bluuebunny/crossref_metadata_2025 huggingface dataset:
Relative contributions of various endogenous and exogenous factors to the mosquito microbiota
Authors: Bogale Haikel N. , Cannon Matthew V. , Keita Kalil , Camara Denka , Barry Yaya , Keita Moussa , Coulibaly Drissa , Kone Abdoulaye K. , Doumbo Ogobara K. , Thera Mahamadou A. , Plowe Christopher V. , Travassos Mark , Irish Seth , Serre David
Published: December 2020

Background

The commensal microbiota of mosquitoes impacts their development, immunity, and competency, and could provide a target for alternative entomological control approaches. However, despite the importance of the mosquito/microbiota interactions, little is known about the relative contribution of endogenous and exogenous factors in shaping the bacterial communities of mosquitoes.

Methods

We used a high-throughput sequencing-based assay to characterize the bacterial composition and diversity of 665 individual field-caught mosquitoes, as well as their species, genotype at an insecticide resistance locus, blood-meal composition, and the eukaryotic parasites and viruses they carry. We then used these data to rigorously estimate the individual effect of each parameter on the bacterial diversity as well as the relative contribution of each parameter to the microbial composition.

Results

Overall, multivariate analyses did not reveal any significant contribution of the mosquito species, insecticide resistance, or blood meal to the bacterial composition of the mosquitoes surveyed, and infection with parasites and viruses only contributed very marginally. The main driver of the bacterial diversity was the location at which each mosquito was collected, which explained roughly 20% of the variance observed.

Conclusions

This analysis shows that when confounding factors are taken into account, the site at which the mosquitoes are collected is the main driver of the bacterial diversity of wild-caught mosquitoes, although further studies will be needed to determine which specific components of the local environment affect bacterial composition.

Graphical Abstract
Intruder (DD38E), a recently evolved sibling family of DD34E/Tc1 transposons in animals
Authors: Gao Bo , Zong Wencheng , Miskey Csaba , Ullah Numan , Diaby Mohamed , Chen Cai , Wang Xiaoyan , Ivics Zoltán , Song Chengyi
Published: December 2020

Background

A family ofTc1/marinertransposons with a characteristic DD38E triad of catalytic amino acid residues, namedIntruder(IT), was previously discovered in sturgeon genomes, but their evolutionary landscapes remain largely unknown.

Results

Here, we comprehensively investigated the evolutionary profiles ofITs, and evaluated their cut-and-paste activities in cells.ITsexhibited a narrow taxonomic distribution pattern in the animal kingdom, with invasions into two invertebrate phyla (Arthropoda and Cnidaria) and three vertebrate lineages (Actinopterygii, Agnatha, and Anura): very similar to that of the DD36E/ICfamily. Some animal orders and species seem to be more hospitable toTc1/marinertransposons, one order of Amphibia and seven Actinopterygian orders are the most common orders with horizontal transfer events and have been invaded by all four families (DD38E/IT, DD35E/TR, DD36E/ICand DD37E/TRT) ofTc1/marinertransposons, and eight Actinopterygii species were identified as the major hosts of these families. IntactITshave a total length of 1.5–1.7 kb containing a transposase gene flanked by terminal inverted repeats (TIRs). The phylogenetic tree and sequence identity showed thatITtransposases were most closely related to DD34E/Tc1.ITshave been involved in multiple events of horizontal transfer in vertebrates and have invaded most lineages recently (< 5 million years ago) based on insertion age analysis. Accordingly,ITspresented high average sequence identity (86–95%) across most vertebrate species, suggesting that some are putatively active.ITs can transpose in human HeLa cells, and the transposition efficiency of consensus TIRs was higher than that of the TIRs of natural isolates.

Conclusions

We conclude that DD38E/IToriginated from DD34E/Tc1and can be detected in two invertebrate phyla (Arthropoda and Cnidaria), and in three vertebrate lineages (Actinopterygii, Agnatha and Anura).IThas experienced multiple HT events in animals, dominated by recent amplifications in most species and has high identity among vertebrate taxa. Our reconstructedITtransposon vector designed according to the sequence from the “cat” genome showed high cut-and-paste activity. The data suggest thatIThas been acquired recently and is active in many species. This study is meaningful for understanding the evolution of theTc1/marinersuperfamily members and their hosts.
Speech enhancement by LSTM-based noise suppression followed by CNN-based speech restoration
Authors: Strake Maximilian , Defraene Bruno , Fluyt Kristoff , Tirry Wouter , Fingscheidt Tim
Published: December 2020

Single-channel speech enhancement in highly non-stationary noise conditions is a very challenging task, especially when interfering speech is included in the noise. Deep learning-based approaches have notably improved the performance of speech enhancement algorithms under such conditions, but still introduce speech distortions if strong noise suppression shall be achieved. We propose to address this problem by using a two-stage approach, first performing noise suppression and subsequently restoring natural sounding speech, using specifically chosen neural network topologies and loss functions for each task. A mask-based long short-term memory (LSTM) network is employed for noise suppression and speech restoration is performed via spectral mapping with a convolutional encoder-decoder network (CED). The proposed method improves speech quality (PESQ) over state-of-the-art single-stage methods by about 0.1 points for unseen highly non-stationary noise types including interfering speech. Furthermore, it is able to increase intelligibility in low-SNR conditions and consistently outperforms all reference methods.
Conversion hepatectomy for advanced hepatocellular carcinoma after right portal vein transection and lenvatinib therapy
Authors: Ohya Yuki , Hayashida Shintaro , Tsuji Akira , Kuramoto Kunitaka , Shibata Hidekatsu , Setoyama Hiroko , Hayashi Hironori , Kuriwaki Kazumi , Sasaki Masato , Iizaka Masayoshi , Nakahara Osamu , Inomata Yukihiro
Published: December 2020

Background

Lenvatinib is a novel tyrosine kinase inhibitor that exhibits an antitumor effect on hepatocellular carcinoma (HCC). An established strategy that involves surgery and usage of lenvatinib for advanced HCC remains elusive.

Case presentation

A 58-year-old male patient with advanced HCC and untreated hepatitis B was referred to our hospital. The tumor at the right lobe was 10 cm in diameter with right portal vein thrombus. Because of the possible lung metastasis and concern about the remaining hepatic function after extended right hepatectomy, lenvatinib was initiated before surgery. After the confirmation of a sharp decrease of tumor markers during the 3-week lenvatinib therapy, only a right portal vein transection was done leaving the enlargement of the left lobe for improved post-hepatectomy liver function while lenvatinib therapy was continued. The laparotomy revealed that the tumor was invading the right diaphragm. After 7 weeks of lenvatinib administration after right portal vein transection, an extended right hepatectomy with resection of the tumor-invaded diaphragm was successfully done. The lung nodules that were suspected as metastases had disappeared. The patient has been doing well without any sign of recurrence for 1 year.

Conclusion

The strategy involving the induction of lenvatinib to conversion hepatectomy including the portal vein transection was effective for advanced HCC.
Regulatory sampling of industrial hemp plant samples (Cannabis sativa L.) using UPLC-MS/MS method for detection and quantification of twelve cannabinoids
Authors: Berthold Erin C. , Yang Rui , Sharma Abhisheak , Kamble Shyam H. , Kanumuri Siva R. , King Tamara I. , Popa Raluca , Freeman Joshua H. , Brym Zachary T. , Avery Bonnie A. , McCurdy Christopher R.
Published: December 2020

Background

In 2018, the Farm Bill mandated the United States Department of Agriculture to develop regulations governing the cultivation, processing, and marketing of industrial hemp. Industrial hemp is defined as Cannabis sativa L. with a total Δ-9-tetrahydrocannabinol (Δ-9-THC) content ≤0.3%. Therefore, for hemp to become an agricultural commodity, it is important to regulate production by developing standard methods for sampling and testing of the plant material.

Methods

An ultra-performance liquid chromatography-tandem mass spectrometry analytical method for the quantification of twelve cannabinoids was developed. The method was applied to a regulatory sampling trial of three hemp varieties cultivated for cannabidiol (CBD) production. Two samples were taken from 28 plants with one sample being flower only while the other was a composite sample that included flowers, leaves, and stems.

Results

The assay method was validated for specificity, range, repeatability, reproducibility, and recovery in accordance with all applicable standards for analytical methods. The results of the regulatory study indicated a significant decrease in the concentration of total Δ-9-THC and total CBD of 0.09% and 1.32%, respectively, between a flower only and a composite sample.

Conclusions

There are many factors that may influence reported total Δ-9-THC content in industrial hemp. A robust analytical method was developed to analyze hemp samples in a trial regulatory study. The results indicate that the way hemp is sampled and analyzed may influence the legality of a crop, which could have negative economic and legal consequences.
Nose to brain delivery of antiretroviral drugs in the treatment of neuroAIDS
Authors: Sarma Anupam , Das Malay K.
Published: December 2020

NeuroAIDS (Neuro Acquired Immunodeficiency Syndrome) or HIV (Human Immunodeficiency Virus) associated neuronal abnormality is continuing to be a significant health issue among AIDS patients even under the treatment of combined antiretroviral therapy (cART). Injury and damage to neurons of the brain are the prime causes of neuroAIDS, which happens due to the ingress of HIV by direct permeation across the blood-brain barrier (BBB) or else via peripherally infected macrophage into the central nervous system (CNS). The BBB performs as a stringent barricade for the delivery of therapeutics drugs. The intranasal route of drug administration exhibits as a non-invasive technique to bypass the BBB for the delivery of antiretroviral drugs and other active pharmaceutical ingredients inside the brain and CNS. This method is fruitful for the drugs that are unable to invade the BBB to show its action in the CNS and thus erase the demand of systemic delivery and thereby shrink systemic side effects. Drug delivery from the nose to the brain/CNS takes very less time through both olfactory and trigeminal nerves. Intranasal delivery does not require the involvement of any receptor as it occurs by an extracellular route. Nose to brain delivery also involves nasal associated lymphatic tissues (NALT) and deep cervical lymph nodes. However, very little research has been done to explore the utility of nose to brain delivery of antiretroviral drugs in the treatment of neuroAIDS. This review focuses on the potential of nasal route for the effective delivery of antiretroviral nanoformulations directly from nose to the brain.
Insight and challenges: mental health services in Nepal
Authors: Rai Yugesh , Gurung Deoman , Gautam Kamal
Published: December 2020

This paper describes the current state of mental health services in Nepal and reflects on the significant changes over the past decade. The main challenges to overcome are proper implementation of community-based services, the high suicide rate, stigma of mental illness, financial constraints, lack of mental health legislation and proper utilisation of human resources.
Phenome-wide and genome-wide analyses of quality of life in schizophrenia
Authors: Pazoki Raha , Lin Bochao Danae , van Eijk Kristel R. , Schijven Dick , de Zwarte Sonja ,   GROUP Investigators, Guloksuz Sinan , Luykx Jurjen J.
Published: December 2020

Background

Schizophrenia negatively affects quality of life (QoL). A handful of variables from small studies have been reported to influence QoL in patients with schizophrenia, but a study comprehensively dissecting the genetic and non-genetic contributing factors to QoL in these patients is currently lacking.

Aims

We adopted a hypothesis-generating approach to assess the phenotypic and genotypic determinants of QoL in schizophrenia.

Method

The study population comprised 1119 patients with a psychotic disorder, 1979 relatives and 586 healthy controls. Using linear regression, we tested >100 independent demographic, cognitive and clinical phenotypes for their association with QoL in patients. We then performed genome-wide association analyses of QoL and examined the association between polygenic risk scores for schizophrenia, major depressive disorder and subjective well-being and QoL.

Results

We found nine phenotypes to be significantly and independently associated with QoL in patients, the most significant ones being negative (β = −1.17; s.e. 0.05; P = 1 × 10–83; r2 = 38%), depressive (β = −1.07; s.e. 0.05; P = 2 × 10–79; r2 = 36%) and emotional distress (β = −0.09; s.e. 0.01; P = 4 × 10–59, r2 = 25%) symptoms. Schizophrenia and subjective well-being polygenic risk scores, using various P-value thresholds, were significantly and consistently associated with QoL (lowest association P-value = 6.8 × 10–6). Several sensitivity analyses confirmed the results.

Conclusions

Various clinical phenotypes of schizophrenia, as well as schizophrenia and subjective well-being polygenic risk scores, are associated with QoL in patients with schizophrenia and their relatives. These may be targeted by clinicians to more easily identify vulnerable patients with schizophrenia for further social and clinical interventions to improve their QoL.
First-in-Human Phase I Study of MP0250, a First-in-Class DARPin Drug Candidate Targeting VEGF and HGF, in Patients With Advanced Solid Tumors
Authors: Baird Richard D. , Linossi Constanza , Middleton Mark , Lord Simon , Harris Adrian , Rodón Jordi , Zitt Christof , Fiedler Ulrike , Dawson Keith M. , Leupin Nicolas , Stumpp Michael T. , Harstrick Andreas , Azaro Analía , Fischer Stefanie , Omlin Aurelius
Published: December 2020

PURPOSE

A first-in-human study was performed with MP0250, a DARPin drug candidate. MP0250 specifically inhibits both vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) with the aim of disrupting the tumor microenvironment.

PATIENTS AND METHODS

A multicenter, open-label, repeated-dose, phase I study was conducted to assess the safety, tolerability, and pharmacokinetics of MP0250 in 45 patients with advanced solid tumors. In the dose-escalation part, 24 patients received MP0250 as a 3-hour infusion once every 2 weeks at five different dose levels (0.5-12 mg/kg). Once the maximum tolerated dose (MTD) was established, 21 patients were treated with a 1-hour infusion (n = 13, 8 mg/kg, once every 2 weeks and n = 8, 12 mg/kg, once every 3 weeks) of MP0250 in the dose confirmation cohorts.

RESULTS

In the dose-escalation cohort, patients treated with 12 mg/kg MP0250 once every 2 weeks experienced dose-limiting toxicities. Therefore, MTD was 8 mg/kg once every 2 weeks or 12 mg/kg once every 3 weeks. The most common adverse events (AEs) were hypertension (69%), proteinuria (51%), and diarrhea and nausea (both 36%); hypoalbuminemia was reported in 24% of patients. Most AEs were consistent with inhibition of the VEGF and HGF pathways. Exposure was dose-proportional and sustained throughout the dosing period for all patients (up to 15 months). The half-life was about 2 weeks. Signs of single-agent antitumor activity were observed: 1 unconfirmed partial response with a time to progression of 23 weeks and 24 patients with stable disease, with the longest duration of 72 weeks and a median duration of 18 weeks.

CONCLUSION

MP0250 is a first-in-class DARPin drug candidate with suitable tolerability and appropriate pharmacokinetic properties for further development in combination with other anticancer therapies.
Male infertility due to testicular disorders
Authors: Sharma Aditi , Minhas Suks , Dhillo Waljit S , Jayasena Channa N
Published: December 2020

Context

Male infertility is defined as the inability to conceive following 1 year of regular unprotected intercourse. It is the causative factor in 50% of couples and a leading indication for assisted reproductive techniques (ART). Testicular failure is the most common cause of male infertility, yet the least studied to date.

Evidence Acquisition

The review is an evidence-based summary of male infertility due to testicular failure with a focus on etiology, clinical assessment, and current management approaches. PubMed-searched articles and relevant clinical guidelines were reviewed in detail.

Evidence Synthesis/Results

Spermatogenesis is under multiple levels of regulation and novel molecular diagnostic tests of sperm function (reactive oxidative species and DNA fragmentation) have since been developed, and albeit currently remain as research tools. Several genetic, environmental, and lifestyle factors provoking testicular failure have been elucidated during the last decade; nevertheless, 40% of cases are idiopathic, with novel monogenic genes linked in the etiopathogenesis. Microsurgical testicular sperm extraction (micro-TESE) and hormonal stimulation with gonadotropins, selective estrogen receptor modulators, and aromatase inhibitors are recently developed therapeutic approaches for men with the most severe form of testicular failure, nonobstructive azoospermia. However, high-quality clinical trials data is currently lacking.

Conclusions

Male infertility due to testicular failure has traditionally been viewed as unmodifiable. In the absence of effective pharmacological therapies, delivery of lifestyle advice is a potentially important treatment option. Future research efforts are needed to determine unidentified factors causative in “idiopathic” male infertility and long-term follow-up studies of babies conceived through ART.
Assessment of Anesthesia Capacity in Public Surgical Hospitals in Guatemala
Authors: Zha Yuanting , Truché Paul , Izquierdo Erick , Zimmerman Kathrin , de Izquierdo Sandra , Lipnick Michael S. , Law Tyler J. , Gelb Adrian W. , Evans Faye M.
Published: December 2020

BACKGROUND:

International standards for safe anesthetic care have been developed by the World Federation of Societies of Anaesthesiologists (WFSA) and the World Health Organization (WHO). Whether these standards are met is unknown in many nations, including Guatemala, a country with universal health coverage. We aimed to establish an overview of anesthesia care capacity in public surgical hospitals in Guatemala to help guide public sector health care development.

METHODS:

In partnership with the Guatemalan Ministry of Public Health and Social Assistance (MSPAS), a national survey of all public hospitals providing surgical care was conducted using the WFSA anesthesia facility assessment tool (AFAT) in 2018. Each facility was assessed for infrastructure, service delivery, workforce, medications, equipment, and monitoring practices. Descriptive statistics were calculated and presented.

RESULTS:

Of the 46 public hospitals in Guatemala in 2018, 36 (78%) were found to provide surgical care, including 20 district, 14 regional, and 2 national referral hospitals. We identified 573 full-time physician surgeons, anesthesiologists, and obstetricians (SAO) in the public sector, with an estimated SAO density of 3.3/100,000 population. There were 300 full-time anesthesia providers working at public hospitals. Physician anesthesiologists made up 47% of these providers, with an estimated physician anesthesiologist density of 0.8/100,000 population. Only 10% of district hospitals reported having an anesthesia provider continuously present intraoperatively during general or neuraxial anesthesia cases. No hospitals reported assessing pain in the immediate postoperative period. While the availability of some medications such as benzodiazepines and local anesthetics was robust (100% availability across all hospitals), not all hospitals had essential medications such as ketamine, epinephrine, or atropine. There were deficiencies in the availability of essential equipment and basic intraoperative monitors, such as end-tidal carbon dioxide detectors (17% availability across all hospitals). Postoperative care and access to resuscitative equipment, such as defibrillators, were also lacking.

CONCLUSIONS:

This first countrywide, MSPAS-led assessment of anesthesia capacity at public facilities in Guatemala revealed a lack of essential materials and personnel to provide safe anesthesia and surgery. Hospitals surveyed often did not have resources regardless of hospital size or level, which may suggest multiple factors preventing availability and use. Local and national policy initiatives are needed to address these deficiencies.
A Novel Syngeneic Immunocompetent Mouse Model of Head and Neck Cancer Pain Independent of Interleukin-1 Signaling
Authors: Heussner Matthew J. , Folger Joseph K. , Dias Christina , Massri Noura , Dahdah Albert , Vermeer Paola D. , Laumet Geoffroy
Published: December 2020

BACKGROUND:

Pain is one of the first presenting symptoms in patients with head and neck cancer, who often develop chronic and debilitating pain as the disease progresses. Pain is also an important prognostic marker for survival. Unfortunately, patients rarely receive effective pain treatment due to our limited knowledge of the mechanisms underlying head and neck cancer pain (HNCP). Pain is often associated with neuroinflammation and particularly interleukin (IL)-1 signaling. The purpose of this study is to develop a novel syngeneic model of HNCP in immunocompetent mice to examine the contribution of IL-1 signaling.

METHODS:

Male C57BL/6 mice were injected with a murine model of human papillomavirus (HPV+)–induced oropharyngeal squamous cell carcinoma in their right hindlimb to induce tumor growth. Pain sensitivity was measured via von Frey filaments. Spontaneous pain was assessed via the facial grimace scale. IL-1β was measured by quantifying gene expression via quantitative polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assay (ELISA).

RESULTS:

Pain hypersensitivity and spontaneous pain develop quickly after the implantation of tumor cells, a time when tumor volume is still insignificant. Spinal and circulating IL-1β levels are significantly elevated in tumor-bearing mice. Blocking IL-1 signaling either by intrathecal administration of interleukin-1 receptor antagonist (IL-1ra) or by genetic deletion (interleukin-1 receptor knockout [Il1r1
−/−]) does not alleviate HNCP.

CONCLUSIONS:

We established the first syngeneic model of HNCP in immunocompetent mice. Unlike inflammatory or nerve-injured pain, HNCP is independent of IL-1 signaling. These findings challenge the common belief that pain results from tissue compression or IL-1 signaling in patients with head and neck cancer.
Real-Time Injection Pressure Sensing and Minimal Intensity Stimulation Combination During Ultrasound-Guided Peripheral Nerve Blocks: An Exploratory Observational Trial
Authors: Varobieff Maxime , Choquet Olivier , Swisser Fabien , Coudray Adrien , Menace Cecilia , Molinari Nicolas , Bringuier Sophie , Capdevila Xavier
Published: December 2020

BACKGROUND:

Nerve damage can occur after peripheral nerve block (PNB). Ultrasound guidance does not eliminate the risk of intraneural injection or nerve injury. Combining nerve stimulation and injection pressure (IP) monitoring with ultrasound guidance has been suggested to optimize needle tip location in PNB. In this prospective observational study, we hypothesized that measured pairs of IP and minimum intensity of stimulation (MIS) might differentiate successive needle tip locations established by high-resolution ultrasound during PNB.

METHODS:

For this exploratory study, 240 observations for 40 ultrasound-guided PNBs were studied in 28 patients scheduled for orthopedic surgery. During the progression of the needle to the nerve observed by ultrasonography, the IP was measured continuously using a computerized pressure-sensing device with a low flow rate of solution. Stimulation thresholds and electrical impedance were obtained by an impedance analyzer coupled to the nerve stimulator at 6 successive needle positions. The median (quartile) or mean (95% confidence interval [CI]) was reported. A mixed model analysis was used, and the sample was also explored using a classification and regression tree (CART) algorithm.

RESULTS:

Specific combinations of IP and MIS were measured for subcutaneous, epimysium contact, intramuscular, nerve contact (231 mm Hg [203–259 mm Hg] and 1.70 mA [1.38–2.02 mA]), intraneural location (188 mm Hg [152–224 mm Hg] and 0.58 mA [0.46–0.70 mA]), and subparaneural location (47 mm Hg [41–53 mm Hg] and 1.35 mA [1.09–1.61 mA]). The CART algorithm shows that the optimal subparaneural needle tip position might be defined by the lowest pressure (<81.3 mm Hg) and MIS (<1.5 mA) cutoffs.

CONCLUSIONS:

Our exploratory study evaluated concepts to generate hypotheses. The combinations of IP and MIS might help the physician during a PNB procedure. A low IP and low MIS might confirm a subparaneural location, and a high IP and a low MIS might be an alert for the intraneural location of the needle tip.
Making a Strong Case for Prioritizing Muscular Fitness in Youth Physical Activity Guidelines
Authors: Faigenbaum Avery D. , MacDonald James P. , Stracciolini Andrea , Rebullido Tamara Rial
Published: December 2020

Although evidence indicates that muscular fitness is foundational for ongoing participation in active play, exercise and sport, current national and international youth physical activity guidelines underplay the critical importance of strength-building activities during this developmental phase of life. In view of troubling trends in muscular fitness in today's youth, specific recommendations to address neuromuscular deficiencies are required. An understanding of the multidimensional development of youth physical inactivity and the importance of muscular fitness are needed to have the most significant impact on youth physical activity at the population level. The mounting evidence of the detrimental effects of physical inactivity on youth warrant a review of existing physical activity recommendations and guidelines. The proposed pediatric activity pyramid recognizes the shared importance of strength, skill, and aerobic activities required for the successful implementation of sustainable youth physical activity interventions.
The effectiveness of three different 7 + 3 induction regimes in China: A retrospective analysis in adult patients with acute myeloid leukemia
Authors: Lin Peng , Zhou Boliang , Yao Haiying
Published: December 2020

Objectives: In China, for economic reasons, induction regimes for acute myeloid leukemia (AML) often involve domestically produced idarubicin (IDA) rather than imported IDA. Our objective was to compare the effectiveness of induction regimens in combination with cytarabine; involving imported or domestic IDA, or daunorubicin (DNR).

Methods: The study was conducted from 1st July 2012 to 30th November 2015 at Baoding No.1 Central Hospital. This was a retrospective cohort study of patients with newly diagnosed AML admitted to Baoding First Central Hospital, China. Patients were divided into three groups according to their treatment regimen: the IA-imported group, the IA-domestic group, and the DNR group. Clinical data, complete remission (CR), partial remission (PR), non-remission (NR) rates, and side effects were compared.

Results: Total 282 patients were enrolled, including 123 patients in the IA-imported group, 98 in the IA-domestic group and 61 in the DNR group. The IA-domestic and IA-imported groups’ remission rates were similar (P=0.123) but significantly different from the DNR group (both P<0.05). Side effects were similar in all three groups and no severe side effects were reported.

Conclusion: Cytarabine induction regimens showed similar remission rates in combination with IDA produced in China compared to imported IDA and were more effective than DNR.

doi: https://doi.org/10.12669/pjms.37.1.2563

How to cite this:Lin P, Zhou B, Yao H. The effectiveness of three different 7 + 3 induction regimes in China: A retrospective analysis in adult patients with acute myeloid leukemia. Pak J Med Sci. 2021;37(1):21-27. doi: https://doi.org/10.12669/pjms.37.1.2563

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.
Predictive value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Patients with Vaginitis
Authors: Pek Eren , Beyazit Fatma , Korkmaz Nilay Sen
Published: December 2020

Objectives: This study was conducted to evaluate the diagnostic value of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in vaginitis patients.

Methods: This cross-sectional retrospective study was performed in Afyon Dinar State Hospital between July 2016 to August 2017. A total of 64 bacterial vaginosis (BV) patients, 66 vulvovaginal candidiasis (VVC) patients and 65 age-matched control subjects were enrolled. NLR, PLR, mean platelet volume (MPV), red cell distribution width (RDW) and other conventional inflammatory marker values were recorded for all patients before and after treatment.

Results: In the BV group, NLR values were found to be elevated compared to VVC and healthy controls [2.9 (1.2-14.7), 2.1 (1.1-11.7) and 2.1 (0.8-7.0), respectively] (p=0.008). Although not found to be statistically significant, the median NLR levels of BV patients decreased from 2.9 (1.2-14.7) to 2.4 (1.2-7.0) after treatment. PLR levels did not show a statistically significant difference between the three groups (p=0.970). The cut-off value of the NLR for BV was 2.19, with 67.2% sensitivity and 63.8% specificity.

Conclusions: The present study demonstrated that NLR levels are elevated in bacterial vaginosis and NLR levels can be used as a reflection of systemic inflammatory response in vaginosis patients.

doi: https://doi.org/10.12669/pjms.37.1.2774

How to cite this:Pek E, Beyazit F, Korkmaz NS. Predictive value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Patients with Vaginitis. Pak J Med Sci. 2021;37(1):250-255. doi: https://doi.org/10.12669/pjms.37.1.2774

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.
Online Academics in Pakistan: COVID-19 and Beyond
Authors: Mumtaz Nazia , Saqulain Ghulam , Mumtaz Nadir
Published: December 2020

COVID-19 is a menace for Pakistan’s fragile and overburdened health care system and infrastructure, insidiously permeating the socio-economic fabric. Globally complete to partial shutdown of educational institutions has been enforced, transitioning from face to face to online academics. Academic institutes are floundering to withstand the brunt. Therefore, the current study was conducted to attempt to review and highlight the impact and challenges posed by transition from conventional to online academics and how to approach them, in the wake of COVID-19 pandemic with the perspective of developing countries like Pakistan. For this purpose, search for relevant literature using search engines and websites including Google, Google Scholar and Web of Science as well as Medline database was conducted with keywords “Covid-19, academics, mental health, social impact and e-learning and combination of words”. Thirty two English language, full text articles published in the last ten years from 2010 to 2020 were selected for the literature review. With this literature review, we conclude that this lockdown has caused significant distortion in the academic world yet unequal interruption in learning with significant disruptions in internal assessments and qualification examinations with developing countries like Pakistan, compounded by a compromised educational system. However, COVID-19 is spurring the case for conversion to online academics and developing countries like Pakistan are poised to develop reliable, cost effective and secure online academic system whether it is bane or boon.

doi: https://doi.org/10.12669/pjms.37.1.2894

How to cite this:Mumtaz N, Saqulain G, Mumtaz N. Online Academics in Pakistan: COVID-19 and Beyond. Pak J Med Sci. 2021;37(1):283-287. doi: https://doi.org/10.12669/pjms.37.1.2894

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.
Analysis of risk factors for lower limb deep vein thrombosis in patients after Lumbar Fusion Surgery
Authors: Li Qiang , Yu Zongxue , Chen Xiao , Zhang Wenli
Published: December 2020

Objective: To identify the risk factors of deep vein thrombosis (DVT) of lower limb in patients undergoing lumbar fusion surgeries, to provide a better understanding of DVT and take prophylactic measures.

Methods: This study was carried out in our hospital between January 2016 and February 2020, patients undergoing lumbar fusion surgeries were included and divided into DVT group and non-DVT group, and the medical data including basic demographics, clinical characteristics, operative data, and routine biochemical parameters were collected and analyzed.

Results: In the current study, 390 cases were included, 48 cases were enrolled in DVT group and 342 in non-DVT group. The incidence of DVT was 12.3%. There were significant differences in age, hyperlipemia, hypertension, occupation type, D-dimer level, hospital stay, and postoperative exercises (p<0.05), but no significant differences in gender, smoking status, drinking status, coronary heart disease, diabetes mellitus, fused segments, and operation time (p>0.05) between the two groups. In multivariate analysis, age>50 years, hypertension, D-dimer>500ug/L were independent risk factors, while postoperative exercises were protective factor for DVT.

Conclusion: Those patients undergoing lumbar fusion surgeries should take more prophylactic measures including postoperative exercises if they were elderly, or hypertensive, or have high D-dimer level, in order to decrease the incidence of DVT.

doi: https://doi.org/10.12669/pjms.37.1.3041

How to cite this:Li Q, Yu Z, Chen X, Zhang W. Analysis of risk factors for lower limb deep vein thrombosis in patients after Lumbar Fusion Surgery. Pak J Med Sci. 2021;37(1):239-243. doi: https://doi.org/10.12669/pjms.37.1.3041

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.
Efficacy of Platelet Rich Fibrin in Myringoplasty
Authors: Riaz Nida , Muhammad Ajmal , Khan Muhammad sheharyar
Published: December 2020

Objective: To determine the efficacy of usage of topical autologous platelet rich fibrin (PRF) in improving outcomes of myringoplasty regarding graft uptake and hearing improvement.

Methods: This study was conducted in the ENT department of Holy Family Hospital, Rawalpindi, over a period of six months from August 2019 to January 2020. It was designed as a prospective single blinded randomized controlled trial. The study involved a total of 50 participants in whom myringoplasty was done through post auricular approach using underlay technique. In 25 patients topical drops of PRF were used. Outcomes were compared after three months with the control group (n=25), who underwent myringoplasty without PRF.

Results: After three months follow-up, graft uptake was reported 78% and 52% in cases and controls, respectively (P=0.070). Mean hearing improvement was 18 dB and 6 dB in cases and controls, respectively (P=0.014). Postoperative infection occurred in 8% of the cases, and in 32% controls (P=0.037).

Conclusion: Topical use of Platelet-Rich Fibrin during myringoplasty results in improved graft uptake. Hence, resulting in much improved hearing, significant reduction in infection rates and decrease in perforation sizes.

doi: https://doi.org/10.12669/pjms.37.1.3059

How to cite this:Riaz N, Ajmal M, Khan MS. Efficacy of Platelet Rich Fibrin in Myringoplasty. Pak J Med Sci. 2021;37(1):212-216. doi: https://doi.org/10.12669/pjms.37.1.3059

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.
To determine the frequency of stroke and common factors leading to it after coronary artery bypass grafting
Authors: Shah Sayed Mumtaz Anwar , Rehman Mujeeb Ur , Awan Nabil I , Jan Azam
Published: December 2020

Objective: To determine the frequency of stroke and common factors leading to it after coronary artery bypass grafting.

Methods: This study was conducted at Cardiothoracic Surgery Department, Rehman Medical Institute, Peshawar. Study design was descriptive cross sectional study and the duration of the study was six months. The total sample size was 183 cases using 8.3% frequency of stroke after coronary artery bypass grafting, 95% confidence interval, 4% margin of error, using WHO sample size calculator.

Results: In this study mean age was 45 years with SD ± 1.26. Seventy five percent patients were male while 46(25%) females. Six patients (3%) patients had stroke while 177(97%) patients did not have any stroke. Among the six patients who were analyzed, all of them had Diabetes Mellitus and 50% patients had recent AMI, while only one patient had prior history of Atrial Fibrillation.

Conclusions: Diabetes Mellitus is an independent risk factor for stroke after CABG surgery. whereas, recent MI is also associated with increased incidence of stroke in post CABG patients.

Abbreviations: OPCAB: off-pump coronary artery bypass, CABG: Coronary artery bypass grafting surgery, POAF: Postoperative atrial fibrillation, MI: myocardial infarction, LMS: Left main stem, CPB: cardiopulmonary bypass, AWMI: Anterior wall myocardial infarction, AMI: Acute myocardial Infarction.

doi: https://doi.org/10.12669/pjms.37.1.3242

How to cite this:Shah SMA, Ur-Rehman M, Awan NI, Jan A. To determine the frequency of stroke and common factors leading to it after coronary artery bypass grafting. Pak J Med Sci. 2021;37(1):261-266. doi: https://doi.org/10.12669/pjms.37.1.3242

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.
Characteristics of healthcare workers who died during the fight against COVID-19 in China
Authors: Wang Yujun , Ji Yun , Wang Yuedong
Published: December 2020

Coronavirus disease 2019 (COVID-19), first reported in December 2019 in Wuhan, China, has progressed to a pandemic associated with substantial morbidity and mortality. Little is known about the healthcare workers who died fighting the disease in China. This paper analyzed the data of 78 Chinese healthcare workers who died in the fight against COVID-19 between 23 January and 2 June, 2020, and revealed the following characteristics. First, compared to the number of deaths directly attributable to COVID-19, more healthcare workers died from pre-existing disease attack induced by excessive fatigue or died from accidents. Second, the median age of the healthcare workers who died directly from COVID-19 was younger than that of the Wuhan non- healthcare workers who died of COVID 19. Third, although more women than men were involved in fighting the pandemic, more men died. Fourth, more healthcare workers died in Hubei than in other provinces. Fifth, most of the healthcare workers who died directly from COVID-19 were non-professionals.

doi: https://doi.org/10.12669/pjms.37.1.3384

How to cite this:Wang Y, Ji Y, Wang Y. Characteristics of healthcare workers who died during the fight against COVID-19 in China. Pak J Med Sci. 2021;37(1):292-294. doi: https://doi.org/10.12669/pjms.37.1.3384

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.
Genetic polymorphism of the prostasin gene in hypertensive pregnant Pakistani females
Authors: Ejaz Saima , Ali Anwar , Riffat Sumaira , Mahmood Atif , Azim Kamran
Published: December 2020

Objective: The study was performed to investigate the association of hypertension in pregnancy with prostasin gene polymorphism in Pakistani females.

Methods: This case-control study was performed at University of Karachi, Pakistan from April 2018 to May 2019. A total of 160 females, including 90 hypertensives and 70 healthy pregnant females, were recruited by purposive sampling after obtaining informed written consent. Genotyping was performed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP).

Results: The frequencies of the TC and CC genotypes were higher in hypertensive pregnant females compared to healthy controls. A significant difference was evident for CC (P=0.012) genotype; however, no significant difference was observed for TC (P=0.49) and TT genotypes (P=0.06) between control and hypertensive groups. The adjusted odds ratio for CC genotype was 6.2 (P=0.025) and 1.48 (P=0.44) for TC genotype compared to the TT genotype. There was a significantly higher prevalence of the C allele of the prostasin gene at rs12597511 in the hypertensive group, suggesting that this allele is a risk factor for hypertension and cardiovascular diseases.

Conclusion: C allele at rs12597511 of prostasin gene demonstrate as a risk factor for having hypertension in pregnancy.

doi: https://doi.org/10.12669/pjms.37.1.3666

How to cite this:Ejaz S, Ali A, Riffat S, Mahmood A, Azim K. Genetic polymorphism of the prostasin gene in hypertensive pregnant Pakistani females. Pak J Med Sci. 2021;37(1):109-113. doi: https://doi.org/10.12669/pjms.37.1.3666

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.
The prevalence and Covariates of Stroke in Khyber Pakhtunkhwa; From a European Perspective
Authors: Saeed Sahrai , Tadic Marijana , Putaala Jukka
Published: December 2020

doi: https://doi.org/10.12669/pjms.37.1.3815

How to cite this:Saeed S, Tadic M, Putaala J. The prevalence and Covariates of Stroke in Khyber Pakhtunkhwa; From a European Perspective. Pak J Med Sci. 2021;37(1):1-3. doi: https://doi.org/10.12669/pjms.37.1.3815

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.
In the preparation and administration of intravenous medicines, what are the best practice standards that healthcare professionals need to follow to ensure patient safety? Protocol for a systematic review.
Authors: Carr Peter J. , O'Connor Laura , Gethin Georgina , Ivory John D. , O'Hara Paul , O'Toole Orla , Healy Patricia
Published: December 2020

Introduction: Intravenous therapy and medicines (IVTM) are the most common invasive interventions in use in healthcare. Prescribed IVTM play an essential role in the treatment of illness, management of chronic conditions and in maintaining health and wellbeing. The intravenous (IV) route is the administration of concentrated medications (diluted or undiluted) directly into peripherally or centrally inserted vascular access devices. Medication safety is a key priority and best practice standards are required to guide the safe preparation and administration of IVTM.

Methods: We will conduct a systematic review of the literature pertaining to the preparation and administration of intravenous therapy and medicines. Our search will include studies concerned with the preparation and/or administration of IVTM via peripheral or central vascular access devices. We will be guided by the preferred reporting items for systematic review and meta-analysis (PRISMA) in this review. Literature will include all trial designs, national/international guidelines, and expert consensus opinion made available in English from 2009 to present day.

Conclusions: We will synthesise the evidence concerning safe and effective preparation and administration of intravenous therapy and medicines to inform the development of a national guideline for healthcare professionals in Ireland. The availability of up-to-date, contemporaneous evidence-based practice standards will ensure quality and safety for service-users.

Registration:  This study has been submitted to PROSPERO and we are awaiting confirmation of registration.
Reivindicación irredenta de la memoria histórica femenina: lucha desde la prisión contra las dictaduras.
Authors: Pinto Barragán Manuel
Published: December 2020

La obra de Dulce Chacón, La voz dormida (2002), apareció en el panorama literario español visibilizando los testimonios de las mujeres presas durante la dictadura franquista. La ficción de la novela propone compensar el déficit de conocimientos históricos sobre ese período y enfatizar el papel de la mujer en la lucha contra el régimen. Este estudio analiza algunos hechos históricos que aparecen en la obra de ficción y como la autora los utiliza como materia diegética para integrarlos en la memoria histórica de la lucha femenina contra los regímenes políticos.
Reflexiones sobre el ambiente cultural de Camilla Herculiana.
Authors: Muñoz Maria
Published: December 2020

Camilla Herculiana era una boticaria en Padua en el siglo XVI. En 1584 publica sus Lettere di philosophia naturale, en las que debate sobre las causas del Diluvio Universal, la naturaleza del ser humano y la formación del arco iris. Esta obra está escrita en forma de cartas con Georges Garnier y el canciller de Transilvania, Márton Berzeviczy, a quienes conoció gracias al ambiente cultural e intelectual de Padua, del que también formaban parte sus interlocutores. El objetivo de este trabajo es estudiar y destacar la importancia del ambiente en el que se formó y desarrolló su trabajo Camilla Herculiana.
Vínculos rotos. Madres e hijas en dos novelas de Lucía Etxebarria.
Authors: Zhao Xinyi
Published: December 2020

La presente investigación analiza las relaciones entre madres e hijas en dos de las novelas más sobresalientes de Lucía Etxebarria, (Beatriz y los cuerpos celestes y Un milagro en equilibrio) teniendo en cuenta tanto el contexto social en el que se desarrolla, como el discurso feminista que le sirve de marco conceptualfilosófico. En el imaginario colectivo, se tiende a concebir la madre como poseedora de virtudes propias, que tienden a satisfacer las necesidades de los hijos en lo que se refiere al amor, cuidado y protección y, sin embargo, la madre en estas dos novelas desvirtúa y contradice ese imaginario, al igual que lo hacen las hijas. Esta investigación indaga en algunos de los resortes afectivos que rigen las relaciones entre madres-hijas, en cuya maraña de amor-odio se implica la división de los roles sociales entre hombres y mujeres y la inestabilidad de la identidad femenina construida por los patrones patriarcales.