bluuebunny/crossref_metadata_2025_split huggingface dataset:
A novel approach for characterizing variations in serum peptides in rheumatic heart disease
Authors: Wu Xiaochen , Yue Qin , Jia Weikun , Zhang Jinbao , Ouyang Hui , Xin Dong , Xiao Yingbin 
Published: December 2024

Background & objectives:
Acute rheumatic fever and rheumatic heart disease (RHD) are important public health problems in developing countries. In this study, peptidomic analyses on RHD patients and healthy individuals were performed to characterize variations in serum peptide levels using label-free quantitation approaches.

Methods:
Blood samples were obtained from 160 healthy controls and 160 RHD patients. Of the 448 identified peptides, 272 were analyzed by two label-free mass spectrometry methods, the spectral count and spectral index.

Results:
There were 38 proteins and 95 peptides with significant (adjusted P<0.001) differences in the abundance of peptides between healthy controls and RHD patients, including multiple peptides derived from histone H2B, villin-like protein, complement C4-B and motile sperm domain containing protein-2. The levels of 10 peptides were upregulated, and 85 peptides were downregulated in patients compared to controls. In addition, in patients, the levels of four proteins were upregulated and 34 were downregulated compared to controls.

Interpretation & conclusions:
This study shows that detection of significant changes in serum peptides reflects the difference between RHD patients and healthy controls. This label-free method may be helpful for clinicians to treat RHD patients during the perioperative period.
Coverage of childhood vaccination among children aged 12-23 months, Tamil Nadu, 2015, India
Authors: Murhekar Manoj V. , Kamaraj P. , Kanagasabai K. , Elavarasu G. , Rajasekar T. Daniel , Boopathi K. , Mehendale Sanjay 
Published: December 2024

Background & objectives:
District-Level Household Survey-4 (DLHS-4) indicated that during 2012-2013, only 56 per cent of children aged 12-23 months in Tamil Nadu were fully vaccinated, which were lesser than those reported in earlier national surveys. We, therefore, conducted cluster surveys to estimate coverage of childhood vaccination in the State, and also to identify the factors associated with low coverage.

Methods:
Cross-sectional surveys were conducted in 15 strata [municipal corporation non-slum (n=1), municipal corporation slum (n=1), hilly (n=1), rural (n=6) and urban (n=6)]. From each stratum, 30 clusters were selected using probability proportional to the population size linear systematic sampling; seven children aged 12-23 months were selected from each cluster and their mothers/care-takers were interviewed to collect information about vaccination status of the child. A child was considered fully vaccinated if he/she received bacillus Calmette-Guérin (BCG), three doses of pentavalent, three doses of oral polio vaccine and one dose of measles vaccine, and appropriately vaccinated if all vaccine doses were given at right age and with right interval. Further, coverage of fully vaccinated children (FVC) as per vaccination cards or mothers’ recall, validated coverage of FVC (V-FVC) among those having cards, and coverage of appropriately vaccinated children (AVC) were estimated using survey data analysis module with appropriate sampling weights.

Results:
A total of 3150 children were surveyed, of them 2528 (80.3%) had vaccination card. The weighted coverage of FVC, V-FVC and AVC in the State was 79.9 per cent [95% confidence interval (CI): 78.2-81.5], 78.8 per cent (95% CI: 76.9-80.5) and 69.7 per cent (95% CI: 67.7-71.7), respectively. The coverage of individual vaccine ranged between 84 per cent (measles) and 99.8 per cent (BCG). About 12 per cent V-FVC were not vaccinated as per the vaccination schedule.

Interpretation & conclusions:
The coverage of FVC in Tamil Nadu was high, with about 80 per cent children completing primary vaccination. Efforts to increase vaccination coverage in the State need to focus on educating vaccinators about the need to adhere to the national vaccination schedule and strengthening supervision to ensure that children are vaccinated appropriately.
Impact of embryo co-culture with cumulus cells on pregnancy & implantation rate in patients undergoing in vitro fertilization using donor oocyte
Authors: Bhadarka Harsha K. , Patel Nayana H. , Patel Niket H. , Patel Molina , Patel Kruti B. , Sodagar Nilofar R. , Phatak Ajay G. , Patel Jagdish S. 
Published: December 2024

Background & objectives:
Cumulus cell co-culture of embryo had been found to be beneficial for achieving better pregnancy and implantation rate (IR). The present study was aimed to evaluate efficiency of cumulus co-culture technique over simple culture of embryo in terms of pregnancy rate (PR) and IR in patients undergoing treatment for infertility using donor oocytes fertilized by intracytoplasmic sperm injection.

Methods:
This was a quasi-experimental study between control and study groups. The primary endpoint was achievement of pregnancy. Control group included 508 women who underwent embryo development without cumulus cell co-culture and study group included 394 women who underwent embryo development with cumulus cell co-culture using donor's cumulus cells.

Results:
The present study demonstrated a significant increase in the IR (37.2 vs 24.2%, P<0.001) and in PR (45.7 vs 37.8%, P<0.05) in study group than in control group. The PR and IR were found to be higher in study group, among all groups of women, grouped on the basis of different indications for use of donor oocytes.

Interpretation & conclusions:
Cumulus cell co-culture technique was found to be more effective than simple culture technique for embryo development in women undergoing treatment for infertility using donor oocytes fertilized by intracytoplasmic sperm injection.
Spectrum of prenatally detected central nervous system malformations
Authors: Siddesh Anjurani , Gupta Geetika , Sharan Ram , Agarwal Meenal , Phadke Shubha R. 
Published: December 2024

Background & objectives:
Prenatal diagnosis of malformations is an important method of prevention and control of congenital anomalies with poor prognosis. Central nervous system (CNS) malformations amongst these are the most common. The information about the prevalence and spectrum of prenatally detected malformations is crucial for genetic counselling and policymaking for population-based preventive programmes. The objective of this study was to study the spectrum of prenatally detected CNS malformations and their association with chromosomal abnormalities and autopsy findings.

Methods:
This retrospective study was conducted in a tertiary care hospital in north India from January 2007 to December 2013. The details of cases with prenatally detected CNS malformations were collected and were related with the foetal chromosomal analysis and autopsy findings.

Results:
Amongst 6044 prenatal ultrasonographic examinations performed; 768 (12.7%) had structural malformations and 243 (31.6%) had CNS malformations. Neural tube defects (NTDs) accounted for 52.3 per cent of CNS malformations and 16.5 per cent of all malformations. The other major groups of prenatally detected CNS malformations were ventriculomegaly and midline anomalies. Chromosomal abnormalities were detected in 8.2 per cent of the 73 cases studied. Foetal autopsy findings were available for 48 foetuses. Foetal autopsy identified additional findings in eight foetuses and the aetiological diagnosis changed in two of them (4.2%).

Interpretation & conclusions:
Amongst prenatally detected malformations, CNS malformations were common. NTD, which largely is a preventable anomaly, continued to be the most common group. Moreover, 60 per cent of malformations were diagnosed after 20 weeks, posing legal issues. Chromosomal analysis and foetal autopsy are essential for genetic counselling based on aetiological diagnosis.
Development & standardization of an in-house IgM indirect ELISA for the detection of parvovirus B19 infections
Authors: Vadivel Kumaran , Ramamurthy Mageshbabu , Sankar Sathish , Jain Amita , Srikanth Padma , Ghosh Asit Ranjan , Nandagopal Balaji , Nair Aravindan , Sridharan Gopalan 
Published: December 2024

Background & objectives:
Parvovirus B19 infections occur worldwide; the infection is acquired early in childhood but could occur later. B19 is reported to cause infection in childhood febrile illnesses, and arthropathies in adults and children and in end-stage renal disease (ESRD) seen in adults. This study was designed to develop an in-house IgM indirect ELISA for serological screening among patients and controls, and to compare ELISA results with those of nested polymerase chain reaction (nPCR) assay.

Methods:
An in-house IgM indirect ELISA was standardized using peptide sequence of VP1/VP2 region of parvovirus B19. A total of 201 children and adult with febrile illnesses, 216 individuals with non-traumatic arthropathies, 201 cases of chronic anaemia associated with ESRD and 100 healthy controls were tested. Serum was separated from the blood and subsequently used for DNA extraction. The nested polymerase chain reaction (nPCR) for the detection of B19V DNA was performed using primers targeting the overlapping region of VP1/VP2 capsid protein genes.

Results:
A total of 618 samples were tested for parvovirus B19 by an in-house IgM indirect ELISA. Among these samples, six were positive by in-house ELISA. The inter-rater agreement between ELISA and PCR assays was calculated using kappa coefficient analysis. The value of κ was 0.77 and the strength of agreement was ‘good’ (P<0.001).

Interpretation & conclusions:
The in-house IgM indirect ELISA was found to be simple with high sensitivity and specificity when compared with nPCR and could be used as an alternative to expensive commercial kits in resource-poor settings.
Action-oriented colour-coded foot length calliper for primary healthcare workers as a proxy for birth weight & gestational period
Authors: Pratinidhi Asha K. , Bagade Abhijit C. , Kakade Satish V. , Kale Hemangi P. , Kshirsagar Vinayak Y. , Babar Rohini , Bagal Shilpa 
Published: December 2024

Background & objectives:
Foot length of the newborn has a good correlation with the birth weight and is recommended to be used as a proxy measure. There can be variations in the measurement of foot length. A study was, therefore, carried out to develop a foot length calliper for accurate foot length measurement and to find cut-off values for birth weight and gestational age groups to be used by primary healthcare workers.

Methods:
This study was undertaken on 645 apparently healthy newborn infants with known gestational age. Nude birth weight was taken within 24 h of birth on a standard electronic weighing machine. A foot length calliper was developed. Correlation between foot length and birth weight as well as gestational age was calculated. Correctness of cut-off values was tested using another set of 133 observations on the apparently healthy newborns. Action-oriented colour coding was done to make it easy for primary healthcare workers to use it.

Results:
There was a significant correlation of foot length with birth weight (r=0.75) and gestational age (r=0.63). Cut-off values for birth weight groups were 6.1, 6.8 and 7.3 cm and for gestational age of 6.1, 6.8 and 7.0 cm. Correctness of these cut-off values ranged between 77.1 and 95.7 per cent for birth weight and 60-93.3 per cent for gestational age. Considering 2.5 kg as cut-off between normal birth weight and low birth weight (LBW), cut-off values of 6.1, 6.8 and 7.3 were chosen. Action-oriented colour coding was done by superimposing the colours on the scale of the calliper, green indicating home care, yellow indicating supervised home care, orange indicating care at newborn care units at primary health centres and red indicating Neonatal Intensive Care Unit care for infants.

Interpretation & conclusions:
A simple device was developed so that the primary health care workers and trained Accredited Social Health Activist workers can identify the risk of LBW in the absence of accurate weighing facilities and decide on the type of care needed by the newborn and take action accordingly.
Devising a method towards development of early warning tool for detection of malaria outbreak
Authors: Verma Preeti , Sarkar Soma , Singh Poonam , Dhiman Ramesh C. 
Published: December 2024

Background & objectives:
Uncertainty often arises in differentiating seasonal variation from outbreaks of malaria. The present study was aimed to generalize the theoretical structure of sine curve for detecting an outbreak so that a tool for early warning of malaria may be developed.

Methods:
A ‘case/mean-ratio scale’ system was devised for labelling the outbreak in respect of two diverse districts of Assam and Rajasthan. A curve-based method of analysis was developed for determining outbreak and using the properties of sine curve. It could be used as an early warning tool for Plasmodium falciparum malaria outbreaks.

Result:
In the present method of analysis, the critical Cmax (peak value of sine curve) value of seasonally adjusted curve for P. falciparum malaria outbreak was 2.3 for Karbi Anglong and 2.2 for Jaisalmer districts. On case/mean-ratio scale, the Cmax value of malaria curve between Cmax and 3.5, the outbreak could be labelled as minor while >3.5 may be labelled as major. In epidemic years, with mean of case/mean ratio of ≥1.00 and root mean square (RMS) ≥1.504 of case/mean ratio, outbreaks can be predicted 1-2 months in advance.

Interpretation & conclusions:
The present study showed that in P. falciparum cases in Karbi Anglong (Assam) and Jaisalmer (Rajasthan) districts, the rise in Cmax value of curve was always followed by rise in average/RMS or both and hence could be used as an early warning tool. The present method provides better detection of outbreaks than the conventional method of mean plus two standard deviation (mean+2 SD). The identified tools are simple and may be adopted for preparedness of malaria outbreaks.
Food significantly reduces plasma concentrations of first-line anti-tuberculosis drugs
Authors: Kumar Agibothu Kupparam Hemanth , Chandrasekaran Vedachalam , Kumar Angadi Kiran , Kawaskar M. , Lavanya J. , Swaminathan Soumya , Ramachandran Geetha 
Published: December 2024

Background & objectives:
Concomitant feeding and anti-tuberculosis (TB) drug administration are likely to reduce nausea and enhance compliance to treatment. However, food could lower plasma drug concentrations. This study was undertaken to examine the effect of food on two-hour plasma concentrations of rifampicin (RMP), isoniazid (INH) and pyrazinamide (PZA), and pharmacokinetics of these drugs in adult TB patients.

Methods:
Newly diagnosed adult TB patients were recruited from the Revised National Tuberculosis Control Programme (RNTCP) treatment centres in Chennai Corporation, Chennai, India. Two-hour post-dosing plasma concentrations were determined in 25 patients, and a semi-intensive pharmacokinetic study was undertaken in six patients. RMP, INH and PZA concentrations were determined by high-performance liquid chromatography.

Results:
The geometric mean two-hour concentrations with food and under fasting conditions were 2.2 and 5.5 μg/ml for RMP (P<0.001), 3.9 and 11.3 μg/ml for INH (P<0.001), and 18.0 and 28.2 μg/ml for PZA (P<0.001), respectively. Drug administration with food caused the plasma concentration to decrease by 50, 45 and 34 per cent for RMP, INH and PZA, respectively. Significant decreases in peak concentrations and exposures of drugs and delay in time to attain peak concentrations of drugs when taken with food were also observed.

Interpretation & conclusions:
Our findings showed that food lowered anti-TB drug concentrations significantly and delayed absorption. Patients may be explained the beneficial effects of taking anti-TB drugs in a fasting state and advised to do so. There is a need for more research on optimization of dosing to maximize efficacy and safety of currently used drugs.
A meta-analysis to assess usefulness of procalcitonin-guided antibiotic usage for decision making
Authors: Shafiq Nusrat , Gautam Vikas , Pandey Avaneesh Kumar , Kaur Navjot , Garg Shubha , Negi Harish , Kaur Sharonjeet , Ray Pallab , Malhotra Samir 
Published: December 2024

Background & objectives:
Development of antibacterial resistance and its association with antibiotic overuse makes it necessary to identify a specific and sensitive biomarker for the diagnosis of bacterial infection and guiding antibiotic therapy. Procalcitonin (PCT), as a sepsis biomarker, may play a role in guiding antibiotics treatment in hospital settings. The aim of the current meta-analysis was to analyze the utility of PCT on various outcomes of interest in inpatients.

Methods:
Different databases were searched for randomized controlled trials comparing PCT-guided therapy with standard therapy in admitted patients with bacterial infections. Twenty six articles were found suitable for full text search and of these, 16 studies were considered finally for data extraction.

Results:
There were no significant differences found in total mortality [pooled odds ratio (OR) 1.04, 95% confidence interval (CI) 0.89-1.22, P=0.63], 28-day mortality (pooled OR 0.97, 95% CI 0.80-1.19, P=0.79), need of Intensive Care Unit admission (OR=0.80, 95% CI 0.59-1.09, P=0.16) and duration of stay in hospital (pooled mean difference −0.01, 95% CI −0.50-0.49, P=0.98) between treatment and control groups. PCT-guided treatment significantly decreased the duration of antibiotic treatment (pooled mean difference −2.79, 95% CI −3.52-−2.06, P<0.00001).

Interpretation & conclusions:
PCT-guided therapy significantly decreased antibiotics exposure and thus treatment cost. However, the hard endpoints did not demonstrate any significant benefits, possibly due to low power to detect differences and/or the presence of comorbidities.
TcPO2 as a Predictor of Limb Salvage or Amputation in Patients of Critical Limb Ischemia
Authors: Merkhed Rahul , Patra Vikram , Dhillon Rishi , Mehra Rohit , Dattatreya CVNM , Kaur Ramandeep , Vohra Gagandeep Singh , Dwivedi Surjeet 
Published: December 2024

Abstract

Introduction:
Critical limb-threatening ischemia presents a significant challenge in clinical management, often necessitating lower limb amputation if not managed promptly and effectively. A crucial aspect of managing CLTI involves determining the optimal level of amputation to maximize post-surgical healing and functional outcomes. Among various non-invasive diagnostic tools, Transcutaneous Oximetry (TcPO2) has garnered attention, yet a consensus on predictive cutoff levels remains elusive in the literature.

Aim and Objective:
This study addresses this gap by investigating the predictive utility of TcPO2 in assessing healing outcomes following amputation or ulcer management, aiming to provide valuable insights for clinical practice and enhance patient outcomes in CLTI management.

Methodology:
It was conducted at a tertiary care centre in North India . Our study of 128 patients examines TcPO2 as a predictor for ulcer or amputation stump healing. By applying a cutoff of 40 mmHg, informed by previous retrospective studies suggesting its predictive efficacy, our approach seeks to standardise decision-making and optimise tissue oxygenation to improve clinical outcomes.

Results:
We found that a TcPO2 cutoff of 40 mmHg or higher significantly correlated with increased healing likelihood, whereas values below this threshold, particularly in patients with diabetes mellitus (DM) and chronic kidney disease (CKD), posed greater risks of non-healing outcomes.

Discussion And Conclusion:
This underscores the critical role of TcPO2 in assessing vascular compromise, especially in cases where conventional methods like ankle-brachial pressure index (ABPI) may be unreliable due to arterial calcifications. In our analysis, CKD and TcPO2 < 40 emerged as independent predictors of non-healing ulcers or stump in univariate regression. Interestingly, DM did not show a significant association with non-healing outcomes in this context. Moreover, in multivariate analysis, DM, CKD, and TcPO2 < 40 retained their significance as predictors of poor healing, with TcPO2 < 40 demonstrating the strongest association. Further prospective studies are warranted to validate these findings and establish robust correlations between TcPO2 values and clinical outcomes. Additionally, exploring the influence of various comorbidities and demographic factors could refine predictive models, offering tailored interventions for patients with CLTI.
Accuracy of Lone Three-dimensional Transthoracic Echocardiography in Tricuspid Valve Function and Geometry Assessment: Implication for Preoperative Evaluation of Transcatheter Tricuspid Valve Therapies
Authors: Bruno Noemi , Russo Marco , Pergolini Amedeo , Cammardella Antonio Giovanni , Musumeci Francesco , Ranocchi Federico 
Published: December 2024

Introduction:
Tricuspid regurgitation (TR) is associated with high rate and poor prognosis in patient undertreated. In recent years, transcatheter tricuspid valve interventions (TTVI) appears like a valuable option in high risk surgical candidates in presence of suitable anatomy. Screening phase with transthoracic, thansoesophageal echocardiography, and cardiac computed tomography (CT) are necessary select patients.

Purpose:
The aim of the study is to compare different imaging modalities as three-dimensional (3D) transthoracic echocardiography (TTE), transesophageal echocardiography (TOE) and ECG-gated cardiac CT for the definition of tricuspid valve (TV) function and geometry assessment.

Materials and Methods:
Twenty-one (age 79 ± 7 years, female 72%) patients under screening for transcatheter treatment of TR were prospectively enrolled in the study and underwent TTE, TOE, and cardiac CT. All measurements were performed in double blind by three different operators and compared.

Results:
In the comparison between 2D/3D TTE and 2D/3D TOE, no statistically significant differences were found regarding the evaluation of the valve anatomy, the site of regurgitation, and the underlying mechanism (TTE vs. TOE: 3D septo-lateral diam 45.8 ± 4,92 vs. 45.87 ± 4,98 mm, P = 0.87; 3D antero-posterior diam 43.5 ± 4,58 vs. 43.5 ± 4,53 mm, P = 0.59; Circularity index 0,75 ± 0,08 vs. 0,76 ± 0,08, P = 0.98). When comparing 3D TTE and cardiac CT, no differences were recorded in terms of TV area 17.58 ± 3 versus 17.71 ± 4,3 cm2, P = 0.1; perimeter 14.89 ± 1,6 versus 14.29 ± 1 cm, P = 0.5 and diameters. Similarly, in the study of right ventricular dimensions, obtained through 3D volumetric reconstruction, TTE was not statistically different to Cardiac CT.

Conclusions:
The present series shows how a lone 3D TTE has a good reliability in the definition of TV function, leaflet characteristics, and geometry when compared with second level imaging modalities and may be safely used to select optimal candidates for complex TTVI.