bluuebunny/crossref_metadata_2025_split huggingface dataset:
A survey about the awareness among the physiotherapists in the use of Matrix Rhythm Therapy in treating chronic low back pain in post-menopausal women
Authors: R Rajeswari , Suresh Anjali 
Published: February 2024

Abstract
Background
Menopause is a stage in a woman's physiology where several chronic illnesses begin to appear, compromising both the quality and quantity of their life. It has been postulated that a decrease in estrogen levels in women may be important for accelerated disc degeneration in postmenopausal women. The overall prevalence of LBP is 52% higher in perimenopausal women with osteoporosis which is considered to be one of the predominant factors for low back pain in women.
There are many modalities like Interferential therapy, ultrasound therapy, and transcutaneous electrical nerve stimulation, that treat nonspecific back pain with varying results, some advanced electrotherapy modalities like shockwave, low-level laser therapy, Matrix Rhythm Therapy (MaRhyThe) also proved to be effective in reducing the nonspecific chronic low back pain.
Matrix Rhythm Therapy was invented by Dr. Med. Ulrich Randoll (1987–1999) at the University of Erlangen, Germany. Matrix Rhythm Therapy includes a wand with a resonating head that oscillates at the frequency of 8-–12 Hz and is connected to the machine with a connecting cable (U.G Randoll p18 The Principles of Matrix Rhythm Therapy – MaRhyThe 3rd edition 2015).

Objective
The main objective of this survey study is to investigate awareness among physiotherapists in the use of Matrix Rhythm Therapy in treating chronic low back pain in post-menopausal women.

Methods
For this study, Google Forms were distributed to physiotherapists of diverse area specializations through social media. The survey was carried out between 16th December 2022 to 18th April 2023.

Results
Out of 103 responses which is 10% of the total sample size, 69.9% of the physiotherapists were aware of Matrix Rhythm Therapy whereas 30.1% were not aware of the same. Meanwhile, when it comes to treating chronic low back pain in post-menopausal women, only 49.5% of the physiotherapists say that the condition can be treated with Matrix Rhythm Therapy, the rest of the 28.2% are not aware and 11.7% are not sure if the condition can be treated with the same.

Conclusion
In conclusion, these findings show that implementing or using Matrix Rhythm Therapy as a physical therapy intervention in treating chronic low back pain is woefully inadequate, despite Physical therapists and clinicians recognizing the need for or usage of matrix rhythm therapy, they also must maintain a consistent interest and commitment to effectively employ Matrix Rhythm Therapy for clinical conditions and active research.
Validation of administrative claims to identify ultrasound enhancing agent use
Authors: Strom Jordan B. , Song Yang , Jiang Wenting , Lou Yingbo , Pfeffer Daniel N. , Massad Omnya E. , Russo Pierantonio 
Published: February 2024

Abstract
Background
Ultrasound enhancing agents (UEAs) are an invaluable adjunct to stress and transthoracic echocardiography (STE) to improve left ventricular visualization. Despite multiple single center studies evaluating UEA use, investigation into the rates, sources of variation, and outcomes of UEA use on a national level in the United States (US) has been limited by lack of validation of UEA codes for claims analyses.

Methods
We conducted a retrospective cross-sectional study, 2019–2022, using linked multicenter electronic medical record (EMR) data from > 30 health systems linked to all-payor claims data representing > 90% of the US population. Individuals receiving STE in both EMR and claims data on the same day during the study window were included. UEA receipt as identified by presence of a Current Procedural Terminology (CPT) or National Drug Code (NDC) for UEA use within 1-day of the index STE event. We evaluated the performance of claims to identify UEA use, using EMR data as the gold standard, stratified by inpatient and outpatient status.

Results
Amongst 54,525 individuals receiving STE in both EMR and claims data, 12,853 (23.6%) had a UEA claim in EMR, 10,461 (19.2%) had a UEA claim in claims, and 9140 (16.8%) had a UEA claim in both within the 1-day window. The sensitivity, specificity, accuracy, positive, and negative predictive values for UEA claims were 71.1%, 96.8%, 90.8%, 87.4%. and 91.6% respectively. However, amongst inpatients, the sensitivity of UEA claims was substantially lower (6.8%) compared to outpatients (79.7%).

Conclusions
While the overall accuracy of claims to identify UEA use was high, there was substantial under-capture of UEA use by claims amongst inpatients. These results call into question published rates of UEA use amongst inpatients in studies using administrative claims, and highlight ongoing need to improve inpatient coding for UEA use.
Safety and Effectiveness of an Enhanced Recovery Protocol in Patients Undergoing Burr Hole Evacuation for Chronic Subdural Hematoma
Authors: Staartjes Victor E. , Spinello Antonio , Schwendinger Nina , Germans Menno R. , Serra Carlo , Regli Luca 
Published: February 2024

BACKGROUND AND OBJECTIVES:
Enhanced recovery programs may be especially useful in patients with chronic subdural hematoma or hygroma (cSDH), who frequently exhibit frailty and multimorbidity. We aim to evaluate the real-world safety and effectiveness of an enhanced recovery protocol in this population.

METHODS:
From a prospective registry, burr hole evacuations for cSDH carried out under the protocol (including early thromboprophylaxis, no flat bed rest, early mobilization without drain clamping, and early resumption of antithrombotic medication) were extracted, along with those procedures carried out within the past year before protocol change. Propensity score–based matching was carried out. A range of clinical and imaging outcomes were analyzed, including modified Rankin Scale as effectiveness and Clavien–Dindo adverse event grading as safety primary end points.

RESULTS:
Per group, 91 procedures were analyzed. At discharge, there was no significant difference in the modified Rankin Scale among the standard and enhanced recovery groups (1 [1; 2] vs 1 [1; 3], P = .552), or in Clavien–Dindo adverse event grading classifications of adverse events (P = .282) or occurrence of any adverse events (15.4% vs 20.9%, P = .442). There were no significant differences in time to drain removal (2.00 [2.00; 2.00] vs 2.00 [1.25; 2.00] days, P = .058), time from procedure to discharge (4.0 [3.0; 6.0] vs 4.0 [3.0; 6.0] days, P = .201), or total hospital length of stay (6.0 [5.0; 9.0] vs 5.0 [4.0; 8.0] days, P = .113). All-cause mortality was similar in both groups (8.8% vs 4.4%, P = .289), as was discharge disposition (P = .192). Other clinical and imaging outcomes were similar too (all P > .05).

CONCLUSION:
In a matched cohort study comparing perioperative standard of care with a novel enhanced recovery protocol focusing on evidence-based drainage, mobilization, and thromboprophylaxis regimens as well as changes to the standardized reuptake of oral anticoagulants and antiaggregants, no differences in safety or effectiveness were observed after burr hole evacuation of cSDH.
Clinical efficacy of recombinant human basic fibroblast growth factor combined with ranitidine in the treatment of recurrent oral ulcer and its effect on serum TNF, IL-2 and T-lymphocyte subsets
Authors: Chen Peng , Liu Bing , Sun Hui 
Published: February 2024

Objective: To evaluate the clinical efficacy of recombinant human basic fibroblast growth factor (rh-bFGF) combined with ranitidine in the treatment of recurrent oral ulcer and its effects on serum TNF, IL-2 and T-lymphocyte subsets.
Methods: This was a retrospective study. Eighty patients with oral ulcers admitted to First Medical Center, Chinese PLA General Hospital from July 2021 to June 2022 were randomly divided into the control group and the experimental group (n=40). Patients in the control group were given topical treatment with rh-bFGF gel, while those in the experimental group were given oral treatment combined with ranitidine based on the control group, and both groups were treated continuously for 14 days. The therapeutic effect, pain relief time, ulcer healing time, as well as the differences in the levels of inflammatory factors and T-lymphocyte subsets were compared and analyzed between the two groups.
Results: The overall response rate of the experimental group was 92.5%, while that of the control group was 75%, with a statistically significant difference(P=0.03). After treatment, inflammatory factors indexes in the experimental group were significantly lower than those in the control group, with statistically significant differences (P=0.00). The indexes of T-lymphocyte subsets in the experimental group were significantly higher than those in the control group after treatment, with statistically significant differences (P=0.00).
Conclusion: Recombinant human basic fibroblast growth factor combined with ranitidine is effective in the treatment of recurrent oral ulcers, boasting various benefits such as effectively promoting ulcer healing, reducing pain and inflammatory response, and enhancing immune function.
doi: https://doi.org/10.12669/pjms.40.4.7881
How to cite this: Chen P, Liu B, Sun H. Clinical efficacy of recombinant human basic fibroblast growth factor combined with ranitidine in the treatment of recurrent oral ulcer and its effect on serum TNF, IL-2 and T-lymphocyte subsets. Pak J Med Sci. 2024;40(4):679-684. doi: https://doi.org/ 10.12669/pjms.40.4.7881
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.
Knowledge, attitude, and awareness of cardiopulmonary resuscitation among university enrolled medical and non-medical students of Pakistan: An online study
Authors: Muhammad Mudassar Bilal  , Syed Bilal Shah  , Tanzeel Ur Rehman  , Noman Sadiq  , Ghulam Rehmani Lakho  
Published: February 2024

Objective: To evaluate the awareness, attitude and knowledge of cardiopulmonary resuscitation (CPR) among university-enrolled medical and non-medical undergraduate students of Pakistan.
Methods: Cross-sectional online survey-based study was conducted across institutes in Pakistan from December, 2022 to January, 2023. The study involved university-enrolled undergraduate students across the country. The structured questionnaire was disseminated via Google forms. For statistical analysis, SPSS version 20 was used to analyze the data by applying independent sample t-tests and ANOVA.
Results: A total of 249 responses were received. After the exclusion of two responses, the overall awareness score of participants was found to be 2.49 ± 1.33, attitude score of 4.09 ± 1.74, and knowledge score of 3.51 ± 2.13. Female respondents, medical students, unmarried (single), private institutes, and respondents with educated parents achieved relatively higher scores. The overall difference in awareness scores among different regions of Pakistan was also significant (p <0.05). Gender, region, and parental literacy rate also showed effects on participants’ basic life support (BLS) and CPR knowledge (p <0.05).
Conclusions: Overall knowledge and awareness were unsatisfactory and inadequate in university-enrolled undergraduate students, with no one getting a complete score on very basic knowledge questions. Significant differences in awareness, attitude, and knowledge among different regions, genders, and parental literacy rates were found.
doi: https://doi.org/10.12669/pjms.40.4.7933
How to cite this: Bilal MM, Shah SB, Tanzeel Ur Rehman, Sadiq N, Lakho GR. Knowledge, attitude, and awareness of cardiopulmonary resuscitation among university enrolled medical and non-medical students of Pakistan: An online study. Pak J Med Sci. 2024;40(4):767-772. doi: https://doi.org/10.12669/pjms.40.4.7933
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.
Theory of change framework for program evaluation in Health Professional Education
Authors: Farrukh Khadija 
Published: February 2024

doi: https://doi.org/10.12669/pjms.40.4.8960
How to cite this: Farrukh K. Theory of change framework for program evaluation in Health Professional Education. Pak J Med Sci. 2024;40(4):793. doi: https://doi.org/10.12669/pjms.40.4.8960
Pectus Excavatum: A review of current treatment possibilities
Authors: Hedesz Patryk , Taras Andrzej , Woźniak Kinga , Gardian-Baj Monika , Jung Magdalena , Jung Maximilian , Żuk-Łapan Aleksandra , Doryń Aleksandra , Włodarczyk Aleksandra , Popczyńska Justyna 
Published: February 2024

Anterior chest wall depression known as Pectus excavatum (PE) , is currently the most common congenital chest wall deformation, with incidence estimated at 1/400 births, five times more frequently in boys than girls (5:1 ratio in occurrence). 1 Etiology of this deformity is formed by several hypothesis, including overgrowth of the ribs, developmental failure of the bony thorax or weakness and abnormal flexibility of the sternum. While theoretical concepts of its origin may differ, the common ground is the characteristics of said deformation: a posterior depression of the sternum and the lower costal cartilages. 2Surgical treatment options were described since 1949 with Ravitch procedure and since then a number of new ones has been developed.
For many years Ravitch and Nuss procedures were the main way to treat pectus excavatum, with a growing bias towards latter one. Since the Nuss procedure characterizes with less invasive approach and fever overall complications 3 its popularity outgrew Ravitch procedure and currently is described as MIRPE – Minimally Invasive Pectus Excavatum Repair. 4 However afterward then many new techniques were developed, focusing on reducing overall procedure risks, improving patient safety and quality of life and including new technical possibilities.
The aim of this study was to gather and evaluate current literature to highlight new treatment options.
Impact of anabolic steroids on male fertility and the role of post-cycle therapy in recovery
Authors: Dorobek Wioleta , Szerej Krzysztof , Walczak Dawid , Stankiewicz Katarzyna , Świeczkowski-Feiz Janusz 
Published: February 2024

Introduction: AAS are a group of hormones that greatly influence the strength and size of muscle. They are widely used by athletes and bodybuilders. Yet research indicates that the use of these compounds has significant implications for male reproductive health as well.
The aim of the study: This study was intended to analyze systematically the relationship between AAS use and men's reproductive health; looking at both what influence AAS has on semen quality and male hormone levels and how post-cycle treatment (PCT) might help in the restoration of any adverse effects caused by AS.
Methods: This review was based on available data collected in the PubMed database and Google Scholar web search engine using anabolic-androgenic steroids, male fertility, hypogonadism, post-cycle therapy, and reproductive health.
Results: Results suggest that AAS use can lead to testicular atrophy, while research shows that anabolic steroid abuse impairs normal sperm production. These findings include aspermia, oligospermia, or aspermatogenesis. The time period for recovery of sperm quality is also different after use of anabolic steroids, and all cases are expected to have a profound impact on spermatogenesis over the long term. Anabolic steroids may suppress the HPG axis and decrease the male's fertility hormone, testosterone. If PCT is combined with hCG or SERMs, a person's own regular hormone levels return after 10 weeks with good prospects for recovery from low testosterone.
Conclusion: Studies show that the use of AAS seriously affects the male reproductive system and may even have long-term consequences for this function. PCT seems to offer a reasonable method for re-establishing the hormonal equilibrium and hence proving fertile offspring, which reinforces the need for careful AAS use and monitoring. Further research will be needed before any moves can be taken towards optimizing PCT regimes, in addition to the as-yet-determined long-term consequences for male fertility.
A INTERVENÇÃO JUDICIAL COMO TÉCNICA EXECUTIVA NOS PROCESSOS ESTRUTURAIS: LIMITES E POSSIBILIDADES DE SUA APLICAÇÃO EM RELAÇÃO AOS ENTES PÚBLICOS
Authors: Martinez Fervenza Cantoario Diego 
Published: February 2024

Apesar dos litígios estruturais receberem grande atenção da literatura jurídica, poucos estudos investigaram a execução das decisões estruturais. Nesta área de conhecimento, o papel da intervenção judicial tem sido amplamente negligenciado pela doutrina e este artigo destaca os principais aspectos referentes a este instituto como uma técnica processual nos litígios estruturais. A literatura sobre o tema destaca a importância dessa medida executiva como uma técnica confiável para alcançar o objetivo da melhoria da efetividade judicial, em razão de sua flexibilidade e da possibilidade de monitoramento das atividades dos executados. Neste sentido, nós sustentamos que o caráter de monitoramento de certos tipos de intervenção reduz a assimetria informacional entre as partes, e então permite decisões consensuais sobre as medidas executivas, que são importantes nos litígios de interesse público. Por outro lado, nós discutimos os limites da intervenção, dando atenção particular à separação de poderes e às medidas aplicáveis às entidades públicas. Assim, aponta-se para as vantagens decorrentes da intervenção na modalidade monitoramento, na medida em que implica em intervenção menos drástica, sobretudo ao se considerar as pessoas jurídicas de direito público, de forma a evitar o eventual afastamento de agentes públicos. Do mesmo modo, apresenta-se esta última espécie de intervenção como vantajosa também para a fixação de outras medidas executivas pelo magistrado, na medida em que permite a melhor compreensão do funcionamento da entidade pelo julgador. Nós concluímos que o Direito brasileiro comporta a aplicação da intervenção judicial, e que o instituto não consiste uma ameaça à separação de poderes, seja em razão do fato de ser menos drástica do que as medidas usadas no processo coletivo, seja em decorrência de seu objetivo de assegurar direitos fundamentais. Empregou-se o método dedutivo como referencial metodológico, com base em pesquisas doutrinárias, que utilizou como revisão de literatura sobre o tema, composta principalmente de artigos científicos, dissertações, e teses acadêmicas.
PENSAMENTOS SOBRE O ENSINO DO DIREITO DAS CRIANÇAS EM PORTUGAL
Authors: Martingo Cruz Rossana 
Published: February 2024

O Direito da Família, onde se enquadra o Direito das Crianças, tem sofrido várias alterações legislativas nas últimas décadas. Na verdade, o seu objeto sempre foi especialmente suscetível às mudanças (sociais, económicas, morais, políticas, etc). A própria noção de família vai alterando com o tempo. O conceito variará conforme a interpretação de cada um, ainda que existam balizas legais que auxiliem a interpretação. Ainda assim, é clara a evolução que tem ocorrido neste contexto, desafiando o legislador e o intérprete a progredirem e a se adaptarem. Foi esta a premissa do presente texto: analisar autonomamente o Direito das Crianças, perceber os avanços que têm ocorrido nestas matérias e refletir sobre a a forma de transmitir os conteúdos programáticos aos alunos destas temáticas. Os conhecimentos lecionados nas aulas e apreendidos pelos estudantes deverão permitir uma sensibilidade jusfamiliar que lhes servirá na vida prática. Conhecer os princípios e os fundamentos teóricos não será o bastante. A formação nestas matérias deve almejar dotar os estudantes de conhecimentos suficientes para que estes, perante situações concretas, saibam empregá-los. Promover a ciência jurídico-familiar aplicada será um desafio a que julgamos essencial na abordagem destas matérias.
DNA quality and quantity in adipose tissue: a comparison of the effects of bomb explosion
Authors: Leonardo  , Sugiharto Ade Firmansyah , Indriatmi Wresti , Atmadja Djaja Surya , Yudianto Ahmad , Herkutanto  , Widodo Wahyu 
Published: February 2024

BACKGROUND Adipose tissue is often overlooked in DNA testing due to misconceptions about its DNA content. However, its shock-absorbing qualities may be useful for high-pressure scenarios like bomb blasts. This study aimed to evaluate DNA quality and quantity in adipose tissue affected by blasts compared to that in unaffected tissue.
METHODS 10 adipose tissue samples were taken from regions near and far from the blast, representing the blast-exposed and non-blast-exposed groups. The adipose tissue was stored at a low temperature for 5 days, after which an organic extraction method was applied. The purity of the DNA extract was assessed using a NanoDrop spectrophotometer, and its integrity was evaluated using 0.8% concentration gel electrophoresis at 60 V for 90 min. DNA typing was conducted using the GlobalFiler™ kit, and DNA quantity was determined with the Quantifiler™ Trio DNA Quantification kit.
RESULTS Of 20 DNA extracts from adipose tissue, all samples demonstrated purity, integrity, and complete typing results. Adequate integrity was found in 90% of samples in both groups. A 50% incidence of allele shifting was observed at the D7S820 locus within the blast-exposed group.
CONCLUSIONS DNA from blast-exposed adipose tissue exhibited no significant quality or quantity differences from non-blast-exposed tissue. This suggested adipose tissue’s potential as an alternative DNA source in a bomb explosion.