bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of bidirectional Glenn surgery done without prior cardiac catheterization
Authors: Azhar Ahmad , Eid Rehan , Elakaby Ahmed , Abdelsalam Mohamed , Al-Ata Jameel , Alkhushi Naif , Bahaidarah Saud , Zaher Zaher , Maghrabi Khadijah , Noaman Nada , Abdelmohsen Gaser 
Published: August 2022

Abstract
Background
Cardiac catheterization is usually done routinely in patients with univentricular hearts before palliative Bidirectional Glenn (BDG) surgery. The objective of this study was to compare the outcomes of patients with physiological univentricular hearts and restrictive pulmonary flow that did not undergo routine cardiac catheterization before BDG with the patients that did have cardiac catheterization done. We retrospectively reviewed the data of all patients with single ventricle physiology and restrictive pulmonary blood flow who underwent BDG surgery from January 2016 till December 2020. Patients were divided into two groups: the catheterization and the non-catheterization groups.

Results
Out of 93 patients, 25 (27%) underwent BDG surgery without prior cardiac catheterization. The median age of patients was ten months, interquartile range (IQR) was 5–18 months. Tricuspid atresia represented 36% of the non-catheterization group, while unbalanced atrioventricular septal defect and hypoplastic left heart syndrome represented 19% and 17.6% of the catheterization group. No patients in the catheterization group were excluded from further BDG surgery based on the catheterization data. Moreover, no significant differences were found between the patients' groups regarding the length of hospital stay, length of intensive care unit stay, postoperative oxygen saturation, or survival (P = 0.266, P = 0.763, P = 0.543, P = 0456).

Conclusions
Although pre-BDG cardiac catheterization is the routine and standard practice, in certain situations, some patients with single ventricle physiology and restrictive pulmonary blood flow may go directly to BDG without cardiac catheterization if noninvasive imaging is satisfactory on a case-by-case basis and according to center experience. Pre-BDG catheterization could be reserved for patients with limited echocardiographic studies, high-risk patients, or those indicated for catheter intervention before BDG surgery.
Biliary drainage guided by endoscopic ultrasonography is a doable objective
Authors: Abdellatef Abeer , Wifi Mohamed-Naguib 
Published: August 2022

AbstractThe therapeutic usage of EUS is being developed. EUS-guided biliary drainage (EUSBD) is a recognized viable replacement for percutaneous transhepatic biliary drainage (PTBD) in severe cases with the obstructive biliary disease having ERCP failure due to a failure in cannulation or those with surgically altered anatomies, such as hepatico-jejunal anastomosis following Billroth II reconstruction, Roux-en-Y limb, Whipple procedure, or Roux-en-Y gastric bypass, or cases with inaccessible papilla because of severe duodenal inflammatory structure.
Iron status and its relation to lung function in pediatric asthmatics: a cross-sectional study
Authors: Ali Heba A. , Deraz Tharwat E. , Reyad Noha I. , Mohammed Yasser H. , Husseiny Assmaa A. 
Published: August 2022

Abstract
Background
Asthma and iron deficiency are common pediatric conditions. In addition, iron deficiency may affect spirometry results in asthmatic children. So, we aimed to assess the effect of ion status on lung function in childhood asthma.

Results
In this cross-sectional study, fifty asthmatic pediatric patients aged from 6 to 16 years presented to our institute during the period from (June 2018 to December 2018) were enrolled. Asthmatic patients were classified according to their complete blood count and iron profile into 2 groups: group 1, asthmatic children without iron deficiency anemia (IDA); and group 2, asthmatic children with IDA. All patients underwent full history taking, clinical examination, laboratory investigations, asthma control test, and pulmonary function tests (PFTs). The study showed that PFTs’ parameters (forced expiratory volume in one second (FEV1) % of predicted, FEV1/forced vital capacity, and maximal mid expiratory flow (MMEF) 25–75% of predicted) were significantly lower among asthmatics with IDA (80.62 ± 18.13, 78.36 ± 11.22, 62.35 ± 26.67) than among asthmatics without IDA (93.45 ± 15.51, 87.68 ± 10.81, 82.10 ± 24.74), respectively (p =0.012, 0.006, 0.012). Also, poorly controlled asthma was significantly higher among asthmatics with IDA (p =0.001). In addition, there was a statistically significant positive correlation between forced spirometry parameters, hemoglobin, and ferritin level (p=0.012, 0.042). Moreover, there was a significant positive correlation between hemoglobin level and MMEF 25–75% of predicted (p=0.012).

Conclusions
Lower iron status negatively affects the lung function in asthmatic children with a more obstructive pattern among asthmatics with IDA.
Preoperative Medical Treatment for Patients With Acromegaly: Yes or No?
Authors: Albarel Frederique , Cuny Thomas , Graillon Thomas , Dufour Henry , Brue Thierry , Castinetti Frederic 
Published: August 2022

Abstract
Transsphenoidal surgery is the first-line treatment for acromegaly. However, several factors can modify surgical remission rates, such as the initial hormone levels, the size and invasiveness of the tumor, and the degree of experience of the surgeon. Physicians treating patients with acromegaly should thus consider how to improve surgical remission rates. As stated in recent guidelines, the major point is to consider that any patient with acromegaly should be referred to an expert neurosurgeon to maximize the chances of surgical sure. The benefits of presurgical medical treatment, mainly using somatostatin receptor ligands (SRLs), given 3 to 6 months before surgery, remain controversial. By normalizing growth hormone and insulin-like growth factor 1 levels, SRLs may improve the overall condition of the patient, thus decreasing anesthetic and surgical complications. By decreasing the tumor size and modifying the consistency of the tumor, SRLs might also make surgical excision easier. This is however theoretical as published data are contradictory on both points, and only limited data support the use of a systematical presurgical medical treatment. The aim of this review is to analyze the potential benefits and pitfalls of using presurgical medical treatment in acromegaly in view of the contradictory literature data. We also attempt to determine the profile of patients who might most benefit from this presurgical medical treatment approach as an individualized therapeutic management of acromegaly.
Frequency of Adrenal Insufficiency in Patients With Hypoglycemia in an Emergency Department: A Cross-sectional Study
Authors: Kawahara Tetsuya , Tsuji Maiko , Tominaga Naoki , Toyama Nagahiro , Toda Mikio 
Published: August 2022

Abstract

Context
In most patients presenting with hypoglycemia in emergency departments, the etiology of hypoglycemia is identified. However, it cannot be determined in approximately 10% of cases.

Objective
We aimed to identify the causes of unknown hypoglycemia, especially adrenal insufficiency.

Methods
In this cross-sectional study, we evaluated the etiology of hypoglycemia among patients in our emergency department with hypoglycemia (plasma glucose level &lt; 70 mg/dL (3.9 mmol/L)] between April 1, 2016 and March 31, 2021 using a rapid adrenocorticotropic hormone (ACTH) test.

Results
There were 528 cases with hypoglycemia included [52.1% male; median age 62 years (range 19-92)]. The majority [389 (73.7%)] of patients were using antidiabetes drugs. Additionally, 33 (6.3%) consumed alcohol; 17 (3.2%) had malnutrition; 13 (2.5%), liver dysfunction; 12 (2.3%), severe infectious disease; 11 (2.1%), malignancy; 9 (1.7%), heart failure; 4 (0.8%), insulin autoimmune syndrome; 3 (0.6%), insulinoma; 2 (0.4%) were using hypoglycemia-relevant drugs; and 1 (0.2%) suffered from non-islet cell tumor. Rapid ACTH tests revealed adrenal insufficiency in 32 (6.1%). In those patients, serum sodium levels were lower (132 vs 139 mEq/L, P &lt; 0.01), eosinophil counts were higher (14 vs 8%, P &lt; 0.01), and systolic blood pressure was lower (120 vs 128 mmHg, P &lt; 0.05) at baseline than in patients with the other etiologies.

Conclusion
The frequency of adrenal insufficiency as a cause of hypoglycemia was much higher than what we anticipated. When protracted hypoglycemia of unknown etiology is recognized, we recommend that the patient is checked for adrenal function using a rapid ACTH test.
Migrant Identity and Culture Maintenance: The Welsh in Johnstown, Cambria County, Pennsylvania, 1870–1930
Authors: Tyler Robert Llewellyn 
Published: August 2022

AbstractWelsh immigrants and their children comprised a distinct ethnolinguistic community in Johnstown, Pennsylvania, during the late nineteenth and early twentieth centuries. This article analyzes the nature of that community and suggests that while ethnic integrity was initially maintained due to linguistic ability, religious adherence, and the creation of popular cultural institutions, it was ultimately undermined, not only by the general forces of acculturation, but also by specifically Welsh factors. While the Welsh experience in Johnstown differed sharply from that undergone by the English, it did not simply mirror that of other non-Anglophone groups.
Tangled Strands of Silk: Globalizing the Local in Early Modern San Miguel Achiutla, Oaxaca
Authors: Forde Jamie E. 
Published: August 2022

AbstractThis article takes the community of San Miguel Achiutla, located in the Mixtec highlands of Oaxaca, as a case study through which to examine the complex involvements of Indigenous pueblos de indios of Mexico in the early modern dynamics of globalization. Drawing from both ethnohistorical and archaeological evidence, this analysis shows not only how residents of this community were affected by forces of globalization as they appropriated new goods and ideas from across the Pacific and Atlantic, but also how they played an active economic role in driving colonial expansion during the sixteenth century, particularly through the silk trade. In tracing these connections, we see how locally focused microhistories can shed light on aspects of early modern globalization that we might not otherwise attend to.
Head removal enhances planarian electrotaxis
Authors: Sabry Ziad , Wang Rui , Jahromi Aryo , Rabeler Christina , Kristan William B. , Collins Eva-Maria S. 
Published: August 2022

ABSTRACT
Certain animal species utilize electric fields for communication, hunting and spatial orientation. Freshwater planarians move toward the cathode in a static electric field (cathodic electrotaxis). This planarian behavior was first described by Raymond Pearl more than a century ago. However, planarian electrotaxis has received little attention since, and the underlying mechanisms and evolutionary significance remain unknown. To close this knowledge gap, we developed an apparatus and scoring metrics for automated quantitative and mechanistic studies of planarian behavior upon exposure to a static electric field. Using this automated setup, we characterized electrotaxis in the planarian Dugesia japonica and found that this species responds to voltage instead of current, in contrast to results from previous studies using other planarian species. Surprisingly, we found differences in electrotaxis ability between small (shorter) and large (longer) planarians. To determine the cause of these differences, we took advantage of the regenerative abilities of planarians and compared electrotaxis in head, tail and trunk fragments of various lengths. We found that tail and trunk fragments electrotaxed, whereas head fragments did not, regardless of size. Based on these data, we hypothesized that signals from the head may interfere with electrotaxis when the head area/body area reached a critical threshold. In support of this hypothesis, we found that (1) smaller intact planarians that cannot electrotax have a relatively larger head-to-body-ratio than large planarians that can electrotax, and (2) the electrotaxis behavior of cut head fragments was negatively correlated with the head-to-body ratio of the fragments. Moreover, we could restore cathodic electrotaxis in head fragments via decapitation, directly demonstrating inhibition of electrotaxis by the head.
Society of Obstetricians and Gynecologists Pakistan Guideline on Second Trimester Anomaly Scan
Authors: Zohra Nishat , Munim Shama , Ijaz Shamila , Baqai Shehla , Yasmin Haleema , Korejo Razia , CC Lees 
Published: August 2022

The Guideline on Second trimester anomaly scan has been prepared by the National Maternal Fetal Medicine guidelines committee, approved by the Society of Obstetricians and Gynecologists Pakistan. These guidelines are developed in 2022 and will be reviewed after two years.The current document provides guidance about the importance of second trimester scan to practicing clinicians and sonologists. It will enable them to offer it timely offer to their patient this scan and refer them to the Fetal medicine specialist when indicated. It is unique as the document is modified according to local needs. The Guidelines are developed in 2022 and will be reviewed after two years.
doi: https://doi.org/10.12669/pjms.38.7.6212
How to cite this:Zohra N, Munim S, Ijaz S, Baqai S, Yasmin H, Korejo R, et al. Society of Obstetricians and Gynecologists Pakistan Guideline on Second Trimester Anomaly Scan. Pak J Med Sci. 2022;38(7):---------. doi: https://doi.org/10.12669/pjms.38.7.6212
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.
Editorial: The Sociology of Vaccines
Authors: Calnan Michael , Zinn Jens O. , Douglass Tom 
Published: August 2022

In this editorial, we identify the key questions requiring further exploration in the sociology of vaccines. In doing so, we discuss the socio-structural forces shaping views towards knowledge about and access to vaccination, trust in vaccines and regulators/decision makers, the associated problem of financial interests in vaccine development and regulation, and global vaccine inequalities. Across the breadth of these issues, we additionally identify a range of theoretical perspectives and conceptual directions that sociologists might utilise when producing innovative empirical, methodological and theoretical research on vaccination relating to risk and uncertainty, conflicts of interest, power and inequality.
Changing the method of consent to increase the numbers of cadaveric donors in Saudi Arabia: the autonomy paradox
Authors: AL Shawan Deema , Albagmi Faisal , AlNujaidi Heba 
Published: August 2022

Background: In Saudi Arabia, the gap between the demand and availability of organs persists, with a total of 13,731 patients who remain on the waiting list in 2019. Family refusal is a major obstacle limiting donation since their consent must be obtained prior to the retrieval of organs. The cause of family refusal is mainly due to the unknown wishes of their loved one to become a donor. This analysis aimed to compare three systems of obtaining consent in terms of effectiveness, respect for personal autonomy, and the cultural role of families in Saudi Arabia to ensure feasibility and effectiveness in increasing the number of donors. Policy alternatives and implications: The consent systems include opt-in (explicit consent), opt-out (presumed consent), and mandated choice systems. The mandated choice policy might be the optimal solution to investigate since it could balance the respect for individual autonomy and the cultural role of families in Saudi Arabia. Conclusions and recommendations: Mandated choice ensures the respect of personal autonomy while influencing the next of kin's decision to donate the organs. Additionally, a recommendation to decision makers is to utilize the Tawakkalna app to send alerts to the next of kin when a user registers as a donor with the user's consent. Moreover, more research should be dedicated to investigating the Saudi public's current culture and perceptions of organ donation to ensure feasibility.
Yoga to improve maternal mental health and immune function during the COVID-19 crisis (Yoga-M2 trial): study protocol for a pilot randomized controlled trial.
Authors: Shidhaye Rahul , Bangal Vidyadhar , Bhargav Hemant , Tilekar Swanand , Thanage Chitra , Suradkar Rakhee , Game Kalpesh , Pulate Vandana , Tambe Sonali , Murhar Vaibhav , Kunkulol Rahul 
Published: August 2022

Background: Mental health of women is adversely affected during pregnancy. Stress and depression during pregnancy negatively impact birthweight and neuro-cognitive development of the fetus. The current crisis due to the COVID-19 pandemic further adds to the stressful situation. Yoga practiced during pregnancy has beneficial effects on improving stress and depression and preliminary evidence suggests that yoga-based interventions can improve immunity. This study aims to examine the feasibility, acceptability, and preliminary efficacy of a Yoga -based intervention for maternal Mental health and iMmunity (Yoga-M 2) in a rural community in India. Methods: The study design will be a single-blind individual randomized parallel group-controlled pilot trial with 1:1 allocation ratio. Adult pregnant women, with gestational age between 12–24 weeks will be randomly allocated to either the Yoga-M 2 group or the Enhanced Usual Care (EUC) group. Participants in the Yoga-M 2 arm will attend weekly group yoga sessions for 12 weeks and will be encouraged to practice yoga at home. In the EUC arm, participants will receive a single session of health education. Eligibility of the participants, recruitment, retention-in-care, and study completion rates will be estimated and feasibility of delivering Yoga-M 2 and acceptability of this intervention by the participants will be assessed. Change in the scores of the Perceived Stress Scale (PSS), EuroQoL 5 Dimensions Score (EQ-5D-5L), Wisconsin Upper Respiratory Symptom Severity Scale (WURSS-21), and serum C-Reactive Protein at three-months from baseline will be used to assess preliminary efficacy. Discussion: The key outputs of this trial will be a structured intervention manual and evidence about the feasibility, acceptability, and preliminary efficacy of the intervention, establishing the foundation to undertake an explanatory randomized controlled trial to assess efficacy and cost-effectiveness of Yoga-M 2 intervention. Trial registration: CTRI/2022/01/039701. Prospectively registered with the Clinical Trials Registry of India on 25 January 2022.
Impact of gut microbiota on severity of obsessive-compulsive disorder (OCD) - a short review
Authors: Niewęgłowski Kacper , Wilczek Natalia , Rycharski Michał , Niewęgłowska Julita 
Published: August 2022

Introduction and purpose
Obsessive-compulsive disorder (OCD) has an unclear etiology. Genetic and environmental factors dominate among the etiologic factors. The disorder is characterized by the presence of obsessions (repetitive and persistent thoughts, images, impulses or urges) and compulsions (rituals; repetitive behaviours or mental acts that the individual feels driven to perform in response to an obsession). This disorder has less than 4% of the population. Treatment is a long and difficult process, and the best results are with SSRIs (e.g., fluoxetine) and cognitive behavioral therapy (CBT). The aim of the study was to review articles linking gut microbiota and obsessive-compulsive disorder issues.

A brief description of the state of knowledge
The gut microbiota-gut-brain axis perhaps has an impact on the etiology of psychiatric diseases. Its existence has been well researched in animals. Researches suggest that there possibly may be changes in the composition of the gut microbiota in people with obsessive-compulsive disorder. Quantitative and qualitative changes in the gut microbiota composition may worsen the patient's condition. The use of probiotics may help improve the patient's condition and reduce symptoms of the disorder.

Summary (conclusions)
More research is needed to explore the potential impact of the gut microbiota on obsessive-compulsive disorder. This could perhaps lead to future applications of probiotics, e.g., in the adjunctive treatment of obsessive-compulsive disorder.
Cultura de segurança em unidade de terapia intensiva materna [Safety culture in a maternal intensive care unit] [Cultura de seguridad en una unidad de cuidados intensivos maternos]
Authors: Santos José Augustinho Mendes , Santos Amuzza Aylla Pereira dos , Bernardo Thaís Honório Lins , Gaedke Mari Ângela , Santos Wanderlei Barbosa dos , Oliveira Julio Cesar Silva 
Published: August 2022

Objetivo: identificar a cultura de segurança do paciente em uma unidade de terapia intensiva materna, na perspectiva da equipe de saúde. Método: estudo do tipo survey, aprovado pelo Comitê de Ética em Pesquisa, que utilizou o instrumento Hospital Survey on Patient Safety Culture para coleta de dados. Os dados foram analisados mediante estatística descritiva e as dimensões da cultura foram classificadas em forte, neutra e frágil. Resultados: identificou-se uma dimensão forte, quatro neutras e seis frágeis. A dimensão com maior percentual de respostas positivas foi “Trabalho em equipe dentro da unidade”, já a com menor percentual foi “Frequência de notificações de eventos”. Conclusão: a cultura de segurança do paciente na unidade de terapia intensiva materna foi considerada frágil, apontando para necessidade de prestação de cuidados com maior segurança as gestantes e puérperas que necessitam de cuidados intensivos.ABSTRACTObjective: to identify the patient safety culture in a maternal intensive care unit as seen by the healthcare team. Method: in this survey study approved by the research ethics committee, data were collected using the Hospital Survey on Patient Safety Culture and analyzed using descriptive statistics. The culture dimensions were classified as strong, neutral or weak. Results: one dimension was found to be strong, four neutral, and six weak. "Unit teamwork" returned the highest percentage of positive responses, while the lowest-scoring dimension was "Event notification frequency". Conclusion: the patient safety culture in the maternal intensive care unit was considered weak, pointing to the need to provide safer care to pregnant and postpartum women requiring intensive care.RESUMENObjetivo: identificar la cultura de seguridad del paciente en una unidad de cuidados intensivos maternos, desde la perspectiva del equipo sanitario. Método: estudio por encuesta de opinión (Survey), aprobado por el Comité de Ética de la Investigación, que utilizó el instrumento Hospital Survey on Patient Safety Culture para la recolección de datos. Los datos se analizaron por medio de una estadística descriptiva y las dimensiones de la cultura se clasificaron en fuerte, neutra y frágil. Resultados: se identificaron una dimensión fuerte, cuatro neutras y seis frágiles. La dimensión cuyo porcentaje de respuestas positivas fue más alto: "Trabajo en equipo dentro de la unidad"; mientras que la dimensión cuyo porcentaje fue más bajo fue: "Frecuencia de las notificaciones de eventos". Conclusión: la cultura de seguridad del paciente en la unidad de cuidados intensivos maternos se consideró frágil, lo que apunta hacia la necesidad de proporcionar una atención con mayor seguridad a las mujeres embarazadas y puérperas que requieren cuidados intensivos.