bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diurnal Changes in Retinula Cell Sensitivities and Receptive Fields (Two-Dimensional Angular Sensitivity Functions) in the Apposition Eyes of Ligia Exotica (Crustacea, Isopoda)
Authors: Hariyama Takahiko , Meyer-Rochow V. Benno , Kawauchi Tsutomu , Takaku Yasuharu , Tsukahara Yasuo 
Published: April 2021

ABSTRACT
The structural organization of the retinula cells in the eye of Ligia exotica changes diurnally. At night, the microvilli elongate, losing the regular and parallel alignment characteristic of the day condition. Crystalline cones and distal rhabdom tips are not pushed into each other during the day, but at night the rhabdoms protrude into the crystalline cones by up to 5 μm. Screening pigment granules in the retinula cells disperse during the night, but migrate radially towards the vicinity of the rhabdom during the day. No such displacements of the pigment granules of either distal or proximal screening pigment cells were observed.
The sensitivity of the eye, monitored by electroretinogram (ERG) recordings, changes diurnally: values at midnight are, on average, 10 times those occurring during the day. However, intracellular recordings from single retinula cells (50 duing the day and 50 at night) indicate that the difference between night and day sensitivities is only 2.5-fold.
Two-dimensional angular sensitivity curves, indicative of a single unit’s spatial sensitivity, had considerably less regular outlines at night than during the day. If based on the 50 % sensitivity level, day and night eyes possessed receptive fields of almost identical width (approximately 2 °), but if sensitivities below the 50 % limit were included, then receptive fields at night were significantly more extensive.
We suggest that the morphological adaptations and diurnal changes in chromophore content seen in the apposition eye of L. exotica allow this animal to improve its photon capture at night while preserving at least some of the spatial resolving power characteristic of the light-adapted state. This would explain why this animal is capable of performing complex escape behaviours in the presence of predators both in bright and in very dim light.
Continued use of Warfarin in lower dose has safe maternal and neonatal outcomes in pregnant women with Prosthetic Heart Valves
Authors: Nadeem Shafaq , Khilji Shahbaz Ahmad , Ali Faisal , Jalal Anjum 
Published: April 2021

Background and Objective: There has been concerns regarding the safety of Warfarin in pregnant females due to its teratogenic potential. At the same time warfarin provides best anticoagulation in patients with prosthetic valves. Various dosage regimes have been tried to strike a balance between safety of mother and the avoidance of congenital anomalies in the newborn. This study was conducted to observe the effect of Warfarin in pregnant mothers taking different doses of warfarin, and their neonatal outcome, in our outdoor patients.
Methods: This is a cross sectional observational study conducted at the Faisalabad Institute of Cardiology. The pregnant mothers taking warfarin for prosthetic valve replacement who presented to our specialized clinic between November 2016 to April 2017 were included in the study. These included a total of 75 females between the age of 20-35 years. To compare the dose related effect of warfarin, two groups of the patients were formed. One group comprised of patients taking warfarin ≤5mg while the other group consisted of those who were taking >5mg of warfarin daily. These patients were followed till their delivery. The information was collected about the maternal and fetal outcomes. The maternal outcomes including mode of delivery/miscarriage, peripartum bleeding and any valve related thromboembolic complications. The fetal outcomes included birth weight, maturity, embryopathy and congenital anomaly in the baby.
Results: Patient’s mean age was 29.25±3.75 years. The mitral valve replacement was present in 60% patients (n=45) while 25.3% patients (n=19) had aortic valve replacement and 14.7% patients (n=11) had double valve replacement. In this group 30 patients (40%) had taken <5 mg warfarin and 45 patients (60%) had received >5 mg warfarin medicine. Miscarriages, cesarean sections, low birth weight and prematurity were more common in patients receiving warfarin >5 mg with p-values 0.005, 0.046, 0.01 and 0.033 respectively. No case of fetal embryopathy was found in both groups.
Conclusion: No case of embryopathy was found in each group which signifies that warfarin in lower doses is safe anticoagulant in patients with prosthetic valve replacements.
doi: https://doi.org/10.12669/pjms.37.4.3924
How to cite this:Nadeem S, Khilji SA, Ali F, Jalal A. Continued use of Warfarin in lower dose has safe maternal and neonatal outcomes in pregnant women with Prosthetic Heart Valves. Pak J Med Sci. 2021;37(4):933-938. doi: https://doi.org/10.12669/pjms.37.4.3924
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.
Scoping Review of frequently highlighted attributes of Medical Professionalism in an Undergraduate Medical Education Context
Authors: Sattar Kamran , Yusoff Muhamad Saiful Bahri , Arifin Wan Nor , Yasin Mohd Azhar Mohd , Mat Nor Mohd Zarawi 
Published: April 2021

Background and Objectives: Medical Professionalism (MP) establishes the trust between society and doctors. We aimed at finding frequently highlighted qualities of MP in the literature.
Methods: We searched PubMed and Scopus for attributes of MP, using terms, “Professionalism,” “Medical Students,” and “Undergraduate Medical Education”. We included English language, original research articles with MP attributes from the perspective of undergraduate medical education, any nationality, race, gender, and age range, as the central topic of the article. Papers published from January 1st 1986 to 29th February 2020 were included.
Results: From 1349 identified articles, finally, 18 were included, authored in 10 countries, collectively contributing to answering the scoping review question. Two themes were identified: (1) Nurturing of MP, 11 (61.11%) out of 18 included articles, highlighted “respect” as the most dominant attribute as it appeared in 6 (54.55%) out of 11 reviews, “communication” 5 (45.45 %) studies and “honesty” and “integrity” 4 (36.36%). (2) Assessment of MP, 7 (38.89%) studies, and majority, 4 (57.14 %) assessed MP using American Board of Internal Medicine’s elements of MP, viz, “altruism, accountability, excellence, duty, honor and integrity, respect for others.”
Conclusions: Themes exemplified MP’s most discoursed issues. The attributes are frequently used worldwide. MP deliberates as a commitment toward the individual patient, society, and necessitates transforming from its present generic form to more explicit details.
doi: https://doi.org/10.12669/pjms.37.4.4004
How to cite this:Sattar K, Yusoff MSB, Arifin WN, Yasin MAM, Nor MZM. Scoping Review of frequently highlighted attributes of Medical Professionalism in an Undergraduate Medical Education Context. Pak J Med Sci. 2021;37(4):1221-1229. doi: https://doi.org/10.12669/pjms.37.4.4004
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.
Observation on the Clinical Effect of Apatinib Combined with Chemotherapy in the Treatment of Advanced Non-Small Cell Lung Cancer
Authors: Cui Yu-jie , Liu Jia , Liu Miao-miao , Zhang Hong-zhen 
Published: April 2021

Objectives: To evaluate the clinical effect of apatinib combined with chemotherapy in the treatment of advanced non-small cell lung cancer (NSCLC).
Methods: Eighty patients with advanced NSCLC treated in Hebei General Hospital from January 2017 to July 2020 were randomly divided into two groups: the experimental group and the control group, each with 40 cases. Patients in the control group were treated with conventional paclitaxel combined with cisplatin chemotherapy, while patients in the experimental group were treated with apatinib mesylate tablets based on the treatment of the control group. After treatment, tumor efficacy evaluation was conducted on all patients every two cycles, and the therapeutic effect, adverse drug reactions, improvement of quality-of-life scores prior to and after treatment, and changes of indicators such as tumor markers carcinoembryonic antigen (CEA) and carbohydrate antigen 153(CA153) were compared and analyzed between the two groups.
Results: The total effective rate of the experimental group was 67.5%, which was significantly better than the 45% of the control group (p=0.04); The incidence of adverse drug reactions in the experimental group was 25%, while that in the control group was 37.5%, with no significant difference (p=0.23); Moreover, the improvement rate of quality of life scores in the experimental group was significantly higher than that in the control group (p=0.03), and the levels of CEA and CA153 in the experimental group were significantly lower after treatment than those in the control group, with a statistically significant difference (p=0.01).
Conclusion: Apatinib combined with conventional chemotherapy is effective in the treatment of advanced non-small cell lung cancer, the quality of life can be significantly improved, tumor markers can be significantly reduced, and adverse reactions will not be significantly increased.
doi: https://doi.org/10.12669/pjms.37.4.4066
How to cite this:Cui Y, Liu J, Liu M, Zhang H. Observation on the Clinical Effect of Apatinib Combined with Chemotherapy in the Treatment of Advanced Non-Small Cell Lung Cancer. Pak J Med Sci. 2021;37(4):1036-1041. doi: https://doi.org/10.12669/pjms.37.4.4066
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.
Prevalence and associated risk factors among patients with overactive bladder syndrome in Pakistan
Authors: Rashid Sajid , Babur Muhammad Naveed , Khan Rehan Ramzan , Khalid Muhammad Usman , Mansha Haroon , Riaz Saima 
Published: April 2021

Objectives: To determine the Prevalence and associated risk factors among patients with overactive bladder syndrome in Pakistan.
Methods: This was a community-based, face to face, cross sectional survey to calculate the prevalence and its associated risk factors. A sample of 1058 patients, women and men aged between 35 to 60 years having symptoms of overactive bladder was selected through convenience sampling from different cities of Pakistan during September to December 2020. Data was collected by using an Overactive Bladder Scoring System (OABSS) tool for prevalence and a developed questionnaire to rule out the risk factors.
Results: The prevalence was 27.4% (n=289) and it increased with age. The average ages for women and men were 44.60±7.88 and 46.14±7.69 years respectively. The OAB prevalence was the lowest among the participants aged 35-43 years 15.2% (n=55) while it was highest among those who were aged 53-60 years 49.6%, (n=127). The age, body mass index, diabetes mellitus, income, family history, parity and urinary tract infection were found to be significant associated risk factors for overactive bladder with p value <0.05.
Conclusion: The overall prevalence of overactive bladder was 27.4% and it does not differ by gender, hypertension, pelvic surgery, smoking, constipation and sleep while it has significant association with age, body mass index, diabetes mellitus, income, parity and urinary tract infections.
doi: https://doi.org/10.12669/pjms.37.4.4262
How to cite this:Rashid S, Babur MN, Khan RR, Khalid MU, Mansha H, Riaz S. Prevalence and associated risk factors among patients with overactive bladder syndrome in Pakistan. Pak J Med Sci. 2021;37(4):1185-1189. doi: https://doi.org/10.12669/pjms.37.4.4262
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.
Glycemic index and Glycemic load values
Authors: Ahmed Jameel , Riaz Musarrat , Imtiaz Rabia 
Published: April 2021

doi: https://doi.org/10.12669/pjms.37.4.4555
How to cite this:Ahmed J, Riaz M, Imtiaz R. Glycemic index and Glycemic load values. Pak J Med Sci. 2021;37(4):1246-1247.doi: https://doi.org/10.12669/pjms.37.4.4555
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.
Development of a semi-empirical calibration method by using a LaBr3(Ce) scintillation detector for NORM samples analyses
Authors: Ntalla E. , Markopoulos A. , Karfopoulos K. , Potiriadis C. , Clouvas A. , Savidou A. 
Published: April 2021

In this study, a semi-empirical calibration method for NORM samples measurement by using a LaBr3(Ce) scintillator was developed based on a combination of experimental gamma spectrometry measurements and MCNP-X simulations. The aim of this work is to provide us with full energy peak efficiency calibration curves in a wide photon energy range which is of particular importance when selected photon energies of 234Th, 214Pb, 214Bi, 228Ac, 208Tl and 226Ra are to be measured with accuracy.
Radiological Characterization of Contaminated Pipes of Different Dimensions and Densities
Authors: Mavrikis D. , Markopoulos A. , Ioannidou A. , Savidou A. 
Published: April 2021

The present work concerns a preliminary study for development of a technique for radiological characterization and segregation of raw historical radioactive waste in different management routes. The efficiency of a 3x3 NaI (Tl) detector for a contaminated cylindrical pipe - detector configuration was evaluated by Monte Carlo simulations performed by using the MCNP code. The efficiency for detector source configuration as well as the measurement bias due to possible inhomogeneity in the distribution of the activity were examined for cylindrical pipes of different densities and dimensions. Cylinders of three different densities made by Pb, Fe, Al were examined. All studied cylinders keep the same ratio between length, diameter and thickness, although the absolute values are different, in order to study the difference in efficiencies of similar geometric objects
Revisiting early-stage COVID-19 strategy options
Authors: Machanick Philip 
Published: April 2021

Background: Early-stage interventions in a potential pandemic are important to understand as they can make the difference between runaway exponential growth that is hard to turn back and stopping the spread before it gets that far. COVID19 is an interesting case study because there have been very different outcomes in different localities. These variations are best studied after the fact if precision is the goal; while a pandemic is still unfolding less precise analysis is of value in attempting to guide localities to learn lessons of those that preceded them. Methods: I examine two factors that could differentiate strategy: asymptomatic spread and the risks of basing strategy on untested claims, such as potential protective value of the Bacillus Calmette-Guerin (BCG) tuberculosis vaccine. Results: Differences in disease progression as well as the possibility of alternative strategies to prevent COVID-19 from entering the runaway phase or damping it down later can be elucidated by a study of asymptomatic infection. An early study to demonstrate not only what fraction are asymptomatic but how contagious they are would have informed policy on nonpharmaceutical interventions but could still be of value to understand containment during vaccine roll out. Conclusions: When a COVID-19 outbreak is at a level that makes accurate trace-and test possible, investigation of asymptomatic transmission is viable and should be attempted to enhance understanding of spread and variability in the disease as well as policy options for slowing the spread. Understanding mild cases could shed light on the disease in the longer term, including whether vaccines prevent contagiousness.
Atypical odontalgia and trigeminal neuralgia: psychological, behavioural and psychopharmacologic approach – an overview of the pathologies related to the challenging differential diagnosis in orofacial pain
Authors: Tizzoni Riccardo , Tizzoni Marta , Clerici Carlo Alfredo 
Published: April 2021

Orofacial pain represents a challenge for dentists, especially if with a non-odontogenic basis. Orofacial neuropathic pain is chronic, arduous to localize and develops without obvious pathology. Comorbid psychiatric disorders, such as anxiety and depression, coexist and negatively affect the condition. This article presents one case of atypical odontalgia and one of trigeminal neuralgia treated with psychological and psychopharmacologic tailored and adapted therapies, after conventional medications had failed. In addition, an overview of the pathologies related to the challenging differential diagnosis in orofacial pain is given, since current data are insufficient. A 68-year-old male complained of chronic throbbing, burning pain in a maxillary tooth, worsening upon digital pressure. Symptoms did not abate after conventional amitriptyline therapy; psychological intervention and antianxiety drug were supplemented and antidepressant agent dosage incremented; the patient revealed improvement and satisfaction with the multidisciplinary approach to his pathology. A 72-year-old male lamented chronic stabbing, intermittent, sharp, shooting and electric shock-like pain in an upper tooth, radiating and following the distribution of the trigeminal nerve. Pain did not recur after psychological intervention and a prescription of antidepressant and antianxiety agents, while conventional carbamazepine therapy had not been sufficient to control pain. Due to concern with comorbid psychiatric disorders, we adopted a patient-centered, tailored and balanced therapy, favourably changing the clinical outcome. Comorbid psychiatric disorders have a negative impact on orofacial pain and dentists should consider adopting tailored therapies, such as psychological counselling and behavioural and psychopharmacologic strategies, besides conventional treatments. They also need to be familiar with the signs and symptoms of orofacial pain, recollecting a comprehensive view of the pathologies concerning the differential diagnosis. A prompt diagnosis prevents pain chronicity, avoiding an increase in complexity and a shift to orofacial neuropathic pain and legal claims.
Cost-effectiveness of patient navigation for lung cancer – a systematic review
Authors: Kass Benjamin , Dornquast Christina , Rieckmann Nina , Goerling Ute , Holmberg Christine , Reinhold Thomas 
Published: April 2021

Background: Patient navigation (PN) programs have been shown to increase patient satisfaction and quality of life among patients with lung cancer and to decrease time to treatment. However, the general cost-effectiveness of such programs in the context of lung cancer remains unknown. Hence, the aim of the present systematic review was to analyze the scientific literature and quantitatively assess the level of evidence on the cost-effectiveness of PN programs for patients diagnosed with lung cancer. Methods: A systematic literature search was carried out in PubMed, EMBASE, CENTRAL, CINAHL and PsycINFO databases without time limitations. Randomized controlled trials written in English or German were eligible for inclusion if any results regarding the cost-effectiveness of personally delivered PN programs for patients after lung cancer diagnosis were reported. A manual search was carried out to supplement the systematic search. Additionally, the authors of ongoing or unpublished relevant research were contacted. The titles, abstracts and full texts of relevant citations were screened independently by two reviewers. Results: The initial search yielded 814 articles, including four papers identified manually. Twenty-one articles were included in the full text screening. However, no study met the inclusion criteria. Contacting the authors of ongoing or unpublished research and cross-cancer studies did not yield any studies that met the inclusion criteria. Conclusion: Since no study met the inclusion criteria, this study reveals a research gap in this area. Furthermore, no conclusive statement regarding the cost-effectiveness of patient navigation programs for patients diagnosed with lung cancer can be made. Since the implementation of new healthcare models such as PN at least partially depends on their cost-effectiveness, future attempts to evaluate PN programs for lung cancer patients should consider examining outcomes related to cost-effectiveness to overcome the identified research gap.
Signalling and putative therapeutic molecules on the regulation of synoviocyte signalling in rheumatoid arthritis
Authors: Ji Minjeong , Ryu Hee Jung , Hong Jeong Hee 
Published: April 2021

Rheumatoid arthritis (RA) is an autoimmune disease characterized by symmetrical and chronic polyarthritis. Fibroblast-like synoviocytes are mainly involved in joint inflammation and cartilage and bone destruction by inflammatory cytokines and matrix-degrading enzymes in RA. Approaches that induce various cellular growth alterations of synoviocytes are considered as potential strategies for treating RA. However, since synoviocytes play a critical role in RA, the mechanism and hyperplastic modulation of synoviocytes and their motility need to be addressed. In this review, we focus on the alteration of synoviocyte signalling and cell fate provided by signalling proteins, various antioxidant molecules, enzymes, compounds, clinical candidates, to understand the pathology of the synoviocytes, and finally to achieve developed therapeutic strategies of RA.Cite this article: Bone Joint Res 2021;10(4):285–297.