bluuebunny/crossref_metadata_2025 huggingface dataset:
Consequences of Atrial or Ventricular Tachypacing on the Heat Shock Proteins (HSP) level of Expression and Phosphorylation
Authors: Shorofsky Matthew , Maguy Ange , Nattel Stanley
Published: February 2021

Background - Uncontrolled atrial fibrillation (AF) results in complex changes in the cardiomyocyte electrical and contractile functioning that promote atrial remodeling and the continuation of AF. Recently there has been a growing interest in understanding the role of heat shock proteins (HSPs), which are cytoprotective molecular chaperones, in the pathophysiology of AF. Several groups have examined HSP expression in patients with AF but have yielded mixed results. To allow for  better consistency and reproducibility between subjects, we utilized canine models to reproduce AF- promoting conditions to better investigate the role of HSPs in the pathophysiology of AF. Methods - AF  promoting conditions were simulated in canine models with fifteen adult mongrel dogs (20.6 to 36.0 kg) divided into three groups: (1) Control (n=5), (2) two week ventricular tachypacing (VTP) induced congestive heart failure (CHF) (n=5), and (3) one week atrial tachypacying (ATP) (n=5). Quick frozen right atrial free wall tissue samples were used for protein isolation and were analyzed via Western  blotting with data was expressed as a relative ratio and were analyzed using a two-tailed, unpaired t- test and significance was set at p < 0.05. The expression levels of HSP 90, 70, and 25 were studied along  with the phosphorylation status of HSP27 at serine-78. Results - We first examined the effects of the ATP and CHF heart models on the expression of a select group of HSPs via Western Blot. We found that there was no significant difference in levels of expression of HSP 90, 70, or 25 when either ATP or CHF models were compared to control canines. The phosphorylation status of HSP27 was significantly decreased in the CHF canine model when compared to control (p < 0.0111) and it tended towards a decrease in the ATP canine model when compared to control (p=0.0923). Conclusion - This study showed that even though the expression levels of HSPs may remain constant, there are protein phosphorylation and dephosphorylation events that occur in AF that may have important consequences in its pathophysiology. It is therefore necessary to investigate the full scale of HSP modifications during AF and AF-promoting conditions.
A Rare Variant of a Common Nodule
Authors: Xi Nancy , Assaad Dalal , Adam David N
Published: February 2021

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Teenage Female with Knee Pain and Instability
Authors: Jo Patricia , Leswick David A , Allen Lauren A
Published: February 2021

Congenital dislocation of the knee, result- ing from an absence of the cruciate ligaments, is  a condition affecting 0.017 per 1000 live births (1).  Although very rare, it has drawn the attention of or- thopaedic surgeons and radiologists because it is  associated with other congential anomalies. This paper presents abnormalities that are isolated to the knee and without evidence of associated syndrome. The absent anterior cruciate ligament (ACL) is associated with a hypoplastic posterior cruciate ligament (PCL), a shallow femoral notch, and hypoplastic tibial spines seen with radiographic and magnetic resonance imaging. The objective of this article is to review the clinical presentation and imaging fndings associated with congenitally absent ACL.
Evolutionary approaches to autism- an overview and integration
Authors: Ploeger Annemie , Galis Frietson
Published: February 2021

Autism is a highly heritable neurodevelopmental disorder, which great- ly reduces reproductive success. The combination of high heritability and low re- productive success raises an evolutionary question: why was autism not eliminated  by natural selection? we review different perspectives on the evolution of autism  and propose an integration which emphasizes epistatic interactions between the ef- fects of genes during development. It is well-established that autism is a polygenic  disorder, and that the genes contributing to autism interact. If a disorder is poly- genic, it is likely that the genes underlying the disorder are also involved in traits  that are benefcial for the individual. For example, it is possible that genes involved in the development of autism are also involved in the development of intelligence. As intelligence is positively correlated with reproductive success, genes involved  in autism can possibly spread in the population. we propose that in most individu- als, the interactions between genes result in normal or high intelligence and the  absence of autism. However, in some unlucky situations, often in combination with spontaneous negative mutations, the interactions between genes can lead to the  development of autism (or other pathologies). Thus, the combination of high herita- bility and low reproductive success in autism can be explained from an evolution- ary developmental perspective that emphasizes the role of epistatic interactions in  polygenic disorders.
A New Palmo-Shoulder Compression Association
Authors: Sinno Hani , Zadeh Teanoosh
Published: February 2021

Carpal tunnel syndrome is a most common peripheral compression neuropathy (1). It is caused by mechanical compression of the median nerve as it traverses the carpal tunnel of the wrist. Classic signs and symptoms are numbness of the lateral three digits and weakness of the thenar muscles  due to atrophy (2). Important diagnostic tests in- clude electromyography (EMG) and nerve con- duction studies. The gold standard for the surgical  treatment is transection of the transverse carpal ligament.
Exploring the Possibility for a Common System for Joint Aeromedical Standards
Authors: Woodson Justin , Dalitsch III Walter M , Persson James L , McGhee James , Ciccone Charles , Parsa Brian
Published: February 2021

The Physical qualifcation standards for aviation service used by the united States Army, Navy/Marine Corps, Air Force, and Coast guard developed in parallel, diverging in many instances due to differences ranging from terminology to mission. Presently, standards and requirements for waiver vary widely between the services, in spite of minimal differences in aeromedical concerns for any given medical condition. Standardization or increased concordance between the services would have several advantages leading to more effcient and effective delivery of aviation medical support to the operational forces. This is particularly true in an increasingly joint operational environment. The authors have identifed four major  hurdles that must be overcome before the concept of joint aviation physical stan- dards can be explored. These include: a difference in terminology including aviator  classifcation, a difference in mission defnitions and requirements, a difference in the processes of policy development, and a difference in the review and application of those policies. These hurdles are explored, and suggestions for their mitigation are presented with open discussion following.
Appreciating the global impact of cleft lip and palate at the medical school level
Authors: Tahiri Youssef , Salhi Saoussen , Sinno Hani , Luc Mario
Published: February 2021

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Type IV paraesophageal hiatal hernia and organoaxial gastric volvulus
Authors: Zachry Alison , Liu Alan , Raja Sabiya , Maboud Nadeem , Sandhu Jyotu , Sims DeAndrea , Malik Umer Feroze , Mahmoud Ahmed
Published: February 2021

Organoaxial gastric volvulus occurs when the stomach rotates on its longitudinal axis connecting the gastroesophageal junction to the pylorus. With that, the antrum of the stomach usually rotates in the opposite direction in rela-tion to its fundus (1). This phenomenon has often been known to be associated with diaphragmatic defects (2) Importantly, abnormal rotation of the stomach of more than 180° is a life threatening emergency that may create a closed loop ob- struction which may result in incarceration leading to strangulation, and hence, a surgical emergency. We present the case of a middle-aged female who presented with organoaxial gastric volvulus and had an associated Type IV paraesophageal hiatal hernia that was treated electively. Normally an emergent gastric volvulus is diagnosed via Borchardt’s classic triad (epigastric pain, unproductive vomiting and diffculty inserting a nasogastric tube); however in this patient the nasogastric tube (NGT) was passed into the antrum which allowed additional time for resusci-tation with fuids and other symptomatic relief.
Mortality trends in a Cohort of Canadian Psoriatic Arthritis Patients
Authors: Ogunyemi Boluwaji
Published: February 2021

Methods: We reviewed retrospectively the charts of psoriatic arthritis patients who died from 1995-2010.We included 13 deceased patients with a psoriatic arthritis di-agnosis and compared them with 140 patients living with psoriatic arthritis that at-tend the same clinic. The population was derived from a single academic rheumatol-ogist’s practice in St. John’s, Newfoundland, Canada. Patients are seen at six-month intervals with a history and physical exam performed at each visit. Laboratory data was collected at each visit. Diagnosis of psoriatic arthritis is based on the CASPAR Classifcation and Diagnostic Criteria for Psoriatic Arthritis. Results: The mean age of the 13 deceased patients was 62.9 years. Of these, 38.5% were female and 85.7% had an erythrocyte sedimentation rate greater than 15 mm/hour vs. 36.4% of patients living with psoriatic arthritis. Of deceased patients, 16%had dystrophic nail changes of vs. 59.6% of living patients. Health Assessment Questionnaire was found to show a signifcantly greater loss in function in deceasedpatients. (1.39 vs. 0.70, p= 0.002). Almost half of the deceased patients had used Prednisone (46.2%) as opposed to 11.2% of living patients. Conclusions: We realize that this study employs a small sample size. Increased ESR and Health Assessment Questionnaire score were found to be associated with mor-tality in psoriatic arthritis patients. Dystrophic nail changes were found to be pro-tective for psoriatic arthritis patients.
Questioning What the Doctor Ordered: The Shortcomings of Defensive Medicine
Authors: Teng Janelle Wen Hui
Published: February 2021

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Challenges of Stroke Care in Rural & District General Hospitals; A United Kingdom National Health Service Perspective
Authors: Abdus Sami Eman , Naqvi Naseem
Published: February 2021

Stroke Medicine being an independent and recognised sub-specialty in the United Kingdom, is faced with unique challenges across District and Rural Hospitals. Delivering a comprehensive stroke service in the rural areas requires collaborative team work, effective communication, pre planning and efficient leadership. In this article we have summarized these challenges and shared some proposals for future development of a holistic and integrated Stroke Service in district hospitals across United Kingdom.
FT4 Should Replace TSH in Diagnosing Abnormal Thyroid Function
Authors: Yaun Kristen Marie , Kennedy Ashley
Published: February 2021

In this paper, I argue that the method for diagnosing abnormal thyroid function should be the free serum thyroxine (FT4) test. The current and most widely used method for diagnosis is the thyroid stimulating hormone (TSH) test. The FT4-first testing approach is more accurate and more cost-effective and should replace the TSH test.
A Tale of Two Brains- Cortical localization and neurophysiology in the 19th and 20th century
Authors: Bilodeau Philippe-Antoine
Published: February 2021

Introduction: Other authors have well described the importance of experimental physiology in the development of brain sciences and the individual discoveries of the founding fathers of modern neurology. Here is discussed the birth of neurological sciences in the 19th and 20th century and their epistemological origins.Discussion: In the span of two hundred years, we saw the emergence of two different brains: the neuroanatomical brain, exemplified by cortical localization and the anatomo-clinical approach pioneered by Jean-Martin Charcot, and the neurophysiological brain, exemplified by Santiago Ramon y Cajal’s neuron doctrine and pre-modern electrophysiology. We can distinguish between brain function, understood as the attribution of physiological functions to discrete anatomical structures, and brain functioning, understood as an approach to nervous system functioning and physiology that emphasizes mechanisms.Conclusion:   In the 19th and 20th century, the brain became an organ with a physiology that could be understood. However, we saw the development of two different conceptions of the brain, which continue to influence neurological sciences to this day.Relevance: With modern cognitive neuroscience, functional neuroanatomy, cellular and molecular neurophysiology and neural networks, neurological sciences all have different analytical units, which are tributaries of the 19th and 20th century development of the neuroanatomical and neurophysiological brains.
Training global surgery advocates: Strengthening the global surgery voice
Authors: Ma Xiya , Vervoort Dominique , Poenaru Dan
Published: February 2021

Objective: To strengthen medical trainees around the world on global surgery and advocacy and help develop future generations of global surgeons, anaesthesiologists, and obstetricians.Design: Training Global Surgery Advocates (TGSA), a standardized three-day advocacy workshop developed by the International Student Surgical Network (InciSioN), was built on traditional didactic lectures, role-play exercises, small working group activities, and advocacy and diplomacy training. Assessment was done using a 5-point Likert scale for 18 components regarding the perceived familiarity, knowledge, and motivation for global surgery.Setting: The training was given in the context of the pre-general assembly of the International Federation of Medical Students Associations (IFMSA) at Université Laval, in Quebec City, Canada.Participants: Twenty-five participants were selected to attend the workshop from a pool of 52 applicants, of which 14 medical students from 7 high-income countries and 7 low- and middle-income countries.Results: An average increase of 1.73 points across all 18 workshop components was observed among participants. After the workshop, all participants agreed or strongly agreed (4.64 average) on their motivation to train other medical students in their respective countries to become global surgery advocates.Conclusion: TGSA significantly improved participants’ knowledge and advocacy skills underlying global surgery. A mixed didactic and hands-on workshop appears to be feasible, enjoyable for participants, and effective in improving medical students involvement in the emerging field of global surgery.
The pre-clerkship medical student's experience during the COVID-19 pandemic: An international conversation with recommendations for progress
Authors: Al-Zubi Sara , Coleman Julianna , Kordlouie Sarah , Lee Caroline , Nuechterlein Kaitlin , Rahmani Feriel , Shade Jamie E. , Talat Zahra , Teutenberg Michael , Wu Emily
Published: February 2021

In response to the spread of SARS-CoV-2 across North America in early March of 2020, Canadian and United States medical schools swiftly virtualized medical education for pre-clerkship students. With remote learning arrived novel challenges: barriers to students’ comprehension of course material, difficulties conveying the nuances of patient interaction, and social hardships hindering students’ continued progress. The 2020 Harvard-McGill Medical Student Exchange, a group of ten McGill University Faculty of Medicine and Harvard Medical School students, analyzed their institutions’ respective responses in the virtualization of medical education and their personal experiences with remote pre-clerkship education. The authors’ work provides insight into opportunities for mutual progress and cross-cultural exchange between Canadian and American medical schools, in the context of the COVID-19 pandemic. The authors detail potential changes to didactics, student research opportunities, support for students, and clerkship preparation that they expect would benefit pre-clerkship students in an ever-changing biomedical landscape. With gratitude toward their respective programs for their efforts in transitioning to virtual learning, the authors look toward a future of medical education increasingly interwoven with digital technology and responsive to social change.
On psychiatry in cinema
Authors: Curry Dennis
Published: February 2021

Hannibal Lecter, Malcolm Crowe, and Arthur Fleck are three cinematic characters that relentlessly pull the viewer in for different but powerful reasons. A common thread between these characters is their explicit connection to psychiatric illness or its treatment. The author explains how these characters obtain the attention of the audience through the lens of mental illness and how the viewer’s reservoir for compassion stands to deepen during this process. The author concludes with a social commentary on Todd Phillips’ Joker (2019) and the controversy surrounding its depiction of mental illness on the silver screen.
Women in Medicine: Dr. Theresa Tam
Authors: Dunbar-Lavoie Ellen
Published: February 2021

Canada’s Chief Public Health Officer, Dr. Theresa Tam (BMBS (UK), FRCPC) attended medical school in the United Kingdom before immigrating to Canada where she trained in pediatrics and specialized in infectious disease. She has maintained a ‘pourquoi pas’ attitude throughout her career that has helped her realize her vocation in public health, gain experience in the healthcare field—both around the globe and on Canadian soil—and advance into prominent leadership positions. Today, as Canada’s Chief Public Health Officer, known colloquially as Canada’s Top Doctor, Dr. Tam has been thrust into the spotlight as a result of the COVID-19 pandemic. This article outlines her exciting career trajectory and explores the challenges she faces while informing Canadians of guidelines for staying healthy during the pandemic.
Approach to: Ocular trauma
Authors: Dhillon Jobanpreet
Published: February 2021

Ocular trauma can be a common presentation in the emergency department. It is therefore important for a physician to be able to quickly recognize vision-threatening conditions and provide necessary medical management prior to consulting ophthalmology. This article describes the pertinent information that should be gathered during a focused ocular history in a patient with ocular injury, and also provides a systematic approach to evaluating ocular trauma. As an example, a case study of open globe injury is used to illustrate the appropriate pre-ophthalmologic management and common medical errors that must be avoided for a good prognosis. Additional ocular conditions such as traumatic hyphema, traumatic optic neuropathy, traumatic vitreous hemorrhage, orbital compartment syndrome, chemical burns, and eyelid lacerations are also described as differential diagnosis. Ultimately, the aim of this work is to provide medical students with a fundamental understanding in approaching ocular trauma in emergency clinics.
Wilms' Tumor: Long-Term Effect of Multimodal Treatment on Renal Function
Authors: S. McLauchlin Michelle , Cairney Elizabeth , DeVeber Barry , Morrison Hurley R. , G. Matsell Douglas
Published: February 2021

Patients with Wilms' tumor, a common malignant childhood tumor, have an excellent survival rate. The treatment protocol, which consists of a combination of surgery, chemotherapy, and irradiation, may induce both short- and long-term systemic effects. This paper addresses concerns regarding the effects of treatment on long-term renal function in the survivors of Wilms' tumor. In a retrospective study, the charts of 36 patients treated at the Children's Hospital of Western Ontario were analyzed with respect to the epidemiology and parameters of renal function. It was determined that patients with Stage I disease maintained normal renal function over five years. However, those with Stage III and IV disease exhibited decreased renal function immediately after treatment but regained normal renal function within five years. This investigation clearly establishes the need for future prospective studies of long-term renal function of the remaining kidney in children who have undergone treatment for Wilms' tumor.
Congratulations to the MJM
Authors: H. Hubel David
Published: February 2021

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The Childbed Fever Mystery and the Meaning of Medical Journalism
Authors: Caplan Caralee E.
Published: February 2021

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On the Making of Tomorrow's Professionals
Authors: Del Duca Danny
Published: February 2021

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The Social Construction of Disease: Two Metaphors of the Tuberculous Patient
Authors: Caplan Caralee
Published: February 2021

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Case Report: Surgical Treatment of Drug-Resistant Temporal Lobe Epilepsy
Authors: Cendes Fernando
Published: February 2021

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The Role of Community Health Agents in Northeastern Brazil: An Analysis of Health Knowledge Transfer in the Community
Authors: Edpuganti Renu
Published: February 2021

The objective of this study was to describe and evaluate the health education component of a community health program in Pacatuba, a municipality in the Brazilian state of Ceará. The study focuses on health-related knowledge, measured through questionnaire-guided interviews, in the community and among the health agents as an indicator of program success. The sample size consisted of 18 health agents and 44 households, of which 28 were urban and 16 were rural. Comparisons between urban and rural households and general trends in knowledge transfer were examined. These observations then formed the basis for recommendations to increase program success. Overall, white agents revealed high levels of health-related knowledge, the results from the community sample varied. The community displayed proficient knowledge with respect to oral rehydration therapy preparation and use, the role of vaccines, and the purpose of prenatal exams. However, there was less subject knowledge regarding the function of child weighing, the importance of breastfeeding, and the knowledge of several family planning methods. Some of the factors believed to influence knowledge transfer to the community include the quality of health agent supervision, the supply of the agents' materials, and health orientations in the community. The possibilities for dealing with these concerns are discussed and elements for further program enhancement in health knowledge transfer, such as organizational stabilization and creative health education methods, are considered.
Apoptosis in Response to Anti-estrogens in MCF-7 Human Mammary Adenocarcinoma Cells
Authors: Jacobson Avrum , Delic Jozo , Magdelenat Henri
Published: February 2021

Programmed Cell Death (PCD) is a highly regulated but not yet fully understood process by which selective gene expression leads to cell demise. The term apoptosis refers to the typical morphological changes observed with PCD. In the present study, we investigated the potential role of apoptosis as a mechanism by which anti-estrogens mediate tumor regression. Estrogen receptor-positive MCF-7 human mammary adenocarcinoma cells were treated with three different estrogen antagonists: RU 58668, ICI 182,780, and 4OH-Tam, in order of increasing potency. At selected time intervals, for up to seven days of culture, the degree of apoptosis induced by the anti-estrogens was assessed. Apoptotic cells were scored on the basis of specific morphological criteria disernable by fluorescence microscopy. It was hypothesised that the more potent the anti-estrogen, the greater the number of apoptotic cells we would observe. However, only minimal apoptosis was noted even at the highest concentration of anti-estrogen assayed (10-5 M). This is in contrast to some, but not all, previous reports. Possible confounding factors are discussed and include the presence of exogenous estrogen in the culture media, as well as a genetic drift in the clonal lineage of MCF-7 cells such that a resistance to induced apoptosis had been acquired.
Atrial Pacing May Decrease the Incidence of Atrial Fibrillation Following Coronary Artery Bypass Graft Surgery
Authors: Cohen M , Morin JF , Rosengarten M
Published: February 2021

At the Montreal General Hospital in 1994, the incidence of atrial fibrillation (AF) following coronaryartery bypass graft (CABG) surgery was 30%. With the goal of reducing the incidence of thiscomplication, 20 patients (15 males and 5 females) undergoing CABG surgery were studied

prospectively for the occurrence of AF following a three-day "on demand" atrial pacing at 90 beats-per-minute. The age range of the group was 39 to 79 years, with a mean age of 60 and a median age of

63. Two patients were categorized in NYHA class II, 13 in class III, and five in class IV. Of the latter

five, two patients received intravenous nitroglycerin preoperatively. ß-blockers were taken pre-operatively by 13 patients, Ca2+ channel blockers by 12, and ACE inhibitors by two. Only one patient

had suffered a myocardial infarction within the last year. Preoperative ejection fractions ranged from15 to 60% with a mean of 45%. In all cases, the CABG operation achieved complete revascularizationusing left internal mammary artery (LIMA) grafts in addition to saphenous vein grafts. The averagenumber of bypasses performed was 3.15. Cardiac arrest was induced using intermittent cold bloodcardioplegia, and cardiopulmonary bypass time averaged 60 minutes. Aortic occlusion time averaged36 minutes. Intraoperative inotrope use was infrequent, used intraoperatively with two cases requiringneosynephrine, one case requiring levophed, and one case requiring dobutamine. Post-pacing cardiacassessment revealed non-specific T wave abnormalities in five (25%) of patients, but no patient showedany evidence of acute myocardial infarction. In no cases did any complications related to the atrialpacing develop in the postoperative period. The results reveal that only two patients (15%) experiencedAF following, and one during, the three-day regimen of atrial pacing. Thus, this study providespreliminary evidence of a decrease in the incidence of post-CABG AF using atrial pacing.
Psychiatry and the Law: A History of Our Duty to Protect
Authors: Goldstein Mara Suzanne
Published: February 2021

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Update on Cardiac Valve Surgery
Authors: Morin JF , Baslaim G
Published: February 2021

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Physicians, Fads, and Pharmaceuticals: A History of Aspirin
Authors: Andermann Anne
Published: February 2021

Aspirin is a product of the late-nineteenth-century laboratory, pharmaceutical industry, and medical community. The prevailing scientific techniques, industrial approaches, and medical beliefs were instrumental in the development, promotion and reception of the drug. As a result, the present account does not extend further back than a few decades prior to the release of aspirin from the laboratories of Farbenfabriken vormals Friedrich Bayer & Co. in 1899. In contrast, much of the current literature on aspirin (2,3,4) attempts to trace the compound back to antiquity through the Ebers papyrus, the Hippocratic writings, and the works of Galen. Such histories tell a simple, linear tale of the numerous "discoveries" proposed to have led to the use of certain salicylate-containing plants, such as willow bark and wintergreen, or salicylate-related compounds, including salicilin and salicylic acid, as cures for a variety of ailments. Indeed, according to Mann and Plummer: Both [salicilin and salicylic acid] attacked fever and pain, and their partisans advocated the salicylates' use as antiseptics, mouthwashes, and water preservatives for ocean voyages; one important chemist further suggested (erroneously) that sodium salicylate, a chemical relative, would successfully treat scarlet fever, diphtheria, measles, syphilis, cholera, rabies and anthrax (5). However, it is difficult to establish what effect, if any, these examples of the "historical" uses of "proto-aspirin" had on the impetus for and modes of developing and using the actual drug called aspirin. As a matter of course, aspirin is usually described as the natural descendant from these salicylate forefathers. However, the history of aspirin is not as straightforward a tale as conventional histories suggest, but rather is a complex narrative of the people and circumstances involved in transforming a simple chemical compound into a popular pharmaceutical product that has remained one of the most widely consumed drugs for almost a century.
Towards the Future: The Continuing Evolution of the MJM
Authors: Taylor Jana
Published: February 2021

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Treatment Strategies for Alzheimer’s Disease
Authors: Gauthier Serge
Published: February 2021

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Commentary on MJM Crossroads: Human Germline Gene Therapy
Authors: Sklar Ronald
Published: February 2021

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Expanding the frontiers of the MJM
Authors: Taylor Jana
Published: February 2021

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A Friendly Word from the Editor of the McGill Medical Journal (1956/1957)
Authors: Van de Leuv John H.
Published: February 2021

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Antimicrobial Resistant Streptococcus pneumoniae Infections: Clinical and Epidemiological Trends
Authors: Kellner James , Low Donald
Published: February 2021

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The Use of AZT to Reduce the Risk of Vertical Transmission of Human Immunodeficiency Virus
Authors: Rao V. Bhargavi
Published: February 2021

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Science, Medicine and the Student
Authors: Auld Daniel
Published: February 2021

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Inhibition of Ethanol Neurotoxicity by Treatment with Growth Factors and Estrogen
Authors: Zell Jason , Montague Jeremy , Lopez Tomas , Laura Mudd
Published: February 2021

Ethanol ingestion by pregnant women is the primary cause of fetal alcohol syndrome, which is characterized by brain abnormalities and decreased mental capacity. In the present study,cultured neurons from embryonic rat cortices were used to study the effects of ethanol on cell survival and the potential for neuroprotection by certain growth factors and estrogen. Neurons were grown in the presence of a glial plane and in the absence of serum. Survival was assessed following chronic treatment with ethanol (45 mM) in the presence and absence of either nerve growth factor (NGF, 100ng/ml), basic fibroblast growth factor (bFGF, 5ng/ml), insulin-like growth factor I or II (IGF-I, IGF-II, both 10ng/ml), or estrogen (Es, 10nM) added on days one and four in vitro. On day in vitro 4 (DIV4) ethanol effects on neuronal viability were significantly prevented by NGF, bFGF, IGF-I, and Es. DIV6 survival of ethanol-treated neurons was increased significantly by treatment with NGF, bFGF, IGF-I, IGF-II, and Es. Nerve growth factor, bFGF, and IGF-I effects were shown to be dose-dependent. Administration of 1-100 ng/ml NGF, 0.05-5 ng/ml bFGF and 0.1-10ng/ml IGF-I led to statistically significant effects at 10, 5, and 1 ng/ml, respectively. Thus, ethanol’s effect on neuronal survival may be inhibited by simultaneous treatment with physiological doses of these factors.
Association of Occupation and Breast Cancer Mortality in the State of Vermont, 1989-1993
Authors: Geffken Dominic F , Perry Melissa J , Callas Peter
Published: February 2021

Vermont’s breast cancer death rate is among the highest in the U.S. This study analyzed the association between breast cancer mortality and occupation in Vermont women. Given that Vermont is a rural state, one initial hypothesis was that occupational exposure to pesticides might partly explain the high death rate. Death certificate data from 1989-1993 were analyzed to determine relative risk of breast cancer death according to occupation. Case-control analysis demonstrated increased relative risk of breast cancer death for women in two broad occupational groups: 1) Executive, Administrator and Managers and 2) Professionals. Decreased relative risk of breast cancer death was seen for the occupational group of Homemaker. Data indicated that women in the occupational group of Farming, Forestry, and Fishing were not at increased risk of dying from breast cancer. The associations of occupation and breast cancer mortality in Vermont women do not differ significantly from those seen in larger U.S. studies.
Medical Challenges - In Space
Authors: Grenon Marlene , Chahine Carol
Published: February 2021

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Psychological and Human Factors in Long Duration Spaceflight
Authors: Morphew Ephimia
Published: February 2021

The spaceflight environment is characterized by temperature extremes, microgravity, solar and galactic cosmic radiation, lack of atmospheric pressure, and high-speed micrometeorites. While these factors induce a host of physiological, biomedical, and environmental stressors to flight crews, long duration spaceflight has revealed an additional group of stressors that impact crew performance and health. This paper will provide members of the medical community with a basic understanding of human-related stressors in the spaceflight environment, the effects of these stressors, and the role that the behavioral sciences (e.g., psychology, human factors, sociology, habitability) play in supporting crew health in space. Some of the current tools and methodologies used by behavioral scientists for countering spaceflight stressors and promoting crew health, productivity, and mission success will also be discussed.
Physician-Scientist Training Through MD/PhD Program
Authors: Lee Anna
Published: February 2021

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Anthrax: An Old Disease Raising New Fears
Authors: Morris Shaun
Published: February 2021

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EMERGING PATTERNS IN THE RESISTANCE TO THE MEDICALIZATION OF BIRTH IN NORTH AMERICA
Authors: Morantz-Ornstein Gillian , Haraoui Louis-Patrick
Published: February 2021

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Lady Lazarus Revisited: Reflections of a psychiatrist on the poetry and illness of Sylvia Plath
Authors: Varga Laszlo
Published: February 2021

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Complete Unilateral Absence of Trapezius Muscle
Authors: Allouh Mohammed , Mohamed Adel , Mhanni Azedean
Published: February 2021

Congenital partial absence of the trapezius muscle is a relatively common variation. Several cases of partial absence of the trapezius muscle have been reported. However, complete unilateral agenesis of this muscle has not been previously reported. In our case, a complete cadaver dissection of an 87-year-caucasian male was performed at the Department of Anatomy, College of Medicine in Saskatoon, Canada. The entire body dissection revealed a complete agenesis of the left trapezius muscle fibers. No other significant congenital anomalies were found.
Designing Inhibitors for the SARS CoV Main Protease as Anti-SARS Drugs
Authors: Bari Hamza , Awan Arif Ali
Published: February 2021

Severe Acute Respiratory Syndrome (SARS) is a serious respiratory illness reported in parts of Asia and Canada. A novel coronavirus (CoV) has been isolated and identified as the cause of the SARS for which there is currently no effective treatment. Given the epidemic, the rapid development of efficacious antiviral drugs is needed. The key replicative enzyme SARS CoV main protease (Mpro) represents an attractive target for antiviral chemotherapy. Detailed structural study of the substrate binding cavity led to the generation of a 3-D pharmacophore. Subsets of chemical structures were extracted from the commercial databases by using the defined pharmacophore. Compound mapping to the pharmacophore were docked into the substrate-binding cavity and scored. The selected chemicals were assayed against the SARS CoV Mpro for their inhibitory activity. Three of the compounds showed significant inhibition of the SARS CoV Mpro at low micromolar concentration. This study provides potential lead compounds for specific SARS CoV protease inhibitors. It also signifies the utility of computational techniques for rapid discovery of inhibitors for novel targets.
Towards a Comprehensive Understanding of Bipolar Disorder: In Vivo MRS Investigation of the Phosphatidylinositol Cycle
Authors: McGrath Brent M.
Published: February 2021

At present, both the neuropathophysiology of bipolar disorder as well as the mechanism(s) through which current mood-stabilizing agents provide symptom relief are unknown. Through the recent utilization of magnetic resonance spectroscopy (MRS), progress has been made; with optimistic interest being focused on the phosphatidylinositol (PI) cycle as a likely neuropathophysiological factor in bipolar disorder. The present manuscript reviews this interesting and promising area, placing emphasis on the magnetic resonance spectroscopy investigations of PI- cycle function in bipolar disorder reported to date. While relatively few well-designed MRS studies have investigated PI-cycle function in bipolar disorder, current evidence does lend support to PI-cycle involvement in bipolar neuropathophysiology as a means through which mood-stabilizing agents act; pointing to PI-cycle dysfunction as an important neuropathophysiological factor in bipolar disorder. However, there still remains a dearth of information about this interesting hypothesis. In addition to lithium, more data is needed regarding the effects on PI-cycle function of the other commonly prescribed mood-stabilizing agents. As well, studies investigating the temporal relationship between medication effect on PI-cycle functioning and symptom improvement are warranted. In tandem with clinical MRS investigation of bipolar disorder, further preclinical study of the neurochemical effects of mood-stabilizing agents is needed. Finally, greater methodological rigor needs to be implemented during the design phase of any future MRS investigation into bipolar disorder, with particular attention aimed at recruiting a large homogenous sample of bipolar patients.
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Authors: Pankhania Mayur
Published: February 2021

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The Why and the How of Evidence-Based Medicine
Authors: Lang Eddy
Published: February 2021

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Female Sexual Dysfunction in Married Medical Students
Authors: Roodsari Alaleh Asghari , Khademi Afsaneh , Hamed Ehsan Akbari , Tabatabaiifar Seideh Leila , Alleyassin Ashraf
Published: February 2021

Background: Sexuality and its manifestation constitute some of the most complex of human behavior. Sexual dysfunction is more prevalent in women than in men. Prevalence of the subgroups of female sexual disorders is: desire disorder in 5-46%, arousal disorders in 7-10% and orgasmic disorders in 7- 10%. The objective of our study was to measure the prevalence of female sexual dysfunction in female medical students. Materials and Methods: Thirty two medical students participated in the study. The mean age was 24.30± 1.29 years. Duration of marriage was 2.68±1.5 years. Their husbands’ education ranges from secondary school diploma to PhD. Persian version of Sexual Function Questionnaire (SFQ) was piloted among medical students with and without chief complaint of female sexual dysfunction. Results: Prevalence of an abnormal score in each subgroup of SFQ was as follows: 20.0% in desire, 56.7% in arousal sensation, 33.3% in arousal lubrication, 36.7% in orgasm, 6.7% in pain and 20.0% in enjoyment. In our study 40.0% had sexual problems at least in one subgroup and 6.7% had problems in all subgroups. Only 2 participants were unsatisfied with their sexual life and seeking for any treatment. Discussion: In this study, prevalence of Female Sexual Dysfunction (FSD) ranges from 6.7% to 56.7% in subgroups of the disorder. Solving social problems have critical effect on quality of life. Evaluation of FSD is important in total and especially in women who are university educated and will be occupied in essential positions.
The physician as leader
Authors: Carsen Sacha , Xia Chenjia
Published: February 2021

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An Element of Hope: Radium and the Response to Cancer in Canada, 1900-1940, by Charles Hayter
Authors: Stein Richard
Published: February 2021

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Student Journals: Facilitating Medical Student Research And Physician-Scientist Development
Authors: Lin Steven
Published: February 2021

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Ventilatory management in extremely low birth weight infants
Authors: Morris Shaun , Choong Karen
Published: February 2021

The improvement in survival in premature infants associated with the evolution of mechanical ventilation has been accompanied by an increase in ventilator induced lung injury. High frequency ventilation has been shown to reduce the incidence of ventilator induced lung injury and hence chronic lung disease in the very low birth weight infant. The evolution in understanding how to best use high frequency ventilation in this population has prompted us to ask whether similar strategies to optimize lung volumes on conventional mechanical ventilation can minimize chronic lung disease in the neonate. We retrospectively reviewed the medical charts of 51 extremely low birth weight infants born in Kingston, Ontario in two epochs, 1990 to 1991 and 1999 to 2000, for ventilatory strategy and outcome. From our review, it is clear that surfactant therapy rapidly changes lung mechanics by improving pulmonary compliance and that lung damage may result if there are not changes in the ventilatory management to reflect the altered compliance. Early ventilation strategies during the apparently stable "honeymoon period" in a patient with respiratory distress syndrome (RDS) has significant implications on long term morbidity. In the era prior to the use of surfactant, 30% of infants died and 40% developed chronic lung disease (CLD). Immediately following the use of surfactant, mortality was reduced to 18%, however, the incidence of CLD increased to 78%. In the most recent era, following 10 years of experience with surfactant and mechanical ventilation, morbidity was 17% and CLD 21%. This study demonstrates that a particularly crucial time is in the immediate period following surfactant administration. The use of lower peak inspiratory pressure (PIP) and mean airway pressure (MAP) over the first 24 hours and an increase in the use of synchronous intermittent mandatory ventilation (SIMV) was associated with an improved outcome. The challenge remaining is to determine how to best utilize a conventional mode of ventilation to best optimize lung volume and protect the immature lung.
Scrutinized: The TRIPS Agreement and Public Health
Authors: Subhan Junaid
Published: February 2021

The World Trade Organization's (WTO's) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) of 1994 seeks to implement a uniform set of intellectual property protection across member nations to provide greater stability in international economic relations. Critics argue that the TRIPS agreement provides unnecessarily strong protection of intellectual property rights which serves to prevent the ill in developing nations from having access to affordable essential medications. The first recommendation that this paper makes is to provide two sets of intellectual property protection, one that applies to essential medications such as AIDS drugs and certain antibiotics and another that applies to drugs that treat non-life threatening conditions. The second recommendation builds upon the first recommendation: if two sets of intellectual property protection legislation are enacted, patents on essential medications should be restricted to patents on processes rather than the product itself. The third recommendation seeks to amend the language of the TRIPS agreement to make it obligatory for member nations to implement provisions on compulsory licensing within their domestic legislation.
The three princes of Serendip - Notes on a mysterious phenomenon
Authors: Colman David R.
Published: February 2021

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Accounting signifiers, political discourse, popular resistance and legal identity during Pakistan Steel Mills attempted privatization
Authors: Ashraf MJ , Muhammad F , Hopper Trevor
Published: February 2021

© 2018 Elsevier Ltd Using the privatization of Pakistan Steel Mills (PSM)as an empirical site and drawing on Laclau and Mouffe's (1985)discourse theory, this paper traces the discursive struggle between two discourses on the valuation and privatization of PSM. Specific signifiers were articulated and re-articulated into different chains of equivalence to create an appeal for each discourse surrounding the steel mill's valuation. The anti-privatization discourse's ‘success’ derived from its ‘interdiscursivity’ i.e. drawing on disparate signifiers from different meta-discourses; accounting, nationalism, state corruption and ‘informal’ signifiers such as ‘family silver’, ‘market value’ and ‘throw away price’. In contrast, the pro-privatization discourse drew on a homogenous (financial)economics discourse using more formal and technical signifiers such as ‘going concern’ and ‘sensitivity adjusted discounted cash flow value’. The anti-privatization discourse, with its diverse and informal (accounting)signifiers gained ‘empirical validity’, ‘narrative fidelity’, ‘and experiential commensurability’, appealed more to the masses, the media, and the judiciary. It convinced them selling PSM was a grave injustice, which must be prevented. Hence the Supreme Court reversed the privatization decision, which soured executive-judiciary relations, and led the military government to suspend the Chief Justice of Pakistan, and later the judiciary, media outlets, and the Constitution, which precipitated a successful social movement for an independent judiciary and the restoration of democracy. Events were shaped by the various interests of parties concerned and created new identities for them. The paper concludes by reflecting on how the findings contribute to, and add new issues for accounting research using discourse analysis.
Investment Complex of Russia: Structural Shifts
Authors: Kirichenko I. A. , Smirnov A. V.
Published: February 2021

The article presents the results of the analysis of the main parameters of the investment sphere development over the past twelve years. The base year for comparison is pre-crisis 2007. We considered the main trends in the development of investment activity both for the full range of enterprises and organizations, and for large and medium-sized enterprises (without small businesses and the volume of investment that is not observed by direct statistical methods). We concluded that it is advisable to base further research on data collected by Rosstat for large and medium-sized enterprises., We grouped economic activities into 14 homogeneous industry complexes to identify areas of activity in the investment sphere. We carried out the analysis of sources of financing for investment activities in the context of own and attracted funds. The specific section of investments is linked to the investigation by economic sectors since it is the nature of the industry and its functionality that determine its specific structure. As a result of the analysis of the investment sphere, the authors have established the extreme instability of investment dynamics in recent years, identified problem points in the field of investment, the solution of which will contribute to the growth of investment activity in the country.