bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cerebrovascular intervention therapy worked positively in one patient with severe cerebral venous sinus thrombosis due to hyperthyroidism: a case report and review of the literature
Authors: Jia Jia , Xi Gangmin , Fan Wei , Wang Guiping , Li Junwen , Huang Jing 
Published: June 2022

Abstract
Background
With further understanding of cerebral venous sinus thrombosis, hyperthyroidism has gradually been revealed as a rare predisposing factor for cerebral venous sinus thrombosis, which may present as more compact clots and resistance to fibrinolysis, also known as a predictor of worse outcomes. For patients with severe cerebral venous sinus thrombosis, proper treatment method should be initiated as soon as possible since they may deteriorate rapidly.

Case presentation
In this case report, we present a 32-year-old Mongoloid woman admitted with progressive headache, impaired consciousness, and right limb weakness, diagnosed with cerebral venous sinus thrombosis caused by hyperthyroidism. A cerebrovascular intervention with local thrombolytic infusion was performed at the site of thrombosis, followed by dilatation with balloon and thrombus aspiration in venous sinus, with partial recanalization observed and anticoagulation given as a next step. After cerebrovascular intervention, the patient’s condition improved rapidly and she was discharged with her National Institute of Health Stroke Scale score being decreased from 17 to 2.

Conclusions
When patients with hyperthyroidism suffer from headache, progressive disturbance of consciousness, seizures, and other symptoms, the presence of cerebral venous sinus thrombosis should be considered and corresponding examinations should be performed as soon as possible. For patients with severe cerebral venous sinus thrombosis, cerebrovascular intervention might be a safe and effective approach if conventional management fails.
Atypical dermatologic manifestations in complex regional pain syndrome: a case report
Authors: Langford Brendan , Pittelkow Thomas P. , Abcejo Arnoley S. 
Published: June 2022

Abstract
Background
Complex regional pain syndrome is a chronic pain condition characterized by autonomic dysfunction, changes in sympathetic and vasomotor activity, and sensory and motor changes. Complex regional pain syndrome is a clinical diagnosis and may occur after trauma or surgery. Complex regional pain syndrome-related pain may occur spontaneously and is out of proportion with the inciting event. We report herein the rare case of a man who developed concomitant painful generalized ulcerations after diagnosis of complex regional pain syndrome.

Case presentation
A 43-year-old Caucasian male with history of four-extremity complex regional pain syndrome type 2 secondary to right rotator cuff surgery performed at an outside hospital presented to a tertiary care center for treatment of generalized ulcerations on all extremities of unknown etiology. Dermatology performed an extensive work-up including laboratory evaluations and biopsies, which were relatively unremarkable. His ulcers were treated with vinegar-based dressings, hydrotherapy, and irrigation and debridements. He was started on methadone (replacing a home fentanyl patch), ketamine infusion, and amitriptyline in addition to his home adjuncts. He obtained good symptom control, improved sleep, and diminished cognitive slowing, compared with his fentanyl patches.

Conclusion
This case report emphasizes an atypical case of generalized ulceration formation in the setting of complex regional pain syndrome. This case highlights the challenging nature of treating complex regional pain syndrome and using multimodal analgesia to target various nociceptive receptors to successfully reduce symptoms.
Designing optimized drug candidates with Generative Adversarial Network
Authors: Abbasi Maryam , Santos Beatriz P. , Pereira Tiago C. , Sofia Raul , Monteiro Nelson R. C. , Simões Carlos J. V. , Brito Rui M. M. , Ribeiro Bernardete , Oliveira José L. , Arrais Joel P. 
Published: June 2022

AbstractDrug design is an important area of study for pharmaceutical businesses. However, low efficacy, off-target delivery, time consumption, and high cost are challenges and can create barriers that impact this process. Deep Learning models are emerging as a promising solution to perform de novo drug design, i.e., to generate drug-like molecules tailored to specific needs. However, stereochemistry was not explicitly considered in the generated molecules, which is inevitable in targeted-oriented molecules. This paper proposes a framework based on Feedback Generative Adversarial Network (GAN) that includes optimization strategy by incorporating Encoder–Decoder, GAN, and Predictor deep models interconnected with a feedback loop. The Encoder–Decoder converts the string notations of molecules into latent space vectors, effectively creating a new type of molecular representation. At the same time, the GAN can learn and replicate the training data distribution and, therefore, generate new compounds. The feedback loop is designed to incorporate and evaluate the generated molecules according to the multiobjective desired property at every epoch of training to ensure a steady shift of the generated distribution towards the space of the targeted properties. Moreover, to develop a more precise set of molecules, we also incorporate a multiobjective optimization selection technique based on a non-dominated sorting genetic algorithm. The results demonstrate that the proposed framework can generate realistic, novel molecules that span the chemical space. The proposed Encoder–Decoder model correctly reconstructs 99% of the datasets, including stereochemical information. The model’s ability to find uncharted regions of the chemical space was successfully shown by optimizing the unbiased GAN to generate molecules with a high binding affinity to the Kappa Opioid and Adenosine $$A_ {2a}$$

A

2
a

receptor. Furthermore, the generated compounds exhibit high internal and external diversity levels 0.88 and 0.94, respectively, and uniqueness.
A note on hypercircle inequality for data error with $l^{1}$ norm
Authors: Khompungson Kannika , Nammanee Kamonrat 
Published: June 2022

AbstractIn our previous work, we have extended the hypercircle inequality (HI) to situations where the data error is known. Furthermore, the most recent result is applied to the problem of learning a function value in the reproducing kernel Hilbert space. Specifically, a computational experiment of the method of hypercircle, where the data error is measured with the $l^{p}$

l
p

norm $(1< p \leq \infty )$
(
1
<
p
≤
∞
)
, is compared to the regularization method, which is a standard method of the learning problem. Despite this breakthrough, there is still a significant aspect of data error measure with the $l^{1}$

l
1

norm to consider in this issue. In this paper, we do not only explore the hypercircle inequality for the data error measured with the $l^{1}$

l
1

norm, but also provide an unexpected application of hypercircle inequality for only one data error to the $l^{\infty}$

l
∞

minimization problem, which is a dual problem in this case.
Responding to “Terminal anorexia nervosa: three cases and proposed clinical characteristics”
Authors: Mack Rebekah A. , Stanton Caroline E. 
Published: June 2022

AbstractThe treatment of eating disorders raises many ethical debates given the pervasiveness with which this illness impacts individuals, especially as the length of time with the illness increases. A recent case study supported the appropriateness of pursuing medical aid in dying for individuals with eating disorders who wish to end their fight with their disorder. This correspondence raises concerns related to this controversial proposal as the current authors dispute that the use of medical aid in dying for individuals with eating disorders is ethically judicious or appropriate. Additionally, this correspondence highlights additional treatment implications that should be considered when trying to provide individuals with eating disorders with the best evidence-based care possible, with the goal of promoting steps toward recovery.
Resuming Training in High-Level Athletes After Mild COVID-19 Infection: A Multicenter Prospective Study (ASCCOVID-19)
Authors: Chevalier Laurent , Cochet Hubert , Mahida Saagar , S Sylvain Blanchard , Benard Antoine , Cariou Tanguy , Sridi-Cheniti Soumaya , Benhenda Samy , Doutreleau Stéphane , Cade Stéphane , Guerard Sylvain , Guy Jean-Michel , Trimoulet Pascale , Picard Stéphane , Dusfour Bernard , Pouzet Aurelie , Roseng Stéphanie , Franchi Marco , Jaïs Pierre , Pellegrin Isabelle ,   ASCCOVID Investigators, Chevalier Laurent , Pellegrin Isabelle , Babeau Michel , Bensaïd Akram , Bernard Jeremy , Blanchard Sylvain , Chadourne Cédric , Claisse Patrick , Cubillé Victor , Dindart Jean-Michel , Franchi Marco , Goguillot Sophie , Humetz Ludovic , Izard Philippe , Laffourcade Benjamin , Lemahieu Bernard , Monnot Damien , Poirier Cédric , Pouget Philippe , Rebeyrol Jean-Louis , Rubio Elliot , Vela Carlos , Vincent Quentin 
Published: June 2022

Abstract
Background
There is a paucity of data on cardiovascular sequelae of asymptomatic/mildly symptomatic SARS-Cov-2 infections (COVID).

Objectives
The aim of this prospective study was to characterize the cardiovascular sequelae of asymptomatic/mildly symptomatic COVID-19 among high/elite-level athletes.

Methods
950 athletes (779 professional French National Rugby League (F-NRL) players; 171 student athletes) were included. SARS-Cov-2 testing was performed at inclusion, and F-NRL athletes were intensely followed-up for incident COVID-19. Athletes underwent ECG and biomarker profiling (D-Dimer, troponin, C-reactive protein). COVID(+) athletes underwent additional exercise testing, echocardiography and cardiac magnetic resonance imaging (CMR).

Results
285/950 athletes (30.0%) had mild/asymptomatic COVID-19 [79 (8.3%) at inclusion (COVID(+)prevalent); 206 (28.3%) during follow-up (COVID(+)incident)]. 2.6% COVID(+) athletes had abnormal ECGs, while 0.4% had an abnormal echocardiogram. During stress testing (following 7-day rest), COVID(+) athletes had a functional capacity of 12.8 ± 2.7 METS with only stress-induced premature ventricular ectopy in 10 (4.3%). Prevalence of CMR scar was comparable between COVID(+) athletes and controls [COVID(+) vs. COVID(−); 1/102 (1.0%) vs 1/28 (3.6%)]. During 289 ± 56 days follow-up, one athlete had ventricular tachycardia, with no obvious link with a SARS-CoV-2 infection. The proportion with troponin I and CRP values above the upper-limit threshold was comparable between pre- and post-infection (5.9% vs 5.9%, and 5.6% vs 8.7%, respectively). The proportion with D-Dimer values above the upper-limit threshold increased when comparing pre- and post-infection (7.9% vs 17.3%, P = 0.01).

Conclusion
The absence of cardiac sequelae in pauci/asymptomatic COVID(+) athletes is reassuring and argues against the need for systematic cardiac assessment prior to resumption of training (clinicaltrials.gov; NCT04936503).
Intermittent white noise exposure is associated with rat cochleae damage and changes in the gene expression
Authors: Hotkani Maryam Mirzaei , Esmaeilpoor Mohammad Reza Monazzam , Khadem Monireh , Garmaroudi Amir Abbasi , Inanloorahatloo Kolsoum 
Published: June 2022

Abstract
Background
Noise, a physical factor in most work environments, has many effects on human health. Exposure to excessive noise can modify the expression of associated genes with NIHL. The aim of this study to elucidate changes in expression of GJB2 and SLC26A4 after exposure to intense noise which are the most frequent causing genes to apparent autosomal recessive non-syndromic hearing loss.

Methods
In this experimental and case–control study, 17 male Wistar rats were randomly divided into exposure groups (n = 12) and without exposure (n = 5). First group was exposed to noise (90–120 dB, 70 Hz–16 kHz, 8 h/day) for 3–6 days. Cochlear biopsies performed 1 h and 1 week post-exposure, relative gene expression levels were calculated using $${2}^{-\Delta \Delta Ct}$$

2

-
Δ
Δ
C
t

. From each group, one ear was stained by hematoxylin and eosin method for histopathological survey. Real-time PCR technique took place, and gene expression data were normalized by GAPDH gene. One-way ANOVA test was performed with a significance level of 0.05 by GraphPad prism software.

Results
Both GJB2 and SLC26A4 in all groups were down-regulated after exposure compared to their controls. Fold changes in the highest times were related to 1 week after 6 days of exposure, 0.052 and 0.015, respectively. Serious damages occurred in different parts of cochlea, and they were more severe after 6 days and 1-week later.

Conclusion
It is expected that if the hearing threshold tests be performed before/after exposure and considering longer post-exposure times, subsequently, the expression of these genes does not return to basal level, and irrecoverable damage to the cochlea, progressive and irreversible ARNSHL will be expected.
Comparison between early and late mortalities due to severe sepsis in a pediatric intensive care unit: five-years-experience
Authors: Zaher Salah Rafik , Elgohary Dina Adel , Antonios Manal A. M. 
Published: June 2022

Abstract
Background
The majority of children who die of sepsis suffer from refractory shock and/or multiple organ dysfunction syndrome, with many deaths occurring within the initial 48–72 h of treatment.

Methods
A retrospective observational study of deceased patients due to severe sepsis over 5 years, from the 1st of August 2015 to the end of July 2020, that were admitted in a pediatric intensive care unit.

Results
Over 5-year duration of the study, the trend of cases with severe sepsis increased from 26.4% in 2015 to 40.7% in 2020. Meanwhile, the trend of mortality among this category of patients dropped from 66.7% in 2015 to 33.9% in 2020. From the studied 163 deceased patients, results showed predominance of Klebsiella pneumoniae of the extended resistance pattern in bronchoalveolar lavage and blood cultures, and it came second to Candida in urine cultures. Pandrug-resistant organism was recorded in 8.59% (n = 14 patients). Patients with bacteremia, acidosis, high pediatric index of mortality (PIM-2), and pediatric logistic organ dysfunction (PELOD) scores were statistically related to early fatality fate.

Conclusion
High mortality was associated with the increasing spread of resistant organisms especially Klebsiella pneumoniae. Patients with bacteremia, acidosis, and high PIM-2 and PELOD scores probably will need immediate, vigorous, and intense care in order to save their lives.
An Audit to optimize antibiotics use in neonatal septicemia
Authors: Usman Ayesha , Khan Maria Zamurad , Khan Maimoona Zamurad , Hussain Abdullah 
Published: June 2022

Objectives: To assess appropriate antibiotics use in neonatal sepsis and to highlight the need for developing an Antibiotic stewardship program at local levels.
Methods: A clinical audit was conducted in the neonatal ward of the tertiary care hospital of Lahore for one year from May 2019 to May 2020. Reports of blood culture and drugs susceptibility were gathered from the microbiology department, and clinical records were evaluated about the choice of the antimicrobials, dosage, frequency, and clinical prognosis. The statistics were applied using SPSS software.
Results: Eighty five neonates with the mean age of five days were treated in tertiary care hospital for septicemia. Every patient received more than one antibiotic empirically. The most prescribed drug combination (90.6%) was Cefotaxime and Amikacin. Optimum antibiotics dose was prescribed in only 70.2% of cases. Blood isolates showed gram-negative bacilli in 69 (81.2%) cases, gram positive cocci in 14 (16.5%) cases, two (2.3%) culture susceptibility reports showed growth of candida. Gram negative organisms were most susceptible to Imipenem (54%), Piperacillin-Tazobactam (48%) and Gentamicin (48%). Gram-positive organisms showed the most susceptibility to Vancomycin (100%), Amikacin (92%), and Co-amoxiclav (85%). Meropenem (39%), Linezolid (28%), and Vancomycin (27%) were the most commonly given alternate antibiotics. All the patients (n=10, 11.8%) whose culture sensitivity reporting showed susceptibility to empirical therapy survived.
Conclusion: Due to poor availability of latest data about local antibacterial resistance pattern and lack of knowledge among pediatricians about latest antibiotic prescribing protocols, many inconsistencies were noted in the use of antibiotics in neonatal sepsis which resulted in a poor outcome hence, reflecting in international key health indicators (neonatal mortality rate) of country. Concerning the change in the resistance pattern of microorganisms to antimicrobials, it is high time to collect local data about antibacterial susceptibility and develop an antibiotic stewardship program to stop inappropriate use of antibiotics.
doi: https://doi.org/10.12669/pjms.38.6.5073
How to cite this:Usman A, Khan MZ, Khan MZ, Hussain A. Audit to optimize antibiotics use in neonatal septicemia. Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.5073
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.
Impact of COVID pandemic upon radiological services in a tertiary care hospital - A clinical audit
Authors: Masood Laiba , Gul Salma , Saeed Rohama , Bano Suraya 
Published: June 2022

Background and Objectives: Radiology emerged as one of the frontline clinical services in the COVID-19 pandemic. This audit study aimed to evaluate the impact of COVID-19 on the radiological services in a tertiary care hospital in terms of workload and case mix.
Methods: We compared the overall workload of the radiology department between March 2019 to December 2020, emphasizing the number of CTs and Chest radiographs performed during the pandemic. The first period starting when the first confirmed case presented to our hospital and the second control period in the same months in 2019. The imaging parameters included the total number of CTs, MRIs, Ultrasounds, Radiographs, CTs from the emergency room (ER), OPD, IPD, CT chest performed for COVID-19 and other emergency indications. All parameters were calculated by taking average each month in both study periods.
Results: An overall decrease was observed in the number of all primary imaging modalities during the pandemic, with ultrasound showing a maximum reduction in numbers (36.5%) followed by radiographs (29.6%) and MRIs (13.8%) compared to 2019. However, total CTs showed a minimal decrease of 1.6% with a significant leap in HRCTs performed reaching up to 80.5%.
Conclusion: COVID-19 and resultant movement restrictions, although they did lead to a reduction in overall radiology work volume, were compensated by an increase in the number of studies performed through emergency and for management of COVID-19 infection.
Abbreviations:COVID-19= Coronavirus disease 2019, CT = Computed Tomography, HRCT = High resolution CT, MRI = Magnetic Resonance Imaging, USG = Ultrasound, CXR = Chest Radiograph, RIS = Radiology Information system, ER = Emergency Department, IPD = In patient Department, OPD = Outpatient Department.
doi: https://doi.org/10.12669/pjms.38.6.5272
How to cite this:Masood L, Gul S, Bano S, Saeed R. Impact of COVID pandemic upon radiological services in a tertiary care hospital - A clinical audit. Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.5272
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Analysis of diagnostic characteristics and clinical related factors of 70 patients with atelectasis by painless bronchoscopy
Authors: Li Qiang , Sun Jun , Shuai Xuefen , Ren Junqing , Chen Xuedong 
Published: June 2022

Objectives: To analyze the diagnostic characteristics and clinical related factors of patients with atelectasis by painless electronic bronchoscopy.
Methods: A retrospective analysis was performed on 70 patients with atelectasis admitted to Xuancheng People’s Hospital from April 2019 to June 2021. The clinical data of the patients and the diagnosis characteristics under painless electronic bronchoscope were analyzed, and the clinical related factors were investigated.
Results: Seventy patients with atelectasis underwent pathological examination and bacteriological examination after painless electronic bronchoscopy, including 16 cases (22.86%) of inflammation, 11 cases (15.71%) of tuberculosis, 36 cases (51.43%) of tumor, one case (1.43%) of inflammatory polyp, one case (1.43%) of congenital dysplasia, two cases (2.86%) of foreign body inhalation, and three cases (4.29%) of other symptoms. Male patients with atelectasis showed most cauliflower-like tumors and mucosal swelling under electronic bronchoscopy (P<0.05), while female patients showed scar occlusion/stenosis at most (P<0.05). Middle-aged and elderly patients under electronic bronchoscopy showed most cauliflower-like tumors, scar stenosis/occlusion and mucosal swelling cavity, while young patients mainly showed necrosis and purulent secretions. Heavy smokers were most likely to have cauliflower-like tumors, while non-smokers were predominantly with scar stenosis/occlusion.
Conclusions: Painless electronic bronchoscopy is of great value in the clinical diagnosis of patients with atelectasis, and it is likely to further clarify the etiology of atelectasis. Age, sex, and quantity of smoking may be clinical factors associated with atelectasis.
doi: https://doi.org/10.12669/pjms.38.6.5273
How to cite this:Li Q, Sun J, Shuai X, Ren J, Chen X. Analysis of diagnostic characteristics and clinical related factors of 70 patients with atelectasis by painless bronchoscopy. Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.5273
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.