bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute‐phase blood pressure trajectories and clinical outcomes in ischemic stroke
Authors: Xu Jie , Dai Liye , Chen Zimo , Wang Anxin , Mo Jinglin , Cheng Aichun , Meng Xia , Wang Yilong , Zhao Xingquan , Wang Yongjun ,   the BOSS Study Group
Published: June 2019

AbstractHigh blood pressure (BP) is frequent in acute ischemic stroke (IS). However, the impact of BP change patterns during acute phase on clinical outcomes is not conclusive. This study aims to investigate the association between the acute‐phase BP trajectories and clinical outcomes in IS patients with high admission BP. The cohort consisted of 316 IS patients with admission systolic BP (SBP) ≥160 mm Hg. SBP trajectories during the first 7 days after onset were characterized using a random effects model. The patients were classified into three groups based on the SBP trajectory curve parameters: sustained high SBP (T1), moderate decrease (T2), and rapid decrease in SBP (T3). Poor outcomes were defined as modified Rankin scale score ≥3 in 3 months after onset. The relationship between SBP trajectory groups and the outcome was examined in multivariable logistic regression models. The decreasing trend was greater in the favorable than in the poor outcome group (P = 0.028 for difference in linear slopes). The incidence of poor outcomes was 25.9%, 13.5%, and 9.8% in T1 (n = 54), T2 (n = 170), and T3 (n = 92) groups, respectively. Compared with T1 group, the decrease in SBP in T2 and T3 groups was significantly associated with lower risk of the poor outcome (odds ratio = 0.25, 95% confidence interval = 0.10‐0.67, P = 0.006). These findings suggest that a decrease in BP in the acute phase is predictive of favorable outcomes in IS patients. BP trajectories have a greater power to detect the association than individual BP values at one time‐point.
Estimation of the leaf chlorophyll content using multiangular spectral reflectance factor
Authors: Li Wange , Sun Zhongqiu , Lu Shan , Omasa Kenji 
Published: June 2019

AbstractChlorophyll is one of the primary pigments of plant leaves, and changes in its content can be used to characterize the physiological status of plants. Spectral indices have been devised and validated for estimating leaf chlorophyll content (LCC). However, most of the existing spectral indices do not consider the influence of angular reflection on the accuracy of the LCC estimation. In this study, the spectral reflectance factors of leaves from three plant species were measured from several observations in the principal plane. The relationship between the existing spectral indices and the LCC from different directions suggests that the directional reflection of a leaf surface impacts the accuracy of its LCC estimation. Subsequently, the ratio of reflectance differences, that is, the modified Datt index, was tested to reduce the directional reflection effect when predicting LCC. Our results indicated that the modified Datt index not only estimated LCC with high accuracy for all observation directions and plant species but also consistently predicted the LCC of each species in individual observation directions. Our method opens the possibility for optical detection of LCC using multiangular spectral reflection, which is convenient for plant science studies focused on the variation in LCC.
Stuck in the blend: Challenges faced by students enrolled in blended programs of Masters in Health Professions Education
Authors: Naeem Noor-i-Kiran , Khan Rehan Ahmed 
Published: June 2019

Objectives: The advent of computer technology and widespread use of internet has given rise to e-learning and blended programs all over the world. The aim of this study was to explore problems faced by students enrolled in blended program of MHPE in Pakistan.
Methods: This was a qualitative exploratory study done between October 2017 and February 2018. Data included semi-structured individual interviews of eighteen students and four facilitators involved in blended MHPE programs of three leading Universities of Pakistan. Nine hundred and two students’ reflective essays were also included for data triangulation. Data was organized in Atlas-ti and analyzed through thematic analysis using Revised Community of Inquiry framework.
Results: Seventy open codes were condensed to fifteen sub-themes and five themes. Learner related problems comprised difficulty in self-regulation and self-directed learning as emphasized by the facilitators whereas students quoted teacher related problems focusing on feedback provision. Cognitive issues included huge cognitive load with engagement issues. Students also highlighted issues with social interaction encompassed difficulties in interacting with facilitators and managing group dynamics. Both students and facilitators agreed on institutional issues focused on limited resource provision, unsatisfactory administrative support and financial issues.
Conclusion: Students of MHPE are challenged with variety of issues in blended learning program relating to self-regulation, heavy cognitive load with engagement, social interaction especially with facilitators and managing group dynamics Addressing these issues can improve the experience of these students in blended programs.
doi: https://doi.org/10.12669/pjms.35.4.12
How to cite this:Naeem NK, Khan RA. Stuck in the blend: Challenges faced by students enrolled in blended programs of Masters in Health Professions Education. Pak J Med Sci. 2019;35(4):929-933. doi: https://doi.org/10.12669/pjms.35.4.12
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.
Role of intensive care nurses on guiding patients’ families/relatives to organ donation
Authors: Karaman Ahmet , Akyolcu Neriman 
Published: June 2019

Objective: The aim was to determine the role of intensive care nurses on guiding the families/relatives of brain-death patients to organ donation.
Methods: This research is a descriptive study. While the population of the study consisted of 1710 nurses working in the intensive care units of public, private and university hospitals in the city of Istanbul, the sample consisted of 353 intensive care nurses selected with stratified random sampling method from the probability sampling methods from this population. The data were collected by using “Data Collection Form”.
Results: It was determined that 74.5% of the intensive care nurses carefully listened the family/relatives of the patient with possible brain death or suffering from brain death and supported them to express their emotion and thoughts clearly; when the family/relatives of the patients hospitalised in the intensive care unit wanted to get information about organ donation, 20.7% of the nurses made the preliminary explanation themselves and then guided the patient to an organ transplant coordinator for detailed information and 3.1% of the nurses generally gave this information themselves.
Conclusions: It was determined that the knowledge of the intensive care nurses about brain death and organ donation was partially adequate and the function of guiding the families/relatives of brain-death patients to organ donation was mostly done by the physician.
doi: https://doi.org/10.12669/pjms.35.4.1285
How to cite this:Karaman A, Akyolcu N. Role of intensive care nurses on guiding patients’ families/relatives to organ donation. Pak J Med Sci. 2019;35(4):1115-1121. doi: https://doi.org/10.12669/pjms.35.4.1285
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.
Accuracy of BISAP score in prediction of severe acute pancreatitis
Authors: Arif Anum , Jaleel Farhat , Rashid Khalid 
Published: June 2019

Objective: To determine the accuracy of BISAP score in comparison with Ranson’s score in detection of severe acute pancreatitis.
Methods: This cross sectional study was performed in Emergency department and Surgery department of Dow university hospital from January 2015 to December 2015. A total of 206 patients were included. Those diagnosed with acute pancreatitis on the basis of epigastric pain, serum amylase levels more than 300 (more than 3 times normal) and meeting the inclusion criteria were subjected to investigations for Ranson’s and BISAP scoring. BISAP score was calculated at 24 hours and Ranson’s score both at 24 and 48 hours. A score of > 3 was used to label severe acute pancreatitis according to both scoring systems.
Results: In our study accuracy to predict SAP by BISAP score was 76.2% and Ranson’s score was 82.2%. On the basis of sensitivity, Ranson’s scores predicted SAP more accurately than BISAP scores (97.4% vs. 69.2%). Regarding specificity, both scores predicted SAP almost equally (78.4% vs. 77.8%).
Conclusion: BISAP score is a valuable tool in predicting severe Acute Pancreatitis in early hours.
doi: https://doi.org/10.12669/pjms.35.4.1286
How to cite this:Arif A, Jaleel F, Rashid K. Accuracy of BISAP score in prediction of severe acute pancreatitis. Pak J Med Sci. 2019;35(4):1008-1012. doi: https://doi.org/10.12669/pjms.35.4.1286
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.
Comparative effect of driving side on low back pain due to Repetitive Ipsilateral Rotation
Authors: Arslan Syed Asadullah , Hadian Mohammad Reza , Olyaei Gholamreza , Talebian Saeed , Yekaninejad Mir Saeed , Hussain Mir Arif 
Published: June 2019

Objective: To determine the effects of repetitive ipsilateral rotation on low back pain among the taxi drivers of right and left hand drive.
Methods: A total of 1200 (600 Iran+600 Pakistan) male taxi drivers, aged between 20-60 years with work experience of more than one year were randomly selected and interviewed in Tehran (Iran) & Lahore (Pakistan) to fill self-administered questionnaires in Persian and Urdu languages which contained socio-demographic, work related and LBP characteristics. Chi-square test and multiple logistic regression models were employed for statistical analyses.
Results: Point, one week, one year and lifetime prevalence of LBP among right hand drive taxi drivers was 26.7%, 35.5%, 49.8% and 77.7% respectively. Point, one week, one year and lifetime prevalence of LBP among left hand drive taxi drivers was 37%, 42.7%, 53.5% and 72.3% respectively. Mean Numeric Pain rating scale (NPRS) score was 4.15 (SD=1.42) in Pakistan, while in Iran it was 4(SD=1.57). There was no significant difference regarding pain intensity (p=0.123) between drivers from both countries. Mean Roland-Morris Questionnaire (RMQ) score among drivers in Pakistan with LBP was 7.76(SD= 2.50), while in Iranian drivers who had LBP, mean RMQ score was 7.71(SD=2.99).
Conclusion: Static or less dynamic muscles are more prone to LBP due to lower endurance. Lack of exercising habit, work as a driver for more number of years, driving within city, more driving hours in a day, forward bending, lifting, no seat comfort, lack of awareness regarding ergonomics and lower satisfaction level of job were the main reasons of LBP.
doi: https://doi.org/10.12669/pjms.35.4.488
How to cite this:Arslan SA, Hadian MR, Olyaei G, Talebian S, Yekaninejad MS, Hussain MA. Comparative effect of driving side on low back pain due to Repetitive Ipsilateral Rotation. Pak J Med Sci. 2019;35(4):1018-1023. doi: https://doi.org/10.12669/pjms.35.4.488
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.
Short-Term impacts of pulsed electromagnetic field therapy in middle-aged university’s employees with non-specific low back pain: A pilot study
Authors: Abdelhalim Nermeen Mohamed , Samhan Ahmed Fathy , Abdelbasset Walid Kamal 
Published: June 2019

Objective: Non-specific low back pain (non-specific LBP) is common problem between office-work employees. This study aimed to evaluate the short-term impacts of Pulsed Electromagnetic Field (PEMF) therapy in the treatment of non-specific LBP symptoms as pain, back mobility, LBP disabilities, and Health–Related Quality of Life (HRQOL).
Methods: Forty-two University’s employees with non-specific LBP and aged from 35 to 55 years who participated in this study from January to June 2018 were divided into two groups: group A; received PEMF therapy and group B; received sham treatment. The outcome measures were; numerical rating scale, Modified Oswestry LBP Disability Score, Modified Schober test, and the Short Form-36 questionnaire. Evaluations were performed for both groups before and after finishing treatment.
Results: All outcome measures were significantly improved statistically in the experimental group at the end of the intervention (p<0.05). On the other hand, there were non-significant differences in all outcome measures in the sham group (p>0.05).
Conclusions: PEMT therapy may decrease pain, LBP disability, increase lumbar spine mobility, and improve HRQOL in middle-aged university’s employees with nonspecific LBP.
doi: https://doi.org/10.12669/pjms.35.4.49
How to cite this:Abdelhalim NM, Samhan AF, Abdelbasset WK. Short-Term impacts of pulsed electromagnetic field therapy in middle-aged university’s employees with non-specific low back pain: A pilot study. Pak J Med Sci. 2019;35(4):987-991. doi: https://doi.org/10.12669/pjms.35.4.49
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.
Assessment of knowledge about childhood autism spectrum disorder among healthcare workers in Makkah-Saudi Arabia
Authors: Hayat Aalia Akhtar , Meny Areej Habib , Salahuddin Nabila , Alnemary Faisal M. , Ahuja Kumar-Ricky , Azeem Muhammad Waqar 
Published: June 2019

Objective: To measure the knowledge of healthcare professionals about increasingly prevalent Autism Spectrum Disorder (ASD) along with perceptions around its management and prognosis and comparison across various specialties.
Methods: This Cross sectional survey based comparative analysis took place at Maternity and Children Hospital and King Faisal Hospital Makkah from December 2017 to May 2018. The validated self-administered “Knowledge about childhood autism among health workers” questionnaire was used along with additional questions regarding perceptions about ASD. The mean and mean percent scores were calculated. Chi squared test and ANOVA were applied to find the association between quantitative and qualitative variables respectively.
Results: Out of 162 participants, 153 returned the questionnaire and 147 were included in final analysis. Physicians constituted 81.6% (120) of participants. The mean score for participants was 9.80(S.E.M ±0.32) where non-physicians yielded higher mean score (11.2±4.41) as compared to physicians (9.6±3.28) (p=0.113). Psychiatrists had highest score of 16/19 while general physicians had lowest (6/19). Participants with more years of experience had higher mean scores (p-value = 0.01). About 72.10% (106) of participants opted for medication as a treatment option. Nearly 38.1% (56) of participants were skeptical about improvement of ASD with early interventions.
Conclusion: There is a lack of knowledge about ASD amongst healthcare professionals in Saudi Arabia. Experienced professionals working with ASD children can be utilized to deliver targeted trainings nationwide.
doi: https://doi.org/10.12669/pjms.35.4.605
How to cite this:Hayat AA, Meny AH, Salahuddin N, Alnemary FM, Ahuja KR, Azeem MW. Assessment of knowledge about childhood autism spectrum disorder among healthcare workers in Makkah- Saudi Arabia. Pak J Med Sci. 2019;35(4):951-957. doi: https://doi.org/10.12669/pjms.35.4.605
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.
High re-operation and complication rates 11 years after arthrodesis of the wrist for non-inflammatory arthritis
Authors: Reigstad O. , Holm-Glad T. , Korslund J. , Grimsgaard C. , Thorkildsen R. , Røkkum M. 
Published: June 2019

Aims Plate and screw fixation has been the standard treatment for painful conditions of the wrist in non-rheumatoid patients in recent decades. We investigated the complications, re-operations, and final outcome in a consecutive series of patients who underwent wrist arthrodesis for non-inflammatory arthritis. Patients and Methods A total of 76 patients, including 53 men and 23 women, with a mean age of 50 years (21 to 79) underwent wrist arthrodesis. Complications and re-operations were recorded. At a mean follow-up of 11 years (2 to 18), 63 patients completed questionnaires, and 57 attended for clinical and radiological assessment. Results Of the 76 patients, 46 (60.5%) had complications, resulting in 65 re-operations, mainly related to the plate and screws. In the 63 patients who completed the questionnaires, the mean Quick Disabilities of Arm, Shoulder and Hand (QuickDASH) score was 36 (0 to 91), the mean Patient-Rated Wrist and Hand Evaluation (PRWHE) score was 40 (0 to 96), and 14 patients (22%) reported no wrist pain. Grip strength, pinch strength, and pronation and supination were significantly reduced compared with the contralateral forearm. The outcome was worse in patients who had previously undergone surgery to the wrist, and those with complications. A total of 13 are awaiting further re-operations, giving a total re-operation rate of 63% (40/63). Conclusion We observed complications and re-operations throughout the follow-up period and therefore consider wrist arthrodesis to be more complicated than previously assumed. Many of the patients never got used to or accepted their stiff wrists and reported a substantial reduction in function and residual pain. Motion-sparing surgery should be offered prior to wrist arthrodesis. Cite this article: Bone Joint J 2019;101-B:852–859.
Reconstruction of the pelvic ring after total en bloc sacrectomy using a 3D-printed sacral endoprosthesis with re-establishment of spinopelvic stability
Authors: Wei R. , Guo W. , Yang R. , Tang X. , Yang Y. , Ji T. , Liang H. 
Published: June 2019

Aims The aim of this study was to describe the use of 3D-printed sacral endoprostheses to reconstruct the pelvic ring and re-establish spinopelvic stability after total en bloc sacrectomy (TES) and to review its outcome. Patients and Methods We retrospectively reviewed 32 patients who underwent TES in our hospital between January 2015 and December 2017. We divided the patients into three groups on the basis of the method of reconstruction: an endoprosthesis group (n = 10); a combined reconstruction group (n = 14), who underwent non-endoprosthetic combined reconstruction, including anterior spinal column fixation; and a spinopelvic fixation (SPF) group (n = 8), who underwent only SPF. Spinopelvic stability, implant survival (IS), intraoperative haemorrhage rate, and perioperative complication rate in the endoprosthesis group were documented and compared with those of other two groups. Results The mean overall follow-up was 22.1 months (9 to 44). In the endoprosthesis group, the mean intraoperative hemorrhage was 3530 ml (1600 to 8100). Perioperative complications occurred in two patients; both had problems with wound healing. After a mean follow-up of 17.7 months (12 to 38), 9/10 patients could walk without aids and 8/10 patients were not using analgesics. Imaging evidence of implant failure was found in three patients, all of whom had breakage of screws and/or rods. Only one of these, who had a local recurrence, underwent re-operation, at which solid bone-endoprosthetic osseointegration was found. The mean IS using re-operation as the endpoint was 32.5 months (95% confidence interval 23.2 to 41.8). Compared with the other two groups, the endoprosthesis group had significantly better spinopelvic stability and IS with no greater intraoperative haemorrhage or perioperative complications. Conclusion The use of 3D-printed endoprostheses for reconstruction after TES provides reliable spinopelvic stability and IS by facilitating osseointegration at the bone-implant interfaces, with acceptable levels of haemorrhage and complications. Cite this article: Bone Joint J 2019;101-B:880–888.
Prospective randomized trial of standardversushighly crosslinked tibial polyethylene in primary posterior-stabilized total knee arthroplasty
Authors: Lachiewicz P. F. , O’Dell J. A. 
Published: June 2019

AimsThere is insufficient evidence to recommend the use of alternative polyethylene bearings in modular, fixed-bearing total knee arthroplasty (TKA). The purpose of this study was to compare standard polyethylene (SP) and highly crosslinked polyethylene (XLP) tibial liners in posterior-stabilized TKA, with osteolysis as the primary outcome and clinical results and the rate of re-operation as the secondary outcomes.Patients and MethodsThis is a single-surgeon, prospective randomized study involving one design of modular posterior-stabilized TKA. An analysis of 122 TKAs with an SP compression moulded liner and 123 with an XLP liner was performed, with a mean follow-up of six years (2 to 11). Patients were evaluated clinically using the Knee Society score, Lower Extremity Activity Score (LEAS), and the presence of an effusion, and standard radiographs were assessed for radiolucent lines and osteolytic lesions.ResultsOsteolysis was present in four TKAs (3.3%) in the SP group, and no knees in the XLP group (p = 0.06). There were no significant differences between the Knee Society total score, change in total score, knee function score, change in function score, LEAS, and change in LEAS in the two groups. There was a significant difference in the presence of an effusion (10/122 with SP liners, 1/123 with XLP liners; p = 0.02). There was no significant difference in the rate of re-operation between the two groups (p = 0.36). There were no complications related to the XLP liner.ConclusionAt this length of follow-up, there were no advantages and no complications related to the use of this XLP tibial liner. The presence of effusion and small osteolytic lesions was more frequent with SP than XLP liners, but of unknown clinical significance. Cite this article: Bone Joint J 2019;101-B(7 Supple C):33–39