bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of age, period, and birth cohort effects on suicide mortality in Brazil and the five major geographic regions
Authors: Galvão Pauliana Valéria Machado , da Silva Cosme Marcelo Furtado Passos 
Published: July 2023

AbstractObjectiveEstimate the effects of age, period, and birth cohort on suicide mortality in Brazil by major geographic region in the overall population and by sex.MethodsThis was a time trend ecological study. National and regional suicide mortality data from 1981 to 2020 were analyzed for the overall population and by sex. Age, period, and cohort effects were calculated with a Poisson regression model using estimable functions with the Epi package of the R statistical program, version 4.2.1.ResultsThere were 272,716 suicides in individuals ranging from 20 to 79 years old. In the overall population, the age model-adjusted suicide mortality rates showed an upward pattern for Brazil. The most recent cohort showed the highest associated risk, 1.67 (95%CI 1.63; 1.71), while for the reference period, it was the highest risk among all the periods.ConclusionsSuicide mortality rates have shown an upward trend with advancing age in both men and women in the Brazilian population. However, the behavior of the period effect and cohort depends on the population analyzed and regional distribution.
Application of mesohepatectomy with caudate lobectomy for the treatment of type III–IV hilar cholangiocarcinoma: a single-center retrospective study
Authors: Wang Dongdong , Sun Wanliang , Zhou Shuo , Liu Zhong , Lu Zheng , Zhang Dengyong 
Published: July 2023

Abstract
Background
The main surgical procedure for Bismuth‒Corlette III–IV hilar cholangiocarcinoma (HCCA) is hemihepatectomy/extended hemihepatectomy. However, many patients have no opportunity for surgery due to having an insufficient remnant liver volume. Preservation of more liver volume on the premise of ensuring R0 resection is the goal. Mesohepatectomy with caudate lobectomy may be a new method to meet these requirements.

Methods
The clinical data of 41 patients with Bismuth‒Corlette III–IV HCCA, including 18 patients who underwent mesohepatectomy with caudate lobectomy (the mesohepatectomy group) and 23 patients who underwent hemihepatectomy or extended hemihepatectomy (the hemihepatectomy group), were analyzed retrospectively. The perioperative indicators and prognostic survival time between the two groups were analyzed.

Results
The mesohepatectomy group was compared with the hemihepatectomy group, and the operation time was 7.95 ± 1.2 vs. 7.15 ± 1.5 h (P > 0.05); the intraoperative blood loss was 600.0 ± 153.4 vs. 846.1 ± 366.8 mL (P < 0.05); the postoperative hospital stay was 9.9 ± 2.2 vs. 13.8 ± 3.0 days (P < 0.05); and the R0 resection rate was 100% vs. 87.0% (P > 0.05). The postoperative complications of the two groups included bile leakage (22.2% vs. 21.7%), pleural effusion (11.1% vs. 8.7%), and fever (16.7% vs. 8.7%), with no significant differences in the incidences (P > 0.05). The 1-, 3-, and 5-year survival rates of the two groups were 87.5%, 55.7%, 27.8% and 83.5%, 56.1%, 24.5%, respectively, with no significant differences (P > 0.05).

Conclusions
Mesohepatectomy with caudate lobectomy can preserve more functional liver volume while ensuring the bile duct margin. It can be applied as the surgical treatment of Bismuth‒Corlette III–IV HCCA.
Diagnostic value of mesenteric CTA combined with D-dimer level and inflammatory factor changes in severity of mesenteric artery embolism
Authors: Yi-ru  , Li Zhao-yang , Liang Jing , Bai Song , Zhang Zhu-fen 
Published: July 2023

Objective: To investigate the value of mesenteric CTA combined with D-dimer (DD) level and inflammatory factor changes in evaluating the severity of mesenteric artery embolism.
Methods: This is a retrospective study. The imaging data of mesenteric CTA and the levels of plasma DD and inflammatory factors in 120 patients with mesenteric artery embolism confirmed by DSA or surgery in Baoding No.1 Central Hospital were analyzed retrospectively from January 2021 to December 2022. The coincidence rate of CTA alone and CTA combined with DD and inflammatory factors with the results of surgery or DSA was compared and analyzed. The specificity, sensitivity and accuracy of CTA alone and CTA combined with DD and inflammatory factors in diagnosing superior mesenteric artery embolism were compared. The correlations of different severity of mesenteric artery embolism with DD and inflammatory factor levels were compared and analyzed.
Results: There was a significant difference in the coincidence rate between CTA diagnosis and CTA combined with DD and inflammatory factors diagnosis (p= 0.01). And the sensitivity and accuracy of the latter were significantly higher than those of the former (sensitivity, p= 0.01; accuracy, p= 0.00). The levels of plasma DD, TNF-a, CRP and IL-6 in the intestinal wall thinning group were significantly higher than those in the thickening group (p= 0.00). The above indexes increased significantly in the decreased intestinal wall enhancement group compared with the increased intestinal wall enhancement group (p= 0.00). DD, TNF-α, CRP and IL-6 levels increased with the increase in stenosis severity.
Conclusion: Mesenteric CTA combined with plasma DD and inflammatory factor levels can effectively determine the severity of mesenteric arterial embolism, and provide a scientific basis for early clinical diagnosis and treatment.
doi: https://doi.org/10.12669/pjms.39.5.6719
How to cite this: Zhang Y, Li Z, Liang J, Bai S, Zhang Z. Diagnostic value of mesenteric CTA combined with D-dimer level and inflammatory factor changes in severity of mesenteric artery embolism. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.6719
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.
Comparison of the Efficacy of Diclofenac 0.1% and Nepafenac 0.1% on anterior chamber cells in patients Undergoing Cataract Surgery: A prospective clinical practice trial
Authors: Ahmad Adnan , Haq Shmas Ul , Hussain Jamal , Rasul Javed 
Published: July 2023

Objectives: To compare the efficacy of topical Nepafenac 0.1 % and Diclofenac 0.1% eye drops in reducing the aqueous cells in the anterior chamber in an un-eventful post cataract surgery.
Methods: This prospective, clinical trial was conducted at an Eye OPD of Qazi Hussain Ahmad Medical Complex, Nowshera from January till December 2021. Ophthalmic assessment included Visual acuity (VA), slit-lamp examination, Intraocular pressure (IOP), Central macular thickness (CMT) by Optical coherence tomography (OCT) and anterior chamber-aqueous cells measurement pre-operatively and at day 1st, 2nd, 4th and 8th week post-operatively. Patients were randomly allocated to topical diclofenac 0.1% (TD) four times a day and nepafenac 0.1% (TN) three times a day for four weeks each along with topical steroids and antibiotics.
Results: Seventy patients (70) were randomly distributed into two treatment arms of 35 each. In both the arms VA improved which achieved a level of statistical significance post-operatively, however statistically insignificant difference was observed between the groups at 8th week follow up visit (p= 0.62). However, IOP and CMT values didn’t achieve statistical significance between the arms pre and post operatively. In TN arm, level of AC-cells at 2nd and 4th week post-operatively were significantly lower (10.54 ± 4.05 and 08.20 ± 4.44) than TD arm (11.28 ± 5.04 and 09. 66 ± 5.50) with statistically significant difference (p < 0.05).
Conclusions: Topical Nepafenac 0.1% was more effective in suppressing the anterior chamber inflammation as compared to diclofenac during the early few post-operative weeks.
doi: https://doi.org/10.12669/pjms.39.5.6862
How to cite this: Ahmad A, Haq S, Hussain J, Rasul J. Comparison of the Efficacy of Diclofenac 0.1% and Nepafenac 0.1% on anterior chamber cells in patients Undergoing Cataract Surgery: A prospective clinical practice trial. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.6862
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.
Association of different blood groups in patients with Dengue fever and their relationship with the severity of the illness
Authors: Iqbal Naveed , Afridi Muhammad Abdur Rahman , Ali Zafar , Rafiq Adnan 
Published: July 2023

Objective: To determine the association of different blood groups in patients with Dengue fever and their relationship with the severity of the illness.
Methods: A hospital-based descriptive study was conducted in the Dengue Isolation Ward of Lady Reading Hospital Peshawar from March 2020 to September 2020. Patients with Dengue fever were included in the study. The severity of the illness was categorized as “Dengue fever (DF)”, “Dengue hemorrhagic fever (DHF)”, and “Dengue shock syndrome (DSS)”. The patients’ blood groups were determined as A, B, AB, and O groups. All the data were recorded and analyzed using SPSS® version 23. Chi-square (χ2) and student t-test were applied, and a p-value of ≤0.05 was considered significant.
Results: Out of 160 patients, 119(74.4%) were males; the patient’s mean age was 38.09±15.68 SD, IQR=25 years. Greater proportion (28%) of the young men (up to 40 years) was affected compared to 9% young women. Fever (99%) and body aches (96%) were the most common presentation of DF, complicated by bleeding in 30.6% and shock in 9.4% of the patients. The majority (63.1%) of the patients had DF; 27.5% had DHF, and 9.4% had DSS. Sixty three (39.4%) patients had blood Group-B and 5.6% had Group-AB (p=0.97). The proportion of patients with different blood groups and the type/severity of the DF were almost identical except the fact that none of the patient with group AB had DSS. There was significant gender difference of hemoglobin (p=0.008, 95%CI=0.439, 2.844), hematocrit (p=0.012, 95%CI=0.00974, 0.07946); and Alanine Aminotransferase levels (p=0.002, 95%CI=-332.032, -72.233).
Conclusion: Patients with blood Group-B were more frequent and AB was least commonly affected by the Dengue-virus infections. However, no association was found between a particular blood group and disease severity. Greater proportions of the younger men had Dengue infections.
doi: https://doi.org/10.12669/pjms.39.5.7275
How to cite this: Iqbal N, Afridi MAR, Ali Z, Rafiq A. Association of different blood groups in patients with Dengue fever and their relationship with the severity of the illness. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.7275
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.
Identifying determinants for the seropositive rate of schistosomiasis in Hunan province, China: A multi-scale geographically weighted regression model
Authors: Tong Yixin , Tang Ling , Xia Meng , Li Guangping , Hu Benjiao , Huang Junhui , Wang Jiamin , Jiang Honglin , Yin Jiangfan , Xu Ning , Chen Yue , Jiang Qingwu , Zhou Jie , Zhou Yibiao 
Published: July 2023

Background
Schistosomiasis is of great public health concern with a wide distribution and multiple determinants. Due to the advances in schistosomiasis elimination and the need for precision prevention and control, identifying determinants at a fine scale is urgent and necessary, especially for resource deployment in practice. Our study aimed to identify the determinants for the seropositive rate of schistosomiasis at the village level and to explore their spatial variations in local space.

Methodology
The seropositive rates of schistosomiasis were collected from 1714 villages or communities in Human Province, and six spatial regression models including ordinary least squares (OLS), spatial lag model (SLM), spatial error model (SEM), geographically weighted regression (GWR), robust GWR (RGWR) and multiscale GWR (MGWR) were used to fit the data.

Principal/Findings
MGWR was the best-fitting model (R2: 0.821, AICc:2727.092). Overall, the nearest distance from the river had the highest mean negative correlation, followed by proportion of households using well water and the annual average daytime surface temperature. The proportions of unmodified toilets showed the highest mean positive correlation, followed by the snail infested area, and the number of cattle. In spatial variability, the regression coefficients for the nearest distance from the river, annual average daytime surface temperature and the proportion of unmodified toilets were significant in all villages or communities and varied little in local space. The other significant determinants differed substantially in local space and had significance ratios ranging from 41% to 70%, including the number of cattle, the snail infested area and the proportion of households using well water.

Conclusions/Significance
Our study shows that MGWR was well performed for the spatial variability of schistosomiasis in Hunan province. The spatial variability was different for different determinants. The findings for the determinants for the seropositive rate and mapped variability for some key determinants at the village level can be used for developing precision intervention measure for schistosomiasis control.
Differential expression profile of genes involved in the immune response associated to progression of chronic Chagas disease
Authors: Gómez Inmaculada , López Manuel Carlos , Egui Adriana , Palacios Génesis , Carrilero Bartolomé , Benítez Celia , Simón Marina , Segovia Manuel , Carmelo Emma , Thomas M Carmen 
Published: July 2023

Background
Patients with chronic Chagas disease present marked clinical and immunological heterogeneity. During the disease, multiple immune mechanisms are activated to fight the parasite. The purpose of this study was to investigate the expression patterns of genes involved in relevant immunological processes throughout the disease in patients with chronic Chagas disease.

Methodology/Principal findings
High-throughput RT-qPCR with QuantStudio 12K Flex real-time PCR system was used to evaluate the expression of 106 immune-related genes in PBMC from a cohort of cardiac Chagas disease patients (CCC I), asymptomatic patients (IND) and healthy donors (HD) after being stimulated with T. cruzi soluble antigens. Principal component analysis (PCA), cluster analysis and volcano plots were used to identify differentially expressed genes. In addition, gene set enrichment analysis (GSEA) was employed to identify the enriched immunological pathways in which these genes are involved. PCA revealed the existence of a statistically divergent expression profile of the 36 genes correlated with PC1 between CCC I patients and HD (p < 0.0001). Differential gene expression analysis revealed upregulation of 41 genes (expression fold-change > 1.5) and downregulation of 14 genes (expression fold-change < 0.66) (p = 8.4x10-13 to p = 0.007) in CCC I patients versus HD. Furthermore, significant differences in the expression level of specific genes have been identified between CCC I and IND patients (8 up and 1 downregulated). GSEA showed that several upregulated genes in CCC I patients participate in immunological pathways such as antigen-dependent B cell activation, stress induction of HSP regulation, NO2-dependent IL12 pathway in NK cells, cytokines-inflammatory response and IL-10 anti-inflammatory signaling.

Conclusions
Cardiac Chagas disease patients show an antigen-specific differential gene expression profile in which several relevant immunological pathways seem to be activated. Assessment of gene expression profiles reveal unique insights into the immune response that occurs along chronic Chagas disease.
Prevalence of occupational respiratory symptoms and associated factors among industry workers in Ethiopia: A systematic review and meta-analysis
Authors: Daba Chala , Debela Sisay Abebe , Atamo Amanuel , Desye Belay , Necho Mogesie , Tefera Yonatal Mesfin , Yeshanew Fanos , Gebrehiwot Mesfin 
Published: July 2023

Background
Occupational respiratory diseases are major global public health problems, particularly for industry workers. Several studies have investigated occupational respiratory symptoms in various parts of Ethiopia. The findings have been inconsistent and inconclusive, and there is no nationally representative data on the subject. Therefore, this study aimed to estimate the pooled prevalence and factors associated with occupational respiratory symptoms among industry workers in Ethiopia (2010–2022).

Methods
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework Guidelines, search was conducted on several international databases including PubMed, CINAHL, African Journals Online, Hinari, Global Health, and Google scholar. The extracted data was analyzed using STATA 14. Random effect model was used to estimate the effect size. Egger regression test and I2 statistics were used to determine potential publication bias and heterogeneity, respectively among the reviewed articles.

Results
The meta-analysis included a total of 15 studies with 5,135 participants, revealing a pooled prevalence of 51.6% (95% CI: 43.6–59.6) for occupational respiratory symptoms among industry workers in Ethiopia. The absence of personal protective equipment (OR = 1.97, 95% CI: [1.17–3.32]), lack of occupational health and safety training (OR = 3.04, 95% CI: [2.36–3.93]), previous dust exposure (OR = 3.17, 95% CI: [2.3–4.37]), poor working environment (OR = 2.4, 95% CI: [1.7–3.2]), work experience greater than five years (OR = 4.04, 95% CI: [1.61–10.16]), smoking (OR = 6.91, 95% CI: [2.94–16.2]), and previous respiratory illness (OR = 4.25, 95% CI: [2.44–7.42]) were found to associate with the symptoms.

Conclusions
The high prevalence of occupational respiratory symptoms among industry workers in Ethiopia underscores the urgent need for effective interventions. The provision of personal protective equipment and improvement of working environments by the government, industry owners, and other stakeholders are crucial in reducing occupational respiratory symptoms. Additionally, prioritizing occupational health and safety training for industry workers can help prevent and mitigate the impact of occupational respiratory diseases.

Registration
This systematic review has been registered in the International Prospective Registry of Systematic Review (PROSPERO) with a specific registration number CRD42022383745.
Benefits and harms of gastric suction or lavage at birth for gastrointestinal outcomes: A systematic review and meta-analysis
Authors: Phattraprayoon Nanthida , Ungtrakul Teerapat , Na Takuathung Mingkwan 
Published: July 2023

The benefits of routine gastric suctioning or lavage in neonates remain uncertain, despite the common practice worldwide. To investigate the potential advantages and harms, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the effects of these procedures in healthy or meconium-stained neonates at birth. We systematically searched PubMed, Scopus, Embase, Ovid, and the Cochrane Library databases from inception to February 9, 2023. We included only RCTs assessing the outcomes of gastric suction or lavage in neonates at birth. We calculated risk ratio (RR) and weighted mean differences with 95% confidence intervals (CIs) using a random-effects model. The primary outcomes were gastrointestinal symptoms including vomiting, retching, feeding intolerance, and secondary aspiration. The secondary outcomes included time to initiation of breastfeeding and potential adverse procedure-related events. Twelve RCTs with a total of 4,122 neonates were analyzed. All the studies compared neonates who received gastric suction or lavage with those who received usual care. Gastrointestinal symptoms were significantly reduced in neonates receiving gastric suction or gastric lavage compared with the control group (RR, 0.75; 95% CI, 0.63–0.89). Gastric lavage was beneficial for infants with meconium-stained amniotic fluid (RR 0.71; 95% CI, 0.60–0.84), while gastric suction had no significant benefit in reducing gastrointestinal symptoms in infants without meconium-stained amniotic fluid (RR 0.91; 95% CI, 0.61–1.37). Our findings suggest that gastric suction or lavage may reduce gastrointestinal symptoms in neonates; however, these procedures may only benefit infants born with meconium-stained amniotic fluid. Vigorous newborns without meconium-stained amniotic fluid may not benefit from these procedures. Furthermore, gastric suction may lead to adverse outcomes such as apnea and bradycardia.
Registration: This study was registered in the PROSPERO International prospective register of systematic reviews in health and social care (CRD42023247780).
Evaluation of multiple sclerosis severity using a new OCT tool
Authors: Viladés Elisa , Cordón Beatriz , Pérez-Velilla Javier , Orduna Elvira , Satue Maria , Polo Vicente , Sebastian Berta , Larrosa Jose Manuel , Pablo Luis , García-Martin Elena 
Published: July 2023

Purpose
To assess the ability of a new posterior pole protocol to detect areas with significant differences in retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness in patients with multiple sclerosis versus healthy control subjects; in addition, to assess the correlation between RNFL and GCL thickness, disease duration, and the Expanded Disability Status Scale (EDSS).

Methods
We analyzed 66 eyes of healthy control subjects and 100 eyes of remitting-relapsing multiple sclerosis (RR-MS) patients. Double analysis based on first clinical symptom onset (CSO) and conversion to clinically definite MS (CDMS) was performed. The RR-MS group was divided into subgroups by CSO and CDMS year: CSO-1 (≤ 5 years) and CSO-2 (≥ 6 years), and CDMS-1 (≤ 5 years) and CDMS-2 (≥ 6 years).

Results
Significant differences in RNFL and GCL thickness were found between the RR-MS group and the healthy controls and between the CSO and CDMS subgroups and in both layers. Moderate to strong correlations were found between RNFL and GCL thickness and CSO and CDMS. Furthermore, we observed a strong correlation with EDSS 1 year after the OCT examination.

Conclusions
The posterior pole protocol is a useful tool for assessing MS and can reveal differences even in early stages of the disease. RNFL thickness shows a strong correlation with disability status, while GCL thickness correlates better with disease duration.
Language, race and work in the Caribbean: a Bakhtinian approach
Authors: Valldejuli Luis Galanes 
Published: July 2023

Abstract
This essay is interested in exploring the interconnections between language, race, work and power, particularly as it concerns the Caribbean region. Drawing on ethnographic data gathered in the Puerto Rican island-municipality of Vieques, and borrowing theoretical insight from the ideas of Mikhail Bakhtin, among others, we try to make sense of the linguistic strategies employed by racially marginalized subjects to resist and contest racism, colonialism and labor exploitation in their daily lives, within the context of a tourism economy. We argue that Bakhtin’s approach to language use in conflict-ridden and ideologically-saturated contexts, particularly his treatment of linguistic phenomena like double-voicing, multilingualism and heteroglossia, proves useful in shedding light on the strategic uses of language of, or to the ways in which racially-marginalized subjects create and employ locally-specific linguistic registers as a form of claiming agency and as a mechanism of resistance. In the context of Vieques, we argue, language has become the main vehicle through which Viequense workers resist and accommodate to work in the tourism sector while retaining and preserving a unique ethnic identity.