bluuebunny/crossref_metadata_2025_split huggingface dataset:
In search of a daily physical activity “sweet spot”: Piloting a digital tracking intervention for people with multiple sclerosis
Authors: Chiauzzi Emil , Hekler Eric B , Lee Jisoo , Towner Auriell , DasMahapatra Pronabesh , Fitz-Randolph Marcy 
Published: August 2019

Objective This pilot study tested a course-based intervention to help people with multiple sclerosis (MS) match their daily activity to symptom severity (“sweet spot”) using wearable activity trackers. Methods This two-phase study recruited online research network members reporting MS and who were utilizing Fitbit One™ activity trackers. In the first phase, participant interviews assessed demand based on physical activity and the use of behavior-change techniques. The second phase assessed the demand, limited efficacy, acceptability, and practicality of a “Wearables 101” course that integrated behavior change and self-experimentation principles. Tracker data were used to determine the percent of matches between daily symptom-based step goals and step counts. Results Participants expressed demand in the form of interest in gaining insights about a possible “sweet spot” behavioral target, if a system could be produced to support that. Limited efficacy results were mixed, with approximately one-third of participants dropping out and only half matching their daily target goals for at least 50% of days. In terms of practicality, participants commented on the burden of daily measurement and the need for a longer baseline period. Participants noted that tracking helped support an understanding of the link between activities and symptom severity, suggesting acceptability. Conclusions Results suggested that the intervention demand and acceptability criteria were demonstrated more strongly than limited efficacy and practicality. The matching intervention tested in this study will require refinement in baseline measurement, goal definition, and reduced data-gathering burden. Such changes may improve efficacy and practicality requirements and, by extension, later impact of the intervention on MS outcomes. Overall, these results provide justification for additional work on refining the intervention to increase practicality and efficacy.
Telling the Story of Childhood Cancer—The Experience of Families After Treatment
Authors: Slater Penelope J 
Published: August 2019

Background: The Discovery Interview methodology was introduced to Oncology Services Group in 2012 as a service improvement strategy and was evaluated positively by staff and families. It enabled clinical staff to hear the deidentified families’ stories, understand their experience, and implement process and practice enhancements. Objective: This study collected family stories following treatment for childhood cancer at the tertiary center in Queensland, with the goal of raising awareness and improving family experience. Method: Twenty-five families were interviewed via an interview spine which covered the major stages of cancer treatment and themes were extracted. Results: Major themes were psychological support needs, adapting to the new normal, and rebuilding relationships. After treatment, the parent had time to reflect on their experience and lost the reassurance of regularly attending the tertiary hospital. There was ongoing anxiety regarding relapse. Parents reported various coping strategies and some wanted to maintain contact with other oncology families. Families strived to get back to a level of normality such as attending school and experienced some challenges in relationships with family and friends. Conclusion: Families needed support and reassurance from their local health professionals to navigate the ongoing challenges following treatment.
Patient perception of disease burden in diffuse cutaneous systemic sclerosis
Authors: Khanna Dinesh , Allanore Yannick , Denton Christopher P , Matucci-Cerinic Marco , Pope Janet , Hinzmann Barbara , Davies Siobhan , de Oliveira Pena Janethe , Distler Oliver 
Published: August 2019

Purpose: Systemic sclerosis is a rare multi-organ autoimmune rheumatic disease, resulting in progressive fibrosis of the skin/internal organs. This study aimed to understand the impact of diffuse cutaneous systemic sclerosis symptoms and disease burden from the patient’s perspective. Methods: This was a mixed methodology, market research study involving ethnography, structured interviews, video diaries, and patient tasks. Patients had been diagnosed with diffuse cutaneous systemic sclerosis for ⩾ 6 months and were recruited via healthcare professionals or patient associations (France, Italy, the United Kingdom, and the United States). Patients filmed short (~15 min) daily video diaries about their lives over 7 days and participated in ethnographic sessions, patient tasks, and structured video interviews. In Germany and Spain, patients participated in 60-min telephone interviews. Results: Twenty-three patients (mean age: 54 years; 83% women; minimum disease duration: 6 months) participated in the study. Time to diagnosis was prolonged, as patients overlooked their symptoms and some healthcare professionals attributed symptoms to other causes. Patients rarely received additional information or support services at diagnosis. Importantly, although patients were aware of the seriousness of organ involvement, they reported that skin changes, pain, and fatigue impaired their ability to perform routine tasks. Patients had a high prescription treatment burden (mean: 10 tablets/day; up to >25 tablets/day) with additional non-prescription medication taken for other comorbidities. Treatment discontinuation was common due to side effects. Patients experienced diffuse cutaneous systemic sclerosis as a loss of independence and self-esteem. Moreover, patients tended to have small support networks, and emotional support services were not offered as standard care. Conclusion: Patients with diffuse cutaneous systemic sclerosis had high treatment and disease burdens, with skin changes, pain, and fatigue profoundly affecting their lives. There is an unmet need for patient information at the time of diagnosis and emotional support services throughout the patient’s journey with diffuse cutaneous systemic sclerosis. Based on the results of this study, we provide recommendations for improving diffuse cutaneous systemic sclerosis care.
Efficacy of tyrosine kinase inhibitors in Ph-like acute lymphoblastic leukemia harboring ABL-class rearrangements
Authors: Tanasi Ilaria , Ba Ibrahima , Sirvent Nicolas , Braun Thorsten , Cuccuini Wendy , Ballerini Paola , Duployez Nicolas , Tanguy-Schmidt Aline , Tamburini Jérôme , Maury Sébastien , Doré Eric , Himberlin Chantal , Duclos Cédric , Chevallier Patrice , Rousselot Philippe , Bonifacio Massimiliano , Cavé Hélène , Baruchel André , Dombret Hervé , Soulier Jean , Landman-Parker Judith , Boissel Nicolas , Clappier Emmanuelle 
Published: August 2019

Abstract
Tanasi et al present a prospective strategy for identifying patients with Philadelphia-like acute lymphoblastic leukemia, demonstrating the efficacy of early introduction of tyrosine kinase inhibitors in improving outcomes.
Is consumer behaviour towards footwear predisposing for lower extremity injuries in runners and walkers? A prospective study
Authors: Willems Tine Marieke , De Ridder Roel , Roosen Philip 
Published: August 2019

AbstractBackgroundRunners and walkers often suffer from lower extremity injuries. Little is known about the relationship between their consumer behaviour towards footwear and the development of those injuries. Therefore, the aim of this study was to investigate if consumer behaviour towards footwear is a risk factor for lower extremity injuries.MethodsA prospective cohort study was set‐up in leisure‐time walkers and runners. Potential risk factors in consumer behaviour were obtained by means of a baseline questionnaire related to the acquisition of current walking or running shoes. Information on injuries sustained during a 24 week period after the baseline questionnaire was obtained in 104 runners and 104 walkers using a 2‐weekly questionnaire. Binary logistic regression analysis was used to identify risk factors for lower extremity injuries in the consumer behaviour.ResultsForty‐ nine (24%) subjects suffered a self‐reported lower extremity injury. 35 injuries occurred in runners and 14 among walkers.Undergoing a gait analysis before buying shoes was associated with an increased occurrence of lower extremity injuries (odds ratio (OR) 4.76). A protective factor was caring a lot about the right fitting of the shoes (OR 0.11).ConclusionRunners and walkers should pay attention to the correct size when buying footwear to diminish the risk of lower extremity injury. Buying footwear after a gait analysis increased the risk of a lower extremity injury in runners and walkers, however, this might be associated with the increased risk that was already present because of previous injury.Trial registrationThis trial was not registered since this was an observational study and no intervention took place.
On Women and their Wombs: Capitalism, Racialization, Feminism
Authors: Vergès Françoise 
Published: August 2019

Abstract
This article draws from Françoise Vergès's book, Le ventre des femmes: Capitalisme, racialisation, féminisme,* which traces the history of the colonization of the wombs of Black women by the French state in the 1960s and 1970s through forced abortions and the forced sterilization of women in French foreign territories. Vergès retraces the long history of colonial state intervention in Black women's wombs during the slave trade and post-slavery imperialism, and after World War II, when international institutions and Western states blamed the poverty and underdevelopment of the Third World on women of color. Vergès looks at the feminist and Women's Liberation movements in France in the 1960s and 1970s and asks why, at a time of French consciousness about colonialism brought about by Algerian independence and the social transformations of 1968, these movements chose to ignore the history of the racialization of women's wombs in state politics. In making the liberalization of contraception and abortion their primary aim, she argues, French feminists inevitably ended up defending the rights of white women at the expense of women of color, in a shift from women's liberation to women's rights.
Strong association of anemia in people with diabetic foot ulcers (DFUs): Study from a specialist foot care center
Authors: Shareef Abdul Majid , Ahmedani Muhammad Yakoob , Waris Nazish 
Published: August 2019

Background & Objective: Anemia is common finding in people with diabetes and diabetic foot ulcers. Therefore, our objective was to observe and compare the association of anemia in people with diabetic foot ulcers (DFUs) with age and sex matched people without DFUs.
Methods: This prospective case control study was undertaken at a multidisciplinary diabetic foot clinic of Baqai Institute of Diabetology and Endocrinology (BIDE) between October 2014 and October 2015. Participants were categorized into two groups; Case group (people with DFUs) and Control group (people without DFUs). Baseline demographic characteristics, biochemical and hematological parameters were recorded. University of Texas (UT) classification system was used to grade and stage DFU in case group. Subjects with other apparent causes of anaemia were excluded. Age and sex matched controls were taken from diabetic clinic presented during same time period. Data was analyzed by using statistical package for social science (SPSS) version 20.
Results: Total of 161 participants in case group were compared with similar number of age and sex matched participants of control group. Most of the participants were males 119(73.9%). Age and sex matched case and control groups were comparable except for duration of diabetes, BMI and HDL levels. Overall, 85.67% case group (males 64.56%); females 21.11%) and 35.3% control group (males 22.9%; females12.4%) have anemia. Mean Hb level was 10.49g/dl in case group and 13.39g/dl in control group. Significant differences were also noted in other blood parameters.
Conclusion: Our study concludes that anaemia is strongly associated with DFU disease. Anaemia should be considered and treated as co-morbidity while managing patients with foot ulcers.
doi: https://doi.org/10.12669/pjms.35.5.1421
How to cite this:Shareef AM, Ahmedani MY, Waris N. Strong association of anemia in people with diabetic foot ulcers (DFUs): Study from a specialist foot care center. Pak J Med Sci. 2019;35(5):1216-1220. doi: https://doi.org/10.12669/pjms.35.5.1421
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.
Identification of risk factors for human immunodeficiency virus-1 infection in Khyber Pakhtunkhwa population: A case control study
Authors: Haider Jamila , Lutfullah Ghosia , Rehman Irshad ur , Khattak Irfan 
Published: August 2019

Objectives: The present study aims to identify the risk factors for Human Immunodeficiency Virus-1(HIV-1) infection in Khyber Pakhtunkhwa (KP) population by comparing HIV-antibody positive cases with HIV-antibody-negative controls.
Methods: The study was designed at the Family Care Centre (FCC), Hayatabad Medical Centre (HMC) Peshawar from February 2015 to December 2016. A total of 280 individuals were selected randomly for the study as cases and control. Data was collected on a structured questionnaire with informed oral consent. The collected data was analysed statistically using SPSS version 20.
Results: Out of 280 individuals, 56% were males, 44% were females, and 53.21% belonged to the urban areas. The literacy rate was 48.6%, and 75.4% were married. The statistical analysis of risk factors revealed the following factors as of significance value (p < 0.05). Family history of HIV (OR = 9.46), spouse status of HIV (OR=22.22), injection drug users (IDUs), migrants (OR=2.234), use of therapeutic injections (OR= 2.791), employment (OR=2.545), male gender (OR=2.35), tattooing (OR=7.667) and history of blood transfusion (OR= 2.69).
Conclusion: The present study revealed spouse status of HIV, tattooing, migrants, IDUs, use of therapeutic injections, history of blood transfusion, male gender and employment as significant risk factors for HIV infection in the population of KP.
doi: https://doi.org/10.12669/pjms.35.5.258
How to cite this:Haider J, Lutfullah G, Irshad ur Rehman, Khattak I. Identification of risk factors for human immunodeficiency virus-1 infection in Khyber Pakhtunkhwa population: A case control study. Pak J Med Sci. 2019;35(5):1258-1263. doi: https://doi.org/10.12669/pjms.35.5.258
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.
Prognostic factors and outcome of Post-Neonatal Tetanus in an intensive care unit of a Tertiary Care Hospital
Authors: Sultana Nighat , Bari Attia , Faizan Mehwish , Sarwar Muhammad 
Published: August 2019

Objective: To determine the prognostic factors and outcome of tetanus in children of post-neonatal age admitted in the intensive care unit (ICU) of a tertiary care hospital.
Methods: This prospective cross sectional study, carried out in the Pediatric ICU of The Children’s Hospital Lahore from Jan 2013 to March 2017. Children of both genders with age range of two months to 16 years diagnosed clinically as tetanus were included. All 132 patients were scrutinized for all possible risk factors, need for mechanical ventilation and outcome. Data was analyzed by SPSS version 20.
Results: Mean age of children was 7.5±3.4 years with male predominance (70.5%). Only (38.6%) received three doses of vaccination but none had booster dose. Trauma (43.2%) encompassed maximum predisposing factor followed by ear or nose prick and ear discharge. Mean duration of ICU stay was 20±13.3 days. Mortality rate was (17.4%). Ventilator support was given to (78.8%). Neurological outcome was normal in (82.6%). Trauma, ear or nose prick in girls and ear discharge were significantly associated with poor outcome and death with p-value of <0.001, 0.011 and <0.001 respectively. Other factors associated with poor outcome were need for mechanical ventilation and neurological impairment with p-value of 0.001 and <0.001 respectively.
Conclusion: Tetanus is causing our children to suffer from devastating disease. Vaccination status is not satisfactory and along with trauma, ear discharge and ear or nose prick are identifiable risk factors. To combat these issues large scale vaccination and booster doses remains promising option.
doi: https://doi.org/10.12669/pjms.35.5.656
How to cite this:Sultana N, Bari A, Faizan M, Sarwar M. Prognostic factors and outcome of Post-Neonatal Tetanus in an intensive care unit of a Tertiary Care Hospital. Pak J Med Sci. 2019;35(5):1233-1237. doi: https://doi.org/10.12669/pjms.35.5.656
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.
Targeted need’s assessment: Medical ethics in MBBS curriculum of Pakistan
Authors: Javaeed Arslaan 
Published: August 2019

Objective: To assess the learner need’s assessment of medical ethics in undergraduate medical curriculum of Pakistan.
Methods: To establish an actual need, three methods were employed during October 2018. The first included a review of the curriculum for medical ethics as designed by the Pakistan Medical and Dental College (PMDC). A supplementary document “Code of Ethics”, published by Pakistan Medical and Dental College (PMDC), was also reviewed. In the second method, a self-administered questionnaire was distributed to all 500 undergraduate medical students at Poonch Medical College. Data analysis was performed through SPSS v 23.0 (IBM Corporation, Armonk, NY, US) at 95% CI. The results were expressed in the form of frequencies. The third method employed was an extensive review of literature to identify gaps and to propose learning strategies.
Results: In the section on guiding principles in the curriculum, Ethics is considered as an optional subject. Bioethics is designated to be taught in the 3rd year of the MBBS, as part of Forensic Medicine. The agreement to study Medical Ethics Principles as part of the curriculum among final-year medical students saw numbers almost double to 84.61%. The highest majority was seen among final year medical students where 84.6% of the students agreed to study principles of medical ethics as part of their curriculum.
Conclusions: Data and the PMDC curriculum support the incorporation of medical ethics in undergraduate education. Thus, an effective educational program based on the assessment of needs could be developed for medical ethics.
doi: https://doi.org/10.12669/pjms.35.5.873
How to cite this:Javaeed A. Targeted need’s assessment: Medical ethics in MBBS curriculum of Pakistan. Pak J Med Sci. 2019;35(5):1253-1257. doi: https://doi.org/10.12669/pjms.35.5.873
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.
Association between core body temperature and mean airway pressure with endotracheal cuff pressure in intubated patients of emergency department
Authors: Parsian Zahra , Rahmani Farzad , Mahmoodpoor Ata , Pouraghaei Mahboob , Barzegar Jalali Maryam , Mehdizadeh Esfanjani Robab , Soleimanpour Hassan 
Published: August 2019

Background & Objective: Endotracheal intubation is routinely performed in the critical situations. In order to prevent microaspiration and tracheal injury endotracheal cuff pressure is important to remain constant between 20 and 30 cmH2O. Positive pressure ventilation, duration of intubation, body temperature, and body movements can alter endotracheal cuff pressure. This survey was conducted to evaluate core body temperature and cuff pressure relation with airway pressure simultaneously.
Methods: This was a descriptive analytic study conducted from March 2018 to July 2018 on 150 intubated patients in the emergency department. All were ventilated with SIMV mode and had Ramsi sedation level of 2‑3. Mean airway pressure was measured simultaneouly with core body temperature measurement from ventilator monitor. All these parameters were measured 10 times each hour and documented.
Results: There was a statistically meaningful relation between airway pressure and cuff pressure in the primary evaluation (P=0.02, r=0.19), while none of the subsequent evaluations showed meaningful relation (P>0.05). No significant relation was found between cuff pressure and core body temperature in any of the measurements (P>0.05).
Conclusion: The pressure of cuff should be checked repeatedly after intubation because of substantial variation over time. Factors other than core body temperature and airway pressure can influence cuff pressure.
doi: https://doi.org/10.12669/pjms.35.5.886
How to cite this:Parsian Z, Rahmani F, Mahmoodpoor A, Pouraghaei M, Jalali MB, Esfanjani RM, et al. Association between core body temperature and mean airway pressure with endotracheal cuff pressure in intubated patients of emergency department. Pak J Med Sci. 2019;35(5):1248-1252. doi: https://doi.org/10.12669/pjms.35.5.886
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.
Urinary Amino-Terminal Pro–C-Type Natriuretic Peptide: A Novel Marker of Chronic Kidney Disease in Diabetes
Authors: Prickett Timothy C R , Lunt Helen , Warwick Julie , Heenan Helen F , Espiner Eric A 
Published: August 2019

Abstract

BACKGROUND
Chronic renal inflammation and fibrosis are common sequelae in diabetes mellitus (DM) and are major causes of premature mortality. Although upregulation of NPPC expression occurs in response to renal inflammation in experimental animals, nothing is known of the molecular forms of C-type natriuretic peptide (CNP) products in urine of people with DM or links with renal function.

METHODS
ProCNP products in urine were characterized with HPLC and a range of antisera directed to specific epitopes of amino-terminal proCNP (NTproCNP). The 5-kDa intact peptide was quantified in spot urine samples from healthy adults and 202 participants with DM selected to provide a broad range of renal function.

RESULTS
The predominant products of proCNP in urine were consistent with the 2-kDa fragment (proCNP 3–20) and a smaller peak of intact (5-kDa) fragment (proCNP 1–50, NTproCNP). No peaks consistent with bioactive forms (proCNP 82–103, 50–103) were identified. The urine NTproCNP to creatinine ratio (NCR) was more reproducible than the albumin to creatinine ratio (ACR) and strongly associated with the presence of chronic kidney disease. In models predicting independence, among 10 variables associated with renal function in DM, including plasma NTproCNP, only 3 (sex, ACR, and plasma creatinine) contributed to NCR.

CONCLUSIONS
Characterization of the products of proCNP in urine confirmed the presence of NTproCNP. In spot random urine from study participants with DM, NCR is inversely associated with estimated glomerular filtration rate. In contrast to ACR, NCR reflects nonvascular factors that likely include renal inflammation and fibrosis.