bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spectrum of preneoplastic and Neoplastic lesions of intestine in a tertiary care hospital of Karachi, Pakistan
Authors: Shabbir Asma , Qureshi Muhammad Asif , Akram Saadia , Mirza Talat 
Published: December 2019

Objectives: To present 7 years data mentioning the spectrum of preneoplastic & neoplastic cases of intestine received at Dow Diagnostic Research and Reference Laboratory.
Methods: All the cases of preneoplastic & neoplastic lesions of intestine received during 2009 – 2015 were reviewed. The data obtained were subjected to descriptive statistical analysis using SPSS version 22. Furthermore, the association of diagnosis was seen with various other variables including age, gender & site of the lesion. A p-value of < 0.05 was considered as significant.
Results: The total samples were 486, out of which 33 cases were of premalignant and 453 were of malignant lesions. Out of total 33 cases of premalignant lesions of intestine, it consisted adenomatous polyp = 39.4% (n=13), dysplasia = 36.4% (n=12) and adenoma = 24.2% (n=8). From the total of 453 cases diagnosed as malignant lesions; adenocarcinoma as Grade-I were 14.2% (n=64), Grade-II were 7.6% (n=260) and Grade-III were 22% (n=99). Squamous cell carcinoma Grade-I were 0.4% (n=2), Grade-II 1.6% (n=7) and Grade-III 0.9% (n=4). 2.4% (n=11) cases were of metastatic adoncarcinoma, 0.9% (n=4) were diagnosed as neuroendocrine tumors and 0.4% (n=2) as lymphoma. A significant association was seen between site of the tumor and diagnosis, rectum was the commonest site for adenocarcinomas (p=0.001). Moderately differentiated adenocarcinoma was predominantly present in young age (p=0.001).
Conclusion: Colorectal carcinoma is on rise in Pakistan, predominantly in young males, and rectum being the commonest site. In our study, all the lesions showed male predominance with adenomatous polyp as the commonest premalignant lesion & Grade-II adenocarcinoma the most common malignancy of intestine.
doi: https://doi.org/10.12669/pjms.36.2.687
How to cite this:Shabbir A, Qureshi MA, Akram S, Mirza T. Spectrum of preneoplastic and Neoplastic lesions of intestine in a tertiary care hospital of Karachi, Pakistan. Pak J Med Sci. 2020;36(2):75-79. doi: https://doi.org/10.12669/pjms.36.2.687
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinical exploration of marking targeting biopsy in the intraoperative localization value of colon polypectomy
Authors: Song Ling Yun , Lin Qi , Li Lian Biao , Cheng Xiu 
Published: December 2019

Objective: To evaluate the feasibility and safety of marking targeting biopsy (MTB) in the intraoperative localization value of colon polypectomy.
Methods: The clinical data from patients with polyp of colon discovered under colonoscopy from January 2014 to January 2016 were retrospectively analyzed. A total of 87 patients conformed to the inclusion criteria, among them, 43 received colonoscopic polypectomy one week after MTB (MTB group), while 44 underwent colonoscopic polypectomy one week after conventional biopsy (conventional group). The time consumption in colonoscopic treatment, polypectomy rate and postoperative complications between two groups were compared.
Results: The time consumed in operation in the MTB group was 25.5 (±8.6) minutes, while that in conventional group was 42.0 (±20.5) minutes, and the difference was statistically significant (P<0.01). There were a total of 86 polyps in the MTB group, among which 83 were removed, yielding the removal rate of 96.5%. There were altogether 88 polyps in the conventional group, among which 54 were removed, resulting in the removal rate of 61.4%, and the difference was statistically significant (P<0.05). three polyps in the MTB group were detached after MTB, or the wound surface became flat after gross polyp removal, and no polypectomy was required, but the marking targeting solution was clearly visible. two respective polyps in 12 cases in conventional group could not be found in colonoscopic treatment, and 10 of them had respective one polyp that could not be found again. 12 cases in MTB group suffered from abdominal pain after surgery, and no hemorrhage was seen intraoperatively and postoperatively. 10 cases in the conventional group had abdominal pain after surgery, and one case had delayed hemorrhage after surgery. The results between two groups displayed no statistical significance (P>0.05).
Conclusions: The localization value of MTB in colon polypectomy is definitely feasible, safe and effective, which can greatly shorten the time of endoscopic colon polypectomy, mitigate patient sufferings, and reduce the incidence of false negative rate of polyp. It displays favorable clinical application value and is worthy of being promoted in clinic.
doi: https://doi.org/10.12669/pjms.36.2.756
How to cite this:Song LY, Lin Q, Li LB, Cheng X. Clinical exploration of marking targeting biopsy in the intraoperative localization value of colon polypectomy. Pak J Med Sci. 2020;36(2):100-104. doi: https://doi.org/10.12669/pjms.36.2.756
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.
Application value of color doppler ultrasound and ultrasound contrast in the differential diagnosis of ovarian tumor
Authors: Zhang Haijing , Wang Jinming , Guo Rui 
Published: December 2019

Objective: To study the value of color Doppler ultrasound and ultrasound contrast in differential diagnosis of ovarian tumors.
Methods: Ninety-six patients with ovarian tumors who were treated in our hospital from May 2017 to July 2018 and confirmed by pathological examination were selected as the research subjects. All patients were examined by color Doppler ultrasound and ultrasound contrast. The sensitivity, specificity and accuracy of the two methods were compared, and the parameters of ultrasound contrast in the diagnosis of benign and malignant tumors were observed and compared.
Results: The sensitivity, specificity and accuracy of ultrasound contrast in the diagnosis of ovarian tumors were higher than those of color Doppler ultrasound (P<0.05). There were significant differences in the time of initiation enhancement, time to peak and perfusion intensity in the diagnosis of benign and malignant lesions by ultrasound contrast (P<0.05).
Conclusion: In the differential diagnosis of ovarian tumors, ultrasound contrast has more advantages than color Doppler ultrasound in displaying the blood perfusion information of tumors. It has high diagnostic accuracy and clinical application value.
doi: https://doi.org/10.12669/pjms.36.2.847
How to cite this:Zhang H, Wang J, Guo R. Application Value of color doppler ultrasound and ultrasound contrast in the differential diagnosis of ovarian tumor. Pak J Med Sci. 2020;36(2):80-84. doi: https://doi.org/10.12669/pjms.36.2.847
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.
Strength of Association. Report 2. Graduations of Correlation Size
Authors: Koterov A. , Ushenkova L. , Zubenkova E. , Kalinina M. , Biryukov A. , Lastochkina E. , Molodtsova D. , Vaynson A. 
Published: December 2019

Purpose: To summarize data on graduation of the effect size on the base of Hill’s first causality criterion ‘strength of association’ on the magnitude of the correlation coefficient (mainly Pearson r).
Material and methods: Survey of published sources: monographs, handbooks, papers, educational material on statistics in various disciplines (including on-line), etc. (121 references; of which more than 20 textbooks on statistical methods and statistics in psychology and 8 textbooks on epidemiology).
Results: Estimation of the strength of association by the correlation size is most common in psycho-sociological disciplines and is almost never used in epidemiology (since the establishment of a fact of statistically significant association/correlation in epidemiology is only the initial stage of evidence, unlike the experimental and named disciplines). A number of known scales for r were obtained: the Chaddok scale (R.E. Chaddock) from 1925, which is now apparently not used abroad, but widely represented in the countries of the former USSR, the Cohen scale (J. Cohen) from 1969–1988, reflecting the ‘soft’ criteria of causality in psychology, D.E. Hinkle with co-authors scale (1979–2003) and the Evans scale (J.D. Evans) from 1996. A number of other graduations, published in the singular, are also given. A total of at least 16 different scales of varying degrees were collected for the correlation coefficient r (1925–2019). The information about the value of r for correlations, which should be neglected was presented. Depending on the source, this is r <0.1; r <0.2 or r <0.3. The data on the possibility of transferring graduations from the Pearson coefficient r to the Spearman correlation coefficient and other parameters of the effect size are given.
The question of the difference between estimation of strength of association in epidemiology and medicine and in psycho-sociological disciplines is considered. Unlike the second, in epidemiology and medicine a small value of the correlation coefficient does not necessarily mean a small effect size.
Conclusions: To estimate the value of r one should use the most common and officially established scales, with the exception of the strongly ‘soft’ Cohen scale. The present study can be used as a reference guide on the graduations of effect size on r for a wide variety of observation disciplines.
On the Categorization of Radiological Terrorism Threats
Authors: Grachev M. , Salenko Yu. , Frolov G. , Moroz B. 
Published: December 2019

Purpose: To develop approaches to categorizing (ranking) radiological terrorism (RT) threats on the basis of expert assessment of the possibility (likelihood) of the implementation of certain RT scenarios and assessment of their medical and hygienic consequences.
Results: Five categories of RT threats are highlighted. The first (most hazardous) threat category includes situations related to the use of radioactivity dispersing devices (RDD), including the “dirty bomb”. It is shown that the creation of a potential threat of radiation exposure to people at the thresholds of deterministic effects may require the activity of radionuclides in RDD in the range of several hundred TBq. The second category of threats includes scenarios of RT related to the placement of high dose rate radionuclide sources in areas of permanent location or mass gathering of people. The third category of threats includes situations when radionuclide sources maliciously place (enclose) into technological equipment and processes, which leads to radioactive contamination of the environment, industrial and socially significant facilities (water treatment plants, warehouses of food and raw materials), manufactured products. It is shown that in the case of the implementation of such RT scenarios, the dose criteria that require protective measures for the public are unlikely to be achieved. The fourth category of threats includes the physical impact on radioactive materials in the nuclear reactors, fuel element storage pools, and radioactive waste storage facilities. The fifth category of threats includes scenarios of RT related to the use of improvised nuclear devices or nuclear weapons by terrorists.
Conclusion: Threats of categories I–III, given the combination of the possibility of implementing RT scenarios and the scale of medical and hygienic consequences, are estimated as relatively high. Threats of category IV and V due to the extremely low probability of their implementation have the lowest rating, despite the great and even catastrophic nature of the consequences.
On the Selection of the Neutron to Photon Dose Ratio in Neutron-Photon Therapy for Cancer
Authors: Lisin V. 
Published: December 2019

Purpose: To evaluate the methodological approaches to the prevention of radiation-induced complications after neutron-photon therapy considering the neutron-photon dose ratio in the tumor.
Material and methods: The linear-quadratic model (LQM) and principles of neutron and photon dose distributions in a tissue-equivalent medium were used. Cases with the highest risk of radiation-induced complications (treatment by a single or two opposite fields) were discussed. The number of neutron-photon therapy sessions to ensure a combined total neutron and photon dose was determined where the RBE concept was used. When calculating the total effect (TE) and TDF factor characterizing the damage to the irradiated tissue, the effect of the radiation field size and subcutaneous fat layer on their values was taken into account.
Results: Methods for selecting the ratio of the neutron and photon dose contribution to the total dose, providing the maximum permissible radiation dose, were developed. It was established that the dependences of TDF and TE factors and the differences in the values of the allowable number of photon therapy sessions on the depth of the tumor were less pronounced in cases with two opposite radiation fields compared to those with a single field. It can be explained by the fact that with increasing depth, an increase in the entrance dose is compensated by a decrease in the dose contribution formed during irradiation from the opposite field.
Conclusion: For neutron-photon therapy using a linear-quadratic model, methodical approaches that might be used to provide an acceptable level of radiation-induced skin reactions for any ratio of neutron-photon doses in a tumor were proposed. The use of these techniques for planning neutron-photon therapy will minimize the risk of radiation-induced complications.
Method of Quatitative Evaluation of the Size and Density of the Tumor During Adaptive Radiotherapy Using CT Images
Authors: Lebedenko I. , Gavrikov B. , Borisova T. 
Published: December 2019

Purpose: Clinically available quantitative method for assessing the dynamics of the size and physical density (in g/cm3) of the tumor in adaptive radiotherapy for cancer patients and any cases of visualization of tumor boundaries including the cases when the border of a tumor is not clearly visualized.
Material and methods: A preliminary analysis of the images transmitted over the CT network was carried out in the Eclipse planning system (PS). The radiotherapy treatment planning using electron accelerators with a multi-leaf collimator( Varian (USA)) was carried out at the Eclipse PS. The image quality control of Light Speed RT 16 (manufactured by GE) X-ray computed tomography scanner was performed using the multi-modular phantom Catphan® 504. The assessment of the densitometric characteristics CT imaging made using eight tissue-equivalent a test object with mass densities from 0.03 to 1.37 g/cm3 which corresponding to the density of biological tissues of the human body. To quantify the size and density of the tumor in a dynamic mode, we have written and used our own Matlab program installed on a separate computer. For lossless compression of graphic information, the PNG-image scale (raster graphic information storage format) is used, which is equivalent to the scale of the original DICOM file at the Eclipse PS. A program consists of subroutines that include calibration, contour integration, and integration along a horizontal line.
Results: The quantitative information content of the method is shown. The method is used in clinical practice.
Conclusions: A clinically available quantitative method for assessing dynamics of the size and physical density of the tumor has been developed and proposed for use in adaptive radiatiotherapy for cancer patients for any cases of visualization of tumor boundaries. When a positive dynamics in the tumor, the integral index is greater than 1 (M > 1), when a negative dynamics (in the absence of response to treatment) M ≤ 1. Quantitative characteristics are objective, do not depend on the subjective assessments of personnel and can serve as a basis for rescheduling exposure plans.
Is an employee's commitment to an organisation related to staff productivity?
Authors: Koushki Mohammad Saleh , Valinezhad Sara , Amini Saeed 
Published: December 2019

Background/Aims The effects of organisational commitment on the overall performance of employees is significant and unique. This study aimed to determine the relationship between organisational commitment and staff productivity. Method The study population comprised of the staff in a health centre in the city of Khorramabad. A total of 110 questionnaires were distributed among the health centre staff and 102 completed questionnaires were collected. The Statistical Package for the Social Sciences was used to analyse the collected data using descriptive statistics. Results The results showed that 66.7% of the participants had an intermediate level of commitment to the organisation, while 33.3% of the participants had a good level of commitment. Furthermore, 2.9% of the participants had low levels of productivity, 91.2% of the participants had an intermediate level of productivity, and 5.9% of participants reported good productivity levels. The Pearson test showed a significant positive relationship between commitment to the organisation and productivity (r=0.365; p=0.01). Conclusion In this study, a significant positive correlation was found between commitment to the organisation and productivity. There is a potential to increase commitment further.
Developing a ‘core of steel’: the key attributes of effective practice assessors
Authors: Hunt Louise A 
Published: December 2019

Background: the Nursing and Midwifery Council has emphasised that its recently introduced standards for student supervision and assessment aim to ‘ensure that no one gets onto the register who shouldn't be there’. A key element in achieving this is the new practice assessor role, implemented to bolster practical assessment processes. Aim: to identify the key personal characteristics of robust practice assessors who are prepared to fail underperforming students. Method: a national study, using a grounded theory approach. Thirty-one nurses were interviewed about their experiences of failing students in practice-based assessments. Findings: robust practical assessors have a ‘core of steel’, characterised as having five key features: solidarity, tenacity, audacity, integrity and dependability. Conclusion: organisations should base their selection of practice assessors on how strongly they exhibit these five characteristics. Designating all current mentors as new practice assessors, when it is known that often they are reluctant to fail, could perpetuate failure to fail.
Factors influencing health-related quality of life of those in the Netherlands living with an ostomy
Authors: Goldstine Jimena , van Hees Ruud , van de Vorst Dick , Skountrianos George , Nichols Thomas 
Published: December 2019

Background: this study examined the health-related quality of life (HRQoL) and wellbeing of people in the Netherlands who had undergone ostomy surgery. Aims: to assess how an ostomy population perceives their HRQoL and determine key stressors that influence HRQoL in this population. Methods: a cross-sectional survey, including the City of Hope National Medical Center Quality of Life Questionnaire for patients with an ostomy and a Visual Analogue Scale measuring HRQoL, was used to evaluate postsurgical patients. Findings: people with an ostomy in the Netherlands have a generally positive HRQoL, but this may be affected by peristomal skin irritation, experience of leakage on to the peristomal skin and whether their surgery was planned. Conclusions: access to specialist nurse support and products designed to prevent leakage and prevent skin irritation—two key drivers of HRQoL—may be able to maximise an individual's health status throughout their lifelong journey as a person with an ostomy.
A Note on the Relation between Government Expenditure and Receipts in Italy: A Quarterly Analysis
Authors: Tagliabue Giovanna 
Published: December 2019

A precise knowledge of the relation between government expenditure and revenues may be useful to control budget deficits because, if there is interdependence, raising taxes to reduce deficits may lead directly to more spending. An effective manipulation of central government spending and tax revenues requires information on the direction of causality between these economic variables.
The purpose of this paper is to investigate the relationship between government expenditure and receipts based on quarterly data, using the structural cointegration approach of Pesaran and Pesaran [1997]. In the results presented below, the structural cointegration approach provides evidence of a long and short-run equilibrium between government spending and receipts, supporting the assumption that the Italian Government’s expenditure is a sort of automatic stabiliser as opposed to Wagner’s Law.
Backward–Looking and Forward–Looking NDC Pension Schemes
Authors: Gronchi Sandro , Gismondi Fulvio 
Published: December 2019

In order to spread notional capital accrued at retirement by members of a cohort over their own life expectancy, pay-as-you-go notional-defined-contribution (payg-ndc) scheme uses multipliers (different by retirement age) called conversion coefficients. These are backward-looking (b.l.) in that they relay on survival rates observed for previous cohorts in the past. Under increasing longevity, b.l. coefficients undervalue life expectancies, thus preventing full implementation of actuarial fairness (benefits equivalent to contributions) which is the main objective of ndc scheme. They also engender chronic deficits.
Forward-looking (f.l.) coefficients, relaying on forecast survival rates can improve actuarial fairness. Nevertheless, they face a rather serious political difficulty in that forecasting tools are fallible. This explains why switching to f.l. coefficients is unable to gain social consensus. Apart from this, the paper shows that f.l. coefficients produce ‘overshooting’. In fact, they generate chronic surpluses. The paper also shows that frontloading pension profile helps sustainability because it reduces both surpluses and deficits generated, respectively, by f.l. and b.l. coefficients.