bluuebunny/crossref_metadata_2025 huggingface dataset:
Dust emission source characterization for visibility hazard assessment on Lordsburg Playa in Southwestern New Mexico, USA
Authors: Van Pelt R. Scott , Tatarko John , Gill Thomas E. , Chang Chunping , Li Junran , Eibedingil Iyasu G. , Mendez Marcos
Published: December 2020

In drylands around the world, ephemeral lakes (playas) are common. Dry, wind-erodible playa sediments are potent local and regional sources of dust and PM10 (airborne particles with diameters less than 10 μm). Dust clouds often cause sudden and/or prolonged loss of visibility to travelers on downwind roadways. Lordsburg Playa, in southwestern New Mexico, USA is bisected by Interstate Highway 10. Dust storms emanating from the playa have been responsible for numerous visibility-related road closures (including 39 road closures between 2012 and 2019) causing major economic losses, in addition to well over a hundred dust-related vehicle crashes causing at least 41 lost lives in the last 53 years. In order to improve understanding of the surfaces responsible for the dust emissions, we investigated the critical wind friction velocity thresholds and the dust emissivities of surfaces representing areas typical of Lordsburg Playa’s stream deltas, shorelines, and ephemerally flooded lakebed using a Portable In-Situ Wind ERosion Laboratory (PI-SWERL). Mean threshold friction velocities for PM10 entrainment ranged from less than 0.30 m s− 1 for areas in the delta and shoreline to greater than 0.55 m s− 1 for ephemerally flooded areas of the lakebed. Similarly, we quantified mean PM10 vertical flux rates ranging from less than 500 μg m− 2 s− 1 for ephemerally flooded areas of lakebed to nearly 25,000 μg m− 2 s− 1 for disturbed delta surfaces. The unlimited PM10 supply of the relatively coarse sediments along the western shoreline is problematic and indicates that this may be the source area for longer-term visibility reducing dust events and should be a focus area for dust mitigation efforts.
A comparative study of parental knowledge and adaptation of immigrant youth
Authors: Turjanmaa Elina , Jasinskaja-Lahti Inga
Published: December 2020

In general, parental knowledge is known to support adolescents’ adaptation. Less is known about the role of parental knowledge in psychological (i.e., anxiety) and socio-cultural (i.e., school achievement) adaptation of adolescents with immigrant background, and how parental knowledge and social characteristics (i.e., gender, generational status, immigrant background, and family’ socioeconomic background) of immigrant adolescents jointly influence their adaptation outcomes. This study explores the role of adolescent-reported parental knowledge in explaining adaptation outcomes among first- and second-generation immigrant boys and girls from four different immigrant groups. The study utilizes the national Finnish School Health Promotion survey data (N = 2697, 45% female, M age = 15.6 years, SD = .91) and illustrates the complex relationship between parental knowledge and adolescents’ adaptation.
The endogenous development of pastoral society: an anthropological case study in East Ujimqin Banner in Inner Mongolia
Authors: Zhang Kun , Shang Hailin
Published: December 2020

Through empirical research on the social development of pastoral society in the East Ujimqin Banner, this study puts forward that within the government’s “passive development” discourse, local herders would prefer to consciously practice “active development”. This method both respects local culture and traditions, and triggers a shift from exogenous to endogenous development. My study shows that only by cultivating the self-development mechanism of ethnic minorities and the initiative to participate in development can we realize the social development of pastoral areas. The survival practices constructed by the local society according to its traditional mechanisms are not only connected with the external market and the state as modes of production, but also enable the local society’s modes of livelihood to be maintained and the traditional social culture to continue amid the continuous transformation taking place under the impact of pastoral modernization.
Emergency tips recanalisation and gastroesophageal varices embolisation with an ethylene vinyl alcohol copolymer agent (Squid) and detachable coils
Authors: Venturini Massimo , Augello Luigi , Lanza Carolina , Curti Marco , Coppola Andrea , Piacentino Filippo , De Cobelli Francesco
Published: December 2020

Transjugular intrahepatic portosystemic shunt (TIPS) is currently indicated as first therapeutic option in the main complications of portal hypertension, including bleeding gastroesophageal varices and refractory ascites. In case of bleeding gastroesophageal varices, an adjuvant embolisation within TIPS can be useful to prevent rebleeding. In the present technical note, the management in emergency of a patient with haemorrhagic shock due to bleeding gastroesophageal varices and occluded TIPS is reported. TIPS recanalisation with an adjunctive stent and high-pressure balloon angioplasty and gastroesophageal varices embolisation using detachable coils and a non-adhesive liquid embolic agent were performed during the same emergent procedure. After the procedure, clinical stabilisation of the patient was achieved, with blood transfusions suspension and Blakemore tube removal. At 6 months, regular TIPS patency at colour Doppler and no rebleeding episodes were recorded. To our knowledge, whilst coils are routinely used for varices embolisation, non-adhesive liquid embolic agents have been never mentioned. Liquid embolic agents seem to provide a stable plug strengthening the embolising action of the coils. Further studies involving a cohort of patients with long-term follow-up will be necessary to confirm whether this association can be more effective than coils alone in gastroesophageal varices embolisation.
Prevention of thromboembolism in spinal cord injury -S1 guideline
Authors: Weidner Norbert , Müller Oliver J. , Hach-Wunderle Viola , Schwerdtfeger Karsten , Krauspe Rüdiger , Pauschert Rolf , Waydhas Christian , Baumberger Michael , Göggelmann Christoph , Wittgruber Gabriela , Wildburger Renate , Marcus Oswald
Published: December 2020

Introduction

Traumatic and non-traumatic spinal cord injury bears a high risk for thromboembolism in the first few months after injury. So far, there is no consented guideline regarding diagnostic and prophylactic measures to prevent thromboembolic events in spinal cord injury. Based on a Pubmed research of related original papers and review articles, international guidelines and a survey conducted in German-speaking spinal cord injury centers about best practice prophylactic procedures at each site, a consensus process was initiated, which included spinal cord medicine experts and representatives from medical societies involved in the comprehensive care of spinal cord injury patients. The recommendations comply with the German S3 practice guidelines on prevention of venous thromboembolism.

Recommendations

Specific clinical or instrument-based screening methods are not recommended in asymptomatic SCI patients. Based on the severity of neurological dysfunction (motor completeness, ambulatory function) low dose low molecular weight heparins are recommended to be administered up to 24 weeks after injury. Besides, mechanical methods (compression stockings, intermittent pneumatic compression) can be applied. In chronic SCI patients admitted to the hospital, thromboembolism prophylactic measures need to be based on the reason for admission and the necessity for immobilization.

Conclusions

Recommendations for thromboembolism diagnostic and prophylactic measures follow best practice in most spinal cord injury centers. More research evidence needs to be generated to administer more individually tailored risk-adapted prophylactic strategies in the future, which may help to further prevent thromboembolic events without causing major side effects. The present article is a translation of the guideline recently published online (https://www.awmf.org/uploads/tx_szleitlinien/179-015l_S1_Thromboembolieprophylaxe-bei-Querschnittlaehmung_2020-09.pdf).
Feasibility and outcome of mitral valve repair in patients with infective endocarditis
Authors: Scheggi Valentina , Olivotto Iacopo , Del Pace Stefano , Zoppetti Nicola , Brunetto Alterini , Marchionni Niccolò , Cerillo Alfredo , Stefàno Pier Luigi
Published: December 2020

Background

Valve repair is the treatment of choice for native mitral valve regurgitation. The feasibility of repair when the defect is caused by acute infective endocarditis (IE) is debated. This study aims to compare the outcome of repair and replacement procedures, to report the rate of repair in a single surgical center, and to review the literature on this topic.

Results

We retrospectively analyzed 108 patients with native mitral IE, potentially eligible for surgical repair. Of these 108, 90 (83%) underwent surgery, and 18 were treated conservatively. Among the 90 surgical patients, 57 (63%) underwent valve replacement and 33 valve repair (37%). The mean follow-up duration was 3 years. The two primary endpoints were mortality and freedom from recurrent endocarditis. Secondary endpoints were the post-operative incidence of major adverse events (hospitalization for any cause, pacemaker implantation, new onset of atrial fibrillation, sternal dehiscence), left ventricular systolic function (LVSF), and valvular function at 1-year echocardiographic follow-up. All-cause mortality was lower for valve repair, although not significantly (p = 0.86), as well as nonfatal adverse events (p = 0.92) and relapse rate (p = 0.20) at 3 years. We did not find differences between the two groups at echocardiographic follow-up, neither for left ventricular systolic function (p = 0.22), nor for valvular continence (p = 0.28).

Conclusions

In our experience, the mid-term outcome of repair in IE is comparable to valve replacement and should be considered whenever possible, as in degenerative valve disease. The review of the literature supports this strategy.
Treating patients with severe mental illness with narrative exposure therapy for comorbid post-traumatic stress disorder
Authors: Mauritz Maria W. , van Gaal Betsie G.I. , Goossens Peter J.J. , Jongedijk Ruud A. , Vermeulen Hester
Published: December 2020

Background

Interpersonal trauma and post-traumatic stress disorder (PTSD) in patients with severe mental illness (SMI) negatively affect illness course. Narrative exposure therapy (NET) is effective in vulnerable patient groups, but its efficacy and applicability has not been studied in out-patients with SMI.

Aims

We aimed to evaluate the efficacy and applicability of NET in SMI on changes in PTSD, dissociation, SMI symptoms, care needs, quality of life, global functioning and care consumption.

Method

The study had a single-group, pre-test–post-test, repeated-measures design and was registered in The Netherlands National Trial Register (identifier TR571). Primary outcomes were assessed at pre-treatment (T0), 1 month post-treatment (T1) and 7 months’ follow-up (T2), with a structured interview for PTSD and dissociation screening. Secondary outcomes followed routinely SMI measurements and medical data. Mixed models were used for data analysis.

Results

The majority of the 23 participants was female (82%). Mean age was 49.9 years (s.d. 9.8) and mean PTSD duration was 24.1 years (s.d. 14.5). Mean PTSD severity decreased from 37.9 at T0 to 31.9 at T1 (−6.0 difference, 95%CI −10.0 to −2.0), and decreased further to 24.5 at T2 (−13.4 difference, 95%CI −17.4 to −9.4). Dissociation, SMI symptoms, duration of contacts, and medication decreased; global functioning increased; and quality of life and perceived needs did not change. Eleven participants were in remission for PTSD at T2, of which five were also in remission for major depression.

Conclusions

NET appeared efficacious and applicable to out-patients with SMI and PTSD, and was well tolerated.
Mental health and well-being of healthcare workers during the COVID-19 pandemic in the UK: contrasting guidelines with experiences in practice
Authors: Vera San Juan Norha , Aceituno David , Djellouli Nehla , Sumray Kirsi , Regenold Nina , Syversen Aron , Mulcahy Symmons Sophie , Dowrick Anna , Mitchinson Lucy , Singleton Georgina , Vindrola-Padros Cecilia
Published: December 2020

Background

Substantial evidence has highlighted the importance of considering the mental health of healthcare workers during the COVID-19 pandemic, and several organisations have issued guidelines with recommendations. However, the definition of well-being and the evidence base behind such guidelines remain unclear.

Aims

The aims of the study are to assess the applicability of well-being guidelines in practice, identify unaddressed healthcare workers’ needs and provide recommendations for supporting front-line staff during the current and future pandemics.

Method

This paper discusses the findings of a qualitative study based on interviews with front-line healthcare workers in the UK (n = 33), and examines them in relation to a rapid review of well-being guidelines developed in response to the COVID-19 pandemic (n = 14).

Results

The guidelines placed greater emphasis on individual mental health and psychological support, whereas healthcare workers placed greater emphasis on structural conditions at work, responsibilities outside the hospital and the invaluable support of the community. The well-being support interventions proposed in the guidelines did not always respond to the lived experiences of staff, as some reported not being able to participate in these interventions because of understaffing, exhaustion or clashing schedules.

Conclusions

Healthcare workers expressed well-being needs that aligned with socio-ecological conceptualisations of well-being related to quality of life. This approach to well-being has been highlighted in literature on support of healthcare workers in previous health emergencies, but it has not been monitored during this pandemic. Well-being guidelines should explore the needs of healthcare workers, and contextual characteristics affecting the implementation of recommendations.
Appetite-Regulating Hormones Are Reduced After Oral Sucrose vs Glucose: Influence of Obesity, Insulin Resistance, and Sex
Authors: Yunker Alexandra G , Luo Shan , Jones Sabrina , Dorton Hilary M , Alves Jasmin M , Angelo Brendan , DeFendis Alexis , Pickering Trevor A , Monterosso John R , Page Kathleen A
Published: December 2020

Context

Fructose compared to glucose has adverse effects on metabolic function, but endocrine responses to oral sucrose vs glucose is not well understood.

Objective

We investigated how oral sucrose vs glucose affected appetite-regulating hormones, and how biological factors (body mass index [BMI], insulin sensitivity, sex) influence endocrine responses to these 2 types of sugar.

Design

Sixty-nine adults (29 men; 23.22 ± 3.74 years; BMI 27.03 ± 4.96 kg/m2) completed the study. On 2 occasions, participants consumed 300-mL drinks containing 75 g of glucose or sucrose. Blood was sampled at baseline, 10, 35, and 120 minutes post drink for plasma glucose, insulin, glucagon-like peptide (GLP-1)(7–36), peptide YY (PYY)total, and acyl-ghrelin measures. Hormone levels were compared between conditions using a linear mixed model. Interaction models were performed, and results were stratified to assess how biological factors influence endocrine responses.

Results

Sucrose vs glucose ingestion provoked a less robust rise in glucose (P < .001), insulin (P < .001), GLP-1 (P < .001), and PYY (P = .02), whereas acyl-ghrelin suppression was similar between the sugars. We found BMI status by sugar interactions for glucose (P = .01) and PYY (P = .03); obese individuals had smaller increases in glucose and PYY levels after consuming sucrose vs glucose. There were interactions between insulin sensitivity and sugar for glucose (P = .003) and insulin (P = .04), and a sex by sugar interaction for GLP-1 (P = .01); men demonstrated smaller increases in GLP-1 in response to oral sucrose vs glucose.

Conclusion

Sucrose is less efficient at signaling postprandial satiation than glucose, and biological factors influence differential hormone responses to sucrose vs glucose consumption.
Incidence, Mortality, and Characteristics of 18 Pediatric Perioperative Cardiac Arrests: An Observational Trial From 22,650 Pediatric Anesthesias in a German Tertiary Care Hospital
Authors: Jansen Gerrit , Borgstedt Rainer , Irmscher Linda , Popp Jakob , Schmidt Benjamin , Lang Eric , Rehberg Sebastian W.
Published: December 2020

BACKGROUND:

Recently, a very low incidence of 3 per 10,000 and a mortality of 30% were reported for pediatric perioperative cardiac arrest (POCA). However, high-risk patients, namely children already anesthetized on the intensive care unit (ICU), were excluded. This study investigates the incidence and mortality of POCA in children in whom anesthesia was induced in the ICU or in the operating room using real-world data. In addition, different classifications of POCA were compared with respect to outcome relevance.

METHODS:

This is a retrospective observational study conducted at a German level 1 perinatal center and tertiary care hospital between 2008 and 2018. Children ≤15 years who underwent an anesthetic procedure and suffered from POCA (defined as any condition requiring chest compressions and/or defibrillation) from the beginning of care provided by an anesthesiologist to 60 minutes after anesthesia or sedation were included. Primary end points were incidence and mortality of POCA in children with anesthesia induced in the ICU versus in the operating room. Secondary end points included incidences and outcomes with respect to the pathophysiological cause (respiratory versus circulatory associated).

RESULTS:

There were 18 POCA during 22,650 anesthetic procedures (incidence 7.9 per 10,000; 95% confidence interval [CI], 4.7-12.5). Thirty-day mortality was 3.5 per 10,000 (95% CI, 1.5-6.9). Incidence and mortality were higher in children in whom anesthesia was induced in the ICU versus in the operating room (incidence: 131.6; 95% CI, 57 to 257.6 versus 4.5; 95% CI, 2.2-8.3; P < .001; and mortality: 82.2; 95% CI, 26.7-190.8 versus 1.4; 95% CI, 0.3-3.9; P < .001). Mortality in circulatory-induced POCA (n = 8; 44%) was 100%, in respiratory-induced POCA (n = 9; 50%) 0% (P < .001).

CONCLUSIONS:

Children with anesthesia induction in the ICU represent a high-risk population for POCA and POCA-associated mortality. POCA classification should be based on the individual cause (respiratory versus circulatory) rather than on the perioperative phase or the responsible specialty.
Association Between High Body Mass Index and Mortality Following Myocardial Injury After Noncardiac Surgery
Authors: Lee Seung-Hwa , Yang Kwangmo , Park Jungchan , Lee Jong Hwan , Min Jeong Jin , Kwon Ji-hye , Yeo Junghyun , Kim Jihoon , Hyeon Cheol Won , Choi Jin-ho , Lee Sang-Chol , Gwon Hyeon-Cheol , Kim Kyunga , Ahn Joonghyun , Lee Sangmin Maria
Published: December 2020

BACKGROUND:

Despite an association between obesity and increased risks for various diseases, obesity has been paradoxically reported to correlate with improved mortality in patients with established cardiovascular disease. However, its effect has not been evaluated to date in patients with myocardial injury after noncardiac surgery (MINS).

METHODS:

From January 2010 to June 2019, of a total of 35,269 adult patients with postoperative cardiac troponin level data, 5633 (16.0%) patients had MINS as diagnosed by postoperative cardiac troponin I above the 99th-percentile upper reference of 40 ng·L−1 using the TnI-Ultra immunoassay. Patients with MINS were divided into 3 groups according to body mass index (BMI), with 3246 (57.6%) were in the normal (18.5–25 kg·m−2), 425 (7.5%) in the low BMI (<18.5 kg·m−2), and 1962 (34.8%) in the high BMI (≥25 kg·m−2) groups, respectively. The primary outcome was mortality during the first year after surgery, and the mortality during 30 days was also compared.

RESULTS:

Following adjustment for confounding with inverse probability of treatment weighting, mortality within the first year appeared to be significantly lower in the high BMI group compared with the normal (14.8% vs 20.9%; hazard ratio [HR], 0.75; 95% confidence interval [CI], 0.66-0.85; P < .001) and the low BMI (14.8% vs 25.6%; HR: 0.56; 95% CI, 0.48-0.66; P < .001) groups.

CONCLUSIONS:

High BMI may be associated with decreased mortality following MINS. Further investigations are needed to support this finding.
Clinician Well-being during a Pandemic: Practices to Boost Resilience and Life Satisfaction
Authors: Wiederman Michael W. , Toresdahl Brett , Asif Irfan M.
Published: December 2020

The role of the sports medicine physician has been challenged in several ways during the COVID-19 pandemic, potentially eroding a sense of well-being. Four universal human needs related to flourishing and a sense of life satisfaction are the framework we use to examine the effects of a pandemic on sports medicine clinicians. We offer two evidence-based practices to promote well-being and resilience within each of the four universal needs.
A comparative study of Lumbar Decompression and Fusion with Internal Fixation versus Simple Decompression in elderly patients with two-segment Lumbar Spinal Stenosis
Authors: Tu Pengfa , Cao Shuo , Jiang Chenyang , Yan Chong-chao
Published: December 2020

Objective: To investigate and compare the effect of decompression and fusion with internal fixation vs. simple decompression in the treatment of elderly patients with two-segment lumbar spinal stenosis (LSS) in perioperative and postoperative follow-up periods.

Methods: Twenty-eight elderly patients with two-segment LSS admitted in Baoding First Hospital between Mar. 2017 and Jan. 2018 were retrospectively analyzed. Fifteen patients who underwent simple decompression were included in the simple decompression group, and 13 who underwent decompression and fusion with internal fixation were included in the decompression-fixation group. The general data and perioperative conditions including wound complications, operation time, blood loss, and VAS (legs) and JOA score were analyzed and compared between the two groups.

Results: There was no significant difference in postoperative leg pain (VAS) between the two groups, and a statistically significant difference in JOA score was found between the two groups one month after the operation. The operation time, length of stay, and blood loss in the decompression-fixation group were significantly different from those in the simple decompression group and no significant difference in wound complications was observed between the two groups.

Conclusion: There is no significant difference in leg pain relief in elderly patients with two-segment LSS when treated with decompression and fusion with internal fixation or simple decompression. Simple decompression is associated with less intraoperative injuries, better postoperative functional recovery, and reduced hospital stay.

doi: https://doi.org/10.12669/pjms.37.1.2287

How to cite this:Tu P, Cao S, Jiang C, Yan CC. A comparative study of Lumbar Decompression and Fusion with Internal Fixation versus Simple Decompression in elderly patients with two-segment Lumbar Spinal Stenosis. Pak J Med Sci. 2021;37(1):256-260.  doi: https://doi.org/10.12669/pjms.37.1.2287

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.
Clinical correlation and prognostic significance of immunofluorescence in renal biopsies of patients having Glomerulonephritis
Authors: Zafar Fauzia , Mehar M. Faisal , Khan Afsheen Asghar , Safdar Rabia Saleem
Published: December 2020

Objective: To correlate the immunofluorescence (IF) findings on renal biopsies of patients of glomerulonephritis (GN) with the clinical course of the disease.

Methods: This retrospective descriptive study was done at the Department of Pediatrics Medicine Unit-I, Nishtar Hospital Multan, from January 2008 to January 2019. A total of 387 cases of both gender, aged up to 16 years, diagnosed having GN on the basis of renal biopsies by light microscopy (LM) and IF findings, were included. Outcome as remission, partial remission, no remission with stable kidney disease, no remission with progressive kidney disease and end-stage kidney disease (ESKD) were computed. Chi square test was applied to see the correlation of IF findings and outcome by taking p value less than 0.05 as statistically significant.

Results: Focal segmental glomerulosclerosis (FSGS) was found to be the commonest histopathology finding noted in 158 (40.8%) followed by mesangioproliferative GN 74 (19.1%) and membranous nephropathy 42 (10.9%). Complete remission was observed in 145 (37.5%) cases whereas ESKD was seen in 26 (6.7%). Distinct pattern of IF findings were shown when distribution of IF findings were seen with respect to all study variables (p value < 0.001). For outcome, 134 (51.3%) IF negative cases had complete remission while 93 (35.6%) negative IF findings also had partial remission. ESKD was seen among 14 (25.9%) IgM positive and three (33.3%) IgA positive cases.

Conclusion: Immunofluorescence proved an important diagnostic tool in reaching the exact diagnosis in various types of GN. Distinct correlation between IF findings and clinical course of various types of GN was observed. IF negative cases had better outcome and was not having progressive course of disease so prognosis remained better than IF positive cases in this study.

doi: https://doi.org/10.12669/pjms.37.1.2497

How to cite this:Zafar F, Mehar MF, Khan AA, Safdar RS. Clinical correlation and prognostic significance of immunofluorescence in renal biopsies of patients having Glomerulonephritis. Pak J Med Sci. 2021;37(1):76-80. doi: https://doi.org/10.12669/pjms.37.1.2497

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.
Loss of expression of Syndecan-1 is associated with Tumor Recurrence, Metastatic Potential, and Poor Survival in patients with Colorectal carcinoma
Authors: Al-Maghrabi Jaudah Ahmed
Published: December 2020

Objective: The loss of expression of syndecansyndecan-1 is associated with poor prognosis in many types of human cancer. The objective of this study was to evaluate the relation between syndecan-1 immunoexpression and several clinicopathological parameters in a subset of colorectal carcinoma (CRC) patients.

Methods: Pathology tissue blocks of 202 primary tumors, 41 adenomas, and 37 normal colonic mucosae were used in this study. The cases diagnosed in the period 1995–2015 was included in the study. Immunohistochemistry analysis was performed using anti-CD138/syndecan-1 (B-A38) mouse monoclonal antibody. A semiquantitative method was used to score the syndecan-1 expression based on an evaluation of the percentage and intensity of the membranous and cytoplasmic expression. The data collected from Pathology Department at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. This is a retrospective cohort study that was conducted from July 2018 until August 2019.

Results: Loss of syndecan-1 immunoexpression was observed in 72 (42.6%), 5 (12.2%), and 3 (8.1%) cases of CRC, adenomas, and normal mucosae, respectively. Low expression of syndecan-1 showed an association with nodal (p=0.003) and distant (p=0.001) metastasis, lymphovascular invasion (p=0.001), and tumor recurrence (p=0.006). Low syndecan-1 expression were associated with short overall survival (OS) (log rank 4.019, p=0.045) and disease-free survival (DFS) probabilities (log rank 4.748, p=0.029).

Conclusion: Loss of syndecan-1 immunoexpression is associated with metastatic potential, tumor recurrence and shorter survival in CRC and is considered a potential biomarker of poor prognosis in CRC patients.

doi: https://doi.org/10.12669/pjms.37.1.2592

How to cite this:Al-Maghrabi J. Loss of expression of Syndecan-1 is associated with Tumor Recurrence, Metastatic Potential, and Poor Survival in patients with Colorectal carcinoma. Pak J Med Sci. 2021;37(1):114-120. doi: https://doi.org/10.12669/pjms.37.1.2592

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.
Domestic violence and its relationship with depression, anxiety and quality of life: A hidden dilemma of Pakistani women
Authors: Malik Mazhar , Munir Nargis , Ghani Usman , Ahmad Nasir
Published: December 2020

Objectives: To find out the relationship of domestic violence with depression, anxiety and quality of life in married women in hospitals of Rawalpindi and Islamabad.

Methods: This co-relational study was conducted in Rawalpindi Institute of Health Sciences from January 2019 to December 2019. All the females’ patients who were the victim of domestic violence were the population of the study. Consecutive non-probability sampling technique was used for selection of sampling from the target population. The inclusion criterion for this study was diagnosed case of domestic violence. DASS 21 (The Depression, Anxiety and Stress Scale) and Quality of life (WHO) scales were administered to 116 patients.

Results: The study’s key results were that domestic abuse has positive relationship with depression, anxiety, and stress. It was also found that domestic abuse has a negative relationship with quality of life of those who have been subjected to domestic violence of this sort.

Conclusion: It was concluded that domestic violence whether verbal, physical, emotional or sexual has strongly effects the mental health and quality of life of abused women.

doi: https://doi.org/10.12669/pjms.37.1.2893

How to cite this:Malik M, Munir N, Ghani MU, Ahmad N. Domestic violence and its relationship with depression, anxiety and quality of life: A hidden dilemma of Pakistani women. Pak J Med Sci. 2021;37(1):191-194. doi: https://doi.org/10.12669/pjms.37.1.2893

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.
Effects of etibatide combined with emergency percutaneous coronary intervention on blood perfusion and cardiac function in patients with acute myocardial infarction
Authors: Hu Ying , Qi Fan-xing , Yu Li-na , Geng Wei
Published: December 2020

Objectives: To investigate the effects of etibatide combined with emergency percutaneous coronary intervention (PCI) on blood perfusion and cardiac function in acute myocardial infarction (AMI) patients.

Methods: This was a prospective, randomized, controlled study. From November 2015 to June 2019, 196 patients with ST-segment elevation myocardial infarction (STEMI) undergoing emergency PCI admitted to Baoding First Central Hospital were enrolled. The 196 STEMI patients were randomly divided into experimental group and control group. In the experimental group, STEMI patients were treated with emergency PCI + etibatide; while in the control group, only PCI was performed. Observation indexes included: general data, myocardial perfusion and cardiac function indexes and major adverse cardiac events (MACE).

Results: There was no significant difference in general data between the two groups (P > 0.05). The rate of ST-segment resolution (STR) in the experimental group was better than that in the control group (P < 0.05). In myocardial contrast echocardiography (MCE), higher peak intensity (PI) and shorter time-to-peak (TP) were observed in the experimental group compared with the control group (P < 0.05). The platelet aggregation rate was compared between the two group at the time points of before PCI, after PCI and two hour after drug withdrawal, and there was no significant change in the platelet aggregation rate of the control group between different time points (before PCI, after PCI and two hour after drug withdrawal); while the platelet aggregation rate of the experimental group was significantly lower after PCI and two hour after drug withdrawal than that before PCI (P < 0.05), and an obviously decreased platelet aggregation rate was found in the experimental group(P < 0.05). After three months of follow-up, there was one case of MACE in the experimental group and 1 case of MACE in the control group, without any difference in the incidence of MACE between the two groups (P > 0.05).

Conclusion: Etibatide combined with emergency PCI could improve myocardial reperfusion and cardiac function in patients with acute STEMI without increasing the incidence of MACE.

doi: https://doi.org/10.12669/pjms.37.1.2950

How to cite this:Hu Y, Qi F, Yu L, Geng W. Effects of etibatide combined with emergency percutaneous coronary intervention on blood perfusion and cardiac function in patients with acute myocardial infarction. Pak J Med Sci. 2021;37(1):185-190.  doi: https://doi.org/10.12669/pjms.37.1.2950

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.
Sleep Quality in Pamukkale University Students and its relationship with smartphone addiction
Authors: Ozcan Betul , Acimis Nurhan Meydan`
Published: December 2020

Objective: Research shows that poor sleep quality and smartphone addiction are common problems among university students. This study was planned to evaluate the quality of sleep in students at Pamukkale University and to investigate its relationship with smartphone addiction.

Methods: This cross-sectional study was carried out at the university campus in 2017-2018. Its dependent variable was low sleep quality. Independent variables were smartphone addiction, features related to smartphone addiction, socio-demographic features and other questioned features. The total number of students attending normal education in seven faculties and two colleges for four years was 20862. The minimum sample size of the study was calculated as 1088. Smartphone Addiction Scale-Short Version (SAS-SV) and Pittsburgh Sleep Quality Index (PSQI) were used. The data were analyzed with the SPSS program.

Results: The mean age was of the participants 21.39 ± 2.21. The sleep quality of students with a PSQI total score of more than five was defined as ‘poor’. The frequency of poor sleep quality was 52.4%. The frequency of smartphone addiction was 34.6% according to the SAS-SV scale. It was found that the frequency of poor sleep quality was significantly higher in students with smartphone addiction compared to others.

Conclusion: Smartphone addiction was found as one of the risk factors for poor sleep quality.

doi: https://doi.org/10.12669/pjms.37.1.3130

How to cite this:Ozcan B, Acimis NM. Sleep Quality in Pamukkale University Students and its relationship with smartphone addiction. Pak J Med Sci. 2021;37(1):206-211. doi: https://doi.org/10.12669/pjms.37.1.3130

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.
Sub-genomic analysis of Chikungunya virus E2 mutations in Pakistani isolates potentially modulating B-cell & T-Cell immune response
Authors: Khan Bilal Ahmed , Ullah Saif , Lail Amanullah , Khan Saeed
Published: December 2020

Background & Objectives: The Chikungunya virus (CHIKV) transmitted to the humans through Aedes species of the mosquitoes. In December 2016, a severe outbreak reported from Pakistan. However, there is no vaccine or anti-viral treatment currently available so host immune response against CHIKV gained significant interest. Therefore, this study was conducted to identify the mutations in CHIKV E2 region of currently circulating Pakistani strains & determine their potential immunogenicity in Pakistani population.

Methods: It was a cross sectional study in which a total of 60 CHIKV PCR positive samples were collected from Molecular Department of Pathology, Dow University of Health Sciences (DUHS), Karachi during November 2017 to February 2018. CHIKV E2 gene was amplified by PCR & sequenced. Sequences were analyzed by using bioinformatic tools followed by epitope prediction in E2 sequences by In-silico immunoinformatic approach.

Results: Several single nucleotide variations (SNVs) were identified in Pakistani isolates with six novel mutations in E2 sequences. Immunoinformatic analyses showed more proteasomal sites, CTL & B-Cell epitopes in Pakistani strains with respect to S27 prototype with 69.4% population coverage against these epitopes in Pakistan. The study also identified key mutations responsible for generation of unique epitopes and HLA restriction in Pakistani isolates. The strain specific mutations revealed the current outbreak was caused by ESCA.IOL lineage of CHIKV.

Conclusion: The evolution of E2 protein in Pakistani strains has increased its immunogenicity in comparison to ancestral s27 strain. The identification of most immunogenic and conserved epitopes with high population coverage has high potential to be used in vaccine development against these local strains.

doi: https://doi.org/10.12669/pjms.37.1.3236

How to cite this:Khan BA, Saifullah, Lail A, Khan S. Sub-genomic analysis of Chikungunya virus E2 mutations in Pakistani isolates potentially modulating B-cell & T-Cell immune response. Pak J Med Sci. 2021;37(1):93-98. doi: https://doi.org/10.12669/pjms.37.1.3236

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.
Upper gastrointestinal endoscopy; A study from a rural population of Sindh, Pakistan
Authors: Kamran Muhammad , Fawwad Asher , Haider Syed Iftikhar , Hussain Tahir , Ahmed Jameel
Published: December 2020

Objective: To discuss common indications and findings on upper gastrointestinal endoscopy as well as to correlate these findings with alarm symptoms in the rural population of Gadap town, Sindh.

Methods: This was a retrospective study on 1288 patients conducted in the medical ward of Fatima Hospital, Baqai Medical University. Patients’ demographics and other data related to the procedure were recovered from patients’ records. SPSS version 20 was used for statistical analysis.

Results: Ratio of male and female patients was approximately 1:1. Majority of the patients were young, and most procedures were done as outpatients without the requirement of conscious sedation. Epigastric pain was the primary indication for upper GI endoscopy (62.6%). One third of the procedures performed did not report any pathological finding. Probability of a positive finding was more likely if a patient presented with dysphagia, heart-burn, hematemesis, vomiting, or for screening endoscopy (for varices). Patients who were diagnosed with esophageal candidiasis, esophageal varices or esophageal growth/ ulcer had reported one or more alarm symptoms in their history.

Conclusions: Upper gastrointestinal endoscopy is a useful test to diagnose disorders of the esophagus, stomach and duodenum. However, it is an expensive procedure and therefore referring physicians should keep appropriate clinical indication and ethical considerations in mind before recommending such an investigation to their patients.

doi: https://doi.org/10.12669/pjms.37.1.3297

How to cite this:Kamran M, Fawwad A, Haider SI, Hussain T, Ahmed J. Upper gastrointestinal endoscopy; A study from a rural population of Sindh, Pakistan. Pak J Med Sci. 2021;37(1):9-14. doi: https://doi.org/10.12669/pjms.37.1.3297

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.
Measuring indicators of health system performance for palliative and end-of-life care using health administrative data: a scoping review
Authors: Budhwani Suman , Gill Ashlinder , Scott Mary , Wodchis Walter P. , Kim JinHee , Tanuseputro Peter
Published: December 2020

Background: A plethora of performance measurement indicators for palliative and end-of-life care currently exist in the literature. This often leads to confusion, inconsistency and redundancy in efforts by health systems to understand what should be measured and how.  The objective of this study was to conduct a scoping review to provide an inventory of performance measurement indicators that can be measured using population-level health administrative data, and to summarize key concepts for measurement proposed in the literature. 

Methods: A scoping review using MEDLINE and EMBASE, as well as grey literature was conducted.  Articles were included if they described performance or quality indicators of palliative and end-of-life care at the population-level using routinely-collected administrative data.  Details on the indicator such as name, description, numerator, and denominator were charted.

Results: A total of 339 indicators were extracted.  These indicators were classified into nine health care sectors and one cross-sector category.  Extracted indicators emphasized key measurement themes such as health utilization and cost and excessive, unnecessary, and aggressive care particularly close to the end-of-life.  Many indicators were often measured using the same constructs, but with different specifications, such as varying time periods used to ascribe for end-of-life care, and varying patient populations. 

Conclusions: Future work is needed to achieve consensus ‘best’ definitions of these indicators as well as a universal performance measurement framework, similar to other ongoing efforts in population health.  Efforts to monitor palliative and end-of-life care can use this inventory of indicators to select appropriate indicators to measure health system performance.
Sub-Saharan Africa preparedness and response to the COVID-19 pandemic: A perspective of early career African scientists
Authors: Umviligihozo Gisele , Mupfumi Lucy , Sonela Nelson , Naicker Delon , Obuku Ekwaro A. , Koofhethile Catherine , Mogashoa Tuelo , Kapaata Anne , Ombati Geoffrey , Michelo Clive M. , Makobu Kimani , Todowede Olamide , Balinda Sheila N.
Published: December 2020

Emerging highly transmissible viral infections such as SARS-CoV-2 pose a significant global threat to human health and the economy. Since its first appearance in December 2019 in the city of Wuhan, Hubei province, China, SARS-CoV-2 infection has quickly spread across the globe, with the first case reported on the African continent, in Egypt on February 14th, 2020. Although the global number of COVID-19 infections has increased exponentially since the beginning of the pandemic, the number of new infections and deaths recorded in African countries have been relatively modest, suggesting slower transmission dynamics of the virus on the continent, a lower case fatality rate, or simply a lack of testing or reliable data. Notably, there is no significant increase in unexplained pneumonias or deaths on the continent which could possibly indicate the effectiveness of interventions introduced by several African governments. However, there has not yet been a comprehensive assessment of sub-Saharan Africa’s (SSA) preparedness and response to the COVID-19 pandemic that may have contributed to prevent an uncontrolled outbreak so far. As a group of early career scientists and the next generation of African scientific leaders with experience of working in medical and diverse health research fields in both SSA and resource-rich countries, we present a unique perspective on the current public health interventions to fight COVID-19 in Africa. Our perspective is based on extensive review of the available scientific publications, official technical reports and announcements released by governmental and non-governmental health organizations as well as from our personal experiences as workers on the COVID-19 battlefield in SSA. We documented public health interventions implemented in seven SSA countries including Uganda, Kenya, Rwanda, Cameroon, Zambia, South Africa and Botswana, the existing gaps and the important components of disease control that may strengthen SSA response to future outbreaks.
MendelianRandomization v0.5.0: updates to an R package for performing Mendelian randomization analyses using summarized data
Authors: Broadbent Jim R. , Foley Christopher N. , Grant Andrew J. , Mason Amy M. , Staley James R. , Burgess Stephen
Published: December 2020

The MendelianRandomization package is a software package written for the R software environment that implements methods for Mendelian randomization based on summarized data. In this manuscript, we describe functions that have been added to the package or updated in recent years. These features can be divided into four categories: robust methods for Mendelian randomization, methods for multivariable Mendelian randomization, functions for data visualization, and the ability to load data into the package seamlessly from the PhenoScanner web-resource. We provide examples of the graphical output produced by the data visualization commands, as well as syntax for obtaining suitable data and performing a Mendelian randomization analysis in a single line of code.
Eltern während der Corona-Krise: Zur Improvisation gezwungen
Authors: Bujard Martin , Laß Inga , Diabaté Sabine , Sulak Harun , Schneider Norbert F.
Published: December 2020

Die Studie gibt einen Überblick über die Größenordnungen der von der Schließung von Kindertagesstätten (Kitas) und Schulen betroffenen Elterngruppen sowie der Veränderungen auf dem Arbeitsmarkt in den Monaten des Lockdowns. Im Anschluss werden vier Themenbereiche, die während der Krise an Relevanz gewannen, näher betrachtet: Eltern in systemrelevanten Berufen, Homeoffice als Lösung, Arbeitsteilung zwischen Frau und Mann sowie psychologische Folgen der Krise für Eltern.
Physical activity during the COVID-19 pandemic: a survey with adults in Northern Brazil
Authors: Marques Marcelo , Gheller Rodrigo , Henrique Nayana , Menezes Enaiane Cristina , Streit Inês , Franchini Emerson , Autran Roseanne
Published: December 2020

The aim of this study was to analyze the impact of the social distancing recommendations during COVID-19 pandemic on the physical activity behavior in adults living in region of Northern Brazil. A final sample of 654 adults (386 women) aged 33 ± 10 years old participated in this study. A questionnaire with 45 questions concerning sociodemographic characteristics, self-perception of health and characteristics of physical activity behavior before and after the recommendations of social distancing was applied in an online format. Comparisons between levels of physical activity before and after pandemic were conducted applying a McNemar test. A binary logistic regression was applied to analyze the factors associated to being physically active during the pandemic. Analyzing the percentage levels of physical activity before and during social distancing, we observed an increase of physically inactive behavior (19% vs. 36.7%), as well as a decrease in active (32.6% vs. 18.6%) and very active (16.7% vs. 6.6%) behaviors, respectively. Among participants, 59.2% of them became sedentary during pandemic. Walking and running activities continued to be among the most practiced, although they showed a reduction during social distancing. Social distancing recommendations due to the COVID-19 pandemic caused decrease in the overall levels of physical activity in adults living in the Amazonas State and specifically in the practice of individuals who were physically active and very physically active before pandemic.