bluuebunny/crossref_metadata_2025_split huggingface dataset:
FREQUENCY OF COMPLIANCE TO GUIDELINE RECOMMENDED TREATMENT IN HEART FAILURE PATIENTS WITH LVEF <40%
Authors: Avais Ammara , Khan Imtiaz Ahmed , Iqbal Hafiza Sonia , Janjua Anam Fatima , Asghar Javeria , Kamran Javeria , Rashid Samina , Nisa Erum -Un- , Samore Naseer , Aziz Sohail 
Published: January 2021

Objective: To determine the frequency of compliance to guideline recommended treatment among patients with STAGE-C or STAGE-D heart failure and LVEF<40%.
Study Design: Descriptive cross-sectional study.
Place and Duration of Study: Adult cardiology department of AFIC/NIHD, Rawalpindi, from Sept to Dec 2019.
Methodology: Eighty Four patients of Heart Failure with reduced LVEF after satisfying inclusion and exclusion criteria were recruited in this study through non-probability consecutive sampling technique. Data was collected from ER and OPD patients through complete history based on demographics (i.e. age and gender), co-morbidities (i.e. diabetes, hypertension, CAD and smoking history), previous EF record measured on 2D-echo, functional improvement of the patients using NYHA dyspnea class and guideline recommended medication history with compliance. The data was analyzed using SPSS version 23.
Results: A total of 84 patients of Heart Failure with LVEF = 31.61 ± 7.61% were enrolled out of whom 62 (73.8%) were male and 22 (26.2%) female patients. The mean age of patients was 62.26 ± 9.879 years. About 30 (35.7%) patients were diabetic, 44 (52.4%) were hypertensive, 19 (22.6%) were current smokers, 16 (19%) were ex-smokers and 49 (58.2%) were nonsmokers. Those with history of CAD were (SVCAD=8 (9.5%), DVCAD=14 (16.7%),TVCAD 15 (17.9%). Compliance of patients to treatment was 74 (88.1%) good. Patients presenting with NYHA Class I/II 3 (3.6%)/20 (23.6%) showed significant improvement after medical therapy 34 (40.5%)/30 (35.7%), whereas those with class III/IV did not show significant improvement in functional status.
Conclusion: This survey shows that patient’s compliance is relatively goods but patients with NYHA III/IV were receiving suboptimal treatment. Secondly patients presenting with NYHAI/II after medical therapy showed significant improvement in functional status as compared to those with NYHA III/IV. Thereby further actions are needed for improving quality of life and standard of care among HF patients by optimization of treatmentaccording to guidelines.
OUTCOME OF PRIMARY PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION ARRIVING IN ARMY CARDIAC CENTER LAHORE
Authors: Shahzad Khurram , Ali Jahanzab , Ahmad Ayaz , Usman Ahmad , Rashdi Amna , Shafiq Faisal 
Published: January 2021

Objective: To evaluate the feasibility and outcomes of primary percutaneous coronary intervention (PCI) as a mode of treatment in acute ST segment elevation myocardial infarction (STEMI).
Study Design: Descriptive cross sectional study.
Place and Duration of Study: The study was conducted in Army Cardiac Center Lahore, from Nov 2019 to Feb 2020.
Methodology: All patients diagnosed as acute ST-segment elevation myocardial infarction during the study period were offered primary percutaneous coronary intervention among treatment options. Patients who chose primary percutaneous coronary intervention were included in the study. Informed consent was taken. Patient demographics, risk factors, time variables, procedural characteristics and in-hospital adverse events were evaluated.
Results: On admission, Out of 50, 30 (60%) of the patients were current smokers, 25 (50%) were hypertensive, 22 (44%) were diabetic, and 1 (2%) had cardiogenic shock. The mean time from symptom onset to hospital arrival was 5 hours and the mean door-to-balloon time was 34 minutes. Culprit coronary artery was the left anterior descending artery (LAD) in 56% cases and multi-vessel disease was present in 38% cases. Primary percutaneous coronary intervention involved balloon dilatation (2%) and stent implantation (98%). The incidence of postprocedural angiographic no-reflow was 0%. All-cause mortality was 1%.
Conclusion: This study has shown efficiency, feasibility and safety in performing of primary percutaneous coronary intervention with excellent outcomes in Army Cardiac Center Lahore. In order to further improve its outcomes, our goal should be to decrease reperfusion time which can be achieved by reducing patient delay, increasing public awareness and improving the management of first medical contact.
INCIDENCE AND CHARACTERISTICS OF CORONARY ARTERY ECTASIA IN PATIENTS UNDERGOING CORONARY ANGIOGRAPHY AT ARMY CARDIAC CENTER LAHORE
Authors: Shafiq Faisal , Usman Ahmad , Sultan Mehboob , Shehzad Khurram , Haroon Namra , . Osama 
Published: January 2021

Objective: To estimate the incidence and characteristics of coronary artery ectasia in patients undergoing coronary angiography.
Study Design: A prospective analysis.
Place and Duration of Study: This study was conducted at Army Cardiac Center, Lahore over a period of two years from Jan 2018 to Dec 2019.
Methodology: Its prospective analysis of all coronary angiograms performed in our catheterization laboratory during study period. Markis classification was the basis to define and classify coronary artery ectasia. Demographical, clinical, and laboratory data were collected for each patient in this study.
Results: A total of 172 (3.9%) out of 4,372 coronary angiograms showed coronary artery ectasia. Among coronary artery ectasia group, mean age 58 ± 10 years, 90% were male, 47% were current smokers, 32% were hypertensive, 15% had diabetes Mellitus and 37% had dyslipidemia. The most common clinical presentation was Non STsegment elevation myocardial infarction (31%), followed by Stable ischemic heart disease in 28%. Right coronary artery was the most frequent coronary artery involved (57%) while Markis Class 3 pattern was seen as most common type of coronary artery ectasia.
Conclusion: The frequency of coronary artery ectasia among our patients undergoing coronary angiography was about 4%. Right coronary artery remained the most common affected artery.
SURGERY OF TETRALOGY OF FALLOT-15 YEAR EXPERIENCE AT AFIC-NIHD RAWALPINDI
Authors: Zaidi Syed Shahid Nafees , Khan Inamullah , Bakht Nausheen , Shahid Syeda Aliza , Akhtar Khurram , Akbar Hajira , Mahmood Amjad , Haq Intisar Ul , Sadiq Nadeem , Kamal Dawood , Khalil Hafsa 
Published: January 2021

Objective: To compare trans-atrial/Trans-pulmonary and trans-annular/trans-ventricular techniques of surgical correction of tetralogy of fallot.
Study Design: Descriptive cross sectional study.
Place and Duration of Study: AFIC-NIHD Rawalpindi, from Jan 2005 to Jan 2020.
Methodology: Pre-op variables included age, gender, weight, SaO2 and any previous operation (like Modified Blalock Taussig Shunt.) Operative variables were any previous Blalock Taussig Shunts and if present, then their takedown, Cardiopulmonary Bypass Time, Aortic Clamp Time, any Right Ventricle - Pulmonary Artery conduit, Main Pulmonary Artery patch-plasty, Left Pulmonary Artery/ Right Pulmonary Artery patch-plasty, dosage of inotropes and pacing started during weaning off CPB. Post-op variables were mechanical ventilation time (hrs), ventilation time >72 hrs, dosage and duration of inotropes, pacing >24 hrs, renal complications, neurological complications, sepsis, low cardiac output, re-ventilation, tachyarrythmias, any re-opening surgery, mean intensive care unit stay (hrs), overall hospital stay (days) and overall all-cause mortality.
Results: A total of 1271 TOF patients were operated. In (38.6%) cases Trans-atrial / Trans-pulmonary approach was used while in 780 (61.3%) correction was done by TAP/TV technique. In both techniques, male patients were 365 (66.4%) vs. 73 (64.1%) females. Mean age was 5 ± 2.3 vs. 4 ± 2.5 years, MPA patch-plasty was 190 ± 5 (38.6%) vs. 780 ± 8 (100%) (p-0.058), RPA/LPA Patch Plasty was 25 ± 6 (5%) vs. 180 ± 10 (23%) (p- 0.025), In ICU, Ventilation hours was 25 ± 8 and 30 ± 12, Ventilation >72 Hrs was 15 (3%) vs. 65 (8.3%) (p-0.015), Inotrope duration >72 Hours was 90 (18.3%) vs. 400 (51.2%) (p-0.338), pacing >24 hours was 30 (6.1%) vs. 150 (19.2%) (p-0.0001), renal complications were 10 (2.3%) vs. 35 (4.4%) (p- 0.285), Neurological complications were 7 (1.4%) vs. 15 (1.9%) (p0.553), Sepsis was 11 (2.2%) vs. 47 (6%) (p-0.33), Low cardiac output was 15 (3%) vs. 66 (8.4%) (p- 1.000), re-ventilation was 10 (2%) vs. 110 (14%) (p- 0.41), Tachy-arrhythmia was 25 (5%) vs. 150 (19.2%) (p- 0.11), re-openings were 19 (3.8%) vs. 65 (8.3%) (p- 0.0003), ICU stay (Hours) was 87 ± 8 vs. 108 ± 10, Mortality was 35 (7.1%) vs. 75 (9.6%) (p-0.094), Mean hospital stay (Days) was 12.2 ± 2.5 vs. 15.8 ± 4.9.
Conclusion: Fifteen years’ experience of Tetralogy of fallot corrections at AFIC-NIHD indicates that Trans-atrial / Trans-pulmonary approach is more beneficial to patients due to high survival rate, less morbidity, less hospital stay and an early discharge. This ultimately translates into less financial burden on the patients, hospital, society and the country at large.
Crude and Partition Extracts of Newbouldia laevis Leaves Attenuate Excitotoxin-induced Stereotypy in Mice
Authors: Kolawole Oyetunji Timothy , Adeyeba Oluwaseyi Adegboyega , Awodele Olufunsho , Wakeel Olayemi Kamoru , Ayankunle Akeem Ademola 
Published: January 2021

Aims: This study was designed to investigate the effects of crude ethanol and partition extracts of Newbouldia laevis leaves on excitotoxin-induced stereotypy in mice.
Place and Duration of Study: The study was carried out in the Laboratory of the Department of Pharmacology and Therapeutics, College of Health Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria, between July and October, 2020.
Methodology: Following pretreatment of mice with graded doses (150 - 600 mg/kg b.w) of crude extract (NLE) and partition fractions [n-butanol partition fraction (BPE), n-hexane partition fraction (HPE) and ethylacetate partition fraction (EAPE)] of Newbouldia laevis leaves, stereotypy was induced by the administration of methamphetamine (35 mg/kg b.w) and apomorphine (5mg/kg b.w.), and stereotypy scores were recorded thereafter. The effects of BPE and NLE on catalepsy were also determined. Statistical significance was taken at P<0.05
Results: In both apomorphine and methamphetamine models, stereotyped behavior was significantly decreased (P<0.05) in the treated mice compared to the control. The degree of protection offered by Newbouldia laevis extracts against excitotoxin-induced stereotypy was in the order: BPE>NLE>EAPE>HPE. In the catalepsy test, BPE (600 mg/kg b.w) significantly potentiated haloperidol-induced catalepsy compared to control (P<0.05). Likewise, NLE significantly increased catalepsy compared to control (P<0.05).
Conclusion: Findings from this study indicate that crude and partition extracts of Newbouldia laevis leaves attenuated stereotypy in methamphetamine and apomorphine models, and thus could be effective remedy for schizophrenia-like psychosis.
Kaulonia (Caulonia)
Authors: De Vido Stefania 
Published: January 2021

AbstractKaulonia, Greek city in southern Italy, founded on the Ionian Sea by the Achaians from Kroton and from Greek Achaia (ca. 650bce); it was a member of the Achaian League in Magna Graecia. It was destroyed by Dionysios I, restored soon afterward, captured by Campanian troops during the war against Pyrrhos, and finally destroyed by the Romans in 209bce. Kaulonia has an important sanctuary on Punta Stilo (peripteros temple, great altar, metallurgical workshops), where the so‐called “Tabula Kauloniensis” was discovered.
Chondrodysplasia and growth failure in children after early hematopoietic stem cell transplantation for non‐oncologic disorders
Authors: Botto Lorenzo D. , Meeths Marie , Campos‐Xavier Belinda , Bergamaschi Rosalba , Mazzanti Laura , Scarano Emanuela , Finocchi Andrea , Cancrini Caterina , Zirn Birgit , Kühnle Ingrid , Kramm Christof Maria , Alanay Yasemin , Jones Wendy D. , Irving Melita , Sabir Ataf , Henter Jan‐Inge , Borgström Birgit , Nordgren Ann , Hammarsjö Anna , Putti Caterina , Mozzato Chiara , Zuccarello Daniela , Nishimura Gen , Bonafè Luisa , Grigelioniene Giedre , Unger Sheila , Superti‐Furga Andrea 
Published: January 2021

AbstractBone dysplasias (osteochondrodysplasias) are a large group of conditions associated with short stature, skeletal disproportion, and radiographic abnormalities of skeletal elements. Nearly all are genetic in origin. We report a series of seven children with similar findings of chondrodysplasia and growth failure following early hematopoietic stem cell transplantation (HSCT) for pediatric non‐oncologic disease: hemophagocytic lymphohistiocytosis or HLH (five children, three with biallelic HLH‐associated variants [in PRF1 and UNC13D] and one with HLH secondary to visceral Leishmaniasis), one child with severe combined immunodeficiency and one with Omenn syndrome (both children had biallelic RAG1 pathogenic variants). All children had normal growth and no sign of chondrodysplasia at birth and prior to their primary disease. After HSCT, all children developed growth failure, with standard deviation scores for height at or below −3. Radiographically, all children had changes in the spine, metaphyses and epiphyses, compatible with a spondyloepimetaphyseal dysplasia. Genomic sequencing failed to detect pathogenic variants in genes associated with osteochondrodysplasias. We propose that such chondrodysplasia with growth failure is a novel, rare, but clinically important complication following early HSCT for non‐oncologic pediatric diseases. The pathogenesis is unknown but could possibly involve loss or perturbation of the cartilage‐bone stem cell population.
Outsourced attribute‐based signatures with perfect privacy for circuits in cloud computing
Authors: Huang Zhenjie , Lin Zhiwei , Chen Qunshan , Zhou Yuping , Huang Hui 
Published: January 2021

SummaryAttribute‐based signature (ABS) is a widely used cryptographic primitive, that provides both data integrity and fine‐grained privacy protection. However, the signing overhead of ABS is usually too large, making it unsuitable for resource‐constrained devices. Using cloud computing technology, the notion of outsourced attribute‐based signatures (OABS) was introduced to overcome this drawback. In OABS, the user can outsource him/her signing tasks to the signing‐cloud service provider (S‐CSP). The previous notion of privacy of OABS does not take the S‐CSP's attack into account, so it is not strong enough. To conform to the reality of cloud computing, we present a more accurate notion of privacy, called perfect privacy, which ensures that any adversary, even the S‐CSP, cannot identify which policy is used to generate the signature. Then, we propose a key‐policy OABS scheme for circuits based on multilinear mapping with perfect privacy. By using the outsourcing technique, in our scheme, the computation cost of the signer is only three or four pairing operations, which is independent of the complexity of the policy and the size of the attribute set. Our scheme achieves three advantages: perfect privacy, expressive policy, and constant signing cost, simultaneously.
Entrepreneurial space and the freedom for entrepreneurship: Institutional settings, policy, and action in the space industry
Authors: Lamine Wadid , Anderson Alistair , Jack Sarah L. , Fayolle Alain 
Published: January 2021

AbstractResearch SummaryAnticipating that innovation nurtures entrepreneurship, we began an extended case study of an innovative start‐up in the space industry. We quickly saw that institutions imposed formidable barriers to implementing entrepreneurship from innovation. Curious about how, why and the extent of this situation, we widened our study to other start‐ups, CEOs of existing businesses, an incubator, a technology transfer office and key influencers in large space companies and agencies. We found that institutions and policies had, in effect, shrunk the entrepreneurial field, leaving little room for enterprise. Conceptualizing from this, we propose the institutions create an “entrepreneurial space.” Theoretically, we explain how this concept of an entrepreneurial space can be usefully applied in other contexts.Managerial SummaryThe space industry is extremely innovative. It is also dominated by two powerful incumbent firms and a third that is highly regulated. This research examines how entrepreneurship in the space industry is shaped by institutions, and what this implies for the freedom to be entrepreneurial. We investigate this question in the French European context. We find that while the industrial context and institutions had completely pushed entrepreneurship out of the upstream segments it flourished in the margins of this industry. The upstream segment is not at all entrepreneurial; downstream is the entrepreneurial milieu of the space industry. We recommend that policymakers (a) strengthen private‐public‐partnership arrangements; (b) implement policies to attract venture capitalists to transform and reinvigorate the upstream segment; and (c) design specific incubation mechanisms for space start‐ups.
Air Oxidation of Corn Starch: Effect of Heating Temperature on Physicochemical Properties and In Vitro Digestibility
Authors: Reyes Isabel , Hernandez‐Jaimes Carmen , Vernon‐Carter Eduardo Jaime , Bello‐Perez Luis A. , Alvarez‐Ramirez Jose 
Published: January 2021

AbstractCorn starch is heated (100, 120, 140, and 160 °C) under air convective conditions for 4 h. Scanning electron micrograph images show that the treatment produced pores and fractures on the granule surface. Hydroxyl groups of starch molecules are oxidized to carboxyl and carbonyl groups. Increasing heating temperature conditions lead to significant increases in the carboxyl and carbonyl groups contents. Solubility profiles increase while the apparent viscosity of the starch gels (5% w/v) decreases as heating temperature increases. X‐ray diffraction shows that the modified starch heated at 160 °C has a crystallinity of 6.42% and a short‐range ordering of 0.14 as revealed by Fourier‐transform infrared ratio 1047/1022, which is significantly lower than the respective values of 24.42% and 0.2 exhibited by native starch. The onset, peak, conclusion gelatinization temperatures, and enthalpy of the modified starches tend to decrease slightly with increasing temperature. The air oxidation treatment affects the digestibility of corn starch, and as temperature increases, the rapidly digestible and slowly digestible starch fractions decrease, while the resistant starch fraction increases significantly. Overall, the results show that heating of corn starch at mild temperature conditions lead to important modifications of the molecular organization and to moderate oxidation of starch chains.
Recent advances in combination of microneedles and nanomedicines for lymphatic targeted drug delivery
Authors: Permana Andi Dian , Nainu Firzan , Moffatt Kurtis , Larrañeta Eneko , Donnelly Ryan F. 
Published: January 2021

AbstractNumerous diseases have been reported to affect the lymphatic system. As such, several strategies have been developed to deliver chemotherapeutics to this specific network of tissues and associated organs. Nanotechnology has been exploited as one of the main approaches to improve the lymphatic uptake of drugs. Different nanoparticle approaches utilized for both active and passive targeting of the lymphatic system are discussed here. Specifically, due to the rich abundance of lymphatic capillaries in the dermis, particular attention is given to this route of administration, as intradermal administration could potentially result in higher lymphatic uptake compared to other routes of administration. Recently, progress in microneedle research has attracted particular attention as an alternative for the use of conventional hypodermic injections. The benefits of microneedles, when compared to intradermal injection, are subsequently highlighted. Importantly, microneedles exhibit particular benefit in relation to therapeutic targeting of the lymphatic system, especially when combined with nanoparticles, which are further discussed. However, despite the apparent benefits provided by this combination approach, further comprehensive preclinical and clinical studies are now necessary to realize the potential extent of this dual‐delivery platform, further taking into consideration eventual usability and acceptability in the intended patient end‐users.This article is categorized under:
Therapeutic Approaches and Drug Discovery > Emerging Technologies
Nanotechnology Approaches to Biology > Nanoscale Systems in Biology
Informed Consent and the Elusive Dichotomy Between Standard and Experimental Therapy
Authors: Noah Lars 
Published: January 2021

A rich academic literature exists about issues of informed consent in medical care, and, to a lesser extent, about a variety of issues posed by human experimentation. Most commentators regard patient autonomy as a desirable— though in practice often unattainable—goal, and near unanimity exists about the necessity for even fuller disclosure before experimenting on subjects. Although this Article intentionally side-steps the broader debate about informed consent, it challenges the conventional wisdom that special disclosure rules should apply in the experimental context.Clinical trials have become big business. Estimates suggest that as many as twenty million Americans have enrolled in formal biomedical studies, though, as a measure of the full scope of medical experimentation on humans, that figure may represent only the proverbial tip of the iceberg. Historically, sponsors of clinical trials recruited subjects informally, counting on word of mouth among physicians and also perhaps posting flyers around college campuses.
Equitable Health Systems: Cultural and Structural Issues for Latino Elders
Authors: Wallace Steven P. , Villa Valentine M. 
Published: January 2021

This Article examines the extent to which the U.S. healthcare system is equitable for older Latinos, using the World Health Organization (WHO) and the related Organization for Economic Cooperation and Development (OECD) criteria on health outcomes, access/responsiveness and financing. We argue that improving health equity requires more than actions aimed at health behavior and culturally-based beliefs targeted at the individual. Improving equity also requires changes in broader social and political processes affecting entire populations and organizations of care, paying special attention to how these changes affect the Latino elderly.Healthcare is particularly important for the older population. Persons age 65 and older have the highest overall rates of death, disease and disability, as well as the most frequent and intense use of medical services. U.S. public policy has acknowledged the high medical care needs of many elderly by establishing Medicare as a universal health insurance starting at age 65, and supplementing it with Medicaid, the public-assistance program for low-income older persons.
Minority Children in Pediatric Research
Authors: Ross Lainie Friedman , Walsh Catherine 
Published: January 2021

Medical research is heavily funded: the National Institutes of Health had a budget of over $20 billion in 2001, and even more money was spent by the pharmaceutical industry on research. Children's health issues, however, receive only a small fraction of these funds. In 2001, for example, less than $1 billion of NIH funding was allocated to the National Institute of Child Health and Human Development (NICHD). In part, the problem stems from a modern predisposition to protect children from participating in research.Several federal policies in the 1990s changed the face of the “typical research subject.” Historically, researchers sought “white men,” but the NIH announced in 1994 that all research would need to include women and minorities, and in 1998, the NIH added the requirement of including children. The shift in policies reflects a shift in focus. When the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research addressed fairness in subject selection in the Belmont Report of 1979, the main concern was ensuring fairness in the distribution of risks.