bluuebunny/crossref_metadata_2025 huggingface dataset:
Piperine, a functional food alkaloid, exhibits inhibitory potential against TNBS-induced colitis via the inhibition of IκB-α/NF-κB and induces tight junction protein (claudin-1, occludin, and ZO-1) signaling pathway in experimental mice
Authors: Guo G , Shi F , Zhu J , Shao Y , Gong W , Zhou G , Wu H , She J , Shi W
Published: December 2019

Background:

Inflammatory bowel disease is a chronic immunoinflammatory disease of the gastrointestinal tract. Piperine, an alkaloid, has been reported to possess antioxidant, anti-inflammatory, antiapoptotic, and antiulcer potential.

Aim:

To elucidate the plausible mechanisms of action of piperine on experimental trinitrobenzenesufonic acid (TNBS)-induced colitis by assessing various biochemical, molecular, histological, and ultrastructural modifications.

Methods:

Colitis was induced in male Sprague–Dawley rats via intrarectal instillation of TNBS. Then, the rats were treated with piperine (10, 20, and 40 mg/kg, p.o.) for 14 days.

Results:

TNBS induced significant ( p < 0.05) colonic damage, which was assessed by disease activity index, macroscopic score, and stool consistency. The administration of piperine (20 and 40 mg/kg) significantly inhibited ( p < 0.05) these damages. Treatments with piperine (20 and 40 mg/kg) notably inhibited ( p < 0.05) the TNBS-induced elevation of oxido-nitrosative stress (superoxide dismutase, glutathione, malondialdehyde, and nitric oxide), 5-hydroxytryptamine, and hydroxyproline content in the colon. Furthermore, colonic inducible nitric oxide synthase (iNOs), tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, IL-6, interferon-gamma, and cyclooxygenase-2 (COX-2) messenger RNA (mRNA) expressions were upregulated after TNBS instillation and piperine (20 and 40 mg/kg) significantly attenuated ( p < 0.05) these elevated mRNA expressions. TNBS decreased the expressions of tight junction (TJ) protein (claudin-1, occludin, and zonula occludens-1 (ZO-1)) and increased the expressions of proapoptotic (caspase-1) protein. These expressions were markedly inhibited ( p < 0.05) by piperine treatment. Histological and ultrastructural studies of transmission electron microscopy suggested that piperine significantly ameliorated ( p < 0.05) TNBS-induced colonic aberrations.

Conclusion:

Piperine ameliorated the progression of TNBS-induced colitis by modulating the nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor-alpha/nuclear factor-kappa B signaling pathway, thus inhibiting the overexpression of proinflammatory cytokines (TNF-α and IL’s), COX-2, iNOs, oxido-nitrosative stress, and proapoptotic proteins (caspase-1) that may improve the expression of TJ protein (claudin-1, occludin, and ZO-1).
Influence of fly ash on the curing characteristics of an epoxy resin
Authors: Yin Jicai , Teng Yanli , Meng Xiaojun , Ge Yuanyuan , Zhang Xiuhong
Published: December 2019

With excellent damping capacity, growing interest has been focused on polymer concrete (PC) as a novel machine tool bed material in the field of ultraprecision machining. It is widely acknowledged that the fly ash (FA) is an essential component material in reducing the curing shrinkage of PC, which can significantly affect the curing characteristic of PC. However, the effect of FA on the curing characteristic of epoxy resin is not studied in detail. In this article, the effect of FA on the curing characteristic of epoxy resin was examined by differential scanning calorimetry. Experimental results show that the peak temperature and curing rates of epoxy resin/curing agent and epoxy resin/curing agent/FA increase with the increasing heating rates, and the peak temperature and curing rates of epoxy resin/curing agent are greater than that of the epoxy resin/curing agent/FA with the same heating rates. In addition, the difference between the maximum curing rates of epoxy resin/curing agent and epoxy resin/curing agent/FA decreased with the increasing heating rates. This article can provide technical reference for curing process of PC for machine tool beds and further improve the machining accuracy.
Maternal Folic Acid Intake and Risk of Nonsyndromic Orofacial Clefts: A Hospital-Based Case–Control Study in Bangalore, India
Authors: Mendonca Vivienne J.
Published: December 2019

Background:

Orofacial clefts are the most common congenital anomaly worldwide. Cleft etiology appears to be multifactorial, with genetic and environmental components. Although periconceptional folic acid supplementation has been shown to be protective for neural tube defects, current evidence for its role in cleft prevention is mixed with few studies from low- and middle-income countries.

Aim:

To investigate the association between periconceptional folic acid intake and incidence of nonsyndromic orofacial clefts among infants in Bangalore, India.

Methods:

A hospital-based case–control study (106 cases, 212 controls) utilizing a questionnaire to collect data on prenatal supplements, dietary folate, and potentially confounding factors. Multivariate logistic regression analysis was used to assess relationships between folic acid supplementation and all nonsyndromic clefts, and in separate analyses for cleft lip and/or palate (CL/P) and cleft palate (CP), adjusting for statistically significant variables.

Results:

A statistically significant protective association was found for separate folic acid supplements (not combined with iron or multivitamins) taken in the periconceptional period and all clefts combined (adjusted odds ratio [OR]: 0.62, 95% confidence interval [CI], 0.45-0.86) and CL/P (adjusted OR: 0.57; 95% CI, 0.38-0.86). Higher levels of dietary folate were found to be associated with a reduced risk for all clefts (adjusted OR: 0.98, 95% CI, 0.96-0.99), CL/P (adjusted OR: 0.98, 95% CI, 0.96-0.99), and CP (adjusted OR: 0.96, 95% CI, 0.93-0.99).

Conclusion:

This study provides limited evidence for a protective association of periconceptional folic acid supplementation with nonsyndromic orofacial clefts. The low proportion of mothers taking folic acid supplements in the periconceptional period highlights the need for increased education and awareness regarding prenatal nutrition.
Patient Position Affects Venodilation for Peripheral Intravenous Cannulation
Authors: Yamagami Yuki , Inoue Tomoko
Published: December 2019

Background:

Larger veins are associated with a higher rate of success of peripheral intravenous cannulation. Although patient position affects venodilation during central venous cannulation, the association between patient position and vein size for peripheral intravenous cannulation remains unclear.

Purpose:

We examined the effect of seated versus supine positioning on vein size during peripheral intravenous cannulation before and after tourniquet application.

Methods:

In the present study, we recruited 81 participants (20–64 years) and included 80 in the analysis. We measured outcomes before and after tourniquet application in the seated and supine positions. The primary outcome was the cross-sectional area of the target forearm vein (ultrasonography by a blinded assessor). Subgroup analysis was used to test the effects of positioning combined with difficult peripheral intravenous cannulation (DPIVC) defined as poor visibility and/or palpability of the target vein.

Results:

Results of paired t tests demonstrated that the venous cross-sectional area significantly increased in the supine position with tourniquet application compared with the seated position with tourniquet application. Subgroup analysis with two-way repeated measures analysis of variance revealed that the venous cross-sectional area was significantly larger in the supine position than in the seated position despite DPIVC.

Conclusion:

Vein size during tourniquet application was greater in the supine than in the seated position even in cases of DPIVC. We thus recommend the supine position over the seated position for peripheral intravenous cannulation.
Evaluation of the relationship between emotional and behavioral problems and quality of life of adolescents in school
Authors: Hendekçi Ayla , Bilgin Sonay
Published: December 2019

This study was conducted to determine the quality of life and difficulties of adolescents in school age. This descriptive study was conducted in a city center three secondary School. Similarly from each school 114,114,116 people participated in the study, 4 students could not be included in the study due to insufficient data and the study was completed with 344 students. Questionnaire developed by the researcher, the Strengths and Difficulties Questionnaire (SDQ), and the Pediatric Quality of Life Inventory (PedsQL) were used for data collection. Research was completed in line with the ethical principles. According to the evaluations, it was observed that 50.6% of the students was 13 years old, 52% was male, and 53.5% was in the seventh grade. The total score average for PedsQL was 81.58 ± 13.65, and the mean total score for SDQ was 25.02 ± 4.813. A positive and significant correlation was found between “behavioral problems” subscale score of the SDQ and all subscales of PedsQL except the “physical health” subscale as well as the positive and significant correlation between the mean total scores of PedsQL and SDQ. It was observed that the quality of life of the students is affected negatively as the difficulties experienced during adolescence increase. Some recommendations were made to reveal the problems experienced by school-age adolescents and to increase their quality of life.
Current Clinical Progress of PD-1/PD-L1 Immunotherapy and Potential Combination Treatment in Non–Small Cell Lung Cancer
Authors: Li Jia-Xin , Huang Ju-Min , Jiang Ze-Bo , Li Run-Ze , Sun Ao , Lai-Han Leung Elaine , Yan Pei-Yu
Published: December 2019

Conventional methods in treating non–small cell lung cancer contain surgery, chemotherapy, radiotherapy, and targeted therapy, which have various defects. Recently, with the deeper research on tumor immunity, immunotherapy has made the breakthrough in the treatment of cancers. Especially developments of programmed cell death-1/programmed cell death ligand-1 (PD-1/PD-L1) inhibitors bring the therapy into a new stage. This review mainly focuses on introducing existing monoclonal antibodies containing nivolumab, pembrolizumab, atezolizumab, avelumab, and durvalumab, along with 3 ordinary biomarkers such as PD-L1 expression, tumor mutation burden, and microsatellite instability. By understanding the resistance mechanism of anti-PD-1/L1 blockade, research is further improving the survival benefit and expanding the benefit population. So, PD-1/PD-L1 inhibitors begin to be combined with various therapeutic strategies clinically. Discussion and comparison of their effectiveness and safety are also comprehensively reviewed. Meanwhile, we explore the potential, the impact, and mechanisms of combining traditional Chinese medicine with immunotherapy.
Effects of a Group-Mediated Cognitive Behavioral Lifestyle Intervention on Select Social Cognitive Outcomes in Prostate Cancer Patients Undergoing Androgen Deprivation Therapy
Authors: Focht Brian C. , Lucas Alexander R. , Grainger Elizabeth , Simpson Christina , Fairman Ciaran M. , Thomas-Ahner Jennifer M. , Chaplow Zachary L. , DeScenza Victoria R. , Bowman Jessica , Clinton Steven K.
Published: December 2019

Objective. To compare the effects of a group-mediated cognitive behavioral (GMCB) exercise and dietary (EX+D) intervention with those of standard-of-care (SC) treatment on select social cognitive outcomes in prostate cancer (PCa) patients undergoing androgen deprivation therapy (ADT). Methods. In the single-blind, 2-arm, randomized controlled Individualized Diet and Exercise Adherence–Pilot (IDEA-P) trial, 32 PCa patients (mean age = 66.2 years; SD = 7.8) undergoing ADT were randomly assigned to a 12-week EX+D intervention (n = 16) or SC treatment (n = 16). The exercise component of the personalized EX+D intervention integrated a combination of supervised resistance and aerobic exercise performed twice per week. The dietary component involved counseling and education to modify dietary intake and composition. Blinded assessments of social cognitive outcomes were obtained at baseline and 2-month and 3-month follow-up. Results. Intent-to-treat analysis of covariance demonstrated that the EX+D intervention resulted in significantly greater improvements in scheduling ( P < .05), coping ( P < .01), and exercise self-efficacy ( P < .05), and satisfaction with function ( P < .01) at 3 months relative to SC. Results of partial correlation analysis also demonstrated that select social cognitive outcomes were significantly correlated with primary trial outcomes of mobility performance and exercise participation ( P < .05) at 3-month follow-up. Conclusions: The GMCB lifestyle intervention yielded more favorable improvements in relevant social cognitive outcomes relative to SC among PCa patients undergoing ADT. Additionally, more favorable social cognitive outcomes were associated with superior mobility performance and exercise participation following the independent maintenance phase of the EX+D intervention.
Sport Medicine in the Prevention and Management of Cancer
Authors: Luo Hao , Galvão Daniel A. , Newton Robert U. , Fairman Ciaran M. , Taaffe Dennis R.
Published: December 2019

Physical inactivity is a major concern in cancer patients despite the established preventative and therapeutic effects of regular physical exercise for this patient group. Sport not only plays an important role in supporting the development and maintenance of a physically active lifestyle but also is increasingly used as a health promotion activity in various populations. Nevertheless, the potential of sport as an effective strategy in the prevention and management of cancer has gained little attention. Based on the scant evidence to date, participation of cancer patients in supervised, well-tailored sport programs appears to be safe and feasible and is associated with an array of physical and psychological benefits. We propose that sport participation may serve as an alternative strategy in the prevention of cancer and sport medicine in the management of cancer. As with the traditional exercise modes, benefits derived from sport participation will be dependent on the sport undertaken and the physical/physiological, motor, and cognitive demands required. To this end, further work is required to develop a solid evidence base in this field so that targeted sport participation can be recommended for cancer patients.
Comparison Between 1-Day and Inpatient Procedure of Holmium Laser Enucleation in Patients With Benign Prostate Hyperplasia
Authors: Sun Jie , Tong Zhen , Shi An , Li Dong , Xue Wei , Huang Yiran
Published: December 2019

Holmium laser enucleation of the prostate (HoLEP) is one of the minimally invasive procedures that is used for patients with benign prostate hyperplasia. The procedure usually requires patients to stay in the hospital 2 nights or longer. The present study evaluated the safety and feasibility of HoLEP with discharge of the patients on Day 1 after surgery (1-day surgery). A total of 1,164 patients were included in the study, with 510 of them planned for 1-day surgery and others planned for inpatient surgery. The primary outcomes included complication rate and clinical outcomes. A total 489 out of 510 patients received 1-day HoLEP and were discharged on Day 1 after surgery. In a 30-day follow-up period, no significant differences were found between the 1-day and inpatient surgery groups in terms of the rate of complications and clinical outcomes. Patients in the 1-day surgery group had a significantly shorter waiting time for admission (9.5 ± 4.8 vs. 17.6 ± 7.4 days, p < .05), and the mean hospitalization cost was lower (CNY$ 9140.6 ± 1452.2 vs. 10533.4 ± 1594, p < .05).The 1-day HoLEP surgery was safe and had satisfactory clinical outcomes. This treatment strategy could reduce the waiting time for admission and cost of hospitalization. Majority of the patients found this 1-day surgery beneficial, especially elderly patients who prefer to have an early return home and rapid resumption of activities.
Aorto-Mitral Patch Enlargement for Elective Substantial Double Valve Upsizing
Authors: Fudulu Daniel , Zakkar Mustafa , Stoica Serban
Published: December 2019

Reconstruction of the intervalvular fibrosa is normally associated with endocarditis and the surgical principles are well established. Here, we describe how these principles are further extended and applied for the elective enlargement of the aorto-mitral continuity. Our aim was to achieve double valve upsizing in noninfective conditions. The first patient had rheumatic fever and a first double valve replacement as an adult. Her two tissue valves were later upsized at the time of replacement with mechanical prostheses. The concept was then used to perform a substantial annular enlargement in another adult patient whose original double valve replacement was done in childhood, when she received aortic and mitral prostheses measuring 17 and 23 mm, respectively. After upsizing with the technique described, her new valves were 25 and 29 mm in diameter.
Surgical Management of Fallot’s Tetralogy With Pulmonary Atresia and Major Aortopulmonary Collateral Arteries: Multistage Versus One-Stage Repair
Authors: Carotti Adriano
Published: December 2019

A strict and rational approach to Fallot’s tetralogy with pulmonary atresia and major aortopulmonary collateral arteries allows to achieve optimal results. Rehabilitative and unifocalization strategies do not constitute separate philosophies; instead the surgical strategy should be tailored to each individual patient. Based on our previous experience, the ability to achieve definitive intracardiac repair is the real determinant of both improved survival and adequate systolic right ventricular performance on mid-term follow-up.
Diepoxy- Versus Glutaraldehyde-Treated Xenografts: Outcomes of Right Ventricular Outflow Tract Reconstruction in Children
Authors: Nichay Nataliya R. , Zhuravleva Irina Y. , Kulyabin Yuriy Y. , Zubritskiy Alexey V. , Voitov Alexey V. , Soynov Ilia A. , Gorbatykh Artem V. , Bogachev-Prokophiev Alexander V. , Karaskov Alexander M.
Published: December 2019

Background:

Xenografts used for right ventricular outflow tract (RVOT) reconstruction are typically treated with glutaraldehyde. However, potential benefit of epoxy treatment was demonstrated in experimental studies. We aimed to compare diepoxy-treated bovine pericardial valved conduits (DE-PVCs) and glutaraldehyde-treated bovine pericardial valved conduits (GA-PVCs) for RVOT reconstruction in pediatric patients.

Methods:

Between 2002 and 2017, 117 patients underwent RVOT reconstruction with PVC in single center: DE-PVC group, n = 39; and GA-PVC group, n = 78. After performing propensity score analysis (1:1) for the entire sample, 29 patients from the DE-PVC group were matched with 29 patients from the GA-PVC group.

Results:

There were no conduit-related deaths. In the DE-PVC group, the freedom from conduit failure was 90.9% at four years and 54.3% at eight years postoperatively. In the GA-PVC group, it was 46.3% and 33.1%, respectively. The difference was significant ( P = .037). Conduit failure was typically caused by stenosis in both groups. In the DE-PVC group, the main cause of stenosis was xenograft calcification (27.6%); while in the GA-PVC group, it was mostly due to neointimal proliferation (25.0%) and, less often, calcification (14.3%). Conduit thrombosis was the cause of replacement in 6.9% of patients from the GA-PVC group.

Conclusions:

Diepoxy-treated bovine pericardial valved conduit is a suitable alternative to GA-PVC for RVOT reconstruction in pediatric patients. Diepoxy-treated bovine pericardial valved conduits may be less prone to conduit failure and more resistant to neointimal proliferation and conduit thrombosis than GA-PVCs.
Utility of Cervical Cannulation During Difficult Resternotomy in Congenital Heart Surgery
Authors: Temur Bahar , Davutoglu Arda , Dogruoz Alper , Aydin Selim , Suzan Dilek , Kırat Barış , Odemis Ender , Erek Ersin
Published: December 2019

Background:

Adhesions due to previous surgeries and some anatomical difficulties may make resternotomy dangerous in children. Femoral vessels are usually small and may not be suitable for cannulation. The aim of this report is to describe our experience with cervical cannulation during risky resternotomy in children.

Methods:

Between January 2014 and January 2018, cervical cannulation was performed in eight pediatric patients during sternal reentry. Their ages were between 3 months and 17 years (mean: 5.4 years). Three patients underwent stage III extracardiac Fontan operation with the diagnosis of hypoplastic left heart syndrome. Three patients had supravalvular aortic and/or pulmonary stenosis after previous arterial switch operation. One patient had proximal aortic arch stenosis and subvalvular aortic stenosis after interrupted aortic arch repair. The last patient had aortic root pseudoaneurysm and aortic insufficiency due to endocarditis. Through a separate cervical incision, a polytetrafluoroethylene graft was anastomosed to the common carotid artery and the arterial cannula was inserted into the graft. Antegrade selective cerebral perfusion (ASCP) was used in two patients.

Results:

During resternotomies, no major injury or bleeding occurred. Three-month-old patient who had previous interrupted aortic arch repair died despite extracorporeal membrane oxygenation support due to sepsis and multi-organ failure. Median intensive care unit stay and hospital stay were 3 days (1-40 days) and 17 days (7-60 days), respectively. Mean follow-up was 17.9 ± 15.8 months. All patients were in good clinical condition.

Conclusions:

Cervical cannulation may be a useful and safe technique during high-risk resternotomy in children. This technique may also simplify the performance of ASCP if necessary.
Platelet Administration During Cardiopulmonary Bypass in Neonates: A Universal Therapy Applied in a Novel Way
Authors: Wise-Faberowski Lisa , Machovec Kelly
Published: December 2019

Advances in pharmaceuticals (eg, factor concentrates), laboratory testing (eg, rotational thromboelastometry), and processes (eg, transfusion protocols) have contributed to improved outcomes regarding transfusion in neonates undergoing surgical repair for congenital heart disease. A novel strategy, platelets administered during the rewarming phase of cardiopulmonary bypass, as a solution to improved hemostasis, was prospectively evaluated in 42 neonates. Improved intraoperative and postoperative hemostasis was observed in neonates given platelets during the rewarming phase of cardiopulmonary bypass.
Peritonitis Secondary to Uncommon Gram-Negative Coccobacillus Transmitted From a Cat in a Patient on Peritoneal Dialysis
Authors: Adapa Sreedhar , Naramala Srikanth , Madhira Bhaskar Reddy , Gayam Vijay , Sahasranam Prem , Konala Venu Madhav
Published: December 2019

Peritonitis caused by gram-negative organisms is a significant complication encountered in patients undergoing peritoneal dialysis and is associated with high morbidity and mortality. There has been recognition of peritonitis caused by uncommon organisms because of improved microbiological detection techniques. In this article, we report a rare case of peritonitis caused by Pasteurella multocida. We present a 58-year-old male on peritoneal dialysis with fever and abdominal pain. The peritoneal fluid was cloudy, and the analysis was consistent with peritonitis. The peritoneal fluid culture grew Pasteurella multocida. The patient was treated with a 3-week course of intraperitoneal ceftazidime, which resulted in the resolution of infection with the salvation of the peritoneal dialysis catheter. Patient education plays a very critical role in the prevention of peritonitis from Pasteurella multocida, particularly if patients have pets at home. The domestic pets should be kept away from the dialysis equipment and should not be allowed into the room during dialysis treatment. Incorporating the education in handing pets during the training session is the key aspect.
The effect of medial open wedge high tibial osteotomy on the patellofemoral joint: comparative analysis according to the preexisting cartilage status
Authors: Moon Hyun-Soo , Choi Chong-Hyuk , Jung Min , Park Sang-Hoon , Lee Dae-Young , Shin Jong-Kwan , Kim Sung-Hwan
Published: December 2019

Background

Although it has been known that medial open wedge high tibial osteotomy (MOWHTO) would adversely affect the patellofemoral joint, no previous study examined the surgical outcome of MOWHTO according to the preexisting cartilage status of the patellofemoral joint. The aim of this study was to investigate the effect of MOWHTO on the patellofemoral joint with regard to objective and subjective aspects according to the preexisting cartilage status.

Methods

Ninety-two patients who underwent MOWHTO and a following second-look arthroscopic assessment were included in this study. The patients were divided into two groups according to the preexisting cartilage status of the patellofemoral joint: group 1 (International Cartilage Repair Society [ICRS] grade 2 or 3) and group 2 (ICRS grade 0 or 1). Comparative analysis was performed regarding clinical scores, radiographic parameters, and arthroscopic measurements between the two groups.

Results

Clinical outcomes showed overall improvement from baseline to the time of second-look operation, with no significant difference between the two groups at each time point. There were no significant differences in radiographic parameters between the two groups. Radiographic grade of patellofemoral osteoarthritis in both groups showed a tendency to progress, without statistical significance. In arthroscopic assessment, the size of the cartilage lesion on the patellofemoral joint increased with time in both groups (P = 0.003), but the degree of change over time between the two groups was not statistically significant. Consistently, there was no significant difference in the frequency of progression of cartilage lesion grade in the patellofemoral joint between the two groups.

Conclusions

MOWHTO would contribute to osteoarthritis progression of the patellofemoral joint regardless of the preexisting cartilage status, without an association with clinical outcomes in short-term follow-up.
Maternal elevated salt consumption and the development of autism spectrum disorder in the offspring
Authors: Afroz Kazi Farhana , Alviña Karina
Published: December 2019

Autism spectrum disorder (ASD) is a prevalent neurodevelopmental condition with no known etiology or cure. Several possible contributing factors, both genetic and environmental, are being actively investigated. Amongst these, maternal immune dysregulation has been identified as potentially involved in promoting ASD in the offspring. Indeed, ASD-like behaviors have been observed in studies using the maternal immune activation mouse model. Furthermore, recent studies have shed light on maternal dietary habits and their impact on the gut microbiome as factors possibly facilitating ASD. However, most of these studies have been limited to the effects of high fat and/or high sugar. More recent data, however, have shown that elevated salt consumption has a significant effect on the immune system and gut microbiome, often resulting in gut dysbiosis and induction of pro-inflammatory pathways. Specifically, high salt alters the gut microbiome and induces the differentiation of T helper-17 cells that produce pro-inflammatory cytokines such as interleukin-17 and interleukin-23. Moreover, elevated salt can also reduce the differentiation of regulatory T cells that help maintaining a balanced immune system. While in the innate immune system, high salt can cause over activation of M1 pro-inflammatory macrophages and downregulation of M2 regulatory macrophages. These changes to the immune system are alarming because excessive consumption of salt is a documented worldwide problem. Thus, in this review, we discuss recent findings on high salt intake, gut microbiome, and immune system dysregulation while proposing a hypothesis to link maternal overconsumption of salt and children’s ASD.
Whole exome sequencing in a child with acute disseminated encephalomyelitis, optic neuritis, and periodic fever syndrome: a case report
Authors: Ledesma Pablo A. , Guerra Juan Carlos , Burbano Manuel , Procel Patricio , Pedroza Luis Alberto
Published: December 2019

Background

Acute disseminated encephalomyelitis is generally preceded by an infection, and it is usually self-limiting and non-recurrent. However, when there are multiple attacks of acute disseminated encephalomyelitis followed by optic neuritis, it is defined as acute disseminated encephalomyelitis-optic neuritis. To the best of our knowledge, there are no previous reports of acute disseminated encephalomyelitis and optic neuritis preceded by autoinflammation, triggered by periodic fever syndrome.

Case summary

We report on a case of acute disseminated encephalomyelitis with optic neuritis and periodic fever syndrome in a 12-year-old Ecuadorian Hispanic boy with several relapses over the past 10 years, always preceded by autoinflammatory manifestations and without evidence of infectious processes. Whole exome sequencing was performed, and although the results were not conclusive, we found variants in genes associated with both autoinflammatory (NLRP12) and neurological (POLR3A) phenotypes that could be related to the disease pathogenesis having a polygenic rather than monogenic trait.

Conclusion

We propose that an autoinflammatory basis should be pursued in patients diagnosed as having acute disseminated encephalomyelitis and no record of infections. Also, we show that our patient had a good response after 1 year of treatment with low doses of intravenous immunoglobulin and colchicine.
Students’ reasons for STEM choices and the relationship of mathematics choice to university admission
Authors: Kaleva Satu , Pursiainen Jouni , Hakola Mirkka , Rusanen Jarmo , Muukkonen Hanni
Published: December 2019

Background

Despite the increasing need for STEM skills, to date, the connection between STEM subject choices and their impact on students’ educational pathways has not been widely studied. Focusing on the mathematics choice (basic/advanced/no mathematics), a large register dataset that covered students admitted to Finnish universities during 2013–2015 (N = 46,281) was combined with upper-secondary school matriculation examination data (N = 93,955) to find out how this choice influenced the students’ university admissions. This large dataset was also examined to establish the current gender distributions in different university degree programs from the perspective of mathematics choices. Further, to find out the students’ reasons behind their mathematics choices, a cohort sample of 802 student responses was collected from upper-secondary schools. We also investigated the students’ interests in different fields of study to establish any gender differences in them.

Results

The register data analysis suggested that in Finland, students’ mathematics choices had a strong influence on the university admission outcomes. For instance, only 33% of the upper-secondary school graduates took the advanced mathematics ME test in 2013–2015, yet the number of those admitted to universities who had taken the advanced mathematics ME test was 55%. Most of the university degree programs were female dominated, yet the university students with advanced mathematics were mostly male, and especially the STEM fields in the Finnish universities were male dominated. As for the reasons behind the mathematics choices, students who chose advanced mathematics believed in its usefulness for their future studies and careers. We also found significant gender-based educational differences regarding all the study fields, with STEM careers attracting more males than females.

Conclusion

Advanced mathematics was highly valued in Finnish universities, and many students chose advanced mathematics believing in its usefulness for their future studies or careers. Yet, their further study interests and career plans were segregated by gender. As there is a rising need for STEM skills, we must seek effective ways to deliver the evolving possibilities of STEM fields to students, especially girls, during the earlier years of their educations.
Hepatic Estrogen Sulfotransferase Distantly Sensitizes Mice to Hemorrhagic Shock-Induced Acute Lung Injury
Authors: Xie Yang , Barbosa Anne Caroline S , Xu Meishu , Oberly Patrick J , Ren Songrong , Gibbs Robert B , Poloyac Samuel M , Song Wen-Chao , Fan Jie , Xie Wen
Published: December 2019

Hemorrhagic shock (HS) is a potential life-threatening condition that may lead to injury to multiple organs, including the lung. The estrogen sulfotransferase (EST, or SULT1E1) is a conjugating enzyme that sulfonates and deactivates estrogens. In this report, we showed that the expression of Est was markedly induced in the liver but not in the lung of female mice subject to HS and resuscitation. Genetic ablation or pharmacological inhibition of Est effectively protected female mice from HS-induced acute lung injury (ALI), including interstitial edema, neutrophil mobilization and infiltration, and inflammation. The pulmonoprotective effect of Est ablation or inhibition was sex-specific, because the HS-induced ALI was not affected in male Est-/- mice. Mechanistically, the pulmonoprotective phenotype in female Est-/- mice was accompanied by increased lung and circulating levels of estrogens, attenuated pulmonary inflammation, and inhibition of neutrophil mobilization from the bone marrow and neutrophil infiltration to the lung, whereas the pulmonoprotective effect was abolished upon ovariectomy, suggesting that the protection was estrogen dependent. The pulmonoprotective effect of Est ablation was also tissue specific, as loss of Est had little effect on HS-induced liver injury. Moreover, transgenic reconstitution of human EST in the liver of global Est-/- mice abolished the pulmonoprotective effect, suggesting that it is the EST in the liver that sensitizes mice to HS-induced ALI. Taken together, our results revealed a sex- and tissue-specific role of EST in HS-induced ALI. Pharmacological inhibition of EST may represent an effective approach to manage HS-induced ALI.
Effectiveness of occupational therapy in improving activities of daily living performance in complete cervical tetraplegic patients; A quasi experimental study
Authors: Arsh Aatik , Anwar Zunaira , Zeb Amir , Ilyas Syed Muhammad
Published: December 2019

Objective: To determine the effectiveness of Occupational therapy (OT) in improving activities of daily living performance in complete cervical tetraplegic patients.

Methods: A quasi experimental study was conducted at Paraplegic Center Peshawar from May 2018 to March 2019. Seventy two spinal cord injury patients with complete cervical tetraplegia having age 18-60 years were included in the study using non probability convenience sampling technique. A trained Occupational therapist conducted two occupational therapy sessions per day, three times a week on alternative days for a period of six weeks. Self-care portion of Spinal cord injury independence measure (SCIM) was used to collect pre and post data. Data was analyzed using SPSS version 20.

Results: Mean age of the participants was 30.21±13.52.Majority of the participants were (n= 61, 84.7%) male while remaining 11 (15.3%) participants were female. Pre self-care total score was 0.39±0.987 and post self-care total score was 7.17±5.536. There was significant differences (P value <0.05) between pre and post scores of feeding, upper & lower body bathing, upper & lower body dressing, grooming and total self-care scores.

Conclusion: Occupational therapy significantly improves activities of daily living performance in complete cervical tetraplegic spinal cord injury patients.

doi: https://doi.org/10.12669/pjms.36.2.1002

How to cite this:Arsh A, Anwar Z, Zeb A, Ilyas SM. Effectiveness of occupational therapy in improving activities of daily living performance in complete cervical tetraplegic patients; A quasi experimental study. Pak J Med Sci. 2020;36(2):96-99.  doi: https://doi.org/10.12669/pjms.36.2.1002

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.
Dentin bond strength of bioactive cement in comparison to conventional resin cement when photosensitized with Er,Cr:YSGG Laser
Authors: Alkhudhairy Fahad , Al-Johany Sulieman S. , Naseem Mustafa , Bin-Shuwaish Mohammed , Vohra Fahim
Published: December 2019

Objective: The purpose of the present study was to assess dentin shear bond strength (SBS) and mode of bond failure of bioactive cement (BA) in comparison to conventional resin cement when photosensitized by Er,Cr:YSGG Laser (ECL).

Methods: The present in-vitro study was carried out from March 2019 to May 2019. Sixty permanent non-carious, intact, non-fractured molars were isolated and mounted vertically in acrylic resin. Buccal surface of each molar tooth was ground, polished and surface treated with ECL. Ketac conditioner was applied on the surface washed and air dried surface. Tetric -N-Bond adhesive was applied on forty-five samples and light cured. The specimens were allocated into four groups (n=15) according to the type of cement used i.e., Calibra (C), BA, Variolink II (V) and Maxcem-Elite (ME). For SBS testing was performed using the universal testing machine. Eight samples from each group were assessed for modes of failure. Means and standard deviations were compared using analysis of variance (ANOVA) and Tukey’s post hoc test at a significance level of p < 0.05.

Results: The highest mean SBS was observed in group ECL-C (21.55±3.08). The lowest mean SBS was displayed in group ECL-ME (14.25±3.55). Mean SBS values for group ECL-C (21.55±3.08) and group ECL-V (20.74±4.15) were comparable (p <0.05). Similarly, SBS values of group ECL-BA (15.48±3.62) and group ECL-ME (14.25±3.55) were comparable (p <0.05).

Conclusion: Dentin surface conditioned with Er,Cr:YSGG and bonded to C and V cements exhibit favourable bond strength values.

doi: https://doi.org/10.12669/pjms.36.2.1284

How to cite this:Alkhudhairy F, Al-Johany SS, Naseem M, Bin-Shuwaish M, Vohra F. Dentin bond strength of bioactive cement in comparison to conventional resin cement when photosensitized with Er,Cr:YSGG Laser. Pak J Med Sci. 2020;36(2):85-90.   doi: https://doi.org/10.12669/pjms.36.2.1284

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.
Uterine manipulator requirement in laparoscopic surgery of Ectopic Pregnancy
Authors: Beyan Emrah , Kanmaz Ahkam Göksel , Budak Adnan , Emirdar Volkan , Tutar Sadettin Oğuzhan , İnan Abdurrahman Hamdi
Published: December 2019

Objective: The advantages of laparoscopic surgery used in the treatment of ectopic pregnancy is well-known; however, the efficacy of uterine manipulators remains unknown. In this study, we aimed to investigate the efficacy of uterine manipulators in the laparoscopic treatment of ectopic pregnancy.

Methods: Overall, 118 patients who underwent laparoscopy due to ectopic pregnancy in Department of Obstetrics and Gynaecology at Tepecik Education and Research Hospital between January 2010 and January 2018 and who met the inclusion criteria were included in the study. Groups of patients undergoing surgery with or without the use of a uterine manipulator were compared in terms of demographic data, operative and postoperative results.

Results: No difference was noted between the groups in terms of age, parity, body mass index, smoking, side of ectopic pregnancy mass, previous operations and pregnancy type. However, the size of ectopic pregnancy mass measured by ultrasonography was significantly larger (p = 0.006) and the operation time was significantly shorter (p<0.001) in the group where uterine manipulators were not used than in the uterine manipulator group.

Conclusion: We concluded that not using a uterine manipulator in laparoscopic procedures for ectopic pregnancy did not increase operative complications and that operation time was higher in procedures using uterine manipulators.

doi: https://doi.org/10.12669/pjms.36.2.1294

How to cite this:Beyan E, Kanmaz AG, Budak A, Emirdar V, Tutar SO, Inan AH. Uterine manipulator requirement in laparoscopic surgery of Ectopic Pregnancy. Pak J Med Sci. 2020;36(2):105-110. doi: https://doi.org/10.12669/pjms.36.2.1294

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.
Effects of Life style factors on the symptoms of gastro esophageal reflux disease: A cross sectional study in a Pakistani population
Authors: Ahmed Shahid , Jamil Sajjad , Shaikh Hafeezullah , Abbasi Maryam
Published: December 2019

Background & Objective: Gastro esophageal reflux disease (GERD) broadly includes the whole spectrum of reflux disease symptoms like heartburn or acid regurgitation to endoscopic, reflux esophagitis or Barrett’s esophagus. Our aim therefore was to study the association between Gastroesophageal reflux disease symptoms and various lifestyle factors.

Methods: A descriptive cross-sectional study was carried out in the outpatient department of Darul Sehat Hospital, Zubaida Medical Center and Liaquat National Hospital & Medical College, Karachi, Pakistan from January 2018 to October 2018. The selected candidates were asked to fill a validated GERD questionnaire and they were also asked about their lifestyle factors. Odds ratio and their 95% confidence interval were estimated using binary logistic regression with GERD symptoms as the study outcome.

Results: A total of 2000 respondents completed the questionnaire. 69.3% gastroesophageal reflux disease cases were found in participants above 35 years of age while 56.9% subjects were male. The most common lifestyle factors associated with GERD were less exercise time (90.9%) (OR, 6.47; 95% CI, 4.91-8.53), 78.3% participants had habit of eating midnight snacks (OR, 5.08; 95% CI, 4.03-6.40), 87.3% participants reported less interval between dinner and sleep (OR, 6.98; 95% CI, 5.36-9.08). The most important factor relieving GERD symptoms was raising the head of bed during sleep (79.4%) while 43.3% subjects with the habit of post dinner walk reported fewer symptoms of GERD.

Conclusion: Lifestyle factors particularly less physical activity, late evening meals, inadequate sleep, smoking and post dinner lying were found to be associated with GERD symptoms.

doi: https://doi.org/10.12669/pjms.36.2.1371

How to cite this:Ahmed S, Jamil S, Shaikh H, Abbasi M. Effects of Life style factors on the symptoms of gastro esophageal reflux disease: A cross sectional study in a Pakistani population. Pak J Med Sci. 2020;36(2):115-120. doi: https://doi.org/10.12669/pjms.36.2.1371

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.
Application value of minimally invasive percutaneous dilational tracheostomy for ICU critical patients
Authors: Gan Hongmei , Dong Aihong , Xu Haiyan
Published: December 2019

Objective: To find out the application value of minimally invasive percutaneous dilational tracheostomy in critically ill patients in intensive care unit (ICU).

Methods: One hundred and forty critically ill patients who underwent tracheostomy in ICU of our hospital were included in the study from August 2016 to December 2017. They were divided into an observation group and a control group by random number table method, 70 in each group. The control group received conventional tracheotomy, while the observation group received percutaneous dilational tracheostomy. The operation time, incision length, amount of intraoperative bleeding and healing time of incision were compared between the two groups, and the changes of vital signs and complications after operation were recorded. The family members of the patients signed the informed consent.

Results: The operation time, healing time and incision length of the observation group were (9.92±4.13) min, (1.31±0.21) cm and (6.91±0.72) respectively, shorter than (24.09±6.82) min, (3.40±0.65) cm and (67.48±0.61) d in the control group, and the differences were statistically significant (P<0.05). The amount of intraoperative bleeding of the observation group was (7.81±1.83) mL, less than (16.34±2.83) mL in the control group; the difference was statistically significant (P<0.05). The heart rate and oxygen saturation of the observation group before and during the operation were not significantly different (P>0.05). The heart rate of the control group during the operation was significantly higher than that before the operation (P<0.05); the oxygen saturation of the control group before and during the operation had no significant difference (P>0.05). The incidence of complications in the observation group was 24.3%, which was significantly lower than that in the control group (55.7%, X2=8.279, P=0.014).

Conclusion: Minimally invasive percutaneous dilational tracheostomy has advantages of small trauma, less infection and beautiful incision, and it will not increase postoperative complications. It is of great value in the treatment of ICU critical patients.

doi: https://doi.org/10.12669/pjms.36.2.594

How to cite this:Gan H, Dong A, Xu H. Application value of minimally invasive percutaneous dilational tracheostomy for ICU critical patients. Pak J Med Sci. 2020;36(2):59-63. doi: https://doi.org/10.12669/pjms.36.2.594

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.