bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emigrant citizenship, privileged local belonging and the option to return: Germans on the Turkish coast
Authors: Fauser Margit 
Published: February 2020

AbstractThe current migratory dynamics in the Mediterranean are characterized by large numbers of displaced people, refugees, and other vulnerable groups. In addition, the Mediterranean attracts more privileged individuals who are migrating for lifestyle reasons to find a better life abroad. But, while political and economic crises are at the roots of many movements across the Mediterranean, the question is whether these are also leading to the “displacement” of the privileged. In addressing this question, the article links privileged lifestyle migration to a perspective on mobile citizenship, focusing on German retirees who have found a new home on the Turkish coast. It builds on various stages of field research, including a recent field trip in May 2018. The article shows how lifestyle migrants engage and entangle emigrant and other sites of citizenship when navigating residential security and when expressing their way of local belonging in times of turmoil, and how their decision to stay in Turkey is paradoxically enabled by their option to return. The article’s focus on privileged migration thus also reveals the role of return as a neglected aspect in the study of (emigrant) citizenship.
How causal information affects decisions
Authors: Zheng Min , Marsh Jessecae K. , Nickerson Jeffrey V. , Kleinberg Samantha 
Published: February 2020

AbstractBackgroundCausality is inherently linked to decision-making, as causes let us better predict the future and intervene to change it by showing which variables have the capacity to affect others. Recent advances in machine learning have made it possible to learn causal models from observational data. While these models have the potential to aid human decisions, it is not yet known whether the output of these algorithms improves decision-making. That is, causal inference methods have been evaluated on their accuracy at uncovering ground truth, but not the utility of such output for human consumption. Simply presenting more information to people may not have the intended effects, particularly when they must combine this information with their existing knowledge and beliefs. While psychological studies have shown that causal models can be used to choose interventions and predict outcomes, that work has not tested structures of the complexity found in machine learning, or how such information is interpreted in the context of existing knowledge.ResultsThrough experiments on Amazon Mechanical Turk, we study how people use causal information to make everyday decisions about diet, health, and personal finance. Our first experiment, using decisions about maintaining bodyweight, shows that causal information can actually lead to worse decisions than no information at all. In Experiment 2, we test decisions about diabetes management, where some participants have personal domain experience and others do not. We find that individuals without such experience are aided by causal information, while individuals with experience do worse. Finally, our last two experiments probe how prior experience interacts with causal information. We find that while causal information reduces confidence in individuals with prior experience, it has the opposite effect on those without experience. In Experiment 4 we show that our results are not due to an inability to use causal models, and that they may be due to familiarity with a domain rather than actual knowledge.ConclusionWhile causal inference can potentially lead to more informed decisions, we find that more work is needed to make causal models useful for the types of decisions found in daily life.
The colon cancer screening behaviours survey for South Asians: a pilot study of feasibility and psychometric evaluation
Authors: Crawford Joanne , Morfaw Frederick , Ahmad Farah , Thabane Lehana , Frisina Angela 
Published: February 2020

Abstract
Purpose
The purpose of the study was to pilot test the English and Urdu version of the Colon Cancer Screening Behaviours Survey among South Asians in Canada. The first objective was to evaluate feasibility of administration, data collection using computer assisted personal interviewing software on a tablet, and response burden. The second objective was to examine the prevalence of colorectal cancer screening among South Asians and evaluate the psychometric properties of sub-scales in the survey.

Methods
Purposive, network and snowball sampling were used to recruit participants for this cross-sectional study. Interviewer-led administration of the Colon Cancer Screening Behaviours Survey was conducted across two cities in Ontario, Canada. Qualitative data analysis assessed feasibility; and sub-scales were evaluated through principal component analysis, item-scale correlations, and construct validity using multiple linear and logistic regression.

Results
A total of 328 South Asians participated, 47% Urdu speaking, and 53% English speaking. There was a 23% refusal rate to participate. Feasibility identified: (1) successful recruitment despite reasons for refusal; (2) problematic items and response categories; and (3) computer/tablet limitations. Principal component analysis identified 14 components that explained 68.7% of total variance; 34 items were retained after factor analysis. Internal consistency of 4 scales ranged from 0.79–0.91. There were significant differences in perceived barriers scale scores (− 12.21; 95% CI, − 17.13 to - 7.28; p <  0.0001) between those who participated and those who did not participate in screening. No association was found with years of residence and uptake of screening after adjustment (OR 0.91 (0.46–1.79), p = 0.783).

Conclusions
Recruitment and data collection methods are feasible among South Asians if functionality of the tablet selected is improved. The Colon Cancer Screening Behaviours Survey was finalized and retained items in sub-scales demonstrated good psychometric properties to assess behaviours for colon cancer screening among South Asians in Canada. The interviewer-led survey may be used by public health, cancer care or other health practitioners to describe or predict colorectal cancer screening behaviours among South Asians in similar settings or adapted and tested in other contexts.
15O-water PET for evaluation of cardiopulmonary perfusion in complex cyanotic heart disease
Authors: Madsen S. , Tolbod L. P. , Mortensen U. M. , Andersen G. , Bouchelouche K. 
Published: February 2020

Abstract
Background
Dynamic 15O-water PET may provide information about cardiopulmonary circulation complementary to MRI and CT in complex cyanotic heart disease.

Case presentation
We present a case in which a 15O-water PET scan was used for the first time to map the complex circulation in a univentricular heart patient with dual pulmonary blood supply. The pulmonary blood supply consisted of partially oxygenated blood led from the univentricle to the lungs by the pulmonary artery, plus of venous blood from the upper body lead by a bidirectional Glenn anastomosis to the right pulmonary artery. Despite the bidirectional Glenn anastomosis, the patient developed increasing cyanosis and was considered for heart transplantation. Pulmonary perfusion measurements using MRI were inconclusive due to metal artifacts, and the patient was referred for a 15O-water PET scan. The scan showed significant venovenous collaterals bypassing the lungs. Only the left upper lung lobe was properly perfused. The mean transit time from the superior vena cava to the left ventricle was approximately four times longer than would be expected from a healthy person.

Conclusion
The case illustrates that 15O-water PET can complement CT and MRI for quantitative characterization of cardiopulmonary circulation in complex cyanotic heart disease.
Anti-GAD-associated limbic encephalitis: an unusual clinical manifestation from northwest of Ireland
Authors: Mansoor Salman , Murphy Kevin 
Published: February 2020

AbstractWe report an unusual manifestation of anti-GAD-associated limbic encephalitis in a 59-year-old man following pacemaker insertion for cardiac pauses. Clinically, the association of anti-GAD antibody with limbic encephalitis is rare. He presented with a complex constellation of symptoms, posing a diagnostic and therapeutic challenge.
Functional Analyses of HNF1A-MODY Variants Refine the Interpretation of Identified Sequence Variants
Authors: Malikova Jana , Kaci Alba , Dusatkova Petra , Aukrust Ingvild , Torsvik Janniche , Vesela Klara , Kankova Pavla Dvorakova , Njølstad Pål R , Pruhova Stepanka , Bjørkhaug Lise 
Published: February 2020

AbstractContextWhile rare variants of the hepatocyte nuclear factor-1 alpha (HNF1A) gene can cause maturity-onset diabetes of the young (HNF1A-MODY), other variants can be risk factors for the development of type 2 diabetes. As has been suggested by the American College of Medical Genetics (ACMG) guidelines for variant interpretation, functional studies provide strong evidence to classify a variant as pathogenic.ObjectiveWe hypothesized that a functional evaluation can improve the interpretation of the HNF1A variants in our Czech MODY Registry.Design, Settings, and ParticipantsWe studied 17 HNF1A variants that were identified in 48 individuals (33 female/15 male) from 20 Czech families with diabetes, using bioinformatics in silico tools and functional protein analyses (transactivation, protein expression, DNA binding, and nuclear localization).ResultsOf the 17 variants, 12 variants (p.Lys120Glu, p.Gln130Glu, p.Arg131Pro, p.Leu139Pro, p.Met154Ile, p.Gln170Ter, p.Glu187SerfsTer40, p.Phe215SerfsTer18, p.Gly253Arg, p.Leu383ArgfsTer3, p.Gly437Val, and p.Thr563HisfsTer85) exhibited significantly reduced transcriptional activity or DNA binding (&lt; 40%) and were classified as (likely) pathogenic, 2/17 variants were (likely) benign and 3/17 remained of uncertain significance. Functional analyses allowed for the reclassification of 10/17 variants (59%). Diabetes treatment was improved in 20/29 (69%) carriers of (likely) pathogenic HNF1A variants.ConclusionFunctional evaluation of the HNF1A variants is necessary to better predict the pathogenic effects and to improve the diagnostic interpretation and treatment, particularly in cases where the cosegregation or family history data are not available or where the phenotype is more diverse and overlaps with other types of diabetes.
Pharmacokinetic/Pharmacodynamic Evaluation of Hydrocortisone Therapy in Pediatric Patients with Congenital Adrenal Hyperplasia
Authors: Melin Johanna , Parra-Guillen Zinnia P , Michelet Robin , Truong Thi , Huisinga Wilhelm , Hartung Niklas , Hindmarsh Peter , Kloft Charlotte 
Published: February 2020

AbstractObjectivesPatients with congenital adrenal hyperplasia (CAH) require lifelong replacement therapy with glucocorticoids. Optimizing hydrocortisone therapy is challenging, since there are no established cortisol concentration targets other than the cortisol circadian rhythm profile. 17-hydroxyprogesterone (17-OHP) concentrations are elevated in these patients and commonly used to monitor therapy. This study aimed to characterize the pharmacokinetics/pharmacodynamics (PK/PD) of cortisol using 17-OHP as a biomarker in pediatric patients with CAH and to assess different hydrocortisone dosing regimens.MethodsCortisol and 17-OHP concentrations from 30 CAH patients (7–17 years of age) receiving standard hydrocortisone replacement therapy (5–20 mg) twice (n = 17) or 3 times (n = 13) daily were used to develop a PK/PD model. Sequentially, simulated cortisol concentrations for clinically relevant 3- and 4-times daily dosing regimens were compared with cortisol and 17-OHP target ranges and to concentrations in healthy children.ResultsCortisol concentration-time profiles were accurately described by a 2-compartment model with first-order absorption and expected high bioavailability (82.6%). A time-delayed model with cortisol-mediated inhibition of 17-OHP synthesis accurately described 17-OHP concentrations. The cortisol concentration inhibiting 50% of 17-OHP synthesis was 48.6 nmol/L. A 4-times-daily dosing better attained the target ranges and mimicked the cortisol concentrations throughout the 24-hour period than 3-times-daily.ConclusionsA PK/PD model following hydrocortisone administration has been established. An improved dosing regimen of 38% at 06:00, 22% at 12:00, 17% at 18:00, and 22% at 24:00 of the daily hydrocortisone dose was suggested. The 4-times-daily dosing regimen was superior, avoiding subtherapeutic cortisol concentrations and better resembling the circadian rhythm of cortisol.
Basal Plasma Aldosterone Concentration Predicts Therapeutic Outcomes in Primary Aldosteronism
Authors: Saiki Aya , Otsuki Michio , Mukai Kosuke , Hayashi Reiko , Shimomura Iichiro , Kurihara Isao , Ichijo Takamasa , Takeda Yoshiyu , Katabami Takuyuki , Tsuiki Mika , Wada Norio , Ogawa Yoshihiro , Kawashima Junji , Sone Masakatsu , Inagaki Nobuya , Yoshimoto Takanobu , Okamoto Ryuji , Takahashi Katsutoshi , Kobayashi Hiroki , Tamura Kouichi , Kamemura Kohei , Yamamoto Koichi , Izawa Shoichiro , Kakutani Miki , Yamada Masanobu , Tanabe Akiyo , Naruse Mitsuhide 
Published: February 2020

Abstract

Purpose
Normal basal plasma aldosterone concentration (PAC) reflects mild aldosterone excess compared to high basal PAC. We previously reported lower risk for cardiovascular and cerebrovascular events in patients with primary aldosteronism (PA) and normal basal PAC (nPA) than in those with high basal PAC (hPA). However, the differences in therapeutic outcomes between nPA and hPA are unclear. The aim of this multi-institutional, retrospective cohort study was to determine the clinical significance of nPA to therapeutic outcomes, including adrenalectomy (ADX) and treatment with mineralocorticoid receptor antagonists (MRAs).

Methods
A total of 1146 patients with PA who were diagnosed and underwent adrenal venous sampling (AVS) between January 2006 and October 2016 were enrolled. The clinical parameters at baseline and after ADX or treatment with MRA were compared between the nPA and hPA groups.

Results
Significantly higher rates of absent clinical success (36.6 vs. 21.9%, P = 0.01) and absent biochemical success (26.4 vs. 5.2%, P &lt; 0.01) were found for the nPA group than for the hPA group, respectively. Logistic regression analysis identified baseline PAC as a significant independent predictor of absent clinical success of ADX and MRAs.

Conclusions
Plasma aldosterone concentration at baseline was a significant and independent predictor of absent clinical success of ADX and MRA. Mineralocorticoid receptor antagonist treatment appeared to be a better therapeutic choice than ADX in the nPA group.
Stunting and associated factors in children of less than five years: A hospital-based study
Authors: Fatima Sehrish , Manzoor Iram , Joya Aneeqa Mumtaz , Arif Shehzeen , Qayyum Sadia 
Published: February 2020

Objectives: To estimate frequency of stunting and associated factors in children aged less than five years in a tertiary care hospital of Lahore.
Methods: An Analytical cross-sectional study was conducted in Pediatrics Outpatient Department at Akhtar Saeed Trust Teaching Hospital, Lahore from December 2017 to July 2018. Two hundred children of ages under five years coming to outdoor for treatment of minor ailments were included after informed consent from their parents. Non-probability, convenient sampling technique was used to collect sample. Data collected and analyzed on SPSS version 19. To find out association of stunting with multiple qualitative variables, chi-square test was applied and p-value was fixed at ≤ 0.05 to be significant.
Results: Out of 200 children screened in OPD, 42 (21.0%) were found to be stunted. The total percentage of stunting in male children was 28 (66.6%) and in female children were 14 (33.3%). Stunting was significantly associate with male gender (p=0.047), joint family system (p=0.049), low literacy level in mothers (p=0.031), unvaccinated status (p=0.003) and history of bottle feeding (p=0.037).
Conclusion: The frequency of stunting in children less than five years of age is 42 (21.0%). The significant risk factors associated with stunting were found as male gender (p= 0.047), joint family system (p=0.049), low maternal education (p=0.031), unvaccinated status (p=0.03).
doi: https://doi.org/10.12669/pjms.36.3.1370
How to cite this:Fatima S, Manzoor I, Joya AM, Arif S, Qayyum S. Stunting and associated factors in children of less than five years: A hospital-based study. Pak J Med Sci. 2020;36(3):581-585. doi: https://doi.org/10.12669/pjms.36.3.1370
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.
Characteristics of Chronic Cough in adults in Pakistani population: A cross sectional study
Authors: Toori Kaleem Ullah , Chaudhry Asma 
Published: February 2020

Background and Objective: Data about causes of chronic cough are lacking in our part of world. The aim of our study was to look for spectrum of causes in our setup and to determine a correlation between causes of cough and baseline factors of age, gender, and BMI and compare it to other populations.
Methods: Total 236 chronic cough patients who attended chest clinic at KRL Hospital Islamabad from January 2018 to June 2019 were included in this cross-sectional study. Chronic cough was defined as cough greater than eight weeks. Main causes of chronic cough taken were cough variant asthma, allergic rhinitis, interstitial lung disease, Gastro-esophageal reflux disease, bronchial hyper-reactivity, ACE-I induced cough and others’. Other demographic and clinical data were also recorded.
Results: The mean age was 45.16± 16.50 years and BMI was 26.23 ± 4.68kg/m2. Major cause of chronic cough was cough variant asthma in 111(47%). Age had significant positive correlations with ILD, ACE-I induced cough and CCF, while significant negative correlations with CVA and AR. On gender correlation, ILD and ACE-I cough were significantly found more in females. BMI had significant correlation with ACE-I cough only.
Conclusion: Variability of epidemiology of cough variant asthma, allergic rhinitis and ACE-I induced cough is comparable to worldwide data while differences exist with epidemiology of interstitial lung disease. Further research is needed in the field to delineate the local trends in this regard and compare to other population groups.
doi: https://doi.org/10.12669/pjms.36.3.1868
How to cite this:Toori KU, Chaudhry A. Characteristics of Chronic Cough in adults in Pakistani population: A cross sectional study. Pak J Med Sci. 2020;36(3):360-364. doi: https://doi.org/10.12669/pjms.36.3.1868
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.
Effect of inter-aural modulation depth difference on interaural time difference thresholds for speech: An observational study
Authors: Pitchaimuthu Arivudainambi , Kanagokar Vibha , Grama Bhagavan Srividya , Bhat Jayashree S. 
Published: February 2020

Background: The temporal envelope (ENV) plays a vital role in conveying inter-aural time difference (ITD) in many clinical populations. However, the presence of background noise and electronic features, such as compression, reduces the modulation depth of ENV to a different degree in both ears. The effect of ENV modulation depth differences between the ears on ITD thresholds is unknown; therefore, this was the aim of the current study’s investigation. Methods: Six normally hearing young adults (age range 20-30 years) participated in the current study. Six vowel-consonant-vowel (VCV) (/aka/, /aga/, /apa/, /aba/, /ata/, /ada/) tokens were used as the probe stimuli. ENV depth of VCV tokens was smeared by 0%, 29%, and 50%, which results in 100%, 71%, and 50% of the original modulation depth. ITD thresholds were estimated as a function of the difference in temporal ENV depth between the ears, wherein in one ear the modulation depth was retained at 100% and in the other ear, the modulation depth was changed to 100%, 71%, and 50%. Results: Repeated measures of ANOVA revealed a significant main effect of interaural modulation depth differences on the ITD threshold (F(2,10)= 9.04, p= 0.006). ITD thresholds increased with an increase in the inter-aural modulation depth difference. Conclusion: Inter-aural ENV depth is critical for ITD perception.
Estimating the burden of antimicrobial resistance in Malawi: protocol for a prospective observational study of the morbidity, mortality and economic cost of third-generation cephalosporin resistant bloodstream infection
Authors: Lester Rebecca , Maheswaran Hendran , Jewell Christopher P. , Lalloo David G. , Feasey Nicholas A. 
Published: February 2020

Introduction: Antimicrobial resistance is a global public health concern, but the problems are context specific, with each county or setting facing differing challenges. In Africa, third-generation cephalosporin resistant Enterobacterales (3GCR-E) are of particular concern, given the widespread reliance on ceftriaxone for treatment of severe infection in this setting. In Malawi, despite the rising prevalence of 3GCR-E, the health impact of these infections has not been described. This study is designed to estimate attributable mortality, morbidity and economic cost of 3GC-R bloodstream infection (BSI) in a large, urban hospital. Methods: This study will investigate the burden of antimicrobial resistance by recruiting a a prospective longitudinal cohort of patients who have bloodstream infection with 3GCR-E, at Queen Elizabeth Central Hospital, Blantyre, Malawi. Patients whose blood culture is positive for either 3GC-S or 3GC-R Enterobacterales will be enrolled and provide clinical and healthcare economic data. Patients will be followed throughout their hospital stay and to 6-months post discharge. Mortality, direct and indirect costs and other health outcomes will be compared between patients with 3GC-R and comparable 3GC-sensitive BSI. Based on our observation that some patients with clinical suspicion of sepsis and 3GC-R BSI are surviving without an effective antibiotic, we review each patient prospectively and classify what role the isolated bacteria is playing in the patient’s clinical presentation. These classifications will then be incorporated into our analysis. Ethics and dissemination: The study protocol has been approved by the Malawi College of Medicine Research Ethics Committee and by the Liverpool School of Tropical Medicine Research Ethics committee. Written informed consent will be obtained from study participants or their parents/guardians. Results will be submitted to international peer-reviewed journals, presented at international conferences and shared with participating communities and collaborators.