bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical Activity Reduces Epilepsy Incidence: a Retrospective Cohort Study in Swedish Cross-Country Skiers and an Experimental Study in Seizure-Prone Synapsin II Knockout Mice
Authors: Ahl Matilda , Avdic Una , Strandberg Maria Compagno , Chugh Deepti , Andersson Emelie , Hållmarker Ulf , James Stefan , Deierborg Tomas , Ekdahl Christine T. 
Published: December 2019

Abstract
Background
Epilepsy patients commonly exercise less than the general population. Animal studies indicate beneficial effects of physical activity in established epilepsy, while its effect on the development is currently less known.

Methods
Here, we investigated the incidence of epilepsy during 20 years in a cohort of participants from the long-distance Swedish cross-country ski race Vasaloppet (n = 197,685) and compared it to the incidence of non-participating-matched controls included in the Swedish population register (n = 197,684). Individuals diagnosed with diseases such as stroke and epilepsy before entering the race were excluded from both groups. Experimentally, we also determined how physical activity could affect the development of epilepsy in epilepsy-prone synapsin II knockout mice (SynIIKO), with and without free access to a running wheel.

Results
We identified up to 40–50% lower incidence of epilepsy in the Vasaloppet participants of all ages before retirement. A lower incidence of epilepsy in Vasaloppet participants was seen regardless of gender, education and occupation level compared to controls. The participants included both elite and recreational skiers, and in a previous survey, they have reported a higher exercise rate than the general Swedish population. Sub-analyses revealed a significantly lower incidence of epilepsy in participants with a faster compared to slower finishing time. Dividing participants according to specified epilepsy diagnoses revealed 40–50% decrease in focal and unspecified epilepsy, respectively, but no differences in generalized epilepsy. Voluntary exercise in seizure-prone SynIIKO mice for 1 month before predicted epilepsy development decreased seizure manifestation from > 70 to 40%. Brain tissue analyses following 1 month of exercise showed increased hippocampal neurogenesis (DCX-positive cells), while microglial (Iba1) and astrocytic activation (GFAP), neuronal Map2, brain-derived neurotrophic factor and its receptor tyrosine receptor kinase B intensity were unaltered. Continued exercise for additionally 2 months after predicted seizure onset in SynIIKO mice resulted in a 5-fold reduction in seizure manifestation (from 90 to 20%), while 2 months of exercise initiated at the time of predicted seizure development gave no seizure relief, suggesting exercise-induced anti-epileptogenic rather than anti-convulsive effect.

Conclusion
The clinical study and the experimental findings in mice indicate that physical activity may prevent or delay the development of epilepsy.
A self-marker-like protein governs hemocyte allorecognition in Halocynthia roretzi
Authors: Ema Masaki , Okada Taizo , Takahashi Miki , Uchiyama Masato , Kubo Hideo , Moriyama Hideaki , Miyakawa Hitoshi , Matsumoto Midori 
Published: December 2019

AbstractBackgroundSelf-incompatibility, fusion/non-fusion reactions, and contact reactions (CRs) have all been identified as allorecognition phenomena in ascidians. CR is a reaction characteristic of the hemocytes ofHalocynthia roretzi, whereby they release phenol oxidase (PO) upon contact with non-self hemocytes. Thus, these cells may represent a primitive form of the vertebrate immune system. In the present study, we focused on the CR ofH. roretzihemocytes and sought to identify self-marker proteins that distinguish between self and non-self cells.ResultsWe initially generated a CR-inducing monoclonal antibody against the complete hemocyte membrane-protein complement (mAb11B16B10). This antibody was identified based on the differential induction of PO activity in individual organisms. The level of PO activity induced by this antibody in individual ascidians was consistent with the observed CR-induced PO activity. mAb11B16B10 recognized a series of 12 spots corresponding to a 100-kDa protein, with differing isoelectric points (pIs). A comparison of the 2D electrophoresis gels of samples from CR-reactive/non-reactive individuals revealed that some spots in this series in hemocytes were common to the CR-non-inducible individuals, but not to CR-inducible individuals. We cloned the corresponding gene and named itHalocynthia roretziself-marker-like protein-1 (HrSMLP1). This gene is similar to the glycoprotein DD3–3 found inDictyostelium,and is conserved in invertebrates.ConclusionWe generated a CR-inducing monoclonal antibody (mAb11B16B10) that recognized a series of novel membrane proteins (HrSMLP1) in the hemocytes ofH. roretzi. The combination of expressed spots of HrSMLP1 distinguishes non-self cells from self cells with respect to CR inducibility. Given that the HrSMLP1 gene is a single gene, it may represent a novel type of self-marker protein with a role in CR.
Power system voltage instability risk mitigation via emergency demand response-based whale optimization algorithm
Authors: Amroune Mohammed , Bouktir Tarek , Musirin Ismail 
Published: December 2019

AbstractIn recent years, due to the economic and environmental issues, modern power systems often operate proximately to the technical restraints enlarging the probable level of instability risks. Hence, efficient methods for voltage instability prevention are of great importance to power system companies to avoid the risk of large blackouts. In this paper, an event-driven emergency demand response (EEDR) strategy based on whale optimization algorithm (WOA) is proposed to effectively improve system voltage stability. The main objective of the proposed EEDR approach is to maintain voltage stability margin (VSM) in an acceptable range during emergency situations by driving the operating condition of the power system away from the insecure points. The optimal locations and amounts of load reductions have been determined using WOA algorithm. To test the feasibility and the efficiency of the proposed method, simulation studies are carried out on the IEEE 14-bus and real Algerian 114-bus power systems.
Dexmedetomidine versus midazolam sedation for autistic children undergoing electroencephalogram: a prospective randomized trial
Authors: Shokri Hoda , Kasem Amr A. 
Published: December 2019

Abstract
Background
Dexmedetomidine procedural sedation for pediatric patients undergoing radiological imaging has proved to be effective and safe.

Objective
We compared the efficacy of outpatient sedation with intravenous dexmedetomidine versus intravenous midazolam in autistic children undergoing electroencephalogram.

Patients and methods
Forty pediatric autistic patients aged 6–11 years old undergoing electroencephalogram were studied. In the dexmedetomidine group, patients received a loading dose of IV dexmedetomidine 1 μg/kg slowly over 10 min followed by an IV infusion of dexmedetomidine 0.7 μg/kg/h stopped when Ramsay sedation score (RSS) reached 4. In the midazolam group (n = 20), patients received induction with a loading dose of 0.05 mg/kg midazolam given over 2 min, then wait another 2 to 5 min to evaluate the sedative effect. Additional doses of IV midazolam (0.05 mg/kg) were given until we reached RSS reached 4.
Sedation score, induction time, recovery time, behavioral scores, parents’ satisfaction scores, success rate, oxygen saturation, and the incidence of complications as bradycardia and attacks of agitation were recorded.

Results
Dexmedetomidine was associated with shorter induction and recovery times(< 0.001) and higher percentage of oxygen saturation compared with midazolam group (P < 0.001).
The dexmedetomidine group showed higher sedation and behavioral scores as well as success rate compared with midazolam. Parents’ satisfaction scores were significantly higher in the dexmedetomidine group. The incidence of agitation was significantly higher in the midazolam group compared with the dexmedetomidine group (p = 0.035).

Conclusion
Dexmedetomidine is a feasible sedation technique in autistic children undergoing outpatient electroencephalogram in terms of faster recovery and less incidence of complications.
Economic efficiency and productivity of lifting and distribution methods of groundwater for wheat and tomato in New Valley governorate
Authors: El-Shatla Hani , Ahmed Eman A. , Essa Reda , Mohamed Manal F. 
Published: December 2019

Abstract
Background
This research was aimed to study the structure of actual investment costs and operating and maintenance costs for raising and distributing ground water through the use of different irrigation methods and for estimating the most important economic and technical indicators for raising and distributing groundwater for the most important agricultural crops in Wadi El-Gadid (New Valley province).

Methods
This work was based on secondary data issued by the Ministry of Agriculture and Land Reclamation and field data obtained through personal interviews of wheat and tomato farmers by irrigation method (spray, flooding, and the method of lifting and distribution of water in the case of the use of diesel and conveyor belts), and the use of electricity and deep pumps, through the questionnaire design. A sample of 40 farmers was used.

Results
The results showed that the productivity and economic efficiency indicators for the lifting and distribution of groundwater by a power source during the agricultural season 2017/2018 increased the average productivity of total yield, net revenue/fed., net return/pound, and irrigation water in both crops.

Conclusion
The results showed that the method of lifting and distribution of water is more efficient than irrigation by flooding.
Role of trans-abdominal and trans-perineal venous duplex ultrasound in cases of pelvic congestion syndrome
Authors: Baz Ahmed A. 
Published: December 2019

Abstract
Background
For evaluation the role of trans-abdominal and trans-perineal venous duplex ultrasound in cases of pelvic congestion syndrome, fifty patients with pelvic congestion syndrome were included in the current research. All were evaluated by trans-abdominal and trans-perineal venous duplex.

Results
An incompetent left gonadal vein was detected in all cases with a mean diameter (± SD) = 7.9 ± 1.1 mm. The right gonadal vein was incompetent in 4 cases (8%) with a mean diameter (± SD) 5.9 ± 0.4 mm.
A refluxing proximal internal iliac vein was detected in 3cases (6%). Left renal vein nutcracker was present in 41cases (82%) while the left common iliac vein compression was present in 3 cases (6%).
Vulvoperineal varicosities were seen in all cases {right side = (36%, n = 18), left side = (30%, n = 15), and bilateral = (34%, n = 17)}.Thigh extension of the vulvoperineal varicosities was present in (74%, n = 37).
Round ligament varicosities were present in (6%, n = 3).

Conclusions
Trans-abdominal and trans-perineal venous duplex offer a simple, noninvasive, and quick technique that can help in an accurate evaluation of the ovarian vein reflux, diameters as well as the presence of vulvoperineal, and round ligament varicosities, Moreover, it is useful in the assessment of the left renal and iliac veins compression.
Use of Maximum Surgical Order Schedule (MSBOS) among pediatric patients to optimize blood utilization
Authors: Guzman Johann Paulo S. , Resurreccion Leandro L. , Gepte Maria Beatriz P. 
Published: December 2019

Abstract
Background
Evaluating blood ordering and subsequent development of a blood ordering schedule can decrease over-ordering of blood among pediatric surgical patients. The objective is to assess our practice of blood utilization using various blood utilization indices and calculate the Maximal Surgical Blood Order Schedule (MSBOS). This is a cross-sectional study for 3 years that included patients (≤ 18 years old) who underwent major surgical procedures in the Philippine Children’s Medical Center. Data included type of surgery, age and sex, number of units crossmatched, number of units transfused, and timing of transfusion. Indices were calculated.

Results
This study revealed that the utilization rate was only 39.1% of blood among a total of 5314 cases done. The indices were analyzed according to different procedures among different age groups. Procedures for head and neck, colorectal, ostomy, solid tumors, genitourinary abnormalities, upper gastrointestinal, and appendectomy had CT (crossmatched to transfusion) ratio exceeding 2.0, indicating inappropriate blood ordering. Major abdominal, major thoracic, and hepatobiliary surgery all have CT ratio < 2.0. MSBOS was calculated, and a requisition of 1 unit of blood among patients undergoing these procedures is suggested.

Conclusions
The MSBOS is largely utilized to the adult population but its creation can also be utilized among pediatric patients. Our data shows that in majority of elective pediatric surgical procedures, routine crossmatch is not necessary which is proven by our high underutilization of requested blood products.
AAPS Workshop Report on ICH M10
Authors: Booth Brian , Vazvaei Faye , Fluhler Eric , Myler Heather , Woolf Eric 
Published: December 2019

AbstractOver the last decade, several regulatory guidelines on bioanalytical method validation (BMV) have been issued by regulatory agencies around the world. This has left the bioanalytical community struggling with regional differences in regulatory expectations when preparing for global pharmaceutical submissions. The International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH) has the mission to achieve greater harmonization worldwide to ensure that safe, effective, and high-quality medicines are developed and registered in the most resource-efficient manner. Following calls for harmonization, ICH-selected bioanalytical method validation and sample analysis among its topics for guidance development and earlier this year released a draft guideline (M10) on BMV for public consultation. In response, the American Association of Pharmaceutical Scientists (AAPS) held a 3-day workshop to provide a forum for regulatory, industry, and academic scientists to discuss the guideline and hear various points of view on key aspects. While there was agreement that the draft guideline is generally well written and comprehensive, specific topics generated considerable discussion and, in some cases, revision recommendations for consideration by the expert working group (EWG) responsible for the guideline content. This report provides a summary of the workshop proceedings.
Relationship between internet addiction and academic performance of undergraduate medical students of Azad Kashmir
Authors: Javaeed Arslaan , Jeelani Raheema , Gulab Shazia , Ghauri Sanniya Khan 
Published: December 2019

Objective: To assess the relationship between internet addiction (IA) and academic performance among the medical students of Azad Kashmir, Pakistan.
Methods: A cross-sectional study was done involving 316 medical students of Poonch Medical College, Azad Kashmir, Pakistan from May 2018 to November 2018. Dr. Young’s Internet Addiction Test questionnaire was used as the tool of data collection. The questionnaire contained twenty 5-points Likert scale questions to assess internet addiction. IA score was calculated and the association between IA and academic performance was observed by Spearman Rank Correlation test. Relationship between baseline characteristics of the medical students and IA was also seen.
Results: Eighty-nine (28.2%) medical students fell under the category of ‘severe addiction’ and most importantly only 3 (0.9%) were not internet addicted according to Dr. Young’s questionnaire. Internet addicted medical students scored significantly poor in their exams (p. <.001). One hundred thirty one (41.4%) students with a median IA score of 45 scored in the range of 61-70% marks as compared to 3 (0.9%) students with a median IA score of 5, secured greater than 80% marks.
Conclusion: This study and many other previous studies have revealed that internet addiction affects academic performance. The number of internet users is ever increasing therefore, the number of internet misusers will also increase. If no step is taken to control internet addiction, it may cause a serious impact in the future.
doi: https://doi.org/10.12669/pjms.36.2.1061
How to cite this:Javaeed A, Jeelani R, Gulab S, Ghauri SK. Relationship between internet addiction and academic performance of undergraduate medical students of Azad Kashmir. Pak J Med Sci. 2020;36(2):229-233. doi: https://doi.org/10.12669/pjms.36.2.1061
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.
Non Invasive Follicular Thyroid Neoplasm with Papillary like nuclear features (NIFTP): A time for change in Pakistan
Authors: Jabeen Sumerah , Fatima Saira , Sheikh Aisha , Islam Najmul 
Published: December 2019

Objective: To determine the cases of Noninvasive Follicular thyroid neoplasm with papillary like nuclear features (NIFTP) in Pakistani population retrospectively. Another objective was to determine their clinical and radiological outcomes with respect to local and systemic disease recurrence, reconfirming the benign course of this new nomenclature in Thyroid tumors by WHO in our population would encourage adopting the new conservative treatment approach in such patients.
Methods: This is a retrospective cohort study conducted at a tertiary care center in Karachi, Pakistan from 2007-2016. All follicular Variant papillary thyroid cancer (FVPTC) reported from a single institute had their histopathology slides reexamined for diagnosing NIFTP as per the new WHO criteria. These cases were then followed retrospectively from their diagnosis onset through their medical and electronic health record for any local or systemic disease recurrence.
Results: There were 199 cases of Papillary Thyroid cancer (PTC) which included 22 cases of FVPTC. Eleven cases fulfilled NIFTP criteria with tumor size ranging from 1.1cm to ≥ 5.5cm. All patients in the NIFTP group underwent total thyroidectomy. Nine patients (81.81%) received RAI131 therapy. Four (45%) patients had a median follow up of three to four years. There was no disease recurrence seen on both ultrasound and RAI scans of patients in the NIFTP group. Seven patients (87.5%) had normal surveillance thyroglobulin levels except one whereas three patients were lost to follow up. There was no disease recurrence seen both radiologically and biochemically in the NIFTP group.
Conclusion: Our study favors the low risk nature of NIFTP with no disease recurrence in the cases studied and encourages de-escalation of treatment.
doi: https://doi.org/10.12669/pjms.36.2.1123
How to cite this:Jabeen S, Fatima S, Sheikh A, Islam N. Non Invasive Follicular Thyroid Neoplasm with Papillary like nuclear features (NIFTP): A time for change in Pakistan. Pak J Med Sci. 2020;36(2):151-155. doi: https://doi.org/10.12669/pjms.36.2.1123
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.
Physician’s prescription pattern in young infants with upper respiratory infections/cough and cold in emergency department
Authors: Turan Caner , Yurtseven Ali , Saz Eylem Ulas 
Published: December 2019

Objective: Despite the national/international warnings and little evidence as to whether over-the-counter cough and cold medications (OTC-CCM) are effective, physicians frequently overprescribe, parents overuse these drugs and antibiotics for URTIs in young child. This study aimed to determine the prescription pattern of over-the-counter cough and cold medications (OTC-CCM) in children less than two years.
Methods: This was a cross-sectional study in which we collected physicians prescriptions in young infants less than two years of age with ARI (acute respiratory infections) who visited pediatric emergency department (ED) between September 2017-April 2018 and received prescription with OTC-CCM enrolled. Infants who did not receive OTC-CCM were excluded.
Results: During the study period 2476 infants presented to the ED and 1452 (58.6%) had prescription with OTC-CCM. Analyzing the prescription details revealed that 63.8% was with decongestants, 53.5% antitussive and 52.7% antibiotics. One third of the prescriptions with these medications were written by pediatricians (p=0.001). Physicians had tendency to prescribe antibiotic if the infants had fever higher than 38°C (p=0.02).
Conclusion: We observed that international and national warnings did not show a considerable impact on the prescription pattern. Despite international and national reports, physicians frequently prescribe OTC-CCM in infants.
doi: https://doi.org/10.12669/pjms.36.2.1240
How to cite this:Turan C, Yurtseven A, Saz EU. Physician’s prescription pattern in young infants with upper respiratory infections/cough and cold in emergency department. Pak J Med Sci. 2020;36(2):166-171. doi: https://doi.org/10.12669/pjms.36.2.1240
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.
Antibiogram and recent incidence of multi-drug resistant carbapenemase producing Escherichia coli isolated from paediatric patients
Authors: Nosheen Sumbal , Bukhari Nadeem Irfan , Ejaz Hasan , Abbas Nasir 
Published: December 2019

Objective: To gauge the recent breadth of MDR E. coli along with antibiogram of carbapenemase producing (CP) E. coli among children from an institute which receives patients from all over Punjab.
Methods: The bacterial strains of E. coli isolated from various specimens of patients were collected from April 2017 to August 2018 and processed using standard biochemical tests and API 20E system (bioMerieux). Phenotypic screening for CP E. coli was done by the modified Hodge test, whereas antibiotic susceptibility testing was done with Kirby-Bauer disc diffusion technique.
Results: Total of 6,468 bacterial strains were isolated, out of which 1,552 (24%) were E. coli. Carbapenem resistance was observed in 245 (16%) strains, amongst which 113 (46%) were confirmed to be CP. E. coli isolated from males were higher as compared to females (p<0.05). Majority of the organisms were isolated from blood (37.2%) samples. The hospital discharged about 65% of patients, while 23% left against medical advice. Overall MDR amongst E. coli was 93.26%. Colistin sulphate (15.9%) and nitrofurantoin (16.8%) showed the most efficacy followed by amikacin (15%) and fosfomycin (10.6%).
Conclusion: The isolation of high number of MDR E. coli amongst the paediatric patients is worrisome, which could serve as a potential source of horizontal genes transfer to other genera.
doi: https://doi.org/10.12669/pjms.36.2.928
How to cite this:Nosheen S, Bukhari NI, Ejaz H, Abbas N. Antibiogram and recent incidence of multi-drug resistant carbapenemase producing Escherichia coli isolated from paediatric patients. Pak J Med Sci. 2020;36(2):246-250. doi: https://doi.org/10.12669/pjms.36.2.928
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.