bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diurnal Patterns for Cortisol, Cortisone and Agouti-Related Protein in Human Cerebrospinal Fluid and Blood
Authors: Panigrahi Sunil K , Toedesbusch Cristina D , McLeland Jennifer S , Lucey Brendan P , Wardlaw Sharon L 
Published: December 2019

Abstract

Context
Cortisol in blood has a robust circadian rhythm and exerts potent effects on energy balance that are mediated in part by central mechanisms. These interactions involve orexigenic agouti-related protein (AgRP) neurons that are stimulated by glucocorticoids. However, diurnal changes in brain or cerebrospinal fluid (CSF) cortisol and cortisone, which are interconverted by 11ß-HSD1, have not been characterized in humans.

Objective
To conduct a secondary analysis of existing samples to characterize diurnal changes in cortisol and cortisone in CSF and examine their relationships to changes in AgRP.

Methods
Stored CSF and plasma samples were obtained from 8 healthy subjects who served as controls for a sleep study. CSF was collected every 2h for 36h via indwelling lumbar catheter; plasma was collected every 2h.

Results
There was a diurnal rhythm for cortisol and cortisone in CSF that closely followed the plasma rhythm by 2 h with peak and nadir levels at 0900h and 0100h. The ratio of cortisol (active) to cortisone (inactive) in CSF was 48% higher at the peak versus nadir. There was a diurnal rhythm for AgRP in plasma that was out of phase with the cortisol rhythm. There was a less distinct diurnal rhythm for AgRP in CSF that oscillated with a similar phase as cortisol.

Conclusions
There is a robust diurnal rhythm for cortisol and cortisone in CSF. Diurnal changes were noted for AgRP that are related to the cortisol changes. It remains to be determined if AgRP mediates adverse metabolic effects associated with disruption of the cortisol circadian rhythm.
Hypercoagulability in Cushing Syndrome, Prevalence of Thrombotic Events: A Large, Single-Center, Retrospective Study
Authors: Suarez Maria Gabriela , Stack Madeleine , Hinojosa-Amaya Jose Miguel , Mitchell Michael D , Varlamov Elena V , Yedinak Chris G , Cetas Justin S , Sheppard Brett , Fleseriu Maria 
Published: December 2019

Abstract

Background
The risk of Cushing syndrome (CS) patients experiencing a thrombotic event (TE) is significantly higher (odds ratio; OR 18%) than that of the general population. However, there are currently no anticoagulation guidelines.

Methods
A retrospective, single-center, longitudinal study of patients undergoing all types of treatment—surgical (pituitary, unilateral, and bilateral adrenalectomy) and medical treatment—was undertaken. TEs were recorded at any point up until last patient follow-up; myocardial infarction (MI), deep venous thrombosis (DVT), and pulmonary embolism (PE) or stroke. Patients’ doses and complications of anticoagulation were recorded.

Results
Included were 208 patients; a total of 165 (79.3%) were women, and mean age at presentation was 44 ± 14.7 years. Thirty-nine (18.2%) patients had a TE; extremity DVT (38%), cerebrovascular accident (27%), MI (21%), and PE (14%). Of 56 TEs, 27 (48%) were arterial and 29 (52%) were venous. Patients who underwent bilateral adrenalectomy (BLA) had an odds ratio of 3.74 (95% CI 1.69-8.27) of developing a TE. Of patients with TEs, 40.5% experienced the event within the first 60 days after surgery. Baseline 24-hour urinary free cortisol levels did not differ in patients with or without TE after BLA. Of 197 patients who underwent surgery, 50 (25.38%) received anticoagulation after surgery, with 2% having bleeding complications.

Conclusions
The risk of TEs in patients with CS was approximately 20%. Many patients had more than 1 event, with higher risk 30 to 60 days postoperatively. The optimal prophylactic anticoagulation duration is unknown, but most likely needs to continue up to 60 days postoperatively, particularly after BLA.
Association of fetuin-A with dyslipidemia and insulin resistance in type-II Diabetics of Pakistani population
Authors: Fatima Fasiha , Ahsan Naveed , Nasim Aliya , Alam Faiza 
Published: December 2019

Background & Objective: Fetuin-A, hepatokine is responsible for instigating insulin resistance by inhibiting tyrosine kinase receptors. Our objective was to investigate the relationship of fetuin-A with dyslipidemia and insulin resistance in type-II diabetics of Pakistani population.
Methods: In this cross sectional study which was conducted at Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi between October 2013 to March 2014, a total of 330 participants were selected and divided into two groups. Group-A (n = 165) normal healthy individual and Group-B (n = 165) Type-II diabetes mellitus mellitus with no comorbidities. Serum fetuin-A and insulin levels were determined by commercially prepared ELISA kits while fasting blood glucose (FBG) and lipid profile were performed by enzymatic kit method. Employing independent t-test, comparison of groups was done and correlation was achieved by using spearman correlation.
Results: The results demonstrate a significant difference in mean values of fetuin-A, lipid profile, glucose, insulin and Homoeostasis Model Assessment of Insulin resistance (HOMA-IR) in type-II diabetics when compared to normal healthy individuals (p<0.01). A positive correlation was found between serum fetuin-A levels and FBG(r= 0.495, p< 0.001), insulin(r= 0.227, p< 0.001), HOMA-IR(r= 0.336, p<0.001, triglycerides(r= 0.197, p< 0.001) and LDL-cholesterol(r= 0.170, p= 0.002), while negative correlation with HDL-cholesterol(r= -0.251, p< 0.001).
Conclusion: The study concludes that fetuin-A might be accountable for dyslipidemia and insulin resistance in type-II diabetes mellitus mellitus. So the high levels of Fetuin-A responsible for insulin resistance might alters endothelium and causes inflammation, vasoconstriction and thrombosis and ultimately atherosclerosis.
doi: https://doi.org/10.12669/pjms.36.2.1106
How to cite this:Fatima F, Ahsan N, Nasim A, Alam F. Association of fetuin-A with dyslipidemia and insulin resistance in type-II Diabetics of Pakistani population. Pak J Med Sci. 2020;36(2):64-68. doi: https://doi.org/10.12669/pjms.36.2.1106
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 effect and safety evaluation of different dosage of Rituximab combined with Cyclophosphamide in treatment of refractory immune Thrombocytopenia
Authors: Wang Zhibin , Ren Yu , Huang Weibo , Yao Haiying 
Published: December 2019

Objective: To discuss clinical effect of different dosage of rituximab combined with cyclophosphamide in treatment of refractory immune thrombocytopenia (rITP).
Method: This study was conducted at Department of Hematopathology in XX Hospital from January 2016 to January 2018. In this study. Seventy-eight patients with rITP were selected as the objects, divided into observation group (39 cases) and control group (39 cases) according to random number table. Patients in the control group were treated with conventional rituximab and cyclophosphamide, while the observation group received low-dose rituximab. The same amount of cyclophosphamide was used in the two groups. The statistics of clinical effect, recurrence rate, untoward effect and Laboratory inspection of both groups were made before and after the treatment.
Results: Compared with the control group, the total occurrence rate of side effects in the observation group decreased significantly; the level of IgM and CD20+ in the observation group also decreased significantly, while. The level of IgA, IgG, CD3+ and CD4+ rose significantly (P<0.05). The differences in the level of Th1, TNF-a, IL-18 and Sc5b-9 had statistical significance before and after the treatment (P<0.05).
Conclusion: Rituximab combined with cyclophosphamide has the definite curative effect on rITP. The small dosage of rituximab combined with cyclophosphamide has higher clinical safety in the treatment.
doi: https://doi.org/10.12669/pjms.36.2.1168
How to cite this:Wang Z, Ren Y, Li M, Huang W, Yao H. Clinical effect and safety evaluation of different dosage of Rituximab combined with Cyclophosphamide in treatment of refractory immune Thrombocytopenia. Pak J Med Sci. 2020;36(2):69-74. doi: https://doi.org/10.12669/pjms.36.2.1168
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.
Histopathological analysis of sinonasal lesions associated with chronic rhinosinusitis and comparison with computed tomography diagnoses
Authors: Alshoabi Sultan Abdulwadoud , Binnuhaid Abdulkaleq Ayedh , Gameraddin Moawia Bushra , Alsultan Kamal Dahhan 
Published: December 2019

Background & Objective: Chronic rhino sinusitis (CRS) is an inflammatory condition of the paranasal sinuses and the nasal passage lasting more than three months either with or without sinonasal polyps. This study aimed to report the common sinonasal lesions associated with CRS according to the histopathology results, to compare between clinical and histopathological diagnoses, and to compare between radiological and histopathological diagnoses of the sinonasal lesions.
Methods: A retrospective study of the electronic records of 82 patients diagnosed with CRS with nasal polyps. All patients underwent endoscopic sinus surgery and histopathological examination of surgical biopsies. The collected data were analyzed using SPSS program. Coparison between clinical and histopathological diagnoses was done. This study was conducted at Alsafwa Consultative Medical center (ACMC) in Almukalla city, Hadhramout province in Republic of Yemen.
Results: Out of 82 patients, the ages ranged from 4 to 90 years (mean: 34.48±17.74 years), and 54.88% were females. Inflammatory polyps were the most common lesion (31.4%), then allergic polyps (30.5%). Nasopharyngeal carcinoma (NPC) was reported in 9.8% of the lesions and all were unilateral. The results revealed strong compatibility between clinical and histopathological diagnoses (p<0.001, kappa= 0.215), and significant compatibility between radiological and histopathology diagnoses (p=0.007).
Conclusion: Inflammatory and allergic polyps are the most common benign bilateral lesions associated with chronic rhinosinusitis, which can be correctly diagnosed clinically in most cases. Unilateral nasal polyps have high rates of malignancies and should be check carefully by endoscopy and histopathology. Computed tomography has some pitfalls in diagnosing of fungal sinusitis.
Abbreviations: CRS: Chronic rhino sinusitis, CRSwNP: CRS with nasal polyps, CRSsNP: CRS without nasal polyp, Eos CRSwNP: CRSwNP and eosinophilic inflammation, PNS: paranasal sinuses, EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012, ACMC: Alsafwa Consultative Medical center, NECT: non-enhanced computed tomography, SPSS: Statistical Package for the Social sciences, IBM: International Business Machines, NY: New York, NPC: Nasopharyngeal carcinoma.
doi: https://doi.org/10.12669/pjms.36.2.1453
How to cite this:Alshoabi SA, Binnuhaid AA, Gameraddin MB, Alsultan KD. Histopathological analysis of sinonasal lesions associated with chronic rhinosinusitis and comparison with computed tomography diagnoses. Pak J Med Sci. 2020;36(2):146-150. doi: https://doi.org/10.12669/pjms.36.2.1453
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.
Decitabine combined with CAG regimen in the treatment of elderly patients with acute myeloid leukemia
Authors: Zhao Haitao , Wang Chunyan , Yu Fengying , Guo Qingwei 
Published: December 2019

Objective: To analyze the efficacy and safety of decitabine combined with CAG ((cytarabine + aclacinomycin + granulocyte colony stimulating factor)) regimen and CAG regimen alone in the treatment of elderly acute myeloid leukemia.
Methods: 96 elderly patients with acute myeloid leukemia who were admitted to our hospital from July 2015 to July 2017 were randomly divided into an observation group and a control group, 48 cases in each group. The patients in the control group were treated with CAG regimen, while the patients in the observation group were treated with decitabine on the basis of the control group. The clinical curative effect, changes of immune indicators, occurrence of adverse reactions and survival rate at different time after treatment were compared between the two groups.
Results: The total effective rate of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the indicators of cellular immunity in the two groups were significantly lower than those before treatment, and the indicators of cellular immunity in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). The 9-month survival rate and 1-year survival rate in the observation group were significantly higher than those in the control group (P<0.05).
Conclusion: The combination of decitabine and CAG regimen is effective in the treatment of elderly patients with acute myeloid leukemia. The therapy can fully inhibit cellular immune function and improve long-term survival rate, and its safety has a small difference with that of CAG regimen alone. It is worth clinical promotion.
doi: https://doi.org/10.12669/pjms.36.2.850
How to cite this:Zhao H, Wang C, Yu F, Guo Q. Decitabine combined with CAG regimen in the treatment of elderly patients with acute myeloid leukemia. Pak J Med Sci. 2020;36(2):141-145. doi: https://doi.org/10.12669/pjms.36.2.850
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.
Psychology of financial literacy of military personnel
Authors: Petrov Vladislav 
Published: December 2019

The article is devoted to the problem of psychology of financially competent behavior of servicemen. The psychological etiology of financial literacy / illiteracy of the personnel of the Armed Forces of the Russian Federation is shown. The study was conducted using: 1) content analysis of information (publications, materials of official inspections, etc.) about the attitude of the personnel of law enforcement agencies to money and financial behavior; 2) expert survey; 3) psychodiagnostic examination (method "California psychological questionnaire". Experts and subjects were 67 soldiers.
The study found that financially literate / illiterate behavior is determined by a pattern of both General and specific qualities. The basis of the pattern of General qualities of a soldier with a financially competent command were such characteristics as responsibility, self-control and developed intellectual and prognostic abilities. Persons with financially illiterate behavior were distinguished by: inability to competently plan a personal budget; propensity to risky financial transactions; promiscuity and inattention to spending money; frivolous attitude to debts and loans; focus on spending money, not saving it. Thus, the more socially responsible is the behavior of the soldier, the more they demonstrate financially competent behavior.
The material of the article allows to justify the involvement of military psychologists to solve the problem of improving the financial literacy of personnel. First of all, it concerns preventive psychodiagnostics of propensity of the military personnel to financially illiterate behavior. This should be followed by the provision of psychological assistance to persons in need of it, as well as the formation of the personnel of financial responsibility and predictability, the ability to plan and control personal spending. Ultimately, the work to improve the financial literacy of military personnel will have a positive impact on overcoming the problem of deviant behavior of personnel, as a consequence, to maintain a high level of combat readiness of the Armed Forces.
Pulmonary rehabilitation for chronic obstructive pulmonary disease: effects of a high versus low intensity programme
Authors: Bianco Jean Paul , Sciriha Anabel , Lungaro-Mifsud Stephen , Agius Tonio , Scerri Josianne , Montefort Stephen 
Published: December 2019

Background/Aims Pulmonary rehabilitation is known to facilitate improvements in chronic obstructive pulmonary disease symptoms, exercise tolerance and quality of life. Despite this, there is no consensus on the ideal programme intensity. This article aims to explore and compare the benefits of a high intensity and low intensity pulmonary rehabilitation programme. Methods A total of 30 patients with a diagnosis of chronic obstructive pulmonary disease were randomly and blindly allocated to either a high intensity or low intensity 12-week pulmonary rehabilitation programme. Results Significant improvements in functional and health-related quality of life measures were obtained in both groups. Most of the significant changes for the high intensity group were achieved by week 8. The low intensity group required a further 4 weeks of rehabilitation in order to reach a significant difference. Conclusions Results show that both low and high intensity pulmonary rehabilitation programmes were beneficial. However, the high intensity programme was more efficient in achieving these improvements than the low intensity group.
Stability of the Exchange–Rate Agreements and Public Debt Management: the Italian Experience within the EMS
Authors: Maggi Bernardo 
Published: December 2019

This paper analyses the issue of the interdependence between fundamentals and expectations in the emergence of a currency crisis from both a theoretical and an empirical point of view with specific reference to the Italian case.
Theoretically, currency crises depend as much on fundamentals as on expectations, and the latter again on the critical condition of the former for the associated profit opportunity. Hence, in order to reduce the risk of a new speculative attack, an appropriate public debt management, which for its high level is the main fundamental in Italy, and fiscal policy must be adopted. These may be implemented with the evaluation of the probability associated to devaluation, which enables the policy-maker to identify the critical condition for die occurrence of the crisis. The empirical analysis also provides evidence in favour of the theory that points public budget government policy as one of the major factors in leading to a non-viable fixed exchange rate regime.
Experiments all the way in programmatic design research
Authors: Bang Anne Louise , Eriksen Mette Agger 
Published: December 2019

Abstract
Experiments take various forms, have various purposes, and generate various knowledge; depending on how, when and why they are integrated in a design research study with a programmatic approach. This is what we will argue for throughout this article using examples and experiences from our now finalized Ph.D. studies. Reviewing the prevailing literature on research through design the overall argument is that design experiments play a core role both in conducting the research, in theory construction and in knowledge generation across the different design domains and methodological directions. However, we did not identify sources that explicitly discuss and operationalize roles and characteristics of design experiments in different stages of programmatic design research. The aim of this article is therefore to outline a (tentative) systematic account of roles and characteristics of design experiments. Building upon Schön’s definition of experiments in practice we propose adding to the prevailing understanding of experiments in research through design understanding and operationalizing design experiments (1) as initiators or drivers framing a research programme, (2) as ways to reflect on and mature the research programme serving as vehicles for theory construction and knowledge generation and finally (3) as a ‘designerly’ approach to the written knowledge dissemination and clarification of research contributions.
Normalized multi-bump solutions for saturable Schrödinger equations
Authors: Wang Xiaoming , Wang Zhi-Qiang 
Published: December 2019

AbstractIn this paper, we are concerned with the existence of multi-bump solutions for a class of semiclassical saturable Schrödinger equations with an density function:$$\begin{array}{} \displaystyle -{\it\Delta} v +{\it\Gamma} \frac{I(\varepsilon x) + v^2}{1+I(\varepsilon x) +v^2} v =\lambda v,\, x\in{{\mathbb{R}}^{2}}. \end{array}$$We prove that, with the density function being radially symmetric, for given integerk≥ 2 there exist a family of non-radial,k-bump type normalized solutions (i.e., with theL2constraint) which concentrate at the global maximum points of density functions whenε→ 0+. The proof is based on a variational method in particular on a convexity technique and the concentration-compactness method.
Mechanical characterization of pore-graded bioactive glass scaffolds produced by robocasting
Authors: Barberi Jacopo , Nommeots-Nomm Amy , Fiume Elisa , Verné Enrica , Massera Jonathan , Baino Francesco 
Published: December 2019

Abstract
Since the discovery of 45S5 Bioglass® by Larry Hench, bioactive glasses have been widely studied as bone substitute materials and, in more recent years, have also shown great promise for producing three-dimensional scaffolds. The development of additive manufacturing techniques and their application in bone tissue engineering allows the design and fabrication of complex structures with controlled porosity. However, achieving strong and mechanically-reliable bioactive glass scaffolds is still a great challenge. Furthermore, there is a relative paucity of studies reporting an exhaustive assessment of other mechanical properties than compressive strength of glass-derived scaffolds. This research work aimed at determining key mechanical properties of silicate SiO2-Na2O-K2OMgO-CaO-P2O5 glass scaffolds fabricated by robocasting and exhibiting a porosity gradient. When tested in compression, these scaffolds had a strength of 6 MPa, a Young’s modulus around 340 MPa, a fracture energy of 93 kJ/m3 and a Weibull modulus of 3, which provides a quantification of the scaffold reliability and reproducibility. Robocasting was a suitable manufacturing method to obtain structures with favorable porosity and mechanical properties comparable to those of the human cancellous bone, which is fundamental regarding osteointegration of bone implants.
The Use of Alliteration in a Norwegian Medieval Law – just for Fun?
Authors: Landro Torgeir 
Published: December 2019

AbstractThe article explores the use of alliteration in an ecclesiastical law from medieval Norway. While earlier scholars considered alliteration to be a remnant from preliterate times, von See’s and Ehrhardt’s studies revealed that alliteration was more frequent in younger laws, and therefore supposedly introduced by the Church and the royal government. The material from the Norwegian law confirms that the alliterative formulations are added later on. However, in this particular case, the alliteration has contributed to corrupting the content, an observation which clashes with the ideal of clarity, which was also important in medieval canon law. This fact, in turn, leads to the conclusion that the paragraph draws on different legal traditions, both native, customary law and learned, canon law.