bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corrected integrated density: a novel method for liver elastic fibers quantification in chronic hepatitis C
Authors: Leite Carine , Starosta Rodrigo Tzovenos , Trindade Eduardo Neubarth , Trindade Manoel Roberto Maciel , Álvares-da-Silva Mário Reis , Cerski Carlos Thadeu Schmidt 
Published: February 2020

Abstract
Background
Elastic fibers deposition is triggered during liver fibrosis and is related to worse clinical prognosis in chronic hepatitis C patients. This study aimed to verify if a new method for elastic fiber quantification can be used to discriminate between different degrees of fibrosis in liver biopsies of patients with hepatitis C.

Methods
Individuals presenting with different degrees of fibrosis in liver biopsy were included. Slides of liver samples were stained with orcein with and without prior oxidation. Morphometric analysis was proceeded, and quantification accomplished by corrected integrated density.

Results
Twenty-seven patients, mean age 52 years-old, 59% women, were included. Elastic fibers density was higher in advanced fibrosis patients and there was a positive correlation with Metavir score (Spearman r = 0.609, p < 0.001), as well as with the noninvasive scores Fib-4 (Pearson r = 0.46, p = 0.029) and APRI (r = 0.52, p = 0.01).

Conclusion
Morphometric analysis by corrected integrated density demonstrates that elastic fibers abundance is higher in advanced stage of fibrosis in patients with hepatitis C.
Accuracy of p53 and ki-67 in the graduation of phyllodes tumor, a model for practical application
Authors: Rivero L. F. , Graudenz M. S. , Aschton-Prolla P. , Delgado A. M. , Kliemann L. M. 
Published: February 2020

Abstract
Background
The accurate graduation of a phyllodes tumor (PT) is critical for effective treatment as it allows correct surgical management, and avoids inadequate excision for malignant or borderline PT, or surgical overtreatment in benign PT. PTs of the breast are notoriously difficult to classify, and reliable differentiation of a benign PT from a borderline or malignant PT can be problematic, especially among relatively inexperienced pathologists. Although several authors acknowledge a strong relationship between the immunohistochemical expression of p53 and Ki-67 and the histopathological grade of PT—with potential impact on diagnostic accuracy—the literature lacks consensus about which cutoff defines a positive index test. The objective of this study is to establish a practical application score that increases the graduation accuracy of PT through the appropriate use of these auxiliary methods.

Methods
A retrospective study cohort of 146 pathology reviewed PTs surgically removed between January 2000 and December 2015. The Ki-67 test was considered positive if > 10% of neoplastic cells showed nuclear staining. The p53 test was considered positive if > 10% of neoplastic nuclear cells showed nuclear staining in a moderate or strong intensity.

Results
Of the 146 PT cases reviewed, 110 were classified as benign, 16 as borderline, and 20 as malignant. The correlation between age and size with benign, borderline, and malignant subgroups was statistically significant (p < 0.001). Significance was observed in the expression of both Ki-67 and p53 in the comparison of benign, borderline, and malignant PT with p < 0.001 and a 95% confidence interval (CI). When correlating the presence of positivity in either of the two index tests with the diagnosis of borderline or malignant PT, we reached a sensitivity of 100% and a specificity of 91.8 (p < 0.001; 95% CI).

Conclusion
We propose a practical methodology to achieve an accurate grade of PT, based on clearly defined and easy to apply cutoffs of a simple immunohistochemical panel of Ki-67 and p53. A PT positive for either of the index tests should be graded as borderline or malignant, so pathologists can use this test to improve accuracy. We hope this new approach might provide the basis for the development of standardization in using p53 and Ki-67 for grading PT.
Biological activities of phenolic compounds extracted from flaxseed meal
Authors: Akl Engy M. , Mohamed Samira S. , Hashem Ahmed I. , Taha Fakhriya S. 
Published: February 2020

Abstract
Background
There is a worldwide demand for phenolic compounds (PC) because they exhibit several biological activities. The present investigation deals with a comprehensive study on the biological activities of phenolic compounds extracted from flaxseed meal (FM) with the aid of ultrasonic waves.

Results
The antioxidant activity of the PC extract of FM is considerably high when measuring it by the three methods (the β-carotene coupled oxidation method, the DPPH free radical scavenging activity method, and measuring the reducing antioxidant power). The toxicity test revealed that the PC extract was nontoxic on normal retina cell line. Also, it has no anticoagulating activity. Evaluation of antimicrobial activity showed that it is effective towards four strains only from seven. FM phenolic extract has been evaluated as chemo-preventive agents by testing the product for any cytotoxic activity against human tumor cell lines. The highest inhibitory effect was achieved on cell lines of colon carcinoma and lung carcinoma with IC50 = 22.3 and 22.6 μ/ml respectively.

Conclusion
The PC extracted from FM showed high antioxidant activity, nontoxic on normal retina cell line, no anticoagulating activities, and an antimicrobial effect on some pathogenic bacteria, so the phenolic compounds extracted from flaxseed meal showed significant biological activities.
Multi-constellation GNSS precise point positioning with multi-frequency raw observations and dual-frequency observations of ionospheric-free linear combination
Authors: An Xiangdong , Meng Xiaolin , Jiang Weiping 
Published: February 2020

AbstractPrecise point positioning (PPP) is famous for its capability of high-precision positioning with just one station as long as the receiver can receive global navigation satellite system (GNSS) signals. With the rapid development of BDS and Galileo, the number of available satellites for positioning has increased significantly. In addition, GPS III, GLONASS-K, BDS, and Galileo satellites can transmit triple-frequency signals. The potentials of multi-constellation GNSS PPP requires further analysis on a global scale. Therefore, we selected 96 multi-GNSS experiment (MGEX) stations with a global distribution and used 1 week’s data to assess the PPP performance. The results show that the PPP based on multi-frequency raw observations with spatial and temporal constraints has better performance than PPP using dual-frequency ionospheric-free observations. The main contribution of multi-constellation GNSS PPP is to shorten the convergence time. The convergence time for GPS PPP is approximately 40 min, which can be shortened to less than 20 min in multi-GNSS PPP. After convergence, the positioning accuracy of multi-GNSS PPP is improved by 0.5 to 1.0 cm compared with GPS or GLONASS PPP. The positioning accuracy of multi-GNSS could be further improved in the future with the BDS and Galileo precise products of orbits, clock and phase center offset/variation.
Mitochondrial Dysfunction, Insulin Resistance, and Potential Genetic Implications
Authors: Sangwung Panjamaporn , Petersen Kitt Falk , Shulman Gerald I , Knowles Joshua W 
Published: February 2020

Abstract
Insulin resistance (IR) is fundamental to the development of type 2 diabetes (T2D) and is present in most prediabetic (preDM) individuals. Insulin resistance has both heritable and environmental determinants centered on energy storage and metabolism. Recent insights from human genetic studies, coupled with comprehensive in vivo and ex vivo metabolic studies in humans and rodents, have highlighted the critical role of reduced mitochondrial function as a predisposing condition for ectopic lipid deposition and IR. These studies support the hypothesis that reduced mitochondrial function, particularly in insulin-responsive tissues such as skeletal muscle, white adipose tissue, and the liver, is inextricably linked to tissue and whole body IR through the effects on cellular energy balance. Here we discuss these findings as well as address potential mechanisms that serve as the nexus between mitochondrial malfunction and IR.
Dynamics of ACTH and Cortisol Secretion and Implications for Disease
Authors: Lightman Stafford L , Birnie Matthew T , Conway-Campbell Becky L 
Published: February 2020

Abstract
The past decade has seen several critical advances in our understanding of hypothalamic–pituitary–adrenal (HPA) axis regulation. Homeostatic physiological circuits need to integrate multiple internal and external stimuli and provide a dynamic output appropriate for the response parameters of their target tissues. The HPA axis is an example of such a homeostatic system. Recent studies have shown that circadian rhythmicity of the major output of this system—the adrenal glucocorticoid hormones corticosterone in rodent and predominately cortisol in man—comprises varying amplitude pulses that exist due to a subhypothalamic pulse generator. Oscillating endogenous glucocorticoid signals interact with regulatory systems within individual parts of the axis including the adrenal gland itself, where a regulatory network can further modify the pulsatile release of hormone. The HPA axis output is in the form of a dynamic oscillating glucocorticoid signal that needs to be decoded at the cellular level. If the pulsatile signal is abolished by the administration of a long-acting synthetic glucocorticoid, the resulting disruption in physiological regulation has the potential to negatively impact many glucocorticoid-dependent bodily systems. Even subtle alterations to the dynamics of the system, during chronic stress or certain disease states, can potentially result in changes in functional output of multiple cells and tissues throughout the body, altering metabolic processes, behavior, affective state, and cognitive function in susceptible individuals. The recent development of a novel chronotherapy, which can deliver both circadian and ultradian patterns, provides great promise for patients on glucocorticoid treatment.
Correlation between Serum Ferritin Levels and Liver Stiffness measured by Fibroscan in patients with Chronic Hepatitis C
Authors: Latif Saba , Kalam Quratulain , Zuberi Bader Faiyaz 
Published: February 2020

Objective: To determine correlation between transient elastography values with serum ferritin and duration of infection in patients of hepatitis C.
Methods: A cross-sectional study was conducted at medical units of Civil Hospital, Karachi. The study protocol was approved by the Research Evaluation Unit of College of Physician and Surgeon Pakistan (CPSP). Patients fulfilling inclusion criteria were included after taking informed consent. Serum ferritin levels were tested by standard laboratory procedures and transient elastography by fibroscan. Regression analysis was done to see correlation of ferritin with transient elastography and duration of HCV.
Results: Over all 120 patients fulfilling the selection criteria were selected after informed consent. These included 68 (56.7%) male & 52 (43.3%) female. Significant differences in ferritin levels by Fibrosis stages were observed by ANOVA (df = 3; F =12.768; p = <0.001). Serum ferritin showed linear pattern across Fibrosis stages (F = 33.948; p = <0.001). Regression analysis of ferritin and duration of HCV showed significant impact on TE scores (r2 = 0.317).
Conclusions: There is significant correlation between serum ferritin and duration of HCV with TE scores.
doi: https://doi.org/10.12669/pjms.36.3.1288
How to cite this:Latif S, Kalam Q, Zuberi BF. Correlation between Serum Ferritin Levels and Liver Stiffness measured by Fibroscan in patients with Chronic Hepatitis C. Pak J Med Sci. 2020;36(3):355-359. doi: https://doi.org/10.12669/pjms.36.3.1288
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.
Nephron sparing surgery for renal tumors-comparison of off-clamp partial nephrectomy with hilar clamping
Authors: Jalbani Imran Khan , Nazim Syed Mohammad , Ahmed Maria , Abbas Farhat 
Published: February 2020

Background and Objective: Open partial nephrectomy (PN) is still considered gold standard procedure for T1 localized renal tumors. Conventional technique involves clamping of the renal artery with or without vein however, renal ischemia produces a certain level of damage to the kidneys. This study aims to investigate potential effect of off-clamp vs. hilar clamping PN on renal function.
Methods: This is a retrospective cohort study of patients who underwent unilateral, open partial nephrectomy for renal tumors b/w January 2009 December 2016 at our institution. A total of 90 partial nephrectomies were performed of which 65 cases were eligible for analysis. Non clamping technique was used in 43 while clamp was applied in 22 patients. Variables studied were patients’ demographics, clinical variables, the laterality, tumors size and location, R.E.N.A.L nephrometry score, blood loss, tumor histology and surgical margins. Patients’ renal function (serum creatinine and eGFR) were determined pre-operatively, at 3 and 12 months follow up. Data was analyzed on SPSS v. 22.
Results: Both the groups were comparable with regards to pre-operative renal function. Mean radiological size of tumor was 4.71±1.31 and 3.81±1.0 (0.003) in two groups respectively. Mean R.E.N.A.L nephrometry score was 6.1±1.5 in off-clamp group compared to 7.05±1.7 in clamp group (p=0.04). No statistically significant difference was found in operative duration, blood loss, positive surgical margins and intra/ peri-operative complications. At three months and one year, renal function was better preserved in non-clamp group compared to clamp group (p=0.001 and 0.007 respectively).
Conclusion: Off clamp open partial nephrectomy is safe and feasible option leading to less decline in renal function.
doi: https://doi.org/10.12669/pjms.36.3.1533
How to cite this:Jalbani IK, Nazim SM, Ahmed M, Abbas F. Nephron sparing surgery for renal tumors- comparison of off-clamp partial nephrectomy with hilar clamping. Pak J Med Sci. 2020;36(3):316-321. doi: https://doi.org/10.12669/pjms.36.3.1533
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.
Hepatocellular Carcinoma (HCC), Where do we stand? Current situation
Authors: Hafeez Muhammad , Nadeem Muhammad , Ahmed Mahmood , Rehman Faheem-ur- 
Published: February 2020

Objective: To identify the stage of Hepatocellular Carcinoma (HCC) at the time of presentation.
Methods: This cross sectional observational prospective study was carried out at Gastro Department of Combined Military Hospital (CMH) Multan from August 2017 to December 2018. Patients were diagnosed on the basis of alpha fetoprotein, abdominal ultrasound, triphasic contrast enhanced computerized tomography (CECT). They were evaluated for etiology including Hepatitis B, C and non B & C. The patients were inquired about the previous treatment and when they came to know about the HCC. Staging of the tumor was done on the basis BCLC (Barcelona cancer liver clinic) and Melan’s criteria. Performance status (PS) of the patient was checked by Eastern Cooperative Oncology Group (ECOG) criteria. Severity of cirrhosis was assessed by CTP (Child Turcotte Pugh) and Model for end stage liver disease (MELD) score. The data was analyzed in IBM SPSS version 22.
Results: Out of 135 patients 78% were males and 22% females. Age Mean SD was 58.81± 9.366. Frequency of hepatitis C, B, combined B, C and non-B non-C was 80%, 11%, 2.8% and 6.2% respectively. 96(73.8%) never got the treatment before for Hepatitis. 81(62.3%) came to know first time on this index admission. Maximum numbers of patients were in BCLC stage B i.e. 82(55.2%) with ECOG grade of one i.e.57 (39.3%), at the time of presentation. Mean MELD and CTP score were 12.24, 7.34 (class B) respectively.
Conclusion: HCV was the most common in HCC, never treated before, presented for the first time in advance stage of the disease where very limited treatment options left behind.
doi: https://doi.org/10.12669/pjms.36.3.1594
How to cite this:Hafeez M, Nadeem M, Ahmed M, Faheem-ur-Rehman. Hepatocellular Carcinoma (HCC), Where do we stand? Current situation. Pak J Med Sci. 2020;36(3):344-348. doi: https://doi.org/10.12669/pjms.36.3.1594
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.
Therapeutic effects of internal fixation with support plates and cannulated screws via the posterolateral approach on supination external rotation stage IV ankle fracture
Authors: Liu Zhongbing , Tang Genling , Guo Shuguang , Cai Bin , Li Qingsong 
Published: February 2020

Objective: To evaluate the therapeutic effects of internal fixation with support plates and cannulated screws via the posterolateral approach on supination external rotation stage IV ankle fracture.
Methods: Eighty-five patients with SER-IV°ankle fracture and large posterior malleolar fracture treated from June 2016 to June 2018 in our hospital, were randomly divided into a support plate group (n=47) and a cannulated screw group (n=38). The treatment outcomes were compared regarding surgical time, amount of bleeding, time of fracture healing, postoperative complications, as well as the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score and excellent rate one year later.
Results: The surgical time and intraoperative blood loss of cannulated screw group were significantly lower than those of support plate group (P<0.05). There were four cases of posterior lateral incision redness complicated with obvious bloody exudation in support plate group on the postoperative 2nd day. One case developed into superficial incision infection subsequently, and one case suffered from deep infection. After dressing and treatment with sensitive antibiotics, stitch removal was delayed, and primary healing was obtained. In cannulated screw group, there were two cases of posterior lateral incision redness complicated with obvious bloody exudation on the postoperative 3rd day, without skin incision infection. One case had cannulated screw loosening two months after surgery, and the posterior malleolar fracture block was slightly displaced. The incidence of surgical complications in support plate and cannulated screw groups were 8.51% and 7.89%, respectively (P>0.05). The AOFAS scores of cannulated screw ((81.71 ± 12.39) points) and support plate groups ((86.62 ± 10.12) points) were significantly different (P<0.05).
Conclusion: For patients with posterior malleolar fracture or osteoporosis, fixation using support plate is recommended. Cannulated screw fixation is suitable for for patients with poor conditions of skin soft tissues or basic diseases such as diabetes intolerant to long surgery.
doi: https://doi.org/10.12669/pjms.36.3.1671
How to cite this:Liu Z, Tang G, Guo S, Cai B, Li Q. Therapeutic effects of internal fixation with support plates and cannulated screws via the posterolateral approach on supination external rotation stage IV ankle fracture. Pak J Med Sci. 2020;36(3):438-444. doi: https://doi.org/10.12669/pjms.36.3.1671
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.
Influence of Bioactive, Resin and Glass Ionomer luting cements on the fracture loads of dentin bonded ceramic crowns
Authors: Vohra Fahim , Altwaim Manea , Alshuwaier Abdulaziz , Al Deeb Modhi , Alfawaz Yasser , Alrabiah Mohammed , Abduljabbar Tariq 
Published: February 2020

Objective: To investigate the failure loads of dentin bonded all-ceramic crowns when luted with Bioactive, resin and glass ionomer cements (GIC) in an in-vitro setting.
Methods: This study was conducted at King Saud University, Saudi Arabia, from Nov.2018 to March 2019. In this study, 60 premolar teeth were prepared for dentin-bonded ceramic crowns. Lithium disilicate ceramic crowns fabricated using CAD-CAM technique were cemented to teeth using Bioactive (ACITVA), Resin (Nexus 3 Gen) and GIC (Ketac Cem- Maxicap). Half of the bonded specimens in each group were thermocycled (50000 cycles), however the remaining half were not aged (n=10). Fracture loads of bonded crowns were assessed by exposing them to static axial occlusal loads (1mm/min) using a round ended metal probe in a Universal testing machine. Means and standard deviations among the study groups were compared with ANOVA and Tukey-Kramer multiple comparisons test.
Results: Highest failure loads were observed in resin group without ageing (thermocycling) (689.13±89.41 N), however, the lowest loads were observed in GIC specimens with ageing (243.16±49.03 N). Among non-aged samples, failure loads for Bioactive (480.30±47.26 N) group were less than Resin (689.13±89.41 N) samples but higher than GIC (307.51±45.29 N) specimens respectively. Among the aged specimens, Bioactive (404.42±60.43 N) showed significantly higher failure loads than GIC (243.16±49.03 N), however lower failure loads than Resin (582.33±95.95 N) samples.
Conclusions: Dentin boned crowns with resin cementation showed higher failure loads than Bioactive and GIC luted crowns. Crowns luted with Bioactive cement showed acceptable failure loads for use as restoration on anterior teeth.
doi: https://doi.org/10.12669/pjms.36.3.1946
How to cite this:Vohra F, Altwaim M, Alshuwaier AS, Al-Deeb M, Alfawaz Y, Alrabiah M, et al. Influence of Bioactive, Resin and Glass Ionomer luting cements on the fracture loads of dentin bonded ceramic crowns. Pak J Med Sci. 2020;36(3):416-421. doi: https://doi.org/10.12669/pjms.36.3.1946
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.