bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening of thyroid disorders in age and gender groups in a teaching hospital of Nowshera
Authors: Khan Hamzullah , Khan Fawad , Khan Zahid , Ahmed Naseer , Khan Waseemyar 
Published: August 2021

Background: In Pakistan 28.7% of the population had some degree of goiter. Out of those 40% of the nodules behaved hyperthyroidism based on the lower-than-normal values of thyroid stimulating hormones (TSH). Present study was designed as to determine the screening of thyroid disorders on the basis Thyroid Stimulating Hormone (TSH) in age and gender groups in a hospital-based study.
Patients and methods: This cross-sectional study was conducted in Qazi Hussain Ahmed Medical Complex Nowshera from March 2019 to Jan 2020. Total 392 cases, 167 (42.6%) males and 225 (57.4%) females were included. All patients referred to pathology laboratory for measurement of TSH levels irrespective of age and gender were included to measure incidence of hyper, hypo or euthyroid status. Exclusion criteria were patients taking medications or iodine supplementation. Numerical variables like age and TSH values were presented with Mean with SD, Median and range. Inferential statistics and correlation statistics (chi-Square, ANOVA, Mann-Whitney U test and Spearman correlation) were used to determine the difference of TSH values in gender and age groups.
Results: Mean age of the patients was 31+8.1 years. Mean TSH was 5.22+16.5 ng/ml. The difference of TSH values in the age categories using one way ANOVA statistics was insignificant (p = 0.15). Mann Whitney U Test confirmed that the distribution of TSH is the same across the categories of gender (p=0.001). Total 55 (14%) patients were hyperthyroid, and 23 (5.9%) mild hypothyroid and 30 (7.7%) hypothyroid. Chi square test showed the relation of gender with hypo and hyperthyroidism as statistically isignificant ( p= 0.18, p=0.8) respectively. Spearman ranked correlation test showed a mild to moderate inverse correlation of hypothyroidism with increase in age categories (p=0.88, r=-0.47) and a moderate uphill correlation of hyperthyroidism with increase in age categories, again statistically insignificant (p= 0.31, r=0.51).
Conclusion: We observed a skewed distribution of TSH in our population. On the basis of the TSH values the thyroid disorders were categorized in hyper and hypothyroidism. There was a negative correlation of Hypothyroidsim (TSH<0.4) with age. While a positive correlation of age was noted with hyperthyroidism. While no significant relationship of hyper or hypothyroidism was noted in gender groups.
Hemispheric encephalitis secondary to HAV
Authors: Ahmed Aijaz , Ashfaq Muhammad , Nisa Bader -U- , Waseem Hira 
Published: August 2021

A 2-year male child, presented to National Institute of Child Health (NICH), with acute onset high grade fever and focal left sided seizures for 1 day, followed by left hemiparesis and encephalopathy. Developmental and family history was unremarkable. On physical examination, patient’s body temperature rose up to 38.7 °C. Though he had pallor along with hepatomegaly, there were no signs of jaundice or ascites. Central nervous system examination showed encephalopathy as well as positive neck stiffness. Motor system examination revealed generalized decrease in bulk of upper and lower limbs, but rest of the findings were localized to left side of the body, showing hypertonia, decreased power, brisk muscle stretch reflex, and positive ankle clonus and left Babinski sign.
Blood investigations showed anemia (hemoglobin 9.1g/dl), leukocytosis (white blood cells 22.1 cells/μL) and raised aspartate aminotransferase (AST) levels (826 IU/L). Total bilirubin and direct bilirubin levels were normal (0.3 mg/dL and 0.1 mg/dL, respectively). Serum ammonia (64 μg/dL) and lactic acid (1.6 μg/dL) levels were also within normal ranges. The cerebrospinal fluid (CSF) was also clear, with 0 leukocytes/μL, protein levels of 25 mg/dL, and normal glucose levels (82 mg/dL), no organism was seen on gram stain. Hepatitis A Ig M antibody came out to be reactive.
Brain computed tomography showed large hypo density along with effacement of sylvian fissure, sulci, gyri on right side involving frontal, parietal, and temporal and occipital lobe on ipsilateral side. On post contrast, there was remarkable meningeal enhancement on right side. MRI brain revealed cortical and subcortical large area of abnormal signal intensity seen in fronto-parietal and occipital cortex on the right side along with laminar necrosis.
Seizures were controlled by given intravenous injection phenytoin and leviteracetam in bolus and then maintenance doses. Intravenous acyclovir was started
due to clinical suspicion of herpes encephalitis but was stopped after observing clinical improvement and identification of Ig M antibody of HAV. Patient conscious level improved after 2 weeks. AST levels also decreased to 20 IU/L and he was discharged with advice to follow up after 14 days
Assessment of risk factors associated with pre-term labour in Tertiary care Hospitals, Lahore
Authors: Zafar Tanzeela , Manzoor Iram , Farooq Fariha 
Published: August 2021

Background: Pakistan has one of the highest rates of preterm births, nearly 16 for every 100 babies born. Around 4% of these premature babies, are at highest likelihood of death. The objective of this study was to assess association of multiple risk factors with preterm birth in Pakistani women.
Patients and methods: An analytical cross-sectional study was carried out in Obstetrics and Gynecology Department of Akhtar Saeed Trust Hospital and Farooq Hospital, West Wood Branch, Lahore from October 2018 to December 2019. Total 116 pregnant females who gave birth to preterm babies with gestational age between 20-37 weeks were included. Data about patients’ socio-demographic profile, previous obstetric history and current gestational profile was collected using closed ended structured questionnaire. Variables were presented in the form of frequency tables. Chi-square and Fisher exact test were applied to establish association of various risk factors and preterm presentation of patients’ in hospital. A p-value ≤ 0.05 was taken as significant.
Results: Out of 116 participants, 49 (42.2%) were aged between 20-25 years, 47 (40.5%) were illiterate. Of the total sample 60 (51.7 %) participants were obese (BMI >30). Eighty-two (70.7%) patients were multigravida and 65 (56.1%) gave the history of previous cesarean section. Significant association was found between preterm birth and multi-parity (p=0.001), previous history of abortion (p=0.000), intrauterine death (p=0.001), infertility (p=0.04), cesarean-section (p=0.000), and inter-pregnancy interval of less than 24 months (p=0.007). Other significant factors associated with preterm labour were urinary tract infections (p=0.001), documented fever more than 101oF (p=0.000), anemia (p=0.000), singleton pregnancy (p=0.000) and cephalic fetal presentation (p=0.002), during current pregnancy.
Conclusion: Multi-gravidity, history of abortion, intrauterine death, previous infertility, cesarean-section, inter-pregnancy interval of less than 24 months, UTI, genital tract infection, anemia, singleton pregnancy and cephalic fetal presentation during current pregnancy were observed to be significantly associated with preterm births.
Idiopathic CD4+ Lymphocytopenia in Overlap Syndrome (Systemic Sclerosis with Dermatopolimyositis)
Authors: Sumartini Dewi  , Yusuf Tasya Aniza , Fahrizal Yanuar  
Published: August 2021

Background : Idiopathic CD4 T cell lymphocytopenia (ICL) is a rare syndrome with varied clinical manifestation, characterized with lymphopenia and decreased in CD4 level without HIV infection or other possible cause of immunodeficiency state. Autoimmune diseases might be a clinical manifestation of ICL. However, it is not known whether ICL triggered an autoimmune diseases, or it is a complication of said diseases.
Objective : Awareness of ICL in patient with known autoimmune diseases whom admitted to the hospital for severe infection.
Methods : This case report showed a 24-years old woman with prolonged fever since 4 moths ago. It was accompanied with oral ulcers, skin rash in face and trunks, and weakness of lower extremities. She was diagnosed with systemic sclerosis since 2016 and routinely came to rheumatology outpatient clinic in Hasan Sadikin Hospital but stopped coming for past 4 months since pandemic. Her current medication was only 4 mg of methylprednisolone.
Results : She had high temperature (38.5 degree Celsius) and tachycardia. Physical examination revealed a single lymphadenopathy at neck. Raynaud phenomenon, calcinosis, and sclerodactyly was found in lower extremities. Dermatomyositis was diagnosed based by heliotropic skin rash. Laboratory tests showed leukopenia, absolute lymphocyte count 135.2 cell/mm3, absolute CD4 39/uL, CK level of 3296 and nonreactive anti-HIV. The patient underwent empirical antibiotic treatment, but unfortunately passed away.
Conclusion : ICL is a rare case, following an infection, autoimmune diseases, or unspecified malignancy. Clinician’s awareness toward ICL could prevent fatal opportunistic infection which often happens to patients with immunodeficiency state.
The Chemical Inventory of the Planet-hosting Disk PDS 70
Authors: Facchini Stefano , Teague Richard , Bae Jaehan , Benisty Myriam , Keppler Miriam , Isella Andrea 
Published: August 2021

Abstract
As host to two accreting planets, PDS 70 provides a unique opportunity to probe the chemical complexity of atmosphere-forming material. We present ALMA Band 6 observations of the PDS 70 disk and report the first chemical inventory of the system. With a spatial resolution of 0.″4–0.″5 (∼50 au), 12 species are detected, including CO isotopologs and formaldehyde, small hydrocarbons, HCN and HCO+ isotopologs, and S-bearing molecules. SO and CH3OH are not detected. All lines show a large cavity at the center of the disk, indicative of the deep gap carved by the massive planets. The radial profiles of the line emission are compared to the (sub)millimeter continuum and infrared scattered light intensity profiles. Different molecular transitions peak at different radii, revealing the complex interplay between density, temperature, and chemistry in setting molecular abundances. Column densities and optical depth profiles are derived for all detected molecules, and upper limits obtained for the nondetections. Excitation temperature is obtained for H2CO. Deuteration and nitrogen fractionation profiles from the hydrocyanide lines show radially increasing fractionation levels. Comparison of the disk chemical inventory to grids of chemical models from the literature strongly suggests a disk molecular layer hosting a carbon-to-oxygen ratio C/O > 1, thus providing for the first time compelling evidence of planets actively accreting high C/O ratio gas at present time.
Seeking Echoes of Circumstellar Disks in Kepler Light Curves
Authors: Bromley Benjamin C. , Leonard Austin , Quintanilla Amanda , King Austin J. , Mann Chris , Kenyon Scott J. 
Published: August 2021

Abstract
Light echoes of flares on active stars offer the opportunity for direct detection of circumstellar dust. We revisit the problem of identifying faint echoes in postflare light curves, focusing on debris disks from ongoing planet formation. Starting with simulations, we develop an algorithm for estimating the radial extent and total mass from disk echo profiles. We apply this algorithm to light curves from over 2100 stars observed by NASA’s Kepler mission, selected for multiple short-lived flares in either the long-cadence or short-cadence data sets. While flux uncertainties in light curves from individual stars preclude useful mass limits on circumstellar disks, catalog-averaged light curves yield constraints on disk mass that are comparable to estimates from known debris disks. The average mass in micron- to millimeter-sized dust around the Kepler stars cannot exceed 10% of an Earth mass in exo-Kuiper belts or 10% of a lunar mass in the terrestrial zone. We group stars according to IR excess, based on WISE W1–W3 color, as an indicator for the presence of circumstellar dust. The mass limits are greater for stars with strong IR excess, a hint that echoes are lurking not far beneath the noise in postflare light curves. With increased sensitivity, echo detection will let time-domain astronomy complement spectroscopic and direct-imaging studies in mapping how, when, and where planets form.
Signatures of Recent Cosmic-Ray Acceleration in the High-latitude Gamma-Ray Sky
Authors: Jóhannesson Guđlaugur , Porter Troy A. 
Published: August 2021

Abstract
Cosmic-ray (CR) sources temporarily enhance the relativistic particle density in their vicinity over the background distribution accumulated from the Galaxy-wide past injection activity and propagation. If individual sources are close enough to the solar system, their localized enhancements may present as features in the measured spectra of the CRs and in the associated secondary electromagnetic emissions. Large-scale loop-like structures visible in the radio sky are possible signatures of such nearby CR sources. If so, these loops may also have counterparts in the high-latitude γ-ray sky. Using ∼10 yr of data from the Fermi Large Area Telescope, applying Bayesian analysis including Gaussian Processes, we search for extended enhanced emission associated with putative nearby CR sources in the energy range from 1 GeV to 1 TeV for the sky region ∣b∣ > 30°. We carefully control the systematic uncertainty due to imperfect knowledge of the interstellar gas distribution. Radio Loop IV is identified for the first time as a γ-ray emitter, and we also find significant emission from Loop I. Strong evidence is found for asymmetric features about the Galactic l = 0° meridian that may be associated with parts of the so-called “Fermi Bubbles,” and some evidence is also found for γ-ray emission from other radio loops. Implications for the CRs producing the features and possible locations of the sources of the emissions are discussed.
White Dwarf Subsystems in Core-Collapsed Globular Clusters
Authors: Kremer Kyle , Rui Nicholas Z. , Weatherford Newlin C. , Chatterjee Sourav , Fragione Giacomo , Rasio Frederic A. , Rodriguez Carl L. , Ye Claire S. 
Published: August 2021

Abstract
Numerical and observational evidence suggests that massive white dwarfs dominate the innermost regions of core-collapsed globular clusters by both number and total mass. Using NGC 6397 as a test case, we constrain the features of white dwarf populations in core-collapsed clusters, both at present day and throughout their lifetimes. The dynamics of these white dwarf subsystems have a number of astrophysical implications. We demonstrate that the collapse of globular cluster cores is ultimately halted by the dynamical burning of white dwarf binaries. We predict that core-collapsed clusters in the local universe yield a white dwarf merger rate of



(
10
)

Gpc

−
3

yr

−
1

, roughly 0.1%–1% of the observed Type Ia supernova rate. We show that prior to merger, inspiraling white dwarf binaries will be observable as gravitational-wave sources at millihertz and decihertz frequencies. Over 90% of these mergers have a total mass greater than the Chandrasekhar limit. We argue that the merger/collision remnants, if not destroyed completely in an explosive transient, may be observed in core-collapsed clusters either as young neutron stars/pulsars/magnetars (in the event of accretion-induced collapse) or as young massive white dwarfs offset from the standard white dwarf cooling sequence. Finally, we show that collisions between white dwarfs and main-sequence stars, which may be detectable as bright transients, occur at a rate of



(
100
)

Gpc

−
3

yr

−
1

in the local universe. We find that these collisions lead to depletion of blue straggler stars and main-sequence star binaries in the centers of core-collapsed clusters.
Characterizing the Discovery of a New Trans-Neptunian Object Binary in a Trailed Point-spread Function Search
Authors: Pike Rosemary E. , Kanwar Jayatee , Alexandersen Mike , Chen 陳 Ying-Tung 英同 , Schwamb Megan E. 
Published: August 2021

Abstract
The Latitude Density Search utilized the Hyper Suprime-Cam on the Subaru Telescope to discover 60 moving objects in the outer solar system, 54 of which have semimajor axes beyond 30 au. The images were acquired in exceptional seeing (0.″4) and reached a detection limit of m

r
≃ 25.2. The two night arcs were used to calculate orbits that are poorly constrained; however, the distance and inclination are the parameters best constrained by short arcs, and a reasonable determination can be made of which objects are cold classical trans-Neptunian objects (TNOs) and which are dynamically excited. We identify 10 objects as likely cold classical objects. We searched all of the detections for binary sources using a trailed point-spread function (PSF) subtraction method and identified one binary object with a separation of 0.″34 and a secondary with 17% the brightness of the primary (2.0 magnitudes fainter). This is the brightest TNO in the sample, the previously known object (471165) 2010 HE79, which has a dynamically excited orbit. Because of the excellent seeing, this search was sensitive to secondaries with 0.″34 separation and a brightness of ≥50% the primary brightness for seven objects, including one cold classical. This gives an intrinsic binary fraction of

17

−
10

+
19

% (one of six) for the dynamically excited objects within our detection limits. The trailed PSF subtraction method used in the Latitude Density Search to identify binaries, fit the two components, and determine the sensitivity limits is a useful tool that could be more broadly applied to identify binary TNOs and track known binary TNO orbits.
Understanding Teach-Back and Teach-To-Goal Strategies Embedded in Support Calls for a Health Literacy-Sensitive Childhood Obesity Treatment Trial
Authors: Yuhas Maryam , Zoellner Jamie , Hou Xiaolu , Alexander Ramine , Hill Jennie , You Wen , Estabrooks Paul 
Published: August 2021

Background:
Low caregiver health literacy (HL) is related to increased obesity risk for their children. Teach-Back and Teach-to-Goal (TB/TTG) are strategies that may improve comprehension of key concepts for people who have low HL but have yet to be examined in the context of childhood obesity treatment.

Objective:
This study evaluated TB/TTG strategies integrated within support calls delivered to caregivers as part of a 3-month childhood obesity intervention.

Methods:
Ninety-four caregivers (60% Black, 42% high school education or less, 53% with income ≤$29,999, and 34% low HL) with overweight/obese children age 8 to 12 years enrolled in a childhood obesity intervention. Caregiver HL was assessed at baseline using the Newest Vital Sign and caregivers were dichotomized to low and adequate HL groups for analyses. Caregivers received 6 bi-weekly support calls that alternated with in-person, family sessions. Call completion rates, comprehension of key content (correct responses on TB/TTG questions), and satisfaction with support calls were evaluated. Qualitative information on call satisfaction was gathered at the 3-month time point.

Key Results:

Average completion rate across all calls was 62% with a mean call time of 26 minutes (no significant difference between HL groups). Caregivers had an average score of 0.90 out of 1 when evaluating overall call comprehension by scoring TB/TTG performance. Content comprehension in calls 1, 3, and 4 was significantly higher among caregivers with adequate HL relative to low HL (
p
< .1). Caregivers from both HL groups felt satisfied with calls [9.1 (2.0)/10-point scale] and agreed that calls helped them learn class material better [8.1 (2.7)]. Qualitatively, caregivers provided 81 (75%) positive responses (e.g., good content) and 27 (25%) negative responses (e.g., too lengthy) regarding the support calls.

Conclusions:

Support calls using TB/TTG strategies were feasible, well received, and should be considered for incorporation into childhood obesity interventions.

[
HLRP: Health Literacy Research and Practice
. 2021;5(3):e208–e217.]

Plain Language Summary:
This study evaluated support calls that used Teach-Back and Teach-to-Goal health literacy strategies as part of a childhood obesity treatment trial. Support calls were well accepted and facilitated comprehension of the key learning objectives in caregivers, regardless of health literacy level. These strategies should be considered for incorporation into childhood obesity treatment interventions to increase uptake of main concepts.
Chronic illnesses and polypharmacy in elderly patients: A hospital-based study in Northern Sri Lanka
Authors: Thiyahiny S. N. , Kumanan T. , Surenthirakumaran R. 
Published: August 2021

Population aging and multiple pathology among older people have increased medicines use in elderly. Aim of this study was to evaluate chronic illnesses and polypharmacy and to determine factors associated with polypharmacy among hospitalized elderly at Teaching Hospital-Jaffna. This was a cross sectional, descriptive study. Elderly and polypharmacy were defined as ≥65years and concomitant use of ≥6 medications for ≥1 month respectively. Data were collected from bedhead-tickets of 288 elderly patients using data extraction sheet. Chi-squared and paired t-test were performed to determine the level of significance and unadjusted odd ratios were calculated to determine the association between polypharmacy and common chronic illnesses. A p value <0.05 was set as statistically significance. Mean age was 72 (SD±6.2) and majority were males (53.5%). Relatively higher proportion, 58.7% (n=169) of patients had polypharmacy. Seven chronic illnesses were prevalent in >10% of the patients. Lipid-modifying (80.9%) and antithombotic agents (76.4%) were the top two subgroups prescribed to elderly. Polypharmacy was substantially increased with increasing number of chronic illnesses (p<0.05). Significant association (p<0.05) was found between polypharmacy and coronary heart disease, anaemia, heart failure, asthma and diabetes mellitus. Significantly greater number of medications were prescribed on discharge compared to admission (p<0.05). This study concluded that polypharmacy was common among hospitalized elderly and increases with hospitalization. There was increased tendency to prescribe antithrombotic and lipid-modifying agents. These findings indicate the need for medication reconciliation and review in elderly patient. Further studies targeting wider population are needed to determine the appropriateness of polypharmacy in elderly.