bluuebunny/crossref_metadata_2025 huggingface dataset:
The diagnostic challenge of a tuberculous cold abscess of the epididymis: a case report
Authors: Undie Celsus Ukelina , Jibrin Paul , Nnana Ewomazino Ibanga , Torporo Kalenebari Raymond
Published: August 2022

Background

While genitourinary tuberculosis is a common form of extra-pulmonary tuberculosis, cold abscess of the epididymis is rare with our literature search finding no reports from the West African subregion. Where the index of suspicion is low, diagnosis is missed and unnecessary surgery may be performed on suspicion of a tumour. The aim of this case report is to highlight the diagnostic challenges of this condition in resource-limited settings in order to create awareness within the health community, increase the chance of appropriate diagnosis, thereby facilitating early commencement of treatment so as to avoid needless testicular loss or complications, such as infertility.

Case presentation

A 33-year-old Black African College-educated public service employee resident in Abuja, Nigeria, presented with a one-week history of right scrotal pain and swelling. Genital examination revealed a firm, non-tender epididymal mass which was initially mistaken for a malignancy. There were no constitutional symptoms, and the contralateral testis was normal. The swelling involved only the epididymis. The testis was distinctly palpable but not oedematous. There was some hemi-scrotal oedema. Blood count and urine cultures were normal. Ultrasound scan showed a hypoechogenic, uniformly enlarged epididymis. Testicular tumour markers were negative. However, CT-abdomen showed enlarged para-caval and pelvic nodes which were thought to be due to secondary deposits from a testicular tumour. Scrotal swelling was later found to be due to an abscess of the epididymis at surgery. Histology showed caseous granulomas typical of Mycobacterium tuberculosis. Gene-Xpert, a cartridge-based nucleic acid amplification test, later confirmed that patient had tuberculosis, for which he is being treated.

Conclusion

The differential diagnosis of an epididymal cold abscess from testicular tumour or chronic epididymitis can be challenging. Therefore, a high index of suspicion as well as a complete tuberculosis screen is essential in an apparently healthy patient presenting with a chronic epididymal swelling.
PhUGT78A22, a novel glycosyltransferase in Paeonia ‘He Xie’, can catalyze the transfer of glucose to glucosylated anthocyanins during petal blotch formation
Authors: Li Yang , Kong Fan , Liu Zheng’an , Peng Liping , Shu Qingyan
Published: August 2022

Background

Flower color patterns play an important role in the evolution and subsequent diversification of flowers by attracting animal pollinators. This interaction can drive the diversity observed in angiosperms today in many plant families such as Liliaceae, Paeoniaceae, and Orchidaceae, and increased their ornamental values. However, the molecular mechanism underlying the differential distribution of anthocyanins within petals remains unclear in Paeonia.

Results

In this study, we used an intersectional hybrid between the section Moutan and Paeonia, hereafter named Paeonia ‘He Xie’, which has purple flowers with dark purple blotches. After Ultra-high performance liquid chromatography-diode array detector (UPLC-DAD) analysis of blotched and non-blotched parts of petals, we found the anthocyanin content in the blotched part was always higher than that in the non-blotched part. Four kinds of anthocyanins, namely cyanidin-3-O-glucoside (Cy3G), cyanidin-3,5-O-glucoside (Cy3G5G), peonidin-3-O-glucoside (Pn3G), and peonidin-3,5-O-glucoside (Pn3G5G) were detected in the blotched parts, while only Cy3G5G and Pn3G5G were detected in the non-blotched parts. This suggests that glucosyltransferases may play a vital role in the four kinds of glucosylated anthocyanins in the blotched parts. Moreover, 2433 differentially expressed genes (DEGs) were obtained from transcriptome analysis of blotched and non-blotched parts, and a key UDP-glycosyltransferase named PhUGT78A22 was identified, which could use Cy3G and Pn3G as substrates to produce Cy3G5G and Pn3G5G, respectively, in vitro. Furthermore, silencing of PhUGT78A22 reduced the content of anthocyanidin 3,5-O-diglucoside in P. ‘He Xie’.

Conclusions

A UDP-glycosyltransferase, PhUGT78A22, was identified in P. ‘He Xie’, and the molecular mechanism underlying differential distribution of anthocyanins within petals was elucidated. This study provides new insights on the biosynthesis of different kinds of anthocyanins within colorful petals, and helps to explain petal blotch formation, which will facilitate the cultivar breeding with respect to increasing ornamental value. Additionally, it provides a reference for understanding the molecular mechanisms responsible for precise regulation of anthocyanin biosynthesis and distribution patterns.
Fetal echocardiographic parameters in pregnancies complicated by diabetes: a case control study
Authors: Darwish Amal , Abdel-Raouf Maged , Kamel Rasha , Salah Emad , Salah Mai , Okasha Ahmed
Published: August 2022

Background

At present, the prevalence of pregestational diabetes is 2.2% with an overall prevalence of hyperglycaemia in pregnancy of about 16.2%. Fetuses of diabetic mothers are at risk of functional cardiac abnormalities without structural cardiac anomalies especially in the third trimester. The main aim of this study was to assess the association of diabetes with different fetal echocardiographic parameters.

Methods

A case control study comprising a total of 120 pregnant women (60 cases and 60 controls). The cases group included fetuses of mothers known to have pre-gestational type 2 diabetes (DM group) while the control group included fetuses of euglycaemic healthy pregnant women. They were examined twice at 23–24 weeks' gestation (visit 1) and followed up at 27–28 weeks’ gestation (visit 2). The Modified Myocardial Performance Index (Mod MPI) was obtained in all fetuses. Also, M-mode echocardiography was used to measure the interventricular septum thickness at diastole in a transverse four chamber view.

Results

There was a significant increase in Iso-volumetric contraction time (ICT) (45.4 ms ± 8.9), Iso-volumetric relaxation time (IRT) (54.7 ms ± 11.22), Interventricular septal thickness (IVST) (4.08 mm ± 0.8), aortic acceleration time (AAT) (54.16 ms ± 12.77) and MPI (0.64 ± 0.09) in the diabetic group compared to the normal control group ICT (38.5 ms ± 9.59), IRT (46.13 ms ± 10.29), IVST (3.17 mm ± 0.6), AAT (49.73 ms ± 10.68) and MPI (0.5 ± 0.1) (all P values were < 0.001).

When comparing parameters assessed at both visits among diabetic patients, there was a significant increase in IVST in the second visit (4.74 ± 0.78 mm) compared to the first visit (4.08 ± 0.8 mm) (P value < 0.05).

The incidence of hypertrophic cardiomyopathy (HCM) was significantly higher in diabetic patients than in the control group. This is was observed in both first and second visit (33.4% and 56.7%) (P value < 0.001).

Conclusions

Fetuses of diabetic pregnant females show a significant increase in MPI, decrease in E\A ratio and HCM. These alterations in cardiac functions and structure were found to be continuous throughout the period of time between the two visits.
Longitudinal comparison of direct medical cost, radiological and health-related quality of life treatment outcomes between traditional growing rods and magnetically controlled growing rods from preoperative to maturity
Authors: Cheung Prudence Wing Hang , Wong Carlos King Ho , Sadiang-abay Jewel T. , Lau Sin Ting , Cheung Jason Pui Yin
Published: August 2022

Background

Magnetically controlled growing rods (MCGR) have replaced traditional growing rods (TGR) in the past decade, however, a comparison of their direct costs and treatment outcomes based on real longitudinal data is lacking. This study aims to compare the direct cost and treatment outcomes between TGR and MCGR, whilst incorporating complications, reoperations and changes in health-related quality of life (HRQoL) throughout the entire treatment course.

Methods

Patients with early onset scoliosis (EOS) who underwent initial growing rod surgery between 2003 and 2016 at a tertiary scoliosis clinic were studied with longitudinal data. Accumulated direct medical costs were calculated based on the unit cost of surgeries of each TGR and MCGR, costs incurred for any rod exchange or remedial surgery for post-operative complication. Treatment outcomes were evaluated via: Patient’s HRQoL using SRS-22r questionnaire, and radiological parameters (including major curve correction, spine length gains, spinal balance) throughout the treatment until maturity.

Results

A total of 27 EOS patients (16 MCGR, 11 TGR) were studied. Total direct cost of index surgery for MCGR was HKD$223,108 versus lower cost of HKD$135,184 for TGR (p < 0.001). At 2–3 years post-index surgery, accumulative total direct medical cost of MCGR and TGR became most comparable (TGR:MCGR ratio = 1.010) and had reached neutrality between the two groups since. Radiological parameters had no intergroup differences at maturity. For HRQoL, TGR group had shown the trend of less pain (domain score mean difference: 0.53, p = 0.024) post-index surgery and better self-appearance (domain score mean difference: 1.08, p = 0.017) before fusion. Higher satisfaction with treatment (domain score mean difference: 0.76, p = 0.029) was demonstrated by TGR patients at fusion/maturity. MCGR had negative (rs = -0.693) versus TGR’s positive (rs = 0.989) correlations (p < 0.05) of cost and SRS-22r total scores at 2–3 years post-index surgery.

Conclusions

From index surgery to maturity, TGR demonstrated better satisfaction with treatment by patients and comparable overall HRQoL with MCGR during the treatment course, as MCGR did not show apparent benefit despite less surgeries and cost neutrality between the two groups at 2–3 years post-index surgery.
Caregiver satisfaction and its associated factors in pediatric wards of Jimma University Medical Center, Southwest Ethiopia
Authors: Beshir Mohammed , Tilahun Tsion , Hordofa Diriba Fufa , Abera Gersam , Tesfaye Workineh , Daba Kumale Tolesa , Workineh Netsanet , Woldeyesus Samson Nadew , Debela Tilahun Fufa , Yesuf Elias Ali
Published: August 2022

Background

Measuring the caregivers' satisfaction is vital for the effectiveness of childcare. Children admitted to pediatric wards require special hospital situations, a bespoke approach from the medical team, and the participation of caregivers. It is important to give attention to the caregivers while planning for child services. The purpose of this study was to assess the caregiver’s satisfaction with the services provided in pediatric wards of Jimma University Medical Center and identify its associated factors.

Methods

Facility-based cross-sectional study design was done at Jimma University Medical Center. Participants in the study were primary caregivers who spent two or more days in the pediatric ward with their admitted children. Data were collected from 400 selected caregivers. A consecutive sampling method was employed. Principal component analysis was done for all Likert scale instruments to extract factor (s) representing each of the scales and to have factor scores. Variables with the Likert scale were treated as continuous after principal component analysis was employed. Using these factor scores, a multiple linear regression analysis was carried out to identify factors associated with caregivers' satisfaction with service in pediatric wards. A significance level of less than 0.05 was used in the final model to determine statistical significance.

Result

This study showed that caregivers' satisfaction with the services in the pediatric ward was 68%. Level of education (β = -0.24, (95% CI; -.411, -.070)), availability of basic facilities (β = 0.163, (95% CI; .063, .263)), patience to listen to patients' problem (β = 0.431, (95% CI; .324, .537, staff communication with client (β = 0.163, (95% CI; -4.839, -1.610)), availability of laboratory tests and its service (β = -0.964, (95% CI; -1.435, -.493)), availability of drug, imaging and service at radiology (β = 2.907, (95% CI; 1.470, 4.344)) and availability of pathology and its service (β = 1.869, (95% CI; .993, 2.746)) were significant factors associated with caregivers satisfaction with health service in pediatrics ward.

Conclusion

Caregivers were moderately satisfied. Education level, availability of basic facilities communication with client, and the availability of laboratory tests and drugs were factors that significantly associated with caregiver satisfaction. Hospital should avail laboratory tests and drugs in order to maintain high levels of caregiver satisfaction.
Changes in health-related quality of life in adolescents and the impact of gender and selected variables: a two-year longitudinal study
Authors: Mikkelsen Hilde Timenes , Småstuen Milada Cvancarova , Haraldstad Kristin , Helseth Sølvi , Skarstein Siv , Rohde Gudrun
Published: August 2022

Background

Increased knowledge about factors that can impact changes in adolescents’ health-related quality of life (HRQOL) is needed. The present study aimed to investigate possible HRQOL changes in adolescents at 14 and 16 years, and assess the impact of sociodemographic factors, gender, pain, self-esteem, self-efficacy, loneliness, and stress on HRQOL changes over time. Further, to assess HRQOL stratified by gender.

Methods

A longitudinal study involving 211 adolescents was conducted. Sociodemographic variables, pain, self-esteem, self-efficacy, loneliness, and stress were all assessed with well-validated instruments. KIDSCREEN-27 was used to measure HRQOL. Data were analyzed using independent t-tests, paired samples t-tests, and linear mixed models for repeated measures.

Results

When all variables were added to the linear mixed models, stress, loneliness, and pain were significantly, independently associated with a reduction in HRQOL change scores for four of the five KIDSCREEN subscales. Time was significantly associated with a reduction in physical and psychological well-being. Self-efficacy and self-esteem were significantly associated with an increase in HRQOL change scores for four and two subscales, respectively. Male gender was significantly negatively associated with changes in social support and peers compared to female gender.

Conclusion

Our results demonstrated a significant decline in adolescents’ HRQOL regarding physical and psychological well-being for the age range 14–16 years. Furthermore, we found that stress, loneliness, and pain have a significant negative impact on HRQOL changes, whereas self-esteem and self-efficacy have a significant positive impact. Our results highlight the importance of increased understanding regarding factors associated with changes in adolescents’ HRQOL to enable accurate and strategic interventions.
Olverembatinib (HQP1351), a well-tolerated and effective tyrosine kinase inhibitor for patients with T315I-mutated chronic myeloid leukemia: results of an open-label, multicenter phase 1/2 trial
Authors: Jiang Qian , Li Zongru , Qin Yazhen , Li Weiming , Xu Na , Liu Bingcheng , Zhang Yanli , Meng Li , Zhu Huanling , Du Xin , Chen Suning , Liang Yang , Hu Yu , Liu Xiaoli , Song Yongping , Men Lichuang , Chen Zi , Niu Qian , Wang Hengbang , Lu Ming , Yang Dajun , Zhai Yifan , Huang Xiaojun
Published: August 2022

Background

BCR-ABL1T315I mutations confer resistance to tyrosine kinase inhibitors (TKIs) in chronic myeloid leukemia (CML). Olverembatinib is a new potent BCR-ABL1 TKI with preclinical activity against T315I-mutated CML. In phase 1/2 studies, we explored the safety and efficacy of olverembatinib in Chinese adults with TKI-resistant CML in the chronic phase (CML-CP) and accelerated phase (CML-AP).

Methods

In the phase 1 study, olverembatinib was orally administered once every other day in 28-day cycles at 11 dose cohorts ranging from 1 to 60 mg, and we evaluated the maximum tolerated dose, recommended phase 2 dose (RP2D), safety, efficacy, and pharmacokinetics of olverembatinib. In the phase 2 studies, olverembatinib was administered at the RP2D of 40 mg orally on alternate days for 28-day cycles. The primary outcome measure is major cytogenetic response (MCyR) and major hematologic response by the end of Cycle 12 in CML-CP and CML-AP, respectively. Fine and Gray's hazard models were used to identify covariates associated with responses.

Results

A total of 165 patients (> 80.0% of whom had received ≥ 2 TKIs) were enrolled in this study. Among 127 patients with CML-CP, the 3-year cumulative incidences of achieving MCyR, complete cytogenetic response (CCyR), major molecular response (MMR), MR4.0, and MR4.5 were 79.0, 69.0, 56.0, 44.0 and 39.0%, respectively. The highest response rates were observed in patients with a single T315I mutation. Among 38 patients with CML-AP, the 3-year cumulative incidences of achieving MCyR, CCyR, MMR, MR4.0, and MR4.5 were 47.4%, 47.4%, 44.7%, 39.3%, and 32.1%, respectively. In multivariate analyses, baseline BCR-ABL1 mutation status was significantly associated with cytogenetic and molecular responses. Common treatment-related adverse events included skin hyperpigmentation, hypertriglyceridemia, proteinuria, and severe thrombocytopenia.

Conclusions

Olverembatinib was well tolerated, with significant antileukemic activity in adults with TKI-resistant CML-CP and CML-AP, especially those with the T315I mutation.

Trial registration: The phase 1 trial is registered at CTR20220566, and the two single-arm, open-label phase 2 studies are registered at ClinicalTrials.gov: NCT03883087 (CML-CP) and NCT03883100 (CML-AP).
Adaptive interventions to optimise the mobile phone-based smoking cessation support: study protocol for a sequential, multiple assignment, randomised trial (SMART)
Authors: Zhao Sheng Zhi , Weng Xue , Luk Tzu Tsun , Wu Yongda , Cheung Derek Yee Tak , Li William Ho Cheung , Tong Henry , Lai Vienna , Lam Tai Hing , Wang Man Ping
Published: August 2022

Background

Mobile health (mHealth) is promising in developing personalised smoking cessation interventions. By using an adaptive trial design, we aim to evaluate the effectiveness of personalised mHealth intervention in increasing smoking cessation.

Methods

This study is a two-arm, parallel, accessor-blinded Sequential Multiple-Assignment Randomised Trial (SMART) that randomises 1200 daily cigarette smokers from 70 community sites at two timepoints. In the first phase, participants receive brief cessation advice plus referral assistance to smoking cessation services and are randomly allocated to receive personalised instant messaging (PIM) or regular instant messaging (RIM). In the second phase, PIM participants who are non-responders (i.e. still smoking at 1 month) are randomised to receive either optional combined interventions (multi-media messages, nicotine replacement therapy sampling, financial incentive for active referral, phone counselling, and family/peer support group chat) or continued-PIM. Non-responders in the RIM group are randomised to receive PIM or continued-RIM. Participants who self-report quitting smoking for 7 days or longer at 1 month (responders) in both groups continue to receive the intervention assigned in phase 1. The primary outcomes are biochemical abstinence validated by exhaled carbon monoxide (< 4 ppm) and salivary cotinine (< 10 ng/ml) at 3 and 6 months from treatment initiation. Intention-to-treat analysis will be adopted.

Discussion

This is the first study using a SMART design to evaluate the effect of adaptive mHealth intervention on abstinence in community-recruited daily smokers. If found effective, the proposed intervention will inform the development of adaptive smoking cessation treatment and benefits smokers non-responding to low-intensity mHealth support.

Trial registration

ClinicalTrials.govNCT03992742. Registered on 20 June 2019.
Cone-Beam CT-assisted navigation for endovascular treatment of erection-related artery stenosis in patients with erectile dysfunction
Authors: Rosenov Alexander , Mertineit Nando , Baumgartner Iris , Schindewolf Marc
Published: August 2022

Background

Angioplasty and stenting have emerged as endovascular treatment options for arteriogenic erectile dysfunction over the past few years. Considerable anatomical variation of the erection related pelvic arteries can be challenging during these procedures, leading to time-consuming repetitive super-selective angiograms for navigation.

Technique

We report a novel technique of using C-arm Cone-Beam CT and vessel navigation software to facilitate super-selective catheterization.

Conclusion

Cone-Beam CT-guided navigation for vascular assessment of arteriogenic ED is an optional approach compared to exclusive angiographic assessment. Compared to CT angiography, C-arm Cone-Beam CT offers benefits regarding usage of contrast media and radiation exposure. It has the advantage to combine imaging with endovascular procedures in a single session, reduces time to target navigation in complex pelvic arteries anatomy and may increase therapy safety in endovascular treatment of ED.
Loss of glucosylceramide synthase impairs the growth and virulence of Fusarium oxysporum f. sp. cubense
Authors: Wang Jian , Zhang Kun , Huang Li-Qun , Bao He-Nan , Hai Na , Yang Yu-Bing , Liu Si-Wen , Li Chun-Yu , Yao Nan
Published: August 2022

Glucosylceramides are a class of membrane lipids that serve as vital structural and signaling molecules in eukaryotes. In this study, we explored the function of FocGCS, a glucosylceramide synthase (GCS) in Fusarium oxysporum f. sp. cubense tropical race 4 (Foc TR4) that causes Fusarium wilt in banana plants. FocGCS is highly expressed in germinating conidia and during early infection stage of Foc TR4. Disruption of FocGCS resulted in severely retarded vegetative growth, reduced conidiation, and production of morphologically abnormal conidia. Sphingolipid profiling revealed that the FocGCS null mutant lacks glucosylceramide. Pathogenicity assays on banana plants revealed substantial loss of virulence in the FocGCS null mutant. Moreover, biochemical analyses indicated that FocGCS is involved in cell wall integrity but is not required for oxidative and osmotic stress tolerance in Foc TR4. Transcriptome analysis suggested that disruption of FocGCS strongly affects transmembrane transport in Foc TR4. Our findings show that GCS is essential for normal fungal growth and pathogenesis in Foc TR4.
Regression Derived Staging Model to Predict Overall and Disease Specific Survival in Patients With Major Salivary Gland Carcinomas With Independent External Validation
Authors: Ramalingam Natarajan , Thiagarajan Shivakumar , Chidambaranathan Nithyanand , Singh Arjun Gurmeet , Chaukar Devendra , Chaturvedi Pankaj
Published: August 2022

PURPOSE

The current American Joint Cancer Committee (AJCC) staging system for salivary gland tumors does not include histology and grade in its classification despite their proven prognostic importance. We planned to analyze if a modified staging system integrating these two factors into the staging improves prognostic performance and then validate it externally.

MATERIALS AND METHODS

From SEER database (2000-2018), patients with major salivary gland carcinoma who underwent surgical resection between 2004 and 2015 were analyzed. Histologies were recoded into two groups based on grade and type of histology into “Low Aggression” and “High aggression” groups. Cox proportional hazards model was used to identify predictor variables for overall survival and disease-specific survival and models were generated based on least absolute shrinkage and selection operator regression. Model performance was evaluated by Akaike Information Criterion, concordance index and calibration plot. The best model chosen was externally validated from our hospital database of patients who underwent surgery for salivary gland tumor between January 1, 2012 to December 31, 2019.

RESULTS

Six thousand two hundred forty-six patients were analyzed with a median follow up of 58 months. Age > 65 years, male sex, metastatic disease, Histological Stratification, Grade of tumor, AJCC stage and Primary Site were the significant factors influencing overall survival and disease-specific survival. By least absolute shrinkage and selection operator regression method, Correlation analysis and Interaction testing by multiple regression, AJCC stage and Histological Risk stratification were used for generating four models, out of which the best model was selected by Akaike Information Criterion, C index and calibration plot. This model was then externally validated in our hospital database of 269 patients.

CONCLUSION

We propose an externally validated modified salivary gland staging system that incorporates histology and grade of tumor for improved hazard discrimination among patient subgroups.
Approach to Hypophosphatemic Rickets
Authors: Ackah Sarah A , Imel Erik A
Published: August 2022

Hypophosphatemic rickets typically presents in infancy or early childhood with skeletal deformities and growth plate abnormalities. The most common causes are genetic (such as X-linked hypophosphatemia), and these typically will result in lifelong hypophosphatemia and osteomalacia. Knowledge of phosphate metabolism, including the effects of fibroblast growth factor 23 (FGF23) (an osteocyte produced hormone that downregulates renal phosphate reabsorption and 1,25-dihydroxyvitamin-D (1,25(OH)2D) production), is critical to determining the underlying genetic or acquired causes of hypophosphatemia and to facilitate appropriate treatment. Serum phosphorus should be measured in any child or adult with musculoskeletal complaints suggesting rickets or osteomalacia. Clinical evaluation incudes thorough history, physical examination, laboratory investigations, genetic analysis (especially in the absence of a guiding family history), and imaging to establish etiology and to monitor severity and treatment course. The treatment depends on the underlying cause, but often includes active forms of vitamin D combined with phosphate salts, or anti-FGF23 antibody treatment (burosumab) for X-linked hypophosphatemia. The purpose of this article is to explore the approach to evaluating hypophosphatemic rickets and its treatment options.
FRaeppli: a multispectral imaging toolbox for cell tracing and dense tissue analysis in zebrafish
Authors: Caviglia Sara , Unterweger Iris A. , Gasiūnaitė Akvilė , Vanoosthuyse Alexandre E. , Cutrale Francesco , Trinh Le A. , Fraser Scott E. , Neuhauss Stephan C. F. , Ober Elke A.
Published: August 2022

Visualizing cell shapes and interactions of differentiating cells is instrumental for understanding organ development and repair. Across species, strategies for stochastic multicolour labelling have greatly facilitated in vivo cell tracking and mapping neuronal connectivity. Yet integrating multi-fluorophore information into the context of developing zebrafish tissues is challenging given their cytoplasmic localization and spectral incompatibility with common fluorescent markers. Inspired by Drosophila Raeppli, we developed FRaeppli (Fish-Raeppli) by expressing bright membrane- or nuclear-targeted fluorescent proteins for efficient cell shape analysis and tracking. High spatiotemporal activation flexibility is provided by the Gal4/UAS system together with Cre/lox and/or PhiC31 integrase. The distinct spectra of the FRaeppli fluorescent proteins allow simultaneous imaging with GFP and infrared subcellular reporters or tissue landmarks. We demonstrate the suitability of FRaeppli for live imaging of complex internal organs, such as the liver, and have tailored hyperspectral protocols for time-efficient acquisition. Combining FRaeppli with polarity markers revealed previously unknown canalicular topologies between differentiating hepatocytes, reminiscent of the mammalian liver, suggesting common developmental mechanisms. The multispectral FRaeppli toolbox thus enables the comprehensive analysis of intricate cellular morphologies, topologies and lineages at single-cell resolution in zebrafish.
Association of extensively drug resistant salmonella infection in children with typhoid fever
Authors: Memon Hanif , Saeed Farhan , Iqbal Muhammad , Saboohi Erum , Hanif Shahina , Mallick Abdul Hadi Hassan
Published: August 2022

Objectives: In resource limited countries facing a huge burden of multidrug resistant and extensively drug resistant (XDR) enteric fever, treatment is a great challenge on the part of a patient as well as a health care professional. This study was conducted to determine the association of XDR enteric fever with various studied factors among hospitalized culture-positive pediatric patients in a tertiary care hospital setup.
Methods: We conducted a descriptive observational study at The Karachi Adventist Hospital from July 01, 2019, to March 31, 2020 on 143 hospitalized children with culture proven enteric fever who were already on empirical antibiotics. Depending on the variability of the course of illness and clinical responses to given antibiotics, the data was gathered on a structured data sheet. Association of various study parameters and their significance in relation to XDR salmonella infection was analyzed and studied.
Results: The age group highly affected was 5-7.5 years, with a male preponderance of 61.5%. Majority were from urban slums areas of Karachi (53.8%) and 52% were admitted between 7 to 14 days of fever onset. XDR salmonella infection was observed in 79% of blood culture isolates. None of the XDR patients were consuming boiled water and neither of these infected children were vaccinated against salmonella typhi. Duration of fever before hospitalization, non-consumption of boiled or mineral water, ciprofloxacin use and lack of typhoid vaccination showed statistically strong association with XDR enteric fever (p<0.01).
Conclusion: Prehospitalization fever duration, use of boiled/mineral water, ciprofloxacin use and typhoid vaccine status showed strong association with XDR salmonella infection. Prioritizing the focus on healthcare awareness, early access to proper health care facility, discouraging over-the-counter drugs and enforcement of immunization will help decline the dissemination of this dreadful disease.
doi: https://doi.org/10.12669/pjms.38.7.5868
How to cite this:Memon H, Saeed F, Iqbal M, Saboohi E, Hanif S, Mallick AHH. Association of extensively drug resistant salmonella infection in children with typhoid fever. Pak J Med Sci. 2022;38(7):---------. doi: https://doi.org/10.12669/pjms.38.7.5868
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.
Dietary Intake patterns in women with GDM and Non-GDM: A comparative study
Authors: Nadeem Shabnam , Khatoon Aisha , Rashid Shaista , Ali Fauzia
Published: August 2022

Objectives: The study aimed to determine dietary Intake patterns in women with GDM and Non-GDM, a comparative study in a tertiary care hospital, Pakistan.

Methods: This comparative cross sectional study was conducted through questionnaire spread over a period of six months of pregnant women visiting to Abbasi Shaheed Hospital for ante-natal visit having 24 to 28 weeks of gestation. With the written consent of the participants dietary intake patterns were assessed in GDM & Non-GDM subjects by a three day 24 hours’ recalls and food frequency questionnaire. A 24-hour dietary recall chart is a dietary assessment tool in which participants were asked to recall all food and drink they have consumed in the last 24 hours. The FFQ (food frequency questionnaire) provide a list of foods and participants were asked how often they eat each item on the list. This FFQ has 70 food items. The food frequency was reported as never, per year, per month, once a week, once and a day. The reported intake of food was converted into nutrients intake (carbohydrate, protein, fat) which was calculated by reported intake frequency of each food multiplied by reported portion size and its respective nutrient composition, summing over all foods by a trained Nutritionist.

Results: A total of 75 participants with GDM, and 75 with Non-GDM were enrolled in this study over a period of six months. It was observed that dietary intake patterns have a significant association with GDM. Those who consume carbohydrate mainly containing diet have likely to have GDM. It has been seen that those who have family history of diabetes are more likely to have GDM. Family dietary patterns can affect risk of GDM. Our study has shown that timings of meals did not find have any significant association with GDM.

Conclusion: Dietary patterns strongly influence the risk of GDM. The most contributing factors to risk of GDM are higher intake of carbohydrate rich diet and lesser consumption of fruits and vegetables.

doi: https://doi.org/10.12669/pjms.38.7.5889

How to cite this:Nadeem S, Khatoon A, Rashid S, Ali F. Dietary Intake patterns in women with GDM and Non-GDM: A comparative study. Pak J Med Sci. 2022;38(7):---------. doi: https://doi.org/10.12669/pjms.38.7.5889

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.
Assessment of the toxicity of xenobiotics in aquatic organisms through targeted and un-targeted metabolomics analysis, by the use of high resolution mass spectrometry techniques
Authors: Δαμάλας Δημήτριος
Published: August 2022

Δεδομένου του μεγάλου αριθμού αναδυόμενων ρύπων (ΑΡ) στο περιβάλλον , υπάρχει ένα σημαντικό κενό στη βιβλιογραφία σχετικά με τις δυσμενείς επιπτώσεις τους στους υδρόβιους οργανισμούς. Ο αντίκτυπος των ξενοβιοτικών ενώσεων στο υδάτινο οικοσύστημα αξιολογείται σε μεγαλύτερο βάθος όταν μελετηθεί τόσο το ξενοβιοτικό μεταβόλωμα (ξενοβιοτικές ενώσεις και τα προϊόντα βιομετατροπής (ΠΒΜ) τους) όσο και το ενδο μεταβόλωμα (μεταβολίτες και λιπίδια) των υδρόβιων οργανισμών. Η μεγάλη πολυπλοκότητα των περιβαλλοντικών μητρών και ο τεράστιος αριθμός ξενοβιοτικών και ενδογενών χημικών ουσιών που δυνητικά υπάρχουν σε χαμηλές συγκεντρώσεις, αποτελούν μια αναλυτική πρόκληση. Ως εκ τούτου, η ανάπτυξη ισχυρών αναλυτικών μεθόδων που παρέχουν εκτεταμένα αναλυτικά στοιχεία είναι ζωτικής σημασίας. Εκτός από την αναλυτική πλατφόρμα που εφαρμόζεται, είναι επιβεβλημένη η δημιουργία περιεκτικών ροών επεξεργασίας δεδομένων που αξιοποιούν τα αναλυτικά στοιχεία στο μέγιστο.Ο γενικός στόχος αυτής της διατριβής ήταν να αναδείξει μια ολιστική προσέγγιση που θα προσφέρει ολοκληρωμένη κάλυψη του ξενο-μεταβολώματος και ενδο-μεταβολώματος για να επιτευχθεί ολοκληρωμένη αξιολόγηση της τοξικότητας των υδρόβιων οργανισμών που εκτίθενται σε ξενοβιοτικές ενώσεις.Σε αυτό το πλαίσιο, αναπτύχθηκε μια αναλυτική πλατφόρμα που βασίζεται σε τεχνικές τελευταίας τεχνολογίας (RPLC/HILIC-HRMS (Κεφάλαιο 3) και LC-TIMS-HRMS (Κεφάλαιο 4)) που συνδυάζει πολλαπλές διαστάσεις διαχωρισμού με φασματομετρία μάζας υψηλής διακριτικής ικανότητας, προκειμένου να παρέχει εκτεταμένα πειραματικά στοιχεία για την ταυτοποίηση ΠΒΜ και ενδογενών μεταβολιτών/λιπιδίων. Αναπτύχθηκε επίσης μια ροή εργασιών επεξεργασίας δεδομένων, αποτελούμενη από προσεγγίσεις σάρωσης ύποπτων ενώσεων και μη στοχευμένης σάρωσης, που συνδυάζει διαφορετικά εργαλεία ταυτοποίησης για την αναγνώριση της δομής των ΠΒΜ (Κεφάλαια 3 & 4). Επιπλέον, αναπτύχθηκαν ευρέως πεδίου εφαρμογής στοχευμένη και μη στοχευμένη προσέγγιση μεταβολομικής, αποτελούμενες από εξελιγμένα εργαλεία επεξεργασίας δεδομένων που μπορούν να αξιοποιήσουν δεδομένα 4-D (Κεφάλαιο 5).
Νέοι λακταμικοί στεροειδείς αλκυλιωτές αναστολείς των PARP-1/PARP-2 για τη στοχευμένη θεραπεία του καρκίνου των ωοθηκών
Authors: Νικολεουσάκος Νικόλαος
Published: August 2022

Στην παρούσα διδακτορική διατριβή ερευνάται η αντικαρκινική δράση νεοσυντιθέμενων ομο-αζα-στεροειδικών παραγώγων έναντι καρκινικών κυττάρων ωοθηκών. Ο καρκίνος των ωοθηκών αποτελεί μία από τις κυριότερες αιτίες θανάτου από καρκίνο για το γυναικείο πληθυσμό. Επί του παρόντος, η συνηθέστερη θεραπεία περιλαμβάνει χειρουργική επέμβαση και συνδυαστική χημειοθεραπεία πλατίνας / ταξανών. Ωστόσο, η θεραπεία αποδεικνύεται αναποτελεσματική για ένα μεγάλο ποσοστό των ασθενών λόγω της εμφάνισης ανθεκτικότητας στα χημειοθεραπευτικά σχήματα. Κατά συνέπεια, κρίνεται απαραίτητη η ανάπτυξη νέων θεραπευτικών προσεγγίσεων ικανών να παρακάμπτουν τη χημειο-ανθεκτικότητα και παράλληλα να βελτιστοποιούν την αποτελεσματικότητα της θεραπείας, ελαττώνοντας ταυτόχρονα τις τοξικές δράσεις των φαρμάκων. Κληρονομούμενες μεταλλάξεις στα γονίδια BRCA1 και BRCA2 έχουν συσχετιστεί με αυξημένο κίνδυνο εμφάνισης καρκίνου των ωοθηκών. Τα γονίδια αυτά εμπλέκονται στην επιδιόρθωση του DNA, μέσω του ομόλογου ανασυνδυασμού και της δίκλωνης επιδιόρθωσης του γενετικού υλικού. Οι PARPs, με έμφαση στην PARP-1 και PARP-2 που κυριαρχούν (80% περίπου όλων των λειτουργιών), αποτελούν πρωτεϊνικά μόρια που εμφανίζονται σε ποικιλία από βιοχημικές διαδικασίες και μοριακά μονοπάτια. Ένα από αυτά, είναι ένας δεύτερος βασικός μηχανισμός επιδιόρθωσης, η επιδιόρθωση μονού κλώνου του DNA, που αναλαμβάνει σε κύτταρα με έλλειψη BRCA λειτουργικότητας και αφορά την ενεργότητα των ενζύμων PARP-1/2. Καρκινικά κύτταρα με τέτοια δυσλειτουργικότητα, αποτελούν εξαιρετικό στόχο για φαρμακευτική χρήση αναστολέων των ενζύμων PARP, αφού παρακάμπτεται η επιδιόρθωση και επέρχεται κυτταρικός θάνατος. Η μεθοδολογία της παρούσας ερευνητικής διατριβής περιλαμβάνει δύο πειραματικές προσεγγίσεις: Η πρώτη αφορά τον in silico σχεδιασμό, την αξιολόγηση των ADMET ιδιοτήτων και της ανασταλτικής προς τις PARP λειτουργίας μέσω μοντελικής μοριακής πρόσδεσης (molecular docking), αλλά και τη σύνθεση όσων νέων αζωτούχων στεροειδών μορίων προκριθούν από τις παραπάνω διαδικασίες, ενώ η δεύτερη επικεντρώνεται στην αξιολόγηση της βιολογικής δραστηριότητας τους in vitro και μοριακά, μέσω μεθόδων MTT, χρωματομετρίας ELISA και PCR ως προς την κυτταροτοξικότητα, την αναστολή της PARP και τις μεταγραφικές τους επιδράσεις αντίστοιχα. Τα νέα μελετούμενα μόρια έχουν δομή υβριδικών- λακταμικών στεροειδών παραγώγων, συζευγμένα με αλκυλιωτές, δηλαδή τοξικά μόρια που προκαλούν βλάβη στο DNA. Από τα αποτελέσματα της μελέτης, αποδεικνύεται ότι αποτελούν αντικαρκινικούς παράγοντες με εξειδικευμένη κυτταροτοξική δράση ενάντια στα καρκινικά κύτταρα, ενώ παράλληλα εμφανίζουν μειωμένη τοξικότητα και σημαντική ανασταλτική δράση προς τις πρωτεΐνες PARP-1 και PARP-2.
Μελέτη ηχωκαρδιογραφικών δεικτών σε ασθενείς με ανεπάρκεια μιτροειδούς που αντιμετωπίστηκαν με διακαθετηριακή επιδιόρθωση (EDGE- to - EDGE repair)
Authors: Παπαδόπουλος Κωνσταντίνος
Published: August 2022

Σκοπός αυτής της μελέτης είναι να αναγνωρίσει προγνωστικούς δείκτες ηχοκαρδιογραφικής και κλινικής ανταπόκρισης και ανάστροφης αναδιαμόρφωσης της αριστερής κοιλίας (LV) σε ασθενείς με λειτουργική ανεπάρκεια μιτροειδούς (FMR) που έλαβαν θεραπεία με MitraClip.Αναλύσαμε αναδρομικά 86 ασθενείς υψηλού χειρουργικού κινδύνου με σοβαρή FMR. Από αυτούς, στους 58 εμφυτεύτηκε συσκευή MitraClip και 28 έλαβαν συντηρητική φαρκαμευτική θεραπεία και λειτούργησαν ως ομάδα ελέγχου. Κατά την έναρξη και στην παρακολούθηση του ενός έτους, πραγματοποιήσαμε κλινική και υπερηχοκαρδιογραφική αξιολόγηση για την εκτίμηση της μυοκαρδιακής παραμόρφωσης της αριστερής κοιλίας (GLS) και του μυοκαρδίου έργου (global work index-GWI, global constructive work-GCW, global wasted work-GWW, global work efficiency-GWE).Η ανεπάρκεια μιτροειδούς (MR) μειώθηκε σημαντικά μετά την εμφύτευση MitraClip (3.7±0,4 έναντι 1.7±0.8, p<0.001) και συσχετίστηκε με βελτίωση των επιπέδων του νατριουρητικού πεπτιδίου (BNP) (980±1027 έναντι 38±3 pg/ml, p<0.001), βελτίωση της New York Heart Association (NYHA) λειτουργικής κατάστασης καρδιακής ανεπάρκειας (3.2±0.55 vs 2.0±0.6, p<0.001), βελτίωσης της εξάλεπτης δοκιμασίας (233±154 vs 286±114m, p=0.01), μείωση του τελοσυστολικού και τελοδιαστολικού όγκου της αριστερής κοιλίας (152±68 έναντι 136±43 ml, p=0.004 & 219±74 έναντι 193±66 ml, p=0.001, αντίστοιχα). Η διαδικασία MitraClip συσχετίστηκε με βελτίωση της απόδοσης της ΑΡ κοιλίας και σημαντική αύξηση του GWI (607±282 έναντι 650±260mmHg%, p=0.045) και του GCW (854±288 vs 949±325mmHg%, p<0.001). Το αρχικό κλάσμα εξώθησης (EF), το GLS, το GWI, το GCW και το παλινδρομούν στόμιο (EROA) ήταν οι μεταβλητές που συσχετίστηκαν με τη μείωση του LVEDV ένα χρόνο μετά την παρέμβαση (p<0.05 για όλους) και το αρχικό GCW ήταν η μόνη μεταβλητή που σχετίστηκε με μείωση του LVESV (p=0.002). Η ROC curve ανάλυση εντόπισε ότι μια τιμή αποκοπής GLS -8.65% (AUC 0.815, p=0.007) συσχετίστηκε με μείωση 20% του LVEDV με ευαισθησία και ειδικότητα 72% και 70% αντίστοιχα και ότι μια τιμή αποκοπής GCW 846 mmHg% (AUC 0.759, p=0.007) συσχετίστηκε με 10% μείωση του LVESV με ευαισθησία και ειδικότητα 79% και 74% αντίστοιχα.Η επιδιόρθωση της μιτροειδούς βαλβίδας με MitraClip έχει θετική κλινική και ηχοκαρδιογραφική επίδραση σε ασθενείς με FMR ένα χρόνο μετά την εμφύτευση. Οι διατηρημένες αρχικές τιμές GLS και GCW φαίνεται να σχετίζονται με την αντίστροφη αναδιαμόρφωση της LV μετά την παρέμβαση.
The influence of strategic innovation management on firm innovation performance in the Indonesian mid-size telecommunication industry
Authors: Rismayani Risris , Manuel Bram , Latifah Umi
Published: August 2022

Background: The telecommunication industry was one of the Indonesian government's priorities in the national development plan 2015-2035. “Primary Industry” was the term for the priority industries with the central role as the prime mover in the future national economy. Various natural, human, technological, innovative, and creative resources were imperative in supporting the underlining national industry development plan. Strategic innovation management refers to the entire sequence of innovation practices, including competition mechanism analysis, such as creating an innovative vision, business strategy alignment, disseminating strategy at an entire organizational level, market tendency, technology, and competitor’s action. Firm innovation performance refers to the measurement of innovation efficiency (the number of new products, product novelty, new product development speed, and new product success rate) and innovation profitability (new product revenue proportion, quality enhancement, cost reduction, and value improvement) conducted by the firm. This study investigates the effect of Innovation Strategy, Organizational Structure, Innovation Culture, Technological Capability, and Customer-Supplier Relationship (these were the practice of Strategic Innovation Management mentioned in various literature) on Firm Innovation Performance. 

Methods: A quantitative method, from a practical perspective, was employed to investigate the causal relationship between strategic innovation management and firm innovation performance. Data was gathered through a validated and reliable questionnaire disseminated to 90 respondents. It included a representative from the four sub-sectors of the telecommunication industry, namely fixed networks, wireless networks, telecommunication services, and special telecommunication. 

Results: The survey found that firms within the telecommunication industry already employed Strategic Innovation Management practices. Moreover, this study also found that Innovation Culture, Technological Capability, and Customer-Suppler Relationship significantly influence Firm Innovation Performance. 

Conclusion:  

The implementation of Strategic Innovation Management in the mid-size companies within Indonesia's telecommunication industry appears to be relatively high. It indicates that firms within the industry were able to strategically compete by implementing Strategic Innovation Management.
Pain treatment in patients with renal insufficiency
Authors: Gras-Ozimek Jordi , Kozinska Urszula
Published: August 2022

Chronic pain is experienced by the majority of patients with renal insufficiency. Pain management in patients with chronic kidney disease is difficult because a significant part of painkillers is excreted through the kidneys, therefore side effects are more common among this population. The aim of this review is to draw attention to the available pain management options in patients with CKD based on an analysis of published articles. The following article is based on the literature found in the pubmed database. Treatment should include pharmacological, non-pharmacological methods and treatment of comorbidities, whereas patients should be carefully monitored for side effects and possible complications. More research is needed in this area.
An exploration of undergraduate nursing students' experiences of mentorship in an Irish hospital
Authors: Baxter Gerard , McGowan Brian
Published: August 2022

Background:

Mentorship is the support model of choice for nursing practice in Ireland and although it follows a similar approach to that provided thus far in the UK, there is little available evidence about the students' lived experience of mentorship and the extent to which it facilitates their development.

Aim:

To explore undergraduate nursing students' experiences of mentorship in hospital.

Method:

The study used a qualitative approach. Newell and Burnard's (2011) 6-stage pragmatic approach to qualitative data analysis guided the collection and analysis of data. A purposive sample of six was drawn from fourth-year students who participated in a semi-structured interview.

Findings:

Six main categories emerged from the data: reality versus expectation of mentorship; student's perception of self; personal feelings and expectations of mentorship; perception of workload; barriers and enablers of mentorship; student perceptions of mentor preparedness. Interpersonal relationships between student and mentor were a pivotal concept in all of the categories. Despite its flaws, participants felt that the concept of mentorship was valuable and worthwhile.

Conclusion:

This study has shown that the personal and interpersonal aspects of mentorship can have both positive and negative effects on the participants' development as nurses. Although students felt that they achieved their learning outcomes, there were times when this was despite guidance from their mentors. Although this was a small study, the generalisability of the findings and conclusions to similar clinical contexts is likely to be high.
Multisystem involvement in COVID-19: what have we learnt?
Authors: Mangion Kenneth , Berry Colin
Published: August 2022

The COVID-19 illness trajectory involves persistent cardio-renal inflammation, activation of the haemostatic pathway and lung involvement. Results of a study carried out by the authors' team demonstrate a link between post-COVID-19 syndrome (people who have long COVID) and multisystem disease, which partly explains the lingering impairments in patient-reported health-related quality of life, physical function and psychological wellbeing after COVID-19. This article discusses what hospital physicians need to be aware of when considering the likelihood of myocarditis in patients with post-COVID-19 syndrome and the implications in the longer term.