bluuebunny/crossref_metadata_2025_split huggingface dataset:
Esophageal cancer patient survival: A retrospective study from a tertiary care hospital in Pakistan
Authors: Sajida Qureshi  , Sumayah Khan  , M.Saeed Quraishy  , Zaheer Sidra 
Published: March 2024

Objective: To determine the pattern, tumor characteristics of esophageal cancer (EC) and survival of esophageal carcinoma patients presenting to upper GI Unit at Dr. Ruth K.M. Pfau Civil Hospital Karachi.
Methods: We conducted a retrospective analysis of histologically confirmed EC patients from 2016 to 2021 at Upper GI Unit – Dr. Ruth K.M. Pfau Civil Hospital, Karachi. Data were collected using a filled Proforma, medical records, pathology reports and surgical notes, and patients or their family members were contacted for informed consent. Statistical analyses were performed using STATA version 16.0. Time to event was measured from the date of diagnosis to the date of the last follow-up or recorded death. Descriptive statistics and survival analyses, including Kaplan–Meier method and log-rank test, were employed. Univariate and multivariate Cox regression analyses were conducted to assess independent predictors of survival.
Results: Total 152 patients with a median age of 45 (range 80-15) years were enrolled in this study. Clinical stages-III, IV-A and IV-B were identified in 35.5% (n = 54), 23.7% (n = 36) and 34.2% (n = 52), respectively. Total of 62% (n=94) had died at median follow up of 9.56 months and three years overall survival rate was 10.0%. Univariate survival analysis revealed that patients with clinical stage-II (p-value 0.002) and patients treated with combined surgery plus chemo-radiotherapy (p-value 0.040) was significantly associated with lower risk of mortality among other stages and treatment modality groups. Conversely, patients having metastasis (p value <0.001) and those with vascular involvement >90 degrees (p value <0.001) showed worse survival outcomes.
Conclusion: Our study reveals a three years survival rate of 10.0%, emphasizing the formidable challenge of advanced-stage malignancies. Clinical stage, vascular involvement, and metastasis emerged as significant predictors of mortality. Moreover, integrating surgery with chemo-radiotherapy significantly improved three years survival (36.8% vs. 14.2%). Despite single-center limitations, our findings provide crucial regional insights into esophageal carcinoma outcomes.
doi: https://doi.org/10.12669/pjms.40.5.7582
How to cite this: Qureshi S, Khan S, Quraishy MS, Zaheer S. Esophageal cancer patient survival: A retrospective study from a tertiary care hospital in Pakistan. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.7582
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.
APPLICATION OF VOSYS-OPTIMA SYSTEM COMPONENTS IN CONSTRUCTION OF HARDWARE LAYOUTS OF MONOLATERAL COMBINATION WITH ANGULAR SUPPORT IN CASES OF TREATMENT OF INTRAARTICULAR KNEE FRACTURES AND DISTAL CIRCUMARTICULAR FRACTURES OF THE FEMUR IN DOGS AND CATS
Authors: Kiselev Igor G. , Yemanov Andrey A. , Rodin Matvei I. 
Published: March 2024

For treatment of prearticular and intraarticular fractures including knee joint area in dogs and cats, as a rule, thin pins, serclage, plates, and their combinations are used depending on fracture area and fracture complexity, which fails to fully provide sufficient stability of osteosynthesis.
Purpose of the study was to study the processes taking place in the joints of operated animals at prolonged blockage with hardware constructions for the period of healing of the prearticular and intraarticular fractures.
Scientific novelty. Based on a comprehensive study, the use of monolateral combination arrangements with angular support for the treatment of intra-articular fractures of the stifle joint, as well as distal periarticular femur fractures in dogs and cats, was evaluated. The feasibility of the need to protect the operated area from force during fracture healing was determined.
Methods. To treat fractures in the knee joint area, polyfunctional monoblocks without a push-back rod, transosseous insertion rods of different diameters depending on the size of the animal, and supports of different diameters with a 125-130° bend were used.
A total of 16 operations were performed, 5 dogs and 11 cats. The dogs came in weighing from 4 to 15 kg. The age was from 5 to 38 months old. The cats were 4 to 41 months old, their weights ranging from 1.2 to 5 kg. The supports used were 3, 4, and 5 mm in diameter.
Results. Contracture of the operated limbs in the animals after removal of the hardware constructs in our study was more or less pronounced in the animals with more than 2 weeks of hardware fixation. We did not find the presence of contracture in animals with hardware structures removed after two weeks, while lameness in these animals could be observed from 3 to 12 days, the loss of muscle mass of the thigh in the form of a decrease in its volume was not observed. The picture was similar for both cats and dogs.
Conclusion. The use of monolateral combinations with angular support for treatment of intraarticular fractures of the knee joint as well as distal circumarticular fractures of the femur in dogs and cats is reasonable in terms of the need to protect the operated area from forceful influences during fracture healing.
The most physiological period of blocking the area of the knee joint with the external fixation apparatus in our study was from 2 to 3 weeks regardless of the age of the animal.
Bladder perforation and vesico-haematoma fistula: an uncommon complication of rectus sheath haematoma
Authors: Cheng Novena Lin Sing , Wong Chung Wai , Yu Wen Ming , Tsang Kim Hung 
Published: March 2024

Introduction: Rectus sheath haematoma (RSH) has become increasingly common but is often underdiagnosed. Prompt diagnosis will avoid unnecessary investigations and procedures, resulting in early treatment and a better outcome. Case description: We described a case of a spontaneous RSH with intraperitoneal extension and formation of a vesico-haematoma fistula, which was initially misdiagnosed as a urinary tract infection. The diagnosis was made ten days after admission, when a CT scan showed an over-16 cm RSH with intraperitoneal extension, bladder perforation and a vesico-haematoma fistula. The patient was managed conservatively. Discussion: RSH accounts for less than 2% of acute abdomen cases and is often unrecognised. Its presentation can mimic other intra-abdominal pathologies, and the diagnosis is often delayed or missed. Complications can arise from an RSH although it is generally viewed as a self-limiting condition. Conclusion: RSH has become increasingly common, and we would like to highlight the need to include abdominal wall pathologies in the initial differential diagnoses of acute abdomen to avoid delay in diagnosis.
Upadacitinib for refractory ulcerative colitis with primary nonresponse to infliximab and vedolizumab: A case report
Authors: Xu Xuan , Jiang Jing-Wen , Lu Bing-Yun , Li Xia-Xi 
Published: March 2024

BACKGROUND
Many patients with ulcerative colitis (UC) do not respond well to, or tolerate conventional and biological therapies. There is currently no consensus on the treatment of refractory UC. Studies have demonstrated that the selective Janus kinase 1 inhibitor upadacitinib, a small-molecule drug, is effective and safe for treating UC. However, no studies have revealed that upadacitinib is effective in treating refractory UC with primary nonresponse to infliximab and vedolizumab.
CASE SUMMARY
We report the case of a 44-year-old male patient with a chief complaint of bloody diarrhoea with mucus and pus, in addition to dizziness. The patient had recurrent disease after receiving mesalazine, prednisone, azathioprine, infliximab and vedolizumab over four years. Based on the endoscopic findings and pathological biopsy, the patient was diagnosed with refractory UC. In particular, the patient showed primary nonresponse to infliximab and vedolizumab. Based on the patient’s history and recurrent disease, we decided to administer upadacitinib. During hospitalisation, the patient was received upadacitinib under our guidance. Eight weeks after the initiation of upadacitinib treatment, the patient’s symptoms and endoscopic findings improved significantly. No notable adverse reactions have been reported to date.
CONCLUSION
Our case report suggests that upadacitinib may represent a valuable strategy for treating refractory UC with primary nonresponse.
Exogenous insulin autoimmune syndrome: A case report and review of literature
Authors: Xu Ling-Ling , Chen Jia-Xin , Cheng Jing-Ping , Luo Ni 
Published: March 2024

BACKGROUND
Insulin autoimmune syndrome (IAS) is a severe manifestation of spontaneous hypoglycemia. It is characterized by elevated levels of immune-reactive insulin and highly potent insulin autoantibodies (IAAs), which are induced by endogenous insulin circulating in the bloodstream. It is distinguished by recurring instances of spontaneous hypoglycemia, the presence of IAA within the body, a substantial elevation in serum insulin levels, and an absence of prior exogenous insulin administration. Nevertheless, recent studies show that both conventional insulin and its analogs can induce IAS episodes, giving rise to the notion of non-classical IAS. Therefore, more attention should be paid to these diseases.
CASE SUMMARY
In this case report, we present a rare case of non-classical IAS in an 83-year-old male patient who present with symptoms of a psychiatric disorder. Upon symptom onset, the patient exhibited Whipple's triad (including hypoglycemia, blood glucose level less than 2.8 mmol/L during onset, and rapid relief of hypoglycemic symptoms after glucose administration). Concurrently, his serum insulin level was significantly elevated, which contradicted his C-peptide levels. After a comprehensive examination, the patient was diagnosed with exogenous insulin autoimmune syndrome. Considering that the patient had type 2 diabetes mellitus and a history of exogenous insulin use before disease onset, it was presumed that non classical IAS was induced by this condition. The PubMed database was used to search for previous cases of IAS and non-classical IAS to analyze their characteristics and treatment approaches.
CONCLUSION
The occurrence of non-classical IAS is associated with exogenous insulin or its analogs, as well as with sulfhydryl drugs. Symptoms can be effectively alleviated through the discontinuation of relevant medications, administration of hormones or immunosuppressants, plasma exchange, and lifestyle adjustments.
Channelized multi-frequency measurement system based on asymmetric double sideband detection
Authors: Jiang Yuzheng , Li Jing , Yan Miaoxia , Tian Cheng , Pei Li , Ning TiGang 
Published: March 2024

A channelized multi-frequency measurement system based on asymmetric double sideband detection is proposed. In this scheme, the sub-modulators of the dual-parallel Mach–Zehnder modulator are utilized for optical frequency comb (OFC) generation and under-test signal modulation. Subsequently, a sawtooth wave voltage is applied to the main modulator to introduce frequency shift to the modulated signals, breaking the symmetry between the RF signals and the OFC. The coupled signal is then divided into upper and lower sidebands for frequency down-conversion. By calibrating the measurement results of the two sidebands with each other, the frequency of the signal can be accurately measured. Simulation is preformed to realize multi-frequency measurement of microwave signals with measurement error less than 2 MHz in the range of 2.2–20 GHz. It is also found that the proposal can solve the problem of frequency ambiguity.
Infrared-based temperature measurement in three dimensions
Authors: Sumriddetchkajorn Sarun , Rayanasukha Sirajit , Somboonkaew Armote , Wannason Uayphorn 
Published: March 2024

A highly accurate and low-cost mobile platform for multiple object temperature measurement in 3D coordinate positions is introduced. The key idea relies on not only a combination of a 3D optical depth sensor and the 2D infrared thermal imager but also a determined distant-dependent compensation model. As a result, a cost-effective yet wider (>100.0∘C) temperature measurement range under the fluctuation of working distant shift is realized with a low standard deviation of 0.16°C at the working distance of 1.0 m. Accurate temperature measurement at different positions of objects along the suitable working distance is also demonstrated.
Simulation and implementation of photonic integrated circuits for the filtering and optical heterodyning of mode-locked comb-lines
Authors: Ng W. , Thiessen T. 
Published: March 2024

We present the simulation
and implementation of a
photonic integrated circuit (PIC) designed for the filtering and
optical heterodyning of comb-lines generated by a 20.97 GHz
mode-locked fiber ring laser emitting at the optical C-band. We
compare simulations obtained for the coupling junction of the
microrings in the PIC with the use of an analytic approach and the
finite difference time-domain (FDTD) method. A PIC designed for
fabrication with the Triplex asymmetric double-stripe (ADS) waveguides
was demonstrated. Using the PIC, we demonstrated the optical
heterodyning of pairs of comb-lines filtered by tunable microrings.
The phase noise of beat signals located at 20.97 and 41.94 GHz
was characterized. We provide a discussion on enhancing the RF power
of the beat signals with the use of optical injection locking.
Low phase noise K-band signal generation using polarization diverse single-soliton integrated microcombs
Authors: Aldhafeeri Alwaleed , Chin Hsiao-Hsuan , Melton Tristan , Lee Dong IL , Chu Allen , Wang Wenting , Yu Mingbin , Lo Patrick Guo-Qiang , Kwong Dim-Lee , Wong Chee Wei 
Published: March 2024

Frequency microcombs with microwave and millimeter-wave repetition rates provide a compact solution for coherent communication and information processing. The implementation of these microcombs using a CMOS-compatible platform further paves the way for large-scale photonic integration and modularity. Here, we demonstrate free-running soliton microcombs with K-band repetition rates with very low phase noise over a 4 GHz pump detuning range reaching −117  (−123)  dBc/Hz at 10 kHz offset for a 19.7 (10) GHz carrier without active pump stabilization, exceeding commercial electronic microwave oscillators at frequency offsets above 40 kHz. The minimum laser noise to soliton microwave signal transduction factor observed is −73  dB. This noise performance is achieved using a hybridized dual-mode for soliton generation to achieve passive thermal stabilization and minimal soliton spectrum shift from prior Raman scattering and dispersive wave formation. We further examine the locking of the repetition rate to an external ultrastable photonic oscillator to illustrate the feasibility of phase noise suppression below the thermorefractive noise limits of microresonator frequency combs.
Prevalence and associated factors of refractive error among adults in South Ethiopia, a community-based cross-sectional study
Authors: Abebe Marshet Gete , Alemayehu Abiy Maru , Munaw Minychil Bantihun , Tilahun Mikias Mered , Alemayehu Henok Biruk 
Published: March 2024

IntroductionThe increasing prevalence of refractive error has become a serious health issue that needs serious attention. However, there are few studies regarding the prevalence and associated factors of refractive error at the community level in Ethiopia as well as in the study area. Therefore, providing updated data is crucial to reduce the burdens of refractive error in the community.ObjectiveTo assess the prevalence and associated factors of refractive error among adults in Hawassa City, South Ethiopia, 2023.MethodA community-based cross-sectional study was conducted on 951 adults using a multistage sampling technique from May 8 to June 8, 2023, in Hawassa City, South Ethiopia. A pretested, structured questionnaire combined with an ocular examination and a refraction procedure was used to collect data. The collected data from the Kobo Toolbox was exported to a statistical package for social sciences for analysis. Binary and multivariable logistic regression analyses were performed. A P-value of less than 0.05 was considered statistically significant in the multivariable analysis.ResultA total of 894 study participants were involved in this study with a 94.1% response rate. The prevalence of refractive error was 12.3% (95% CI: 10.2, 14.5%). Regular use of electronic devices (adjusted odds ratio = 3.64, 95% CI: 2.25, 5.91), being diabetic (adjusted odds ratio = 4.02, 95% CI: 2.16, 7.48), positive family history of refractive error (adjusted odds ratio = 2.71, 95% CI 1.59, 4.61) and positive history of cataract surgery (adjusted odds ratio = 5.17, 95% CI 2.19, 12.4) were significantly associated with refractive error.Conclusion and recommendationThe overall magnitude of refractive error in our study area was high. Regular use of electronic devices, being diabetic, positive family history of refractive error, and a positive history of cataract surgery were associated with refractive error.
Assessing malnutrition in patients with nasopharyngeal carcinoma: Diagnostic protocol for the development and validation of a new nutritional assessment tool
Authors: Wang Pengpeng , Soh Kim Lam , Japar Salimah Binti , Khazaai Huzwah binti , Liao Jinlian , Ying Yanping , Ning Chuanyi , Xue Li , Pan Xiao 
Published: March 2024

IntroductionThere is currently no gold standard or specific nutritional assessment tool to assess malnutrition in patients with nasopharyngeal carcinoma (NPC). Our study aims to develop a new nutritional assessment tool for NPC patients.Methods and analysisNPC patients will be required to complete a risk factor questionnaire after obtaining their informed consent. The risk factor questionnaire will be used to collect potential risk factors for malnutrition. Univariate and multivariate logistic regression analyses will be used to identify risk factors for malnutrition. A new nutritional assessment tool will be developed based on risk factors. The new tool’s performance will be assessed by calibration and discrimination. The bootstrapping will be used for internal validation of the new tool. In addition, external validation will be performed by recruiting NPC patients from another hospital.DiscussionIf the new tool is validated to be effective, it will potentially save medical staff time in assessing malnutrition and improve their work efficiency. Additionally, it may reduce the incidence of malnutrition and its adverse consequences.Strengths and limitations of this studyThe study will comprehensively analyze demographic data, disease status, physical examination, and blood sampling to identify risk factors for malnutrition. Furthermore, the new tool will be systematically evaluated, and validated to determine their effectiveness. However, the restricted geographical range may limit the generalizability of the results to other ethnicities. Additionally, the study does not analyze subjective indicators such as psychology.Ethics and disseminationThe ethical approval was granted by the Ethical Committee of the First Affiliated Hospital of Guangxi Medical University (NO. 2022-KT-GUI WEI-005) and the Second Affiliated Hospital of Guangxi Medical University (NO. 2022-KY-0752).Clinical trial registration numberChiCTR2300071550.
Firefighters’ medical use and Korean Medicine experience in Korea: A qualitative study protocol
Authors: Ha Jisu , Youn Inae , Han Yuri , Kim Jinwon , Kim Sunjoong , Jin Hanbit , Kang Jung Won , Leem Jungtae 
Published: March 2024

IntroductionFirefighters, compared to other occupational groups, are exposed more frequently in their working environment not only to physical issues, such as musculoskeletal disease, respiratory disease, and burns but also to mental health issues, such as PTSD and depression. Specifically, Korean firefighters experience significantly higher rates of work-related injuries compared to those in other countries. Recent statistics from the Korea National Fire Agency indicate a steady increase in the number of firefighting work-related injuries. However, there is a shortage of measures in place to address these issues. This study aims to investigate the health needs, overall healthcare usage, and unmet needs of firefighters in Korea. We also aim to investigate, through in-depth interviews, perceptions and hindering factors for integrative medicine approaches to fulfilling unmet needs.MethodThis study was conducted in accordance with the consolidated criteria for reporting qualitative research. Convenience and snowball sampling methods will be used to recruit firefighters to participate in the study, and interviews will be conducted using a semi-structured interview guide. The data will be analyzed in four stages using the qualitative analysis method of Krippendorff.DiscussionIn this study, we examine the state of health issues and healthcare usage among Korean firefighters and investigate their perceptions of and needs for integrative medicine. In this way, we aim to explore how integrative medicine and Korean medicine approaches could improve and assist healthcare services for firefighters. Furthermore, our findings will provide policymakers and healthcare providers with the necessary basic information to develop integrative medicine systems suited to firefighters.
Natalizumab promotes anti-inflammatory and repair effects in multiple sclerosis
Authors: Lereim Ragnhild Reehorst , Nytrova Petra , Guldbrandsen Astrid , Havrdova Eva Kubala , Myhr Kjell-Morten , Barsnes Harald , Berven Frode S. 
Published: March 2024

Background
Multiple sclerosis is an inflammatory and degenerative disease of the central nervous system leading to demyelination and axonal loss. Relapsing-remitting multiple sclerosis (RRMS) is commonly treated by anti-inflammatory drugs, where one of the most effective drugs to date is the monoclonal antibody natalizumab.

Methods
The cerebrospinal fluid (CSF) proteome was analyzed in 56 patients with RRMS before and after natalizumab treatment, using label-free mass spectrometry and a subset of the changed proteins were verified by parallel reaction monitoring in a new cohort of 20 patients, confirming the majority of observed changes.

Results
A total of 287 differentially abundant proteins were detected including (i) the decrease of proteins with roles in immunity, such as immunoglobulin heavy constant mu, chitinase-3-like protein 1 and chitotriosidase, (ii) an increase of proteins involved in metabolism, such as lactate dehydrogenase A and B and malate-dehydrogenase cytoplasmic, and (iii) an increase of proteins associated with the central nervous system, including lactadherin and amyloid precursor protein. Comparison with the CSF-PR database provided evidence that natalizumab counters protein changes commonly observed in RRMS. Furthermore, vitamin-D binding protein and apolipoprotein 1 and 2 were unchanged during treatment with natalizumab, implying that these may be involved in disease activity unaffected by natalizumab.

Conclusions
Our study revealed that some of the previously suggested biomarkers for MS were affected by the natalizumab treatment while others were not. Proteins not previously suggested as biomarkers were also found affected by the treatment. In sum, the results provide new information on how the natalizumab treatment impacts the CSF proteome of MS patients, and points towards processes affected by the treatment. These findings ought to be explored further to disclose potential novel disease mechanisms and predict treatment responses.