bluuebunny/crossref_metadata_2025 huggingface dataset:
Pain-guided activity modification during treatment for patellar tendinopathy: a feasibility and pilot randomized clinical trial
Authors: Sprague Andrew L. , Couppé Christian , Pohlig Ryan T. , Snyder-Mackler Lynn , Silbernagel Karin Grävare
Published: February 2021

Background

Activity modification is a key component of patellar tendinopathy treatment but there is a lack of evidence guiding activity modification prescription. Use of activity modification in treatment studies has varied widely and the impact of those recommendations has not been directly investigated or compared. The purpose of this study was to assess (1) the feasibility of using pain-guided activity modification during treatment for patellar tendinopathy and (2) if our outcome measures are responsive to changes in tendon health over the course of treatment.

Methods

This was an unblinded, randomized two-arm pilot and feasibility study randomized clinical trial with parallel assignment, conducted in Newark, DE. Individuals between the ages of 16 and 40 years old with patellar tendinopathy were included. Participants were randomly assigned to apain-guided activity(PGA) orpain-free activity(PFA) group using a spreadsheet-based randomization scheme.All participants received standardized treatment using a modified version of the heavy-slow resistance protocol 3×/week for 12 weeks. For the first 6 weeks, the PGA group used the Pain-Monitoring Model to guide activity outside of treatment and the PFA group was restricted from running, jumping, or activities that provoked their patellar tendon pain. Feasibility outcomes included recruitment, enrollment, randomization, compliance, and retention percentages. Clinical evaluations were conducted at baseline, 6, and 12 weeks to assess symptom severity, psychological factors, tendon morphology and mechanical properties, lower extremity function, and quadriceps muscle performance.

Results

In a ~ 13-month period, 108 individuals were screened, 47/108 (43.5%) were eligible for participation, and 15/47 (32.0%) of those were enrolled (9 PGA, 6 PFA). The recruitment rate was 1.15 participants/month. The mean ± SD compliance with treatment was PGA: 86.1 ± 13.0% and PFA: 67.1 ± 30.7%. There was one missed evaluation session and two adverse events, which were not due to study interventions. Changes exceeding the smallest detectable change were observed for at least one outcome in each domain of tendon health.

Conclusions

Use of pain-guided activity modification during exercise therapy for patellar tendinopathy was found to be feasible, and the proposed outcome measures appropriate. Computer-based allocation concealment, blinding of evaluators, and greater recruitment of high-level athletes should be implemented in future trials.

Trial registration

ClinicalTrials.gov identifier:NCT03694730. Registered 3rdof October, 2018.
Entomopathogenic efficacy of the endophytic fungi: Clonostachys sp. and Beauveria bassiana on Tuta absoluta (Meyrick) (Lepidoptera: Gelechiidae) larvae under laboratory and greenhouse conditions
Authors: Mohamed Mahmoud Fadhela , Bendebbah Rachida , Benssaci Bouchra , Toudji Fethia , Tafifet Lamia , Krimi Zoulikha
Published: February 2021

Background

Endophytic fungi are excellent sources of new natural bioactive products with potential for exploitation in medical, agricultural, and industrial fields. Beneficial effects of endophytes are not only limited to promoting plant growth, but also to react as plant protection agents against phytopathogenic microorganisms and plant pests. The tomato leaf miner,Tuta absoluta(Meyrick) (Lepidoptera: Gelechiidae) is one of the main tomato pests in South America and in the Mediterranean basin.

Results

In the present work, the effectiveness of two endophytic fungiClonostachysspp. andBeauveria bassianawere tested againstT.absolutalarvae. Evaluation of the larvicidal effect in the laboratory by spraying 3 concentrations (D1= 4 × 107spores/ml,D2= 4 × 106spores/ml andD3= 4 × 105spores/ml) of fungal suspensions showed remarkable efficacy, which varied depending on the tested strain, concentration of application and time of exposure. Statistical analysis showed highly significant results on larval mortality rates for both endophytic than the control. After 15 days, dead larvae were mummified. Applications of tested isolates in greenhouse experiments confirmed their marked biological control efficacy than the synthetic insecticide (Emamectin benzoat). Number of mined leaves decreased depending on the contact time of the larvae with the fungal spores.

Conclusion

Results suggest that the two endophytic fungiB. bassianaandClonostachysspp. were very effective entomopathogenic fungi againstT. absoluta. Indeed, the present study revealed the pathogenicity ofClonostachysspp. againstT. absolutalarvae for the first time.
Psoriatic Arthritis Quality of Life Questionnaire: translation, cultural adaptation and validation into Brazilian Portuguese language
Authors: Gonçalves Rafaela Silva Guimaraes , Heaney Alice , McKenna Stephen P. , Carvalho Jonas Braynner , Vidal Maria Eduarda Lima , de Brito Marina Coelho Mores , Duarte Angela Luzia Branco Pinto
Published: February 2021

Introduction

Psoriatic arthritis (PsA) is a multifaceted inflammatory disease that can cause joint destruction and impair quality of life. The Psoriatic Arthritis Quality of Life Questionnaire (PsAQoL) was the first disease-specific tool for determining the impact of the disease on the quality of life of people with PsA.

Objectives

The primary objective was to develop and validate a Brazilian Portuguese version of the PsAQoL.

Methods

The UK PsAQoL was translated into Brazilian Portuguese using two translation panels. This translation then checked for face validity and construct validity with new samples of patients. Finally, a test-retest validation study was conducted with 52 patients with PsA. The survey included the Nottingham Health Profile (NHP) as a comparator instrument.

Results

Internal consistency and reproducibility were both excellent for the new adaptation (0.91 and 0.90 respectively Scores on the PsAQoL were found to correlate as expected with the comparator measure and the instrument was able to detect differences in score related to perceived severity of PsA, general health status and presence of a flare.

Conclusion

The Brazilian PsAQoL was found easy to understand and complete and has excellent reliability and construct validity. The new measure will be a valuable new tool for use in routine PsA practice and clinical trials.
Sex-dependent liver cancer xenograft models for predicting clinical data in the evaluation of anticancer drugs
Authors: Oh Sungryong , Jung Joohee
Published: February 2021

Background

The incidence and mortality of liver cancer show a great difference between the sexes. We established sex-dependent liver cancer xenograft models and investigated whether such sex-dependent models could be used to simultaneously evaluate the therapeutic and adverse effects of anticancer drugs for drug screening.

Results

In the in-vitro test, the cytotoxicity of anticancer drugs (cisplatin, 5-fluorouracil, and doxorubicin) was compared between male- and female-derived liver cancer cell lines. Cisplatin and 5-fluorouracil exhibited cytotoxicity without sex-difference, but doxorubicin showed dose-dependently significant cytotoxicity only in male-derived cells. Our results showed a strong correlation between preclinical and clinical data with the use of sex-dependent liver cancer xenograft models. Moreover, the male-derived Hep3B-derived xenograft model was more sensitive than the female-derived SNU-387-derived xenograft model against doxorubicin treatment. Doxorubicin showed more severe cardiotoxicity in the male xenograft model than in the female model. We investigated the occurrence frequency of doxorubicin-related cardiotoxicity using data obtained from the Korea Institute of Drug Safety & Risk Management Database, but no significant difference was observed between the sexes.

Conclusions

Our results suggest that sex-dependent xenograft models are useful tools for evaluating the therapeutic and adverse effects of anticancer drugs, because sex is an important consideration in drug development.
Systematic review: total knee arthroplasty (TKA) in patients with pigmented villonodular synovitis (PVNS)
Authors: Tan Yi Chuen , Tan Jia Yin , Tsitskaris Konstantinos
Published: February 2021

Background

To determine the functional outcomes, complications and revision rates following total knee arthroplasty (TKA) in patients with pigmented villonodular synovitis (PVNS).

Materials and methods

We conducted a systematic review of the literature. Five studies with a total of 552 TKAs were included for analysis. The methodological quality of the articles was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) scale. Functional outcomes, complications and revision rates were assessed. The mean age was 61 years (range 33–94 years) and the mean follow-up period was 61.1 months (range 0.2–35 years).

Results

All the studies reported improvement in knee function following TKA. Post-operative stiffness was the most frequently reported complication, affecting 32.7% (n = 32) of patients in our review. Symptomatic recurrence of PVNS, component loosening, tibial-component fracture, instability and periprosthetic infection were the main factors leading to the need for revision TKA.

Conclusion

The findings of this review support the use of TKA to alleviate the functional limitations and pain due to knee degeneration in patients with PVNS. The operating surgeon should be aware of the increased risk of post-operative stiffness, as well as a potentially higher risk of infection. Implant survival should also be considered inferior to the one expected for the general population undergoing TKA.
High-degree atrioventricular block. An unusual presentation of Takotsubo cardiomyopathy: a case report
Authors: Revilla-Martí Pablo , Cueva-Recalde Juan F. , Linares-Vicente Jose A. , Río-Sánchez Sara , Ruiz-Arroyo Jose R.
Published: February 2021

Background

Takotsubo cardiomyopathy is a non-ischemic cardiomyopathy characterized by acute left ventricular systolic dysfunction with transient wall motion abnormalities without a culprit coronary stenosis or other concurrent diagnoses. Its coexistence with transient high-degree AV block is very infrequent.

Case presentation

A 61-year-old man presented with a new onset of high degree AV block without ST segment deviations developing an anterior and apical dyskinesia with a low left ventricular ejection fraction in the absence of coronary artery disease.

Conclusion

Atrioventricular block is an uncommon presentation of Takotsubo syndrome. The management of patients with relevant conduction disorders in this scenario is a challenge for the clinician. In case of persistence of advanced conduction disorders, it seems appropriate to implant a pacemaker.
Efficacy of heart transplantation in patients with a failing Fontan: a systematic review and meta-analysis
Authors: Hassan Wardah , Kotak Sohny , Khatri Mahima , Ahmed Areeba , Ahmed Jawad , Ali Syed Saad , Khan Taj M.
Published: February 2021

Background

As the population of patients with Fontan palliation grows, so does the number of patients with Fontan failure, necessitating heart transplantation. However, due to mainly small-sized studies, outcomes after heart transplantation in these patients remain unclear. The objective of this study was to review the available literature and conduct a meta-analysis to provide well-powered and generalizable estimates of outcomes after heart transplantation in patients with a failing Fontan.

Main text

PubMed, Embase, and MEDLINE databases were searched for original studies of patients with a failing Fontan who underwent heart transplantation. The outcomes included were 1-year and 5-year survival, acute rejection, renal dysfunction, sepsis, and multi-organ failure. Proportions were pooled using random effects models to derive pooled proportions (PPs) and corresponding 95% confidence intervals (CIs). Meta-regression analysis was done to study the effects of age and gender on key outcomes. Sixteen retrospective single-center cohort studies with 426 Fontan patients undergoing heart transplantation were included in this meta-analysis. Pooled analysis of this study further revealed that 1-year survival after heart transplantation was 79.9% ([75.8%, 83.7%]; I2 = 1.92%), and 5-year survival rate was 72.5% ([62.1%, 81.9%]; I2 = 72.12%). Secondary outcomes after heart transplantation of failed Fontan procedure were acute rejection (PP 20% [7.4%, 36.8%]; I2 = 72.48%), renal dysfunction (PP 31.3% [10.5%, 57.2%]; I2 = 75.42%), multi-organ failure (PP 18.6% [2.8 to 43.9%]; I2= 69.60%), and sepsis (PP 21.1% [9%, 36.8%]; I2 = 61.19%).

Conclusion

Cardiac transplantation in patients with a failing Fontan is associated with acceptable interventional success and improved survival rates.
Embelin: an HPTLC method for quantitative estimation in five species of genus Embelia Burm. f.
Authors: Vijayan K. P. Rini , Raghu A. V.
Published: February 2021

Background

The plants belonging to the genus Embelia, a significant tropical genus with many biological activities, are benefiting because of their robust medicinal properties. Embelin is one of the principal bioactive molecules responsible for the medicinal properties of the genus Embelia. The quantification of the embelin compound among different species in this genus has not yet been investigated, so still uncertain which species and which part should be accepted. The present study was intended to establish a speedy and precise high-performance thin-layer chromatographic (HPTLC) method for quantitative study of embelin in various plant parts of Embelia ribes, Embelia tsjeriam-cottam, Embelia basaal, Embelia adnata, and Embelia gardneriana.

Result

This research confirmed the method as per the International Conference on Harmonization (ICH) guidelines. We achieved separation on silica gel 60 F254 HPTLC plates using propanol: butanol: ammonia (7:3:7 v/v/v) as a mobile phase. Densitometry scanning performed for detection and quantification at 254 nm and 366 nm. Among the species investigated, the highest amount of embelin was found in E. ribes fruits.

Conclusion

Embelia ribes fruits are the best source of embelin. Embelin was first described in the endemic species, such as E. adnata and E. gardneriana. The method illustrated in this research may be applied for quantification of embelin and fingerprint analysis of other species within Embelia genus or described genera and chemo taxonomic studies of this genus.
Disparities in Refusal of Locoregional Treatment for Prostate Adenocarcinoma
Authors: Dee Edward Christopher , Arega Melaku A. , Yang David D. , Butler Santino S. , Mahal Brandon A. , Sanford Nina N. , Nguyen Paul L. , Muralidhar Vinayak
Published: February 2021

PURPOSE:

We assessed sociodemographic factors associated with and survival implications of refusal of potentially survival-prolonging locoregional treatment (LT, including radiotherapy and surgery) despite provider recommendation among men with localized prostate adenocarcinoma.

METHODS:

The National Cancer Database (2004-2015) identified men with TxN0M0 prostate cancer who either received or refused LT despite provider recommendation. Multivariable logistic regression defined adjusted odds ratios (AORs) with 95% CI of refusing LT, with sociodemographic and clinical covariates. Models were stratified by low-risk and intermediate- or high-risk (IR or HR) disease, with a separate interaction analysis between race and risk group. Multivariable Cox proportional hazard ratios compared overall survival (OS) among men who received versus refused LT.

RESULTS:

Of 887,839 men (median age 64 years, median follow-up 6.14 years), 2,487 (0.28%) refused LT. Among men with IR or HR disease (n = 651,345), Black and Asian patients were more likely to refuse LT than White patients (0.35% v 0.29% v 0.17%; Black v White AOR, 1.75; 95% CI, 1.52 to 2.01; P < .001; Asian v White AOR, 1.47; 95% CI, 1.05 to 2.06; P = .027, race * risk group interaction P < .001). Later year of diagnosis, community facility type, noninsurance or Medicaid, and older age were also associated with increased odds of LT refusal, overall and when stratifying by risk group. For men with IR or HR disease, LT refusal was associated with worse OS (5-year OS 80.1% v 91.5%, HR, 1.65, P < .001).

CONCLUSION:

LT refusal has increased over time; racial disparities were greater in higher-risk disease. Refusal despite provider recommendation highlights populations that may benefit from efforts to assess and reduce barriers to care.
Lateral diffusion on a frozen random surface
Authors: Ohta Takao , Komura Shigeyuki
Published: February 2021

The lateral diffusion coefficient of a Brownian particle on a two-dimensional random surface is studied in the quenched limit for which the surface configuration is time independent. We start with the stochastic equation of motion for a Brownian particle on a fluctuating surface, which has been derived by Naji and Brown. The mean square displacement of the particle projected on a base plane is calculated exactly under the condition that the surface with a constant shape has no spatial correlation. We prove that the obtained lateral diffusion coefficient is in between the known upper and lower bounds.
Lower and upper bounds for unilateral coherence and applying them to the entropic uncertainty relations
Authors: Dolatkhah H. , Haseli S. , Salimi S. , Khorashad A. S.
Published: February 2021

In this paper, a method is provided for obtaining the entropic uncertainty relations in the presence of a quantum memory by using quantum coherence. In the method, firstly, one can use the quantum relative entropy of quantum coherence to obtain the uncertainty relations. Secondly, these relations are applied to obtain the entropic uncertainty relations in the presence of a quantum memory. In comparison with other methods this approach is much simpler. Also, for a given state, the upper bounds on the sum of the relative entropies of unilateral coherences are provided, and it is shown which one is tighter. In addition, using the upper bound obtained for unilateral coherence, the nontrivial upper bound on the sum of the entropies for different observables is derived in the presence of a quantum memory.
Cushing Syndrome in a Pediatric Patient With a KCNJ5 Variant and Successful Treatment With Low-dose Ketoconazole
Authors: Tatsi Christina , Maria Andrea G , Malloy Cole , Lin Lin , London Edra , Settas Nick , Flippo Chelsi , Keil Meg , Hannah-Shmouni Fady , Hoffman Dax A , Stratakis Constantine A
Published: February 2021

Context

Pathogenic variants in KCNJ5, encoding the GIRK4 (Kir3.4) potassium channel, have been implicated in the pathogenesis of familial hyperaldosteronism type-III (FH-III) and sporadic primary aldosteronism (PA). In addition to aldosterone, glucocorticoids are often found elevated in PA in association with KCNJ5 pathogenic variants, albeit at subclinical levels. However, to date no GIRK4 defects have been linked to Cushing syndrome (CS).

Patient

We present the case of a 10-year-old child who presented with CS at an early age due to bilateral adrenocortical hyperplasia (BAH). The patient was placed on low-dose ketoconazole (KZL), which controlled hypercortisolemia and CS-related signs. Discontinuation of KZL for even 6 weeks led to recurrent CS.

Results

Screening for known genes causing cortisol-producing BAHs (PRKAR1A, PRKACA, PRKACB, PDE11A, PDE8B, ARMC5) failed to identify any gene defects. Whole-exome sequencing showed a novel KCNJ5 pathogenic variant (c.506T>C, p.L169S) inherited from her father. In vitro studies showed that the p.L169S variant affects conductance of the Kir3.4 channel without affecting its expression or membrane localization. Although there were no effects on steroidogenesis in vitro, there were modest changes in protein kinase A activity. In silico analysis of the mutant channel proposed mechanisms for the altered conductance.

Conclusion

We present a pediatric patient with CS due to BAH and a germline defect in KCNJ5. Molecular investigations of this KCNJ5 variant failed to show a definite cause of her CS. However, this KCNJ5 variant differed in its function from KCNJ5 defects leading to PA. We speculate that GIRK4 (Kir3.4) may play a role in early human adrenocortical development and zonation and participate in the pathogenesis of pediatric BAH.
Development of a Predictive Enrichment Marker for the Oral GH Secretagogue LUM-201 in Pediatric Growth Hormone Deficiency
Authors: Bright George M , Do Minh-Ha T , McKew John C , Blum Werner F , Thorner Michael O
Published: February 2021

Context

We hypothesize, based on the degree of residual hypothalamic-pituitary function, that some, but not all, children with growth hormone deficiency (GHD) may have beneficial growth responses to the orally administered growth hormone (GH) secretagogue LUM-201.

Objective

To determine if pretreatment testing can identify predictive enrichment markers (PEM) for subjects with adequate residual function who are responsive to LUM-201.

Methods

We performed an analysis of a completed, randomized, placebo-controlled trial of LUM-201, a GH secretagogue receptor agonist, in which all randomized subjects had pretreatment testing.

This international multicenter study conducted in pediatric endocrinology clinics included 68 naïve-to-treatment, prepubertal children with established diagnoses of GHD. Outcome measures included the sensitivity, specificity, and predictive accuracy of potential markers to predict 6-month growth responses to oral LUM-201 and daily rhGH.

Results

Two PEM were identified for use in defining PEM-positive status: (1) baseline insulin-like growth factor I (IGF-I) concentration >30 ng/mL and (2) peak GH response of ≥5 ng/mL upon administration of single-dose LUM-201. PEM-positive status enriches a population for better growth responses to LUM-201. PEM-negative status enriches a population for better growth responses to rhGH.

Conclusion

Combined, the peak GH response to single-dose LUM-201 and the baseline IGF-I concentration are effective PEMs for 6-month growth responses to LUM-201 and rhGH in prepubertal children with GHD.
The Financial Transmission of Housing Booms: Evidence from Spain
Authors: Martín Alberto , Moral-Benito Enrique , Schmitz Tom
Published: February 2021

How does a housing boom affect credit to non-housing firms? Using bank, firm, and loan-level microdata, we show that the Spanish housing boom reduced non-housing credit growth during its first years, but stimulated it later on. These patterns can be rationalized by financial constraints for banks. Constrained banks initially accommodated higher housing credit demand by reducing non-housing credit. Eventually, however, the housing boom increased bank net worth and expanded credit supply. A quantitative model, disciplined by our cross-sectional estimates, indicates that the crowding-out effect was substantial but temporary, and had been fully absorbed by the end of the boom. (JEL E32, E44, G21, R21, R31)
Association amid the comorbidity of Diabetes Mellitus in patients of Active Tuberculosis in Pakistan: A matched case control study
Authors: Khalid Nadia , Ahmad Farah , Qureshi Farhan Muhammad
Published: February 2021

Objectives: This study aims to test the association between diabetes and tuberculosis.

Methods: It is a matched case control study conducted in tertiary care hospitals in 2019-2020. Cases and controls were 144 each, selected on the basis of an odds ratio of 2 at 95% confidence interval with a significance level of 5%. Cases of pulmonary tuberculosis were selected through consecutive sampling technique, either visiting OPD or admitted in hospital. Controls were taken from the general population and frequency matching was done based on age, gender and socioeconomic status. Data was collected through structured questionnaire after taking written consent. Data was analyzed on SPSS version 23. Binary Logistic regression model was applied for finding association between the risk factors and the disease. P value <0.05 was considered statistically significant.

Results: Out of all cases and controls, 45% and 20% were diabetics respectively. The association between the risk factors and tuberculosis was estimated by univariate analysis, positive association was found between diabetes and tuberculosis (OR= 3.32), a high frequency of diabetes in cases as compared to controls were observed with a highly significant p- value (<0.001).

Conclusions: This study provides evidence for a strong positive association between tuberculosis and diabetes.

doi: https://doi.org/10.12669/pjms.37.3.3274

How to cite this:Khalid N, Ahmad F, Qureshi FM. Association amid the comorbidity of Diabetes Mellitus in patients of Active Tuberculosis in Pakistan: A matched case control study. Pak J Med Sci. 2021;37(3):816-820. doi: https://doi.org/10.12669/pjms.37.3.3274

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.
Rare Variant of Adult Rhabdomyosarcoma Presenting as a Palatal Swelling
Authors: Iqbal Hafiz Aamer , Anjum Rabia , Naseem Nadia
Published: February 2021

A 26-year-old male was referred to the Department of Oral and Maxillofacial Surgery of a tertiary care hospital in Lahore with chief complaint of painless swelling on the right palate of 40 days duration. Clinical differential diagnosis included squamous cell carcinoma, Ewing sarcoma, fibrosarcoma, neuroblastoma and rhabdomyosarcoma. Computed tomography scan revealed hypodense mass with necrotic changes. Histological examination of the excised tumor revealed malignant neoplasm arranged in fascicles and bundles comprising of spindle cells with pleomorphic, hyperchromatic nuclei and increased atypical mitosis. Immunohistochemical analysis showed negative staining with Cytokeratin, S100, CD34, Stat6, h-Caldesmon and EMA while the tumour cells were positive for desmin, myogenin, smooth muscle actin, CD-99 and MyoD1 thus confirming the diagnosis of spindle cell rhabdomyosarcoma.

doi: https://doi.org/10.12669/pjms.37.3.3305

How to cite this:Iqbal HA, Anjum R, Naseem N. Rare Variant of Adult Rhabdomyosarcoma Presenting as a Palatal Swelling. Pak J Med Sci. 2021;37(3):922-925. doi: https://doi.org/10.12669/pjms.37.3.3305

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.
Patterns and Outcomes of dog bite injuries presenting to emergency department in a tertiary care hospital at Karachi
Authors: Ali Muhammad Ikram , Jamali Seemin , Ashraf Tehreem , Ahmed Nasibullah
Published: February 2021

Objectives: To assess patterns & outcomes of dog bite injuries coming to a public sector tertiary care hospital in Karachi, Pakistan.

Methods: This was a one-year descriptive cross sectional study from 1st June 2018- 31st May 2019 using consecutive sampling technique. Data of 7512 patients was collected from animal-bite clinic of a tertiary care hospital. Inclusion criteria was animal bite cases that were reported during the dates 1st June 2018 to 31st May 2019, Incomplete records were excluded. Data comprising of time of bite, the location of the victim at the time of bite within the city, animal responsible for the bite, gender and age of victim, date of presentation, site and category of bite (as per WHO criteria) was recorded by the primary investigator. The study was conducted at Jinnah Post-Graduate Medical Centre.

Results: Among 7512 participants 85.8% were males, 32.2% victims reported time of bite between morning and noon, 78.8% of bites involved lower limbs. 51.6% of the bites belonged to category 2. Stray dog bites were observed in 90.3% of cases. Outcome showed 54.9% completed their vaccination, while 44.3% did not show for complete follow up, 3.99% bites were grievous & 0.03% reported with developed rabies.

Conclusion: Research reveals Males belonging to adult age group were most vulnerable, most bites were inflicted in early hours, most common animal inflicting the bites were stray dogs. Many victims did not complete their vaccination from the same centre. Peak of the summer was associated with a decline in number of incidents.

doi: https://doi.org/10.12669/pjms.37.3.3464

How to cite this:Ali MI, Jamali S, Ashraf T, Ahmed N. Patterns and Outcomes of dog bite injuries presenting to emergency department in a tertiary care hospital at Karachi. Pak J Med Sci. 2021;37(3):794-799. doi: https://doi.org/10.12669/pjms.37.3.3464

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.
Spectrum of associated congenital heart defects in patients with “Non-Cardiac Congenital defects at a tertiary care children hospital in Pakistan”
Authors: Arshad Muhammad Sohail , Aslam Muhammad , Ahmad Shahnab , Kashif Muhammad
Published: February 2021

Objectives: To assess the frequency and pattern of associated congenital heart disease (CHD) among patients with “non-cardiac congenital defects”.

Methods: An observational study was done at Paediatric Cardiology Department, The Children’s Hospital and The Institute of Child Health, Multan, Pakistan, from December 2018 to November 2019. Children from birth to 15 years having non-cardiac congenital defects, referred for cardiac evaluation from surgical unit during the study period were enrolled. Echocardiography was done to confirm diagnosis of CHD by consultant pediatric cardiologist.

Results: Out of a total of 323 cases, 176 (54.5%) were male. Out of 323 patients, 160 (49.5%) belonged to age one month to one year. Vascular malformations were the most frequent primary diagnosis among our cases, seen in 69 (21.4%) children followed by cleft lip and palate 55 (17.2%), cleft palate only 52 (16.1%), Cleft lip only 40 (12.4%) and ARM high variety 33 (10.2%). CHD was found among 42 (13.0%) children while patent ductus arteriosus (PDA) and VSD were the commonest finding seen in 14 (33.3%) and 6 (14.3%) children respectively.

Conclusion: Frequency of associated CHD among patients with non-cardiac congenital defects was high (13.0%). Children with cleft lip and/or palate should be given more attention because of the high incidence of CHD in this group. Echocardiography must be advised for the timely identification of any possible type of CHD.

doi: https://doi.org/10.12669/pjms.37.3.3604

How to cite this:Arshad MS, Aslam M, Ahmad S, Kashif M. Spectrum of associated congenital heart defects in patients with “Non-Cardiac Congenital defects at a tertiary care children hospital in Pakistan”. Pak J Med Sci. 2021;37(3):695-699. doi: https://doi.org/10.12669/pjms.37.3.3604

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 effectiveness of community neurorehabilitation for persons with an acquired brain injury: protocol for a systematic review
Authors: Mitchell Eileen , Philips Nicola , Ahern Elayne , McGettrick Grainne , Mockler David , Fitzpatrick Kyle , Trepel Dominic
Published: February 2021

Background: Acquired brain injury (ABI) refers to any type of brain damage after birth.  ABI from either traumatic or non-traumatic origin is a leading cause of death and long-term disability globally.  The impact of an ABI can be cognitive and/ or physical, greatly affecting their ability to function independently.  With a lack of specialist inpatient rehabilitation facilities and services many of these survivors reside within the community either alone, with family or in residential facilities.  Up-to-date evidence is required to indicate which forms of community rehabilitation are most effective in improving cognitive and physical outcomes for survivors. This systematic review aims to explore the clinical effectiveness of community neuro-rehabilitation services for persons living with an ABI.

Methods: A systematic review of relevant electronic databases will be undertaken to identify eligible published randomised controlled trials.  The PRISMA statement will be used to guide the systematic review.  From running the initial search, we aim to submit the paper for publishing within 6 months.  This process will be completed using Covidence software.  Two reviewers will independently screen the search results and select studies using pre-defined selection criteria, extract data from and assess risk of bias for selected studies.    

Discussion: This systematic review will aim to explore the clinical effectiveness of community neuro-rehabilitation services for persons with an ABI.  It plans to review and synthesize the current best available evidence base. A goal of this study is to positively inform ongoing service development within a quality framework.

Systematic review registration: PROSPERO CRD42020148604 (26/02/2020)
Parentalidad Postdivorcio: Características Relacionadas con la Asignación de la Custodia de Hijos e Hijas tras la Ruptura de Matrimonios Heterosexuales. El Caso de Andalucía.
Authors: Jiménez-Cabello José Manuel , Puertas-Cañaveral Inmaculada , Paniza-Prados José Luis , García-Moreno José Manuel
Published: February 2021

La presente investigación se centra en identificar la relación de determinadas variables sociales con la asignación de la custodia tras el divorcio de matrimonios heterosexuales en Andalucía. Para ello se emplea metodología cuantitativa, utilizando la Estadística de Nulidades, Separaciones y Divorcios (INE, 2017) y datos de indicadores económicos como el Producto Interior Bruto (2017). Su explotación permite tener en cuenta todo un conjunto de variables necesarias para comprender el fenómeno objeto de estudio. Se realizan análisis de tipo descriptivo y multivariante (análisis factorial y de correspondencias). Los principales resultados obtenidos confirman que variables como el número de hijos menores o mayores dependientes, el fallo de la sentencia y el PIB de cada provincia, están relacionadas significativamente con la modalidad de custodia finalmente asignada. Otras variables como la edad de los cónyuges o su nacionalidad no parecen tener asociación en la modalidad que se otorga.
Caracterización y Evaluación Biogeográfica a través del Método Lanbioeva de los Bosques de Quercus Petraea del País Vasco y Navarra (Península Ibérica).
Authors: Lozano-Valencia Pedro José , Varela-Ona Rakel , Lozano-Fernández Asier , Meaza-Rodriguez Guillermo
Published: February 2021

Se caracterizan y evalúan los bosques de Quercus petraea del País Vasco y Navarra. Tres son las ubicaciones elegidas: sur de Bizkaia, sur de Guipúzcoa y norte de Navarra. Se acomete un inventariado de 10 parcelas por cada ubicación y se analizan diferentes características: diversidad específica, filiación corológica, estatus de las especies y aplicación del método LANBIOEVA. Estos robledales son muy escasos dentro de la Península Ibérica y cuentan con cortejos donde dominan también las plantas escasas. En estos bosques, en general, dominan las filiaciones eurosiberianas o euroasiáticas, atlánticas y de transición entre el mediterráneo y el atlántico. Las formaciones de Navarra se configuran como las más diversas, seguidas por las de Guipúzcoa y las de Vizcaya. La evaluación biogeográfica da lugar a altos valores (por encima de los 1.200 puntos) para los tres robledales, pero superiores en Pikandi (Gipuzkoa) y Garralda (Navarra) y más modestos en Garrastatxu (Bizkaia).
Valoración del Capital Social en el Transporte Público y la Movilidad Sostenible en Venezuela. Una Revisión Sistemática de la Literatura.
Authors: Janeth Padron Carmen
Published: February 2021

En este artículo se ha realizado una revisión sistemática entre los años 2008 y 2020 para identificar la valoración del capital social en el transporte público y la movilidad sostenible en Venezuela. Desde el punto de vista metodológico, se realizaron búsquedas en la base de datos abierta Ebscohost, encontrándose 67 estudios, de los cuales al analizarlos conforme a los criterios de inclusión y exclusión, solo 5 tenían relación con la temática. El capital social debe entederse que contribuye a la promoción del desarrollo económico, la superación de la pobreza y gobernabilidad democrática de los países. Sin embargo, en Venezuela este tiende a adquirir un carácter negativo y precario, dada la situación de crisis económica, social y política en la que se encuentra sumida este país. En cuanto al transporte público, su análisis y valoración resulta sustancial en Venezuela ya que este posee un carácter marcadamente débil, pues se constata la existencia en el país de una escasa integración de este con otros modos de transporte, a la vez que la ausencia de una movilidad sostenible.
Coastal Dune Restoration in El Inglés Beach (Gran Canaria, Spain): a Trial Study.
Authors: Sanromualdo-Collado Abel , Hernández-Cordero Antonio I. , Viera-Pérez Manolo , Gallego-Fernández Juan Bautista , Hernández-Calvento Luis
Published: February 2021

A trial study of foredune restoration on El Inglés beach (Gran Canaria, Spain) was carried out between July 2018 and December 2019 as part of the MASDUNAS program of the Gran Canaria Island Council. Among the objectives of that project was the sand relocation from the tip of La Bajeta to the El Inglés beach, the installation of sand collectors and the reintroduction of specimens of Traganum moquinii that act as generators of new mound dunes in the foredune. This study presents results, extracted from the scientific monitoring of the project, on the efficiency of the sand collectors and the evolution of the planted specimens of T. moquinii. The knowledge gained from this trial study is key to improve and adapt the coastal dune restoration procedure in arid systems.
Market demand for conference interpreting in South Korea: Sifting through the signals
Authors: Huh Jiun
Published: February 2021

This study explores the market demand for conference interpreting in South Korea by exploring the signals that users perceive as important for professional conference interpreting services. The findings were derived from a questionnaire-based survey of 109 participants with experience of conference interpreting services. The results indicate that interpreting quality, interpreting experience, and certification of the interpreter are important signals, suggesting that users are aware of the importance of quality. Furthermore, interpreting is primarily used as a communicative act. On the other hand, the low ratings for academic degrees in interpreting reveals the presence of information asymmetry, which negatively affects the elements that users perceive as important for the professionalization of interpreting. The study also addresses the service aspect of conference interpreting, shedding light on the ‘interpreting as a service’ approach based on an end-to-end service concept in both practice and training. The findings suggest a future direction both in terms of market development and interpreter training, thereby contributing to the advancement of interpreting as a profession.
Mortgage Brokers and the Effectiveness of Regulatory Oversights
Authors: Agarwal Sumit , Ang Swee Hoon , Deng Yongheng , Wang Yonglin
Published: February 2021

This paper studies the responses among different types of mortgage brokers to occupational licensing regulations. By explicitly accounting for heterogeneities between sole and corporate brokers, we find evidence that sole brokers respond to financial regulatory oversight by applying a more stringent screening process in conducting brokerage activities, hence achieving better loan performances. Specifically, loans originated through sole brokers exhibit higher quality on an array of credit-relevant characteristics, including those reported and unreported to future investors. By contrast, we find no such regulatory effect on corporate brokers who tend to rely extensively on reported characteristics that are critical to the subsequent loan securitization at the expense of unreported information despite the latter indicating potential risks. Hence, the agency problem among sole brokers can be mitigated by the consolidated financial requirement for occupational licensing. However, such provision is ineffective in governing corporate brokers. Additionally, welfare gains associated with the occupational licensing regulation are achieved at the expense of prospective borrowers paying a higher loan price and having reduced credit access. Stricter licensing regulations may induce welfare loss related to credit rationing as reasonable loan applications are not funded, including those with potentially lower default risk.

This paper was accepted by Kay Giesecke, finance.
philosophy and childhood: theory and practice: presentation
Authors: Demozzi Silvia , Zanetti Luca
Published: February 2021

A concern with children doing philosophy is inseparable from a preoccupation with childhood and asks for a redefinition of childhood itself. This exploration is at least one fundamental dimension of the group of philosophers and educators who presented their work and experience at the Conference “Philosophy and Childhood: Theory and Practice. A Conference on the Pedagogical and Philosophical Foundations of Philosophical Practices with Children” that took place at Bologna University, from December 3 to 5, 2018. This present dossier was born from the need to foster and deepen the theoretical and practical value of the philosophy for children (P4C) movement, which includes the more classical philosophy for children program and many other forms inspired by it. We could affirm that for these educators and philosophers it is at least as important to bring children to philosophy as it is to bring philosophical thinking to children and childhood.
pensamento, experiência e o tempo do ócio na educação infantil
Authors: Venturini Gabriela , Schuler Betina
Published: February 2021

This paper aims to examine the way that the concepts of thought and interest have been described in the three main documents that currently guide Brazilian Child Education – National Education Guidelines and Bases/1996, National Curriculum Guidelines for Child Education/2010, and National Curriculum Basis/2018 for Child Education – and their implications for relations between childhood and thinking. In order to do that, we have relied on studies in the philosophy of difference, considering authors such as Kohan, Larrosa, López and Ribeiro, among others, to problematize thought as linked to individual interest. We notice how much thought has been regarded as a problem-resolution tool in these documents, following a neoliberal logic that has been increasingly displaced from collective to individualized interest. Furthermore, the whole functioning of a disciplinary society is evident in the documents, as the latter moves towards a performance society, with greater emphasis on assessment practices and records of children’s “production.” We consider, both in the concept of childhood and the concept of experience, the possibility of experiencing other relationships with childhoods and temporalities in  schools, and  the power of both free time and play as open breathing spaces among routines that are both full of compulsory activities and empty of meaning.
The effect of multidrug-resistant organisms on social participation and quality of life in children with life-limiting conditions
Authors: Schmidt Pia , Hartenstein-Pinter Almut , Hasan Carola , Stening Kathrin , Zernikow Boris , Wager Julia
Published: February 2021

Background:

Children with life-limiting conditions have a high risk of colonisation with a multidrug-resistant organism (MDRO). To avoid the spread of hospital-aquired infections to other patients, children with a MDRO are moved to an isolated room or ward. However, such isolation prevents social participation, which may reduce the child's quality of life (QoL). To overcome this challenge of conflicting interests on a paediatric palliative care inpatient unit, a hygiene concept for patients colonised with MDRO, called PALLINI, was implemented. PALLINI advises that, instead of isolating the affected children, strict barrier nursing should be used.

Aim:

To identify the impact of a complex hygiene concept on children's and parents' QoL and social participation.

Methods:

Cross-sectional mixed-methods research approach, comprising semi-structured interviews with parents and staff members, and a QoL-questionnaire focusing on the child which was completed by parents.

Findings:

In paediatric patients with life-limiting conditions who have MDRO colonisation, using a complex hygiene protocol resulted in both benefits and barriers to social participation. However, the child's QoL did not appear to be affected.

Conclusion:

All staff members and families have to be familiar with the hygiene concept and the concept has to be self-explanatory and easy to apply.
Children's palliative care: examination of a nursing rotation programme
Authors: Whiting Lisa , Whiting Mark , Petty Julia , O'Grady Michele
Published: February 2021

Background:

An 8-month rotation programme was implemented for five nurses employed in two kinds of children's palliative care environments: hospital wards and hospices. This study reports the views of the nurses completing the rotation. The research drew on appreciative inquiry and involved a pre- and post-rotation interview and questionnaire. Thematic analysis of the interviews revealed seven themes: adjusting to the rotation programme; support mechanisms; being safe; new knowledge and skills; knowledge exchange; misconceptions; future plans. These were supported by the questionnaire findings. Although the nurses identified some frustration at having to undertake competency assessments relating to previously acquired skills, as well as being out of their ‘comfort zone’, all the participants highly recommended the programme. They commented very positively on the support they received and the overall learning experience as well as the new insight into different aspects of care. In addition, they were able to share their newfound knowledge and expertise with others.