bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-expandable metallic stenting as a bridge to elective surgery versus emergency surgery for acute malignant right-sided colorectal obstruction
Authors: Li Bing , Cai Shi-Lun , Lv Zhen-Tao , Zhou Ping-Hong , Yao Li-Qing , Shi Qiang , Qi Zhi-Peng , Sun Di , Yalikong Ayimukedisi , Xu En-Pan , Xu Jian-Min , Zhong Yun-Shi
Published: December 2020

Background

The use of a self-expandable metallic stent (SEMS) as a bridge to surgery has increased for patients with obstructing colorectal cancer. However, relatively few reports have compared SEMS as a bridge to elective surgery for acute malignant obstruction of the right-sided colon (MORC) vs. emergency surgery (ES). This study aimed to evaluate the benefits of elective surgery after SEMS placement vs. ES for patients (including stage IV cases) with acute MORC.

Methods

Patients with acute MORC who underwent radical resection for a primary tumour from July 2008 to November 2016 at Zhongshan Hospital of Fudan University were retrospectively enrolled. Postoperative short-term outcomes, progression-free survival (PFS), and overall survival (OS) were compared between the SEMS and ES groups.

Results

In total, 107 patients with acute MORC (35 in the SEMS group and 72 in the ES group) were included for analysis. The Intensive Care Unit admission rate was lower (11.4% vs. 34.7%,P = 0.011), the incidence of complications was reduced (11.4% vs. 29.2%,P = 0.042), and the postoperative length of hospitalisation was significantly shorter (8.23 ± 6.50 vs. 11.18 ± 6.71 days,P = 0.033) for the SEMS group. Survival curves showed no significant difference in PFS (P = 0.506) or OS (P = 0.989) between groups. Also, there was no significant difference in PFS and OS rates between patients with stage II and III colon cancer. After colectomy for synchronous liver metastases among stage IV patients, the hepatectomy rates for the SEMS and ES groups were 85.7% and 14.3%, respectively (P = 0.029). The hazard ratio for colectomy alone vs. combined resection was 3.258 (95% CI 0.858–12.370;P = 0.041).

Conclusion

Stent placement offers significant advantages in terms of short-term outcomes and comparable prognoses for acute MORC patients. For synchronous liver metastases, SEMS placement better prepares the patient for resection of the primary tumour and liver metastasis, which contribute to improved survival.
Purple-leaf tea (Camellia sinensis L.) ameliorates high-fat diet induced obesity and metabolic disorder through the modulation of the gut microbiota in mice
Authors: Lin Yu-Chun , Lu Hsu-Feng , Chen Jui-Chieh , Huang Hsiu-Chen , Chen Yu-Hsin , Su Yen-Shuo , Tung Chien-Yi , Huang Cheng
Published: December 2020

Background

Obesity and its associated diseases have become a major world-wide health problem. Purple-leaf Tea (Camellia sinensis L.) (PLT), that is rich of anthocyanins, has been shown to have preventive effects on obesity and metabolic disorders. The intestinal microbiota has been shown to contribute to inflammation, obesity, and several metabolic disorders. However, whether PLT consumption could prevent obesity and diet-induced metabolic diseases by modulating the gut microbiota, is not clearly understood.

Methods

In this study, six-week-old male C57BL/6 J mice were fed a normal diet (ND) or a high fat diet (HFD) without or with PLT for 10 weeks.

Results

PLT modulated the gut microbiota in mice and alleviated the symptoms of HFD-induced metabolic disorders, such as insulin resistance, adipocyte hypertrophy, and hepatic steatosis. PLT increased the diversity of the microbiota and the ratio of Firmicutes to Bacteroidetes. f_Barnesiellaceae, g_Barnesiella, f_Ruminococcaceae, and f_Lachnospiraceae were discriminating faecal bacterial communities of the PLT mice that differed from the HFD mice.

Conclusions

These data indicate that PLT altered the microbial contents of the gut and prevented microbial dysbiosis in the host, and consequently is involved in the modulation of susceptibility to insulin resistance, hepatic diseases, and obesity that are linked to an HFD.
Doctors in Chinese public hospitals: demonstration of their professional identities
Authors: Liang Zhanming , Xu Min , Liu Guowei , Zhou Yongli , Howard Peter F
Published: December 2020

Background

An increase in the number of medical disputes and violence against doctors indicates a lack of trust in the medical profession by society in Chinese public hospitals. Empirical evidence confirms that one cause is the lack of professional identity demonstrated by doctors. Medical professionals are required to maintain high standards of competence and moral responsibility, and demonstrate qualities such as respect, compassion, integrity, responsiveness to needs, and commitment to sound ethical practice in order to maintain professional privilege. These principles and appropriate professional conduct are the foundation of the professional identity of the medical profession.

Methods

A quantitative approach was adopted by distributing paper-based questionnaires to doctors and patients in two hospitals (Level III and Level II) in Jinan, Shandong province, China.

Findings

In total, 614 doctors and 1184 inpatients on discharge from the surgical and internal medicine units of the two hospitals participated in the survey yielding 90% response rates. The study confirmed the variation amongst doctors in demonstrating their professionalism in terms of respecting patients’ views and preferences when determining diagnostic procedures and treatment plans, and when making ethical decisions. Although 90% patients indicated that they showed respects to doctors, close to 20% of the doctors disagreed that they received high respect from patients. About 12% of doctors prescribed unnecessary diagnostic procedures to patient for the purpose of generating profit and more than 20% of patients indicated that they gave gifts to doctors in order to receive better treatment.

Conclusions

Although about 80% of doctors demonstrated certain aspects of professionalism required by practitioners, the inconsistency across the medical workforce may exacerbate tense doctor-patient relationships. A review of medical curricula and focus of the internship program is required in order to assist medical graduates with forming required professional identity in order to improve patient satisfaction and better clinical outcomes. To be effective, a more systematic approach is recommended.
Reporting of screening and diagnostic AI rarely acknowledges ethical, legal, and social implications: a mass media frame analysis
Authors: Frost Emma K. , Carter Stacy M.
Published: December 2020

Background

Healthcare is a rapidly expanding area of application for Artificial Intelligence (AI). Although there is considerable excitement about its potential, there are also substantial concerns about the negative impacts of these technologies. Since screening and diagnostic AI tools now have the potential to fundamentally change the healthcare landscape, it is important to understand how these tools are being represented to the public via the media.

Methods

Using a framing theory approach, we analysed how screening and diagnostic AI was represented in the media and the frequency with which media articles addressed the benefits and the ethical, legal, and social implications (ELSIs) of screening and diagnostic AI.

Results

All the media articles coded (n = 136) fit into at least one of three frames: social progress (n = 131), economic development (n = 59), and alternative perspectives (n = 9). Most of the articles were positively framed, with 135 of the articles discussing benefits of screening and diagnostic AI, and only 9 articles discussing the ethical, legal, and social implications.

Conclusions

We found that media reporting of screening and diagnostic AI predominantly framed the technology as a source of social progress and economic development. Screening and diagnostic AI may be represented more positively in the mass media than AI in general. This represents an opportunity for health journalists to provide publics with deeper analysis of the ethical, legal, and social implications of screening and diagnostic AI, and to do so now before these technologies become firmly embedded in everyday healthcare delivery.
Hospital service quality based on HEALTHQUAL model and trusting nurses at Iranian university and non-university hospitals: a comparative study
Authors: Nemati Reza , Bahreini Masoud , Pouladi Shahnaz , Mirzaei Kamran , Mehboodi Farkhondeh
Published: December 2020

Background

Establishment and improvement of patients’ trust in healthcare organizations like hospitals necessitate delivery of high-quality services by nurses, as the largest group of healthcare providers. The present study aimed to compare hospital service quality based on the HEALTHQUAL model and trusting nurses at university and non-university hospitals in Iran.

Methods

This comparative cross-sectional study was conducted on 990 patients admitted to university and non-university hospitals located in Bushehr Province, southern Iran, who were selected using the stratified random sampling method. The data were collected through the HEALTHQUAL questionnaire and the Trust in Nurses Scale, and then analyzed via the SPSS Statistics software (version 22) as well as the General Linear Model (GLM) univariate procedure and the Chi-square test with a significance level of 0.05.

Results

The study findings revealed that the mean values of real quality (perceptions) and ideal quality (expectations) were 3.89 ± 0.69 and 4.55 ± 0.47, respectively. The gap between the real and ideal quality (− 0.64) was also larger at non-university hospitals from the patients’ viewpoints. Comparing various dimensions of service quality, the largest gap at university and non-university hospitals was associated with “environment” (− 0.13) and “empathy” (− 0.18), respectively. Additionally, the mean scores of the patient trust in nurses at university and non-university hospitals were 10.34 ± 5.81 and 8.71 ± 4.05, respectively, being a statistically significant difference (p <  0.001).

Conclusion

The study results demonstrated that hospital service quality and trusting in nurses were at higher levels at the university hospital than the non-university one; however, hospital service quality was at a lower level than what the patients had expected. Accordingly, hospital managers and policy-makers were suggested to focus on patients to reduce gaps in service quality, to promote service quality, and to provide better healthcare services to patients.
Midwives’ integration of post abortion manual vacuum aspiration in the Democratic Republic of Congo: a mixed methods case study & positive deviance assessment
Authors: Bourret Kirsty M. , Larocque Sylvie , Hien Amélie , Hogue Carol , Muray Kalum , Lukusa Aurélie Thethe , Ngabo Abel Minani
Published: December 2020

Background

Despite a recognized need for midwives to provide post abortion care, there exist barriers preventing them from integrating lifesaving skills such as manual vacuum aspiration (MVA) into practice. This collaborative research with the Professional Association of Congolese Midwives (SCOSAF), sought to understand how certain midwives in the Democratic Republic of Congo (DRC) have overcome barriers to successfully integrate MVA for post abortion care. Specifically, in order to provide locally-driven solutions to the problem of inadequate post abortion care in the DRC, this study aimed to identify examples of positive deviance, or midwives who had successfully integrated MVA in complex working environments following an in-service training facilitated by their midwifery association, SCOSAF.

Methods

Creswell’s mixed method comparative case study design was used to identify positive deviant midwives who had practiced MVA one or more times post training and to explore their strategies and enabling factors. Other midwives who had not practiced MVA post training permitted for a comparison gro cup and further interpretations. Sources of data included a sequential survey and semi-structured interviews.

Results

All 102 midwives invited to be surveyed were recruited and 34% reported practicing MVA post training (positive deviant midwives). No statistical significance was found between the two groups’ demographics and practice facility type. Overall, both groups had positive attitudes regarding midwifery-led MVA and legalization of abortion. Positive deviant midwives demonstrated and described more confidence and competence to practice and teach MVA. They were more likely to identify as teachers and overcome interprofessional barriers by teaching MVA to physicians, medical students and other midwives and position themselves as experts during post abortion emergencies.

Conclusion

Results provided important insight to midwives’ integration of post abortion care in Kinshasa. Strategies used by positive deviant midwives in emergencies allowed them to navigate challenging contexts in order to practice MVA, while simultaneously increasing the credibility of their profession and the dissemination of evidenced-based MVA practice. Programs designed to work with and promote positive deviant midwives as knowledge brokers could be tested for their overall impact on the diffusion of midwifery-led MVA to improve access to safe, respectful reproductive care.
RETRACTED ARTICLE: The lncRNA XIST promotes colorectal cancer cell growth through regulating the miR-497-5p/FOXK1 axis
Authors: Wang Nan , He Jia-Xing , Jia Guo-Zhan , Wang Ke , Zhou Shuai , Wu Tao , He Xian-Li
Published: December 2020

Background

Recent studies suggest that long noncoding RNAs (lncRNAs) play an important role in tumorigenesis. As a newly identified lncRNA, the role of XIST in colorectal cancer (CRC) has not been established. Here, we sought to characterize the role of XIST and its associated regulatory network in CRC cells.

Methods

Expression of XIST mRNA, miR-497-5p, and forkhead box k1 (FOXK1) in CRC cells and tissues were detected using quantitative real-time polymerase chain reaction (qRT-PCR). Proliferation and apoptosis of CRC cells were determined using the CCK-8 cell counting assay and flow cytometry. The rate of cell migration and invasion was determined using a transwell assay. The relationships between XIST, miR-497-5p, and FOXK1 were predicted and confirmed using a dual-luciferase reporter assay. Expression of FOXK1 protein was quantified by Western blot.

Results

XIST and FOXK1 expression were significantly upregulated in CRC tissues and cell lines, while miR-497-5p expression was downregulated. XIST knockdown significantly suppressed CRC cell proliferation, migration, and invasion. Silencing of XIST also reversed the downregulation of miR-497-5p and upregulation of FOXK1. Moreover, blocking XIST expression was shown to inhibit CRC tumor growth in vivo and the effects were antagonized by the loss of miR-497-5p. miR-497-5p was shown to act as a sponge of XIST and also targeted FOXK1 in CRC cells.

Conclusions

XIST was shown to promote the malignancy of CRC cells by competitively binding to miR-497-5p, resulting in an increase in FOXK1 expression. These results suggest that targeting of XIST may represent a possible treatment for CRC.
Injury mechanism affects the stability of suture-button syndesmosis fixation
Authors: Chen Kuan-Hao , Chen Chih-Hwa , Huang Yu-min , Lee Hsieh-Hsing , Tsuang Yang-Hwei
Published: December 2020

Background

Ankle syndesmosis injury is a common condition, and the injury mechanism can be sorted into pure syndesmosis injury, Weber-B, and Weber-C type fractures. This study aims to evaluate the treatment outcomes and stability of suture-button fixation for syndesmosis injury with different injury mechanisms. We hypothesized that injury mechanisms would alter the stability of suture-button fixation.

Methods

We retrospectively reviewed 63 patients with ankle syndesmosis injury who underwent surgery with TightRope (Arthrex, Naples, FL, USA) from April 2014 to February 2019. The stability of suture-button fixation with TightRope was evaluated by comparing the preoperative, postoperative, and final follow-up measurements of tibiofibular clear space (TFCS), tibiofibular overlap (TFO), and medial clear space (MCS). A subgroup analysis for each demographic group and injury type including pure syndesmosis injury, Weber-B, and Weber-C type fractures were performed.

Results

Syndesmosis was effectively reduced using TightRope. After the index surgery, the tibiofibular clear space was reduced from 7.73 to 4.04 mm, the tibiofibular overlap was increased from 3.05 to 6.44 mm, and the medial clear space was reduced from 8.12 to 3.54 mm. However, syndesmosis widening was noted at the final follow-up, especially in Weber-C type fractures (TFCS 3.82 to 4.45 mm, p < 0.01 and TFO 6.86 to 6.29 mm, p = 0.04). Though widened, the final follow-up values of tibiofibular clear space and tibiofibular overlap were in the acceptable range. Postoperatively and at the final follow-up, medial clear space was found to be significantly larger in the Weber-C group than in the pure syndesmosis and Weber-B groups (p < 0.05).

Conclusions

Suture-button fixation can offer anatomic reduction and dynamic fixation in syndesmosis injuries. However, when using this modality for Weber-C type fractures, more attention should be focused on the accuracy of reduction, especially of medial clear space, and rediastasis should be carefully monitored.

Trial registration

This trial was retrospectively approved by TMU-JIRB. Registration number N202004122, and the date of approval was May 06, 2020.

Level of evidence

III
Developmental vitamin D deficiency increases foetal exposure to testosterone
Authors: Ali Asad Amanat , Cui Xiaoying , Pertile Renata Aparecida Nedel , Li Xiang , Medley Gregory , Alexander Suzanne Adele , Whitehouse Andrew J. O. , McGrath John Joseph , Eyles Darryl Walter
Published: December 2020

Background

Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders which are more common in males. The ‘prenatal sex steroid’ hypothesis links excessive sex-steroid exposure during foetal life with the behavioural differences observed in ASD. However, the reason why sex steroid exposure may be excessive remains unclear. Epidemiological studies have identified several environmental risk factors associated with ASD, including developmental vitamin D (DVD) deficiency. We have demonstrated in an animal model that DVD-deficiency is associated with a hyper-inflammatory response in placentas from male but not female foetuses. Vitamin D also regulates the expression of several steroidogenic enzymes in vitro. Therefore using this animal model, we have examined whether DVD-deficiency leads to increased sex-steroid levels in both the maternal and foetal compartments.

Methods

Female rats are fed a vitamin D deficient diet from 6 weeks before mating until tissue collection at embryonic day 18. We examined the levels of testosterone, androstenedione and corticosterone in maternal plasma, foetal brains and amniotic fluid. We further examined gene expressions of steroidogenic enzymes and DNA methylation of aromatase promoters in foetal brains as a potential molecular mechanism regulating testosterone expression.

Results

We show that DVD-deficiency increases testosterone levels in maternal blood. We also show elevated levels of testosterone and androstenedione in the amniotic fluid of female but not male DVD-deficient foetuses. Testosterone levels were also elevated in DVD-deficient male brains. Vitamin D, like other steroid-related hormones, regulates gene expression via methylation. Therefore we examined whether the significant elevation in testosterone in male brains was due to such a potential gene-silencing mechanism. We show that the promoter of aromatase was hyper-methylated compared to male controls.

Limitations

A reduction in aromatase, in addition to causing excessive testosterone, could also lead to a reduction in estradiol which was not examined here.

Conclusions

This study is the first to show how an epidemiologically established environmental risk factor for ASD may selectively elevate testosterone in male embryonic brains. These findings provide further mechanistic support for the prenatal sex steroid theory of ASD.
FLT-PET for the assessment of systemic sarcoidosis including cardiac and CNS involvement: a prospective study with comparison to FDG-PET
Authors: Martineau Patrick , Pelletier-Galarneau Matthieu , Juneau Daniel , Leung Eugene , Nery Pablo , deKemp Rob , Beanlands Rob , Birnie David
Published: December 2020

Background

2-deoxy-2-[18F]fluoro-d-glucose’s (FDG) biodistribution limits the evaluation of cardiac sarcoidosis (CS) and neurosarcoidosis (NS). While protocols for cardiac suppression exist, they can be inconvenient for patients and lead to incomplete cardiac suppression in many cases. Furthermore, FDG PET is limited in the detection of neurosarcoidosis due to an inability to suppress high level of physiological uptake within the brain. 3′-deoxy-3′-[18F]fluorothymidine (FLT) has been shown to accumulate in sarcoidosis lesions and this tracer lacks significant physiological myocardial and brain uptake, suggesting that this tracer may be useful for the assessment of sarcoidosis, including CS and NS, without the need for patient preparation. This prospective pilot study examined the performance of FLT vs FDG PET for systemic sarcoidosis, including cardiac and neural involvement.

Materials and methods

Fourteen subjects with sarcoidosis were prospectively recruited and imaged with FDG- and FLT-PET. Two blinded, experienced readers independently reviewed the FLT-PET and FDG-PET images. Lesion distribution was compared between FLT and FDG. Agreement between FLT- and FDG-PET was determined using Cohen’s kappa and the intra-class correlation coefficient. Inter-observer variability of FLT and FDG-PET was assessed.

Results

Twelve subjects had CS as per Heart Rhythm Society criteria and 1 had NS. FLT-PET was positive in 12 (86%), and FDG-PET in 11 (79%), with cardiac uptake present in 6 (50%) and 7 (58%) of subjects with CS, respectively. The subject with NS demonstrated uptake on both FLT and FDG-PET, with more lesions on FLT. There were no significant differences in the anatomical distribution of lesions between FLT and FDG. SUVs were significantly (p < 0.001) higher for FDG than FLT (5.8 ± 3.0 vs 2.3 ± 1.1, respectively), but not (p = 0.90) after adjusting for blood pool activity (2.8 ± 1.4 vs 2.8 ± 1.1, respectively). Agreement between FLT- and FDG-PET was good to excellent for the diagnosis of sarcoidosis, lung involvement, CS, and NS (κ = 0.76, 0.69, 0.86, and 1.0, respectively). Inter-observer agreement for FLT was excellent for diagnosing sarcoidosis, CS and NS (κ = 0.81, 0.85, and 1.0, respectively) and comparable to that of FDG.

Conclusions

FLT-PET may be useful for the assessment of systemic sarcoidosis, as well as cardiac and neural involvement.
Prostate cancer and therapeutic challenges
Authors: Hawsawi Yousef MohammedRabaa , Zailaie Samar Abdullah , Oyouni Atif Abdulwahab A. , Alzahrani Othman Rashed , Alamer Osama Mohamed , Aljohani Saad Ali S.
Published: December 2020

Prostate cancer (PC) is the most prevalent type of cancer in men worldwide. In Saudi Arabia, the rate of PC is increasing annually. The sex steroid hormones androgens and their receptors have critical roles in PC development and progression. Additionally, apoptosis-related proteins such as heat-shock proteins are vital molecules in PC development. Steroid hormone-deprivation therapies remain the essential treatment for patients with metastatic PCs; however, acquired resistance to hormone deprivation and the transition to PC androgen independence is a major health obstacle. In this review, we aim to detail the roles of androgens, androgen receptors and sex steroid hormones in inducing apoptosis in PC.
International travel is not a significant risk of exposure for patients at a Midwestern United States travel clinic
Authors: Patel Pooja , House Hans R.
Published: December 2020

The Novel Coronavirus (SARS-CoV-2) was introduced into the United States via travel from Asia and Europe, although the extent of the spread of the disease was limited in the early days of the pandemic. Consequently, international travel may have played a role in the transmission of the disease into Iowa. This study seeks to determine how preferences for international travel changed as novel Coronavirus Disease (COVID-19) spread throughout the world and if any of these returning travelers developed COVID-19 as a result of their trips. This is a retrospective chart review of patients presenting to a travel clinic in Bettendorf, Iowa for pre-travel advice and vaccinations. From October 2019 to March 2020, four hundred twelve (n = 412) patients presented to the clinic. Intended travel to the Western Pacific region (China, Japan, Korea, etc.) decreased dramatically during the study period. All 412 patients were followed in the electronic medical record for the period after their planned travel and only three (3) presented for COVID-19 testing. Two (2) tested positive, and both of these infections were linked to workplace exposures and not due to travel. News of the growing pandemic and travel warnings likely altered patients’ travel plans and decreased travel to the most affected regions of the world in the early months of the COVID-19 pandemic. Based on our study, travel was not a significant source of COVID-19 exposure for patients seen at this clinic.
Capital mobility in Latin American and Caribbean countries: new evidence from dynamic common correlated effects panel data modeling
Authors: Murthy Vasudeva N. R. , Ketenci Natalya
Published: December 2020

This study investigates the degree of capital mobility in a panel of 16 Latin American and 4 Caribbean countries during 1960 to 2017 against the backdrop of the Feldstein-Horioka hypothesis by applying recent panel data techniques. This is the first study on capital mobility in Latin American and Caribbean countries to employ the recently developed panel data procedure of the dynamic common correlated effects modeling technique of Chudik and Pesaran (J Econ 188:393–420, 2015) and the error-correction testing of Gengenbach, Urbain, and Westerlund (Panel error correction testing with global stochastic trends, 2008, J Appl Econ 31:982–1004, 2016). These approaches address the serious panel data econometric issues of cross-section dependence, slope heterogeneity, nonstationarity, and endogeneity in a multifactor error-structure framework. The empirical findings of this study reveal a low average (mean) savings–retention coefficient for the panel as a whole and for most individual countries, as well as indicating a cointegration relationship between saving and investment ratios. The results indicate that there is a relatively high degree of capital mobility in the Latin American and Caribbean countries in the short run, while the long-run solvency condition is maintained, which is due to reduced frictions in goods and services markets causing increase competition. Increased capital mobility in these countries can promote economic growth and hasten the process of globalization by creating a conducive economic environment for FDI in these countries.
Establishing a common metric for patient-reported outcomes in cancer patients: linking patient reported outcomes measurement information system (PROMIS), numerical rating scale, and patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE)
Authors: Lee Minji K. , Schalet Benjamin D. , Cella David , Yost Kathleen J. , Dueck Amylou C. , Novotny Paul J. , Sloan Jeff A.
Published: December 2020

Background

Researchers and clinicians studying symptoms experienced by people with cancer must choose from various scales. It would be useful to know how the scores on one measure translate to another.

Methods

Using item response theory (IRT) with the single-group design, in which the same sample answers all measures, we produced crosswalk tables linking five 0–10 numeric rating scale (NRS) and 15 items from Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE, scored on a 1–5 scale) to the T-Score metric of six different scales from the NIH Patient reported Outcomes Measurement Information System (PROMIS®). The constructs, for which we conducted linking, include emotional distress-anxiety, emotional distress-depression, fatigue, sleep disturbance, pain intensity, and pain interference. We tested the IRT linking assumption of construct similarity between measures by comparing item content and testing unidimensionality of item sets comprising each construct. We also investigated the correlation of the measures to be linked and, by inspecting standardized mean differences, whether the linkage is invariant across age and gender subgroups. For measures that satisfied the assumptions, we conducted linking.

Results

In general, an NRS score of 0 corresponded to about 38.2 on the PROMIS T-Score scale (mean = 50; SD = 10); whereas an NRS score of 10 corresponded to a PROMIS T-Score of approximately 72.7. Similarly, the lowest/best score of 1 on PRO-CTCAE corresponded to 39.8 on T-score scale and the highest/worst score of 5 corresponded to 72.0.

Conclusion

We produced robust linking between single item symptom measures and PROMIS short forms.
Impact of neem-nanoemulsion and neem petroleum ether extract on some biological parameters of the internal parasitoid, Meteorus gyrator (Thub.) (Hymenoptera: Braconidae)
Authors: Ebeid Amany Ramadan
Published: December 2020

Background

The neem tree, Azadirachta indica, is very promising for the control of many insect pests, where it acting as feeding deterrents, oviposition obstruction and as a growth regulator.

Results

In this study, both neem extract and neem nanoemulsion significantly decreased the adult emergence of Meteorus gyrator. It was found that all concentrations of neem nanoemulsion especially high concentrations (800, 400, and 200 ppm) have adversely affected some biological parameters of this parasitoid. Also, they have a harmful effect as reducing fecundity, oviposition, and shortened the longevity of M. gyrator.

Conclusion

It has been proved that neem nanoemulsion is more harmful than neem oil extract for the hymenopteran parasitoid M. gyrator.
Assessment of door handles as potential reservoirs of drug-resistant enterococci
Authors: Otokunefor Kome , Famakin Blessing O. , Douglas Dorothy O.
Published: December 2020

Background

Fomites have long been known to play a key role in the spread of disease causing agents. Hospital-associated fomites in particular have been linked with transmission of members of theEnterococcisp which are key human pathogens. Few studies have explored the role non-hospital door handles might play as potential sources of these isolates. This study therefore set out to explore this role.

Results

A total of hundred toilet and office door handles in a tertiary institution in Rivers State, Nigeria, were sampled using the swab and rinse method. The presence and drug susceptibility of Enterococcus was determined using the selective bile esculin agar (BEA) and standard microbiological methods. Growth on BEA was observed in 71% of cases, with more growth (38/50, 76%) observed from toilet door handles. Only 35% of samples produced the characteristic black pigmentation associated withEnterococcussp. Six different bacterial groups were identified from this subset withEnterococcussp. making up only 14% (5/35) of the isolates. All (100%) Enterococci were isolated from toilet door handles. Antibiotic susceptibility testing revealed very high levels of resistance (80–100%) against 75% of the test antibiotics. An analysis of the antibiotic resistance pattern of each isolate revealed 11 unique antibiogram patterns. Only 2 of these patterns were associated with the enterococci, with majority (4/5) exhibiting resistance to Augmentin (AUG), Ceftazidime (CAZ), Ceftriaxone (CTR), Cefuroxime (CRX), Cloxacillin (CXC), Erythromycin (ERY), Gentamicin (GEN), Ofloxacin (OFL) (antibiogram of AUG–CAZ–CRX–CTR–CXC–ERY). None of the enterococci, however, was resistant to vancomycin.

Conclusion

This study reports low level contamination of door handles by enterococci. Identical antibiogram patterns linked with majority of the enterococci could however point at the occurrence of a single clone perhaps indicating single source contamination. Reports of high levels of ampicillin resistance among these isolates are problematic as ampicillin–gentamicin combination is the treatment of choice for nosocomial enterococci pathogens.
Improved Tissue Processing in Esophageal Adenocarcinoma After Ivor Lewis Esophagectomy Allows Histological Analysis of All Surgically Removed Lymph Nodes with Significant Effects on Nodal UICC Stages
Authors: Quaas A. , Schloesser H. , Fuchs H. , Zander T. , Arolt C. , Scheel A. H. , Rueschoff J. , Bruns C. , Buettner R. , Schroeder W.
Published: December 2020

Background

In esophageal carcinoma, the numbers of metastatic and total removed lymph nodes (LN) are well-established variables of long-term prognosis. The overall rate of retrieved LN depends on neoadjuvant treatment, the extent of surgical lymphadenectomy, and the modality of the pathological workup. The question in this study is whether technically extended histopathological preparation can increase the number of detected (metastatic) LN with an impact on nodal UICC staging.

Patients and Methods

A cohort of 77 patients with esophageal adenocarcinoma was treated with Ivor Lewis esophagectomy including standardized two-field lymphadenectomy. The specimens were grossed, and all manually detectable LN were retrieved. The remaining tissue was completely embedded by the advanced “acetone compression” retrieval technique. The primary outcome parameter was the total number of detected lymph nodes before and after acetone workup.

Results

A mean number of 23,1 LN was diagnosed after standard manual LN preparation. With complete embedding of the fatty tissue using acetone compression, the number increased to 40.5 lymph nodes (p < 0.0001). The mean number of metastatic LN increased from 3.2 to 4.2 nodal metastases following acetone compression (p < 0.0001). Additional LN metastases which caused a change in the primary (y)pN stage were found in ten patients (13.0%).

Conclusions

Advanced lymph node retrieval by acetone compression allows a reliable statement on the real number of removed LN. Results demonstrate an impact on the nodal UICC stage. A future multicenter study will examine the prognostic impact of improved lymph node retrieval on long-term oncologic outcome.
Spectrum of external genital anomalies in disorders of Sex Development at Children Hospital & Institute of Child Health, Lahore, Pakistan
Authors: Khan Sarah , Tafweez Raafea , Haider Areiba , Yaqoob Muhammad
Published: December 2020

Objective: To describe the mode of presentation and frequency of external genital anomalies in disorder of sex development (DSD)

Methods: This cross-sectional study was conducted at Children Hospital & Institute of Child Health, Lahore from January to December, 2016 on Children with DSD above 10 years of age. A detailed history and physical examination were done. Positive findings were recorded on a predesigned proforma and analyzed by SPSS 21. Karyotyping on blood samples was done to determine their genetic sex.

Results: Out of 83 DSD children, 67% (n=56) were assigned a female sex at birth of which 9% (n=5) had ambiguous genitalia. Male sex at birth was given to 33% (n=27) of which 96% (n=26) had genital ambiguity. Mode of presentation other than ambiguous genitalia were delayed puberty, amenorrhea, hirsuitism, gynaecomastia, cyclic hematuria etc. Clitoromegaly was the main finding in 62.5% (n=5) and micropenis in 45% (n=9). Karyotypic sex of 56 female sex of rearing was 46XX 80% (n=45), 45X0 13% (n=7), XXX 2% (n=1) and 46 XY in 5% (n=3). Karyotypic sex of 27 male sex of rearing was 46XY in 78% (n=21), 46XX in 15% (n=4) and 47XXY in 7% (n=2).

Conclusion: Disorders of sex development presented with a wide spectrum of external genital anomalies ranging from clitoromegaly in females to micropenis and hypospadias in males. There was also an extreme diversity in mode of presentation of these cases including pubertal delay, amenorrhea in females and gender confusion disorders.

doi: https://doi.org/10.12669/pjms.37.1.2991

How to cite this:Khan S, Tafweez R, Haider A, Yaqoob M. Spectrum of external genital anomalies in disorders of Sex Development at Children Hospital & Institute of Child Health, Lahore, Pakistan. Pak J Med Sci. 2021;37(1):244-249. doi: https://doi.org/10.12669/pjms.37.1.2991

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.
Real-Time Polymerase chain reaction trends in COVID-19 patients
Authors: Abbas Dr Sana , Rafique Aisha , Abbas Dr Beenish , Iqbal Dr Rashid
Published: December 2020

Objective: To assess trends of real-time Polymerase Chain Reaction test in Coronavirus infected Patients.

Methods: This cross-sectional analytical study was conducted at Tertiary Care Institute, Rawalpindi from March 2020 to June 2020. All patients confirmed COVID positive by real-time Polymerase Chain Reaction (PCR) with recent travel history, close contact with known diagnosed patients and had symptoms of fever or upper respiratory tract with body aches. Nasopharyngeal swabs were taken and results generated within 48 hours. Positive PCR was admission criteria follow up was carried out at 7th and 8th day, with negative PCR were discharged. However, those who had persistent positive PCR on the 8th day were tested again on 11th and 12th day. Those with persistent positive results beyond 12th day were shifted to specialized quarantine centres.

Results: A total of three hundred and ninety-two patients with mild to moderate illness, PCR positive for COVID 19 were included study with age range 9 - 45 and mean 33.22±7.98 years. A total of 8 (2%) patients were females and 384(98%) males. The duration of the negative test result was Mean ± Std. Deviation 9.05±2.00 with 7 – 8 days 152(38.8%)in and 11 – 12 days in 160(40.8%). PCR results on Day 7 and 8 were negative in 144(36.7%) patients whereas positive in 248(63.3%). PCR results on Day 11 and 12 were negative in 312(79.6%) patients whereas positive in 80 (20.4%).

Conclusion: To conclude Real-Time Polymerase Chain Reaction (rT-PCR) inclines to give false negative results additionally can stay positive in asymptomatic patients for moderately longer-term. Hence decision to discharge ought to be intricately adjusted between RT-PCR, clinical judgement, radiological examinations, and biochemical assays.

doi: https://doi.org/10.12669/pjms.37.1.3000

How to cite this:Abbas S, Rafique A, Abbas B, Iqbal R. Real-Time Polymerase chain reaction trends in COVID-19 patients. Pak J Med Sci. 2021;37(1):180-184. doi: https://doi.org/10.12669/pjms.37.1.3000

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.
An innovation in Flipped Class Room: A teaching model to facilitate synchronous and asynchronous learning during a pandemic
Authors: Rehman Rehana , Fatima Syeda Sadia
Published: December 2020

Objective: To conduct an on line Flipped Class Room (FCR) to facilitate synchronous (in class activity) and asynchronous learning [Virtual Learning Environment (VLE)] and acquire feedback of the learning experience from medical students at Aga Khan University.

Methods: This interventional study was conducted with year II students undergoing Endocrine Reproduction Module at the Aga Khan University during April 13 to May 22, 2020. Pre reading material and pretest was shared with the students via Virtual Learning Environment (VLE) one week before the class. Microsoft Teams was used to conduct online session by two facilitators, where student discussion on case studies was encouraged. A WhatsApp group was created with the facilitators to respond to any student queries. The session was recorded and later uploaded on VLE. Posttest and a student satisfaction survey was conducted at the end of the session.

Results: The average score for the pretest and posttest was 19.67 ± 1.37 and 24.60 ± 1.34 respectively (p value <0.05). The learner curve showed an increase in the knowledge learned by 4.93 points (p value <0.05). Fifty-five percent students felt that placement of session was appropriate and were satisfied with the instructions and expected outcomes, received constructive feedback for improvement and generated positive attitude towards learning.

Conclusions: The innovative model of FCR through facilitation of synchronous and asynchronous learning empowered student’s engagement and interactive learning. Students perceived this as a great learning experience which they enjoyed with positive reinforcement from feedback given by the facilitators. They suggested continuation of this model for further learning sessions in other modules of undergraduate medical education at Aga Khan University.

doi: https://doi.org/10.12669/pjms.37.1.3096

How to cite this:Rehman R, Fatima SS. An innovation in Flipped Class Room: A teaching model to facilitate synchronous and asynchronous learning during a pandemic. Pak J Med Sci. 2021;37(1):131-136. doi: https://doi.org/10.12669/pjms.37.1.3096

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.
Artificial Intelligence: Help or Hindrance for Family Physicians?
Authors: Irfan Farhana
Published: December 2020

The use of Artificial Intelligence (AI) and related technologies is rapidly increasing and its application in clinical practice is a promising area of development. Artificial Intelligence can be a solution in the future as a physician’s new assistant; AI-physician combinations can act like models of ‘peaceful co-existence’. While it has the potential to mold many dimensions of patient care and can augment quality improvement, it cannot replace a family physician’s diagnostic intelligence, empathy and relationships. Physicians need to strike a balance between these combinations for better health outcomes without increasing patients’ frustration.

doi: https://doi.org/10.12669/pjms.37.1.3351

How to cite this:Irfan F. Artificial Intelligence: Help or Hindrance for Family Physicians? Pak J Med Sci. 2021;37(1):288-291. doi: https://doi.org/10.12669/pjms.37.1.3351

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.
Memorias en púrpura pasionaria. Carmen Mondragón “Nahui Olin” y Gerardo Murillo “Dr. Atl”.
Authors: Toledo Olivar Araceli
Published: December 2020

Carmen Mondragón Valseca (Nahui Olin), poeta, caricaturista y pintora de origen mexicano, sostuvo una relación amorosa con Gerardo Murillo, más conocido como el Dr. Atl. En Gentes profanas en el convento, Atl recrea, a través de cartas escritas por personajes ficticios, la relación sostenida con la poeta. El presente ensayo aborda el discurso amoroso de Pierre (Atl) y Eugenia (Nahui Olin) a través de la vena teórica de Julia Kristeva, Roland Barthes y Eugenio Trías.
Adelaide Bernardini: polemiche e rivalità.
Authors: Giacobbe Giuliana Antonella
Published: December 2020

Scrittrice di origini umbre oggi quasi sconosciuta, Adelaide Bernardini fu una delle protagoniste della letteratura italiana del XX secolo. La sua vita si vide coinvolta in diversi scandali e polemiche letterarie con autori molto famosi della letteratura italiana come Marinetti o Pirandello, che non le perdonarono il fatto di essere la moglie di Luigi Capuana e di dimostrare un carattere ribelle.
"Militarism is a Movement of Retrogression": the Feminist Pacifism of Jane Addams, Mabel St Clair Stobart and Rose Macaulay in World War I.
Authors: Jiménez Fernández Jaime Francisco
Published: December 2020

The telling of the Great War (1914-1918), mainly through the point of view of combatants, is one of the best scenarios exemplifying how women have been obviated and censored throughout history. Moreover, the engagement of pacifist women in the conflict has been doubly belittled due to a misinterpretation of the term ‘pacifism’. Consequently, this paper aims at re-examining the origins and values of pacifism from a western perspective and giving visibility to pacifists Jane Addams, Mabel St Clair Stobart and Rose Macaulay and their efforts during the event.
La figure de la réfugíee politique dans Le bleu des abeilles.
Authors: Cremades Cano Isaac David
Published: December 2020

Nous proposons de nuancer la définition du concept de “littérature migrante” en langue française, en étudiant le cas de l’écrivaine Laura Alcoba et de son roman Le Bleu des abeilles. Une analyse comparative sur sa quête identitaire nous permet de déterminer à quel point sa condition de réfugiée politique suppose, en quelque sorte, une reformulation originale des questions telles que l’intégration, l’acculturation, les rapports “ici-là” et la perspective de l’entre-deux.
Exercício físico remoto e fadiga em sobreviventes do câncer de mama: uma intervenção em tempos do COVID-19
Authors: Pinto Stephanie Santana , Andrade Luana Siqueira , Fonseca Marindia Lacerda , Nanini Laura dos Reis , Calonego Chaiane , Meireles Esther Gonçalves , Alberton Cristine Lima
Published: December 2020

O objetivo do presente estudo foi verificar os efeitos de um programa de exercício físico supervisionado remotamente sobre a percepção de fadiga de sobreviventes do câncer de mama durante a pandemia da COVID-19. Participaram do estudo dez mulheres (56,30 ± 14,00 anos) fisicamente ativas, participantes de um programa de extensão universitário e que foram diagnosticadas com câncer de mama entre os estágios I-III (5,65 ± 2,19 anos de diagnóstico). O programa de exercício físico foi realizado de forma supervisionada por meio de chamada de vídeo durante 12 semanas, com duas sessões semanais de 30 minutos, em dias não consecutivos. Os treinos foram compostos por exercícios de mobilidade articular, de força, aeróbios e de equilíbrio, sendo modificados a cada três semanas. A percepção de fadiga relacionada ao câncer foi medida pela Piper Fatigue Scale por meio de chamada telefônica, antes e após as 12 semanas de intervenção. Os dados foram analisados utilizando o teste não-paramétrico Wilcoxon. Os resultados demonstraram valores de todos os domínios da fadiga relacionada ao câncer (fadiga total: p = 0,463; comportamental: p = 0,655; afetiva: p = 0,593; sensorial: p = 0,223; cognitiva: p = 0,141) estatisticamente semelhantes entre os momentos pré e pós intervenção. Conclui-se que, após 12 semanas de um programa de exercício físico supervisionado remotamente por chamada de vídeo, durante o distanciamento social devido a pandemia da COVID-19, a percepção de fadiga de mulheres sobreviventes do câncer de mama permaneceu estável.
A VIA JURÍDICA PARA O AMERICANISMO NOS TRÓPICOS: A BIOGRAFIA DE WERNECK VIANNA E A CONSTRUÇÃO NO IUPERJ DE UMA HIPÓTESE DE DEMOCRATIZAÇÃO À BRASILEIRA
Authors: Ferreira Daniel Henrique Da Mota
Published: December 2020

O presente ensaio procura analisar a contribuição da obra de Werneck Vianna para o debate da democratização no Brasil. O eixo do trabalho é a hipótese levantada por Gramsci, em americanismo e fordismo, sobre as possibilidades do direito pavimentar os caminhos para um autogoverno e sobre como essa ideia será incorporada por Werneck em sua obra. A análise observa a importância do IUPERJ nessa trajetória, destacando os grupos de pesquisa importantes para a pavimentação de uma interpretação brasileira da hipótese. No final o ensaio faz um balanço dos ganhos de tal interpretação para pensar no processo de democratização brasileiro em paralelo com a questão do campo de atuação e disputa dos novos atores.