bluuebunny/crossref_metadata_2025 huggingface dataset:
A persistent epidemic of porcine epidemic diarrhoea virus infection by serological survey of commercial pig farms in northern Vietnam
Authors: Myint Ohnmar , Hoa Nguyen Thi , Fuke Naoyuki , Pornthummawat Apisit , Lan Nguyen Thi , Hirai Takuya , Yoshida Ayako , Yamaguchi Ryoji
Published: July 2021

Background

Porcine epidemic diarrhoea (PED) is a highly contagious infectious disease with negative economic impacts on the swine industry. PED outbreaks were reported from 2009 to 2015, but sporadic infection has been observed until now in Vietnam. However, the seroprevalence of PEDV infection has not yet been reported for commercial pig farms in Vietnam. The aim of this study was to assess the seroprevalence of PEDV infection in Vietnamese pig farms to reveal the endemic status of PEDV in northern Vietnam.

Results

A serological survey of PEDV infection was carried out using indirect ELISA in commercial pig farms in Hai Duong, Hung Yen and Thai Binh provinces in northern Vietnam in 2019. Twenty sera were randomly collected from each of 10 commercial pig farms, from each province; none of the farms had vaccinated for PEDV. Serological evidence of natural PEDV infection, expressed as a high antibody titre, was observed in the pig farms in all 3 provinces. The OD values were significantly higher (p < 0.001) for pig sera from Thai Binh than from Hai Duong and Hung Yen. No significant differences (p > 0.05) were detected for seropositivity to PEDV based on locality, age, pig breed and farm size.

Conclusions

This study indicates serological evidence of natural PEDV infection with high antibody titre in commercial pig farms. PEDV infection was widespread among the pig population in these 3 provinces and that good management and strict biosecurity are needed at these pig farms.
Anti-cancer properties of quercetin in osteosarcoma
Authors: Maleki Dana Parisa , Sadoughi Fatemeh , Asemi Zatollah , Yousefi Bahman
Published: July 2021

Osteosarcoma is a primary bone tumor. Although it is a rare disease in general, it is the most common primary bone tumor among children. Despite the significant advances made in the field of osteosarcoma treatment, the outcomes of this disease are still unfavorable. Besides, there is still no targeted therapy for osteosarcoma that can be used in clinical settings. Quercetin is a member of the phytochemical family which is used for different diseases including cardiovascular diseases, diabetes, and cancer. Its anti-cancer effects are examined in many types of cancer including breast, colon, lung, prostate, and pancreatic cancers and have shown promising results. Herein, the studies dealing with the antitumor roles of quercetin in osteosarcoma are reviewed in this article. We take a look into quercetin’s ability to affect proliferation, apoptosis, invasion, and chemo-resistance of the osteosarcoma cells through regulating protein expression and signaling pathways.
Energy drink consumption among Australian adolescents associated with a cluster of unhealthy dietary behaviours and short sleep duration
Authors: Nuss Tegan , Morley Belinda , Scully Maree , Wakefield Melanie
Published: July 2021

Background

Non-alcoholic energy drinks (‘energy drinks’) are high in sugar, as well as caffeine, leading to concerns regarding their suitability for children and adolescents. Despite this, marketing of energy drinks is often directed at adolescents, and there are no age restrictions on the sale of these products in Australia. The current study aimed to examine patterns in consumption of energy drinks among Australian secondary school students and identify sociodemographic and behavioural correlates associated with regular consumption.

Methods

Participants were 8942 students in Years 8 to 11 (aged 12 to 17 years) who participated in the 2018 National Secondary Students’ Diet and Activity (NaSSDA) cross-sectional survey. A multistage stratified random sampling procedure was used. Within the school setting, students self-completed an online questionnaire assessing their dietary, physical activity and sedentary behaviours. A multilevel logistic regression model was used to examine associations between energy drink consumption and sociodemographic and behavioural factors.

Results

Overall, 8% of students reported consuming energy drinks on a weekly basis (‘regular consumers’). A further 16% indicated they consume less than one cup per week of these types of drinks, while around three-quarters (76%) reported they do not consume energy drinks. Regular consumption of energy drinks was independently associated with being male, having greater weekly spending money, high intakes of snack foods, fast food, other sugar-sweetened beverages and fruit juice, as well as short sleep duration. There was no independent association with other sociodemographic characteristics (i.e., year level, level of disadvantage, geographic location), consumption of vegetables and fruit, physical activity level, or sedentary recreational screen time.

Conclusions

While most Australian adolescents do not consume energy drinks, regular consumption is more prevalent among males, and consumption appears to cluster with other unhealthy dietary behaviours and short sleep duration. Findings support the need for policies that will reach identified at-risk groups (e.g., increased regulation of the marketing and sale of energy drinks), as well as suggest opportunities for interventions targeting energy drink consumption alongside other unhealthy dietary behaviours.
Co-administration of HAART and antikoch triggers cardiometabolic dysfunction through an oxidative stress-mediated pathway
Authors: Akhigbe RE , Hamed MA
Published: July 2021

Background

Antikoch and highly active anti-retroviral therapy are effective drugs in the management of tuberculosis and Human Immunodeficiency Virus, respectively. However, these cocktails have been independently associated with the aetiopathogenesis of metabolic syndrome. This study investigated whether or not the co-administration of antikoch and anti-retroviral, as seen in tuberculosis/Human Immunodeficiency Virus co-infection, will produce a similar effect. Also, it evaluated the role of glutathione and adenine deaminase/xanthine oxidase/uric acid signaling in antikoch/anti-retroviral-induced cardiometabolic dysfunction.

Methods

Male rats of Wistar strain were randomized into four groups: the control, which had 0.5 mL of distilled water as a vehicle, anti-Koch-treated rats that were administered a cocktail of anti-Koch, HAART-treated rats that had a combination of anti-retroviral drugs, and anti-Koch + HAART-treated rats that had treatments as anti-Koch-treated and HAART-treated rats. The treatment was once daily and lasted for eight weeks. One way-analysis of variance followed by Tukey’s posthoc test was used to test for significance and pairwise comparisons respectively.

Results

Although no changes in body weight gain and cardiac weight were noted, it was found that antikoch and/or HAART caused insulin resistance and elevated blood glucose level. In addition, antikoch and/or HAART led to dyslipidaemia, increased atherogenic indices, and elevated cardiac injury markers. These were accompanied by increased plasma and cardiac concentrations of malondialdehyde and nitric oxide, C-reactive protein, and myeloperoxidase activity, as well as suppressed activities of glutathione peroxidase and glutathione-S-transferase, and a fall in reduced glutathione level. The observed alterations were more pronounced in animals that received a combination of antikoch and HAART.

Conclusions

This study provides the first evidence that antikoch and/or HAART induce cardiometabolic dysfunction via glutathione suppression and up-regulation of adenine deaminase/xanthine oxidase/uric acid-dependent oxidative stress and inflammatory response. These events were associated with dyslipidaemia and increased atherogenic indices. This infers that regular monitoring of glucose level, insulin sensitivity, lipid profile, and oxido-inflammatory markers is important in patients on antikoch and/or HAART for prompt diagnosis and management of cardiometabolic disorder if it ensues.
Associations of reproductive breast cancer risk factors with breast tissue composition
Authors: Yaghjyan Lusine , Austin-Datta Rebecca J. , Oh Hannah , Heng Yujing J. , Vellal Adithya D. , Sirinukunwattana Korsuk , Baker Gabrielle M. , Collins Laura C. , Murthy Divya , Rosner Bernard , Tamimi Rulla M.
Published: July 2021

Background

We investigated the associations of reproductive factors with the percentage of epithelium, stroma, and fat tissue in benign breast biopsy samples.

Methods

This study included 983 cancer-free women with biopsy-confirmed benign breast disease (BBD) within the Nurses’ Health Study and Nurses’ Health Study II cohorts. The percentage of each tissue type (epithelium, stroma, and fat) was measured on whole-section images with a deep-learning technique. All tissue measures were log-transformed in all the analyses to improve normality. The data on reproductive variables and other breast cancer risk factors were obtained from biennial questionnaires. Generalized linear regression was used to examine the associations of reproductive factors with the percentage of tissue types, while adjusting for known breast cancer risk factors.

Results

As compared to parous women, nulliparous women had a smaller percentage of epithelium (β = − 0.26, 95% confidence interval [CI] − 0.41, − 0.11) and fat (β = − 0.34, 95% CI − 0.54, − 0.13) and a greater percentage of stroma (β = 0.04, 95% CI 0.01, 0.08). Among parous women, the number of children was inversely associated with the percentage of stroma (β per child = − 0.01, 95% CI − 0.02, − 0.00). The duration of breastfeeding of ≥ 24 months was associated with a reduced proportion of fat (β = − 0.30, 95% CI − 0.54, − 0.06; p-trend = 0.04). In a separate analysis restricted to premenopausal women, older age at first birth was associated with a greater proportion of epithelium and a smaller proportion of stroma.

Conclusions

Our findings suggest that being nulliparous as well as having a fewer number of children (both positively associated with breast cancer risk) is associated with a smaller proportion of epithelium and a greater proportion of stroma, potentially suggesting the importance of epithelial-stromal interactions. Future studies are warranted to confirm our findings and to elucidate the underlying biological mechanisms.
Relation between Halls’ Professionalism Scale and nurses’ demographic characteristics
Authors: Rabie Tinda
Published: July 2021

Objective

Nursing Professionalism was measured by Hall’s Professionalism Scale, consisting of 50 items. The scale was developed to measure the attitudes and ideologies held by professionals in various professional occupations by measuring five attitudinal constructs of professionalism, namely ‘sense of calling to the field’, ‘autonomy’, ‘using a professional organisation as a major referent’, ‘belief in self-regulation’, and ‘belief in public service’. This study focussed on determining the practically significant differences that exist between the means of the five constructs of Hall’s Professionalism Scale and certain demographic variables among nurses in South Africa. The 11-item demographic profile included the following variables: gender (1), age (2), age when becoming a professional nurse (3), undergraduate qualifications (4), marital status (5), number of children (6), employment sector (7), years’ of nursing experience (8), international experience (9), employment status (10) and satisfaction with nursing as a career (11).

Results

Only (7/11) demographic profile variables had an association with one or more of the five Hall’s Professionalism Scale constructs The variables included the following items: age (2), age when becoming a professional nurse (3), number of children (6), years of nursing experience (8), international experience (9), employment status (10), and satisfaction with nursing as a career (11).
Determinants of household catastrophic costs for drug sensitive tuberculosis patients in Kenya
Authors: Kirubi Beatrice , Ong’ang’o Jane , Nguhiu Peter , Lönnroth Knut , Rono Aiban , Sidney-Annerstedt Kristi
Published: July 2021

Background

Despite free diagnosis and treatment for tuberculosis (TB), the costs during treatment impose a significant financial burden on patients and their households. The study sought to identify the determinants for catastrophic costs among patients with drug-sensitive TB (DSTB) and their households in Kenya.

Methods

The data was collected during the 2017 Kenya national patient cost survey from a nationally representative sample (n = 1071). Treatment related costs and productivity losses were estimated. Total costs exceeding 20% of household income were defined as catastrophic and used as the outcome. Multivariable Poisson regression analysis was performed to measure the association between selected individual, household and disease characteristics and occurrence of catastrophic costs. A deterministic sensitivity analysis was carried using different thresholds and the significant predictors were explored.

Results

The proportion of catastrophic costs among DSTB patients was 27% (n = 294). Patients with catastrophic costs had higher median productivity losses, 39 h [interquartile range (IQR): 20–104], and total median costs of USD 567 (IQR: 299–1144). The incidence of catastrophic costs had a dose response with household expenditure. The poorest quintile was 6.2 times [95% confidence intervals (CI): 4.0–9.7] more likely to incur catastrophic costs compared to the richest. The prevalence of catastrophic costs decreased with increasing household expenditure quintiles (proportion of catastrophic costs: 59.7%, 32.9%, 23.6%, 15.9%, and 9.5%) from the lowest quintile (Q1) to the highest quintile (Q5). Other determinants included hospitalization: prevalence ratio (PR) = 2.8 (95% CI: 1.8–4.5) and delayed treatment: PR = 1.5 (95% CI: 1.3–1.7). Protective factors included receiving care at a public health facility: PR = 0.8 (95% CI: 0.6–1.0), and a higher body mass index (BMI): PR = 0.97 (95% CI: 0.96–0.98). Pre TB expenditure, hospitalization and BMI were significant predictors in all sensitivity analysis scenarios.

Conclusions

There are significant inequities in the occurrence of catastrophic costs. Social protection interventions in addition to existing medical and public health interventions are important to implement for patients most at risk of incurring catastrophic costs.

Graphic abstract
Epidemiology of pediatric trauma in the Kingdom of Bahrain: a national pediatric trauma registry pilot study
Authors: Liu Jay C. , Ismael Aieshah A. , Zaidi Ayesha , Sha’ban Ban W. , Almutawa Shaikha Ebrahim , Chatha Asad Amin , Abuzeyad Feras H. , Jaafar Ruqaya Isa , Alghanem Salah Ali , Qassim Ghada Al , Kumar Nitya , Corbally Martin
Published: July 2021

Background

A pediatric trauma registry for the Kingdom of Bahrain would be a novel public health tool for the Bahraini health system. The aim of this study was to explore the epidemiology of pediatric trauma at the national level by describing the distribution of pediatric injury in the Kingdom, and quantifying the burden of injury shouldered by the study population.

Methods

This multicenter observational cross-sectional study was conducted in Bahrain using data from the Pediatric Trauma Registry (PTR), which was a short-term paper-based prospective trauma registry that collected data over a three-month period in 2018. PTR was based in the pediatric emergency departments (ED) of the three national referral hospitals in the Kingdom. By simultaneously collecting data from all three trauma hospitals in the country, it was assumed that during the data collection period all major pediatric trauma patients in the country would be captured by the study, and that the data collected would provide national estimates of trauma. Inclusion criteria for the study was any individual under the age of 14, that arrived at the ED seeking care for intentional and unintentional injuries.

Results

A total of 1328 patients were included in the study. Sixty-nine percent of patients were treated and discharged from the ED, 30.5% were admitted to the hospital, admitted for surgery, or seen by a specialist, and 0.5% were declared deceased. The percentage of patients documented as unrestrained during Motor Vehicle Collisions (MVC) was 92.3%, and amongst those involved in MVC, 12% were ejected from the cabin of the vehicle.

Conclusions

There are significant implications that this study holds for policy implementation and practice surrounding injury prevention in the Kingdom of Bahrain. Low seatbelt utilization and the high proportion of ejection amongst MVC victims warrant immediate public health policy implementation, including enforcement of seat belt laws, strengthening of the traffic court system, and awareness campaigns for MVC prevention. Additionally, pediatric drowning prevention programs centered on constant adult supervision, pool isolation fencing, personal flotation devices, and swimming education should be created to address the mortality attributable to drowning in this study.
Firearm purchasing and firearm violence during the coronavirus pandemic in the United States: a cross-sectional study
Authors: Schleimer Julia P. , McCort Christopher D. , Shev Aaron B. , Pear Veronica A. , Tomsich Elizabeth , De Biasi Alaina , Buggs Shani , Laqueur Hannah S. , Wintemute Garen J.
Published: July 2021

Background

Firearm violence is a significant public health problem in the United States. A surge in firearm purchasing following the onset of the coronavirus pandemic may have contributed to an increase in firearm violence. We sought to estimate the state-level association between firearm purchasing and interpersonal firearm violence during the pandemic.

Methods

Cross-sectional study of the 48 contiguous states and the District of Columbia from January 2018 through July 2020. Data were obtained from the National Instant Criminal Background Check System (a proxy for firearm purchasing) and the Gun Violence Archive. Using negative binomial regression models, we estimated the association between cumulative excess firearm purchases in March through July 2020 (measured as the difference between observed rates and those expected from autoregressive integrated moving average models) and injuries (including nonfatal and fatal) from intentional, interpersonal firearm violence (non-domestic and domestic violence).

Results

We estimated that there were 4.3 million excess firearm purchases nationally from March through July 2020 and a total of 4075 more firearm injuries than expected from April through July. We found no relationship between state-level excess purchasing and non-domestic firearm violence, e.g., each excess purchase per 100 population was associated with a rate ratio (RR) of firearm injury from non-domestic violence of 0.76 (95% CI: 0.50–1.02) in April; 0.99 (95% CI: 0.72–1.25) in May; 1.10 (95% CI: 0.93–1.32) in June; and 0.98 (95% CI: 0.85–1.12) in July. Excess firearm purchasing within states was associated with an increase in firearm injuries from domestic violence in April (RR: 2.60; 95% CI: 1.32–5.93) and May (RR: 1.79; 95% CI: 1.19–2.91), though estimates were sensitive to model specification.

Conclusions

Nationwide, firearm purchasing and firearm violence increased substantially during the first months of the coronavirus pandemic. At the state level, the magnitude of the increase in purchasing was not associated with the magnitude of the increase in firearm violence. Increases in purchasing may have contributed to additional firearm injuries from domestic violence in April and May. Results suggest much of the rise in firearm violence during our study period was attributable to other factors, indicating a need for additional research.
CBCT analysis of the tissue thickness at immediate implant placement with contour augmentation in the maxillary anterior zone: a 1-year prospective clinical study
Authors: Fujita Yuya , Nakano Tamaki , Ono Shinji , Shimomoto Takuya , Mizuno Keiichiro , Yatani Hirofumi , Ishigaki Shoichi
Published: July 2021

Background

Immediate implant placement with simultaneous contour augmentation such as guided bone regeneration (GBR) or connective tissue grafting (CTG) has been widely performed. However, few prospective studies have evaluated both peri-implant bone and soft tissue changes between the preoperative and postoperative periods. The purpose of this study is to quantify the horizontal dimensional changes of the facial bone and soft tissue following immediate implant placement with contour augmentation.

Material and methods

Twenty patients who underwent immediate implant placement in the anterior maxilla received GBR and CTG (test group) or GBR only (control group). Cone-beam computed tomography (CBCT) scans were taken preoperatively and 1 year after the definitive prosthesis connection, and then, they were superimposed. On the CBCT images of the two stages, the horizontal distance from the implant platform to the facial bone surface (BW) and the horizontal soft tissue width (GW) were measured at the implant platform level and 2 mm apical to the implant platform level. The sum of BW and GW (=TW) was used to assess the facial mucosal contour.

Results

BW decreased significantly from preoperative to 1 year after prosthesis connection with a mean decrease of 0.47 mm (P =0.021) in the control group and a mean decrease of 0.50 mm (P = 0.019) in the test group at the implant platform level. GW increased significantly with a mean increase of 1.37 mm (P =0.005) in the test group at the implant platform level. TW decreased significantly with a mean decrease of 0.46 mm in the control group (P =0.049) but increased significantly with a mean increase of 0.87 mm in the test group (P =0.005) at the implant platform level.

Conclusions

Immediate implant placement with CTG showed a soft tissue gain of 1.37 mm compensated for bone resorption, thus still preserving the preoperative mucosal contour. CTG should be performed with immediate implant placement in cases where preoperative mucosal contours need to be maintained.
Removal of a suture needle: a case report
Authors: Seon Suyun , Lee Baek-Soo , Choi Byung-Joon , Ohe Joo-Young , Lee Jung-Woo , Jung Junho , Hwang Bo-Yeon , Kim Min-Ah , Kwon Yong-Dae
Published: July 2021

Background

Foreign bodies may be embedded or left behind in the oral cavity during oral surgical procedure. The loss of instruments such as impression material, surgical gauze, and broken injection needles are commonly reported in the dental field. These complications are generally symptomatic and show signs of inflammation, pain, and purulent discharge. Accidental breakage of suture needles is a rare but potentially dangerous event.

Case presentation

In this report, we present one case of lost suture needle during the procedure of flap operation at local dental clinic and its successful removal under local/general anesthesia administration via CBCT with a help of two reference needles to localize the 6-0 nylon needle and consulting with the clinician.

Conclusion

CT scanning taken while mouth-closing may not be accurate with regard to real location measurement performed while mouth-opening. If so, other up-to-date radiographic devices and methods to retrieve a needle are recommended.
Positioning spice tourism as an emerging form of special interest tourism: perspectives and strategies
Authors: Nair Bipithalal Balakrishnan , Mohanty Patita Paban
Published: July 2021

The COVID-19 pandemic has halted activities in the global tourism industry, and the situation has only been worsened by the general air of uncertainty and lack of effective vaccinations. Consequently, people have begun testing various remedies to enhance their immunity, primarily turning to traditional medical practices and home remedies. The medicinal use of spices, given their immune-boosting properties, is increasingly popular globally and has enhanced global awareness of spices and their products. In light of this surging popularity, this study examines spice tourism as a concept of niche tourism. This study proposes spice tourism as a valuable post-COVID-19 strategy by providing four different approaches to position spice tourism within special interest tourism. This paper also suggests a tourism development plan for spice tourism and proposes a strategy for its resilience post-COVID-19.
Metaphloem development in the Arabidopsis root tip
Authors: Graeff Moritz , Hardtke Christian S.
Published: July 2021

The phloem transport network is a major evolutionary innovation that enabled plants to dominate terrestrial ecosystems. In the growth apices, the meristems, apical stem cells continuously produce early ‘protophloem’. This is easily observed in Arabidopsis root meristems, in which the differentiation of individual protophloem sieve element precursors into interconnected conducting sieve tubes is laid out in a spatio-temporal gradient. The mature protophloem eventually collapses as the neighboring metaphloem takes over its function further distal from the stem cell niche. Compared with protophloem, metaphloem ontogenesis is poorly characterized, primarily because its visualization is challenging. Here, we describe the improved TetSee protocol to investigate metaphloem development in Arabidopsis root tips in combination with a set of molecular markers. We found that mature metaphloem sieve elements are only observed in the late post-meristematic root, although their specification is initiated as soon as protophloem sieve elements enucleate. Moreover, unlike protophloem sieve elements, metaphloem sieve elements only differentiate once they have fully elongated. Finally, our results suggest that metaphloem differentiation is not directly controlled by protophloem-derived cues but rather follows a distinct, robust developmental trajectory.
Normoxic limitation of maximal oxygen consumption rate, aerobic scope and cardiac performance in exhaustively exercised rainbow trout (Oncorhynchus mykiss)
Authors: McArley Tristan J. , Morgenroth Daniel , Zena Lucas A. , Ekström Andreas T. , Sandblom Erik
Published: July 2021

In fish, maximum O2 consumption rate (ṀO2,max) and aerobic scope can be expanded following exhaustive exercise in hyperoxia; however, the mechanisms explaining this are yet to be identified. Here, in exhaustively exercised rainbow trout (Oncorhynchus mykiss), we assessed the influence of hyperoxia on ṀO2,max, aerobic scope, cardiac function and blood parameters to address this knowledge gap. Relative to normoxia, ṀO2,max was 33% higher under hyperoxia, and this drove a similar increase in aerobic scope. Cardiac output was significantly elevated under hyperoxia at ṀO2,max because of increased stroke volume, indicating that hyperoxia released a constraint on cardiac contractility apparent with normoxia. Thus, hyperoxia improved maximal cardiac performance, thereby enhancing tissue O2 delivery and allowing a higher ṀO2,max. Venous blood O2 partial pressure (PvO2) was elevated in hyperoxia at ṀO2,max, suggesting a contribution of improved luminal O2 supply in enhanced cardiac contractility. Additionally, despite reduced haemoglobin and higher PvO2, hyperoxia treated fish retained a higher arterio-venous O2 content difference at ṀO2,max. This may have been possible because of hyperoxia offsetting declines in arterial oxygenation that are known to occur following exhaustive exercise in normoxia. If this occurs, increased contractility at ṀO2,max with hyperoxia may also relate to an improved O2 supply to the compact myocardium via the coronary artery. Our findings show ṀO2,max and aerobic scope may be limited in normoxia following exhaustive exercise as a result of constrained maximal cardiac performance and highlight the need to further examine whether or not exhaustive exercise protocols are suitable for eliciting ṀO2,max and estimating aerobic scope in rainbow trout.
New insights into the allosteric effects of CO2 and bicarbonate on crocodilian hemoglobin
Authors: Bautista Naim M. , Malte Hans , Natarajan Chandrasekhar , Wang Tobias , Storz Jay F. , Fago Angela
Published: July 2021

Crocodilians are unique among vertebrates in that their hemoglobin (Hb) O2 binding is allosterically regulated by bicarbonate, which forms in red blood cells upon hydration of CO2. Although known for decades, this remarkable mode of allosteric control has not yet been experimentally verified with direct evidence of bicarbonate binding to crocodilian Hb, probably because of confounding CO2-mediated effects. Here, we provide the first quantitative analysis of the separate allosteric effects of CO2 and bicarbonate on purified Hb of the spectacled caiman (Caiman crocodilus). Using thin-layer gas diffusion chamber and Tucker chamber techniques, we demonstrate that both CO2 and bicarbonate bind to Hb with high affinity and strongly decrease O2 saturation of Hb. We propose that both effectors bind to an unidentified positively charged site containing a reactive amino group in the low-O2 affinity T conformation of Hb. These results provide the first experimental evidence that bicarbonate binds directly to crocodilian Hb and promotes O2 delivery independently of CO2. Using the gas diffusion chamber, we observed similar effects in Hbs of a phylogenetically diverse set of other caiman, alligator and crocodile species, suggesting that the unique mode of allosteric regulation by CO2 and bicarbonate evolved >80–100 million years ago in the common ancestor of crocodilians. Our results show a tight and unusual linkage between O2 and CO2 transport in the blood of crocodilians, where the build-up of erytrocytic CO2 and bicarbonate ions during breath-hold diving or digestion facilitates O2 delivery, while Hb desaturation facilitates CO2 transport as protein-bound CO2 and bicarbonate.
Development and Psychometric Validation of a Patient-Reported Outcome Measure for Arm Lymphedema: The LYMPH-Q Upper Extremity Module
Authors: Klassen Anne F. , Tsangaris Elena , Kaur Manraj N. , Poulsen Lotte , Beelen Louise M. , Jacobsen Amalie Lind , Jørgensen Mads Gustaf , Sørensen Jens Ahm , Vasilic Dalibor , Dayan Joseph , Mehrara Babak , Pusic Andrea L.
Published: July 2021

Background

A multiphased mixed-methods study was performed to develop and validate a comprehensive patient-reported outcome measure (PROM) for arm lymphedema in women with breast cancer (i.e., the LYMPH-Q Upper Extremity Module).

Methods

Qualitative interviews (January 2017 and June 2018) were performed with 15 women to elicit concepts specific to arm lymphedema after breast cancer treatment. Data were audio-recorded, transcribed, and coded. Scales were refined through cognitive interviews (October and Decemeber 2018) with 16 patients and input from 12 clinical experts. The scales were field-tested (October 2019 and January 2020) with an international sample of 3222 women in the United States and Denmark. Rasch measurement theory (RMT) analysis was used to examine reliability and validity.

Results

The qualitative phase resulted in six independently functioning scales that measure arm symptoms, function, appearance, psychological function, and satisfaction with information and with arm sleeves. In the RMT analysis, all items in each scale had ordered thresholds and nonsignificant chi-square p values. For all the scales, the reliability statistics with and without extremes for the Person Separation Index were 0.80 or higher, Cronbach’s alpha was 0.89 or higher, and the Intraclass Correlation Coefficients were 0.92 or higher. Lower (worse) scores on the LYMPH-Q Upper Extremity scales were associated with reporting of more severe arm swelling, an arm problem caused by cancer and/or its treatment, and wearing of an arm sleeve in the past 12 months.

Conclusions

The LYMPH-Q Upper Extremity Module can be used to measure outcomes that matter to women with upper extremity lymphedema. This new PROM was designed using a modern psychometric approach and, as such, can be used in research and in clinical care.
Clinical value of SMI Combined with Low-Dose CT Scanning in differential diagnosis of Thyroid Lesions and Tumor Staging
Authors: Xue Shao-wei , Luo Yu-kun , Jiao Zi-yu , Xu Lin
Published: July 2021

Objectives: To investigate the clinical value of Superb Microvascular Imaging (SMI) combined with low dose CT scanning in differential diagnosis of thyroid lesions and tumor staging.

Methods: A total of 120 patients with thyroid nodules admitted to the Chinese PLA General Hospital from January 2017 to July 2020 were selected. Paired design was adopted in this study. SMI and SMI combined with low-dose CT scanning were respectively carried out to these patients. The results were judged by two senior imaging physicians and two senior sonographers respectively. And t-test, χ2 test, Pearson correlation coefficient check and other methods were adopted to comparatively analyze the above two methods and the pathological results after operation or puncture.

Results: Compared with pathologic findings, the coincidence rate of SMI was 40%, and the coincidence rate of SMI combined with low dose CT scanning was 84%. The difference was significant (p=0.00); among the 120 thyroid nodule patients, 50 were diagnosed as malignant by pathological diagnosis, and 70 as benign; 27 malignant cases and 93 benign cases were detected by SMI; 48 malignant cases and 72 benign cases were detected by SMI combined with low dose CT scanning. The sensitivity and accuracy of the latter were significantly higher than those of the former, and the difference was statistically significant (p=0.00); the enhancement, edge sharpness and homogeneity of SMI increased with the increase of tumor malignancy, showing positive correlation property.

Conclusion: SMI combined with low dose CT scanning has a higher diagnostic coincidence rate. Its sensitivity and accuracy are significantly superior. With the increase of tumor malignancy, the enhancement and unhomogeneity of SMI increase, and the edge is more blurred. That suggests: with the increase of tumor malignancy, neovascularization in the tumor is more obvious and more unevenly distributed; the increase of edge blur indicates more obvious tumor infiltration. The method has considerable clinical value for predicting the malignancy of tumors.

doi: https://doi.org/10.12669/pjms.37.5.4144

How to cite this:Xue SW, Luo YK, Jiao ZY, Xu L. Clinical value of SMI Combined with Low-Dose CT Scanning in differential diagnosis of Thyroid Lesions and Tumor Staging. Pak J Med Sci. 2021;37(5):1347-1352. doi: https://doi.org/10.12669/pjms.37.5.4144

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.
Effect of Intensity Modulated Radiotherapy (IMRT) on the immunity, physical status and clinical effect of locally advanced NSCLC patients
Authors: Xu Jun-kai
Published: July 2021

Objectives: To evaluate the clinical value of radiotherapy combined with Camrelizumab in treating locally advanced non-small cell lung cancer (NSCLC) patients.

Methods: 80 locally advanced NSCLC patients were randomly divided into two groups (n=40). The control group was administered with intensity modulated radiation therapy (IMRT), whereas the experimental group with Camrelizumab in addition to IMRT. All the patients underwent clinical efficacy evaluation in terms of adverse drug reaction (ADR), physical status improvement after the treatment, and changes in T lymphocyte subpopulations (incl. CD3+, CD4+, CD8+, CD4+/CD8+).

Results: The efficacy was found to be 70% and 47.5 in experimental group and control group, respectively, with the former being significantly better than the latter (p=0.03). The ADR rates were 50% and 37.5% in the experimental group and control group, respectively; but the difference remained insignificant (p=0.26). As for physical status improvement, experimental group evidently excelled the control group (p=0.04). The post-treatment indicators such as CD3+, CD4+, CD8+, CD4+/CD8+ were significantly more improved in the experimental group than the control group (CD3+, p=0.02; CD4+, p=0.00; and CD4+/CD8+, p=0.01). However, the changes in CD8+ were not significant at all (p=0.46).

Conclusions: The combined therapy of IMRT with Camrelizumab appeared effective in dealing with the locally advanced NSCLC patients, as such patients presented significantly better immune state and physical status improvement but not increased ADR. The therapy is both safe and effective.

doi: https://doi.org/10.12669/pjms.37.5.4188

How to cite this:Xu JK. Effect of Intensity Modulated Radiotherapy (IMRT) on the immunity, physical status and clinical effect of locally advanced NSCLC patients. Pak J Med Sci. 2021;37(5):1480-1485. doi: https://doi.org/10.12669/pjms.37.5.4188

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.
Predictive factors of treatment success in two-dose methotrexate regimen in ectopic tubal pregnancy: A retrospective study
Authors: Helvacioglu Caglar , Doğan Keziban
Published: July 2021

Objectives: To investigate the predictive factors of success or failure in treating ectopic tubal pregnancies with two-dose methotrexate (MTX).

Methods: The records of patients treated for tubal EP with two-dose MTX were retrospectively reviewed. Patients were divided into two groups; the Group-I (failure) consisted of patients who did not respond to MTX therapy and the Group-II (success) included patients who were successfully treated with MTX. Parameters, including the week of gestation, presence or absence of fetal cardiac activity, gestational sac size, serum β-hCG levels, and adverse effects were compared.

Results: Fifty patients were included in this study, 8 (16%) were in Group-I and 42 (84%) were in Group-II. Patients in Group-I required surgery after a mean duration of 6.7±3 days after administering the initial dose of MTX. There was no difference between the groups in terms of the week of gestation, presence or absence of fetal cardiac activity, gestational sac size, serum β-hCG levels, and adverse effects. The average time to β-hCG negativization was 31 days in Group-II.

Conclusions: The two-dose MTX protocol has a reasonable success rate, which seems to be dependent on serum β-hCG levels.

doi: https://doi.org/10.12669/pjms.37.5.4299

How to cite this:Helvacioglu C, Dogan K. Predictive factors of treatment success in two-dose methotrexate regimen in ectopic tubal pregnancy: A retrospective study. Pak J Med Sci. 2021;37(5):1309-1312. doi: https://doi.org/10.12669/pjms.37.5.4299

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.
Mathematical modeling of two-phase compressible fluid filtration based on modified adaptive method of minimum amendments
Authors: Sukhinov Alexander I. , Grigoryan Lusine A. , Sukhinov Andrey A.
Published: July 2021

The work objective is to build and investigate the modified adaptive method of minimum amendments (MAMMA) which is destined for the numerical simulation of the two-phase compressible fluid filtration in porous media. This approach allows overcoming the known use limitations of other methods of the finite-difference equations solution, such as: crucial differential pressures acting on the oil-and-water bearing formation; and the compressibility of the medium at the considerable gas content in the oil phase. An approximation method - an explicit one for defining the function of water saturation, and an implicit one for the pressure function computation - is selected as the research basis. When setting the initial boundary value problem and its sampling, the process of the two-phase compressible fluid filtration in the space-dimensional domain with the lateral area bounded below by the subface of stratum, and above - by the bed top, is considered. A two-layer iterative method of the variational type - a modified method of minimal amendments adapted for solving finite-difference equations of the two-phase compressible fluid with a non-selfadjoint operator under the most general assumptions on the properties of the grid-problem operator is built. It is shown that a MAMMA has the asymptotic convergence rate characteristic of the “classical” alternate triangular method that does not use the Chebyshev acceleration technique and can be applied to the problems with a self-adjoint operator. Numerical experiments have confirmed the high efficiency of MAMMA. It is established that to achieve the specified accuracy, the number of iterations at the MAMMA reduces to 3-20 times as compared to the method of Seidel and the overrelaxation method.
Las reescrituras de la sustentabilidad: comunicación estratégica en el escenario de desastres socioambientales
Authors: Palma Millanao Karla Beatriz , Sánchez Fabiola
Published: July 2021

A partir de la dimensión discursiva en torno a la sustentabilidad de la empresa forestal Arauco, en este artículo se estudia cómo la comunicación estratégica y sus herramientas ayudan a reconfigurar el rol de la empresa en los desastres socioambientales en que ha estado involucrada. Así, se revela de qué modo los orígenes de los desastres quedan diluidos en medio de las acciones que despliega la empresa para enfrentar las situaciones de crisis, que son entendidas como controversias, y pasa de ser causante a convertirse en un actor más en la reconstitución del orden. A través del análisis de reportes de sustentabilidad y la realización de entrevistas y un grupo focal, se verá cómo el discurso de la empresa evoluciona de manera dinámica en torno a la sustentabilidad y su rol ante las crisis y cómo se entiende el discurso como una estrategia comunicacional que se orienta a transformar prácticas sociales hacia un fin determinado.
Understanding Perthes disease
Authors: Gruetg-Wyatt Loredana
Published: July 2021

Loredana Gruetg-Wyatt discusses Perthes disease, exploring current methods of diagnosis and treatment as well as examining the potential of current and future research
Mothers, Cousins, Sisters, Friends: Black South African Relations in Date My Family
Authors: Sithole Candy , Falkof Nicky
Published: July 2021

This article explores representations of black South African family structure in the popular local reality television programme Date My Family. Focusing on visual and verbal discourses, it considers the programme's cultural relevance, presentation of social circumstances and understandings of black South African identity in relation to family structure. Within the world of Date My Family, western/European conceptions of the nuclear family, so often valorised within reality TV, are renegotiated, and families exhibit the more commonly African extended form. At the same time gender relations within these families shift away from apparently traditional modes, with female-headed households and absent fathers common. The extended families that feature in Date My Family reflect the fluidity and variability of contemporary norms of gender and family among black South Africans.
‘Warfare’ Pentecostalism, Poverty and Welfare Provisioning in Southwestern Nigeria
Authors: Oyelade Olufikayo Kunle , Omobowale Ayokunle Olumuyiwa
Published: July 2021

Warfare Pentecostalism entails a brand of the Pentecostal movement, which views the world in terms of evil machinations of enemies whom every individual must battle spiritually. Warfare Pentecostalism is associated with symbolic demonstrations of offensive and defensive mechanisms against the “enemy” through prayers. The warfare Pentecostal movement has been popular in Nigeria since the 1930s, and research on it has been limited to the larger spectrum of Pentecostalism and its structure, while little is known about the contribution of this brand of Pentecostalism to poverty reduction and welfare provision. Qualitative data was collected through 16 key informant interviews (KIIs), 28 in-depth interviews (IDIs), 6 Focus group discussions (FGDs) and 4 Case studies conducted at Christ Apostolic Church (CAC), Mountain of Fire and Miracle Ministries (MFM), Gethsemane Prayer Ministries (GPM) and Redeemed Christian Church of God (RCCG) in Lagos, Ibadan and Ilesa. The study examines the context of warfare Pentecostalism, its connection to poverty and misery and consequent spiritualist constructions and the welfare interventions provided by warfare Pentecostal churches.
(Re)imagining Mandela's Leadership esiXhoseni
Authors: Mzileni Pedro
Published: July 2021

Much public discourse positions Nelson Mandela as a global figure who embraced Western English ideals characterised by liberal human rights and heroic individual leadership. This paper challenges that decontextualised presentation of Mandela by locating him esiXhoseni, which is his ancestral, linguistic, geographic and epistemic locality. Pulling Mandela's leadership traits into his indigenous traditions and origins provides an opportunity to (re)imagine the philosophical and moral tools he utilised to form his personal and social sensibilities in the execution of his political responsibilities as an African freedom fighter and statesman. This study also contextualises how Mandela utilised isiXhosa as an African leadership philosophy in the struggle for social justice across his personal and political life. If we are to properly comprehend the primary influences that shaped the ontological canons of Southern African liberation struggle figures, then we must labour to understand how their local and indigenous African languages constructed their political consciousness, principles, ethics, ideals, moral codes and leadership qualities.
Debundling accountability: prosecutor and public defender elections in Florida
Authors: McCannon Bryan C.
Published: July 2021

I explore the impact of public defender and prosecutor elections using caseload data from Florida. While most states within the US use popular elections to select and retain prosecutors, public defenders are typically appointed positions. Florida is novel in that for both positions, popular, partisan elections are used to select the office’s leader. I first document important distortions in pre-trial case handling. A public defender re-election is associated with an increase in the proportion of cases resolved via plea bargaining, while prosecutor re-elections are associated with less plea bargaining. At the trial phase, I present evidence that public defender re-elections are associated with a decrease in the proportion of jury trials that result in a conviction, while a prosecutor re-election coincides with an increase in the conviction rate. The results are consistent with voters holding both elected officials accountable for doing their job. Public defenders obtain plea bargains at a higher rate and secure acquittals for their clients when up for re-election. Prosecutors do not plea bargain as much and win at trial when up for re-election.