bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of changing meteorological parameters on fatal aortic catastrophes
Authors: Szilágyi Brigitta , Berczeli Márton , Lovas Attila , Oláh Zoltán , Törő Klára , Sótonyi Péter 
Published: June 2020

Abstract
Background
Over the span of the last decade, medical research has been increasingly putting greater emphasis on the study of meteorological parameters due to their connection to cardiovascular diseases. The main goal of this study was to explore the relationship between fatal aortic catastrophes and changes in atmospheric pressure and temperature.

Methods
We used a Cox process model to quantify the effects of environmental factors on sudden deaths resulting from aortic catastrophes. We used transfer entropy to draw conclusion about the causal connection between mortality and meteorological parameters. Our main tool was a computer program which we developed earlier in order to evaluate the relationship between pulmonary embolism mortality and weather on data sets comprised of aortic aneurysm (AA) and acute aortic dissection (AAD) cases, where one of these two medical conditions had led to fatal rupture of the aorta. Our source for these cases were the autopsy databases of Semmelweis University, from the time period of 1994 to 2014. We have examined 160 aneurysm and 130 dissection cases in relation to changes in meteorological parameters. The algorythm implemented in our program is based on a non-parametric a Cox process model. It is capable of splitting slowly varying unknown global trends from fluctuations potentially caused by weather. Furthermore, it allows us to explore complex non-linear interactions between meteorological parameters and mortality.

Results
Model measures the relative growth of the expected number of events on the nth day caused by the deviation of environmental parameters from its mean value. The connection between ruptured aortic aneurysms (rAA) and changes in atmospheric pressure is more significant than their connection with mean daily temperatures. With an increase in atmospheric pressure, the rate of rAA mortality also increased. The effects of meteorological parameters were weaker for deaths resulting from acute aortic dissections (AAD), although low mean daily temperatures increased the intensity of occurrence for AAD-related deaths.

Conclusion
The occurrence rate of fatal aortic catastrophes showed a slight dependence on the two examined parameters within our groups.
Definitions of poor outcome after total knee arthroplasty: an inventory review
Authors: te Molder Malou E. M. , Smolders José M. H. , Heesterbeek Petra J. C. , van den Ende Cornelia H. M. 
Published: June 2020

Abstract
Background
A significant proportion of patients experiences poor response (i.e. no or little improvement) after total knee arthroplasty (TKA) because of osteoarthritis. It is difficult to quantify the proportion of patients who experiences poor response to TKA, as different definitions of, and perspectives (clinician’s and patient’s) on poor response are being used. The aim of this study was therefore to review the literature and summarize definitions of poor response to TKA.

Methods
A systematic search was performed to identify and review studies that included dichotomous definitions of poor outcome after primary TKA. The type, amount and combination of domains (e.g. functioning), outcome measures, type of thresholds (absolute/relative, change/cut-off), values and moments of follow-up used in definitions were summarized.

Results
A total of 47 different dichotomous definitions of poor response to TKA were extracted from 2163 initially identified studies. Thirty-six definitions incorporated one domain, seven definitions comprised two domains and four definitions comprised three domains. Eight different domains were used in identified definitions: pain, function, physical functioning, quality of life (QoL), patient satisfaction, anxiety, depression and patient global assessment. The absolute cut-off value was the most common type of threshold, with large variety in value and timing of follow-up.

Conclusions
Our inventory review shows that definitions of poor response to TKA are heterogeneous. Our findings stresses the need for an unambiguous definition of poor response to draw conclusions about the prevalence of poor-responders to TKA across hospitals and countries, and to identify patients at risk.
Biomechanical evaluation of autologous bone-cage in posterior lumbar interbody fusion: a finite element analysis
Authors: Zhu Haodong , Zhong Weibin , Zhang Ping , Liu Xiaoming , Huang Junming , Liu Fatai , Li Jian 
Published: June 2020

Abstract
Background
An autologous bone-cage made from the spinous process and laminae might provide a stability in posterior lumbar interbody fusion (PLIF) close that of the traditional-cage made of polyetheretherketone (PEEK) or titanium. The biomechanical effect of autologous bone-cages on cage stability, stress, and strains, and on the facet contact force has not been fully described. This study aimed to verify whether autologous bone-cages can achieve similar performance as that of PEEK cages in PLIF by using a finite element analysis.

Methods
The finite element models of PLIF with an autologous bone-cage, a titanium cage, and a PEEK cage were constructed. The autologous bone-cage was compared with the titanium and PEEK cages. The mechanical properties of the autologous bone-cage were obtained through mechanical tests. The four motion modes were simulated. The range of motion (ROM), the stress in the cage-end plate interface, and the facet joint force (FJF) were compared.

Results
The ROM was increased at adjacent levels but decreased over 97% at the treated levels, and the intradiscal pressure at adjacent levels was increased under all conditions in all models. The FJF disappeared at treated levels and increased under extension, lateral bending, and lateral rotation in all models. The maximum stress of the cage-endplate interface was much lower in the autologous bone-cage model than those in the PEEK and titanium cage models.

Conclusions
In a finite model of PLIF, the autologous bone-cage model could achieve stability close that of traditional titanium or PEEK cages, reducing the risk of subsidence.
The journey of aftercare for Australia’s First Nations families whose child had sustained a burn injury: a qualitative study
Authors: Coombes Julieann , Hunter Kate , Mackean Tamara , Ivers Rebecca 
Published: June 2020

Abstract
Background
Access to ongoing multidisciplinary healthcare services for children who have sustained a burn injury is critical for optimal recovery. This paper reports on barriers and facilitators to culturally safe and appropriate burn aftercare for Australia’s First Nations children. The voices of First Nations families whose child had sustained a serious burn are central to this paper.

Methods
Eighteen families, which consisted of 59 family members, of children younger than 16 years who had sustained a burn injury were asked to describe their own journey in accessing appropriate burn aftercare. Interviews were conducted in the families’ homes using yarning (dialogue) and Dadirri (deep listening) as Indigenous research methods. Data was gathered in South Australia, the Northern Territory, Queensland and New South Wales, Australia. Using a cyclic process, transcripts and emerging themes were sent back to participants, and a collaborative approach was used to conduct the final analysis.

Results
Lack of culturally safe communication between service providers and family members, in addition to institutionalised racism, were found to be the major barriers to accessing healthcare services. Distance to medical treatment also impacted children’s access to aftercare. Involvement of First Nations Health Workers and/or Liaison Officers working with health providers, the child and family members, was found to be an important facilitator in reducing miscommunication and alleviating fear and anxiety in the children and families.

Conclusion
There are significant barriers to access to aftercare following a serious burn including miscommunication, lack of cultural safety, distance to medical treatment and racism. However, these can be largely mitigated when First Nations families have input into the care received and the care needed for ongoing burn care to be effective and are supported by First Nations Health/Liaison Officers support.
High variability in bodyweight is associated with an increased risk of atrial fibrillation in patients with type 2 diabetes mellitus: a nationwide cohort study
Authors: Lee Hyun-Jung , Choi Eue-Keun , Han Kyung-Do , Kim Da Hye , Lee Euijae , Lee So-Ryoung , Oh Seil , Lip Gregory Y. H. 
Published: June 2020

AbstractBackgroundBodyweight variability is a risk factor for atrial fibrillation (AF). We aimed to examine the relationship between bodyweight variability and the risk of AF in patients with type 2 diabetes mellitus (DM), and whether this relationship was affected by baseline body mass index (BMI), weight change, or advanced diabetic stage.MethodsA nationwide population-based cohort of 670,797 patients with type 2 DM from the Korean National Health Insurance Service database without a history of AF and with ≥ 3 measurements of bodyweight over a 5-year period were followed up for AF development. Intra-individual bodyweight variability was calculated using variability independent of mean, and high bodyweight variability was defined as the quintile with the highest variability with the lower four quintiles as reference.ResultsDuring a median of 7.0 years of follow-up, 22,019 patients (3.3%) newly developed AF. After multivariate adjustment, those in the highest quintile of bodyweight variability showed a higher risk of incident AF (HR 1.16, 95% CI 1.12–1.20) compared to those in the lower 4 quintiles with reference bodyweight variability, irrespective of baseline BMI group and direction of overall weight change. This association was greater in magnitude in subjects with lower BMI, those on insulin, and those with a DM duration of greater than 5 years. In sensitivity analyses, high bodyweight variability was consistently associated with AF development using other indices of variability and adjusting for glycemic variability.ConclusionsHigh variability in bodyweight was associated with AF development, independently of traditional cardiovascular risk factors and baseline BMI. This association was stronger in underweight patients and with advanced diabetic stage. Weight fluctuation may interfere with the beneficial effects of weight loss and should be avoided when possible in weight control regimens for DM patients.
Non-alcoholic steatohepatitis and progression of carotid atherosclerosis in patients with type 2 diabetes: a Korean cohort study
Authors: Lee Hyeok-Hee , Cho Yongin , Choi Young Ju , Huh Byung Wook , Lee Byung-Wan , Kang Eun Seok , Park Seok Won , Cha Bong-Soo , Lee Eun Jig , Lee Yong-ho , Huh Kap Bum 
Published: June 2020

Abstract
Background
There is increasing concern regarding cardiovascular risk in individuals with non-alcoholic fatty liver disease. This study was conducted to evaluate whether hepatic steatosis with or without fibrosis is associated with the progression of carotid atherosclerosis in patients with type 2 diabetes.

Methods
From a longitudinal cohort, we enrolled 1120 patients with type 2 diabetes who underwent repeated carotid artery ultrasonography every 1–2 years. Ultrasonographic findings at baseline and after 6–8 years were compared. Presence of hepatic steatosis was mainly assessed by abdominal ultrasonography; patients with hepatic steatosis were further evaluated for hepatic fibrosis according to fibrosis-4 index. We investigated the association between liver status and atherosclerosis progression.

Results
Of 1120 patients, 636 (56.8%) were classified as having hepatic steatosis at baseline. After 6–8 years, 431 (38.5%) showed atherosclerosis progression. Hepatic steatosis was significantly associated with atherosclerosis progression (adjusted odds ratio[AOR]: 1.370, 95% CI 1.025–1.832; p < 0.05). Among patients with hepatic steatosis, only individuals with fibrosis showed significant association with atherosclerosis progression (AOR: 1.615, 95% CI 1.005–2.598; p < 0.05). The association between hepatic fibrosis and atherosclerosis progression was significant in all metabolic subgroups regardless of age, body mass index, presence of metabolic syndrome, or insulin sensitivity (all p < 0.05). Furthermore, subjects with hepatic steatosis & fibrosis and ≥ 4 components of metabolic syndrome criteria showed markedly increased risk of atherosclerosis progression (AOR: 2.430, 95% CI 1.087–5.458; p < 0.05).

Conclusions
Hepatic steatosis with fibrosis is independently associated with the progression of carotid atherosclerosis in patients with type 2 diabetes.
Rationale and design of an investigator-initiated, multicenter, prospective open-label, randomized trial to evaluate the effect of ipragliflozin on endothelial dysfunction in type 2 diabetes and chronic kidney disease: the PROCEED trial
Authors: Tanaka Atsushi , Shimabukuro Michio , Okada Yosuke , Sugimoto Kazuhiro , Kurozumi Akira , Torimoto Keiichi , Hirai Hiroyuki , Node Koichi ,   the PROCEED trial investigators
Published: June 2020

Abstract
Background
Type 2 diabetes (T2D) is associated with renal impairment and vascular endothelial dysfunction. Therefore, this pathological connection is an important therapeutic target. Recent cardiovascular and renal outcome trials demonstrated that sodium glucose cotransporter 2 inhibitors (SGLT2is) consistently reduced the risks of cardiovascular and renal events and mortality in patients with T2D and various other background risks including chronic kidney disease (CKD). However, the precise mechanisms by which SGLT2is accords these therapeutic benefits remain uncertain. It is also unknown whether these SGLT2is-associated benefits are associated with the amelioration of endothelial dysfunction in patients with T2D and CKD.

Methods
The PROCEED trial is an investigator-initiated, prospective, multicenter, open-label, randomized-controlled trial. The target sample size is 110 subjects. After they furnish informed consent and their endothelial dysfunction is confirmed from their decreased reactive hyperemia indices (RHI), eligible participants with T2D (HbA1c, 6.0–9.0%) and established CKD (30 mL/min/1.73 m2 ≤ estimated glomerular filtration ratio [eGFR] < 60 and/or ≥ urine albumin-to-creatinine ratio 30 mg/g Cr) will be randomized (1:1) to receive either 50 mg ipragliflozin daily or continuation of background treatment (non-SGLT2i). The primary endpoint is the change in RHI from baseline after 24 weeks. To compare the treatment effects between groups, the baseline-adjusted means and their 95% confidence intervals will be estimated by analysis of covariance adjusted for HbA1c (< 7.0% or ≥ 7.0%), age (< 70 y or ≥ 70 y), RHI (< 1.67 or ≥ 1.67), eGFR (< 45 mL/min/1.73 m2 or ≥ 45 mL/min/1.73 m2), and smoking status. Prespecified responder analyses will be also conducted to determine the proportions of patients with clinically meaningful changes in RHI at 24 weeks.

Discussion
PROCEED is the first trial to examine the effects of ipragliflozin on endothelial dysfunction in patients with T2D and CKD. This ongoing trial will establish whether endothelial dysfunction is a therapeutic target of SGLT2is in this population. It will also provide deep insights into the potential mechanisms by which SGLT2is reduced the risks of cardiovascular and renal events in recent outcome trials.
Trial registration Unique Trial Number, jRCTs071190054 (https://jrct.niph.go.jp/en-latest-detail/jRCTs071190054).
Laparoscopic versus open approach in gastrectomy for advanced gastric cancer: a systematic review
Authors: Zhu Zhipeng , Li Lulu , Xu Jiuhua , Ye Weipeng , Zeng Junjie , Chen Borong , Huang Zhengjie 
Published: June 2020

AbstractBackgroundAdditional studies comparing laparoscopic gastrectomy (LG) versus open gastrectomy (OG) for advanced gastric cancer (AGC) have been published, and it is necessary to update the systematic review of this subject.ObjectiveWe conducted the meta-analysis to find some proof for the use of LG in AGC and evaluate whether LG is an alternative treatment for AGC.MethodRandomized controlled trials (RCT) and high-quality retrospective studies (NRCT) compared LG and OG for AGC, which were published in English between January 2010 and May 2019, were search in PubMed, Embase, and Web of Knowledge by three authors independently and thoroughly. Some primary endpoints were compared between the two groups, including intraoperative time, intraoperative blood loss, harvested lymph nodes, first flatus, first oral intake, first out of bed, post-operative hospital stay, postoperative morbidity and mortality, rate of disease recurrence, and 5-year over survival (5-y OS). Besides, considering for this 10-year dramatical surgical material development between 2010 and 2019, we furtherly make the same analysis based on recent studies published between 2016 and 2019.ResultThirty-six studies were enrolled in this systematic review and meta-analysis, including 5714 cases in LAG and 6094 cases in OG. LG showed longer intraoperative time, less intraoperative blood loss, and quicker recovery after operations. The number of harvested lymph nodes, hospital mortality, and tumor recurrence were similar. Postoperative morbidity and 5-y OS favored LG. Furthermore, the systemic analysis of recent studies published between 2016 and 2019 revealed similar result.ConclusionA positive trend was indicated towards LG. LG can be performed as an alternative to OG for AGC.
Quantifying and correcting residual azimuthal anisotropic moveout in image gathers using dynamic time warping
Authors: Decker Luke , Zhang Qunshan 
Published: June 2020

We have developed a novel application of dynamic time warping (DTW) for correcting residual moveout in image gathers, enhancing seismic images, and determining azimuthal anisotropic orientation and relative intensity when moveout is caused by wave propagation through a medium possessing elliptical horizontally transverse isotropy (HTI). The method functions by first using DTW to determine the sequences of integer shifts that most closely match seismic traces within an image gather to its stack and then applying those shifts to flatten the gather. Flattening shifts are fitted to an ellipse to provide an approximation for the orientation and relative strength of elliptical HTI anisotropy. We evaluated the method on synthetic and 3D field data examples to show how it is able to (1) correct for residual azimuthal anisotropic moveout, (2) accurately recover high-frequency information and improve feature resolution in seismic images, and (3) determine the anisotropic orientation while providing a measure of relative strength of elliptic anisotropy. Although the method is not intended to replace anisotropic processing techniques for moveout correction, we find that it has the ability to inexpensively approximate the effects of such operations while providing a representation of the elliptic HTI anisotropy present within a volume.
Morphological spectrum of endometrium with thyroid hormone profile in infertile female population of Khyber Pakhtunkhwa province of Pakistan
Authors: Nasir Sabeen , Ziaullah Sara , Alam Sadaf , Khan Muhammad Mumtaz 
Published: June 2020

Objectives: To study the morphological spectrum of endometrial changes with the thyroid hormone levels in infertile women.
Methods: This cross sectional study was conducted at Department of Pathology, Peshawar Medical College, Health Care Centre and Madina Medical Laboratory, Peshawar from April 2013 to August 2013. Total 160 cases of infertile women were included in the study. Biopsies were taken on 22-23rd day of menstrual cycle. Statistical Analysis was performed using SPSS version 19 statistical program. Difference between endometrial findings of patients with normal thyroid profile and abnormal one were analyzed for statistical significance using Chi square test. Probability values p ≤ 0.05 were considered statistically significant.
Results: In our study, majority infertile women were euthyroid (80%), followed by hyperthyroid (18%) and only two% to be hypothyroid. The correlation of endometrial morphology with thyroid hormones levels turned out to be insignificant. While correlating histological details of endometrial biopsy with thyroid hormone status, we found significant association of leukocytic infiltrate with thyroid hormone levels.
Conclusion: This study shows that thyroid hormones may have role in early leukocytic infiltration into stroma, and a possibility of immune modulation by altered thyroid hormones in causing infertility.
doi: https://doi.org/10.12669/pjms.36.5.1791
How to cite this:Nasir S, Ziaullah S, Alam S, Khan MM. Morphological spectrum of endometrium with thyroid hormone profile in infertile female population of Khyber Pakhtunkhwa province of Pakistan. Pak J Med Sci. 2020;36(5):904-908. doi: https://doi.org/10.12669/pjms.36.5.1791
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.
Internal Displacement: Relationship of mental health and education of children in Swat, Pakistan
Authors: Ahmad Nasir , Shaheen Nasir , Hussain Sajjad 
Published: June 2020

Background and Objectives: Internal displacement causes mental health problems and effect education of school going children. This study intended to find the relationship between mental health problems and education of children displaced during violence in Swat Pakistan.
Methods: This is quantitative co-relational study conducted in Swat, Pakistan during October 2017 to June 2018. The population of the study constitutes all the students of 25 high schools destroyed during violence. Child PTSD symptom scale, Siddiqui-Shah Depression Scale and Beck Anxiety Inventory were used to collect data from the sample (712) students.
Results: High level of PTSD, depression and anxiety were found in female students and those who were not attending schools during displacement. PTSD and depression have negatively affected academic achievements of female students and those students who were out of schools irrespective of their gender.
Conclusion: The study concludes that internal displacement causes mental health problems in children which can be minimize through education to a great extent.
doi: https://doi.org/10.12669/pjms.36.5.1847
How to cite this:Ahmad N, Hussain S, Shaheen N. Internal Displacement: Relationship of mental health and education of children in Swat, Pakistan. Pak J Med Sci. 2020;36(5):909-913. doi: https://doi.org/10.12669/pjms.36.5.1847
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.