bluuebunny/crossref_metadata_2025_split huggingface dataset:
Life After Loss: A Prospective Analysis of Mortality Exposure and Unintended Fertility
Authors: Smith-Greenaway Emily , Yeatman Sara , Chilungo Abdallah 
Published: March 2022

Abstract
The relationship between mortality and fertility is a key component of demographic transition theory, placing it at the center of extensive inquiry. Among other linkages, mortality in women's communities and social networks influences their subsequent fertility. Existing demographic research assumes this is principally due to volitional mechanisms, implying that exposure to mortality consolidates women's desire to become pregnant, leading to intended fertility. Yet, insights from other disciplines suggest that mortality exposure could also increase women's unintended fertility through psychological, relational, and behavioral mechanisms. This study examines the relationships between network mortality exposure and women's hazard of pregnancy, and of unintended pregnancy specifically. We analyze two years (2009–2011) of closely spaced panel data on young Malawian women (N=1,272) enrolled in the Tsogolo la Thanzi study. Our data include information on funeral attendance and fertility desires measured weeks before conception, which is confirmed through frequent pregnancy testing. Hazard models show that the number of funerals women attend corresponds with a higher hazard of pregnancy and of unintended pregnancy specifically. These findings make clear that mortality exposure can influence fertility not by shaping women's desires but by disrupting the realization of those desires.
Risk Stratification to Define the Role of Radiotherapy for Benign and Atypical Meningioma: A Recursive Partitioning Analysis
Authors: Chang Won Ick , Kim Il-Han , Choi Seung Hong , Kim Tae Min , Lee Soon-Tae , Won Jae Kyung , Park Sung-Hye , Kim Min-Sung , Kim Jin Wook , Kim Yong Hwy , Park Chul-Kee , Lee Joo Ho 
Published: March 2022

BACKGROUND:
The role of adjuvant radiotherapy (RT) for benign or atypical meningioma is controversial.

OBJECTIVE:
To identify prognostic factors and a subgroup that could be potentially indicated for adjuvant RT.

METHODS:
A total of 336 patients with benign and 157 patients with atypical meningioma underwent surgical resection between January 2015 and December 2019. We retrospectively analyzed 407 patients who did not receive adjuvant RT to stratify risk groups for recurrence. A recursive partitioning analysis (RPA) with the prognostic factors for their failure-free survival (FFS) divided the patients into risk groups.

RESULTS:
The 3-year FFS with surgical resection only was 76.5%. Identified prognostic factors for FFS were skull base location, tumor size, brain invasion, a Ki-67 proliferation index of ≥5%, and subtotal resection. The RPA-classified patients were divided into 4 risk groups: very low, low, intermediate, and high, and their 3-year FFS were 98.9%, 78.5%, 59.8%, and 34.2%, respectively. Intermediate-risk and high-risk groups comprise the patients with meningioma of sizes ≥2 cm after subtotal resection or meningioma of sizes >3 cm, located in the skull base or with brain invasion, respectively. After combining with patients treated with adjuvant RT, no FFS benefit was found in the very low-risk and low-risk groups after adjuvant RT, whereas significantly improved FFS was found in the intermediate-risk and high-risk groups (P < .05).

CONCLUSION:
The RPA classification revealed a subgroup of patients who could be potentially indicated for adjuvant RT even after gross total resection or for whom adjuvant RT could be deferred.
Effect of acarbose combined with diet intervention on glycolipid metabolism in patients with primary polycystic ovarian syndrome complicated with impaired glucose tolerance
Authors: Yang Qian  , Zhang Wenjuan , Zhang Junfei , Niu Shuai 
Published: March 2022

Objectives: To investigate the efficacy of acarbose combined with diet intervention in patients with primary polycystic ovarian syndrome (PCOS) complicated with impaired glucose tolerance (IGT) and its effect on their glycolipid metabolism.
Methods: A total of 92 patients with primary PCOS complicated with IGT treated in our hospital from December 2018 to December 2020 were selected, and divided into two groups using a random number table. The control group received routine lifestyle intervention. On this basis, the observation group was treated with acarbose combined with diet intervention. The menstrual recovery rate, ovulation rate and pregnancy rate after treatment, as well as sex hormone levels, glycolipid metabolism and inflammatory factor levels before and after treatment were compared between the two groups.
Results: After treatment, the menstrual recovery rate and ovulation rate of the observation group were significantly higher than those of the control group (P < 0.05). Among the patients with fertility needs in the two groups, the pregnancy rate of the observation group was significantly higher compared with the control group (P < 0.05). Before treatment, sex hormone levels showed no obvious differences between the two groups (P > 0.05). After treatment, all indicators of sex hormone were improved in both groups, and the improvement in the observation group was more obvious than that in the control group (P < 0.05). Before treatment, no obvious difference was found in glycolipid metabolism between the two groups (P > 0.05). After treatment, 2hPG, LDL-C and TG were improved in both groups, and the improvement was more significant in the observation group compared with the control group (P < 0.05). Before treatment, inflammatory factor levels were not significantly different between the two groups (P > 0.05). After treatment, inflammatory factor levels in both groups were improved, which was more obvious in the observation group than the control group (P < 0.05).
Conclusions: The application of acarbose combined with diet intervention in patients with primary PCOS complicated with IGT can effectively enhance the efficacy, help patients increase ovulation rate and pregnancy rate, and improve sex hormone levels, glycolipid metabolism and inflammatory factor levels.
doi: https://doi.org/10.12669/pjms.38.4.4598
How to cite this:Riaz A, Sughra U, Jawaid SA, Masood J. Measurement of Service Quality Gaps in Dental Services using SERVQUAL in Public Hospitals of Rawalpindi. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.4598
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.
Time for culture conversion and its associated factors in multidrug-resistant tuberculosis patients at a tertiary level hospital in Peshawar, Pakistan
Authors: Iqbal Zafar , Ali Khan Mazhar , Aziz Aamir , Nasir Syed Muhammad 
Published: March 2022

Objectives: This study aimed to assess the time to sputum culture conversion (SCC) and its determinants among multidrug-resistant tuberculosis (MDR-TB) patients.
Methods: This cross-sectional study was conducted from January 2019 to January 2020. A total of 252 MDR-TB patients presenting at a tertiary level teaching hospital in Peshawar, Khyber Pakhtunkhwa (KP), were included. The patient’s demographic and clinical data were collected using a structured questionnaire. Time to SCC was calculated from the initiation of treatment till the patient had two consecutive negative cultures. The Cox proportional-hazards analysis was performed to check strength and association between the determinants and time for SCC.
Results: Out of 252 MDR-TB patients enrolled, sputum culture conversion was observed in 76.6% of the patients by the end of six months. While, 19.0% of the patients failed to achieve negative culture and remained positive after interim report of their treatment. Age > 45 years (HR = 15.22; 95% CI: 7.27-31.83; p<0.001), female gender (6.22; 2.90-13.36; p<0.001), BMI < 18.5 kg/m2 (10.28; 5.25-20.11; p<0.001), weight loss (0.03; 0.01-0.06; p<0.001), smoking (0.10; 0.05-0.21; p<0.001), diabetes mellitus (0.02; 0.00-0.04 p<0.001) and disease severity on chest X-ray (CXR) (0.03; 0.01-0.09; p<0.001) were the significant determinants of delayed sputum culture conversion.
Conclusion: MDR-TB patients with older age, low BMI, weight loss, diabetes, smokers and those with disease severity on CXR are less likely to respond to treatment as they displayed delayed SCC. Therefore, such patients should be meticulously followed up for successful management.
doi: https://doi.org/10.12669/pjms.38.4.5058
How to cite this:Iqbal Z, Khan MA, Aziz A, Nasir SM. Time for culture conversion and its associated factors in multidrug-resistant tuberculosis patients at a tertiary level hospital in Peshawar, Pakistan. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.5058
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.
The comparison of clinical effect, knee function, prognosis of double plate fixation and locking plate internal fixation for tibial plateau fractures
Authors: Zhang Qing , Zhao Jianzhong , Zhang Guangcheng , Tang Jiazhu , Zhu Wei , Nie Mingjun 
Published: March 2022

Objectives: The purpose of this study was to investigate the clinical effect, knee function improvement and prognosis of double plate internal fixation and locking plate internal fixation in the treatment of tibial plateau fractures.
Methods: Clinical data from 96 tibial plateau fracture patients treated at our hospital were analyzed retrospectively. Of these, 46 had been treated using locking plate internal fixation and 50 were treated with double T-shaped plate fixation. Clinically related indices, Hospital for Special Surgery (HSS) score of knee function, and ability of daily living (ADL) score were evaluated during postoperative follow-up.
Results: No significant differences were observed in pre-operative patient characteristics in both groups. Healing time, time to weight-bearing, tibial plateau angle (TPA) and lateral posterior angle (PA) were all superior in the locking plate fixation group compared to the double plate fixation group. At three months post-operative visit, range of motion, knee function, flexion deformity, muscle strength, pain, and stability metrics were all superior in the locking plate fixation group compared to the double plate fixation group. ADL scores were also higher in the locking plate fixation group than in the double plate fixation group at three and six months follow-up.
Conclusions: The clinical effect, knee function improvement and prognosis of locking plate internal fixation in the treatment of tibial plateau fractures are better than those of double plate fixation.
doi: https://doi.org/10.12669/pjms.38.4.5340
How to cite this:Zhang Q, Zhao J, Zhang G, Tang J, Zhu W, Nie M. The comparison of clinical effect, knee function, prognosis of double plate fixation and locking plate internal fixation for tibial plateau fractures. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.5340
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 and clinical significance of tissue ultrasound for assessment of right ventricular diastolic function in patients with coronary slow flow
Authors: Zhu Xuefang , Xu Xiuping , Wei Zhen , Zhu Zenghua 
Published: March 2022

Objectives: To evaluate right ventricular diastolic function in patients with coronary slow flow phenomenon (CSFP) by using Doppler tissue imaging (DTI).
Methods: CSFP patients diagnosed using coronary angiography from June 2019 to December 2020 at the third Hospital of Quzhou were retrospectively investigated, with a similar number of patients with normal coronary blood flow during the same period taken as the control group. Right ventricular systolic and diastolic function index was measured via DTI.
Results: No differences were found between CSFP and control groups in terms of baseline data, RV end systolic diameter, RV end diastolic diameter, or RV ejection fraction. The peak velocity E in the early diastolic phase of the right ventricle was decreased in CSFP patients, while the peak velocity a in the late diastolic phase of the right ventricle was increased, resulting in a lower E / a ratio.
Conclusions: Right ventricular diastolic function in patients with CSFP is decreased, and this can be identified using DTI. DTI has important applicative value for evaluating right ventricular diastolic function in patients with CSFP.
doi: https://doi.org/10.12669/pjms.38.4.5342
How to cite this:Zhu X, Xu X, Wei Z, Zhu Z. Application and clinical significance of tissue ultrasound for assessment of right ventricular diastolic function in patients with coronary slow flow. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.5342
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.
Promising sequels of a novel nanoformulation of khamira abresham hakim Arshadwala against isoprenaline challenged cardiac damage in rodents
Authors: Mahmood Tarique , Shamim Arshiya , Shariq Mohammad , Siddiqui Mohammed Haris , Ahsan Farogh , Parveen Saba 
Published: March 2022

Background: Khamira Abresham Hakim Arshadwala (KAHAW), a distinguished, traditional Unani formulation comprising constituents of herbal, animal, and mineral origin, holds salubrious cardioprotective potential and has been used for cardiac ailments in the Unani system for ages. KAHAW is a ‘sugar-based’ preparation, which hinders its ‘claim to fame’ amongst cardiac patients with diabetes. Hence, it is fascinating to develop a novel nanoformulation of the traditional one and screen its efficacy experimentally on the male Wistar rats (4-week-old) (150-180gm). The objective was to revolutionize this historic gem of a formulation and enhance its therapeutic efficacy, a novel nanoformulation of KAHAW was developed, and its cardioprotective potential screened against isoprenaline (ISO) induced cardiotoxicity in rodents. The results were analyzed with the traditional formulations and two clinically used drugs, Ramipril and Carvedilol. Methods: Various parameters viz; Physical, Enzymatic, Non-enzymatic, and cardiac-specific biomarkers like α/β-MHC expression (Western Blot), Flow cytometry, Cardiac collagen content, and Mitochondrial enzyme assay were assessed on plasma, blood, and tissue samples followed by histomorphological investigations. Results: The effect of nanoformulation showed highly significant results (***p<0.001) when compared to disease control for different parameters viz, Total protein, GPx and GSH, Lipid peroxidation, and Vitamin E. The cardiac-specific biomarkers like α/β-MHC Expression (Western Blot), Flow Cytometry, Cardiac collagen content, and Mitochondrial enzyme assay also advocated the highly significant (***p<0.001) cardioprotective activity of the developed nanoformulation. Conclusions: The research reiterates that the novel nanoformulation offers improved efficacy at a reduced dose against ISO-induced experimental models of myocardial necrosis.
Current management of adults receiving oral anti-cancer medications: A scoping review protocol
Authors: Richmond Janice P. , Kelly Mary Grace , Johnston Alison , Hynes Lisa , Murphy Patrick J. , Murphy Andrew W. 
Published: March 2022

Oncology has been undergoing a profound transition in the last ten years with the increased usage in oral anti-cancer medication. Approximately 25% of all anti-cancer medication is now designed for oral use and this is likely to increase prospectively. These treatments are convenient for patients and are often preferred by them, yet there are similar safety and toxicity concerns as there are to intravenous treatment. Oral anti-cancer medications (OAMs) have the potential to alleviate capacity issues in cancer treating units as patients receive their treatment at home, however there remains a requirement for safe and efficient assessment and care. Consequently, the management of patients on OAMs is of paramount importance. The optimum setting, whether within primary or secondary care, in addition to the appropriate health care professional to carry out patient assessment and monitoring needs to be established. This paper presents a protocol for a scoping review which aims to systematically and comprehensively map the literature on the current management of adults receiving OAMs. The review will follow the published guidance to direct the various steps involved. The protocol will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) framework to ensure methodological and reporting quality. Independent full text review will be performed by two reviewers and any disagreements resolved through discussion with a third reviewer. The process will be iterative in nature. This scoping review will provide a narrative synthesis and map the literature on the management of individuals receiving OAMs. This work is an appropriate initial stage in presenting the literature to inform the subsequent steps in a multi-phased research study which aims to establish and analyse the safety and efficacy of an integrated care model for the management of patients receiving OAM in the community by an advanced practitioner.
Developing consensus-based recommendations for the delivery of dementia services for the LGBTQIA+ community in the Republic of Ireland
Authors: Oglesby Megan H. , Hynes Sinéad M. 
Published: March 2022

Background: The number of older LGBTQIA+ adults is set to rise significantly in the coming years. The rising numbers sit together with the rise in the number of people in Ireland diagnosed with dementia. In Ireland, no dementia-specific services exist for people from the LGBTQIA+ community. The aim of this research was to 1) identify the future needs that older LGTBQIA+ people and their care partners living in Ireland have in relation to dementia care service delivery; and to 2) develop consensus-based recommendations for dementia service provision in Ireland. Methods: A six-phase consensus process was used to develop the lists of needs and recommendations: 1) development; 2) national survey; 3) interviews with key stakeholders; 4) international review of best practice; 5) consensus meeting; 6) final member checking. Participants, aged over 50, were based in Ireland, identified as a member of the LGBTQIA+ community or supported someone who is/was. Results: Results are reported from the survey (n=49), individual interviews (n=8), and the consensus meeting (n=10). Participants have concerns related to identity management and suppression, creating an LGBTQIA+ affirmative ethos and workforce, and respect and safety. From the results and consensus process, a full list of ten prioritised needs and recommendations have been developed that focus specifically on dementia care in Ireland for the LGBTQIA+ community. Conclusion: The older LGBTQIA+ community has identified essential priorities for improving healthcare access and safety. These priorities now need to be urgently implemented into clinical and dementia care services.
Effect of the additional anteroposterior blocking screw on nail/medullary canal mismatch after cephalomedullary nailing in unstable pertrochanteric fracture
Authors: Kwak Dae-Kyung , Oh Seog-Hyun , Lee Sung-Jae , Lee Seung-Hun , Lee Yong-Min , Yoo Je-Hyun 
Published: March 2022

Aims There are concerns regarding nail/medullary canal mismatch and initial stability after cephalomedullary nailing in unstable pertrochanteric fractures. This study aimed to investigate the effect of an additional anteroposterior blocking screw on fixation stability in unstable pertrochanteric fracture models with a nail/medullary canal mismatch after short cephalomedullary nail (CMN) fixation. Methods Eight finite element models (FEMs), comprising four different femoral diameters, with and without blocking screws, were constructed, and unstable intertrochanteric fractures fixed with short CMNs were reproduced in all FEMs. Micromotions of distal shaft fragment related to proximal fragment, and stress concentrations at the nail construct were measured. Results Micromotions in FEMs without a blocking screw significantly increased as nail/medullary canal mismatch increased, but were similar between FEMs with a blocking screw regardless of mismatch. Stress concentration at the nail construct was observed at the junction of the nail body and lag screw in all FEMs, and increased as nail/medullary canal mismatch increased, regardless of blocking screws. Mean stresses over regions of interest in FEMs with a blocking screw were much lower than regions of interest in those without. Mean stresses in FEMs with a blocking screw were lower than the yield strength, yet mean stresses in FEMs without blocking screws having 8 mm and 10 mm mismatch exceeded the yield strength. All mean stresses at distal locking screws were less than the yield strength. Conclusion Using an additional anteroposterior blocking screw may be a simple and effective method to enhance fixation stability in unstable pertrochanteric fractures with a large nail/medullary canal mismatch due to osteoporosis. Cite this article: Bone Joint Res 2022;11(3):152–161.
Extreme learning machine and genetic algorithm in quantitative analysis
of sulfur hexafluoride by infrared spectroscopy
Authors: Liu Huan , Zhu Jun , Yin Huan , Yan Qiangqiang , Liu Hong , Guan Shouxin , Cai Qisheng , Sun Jiawen , Yao Shun , Wei Ruyi 
Published: March 2022

Owing to the general disadvantages of traditional neural networks in gas concentration
inversion, such as slow training speed, sensitive learning rate
selection, unstable solutions, weak generalization ability, and an
ability to easily fall into local minimum points, the extreme learning
machine (ELM) was applied to sulfur hexafluoride (

S
F

6

) concentration inversion research. To
solve the problems of high dimensionality, collinearity, and noise of
the spectral data input to the ELM network, a genetic algorithm was
used to obtain fewer but critical spectral data. This was used as an
input variable to achieve a genetic algorithm joint extreme learning
machine (GA-ELM) whose performance was compared with the genetic
algorithm joint backpropagation (GA-BP) neural network algorithm to
verify its effectiveness. The experiment used 60 groups of

S
F

6

gas samples with different
concentrations, made via a self-developed Fourier transform infrared
spectroscopy instrument. The

S
F

6

gas samples were placed in an open
optical path to obtain infrared interference signals, and then
spectral restoration was performed. Fifty groups were randomly
selected as training samples, and 10 groups were used as test samples.
The BP neural network and ELM algorithms were used to invert the

S
F

6

gas concentration of the mixed
absorbance spectrum, and the results of the two algorithms were
compared. The sample mean square error decreased from 248.6917 to
63.0359; the coefficient of determination increased from 0.9941 to
0.9984; and the single running time decreased from 0.0773 to 0.0042 s.
Comparing the optimized GA-ELM algorithm with traditional algorithms
such as ELM and partial least squares, the GA-ELM algorithm had higher
prediction accuracy and operating efficiency and better stability and
generalization performance in the quantitative analysis of small
samples of gas under complex noise backgrounds.