bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antimicrobial stewardship: Assessment of knowledge, awareness of antimicrobial resistance and appropriate antibiotic use among healthcare students in a Nigerian University
Authors: Akande-Sholabi Wuraola , Ajamu Amen T. 
Published: September 2021

Abstract
Background
Inappropriate use of antibiotics is a major cause of antimicrobial resistance (AMR). Inadequate knowledge about AMR among healthcare students could affect their practice of antimicrobial stewardship as future healthcare professionals. This study aims to assess the use of antibiotics and knowledge of AMR among future healthcare professionals of a Nigerian University.

Methods
Respondents’ knowledge of antimicrobial resistance, use of antibiotics, and source of antibiotics in the past 12 months was explored using a self-administered questionnaire. Multivariate analyses were used to evaluate the relationship between specific variables and respondents’ knowledge.

Results
Of the 939 questionnaires administered to the students, 866 were filled given a response rate of 92.2 %. A total of (765; 88.3 %) of the respondents were aware that antimicrobial resistance makes it harder to eliminate the infection from the body as existing drugs become less effective. In all 824, (95.2 %) of the respondents had use antibiotics in the past 12 months. The use of antibiotics to treat malaria was self-reported by (175; 21.2 %). About half (432; 52.4 %) purchased the antibiotics from community pharmacies, while others obtained their antibiotics from the hospitals (192; 23.3 %), patent medicine stores (150; 18.2 %), and friends and family (50; 6.1 %) in the last 12 months. In all 506, (58.4 %) had good knowledge of antimicrobial resistance. Logistic regression shows that students in 3rd to 6th year 9.29 [AOR = 9.29, 95 % CI: (3.7–22.96)], had greater knowledge of antimicrobial resistance.

Conclusions
The healthcare students demonstrated a moderate knowledge of AMR. This underscores the need to adopt several educational tactics to introduce the concepts of AMR to the students and ensure there are strict policies to regulate the flow of antibiotics.
Comparison of the impact of allelic polymorphisms in PfAMA1 on the induction of T Cell responses in high and low malaria endemic communities in Ghana
Authors: Ofori Ebenezer A. , Tetteh John K. A. , Frimpong Augustina , Ganeshan Harini , Belmonte Maria , Peters Bjoern , Villasante Eileen , Sedegah Martha , Ofori Michael F. , Kusi Kwadwo A. 
Published: September 2021

Abstract
Background
Malaria eradication requires a combined effort involving all available control tools, and these efforts would be complemented by an effective vaccine. The antigen targets of immune responses may show polymorphisms that can undermine their recognition by immune effectors and hence render vaccines based on antigens from a single parasite variant ineffective against other variants. This study compared the influence of allelic polymorphisms in Plasmodium falciparum apical membrane antigen 1 (PfAMA1) peptide sequences from three strains of P. falciparum (3D7, 7G8 and FVO) on their function as immunodominant targets of T cell responses in high and low malaria transmission communities in Ghana.

Methods
Peripheral blood mononuclear cells (PBMCs) from 10 subjects from a high transmission area (Obom) and 10 subjects from a low transmission area (Legon) were tested against 15 predicted CD8 + T cell minimal epitopes within the PfAMA1 antigen of multiple parasite strains using IFN-γ ELISpot assay. The peptides were also tested in similar assays against CD8 + enriched PBMC fractions from the same subjects in an effort to characterize the responding T cell subsets.

Results
In assays using unfractionated PBMCs, two subjects from the high transmission area, Obom, responded positively to four (26.7%) of the 15 tested peptides. None of the Legon subject PBMCs yielded positive peptide responses using unfractionated PBMCs. In assays with CD8 + enriched PBMCs, three subjects from Obom made positive recall responses to six (40%) of the 15 tested peptides, while only one subject from Legon made a positive recall response to a single peptide. Overall, 5 of the 20 study subjects who had positive peptide-specific IFN-γ recall responses were from the high transmission area, Obom. Furthermore, while subjects from Obom responded to peptides in PfAMA1 from multiple parasite strains, one subject from Legon responded to a peptide from 3D7 strain only.

Conclusions
The current data demonstrate the possibility of a real effect of PfAMA1 polymorphisms on the induction of T cell responses in malaria exposed subjects, and this effect may be more pronounced in communities with higher parasite exposure.
Hsa_circ_0004712 downregulation attenuates ovarian cancer malignant development by targeting the miR-331-3p/FZD4 pathway
Authors: Zhou Xuan , Jiang Jinchi , Guo Shuaishuai 
Published: September 2021

Abstract
Background
Circular RNAs (circRNAs) are gradually reported to be implicated in the development of malignant tumors, including ovarian cancer (OC). This paper intended to explore the function and action mechanism of hsa_circ_0004712 in OC.

Results
In our results, hsa_circ_0004712 was aberrantly overexpressed in OC tissues and cells. Downregulation of hsa_circ_0004712 impaired OC cell proliferation, colony formation, invasion and migration, and accelerated apoptosis. Hsa_circ_0004712 directly targeted miR-331-3p whose inhibitors reversed the effects of hsa_circ_0004712 downregulation. FZD4 was targeted by miR-331-3p, and hsa_circ_0004712 could positively regulated FZD4 expression by targeting miR-331-3p. The anti-tumor effects of miR-331-3p restoration were reversed by FZD4 overexpression. Downregulation of hsa_circ_0004712 also impaired tumor development in vivo by regulating miR-331-3p and FZD4.

Conclusion
In conclusion, hsa_circ_0004712 deficiency repressed OC development by mediating the miR-331-3p/FZD4 pathway, predicting that hsa_circ_0004712 was a promising biomarker for OC diagnosis and therapy.
Impact of Augmented Intelligence on Utilization of Palliative Care Services in a Real-World Oncology Setting
Authors: Gajra Ajeet , Zettler Marjorie E. , Miller Kelly A. , Frownfelter John G. , Showalter John , Valley Amy W. , Sharma Sanya , Sridharan Shreenath , Kish Jonathan K. , Blau Sibel 
Published: September 2021

PURPOSE: For patients with advanced cancer, timely referral to palliative care (PC) services can ensure that end-of-life care aligns with their preferences and goals. Overestimation of life expectancy may result in underutilization of PC services, counterproductive treatment measures, and reduced quality of life for patients. We assessed the impact of a commercially available augmented intelligence (AI) tool to predict 30-day mortality risk on PC service utilization in a real-world setting. METHODS: Patients within a large hematology-oncology practice were scored weekly between June 2018 and October 2019 with an AI tool to generate insights into short-term mortality risk. Patients identified by the tool as being at high or medium risk were assessed for a supportive care visit and further referred as appropriate. Average monthly rates of PC and hospice referrals were calculated 5 months predeployment and 17 months postdeployment of the tool in the practice. RESULTS: The mean rate of PC consults increased from 17.3 to 29.1 per 1,000 patients per month (PPM) pre- and postdeployment, whereas the mean rate of hospice referrals increased from 0.2 to 1.6 per 1,000 PPM. Eliminating the first 6 months following deployment to account for user learning curve, the mean rate of PC consults nearly doubled over baseline to 33.0 and hospice referrals increased 12-fold to 2.4 PPM. CONCLUSION: Deployment of an AI tool at a hematology-oncology practice was found to be feasible for identifying patients at high or medium risk for short-term mortality. Insights generated by the tool drove clinical practice changes, resulting in significant increases in PC and hospice referrals.
Partial thrombosis of the corpus cavernosum – a malignancy mimicker
Authors: Baraças Catarina Ala , Pinto Jorge , Tavares Maria Catarina 
Published: September 2021

Partial thrombosis of the corpus cavernosum is a rare condition, typically seen in young patients. Etiology, physiopathology and treatment are still not entirely understood. The authors report a case of a 49-year-old male with gastric cancer, who successfully treated a thrombosis of the corpus cavernosum conservatively. Diagnostic considerations and treatment options are discussed.
Hirayama disease: the importance of flexion imaging
Authors: Kusel Kieran , Warne Richard , Lakshmanan Rahul , Mason Michael , Bynevelt Michael , Shah Snehal 
Published: September 2021

Hirayama disease is a rare cervical myelopathy characterised by asymmetrical upper limb weakness and muscle atrophy in the forearm and hand. MRI of the cervical spine plays an essential role in diagnosis, however, the characteristic findings are often only seen when the patient is imaged with the neck in flexion. We present a case of a 15-year-old male who presented with left forearm and hand weakness with muscle wasting. An MRI of the cervical spine with the neck in a neutral position demonstrated atrophy of the spinal cord with intrinsic signal abnormality between C5 and C7. Further imaging with the patient’s neck in flexion demonstrated the hallmark features of Hirayama disease. There was anterior displacement of the thecal sac and spinal cord, and an enlarged, crescent-shaped dorsal epidural space which enhanced following i.v. gadolinium administration. The atrophic segment of cord contacted the posterior vertebral bodies when the neck was in full flexion. This case highlights the importance of imaging patients suspected of having this entity with the neck in full flexion in order to make a diagnosis.
Radiological spectrum of invasive mucormycosis in COVID-19
Authors: Passi Nandini , Wadhwa Anshu C , Naik Swati 
Published: September 2021

Mucormycosis, commonly known as the “black fungus” is recently emerging as a deadly complication in COVID patients in the Indian subcontinent. A growing number of cases are being reported from all over the country, with a majority of the patients either undergoing treatment or having recovered from COVID. Here, we report three cases of multisystem mucormycosis in COVID positive patients showing, rhino-orbital, cerebral, pulmonary, and genitourinary involvement. The first is a case of a 41-year-old male patient who during his treatment developed left periorbital swelling with ecchymosis and headache. CT and CE-MRI of the paranasal sinuses and brain revealed features of pan fungal sinusitis and subsequent invasion into the left orbit. The second case is of a 52-year-old male patient who after complaining of a severe left-sided hemicranial headache was diagnosed with cavernous sinus thrombosis. The third is of a 57-year-old male patient who presented with left flank pain and dysuria. HRCT (High-resolution CT) chest revealed a thick-walled cavitary lesion, and NCCT KUB (Non-contrast CT of Kidneys, ureters, and bladder) revealed left-sided pyelonephritis. A cystoscopic and microbiological evaluation revealed fungal growth. In all three patients, a biopsy from the involved area revealed broad aseptate filamentous fungal hyphae suggestive of mucormycosis, which was confirmed on culture. These are all unusual cases and physicians should be aware of the possibility of secondary invasive fungal infections in patients with COVID-19 infection.
Application of MRI images based on Spatial Fuzzy Clustering Algorithm guided by Neuroendoscopy in the treatment of Tumors in the Saddle Region
Authors: Zhang Peng , Zhang Lingdang , Zhao Rui 
Published: September 2021

Objective: The paper applies spatial fuzzy clustering algorithm to explore the role and value of neuroendoscopic assisted technology in the operation of tumors in the saddle region, and analyze the MRI image characteristics of tumors in the saddle region.
Methods: The clinical data of 63 patients from our hospital who underwent neuroendoscopic assisted microscopy to remove tumors in the saddle area from 2017 to 2019 (neuroendoscopy-assisted group) were collected. Seventy six patients who occupied the saddle area by microscopic resection only in the same period (Simple microscope group) clinical data. By comparing the patient’s tumor resection rate, postoperative complication rate and postoperative recurrence rate, the surgical effect was evaluated.
Results: The total resection rates of the tumors in the neuroendoscopy-assisted group and the microscope-only group were 95.24% (60/63) and 80.26% (61/76). The incidence of postoperative vasospasm was 3.17% (2/63) and 13.16% (10/76), the incidence of nerve injury was 0 (0/63) and 6.58% (5/76), the difference was statistically significant (P <0.05). There was no significant difference in the incidence of postoperative infection, cerebrospinal fluid leakage and postoperative recurrence rate between the two groups (P> 0.05).
Conclusion: Neuroendoscopy-assisted microscopy-based removal of the saddle area occupying space based on spatial fuzzy clustering algorithm can increase the total tumor resection rate and reduce the incidence of complications.
doi: https://doi.org/10.12669/pjms.37.6-WIT.4850
How to cite this:Zhang P, Zhang L, Zhao R. Application of MRI images based on Spatial Fuzzy Clustering Algorithm guided by Neuroendoscopy in the treatment of Tumors in the Saddle Region. Pak J Med Sci. 2021;37(6):1600-1604. doi: https://doi.org/10.12669/pjms.37.6-WIT.4850
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.
Value of spiral CT multi-parameter combined preoperative evaluation of microvascular invasion in small liver cancer
Authors: Li Kun , Peng Yongjun , Tian Hongzhe , He Hailin 
Published: September 2021

Objective: To explore the value of multi-slice spiral CT (MSCT) in predicting microvascular invasion in hepatocellular carcinoma (HCC).
Methods: The CT and clinical data of 102 patients with HCC were collected for retrospective analysis from January 2018 to December 2020 at Baoji Center Hospital, China. They were divided into two groups based on the pathological results with or without microvascular invasion. The independent sample t-test was used to compare the age, alpha-fetoprotein (AFP) value, tumor size, and tumor enhancement of the two groups. CT value; χ2 test was used to compare gender, hepatitis type, liver function classification, degree of classification, degree of tumor smoothness, envelope, peripheral enhancement, etc. between the two groups.
Results: There were 52 cases of non-microvascular invasion and 50 cases of microvascular invasion. The tumor size, grade, degree of margin, capsule, portal vein CT value, and peripheral enhancement were related to microvascular invasion.
Conclusion: Microvascular invasion of HCC can be predicted by MSCT manifestations before surgery.
doi: https://doi.org/10.12669/pjms.37.6-WIT.4851
How to cite this:Li K, Peng Y, Tian H, He H. Value of spiral CT multi-parameter combined preoperative evaluation of microvascular invasion in small liver cancer. Pak J Med Sci. 2021;37(6):1605-1609. doi: https://doi.org/10.12669/pjms.37.6-WIT.4851
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Application of ultrasound molecular imaging based on compressed sensing reconstruction algorithm to phase change drug-loaded PLGA nanoparticles targeting breast cancer MCF-7 Cells
Authors: You Yufeng , Cheng Wusong , Chen Hongbo 
Published: September 2021

Objectives: To study the ability of aptamer-modified nano-gold rods and liquid carbon-targeted PLGA nanoparticles to target in vitro using compressed sensing reconstruction algorithm, and observe the phenomenon of mediating ultrasound / photoacoustic imaging.
Methods: PLGA nanoparticles were prepared by a double emulsification method, and the MUC1 aptamer was connected to the PLGA nanoparticles by the carbodiimide method to obtain an “aptamer-PLGA nanoparticle” targeted phase change contrast agent. Fluorescence microscopy was used to detect the in vitro targeting of breast cancer MCF-7 cells specifically identified by it, and three control groups were set up: the ordinary nanoparticle group, the aptamer interference group, and the HELA cell group. A photoacoustic instrument was used to observe the phenomenon of enhanced ultrasound / photoacoustic signal mediated in vitro.
Results: Many targeted nanoparticles were clustered around MCF-7 cells and bound firmly, but no specific binding was observed in the non-targeted nanoparticles group, the aptamer interference group and the HELA cell group. After the targeted nanoparticle was excited by the photoacoustic instrument, the ultrasonic signal and the photoacoustic signal were significantly enhanced compared with before the excitation.
Conclusion: The successfully prepared targeting nanoparticles have good targeting and specificity for breast cancer MCF-7 cells, and it has obvious effects on ultrasound / photoacoustic imaging, and has the potential to become a dual-mode ultrasound / photoacoustic targeted contrast agent. The various characteristics provide experimental basis for subsequent in vivo targeting experiments and are expected to become good target diagnostic molecular probes.
doi: https://doi.org/10.12669/pjms.37.6-WIT.4852
How to cite this:You Y, Cheng W, Chen H. Application of ultrasound molecular imaging based on compressed sensing reconstruction algorithm to phase change drug-loaded PLGA nanoparticles targeting breast cancer MCF-7 Cells. Pak J Med Sci. 2021;37(6):1610-1614. doi: https://doi.org/10.12669/pjms.37.6-WIT.4852
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Application of CT images based on the optimal atlas segmentation algorithm in the clinical diagnosis of Mycoplasma Pneumoniae Pneumonia in Children
Authors: Fu Xilin , Yang Ningfei , Ji Jianwei 
Published: September 2021

Objective: Use of optimal Atlas segmentation algorithm to study the imaging signs of mycoplasma pneumonia with multi-slice spiral CT (HRCT), and to explore the value of HRCT in the diagnosis and efficacy in evaluation of mycoplasma pneumonia in children.
Methods: The study retrospectively analyzed 72 patients diagnosed with mycoplasma pneumonia in our hospital from January 2017 to January 2019. The imaging data and clinical data of 72 patients were collected. The optimal Atlas segmentation algorithm was used to analyze the characteristics of CT examination, and the value of CT in the diagnosis of mycoplasma pneumonia and the evaluation of curative effect was summarized.
Results: Among all patients, 37 cases were unilateral lesions, 35 cases were bilateral lesions, 19 cases were in the left upper lobe, 24 cases were in the left lower lobe, 21 cases were in the right upper lobe, 13 cases were in the right middle lobe, 25 The lesion was located in the right lower lobe. The main CT findings of the lesions before treatment were large patchy, spot-shaped shadows, and strip-shaped or ground-glass shadows. After treatment, the main CT findings of the lesions were reduced lesion density and reduced lesion range.
Conclusion: CT can clearly show the pulmonary lesions of mycoplasma pneumonia, and its unique imaging signs can improve the clinical diagnosis accuracy. In addition, CT scans can evaluate the treatment effect according to the changes in the characteristics of the lesion, which has important value for the evaluation of the effect for clinical diagnosis and efficacy evaluation of mycoplasma pneumonia.
doi: https://doi.org/10.12669/pjms.37.6-WIT.4860
How to cite this:Fu X, Yang N, Ji J. Application of CT images based on the optimal atlas segmentation algorithm in the clinical diagnosis of Mycoplasma Pneumoniae Pneumonia in Children. Pak J Med Sci. 2021;37(6):1647-1651. doi: https://doi.org/10.12669/pjms.37.6-WIT.4860
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.
Efficacy of liver cancer microwave ablation through ultrasonic image guidance under deep migration feature algorithm
Authors: Ye Changkong , Zhang Wenyan , Pang Zijuan , Wang Wei 
Published: September 2021

Objective: To explore the therapeutic effects of ultrasound-guided microwave ablation and radio frequency ablation for liver cancer patients.
Methods: Seventy-eight patients with microwave ablation were rolled into the experimental group and 56 patients with radio frequency ablation were in the control group. This study was conducted from March 1, 2019 to June 30, 2020 in our hospital. Based on Convolutional Neural Networks (CNN) and Migration feature (MF), a new ultrasound image diagnosis algorithm CNNMF was constructed, which was compared with AdaBoost and PCA-BP based on Principal component analysis (PCA) and back propagation (BP), and the accuracy (Acc), specificity (Spe), sensitivity (Sen), and F1 values of the three algorithms were calculated. Then, the CNNMF algorithm was applied to the ultrasonic image diagnosis of the two patients, and the postoperative ablation points, complications and ablation time were recorded.
Results: The Acc (96.31%), Spe (89.07%), Sen (91.26%), and F1 value (0.79%) of the CNNMF algorithm were obviously larger than the AdaBoost and the PCA-BP algorithms (P<0.05); in contrast with the control group. The number of ablation points in the experimental group was obviously larger, and the ablation time was obviously shorter (P<0.05); the experimental group had one case of liver abscess and two cases of wound pain after surgery, which were both obviously less than the control group (four cases; five cases) (P<0.05)
Conclusion: In contrast with traditional algorithms, the CNNMF algorithm has better diagnostic performance for liver cancer ultrasound images. In contrast with radio frequency ablation, microwave ablation has better ablation effects for liver cancer tumors, and can reduce the incidence of postoperative complications in patients, which is safe and feasible.
doi: https://doi.org/10.12669/pjms.37.6-WIT.4885
How to cite this:Riaz A, Sughra U, Jawaid SA, Masood J. Measurement of Service Quality Gaps in Dental Services using SERVQUAL in Public Hospitals of Rawalpindi. Pak J Med Sci. 2021;37(6):1693-1698. doi: https://doi.org/10.12669/pjms.37.6-WIT.4885
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.
Strengthening bonds of Friendship between Pakistan and China through scientific publishing
Authors: Jawaid Shaukat Ali 
Published: September 2021

doi: https://doi.org/10.12669/pjms.37.6-WIT.5037
How to cite this:Jawaid SA. Strengthening bonds of Friendship between Pakistan and China through scientific publishing. Pak J Med Sci. 2021;37(6):1547-1549. doi: https://doi.org/10.12669/pjms.37.6-WIT.5037
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.