bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of magnetic resonance neurography in intercostal neuralgia; diagnostic utility and efficacy
Authors: Chalian Majid , Hoang Diana , Rozen Shai , Chhabra Avneesh 
Published: May 2021

Objective:
To evaluate the utility and efficacy of MR neurography (MRN) in the diagnostic work-up for intercostal neuralgia and to assess the treatment course and outcomes in MRN-imaged clinically suspected intercostal neuropathy cases of chronic chest and abdominal wall pain syndromes.

Methods:
Following a retrospective cross-sectional study, a consecutive series of patients who underwent MRN of torso for suspected intercostal neuralgia were included. Patient demographics, pain location/level/duration, previous work-up for the same indication, MRN imaging results, and MRN cost per patient were recorded. An inter-reader reliability assessment was performed on the MRN findings using Cohen’s weighted κ analysis. Post-MRN treatment choice, as well as success rates of MRN directed perineural injections and surgical management were also evaluated.

Results:
A total of 28 patients (mean ± SD age, 48.3 ± 18.0 years, female/male = 3.0) were included. Pain and/or numbness in the right upper quadrant were the most common complaints. The mean maximum pain level experienced was 7.4 ± 2.5 on a 1 (lowest pain level) - 10 (highest pain level) visual analog scale. The duration of pain before MRN work-up was 36.9 ± 37.9 months. The patients had seen an average of 5 ± 2.8 physicians for such syndromes. 20 (71%) patients had one or multiple other imaging studies for prior work-up. MRN identified positive intercostal nerve abnormality in 19 cases with clinical symptoms of intercostal neuralgia. From the inter-reader reliability assessment, a Cohen’s weighted κ value of 0.78 was obtained. The costs of work-up was about one-third with MRN for diagnostic purposes with less financial and psychological harm. Among the MRN-positive cases, 9/19 patients received perineural injections, of which 6 reported improvement after their first round, lasting an average of 41.1 ± 83 days. Among the nine MRN-negative cases, two received perineural injections, of which none reported improvement. Surgical management was mostly successful with a positive outcome in six out of seven operated cases (85.7%).

Conclusion:
MRN is useful in diagnostic algorithm of intercostal neuralgia and MRN-positive cases demonstrate favorable treatment response to perineural injections and subsequent surgical management.

Advances in knowledge:
The use of MRN in intercostal neuralgia is an application that has not been previously explored in the literature. This study demonstrates that MRN offers superior visualization of pathology in intercostal neuralgia and confirms that treatment directed at MRN identified neuropathy results in good outcomes while maintaining cost efficiency.
Prediction of ICU admission after orthopedic surgery in elderly patients
Authors: Tang Yongzhong , Li Hao , Guo Ziyi 
Published: May 2021

Objectives: Prediction of ICU admission after surgery are important for rational decision-making for different patients in clinical practice. Little information is available about the risk factors of postoperative ICU admission in elderly patients undergoing orthopedic surgery. This study aimed to identify risk factors and develop a predictive model for postoperative ICU admission in elderly patients undergoing orthopedic surgery.
Methods: A total of 2826 cases of elderly patients receiving orthopedic surgery from October 2010 to September 2016 were retrospectively collected and analyzed. Logistic regression was used to evaluate the impacts of covariates. Support vector machine (SVM) was employed to develop a predictive model based on all pre-operative covariates and the demographic information.
Results: There were 256 patients transferred to ICU after surgery. ASA III or IV and emergency surgery were found to be independent risk factors while neuraxial anesthesia and joint surgery were protective factors. In addition, a SVM-based predictive model was developed, which had a sensitivity of 90.99%, a specificity of 99.10% and an area under ROC curve of 0.9678.
Conclusions: Our study revealed that emergency surgery, anesthesia method, surgery type and ASA grade were risk factors to predict postoperative ICU admission in elderly orthopedic patients.
doi: https://doi.org/10.12669/pjms.37.4.3371
How to cite this:Tang Y, Li H, Guo Z. Prediction of ICU admission after orthopedic surgery in elderly patients. Pak J Med Sci. 2021;37(4):1179-1184. doi: https://doi.org/10.12669/pjms.37.4.3371
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.
Outcome of abdominal binder in midline abdominal wound Dehiscence in terms of pain, psychological satisfaction and need for reclosure
Authors: Ammar Ahmed Siddique , Naqi Syed Asghar , Khattak Shehrbano , Noumani Ahmed Raza 
Published: May 2021

Objective: To assess the role of abdominal binder in patients with midline wound dehiscence after elective or emergency laparotomy in terms of pain, psychological satisfaction and need for reclosure.
Methods: It was a comparative study done at EAST Surgical Ward of Mayo Hospital, Lahore from 1st January 2018 to 31st December 2019. One hundred and sixty-two (162) patients were included in this study with post-operative midline abdominal wound dehiscence and after informed consent by consecutive non probability sampling technique. Patients were divided into two groups by lottery method into eighty-one patients each. Group-A included patients where abdominal binder was applied and Group-B included patients without abdominal binder. In both groups pain score, psychological satisfaction and need for reclosure was assessed and compared.
Results: Patients with abdominal binder shows significantly less pain (P value =0.000) and more psychological satisfaction (P value = 0.000) as compared to the patients where abdominal binder was not used. However, there was no difference in reducing the need for reclosure in patients who use abdominal binder (P value = 0.063).
Conclusion: Although abdominal binder helps in reducing the pain and improving the psychological satisfaction in patients with midline abdominal wound dehiscence yet it doesn’t help in healing of wound and reclosure of the dehisced abdominal wound is needed.
doi: https://doi.org/10.12669/pjms.37.4.3671
How to cite this:Ammar AS, Naqi SA, Khattak S, Noumani AR. Outcome of abdominal binder in midline abdominal wound Dehiscence in terms of pain, psychological satisfaction and need for reclosure. Pak J Med Sci. 2021;37(4):1118-1121. doi: https://doi.org/10.12669/pjms.37.4.3671
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.
Horizontal transfer and evolution of wall teichoic acid gene cassettes in Bacillus subtilis
Authors: Sutton Granger , Fogel Gary B. , Abramson Bradley , Brinkac Lauren , Michael Todd , Liu Enoch S. , Thomas Sterling 
Published: May 2021

Background: Wall teichoic acid (WTA) genes are essential for production of cell walls in gram-positive bacteria and necessary for survival and variability in the cassette has led to recent antibiotic resistance acquisition in pathogenic bacteria. Methods: Using a pan-genome approach, we examined the evolutionary history of WTA genes in Bacillus subtilis ssp. subtilis. Results: Our analysis reveals an interesting pattern of evolution from the type-strain WTA gene cassette possibly resulting from horizontal acquisition from organisms with similar gene sequences. The WTA cassettes have a high level of variation which may be due to one or more independent horizontal transfer events during the evolution of Bacillus subtilis ssp. subtilis. This swapping of entire WTA cassettes and smaller regions within the WTA cassettes is an unusual feature in the evolution of the Bacillus subtilis genome and highlights the importance of horizontal transfer of gene cassettes through homologous recombination within B. subtilis or other bacterial species. Conclusions: Reduced sequence conservation of these WTA cassettes may indicate a modified function like the previously documented WTA ribitol/glycerol variation. An improved understanding of high-frequency recombination of gene cassettes has ramifications for synthetic biology and the use of B. subtilis in industry.
Cost analysis of outpatient services for major external structural birth defects: An ingredient approach in selected hospitals in Kiambu County, Kenya
Authors: N. Agot George , K. Wang'ombe Joseph , M. Mweu Marshal 
Published: May 2021

Background: Major external structural birth defects are known to exert an enormous economic burden on individuals and health services; however, they have been vastly unappreciated and underprioritized as a public health problem in settings where cost analyses are limited. Objective: The objective of this study was to conduct a cost analysis of outpatient services for major external structural birth defects in selected hospitals in Kiambu County, Kenya. Methods: A hospital-based cross-sectional study design was adopted in four hospitals where an ingredient approach was used to retrospectively gather data on cost drivers for interventions consisting of castings, bracings, and tendonectomies for the under-fives from health care providers’ perspectives for a one-year time horizon (January 1st, 2018, to December 31st, 2018). The hospitals were selected for providing outpatient corrective and rehabilitative services to the under-fives. Prevalence-based morbidity data were extracted from outpatient occupational therapy clinic registers, whereas staff-time for the hospitals’ executives comprising the medical superintendents, chief nursing officers, orthopedic surgeons, and health administrative officers were gathered through face-to-face enquires from the occupational therapists being the closest proxies for the officers. Following a predefined inclusion criterion, 349 cases were determined, and associated cost drivers identified, measured, and valued (quantified) using prevailing market prices. The costs were categorized as recurrent, and unit economic costs calculated as average costs, expressed in U.S Dollars, and inflated to the U.S Dollar Consumer Price Index from January 2018 to December 2018. Results: The unit economic cost of all the cases was estimated at $1,139.73; and $1,143.51 for neural tube defects, $1,143.05 for congenital talipes equinovarus, and $1,109.81 for congenital pes planus. Conclusions: The highest economic burden of major external structural birth defects in the county was associated with neural tube defects, followed by congenital pes planus despite having the fewest caseloads.
Short communication: Differences in local perceptions of Osteochilus spilurus (Cyprinidae: Labeoninae) from several islands in Indonesia
Authors: Kurniawan Ardiansyah , PRAMONO DASA Y. , INDRAYATI ARTIN , HERMANTO HERMANTO , TRISWIYANA IRA 
Published: May 2021

Abstract. Kurniawan A, Pramono DY, Indrayati A, Hermanto, Triswiyana I. 2020. Short communication: Differences in local perceptions of Osteochilus spilurus (Cyprinidae: Labeoninae) from several islands in Indonesia. Asian J Ethnobiol 3: 79-84. Osteochilus spilurus is native freshwater fish on the islands of Sundaland, Indonesia. No study has been reported on this fish utilization other than in the Belitung Islands, so another local perception of Indonesian island needs to be investigated. Local recreational fishing in Palangkaraya, Pontianak, and Pekanbaru and fishers in Palangkaraya, Eastern and western of Belitung, Southern and Central Bangka, and North Lampung were the sources of local knowledge. We obtained data using a Facebook app survey to see local recreational fishers' awareness, interviews with one fisherman in each region, and a literature review for Belitung public perception. There is a different awareness of people from East Belitung to other regions. In East Belitung, knowledge of O. spilurus has a link to the local culture. Fishermen have the most relevant fishing gear expertise for the catch of O. spilurus, based on environmental factors and fish behavior. Large-scale fishing, consuming, and trade of it only takes place in East Belitung. It has an impact on the use of non-environmentally sustainable mesh size nets that threaten their natural survival.
Agonistic autoantibodies against ß2-adrenergic receptor influence retinal microcirculation in glaucoma suspects and patients
Authors: Hohberger Bettina , Hosari Sami , Wallukat Gerd , Kunze Rudolf , Krebs Johann , Müller Meike , Hennig Till , Lämmer Robert , Horn Folkert , Muñoz Luis E. , Herrmann Martin , Mardin Christian 
Published: May 2021

Purpose
Agonistic β2-adrenergic receptor autoantibodies (β2-agAAb) have been observed in sera of patients with ocular hypertension and open-angle glaucoma (OAG). They target the β2-receptors on trabecular meshwork, ciliary body and pericytes (Junemann et al. 2018; Hohberger et al. 2019). In addition to their influence on the intraocular pressure, an association to retinal microcirculation is discussed. This study aimed to investigate foveal avascular zone (FAZ) characteristics by en face OCT angiography (OCT-A) in glaucoma suspects and its relationship to β2-agAAb status in patients with OAG.

Material and methods
Thirty-four patients (28 OAG, 6 glaucoma suspects) underwent standardized, clinical examination including sensory testing as white-on-white perimetry (Octopus G1, mean defect, MD) and structural measures as retinal nerve fibre layer (RNFL) thickness, neuroretinal rim width (BMO-MRW), retinal ganglion cell layer (RGCL) thickness, and inner nuclear layer (INL) thickness with high-resolution OCT. FAZ characteristics were measured by OCT-A scans of superficial vascular plexus (SVP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). FAZ-R was calculated (area FAZ (SVP)/area FAZ (ICP)). Using cardiomyocyte bioassays we analysed serum samples for the presence of β2-agAAb.

Results
(I) Total mean FAZ area [mm2]: 0.34±0.16 (SVP), 0.24±0.12 (ICP), and 0.49±0.24 (DCP); mean FAZ-R 1.58±0.94. No correlation was seen for FAZ-R with MD, RNFL, BMO-MRW, RGCL thickness and INL thickness (p>0.05). (II) ß2-agAAb have been observed in 91% patients and showed no correlation with MD, RNFL, BMO-MRW, RGCL thickness and INL thickness (p>0.05). (III) FAZ-R correlated significantly with the β2-agAAb-induced increase of the beat rate of cardiomyocyte (p = 0.028).

Conclusion
FAZ characteristics did not correlate with any glaucoma associated functional and morphometric follow-up parameter in the present cohort. However, level of β2-agAAb showed a significantly correlation with FAZ-ratio. We conclude that β2-agAAb might be a novel biomarker in glaucoma pathogenesis showing association to FAZ-ratio with OCT-A.
Increased risk of Alzheimer’s disease among patients with age-related macular degeneration: A nationwide population-based study
Authors: Wen Li-Yen , Wan Lei , Lai Jung-Nien , Chen Chih Sheng , Chen Jamie Jiin-Yi , Wu Ming-Yen , Hu Kai-Chieh , Chiu Lu-Ting , Tien Peng-Tai , Lin Hui-Ju 
Published: May 2021

Objective
This study aimed to investigate the risk of Alzheimer’s disease among patients with age-related macular degeneration and its association with confounding comorbidities.

Method
This was a population-based, retrospective cohort study. By accessing data from the National Health Insurance Research Database of Taiwan, we identified 10,578 patients aged 50–100 years who were newly diagnosed with age-related macular degeneration between 2000 and 2012 and 10,578 non- age-related macular degeneration individuals. The comorbidities assessed were osteoporosis, diabetes, cirrhosis, cerebrovascular disease, chronic kidney disease, hypertension, hyperlipidemia, coronary artery disease, and chronic obstructive pulmonary disease.

Results
Patients with age-related macular degeneration had a 1.23-fold increased risk of their condition advancing to Alzheimer’s disease (aHR = 1.23, 95% CI = 1.04–1.46). The younger patients were diagnosed with age-related macular degeneration, the more likely patients got Alzheimer’s disease (50–64 age group: aHR = 1.97, 95% CI = 1.04–3.73; 65–79 age group: aHR = 1.27, 95% CI = 1.02–1.58; 80–100 age group: aHR = 1.06, 95% CI = 0.78–1.45). In addition, there were significantly higher risks of Alzheimer’s disease for patients with cirrhosis (aHR = 1.50, 95% CI = 1.09–2.06) in the age-related macular degeneration cohort than in the non-age-related macular degeneration cohort.

Conclusion
Patients with age-related macular degeneration may exhibit a higher risk of Alzheimer’s disease than people without age-related macular degeneration.
Prevalence of dyslipidemia and associated risk factors among adult residents of Shenmu City, China
Authors: Gao Huiping , Wang Haiying , Shan Guangliang , Liu Rui , Chen Haiyuan , Sun Shengli , Liu Yonglin 
Published: May 2021

Objective
Dyslipidemia is a leading risk factor for cardiovascular and cerebrovascular diseases. By collecting the blood lipid profiles among adult residents of Shenmu City in Shaanxi Province, China, we aim to assess and elucidate the prevalence and risk factors of dyslipidemia in this city.

Method
Stratified multistage sampling was used to survey 4,598 permanent adult residents in five areas of Shenmu (2 communities in the county seat, 2 in the southern area and 2 in the northern area) from September 2019 to December 2019. Questionnaire surveys and physical examinations were conducted. Data were analyzed using SPSS software version 26.0.

Results
The average level of total cholesterol (TC) is 4.47mmol/L, that of triglyceride (TG) 1.32mmol/L, high-density lipoprotein cholesterol (HDL-C) 1.27mmol/L, apolipoprotein A1 (ApoA1) 1.44g/L, low-density lipoprotein cholesterol (LDL-C) 2.7mmol/L and apolipoprotein B (ApoB) 0.97g/L. The prevalence of hypercholesterolemia (HTC), hypertriglyceridemia (HTG), low high-density lipoprotein (HDL-C) and high low-density lipoprotein (LDL-C) is 22.4%, 33.3%, 14.5%, and 5.81%, respectively, and the overall prevalence of dyslipidemia is 48.27%. Furthermore, blood lipid levels and prevalence of dyslipidemia vary by region, age, gender, occupation and educational level. Nine risk factors of dyslipidemia were identified, which are living in county seat or northern industrial area, increasing age, male, overweight or obesity, abdominal obesity, smoking, hypertension, abnormal glucose metabolism (pre-diabetes or diabetes) and hyperuricemia.

Conclusion
The blood lipid levels and dyslipidemia prevalence of adults in Shenmu City are higher comparing to national averages of China. Combining risk factors of dyslipidemia, early detection and public health interventions are necessary in high-risk population for associated cardiovascular and cerebrovascular diseases prevention.
Heated tobacco product use and its relationship to quitting combustible cigarettes in Korean adults
Authors: Kim Jinyoung , Lee Sungkyu , Kimm Heejin , Lee Juna-Ah , Lee Cheol-min , Cho Hong-Jun 
Published: May 2021

Objective
We assessed the prevalence of, and factors associated with, heated tobacco product (HTP) use and analysed the association between HTP use and quitting combustible cigarettes (CCs) in Korean adults.

Methods
We conducted an online survey with 7,000 adults (males, 2,300; females, 4,700; ages 20–69) out of 70,000 age-, sex- and provincial-distribution-matched individuals based on 2018 national population statistics. Females were oversampled because the prevalence of tobacco product use is very low among women in Korea. Chi-square tests were used for bivariate analyses, and odds ratios were assessed after adjusting for sociodemographic variables.

Results
The prevalence of current CC, electronic cigarette (EC), and HTP use was 24.8% (males, 40.4%; females, 9.3%), 6.8% (males, 10.1%; females, 3.4%), and 10.2% (males, 16.2%; females, 4.3%), respectively. Among the 574 current HTP users, 77 (13.4%) were HTP-only users and >80% were either dual users of HTP and CC/EC, or triple users of HTP, EC, and CC. Among the current CC users, the odds of having attempted to quit CCs in the past year were greater among EC-only users (aOR 2.92; 95% CI 1.81–4.69) and dual users of HTPs and ECs (aOR 8.42; 95% CI 4.85–14.62) than among non-HTP and non-EC users. Among 2,121 ever CC smokers, the likelihood of being a former CC smoker was 0.19 (95% CI 0.15–0.24) for HTP users, 0.29 (95% CI 0.20–0.42) for EC users, and 0.03 (95% CI 0.01–0.06) for users of both HTPs and ECs compared with non-HTP and non-EC users.

Conclusion
EC-only use and dual use of HTPs and ECs were associated with increased attempts to quit CCs; however, HTP and EC use was associated with lower odds of CC smoking abstinence.
Risk for mental illness and family composition after migration to Sweden
Authors: Mangrio Elisabeth , Sjöström Karin , Grahn Mathias , Zdravkovic Slobodan 
Published: May 2021

Objectives
The aim of the present study is to determine how marital status and certain post-migration family structures are associated with the risk of mental illness among recently arrived Arabic- speaking refugees in Sweden.

Methods
A cross-sectional study was conducted during 2015 and 2016. The study population was recruited by inviting all adult refugees who participated in the mandatory public integration support programme. All refugees that participated had received refugee status. A total of 681 of the invited participants returned the GHQ-12 questionnaires, through which the risk for mental illness was measured and only Arabic- speaking refugees (N = 638) were included in the analyses.

Results
Marital status per se was not associated with a risk for mental illness. However, for the whole study sample there was a statistical significant odds ratio of 1.72 (95% CI 1.03–2.86). For male Arabic-speaking refugees with a spouse or child left behind in the home country there was a borderline significant increased risk for mental illness, odds ratio = 1. 87 (95% CI 0.99–3.56). The risk for female Arabic-speaking refugees was non-significant, odds ratio = 1.35 (95% CI 0.55–3.33).

Conclusions
Arabic- speaking refugees who were separated from family members reported an increased risk for mental illness after arriving in the host country. Actions to facilitate family reunion after arriving as a refugee (in Sweden) seems to be an important factor to promote mental health among refugees.