bluuebunny/crossref_metadata_2025 huggingface dataset:
Gun violence and the voices of youth on community safety in the time of COVID-19 in East Harlem, NY: a youth participatory action research cross-sectional study
Authors: Wallace Jacqueline G. , Chernet Rachel , Formica Margaret K. , Adeonigbagbe Olusola , Flores Roseanne L. , Marchesani Robert , Goldberg Danielle , Wridt Pamela , Laraque-Arena Danielle
Published: July 2023

Background

The USA has failed to codify the protection of children from gun violence (GV) as a human right. This study employs a youth participatory action research methodology, within the framework of the United Nations Convention on the Rights of the Child (UNCRC), to investigate the relationships between GV exposure, self-identified gender and perceptions of children’s rights and safety.

Methods

An anonymous survey based on UNICEF USA’s Child Friendly Cities Initiative interactive survey tool targeting adolescents was modified by East Harlem, New York high school student co-researchers in collaboration with near-peer graduate students. The 61-question survey was administered at an East Harlem high school. Analysis consisted of univariate, bivariate and logistic regression using SPSS®.

Results

A total of 153 students completed the survey: 48.4% self-identified as male and 45.8% as female. Thirty-five percent reported witnessing GV. Most (79.1%) were aware of child rights regardless of gender or GV exposure but there were differences in perceptions of safety. Fifteen percent of females reported never feeling safe at school compared to 3% of males (p = 0.01). Females were 2.2 times as likely as males to report transportation waiting areas as never safe (p = 0.008). Almost a third of females reported never feeling safe from sexual harassment in public, compared to 10% of males (p = 0.004). In multivariable logistic regression adjusted for gender, race/ethnicity and grade level, students who witnessed GV were 4.6 times more likely to report never feeling safe from violence (95% CI 1.7–12.4). Thirty percent of students who witnessed GV reported not attending school because of safety concerns. Students who witnessed GV had 2.2 times the odds of carrying a weapon to school (95% CI 1.1–4.5). These patterns continued for other perceptions of safety.

Conclusions

The students in this study affirmed their rights to participate and express their views on matters that may affect them, as articulated in the UNCRC. The study revealed differences in perceptions of safety by self-identified gender and identified gun violence as a major contributor of youth’s perception of lack of safety. The study evinces the efficacy of employing YPAR methodology to identify and answer youth concerns of community safety and prioritize honoring child rights.
Prediction and detection of virtual reality induced cybersickness: a spiking neural network approach using spatiotemporal EEG brain data and heart rate variability
Authors: Yang Alexander Hui Xiang , Kasabov Nikola Kirilov , Cakmak Yusuf Ozgur
Published: July 2023

Virtual Reality (VR) allows users to interact with 3D immersive environments and has the potential to be a key technology across many domain applications, including access to a future metaverse. Yet, consumer adoption of VR technology is limited by cybersickness (CS)—a debilitating sensation accompanied by a cluster of symptoms, including nausea, oculomotor issues and dizziness. A leading problem is the lack of automated objective tools to predict or detect CS in individuals, which can then be used for resistance training, timely warning systems or clinical intervention. This paper explores the spatiotemporal brain dynamics and heart rate variability involved in cybersickness and uses this information to both predict and detect CS episodes. The present study applies deep learning of EEG in a spiking neural network (SNN) architecture to predict CS prior to using VR (85.9%, F7) and detect it (76.6%, FP1, Cz). ECG-derived sympathetic heart rate variability (HRV) parameters can be used for both prediction (74.2%) and detection (72.6%) but at a lower accuracy than EEG. Multimodal data fusion of EEG and sympathetic HRV does not change this accuracy compared to ECG alone. The study found that Cz (premotor and supplementary motor cortex) and O2 (primary visual cortex) are key hubs in functionally connected networks associated with both CS events and susceptibility to CS. F7 is also suggested as a key area involved in integrating information and implementing responses to incongruent environments that induce cybersickness. Consequently, Cz, O2 and F7 are presented here as promising targets for intervention.
How forest management changed the course of the Washburn fire and the fate of Yosemite’s giant sequoias (Sequoiadendron giganteum)
Authors: Hankin Lacey E. , Anderson Chad T. , Dickman Garrett J. , Bevington Parker , Stephens Scott L.
Published: July 2023

Background

The Washburn fire started on July 7, 2022 in the lower Mariposa Grove in Yosemite National Park, posing immediate threats to the iconic giant sequoias (Sequoiadendron giganteum), critical Pacific fisher (Pekania pennanti) habitat, and the community of Wawona. The wildfire quickly gained national attention and the public followed Yosemite’s firefighting efforts closely. In the aftermath of the Washburn fire, we evaluate how decades of fire management and recent roadside thinning in the Park shaped the tactics and outcomes of this wildfire. Fuels reduction and prescribed fire have been at the core of Yosemite’s fire management program since the 1970s and much of this activity has been concentrated in the two areas where firefighting operations were most successful in protecting key resources. We use long-term fire effects monitoring data, airborne light detection and ranging data, and operational perspectives to link together science, management, and fire operations.

Results

Successful initial attack and suppression efforts kept fire out of the Mariposa Grove and the community, where topography and the distribution of heavy fuels largely drove fire behavior throughout the course of the fire. We demonstrate the cumulative effects of decades of fuels treatments in reducing two major drivers of fire behavior – tree density and fuel load – and highlight substantially lower ladder fuels and fire severity in treatment units compared to untreated areas within the Washburn fire footprint.

Conclusions

We show how repeated prescribed fire and fuels treatments can promote forest structure indicative of frequent-fire regimes, moderate extreme fire behavior, improve the ability to protect key resources of concern, and increase human safety in the face of unplanned wildfire. Strategically placed prescribed fire and fuels treatments surrounding the Washburn fire were key considerations in wildfire suppression tactics and were instrumental in protecting the Mariposa Grove.
Evaluation and Comparison of Real-World Databases for Conducting Research in Patients With Colorectal Cancer
Authors: Wang Ching-Yu , Shao Changxia , McDonald Alicia C. , Amonkar Mayur M. , Zhou Wei , Bortnichak Edward A. , Liu Xinyue
Published: July 2023

PURPOSE

Evaluating whether patient populations in clinico-genomic oncology databases are comparable with whom in other databases without genomic component is important.

METHODS

Four databases were compared for colorectal cancer (CRC) cases and stage IV CRC cases: American Association for Cancer Research Project Genomics Evidence Neoplasia Information Exchange Biopharma Collaborative (GENIE-BPC), The Cancer Genome Atlas (TCGA), SEER-Medicare, and MarketScan Commercial and Medicare Supplemental claims databases. These databases were also compared with the SEER registry database which serves as national benchmarks. Demographics, clinical characteristics, and overall survival were compared in patients with newly diagnosed CRC and patients with stage IV CRC across databases. Treatment patterns were further compared in patients with stage IV CRC.

RESULTS

A total of 65,976 patients with CRC and 13,985 patients with stage IV CRC were identified. GENIE-BPC had the youngest patient population (mean age [years]: CRC, 54.1; stage IV CRC, 52.7). SEER-Medicare had the oldest patient population (CRC, 77.7; stage IV CRC, 77.3). Most patients were male and of White race across databases. GENIE-BPC had the highest proportion of patients with stage IV CRC (48.4% v other databases 13.8%-25.4%) and patients receiving treatments (95.7% v 37.6%-59.1%). Infusional fluorouracil, leucovorin, and oxaliplatin with or without bevacizumab was the most common regimen across databases accounting for 47.3%-78.5% of patients receiving first line of therapy. The median survival from diagnosis was 36, 94, 44 months (CRC) and 23, 36, 15 months (stage IV CRC) for patients in GENIE-BPC after left truncation, TCGA, and SEER-Medicare databases, respectively.

CONCLUSION

Compared with other databases, GENIE-BPC had the youngest patients with CRC with the most advanced disease and the largest proportion of patients receiving treatment. Investigators should consider adjustments when extrapolating results from clinico-genomic databases to the general CRC population.
Complexity of networks: A structural heterogeneity approach
Authors: Liu Gang , Tian Tian , Huang Chengfu , Mou Biao
Published: July 2023

The complexity measurement of networks is one of the hot topics in complex networks. How to accurately describe the complexity difference between networks is helpful to the study of network structure. This paper proposes a method for measuring the network complexity considering the local and global structural heterogeneity. This method introduces the k-order neighbors to examine the local structural heterogeneity. Besides, the standard deviation is used to evaluate the global structural heterogeneity. Based on this, the complexity measurement model is established. In order to testify the efficiency of the method, the ER random networks, BA scale-free networks and real networks (including four social networks and two infrastructure networks) are used for experiments. The results show that the proposed method is sensitive and can effectively describe the subtle difference of structure complexity between networks.
Parent Perspectives on Complex Needs in Patients With MCT8 Deficiency: An International, Prospective, Registry Study
Authors: van Geest Ferdy S , Groeneweg Stefan , Popa Veronica M , Stals Milou A M , Visser W Edward
Published: July 2023

Context

Monocarboxylate transporter 8 (MCT8) deficiency is a rare neurodevelopmental and metabolic disorder, with daily care posing a heavy burden on caregivers. A comprehensive overview of these complex needs and daily care challenges is lacking.

Design

We established an international prospective registry to systemically capture data from parents and physicians caring for patients with MCT8 deficiency. Parent-reported data on complex needs and daily care challenges were extracted.

Results

Between July 17, 2018, and May 16, 2022, 51 patients were registered. Difficulties in daily life care were mostly related to feeding and nutritional status (17/33 patients), limited motor skills (12/33 patients), and sleeping (11/33 patients). Dietary advice was provided for 11/36 patients. Two of 32 patients were under care of a cardiologist. Common difficulties in the diagnostic trajectory included late diagnosis (20/35 patients) and visiting a multitude of specialists (15/35 patients). Median diagnostic delay was significantly shorter in patients born in or after 2017 vs before 2017 (8 vs 19 months, P < .0001).

Conclusions

Feeding and sleeping problems and limited motor skills mostly contribute to difficulties in daily care. The majority of patients did not receive professional dietary advice, although being underweight is a key disease feature, strongly linked with poor survival. Despite sudden death being a prominent cause of death, potentially related to the cardiovascular abnormalities frequently observed, patients were hardly seen by cardiologists. These findings can directly improve patient-centered multidisciplinary care and define patient-centered outcome measures for intervention studies in patients with MCT8 deficiency.
The Impact of Gender-Affirming Hormone Therapy on Physical Performance
Authors: Cheung Ada S , Zwickl Sav , Miller Kirsti , Nolan Brendan J , Wong Alex Fang Qi , Jones Patrice , Eynon Nir
Published: July 2023

Context

The inclusion of transgender people in elite sport has been a topic of debate. This narrative review examines the impact of gender-affirming hormone therapy (GAHT) on physical performance, muscle strength, and markers of endurance.

Evidence Acquisition

MEDLINE and Embase were searched using terms to define the population (transgender), intervention (GAHT), and physical performance outcomes.

Evidence Synthesis

Existing literature comprises cross-sectional or small uncontrolled longitudinal studies of short duration. In nonathletic trans men starting testosterone therapy, within 1 year, muscle mass and strength increased and, by 3 years, physical performance (push-ups, sit-ups, run time) improved to the level of cisgender men. In nonathletic trans women, feminizing hormone therapy increased fat mass by approximately 30% and decreased muscle mass by approximately 5% after 12 months, and steadily declined beyond 3 years. While absolute lean mass remains higher in trans women, relative percentage lean mass and fat mass (and muscle strength corrected for lean mass), hemoglobin, and VO2 peak corrected for weight was no different to cisgender women. After 2 years of GAHT, no advantage was observed for physical performance measured by running time or in trans women. By 4 years, there was no advantage in sit-ups. While push-up performance declined in trans women, a statistical advantage remained relative to cisgender women.

Conclusion

Limited evidence suggests that physical performance of nonathletic trans people who have undergone GAHT for at least 2 years approaches that of cisgender controls. Further controlled longitudinal research is needed in trans athletes and nonathletes.
Significant High Lipid Profile in a Woman With Obstructive Jaundice
Authors: Albargawi Mashael , Abdulaal Ibtihal
Published: July 2023

Gallbladder disease is one of the most common gastrointestinal tract diseases. In obstructive jaundice, there is a reduction in bile flow out of the liver secondary to the blocked bile or pancreatic duct, which leads to excess bile and its products accumulating in the blood. One of these products is lipoprotein X (LpX); its presence is associated with a lipoprotein pattern characterized by an increased concentration of low-density lipoprotein (LDL) cholesterol. Few published articles have reported the association between obstructive jaundice and hyperlipidemia. This report describes a unique case of a Saudi female patient diagnosed with obstructive jaundice, presenting with extreme hypercholesterolemia, which was reduced significantly 1 week after endoscopic retrograde cholangiopancreatography (ERCP). Correct recognition and investigation of the lipid profile are important for differentiating LpX-mediated hypercholesterolemia caused by obstructive jaundice from other causes of elevated LDL concentrations. Differentiation may affect the patient's therapeutic management.
A Generational Shift: Race and the Declining Lifetime Risk of Imprisonment
Authors: Robey Jason P. , Massoglia Michael , Light Michael T.
Published: July 2023

Mass incarceration fundamentally altered the life course for a generation of American men, but sustained declines in imprisonment in recent years raise questions about how incarceration is shaping current generations. This study makes three primary contributions to a fuller understanding of the contemporary landscape of incarceration in the United States. First, we assess the scope of decarceration. Between 1999 and 2019, the Black male incarceration rate dropped by 44%, and notable declines in Black male imprisonment were evident in all 50 states. Second, our life table analysis demonstrates marked declines in the lifetime risks of incarceration. For Black men, the lifetime risk of incarceration declined by nearly half from 1999 to 2019. We estimate that less than 1 in 5 Black men born in 2001 will be imprisoned, compared with 1 in 3 for the 1981 birth cohort. Third, decarceration has shifted the institutional experiences of young adulthood. In 2009, young Black men were much more likely to experience imprisonment than college graduation. Ten years later, this trend had reversed, with Black men more likely to graduate college than go to prison. Our results suggest that prison has played a smaller role in the institutional landscape for the most recent generation compared with the generation exposed to the peak of mass incarceration.
Archive of Tongues
Authors: Charania Moon
Published: July 2023

In Archive of Tongues Moon Charania explores feminine dispossession and the brown diaspora through a reflection on the life of her mother. Drawing on her mother's memories and stories of migration, violence, sexuality, queerness, domesticity, and the intimate economies of everyday life, Charania conceptualizes her mother's tongue as an object of theory and an archive of brown intimate life. By presenting a mode of storytelling that is sensual and melancholic, piercing and sharp, Charania recovers otherwise silenced modes of brown mothers' survival, disobedience, and meaning making that are often only lived out in invisible, intimate spaces, and too often disappear into them. In narrating her mother's tongue as both metaphor for and material reservoir of other ways of knowing, Charania gestures to the afflictions, limits, and failures of feminist, queer, and postcolonial scholarly interrogations and the consequences of closing the archive of the brown mother.
DELLA proteins positively regulate seed size inArabidopsis
Authors: Gomez Maria Dolores , Cored Isabel , Barro-Trastoy Daniela , Sanchez-Matilla Joaquin , Tornero Pablo , Perez-Amador Miguel A.
Published: July 2023

Human and animal nutrition is mainly based on seeds. Seed size is a key factor affecting seed yield and has thus been one of the primary objectives of plant breeders since the domestication of crop plants. Seed size is coordinately regulated by signals of maternal and zygotic tissues that control the growth of the seed coat, endosperm and embryo. Here, we provide previously unreported evidence for the role of DELLA proteins, key repressors of gibberellin responses, in the maternal control of seed size. The gain-of-function della mutant gai-1 produces larger seeds as a result of an increase in the cell number in ovule integuments. This leads to an increase in ovule size and, in turn, to an increase in seed size. Moreover, DELLA activity promotes increased seed size by inducing the transcriptional activation of AINTEGUMENTA, a genetic factor that controls cell proliferation and organ growth, in the ovule integuments of gai-1. Overall, our results indicate that DELLA proteins are involved in the control of seed size and suggest that modulation of the DELLA-dependent pathway could be used to improve crop yield.
Physical Activity and Patient-Reported Outcomes in Monoclonal Plasma Cell Disorders
Authors: Joseph Janine , Hillengass Michaela , Sweeney Nathan W. , Molina Thomas H. , Ahlstrom Jennifer M. , Moysich Kirsten , Cannioto Rikki , Hillengass Jens
Published: July 2023

Introduction

Plasma cell disorders (PCD) are a group of conditions characterized by disproportionate proliferation of a single clone of B lymphocytes. Multiple myeloma (MM) is a malignant type of PCD. Improvements in MM survival have led patients and physicians to pursue strategies to improve quality of life for those living longer with this disease. Bone disease and instability associated with MM have made physicians reluctant to recommend physical activity (PA) to this patient population. The goal of this study was to examine the relationship between PA and physical and psychosocial patient-reported outcomes (PRO) in patients with MM and precursor conditions.

Methods

We employed a cross-sectional study design. Questionnaires on PA, demographics, fatigue, distress, and other aspects of quality of life were posted on the HealthTree® Cure Hub website, a patient portal through which individuals with MM and related disorders obtain support, track labs and other information about their diseases, and participate in research.

Results

A total of 794 individuals, including 664 with MM, are included in the current analysis. We observed potential inverse associations between PA and poor quality of life, including problems with sleep, fatigue, neuropathy, distress, and several psychosocial states. On average, patients reported that their PA levels have declined since diagnosis and that they would like to be even more active in the future than they were prior to their diagnosis.

Conclusions

In our cross-sectional study, regular physical activity was associated with multiple quality-of-life indicators and other PROs, including better sleep and less fatigue, neuropathy, and distress. The findings of this study can help guide the design of prospective studies of the role of PA in MM survivorship.
Acute Exercise Increases NK Cell Mitochondrial Respiration and Cytotoxicity against Triple-Negative Breast Cancer Cells under Hypoxic Conditions
Authors: CHO EUNHAN , STAMPLEY JAMES , WALL RACHEL , MATTHEWS RACHEL , ZUNICA ELIZABETH , BROWN JUSTIN C. , JOHANNSEN NEIL M. , IRVING BRIAN A. , SPIELMANN GUILLAUME
Published: July 2023

Purpose

Triple-negative breast cancer (TNBC) is an aggressive, highly metastatic malignancy with high recurrence rates. Hypoxia is a hallmark of the TNBC tumor microenvironment, which promotes tumor growth while impairing natural killer (NK) cell cytotoxic functions. Although acute exercise improves NK cell function under normoxic conditions, the effect of exercise on NK cell cytotoxic functions under hypoxic conditions mimicking O2 tensions observed in solid tumors is unknown.

Methods

The cytotoxic functions of resting and postexercise NK cells isolated from thirteen young inactive healthy women were assessed against breast cancer cells expressing different levels of hormone receptors (MCF-7 and MDA-MB-231) under normoxic and hypoxic conditions. Mitochondrial respiration and H2O2 efflux rates of the TNBC-activated NK cells were assessed via high-resolution respirometry.

Results

Under hypoxia, postexercise NK cells exhibited greater killing of TNBC than resting NK cells. Further, postexercise NK cells were more likely to kill TNBC under hypoxia than normoxic conditions. In addition, mitochondrial respiration associated with oxidative (OXPHOS) capacity of TNBC-activated NK cells was greater in postexercise cells than resting cells under normoxia, but not under hypoxia. Finally, acute exercise was associated with reduced mitochondrial H2O2 efflux by NK cells in both conditions.

Conclusions

Together, we present crucial interrelationships between hypoxia and exercise-induced changes in NK cell functions against TNBC cells. By modulating their mitochondrial bioenergetic functions, we postulate that acute exercise improves NK cell function under hypoxic conditions. Specifically, NK cell O2 and H2O2 flow (pmol·s−1·million NK cells−1) changes in response to 30-min cycling suggest that exercise primes NK cell tumor killing by reducing mitochondrial oxidative stress and, thus, rescuing their function when exposed to harsh hypoxic environments as observed in the microenvironment of breast solid tumors.
Bone, Estrogen, Strength Training Study Translation to Osteoporosis Prevention Research and Education
Authors: Milliken Laurie , Houtkooper Linda , Metcalfe Lauve , Farrell Vanessa , Going Scott , Lohman Timothy
Published: July 2023

Introduction/Purpose: Osteoporosis is a bone disease that a combination of exercise, hormone replacement therapy (HT), and calcium intake may help prevent by preserving or increasing bone mineral density (BMD) in postmenopausal women. The Bone, Estrogen, Strength Training (BEST) Study clinical trial was designed to determine the effects of exercise training on BMD in postmenopausal women either with or without HT. Methods: The BEST Study was unique because it included progressive resistance and weight-bearing exercises, addressed HT use, supplemented and documented calcium intake, provided robust intervention support, and extended the intervention protocol for multiple years. Results: The study findings demonstrated that postmenopausal women who had adequate calcium intake and followed the BEST exercise program maintained or increased their BMD. This article describes key lessons learned from the longitudinal BEST Study for translating the findings to the research community to improve future intervention research studies and to health professionals to inform osteoporosis prevention and bone health education. The BEST Study produced five lessons that can inform and improve osteoporosis prevention research and educational practice: 1) long-term bone health effects are important to study and require proactive strategies to obtain longitudinal funding support, 2) long-term retention of participants and compliance with study protocols require a participant focused study design and protocols, 3) extensive documentation of intervention protocols and sophisticated analytical strategies are essential to determine study intervention effects, 4) heterogeneity in responses to research study interventions should be expected and explored, and 5) osteoporosis prevention can be facilitated by translating the positive results from the BEST Study into practical educational tools. Conclusion: The BEST Study results can be translated into effective exercise and dietary practices to help prevent osteoporosis. Future research studies that use participant motivation and support protocols and meticulous documentation will further advance research in the prevention of osteoporosis.
The Physiological and Subjective Effects of Exercising with a Face Mask at Different Intensities
Authors: Campbell Nicholas S. , LaBotz Michele , Visich Paul S.
Published: July 2023

Introduction

Face masks are used to reduce the spread of respiratory diseases. Physical exertion increases distance traveled by expelled particles, so masking while exercising is recommended to help prevent disease transmission. However, there is limited literature assessing masking during higher-intensity exercise.

Purpose

This study aimed to compare the impact of surgical masks on physiological and subjective measures during 45 min of a progressive exercise protocol as compared with unmasked exercise.

Methods

Each subject completed two random 45-min exercise trials (15 min each at 40%, 60%, and 80% of their oxygen uptake reserve) with and without a surgical mask in random order. Heart rate, oxygen saturation, respiratory rate (RR), ratings of perceived exertion, and dyspnea (Dys) were measured at each intensity. Repeated-measures ANOVA was utilized, and significance was set at P < 0.05.

Results

Thirty subjects (age, 20.4 ± 1.2 yr; peak oxygen uptake, 40.12 ± 11.05 mL·kg−1·min−1; 57% female) completed the study. When comparing masked and unmasked trials at each exercise intensity, differences were found only in RR (40%: 17.6 ± 4.9 vs 15.8 ± 4.9, P < 0.02, d = 0.4; 60%: 23.7 ± 5.5 vs 21.3 ± 6.2, P < 0.01, d = 0.4; 80%: 35.8 ± 9.0 vs 30.1 ± 8.8, P < 0.01, d = 0.6). When comparing masked with unmasked trials across all intensities, a difference was found in Dys (3.5 ± 2.4 vs 2.9 ± 2.2, respectively; P < 0.001, d = 0.3).

Conclusions

The use of surgical masks seems to impact RR and one’s perception of Dys, but has minimal influences on heart rate, oxygen saturation, and rating of perceived exertion. Other than increasing one’s RR and perceptions of Dys, it seems that exercising with a mask at moderate and vigorous intensities is acceptable in healthy individuals.
Seeds of trust ripe as luscious fruits: Faculty mentorship forum at Aga Khan University Medical College
Authors: Ali Rahila , Rehman Dr Rehana , Khalid Saira , Ali Tazeen Saeed
Published: July 2023

Background & Objective: Faculty members require mentoring in all stages of their professional development. Aga Khan University (AKU) has initiated mentorship programs for students and faculty at AKU Medical College (AKU- MC) and AKU School of Nursing and Midwifery (AKU-SONAM). This study aimed to explore perceptions of mentors, mentees, administrators (chairs, co-chairs, founder members and coordinators of the mentoring program) and leadership and further investigate the strengths and challenges faced by ‘Faculty Mentorship Program’ at AKU- MC.

Methods: We conducted a qualitative exploratory study from February till December 2021 after approval from AKU using purposive criterion sampling. Mentors, mentees, administrators and dean of AKU- MC were included in the study. The interview guide was developed, validated and reviewed by experts. After piloting, four focused group discussions and 8 in-depth interviews were conducted in AKU- MC.

Results: The findings described the transition from informal to formal mentorship, identified challenges faced by mentors and mentees and suggested the role of leadership / administrators. The themes identified were “Continuous improvement of mentoring practices”, “Building strong foundations for mentoring relationships”, and “Growth and development through challenging experiences”

Conclusion: The faculty mentorship program at AKU-MC was in line with the goals and vision of the institution. All participants identified the need of additional resources, administrative support, rewards, incentives and recognition of mentors for sustainability of the program.

doi: https://doi.org/10.12669/pjms.39.5.7175

How to cite this: Rehman R, Ali R, Khalid S, Ali TS. Seeds of trust ripe as luscious fruits: Faculty mentorship forum at Aga Khan University Medical College. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.7175

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.
Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction – finding a better diagnostic tool
Authors: Khan Rao Saad Ali , Alam Laima , Khan Zoya Ali , Khan Uzair Ali
Published: July 2023

Objective: To evaluate the diagnostic accuracy of different imaging modalities in patients with partial biliary obstruction with no obvious aetiology on initial imaging.

Methods: This is a prospective single-centre cohort study carried out at Pak Emirates Military Hospital, Rawalpindi from June 2019 to June 2021 with non-probability consecutive sampling. Patients with ages 16 to 75 years, presenting with partial biliary obstruction and undetermined aetiology on initial imaging (TUS and MRCP) were enrolled. EUS was performed for each of these patients and the case was regarded as “true positive” or “true negative” if the findings of imaging modality correlated to those of ERCP. ROC curve, sensitivity, specificity, PPV, NPV and AUC (with 95% confidence interval) were drawn for all the diagnostic tools using SPSS V. 21.

Results: A total of 65 patients were enrolled over a period of two years with male to female ratio of 1.4:1. Forty-four patients had an intermediate risk of choledocholithiasis upon preliminary evaluation whereas, 48(74%) of the participants had CBD calculi or sludge confirmed upon subsequent ERCP. Trans-abdominal ultrasound showed the lowest sensitivity (29.2%), specificity (85%), NPV 12% and PPV 93% for diagnosing CBD calculi. This was followed by MRCP with a sensitivity of 37.5%, specificity of 100%, NPV of 36.2% and PPV of 100%. EUS showed the maximum diagnostic accuracy with AUC of 1.0 and a 100% sensitivity and specificity when compared with ERCP as gold standard.

Conclusion: EUS is superior to MRCP in terms of diagnostic accuracy as minimally invasive diagnostic tool and EUS superiority is particularly relevant in patients with intermediate risk of choledocholithiasis.

doi: https://doi.org/10.12669/pjms.39.5.7280

How to cite this: Khan RSA, Alam L, Khan ZA, Khan UA. Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction – finding a better diagnostic tool. Pak J Med Sci. 2023;39(5):---------.  doi: https://doi.org/10.12669/pjms.39.5.7280

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.
Crisis leadership towards entrepreneurial success: a Sri Lankan perspective
Authors: Koswatte Isuru , Joseph Shehani
Published: July 2023

Modern business environments are characterized by regular crises, and much attention is paid to understanding why certain individuals and businesses endure while others do not. It has been the entrepreneurial ability to see a crisis as an opportunity that has led to many successful business stories emerging from adversity, such as the recent coronavirus disease (COVID-19) pandemic. Much of the discussion on the subject centres on the abilities and some essential attributes found in leaders and entrepreneurs. Their ability to face such problems is explored in the context of two cases reported in Sri Lanka. The essay's primary goal is to shed light on entrepreneurs' mindsets and how such leaders can contribute their experiences and other skill sets such as creative thinking and innovative problem-solving skills, to starting a new business. The essay concludes by attempting to provide some guidance on the widely contested question of whether entrepreneurs are born or produced in the context of a crisis.
Team based collaborative care model, facilitated by mHealth enabled and trained nurses, for management of heart failure with reduced ejection fraction in India (TIME-HF): design and rationale of a parallel group, open label, multi-centric cluster randomised controlled trial
Authors: Jeemon Panniyammakal , Bahuleyan Charantharalyil Gopalan , Chandgalu Javaregowda Devaraju , Punnoose Eapen , Rajendiran Gopalan , Unni Govindan , Abdullakutty Jabir , Balakrishnan Jayakumar , Joseph Johny , Gnanaraj Justin Paul , Sreedharan Madhu , Pillai Meera R , KR Neenumol , Thomas Paul , Sebastian Placid , Daniel Rachel , Edakutty Rajeev , Ahmad Sajan , Mattummal Shafeeq , Thomas Sunu C , Joseph Stigi , Pisharody Sunil , Chacko Susanna , Syam N , Nair Tiny , Nanjappa Veena , Ganesan Vijayan , George Vijo , Ganapathi Sanjay , Harikrishnan Sivadasanpillai
Published: July 2023

Background: Heart failure (HF) is a debilitating condition associated with enormous public health burden. Management of HF is complex as it requires care-coordination with different cadres of health care providers. We propose to develop a team based collaborative care model (CCM), facilitated by trained nurses, for management of HF with the support of mHealth and evaluate its acceptability and effectiveness in Indian setting.

Methods: The proposed study will use mixed-methods research. Formative qualitative research will identify barriers and facilitators for implementing CCM for the management of HF. Subsequently, a cluster randomised controlled trial (RCT) involving 22 centres (tertiary-care hospitals) and more than 1500 HF patients will be conducted to assess the efficacy of the CCM in improving the overall survival as well as days alive and out of hospital (DAOH) at two-years (CTRI/2021/11/037797). The DAOH will be calculated by subtracting days in hospital and days from death until end of study follow-up from the total follow-up time. Poisson regression with a robust variance estimate and an offset term to account for clustering will be employed in the analyses of DAOH. A rate ratio and its 95% confidence interval (CI) will be estimated. The scalability of the proposed intervention model will be assessed through economic analyses (cost-effectiveness) and the acceptability of the intervention at both the provider and patient level will be understood through both qualitative and quantitative process evaluation methods.

Potential Impact: The TIME-HF trial will provide evidence on whether a CCM with mHealth support is effective in improving the clinical outcomes of HF with reduced ejection fraction in India. The findings may change the practice of management of HF in low and middle-income countries.
PORT AND RAILWAY CONNECTIONS AND THE HINTERLAND CONCEPT
Authors: Duranlar Selcuk
Published: July 2023

Intermodal transport began in the early twentieth century with railroad cars loaded onto carrier ships. At that time, only a few systems were available as standard freight units suitable for intermodal transport. By the middle of the twentieth century, the carriage of road vehicles, known as piggybacks, using car carrier ships or flat car trailers, became more common. Considering that that mode of transport will always play a role in the transport of containers, one can conclude that congestion problems in ports burden the infrastructure near the ports also. The deficiency of space forces ports to improve solutions for port tasks such as filling, storage, and congestion, using the new port concepts with the port entrance shifted to the interior. The increasing volume of container transport in ports has also led to a general increase in the transport volume in ports, increased the geographical coverage of the market, and significantly transferred ports into hinterlands. Ports have played a vital role not only in terms of domestic activities and the provision of exports and imports but also in other transport networks. In this study, the author emphasized the importance of hinterland logistics and proposed some solutions.
MECHANISMS FOR SOLVING DEMOGRAPHIC PROBLEMS OF SUSTAINABLE DEVELOPMENT OF RURAL TERRITORIES
Authors: Kovalenko Elena , YAkimova Olga , Ziganshin Bulat , Gazetdinov Shamil
Published: July 2023

An urgent problem of social and economic development of the regions of the Russian Federation is a steady process of depopulation, which is especially acute in rural areas. Thus, the results of a study of the interdependence of the demographic situation, social and economic situation, quality of life and the state of the environment indicate stable negative trends in the regions of Volga Federal District. The assessment of integral indicators for economic, social, environmental and demographic blocks, each of which is represented by official state statistics, made it possible to assess the degree of their differentiation between the constituent entities of the Russian Federation and the causal relationships between them. To classify the regions of Volga Federal District, a hierarchical cluster analysis was carried out using the full connection method, which made it possible to combine them into 3 relatively homogeneous clusters and obtain characteristics for the main blocks - elements of sustainable development. The cluster with a high level of development included 4 regions - the Republic of Tatarstan, Perm Territory, Nizhny Novgorod and Samara regions. The cluster with an average level is represented by 4 subjects of the Russian Federation - the Republic of Bashkortostan, the Republic of Mari El, the Chuvash Republic and the Orenburg region. The regions of 3 clusters have a low level of development, namely the Republic of Mordovia, the Udmurt Republic, the Kirov, Penza, Saratov and Ulyanovsk regions. According to the results of a comparative analysis, both in terms of average indicators of clusters and in individual regions, it is stated that the demographic situation in almost all subjects of Volga Federal District on average for 2019-2021 was unfavorable, the actual indicators significantly exceed the maximum critical values of demographic security. The study of the demographics of the municipalities of the Republic of Mordovia, one of the most crisis regions of Volga Federal District, testifies to an even deeper differentiation of the demographic state, requiring government decisions. This, in turn, is associated with the formation and implementation of an ecistic policy in the regions with the general goal of saving people, especially in peripheral rural areas with a demographic crisis and a low level of economic and social development. It is argued that a regular spatial analysis of the demographic situation is necessary when predicting the social and economic development of regions and municipalities in the long and medium term, as well as when assessing the activities of state regional and municipal authorities.
DEVELOPMENT OF AGRICULTURE IN RUSSIA AND DIRECTIONS FOR INCREASING ITS COMPETITIVENESS IN THE INTERNATIONAL MARKET
Authors: Minakov Andrey , Safiullin Il'nur , Mikhaylova Valerikovna
Published: July 2023

The agriculture of the Russian Federation is an important part of the national economy, the basis for ensuring the country’s food security. The development of agriculture is influenced by both internal factors (climate, economy, labor resources, state support for the industry, etc.) and external factors (sanctions from unfriendly countries, world market prices, etc.). The importance of increasing the competitiveness of the Russian agricultural industry in the international market has increased with the launch of a special military operation in 2022, as it has faced new challenges. As a result of large-scale political pressure from unfriendly states, the country was cut off from imports of equipment, spare parts, technologies and seeds necessary for the agro-industrial sector, supply chains were disrupted, prices for imported goods increased, and problems arose with exports. Despite these difficulties, Russian agriculture, despite the decline in crop production, due to the growth of indicators in dairy and meat animal husbandry, shows a steady increase in total production. So, in comparison with 2017, the volume of milk production by 2021 increased by 7%, and meat of all types - by 10%. The level of self-sufficiency of the Russian Federation in 2021 exceeded the threshold levels of the Food Security Doctrine for the production of grain, sugar, meat and meat products; below the threshold level was the production of potatoes, milk and dairy products, vegetables and gourds, fruits and berries. Also, a positive moment in the development of the agricultural sector is the increase in the volume of exports of the industry’s products both in kind and in monetary terms, the structure of exports has improved, where there are more and more products of processed agricultural raw materials. However, at present, the sanctions of unfriendly countries have a negative impact on the development of agriculture in the Russian Federation and on its competitiveness in the international market. To solve the problems of the industry, it is necessary to strengthen state support for agricultural producers, aimed at increasing investment and innovation activity in the industry, developing import substitution (creating new industries) and ensuring food security.
Coordenação Motora com Bola desenvolvida através do ensino sistematizado da capacidade de jogo
Authors: Batista Kaísa Aparecida Campos , Silva César Milagres , Velten Marcella Campos Castro , Silva Siomara Aparecida
Published: July 2023

A educação física escolar carece de estruturação de seus conteúdos. Neste sentido, o objetivo deste trabalho foi analisar o efeito da prática estruturada no ensino dos jogos para o desenvolvimento da coordenação com bola. A amostra foi composta por 326 escolares, divididos aleatoriamente em grupos controle (GC) e grupos experimental (GE) nos diversos anos da educação básica. Para medir a coordenação com bola utilizou-se do TECOBOL (teste de coordenação motora com bola) nos momentos pré e pós-intervenção. Houve 20 aulas de intervenção nos grupos experimentais com conteúdo sistematizado e estruturas, de observação nos grupos controle. Para a analisar as diferenças entre grupos e momentos utilizou-se teste t para amostra independentes, e entre os momentos de cada grupo utilizou-se o teste t para amostras pareadas. O Tamanho do Efeito foi calculado pelo dm de Cohen. Não foram encontradas diferenças significativas entre os grupos nos dois momentos. O tamanho do efeito da prática estruturada se apresentou mais efetiva nos grupos experimentais, principalmente nos últimos anos da escola básica, aos 15 anos. Houve uma tendência de aumento da correlação da coordenação com bola e a idade com a prática continuada. A prática estruturada apresenta ganhos mais efetivos do que a prática sem um prévio planejamento.
The Impact of the Belt and Road Initiative on China’s Economy
Authors:   Department of Aerospace and Strategic Studies,  Air University, Islamabad, Pakistan, Usman Sahibzada Muhammad
Published: July 2023

This article examines the impact of the Belt and Road Initiative (BRI) on the Chinese economy, particularly in certain provinces. After the 2008 global financial crisis, global economic growth slowed. President Xi Jinping introduced the BRI in 2013. The initiative’s purpose is to energize and strengthen China's economic progress and advance cooperation between countries connected by it. This article considers the BRI's consequences and impacts on Gross Regional Product (GRP) development in some of the Chinese provinces most influenced by it. The data shows diminished GRP development in coming years. However, expanded highways, railways, and different components linked with framework projects demonstrate that the BRI will cast an optimistic effect on GRP development in the region. Keywords: BRI, Economic growth, Chinese economy, Challenges, GRP.
Subacute osteomyelitis due to Staphylococcus caprae in a teenager: A case report and review of the literature
Authors: Vazquez Oscar , De Marco Giacomo , Gavira Nathaly , Habre Celine , Bartucz Marcia , Steiger Christina N , Dayer Romain , Ceroni Dimitri
Published: July 2023

Inflammatory myofibroblastic tumor (IMT) of the biliary tract is rare, and often difficult to diagnose or to distinguish from other tumors due to its atypical clinical presentation and nonspecific radiological features. Histologically, IMTs are (myo)fibroblastic neoplasms with a prominent inflammatory infiltrate. They are characterized by receptor tyrosine kinase gene rearrangements, most often involving an anaplastic lymphoma kinase (ALK ) translocation. The final diagnosis of IMT depends on histopathology and immunohistochemical examination. In this manuscript, we provide a clinical and morphomolecular overview of IMT and the difficulties that may arise in using immunohistochemical and molecular techniques in diagnosing IMT.
Mechanical Characteristics and Correlation Analysis of Crack Propagation and Slip Cracking in Asphalt Pavement Surface Layer
Authors: Zhenyu Yin
Published: July 2023

With the rapid development in the field of road traffic, the problems of slip cracking and U-shaped cracks on the surface of asphalt pavement are becoming more and more prominent, which seriously affect the safety and service life of roads. In order to solve this problem, a reliable asphalt pavement model is established in this study by combining the joint simulation and secondary development of experimental test parameters. The model can accurately simulate the slip cracking of asphalt pavements under different conditions and provide detailed parametric analysis of the factors affecting crack development. The results show that the inter-ply bond damage no longer deteriorates when the inter-ply strength is 0.3 MPa, indicating that the form of inter-ply contact plays a role in controlling the development of slip cracks. In addition, the maximum interlayer shear stress increased by 21.1% during the increase of vehicle axle load from 100 kN to 200 kN on the asphalt pavement, which led to an increase in the length of slip cracks. Meanwhile, the maximum longitudinal tensile stress in the asphalt pavement surface layer increased by 10.2% and the maximum shear stress increased by 18.3% when the elastic modulus of the asphalt pavement surface layer was increased from 7500 MPa to 14500 MPa.