bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breast Cancer Screening Awareness in Educated Pakistani Women.
Authors: Fareeha Shahid  , Capt. Abdul Shakoor  , Muhammad Ibrahim  , Hammad Ali  , Ghulam Muhayyudin  , Esha Khan  , Muhammad Intisar  , Muhammad Intisar  , Asfund Bashir  , Maaz Hassan  
Published: January 2024

Introduction: Breast cancer is the abnormal accumulation of breast cells, and the first symptom is typically a painless breast lump, though other symptoms, such as a change in size or shape, dimpling, redness, pitting, and the appearance of the nipple, or a change in the discharge from the nipple, may also be present.
Objective: To assess women's familiarity with breast screening practices and disseminate information about impact of early detection with favourable outcome.
Methodology: An online cross-sectional study was conducted and non-probability convenient sampling was used. Among 471 participants, complete data of 408 participants was available and used for the purpose of the study. Ethical considerations were followed and study approved by the ethical research committee of Bahria University Karachi. SPSS version 26 was used for the data analysis.
Results: The findings showed that participants had inadequate understanding about breast cancer screening. Women with advanced degrees fared no better in terms of knowledge than their less educated counterparts. Women with a strong family history of breast cancer found to have high levels of awareness about the disease.
Conclusion: The early diagnosis and treatment are key to reducing the risk of breast cancer progressing to a more advance stage. On the other hand, women at risk have limited knowledge about breast cancer that surely has detrimental effects on the diagnosis and management and adding increased mortality.
Keywords: Breast cancer, KAP, educated women, Breast Screening.
Exploring Mother’s Perspectives about Routine Immunization in District Peshawar: A Cross Sectional Survey.
Authors: Hamna Khan  , Muhammad Imran Marwat  , Zumaira Sauleh  , Nimra Akhtar  , Shumaila Shahid  , Azra Shaheen  
Published: January 2024

Objective: of this study was to investigate mothers' opinions and knowledge regarding regular immunization of their chil-dren.Methodology: Between July 2019 to January 2020, this descriptive cross-sectional study was conducted at pediatrics outpatient department, Khyber teaching Hospital Peshawar. Women aged between 19-44 years, having at least one child less than 5 years of age were asked to complete standardized questionnaire. After stratification of the collected data, regression analysis performed.Results: Mean age of participants was 27.72 ±4.07 years, 41.98% received elementary education, while 61.32% were housewives. We observed enough knowledge in 162(88.04%) patients aged 19-29 years as compared to 55 (93.22%) aged 30-44 years (p=0.002). Additionally, knowledge was noticeably greater in situations involving several children.Conclusion: Women having secondary school or higher education and several children has sufficient knowledge of im-munization.
Key words: KAP, Immunization, Mothers, Infectious Diseases, Vaccination
Measurement of distance between maxillary central incisors and incisive papilla in dentate individuals.
Authors: Farzana Memon  , Rabia Chandio  , Rafia Khan  , Amber Faryal  , Ghulam Muhammad  
Published: January 2024

Objective: To measure the distance amongst the incisive papilla’s centre and posterior border to the incisal edge of the upper central incisors in dentate individuals.Methodology: This descriptive cross-sectional study was conducted at Department of Prosthodontics at Isra Dental Col-lege, Hyderabad from May, 2020 to Feb, 2021. During study period, 200 patients aged between 20-40 years of either gender were included. Impressions and casts made. On the cast and distance measured and recorded for maxillary central incisor and incisive papilla with the help of vernier calliper.Results: Mean distance between maxillary central incisive papilla’s centre was 9.20mm while it was 12.47mm from up-per incisor to the incisive papilla’s posterior border. Distance among the maxillary central incisor to the incisive papilla’s center and posterior border were significant statically in both genders.Conclusion: While fabricating removable prosthesis, the results of current study may used as primary point for position of maxillary incisors.
Key words: Anatomical landmarks, Central incisors & Incisive papilla. Removeable prosthesis
Etiology of acute gastroenteritis among pre-school children in Peshawar-KP Pakistan, a case control study.
Authors: Farid Ullah Shah  , Jahangir Anjum  , Muhammad Daud  , Wasim Ahmad  
Published: January 2024

Objective: This study aimed to investigate the etiology of acute viral gastroenteritis among preschool children in Pesha-war, Khyber Pakhtunkhwa, Pakistan.Methodology: A total of 420 stool samples were gathered from children under five, displaying symptoms like diarrhea, vomiting, nausea, and abdominal cramps. Recruitment took place at a Peshawar tertiary care hospital, approved by the institute's IRB. The cohort was split evenly into 210 cases and 210 controls. Healthy controls\ originated from the outpa-tient department with no diarrhea within the last 10 days, while cases were from the emergency, inpatient, and outpa-tient units. Diagnosis criteria encompassed at least one vomiting episode in the last 24 hours and over three loose stools daily, enduring less than 5 days. Moderate to severe cases included indicators like skin turgor loss, sunken eyes, IV treatment, dysentery, or gastroenteritis-related hospitalization. A 2-month follow-up tracked complications and mortal-ity, with parental consent secured.Results: Among participants, 60% (n=126/210) were male and 40% (n=84/210) were female. The average age was 20 months (range 1-50 months). Clinical symptoms were evident during enrollment; cases displayed watery diarrhea (4 episodes on average in 24 hours, lasting 2.50 days), and 48% (n=101) experienced vomiting (3 episodes on average in 24 hours). Acute gastroenteritis symptoms persisted for an average of 4.0 days. Severe and mild dehydration were ob-served in 12% (n=25) and 28% (n=58) of patients, respectively. Additional symptoms included fever (8%, n=17), ab-dominal pain (8%, n=17), and dysentery (5%, n=10). The majority (90%, n=189) received intravenous fluids, while 10% (n=21) were treated orally.Conclusion: The common causative organism for childhood diarrhea is adenovirus.
Key words: Acute gastroenteritis, Acute diarrhea, Vomiting, Nausea, Abdominal Cramps
Proposte di intreccio tra natura e cultura nelle aree protette: il festival Musica in Quota
Authors: Benetti Stefania , Cerutti Stefania 
Published: January 2024

Abstract Proposals for Intertwining Nature and Culture in Protected Areas: the Musica in Quota Festival In a context where nature and culture always appear separate, this contribution aims to overcome this dichotomy, proposing a musical festival as an example. Musica in Quota takes place among mountains and protected areas of the Verbano Cusio Ossola province, in the northwest of Piedmont. In the various events of the traveling exhibition, nature becomes the theatre of musical performances. The particular attention to the environmental, social, and economic needs of the local context makes it a virtuous case of programming able to promote the reappropriation of protected spaces through sustainable and participatory cultural practices that translate into active conservation.
Remembering Yellowstone: Nature Conservation, Popular Culture and Belonging
Authors: Cisani Margherita 
Published: January 2024

Abstract Yellowstone is globally recognised as the world’s first national park, but the depth of its meaning goes beyond the history of nature conservation. This paper presents the park as an assemblage of landscapes, memories and popular environmental discourses. It interweaves the debate around Yellowstone as a landscape idea with an analysis of its representation in popular culture, from The Yogi Bear Show to the more recent Yellowstone television series. Coupled with personal and subjective memoryscapes, the Yellowstone assemblage is presented as capable to inform the global debate on the role of protected areas, especially in relation to climate change, tourism and recreation, as well as matters of natural heritage kinship and belonging.
Quali aree protette nella mondializzazione? Riflessioni a partire dai paesaggi agro-pastorali del Parco nazionale della Maiella
Authors: Zanolin Giacomo 
Published: January 2024

Abstract What Protected Areas in Globalisation? Reflections from the Agro-Pastoral Landscapes of the Maiella National Park This paper aims to reflect on a possible interpretation of the role that protected areas could play in the globalization. Starting from the example of the Maiella National Park (Italy), the paper aims to highlight the role of anthropic action as a key factor that throughout history has contributed to the generation of the current forms of ecosystems, characterized in this context by high levels of biodiversity, especially from the botanical point of view. All this provides an opportunity to reflect on the constructive role played by humankind in ecological dynamics, and so to develop a critical discussion of the significance of protected areas as peculiar places of globalization, capable of conveying crucial ethical values.
Emergency and Urgent Care Network: Analysis of the Stroke Care Line According to Care Times and Outcomes
Authors: Leite Karina Fonseca de Souza , Andrade Rubia Laine de Paula , Faria Mariana Gaspar Botelho Funari de , Isaac Igor Simões da Silva , Ferreira Kamila Santos , Remigio Juan Lacalle , Camilo Millene Rodrigues , Neto Octavio Marques Pontes , Monroe Aline Aparecida 
Published: January 2024

Background: Given the importance of acute stroke care for public health in terms of its burden and consequences like disability and death, evidence-based practice has directed the development of clinical protocols and operational guidelines to care of the populations affected by this pathology.
Aim: To evaluate the impact of implementing the stroke care line in the Urgency and Emergency Care Network of a large Brazilian municipality.
Methods: This is a retrospective study, conducted between 2014 and 2019 in public health services in Ribeirao Preto, SP, a large municipality of Brazil. Data was collected through secondary sources. A total of 403 patients were included in the study, of which: 172 were treated between 2014 and 2016 and 231 between 2017 and 2019; 118 were served by the mobile pre-hospital care services and 285 by the fixed pre-hospital care services. Data comprise clinical, epidemiological characteristics and severity of cases, as well as stroke care times and outcomes and were analyzed using descriptive techniques, Mann-Whitney and Chi-squared tests.
Results: First care provided by a mobile pre-hospital care unit increased from 16.9% to 38.5%. The service times for people undergoing thrombolysis were shorter in the period from 2017 to 2019 compared to 2014 to 2016 in the door-to-needle, stroke onset-to-call, stroke onset-to-ambulance dispatch and regulation-to-door times. Stroke victims treated first by a mobile (ambulance) unit had shorter care times when compared to those who received care in a fixed unit, except in ambulance dispatch-to-door time. No difference was identified in the percentage of outcomes studied in the period from 2017 to 2019 compared to the period from 2014 to 2016. There was a higher craniectomy occurrence in people treated at home than in those attended in health services. The percentage of unfavorable stroke outcomes increased depending on the case severity.
Conclusion: The care flow organization with defined responsibilities for each care point through the creation of a care line and the use of pre-established protocols reduced pre- and in-hospital care times; however, they did not have a significative influence on the case outcomes.
Mechanisms of stroke protection by physical activity
Authors: Endres Matthias , Gertz Karen , Lindauer Ute , Katchanov Juri , Schultze Jörg , Schröck Helmut , Nickenig Georg , Kuschinsky Wolfgang , Dirnagl Ulrich , Laufs Ulrich 
Published: October 2003

AbstractRegular physical activity is associated with a decrease of cerebrovascular and cardiovascular events, which may relate to enhanced endothelium‐dependent vasodilation. Here, we provide evidence that physical activity protects against ischemic stroke via mechanisms related to the upregulation of endothelial nitric oxide synthase (eNOS) in the vasculature. Voluntary training on running wheels or exercise on a treadmill apparatus for 3 weeks, respectively, reduced cerebral infarct size and functional deficits, improved endothelium‐dependent vasorelaxation, and augmented cerebral blood flow in wild‐type mice. The neuroprotective effects of physical training were completely absent in eNOS‐deficient mice, indicating that the enhanced eNOS activity by physical training was the predominant mechanism by which this modality protects against cerebral injury. Our results suggest that physical activity not only decreases stroke risk, but also provides a prophylactic treatment strategy for increasing blood flow and reducing brain injury during cerebral ischemia.
On symptomatic heterozygous alpha‐sarcoglycan gene mutation carriers
Authors: Fischer Dirk , Aurino Stefania , Nigro Vincenzo , Schröder Rolf 
Published: October 2003

AbstractMutations in the human alpha‐sarcoglycan gene on chromosome 17q21.2 have been shown to cause a severe childhood autosomal recessive muscular dystrophy, a less severe limb girdle muscular dystrophy, exercise intolerance, or asymptomatic hyperCKemia. Here, we describe the clinical findings in a German family harboring a 371 T > C (Ile124Thr) missense mutation in the alpha‐sarcoglycan gene. Whereas our index patient, an 11‐year‐old girl homozygous for this mutation, presented with a severe Duchenne‐like phenotype, 7 out of 12 heterozygous mutation carriers from three generations showed mild to moderate scapular winging. In analogy to symptomatic female dystrophinopathy carriers, our results suggest that heterozygous alpha‐sarcoglycan gene mutation carriers can be symptomatic with selective muscle weakness. This finding may be attributed to an additional negative variation in a yet unknown modifier gene essential to the function of the sarcoglycan complex in shoulder girdle muscles.
Preliminary screening study of reproductive outcomes after exposure to yarrow in the pregnant rat
Authors: Boswell‐Ruys Claire L. , Ritchie Helen E. , Brown‐Woodman Patricia D. 
Published: October 2003

AbstractBACKGROUND: Yarrow (Achillea millefolium) is used for the treatment of diarrhea, as a urinary antiseptic, hypotensive, and diuretic. Yarrow also has traditionally been used as an abortifacient, emmenagogue, contraceptive, and for stimulating uterine contractions. For this reason, it is contra‐indicated for use in pregnancy. There has, however, been little scientific research carried out to either confirm or refute this recommendation. METHODS: Female rats were dosed, orally by gavage using 56 times the human dose of yarrow daily on either gestation days (GD) 1–8 or GD 8–15. Two groups of controls were included; the first received water and the second received an equivalent dose of ethanol to that found in the yarrow preparation over the two gestation periods. On GD 20, rats were sacrificed, placentae were weighed, and corpora lutea counted. The fetuses were weighed and examined for signs of external, internal or skeletal malformations.RESULTS: The dose used was not materno‐toxic. There was no increase in pre‐ or post‐implantation losses suggesting that yarrow was neither an abortifacient nor a contraceptive. Placental weights were increased in rats treated with yarrow on GD 8–15 compared to water and ethanol controls and on GD 1–8 compared to water control fetuses. Body weight was reduced in fetuses exposed to yarrow on GD 8–15 compared to water control fetuses. There was no difference in incidence of external or internal malformations.CONCLUSIONS: In the present study it was found that yarrow, when administered to rats at 56 times the human dose, was associated with reduced fetal weight and increased placental weight. In the absence of a no observable effect level for these variables it must be concluded that the consumption of yarrow is contraindicated during pregnancy until further investigations have been carried out. Birth Defects Res B 68:416–420, 2003. © 2003 Wiley‐Liss, Inc.
Docetaxel and ketoconazole in advanced hormone‐refractory prostate carcinoma
Authors: Van Veldhuizen Peter J. , Reed Gregory , Aggarwal Arvind , Baranda Joaquina , Zulfiqar Muhammad , Williamson Stephen 
Published: October 2003

AbstractBACKGROUNDDocetaxel has significant single‐agent activity in patients with prostate carcinoma, and ketoconazole has activity as a second‐line hormonal agent. In vitro, ketoconazole exhibits synergy with several chemotherapeutic agents. A potential drug interaction exists, however, because both docetaxel and ketoconazole are metabolized hepatically by the cytochrome p450 system (CYP3A4). The authors performed a Phase I study and a pharmacokinetic study evaluating the both tolerability of a docetaxel/ketoconazole combination as well as this potential drug interaction.METHODSFor all initial patients, docetaxel was administered intravenously at a dose of 55 mg/m2 over 1 hour every 21 days. Starting on Day 8 after their first docetaxel dose, cohorts of at least 3–5 new patients were enrolled to receive escalating doses of ketoconazole. When the maximally tolerated dose (MTD) of ketoconazole was reached, the subsequent cohort of patients received an escalating dose of docetaxel. Pharmacokinetic studies were performed after docetaxel infusions on Day 1 (prior to ketoconazole) and Day 22 (after starting ketoconazole).RESULTSTwenty‐six patients were enrolled and completed at least 2 cycles of treatment. The MTD was ketoconazole 400 mg twice daily and docetaxel 55 mg/m2. Dose‐limiting toxicities included neutropenia and fatigue. Ketoconazole did not cause a consistent effect on docetaxel pharmacokinetics, although there was significant intrapatient and interpatient variability in serum levels.CONCLUSIONSThe recommended Phase II dose for this combination is ketoconazole 400 mg twice daily and docetaxel 55 mg/m2 every 21 days. Cancer 2003. Published 2003 by the American Cancer Society.
The analysis of immunophenotype of gastrin‐producing tumors of the pancreas and gastrointestinal tract
Authors: Gurevich Larissa , Kazantseva Irina , Isakov Vassili A. , Korsakova Nina , Egorov Alexey , Kubishkin Valeriy , Bulgakov Gennadiy 
Published: October 2003

AbstractBACKGROUNDGastrinomas are located more frequently in the pancreas, which normally has no cells that can produce gastrin. They have a more aggressive course than other pancreatic endocrine tumors and extrapancreatic gastrinomas associated with multiple endocrine neoplasia Type 1 syndrome. The current study analyzed immunophenotypes of gastrinomas and compared them with other pancreatic endocrine tumors.METHODSTwenty‐one formalin‐fixed, paraffin‐embedded specimens (15‐tumors in the pancreas, 1 in the duodenum, 1 in the stomach, 1 in the liver, and 3 of unknown primary location) accompanied by Zollinger—Ellison syndrome and 17 other pancreatic endocrine tumor specimens were investigated. They were stained immunohistochemically for gastrin, chromogranin A, synaptophysin, insulin, glucagon, somatostatin, pancreatic polypeptide, calcitonin, serotonin, chorionic gonadotropin, adrenocorticotropic hormone, carcinoembryonic antigen, epithelial membrane antigen, and cytokeratin 19.RESULTSGastrinomas coexpressed neuroendocrine and exocrine markers, including chromogranin A, synaptophysin, carcinoembryonic antigen, cytokeratin 19, and epithelial membrane antigen. Carcinoembryonic antigen was found in all 17 gastrinomas (100%), cytokeratin 19 was found in 15 of 17 (88.2%) gastrinomas, and epithelial membrane antigen was found in 16 of 18 (88.9 %) gastrinomas. Cytokeratin 19, epithelial membrane antigen, and carcinoembryonic antigen were not found to be present in the pancreatic endocrine tumors, but chromogranin A and synaptophysin were. Chorionic gonadotropin was found in 16 gastrinomas (100%), but only in 2 of 17 other pancreatic endocrine tumors (11.8 %).CONCLUSIONSPancreatic gastrinomas were characterized by the coexpression of neuroendocrine markers, exocrine markers, and chorionic gonadotropin. Therefore, pancreatic gastrinomas made a special intermediate group of tumors, which phenotypically combined features of neuroendocrine and exocrine neoplasms. These findings suggested that sporadic pancreatic gastrinomas and other pancreatic endocrine tumors are different phenotypically and are possibly of different origin. Cancer 2003. © 2003 American Cancer Society.
Estimation of an optimal radiotherapy utilization rate for breast carcinoma
Authors: Delaney Geoff , Barton Michael , Jacob Susannah 
Published: October 2003

AbstractBACKGROUNDRadiotherapy utilization rates for breast carcinoma vary widely, both within and between countries. Current estimates of the proportion of patients with carcinoma who optimally should receive radiotherapy are based either on expert opinion or on the measurement of actual utilization rates, and not on the best scientific evidence.METHODSTo develop an evidence‐based benchmark for radiotherapy utilization in patients with breast carcinoma, the authors undertook a systematic review of treatment guidelines on the use of radiotherapy for breast carcinoma. A decision tree was constructed, and the proportions of patients with clinical features that lead to a decision for radiotherapy were obtained from epidemiological data. This ideal utilization rate was compared with the utilization rates of radiotherapy over the last decade for breast carcinoma in Australia and internationally.RESULTSThe proportion of patients with breast carcinoma in whom radiotherapy would be recommended according to the best available evidence was calculated at 83% (95% confidence interval, 82–85%) of all patients with breast carcinoma. A review of actual radiotherapy utilization rates for breast carcinoma revealed that, in clinical practice, actual utilization rates varied between 24% and 71%.CONCLUSIONSA substantial difference was found between the recommended optimal utilization of radiotherapy based on evidence and the actual rates reported in clinical practice. The reasons for these differences need to be examined, and a plan for addressing the suboptimal use of radiotherapy needs to be implemented. Cancer 2003. © 2003 American Cancer Society.