bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating engineering in K-12 science education: spelling out the pedagogical, epistemological, and methodological arguments
Authors: Purzer Senay , Quintana-Cifuentes Jenny Patricia 
Published: November 2019

AbstractThis position paper is motivated by recent educational reform efforts that urge the integration of engineering in science education. We argue that it is plausible and beneficial to integrate engineering into formal K-12 science education. We illustrate how current literature, though often implicitly, discusses this integration from a pedagogical, epistemological, or methodological argumentative stance. From a pedagogical perspective, a historically dominant argument emphasizes how engineering helps make abstract science concepts more concrete. The epistemological argument is centered on how engineering is inherently interdisciplinary and hence its integrative role in support of scientific literacy and more broadly STEM literacy is natural. From a methodological perspective, arguments focus on the engineering design process, which is compatible with scientific inquiry and adaptable to answering different types of engineering questions. We call for the necessity of spelling out these arguments and call for common language as science and engineering educators form a research-base on the integration of science and engineering. We specifically provide and discuss specific terminology associated with four different models, each effectively used to integrate engineering into school science. We caution educators against a possible direction towards a convergence approach for a specific type of integrating engineering and science. Diversity in teaching models, more accurately represents the nature of engineering but also allows adaptations based on available school resources. Future synthesis can then examine student learning outcomes associated with different teaching models.
Science|Environment|Health – the emergence of a new pedagogy of complex living systems
Authors: Zeyer Albert , Dillon Justin 
Published: November 2019

AbstractScience|Environment|Health (S|E|H) is an emerging science pedagogy for complex living systems. The name highlights a situation of mutual benefit between science education, environmental education and health education. The paper discusses a range of topics from the curriculum-focused origin of the S|E|H movement to the issues that concern S|E|H researchers today. These include, among others, the role of scientific knowledge in S|E|H decision making, medicine education as a paradigmatic example of S|E|H, complexity in S|E|H issues, the role of empathy in S|E|H, and the tension between societal and individual responsibility. In conclusion, it is argued that two insights are essential for current S|E|H work. First, living systems can be understood both in causal and empathetic terms, which makes S|E|H a powerful ‘science for all’ approach. Second, in living systems, there is always a trade-off between predictability and homeostasis. This brings S|E|H in a natural antagonism – but not in opposition – to STEM approaches.
Different lead locations guided by fluoroscopy and ECG parameters and their effect on patients functional status
Authors: MesbahTahaHassanin Mohamed , ShafieAmmar Ahmad , Abdullah Radwa M. , Khedr Mohammad Hassan 
Published: November 2019

Abstract
Background
Right ventricular apical pacing with the resultant left ventricular dyssynchrony often leads to depressed systolic function and heart failure. This study aimed at investigating the relation between various septal locations guided by ECG and fluoroscopy and the intermediate term functional capacity of the patients.

Results
Fifty patients who received a single lead pacemaker with assumed > 90% pacemaker dependency. Patients were randomized according to RV pacing site RV into group 1 “high septum” (n = 15), group 2 “mid septum” (n = 25), and group 3 “low septum” (n = 10) using QRS vector and duration as well as fluoroscopic parameters. Their clinical status was assessed 6 months after device implementation using 6-min walk test (6MWT).
The study showed that paced QRS complex duration itself has no significant difference between the different septal pacing locations (P-value 0.675), although its combination with the paced QRS complex vector can signify the optimal pacing site and 6MWT showed a significant difference among the groups in favor of group 1; group 1 (413.3 ± 148.5), group 2 (359.8 ± 124.6), and group 3 (276.0 ± 98.5) P value 0.04.

Conclusion
There was a significant difference found between the three septal pacing sites concerning the patient functional capacity with superiority of high septal location. By contrast, different septal sites showed no significant difference of the paced QRS complex duration. To optimize the pacing site in the septum, assessment of the paced QRS vector in leads I and III is of a great benefit especially when combined with paced QRS complex duration assessment.
Neonatal Severe Hyperparathyroidism: Novel Insights From Calcium, PTH, and the CASR Gene
Authors: Marx Stephen J , Sinaii Ninet 
Published: November 2019

Abstract

Context
Neonatal severe hyperparathyroidism (NSHPT) is rare and potentially lethal. It is usually from homozygous or heterozygous germline-inactivating CASR variant(s). NSHPT shows a puzzling range of serum calcium and parathyroid hormone (PTH) levels. Optimal therapy is unclear.

Evidence acquisition
We categorized genotype/phenotype pairings related to CASRs. For the 2 pairings in NSHPT, each of 57 cases of neonatal severe hyperparathyroidism required calcium, PTH, upper normal PTH, and dosage of a germline pathogenic CASR variant.

Evidence synthesis
Homozygous and heterozygous NSHPT are 2 among a spectrum of 9 genotype/phenotype pairings relating to CASRs and NSHPT. For the 2 NSHPT pairings, expressions differ in CASR allelic dosage, CASR variant severity, and sufficiency of maternofetal calcium fluxes. Homozygous dosage of CASR variants was generally more aggressive than heterozygous. Among heterozygotes, high-grade CASR variants in vitro were more pathogenic in vivo than low-grade variants. Fetal calcium insufficiency as from maternal hypoparathyroidism caused fetal secondary hyperparathyroidism, which persisted and was reversible in neonates. Among NSHPT pairings, calcium and PTH were higher in CASR homozygotes than in heterozygotes. Extreme hypercalcemia (above 4.5 mM; normal 2.2–2.6 mM) is a robust biomarker, occurring only in homozygotes (83% of that pairing). It could occur during the first week.

Conclusions
In NSHPT pairings, the homozygotes for pathogenic CASR variants show higher calcium and PTH levels than heterozygotes. Calcium levels above 4.5 mM among NSHPT are frequent and unique only to most homozygotes. This cutoff supports early and robust diagnosis of CASR dosage. Thereby, it promotes definitive total parathyroidectomy in most homozygotes.
Metformin and Risk of Alzheimer’s Disease Among Community-Dwelling People With Diabetes: A National Case-Control Study
Authors: Sluggett Janet K , Koponen Marjaana , Bell J Simon , Taipale Heidi , Tanskanen Antti , Tiihonen Jari , Uusitupa Matti , Tolppanen Anna-Maija , Hartikainen Sirpa 
Published: November 2019

Abstract

Context
Type 2 diabetes has been linked with an increased risk of Alzheimer’s disease (AD). Studies on the association between metformin use and AD have reported conflicting results.

Objective
To investigate whether metformin use modifies the association between diabetes and incident, clinically verified AD.

Design
Nested case-control study.

Setting
All community-dwelling people in Finland.

Participants
Cases were all community-dwelling Finns with AD diagnosed from 2005 to 2011 and with diabetes diagnosed ≥ 3 years before AD (n = 9862). Cases were matched with up to 2 control persons by age, sex, and diabetes duration (n = 19 550).

Main outcome measure
Cumulative metformin exposure was determined from reimbursed dispensings over a 10- to 16-year period. Adjusted odds ratios (aORs) were calculated using conditional logistic regression to estimate associations, with adjustment for potential confounders.

Results
A total of 7225 (73.3%) cases and 14528 (74.3%) controls received metformin at least once. Metformin use (ever use) was not associated with incident AD (aOR 0.99; 95% confidence interval [CI], 0.94–1.05). The adjusted odds of AD were lower among people dispensed metformin for ≥ 10 years (aOR 0.85; 95% CI, 0.76–0.95), those dispensed cumulative defined daily doses (DDDs) of &lt; 1825–3650 (aOR 0.91; 95% CI, 0.84–0.98) and &gt; 3650 DDDs (aOR 0.77; 95% CI, 0.67–0.88), and among persons dispensed an average of 2 g metformin daily (aOR 0.89; 95% CI, 0.82–0.96).

Conclusion
In this large national sample we found no evidence that metformin use increases the risk of AD. Conversely, long-term and high-dose metformin use was associated with a lower risk of incident AD in older people with diabetes.
A pilot study on dosimetric and radiomics analysis of urethral strictures following HDR brachytherapy as monotherapy for localized prostate cancer
Authors: Tsang Yat Man , Vignarajah Dinesh , Mcwilliam Alan , Tharmalingam Hannah , Lowe Gerry , Choudhury Ananya , Hoskin Peter 
Published: November 2019

Objective:
A cohort of high dose-rate (HDR) monotherapy patients was analyzed to (i) establish the frequency of non-malignant urethral stricture; (ii) explore the relation between stricture formation with the dose distribution along the length of the urethra, and MRI radiomics features of the prostate gland.

Methods:
A retrospective review of treatment records of patients who received 19 Gy single fraction of HDR brachytherapy (BT) was carried out. A matched pair analysis used one control for each stricture case matched with pre-treatment International Prostate Symptom Score (IPSS) score, number of needles used and clinical target volume volume for each stricture case identified.
For all data sets, pre-treatment T 2 weighted MRI images were used to define regions of interests along the urethra and within the whole prostate gland. MRI textural radiomics features—energy, contrast and homogeneity were selected. Wilcoxon signed-rank test was performed to investigate significant differences in dosimetric parameters and MRI radiomics feature values between cases and controls.

Results:
From Nov 2010 to July 2017, there were 178 patients treated with HDR BT delivering 19 Gy in a single dose. With a median follow-up of 28.2 months, a total of 5/178 (3%) strictures were identified.
10 patients were included in the matched pair analysis. The urethral dosimetric parameters investigated were not statistically different between cases and controls (p &gt; 0.05). With regards to MRI radiomics feature analysis, significant differences were found in contrast and homogeneity between cases and controls (p &lt; 0.05). However, this did not apply to the energy feature (p = 0.28).

Conclusion:
In this matched pair analysis, no association between post-treatment stricture and urethral dosimetry was identified. Our study generated a preliminary clinical hypothesis suggesting that the MRI radiomics features of homogeneity and contrast of the prostate gland can potentially identify patients who develop strictures after HDR BT. Although the sample size is small, this warrants further validation in a larger patient cohort.

Advances in knowledge:
Urethral stricture has been reported as a specific late effect with prostate HDR brachytherapy. Our study reported a relatively low stricture rate of 3% and no association between post-treatment stricture and urethral dosimetry was identified. MRI radiomics features can potentially identify patients who are more prone to develop strictures.
Head position classification of medical imaging studies: an assessment and development of a protocol
Authors: Miller Courtney A. , Lee Yen , Avey Gregory D. , Vorperian Houri K. 
Published: November 2019

Objectives To determine the optimal approach to reliably classify head position of head and neck medical imaging studies as flexion, neutral or extension for use in craniofacial and orthodontic research. Methods and material: A prospective study scanned six participants in flexed, neutral and extended head positions. Additionally, a retrospective dataset of 46 CT studies were visually classified into six categories: flexion, neutral-flexion, neutral, neutral-extension, extension and flexion-extension. 14 landmarks were placed in the head and neck region of all studies to calculate 17 head position angle and distance measurements. Assessment of head position classification was performed for each measure, as well as all measures together using GUIDE forest. Results: No single measure was sufficient to reliably classify head position in both retrospective and prospective imaging studies. Therefore, this study developed a head position protocol that considers multiple measures using two hybrid predictive models, to classify head position. Compared to visual assessment of head position, this protocol classified the imaging studies into the four head position categories with 82% neutral sensitivity and 100% neutral precision where the three neutral groups (neutral-flexion, neutral and neutral-extension) were grouped together. Conclusion: This study established a novel head position classification protocol that uses multiple measures accounting for both head and neck positions to reliably classify head positions in imaging studies as: flexion, neutral or extension. Given the limitation that no single measure reliably classified head position, this protocol is strongly recommended to researchers who need to account for head position to reach valid conclusions.
Epidemiology and outcomes of trauma patients at The Indus Hospital, Karachi, Pakistan, 2017 – 2018
Authors: Salman Saima , Saleem Syed Ghazanfar , Shaikh Quratulain , Yaffee Anna Q 
Published: November 2019

Objective: Structured trauma care has proven to improve patient outcomes, and this is more relevant in the low- and middle-income countries (LMICs). The objective of this study was to determine the distribution, etiology, severity and outcomes of trauma patients at the Indus Hospital.
Methods: All adult poly-trauma patients presenting to The Indus Hospital from July 2017 to June 2018 were included in this retrospective review. Data was extracted on etiology of trauma, severity of injury, investigations and final disposition of patients.
Results: Of 972 trauma patients presenting to TIH Emergency Department, 663 (68.2%) were males with a mean age of 36 (17.4) years. Road traffic accidents (RTAs) led to trauma in 766 patients (78.8%), followed by 121 falls (12.7%). Injury Severity score (ISS) was calculated upon arrival and 528 (54.3%) were found to be critically injured. Median length of stay was 60 (24-720) minutes while none utilized pre-hospital Emergency Medical services.
Conclusion: Most trauma patients were males suffering from RTA. Nearly half of the patients were critically injured on arrival. EMS is not utilized by trauma patients. There were gaps identified in the diagnosis and treatment of trauma.
doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1717
How to cite this:Salman S, Saleem SG, Shaikh Q, Yaffee AQ. Epidemiology and outcomes of trauma patients at The Indus Hospital, Karachi, Pakistan, 2017 – 2018. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S9-S13. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1717
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.
ICON 2020 Supplement
Authors: Shaikh Qurat ul Ain , Saeed Saima 
Published: November 2019

doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1729
How to cite this:Saeed S, Shaikh QA. Guest Editorial. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S3. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1729
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.
Promoting Research Culture at Indus Health Network
Authors: Jawaid Shaukat Ali 
Published: November 2019

doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1861
How to cite this:Jawaid SA. Promoting Research Culture at Indus Health Network. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S2. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1861
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.
Does fMRI neurofeedback in the context of stress influence mood and arousal? A randomised controlled trial with parallel group design
Authors: Belardi Angelo , Lee Jong-Hwan , Kim Hyun-Chul , Stalujanis Esther , Jung Eun Kyung , Oh Minkyung , Yoo Seung-Schik , Pruessner Jens C. , Tegethoff Marion , Meinlschmidt Gunther 
Published: November 2019

Background: Stress-related mental and physical health issues burden modern societies. New treatment opportunities could help to lessen long-term detrimental consequences of stress. Objective: To investigate whether real-time functional magnetic resonance imaging neurofeedback (rtfMRInf), aimed at modulating brain activity associated with a stressor, affects subjective mood and arousal. Methods: In total, 30 males participated in a randomised controlled trial with parallel-group design. rtfMRInf was the intervention, sham-neurofeedback the control condition, and the Stroop task the stressor. We instructed participants to modulate their stress response to the Stroop task via feedback from their anterior cingulate cortex and their insular cortex, concomitantly applying mental strategies. We assessed mood with the Multidimensional Mood State Questionnaire (dimensions: good/bad, GB; awake/tired, AT; and calm/nervous, CN), and subjective arousal with Self-Assessment Manikins (SAM). Results: We found significantly higher subjective arousal after neurofeedback phases in the experimental condition as compared to the control condition [t(26.6) = −2.216, 95%CI [−2.188,−0.083], p = 0.035; t(27.9) = −3.252, 95%CI [−2.685,−0.609], p = 0.003], but no significant differences between the conditions regarding mood [GB: b = 0.4, 95%CI [−0.67, 1.47], p = 0.467; AT: b = 0.769, 95%CI [−0.319, 1.857], p = 0.177; CN: b = 0.5, 95%CI [−0.53, 1.53], p = 0.352]. In both conditions, there was significantly worse and more tired mood after the fMRI session as compared to before [GB:b = −0.77, 95% CI [−1.31, 0.23], p = 0.009; AT: b = −0.652, 95%CI [−1.116,−0.187], p = 0.01]. Conclusions: Findings indicate that rtfMRInf led to higher arousal, which may counteract the aim to reduce stress responses. Whether the multitasking situation has triggered this neurofeedback-related arousal – and how to circumvent it – asks for further study. Trial registration: NCT01921088, ClinicalTrials.gov, 13th August 2013.
Mitigation of methane gas emission in rice by drip irrigation
Authors: Parthasarathi Theivasigamani , Vanitha Koothan , Mohandass Sendass , Vered Eli 
Published: November 2019

Background: Rice farming faces major challenges, including water limitation, drought and climate change in the current scenario of agriculture. Among the innovative water-saving techniques, drip irrigation is a forerunner, with maximized water-saving potential, increased grain yield and methane mitigation. Methods: A field experiment was conducted comprising four different drip irrigation practices: (i) sub-surface drip irrigation (SDI) with 1.0 litre per hour (lph) discharge rate emitters (DRE) (SDI+1.0 lph DRE) (ii) SDI+0.6 lph DRE, (iii) surface drip irrigation (DI) with 1.0 lph discharge rate emitters (DI+1.0 lph DRE), (iv) DI+0.6 lph DRE and were compared with (v) a conventional flood aerobic irrigation (considered conventional). Results: The estimated grain yield of rice was found to be 23.5%, 20.3%, and 15.1% higher under SDI+1.0 lph DRE, SDI+0.6 lph DRE and DI+1.0 lph DRE practices, respectively, than the conventional method. A water saving of 23.3% was also observed for all drip practices compared with conventional practices. Seasonal methane emission flux declined 78.0% in the drip methods over the conventional irrigation: better mitigation than previously reported values (alternate wetting and drying (47.5%) and system of rice intensification (29.0%) practices). Continuous soil aeration and enhanced soil methanotrophs (P<0.05) limit the peak methane emission in rice during the flowering phase in drip irrigation, which is reflected in the methane emission flux values. Consequently, the equivalent CO2 (CO2-eq) emissions and yield-scaled CO2 eq-emission were found to be significantly lower in SDI (43.8% and 49.5%, respectively), and DI (25.1% and 26.7%, respectively) methods as compared with the conventional that ensures better methane mitigation and future climate-smart rice production systems. Conclusions: Drip irrigation could reduce the cumulative methane emission in aerobically grown rice. SDI + 1.0 lph DRE practice can be applied in areas with inadequate water availability and effective in reducing the CO2-eq emission with better yield than conventional.
School adolescents’ knowledge concerning hepatitis C virus (HCV)
Authors: Sierpińska Lidia , Jankowska Ewa 
Published: November 2019

Introduction. Infection with hepatitis C virus (HCV) is a serious clinical, epidemiological and social problem in Poland. Objective. The objective of the study was recognition of knowledge concerning HCV infection among adolescents attending post-secondary schools. Material and method. The study was conducted in 2016, among 106 school adolescents attending two post-secondary schools in Radom, by means of a questionnaire designed by the author and a standardized questionnaire according to the Polish Group of HCV Experts. Statistical analysis was performed using the software Statistica 10.0. Results. The majority of adolescents (84.5%) knew that HCV causes hepatitis C. Boys more frequently than girls knew that the disease spreads by contact with infected blood (72.0% and 50.6%, respectively). Girls significantly more often than boys knew that approximately 700,000 people in Poland are infected with HCV (54.3% and 24.0%, respectively). According to 84.1% of respondents everyone is exposed to this infection. Boys more often than girls (72.0% and 55.6%) correctly provided examples of situations in which the infection may occur. The majority of adolescents (88.5%) knew that the hepatitis C antibody (anti-HCV) blood test indicates whether the person has an infection. A half of the examined adolescents (50.9%) knew thatthere is currently no vaccine available to protect against hepatitis C, and that it is possible to cure the person infected with HCV.Conclusions. The level of adolescents’ knowledge concerning HCV infection varied according to the demographic and social factors. School adolescents should be provided incentives for prophylaxis of infection and participation in prophylactic programmes, in order to limit the risk of contracting hepatitis C.