bluuebunny/crossref_metadata_2025_split huggingface dataset:
The diagnostic performance of CESM and CE-MRI in evaluating the pathological response to neoadjuvant therapy in breast cancer: a systematic review and meta-analysis
Authors: Tang Sudan , Xiang Chunhong , Yang Quan 
Published: June 2020

Objectives:
Neoadjuvant chemotherapy (NAC) is an important method for breast cancer treatment. By monitoring its pathological response, the selection of clinical treatment strategies can be guided. In this study, the meta-analysis was used to compare the accuracy of contrast-enhanced MRI (CE-MRI) and contrast-enhanced spectral mammography (CESM) in detecting the pathological response of NAC.

Methods:
Literatures associated to CE-MRI and CESM in the evaluation of pathological response of NAC were searched from PubMed, Cochrane Library, web of science, and EMBASE databases. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was used to assess the quality of studies. Pooled sensitivity, specificity, and the area under the SROC curve were calculated to evaluate the diagnostic accuracy of CE-MRI and CESM in monitoring the pathological response of NAC.

Results:
There were 24 studies involved, 18 of which only underwent CE-MRI examination, three of which only underwent CESM examination, and three of which underwent both CE-MRI and CESM examination. The pooled sensitivity and specificity of CE-MRI were 0.77 (95%CI, 0.67–0.84) and 0.82 (95%CI, 0.73–0.89), respectively. The pooled sensitivity and specificity of CESM were 0.83 (95%CI, 0.66–0.93) and 0.82 (95%CI, 0.68–0.91), respectively. The AUCs of SROC curve for CE-MRI and CESM were 0.86 and 0.89, respectively.

Conclusions:
Compared to CE-MRI, CESM has equal specificity, greater sensitivity and excellent performance, which may have a brighter prospect in evaluating the pathological response of breast cancer to NAC.

Advances in knowledge:
CESM showed equal specificity, greater sensitivity, and excellent performance than CE-MRI.
The Phenomenon of “Obesity Paradox” in Neck of Femur Fractures
Authors: Tahir Muhammad , Ahmed Nadeem , Ali Samejo Muhammad Qasim , Jamali Allah Rakhio 
Published: June 2020

Objective: To determine the association of body mass index (BMI) with 30 days and 1-year mortality outcomes of orthopedic elderly patients after hip fracture surgery.
Methods: This is prospective study conducted at Department of Orthopaedics, at a tertiary care public sector hospital in Karachi between Jan-2016 to Jan-2018. In this short follow-up study, we included the data of 490 patients, who were operated for neck of femur fractures in a public sector tertiary care hospital between Jan-2016 to Jan-2018. Patients were divided into different categories on the basis of BMI; BMI <20 Kg.m-2 underweight, 20-24.99 Kg.m-2 normal weight, BMI 25-29.99 Kg.m-2 overweight, ≥30 obese. Mortality at 30 days and 1-year mortality were primary study end-points.
Results: Rate of re-admission within 30 days, major adverse cardiovascular events (MACE) within 30 days and 30 days mortality was high in underweight and lowest in obese patients. Thirty-day mortality rate was 2.7% in underweight, 1.3% in normal weight, 0.64% in over-weight and 0.0% in obese patients but this was not significant statistically (p-value 0.29). One-year mortality rate was significantly high in under-weight patients, 34.2%, 25.9% in normal weight, 21.4% in overweight and only 14.5% in obese patients (p-value 0.009). Age ≥ 65 years (odds ratio 0.40 (0.26-0.63), and ASA III-IV (odds ratio; 0.27 (0.16-0.45) are also significant risk factors of 1-year mortality
Conclusion: BMI classification can serve as an important indicator of adverse early outcomes after hip fracture surgery. Over-weight and obese patients have better survival outcomes and have lower 1-year mortality rate.
doi: https://doi.org/10.12669/pjms.36.5.1952
How to cite this:Tahir M, Ahmed N, Samejo MQA, Jamali AR. The Phenomenon of “Obesity Paradox” in Neck of Femur Fractures. Pak J Med Sci. 2020;36(5):1079-1083. doi: https://doi.org/10.12669/pjms.36.5.1952
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.
“We shall have gone to a higher standard”: Training village heath teams (VHTs) to use a smartphone-guided intervention to link older Ugandans with hypertension and diabetes to care
Authors: Mugisha Joseph Okello , Seeley Janet 
Published: June 2020

Background: It is not clear whether village health teams (VHTs) can be empowered to participate in interventions to prevent and control hypertension and diabetes in older adults in Uganda. We conducted this study in rural Uganda to establish the experiences of VHTs in managing older adults with health problems, their knowledge of hypertension and diabetes and their understanding of referral systems. We also explored their experiences with smartphones and whether VHTs could be effectively trained to use a smartphone-guided intervention to link older adults with hypertension and diabetes mellitus to care. Methods: We conducted in-depth interviews (IDIs) with and trained 20 VHTs randomly selected from Bukulula sub-county in Kalungu district from October 2017-December 2018. We used interview guides to explore topics relevant to our study objectives. VHTs were trained to measure blood sugar and blood pressure using digital machines. VHTs were trained on identifying symptoms of diabetes mellitus. Data from IDIs were analysed using thematic content analysis. Competence tests were used to evaluate the training. Results: Most of the VHTs were female (75%). All VHTs had some knowledge on hypertension and diabetes and other chronic diseases. They did not have any experience in treating older adults since they had been trained to deal mainly with children. Half of the VHTs owned smartphones. All were willing to participate in an intervention using a smartphone to link older adults with hypertension and diabetes mellitus to care. By the end of the training, all but three participants could comprehend the symptoms of diabetes and measure blood sugar and blood pressure. Conclusion: Village health teams in the study setting need training in managing the health needs of older adults before engaging with an intervention using smartphones to link older adults with diabetes mellitus and hypertension to care.
COVID-19 IDD: A global survey exploring the impact of COVID-19 on individuals with intellectual and developmental disabilities and their caregivers
Authors: Linehan Christine , Araten-Bergam Tal , Beadle-Brown Julie , Bigby Christine , Birkbeck Gail , Bradley Valerie , Brown Michael , Bredewold Femmianne , Chirwa Masauso , Kanova Sarka , Kroll Thilo , MacLachlan Mac , Narayan Jayanthi , Nearchou Finiki , Nolan Adam , O'Donovan Mary-Ann , Santos Flavia H. , Siska Jan , Tideman Magnus , Tossebro Jan 
Published: June 2020

Background: This protocol outlines research to explore the impact of coronavirus disease 2019 (COVID-19) on individuals who have intellectual and developmental disabilities and their caregivers. Evidence suggests that people with intellectual and developmental disabilities experience disparities in healthcare access and utilisation. This disparity was evident early in the pandemic when discussions arose regarding the potential exclusion of this population to critical care. Methods: An anonymous online survey will be conducted with caregivers, both family members and paid staff, to explore the impact of COVID-19 on this population in terms of demographics, living arrangements, access to services, the impact of social distancing, and also carer wellbeing. The survey will be developed by the research team, many of whom are experts in intellectual disability within their own jurisdictions. Using back-translation our team will translate the survey for distribution in 16 countries worldwide for international comparison. The survey team have extensive personal and professional networks in intellectual disability and will promote the survey widely on social media with the support of local disability and advocacy agencies. Statistical descriptive and comparative analyses will be conducted. Ethical approval has been obtained for this study from University College Dublin’s Human Research Ethics Committee (HS-20-28-Linehan). Dissemination: Study findings will be prepared in a number of formats in order to meet the needs of different audiences. Outputs will include academic papers, lessons learned paper, practice guidelines, reports, infographics and video content. These outputs will be directed to families, frontline and management delivering disability services, national-level policy makers, healthcare quality and delivery authorities, national pandemic organisations and international bodies.
Stroke - diagnosis and treatment methods
Authors: Ręba Patrycja 
Published: June 2020

IntroductionStroke is a very serious health problem. Its typical consequences include chronic physical and mental disability, more than half of all patients who survived stroke are dependent, depending on the help of other people even in everyday activities. Stroke is the death of parts of this organ as a result of stopping the blood supply to the brain tissue. There are two main types of stroke: ischemic and hemorrhagic. Aim The aim of the study is to analyze treatment methods and diagnose stroke.Material and method Review of available literature on the subject.ResultsIschemic stroke (about 4/5 of stroke cases) occurs when an artery supplying some part of the brain with blood becomes obstructed, i.e. blood does not flow through it or it flows from insufficient amount so that brain cells receive as much as they need. Atherosclerosis is the most common cause of narrowing or blockage of the artery. Hemorrhagic stroke (about 1/5 of stroke cases) occurs as a result of a cerebral artery wall rupture and blood spilling out of the vessel, as a result of which the blood does not reach the brain tissue in the area supplied by the ruptured artery. The blood escaping from the damaged vessel destroys the surrounding nervous tissue and causes an increase in pressure inside the skull, which disrupts the functioning of the entire brain. Hemorrhagic strokes are divided into intracerebral hemorrhages andsubarachnoid hemorrhage.According to the World Health Organization, around 15 million cases of stroke are diagnosed worldwide each year. Of this group, approximately 5 million die and another 5 million suffer from permanent disability. ConclusionsAnyone suspected of having a stroke should be taken to hospital immediately and under specialist medical care. Stroke is a medical emergency and the chances of recovery are greater the sooner treatment is started. Stroke, as the most important cause of chronic disability, is a disease that heavily burden the budget of healthcare systems.
Immunohistochemical studies on lymphocyte subpopulation in endometrium samples in women with infertility
Authors: Chistyakova Guzel , Grishkina Anastasia , Remizova Irina , Melkozerova Oxana , Dankova Irina 
Published: June 2020

Uterine leucocytes have been thought to play a key role in endometrial pathology and infertility.The aim of this study was to compare the amount of CD20+, CD3+, CD56+, CD138+ cells in the endometrium from women with simple endometrial hyperplasia without atypia and thin endometrium with the presence of infertility. 95 patients, with simple endometrial hyperplasia without atypia, thin endometrium, and women without endometrial pathology (controls) were selected as research subjects. Hematoxylin and eosin staining were performed on all endometrial biopsies. Immunohistochemical staining for CD20+, CD3+, CD56+, CD138+ cells was applied to all tissue samples. Additionally, the disease histories of patients were collected, were held clinical and laboratory tests. The number of CD20+ cells was higher in 1 group (4,129±0,55) and 2 group (5,872±0,85), compared to fertile patients (1,353±0,16, p<0.05). The ratio of CD3+ cells was higher in women with endometrial hyperplasia (108,871±14,34) and lower in women with a thin endometrium (36,388±3,83), compared to fertile patients (72,848±6,11, p<0.05). The study shows a notable increase of CD138+ in specimens with hyperplasia (19,18±1,2) and thin endometrium (20,81±1.45) compared to fertile patients (1,02±0,5, p<0.05 in both cases), and decreased of CD56-positive cells in stroma (43,4±2,2; 33.6±2.8) and in glands (7,4±1,2; 3.6±1,8) for hyperplasia and thin endometrium respectively compared to control group (51,2±2,5; 14,8±0,9). Women, with endometrial hyperplasia, have larger populations of CD20+, CD3+, and CD138+ and decreased amount of CD56+ in the stroma and glandular cells, as for women with thin endometrium, they have large populations of CD20+ and CD138+ and small of CD3+, CD56+, but bough groups may be at greater risk for infertility disorders resulting from an inflammatory environment occurring during implantation or later during decidualization.
Student’s knowledge of obesity at the Collegium Medicum of the Jan Kochanowski University in Kielce
Authors: Redziak Kamil Grzegorz 
Published: June 2020

Introduction: Obesity is considered to be an epidemic of the XXI century. According to the World Health Organisation (WHO), the number of overweight people aged 18 and over in 2016 was 1.9 billion, 650 million of whom were obese. The causes of obesity are mainly due to erroneous eating habits and low levels of physical activity. Obesity is a disease, but it is also a factor causing many diseases, including chronic diseases that can lead to disability and premature death.Aim: The aim of the study was to assess the level of knowledge of students of the Faculty of Medicine and Health Sciences of Jan Kochanowski University in Kielce about the causes and effects of obesity.Material and methods: In this work, we used a self-assessment questionnaire to conduct the research. The survey was conducted among students of Collegium Medicum of Jan Kochanowski University in Kielce. The research group consisted of 111 students, including 98 students and 13 students. The respondents lived in both urban and rural areas.Results: The analysis of the collected data shows that the students have knowledge about obesity, know the causes, health effects and show that extensive preventive actions will contribute to reduce the incidence of obesity.Conclusions: Students have a high knowledge of obesity, correctly identifying the causes and methods of diagnosis of obesity. They also have sufficient knowledge of the impact of obesity on health.
Limitación de soporte vital. Cuidados paliativos y final de vida en UCI
Authors: Rubio Sanchiz Olga , Ventura Pascual Lara 
Published: June 2020

La misión de los cuidados intensivos es restaurar la situación basal de salud libre de discapacidad severa atendiendo al principio bioético de beneficencia, respetando la dignidad y voluntad del paciente de ser tratado lo que vendría a ser atender al principio bioético de autonomía, y realizando todo esto de una forma adecuada a la mejor evidencia actual, justa y sostenible atendiendo a los principios de no maleficencia y de justicia. Cuando no es posible es cuando los profesionales tienen la obligación ética de iniciar un diálogo de manera respetuosa y prudente con el paciente y/o la familia y el resto de profesionales implicados (atención primaria, enfermería, especialistas...etc.) de cara a llegar a un consenso sobre limitar los tratamientos de soporte vital y/o adecuar los cuidados y continuar el tratamiento con un plan terapéutico de cuidados dirigidos al confort, control de síntomas y a mejorar la calidad de vida (Plan de cuidados paliativos) para preservar la dignidad del paciente, evitar el sufrimiento y proporcionar un tratamiento compasivo de soporte y acompañamiento durante el proceso de muerte si se diera el mismo atendiendo al paciente y a la familia con el máximo cuidado y respeto en un marco de humanización de la salud. Atender de forma excelente el final de la vida significa dignificar a las personas que están pasando por ese proceso, aportar un valor extraordinario de humanidad y debe ser un objetivo prioritario actual en nuestro quehacer diario en las unidades de cuidados intensivos.
Multiwavelength membrane laser array using selective area growth on directly bonded InP on SiO2/Si
Authors: Fujii Takuro , Takeda Koji , Nishi Hidetaka , Diamantopoulos Nikolaos-Panteleimon , Sato Tomonari , Kakitsuka Takaaki , Tsuchizawa Tai , Matsuo Shinji 
Published: June 2020

The cost and power consumption of optical transmitters are now hampering further increases in total transmission capacity within and between data centers. Photonic integrated circuits (PICs) based on silicon (Si) photonics with wavelength-division multiplexing (WDM) technologies are promising solutions. However, due to the inefficient light emission characteristics of Si, incorporating III-V compound semiconductor lasers into PICs via a heterogeneous integration scheme is desirable. In addition, optimizing the bandgap of the III-V material used for each laser in a WDM transmitter becomes important because of recent strict requirements for optical transmitters in terms of data speed and operating temperature. Given these circumstances, applying a direct-bonding scheme is very difficult because it requires multiple bonding steps to bond different-bandgap III-V materials that are individually grown on different wafers. Here, to achieve wideband WDM operation with a single wafer, we employ a selective area growth technique that allows us to control the bandgap of multi-quantum wells (MQWs) on a thin InP layer directly bonded to silicon (InP-on-insulator). The InP-on-insulator platform allows for epitaxial growth without the fundamental difficulties associated with lattice mismatch or antiphase boundaries. High crystal quality is achieved by keeping the total III-V layer thickness less than the critical thickness (430 nm) and compensating for the thermally induced strain in the MQWs. By carrying out one selective MQW growth, we successfully fabricated an eight-channel directly modulated membrane laser array with lasing wavelengths ranging from 1272.3 to 1310.5 nm. The fabricated lasers were directly modulated at 56-Gbit/s with pulse amplitude modulation with four-amplitude-level signal. This heterogeneous integration approach paves the way to establishing III-V/Si WDM-PICs for future data-center networks.
Modelling and Simulation for Preclinical Cardiac Safety Assessment of Drugs with Human iPSC-Derived Cardiomyocytes
Authors: Kügler Philipp 
Published: June 2020

AbstractAs a potentially life threatening side effect, pharmaceutical compounds may trigger cardiac arrhythmias by impeding the heart’s electrical and mechanical function. For this reason, any new compound needs to be tested since 2005 for its proarrhythmic risk both during the preclinical and the clinical phase of the drug development process. While intensive monitoring of cardiac activity during clinical tests with human volunteers constitutes a major cost factor, preclinical in vitro tests with non cardiac cells and in vivo tests with animals are currently under serious debate because of their poor extrapolation to drug cardiotoxicity in humans. For about five years now, regulatory agencies, industry and academia are working on an overhaul of the cardiac drug safety paradigm that is built a) on human heart muscle cells, that can be abundantly bioengineered from donor stem cells without ethical concerns (human induced pluripotent stem cell derived cardiomyocytes, hiPSC-CMs), and b) on computational models of human cardiac electrophysiology both at the cellular and the organ level. The combined use of such human in vitro and human in silico models during the preclinical phase is expected to improve proarrhythmia test specificity (i.e. to lower the false-positive rate), to better inform about the need of thorough heart monitoring in the clinic, and to reduce or even replace animal experiments. This review article starts by concisely informing about the electrical activity of the human heart, about its possible impairment due to drug side effects, and about hiPSC-CM assays for cardiac drug safety testing. It then summarizes the mathematical description of human cardiac electrophysiology in terms of mechanistic ODE and PDE models, and illustrates how their numerical analysis may provide insight into the genesis of drug induced arrhythmias. Finally, this paper surveys proarrhythmic risk estimation methods, that involve the simulation of human heart muscle cells, and addresses opportunities and challenges for future interdisciplinary research.
The Media, European Integration and the Rise of Euro-journalism, 1950s–1970s, Martin Herzer (2019)
Authors: Ojala Markus 
Published: June 2020

Review of: The Media, European Integration and the Rise of Euro-journalism, 1950s–1970s, Martin Herzer (2019)
London: Palgrave Macmillan, 357 pp.,
ISBN 978-3-03028-777-1, h/bk, €82.49, ISBN 978-3-03028-778-8, e/bk, €64.19
Esophageal pH Capsule Retention
Authors: Aulakh Sabreen , Ashley Sharon , Haas Kelly , Truong Trinh 
Published: June 2020

ABSTRACT
The wireless pH capsule is widely used to evaluate gastroesophageal reflux disease in patients. Common complications include premature capsule detachment, dysphagia, chest pain, and technical malfunctions. We present a 6-year-old boy who presented to our institution with a 2-day history of coffee-ground emesis. A pH capsule was found to be lodged in his distal esophagus 45 days after initial placement. We explore the possible reasons for capsule retention and briefly discuss the safety implications of this finding because we believe that this complication may be underreported.
Clinical features in adult multiple sclerosis patients
Authors: Koprivnik Matej , Hojs Fabjan Tanja 
Published: June 2020

Introduction: The purpose of the study was to identify possible correlations between the quality of life, neurological disability, and functional ability in patients with multiple sclerosis.Methods: 258 patients with multiple sclerosis were included in the cross-sectional study. They were assessed with the Expanded Disability Status Scale (EDSS), the Berg Balance Scale (BBS), the Timed 25-Foot Walk Test (T25-FW), the 9-Hole Peg Test (9HPT), the Paced Auditory Serial Addition Test (PASAT-3) and the EQ visual analogue scale (EQ-VAS). Inferential statistics were used.Results: A positive correlation between the EQ-VAS and the BBS (r = 0.43, p < 0.01 ) and the PASAT-3 (r =¸0.19, p < 0.01), and a negative correlation between the EQ-VAS and the T25FW (r = –0.42, p < 0.01) and the 9-HPT (r = –0.40, p < 0.01) were shown. A negative correlation was also observed between the EDSS and the BBS (r = –0.77, p < 0.05) as well as the EDSS and the PASAT-3 (r = –0.25, p < 0.01), and a positive correlation between the EDSS and the 9 HPT (r = 0.67, p < 0.01) and the T25-FW (r = 0.80, p < 0.01).Discussion and conclusion: Associations between the variables indicate the need for complex, personalized and rational monitoring of patients with multiple sclerosis.