bluuebunny/crossref_metadata_2025 huggingface dataset:
New phenylalkanoids from the rhizome of Cnidium officinalis Makino
Authors: Kim Hyoung-Geun , Nguyen Trong Nguyen , Lee Yeong-Geun , Lee Min-Ho , Lee Dae Young , Lee Youn-Hyung , Baek Nam-In
Published: November 2021

Cnidium officinalis rhizomes were immersed in 80% MeOH. The extract was fractionated to water, n-butanol, and ethyl acetate fractions (Fr). Open column chromatography was repeatedly carried out on n-butanol and ethyl acetate Fr using silica gel, octadecyl silica gel, and Sephadex LH-20 as the stationary phase affording five phenyl alkanoids 1–5 including two new ones. The molecular structures including stereochemistry were decided based on spectroscopic interpretation of nuclear magnetic resonance, mass spectrometry, and infrared spectroscopy as well as chemical reaction. Three known compounds, coniferyl alcohol methyl ether (1), vanillin (2), and coniferyl aldehyde (3), were reported in the beginning for this plant by authors. Two new phenyl alkanoids were named, 7-methoxyeugenol and cnidiumoside.
Decreased urinary uromodulin is potentially associated with acute kidney injury: a systematic review and meta-analysis
Authors: You Ruilian , Zheng Hua , Xu Lubin , Ma Tiantian , Chen Gang , Xia Peng , Fan Xiaohong , Ji Peili , Wang Li , Chen Limeng
Published: November 2021

Background

Urinary uromodulin (uUMOD) is one of the novel biomarkers for predicting AKI. However, currently available publications showed inconsistent results. We designed this meta-analysis to evaluate the potential association between uUMOD and AKI.

Methods

We searched research articles with no language restriction in Medline, Web of Science, Cochrane Library, Embase, and 3 Chinese datasets from inception to February 2021. We used random-effects models to estimate the standardized mean difference (SMD) between patients with AKI or not, while the leave-one-out method and random-effects meta-regression to evaluate the sensitivity and the impact of potential confounders such as age and surgery.

Results

The meta-analysis comprising 3148 subjects from 11 studies showed that the uUMOD of the AKI group is significantly lower than the non-AKI group (SMD: − 0.71; 95% confidence interval (CI), − 1.00, − 0.42, P < 0. 001, I2 = 78.8%). Subgroup analysis revealed the difference is also significant in a different age, surgery condition, and assay time but not acute rejection (AR) group, especially in children (SMD: − 1.21, 95% CI: − 1.80, − 0.61; P < 0.001) and patients undergoing surgery (SMD: − 1.03, 95% CI: − 1.75, − 0.30; P < 0.001). Lower uromodulin is associated with higher odds for AKI incidence (odds ratio = 2.47, 95% CI: 1.12, 5.47; P < 0.001, I2 = 89%). Meta-reggression found that age was associated with the SMD of uUMOD. The study outcome was reliably confirmed by the sensitivity analysis.

Conclusion

The present study suggested a negative association between uUMOD and AKI especially in children and surgical patients.
Machine learning adaptation of intraocular lens power calculation for a patient group
Authors: Mori Yosai , Yamauchi Tomofusa , Tokuda Shota , Minami Keiichiro , Tabuchi Hitoshi , Miyata Kazunori
Published: November 2021

Background

To examine the effectiveness of the use of machine learning for adapting an intraocular lens (IOL) power calculation for a patient group.

Methods

In this retrospective study, the clinical records of 1,611 eyes of 1,169 Japanese patients who received a single model of monofocal IOL (SN60WF, Alcon) at Miyata Eye Hospital were reviewed and analyzed. Using biometric metrics and postoperative refractions of 1211 eyes of 769 patients, constants of the SRK/T and Haigis formulas were optimized. The SRK/T formula was adapted using a support vector regressor. Prediction errors in the use of adapted formulas as well as the SRK/T, Haigis, Hill-RBF and Barrett Universal II formulas were evaluated with data from 395 eyes of 395 distinct patients. Mean prediction errors, median absolute errors, and percentages of eyes within ± 0.25 D, ± 0.50 D, and ± 1.00 D, and over + 0.50 D of errors were compared among formulas.

Results

The mean prediction errors in the use of the SRT/K and adapted formulas were smaller than the use of other formulas (P < 0.001). In the absolute errors, the Hill-RBF and adapted methods were better than others. The performance of the Barrett Universal II was not better than the others for the patient group. There were the least eyes with hyperopic refractive errors (16.5%) in the use of the adapted formula.

Conclusions

Adapting IOL power calculations using machine learning technology with data from a particular patient group was effective and promising.
“Self as enterprise”: overmarketization and the self-management of R&D engineers
Authors: Yan Xia
Published: November 2021

This article analyzes the self-enterprising mechanism of research & development (R&D) engineers based on a case study of labor control in a high-tech company. The concept of “self as enterprise” refers to the form of labor control by allowing workers to self-manage according to the market principle. It is neither a form of normative control built upon accepting and internalizing market-oriented values nor responsible autonomy aiming to enhance workers' organizational commitment. R&D engineers' reproduction of current living standards depends heavily on performance-based salaries, which forces them to pragmatically comply with market rules. When both the reproduction of labor and the labor market have been overmarketized, R&D engineers are at high risk of downgrading their living standards and facing double job insecurity. Therefore, they must manage their work and life in an enterprising way to maximize labor value and prevent it from being devalued.
Association between medication adherence and health-related quality of life in patients with chronic obstructive pulmonary disease
Authors: Moradkhani Boyuk , Mollazadeh Samaneh , Niloofar Parastoo , Bashiri Afsaneh , Oghazian Mohammad Bagher
Published: November 2021

Background

Chronic Obstructive Pulmonary Disease (COPD) is one of the prominent cause of mortality worldwide. Nowadays, the level of medication adherence in COPD patients is very low, which reduces the clinical therapeutic effects. The purpose of the present study is to investigate the relationship between medication adherence and Health-Related Quality of Life (HRQoL) in COPD patients referred to the pulmonologist’s office.

Methods

This observational study was performed on 100 COPD outpatient cases. Each patient was interviewed to answer questionnaires regarding demographic and clinical information. To assess quality of life, health status, and severity of dyspnea, the St George’s Respiratory Questionnaire - COPD-Specific Version (SGRQ-C), COPD Assessment Test (CAT), and Modified British Medical Research Council (mMRC) questionnaires were used, respectively. Persian version of the Morisky Medication Adherence Scale (MMAS-8-Item) was used to measure medication adherence. To determine the adherence predictors, an ordinal logistic regression analysis was performed.

Results

Out of 100 patients with mean (±SD) age of 61.35 (±10.79) years, 74% had medium and high medication adherence. In the final ordinal logistic model, quality of life, health status, and education level found to have positive effect on medication adherence while polypharmacy had negative effect. We did not find any significant association between age, gender, Body Mass Index (BMI), and other variables with medication adherence.

Conclusions

Patients with high quality of life are more adherent to their medications. Furthermore, patients who have polypharmacy, tend to have less adherence to their medications.
Treatment outcome and associated factors of bacterial meningitis at pediatric wards of southwestern Ethiopian hospital: a prospective observational study
Authors: Bekele Firomsa , Ahmed Anuwar , Kedir Abas , Sheleme Tadesse
Published: November 2021

Background

Meningitis is a common infectious cause of morbidity and mortality in pediatric age-groups. Acute bacterial meningitis is considered a medical emergency, because it is a life-threatening infection that requires immediate treatment. Therefore the study was aimed to assess the magnitude and predictors of poor treatment outcome among pediatric patients admitted to Bedele General Hospital.

Methods

A prospective observational study was conducted at pediatric wards of Bedele General Hospital from February 12, 2020 to August 11, 2020. Lumbar puncture, in the absence of contraindications, was performed under aseptic conditions for all patients with suspected bacterial meningitis to collect cerebrospinal fluid specimen. Multivariable logistic regression was used to determine the predictors of poor treatment outcome.

Result

Of the 196 pediatric patients involved, 112(57.1%) were male and the mean and standard deviation of their age was 6.09 ± 4.46. Regarding to their clinical profile, a total of 101(51.5%) were completely immunized and 115(58.7%) were given corticosteroid during their treatment. In our study the most frequently occurred clinical manifestation of meningitis was fever 164(83.67%), neck rigidity149 (76.02%), and irritability 122(62.24%). Regarding to their pharmacotherapy, the most commonly prescribed antibiotics were Ampicillin 104(24.82%), and Gentamycin 102(24.34%). The magnitude of good treatment outcome was 132(67.35%) whereas 64(32.65%) were poorly controlled. The presence of comorbidity (AOR = 3.64, 95CI%:1.83–7.23,P = < 0.001),corticosteroid use (AOR = 2.37, 95CI%:1.17–4.81,P = 0.017) and oxygen administration (AOR = 3.12, 95CI%: 1.34–7.25,P = 0.008) was a predictor of meningitis treatment outcome.

Conclusion

The treatment outcome of meningitis was good in of two-third of the patients. It was found that the presence of comorbidity, the administration of oxygen and use of corticosteroid was predictors of the treatment outcomes of bacterial meningitis in children. Therefore, in patients with these factors, appropriate meningitis treatment should be encouraged and locally applicable treatment guidelines should be prepared to improve patient outcome. Finally, the meningitis patients should be given corticosteroid and oxygen as treatment and special attention should be given for patients having co-morbidities.
Knowledge, attitude, and practices toward COVID-19 among the international travelers in Thailand
Authors: Prapaso Suttiporn , Luvira Viravarn , Lawpoolsri Saranath , Songthap Archin , Piyaphanee Watcharapong , Chancharoenthana Wiwat , Muangnoicharoen Sant , Pitisuttithum Punnee , Chanthavanich Pornthep
Published: November 2021

Background

International travel is among the leading impactful factors of COVID-19 transmission; thus, adequate knowledge, good attitude and good preventive practices toward COVID-19 for international travelers are particularly essential for successful pandemic control.

Methods

A cross-sectional, questionnaire-based study was conducted to determine knowledge, attitude and practices (KAP) of international travelers (both Thai and non-Thai) and expatriates in Thailand. The data were collected at the Thai Travel Clinic, Bangkok, Thailand and via online platforms during May to October 2020. The independent T-test, Chi-square test and multiple regression analysis (MRA) were applied to determine factors influencing the KAP.

Results

Of 399 travelers, 46.6% were male, 72.1% had a Bachelor’s degree or higher, and the mean age was 35.6 ± 9.6 years. Due to unexpected travel restrictions and lock down, 77.9% of participants were Thai and the respective major purpose of travel was business/work. Travel cancellation/postponement was reported at 73.9%. While sufficient knowledge (≥ 60% correct answers) was reported in 77.9% of participants, a low percentage of correct answers was found in the questions regarding disease transmission. The travelers reported a neutral attitude and an overall moderate concern regarding the COVID-19 situation. Adequate preventive practices were determined by the average practice score 3.54 ± 0.38 (0 = never and 4 = always). The MRA revealed that the factors influencing good practices were travelers who: i) enrolled from outside the hospital (online platform); ii) received pretravel advice at hospital; iii) were female; iv) participated before the declaration of the end of the outbreak; v) were aged 40–49 years, and vi) visited friends and relatives.

Conclusions

The majority of travelers in this study had sufficient knowledge, a neutral attitude and adequate preventive practices toward COVID-19. The factors influencing good practices included pretravel advice, sex, age and the point in the timeline of the outbreak. In order to better control the COVID-19 pandemic situation, pretravel counselling and advice should be promoted as a means to improve knowledge, particularly in disease transmission, increase awareness and emphasize appropriate preventive measures toward COVID-19 among international travelers. Furthermore, preventive practices should be bolstered at all times regardless of the outbreak situation.
Phenolic rich-extracts from Nauclea latifolia fruit restored Lead acetate-induced liver and kidney damaged in Wistar rats
Authors: Busari Musa Bola , Hamzah Rabiat Unekwu , Muhammad Hadiza Lami , Yusuf Ruqayyah Shehu , Madaki Fatima Mohammad , Adeniyi Jamiu Olabanji , Ibrahim Yunusa Olatunji , Berinyuy Eustace Bonghan
Published: November 2021

Liver and kidney diseases are becoming order of the day in both developed and developing countries as a result of environmental pollutants such as lead. Restorative activities of methanol and methanol/acetone phenolic-rich extracts (MPR and MAPR, respectively) of theN. latifoliafruit (NLF) on lead acetate-induced liver and kidney damaged were assessed in Wistar rats. The antioxidant activities of both phenolic-rich extracts of NLF were also carried out using standard methods. Seven groups of Wistar rats comprising of 5 rats each were used for the study and 1000 mg/kg body weight (bw.) of lead acetate solution was administered orally to the 6 groups of animals to induce liver and kidney damage. The high and low dosages of 300 and of 150 mg/kg body weight (bw.) of both MPR and MAPR were administered orally to four groups for 14 days along positive (100 mg/kg bw. of silymarin), negative (treated with the placebo) and naïve control (non-induced). The percentage DPPH radical scavenging activities, ferric reducing antioxidant power and percentage inhibition of lipid peroxidation show high antioxidants activities dose-dependently. Furthermore, administration of lead acetate significantly (p > 0.05) reduces the weight gain and elevates the liver and kidney relative weight as well as their respective damage biomarkers with distortions in their histologies. However, treatment with MPR and MAPR resulted in significant (p < 0.05) improve in the percentage body weight gain, relative liver and kidney weight as well as restoration of the activities of the liver and kidney functions biomarkers of the treated animals. Likewise, lesser hepatic and renal cells injury were also observed in the treated groups with MAPR being more active at high dosage which significantly (p < 0.05) compared well with normal group. Hence, the phenolics content of theN. latifoliafruit can be exploited further for drug development for the management kidney and liver damage arise from lead-induced toxicity.
Three-dimensional simulator: training for beginners in endovascular embolization with liquid agents
Authors: Matyjas Michal , Sauerbrey Marius , Wyschkon Sebastian , de Bucourt Maximilian , Scheel Michael
Published: November 2021

Background

To design a simulator for novices without prior experience in embolization with liquid agents such as n-Butyl cyanoacrylate (n-BCA) and to evaluate the simulator using surveys and post hoc video analysis.

Materials and methods

The simulator was created using computer-aided design software and three-dimensionally printed. Before an embolization, trainees completed questionnaires regarding their level of expertise and self-reported confidence level. The participants were shown an instruction video and each participant performed four embolizations on the simulator. Subsequently, the participants completed surveys on self-reported confidence level and assessed the simulator’s face and content validity.

Results

Five experts and twelve novices trained on the simulator. The experts were radiology residents and fellows with at least 5 years of work experience in interventional radiology. The novices were medical students and radiology residents without any previous experience with embolization. Based on the surveys, the experts assessed the simulator as very useful for embolization training. Performance, e.g. mean duration embolization between experts (mean ± standard deviation = 189 ± 42 s) and novices (mean ± standard deviation = 235 ± 66 s) were significantly different (p = .001). The overall simulation of the embolization process, simulated complications, and educational capabilities of the simulator were evaluated positively. In the novice group the self-reported confidence level significantly increased (p = .001).

Conclusion

The liquid embolization simulator proposed here is a suitable educational tool for training embolization procedures. It reduces the duration of embolization procedures and improves the confidence level of beginners in embolization.
Evaluation and improvement of the oxidative stability of leather fatliquors
Authors: Yu Yue , Huang Min , Lv Jiaqi , Zeng Yunhang , Sun Qingyong , Shi Bi
Published: November 2021

Fatliquor oxidation may give leather unpleasant odor, and excessive amounts of Cr(VI) and volatile organic compounds. The accurate evaluation and improvement of the oxidative stability of fatliquors are of great significance to high-quality leather manufacturing. We proposed a set of practical methods for evaluating the oxidative stability of fatliquors on the basis of oxidation induction time, change in iodine value (∆ IV), and change in acid value (∆ AV) under accelerated oxidation conditions (at 100 °C with 10 L/h of air). Oxidation induction time is a highly sensitive marker for quantifying the oxidative stability of fatliquors, and ∆ IV and ∆ AV that are low cost and easy to operate are useful in evaluating the oxidative stability of fatliquors when the oxidation induction time is less than 22 h. The number of double bonds in fatliquors is an important factor affecting oxidative stability. The sulfation modification of fatliquors that greatly reduces double bonds and the addition of antioxidants, especially butylated hydroxyanisole and butylated hydroxytoluene, markedly improve oxidative stability of fatliquors.
Arf6 is necessary for senseless expression in response to wingless signalling during Drosophila wing development
Authors: Marcetteau Julien , Matusek Tamàs , Luton Frédéric , Thérond Pascal P.
Published: November 2021

Wnt signalling is a core pathway involved in a wide range of developmental processes throughout the metazoa. In vitro studies have suggested that the small GTP binding protein Arf6 regulates upstream steps of Wnt transduction, by promoting the phosphorylation of the Wnt co-receptor, LRP6, and the release of β-catenin from the adherens junctions. To assess the relevance of these previous findings in vivo, we analysed the consequence of the absence of Arf6 activity on Drosophila wing patterning, a developmental model of Wnt/Wingless signalling. We observed a dominant loss of wing margin bristles and Senseless expression in Arf6 mutant flies, phenotypes characteristic of a defect in high level Wingless signalling. In contrast to previous findings, we show that Arf6 is required downstream of Armadillo/β-catenin stabilisation in Wingless signal transduction. Our data suggest that Arf6 modulates the activity of a downstream nuclear regulator of Pangolin activity in order to control the induction of high level Wingless signalling. Our findings represent a novel regulatory role for Arf6 in Wingless signalling.
Treatment of age-related visual impairment with a peptide acting on mitochondria
Authors: Alam Nazia M. , Douglas Robert M. , Prusky Glen T.
Published: November 2021

Age-related visual decline and disease due to neural dysfunction are major sources of disability that have resisted effective treatment. In light of evidence that visual impairment and mitochondrial dysfunction advance with age, we characterized age-related decline of spatial visual function in mice and investigated whether treatment of aged mice with the mitochondrion-penetrating peptide elamipretide that has been reported to improve mitochondrial function, would improve it. Impaired photopic acuity measured by using a virtual optokinetic system emerged near 18 months and declined to ∼40% below normal by 34 months. Daily application of the synthetic peptide elamipretide, which has high selectivity for mitochondrial membranes that contain cardiolipin and promotes efficient electron transfer, was able to mitigate visual decline from 18 months onwards. Daily application from 24 months onwards, i.e. when acuity had reduced by ∼16%, reversed visual decline and normalized function within 2 months. Recovered function persisted for at least 3 months after treatment was withdrawn and a single treatment at 24 months delayed subsequent visual decline. Elamipretide applied daily from 32 months onwards took longer to take effect, but substantial improvement was found within 2 months. The effects of age and elamipretide treatment on contrast sensitivity were similar to those on acuity, systemic and eye drop applications of elamipretide had comparable effects, scotopic spatial visual function was largely unaffected by age or treatment, and altered function was independent of variation in optical clarity. These data indicate that elamipretide treatment adaptively alters the aging visual system. They also provide a rationale to investigate whether mitochondrial dysfunction is a treatable pathophysiology of human visual aging and age-related visual disease.
Analysis and results from a UK national dose audit of paediatric CT examinations
Authors: Worrall Mark , Holubinka Mike , Havariyoun Glafkos , Hodgson Kirsten , Edyvean Sue , Holroyd John , Davis Anne , Dunn Matthew , Gardiner Anna
Published: November 2021

Objective:

To present the results following a UK national patient dose audit of paediatric CT examinations, to propose updated UK national diagnostic reference levels (DRLs) and to analyse current practice to see if any recommendations can be made to assist with optimisation.

Methods:

A UK national dose audit was undertaken in 2019 focussing on paediatric CT examinations of the head, chest, abdomen/pelvis and cervical spine using the methods proposed by the International Commission on Radiological Protection. The audit pro-forma contained mandatory fields, of which the post-examination dosimetry (volume CT dose index and dose–length product) and the patient weight (for body examinations) were the most important.

Results:

Analysis of the data submitted indicates that it is appropriate to propose national DRLs for CT head examinations in the 0-<1, 1–<5, 5–<10 and 10–<15 year age ranges. This extends the number of age categories of national DRLs from those at present and revises the existing values downwards. For CT chest examinations, it is appropriate to propose national DRLs for the first time in the UK for the 5–<15, 15–<30, 30–<50 and 50–<80 kg weight ranges. There were insufficient data received to propose national DRLs for abdomen/pelvis or cervical spine examinations. Recommendations towards optimisation focus on the use of tube current (mA) modulation, iterative reconstruction and the selection of examination tube voltage (kVp).

Conclusion:

Updated UK national DRLs are proposed for paediatric CT examinations of the head and chest.

Advances in knowledge:

A national patient dose audit of paediatric CT examinations has led to the proposal of updated national DRLs.
Clumpy artifacts can be differentiated from tophi with DECT: comparison between gout-free and gouty patients
Authors: Shin Dong Han , Song You Seon , Choi Yunjung , Yoo Wan-Hee , Kummel Florian , Park Eun Hae
Published: November 2021

Objectives:

To accurately differentiate clumpy artifacts from tophi with foot and ankle DECT.

Methods and materials:

In session 1, 108 clumpy artifacts from 35 patients and 130 tophi images from 25 patients were analyzed. Reviewers classified green pixelation according to anatomic location, shape (linear, stippled, angular, oval), and height and width ratio. In session 2, green pixelation confined to the tendon was evaluated (shape, height and width ratio, occupied area in the tendon, accompanied peritendinous green pixelation).

Results:

In session 1, while tophi were noted at various locations, almost all clumpy artifacts were located at the tendon (99%, p < 0.0001). Most clumpy artifacts were linear, stippled, and wide, while most tophi were angular and oval (p < 0.05). In session 2, the shape of green pixelation from clumpy artifacts and tophi was significantly different (p < 0.0001) and most clumpy artifacts occupied less than 50% of the tendon (p = 0.02), and most tophi were accompanied by peritendinous green pixelation (p < 0.0001). Univariant logistic regression showed that tophi were significantly correlated with peritendinous deposits, angular and oval shape, and more than 50% of the tendon (p < 0.05).

Conclusion:

Clumpy artifacts can be differentiated from tophi in DECT. Clumpy artifacts typically are located in the tendon with a linear or stippled shape, wide, and less than 50% of a tendon’s cross-section. Tophi, on the other hand, typically are oval, larger than 50% of the tendon’s cross-section, and associated with adjacent peritendinous green pixelation.

Advances in knowledge:

Clumpy artifacts can be differentiated from tophi in image findings by their location and shape.
Paradigmas em transe
Authors: Wilner Adriana
Published: November 2021

Vão completar duas décadas desde que Jim O’Neill publicou o artigo “Building Better Global Economic BRICs”. O economista, à época na Goldman Sachs, criou, então, o acrônimo para chamar a atenção para o potencial das economias de Brasil, Rússia, Índia e China – a África do Sul juntou-se ao grupo em 2010.
Parceria próspera
Authors: Reddy Suresh K.
Published: November 2021

A pandemia afetou o crescimento econômico da Índia e do Brasil, mas também criou oportunidades. A Índia recebeu investimento estrangeiro recorde no ano passado, apesar da pandemia.
Relações para o futuro
Authors: Corrêa do Lago André Aranha
Published: November 2021

Brasil e Índia, ainda que grandes países com relacionamento antigo, têm relações muito aquém do potencial. A boa imagem mútua muitas vezes está desatualizada e idealizada.
A recuperação do PIB, a valorização dos terrenos urbanos e a adesão onerosa
Authors: Sandroni Paulo
Published: November 2021

Seria importante criar um instrumento que permitisse ao poder público participar da valorização dos terrenos, no sentido de obter recursos que financiem os investimentos em infraestrutura necessários para atender ao aumento da densidade construtiva e populacional.
Em defesa da democracia
Authors: Antonio  Carvalho Teixeira Marco
Published: November 2021

O que une as diferenças são o respeito e a preservação da vida e dos direitos de todos, incluindo as minorias. Só devemos ser intolerantes com quem não tolera os valores democráticos.
Place & Person involved in delivery: Factors leading to delay in diagnosis of Anorectal Malformation in Newborns
Authors: Perveen Shazia , Ali Sajid , Jabbar Abdul , Fatima Batool
Published: November 2021

Objective: To determine the frequency of place of delivery and person detecting the anomaly among newborn babies presenting with delayed diagnosis of anorectal malformation (ARM).

Methods: This is a Descriptive Cross-Sectional Study, conducted at Department of Paediatric Surgery, National Institute of Child Health (NICH) Karachi, from February 19, 2019 to August 18, 2019. All patients with ARM who were diagnosed beyond two hours of life (Delayed diagnosis) were included in the study. Chi square test was applied for comparison of categorical variables.

Results: Total 110 patients were enrolled in this study. Nineteen (17.3%) patients were delivered at home, while 91 (82.7%) were delivered at the hospital. The first person detecting the anomaly was grandmother (n=25) or a non-medical person in 58 patients (52.7%), 52 were diagnosed by a medical personal either primarily in 31 cases (28.2%) or secondarily by a neonatologist in 21 cases (19.1%).

Conclusion: It is concluded that Non-medical person detected ARM mainly despite the babies being delivered mostly at the hospital, indicating the need for meticulous neonatal examination.

doi: https://doi.org/10.12669/pjms.38.1.4156

How to cite this:Perveen S, Ali S, Jabbar A, Fatima B. Place & Person involved in delivery: Factors leading to delay in diagnosis of Anorectal Malformation in Newborns. Pak J Med Sci. 2022;38(1):297-301. doi: https://doi.org/10.12669/pjms.38.1.4156

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.
Diagnostic accuracy of procalcitonin in maternal plasma to detect early intra-amniotic infection in preterm premature rupture of the membranes with respect of highvaginal swab as gold standard
Authors: Farooqui Rabia , Siddiqui Qurat Aman
Published: November 2021

Objective: To determine the diagnostic accuracy of procalcitonin in maternal plasma to detect early intra-amniotic infection in Preterm premature rupture of the membranes (PPROM) with respect of high vaginal swab as gold standard

Methods: A cross-sectional study was conducted at Liaquat National Hospital, Karachi, from February to August 2017. The blood sample of women with PPROM were collected to measure procalcitonin level. PCT1 and PCT2 were run along with the sample for the accuracy of the results. Sensitivity, specificity, PPV, NPV, and diagnostic accuracy of procalcitonin were calculated taking HVS C/S as gold standard.

Results: Out of total 150 women, mean age was 28.78±4.79 years. Mean gestational age was 30.79±3.07 weeks. Mean procalcitonin level was 0.13±0.24 ng/ml. Intra-amniotic infection was diagnosed in 48.7% cases through procalcitonin levels and 51.3% through HVS culture and sensitivity. Sensitivity, Specificity, PPV (Positive predictive value), NPV (Negative predictive value) and accuracy were 87%, 91.8%, 91.78%, 87%, and 89.3% respectively. For females with gestational age ≤32 weeks, sensitivity, specificity, and diagnostic accuracy were 83.9%, 90.4%, and 87.03% respectively. For females with gestational age >32 weeks, sensitivity, specificity, and diagnostic accuracy were 95.2%, 92.5%, and 95.23% respectively.

Conclusion: Diagnostic accuracy of maternal blood procalcitonin levels were found satisfactory in detection of early intra-amniotic infection in PPROM.

doi: https://doi.org/10.12669/pjms.38.1.4436

How to cite this:Farooqui R, Siddiqui QA. Diagnostic accuracy of procalcitonin in maternal plasma to detect early intra-amniotic infection in preterm premature rupture of the membranes with respect of high vaginal swab as gold standard. Pak J Med Sci. 2022;38(1):310-314. doi: https://doi.org/10.12669/pjms.38.1.4436

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.
Clinical application of compound Glycyrrhizin tablets in the treatment of patients with Simplex Henoch-Schonlein Purpura and its effect on immune function
Authors: Li Chao , Wang Zhi-bin
Published: November 2021

Objectives: To investigate the curative effect of Compound Glycyrrhizin Tablets in the adjuvant treatment of simplex Henoch-Schonlein purpura and its influence in improving immune function.

Methods: In this retrospective study design was used in this study. Eighty newly diagnosed patients with purpura simplex who visited the outpatient department of Baoding First Central Hospital from June 2017 to February 2020 were included. They were randomly divided into treatment group and control group. The two groups were provided with the same conventional comprehensive treatment. Patients in the treatment group received oral administration of Compound Glycyrrhizin Tablets on the basis of conventional treatment. The clinical efficacy of the treatment group and the control group were compared according to the time and effect of purpura regression, followed by the comparison of changes of T cell subsets before and after treatment.

Results: The total effective rate of the treatment group was 92.5%, which was higher than that of the control group (77.5%) (P < 0.05). The purpura subsidence time of effective patients in treatment group was shorter than that in control group (P < 0.05). There was no significant difference in lymphocyte subsets between the treatment group and the control group before treatment. After treatment, the proportion of CD4+ cells and CD4+/CD8+ cells in the treatment group were obviously higher than that in the control group, and the count of CD8+ cells was evidently lower than that in the control group (P < 0.05).

Conclusions: Compound Glycyrrhizin is effective in the adjuvant treatment of simplex Henoch-Schonlein purpura without obvious adverse reactions, which is valuable for clinical application as an adjuvant.

doi: https://doi.org/10.12669/pjms.38.1.4609

How to cite this:Li C, Wang Z. Clinical application of compound Glycyrrhizin tablets in the treatment of patients with Simplex Henoch-Schonlein Purpura and its effect on immune function. Pak J Med Sci. 2022;38(1):271-275. doi: https://doi.org/10.12669/pjms.38.1.4609

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.
Value of combined detection of PCA, ANCA, ASCA, AGA and ANA in early diagnosis of Gastrointestinal Diseases
Authors: Liu Xin , Guo Deli , Li Xiaoyan , Guo Yaping , Song Wenjie
Published: November 2021

Objectives: To investigate the positive detection rate and clinical application value of anti-parietal cell antibody (PCA), anti-neutrophil cytoplasmic antibody (ANCA), anti-Saccharomyces cerevisiae antibody (ASCA), anti-gliadin antibody (AGA) and anti-nuclear antibody (ANA) in patients visiting the Department of Gastroenterology.

Methods: From January 2015 to June 2018, 1,083 patients receiving detection of PCA and other autoantibodies were selected from the Department of Gastroenterology of Baoding First Central Hospital. The positive detection rate of autoantibodies was statistically analyzed. The enumeration data were expressed as rate or constituent ratio, and the rates were compared between groups using the x2 test.

Results: Among the 1,083 patients, the positive detection rate of ANA, ASCA, AGA, PCA and ANCA was 33.52%, 16.71%, 15.51%, 13.66% and 7.66%, respectively. The total positive detection rate was 62.8% (n = 680).

Conclusion: The population with abdominal distension, chronic abdominal pain, diarrhea and other digestive system symptoms should be timely treated with combined detection of PCA, ANCA, ASCA, AGA and ANA, which is of important clinical application value for early diagnosis of gastrointestinal diseases and prevention of missed diagnosis and misdiagnosis.

doi: https://doi.org/10.12669/pjms.38.1.4682

How to cite this:Liu X, Guo D, Li X, Guo Y, Song W. Value of combined detection of PCA, ANCA, ASCA, AGA and ANA in early diagnosis of Gastrointestinal Diseases. Pak J Med Sci. 2022;38(1):227-231. doi: https://doi.org/10.12669/pjms.38.1.4682

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 telenutrition in overweight and obese adults in a nutritional center in Lima, Peru.
Authors: Castrillón Liñan Carolina , Alvarez Mayorga Jimy Henry , Lozada-Urbano Michelle
Published: November 2021

Background: COVID-19 pandemic has been challenging for health services and systems around the world, including Peru.  A viable alternative in the telemedicine field to guarantee patient nutritional care is telenutrition. Telenutrition involves the interactive use of electronic information and telecommunications technologies to implement the nutrition care process with patients at a remote location. Information regarding the experience with this methodology and its potential effect on patients’ nutritional goals, does not exist in Peru. The aim of the study was to report the effect of the evaluation type (telenutrition vs. in-person) on weight, body mass index (BMI), waist circumference (WC) and relative fat mass (RFM) in overweight and obese adult patients.  Methods: This retrospective study included 100 eligible patients in a single nutritional center, from January 2019 to March 2021. Telenutrition and in-person continuous variables were compared with independent sample t-test or U Mann-Whitney test. Results: There were significant differences in weight, BMI, WC and RFM by the end of follow-up period, in both evaluation modalities. Patients on the telenutrition group had a mean decrease of 6.80 ± 4.87 cm in WC, whereas the mean difference observed for the in-person group was 6.74 ± 4.55 cm. There were no significant differences in the changes of any anthropometric parameters when comparing both systems. Reductions were observed in weight (5.93 ± 3.88 kg vs. 4.92 ± 3.29 kg), BMI (2.23 ± 1.39 kg/ m2 vs. 1.83 ± 1.23 kg/ m2), WC (6.80 ± 4.87 cm vs. 6.74 ± 4.55 cm) and RFM (2.43 ± 1.78 vs. 2.63 ± 1.73) in telenutrition and in-person evaluation, respectively by the end of the follow-up period.  Conclusions: Telenutrition may be regarded as an alternative to in-person evaluation offering anthropometric changes and nutritional goals similar to those reported through the in-person modality, in overweight and obese adult people.
Using Machine Learning Methods Incorporating Individual Reader Annotations to Classify Paediatric Chest Radiographs in Epidemiological Studies
Authors: Mwaniki Paul , Kamanu Timothy , Akech Samuel , Eijkemans M. J. C
Published: November 2021

Introduction: Epidemiological studies that involve interpretation of chest radiographs (CXRs) suffer from inter-reader and intra-reader variability. Inter-reader and intra-reader variability hinder comparison of results from different studies or centres, which negatively affects efforts to track the burden of chest diseases or evaluate the efficacy of interventions such as vaccines. This study explores machine learning models that could standardize interpretation of CXR across studies and the utility of incorporating individual reader annotations when training models using CXR data sets annotated by multiple readers.

Methods: Convolutional neural networks were used to classify CXRs from seven low to middle-income countries into five categories according to the World Health Organization's standardized methodology for interpreting paediatric CXRs. We compared models trained to predict the final/aggregate classification with models trained to predict how each reader would classify an image and then aggregate predictions for all readers using unweighted mean.

Results: Incorporating individual reader's annotations during model training improved classification accuracy by 3.4% (multi-class accuracy 61% vs 59%). Model accuracy was higher for children above 12 months of age (68% vs 58%). The accuracy of the models in different countries ranged between 45% and 71%.

Conclusions: Machine learning models can annotate CXRs in epidemiological studies reducing inter-reader and intra-reader variability. In addition, incorporating individual reader annotations can improve the performance of machine learning models trained using CXRs annotated by multiple readers.
The genome sequence of the grey wolf, Canis lupus Linnaeus 1758
Authors: Sinding Mikkel-Holger S. , Gopalakrishnan Shyam , Raundrup Katrine , Dalén Love , Threlfall Jonathan ,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life programme,   Wellcome Sanger Institute Scientific Operations: DNA Pipelines collective,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium, Gilbert Tom
Published: November 2021

We present a genome assembly from an individual male Canis lupus orion (the grey wolf, subspecies: Greenland wolf; Chordata; Mammalia; Carnivora; Canidae). The genome sequence is 2,447 megabases in span. The majority of the assembly (98.91%) is scaffolded into 40 chromosomal pseudomolecules, with the X and Y sex chromosomes assembled.
Seeing gene expression in cells: the future of structural biology
Authors: Dai Wei , Darst Seth A , Dunham Christine M , Landick Robert , Petsco Gregory , Weixlbaumer Albert
Published: November 2021

Although much is known about the machinery that executes fundamental processes of gene expression in cells, much also remains to be learned about how that machinery works. A recent paper by O’Reilly et al. reports a major step forward in the direct visualization of central dogma processes at submolecular resolution inside bacterial cells frozen in a native state. The essential methodologies involved are cross-linking mass spectrometry (CLMS) and cryo-electron tomography (cryo-ET). In-cell CLMS provides in vivo protein interaction maps. Cryo-ET allows visualization of macromolecular complexes in their native environment. These methods have been integrated by O’Reilly et al. to describe a dynamic assembly in situ between a transcribing RNA polymerase (RNAP) and a translating ribosome – a complex known as the expressome – in the model bacterium Mycoplasma pneumoniae 1 . With the application of improved data processing and classification capabilities, this approach has allowed unprecedented insights into the architecture of this molecular assembly line, confirming the existence of a physical link between RNAP and the ribosome and identifying the transcription factor NusA as the linking molecule, as well as making it possible to see the structural effects of drugs that inhibit either transcription or translation. The work provides a glimpse into the future of integrative structural cell biology and can serve as a roadmap for the study of other molecular machineries in their native context.
METHODS TO REDUCE VEHICLE NOISE
Authors: Shvetsov Alexey V. , Doronichev Alexander V. , Kuzmina Natalya A.
Published: November 2021

Reducing the noise generated by vehicles remains an important task for the development of the transport complex. Road traffic noise is one of the causes of the burden on the health of a modern person in the conditions of modern megalopolises. At the same time, technical solutions aimed at solving this problem must take into account the economic constraints caused by the competitiveness of the automaker’s products in the market. The need to reduce the noise generated by vehicles is established by a number of international regulatory documents. In addition, reducing the noise of vehicles is one of the ways to create a comfortable and safe environment.
Purpose: To analyze the main sources of noise generated by a vehicle, as well as methods for its reduction.
Methods: synthesis, induction and deduction, comparison, generalization and other scientific research methods are used.
Results: proposed measures to reduce the noise of a vehicle in the range of 17-25%.
Field of application of the results: the results of the work can be used in the development of systems for reducing traffic noise in cities and in urban planning, in particular, when choosing the composition and location of noise barriers.
Die Reichstagsteilnahme des livländischen Deutschordenszweiges und seine Beziehungen mit dem deutschen Zweig (ca. 1520‒1560)
Authors: Maasing Madis
Published: November 2021

The participation of the Livonian branch of the Teutonic Order at the Imperial Diets and its relations with the German branch (from the 1520s to the 1550s)
 
This article discusses the relations of Livonian branch of the Teutonic Order with the German branch from the secularization of Prussia (1525) to the beginning of the Livonian War (1558), and concentrates on the topics that were connected with the participation of the Order at the Imperial Diet of the Holy Roman Empire. Before the aforementioned period, the branches had very few direct connections, and relations of the Livonian branch with the Empire were usually mediated by the Grand Master of the Order. After 1525, the German Master largely took over the role of a mediator, as he became the acting head of the Order and had close relations with the central Imperial institutions. The latter became increasingly important for the Livonian Master, who became an Imperial prince most probably on the 24th of December 1526. This enabled him to participate in the Imperial Diets. At the Diets, the branches represented their interests usually separately. This was partially caused by the fact that these diverged quite strongly: while the German branch aspired for the recuperation of Prussia, tried to protect the Order’s possessions from increasing intrusions of German princes, and paid the Turkish taxes to obtain support from the Emperor; the Livonian branch wanted to obtain support against the Russian threat and rivals inside Livonia, while also trying to avoid paying Imperial taxes. Additionally, the Duke of Prussia was the neighbour of Livonia with whom the Livonian branch usually tried to maintain normal relations. Nevertheless, the branches communicated quite actively during the Diets and supported each other, at least in a rhetorical capacity. Additionally, Livonian envoys normally went firstly to the German Master for consultations and headed to the Diets only thereafter. Thus, the communication was quite vivid, but did not leave many marks to the official documentation, as especially the Livonian branch preferred to represent itself as a separate and independent member of the Empire in front of the Imperial Estates.
Between Commemoration and Living Memory: Symbolic Acts of the Teutonic Knights in Light of Cultural Theory
Authors: Youmans Nicholas W.
Published: November 2021

The present article investigates the function of ritual acts as a form of communication vis-à-vis cultural meaning in the life of the Teutonic Knights. As a condensed form of communal expression, rituals exhibit an acute potential to render present collective identity and shape the lives of the communities that practice them. Such potential is manifest in the institutional arrangement of the Teutonic Order in various forms with particular reference to their dual standing in society, insofar as they drew upon the societal models of the oratores and the bellatores. Particularly relevant to the current study, considerations of cultural historian and social analyst Jan Assmann regarding symbolic acts and collective living memory assist in creating the theoretical framework for the study’s deliberations. With Assmann’s insights in mind, ritual is understood as a communicative vector of cultural meaning – so to speak – of living memory. The analysis then turns to an examination of select representative examples from diverse scenarios in the existence of the Teutonic Knights, thereby taking into account internal, public, and participatory contexts of symbolic moments. The study thus explores how, while rituals can commemorate memorialised events from the past, they are also able to enact the living memory of a collective entity, ultimately claiming that the examined symbolic acts exhibited both communicative and transformative potential.