bluuebunny/crossref_metadata_2025_split huggingface dataset:
The tail wagging the dog: the diagnostic accuracy of first rank symptoms
Authors: Townsend Leigh , De Giorgi Riccardo 
Published: October 2019

SUMMARYOutcomes for people with schizophrenia are improved by expedient diagnosis and specific treatment. ICD-11 and DSM-5 have reduced the importance of Schneider's first rank symptoms (FRS) in the diagnosis of schizophrenia; however, FRS may still offer a useful triage tool for the early identification of schizophrenia and initiation of antipsychotic therapy in high-demand and resource-poor settings. This commentary considers a Cochrane review that assesses the diagnostic accuracy of one or multiple FRS in diagnosing schizophrenia in adults and adolescents.
Oxaliplatin-Based Adjuvant Chemotherapy for Rectal Cancer After Preoperative Chemoradiotherapy (ADORE): Long-Term Results of a Randomized Controlled Trial
Authors: Hong Yong Sang , Kim Sun Young , Lee Ji Sung , Nam Byung-Ho , Kim Kyu-pyo , Kim Jeong Eun , Park Young Suk , Park Joon Oh , Baek Ji Yeon , Kim Tae-You , Lee Keun-Wook , Ahn Joong Bae , Lim Seok-Byung , Yu Chang Sik , Kim Jin Cheon , Yun Seong Hyeon , Kim Jong Hoon , Park Jin-hong , Park Hee Chul , Jung Kyung Hae , Kim Tae Won 
Published: October 2019

PURPOSE We evaluated the role of oxaliplatin as adjuvant chemotherapy in patients with rectal cancer who received preoperative chemoradiotherapy (CRT) with fluoropyrimidine monotherapy and total mesorectal excision (TME). METHODS The ADORE trial (adjuvant oxaliplatin in rectal cancer) is a multicenter, randomized trial in patients with postoperative ypStage II (ypT3-4N0) or III (ypTanyN1-2) rectal cancer after fluoropyrimidine-based preoperative CRT and TME. Patients were randomly assigned (1:1) to receive adjuvant chemotherapy either with FL (fluorouracil 380 mg/m2 and leucovorin 20 mg/m2) or FOLFOX (oxaliplatin 85 mg/m2, leucovorin 200 mg/m2, and fluorouracil bolus 400 mg/m2 on day 1, fluorouracil infusion 2,400 mg/m2 for 46 hours). Stratification factors included ypStage and participating center. Primary end point was disease-free survival (DFS). RESULTS A total of 321 patients were enrolled between November 19, 2008, and June 12, 2012. Six-year DFS rates were 68.2% in the FOLFOX arm versus 56.8% in the FL arm, with a stratified hazard ratio of 0.63 (95% CI, 0.43 to 0.93; P = .018) by intention-to-treat analysis. In the subgroup analysis for DFS, FOLFOX was favorable versus FL in patients with ypStage III, ypN1b, ypN2, high-grade histology, minimally regressed tumor, and an absence of lymphovascular or perineural invasion. Six-year overall survival rate was 78.1% in the FOLFOX arm versus76.4% in the FL arm (hazard ratio, 0.73; 95% CI, 0.45 to 1.19; P = .21). In the subgroup analysis for OS, FOLFOX was favorable versus FL in patients with ypN2 and minimally regressed tumor. CONCLUSION Adjuvant FOLFOX improved DFS in patients with rectal cancer with ypStage II and III disease after preoperative CRT. Adjuvant FOLFOX may be considered on the basis of the postoperative pathologic stage in those who received preoperative CRT and TME.
Endocrine Regulation of Epimorphic Regeneration
Authors: Easterling Marietta R , Engbrecht Kristin M , Crespi Erica J 
Published: October 2019

AbstractStudies aiming to uncover primary mechanisms of regeneration have predominantly focused on genetic pathways regulating specific stages in the regeneration process: wound healing, blastema formation, and pattern formation. However, studies across organisms show that environmental conditions and the physiological state of the animal can affect the rate or quality of regeneration, and endocrine signals are likely the mediators of these effects. Endocrine signals acting directly on receptors expressed in the tissue or via neuroendocrine pathways can affect regeneration by regulating the immune response to injury, allocation of energetic resources, or by enhancing or inhibiting proliferation and differentiation pathways involved in regeneration. This review discusses the cumulative knowledge in the literature about endocrine regulation of regeneration and its importance in future research to advance biomedical research.
Effect of GLP-1 Receptor Agonists in the Cardiometabolic Complications in a Rat Model of Postmenopausal PCOS
Authors: Torres Fernandez Edgar D , Huffman Alexandra M , Syed Maryam , Romero Damian G , Yanes Cardozo Licy L 
Published: October 2019

AbstractPolycystic ovary syndrome (PCOS) is characterized by hyperandrogenism and ovulatory dysfunction. Women with PCOS have an elevated prevalence of cardiometabolic risk factors that worsen after menopause. Liraglutide (Lira), a glucagon-like peptide-1 receptor agonist, has shown beneficial metabolic effects in small clinic trials in reproductive-age women with PCOS. We have shown that chronic hyperandrogenemia in an experimental model of postmenopausal PCOS is associated with an adverse cardiometabolic profile and upregulation of the intrarenal renin-angiotensin system (RAS). We analyzed the effect of Lira in the cardiometabolic profile, intrarenal RAS, and blood pressure (BP) in postmenopausal PCOS. Four-week-old female Sprague Dawley rats were treated with DHT or placebo for 17 months. Lira administration during the last 3 weeks caused a bigger reduction in food intake, body weight, fat mass, and homeostasis model assessment of insulin resistance index in PCOS than in control rats. Moreover, Lira improved dyslipidemia and elevated leptin levels in PCOS. In contrast, Lira decreased intrarenal expression of RAS components only in the control group. Lira transiently increased heart rate and decreased BP in control rats. However, Lira did not modify BP but increased heart rate in PCOS. The angiotensin-converting-enzyme inhibitor enalapril abolished the BP differences between PCOS and control rats. However, Lira coadministration with enalapril further reduced BP only in control rats. In summary, Lira has beneficial effects for several cardiometabolic risk factors in postmenopausal PCOS. However, hyperandrogenemia blunted the BP-lowering effect of Lira in postmenopausal PCOS. Androgen-induced activation of intrarenal RAS may play a major role mediating increases in BP in postmenopausal PCOS.
Imaging anatomy of the retrotympanum: variants and their surgical implications
Authors: Burd Christian , Pai Irumee , Connor Stephen 
Published: October 2019

The retrotympanic anatomy is complex and variable but has received little attention in the radiological literature. With advances in CT technology and the application of cone beam CT to temporal bone imaging, there is now a detailed depiction of the retrotympanic bony structures.
With the increasing use of endoscopes in middle ear surgery, it is important for the radiologist to appreciate the nomenclature of the retrotympanic compartments in order to aid communication with the surgeon. For instance, in the context of cholesteatoma, clear imaging descriptions of retrotympanic variability and pathological involvement are valuable in pre-operative planning.
The endoscopic anatomy has recently been described and the variants classified. The retrotympanum is divided into medial and lateral compartments with multiple described potential sinuses separated by bony crests.
This pictorial review will describe the complex anatomy and variants of the retrotympanum. We will describe optimum reformatting techniques to demonstrate the structures of the retrotympanum and illustrate the associated anatomical landmarks and variants with CT. The implications of anatomical variants with regards to otologic surgery will be discussed.
Teaching “Shock Pathophysiology” by Flipped Classroom
Authors: Sadia Fatima Syeda , Hashmi Satwat , Rehman Rehana , Akbar Rozmeen 
Published: October 2019

Objective: To assess usefulness of flipped style of teaching conducted as small-group format in Cardiovascular and Respiration module for Year-I undergraduate medical students at Aga Khan University.
Methods: The study was planned and conducted over a period of eight months from March to October 2017 including the time taken for planning, mock run, execution followed by analysis and dissemination. It was carried out at the Aga Khan University Medical College, Karachi. Pre and post test scores of students after flipped class room sessions was compared. Moreover, perception of students was assessed on Likert scale (0-4) by a pretested validated questionnaire.
Results: The mean pre-test scores of the students was 4.86 ± 0.91 which improved to 6.09 ± 0.81 (p = 0.021) after attending the flipped class session. Students approved that the frame work helped to promote their learning motivation and engagement with improvement in understanding of the course materials and enhancement of learning during Face to Face activity.
Conclusions: The flipped classroom approach showed promise in teaching and learning of ‘Pathophysiology of Shock’ by clinical scenarios in small group discussions. Implementation of flipped class room activity on a wider scale however needs careful selection of course objectives and logistics.
doi: https://doi.org/10.12669/pjms.35.6.1211
How to cite this:Fatima SS, Hashmi S, Rehman R, Akbar R. Teaching “Shock Pathophysiology” by Flipped Classroom. Pak J Med Sci. 2019;35(6):1631-1635. doi: https://doi.org/10.12669/pjms.35.6.1211
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.
Genetic polymorphism of miRNA-196a and its target gene annexin-A1 expression based on ethnicity in Pakistani female breast cancer patients
Authors: Rahim Amena , Afzal Muhammad , Naveed Abdul Khaliq 
Published: October 2019

Objective: To evaluate the association of miR-196a rs11614913 C/T genetic variation and its target gene annexin A1 mRNA expression with breast cancer risk in Pakistani female ethnicities.
Methods: This case control study, conducted from March 2017 to November 2018 included 295 breast cancer patients, 295 controls of three Pakistani ethnicities and archived 100 samples of cohort group for genotyping and expression profiling. Genotyping of miR-196a (rs11614913 C/T) was done by ARMS PCR technique. Annexin-A1 (ANXA1) mRNA expression was measured with qRT-PCR and detection of protein expression of ANXA1 was done by immunohistochemistry.
Results: CC homozygous genotype of miR-196a rs11614913 was present in 81.4% of cases and 73.9% controls. C/T polymorphism was found to be significantly associated with decrease risk of breast cancer (OR=0.25 (0.11- 0.58, p <0.05). Similar trend was seen with the minor T allele (OR=0.55 (0.39-0.77, p <0.05, and both dominant and recessive models (OR=0.64; p=0.02 and OR=0.26, p=0.00). In the KPK ethnic group significant decrease association with breast cancer risk was observed (OR= 0.22 (0.09-0.53, p < 0.05). Immunohistochemical staining showed loss of ANXA1 protein expression in 72 samples, and significant association was observed with pathological type p=0. 00 and triple negative receptor status p=0.03 and with genotypes of miR-196a p=0.00. Increase relative expression of 2.81± .88 by qPCR analysis of ANXA1 mRNA was noted with TT genotype.
Conclusions: Our results demonstrate that miR-196a rs11614913 C/T polymorphism is associated with a decreased risk and loss of protein expression in breast cancer in the Pakistani population.
doi: https://doi.org/10.12669/pjms.35.6.1322
How to cite this:Rahim A, Afzal M, Naveed AK. Genetic polymorphism of miRNA-196a and its target gene annexin-A1 expression based on ethnicity in Pakistani female breast cancer patients. Pak J Med Sci. 2019;35(6):1598-1604. doi: https://doi.org/10.12669/pjms.35.6.1322
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.
Nuclear magnetic resonance evaluation of inflammatory activity from chronic viral Hepatitis B
Authors: Dong Jinghui , Liu Yuan , Ye Huiyi , An Weimin , Ren Hongwei 
Published: October 2019

Objectives: To discuss the value of applying magnetic resonance diffusion-weighted imaging (DWI) to evaluate inflammatory activity from chronic viral hepatitis B.
Methods: One hundred forty-two patients with chronic viral hepatitis B who received treatment at The Fifth Medical Center of Chinese PLA General Hospital from January 2014 to December 2015 and 20 healthy persons in the control group who were scheduled to undergo nuclear magnetic resonance scanning and DWI examinations (b value = 0, 800 s/mm2), and the apparent diffusion coefficients (ADCs) were measured and compared with the biopsy results of hepatic tissue.
Results: The ADC value of the group with hepatitis B was lower than that of the healthy group (P<0.05), and the ADC value of the group with mild inflammation (G1) significantly differed from that of the group with moderate inflammation (G2) and that of the group with severe inflammation (G3-G4) (P<0.05).
Conclusions: Magnetic resonance diffusion-weighted imaging technology has high clinical value for evaluating the inflammatory activity from chronic hepatitis B, and the measured ADC value corresponds to the pathological grade well, so this method is worth clinical promotion and application.
doi: https://doi.org/10.12669/pjms.35.6.1364
How to cite this:Dong J, Liu Y, Ye H, An W, Ren H. Nuclear magnetic resonance evaluation of inflammatory activity from chronic viral Hepatitis B. Pak J Med Sci. 2019;35(6):1565-1569. doi: https://doi.org/10.12669/pjms.35.6.1364
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.
Magnetic resonance evaluation of knee osteoarthritis among the Saudi Population
Authors: Alrowali Majed Gorayan 
Published: October 2019

Background and Objectives: Osteoarthritis (OA) is the most prevalent worldwide joint degenerative disorder with high morbidities and disabilities. The current study aimed to investigate the prevalence of knee osteoarthritis (KOA) in Arar by using magnetic resonance imaging (MRI).
Methods: The prevalence of KOA was studied in Arar through MRI evaluation of randomly chosen sample from patients and their relatives attending the Prince Abdul Aziz Bin Mussad Hospital from October 2015 to November 2016.
Results: A total of 410 participants were enrolled in the study [328 (80%) male and 82 (20%) females]. After MRI, 163 participants [39.75% (95% CI) = 35.14 - 44.57%)] were diagnosed with KOA. The prevalence of OA was about 25.6% (95% CI = 20.8 - 31.1%) below the age of 40 years, which was found to increase by age in the enrolled volunteers. KOA prevalence was higher in females than males (75.6% and 27.7% respectively). There was a significant association between the age and genders of the participants and the prevalence of OA (p-value < 0.0001 for both variables). There was also a significant association between the age and gender of the participants and the MRI-estimated grading (p-value < 0.0001 and 0.0044 respectively).
Conclusion: KOA is a common disease among Arar young population, especially females. Its prevalence increases by age with higher grades of severity affecting the elderly.
Abbreviations:KOA: Knee osteoarthritis, MRI: Magnetic resonance imaging, OA: Osteoarthritis.
doi: https://doi.org/10.12669/pjms.35.6.874
How to cite this:Alrowaili MG. Magnetic resonance evaluation of knee osteoarthritis among the Saudi Population. Pak J Med Sci. 2019;35(6):1575-1581. doi: https://doi.org/10.12669/pjms.35.6.874
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.
Cinepulmonary resuscitation
Authors: Baron Jaimie 
Published: October 2019

Abstract
One pronounced effect of Fruhauf's Blow-Up is the discomfort it produces due to the sound of breathing that accompanies the image. In this reediting of footage demonstrating CPR, not only are the dummy and the discarded footage resuscitated; we are also forcibly synched to the rhythm of this archival fragment.
Performing CPR on celluloid in Blow-Up
Authors: Boczkowska Kornelia 
Published: October 2019

Abstract
The article analyses how Blow-Up counteracts the Freudian death drive through hybridizing the materialist-digital dimension of the CPR imagery and the sonic-haptic experience of breathing. Consequently, while operating within the structural film and expanded cinema framework, Fruhauf symbolically embodies the celluloid, hence 'resuscitating' both the archival and contemporary cinematic material.
STRUKTUR TULANG DAN OTOT SIRIP KAUDAL KOMPLEKS Andamia heteroptera Bleeker (IKAN AMFIBI)
Authors: Nugroho Susanto Gatot 
Published: October 2019

Andamia heteroptera, known as rockskipper fish, is one of amphibious fish. Most of amphibious fish use caudal fin to facilitate locomotion in land and water. The modification is fusion of os hypural and reduction-fusion os epural and uroneurals. The aim of this study was to acces skeleton and musculature structure of A. heteroptera caudal fin. Alizarin red-Alcian blue staining revealed that caudal fin of A. heteroptera has wider spina hemalis and spina neuralis support the locomotion. There is modification of caudal fin structure for support the locomotion. Caudal fin musculature of A. heteroptera is identified as primitive type, since its lack of musculus hypochordal longitudinalis.
Protokol Evaluasi Infeksi Bakteri Pre- dan Pasca-Transplantasi Hati Anak
Authors: Karyanti Mulya Rahma , Putri Nina Dwi , Oswari Hanifah 
Published: October 2019

Infeksi pre- dan pasca-transplantasi hati dipengaruhi oleh gangguan sistem imunonlogi resipien karena penggunaan obat-obat imunosupresi. Komplikasi infeksi tersebut merupakan penyebab penting kejadian infeksi terhadap morbiditas dan mortalitas pada anak anak yang menjalani transplantasi hati. Obat-obatan profilaksis sebelum dan setelah operasi yang direkomendasikan disesuaikan dengan pola mikroba yang berkaitan di setiap rumah sakit. Uji tapis infeksi bakteri penting untuk mencegah terjadinya infeksi pasca-transplantasi hati. Komplikasi terjadinya infeksi sekunder oleh bakteri disebabkan oleh karena penggunaan alat-alat invasif dalam jangka waktu yang lama seperti kateter vena sentral, kateter akses arterial, endotracheal tube, kateter ureter, dan sebagainya. Keberhasilan efektivitas pengobatan antimikroba ditentukan oleh pengelolaan pemasangan atau pelepasan semua alat invasif dan pengontrolan infeksi di rumah sakit.
2 Hydrogen Peroxide-Assisted Endoscopic Necrosectomy vs. Standard Endoscopic Necrosectomy for Walled-Off Pancreatic Necrosis: A Multi-Center Retrospective Comparative Study
Authors: Messallam Ahmed , Adler Douglas G. , Shah Raj , Nieto Jose , Moran Robert , Elmunzer Badih , Cosgrove Natalie , Mullady Daniel , Singh Harkirat , Papachristou Georgios , Othman Mohamed , Javaid Huma , Mercado Michael Oliver M. , Tsistrakis Steven , Kumta Nikhil A. , Nagula Satish , DiMaio Christopher J. , Birch Madeleine , Taylor Linda , LaBarre Nicolas , Han Samuel , Hollander Thomas G. , Cristofaro Sarah , Keilin Steven , Cai Qiang , Willingham Field 
Published: October 2019

INTRODUCTION:
Endoscopic necrosectomy has emerged as the preferred treatment modality for walled off pancreatic necrosis (WON). Standard endoscopic necrosectomy can be tedious and time consuming, employs sharp instruments in vascular cavities, and does not provide for microdebridement. Hydrogen peroxide (H2O2) lavage has been reported in small series; however, there have been no comparative studies on its safety and efficacy in the management of WON.

METHODS:
We performed a retrospective chart review of all cases undergoing endoscopic transmural management of WON at 9 major medical centers in the US from November 2011 to August 2018. Cystogastrostomies were performed using lumen apposing metal stents (LAMS). Patients who underwent cystogastrostomy without necrosectomy were excluded. Clinical success was defined as resolution of the WON by imaging within 6 months, without requiring non-endoscopic drainage procedures or surgery.

RESULTS:
A total of 296 patients underwent cystgastrostomy and 206 patients underwent one or more necrosectomies. Clinical success was achieved in 171/192 (89.1%) of those with follow-up data at 6 months. In terms of patients, 122 (59.2%) patients had at least one H2O2 necrosectomy (H2O2 group), and 84 (40.8%) patients had standard endoscopic necrosectomy. Clinical success was higher in the H2O2 group (n = 107 (95.5%) vs 63 (79.7%), P < 0.001). On multivariate logistic regression, the use of hydrogen peroxide (OR 17.4, 95% CI: 2.9–103, P = 0.002) was associated with higher clinical success rates (Table 2). During a mean follow up of 278 days, 29 complications occurred: bleeding (n = 18), perforation (n = 5), respiratory complication (n = 3), and sepsis (n = 3). One death was presumed to be procedure related (splenic pseudoaneurysm rupture day 8; standard necrosectomy group). A total of 394 necrosectomies were performed. Comparing necrosectomy procedures with and without H2O2 (n = 209 vs 185), there was no difference in procedure time (72.5 ± 39.6 vs 72 ± 44.2, P = 0.936), post-procedural bleeding (8 vs 10, P = 0.45), perforation (3 vs 2, P = 1), infection (1 vs 2, P = 0.6) or overall complication rate (n = 15 (7.1%) vs 14 (7.6%), P = 1) (Table 3).

CONCLUSION:
In this multicenter retrospective cohort study, H2O2 necrosectomy appeared to be safe and effective with a higher clinical success rate and equivalent rates of bleeding, perforation, death, and overall complications relative to standard necrosectomy.