bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilateral calcinosis cutis of orbital walls in CREST syndrome
Authors: Ghadimi Hadi , Nikdel Mojgan , Eshraghi Bahram 
Published: January 2019

Purpose: To describe a patient with systemic sclerosis who presented with subcutaneous yellow–white nodules on her lateral orbital rims. Methods: Case report. Results: A 53-year-old female was referred for management of subcutaneous firm nodules on her lateral orbital rims. She was known to have CREST (calcification, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) syndrome, a limited variant of systemic sclerosis. Her drug history included diltiazem, captopril, aspirin, and prednisolone. There were bilateral multiple immobile yellow–white subcutaneous nodules with firm consistency, a few of which were in close proximity of periorbital skin. She was scheduled for surgical resection of the lesions and following tissue dissection, the calcified foci were removed. The incisions healed with some delay but the final postoperative follow-up at third month showed satisfactory appearance. Conclusion: Dystrophic calcinosis cutis occurs in approximately one-fourth of patients with systemic sclerosis (scleroderma), particularly in those with the limited variant or CREST syndrome. The most frequently involved sites are the extremities. Occasionally, calcinosis involves the trunk or head, but involvement of bony orbital walls is extremely rare. Surgical excision can be considered for treatment of discrete foci of calcinosis cutis.
Oral Human Papillomavirus Infection and Head and Neck Squamous Cell Carcinoma in Rural Northwest Cameroon
Authors: Rettig Eleni M. , Gooi Zhen , Bardin Richard , Bogale Mesele , Rooper Lisa , Acha Everistus , Koch Wayne M. 
Published: January 2019

ObjectiveOral human papillomavirus (HPV) infection is the precursor for a growing subset of oropharyngeal squamous cell carcinomas (OPSCCs) in the developed world. This study was designed to characterize oral HPV infection and OPSCC in a region with high rates of HPV‐driven cervical cancer.Study DesignCross‐sectional cohort study, retrospective case series.SettingNorthwest Cameroon referral hospital.Subjects and MethodsIndividuals infected with human immunodeficiency virus attending an outpatient clinic were evaluated for oral HPV infection with oral swabs or rinses that were tested for 51 HPV types. HNSCCs diagnosed and/or treated at the same hospital from 2011 to 2017 were retrospectively reviewed to ascertain demographic and tumor characteristics, and available OPSCCs were tested for HPV.ResultsThe oral HPV infection study population comprised 101 participants. Most (69%) were female and never‐smokers (84%). Participants had median 4 lifetime sexual partners (interquartile range, 3‐7; range, 1‐100). Five participants (5%) had oral HPV infection; one had 2 HPV types. HPV types detected were HPV68 (n = 2), HPV82 (n = 2), HPV32 (n = 1), and unknown (n = 1). No significant demographic or behavioral differences were detected among individuals with vs without oral HPV infection. OPSCCs comprised just 8% (n = 11) of 131 HNSCCs in the retrospective study population. Two of 7 OPSCCs were HPV positive.ConclusionThe low prevalence of OPSCC observed in northwest Cameroon together with the rarity of oral HPV infection suggests low rates of HPV‐driven oropharyngeal carcinogenesis in the region. Future research should examine how geographic differences in oral HPV infection are influenced by cultural norms and affect HPV‐OPSCC epidemiology.
Genomic landscape and clonal evolution of acute myeloid leukemia with t(8;21): an international study on 331 patients
Authors: Christen Friederike , Hoyer Kaja , Yoshida Kenichi , Hou Hsin-An , Waldhueter Nils , Heuser Michael , Hills Robert K. , Chan Willy , Hablesreiter Raphael , Blau Olga , Ochi Yotaro , Klement Piroska , Chou Wen-Chien , Blau Igor-Wolfgang , Tang Jih-Luh , Zemojtel Tomasz , Shiraishi Yuichi , Shiozawa Yusuke , Thol Felicitas , Ganser Arnold , Löwenberg Bob , Linch David C. , Bullinger Lars , Valk Peter J. M. , Tien Hwei-Fang , Gale Rosemary E. , Ogawa Seishi , Damm Frederik 
Published: January 2019

Abstract
Acute myeloid leukemia with t(8;21)(q22;q22) is characterized by considerable clinical and biological heterogeneity leading to relapse in up to 40% of patients. We sequenced coding regions or hotspot areas of 66 recurrently mutated genes in a cohort of 331 t(8;21) patients. At least 1 mutation, in addition to t(8;21), was identified in 95%, with a mean of 2.2 driver mutations per patient. Recurrent mutations occurred in genes related to RAS/RTK signaling (63.4%), epigenetic regulators (45%), cohesin complex (13.6%), MYC signaling (10.3%), and the spliceosome (7.9%). Our study identified mutations in previously unappreciated genes: GIGYF2, DHX15, and G2E3. Based on high mutant levels, pairwise precedence, and stability at relapse, epigenetic regulator mutations were likely to occur before signaling mutations. In 34% of RAS/RTKmutated patients, we identified multiple mutations in the same pathway. Deep sequencing (∼42 000×) of 126 mutations in 62 complete remission samples from 56 patients identified 16 persisting mutations in 12 patients, of whom 5 lacked RUNX1-RUNX1T1 in quantitative polymerase chain reaction analysis. KIThigh mutations defined by a mutant level ≥25% were associated with inferior relapse-free survival (hazard ratio, 1.96; 95% confidence interval, 1.22-3.15; P = .005). Together with age and white blood cell counts, JAK2, FLT3-internal tandem duplicationhigh, and KIThigh mutations were identified as significant prognostic factors for overall survival in multivariate analysis. Whole-exome sequencing was performed on 19 paired diagnosis, remission, and relapse trios. Exome-wide analysis showed an average of 16 mutations with signs of substantial clonal evolution. Based on the resemblance of diagnosis and relapse pairs, genetically stable (n = 13) and unstable (n = 6) subgroups could be identified.
Evaluation of multiple risk factors involved in the development of Diabetic Retinopathy
Authors: Anwar Syeda Birjees , Asif Naveed , Naqvi Syed Abid Hassan , Malik Sidra 
Published: January 2019

Objective: To determine the role of hypertension, hyperlipidemia, smoking and positive family history of diabetes and hypertension in the development of diabetic retinopathy.
Methods: This prospective cohort study was conducted at the Department of Chemical Pathology, Armed Forces Institute of Pathology, Rawalpindi over 2 years period from June 2014 to June 2016. One hundred consecutive diabetic patients with no signs of diabetic retinopathy and good glycemic control (HbA1c<6.5%) were registered by non-probability convenient sampling after taking written informed consent. They were evaluated for hypertension, hyperlipidemia and smoking status. These patients were then followed 6 monthly for 2 years to look for the development of diabetic retinopathy.
Results: The mean age of the patients was 50.72±9.29 years and there were 57 (57%) male and 43 (43%) female patients. Majority (82%) of the patients had NIDDM. The mean duration of diabetes was 8.31±6.83 years. 11% of the patients were smoker, 37% were hypertensive, 6% had hyperlipidaemia, 62% had family history of diabetes and 30% had family history of hypertension. At the end of follow-up, 9 (9.0%) patients had diabetic retinopathy. The frequency of diabetic retinopathy increased with increasing age of the patient; however, the difference was statistically insignificant. A comparatively higher frequency of diabetic retinopathy was also seen in patients with IDDM and those with positive family history of diabetes and hypertension yet again, the difference was statistically insignificant. Also, no significant difference was noted among male and female genders and smokers vs. non-smoker. However, the frequency of diabetic retinopathy increased significantly with increasing duration of diabetes. It was also higher among those with hypertension and hyperlipidemia.
Conclusion: Higher patient age (≥50 years), increasing duration of diabetes (≥20 years), insulin dependent diabetes mellitus, hypertension, hyperlipidemia, and positive family history of diabetes and hypertension were found to be associated with increased frequency of diabetic retinopathy.
How to cite this:Anwar SB, Asif N, Naqvi SAH, Malik S. Evaluation of multiple risk factors involved in the development of Diabetic Retinopathy. Pak J Med Sci. 2019;35(1):156-160. doi: https://doi.org/10.12669/pjms.35.1.279
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.
Marginal accuracy of provisional crowns using three material systems and two techniques: A scanning electron microscope study
Authors: Naqash Talib Amin , Alfarsi Mohammed , Hussain Muhammad Waqar 
Published: January 2019

Objective: The most important desideratum of a provisional crown is an adequate marginal fit that is essential for maintaining optimal periodontal health, reducing the sensitivity of freshly prepared dentin and protection of the pulp. The purpose of this in vitro study was to compare the vertical marginal accuracy of provisional crown materials using three different material systems (chemically activated PMMA powder-liquid system, light activated UDMA single paste system, and chemically activated Bis-GMA two paste auto mix system) and two different techniques (direct and indirect).
Methods: Two customized stainless steel dies, simulating prepared and unprepared tooth were used to fabricate 40 provisional crowns. Additional silicone elastomeric impression and a vacuum-formed polypropylene sheet were used as a matrix. Ten crowns, each of the three material systems used in the study (n = 10 × 3) were fabricated using the direct technique and ten crowns from chemically activated PMMA powder-liquid system (n = 10 × 1) using an indirect technique. Scanning electron microscope (SEM) was used to measure vertical marginal discrepancies at x100 magnification. The results were analyzed using descriptive statistics and comparisons between various groups were made using one way analysis of variance (ANOVA) after checking the normality of data using Shapiro Wilk’s Test. Post Hoc Tukey HSD Test was used to determine the statistical difference between the means of independent group pairs.
Results: The mean marginal discrepancies of Bis-GMA composite resin, UDMA composite resin, and PMMA acrylic resin using direct technique were 67.15 µm, 71.01 µm, and 84.56 µm respectively. PMMA acrylic resin showed a mean marginal discrepancy of 103.03 µm using the indirect technique.
Conclusion: This study has shown that provisional crowns fabricated with Bis-GMA composite resin material (two paste auto mix system) registered the best marginal accuracy. Provisional crowns fabricated with indirect technique recorded less marginal opening than with direct technique.
How to cite this:Naqash TA, Alfarsi M, Hussain MW. Marginal accuracy of provisional crowns using three material systems and two techniques: A scanning electron microscope study. Pak J Med Sci. 2019;35(1):55-60. doi: https://doi.org/10.12669/pjms.35.1.5
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.
HIV treatment and monitoring patterns in routine practice: a multi-country retrospective chart review of patient care
Authors: Musa Baba M , Ibekwe Everistus , Mwale Stanley , Eurien Daniel , Oldenburg Catherine , Chung Gary , Heller Richard F 
Published: January 2019

Background: A study of patient records in four HIV clinics in three sub-Saharan African countries examined routine clinical care patterns and variations. Methods: Clinic characteristics were described, and patient data extracted from a sample of medical records. Data on treatment, CD4 count and viral load (VL) were obtained for the last visit in the records, dates mainly between 2015 and 2017, patient demographic data were obtained from the first clinic visit. Results: Four clinics, two in Nigeria, one in Zambia and one in Uganda, all public facilities, using national HIV treatment guidelines were included. Numbers of patients and health professionals varied, with some variation in stated frequency of testing for CD4 count and VL. Clinical guidelines were available in each clinic, and most drugs were available free to patients. The proportion of patients with a CD4 count in the records varied from 84 to 100 percent, the latest median count varied from 269 to 593 between clinics. 35% had a record of a VL test, varying from 1% to 63% of patients. Lamivudine (3TC) was recorded for more than 90% of patients in each clinic, and although there was variation between clinics in the choice of antiretroviral therapy (ART), the majority were on first line drugs consistent with guidelines. Only about 2% of the patients were on second-line ARTs. In two clinics, 100% and 99% of patients were prescribed co-trimoxazole, compared with 7% and no patients in the two other clinics. Conclusions: The wide variation in available clinic health work force, levels and frequency of CD4 counts, and VL assessment and treatment indicate sub-optimal adherence to current guidelines in routine clinical care. There is room for further work to understand the reasons for this variation, and to standardise record keeping and routine care of HIV positive patients.
Sociodemographic, obstetric and psychological determinants of obesity among women in early to mid-pregnancy in South India
Authors: Venkatesh Shubhashree , Nath Anita , Balan Sheeba , J Vindhya , Metgud Chandra S. , Murthy Gudlavalleti Venkata Satyanarayana 
Published: January 2019

Background: Worldwide, the occurrence of obesity has markedly increased over the past decades with serious public health consequences. Obese pregnant women are more likely to develop hypertension, pre-eclampsia and gestational diabetes, resulting in obstetric complications which in turn may contribute to an increase in adverse child outcomes and maternal mortality. The present study was done to determine the prevalence of obesity and its association with socio-demographic variables, obstetric history and mental health. Methods: This study was nested within an ongoing cohort study, CASCADE, in a public hospital in Bangalore. The study participants comprised of 280 pregnant women who were 18 years of age and above, with a gestational age of less than 24 weeks, enrolled between a period of August 1st, 2017 until April 30th, 2018. Weight and height were measured using calibrated devices to calculate the body mass index. Results: The prevalence of obesity was observed to be 33.9% among the pregnant mothers. Obesity was found to be significantly associated with age, history of abortion, gravidity on multivariate logistic regression. No association was found with depression and anxiety. Conclusions: Obesity is an important health concern among urban pregnant women in the region of South India. The prevalence is much higher than that reported in other studies. Increasing age, multigravidity and past history of abortion were significantly associated with maternal obesity.
The orthopaedic management of long bone deformities in genetically and acquired generalized bone weakening conditions
Authors: Wirth T. 
Published: January 2019

Purpose Diseases such as osteogenesis imperfecta, fibrous dysplasia, hypophosphataemic rickets and others lead to soft and weak bones and long bone deformity in affected patients. As a consequence, these patients lose their walking capacity and functional abilities of the upper extremities as well. Methods In combination with bisphosphonate treatment and physical rehabilitation programmes surgical interventions are being applied to correct and stabilize the deformed and less mechanically resistant long bones. Intramedullary devices, ideally with an elongating telescopic mechanism, have proven to be the most suitable implants. Results The surgical correction and stabilization of deformed bones in weak bone diseases is very beneficial to the patients. Pain restriction, reduction of fracture events, minimization of consequences of traumatic events and falls have resulted in a significant functional improvement. The patients live on a better activity level with a much-improved individual independence. Despite a high complication and revision rate of the intramedullary rods the gain of quality of life outweighs these negative aspects by far. Conclusion Orthopaedic surgical treatment for deformed bones in patients with weak bone diseases has changed the life of the patients and plays a very important role in the disease management protocols. This paper was written under the guidance of the Study Group Genetics and Metabolic Diseases of the European Paediatric Orthopaedic Society.
Complex spine deformities in young patients with severe osteogenesis imperfecta: Current concepts review
Authors: Castelein R. M. , Hasler C. , Helenius I. , Ovadia D. , Yazici M. ,   EPOS Spine Study Group
Published: January 2019

The severity of osteogenesis imperfecta (OI), the associated reduced quality and quantity of collagen type I, the degree of bone fragility, ligamentous laxity, vertebral fractures and multilevel vertebral deformities all impair the mechanical integrity of the whole spinal architecture and relate to the high prevalence of progressive kyphoscoliotic deformities during growth. Bisphosphonate therapy may at best slow down curve progression but does not seem to lower the prevalence of deformities or the incidence of surgery. Brace treatment is problematic due to pre-existing chest wall deformities, stiffness of the curve and the brittleness of the ribs which limit transfer of corrective forces from the brace shell to the spine. Progressive curves entail loss of balance, chest deformities, pain and compromise of pulmonary function and eventually require surgical stabilization, usually around puberty. Severe vertebral deformities including deformed, small pedicles, highly brittle bones and chest deformities, short deformed trunks and associated issues like C-spine and cranial base abnormalities (basilar impressions, cervical kyphosis) as well as deformed lower and upper extremities are posing multiple peri- and intraoperative challenges. Hence, an early multidisciplinary approach (anaesthetist, pulmonologist, paediatric orthopaedic spine surgeon) is mandatory. This paper was written under the guidance of the Spine Study Group of the European Paediatric Orthopaedic Society. It highlights the most pertinent information given in the current literature and various practical aspects on surgical care of spine deformities in young OI patients based on the personal experience of the contributing authors.
Structural analysis of conditions determining the selection of construction technology for structures in the centres of urban agglomerations
Authors: Radziszewska-Zielina Elżbieta , Śladowski Grzegorz , Kania Ewelin 
Published: January 2019

Abstract
The process of constructing structures and the selection of technology is difficult due to a series of highly varied conditions - which are often difficult to foresee - associated with the construction of a building within a city centre. The goal of the article is the performance of a structural analysis of the most commonly occurring conditions that need to be considered in the context of the selection of a technology of constructing buildings in the centre of an urban agglomeration. Based on a literature study that had been performed, aswell as on a survey study performed on expects, the authors listed and characterised conditions that occur during the construction of structures in the centres of urban agglomerations. Afterwards, experts determined the impact of these factors and their mutual relations in the context of the selection of the technology of the construction of said structures. In order to determine the involvement and the role of the factors in the context of the selection of a technology of the construction of a structure, as well as its analysis, the authors used the WINGS (Weighted Influence Non-linear Gauge System) modelling and structural analysis method. This method takes into account both direct, as well as indirect relations between these factors. The study contained in the article constitutes a basis for the development of a comprehensive systemic approach supporting the decision-making process associated with the selection of a construction technology for a building to be built in the centre of an urban agglomeration.
The design method of rubber-metallic expansion joint
Authors: Jaszak Przemysław , Skrzypacz Janusz , Adamek Konrad 
Published: January 2019

Abstract
The paper present the method of designing a rubber expansion joints, intended for operation in the pressure class 25 bar. During the design used a numerical analysis,which based on the finite element method (FEM). The results from experimental test were used to correctly modeled the rubber or polyamide reinforcement. Basis on the obtained results, the hyperelastic model of the rubber was prepared, then the design of the rubber expansion joint was tested in different load case, i.e tensile or compressive deflection and pressurization.
A fuzzy reasoning approach to assess innovation risk in ecosystems
Authors: Abreu António , Martins José Moleiro , Calado João M. F. 
Published: January 2019

Abstract
Currently, companies to be competitive must achieve high rates of innovation and respond quickly to market needs.
According to a number of managers and researches innovation is crucial for companies to stay “alive." Taking into account several reports, the development of co-innovation networks based on a collaborative environment is the best strategy to support innovation projects. However, the absence of mechanisms to detect and even anticipate potential risks of innovation based on a collaborative approach is an obstacle to the proliferation of this way of working.
To address this issue, this paper discusses an approach based on fuzzy reasoning for analyzing the level of risk in co-innovation projects. It is discussed how this approach can be applied to co-innovation projects within the context of a collaborative ecosystem. At last, it is discussed the benefits, and challenges found on experimental results from a Portuguese co-innovation network.
Complexity, accuracy, and fluency in the argumentative writing of ESL and EFL learners
Authors: Barrot Jessie , Gabinete Mari Karen 
Published: January 2019

AbstractDespite the growing body of research on the complexity, accuracy, and fluency (CAF) in second language writing, differences in CAF across ESL and EFL learner productions remain underexplored. Thus, this study sought to determine whether there is a systematic difference in the CAF of English writing among ESL and EFL college students. For this purpose, a total of 1,870 essays were collected from the International Corpus Network of Asian Learners of English-Written or ICNALE-Written. The findings reveal different patterns in various measures of CAF in the written outputs of both the ESL and EFL groups. These findings suggest that writing complexity, accuracy, and fluency are not only influenced by proficiency level but also by learners’ L1 background. Findings further show moderate to high positive correlations between and among the components of each language dimension (i. e. complexity, accuracy, and fluency). Implications for ESL writing pedagogy and future studies are discussed.