bluuebunny/crossref_metadata_2025 huggingface dataset:
Low-moderate arsenic exposure and respiratory in American Indian communities in the Strong Heart Study
Authors: Powers Martha , Sanchez Tiffany R. , Grau-Perez Maria , Yeh Fawn , Francesconi Kevin A. , Goessler Walter , George Christine M. , Heaney Christopher , Best Lyle G. , Umans Jason G. , Brown Robert H. , Navas-Acien Ana
Published: November 2019

Background

Arsenic exposure through drinking water is an established lung carcinogen. Evidence on non-malignant lung outcomes is less conclusive and suggests arsenic is associated with lower lung function. Studies examining low-moderate arsenic (< 50 μg/L), the level relevant for most populations, are limited. We evaluated the association of arsenic exposure with respiratory health in American Indians from the Northern Plains, the Southern Plains and the Southwest United States, communities with environmental exposure to inorganic arsenic through drinking water.

Methods

The Strong Heart Study is a prospective study of American Indian adults. This analysis used urinary arsenic measurements at baseline (1989–1991) and spirometry at Visit 2 (1993–1995) from 2132 participants to evaluate associations of arsenic exposure with airflow obstruction, restrictive pattern, self-reported respiratory disease, and symptoms.

Results

Airflow obstruction was present in 21.5% and restrictive pattern was present in 14.4%. The odds ratio (95% confidence interval) for obstruction and restrictive patterns, based on the fixed ratio definition, comparing the 75th to 25th percentile of arsenic, was 1.17 (0.99, 1.38) and 1.27 (1.01, 1.60), respectively, after adjustments, and 1.28 (1.02, 1.60) and 1.33 (0.90, 1.50), respectively, based on the lower limit of normal definition. Arsenic was associated with lower percent predicted FEV1 and FVC, self-reported emphysema and stopping for breath.

Conclusion

Low-moderate arsenic exposure was positively associated with restrictive pattern, airflow obstruction, lower lung function, self-reported emphysema and stopping for breath, independent of smoking and other lung disease risk factors. Findings suggest that low-moderate arsenic exposure may contribute to restrictive lung disease.
Usefulness and reliability of cell free fetal DNA screening for main trisomies in case of atypical profile on first trimester maternal serum screening
Authors: Carrara Julie , Vivanti Alexandre , Jani Jacques C. , Demain Adèle , Costa Jean-Marc , Benachi Alexandra
Published: November 2019

Background

Patients with atypical values of HCG and/or PAPP-A are at higher risk of chromosomal abnormality and vascular complications of pregnancy. The performance of cfDNA in this particular population has not yet been evaluated.

Objectives

The primary objective was to evaluate the usefulness and reliability of cfDNA in screening for trisomy 21, 18 and 13 for patients with HCG < 0.25 multiple of median (MoM), HCG > 5.0 MoM and/or PAPP-A < 0.25 MoM, PAPP-A > 2.5 MoM. The secondary objective was to evaluate the contribution of cfDNA assay for the prediction of pregnancy’s vascular complications.

Method

Between June 2016 and July 2017, we analysed a women cohort from all over France who had at least one first trimester serum biomarker outside of normal range, in a retrospective, observational and multicentre study. Patients were included if they had a single pregnancy, normal first trimester ultrasound examination, whatever the result of the combined first trimester screening test was. The cfDNA was analysed by massive parallel sequencing technique. The accuracy of cfDNA assay was evaluated by calculation of sensitivity and specificity, and multivariate regression analysis was used to search for predictive factors for pregnancy’s vascular complications.

Results

Among the 498 patients who underwent a cfDNA assay in this context, twenty-one (4.2%) were excluded because of loss to follow-up. Out of 477, test failure occurred for four patients initially, reduced to two patients (0.4%) after redrawn. CfDNA was positive for Trisomy 21 (n = 19), Trisomy 18 (n = 6) and Trisomy 13 (n = 1) and negative in 449. The sensitivity of cfDNA assay for trisomy 21 screening was 100% (19/19) (IC 95% 82.4–100) and specificity 100% (458/458) (IC 95% 99.2–100). Among the 447 patients included for prediction of vascular complications, there were four cases of pregnancy induced hypertension and 10 cases of preeclampsia, for which no predictive factor was identified. Intra Uterine growth restriction under 5th percentile (n = 44, 9.8%) was significantly associated with a low fetal fraction (OR = 0.87, IC 95% 0.79–0.96, p = 0.006).

Conclusion

cfDNA assay is an effective and reliable tool for women with atypical profile of first trimester serum biomarkers.
21st-century capitalism: structural challenges for universal health care
Authors: Sell Susan K.
Published: November 2019

The structural perspective outlined here sheds light on some of the fundamental challenges involved in achieving Universal Health Care (UHC) in this twenty-first-century era of trade and financialized capitalism. This commentary explores connections between the structure of twenty-first-century capitalism and challenges to achieving UHC, discussing three features of today’s capitalism: financialized capitalism; trade, intangibles and global value chains; and inequality (as exacerbated by the first two features). The final section discusses the various opportunities for reform to facilitate UHC—from tinkering with the status quo, to deeper regulatory reform and fundamental structural change.
A mindfulness and compassion-based program applied to pregnant women and their partners to decrease depression symptoms during pregnancy and postpartum: study protocol for a randomized controlled trial
Authors: Sacristan-Martin Olga , Santed Miguel A. , Garcia-Campayo Javier , Duncan Larissa G. , Bardacke Nancy , Fernandez-Alonso Carmen , Garcia-Sacristan Gloria , Garcia-Sacristan Diana , Barcelo-Soler Alberto , Montero-Marin Jesus
Published: November 2019

Background

Pregnancy and the postpartum period are times of great change for women and their partners, often bringing substantial challenges and stress. Approximately 10%–20% of women suffer from mood disorders such as depression in the perinatal period. There are risks involved in using psychopharmacological interventions to treat perinatal depression. Mindfulness and compassion-based educational programs could be efficacious and cost-effective options for the prevention and treatment of perinatal mood disorders. The aim of this study is to assess the efficacy of an adapted Mindfulness-Based Childbirth and Parenting (MBCP) program that includes compassion training for pregnant women in primary care (PC) settings in the Spanish National Health System to decrease perinatal depression.

Methods

A multicenter randomized controlled trial (RCT) will be conducted. Participants will be pregnant women (n = 122) and their partners who wish to participate. They will be enrolled and assessed in PC settings and randomly assigned to either: (1) an adapted MBCP educational program tailored to the Spanish National Health System + treatment as usual (TAU); or (2) TAU only. The main outcome to be assessed will be depression, evaluated with the Edinburgh Postnatal Depression Scale (EPDS). Secondary outcomes will include self-reported measures of perceived stress, affects, mindfulness, self-compassion, maternal self-efficacy, and use of health and social services. Patients will be assessed at four timepoints: baseline; post-treatment; and at three and six months after childbirth. Intention-to-treat and per-protocol analyses will be carried out using linear regression mixed models. Effect sizes will be estimated using Cohen’s d.

Discussion

Perinatal depression is a significant health problem. An effective and low-cost childbirth education program that incorporates mindfulness and compassion practices may be a beneficial preventive complementary healthcare modality for expectant women and their partners. This study will be the first multicenter RCT in Spanish PC settings using adapted MBCP and compassion practices to reduce symptoms of depression during pregnancy and the postpartum period.

Trial registration

ClinicalTrials.gov, NCT03247491. Registered on 31 July 2017.
Risk stratification and clinical course of hepatitis B virus reactivation in rheumatoid arthritis patients with resolved infection: final report of a multicenter prospective observational study at Japanese Red Cross Hospital
Authors: Fukuda Wataru , Hanyu Tadamasa , Katayama Masaki , Mizuki Shinichi , Okada Akitomo , Miyata Masayuki , Handa Yuichi , Hayashi Masatoshi , Koyama Yoshinobu , Arii Kaoru , Kitaori Toshiyuki , Hagiyama Hiroyuki , Urushidani Yoshinori , Yamasaki Takahito , Ikeno Yoshihiko , Suzuki Takeshi , Omoto Atsushi , Sugitani Toshifumi , Morita Satoshi , Inokuma Shigeko
Published: November 2019

Background

The prophylaxis for hepatitis B virus (HBV) reactivation assumes that hepatic injury after reactivation is often rapidly progressive and can evoke fulminant hepatitis. The incidence and prognosis of reactivation in patients with rheumatoid arthritis (RA) may be different from those receiving organ transplantation and cancer chemotherapy. This study aimed to investigate the incidence, risk factors, and clinical course of HBV reactivation and develop a scoring system for risk stratification in RA patients with resolved infection.

Methods

HBV DNA was measured using real-time polymerase chain reaction, and patient data were collected for 4 years in RA patients with resolved HBV infection who were treated with steroids or synthetic or biologic immunosuppressive drugs.

Results

Among 1127 patients, HBV DNA was detected in 57 patients (1.65/100 person-years); none of the reactivated patients exhibited worsening of hepatic function. Multivariate logistical analysis revealed that age > 70 years and HB core antibody (HBcAb) positivity alone were independent risk factors for HBV reactivation. HBV DNA ≥ 2.1 log copies/mL was observed in 15 patients (0.43/100 person-years); seven patients were treated with nucleic acid analogs (NAAs), whereas the remaining eight were observed without treatment. Among reactivated cases, 15 cases changed to HBV DNA-negative status spontaneously, whereas 24 cases remained HBV DNA positive < 2.1 log copies/mL during the observation period. We designed the following scoring system: HBV reactivation risk score = 1 × (age > 70 years) + 2 × (HBcAb positivity alone) + 1 × (treatment other than methotrexate monotherapy). This revealed that patients with the highest score had an odds ratio of 13.01 for HBV reactivation, compared to those with the lowest score.

Conclusions

Rapid progression and poor outcomes after HBV reactivation were not frequent in RA patients with resolved infection. Our new risk scoring system might be useful for screening and optimization of prophylactic treatment by distinguishing patients with significantly lower reactivation risk.
An exploration of the gut and environmental resistome in a community in northern Vietnam in relation to antibiotic use
Authors: Bich Vu Thi Ngoc , Thanh Le Viet , Thai Pham Duy , Van Phuong Tran Thi , Oomen Melissa , Driessen Christel , Beuken Erik , Hoang Tran Huy , van Doorn H. Rogier , Penders John , Wertheim Heiman F. L.
Published: November 2019

Background

Antibiotic resistance is a major global public health threat. Antibiotic use can directly impact the antibiotic resistant genes (ARGs) profile of the human intestinal microbiome and consequently the environment through shedding.

Methods

We determined the resistome of human feces, animal stools, human food and environmental (rain, well, and irrigative water) samples (n = 304) in 40 households within a community cohort and related the data to antibiotic consumption. Metagenomic DNA was isolated and qPCR was used to determine presence of mobile colistin resistance (mcr) genes, genes encoding extended-spectrum β-lactamases (ESBL), carbapenemases and quinolone resistance genes.

Results

Nearly 40 % (39.5%, 120/304) of samples contained ESBL genes (most frequent were CTX-M-9 (23.7% [72/304]), CTX-M-1 (18.8% [57/304]). Quinolone resistance genes (qnrS) were detected in all human and 91% (41/45) of animal stool samples. Mcr-1 and mcr-3 were predominantly detected in human feces at 88% (82/93) and 55% (51/93) and animal feces at 93% (42/45) and 51% (23/45), respectively. Mcr-2, mrc-4 and mcr-5 were not detected in human feces, and only sporadically (< 6%) in other samples. Carbapenemase-encoding genes were most common in water (15% [14/91]) and cooked food (13% [10/75]) samples, while their prevalence in human and animal stools was lower at 4% in both human (4/93) and animal (2/45) samples. We did not find an association between recent antibiotic consumption and ARGs in human stools. Principal component analysis showed that the resistome differs between ecosystems with a strong separation of ARGs profiles of human and animal stools on the one hand versus cooked food and water samples on the other.

Conclusions

Our study indicated that ARGs were abundant in human and animal stools in a rural Vietnamese community, including ARGs targeting last resort antibiotics. The resistomes of animal and human stools were similar as opposed to the resistomes from water and food sources. No association between antibiotic use and ARG profiles was found in a setting of high background rates of AMR.
Transcriptomic analysis of monocytes from HIV-positive men on antiretroviral therapy reveals effects of tobacco smoking on interferon and stress response systems associated with depressive symptoms
Authors: Lorenz David R. , Misra Vikas , Gabuzda Dana
Published: November 2019

Background

Tobacco smoking induces immunomodulatory and pro-inflammatory effects associated with transcriptome changes in monocytes and other immune cell types. While smoking is prevalent in HIV-infected (HIV+) individuals, few studies have investigated its effects on gene expression in this population. Here, we report whole-transcriptome analyses of 125 peripheral blood monocyte samples from ART-treated HIV+ and uninfected (HIV−) men enrolled in the Multicenter AIDS Cohort Study (MACS) (n =25 HIV+ smokers,n= 60 HIV+ non-smokers,n= 40 HIV− non-smoking controls). Gene expression profiling was performed using Illumina HumanHT-12 Expression BeadChip microarrays. Differential expression analysis was performed with weighted linear regression models using the Rlimmapackage, followed by functional enrichment and Ingenuity Pathway analyses.

Results

A total of 286 genes were differentially expressed in monocytes from HIV+ smokers compared with HIV− non-smokers; upregulated genes (n= 180) were enriched for immune and interferon response, chemical/stress response, mitochondria, and extracellular vesicle gene ontology (GO) terms. Expression of genes related to immune/interferon responses (AIM2,FCGR1A-B,IFI16,SP100), stress/chemical responses (APAF1,HSPD1,KLF4), and mitochondrial function (CISD1,MTHFD2,SQOR) was upregulated in HIV+ non-smokers and further increased in HIV+ smokers. Gene expression changes associated with smoking in previous studies of human monocytes were also observed (SASH1,STAB1,PID1,MMP25). Depressive symptoms (CES-D scores ≥ 16) were more prevalent in HIV+ tobacco smokers compared with HIV+ and HIV− non-smokers (50% vs. 26% and 13%, respectively;p= 0.007), and upregulation of immune/interferon response genes, includingIFI35,IFNAR1,OAS1-2,STAT1, andSP100, was associated with depressive symptoms in logistic regression models adjusted for HIV status and smoking (p< 0.05). Network models linked the Stat1-mediated interferon pathway to transcriptional regulator Klf4 and smoking-associated toll-like receptor scaffolding protein Sash1, suggesting inter-relationships between smoking-associated genes, control of monocyte differentiation, and interferon-mediated inflammatory responses.

Conclusions

This study characterizes immune, interferon, stress response, and mitochondrial-associated gene expression changes in monocytes from HIV+ tobacco smokers, and identifies augmented interferon and stress responses associated with depressive symptoms. These findings help to explain complex interrelationships between pro-inflammatory effects of HIV and smoking, and their combined impact on comorbidities prevalent in HIV+ individuals.
The anterolateral ligament of the knee joint: a review of the anatomy, biomechanics, and anterolateral ligament surgery
Authors: Ahn Ji Hyun , Patel Nilay A. , Lin Charles C. , Lee Thay Q.
Published: November 2019

Residual knee instability and low rates of return to previous sport are major concerns after anterior cruciate ligament (ACL) reconstruction. To improve outcomes, surgical methods, such as the anatomical single-bundle technique or the double-bundle technique, were developed. However, these reconstruction techniques failed to adequately overcome these problems, and, therefore, new potential answers continue to be of great interest. Based on recent anatomical and biomechanical studies emphasizing the role of the anterolateral ligament (ALL) in rotational stability, novel surgical methods including ALL reconstruction and anterolateral tenodesis have been introduced with the possibility of resolving residual instability after ACL reconstruction. However, there is still little consensus on many aspects of the ALL, including: several anatomical issues, appropriate indications for ALL surgery, and the optimal surgical method and graft choice for reconstruction surgery. Therefore, further studies are necessary to advance our knowledge of the ALL and its contribution to knee stability.
Recruitment of ανβ3 integrin to α5β1 integrin-induced clusters enables focal adhesion maturation and cell spreading
Authors: Diaz Carolina , Neubauer Stefanie , Rechenmacher Florian , Kessler Horst , Missirlis Dimitris
Published: November 2019

The major fibronectin (FN)-binding α5β1 and αvβ3 integrins exhibit cooperativity during cell adhesion, migration and mechanosensing, through mechanisms that are not yet fully resolved. Exploiting mechanically tunable nano-patterned substrates, and peptidomimetic ligands designed to selectively bind corresponding integrins, we report that focal adhesions (FAs) of endothelial cells assembled on α5β1 integrin-selective substrates rapidly recruit αvβ3 integrins, but not vice versa. Blocking of αvβ3 integrin hindered FA maturation and cell spreading on α5β1 integrin-selective substrates, indicating a mechanism dependent on extracellular ligand binding and highlighting the requirement of αvβ3 integrin engagement for efficient adhesion. Recruitment of αvβ3 integrins additionally occurred on hydrogel substrates of varying mechanical properties, above a threshold stiffness that supports FA formation. Mechanistic studies revealed the need for soluble factors present in serum to allow recruitment, and excluded exogenous, or endogenous, FN as the ligand responsible for αvβ3 integrin accumulation to adhesion clusters. Our findings highlight a novel mechanism of integrin cooperation and a critical role for αvβ3 integrins in promoting cell adhesion on α5β1 integrin-selective substrates.
B cells rapidly target antigen and surface-derived MHCII into peripheral degradative compartments
Authors: Hernández-Pérez Sara , Vainio Marika , Kuokkanen Elina , Šuštar Vid , Petrov Petar , Forstén Sofia , Paavola Vilma , Rajala Johanna , Awoniyi Luqman O. , Sarapulov Alexey V. , Vihinen Helena , Jokitalo Eija , Bruckbauer Andreas , Mattila Pieta K.
Published: November 2019

In order to mount high-affinity antibody responses, B cells internalise specific antigens and process them into peptides loaded onto MHCII for presentation to T helper cells (TH cells). While the biochemical principles of antigen processing and MHCII loading have been well dissected, how the endosomal vesicle system is wired to enable these specific functions remains much less studied. Here, we performed a systematic microscopy-based analysis of antigen trafficking in B cells to reveal its route to the MHCII peptide-loading compartment (MIIC). Surprisingly, we detected fast targeting of internalised antigen into peripheral acidic compartments that possessed the hallmarks of the MIIC and also showed degradative capacity. In these vesicles, internalised antigen converged rapidly with membrane-derived MHCII and partially overlapped with cathepsin-S and H2-M, both required for peptide loading. These early compartments appeared heterogenous and atypical as they contained a mixture of both early and late endosomal markers, indicating a specialized endosomal route. Together, our data suggest that, in addition to in the previously reported perinuclear late endosomal MIICs, antigen processing and peptide loading could have already started in these specialized early peripheral acidic vesicles (eMIIC) to support fast peptide–MHCII presentation.

This article has an associated First Person interview with the first author of the paper.
Pan-SHIP1/2 inhibitors promote microglia effector functions essential for CNS homeostasis
Authors: Pedicone Chiara , Fernandes Sandra , Dungan Otto M. , Dormann Shawn M. , Viernes Dennis R. , Adhikari Arijit A. , Choi Lydia B. , De Jong Ebbing P. , Chisholm John D. , Kerr William G.
Published: November 2019

We show here that both SHIP1 (Inpp5d) and its paralog SHIP2 (Inppl1) are expressed at protein level in microglia. To examine whether targeting of SHIP paralogs might influence microglial physiology and function, we tested the capacity of SHIP1-selective, SHIP2-selective and pan-SHIP1/2 inhibitors for their ability to impact on microglia proliferation, lysosomal compartment size and phagocytic function. We find that highly potent pan-SHIP1/2 inhibitors can significantly increase lysosomal compartment size, and phagocytosis of dead neurons and amyloid beta (Aβ)1−42 by microglia in vitro. We show that one of the more-potent and water-soluble pan-SHIP1/2 inhibitors, K161, can penetrate the blood-brain barrier. Consistent with this, K161 increases the capacity of CNS-resident microglia to phagocytose Aβ and apoptotic neurons following systemic administration. These findings provide the first demonstration that small molecule modulation of microglia function in vivo is feasible, and suggest that dual inhibition of the SHIP1 and 2 paralogs can provide a novel means to enhance basal microglial homeostatic functions for therapeutic purposes in Alzheimer's disease and, possibly, other types of dementia where increased microglial function could be beneficial.
Quantification of gas exchange-related upward motion of the liver during prolonged breathholding—potential reduction of motion artifacts in abdominal MRI
Authors: Khot Rachita , McGettigan Melissa , Patrie James T , Feuerlein Sebastian
Published: November 2019

Objective:

To test the hypothesis that there is a measureable upward motion of the diaphragm during prolonged breath-holds that could have a detrimental effect on image quality in liver MRI and to identify factor that potentially influence the magnitude of this motion.

Methods:

15 healthy volunteers underwent MRI examination using prolonged breath-holds in the maximum inspiratory position and a moderate inspiratory position. Coronal T  1 weighted three-dimensional gradient echo sequences of the entire thorax were acquired every 6 s during breath-holding allowing the calculation of total lung volume and the measurement of the absolute position of the dome of the liver. The potential impact of subject’s gender, body mass index, and total lung capacity on the change in lung volume/diaphragmatic motion was assessed using random coefficient regression.

Results:

All volunteers demonstrated a slow reduction of the total lung volume during prolonged breath-holding up to 123 ml. There was a measurable associated upward shift of the diaphragm, measuring up to 5.6 mm after 24 s. There was a positive correlation with female gender (p = 0.037) and total lung volume (p = 0.005) and a negative association with BMI (p = 0.012) for the maximum inspiratory position only.

Conclusion:

There is a measureable reduction of lung volumes with consecutive upward shift of the diaphragm during prolonged breath-holding which likely contributes to motion artifacts in liver MRI.

Advances in knowledge:

There is a measureable gas exchange-related reduction of lung volumes with consecutive upward shift of the diaphragm during prolonged breath-holding which likely contributes to motion artifacts in liver MRI. Correcting for this predictable upward shift has potential to improve image quality.

The magnitude of this effect does not seem to be related to gender, BMI or total lung capacity if a moderate inspiratory position is used.
A multi-disciplinary, multimodal approach for the management of vascular anomalies
Authors: Mazhar Aqsa , Moosa Shazia , Abbas Alizeh , Mallick Yousuf , Samad Lubna
Published: November 2019

Objective: Vascular anomalies are a diverse group of lesions, ranging from simple to complex, disfiguring anomalies. Our objective was to diagnose and provide comprehensive treatment to patients presenting with vascular anomalies, using a multi-disciplinary approach involving dermatologists, plastic surgeons, radiologists and pediatric surgeons.

Methods: Patients presenting with vascular anomalies to The Indus Hospital, Karachi, from January 2017 to March 2019 were enrolled, using a pre-defined questionnaire. Assessment, diagnostic work up, management and clinical and photographic follow up was maintained to monitor outcomes.

Results: One hundred eighty seven patients with a mean age of 4.6 years, (females 62%) were enrolled. Diagnoses included vascular tumors (n=89, 47.6%), lymphatic malformations (n=38, 20.3%), capillary malformations (n=19, 10%), venous malformations (n=16, 8.5%), arterio-venous malformations (n=14, 7.5%) and mixed anomalies (n=11, 5.9%). Treatment modalities, in isolation or combination, included oral propranolol, topical timolol, pulsed dye laser and intra-lesional sclerotherapy. Mean follow up was in 7.1 months, with 27 patients achieving treatment completion. 26 children were lost to follow-up.

Conclusions: Vascular anomalies have mostly been managed successfully at VAC using single or multimodal treatment. Increasingly complex anomalies can be handled using a multi-disciplinary approach. Establishment of VAC has facilitated many patients who were earlier considered as diagnostic and therapeutic challenges.

doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1710

How to cite this:Mazhar A, Moosa S, Abbas A, Mallick Y, Samad L. A multi-disciplinary, multimodal approach for the management of vascular anomalies. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S14-S19. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1710

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.
Malaria and the climate in Karachi: An eight year review
Authors: Herekar Fivzia , Iftikhar Sundus , Nazish Ahsana , Rehman Sabeen
Published: November 2019

Background and Objective: Malaria is an arthropod-borne infectious disease transmitted by the mosquito Anopheles and claims millions of lives globally every year. Reasons for failure to eradicate this disease are multifactorial. The seasonality of the malaria is principally determined by climatic factors conducive for breeding of the vector. We aimed to study the relationship between climatic variability and the seasonality of malaria over an eight-year duration.

Methods: This was a retrospective medical chart review of 8,844 confirmed cases of malaria which presented to The Indus Hospital, Karachi from January 2008 to November 2015. Cases were plotted against meteorological data for Karachi to elicit monthly variation.

Results: A secular incline and seasonality in malaria cases over the duration of 8 years was seen. More cases were reported in the summer, rainy season compared with the other three seasons in each year. There was significant association with specific climate variables such as temperature, moisture, and humidity.

Conclusion: There is a marked seasonal variation of malaria in Karachi, influenced by various environmental factors. Identification of the ‘the concentrated period’ of malaria can be helpful for policymakers to deploy malaria control interventions.

doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1712

How to cite this:Herekar F, Iftikhar S, Nazish A, Rehman S. Malaria and the climate in Karachi: An eight year review. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S33-S37. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1712

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.
Epidemiology of Injuries in West End Performers
Authors: James Aisha S. M. , Lazarczuk Stephanie L.
Published: November 2019

Epidemiological studies in the performing arts are scarce, and only one such study in the last 20 years directly examined West End productions. Therefore, the aim of this study was to analyze the epidemiology of injuries sustained by West End performers over a 12-month period (2016
to 2017). Injury data were self-reported retrospectively by West End performers using an online injury surveillance questionnaire. The information collected covered participant characteristics, injury location, diagnosis, severity, mechanism of injury, and external risk factors. Simple proportions
were calculated for injury location and type. Categorical data were assessed using chi-squared (p = 0.05) and magnitude-based inferences described between-group differences. Forty-seven performers responded (26 male, 21 female), with 65% suffering at least one injury in the previous year.
The lower limb accounted for 50% of injuries, and muscle strains were the diagnosis in 37% of cases. Males sustained 53% of all injuries, but no differences were found between sexes in locations injured (χ2 = 2.296, p = 0.513). Seventy-two percent of injuries were said
to have occurred during performance, with one-third of the total injuries having a gradual onset. Little or no time was lost in the majority of cases.
The Delivery of a Short-Term Psychological Skills Training Program to College Dance Students: A Pilot Study Examining Coping Skills and Injuries
Authors: Skvarla Leigh A. , Clement Damien
Published: November 2019

Dance makes a number of inherent physical and psychosocial demands that can promote resilience. However, dancers may strive to meet those demands by employing unhealthy coping strategies that can be linked to maladaptive thoughts and behaviors and increased injury risk. The present
study utilized a two-group pretest-posttest quasi-experimental design to examine the impact of a psychological skills training program on coping skills and prevalence of injuries over a 6-week period in a convenience sample of college dance students (N = 30). Participants were drawn from the
same dance program and were assigned to a control or treatment condition based on their current class schedule. At the end of the study, there were no significant quantitative differences observed between the treatment and control groups. However, mean scores for treatment group participants'
coping skills slightly increased over time. A focus group discussion led to several recommendations for future research and programming improvements. Additionally, this study underscores the need for a single operational definition of injury in a college dance context. Best practices for researchers,
practitioners, and educators in the context of psychological skills training are also discussed.
The first experience of surgical treatment of obesity and metaboli desorders with using of minimally invasive technology
Authors: Staіkov P. , Kryvoruchko I. A. , Parkhomenko K. Yu. , Syvozhelіzov A. V. , Sykal M. , Smetskov D. A. , Tonkoglas A. A.
Published: November 2019

The results of barіatrіc іnterventіons іn the clіnіc of the Department of Surgery No. 2 of the KhNMU wіth the use of mіnі-іnvasіve іnterventіons that were performed from September 2015: 7 patіents (3 women, 4 men) wіth morbіd obesіty (7) on the background of dіabetes mellіtus (1) at the age of 37-55 g. The weіght before operatіon was 125.75 [107-143] kg; BMІ - 46.3 [45.2-52.1] kg\m2. The followіng types of surgіcal іnterventіons were performed: іn 4 patіents laparoscopіc sleeve resectіon of the stomach; іn 3  laparoscopіc gastrіc bypass. All patіents began to eat and walk іn 4-6 hours after surgery. There were not complіcatіons and postoperatіve mortalіty. Patіents were dіscharged in a 7 days from the hospіtal. Tіme of observatіon  is from 6 months to 3.5 years.Evaluatіon of the percentage of excess weіght loss (EWL %) was performed.The results are: on the averaged іn patіents undergoіng after gastrіc bypass: 1 months - 21%, sleeve gastrectomy (gastrіc sleeve resectіon): up to 1 months - on the average of 26,4%. The qualіty of patіents lіfe has іmproved sіgnіfіcantly.
The theoretical model of formation of readiness of future teachers of physical education in the organization of extracurricular activities on tourism
Authors: Chalii Liudmyla
Published: November 2019

The article presents a theoretical model of readiness of the future teacher of physical education in the organization of extracurricular activities on tourism as a system of four interconnected blocks: conceptual, content, technological and effective - correctional. Conceptual block contains the purpose, a list of tasks, general scientific approaches and principles of teaching. The purpose of the article is to determine and justify the component model of readiness of the future teacher of physical education in the organization of extracurricular activities with tourism. Content block models constitute the professionally oriented and sports-pedagogical discipline.Technological block of model of readiness of the future teacher of physical education in the organization of extracurricular activities on tourism comprises the steps of the model realization (preparatory, operating, diagnostic - effective), pedagogical conditions of formation of readiness of the future teacher of physical education in the organization of extracurricular activities in tourism and technology of their implementation. Effective - correctional block contains the structural components (motivational - orientation, cognitive, practical and personal), criteria (axiological, epistemological, operational and integrational) and levels (high, medium, basic and low) of formation of readiness of the future teacher of physical education in the organization of extracurricular activities in tourism. Pedagogical conditions of formation of future teachers of physical education in the organization of extracurricular activities with tourism are identified as: formation of future physical education  teachers’ motivational systems to implement extracurricular activities of tourism which are based on consideration of their individual psychological characteristics; strengthening of semantic saturation of the educational process of formation of future physical education in the organization of extracurricular activities in tourism by introducing a variable subject "The organization of extracurricular activities on tourism" and addition of the content of other disciplines with relevant modules; provision of modern information and methodological support of the educational process of formation of future physical education teachers for extracurricular activities in tourism.The set of components of the educational process, designed to ensure the implementation of the pedagogical conditions and to achieve the goal of forming the future teachers of physical education in the organization of extracurricular activities with tourism was justified.
Salutogenetic approach in adult education
Authors: Ionova Elena , Partola Victoriia
Published: November 2019

Purpose: to disclosure the nature and characteristics of the Movement for the renewal of adult education (New Adult Learning Movement – NALM) as salutogenetic approach to adult education. Materials: literature sources on analyzed problem. Methods: theoretical analysis and generalization of specific scientific and methodical literature. Key results: analyzed the nature and characteristics of salutogenetic approach to adult education based on anthroposophic oriented methodological foundations and practical implemented in the world as New Adult Learning Movement (NALM). Described theoretical basis and directions of training (academic training, life experience, inside spiritual development) that enhance the internal intentions of the individual, to awaken the will of the student to learn throughout life and promotes the healthy development of holistic personality structure. Conclusions: illuminated health saving forms and methods of adult education: organization of revitalizing educational space, development of integrated programs (integration of academic elements – lectures, discussions, group work, project work, art classes, social exercises etc.), the rhythmic organization of educational process taking into account human biorhythms, work with the biography of the man, pedagogical diagnosis and others.
The ways of formation health saving educational environment for schoolchildren in Ukraine
Authors: Yermakova Tetiana
Published: November 2019

Aim: to reveal areas of problems of health saving educational environment in the national school system. Materials: it was analyzed 38 literature resources on the item of the article. Results. The main concept of the article is to single out and analyze the ways of formation and development the health saving educational environment in modern school educational system of Ukraine. The first way is national programs, where the author illuminates the main documents concerning school education and reveals the key areas of the formation of healthy environment. The second way is international programs in which Ukraine take part. Such participation aimed at improving the health of schoolchildren, equip them with the skills of healthy lifestyle, use of folk traditions, integration of healthy lifestyles in the educational process etc. The third way is school subjects with the elements of formation health saving skill and knowledge among schoolchildren and teachers at genera.
Ecological condition of post-industrial towns of Ukraine based on the case study of Drohobych town
Authors: Terletska Oksana
Published: November 2019

The current state of most of former powerful industrial cities and towns of Ukraine is characterized by industrial decline; therefore, their ecological condition was expected to improve. Drohobych is a striking example of such a town. The notion “post-industrial” used in the research work, on the one hand, designates the phase after the industrial phase (the one that lasted before the industrial crisis), and on the other hand, it is used to denote the phenomenon of industrial reduction, i.e. significant decrease of industrial potential.The aim and objectives of the research article were dedicated to the study of current ecological state of Drohobych urban environment based on certain research material, as well as detection of the most ecologically threatening season conditions.Based on the elaborated large-scale map of urban landscapes of Drohobych and with the help of the original author’s experimental material, there has been represented the current ecological state of natural components (surface and municipal, soils, atmosphere) within the territory of the town of Drohobych. It has been determined that each of the aforementioned components of the urban environment is associated with chemical compounds exceeding maximum allowable concentrations. Moreover, the most threatening values in terms of bacteriological quality are related to the quality of surface and municipal waters. The most hazardous situation occurs during spring period since due to worn-out condition of the pipelines, snowmelt waters leak in municipal water supply network. The same situation can be observed in water from open wells, which is used by the population for drinking. During the research process, there have been analysed disturbing ecological situations, some of which could be characterized as critical. The research works prove the popular idea that ecological condition of Ukrainian post-industrial cities and towns significantly improved after the cessation of many large enterprises to be wrong.
Psychosomatic disorders in people with Shereshevsky-Turner syndrome
Authors: Ryznychuk M. A. , Pishak V. P.
Published: November 2019

The article deals with topical issues related to the etiology, peculiarities of the phenotypic manifestations of the Shereshevsky-Turner syndrome in different age groups.The incidence of Shereshevsky-Turner syndrome among newborn girls is 1: 2000-1:5000, although some studies mention much more frequent occurrence.An analysis of the features of mental development in patients with partial or complete monosomy was carried out.Patients with Shereshevsky-Turner syndrome should be under a constant supervision of clinical psychologists who are aware of the peculiarities of the disease, and it is also necessary to carefully develop social skills and attitudes in social medium, which will be useful in their further social adaptation.
Features of sorbilact-L-arginine-combined action on the kidneys’ volumoregulatory function of patients with purulent-septic complications
Authors: Maksymchuk N. O. , Konovchuk V. M.
Published: November 2019

The purpose of the work is to investigate the effect of combined use of sorbilact and L-arginine on the kidneys’ volume-regulatory function of patients with endogenous intoxication syndrome (EIS) of purulent-septic origin in the period of stabilization of secondary toxic autoagression.Methods. Indicators of kidney volume receptor function have been studied in patients of the following groups. The first group (І, control) consisted of 31 patients with systemic inflammatory response syndrome (SIRS). The second group (ІІ) consisted of 22 patients with EIS who were treated according to Surviving Sepsis Campaign 2016 (standard therapy) [9]. The third group (ІІ) consisited of 24 patients with EIS, who received sorbilact in addition to standard therapy. The fourth group (IV) included 21 patients with SEI who received standard therapy as well as Sorbilact and L-arginine. Sorbilact infusion to patients of III and IV groups was performed at a rate of 6-7 ml/kg body weight, intravenously dripping at a rate of 7-8 ml/min. After the end of infusion of sorbilact, patients of IV group were infused with 4.2% solution of L-arginine (“Tivortin” intravenous drip according to the instructions). Data was obtained and results gathered on the application of drugs in the period of stabilization of secondary toxic autoagresion (fourth day of drugs’ application).Findings. In the period of stabilization there is a restoration of the volume-regulatory function of the kidneys under standard therapy of endotoxicosis of purulent-septic genesis. The use of sorbilact with standard therapy activates the volume-regulatory function of the kidneys (in terms of sodium clearance by 31%, p <0,05) in the period of stabilization of toxic autoaggression. The combination of sorbilact with L-arginine increases the activity of sodium clearance by 12% (p <0,05) induced by sorbilact.Conclusions. The investigated features of basic adjuvant therapy with L-arginine and sorbilact can be recommended for use in order to restore the volume-regulatory function of the kidneys in cases of endotoxicosis of purulent-septic genesis.
The structure of the brain and human behaviour
Authors: Wróbel Grzegorz
Published: November 2019

Currently, the state of knowing the structure and functionality of the human brain is a source of interest for many researchers. Despite the fact that there are significant advances in neurobiology, there is still a lack of information on neuroanatomy and neurophysiology that could shed a new look at interpersonal behavior. Changes in the structure of the human brain, which may occur as a result of various factors, affect its functioning and thus human behavior. In the context of neuroanatomic and metabolic changes, cognitive functioning, as well as the expression and control of emotions are also modified. It is worth noting that during the adolescence period, the human nervous system is particularly sensitive to injuries, and dysfunctions of the brain structures that can interfere with for overly risky or even aggressive behavior. The aim of this work was to determine the basic anatomical structures in the functional aspect conditioning human behavior.
TENSÕES ENTRE DESEJO E MORAL EM O ESPELHO DE GASTÃO CRULS
Authors: César André Gheti
Published: November 2019

O presente artigo elabora uma análise do conto O Espelho de Gastão Cruls. Nesta análise, o ponto central seria o antagonismo existente entre os valores cultivados pelo protagonista e sua mulher e os desejos que os mesmos possuem. A fim de auxiliar a compreensão do conto, reflete-se sobre o duplo enquanto possibilidade de interpretação de textos literários.  Neste conto, temos um duplo interior, onde o protagonista apresenta um conflito psíquico e uma cisão em seu âmago. Ainda no interior da temática do duplo e do conto, é também possível avaliar a presença de algumas oposições irreconciliáveis entre a espiritualidade e a corporeidade, o cristianismo e o paganismo, a virtude e o vício ou a repressão e a satisfação de impulsos sexuais. Ainda que apresente estas situações sem reconciliação, o conto de Cruls também indica que a emersão do outro não ocorre sem preconceitos e conflitos, mesmo que este estranho ao comum seja também próximo e familiar.
ENTREVISTA COM CID VALE FERREIRA
Authors: França Julio , Silva Alexander , Barros Fernando Monteiro de
Published: November 2019

Recebido em 10 Jun 2019Aprovado em 11 Ago 2019
MOBILIDADE URBANA E CIDADANIA EM DOIS CONTOS DE FERRÉZ
Authors: Salgado Marcus Rogerio
Published: November 2019

O objetivo do presente artigo é o estudo das representações ficcionais da mobilidade urbana em dois contos do escritor paulistano Ferréz, “O grande assalto” e “Terminal (nazista)”. Ambos fazem parte de Ninguém é inocente em São Paulo, volume de contos publicados em 2006 e que apresenta, como as demais obras do escritor, ambientação urbana e cenas que podem funcionar como ponto de partida para importantes debates sobre as relações diretas entre mobilidade urbana e cidadania.