bluuebunny/crossref_metadata_2025 huggingface dataset:
Incomplete autophagy promotes the proliferation of Mycoplasma hyopneumoniae through the JNK and Akt pathways in porcine alveolar macrophages
Authors: Wen Yukang , Chen Zhengkun , Tian Yaqin , Yang Mei , Dong Qingshuang , Yang Yujiao , Ding Honglei
Published: August 2022

Autophagy is an important conserved homeostatic process related to nutrient and energy deficiency and organelle damage in diverse eukaryotic cells and has been reported to play an important role in cellular responses to pathogens and bacterial replication. The respiratory bacterium Mycoplasma hyopneumoniae has been identified to enter porcine alveolar macrophages, which are considered important immune cells. However, little is known about the role of autophagy in the pathogenesis of M. hyopneumoniae infection of porcine alveolar macrophages. Our experiments demonstrated that M. hyopneumoniae infection enhanced the formation of autophagosomes in porcine alveolar macrophages but prevented the fusion of autophagosomes with lysosomes, thereby blocking autophagic flux and preventing the acidification and destruction of M. hyopneumoniae in low-pH surroundings. In addition, using different autophagy regulators to intervene in the autophagy process, we found that incomplete autophagy promoted the intracellular proliferation of M. hyopneumoniae. We also found that blocking the phosphorylation of JNK and Akt downregulated the autophagy induced by M. hyopneumoniae, but pathways related to two mitogen-activated protein kinases (Erk1/2 and p38) did not affect the process. Collectively, M. hyopneumoniae induced incomplete autophagy in porcine alveolar macrophages through the JNK and Akt signalling pathways; conversely, incomplete autophagy prevented M. hyopneumoniae from entering and degrading lysosomes to realize the proliferation of M. hyopneumoniae in porcine alveolar macrophages. These findings raise the possibility that targeting the autophagic pathway may be effective for the prevention or treatment of M. hyopneumoniae infection.
The incidence of TB and MDR-TB in pediatrics and therapeutic options: a systematic review
Authors: Harichander Sheetal , Wiafe Ebenezer , Mensah Kofi Boamah , Bangalee Varsha , Oosthuizen Frasia
Published: August 2022

Background

Tuberculosis (TB) is considered one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent. Multidrug-resistant (MDR) TB can affect people of all age groups, including children (aged 0–15 years). However, very little is known about the extent of this problem in children. This systematic review aims to investigate the incidence of TB and drug-resistant (DR) TB among the pediatric population. It also reviews the therapeutic options available to treat the condition.

Methods

A comprehensive search for all relevant evidence was conducted. The following databases were searched: MEDLINE, CINAHL, and Web of Science. The searched time frame was limited from January 1990 to December 2020 with a focus on the incidence of TB and MDR-TB among pediatrics and the therapeutic options available.

Results

A total of 537 articles were obtained via the selected databases. After title and abstract screening, 418 articles were excluded leaving 119 articles. Full-text screening was conducted on 119 articles, excluding a further 110 articles. Thus, 9 articles were subject to quality assessment and included in this review. The 9 articles represented the age group of 0–15 years and included both males and females. All studies included were of retrospective study design.

Discussion

The included studies mentioned a moderate increase in TB cases among pediatrics exacerbated by malnutrition, lack of bacille Calmette-Guérin (BCG) vaccination, and human immunodeficiency virus (HIV) coinfection. MDR-TB prevalence was especially high in South Africa. Drug therapy for both TB and MDR-TB yielded favorable outcomes among pediatrics. However, one of the biggest challenges with drug therapy includes the dosage forms available.

Systematic review registration

DOI: 10.17605/OSF.IO/G34NF
COVID-19 pandemic vaccination strategies of early 2021 based on behavioral differences between residents of Tokyo and Osaka, Japan
Authors: Yasuda Hidenori , Ito Fuyu , Hanaki Ken-ichi , Suzuki Kazuo
Published: August 2022

Background

During the fourth COVID-19 wave in Japan, marked differences became apparent in the scale of the epidemic between metropolitan Tokyo in eastern Japan and Osaka prefecture in western Japan.

Methods

Public epidemic data were analyzed, with performance of mathematical simulations using simplified SEIR models.

Results

The increase in the number of infected persons per 100,000 population during the fourth wave of expansion was greater in Osaka than in Tokyo. The basic reproduction number in Osaka was greater than in Tokyo. Particularly, the number of infected people in their 20 s increased during the fourth wave: The generation-specific reproduction number for people in their 20 s was higher than for people of other generations. Both Tokyo and Osaka were found to have strong correlation between the increase in the number of infected people and the average number of people using the main downtown stations at night. Simulations showed vaccination of people in their 60 s and older reduced the number of infected people among the high-risk elderly population in the fourth wave. However, age-specific vaccination of people in their 20 s reduced the number of infected people more than vaccination of people in their 60 s and older.

Conclusions

Differences in the epidemic between Tokyo and Osaka are explainable by different behaviors of the most socially active generation. When vaccine supplies are adequate, priority should be assigned to high-risk older adults, but if vaccine supplies are scarce, simulation results suggest consideration of vaccinating specific groups among whom the epidemic is spreading rapidly.
A novel lytic phage potentially effective for phage therapy against Burkholderia pseudomallei in the tropics
Authors: Wang Yanshuang , Li Xuemiao , Dance David A. B. , Xia Han , Chen Chen , Luo Nini , Li Anyang , Li Yanmei , Zhu Qiao , Sun Qinghui , Wu Xingyong , Zeng Yingfei , Chen Lin , Tian Shen , Xia Qianfeng
Published: August 2022

Background

Burkholderia pseudomallei is a tropical pathogen that causes melioidosis. Its intrinsic drug-resistance is a leading cause of treatment failure, and the few available antibiotics require prolonged use to be effective. This study aimed to assess the clinical potential of B. pseudomallei phages isolated from Hainan, China.

Methods

Burkholderia pseudomallei strain (HNBP001) was used as the isolation host, and phages were recovered from domestic environmental sources, which were submitted to the host range determination, lytic property assays, and stability tests. The best candidate was examined via the transmission electron microscope for classification. With its genome sequenced and analyzed, its protective efficacy against B. pseudomallei infection in A549 cells and Caenorhabditis elegans was evaluated, in which cell viability and survival rates were compared using the one-way ANOVA method and the log-rank test.

Results

A phage able to lyse 24/25 clinical isolates was recovered. It was classified in the Podoviridae family and was found to be amenable to propagation. Under the optimal multiplicity of infection (MOI) of 0.1, an eclipse period of around 20 min and a high titer (1012 PFU/ml) produced within 1 h were demonstrated. This phage was found stabile at a wide range of temperatures (24, 37, 40, 50, and 60 °C) and pH values (3–12). After being designated as vB_BpP_HN01, it was fully sequenced, and the 71,398 bp linear genome, containing 93 open reading frames and a tRNA-Asn, displayed a low sequence similarity with known viruses. Additionally, protective effects of applications of vB_BpP_HN01 (MOI = 0.1 and MOI = 1) alone or in combination with antibiotics were found to improve viability of infected cells (70.6 ± 6.8%, 85.8 ± 5.7%, 91.9 ± 1.8%, and 96.8 ± 1.8%, respectively). A significantly reduced mortality (10%) and a decreased pathogen load were demonstrated in infected C. elegans following the addition of this phage.

Conclusions

As the first B. pseudomallei phage was isolated in Hainan, China, phage vB_BpP_HN01 was characterized by promising lytic property, stability, and efficiency of bacterial elimination during the in vitro/vivo experiments. Therefore, we can conclude that it is a potential alternative agent for combating melioidosis.

Graphical Abstract
Salt weathering impact on Nero/Ramses II Temple at El-Ashmonein archaeological site (Hermopolis Magna), Egypt
Authors: Fahmy Abdelrhman , Molina-Piernas Eduardo , Martínez-López Javier , Domínguez-Bella Salvador
Published: August 2022

Nero’s Temple at El-Ashmonein archaeological site, in Minia (middle of Egypt), is considered one of the most important of all temples of Nero. This temple dates back to 1520 BC–1075 BC in the New Kingdom and was reused in the era of Nero (the Fifth Emperor of Rome). The temple construction materials are severely decayed from surrounding environmental impacts, especially contaminated water sources. The main objective of this paper is to identify the construction materials of Nero’s Temple and their decay by-products. To achieve them, X-ray diffraction, micro X-ray fluorescence spectrometry, and portable Raman spectroscopy were utilized to identify the compositions and alteration by-products/degradation compounds (mainly saline efflorescence and crusts) from the construction materials, such as limestone walls, and structural mortars of the temple. In addition, a polarizing microscope was used to identify the minerals inside the construction materials and reveal the alteration of the minerals because of decay. Digital microscopy and scanning electron microscopy with EDS were used to detect decayed materials' morphological features. Finally, results showed that the main decay factor is salt attack (chlorides, sulfates, phosphates, nitrates, carbonates, and bicarbonates) for all architectural and structural elements of the temple, which have been carried to the construction materials from various sources of contaminated water (canal, sewage, and agricultural water).

Graphical Abstract
Feeding controls H2S production in situ in high solid anaerobic digestion
Authors: Ruxiang Cen , Ruiying Chen , Tianyun Pu , Chunyan Huang , Tengbing He , Guangliang Tian
Published: August 2022

In this study, a high frequency monitoring method was used to assess how semi-continuous feeding affects H2S production in high solid anaerobic digestion. The results showed that H2S characteristics at a monitoring frequency of 1 point/3 h were different to that of 1 point/24 h, its concentration decreased from 3449 ± 227 mg/m3 at 0 h to 298 ± 45 mg/m3 at 3 h. H2S concentration was negatively correlated with volatile fatty acids (VFAs), and oxidation reduction potential (ORP). 72–82% of H2S reduction in the first 3 h resulted from the introduction of O2 during feeding, and 18–28% of that was closely related to the production of a large quantity of soluble acidic matter, such as VFAs. A more accurate H2S release model was established according to the content of VFAs. Totally, this study implies that feed carrying air is a promising method for in situ control of H2S production in anaerobic digestion.

Graphical Abstract
Comparison and selection of patient follow-up systems for covid-19 pandemic patients
Authors: Eren Tamer , Danışan Tuğba , Deringöz Ayşegül , Aksüt Güler
Published: August 2022

People have struggled with many infectious diseases throughout history. Today, the Covid-19 is being fought. One of the most important things for people who have or are at risk of getting Covid-19 is social isolation. Many countries resort to different ways to ensure social isolation. For this, remote patient monitoring systems have been developed. In this study, the problem of the selection of Covid-19 remote patient monitoring systems is discussed. Seven Wearable Health Technology (WHT) products were evaluated with a total of 10 criteria, including the important symptoms used in the patient tracking systems. The weights of 10 criteria determined by the Analytical Hierarchy Process (AHP) method were calculated, and these weights were used in the solution of The Preference Ranking Organization Method for Enrichment Evaluation (PROMETHEE), and Technique for Order Preference by Similarity to Ideal Solutions (TOPSIS) methods. WHT products were compared. As a result, the most appropriate patient follow-up system was determined. This study generates differences in terms of evaluating seven different products and ten criteria in total with MCDM methods. A more comprehensive evaluation has been made in the literature than the studies in this field.
Association of vitamin D deficiency and pelvic organ prolapse in postmenopausal women: a cross-sectional study
Authors: Legan Mateja , Barbič Matija , Osredkar Joško , Blaganje Mija
Published: August 2022

Background

Vitamin D is vital for skeletal integrity as well as optimal muscle work. High incidence and prevalence of vitamin D deficiency as well as pelvic organ prolapse are found in postmenopausal women, thus raising the question of whether the entities could be related.

Methods

We compared 50 postmenopausal women aged 50 to 75 years with pelvic organ prolapse (POP) with 48 women of same age without POP. The clinical assessment of the disorder was performed using the Pelvic Organ Prolapse Quantification system (POP-Q). An anamnestic questionnaire was filled out by the participants on their anthropometric data, life habits, reproductive history, previous and actual diseases. A blood sample was collected for determination of 25-OH-vitamin D as well as calcium and phosphorus concentrations.

Results

The group with POP and the control group were comparable in body mass index, physical activity, life habits and general health, but differed significantly in parity (being higher in POP) and vitamin D blood level concentrations, being lower in POP patients. A significantly higher prevalence of vitamin D deficiency (25-OH-vitamin D < 50 nmol/l) was found in the POP group compared to controls. Taking into account the confounding variables the logistic regression model confirmed the significant role of vitamin D for POP.

Conclusions

Vitamin D deficiency might be an important systemic factor associated to pelvic organ prolapse. The determination of vitamin D levels in postmenopausal women and replenishing its deficiency might also be of importance for the pelvic floor.
Entomopathogenic bacteria Photorhabdus luminescens as natural enemy against the African migratory locust, Locusta migratoria migratorioides (Reiche & Fairmaire, 1849) (Orthoptera: Acrididae)
Authors: Muhammad Jihan , Fathy Zeinab , Moussa Saad
Published: August 2022

Background

The African Migratory Locust, Locusta migratoria migratorioides (Reiche & Fairmaire, 1849) (Orthoptera: Acrididae), is a major threat to agricultural crops and food security on a worldwide scale; hence, maintaining control over it is crucial. Photorhabdus luminescens bacteria can accomplish the efficient biocontrol agent criteria. As a result, the aim of this study was to assess the efficacy of the P. luminescens (EGAP3) strain and its cell-free filtrate against L. migratoria migratorioides, as well as to investigate changes in the activity of carbohydrates hydrolyzing enzymes, amylase, invertase, and trehalase in whole-body homogenates of the 5th nymphal instar under laboratory conditions and to investigate the histopathological changes in the midgut of the locust.

Results

The virulence of entomopathogenic bacteria was determined at different densities of 4 × 107, 4 × 106, 4 × 105, and 4 × 104 colony-forming units (CFU)/ml at different exposure times as well as different concentrations of its cell-free filtrate, undiluted cell-free filtrate (100, 50, 25, and 12.5%). The results indicated that higher-density cell suspension up to 4 × 107 cells.ml−1 and undiluted cell-free filtrate (100%) were the most effective insecticidal fluids, reaching up to 76.7 and 80%, respectively, after 7 days. The estimated LC50 value was 2.7 × 106 cells.ml−1 for bacteria, and the estimated LC50 value for cell-free filtrate was the 2nd dilution (50%).

Conclusions

The data clarified the toxicological and histopathological effects and carbohydrate hydrolyzing enzyme activities of the host insect L. migratoria migratorioides, following bacteria and cell-free filtrate infection; that provides an overview of the efficiency of bacteria and their cell-free filtrate on the host. In conclusion, P. luminescens (EGAP3) and its toxins can be an optimal option for bio-controlling of L. migratoria migratorioides.
Treatment of ruptured rectal artery aneurysm in a patient with neurofibromatosis
Authors: Nemoto Hidehiko , Mori Kensaku , Takei Yohei , Kikuchi Shunsuke , Hoshiai Sodai , Yamamoto Yoshiyuki , Nakajima Takahito
Published: August 2022

Background

Superior rectal artery (SRA) aneurysms are rare. Although melena is the most common symptom, it has not been observed in cases of aneurysms located in the SRA trunk. Here, we report a case of a ruptured SRA trunk aneurysm successfully treated with coil embolization. Including our case, three of the four reported cases of SRA trunk aneurysms were related to neurofibromatosis type 1 (NF1).

Case presentation

A 52-year-old woman with NF1 was referred to our hospital for the investigation of an abdominal mass with back pain. She had previously undergone a blood transfusion at another hospital for anemia without melena. Computed tomography angiography revealed a ruptured SRA trunk aneurysm measuring 3 cm in diameter and surrounded by a retroperitoneal hematoma. The aneurysm was isolated by embolizing the SRA trunk distally and proximally. Distal embolization was performed retrogradely from the internal iliac artery (IIA) via the middle rectal artery (MRA)-SRA anastomosis because the antegrade approach from the inferior mesenteric artery (IMA) failed. To our knowledge, this is the first case of successful coil embolization of an IMA branch through the IIA.

Conclusion

SRA trunk aneurysms are rare; however, they are frequently associated with NF1. Antegrade distal embolization beyond the aneurysm is sometimes difficult to achieve. In such cases, a retrograde approach via MRA-SRA anastomosis can be the choice for isolating SRA trunk aneurysms.
Modified and improved performance of local hammermill for mushroom residues chopping
Authors: Amer Mariam A. , Ali El-Sayed A. E. , Dawood Victor M.
Published: August 2022

Background

During the mushroom production process, about one-fifth of the mushroom gets lost. The mushroom residues (MR) are rich in nutrients and can be utilized in diverse applications. Therefore, the goal of this research was to modify a local hammermill to improve the performance of chopping mushroom residues to be efficient used as a by-product.

Results

The experiments were conducted on a hammermill without and with six screen diameters, three drum rotational speeds, three feed rates, two average moisture content and two hammer rotation tracks (long–short). Then, chopper experiments were carried out with a focus on a specified size, power consumption and energy required. The findings of using any size screen offered little productivity since after a short time, the chopping MR was built blocks around the drum and blades. But using no screen gives these phenomena disappear. The chopping MR performed well in long track conditions, with a feeding rate of 700 kg/h, a drum speed of 300 rpm and moisture content of 43% .

Conclusions

The chopping operation had the best at feed rate of 700 kg/h, drum speed of 3000 rpm and 43% moisture content of which gave the appropriate MWD of 5.54 and 5.32 mm, consumed power of 1114.35 and 1189.125 W and required specific energy of 1.59 and 1.7 kW h/Mg for short and long tracks, respectively, and also largest mean weight diameter under such conditions due to a decrease in the amount of mushroom residues and an increase in their dryness, which increases the fragmentation impact of hammers on mushroom remnants.
Biomechanical validation of additively manufactured artificial femoral bones
Authors: Metzner F. , Neupetsch C. , Carabello A. , Pietsch M. , Wendler T. , Drossel W.-G.
Published: August 2022

Replicating the mechanical behavior of human bones, especially cancellous bone tissue, is challenging. Typically, conventional bone models primarily consist of polyurethane foam surrounded by a solid shell. Although nearly isotropic foam components have mechanical properties similar to cancellous bone, they do not represent the anisotropy and inhomogeneity of bone architecture. To consider the architecture of bone, models were developed whose core was additively manufactured based on CT data. This core was subsequently coated with glass fiber composite. Specimens consisting of a gyroid-structure were fabricated using fused filament fabrication (FFF) techniques from different materials and various filler levels. Subsequent compression tests showed good accordance between the mechanical behavior of the printed specimens and human bone. The unidirectional fiberglass composite showed higher strength and stiffness than human cortical bone in 3-point bending tests, with comparable material behaviors being observed. During biomechanical investigation of the entire assembly, femoral prosthetic stems were inserted into both artificial and human bones under controlled conditions, while recording occurring forces and strains. All of the artificial prototypes, made of different materials, showed analogous behavior to human bone. In conclusion, it was shown that low-cost FFF technique can be used to generate valid bone models and selectively modify their properties by changing the infill.
Outcomes of bidirectional Glenn surgery done without prior cardiac catheterization
Authors: Azhar Ahmad , Eid Rehan , Elakaby Ahmed , Abdelsalam Mohamed , Al-Ata Jameel , Alkhushi Naif , Bahaidarah Saud , Zaher Zaher , Maghrabi Khadijah , Noaman Nada , Abdelmohsen Gaser
Published: August 2022

Background

Cardiac catheterization is usually done routinely in patients with univentricular hearts before palliative Bidirectional Glenn (BDG) surgery. The objective of this study was to compare the outcomes of patients with physiological univentricular hearts and restrictive pulmonary flow that did not undergo routine cardiac catheterization before BDG with the patients that did have cardiac catheterization done. We retrospectively reviewed the data of all patients with single ventricle physiology and restrictive pulmonary blood flow who underwent BDG surgery from January 2016 till December 2020. Patients were divided into two groups: the catheterization and the non-catheterization groups.

Results

Out of 93 patients, 25 (27%) underwent BDG surgery without prior cardiac catheterization. The median age of patients was ten months, interquartile range (IQR) was 5–18 months. Tricuspid atresia represented 36% of the non-catheterization group, while unbalanced atrioventricular septal defect and hypoplastic left heart syndrome represented 19% and 17.6% of the catheterization group. No patients in the catheterization group were excluded from further BDG surgery based on the catheterization data. Moreover, no significant differences were found between the patients' groups regarding the length of hospital stay, length of intensive care unit stay, postoperative oxygen saturation, or survival (P = 0.266, P = 0.763, P = 0.543, P = 0456).

Conclusions

Although pre-BDG cardiac catheterization is the routine and standard practice, in certain situations, some patients with single ventricle physiology and restrictive pulmonary blood flow may go directly to BDG without cardiac catheterization if noninvasive imaging is satisfactory on a case-by-case basis and according to center experience. Pre-BDG catheterization could be reserved for patients with limited echocardiographic studies, high-risk patients, or those indicated for catheter intervention before BDG surgery.
Biliary drainage guided by endoscopic ultrasonography is a doable objective
Authors: Abdellatef Abeer , Wifi Mohamed-Naguib
Published: August 2022

The therapeutic usage of EUS is being developed. EUS-guided biliary drainage (EUSBD) is a recognized viable replacement for percutaneous transhepatic biliary drainage (PTBD) in severe cases with the obstructive biliary disease having ERCP failure due to a failure in cannulation or those with surgically altered anatomies, such as hepatico-jejunal anastomosis following Billroth II reconstruction, Roux-en-Y limb, Whipple procedure, or Roux-en-Y gastric bypass, or cases with inaccessible papilla because of severe duodenal inflammatory structure.
Iron status and its relation to lung function in pediatric asthmatics: a cross-sectional study
Authors: Ali Heba A. , Deraz Tharwat E. , Reyad Noha I. , Mohammed Yasser H. , Husseiny Assmaa A.
Published: August 2022

Background

Asthma and iron deficiency are common pediatric conditions. In addition, iron deficiency may affect spirometry results in asthmatic children. So, we aimed to assess the effect of ion status on lung function in childhood asthma.

Results

In this cross-sectional study, fifty asthmatic pediatric patients aged from 6 to 16 years presented to our institute during the period from (June 2018 to December 2018) were enrolled. Asthmatic patients were classified according to their complete blood count and iron profile into 2 groups: group 1, asthmatic children without iron deficiency anemia (IDA); and group 2, asthmatic children with IDA. All patients underwent full history taking, clinical examination, laboratory investigations, asthma control test, and pulmonary function tests (PFTs). The study showed that PFTs’ parameters (forced expiratory volume in one second (FEV1) % of predicted, FEV1/forced vital capacity, and maximal mid expiratory flow (MMEF) 25–75% of predicted) were significantly lower among asthmatics with IDA (80.62 ± 18.13, 78.36 ± 11.22, 62.35 ± 26.67) than among asthmatics without IDA (93.45 ± 15.51, 87.68 ± 10.81, 82.10 ± 24.74), respectively (p =0.012, 0.006, 0.012). Also, poorly controlled asthma was significantly higher among asthmatics with IDA (p =0.001). In addition, there was a statistically significant positive correlation between forced spirometry parameters, hemoglobin, and ferritin level (p=0.012, 0.042). Moreover, there was a significant positive correlation between hemoglobin level and MMEF 25–75% of predicted (p=0.012).

Conclusions

Lower iron status negatively affects the lung function in asthmatic children with a more obstructive pattern among asthmatics with IDA.
Examining the Variations in Undergraduate Students’ Conceptions of Successful Researchers: A Phenomenographic Study
Authors: Zuckerman Austin L. , Lo Stanley M.
Published: August 2022

This paper examines undergraduates’ conceptions of successful researchers. Three conceptions were identified based on variations within the following aspects: process of research, interactions with other researchers, and scope of contribution.
Preoperative Medical Treatment for Patients With Acromegaly: Yes or No?
Authors: Albarel Frederique , Cuny Thomas , Graillon Thomas , Dufour Henry , Brue Thierry , Castinetti Frederic
Published: August 2022

Transsphenoidal surgery is the first-line treatment for acromegaly. However, several factors can modify surgical remission rates, such as the initial hormone levels, the size and invasiveness of the tumor, and the degree of experience of the surgeon. Physicians treating patients with acromegaly should thus consider how to improve surgical remission rates. As stated in recent guidelines, the major point is to consider that any patient with acromegaly should be referred to an expert neurosurgeon to maximize the chances of surgical sure. The benefits of presurgical medical treatment, mainly using somatostatin receptor ligands (SRLs), given 3 to 6 months before surgery, remain controversial. By normalizing growth hormone and insulin-like growth factor 1 levels, SRLs may improve the overall condition of the patient, thus decreasing anesthetic and surgical complications. By decreasing the tumor size and modifying the consistency of the tumor, SRLs might also make surgical excision easier. This is however theoretical as published data are contradictory on both points, and only limited data support the use of a systematical presurgical medical treatment. The aim of this review is to analyze the potential benefits and pitfalls of using presurgical medical treatment in acromegaly in view of the contradictory literature data. We also attempt to determine the profile of patients who might most benefit from this presurgical medical treatment approach as an individualized therapeutic management of acromegaly.
Frequency of Adrenal Insufficiency in Patients With Hypoglycemia in an Emergency Department: A Cross-sectional Study
Authors: Kawahara Tetsuya , Tsuji Maiko , Tominaga Naoki , Toyama Nagahiro , Toda Mikio
Published: August 2022

Context

In most patients presenting with hypoglycemia in emergency departments, the etiology of hypoglycemia is identified. However, it cannot be determined in approximately 10% of cases.

Objective

We aimed to identify the causes of unknown hypoglycemia, especially adrenal insufficiency.

Methods

In this cross-sectional study, we evaluated the etiology of hypoglycemia among patients in our emergency department with hypoglycemia (plasma glucose level < 70 mg/dL (3.9 mmol/L)] between April 1, 2016 and March 31, 2021 using a rapid adrenocorticotropic hormone (ACTH) test.

Results

There were 528 cases with hypoglycemia included [52.1% male; median age 62 years (range 19-92)]. The majority [389 (73.7%)] of patients were using antidiabetes drugs. Additionally, 33 (6.3%) consumed alcohol; 17 (3.2%) had malnutrition; 13 (2.5%), liver dysfunction; 12 (2.3%), severe infectious disease; 11 (2.1%), malignancy; 9 (1.7%), heart failure; 4 (0.8%), insulin autoimmune syndrome; 3 (0.6%), insulinoma; 2 (0.4%) were using hypoglycemia-relevant drugs; and 1 (0.2%) suffered from non-islet cell tumor. Rapid ACTH tests revealed adrenal insufficiency in 32 (6.1%). In those patients, serum sodium levels were lower (132 vs 139 mEq/L, P < 0.01), eosinophil counts were higher (14 vs 8%, P < 0.01), and systolic blood pressure was lower (120 vs 128 mmHg, P < 0.05) at baseline than in patients with the other etiologies.

Conclusion

The frequency of adrenal insufficiency as a cause of hypoglycemia was much higher than what we anticipated. When protracted hypoglycemia of unknown etiology is recognized, we recommend that the patient is checked for adrenal function using a rapid ACTH test.
Migrant Identity and Culture Maintenance: The Welsh in Johnstown, Cambria County, Pennsylvania, 1870–1930
Authors: Tyler Robert Llewellyn
Published: August 2022

Welsh immigrants and their children comprised a distinct ethnolinguistic community in Johnstown, Pennsylvania, during the late nineteenth and early twentieth centuries. This article analyzes the nature of that community and suggests that while ethnic integrity was initially maintained due to linguistic ability, religious adherence, and the creation of popular cultural institutions, it was ultimately undermined, not only by the general forces of acculturation, but also by specifically Welsh factors. While the Welsh experience in Johnstown differed sharply from that undergone by the English, it did not simply mirror that of other non-Anglophone groups.
Tangled Strands of Silk: Globalizing the Local in Early Modern San Miguel Achiutla, Oaxaca
Authors: Forde Jamie E.
Published: August 2022

This article takes the community of San Miguel Achiutla, located in the Mixtec highlands of Oaxaca, as a case study through which to examine the complex involvements of Indigenous pueblos de indios of Mexico in the early modern dynamics of globalization. Drawing from both ethnohistorical and archaeological evidence, this analysis shows not only how residents of this community were affected by forces of globalization as they appropriated new goods and ideas from across the Pacific and Atlantic, but also how they played an active economic role in driving colonial expansion during the sixteenth century, particularly through the silk trade. In tracing these connections, we see how locally focused microhistories can shed light on aspects of early modern globalization that we might not otherwise attend to.
Head removal enhances planarian electrotaxis
Authors: Sabry Ziad , Wang Rui , Jahromi Aryo , Rabeler Christina , Kristan William B. , Collins Eva-Maria S.
Published: August 2022

Certain animal species utilize electric fields for communication, hunting and spatial orientation. Freshwater planarians move toward the cathode in a static electric field (cathodic electrotaxis). This planarian behavior was first described by Raymond Pearl more than a century ago. However, planarian electrotaxis has received little attention since, and the underlying mechanisms and evolutionary significance remain unknown. To close this knowledge gap, we developed an apparatus and scoring metrics for automated quantitative and mechanistic studies of planarian behavior upon exposure to a static electric field. Using this automated setup, we characterized electrotaxis in the planarian Dugesia japonica and found that this species responds to voltage instead of current, in contrast to results from previous studies using other planarian species. Surprisingly, we found differences in electrotaxis ability between small (shorter) and large (longer) planarians. To determine the cause of these differences, we took advantage of the regenerative abilities of planarians and compared electrotaxis in head, tail and trunk fragments of various lengths. We found that tail and trunk fragments electrotaxed, whereas head fragments did not, regardless of size. Based on these data, we hypothesized that signals from the head may interfere with electrotaxis when the head area/body area reached a critical threshold. In support of this hypothesis, we found that (1) smaller intact planarians that cannot electrotax have a relatively larger head-to-body-ratio than large planarians that can electrotax, and (2) the electrotaxis behavior of cut head fragments was negatively correlated with the head-to-body ratio of the fragments. Moreover, we could restore cathodic electrotaxis in head fragments via decapitation, directly demonstrating inhibition of electrotaxis by the head.
Factors disturbing undergraduate students’ interaction during lectures: A university-based survey
Authors: Imran Muhammad , Baig Mukhtiar , Murad Manal Abdulaziz , Almurashi Saleh H
Published: August 2022

Objectives: To explore the factors that disturb students’ interaction during lectures and interfere with their active participation.
Methods: This cross-sectional study was conducted at King Abdulaziz University (KAU), Jeddah, Saudi Arabia. The study lasted approximately nine months, beginning on May 9, 2018, and ending on February 6, 2019. Students of different faculties participated in the study. A valid questionnaire was used after piloting. Four major categories were defined: classmate factors (CMFs), teacher-related factors (TRFs), personal factors (PFs), and class environment factors (CEFs).
Results: A total of 658 students were included. Among all, 428 (65%) were females, and 230 (35%) were males. The comparison of main categories showed that CMFs, TRFs, PFs, and CEFs disturbed students’ interaction 74%, 55%, 50%, and 84%, respectively. The comparison of the factors disturbing students’ interaction showed that females were more disturbed by the CMFs (p=0.036) and CEFs (p<0.001) than males. CMFs, PFs, and CEFs disturbed more married students’ than unmarried. CMF more disturbed science faculty students’ interaction compared to all other groups. CEF showed less disturbance among Engineering/Math group students’ interaction compared to other groups. The male gender and sixth-year students were the predictors of TRF disturbance, while the married students were the predictors of disturbance by PF.
Conclusion: Several factors (PF, CMF, TRF, and CEF) disturbed students’ interaction during a lecture. Additionally, the male gender, married students, and sixth-year students were the associated factors of disturbed interaction during a lecture. We suggest that teachers and educational leaders need to devise a policy to overcome these factors to provide a conducive learning environment.
doi: https://doi.org/10.12669/pjms.38.7.5101
How to cite this:Imran M, Baig M, Murad MA, Almurashi SH. Factors disturbing undergraduate students’ interaction during lectures: A university-based survey. Pak J Med Sci. 2022;38(7):---------. doi: https://doi.org/10.12669/pjms.38.7.5101
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.
Society of Obstetricians and Gynecologists Pakistan Guideline on Second Trimester Anomaly Scan
Authors: Zohra Nishat , Munim Shama , Ijaz Shamila , Baqai Shehla , Yasmin Haleema , Korejo Razia , CC Lees
Published: August 2022

The Guideline on Second trimester anomaly scan has been prepared by the National Maternal Fetal Medicine guidelines committee, approved by the Society of Obstetricians and Gynecologists Pakistan. These guidelines are developed in 2022 and will be reviewed after two years.The current document provides guidance about the importance of second trimester scan to practicing clinicians and sonologists. It will enable them to offer it timely offer to their patient this scan and refer them to the Fetal medicine specialist when indicated. It is unique as the document is modified according to local needs. The Guidelines are developed in 2022 and will be reviewed after two years.

doi: https://doi.org/10.12669/pjms.38.7.6212

How to cite this:Zohra N, Munim S, Ijaz S, Baqai S, Yasmin H, Korejo R, et al. Society of Obstetricians and Gynecologists Pakistan Guideline on Second Trimester Anomaly Scan. Pak J Med Sci. 2022;38(7):---------.  doi: https://doi.org/10.12669/pjms.38.7.6212

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.
Addressing post-COVID-19 musculoskeletal symptoms through telemedicine: A study protocol
Authors: Sánchez Romero Eleuterio A. , Fernández Carnero Josué , Alonso Pérez José Luis , Martínez Rolando Lidia , Villafañe Jorge Hugo
Published: August 2022

Objective: The purpose of the study will be to evaluate the effect of a rehabilitation program on the improvement of patients with post-COVID-19 musculoskeletal symptoms, as well as to quantify the impact of telemedicine that evaluates the evolution of pain, functionality, and quality of life. Methods: We will carry out a case-control study in post-COVID-19 musculoskeletal symptoms patients who will undergo a multicomponent rehabilitation program, together with an intervention and a follow-up using programmed telemedicine sessions. Data will be collected on the improvement of functional capacity and quality of life, in addition to assessing the evolution of musculoskeletal symptomatology, as well as pain and psychological variables. The telemedicine sessions will improve user adherence and follow-up, and the results are expected to be disseminated to the scientific community during and after the end of the study.
Sapporo: A workflow execution service that encourages the reuse of workflows in various languages in bioinformatics
Authors: Suetake Hirotaka , Tanjo Tomoya , Ishii Manabu , P. Kinoshita Bruno , Fujino Takeshi , Hachiya Tsuyoshi , Kodama Yuichi , Fujisawa Takatomo , Ogasawara Osamu , Shimizu Atsushi , Arita Masanori , Fukusato Tsukasa , Igarashi Takeo , Ohta Tazro
Published: August 2022

The increased demand for efficient computation in data analysis encourages researchers in biomedical science to use workflow systems. Workflow systems, or so-called workflow languages, are used for the description and execution of a set of data analysis steps. Workflow systems increase the productivity of researchers, specifically in fields that use high-throughput DNA sequencing applications, where scalable computation is required. As systems have improved the portability of data analysis workflows, research communities are able to share workflows to reduce the cost of building ordinary analysis procedures. However, having multiple workflow systems in a research field has resulted in the distribution of efforts across different workflow system communities. As each workflow system has its unique characteristics, it is not feasible to learn every single system in order to use publicly shared workflows. Thus, we developed Sapporo, an application to provide a unified layer of workflow execution upon the differences of various workflow systems. Sapporo has two components: an application programming interface (API) that receives the request of a workflow run and a browser-based client for the API. The API follows the Workflow Execution Service API standard proposed by the Global Alliance for Genomics and Health. The current implementation supports the execution of workflows in four languages: Common Workflow Language, Workflow Description Language, Snakemake, and Nextflow. With its extensible and scalable design, Sapporo can support the research community in utilizing valuable resources for data analysis.
Key concepts for informed health choices: Where’s the evidence?
Authors: Oxman Andrew D. , Chalmers Iain , Dahlgren Astrid
Published: August 2022

Background: The Informed Health Choices (IHC) Key Concepts is a framework that provides a basis for developing educational resources and evaluating people’s ability to think critically about health actions. We developed the original Key Concepts framework by reviewing texts and checklists for the public, journalists, and health professionals and collecting structured feedback from an international advisory group. We revised the original 2015 framework yearly from 2016 to 2018 based on feedback and experience using the framework. The objectives of this paper are to describe the development of the framework since 2018 and summarise their basis. Methods: For the 2019 version, we responded to feedback on the 2018 version. For the current 2022 version, in addition to responding to feedback on the 2019 version, we reviewed the evidence base for each of the concepts. Whenever possible, we referenced systematic reviews that provide a basis for a concept. We screened all Cochrane methodology reviews and searched Epistemonikos, PubMed, and Google Scholar for methodology reviews and meta-epidemiological studies. Results: The original framework included 32 concepts in six groups. The 2019 version and the current 2022 version include 49 concepts in the same three main groups that we have used since 2016. There are now 10 subgroups or higher-level concepts. For each concept, there is an explanation including one or more examples, the basis for the concept, and implications. Over 600 references are cited that support the concepts, and over half of the references are systematic reviews. Conclusions: There is a large body of evidence that supports the IHC key concepts and we have received few suggestions for changes since 2019.
A research agenda for open energy science: Opportunities and perspectives of the F1000Research Energy Gateway
Authors: Huppmann Daniel , Browell Jethro , Nastasi Benedetto , Vale Zita , Süsser Diana
Published: August 2022

Energy enables the functioning of modern society. However, humanity’s reliance on fossil fuels since the industrial revolution has contributed to many societal problems including climate change, environmental degradation and pollution, and the transition to a renewable and carbon-free energy system is one of the grand challenges for the 21st century. The aim of this editorial is to outline the importance of a fast and transparent sharing of energy research and discuss key themes of the Energy Gateway of F1000Research.
Editorial: The Sociology of Vaccines
Authors: Calnan Michael , Zinn Jens O. , Douglass Tom
Published: August 2022

In this editorial, we identify the key questions requiring further exploration in the sociology of vaccines. In doing so, we discuss the socio-structural forces shaping views towards knowledge about and access to vaccination, trust in vaccines and regulators/decision makers, the associated problem of financial interests in vaccine development and regulation, and global vaccine inequalities. Across the breadth of these issues, we additionally identify a range of theoretical perspectives and conceptual directions that sociologists might utilise when producing innovative empirical, methodological and theoretical research on vaccination relating to risk and uncertainty, conflicts of interest, power and inequality.
Changing the method of consent to increase the numbers of cadaveric donors in Saudi Arabia: the autonomy paradox
Authors: AL Shawan Deema , Albagmi Faisal , AlNujaidi Heba
Published: August 2022

Background: In Saudi Arabia, the gap between the demand and availability of organs persists, with a total of 13,731 patients who remain on the waiting list in 2019. Family refusal is a major obstacle limiting donation since their consent must be obtained prior to the retrieval of organs. The cause of family refusal is mainly due to the unknown wishes of their loved one to become a donor. This analysis aimed to compare three systems of obtaining consent in terms of effectiveness, respect for personal autonomy, and the cultural role of families in Saudi Arabia to ensure feasibility and effectiveness in increasing the number of donors.

Policy alternatives and implications: The consent systems include opt-in (explicit consent), opt-out (presumed consent), and mandated choice systems. The mandated choice policy might be the optimal solution to investigate since it could balance the respect for individual autonomy and the cultural role of families in Saudi Arabia.

Conclusions and recommendations: Mandated choice ensures the respect of personal autonomy while influencing the next of kin's decision to donate the organs. Additionally, a recommendation to decision makers is to utilize the Tawakkalna app to send alerts to the next of kin when a user registers as a donor with the user's consent. Moreover, more research should be dedicated to investigating the Saudi public's current culture and perceptions of organ donation to ensure feasibility.