bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tackling the Tibetan Plateau in a down suit: insights into thermoregulation by bar-headed geese during migration
Authors: Parr Nicole , Bishop Charles M. , Batbayar Nyambayar , Butler Patrick J. , Chua Beverly , Milsom William K. , Scott Graham R. , Hawkes Lucy A. 
Published: October 2019

ABSTRACTBirds migrating through extreme environments can experience a range of challenges while meeting the demands of flight, including highly variable ambient temperatures, humidity and oxygen levels. However, there has been limited research into avian thermoregulation during migration in extreme environments. This study aimed to investigate the effect of flight performance and high altitude on body temperature (Tb) of free-flying bar-headed geese (Anser indicus), a species that completes a high-altitude trans-Himalayan migration through very cold, hypoxic environments. We measured abdominal Tb, along with altitude (via changes in barometric pressure), heart rate and body acceleration of bar-headed geese during their migration across the Tibetan Plateau. Bar-headed geese vary the circadian rhythm of Tb in response to migration, with peak daily Tb during daytime hours outside of migration but early in the morning or overnight during migration, reflecting changes in body acceleration. However, during flight, changes in Tb were not consistent with changes in flight performance (as measured by heart rate or rate of ascent) or altitude. Overall, our results suggest that bar-headed geese are able to thermoregulate during high-altitude migration, maintaining Tb within a relatively narrow range despite appreciable variation in flight intensity and environmental conditions.
Frequency of urinary tract infection and antibiotic sensitivity of uropathogens in patients with diabetes
Authors: Zubair Kaleem Ullah , Shah Abdul Haleem , Fawwad Asher , Sabir Rubina , Butt Anum 
Published: October 2019

Objective: To determine the frequency of urinary tract infections and antibiotic sensitivity among patients with diabetes.
Methods: This observational study was carried out in Microbiology Department of Baqai Institute of Diabetology and Endocrinology (BIDE), Baqai Medical University from April 2015 to June 2016. All patients with diabetes having symptoms of UTI attending out patients department of BIDE were analyzed. All samples received in the laboratory were processed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Antimicrobial susceptibility pattern was determined by disc diffusion method.
Results: A total number of 199 urine specimens, frequency of UTI were 24 (12.06%) in male and 175 (87.94%) in female. UTIs were highly found in (age group 51-60) 70 (35.18%). Escherichia coli was the most frequent pathogen (71%), followed by Klebsiellapneumoniae (7.48%), Proteus mirabilis (1.87%), Staphylococcus aureus (9.35%), Candida (5.61%) and Candidaalbicans were (2.80%). Majority of gram negative uropathogens were shown high sensitivity towards Imipenem and Piperacillin / Tazobactam followed by Nitrofurantion, Ceftriaxone, Levofloxacin, Ofloxacine, Ciprofloxacin, Norfloxacin, Cefixime, Nalidixic acid and Cephradine. Gram positive was most sensitive to Nitrofurantionand Vancomycin followed by Piperacillin / Tazobactam, Imipenem, Cephradine, Ceftriaxone, Norfloxacin and Cefixime.
Conclusion: We observed the higher frequency of UTIs in female as compared to male participants due to poor hygiene. E.coli was the most frequent pathogen responsible for UTI in patients with diabetes, followed by Staphylococcus aureus.
doi: https://doi.org/10.12669/pjms.35.6.115
How to cite this:Zubair KU, Shah AH, Fawwad A, Sabir R, Butt A. Frequency of urinary tract infection and antibiotic sensitivity of uropathogens in patients with diabetes . Pak J Med Sci. 2019;35(6):1664-1668. doi: https://doi.org/10.12669/pjms.35.6.115
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.
Therapeutic effects of percutaneous coronary intervention on acute myocardial infarction complicated with multiple organ dysfunction syndrome
Authors: Qian Dajun , Zhou Daqiong , Liu Huan , Xu Di 
Published: October 2019

Objective: To evaluate the clinical efficacy of percutaneous coronary intervention (PCI) on patients with acute myocardial infarction (AMI) complicated with multiple organ dysfunction syndrome (MODS).
Methods: A total of 216 patients with AMI complicated with MODS enrolled from January 2016 to March 2018 were divided into a PCI group (n=98) and a drug treatment group (n=118). The baseline clinical data, the incidence of each dysfunction organ, the number of dysfunctional organs and the mortality were compared between the two groups.
Results: The number of patients with ST-segment elevation AMI in the PCI group was higher than in the drug treatment group, and the rate of patients with non-ST-segment elevation AMI was lower than in the drug treatment group (P<0.05). The use of temporary pacemakers and IABP was similar between the two groups (P>0.05). The recanalization rate in PCI group was much higher than that in the drug treatment group (P<0.05). The two groups had similar incidence of organ dysfunction in the heart, lungs, kidneys, stomach and intestine, etc. and the PCI group had lower organ dysfunction incidence in the liver, brain and hematological system than the drug treatment group (P<0.05). The dysfunction incidence rate of two organs was higher in PCI group than in drug treatment group (P<0.05), the dysfunction incidence rate of 3 organs was similar between the two groups, and the dysfunction incidence rate of three organs or more was significantly lower in PCI group than in drug treatment group (P<0.05).
Conclusion: Despite the high risk and high mortality of patients with AMI plus MODS, clinical improvement can still be achieved when effective PCI is performed.
doi: https://doi.org/10.12669/pjms.35.6.1162
How to cite this:Qian D, Zhou D, Liu H, Xu D. Therapeutic effects of percutaneous coronary intervention on acute myocardial infarction complicated with multiple organ dysfunction syndrome. Pak J Med Sci. 2019;35(6):1701-1706. doi: https://doi.org/10.12669/pjms.35.6.1162
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.
Biochemical profile changes in stored donor blood for transfusion
Authors: AlMoshary May , Al Mussaed Eman , Arabdin Maria 
Published: October 2019

Objectives: This study’s aim was to find out that how various biochemical parameters of donor blood are affected during storage.
Methods: This cross-sectional study was conducted in hematology Unit of Rehman Medical Institute, Peshawar and Fatimid Foundation, Peshawar Khyber Pakhtunkhwa, over a period of six months from June 2018 to November 2018. This study includes 300 healthy volunteer donors. Analysis of stored blood was done at 0, 3, 7, 14- and 21-days interval. Data were recorded and analyzed in SPSS v 20. A p value of less than 0.05 was taken as significant.
Results: Three hundred healthy volunteer donors were included in the study in which 63% were male and 37% were females. Mean age was 26.54±7.3 years with age range from 23-46 years. Out of 300 donors 15.33% were O+, 35.33%, 9.66% B+, 8.33% A+, 7.66% AB+, 7.66% O-, 7% A- and 9% B-. Significant. Changes were observed in serum potassium, LDH, pH, serum chloride, serum sodium and AST levels. (p:<0.001). however, storage did not affect rest of the parameters.
Conclusion: This study reveals that during storage certain changes occur in haematological and biochemical parameters which ultimately may put patients at risk.
doi: https://doi.org/10.12669/pjms.35.6.220
How to cite this:Al-Moshary M, Al-Mussaed E, Arab-din M. Biochemical profile changes in stored donor blood for transfusion. Pak J Med Sci. 2019;35(6):1697-1700. doi: https://doi.org/10.12669/pjms.35.6.220
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.
Waist to height ratio as a screening tool for identifying childhood obesity and associated factors
Authors: Kılınç Arda , Çöl Nilgün , Demircioğlu-Kılıç Beltinge , Aydin Neriman , Balat Ayse , Keskin Mehmet 
Published: October 2019

Objective: To investigate the prevalence of obesity and associated factors during childhood in Southeastern Turkey. Another objective was to determine the cut-off points of Waist to Height Ratio (WHtR) values for defining obesity/abdominal obesity.
Methods: The community-based descriptive cross-sectional study was conducted in Gaziantep Turkey between November 2011 and December 2011 with 2718 primary school/high schools students aged 6-17 years. The SPSS 22.00 was used for the analysis of data.
Results: The prevalence of overweight, obesity, abdominal obesity, was 13.2%, 4.2% ,26.4%, respectively. There was a reverse relationship between BMI/WC values and sleep durations (p<0.05). The BMI/WC values were higher in students with computer usage time ≥1 hours in a day (p<0.05). Parental obesity status has an effective role on the WC/BMI values of children (p<0.05). The WHtR was a good predictor of diagnosis on obesity and abdominal obesity (AUC=0.928, p<0.0001; AUC=0.920, p<0.0001; respectively). The optimal cut-off values for obesity and abdominal obesity were detected as 0.5077, 0.4741, respectively.
Conclusions: The WHtR can be used for diagnosis of obesity/abdominal obesity. Parental obesity, short sleep duration and computer use more than one hour per day are risk factors for the development of obesity in children and adolescents.
doi: https://doi.org/10.12669/pjms.35.6.748
How to cite this:Kilinc A, Col N, Demircioglu-Kilic B, Aydin N, Balat A, Keskin M. Waist to height ratio as a screening tool for identifying childhood obesity and associated factors. Pak J Med Sci. 2019;35(6):1652-1658. doi: https://doi.org/10.12669/pjms.35.6.748
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.
Case Report: Pancytopenia as an indicator for lysosomal storage disease (Gaucher's Disease)
Authors: Ortega-Rosales Alberto , Burneo-Rosales Carlos , Romero-Ulloa Gilda , Burneo-Rosales Gabriela 
Published: October 2019

Introduction: Lysosomal storage disorders are a rare group of diseases with genetic origin in which Gaucher Disease (GD) stands out as the most frequent. GD type 1 is the most common form of this condition, and patients with this pathology present with unexplained cytopenias, in addition to hepatosplenomegaly, bone involvement, and in other cases neurological disorders. A case of a patient is presented, whose results showed thrombocytopenia and leukopenia in addition to hepatosplenomegaly. In Ecuador, there are very few reported cases of this clinical entity, and information on this disease is very limited. Case: We present a case of a patient diagnosed with GD, who presented with thrombocytopenia and leukopenia in addition to hepatosplenomegaly, with the aim of emphasizing the importance of early recognition of this pathology, especially in patients with unexplained cytopenia’s or hepatosplenomegaly’s. In suspicion of GD, enzymatic quantification of β-glucocerebrosidase was performed, showing its deficit in addition to alteration in the GBA gene. Conclusion: We believe that a high index of suspicion together with enzymatic and genetic testing are essential for an early specific diagnosis, which will allow the administration of timely treatment and avoid irreversible complications in order to reduce morbidity and improve the clinical aspects of the patient.
Seroprevalence of human cytomegalovirus among pregnant women who had undergone abortion(s) attending El-Damazin Hospital for Obstetrics and Gynecology, Sudan: A cross-sectional study
Authors: Elbushra Salih , Ahmed Mohammed Seed , Talha Albadawi Abdelbagi , Gamar Tarig A. , Ahmed Elhadi A. 
Published: October 2019

Background: Human cytomegalovirus (HCMV) is a major cause of congenital infections. It is more widespread in developing countries and communities with low socioeconomic status. The infection can cause pregnancy loss or spontaneous abortion. Tests are available for the detection of HCMV IgG and IgM antibodies. Many pregnant women in Blue Nile State, Sudan, have suffered from recurrent pregnancy loss, and currently there is no available data concerning the prevalence of HCMV in Blue Nile state. This study aimed to determine HCMV antibodies (IgG and IgM) among pregnant women, who had undergone abortion(s), attending El-Damazin Hospital for Obstetrics and Gynecology. Methods: This was a descriptive, cross-sectional hospital-based study. 270 pregnant women, who had undergone abortion(s) and who attended El-Damazin Hospital for Obstetrics and Gynecology, were included in the study from September to December 2018. Personal and clinical data were collected directly from each participant into a predesigned questionnaire. Serum samples were separated and stored at -20˚C until used. Samples were analyzed for HCMV IgG and IgM using enzyme-linked immune-sorbent assay (ELISA). Results: Participants were categorized into three age groups: 15-25 years (33.7%; 91/270); 26-40 years (62.2%; 168/270); and >41 years (4.1%; 11/270). The majority of the participants had IgG antibodies to HCMV (74.8%; 202/270), while only 13.3% (36/270) had IgM antibodies to HCMV. Most abortion cases were documented in the first trimester (85.6%; 231/270) and this had a significant relationship with IgG level (P=0.003). Low socioeconomic status was recorded in 84.8% (229/270) of participants and showed significant correlation with IgG level (P=0.025), whereas illiteracy was reported in 41.9% (113/270) of participants and did not have a significant relationship. Conclusions: Seroprevalence of HCMV in this study population was 74.8% for IgG antibodies. There was an association between HCMV IgG level and first trimester abortion and low socioeconomic status among the studied women.
Altitude and its inverse association with abdominal obesity in an Andean country: a cross-sectional study
Authors: Pajuelo-Ramírez Jaime , Torres-Aparcana Harold , Agüero-Zamora Rosa , Quispe Antonio M. 
Published: October 2019

Background: Abdominal obesity represents an accurate predictor of overall morbidity and mortality, which is worrisome because it is also continuously increasing across Andean countries. However, its relationship with altitude remains unclear. The objective of this study was to assess the association between altitude and abdominal obesity in Peru, and how sociodemographic variables impact this association. Methods: We estimated the prevalence of abdominal obesity in Peru and analyzed its association with altitude using the data from the 2012-2013 National Household Survey (ENAHO). During this survey, a representative sample of Peruvians was screened for abdominal obesity, using waist circumference as a proxy, and the Adult Treatment Panel III guidelines cutoffs. Results: Data were analyzed from a sample of 20,489 Peruvians (51% male). The prevalence of abdominal obesity was estimated at 33.6% (95% CI: 32.5 to 34.6%). In Peru, altitude was significantly and inversely associated with abdominal obesity, decreasing with higher altitudes: 1500-2999 meters above mean sea level (MAMSL) vs <1500 MAMSL, adjusted prevalence rate [aPR]= 0.86 (95% CI: 0.75 to 0.97); ≥3000 MAMSL vs <1500 MAMSL, aPR= 0.98 (95% CI: 0.87 to 1.11), when adjusting by age, gender and residence area (rural/urban). However, this association was significantly modified by age and gender (p< 0.001). Conclusion: Abdominal obesity is highly prevalent in Peru and decreases significantly with altitude, but age and gender modify this association. Thus, abdominal obesity appears to affect older women from low altitudes more than younger men from high altitudes.
The Effect of Reporting Streaks on Ex Ante Uncertainty
Authors: Neururer Thaddeus , Papadakis George , Riedl Edward J. 
Published: October 2019

This paper predicts and finds that investor uncertainty surrounding a key information release event—the earnings announcement—is decreasing in a firm’s reporting streak. We use two proxies related to investor ex ante uncertainty and corresponding pricing of such uncertainty: option-implied volatilities and variance risk premiums; both are measured with maturities surrounding the impending quarterly earnings announcement. Consistent with prior research, we measure reporting streak as the number of consecutive quarters the firm meets or beats the consensus analyst earnings-per-share forecast. Empirical results confirm expectations that the two uncertainty-related constructs are decreasing in the length of the reporting streak. These results, combined with further evidence documenting that lower uncertainty leads to lower stock returns surrounding the earnings announcements, suggest that longer reporting streaks reflect lower risk during earnings announcements. This paper was accepted by Shiva Rajgopal, accounting.
Heuristic Thinking in Patient Care
Authors: KC Diwas Singh 
Published: October 2019

This paper studies heuristic thinking and cognitive bias using a natural experiment from the field. The setting for the study is a set of acute care hospitals, where we examine the care process and discharge decisions for individual patients. Determining a patient’s suitability for discharge is cognitively taxing, calling for the decision maker to draw on up-to-date clinical expertise and detailed information. We postulate that bounded rationality in decision making can lead the care provider to substitute clinical readiness for discharge, a more cognitively complex attribute, with the observed days spent in the hospital, a more easily accessible heuristic. Identifying the use of the heuristic is challenging, as patient readiness for discharge is often correlated with the time spent in the hospital. Our identification strategy, motivated by regression discontinuity design, exploits a discontinuity associated with the admission process at midnight. On the basis of more than 177,000 patient discharges spanning eight years, we find support for the use of the heuristic: 19.2% (95% confidence interval (CI) [14.6%, 23.8%]) of patients incur an increased length of stay by a day on average as a result of the heuristic. We also find that the reliance on the heuristic is associated with overtreatment; postmidnight patients on average cost $512 (95% CI [$100, $923]) more but without any corresponding improvement in healthcare outcomes. A counterfactual analysis shows that eliminating the heuristic lowers the bed capacity needed to maintain the same patient throughput. For example, for a hospital unit in our study with a bed capacity of 106, eliminating the heuristic would allow the hospital to maintain the same throughput with 1.61 fewer beds on average. These findings have a number of implications for policy formulation and managerial decision making. This paper was accepted by Vishal Gaur, operations management.
Wound healing activity of Pimpinella anisum methanolic extract in streptozotocin-induced diabetic rats
Authors: Hashemnia Mohammad , Nikousefat Zahra , Mohammadalipour Adel , Zangeneh Mohammad-Mahdi , Zangeneh Akram 
Published: October 2019

Objective: To assess the wound healing potential of Pimpinella anisum on cutaneous wounds in diabetic rats. Method: Full-thickness excisional wounds were made on the back of male, Sprague-Dawley rats with diabetes. The rats were randomly allocated into four treatment groups: 1ml basal cream; tetracycline (3%); Pimpinella anisum 10% for 14 days; and a control group. At days seven, 14 and 21 post-injury, five animals of each group were euthanised, and wounds were assessed through gross, histopathological and oxidant/antioxidant evaluations. Additionally, the dry matter and hydroxyproline contents of the skin samples were measured. Results: A total of 60 rats were used in the study. A significant decrease in the wound size was observed in treated animals with Pimpinella anisum compared with other groups during the experiment. Additionally, treatment with Pimpinella anisum decreased the number of lymphocytes and improved the number of fibroblasts at the earlier stages and increased a number of fibrocytes at the later stages of wound healing. Other parameters such as re-epithelialisation, tissue alignment, greater maturity of collagen fibres and large capillary-sized blood vessels revealed significant changes when compared with the control. Pimpinella anisum significantly reverted oxidative changes of total antioxidant capacity, malondialdehyde and glutathione peroxidase induced by diabetic wounds (p<0.05). Furthermore, it significantly increased the dry matter and hydroxyproline contents at various stages of wound healing (p<0.05). Conclusion: The present study showed that application of Pimpinella anisum extract promotes wound healing activity in diabetic rats. The wound-healing property of Pimpinella anisum can be attributed to the phytoconstituents present in the plant.
Interpreting Anion Gap Values in Adult and Pediatric Patients: Examining the Reference Interval
Authors: Ayala-Lopez Nadia , Harb Roa 
Published: October 2019

Abstract

Background
The anion gap is primarily used in the diagnosis of acid-base disorders. We conducted a study to determine the anion gap reference interval in our patient population, investigated the workup of abnormal vs normal anion gaps, and examined the anion gap variation upon repeated testing.

Methods
A retrospective review was performed on 17137 adult and pediatric patients who presented to Yale-New Haven Hospital outpatient clinics, emergency department, or intensive care units between 2012 and 2017.

Results
We derived a new reference interval of 7 to 18 mmol/L with a median of 13 mmol/L in healthy adults with no significant differences owing to partitioning by sex or age. Based on the new reference interval, 5%, 23%, and 18% of healthy, emergency department, and intensive care unit adult patients, respectively, were misclassified as having high values with the previous interval of 6 to 16 mmol/L. However, there were no significant differences in the number of tests ordered in patients with anion gaps above and below the upper limit of the previous reference interval. The majority of increased anion gaps that were repeated normalized by 12 h. In a subgroup of healthy adult patients with annual testing, the median percent change in each patient's anion gap from 2015 to 2016 was approximately 13%.

Conclusions
The anion gap should be used with an appropriate reference interval to avoid misclassification. There may be a moderate degree of individuality that argues for comparing the anion gap with its baseline value in the same patient pending further studies that formally derive its biological variation.