reflections on constitutionalism and constitutionalization of international law, this text presents what has up until now been the mainstream understanding of international law as a liberal construct. This showcases the illiberal turn observed among certain countries as exemplified by the anti-liberal and realist language of their constitutional representatives. In this respect, this analysis is a modest contribution to the so far nascent field of sociology of international law. However, the main endeavor of this article is to unchain the notions of international liberalism and constitutionalization of international law as being popularly understood as two sides of the same coin. Consequently, the idea of political constitutionalism of international law is introduced. Seeing things from this perspective, this text focuses on the material rather than formal aspects of international law's constitutionalization. Within the stream of so called thick constitutionalism, there are a few elements listed with which the discussion about international law may continue to engage, if this law is to be considered as legitimate not only formally, but also substantially.
Die programmatische Evolution der FDP in der Ost- und Deutschlandpolitik in den Jahren 1974-1982 im Lichte der neuen Quellen vom Archiv des Deutschen Liberalismus
Authors: Węc Janusz J.
Published: December 2021

The Program Evolution of the FDP in Ostpolitik and Deutschlandpolitik in 1974-1982 in the Light of the New Resources from the Archive of German Liberalism
The main objective of the article is to analyse the program activities of the Free Democratic Party (FDP) in the Eastern policy (Ostpolitik) and German policy (Deutschlandpolitik) of the Federal Republic of Germany in the years 1974-1982. It needs to be emphasised that the author has used new archive resources from the archive of German Liberalism in Gummersbach in this work. This enabled him to present a new assessment of the influence of the FDP on the Eastern policy of the Federal Republic of Germany during the period presented.
Polityka w cieniu koronawirusa
Authors: Żelichowski Ryszard
Published: December 2021

Politics in the Shadow of COVID-19: Parliamentary Election in the Kingdom of the Netherlands
On March 15-17, 2021, the first parliamentary elections in the European Union during the pandemic took place in the Kingdom of the Netherlands. The political authorities of the Kingdom of the Netherlands decided to hold the elections despite severe sanitary restrictions and curfew. On January 15, 2021, the outgoing Prime Minister Mark Rutte, chairman of the People’s Party for Freedom and Democracy (VVD), handed over the resignation of the entire government to the King. The immediate cause was the report of the parliamentary investigative commission announced in December 2020 on the extremely restrictive operation of local tax offices in connection with government child benefits. Mark Rutte has been running the country efficiently since 2010 and was also a favorite in the upcoming parliamentary elections. The elections were conducted without any disturbances. 37 parties were admitted to elections, the largest number in the post-war history of the Kingdom of the Netherlands. The election winners were ruling party VVD party and progressive liberals from D’66. The discussion on the formation of the new government has already started and is accompanied by great emotions. It is going to be a long period of negotiations and their results are difficult to be predicted. The article presents the main actors of this parliamentary game.
Hijos de las nubes i 45 lat marzeń: uchodźcy Saharawi na terytorium Algierii
Authors: Mormul Joanna
Published: December 2021

Hijos de las nubes and 45 Years of Dreams: Saharawi Refugees in Algeria
Over the years, the issue of the protracted exile of the Saharawi people in Algeria as a consequence of the so far unresolved conflict over the Western Sahara has become a highly politicized problem. The protracted standstill and the lack of clear prospects for a referendum that would ultimately end the conflict make it questionable that the Sahrawi refugee situation will change quickly. The article attempts to analyse the status of the Sahrawi people, taking into account the uniqueness of the Sahrawi refugee camps in Algeria and their importance for the still unsolved problem of Western Sahara. It is based largely on qualitative data collected from fieldwork in Algeria (including Sahrawi refugee camps), Mauritania and Morocco, and the Rabat-controlled territory of Western Sahara, as well as interviews and conversations with representatives of Spanish NGOs involved in helping Sahrawi refugees, Sahrawi living or temporarily staying in Spain and researchers working at Spanish universities.
Na autorytarnym kursie
Authors: Kołodziejski Konrad
Published: December 2021

An Authoritarian Course: The Restriction of Civil Rights in Russia after 2012
This article regards the issue of Russian civil rights legislation, which has become very repressive after 2012. It focuses on legal restriction of all political and social activities that are beyond the control of the authorities, in particular the freedom of public meetings. Another goal of the Kremlin's repressive policy is the Internet, which has become the only space for freedom of speech in Russia. The new legislation tries to prevent this by two mechanisms: censorship and self-censorship. The consistent restriction of freedom of speech in Russia proves the growing anxiety of the ruling group, which fears that in the conditions of the deteriorating economic situation, it may lose control over public mood. The analysis of the legislation against civil rights in Russia shows that in recent years the scope of these rights has been constantly reduced. This leads to the conclusion that the main goal of the discussed changes in the law is the complete elimination of independent civic activity perceived as one of the main threats to the authorities.
Discerning Poland’s Contemporary Strategic Culture: An analysis of the 2020 National Security Strategy of the Republic of Poland
Authors: Reeves Christopher
Published: December 2021

The article analyses the Polish government’s recently published National Security Strategy in an attempt to discern the broad outlines of the strategic culture within Poland’s strategic community. The article adopts a ‘fourth generation’ approach to the conception of strategic culture, which posits that there are often rival subcultures within strategic communities, which can often result in dramatic shifts in a state’s security policies over time. There is a brief discussion of how conflicting subcultures can be identified in Poland’s foreign policies in the past before the article discusses what Poland’s current Strategy reveals about the strategic culture of today’s decision-makers. It broadly argues that there are obvious continuities in Poland’s security policies, notably in terms of how the Russian Federation is regarded as a hostile state and the degree to which NATO and the EU serve to strengthen Poland’s security. It is also possible to see more minor shifts in Poland’s security policies in recent years, such as a renewed emphasis on territorial defence and a willingness to align itself with several states which are relatively antagonistic towards the EU.