bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of medial open wedge high tibial osteotomy on the patellofemoral joint: comparative analysis according to the preexisting cartilage status
Authors: Moon Hyun-Soo , Choi Chong-Hyuk , Jung Min , Park Sang-Hoon , Lee Dae-Young , Shin Jong-Kwan , Kim Sung-Hwan 
Published: December 2019

AbstractBackgroundAlthough it has been known that medial open wedge high tibial osteotomy (MOWHTO) would adversely affect the patellofemoral joint, no previous study examined the surgical outcome of MOWHTO according to the preexisting cartilage status of the patellofemoral joint. The aim of this study was to investigate the effect of MOWHTO on the patellofemoral joint with regard to objective and subjective aspects according to the preexisting cartilage status.MethodsNinety-two patients who underwent MOWHTO and a following second-look arthroscopic assessment were included in this study. The patients were divided into two groups according to the preexisting cartilage status of the patellofemoral joint: group 1 (International Cartilage Repair Society [ICRS] grade 2 or 3) and group 2 (ICRS grade 0 or 1). Comparative analysis was performed regarding clinical scores, radiographic parameters, and arthroscopic measurements between the two groups.ResultsClinical outcomes showed overall improvement from baseline to the time of second-look operation, with no significant difference between the two groups at each time point. There were no significant differences in radiographic parameters between the two groups. Radiographic grade of patellofemoral osteoarthritis in both groups showed a tendency to progress, without statistical significance. In arthroscopic assessment, the size of the cartilage lesion on the patellofemoral joint increased with time in both groups (P = 0.003), but the degree of change over time between the two groups was not statistically significant. Consistently, there was no significant difference in the frequency of progression of cartilage lesion grade in the patellofemoral joint between the two groups.ConclusionsMOWHTO would contribute to osteoarthritis progression of the patellofemoral joint regardless of the preexisting cartilage status, without an association with clinical outcomes in short-term follow-up.
Maternal elevated salt consumption and the development of autism spectrum disorder in the offspring
Authors: Afroz Kazi Farhana , Alviña Karina 
Published: December 2019

AbstractAutism spectrum disorder (ASD) is a prevalent neurodevelopmental condition with no known etiology or cure. Several possible contributing factors, both genetic and environmental, are being actively investigated. Amongst these, maternal immune dysregulation has been identified as potentially involved in promoting ASD in the offspring. Indeed, ASD-like behaviors have been observed in studies using the maternal immune activation mouse model. Furthermore, recent studies have shed light on maternal dietary habits and their impact on the gut microbiome as factors possibly facilitating ASD. However, most of these studies have been limited to the effects of high fat and/or high sugar. More recent data, however, have shown that elevated salt consumption has a significant effect on the immune system and gut microbiome, often resulting in gut dysbiosis and induction of pro-inflammatory pathways. Specifically, high salt alters the gut microbiome and induces the differentiation of T helper-17 cells that produce pro-inflammatory cytokines such as interleukin-17 and interleukin-23. Moreover, elevated salt can also reduce the differentiation of regulatory T cells that help maintaining a balanced immune system. While in the innate immune system, high salt can cause over activation of M1 pro-inflammatory macrophages and downregulation of M2 regulatory macrophages. These changes to the immune system are alarming because excessive consumption of salt is a documented worldwide problem. Thus, in this review, we discuss recent findings on high salt intake, gut microbiome, and immune system dysregulation while proposing a hypothesis to link maternal overconsumption of salt and children’s ASD.
Whole exome sequencing in a child with acute disseminated encephalomyelitis, optic neuritis, and periodic fever syndrome: a case report
Authors: Ledesma Pablo A. , Guerra Juan Carlos , Burbano Manuel , Procel Patricio , Pedroza Luis Alberto 
Published: December 2019

Abstract
Background
Acute disseminated encephalomyelitis is generally preceded by an infection, and it is usually self-limiting and non-recurrent. However, when there are multiple attacks of acute disseminated encephalomyelitis followed by optic neuritis, it is defined as acute disseminated encephalomyelitis-optic neuritis. To the best of our knowledge, there are no previous reports of acute disseminated encephalomyelitis and optic neuritis preceded by autoinflammation, triggered by periodic fever syndrome.

Case summary
We report on a case of acute disseminated encephalomyelitis with optic neuritis and periodic fever syndrome in a 12-year-old Ecuadorian Hispanic boy with several relapses over the past 10 years, always preceded by autoinflammatory manifestations and without evidence of infectious processes. Whole exome sequencing was performed, and although the results were not conclusive, we found variants in genes associated with both autoinflammatory (NLRP12) and neurological (POLR3A) phenotypes that could be related to the disease pathogenesis having a polygenic rather than monogenic trait.

Conclusion
We propose that an autoinflammatory basis should be pursued in patients diagnosed as having acute disseminated encephalomyelitis and no record of infections. Also, we show that our patient had a good response after 1 year of treatment with low doses of intravenous immunoglobulin and colchicine.
Students’ reasons for STEM choices and the relationship of mathematics choice to university admission
Authors: Kaleva Satu , Pursiainen Jouni , Hakola Mirkka , Rusanen Jarmo , Muukkonen Hanni 
Published: December 2019

Abstract
Background
Despite the increasing need for STEM skills, to date, the connection between STEM subject choices and their impact on students’ educational pathways has not been widely studied. Focusing on the mathematics choice (basic/advanced/no mathematics), a large register dataset that covered students admitted to Finnish universities during 2013–2015 (N = 46,281) was combined with upper-secondary school matriculation examination data (N = 93,955) to find out how this choice influenced the students’ university admissions. This large dataset was also examined to establish the current gender distributions in different university degree programs from the perspective of mathematics choices. Further, to find out the students’ reasons behind their mathematics choices, a cohort sample of 802 student responses was collected from upper-secondary schools. We also investigated the students’ interests in different fields of study to establish any gender differences in them.

Results
The register data analysis suggested that in Finland, students’ mathematics choices had a strong influence on the university admission outcomes. For instance, only 33% of the upper-secondary school graduates took the advanced mathematics ME test in 2013–2015, yet the number of those admitted to universities who had taken the advanced mathematics ME test was 55%. Most of the university degree programs were female dominated, yet the university students with advanced mathematics were mostly male, and especially the STEM fields in the Finnish universities were male dominated. As for the reasons behind the mathematics choices, students who chose advanced mathematics believed in its usefulness for their future studies and careers. We also found significant gender-based educational differences regarding all the study fields, with STEM careers attracting more males than females.

Conclusion
Advanced mathematics was highly valued in Finnish universities, and many students chose advanced mathematics believing in its usefulness for their future studies or careers. Yet, their further study interests and career plans were segregated by gender. As there is a rising need for STEM skills, we must seek effective ways to deliver the evolving possibilities of STEM fields to students, especially girls, during the earlier years of their educations.
Hepatic Estrogen Sulfotransferase Distantly Sensitizes Mice to Hemorrhagic Shock-Induced Acute Lung Injury
Authors: Xie Yang , Barbosa Anne Caroline S , Xu Meishu , Oberly Patrick J , Ren Songrong , Gibbs Robert B , Poloyac Samuel M , Song Wen-Chao , Fan Jie , Xie Wen 
Published: December 2019

AbstractHemorrhagic shock (HS) is a potential life-threatening condition that may lead to injury to multiple organs, including the lung. The estrogen sulfotransferase (EST, or SULT1E1) is a conjugating enzyme that sulfonates and deactivates estrogens. In this report, we showed that the expression of Est was markedly induced in the liver but not in the lung of female mice subject to HS and resuscitation. Genetic ablation or pharmacological inhibition of Est effectively protected female mice from HS-induced acute lung injury (ALI), including interstitial edema, neutrophil mobilization and infiltration, and inflammation. The pulmonoprotective effect of Est ablation or inhibition was sex-specific, because the HS-induced ALI was not affected in male Est-/- mice. Mechanistically, the pulmonoprotective phenotype in female Est-/- mice was accompanied by increased lung and circulating levels of estrogens, attenuated pulmonary inflammation, and inhibition of neutrophil mobilization from the bone marrow and neutrophil infiltration to the lung, whereas the pulmonoprotective effect was abolished upon ovariectomy, suggesting that the protection was estrogen dependent. The pulmonoprotective effect of Est ablation was also tissue specific, as loss of Est had little effect on HS-induced liver injury. Moreover, transgenic reconstitution of human EST in the liver of global Est-/- mice abolished the pulmonoprotective effect, suggesting that it is the EST in the liver that sensitizes mice to HS-induced ALI. Taken together, our results revealed a sex- and tissue-specific role of EST in HS-induced ALI. Pharmacological inhibition of EST may represent an effective approach to manage HS-induced ALI.
Effectiveness of occupational therapy in improving activities of daily living performance in complete cervical tetraplegic patients; A quasi experimental study
Authors: Arsh Aatik , Anwar Zunaira , Zeb Amir , Ilyas Syed Muhammad 
Published: December 2019

Objective: To determine the effectiveness of Occupational therapy (OT) in improving activities of daily living performance in complete cervical tetraplegic patients.
Methods: A quasi experimental study was conducted at Paraplegic Center Peshawar from May 2018 to March 2019. Seventy two spinal cord injury patients with complete cervical tetraplegia having age 18-60 years were included in the study using non probability convenience sampling technique. A trained Occupational therapist conducted two occupational therapy sessions per day, three times a week on alternative days for a period of six weeks. Self-care portion of Spinal cord injury independence measure (SCIM) was used to collect pre and post data. Data was analyzed using SPSS version 20.
Results: Mean age of the participants was 30.21±13.52.Majority of the participants were (n= 61, 84.7%) male while remaining 11 (15.3%) participants were female. Pre self-care total score was 0.39±0.987 and post self-care total score was 7.17±5.536. There was significant differences (P value <0.05) between pre and post scores of feeding, upper & lower body bathing, upper & lower body dressing, grooming and total self-care scores.
Conclusion: Occupational therapy significantly improves activities of daily living performance in complete cervical tetraplegic spinal cord injury patients.
doi: https://doi.org/10.12669/pjms.36.2.1002
How to cite this:Arsh A, Anwar Z, Zeb A, Ilyas SM. Effectiveness of occupational therapy in improving activities of daily living performance in complete cervical tetraplegic patients; A quasi experimental study. Pak J Med Sci. 2020;36(2):96-99. doi: https://doi.org/10.12669/pjms.36.2.1002
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.
Dentin bond strength of bioactive cement in comparison to conventional resin cement when photosensitized with Er,Cr:YSGG Laser
Authors: Alkhudhairy Fahad , Al-Johany Sulieman S. , Naseem Mustafa , Bin-Shuwaish Mohammed , Vohra Fahim 
Published: December 2019

Objective: The purpose of the present study was to assess dentin shear bond strength (SBS) and mode of bond failure of bioactive cement (BA) in comparison to conventional resin cement when photosensitized by Er,Cr:YSGG Laser (ECL).
Methods: The present in-vitro study was carried out from March 2019 to May 2019. Sixty permanent non-carious, intact, non-fractured molars were isolated and mounted vertically in acrylic resin. Buccal surface of each molar tooth was ground, polished and surface treated with ECL. Ketac conditioner was applied on the surface washed and air dried surface. Tetric -N-Bond adhesive was applied on forty-five samples and light cured. The specimens were allocated into four groups (n=15) according to the type of cement used i.e., Calibra (C), BA, Variolink II (V) and Maxcem-Elite (ME). For SBS testing was performed using the universal testing machine. Eight samples from each group were assessed for modes of failure. Means and standard deviations were compared using analysis of variance (ANOVA) and Tukey’s post hoc test at a significance level of p < 0.05.
Results: The highest mean SBS was observed in group ECL-C (21.55±3.08). The lowest mean SBS was displayed in group ECL-ME (14.25±3.55). Mean SBS values for group ECL-C (21.55±3.08) and group ECL-V (20.74±4.15) were comparable (p <0.05). Similarly, SBS values of group ECL-BA (15.48±3.62) and group ECL-ME (14.25±3.55) were comparable (p <0.05).
Conclusion: Dentin surface conditioned with Er,Cr:YSGG and bonded to C and V cements exhibit favourable bond strength values.
doi: https://doi.org/10.12669/pjms.36.2.1284
How to cite this:Alkhudhairy F, Al-Johany SS, Naseem M, Bin-Shuwaish M, Vohra F. Dentin bond strength of bioactive cement in comparison to conventional resin cement when photosensitized with Er,Cr:YSGG Laser. Pak J Med Sci. 2020;36(2):85-90. doi: https://doi.org/10.12669/pjms.36.2.1284
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.
Uterine manipulator requirement in laparoscopic surgery of Ectopic Pregnancy
Authors: Beyan Emrah , Kanmaz Ahkam Göksel , Budak Adnan , Emirdar Volkan , Tutar Sadettin Oğuzhan , İnan Abdurrahman Hamdi 
Published: December 2019

Objective: The advantages of laparoscopic surgery used in the treatment of ectopic pregnancy is well-known; however, the efficacy of uterine manipulators remains unknown. In this study, we aimed to investigate the efficacy of uterine manipulators in the laparoscopic treatment of ectopic pregnancy.
Methods: Overall, 118 patients who underwent laparoscopy due to ectopic pregnancy in Department of Obstetrics and Gynaecology at Tepecik Education and Research Hospital between January 2010 and January 2018 and who met the inclusion criteria were included in the study. Groups of patients undergoing surgery with or without the use of a uterine manipulator were compared in terms of demographic data, operative and postoperative results.
Results: No difference was noted between the groups in terms of age, parity, body mass index, smoking, side of ectopic pregnancy mass, previous operations and pregnancy type. However, the size of ectopic pregnancy mass measured by ultrasonography was significantly larger (p = 0.006) and the operation time was significantly shorter (p<0.001) in the group where uterine manipulators were not used than in the uterine manipulator group.
Conclusion: We concluded that not using a uterine manipulator in laparoscopic procedures for ectopic pregnancy did not increase operative complications and that operation time was higher in procedures using uterine manipulators.
doi: https://doi.org/10.12669/pjms.36.2.1294
How to cite this:Beyan E, Kanmaz AG, Budak A, Emirdar V, Tutar SO, Inan AH. Uterine manipulator requirement in laparoscopic surgery of Ectopic Pregnancy. Pak J Med Sci. 2020;36(2):105-110. doi: https://doi.org/10.12669/pjms.36.2.1294
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.
Effects of Life style factors on the symptoms of gastro esophageal reflux disease: A cross sectional study in a Pakistani population
Authors: Ahmed Shahid , Jamil Sajjad , Shaikh Hafeezullah , Abbasi Maryam 
Published: December 2019

Background & Objective: Gastro esophageal reflux disease (GERD) broadly includes the whole spectrum of reflux disease symptoms like heartburn or acid regurgitation to endoscopic, reflux esophagitis or Barrett’s esophagus. Our aim therefore was to study the association between Gastroesophageal reflux disease symptoms and various lifestyle factors.
Methods: A descriptive cross-sectional study was carried out in the outpatient department of Darul Sehat Hospital, Zubaida Medical Center and Liaquat National Hospital & Medical College, Karachi, Pakistan from January 2018 to October 2018. The selected candidates were asked to fill a validated GERD questionnaire and they were also asked about their lifestyle factors. Odds ratio and their 95% confidence interval were estimated using binary logistic regression with GERD symptoms as the study outcome.
Results: A total of 2000 respondents completed the questionnaire. 69.3% gastroesophageal reflux disease cases were found in participants above 35 years of age while 56.9% subjects were male. The most common lifestyle factors associated with GERD were less exercise time (90.9%) (OR, 6.47; 95% CI, 4.91-8.53), 78.3% participants had habit of eating midnight snacks (OR, 5.08; 95% CI, 4.03-6.40), 87.3% participants reported less interval between dinner and sleep (OR, 6.98; 95% CI, 5.36-9.08). The most important factor relieving GERD symptoms was raising the head of bed during sleep (79.4%) while 43.3% subjects with the habit of post dinner walk reported fewer symptoms of GERD.
Conclusion: Lifestyle factors particularly less physical activity, late evening meals, inadequate sleep, smoking and post dinner lying were found to be associated with GERD symptoms.
doi: https://doi.org/10.12669/pjms.36.2.1371
How to cite this:Ahmed S, Jamil S, Shaikh H, Abbasi M. Effects of Life style factors on the symptoms of gastro esophageal reflux disease: A cross sectional study in a Pakistani population. Pak J Med Sci. 2020;36(2):115-120. doi: https://doi.org/10.12669/pjms.36.2.1371
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 minimally invasive percutaneous dilational tracheostomy for ICU critical patients
Authors: Gan Hongmei , Dong Aihong , Xu Haiyan 
Published: December 2019

Objective: To find out the application value of minimally invasive percutaneous dilational tracheostomy in critically ill patients in intensive care unit (ICU).
Methods: One hundred and forty critically ill patients who underwent tracheostomy in ICU of our hospital were included in the study from August 2016 to December 2017. They were divided into an observation group and a control group by random number table method, 70 in each group. The control group received conventional tracheotomy, while the observation group received percutaneous dilational tracheostomy. The operation time, incision length, amount of intraoperative bleeding and healing time of incision were compared between the two groups, and the changes of vital signs and complications after operation were recorded. The family members of the patients signed the informed consent.
Results: The operation time, healing time and incision length of the observation group were (9.92±4.13) min, (1.31±0.21) cm and (6.91±0.72) respectively, shorter than (24.09±6.82) min, (3.40±0.65) cm and (67.48±0.61) d in the control group, and the differences were statistically significant (P<0.05). The amount of intraoperative bleeding of the observation group was (7.81±1.83) mL, less than (16.34±2.83) mL in the control group; the difference was statistically significant (P<0.05). The heart rate and oxygen saturation of the observation group before and during the operation were not significantly different (P>0.05). The heart rate of the control group during the operation was significantly higher than that before the operation (P<0.05); the oxygen saturation of the control group before and during the operation had no significant difference (P>0.05). The incidence of complications in the observation group was 24.3%, which was significantly lower than that in the control group (55.7%, X2=8.279, P=0.014).
Conclusion: Minimally invasive percutaneous dilational tracheostomy has advantages of small trauma, less infection and beautiful incision, and it will not increase postoperative complications. It is of great value in the treatment of ICU critical patients.
doi: https://doi.org/10.12669/pjms.36.2.594
How to cite this:Gan H, Dong A, Xu H. Application value of minimally invasive percutaneous dilational tracheostomy for ICU critical patients. Pak J Med Sci. 2020;36(2):59-63. doi: https://doi.org/10.12669/pjms.36.2.594
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.