bluuebunny/crossref_metadata_2025_split huggingface dataset:
Giant Burrowing Mayfly (suggested common name) Hexagenia limbata (Serville 1829) (Insecta: Ephemeroptera: Ephemeroidea: Ephemeridae)
Authors: Orfinger Alexander Benjamin , Lucky Andrea 
Published: July 2020

The giant burrowing mayfly, Hexagenia limbata (Serville, 1829) (Figure 1) is one of the most widespread mayflies in North America and is well known for its importance in ecosystem health and water quality monitoring. The mayflies (order Ephemeroptera) are an ancient lineage of aquatic insects originating more than 300 million years ago (Merritt and Cummins 2008). Within this order, the burrowing mayflies of the family Ephemeridae are well-known for their importance in fly fishing and their massive synchronized mating flights.https://edis.ifas.ufl.edu/in1244
Also published on the Featured Creatures website: http://entnemdept.ufl.edu/creatures/AQUATIC/mayfly.html
Effect of ursodeoxycholic acid on lipid metabolism: through the prism of evidence from 2019.
Authors: Gubergrits N. B. , Byelyayeva N.V. , Mozhyna T. L. , Lukashevich G. M. , Fomenko P. G. 
Published: July 2020

After the discovery of the method of ursodeoxycholic acid’s (UDCA) synthesis and the publication of evidence confirming its ability to reduce the lithogenic properties of bile, active clinical use of UDCA began in the world. This drug, which has pleiotropic effect (choleretic, cytoprotective, immunomodulatory, antiapoptic, litholytic, hypocholesterolemic), has proven its effectiveness in the treatment various diseases: primary biliary cholangitis, intrahepatic cholestasis of pregnancy, gallstone disease.
Being a tertiary bile acid, UDCA stimulates bile acid synthesis by reducing the circulating fibroblast growth factor 19 and inhibiting the activation of the farnesoid X-receptor (FXR), which leads to the induction of cholesterol-7α-hydroxylase, a key enzyme in the synthesis of bile acid de novo, mediating the conversion of cholesterol into bile acids. Changes in the formation of bile acids and cholesterol while taking UDCA intake is accompanied by activation of the main enzyme of cholesterol synthesis - 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR). Under the influence of UDCA the activity of stearoyl-Coa desaturase (SCD) in visceral white adipose tissue increases. According to studies conducted in 2019, UDCA improves lipid metabolism by regulating the activity of the ACT/mTOR signaling pathway, reduces the synthesis of cholesterol, decreases the fractional synthesis rate of cholesterol and the fractional synthesis rate of triglycerides. It has been proved that UDCA is accompanied by a decrease in the level of total cholesterol and low density lipoprotein cholesterol.
Increased awareness enhances physician recognition of the role of smoking in chronic pancreatitis
Authors: Muniraj T. , Yadav D. , Abberbock J. N. , Alkaade S. , Amann S. T. , Anderson M. A. , Banks P. A. , Brand R. E. , Conwell D. , Cote G. A. , Forsmark C. E. , Gardner T. B. , Gelrud A. , Guda N. , Lewis M. D. , Romagnuolo J. , Sandhu B. S. , Sherman S. , Singh V. K. , Slivka A. , Tang G. , Whitcomb D. C. , Wilcox C. M. 
Published: July 2020

Background: We have previously reported that physicians under-recognize smoking as a chronic pancreatitis (CP) risk factor. We hypothesized that availability of empiric data will influence physician recognition of this relationship.
Methods: We analyzed data from 508 CP patients prospectively enrolled in the North American Pancreatitis Study-2 Continuation and Validation (NAPS2-CV) or NAPS2-Ancillary (AS) studies (2008–2014) from 26 US centers who self-reported ever-smoking. Information on smoking status, physician-defined etiology and identification of smoking as a CP risk factor was obtained from structured patient and physician questionnaires. We compared how often physician identified smoking as a CP risk factor in NAPS2-CV/NAPS2-AS studies with NAPS2-original study (2000–2006).
Results: Enrolling physician identified smoking as a risk factor in significantly (all p< 0.001) greater proportion of patients in NAPS2-CV/AS studies when compared with NAPS2-original study among ever (80.7 vs. 45.3%), current (91.3 vs. 53%), past (60.3 vs. 30.2%) smokers, in those who smoked ≤1 pack/day (79.3 vs. 39.5%) or ≥1 packs/day (83 vs. 49.8%). In multivariable analyses, the enrolling physician was 3.32–8.49 times more likely to cite smoking as a CP risk factor in the NAPS2-CV/NAPS2-AS studies based on smoking status and amount after controlling for age, sex, race and alcohol etiology. The effect was independent of enrolling site in a sub-analysis limited to sites participating in both phases of enrollment.
Conclusions: Availability of empiric data likely enhanced physician recognition of the association between smoking and CP. Wide-spread dissemination of this information could potentially curtail smoking rates in subjects with and those at risk of CP.
Complications of pancreatitis: features of the course and tactics of treatment
Authors: Hontsariuk D. A. , Patratii M. V. 
Published: July 2020

The aim of this article is to draw attention of gastroenterologists, surgeons and primary care physicians to the features of the course of pancreatitis complications, which tend to have an acute course and are a complex process that causes medical errors and life tragedies.
The importance of complications of pancreatitis such as cysts, pseudocysts, fistulas, cholestatic syndrome, portal hypertension syndrome, bleeding from varicose veins of the esophagus, stomach and erosive-ulcerative secondary gastroduodenal processes is emphasized.
Attention is focused on the mechanisms of development of these complications, features of the clinical course, management tactics of such patients, depending on the location of the complications, which is important for the treatment strategy (conservative or surgical). The peculiarities of the clinical picture of the syndrome of compression of neighboring organs, thrombosis of the hepatic and splenic veins, biliodigestive bleeding, including hemobilia, bleeding from the large and small duodenal papilla, are directly related to the analytical approach regarding the diagnosis of these complications. Angiographic techniques are considered to be the most effective diagnostic techniques, which include celiacography, upper mesentericography, percutaneous and transhepatic portography. It is indicated that on their basis, techniques for stopping bleeding have been developed, namely endovascular catheter hemostasis.
Pancreatology: debunked myths
Authors: Gubergrits N. B. , Byelyayeva N. V. 
Published: July 2020

Enzyme replacement therapy is not always effective enough upon exocrine pancreatic insufficiency. One of the main reasons is myths — doctors’ misconceptions about the indications and rules of replacement therapy.
In particular, there is an outdated opinion about the effectiveness of tablet enzyme preparations used for the relief of pancreatic pain. However, a number of evidence-based studies have proved that enzyme preparations are not effective enough to relieve pain in chronic pancreatitis, and thus should not be used for this purpose. This statement is recorded in the United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis, as well as in the recommendations of the American College of Gastroenterology. In addition, tablet preparations are characterized by asynchronism of the passage of the chyme and the tablet along the digestive tract.
The second myth is that drugs without an acid-resistant coat start hydrolyzing the components of the chyme in the stomach, which ensures higher efficiency as compared to Creon. But in the absence of a coat, enzymes are inactivated in the acidic environment of the stomach and cannot have any effect at all.
The third myth is that enzyme preparations always cause constipation. In fact, constipation occurs in no more than 10% of cases. They are usually associated with an overdose of the drug, concomitant pathology or insufficient compliance.
The fourth myth is that prescribing the doses of enzyme preparations indicated in the European Guidelines causes addiction. It is crucial to know that such doses do not exceed 10% of the pancreas’s own capacities, therefore, they cannot significantly affect these capabilities, which is also demonstrated by evidence-based studies.
The fifth myth is that patients gain weight because of enzyme preparations, and they should not be prescribed upon overweight and obesity. Numerous data firmly show that pancreatic insufficiency often occurs in such cases, and enzyme preparations are required.
The sixth myth is that a drug with a different composition can be produced under the usual established product name. For example, NEO is added to the name to “mask” a drug with a new composition. Doctors should carefully monitor the composition of such drugs.
The seventh myth is that a minimicrospherical preparation (Creon) is as effective as microspherical preparation. However, this statement turned out to be a myth as well. Minimicrospherical preparations are proved to be significantly more effective in clinical practice.
Thus, the above-mentioned myths, like many others, are based on insufficient knowledge in the field of pancreatology.
Liver fibrosis: pathogenesis, diagnosis, treatment prospects
Authors: Tsymmerman Ya. S. 
Published: July 2020

The review discusses one of the common problems of modern gastroenterology, namely liver fibrosis. Given the lack of a generally accepted definition of liver fibrosis, some of the most successful definitions of this clinical and morphological condition are given first. The main factors triggering a cascade of pathological reactions of fibrogenesis (accumulation of extracellular matrix, stellate cells activation) are considered, and typical triggers (viral hepatitis B, C, hepatotoxins, oxidative stress) of this process are listed. The role of stellate cells in the pathogenesis of liver fibrosis is highlighted. The diagnosis of liver fibrosis is described in detail, the key role of puncture biopsy with subsequent histological assessment according to the METAVIR scale, Klodell index, is emphasized. The existing disadvantages of the liver puncture biopsy are listed, the advantages of using serological tests to determine the degree of fibrogenesis activity (FibroTest and FibroMax panels), as well as modern imaging study based on assessing the degree of density of the liver tissue, namely elastography, are presented. A comparative assessment of the therapeutic capabilities of modern drugs with antifibrotic features is given. The possibility of using various hepatoprotectors (ursodeoxycholic acid, phosphatidylcholine, silymarin), corticosteroids, antiviral drugs (interferon, ribavirin), other medications (vitamin E, colchicine, pentoxifylline, decorin), and genetic engineering to inhibit fibrogen activity was considered. The probability of malignant transformation of fibrosis and the development of hepatocellular liver carcinoma is emphasized.
LESSONS LEARNT FOR THE INDONESIAN MILITARY LEADERS FROM GENERAL PERICLES’ STRATEGIC-TRANSFORMATIVE LEADERSHIP
Authors: Widodo Wibawanto Nugroho 
Published: July 2020

<p>For a nation to be great, such a nation shall have great and professional military leaders which are contextual to the time and social context of their nation. That is why Indonesian military leaders need to take some lesson-learned from historical records of great military leaders, one of them is the strategic and transformative leadership of General Pericles, an Athenian General. Therefore, this article analyzes about Pericles’ great leadership, especially in what ways and how to measure it. The data corpus of this study is “The Landmark Thucydides: A Comprehensive Guide to the Peloponnesian War” by Thucydides<em>.</em> The research uses qualitative study and critical review on related archival documentation. All data collected is validated by cross-checking with other credible open sources about the life and leadership records of General Pericles. The qualitative analysis uses to examine three main variables that are critical to his strategic-transformative leadership: his grand strategy (strategic mindset); his dedication to the highest level of life for Athenian citizens (altruistic mindset and heart); and his statesmanship, generalship, leadership (his leadership traits). The main International Relations theories used for examining General Pericles’s leadership are the theory of realism and institutionalism coupled with personality analysis of General Pericles himself. This article lays out the answer to the two thesis questions. This article proves that as a realist and visionary leader, Pericles’s leadership was central to the Athenian greatness in terms of its political, social, demographic, and military affairs, that successfully brought his nation to the global height. Putting in the current Indonesian context, this strategic-transformative leadership is important for any Indonesian military leaders to possess since any great nations shall have great and professional military leaders which are contextual to the time and social context of their nation.</p>
Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society
Authors: Fontham Elizabeth T. H. , Wolf Andrew M. D. , Church Timothy R. , Etzioni Ruth , Flowers Christopher R. , Herzig Abbe , Guerra Carmen E. , Oeffinger Kevin C. , Shih Ya‐Chen Tina , Walter Louise C. , Kim Jane J. , Andrews Kimberly S. , DeSantis Carol E. , Fedewa Stacey A. , Manassaram‐Baptiste Deana , Saslow Debbie , Wender Richard C. , Smith Robert A. 
Published: July 2020

AbstractThe American Cancer Society (ACS) recommends that individuals with a cervix initiate cervical cancer screening at age 25 years and undergo primary human papillomavirus (HPV) testing every 5 years through age 65 years (preferred); if primary HPV testing is not available, then individuals aged 25 to 65 years should be screened with cotesting (HPV testing in combination with cytology) every 5 years or cytology alone every 3 years (acceptable) (strong recommendation). The ACS recommends that individuals aged >65 years who have no history of cervical intraepithelial neoplasia grade 2 or more severe disease within the past 25 years, and who have documented adequate negative prior screening in the prior 10 years, discontinue all cervical cancer screening (qualified recommendation). These new screening recommendations differ in 4 important respects compared with the 2012 recommendations: 1) The preferred screening strategy is primary HPV testing every 5 years, with cotesting and cytology alone acceptable where access to US Food and Drug Administration‐approved primary HPV testing is not yet available; 2) the recommended age to start screening is 25 years rather than 21 years; 3) primary HPV testing, as well as cotesting or cytology alone when primary testing is not available, is recommended starting at age 25 years rather than age 30 years; and 4) the guideline is transitional, ie, options for screening with cotesting or cytology alone are provided but should be phased out once full access to primary HPV testing for cervical cancer screening is available without barriers. Evidence related to other relevant issues was reviewed, and no changes were made to recommendations for screening intervals, age or criteria for screening cessation, screening based on vaccination status, or screening after hysterectomy. Follow‐up for individuals who screen positive for HPV and/or cytology should be in accordance with the 2019 American Society for Colposcopy and Cervical Pathology risk‐based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors.
Clinico-Pathological Findings of Bangladeshi Covid 19 Patients with their Clinical Outcome: Study of A Cohort of 201 Cases
Authors: Ahmed Nasir Uddin , Islam Md Azizul , Kabir Md Anwarul , Rahman Md Habibur , Sadat SM Anwar 
Published: July 2020

Introduction: COVID-19 is a major threat to human beings. Clinical characterization, rapid identification of cases and isolation are vital for containments of rapidly spreading disease. The objectives of the study were to evaluate the clinico pathologic profile of Covid 19 positive Bangladeshi patients and also to see their clinical outcome within defined period. Methods: This cohort study on 201 Bangladeshi cases was done in Combined Military Hospital, a tertiary level hospital in Dhaka, Bangladesh from April 2020 to May 2020. Total 201 COVID-19 cases were enrolled after getting the result positive for RT-PCR. After collection, data were analysed to show the characteristics of Covid 19 and their outcome after treatment.
Results: Among 201 cases, 180 (90%) were male and 21 (10%) were female. The most prevalent affected age groups were 71 (35.5%) patients in 26-35 years age, 54 (27%) in 16- 25 years, 49 (24.5%) in 35-45 years. Mean age is 32.2±2. Among the total cases, 146 (73%) have positive history of contact, 37 (18.5%) have no history of any contact, 8 (4%) denied any contact with COVID-19 patients. Regarding clinical presentations, 67 (33.5%) patients presented with only one symptoms, 125 (62.5%) had multiple symptoms and 9 (4.5%) cases were asymptomatic. 154 (77%) patients presented with fever. Other presentations were cough 71 (35.5%), headache 27 (13.5%), myalgia 25 (12.5%), sore throat 25 (12.5%), malaise 15 (7.5%), respiratory distress 11 (5.5%). Respiratory system was the dominant domain of clinical presentation. Leukopenia was presented by 12 patients and 12 had lymphopenia. 18 patients had mild thrombocytopenia. Pulse oxymetry showed oxygen saturation below 88% in 12 cases. After oxygen therapy 7 cases were improved and 5 cases were shifted to Corona ICU as their saturation fell below 70. These 5 patients are categorised as severe disease, rest 196 patients were mild in nature.
Conclusion: COVID 19 affects male more than female. Common symptoms are fever, cough, headache, myalgia, sore throat, malaise, respiratory distress. Respiratory system is the dominant domain of clinical presentation. ICU support was needed in 2.5 % cases and death rate was 1% which was associated with comorbidity of CKD.
J Bangladesh Coll Phys Surg 2020; 38(0): 37-42
COVID-19 and Dengue Combination Dilemma: A Case of Probable Dengue False Positivity in a COVID 19 Patient
Authors: Islam Mohammad Rafiqul , Hossan Alamgir , Uddin MM Nasir , Hasan Md Tanvir 
Published: July 2020

A 58-year-old diabetic and hypertensive patient showed symptoms of fever for seven days with cough and irritation in throat for the same duration. He did not complain of any headache, shivering, confusion, breathlessness, tastelessness or smell abnormalities. His first RT-PCR for coronavirus disease 2019 (COVID-19) and IgM for dengue were both positive. His first PCV value and platelet value were normal on seventh and ninth day respectively. False positive serology for dengue may happen in COVID 19 cases.
J Bangladesh Coll Phys Surg 2020; 38(0): 133-135
Vitamin D<sub>3</sub> supplementation on plasma antioxidant enzymes in D<sub>3</sub> deficient patients with COPD - a randomized controlled trial
Authors: Anjum Salma , Ali Taskina , Bennoor Kazi Saifuddin , Hossain Md Ali , Islam Md Saiful , Mahmud Maksuda Bintey , Hassan Samia , Nahar Salsa Bil , Rosy Sharkia Khanam , Sultana Naznin , Akter Khalada 
Published: July 2020

Background: Free radical is a crucial factor for progression of COPD. Antioxidant enzymes, including superoxide dismutase (SOD) and catalase (CAT) have been well known to reduce morbidity of chronic disease. Vitamin D3 has antioxidant effect in human body.
Objectives: To assess the effects of D3 supplementation on plasma SOD and CAT levels in D3 deficient COPD patients.
Method: A double blinded placebo controlled randomized clinical trial was carried out on 30 vitamin D3 deficient male, smoker and stable COPD patients of age >40 years. All the patients were randomly allocated to ‘Study’ (n=15) or ‘Control’ (n=15) and their baseline plasma SOD and CAT were measured. Study patients received 80,000 IU (2 oral capsules) of D3 per week for first 13 weeks. Subsequently, after checking their serum 25(OH)D or Ca2+, they received 40,000 IU (1 oral capsule) of D3 either per 1 week or per 2 weeks or per 6 weeks or no further supplementation for next 13 weeks. All the ‘Control’ patients received two oral capsules of placebo weekly for consecutive 26 weeks. Additionally, all patients of both groups were also advised to have sunlight exposure (within 11 to 14 hrs) at least for 5 to 15 minutes daily. After 26 weeks of follow up, both enzymes, serum 25(OH)D or Ca2+of all patients were measured by spectrophotometry. Data were analyzed by paired sample and independent sample ‘t’ test.
Results: The baseline plasma SOD (14.80±3.86U/ml vs 11.95±4.03U/ml) and CAT (11.0±7.59U/ml vs14.41±4.83U/ml) in study and control was almost similar (p>0.05). However, the mean SOD (18.98±2.98U/ml) and CAT (32.75±9.70U/ml) significantly increased (p<0.01; p<0.001) after 26 weeks of follow up only in ‘Study’ patients. In addition, both enzymes were significantly (p<0.001) higher in the D3 supplemented patients than those of placebo treated patients after 26 weeks of follow up.
Conclusion: The present study reveals that vitamin D3 supplementation increases the plasma antioxidant enzymes in D3 deficient patients with COPD.
Trial registration: www.clinicaltrials.gov identifier NCT04011930
J Bangladesh Soc Physiol. 2020, June; 15(1): 23-32
Rehabilitation Infrastructure and Services in a Tertiary Hospital in Bangladesh
Authors: Hasan Md Israt , Mohammed Emran - , Md Atiquzzaman - , Hossain Md Shahadat , Morshed Taufiq , Newaz Fatema , Banik Amitav , Hasan Abu Saleh Mohammad Mainul 
Published: July 2020

Background: Rehabilitation Medicine is the focal point on the refurbishment of the health and function, and reintegration of the patient into the community. Since inception, department of Physical Medicine and Rehabilitation (PMR) is dispensing state of the art services despite its fewer resources.
Objective: To anticipate a brief recapitulation of the infrastructure of Rehabilitation medicine and its' services as well as demographic data and, disease pattern among the patients dealt by it in a Tertiary Hospital.
Materials and Methods: This is a retrospective study executed in the department of PMR of Kurmitola General Hospital, Dhaka from January 2019 to December 2019.
Results: Currently 4 Rehabilitation Physicians (Physiatrist) and 3 Physical Therapists, are involved in indoor, outdoor and, specialized PMR services with 4 indoor beds. Total thirty four thousands seven hundred thirty six (n=34,736) patients were studied who received our services, among them 35.62% were male and 64.38% were female. 16% of patients were under 20 years of age, about 61% of patients belong to 2nd, 3rd, 4th, 5th decades and 23% were above 60 years of age. Nonspecific Low Back Pain (NSLBP) were 23.80%, 8.29% Neck pain, cervical spondylosis11.15%, lumbar spondylosis 11.52%, frozen shoulder 9.83%, PLID 7.39%, osteoarthritis 9.15%, facial palsy 0.53%, rheumatoid arthritis 4.47%, seronegative spondyloarthopathy 1.26%, Guillain-Barre` Syndrome (GBS) 0.15%, planter fasciitis 4.68%, 2.10 % postsurgical/post-traumatic stiffness and others were 5.13%.
Conclusion: It is time demand to build more infrastructures country wide to improve physical medicine and rehabilitation services for the country people.
KYAMC Journal Vol. 11, No.-2, July 2020, Page 62-66