bluuebunny/crossref_metadata_2025_split huggingface dataset:
Marketing Strategy of the Samosir Lake Toba Regency Culture and Tourism Office in Increasing the Number of Tourists
Authors: Marpaung Durahman , Tamba Dang Panagaman 
Published: December 2024

The urgency of this research is that this research is important because it can provide an in-depth look at the strategies implemented by the Samosir Regency Culture and Tourism Office, so that concrete recommendations can be made to increase the attractiveness and popularity of these tourist destinations. This research aims to provide a deeper understanding of the challenges and opportunities faced by the Samosir Regency Culture and Tourism Office in expanding the number of tourists. The research methods used in this research are data collection obtained from observations, interviews with research subjects, and documentation studies, literature studies, identifying problems, preprocessing, analyzing data using SWOT analysis, BCG analysis, SPACE analysis, and QSPM analysis, data analysis results, final evaluation, research approach with mix method. The results of SWOT analysis on the evaluation of internal factors IFE and evaluation of external factors EFE show that the internal and external positions are in quadrant I, in a growing position and must continue to be improved. The results of the BCG matrix evaluation, Samosir Lake Toba Regency tourist destinations are classified in the Stars position. The results of the SPACE matrix calculation, the tourist position of Samosir Lake Toba Regency is in an aggressive position that occurs when all dimensions are positive. Based on the results of QSPM, 3 prioritized strategies can be taken and implemented as the main steps in developing tourist destinations.
The clinical utility of circulating tumor DNA in colorectal cancer: A narrative review
Authors: Lakshmi VU , Rakesh MP , Narmadha MP , Sudhindran S , Balakrishnan D , Koyakutty M 
Published: December 2024

ABSTRACT
Circulating free DNA (cfDNA) refers to extracellular DNA fragments (50-200 base pairs) in the blood, released during cell apoptosis or necrosis, and linked to tissue injury. Microbial cfDNA (cfmDNA), derived from bacteria, can also be present in both healthy individuals and in patients with colorectal cancer, with some species specific to these categories. Circulating tumor DNA (ctDNA), a subset of cfDNA, originates from tumors and reflects their genetic profile. Elevated ctDNA levels result from increased cell death and impaired clearance during tumor progression. Healthy individuals typically have 30 ng/mL of cfDNA in their blood, whereas patients with cancer can show levels up to 1000 ng/mL. Patients with colon cancer often exhibit higher cfDNA concentrations (500 ng/mL) compared to the patients with rectal cancer (250 ng/mL). ctDNA is a valuable noninvasive biomarker for monitoring colorectal cancer progression and prognosis, particularly since the disease is often diagnosed at advanced stages. Its widespread dispersion of circulating tumor fragments also aids in tracking disease progression and recurrence. This article reviews the life cycle, analysis methods, screening approaches, clinical applications, limitations, and future perspectives of ctDNA. The data for this review were extracted from PubMed, ScienceDirect, ResearchGate, Scopus, and UpToDate, covering publications from January 2016 to December 2023. Out of 95 retrieved articles, 3 were removed before screening. Two were duplicates, and 1 was ineligible record. After reviewing 92 articles for eligibility, 7 were excluded: 3 for being non-human studies, 2 not exclusive to colorectal cancer, and 2 for lacking clinical utility. We selected 85 articles for final analysis. For the purpose of discussion, we have referred to various papers on circulating tumor DNA in colorectal cancer as well (n = 15).
Gut microbiota - A key player in breast cancer initiation and progression: A narrative review
Authors: Mohamed Nouran , Madyan Engy F , Yasser Ahmed , Attia Manar G , Abdel-Ghany Shaimaa , Sabit Hussein 
Published: December 2024

ABSTRACT
As the most common type of cancer, breast cancer accounts for 12.5% of all new cases diagnosed each year worldwide. The human gut houses nearly 100 trillion bacteria that have evolved alongside humans over thousands of years. Because of its crucial roles in tumor behavior and treatment response, evaluating the tumor microenvironment in breast cancer is essential for disease management. In recent years, growing evidence has shown that the gut microbiota can influence how cancer cells behave, thereby affecting treatment outcomes. Furthermore, certain gut microbial species can increase the risk of breast cancer by altering estrogen hormone recycling, host metabolism, and immune response. Therefore, manipulating commensal bacteria could serve as a new therapeutic strategy to combat the disease. In this review, we address the mechanistic actions of gut microbiota and their impact on the initiation, progression, and control of breast cancer. We searched for articles published between January 2010 and July 2023 across various databases, including PubMed, Scopus, Google Scholar, and ResearchGate. Specific keywords related to breast cancer, gut bacteria, and the connection between the two were utilized in our search. Clinical trials, as well as in vitro and in vivo investigations, were included, while review articles (including systematic reviews) and studies on cancer other than breast cancer were excluded. We found 165 pertinent papers after filtering 683 articles in preparation for this manuscript.
Predictors of extra nodal extension in oral squamous cell carcinoma: A retrospective analysis
Authors: Majumdar Kinjal Shankar , Kailey Vikramjit Singh , Abhinav Thaduri , Panuganti Achyuth , Bhardwaj Abhishek , Sahu Madhupriya , Malhotra Manu 
Published: December 2024

ABSTRACT

Background:
Extranodal extension (ENE) has emerged as the strongest predictor of recurrence in oral squamous cell carcinoma (OSCC) and the only operator-independent predictor of treatment intensification in the form of adjuvant chemoradiation.

Objectives:
The primary objective was to identify various clinical and pathological predictors of pathological ENE (pENE) in surgically resected OSCC, and the secondary objective was to determine accuracy of clinical ENE (cENE) in predicting pathological ENE (pENE).

Materials and Methods:
In this retrospective analysis, we included all biopsy proven patients with OSCC who underwent surgery with appropriate neck dissection from April 2018 - December 2022 at the Department of Otolaryngology-Head-and-Neck Surgery, All India Institute of Medical Sciences Rishikesh, India. Tumors were staged according to the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) 8th edition tumor, node and metastasis (TNM) classification. Clinical and pathological variables were subjected to univariate and multivariate analyses.

Results:
We enrolled 299 patients in this study. Pathological bone invasion (BI), presence of perineural invasion (PNI), total number of positive lymph nodes, and lymph node ratio (LNR) were found to be independent predictors of pENE in both univariate and multivariate analyses. Post hoc analysis showed that ≥ 5 positive lymph nodes and LNR of ≥ 0.1 were significantly associated with pENE. Clinical ENE (cENE) exhibited a high specificity (92.9%) and negative predictive value (89.4%) for pENE.

Conclusion:
Clinical tumor characteristics are poor predictors of pENE. BI, PNI, and pathological nodal parameters, namely, total number of positive nodes and lymph node ratio, are the major predictors of pENE.
Prevalence and risk factors of oral premalignant lesions through visual screening among security personnel working at a tertiary care hospital: A descriptive cross-sectional study
Authors: Sreeja C S , Priya Harsh , Gopichandran L , Salve Harshal R , Dahiya Ujjwal , Ravi Priyanka , Agarwal Deepali 
Published: December 2024

ABSTRACT

Background:
Oral cancer is often preceded by oral premalignant lesions. However, most patients present at advanced stages, leading to poor quality of life (QOL).

Objectives:
The primary objective was to assess risk factors and prevalence of oral cancer among security personnel. The secondary objective focused on studying the relationship of selected risk factors with oral cancer and correlating them with prevalence.

Materials and Methods:
A descriptive cross-sectional study was conducted from June - November 2019 on 255 security personnel at AIIMS, New Delhi. Risk exposure was assessed using the WHO STEPwise Approach to Surveillance (STEPS) instrument. Visual examinations were performed using a light source and tongue depressor. Data analysis included descriptive and inferential statistics to determine frequencies, percentages, means, and standard deviations. Chi-square, Fisher’s exact tests, and logistic regression were used to assess associations and risks, with significance set at P ≤ 0.05.

Results:
We included 255 participants in the study. The overall prevalence of premalignant lesions was 29% (n = 74). Among subjects, 15.7% (n = 40) were smokers, and 33.3% (n = 85) used smokeless tobacco. Significant associations were observed for smoking (P, 0.002), smokeless tobacco use (P < 0.001), frequency of smokeless tobacco use (P, 0.041), alcohol and smokeless tobacco combination (P < 0.001), and dental visit frequency (P, 0.023). Binary logistic regression showed smokeless tobacco (Odds ratio, OR, 25.96, P < 0.001) and smoking (OR, 2.98, P, 0.020) as significant risk factors.

Conclusion:
Visual screening is a simple and cost-effective method for early detection of oral cancer. Visual screening along with tobacco cessation can help reduce the incidence of oral cancer and improve outcomes.
Effect of Knee Brace on Patterns of Weight Distribution in Patients with Stroke: A Cross-Sectional Study
Authors: Arunkumar Mishra Simran , Harishchandre Maheshwari , Shyam Ganvir Suvarna 
Published: December 2024

Abstract

Background:
Impaired postural control is a key characteristic of mobility issues in patients with stroke. It increases the risk of falls. Weight-bearing asymmetry (WBA) is found associated with balance, which is considered one of the determinants for the prediction of post-stroke functional outcomes. However, limited data are available regarding patterns of weight distribution in stroke patients and if the provision of orthosis changes this pattern.

Aim:
This study aimed to assess the effect of knee brace on patterns of weight distribution in stroke patients.

Materials and Methods:
It is a cross-sectional study, in which 46 patients with stroke having genu recurvatum were included. BOBO PRO, a balance platform was used to assess patterns of weight distribution. Patients were asked to stand on a balance platform, and readings were recorded during double- and single-leg stances, without and with a knee brace.

Results:
During the double-leg stance, without a knee brace, more weight was on the unaffected side (75%–80%), of which 55%–60 % was on the hindfoot and 20%–25% on the forefoot. On the affected side, weight-bearing was reduced, (20%–25%); of which maximum weight was on the hindfoot (17%–18 %) and minimal weight was on the forefoot (2%–3 %). With a Knee brace weight distribution on the affected side was improved to 35 % (24%–25 % on the hindfoot and 10%–11 % on the forefoot). During single-leg stance without a knee brace, 84%–90 % of the weight was on the hindfoot, which changed to 70%–75 % with the application of a brace.

Conclusion:
The knee brace affects patterns of weight distribution in stroke patients. This indicates that the provision of a knee brace in the rehabilitation of post-stroke patients may lead to better rehabilitation outcomes.
Pharmacognostic profiling, antioxidant, and anticancer potential of Mimusops elengi and Cassia tora extracts
Authors: Dixit Priyanka , Singh Deepika , Singh Narendra Kumar , Gupta Rajiv 
Published: December 2024

Background:
Important Ayurvedic medicinal plants Mimusops elengi L. and Cassia tora L. (CT). have been mentioned and used in the traditional Indian system of medicine for the prophylaxis and treatment of various human ailments.

Aim:
To evaluate the pharmacognostic, chromatographic, antioxidant, and anticancer properties of ethanolic leaf extracts from ME and CT on scientific lines and thereby validate the claims of traditional text.

Materials and Methods:
Chromatographic characterization was performed using high-performance thin-layer chromatography. 2,2-diphenyl-1-picrylhydrazyl assay was performed to evaluate the antioxidant activity. Sulforhodamine B and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays were performed to evaluate anticancer activity on Hop-62, Colo-205, breast cancer cell line (MCF-7), HeLa, and HepG2 cancer cells. Apoptosis was studied through live/dead cellular viability and apoptotic assay.

Results:
The pharmacognostic parameters were obtained to aid in the accurate authentication and identification of ME and CT. Chromatographic analysis revealed the presence of gallic acid, Quercetin, and ursolic acid. The study demonstrated concentration-dependent antioxidant and anticancer activities. Notably, selected extracts exhibited the highest cytotoxicity against MCF-7 cancer cells and the activity might be produced by inducing apoptosis. The extract of ME showed promising results across all selected cancer cell lines compared to CT.

Conclusion:
Further studies are hereby being recommended, particularly related to the exact mechanism of anticancer action, along with the isolation of leads responsible for the activity, to fully explore the anticancer potential of these plants.
A theoretical framework for integration of technology with fundamental principles of Ayurveda to develop a prototype instrument to assess Guna (viz. Gurvadi guna)
Authors: Ram Niranjan , Athul T. P. , Deogade Meena , Nesari Tanuja Manoj 
Published: December 2024

Background:
The foremost challenge for global acceptance of traditional systems of Indian medicine is to establish evidence for all the documentation mentioned in the texts. To make Ayurveda more evidence-based, there is a need for an abundance of data with proper validity and reliability. To ensure that the data collected from various research studies is reliable as well as valid, there is a need to convert possible subjective parameters into objective ones. Guna (~attribute/property), a fundamental concept in Ayurveda, particularly Gurvadi guna (~physical attributes), is a similar subjective parameter that needs more objectivity to be assessed uniformly by all practitioners of Ayurveda.

Aim:
The aim of this study was to propose a conceptual framework for developing a prototype instrument that objectively assesses Gurvadi guna in both substances and the human body, integrating technology with Ayurvedic principles.

Methods:
This concept presents a theoretical framework, synthesizing ideas from Ayurvedic philosophy, modern scientific techniques, and technological innovations. It proposes the integration of chromatography, spectroscopy, biophysical techniques, and nanotechnology for Guna assessment. The framework envisages a multifunctional instrument capable of evaluating Gurvadi guna in substances and human physiology simultaneously.

Expected Outcomes:
The proposed instrument targets to provide a standardized approach to Guna assessment in Ayurvedic practice, objective measurements of Gurvadi guna in various substances and the human body, and enhanced precision in diagnosing imbalances and selecting appropriate treatments.

Conclusion:
This conceptual framework represents a novel approach to bridging traditional Ayurvedic knowledge with modern technology. While acknowledging the challenges in development and implementation, this proposal aims to stimulate interdisciplinary collaboration and innovation in Ayurvedic research and practice.
Perception, attitude, and differences of opinion of Ayurveda students and teachers about virtual classes: A cross-sectional survey
Authors: Binorkar Sandeep V. , Bhat Shobha K. , Sawant Ranjeet S. , Gandhi Piyush K. , Ukey Rashtrapal N. 
Published: December 2024

Background:
The COVID-19 pandemic has brought about a rapid transition in education, with many institutions adopting virtual classes as the primary mode of instruction. This study aims to investigate the perception, attitude, and differences of opinion regarding virtual classes among Ayurveda students and teachers, shedding light on their experiences in adapting to this new educational paradigm.

Methodology:
This was a cross-sectional survey among Ayurveda students and teachers from various institutions across the country. A structured questionnaire comprising both closed and open-ended questions was designed. A convenience sampling method was utilized to recruit the participants from multiple Ayurvedic institutions. Questions were categorized into sections focusing on perceptions of efficacy, challenges, advantages, and suggestions for the improvement of virtual learning. Statistical analysis included descriptive statistics and inferential tests such as Chi-square for the analysis of qualitative responses. Data was analyzed using the statistical software SPSS (IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp) and Microsoft Excel.

Results:
The survey included responses from 290 Ayurveda students and 98 teachers. The survey revealed notable findings among Ayurveda students and teachers. Many participants expressed initial skepticism about virtual classes but gradually adapted to the new format. 40.82% of students and 38.62% of teachers appreciated the flexibility and convenience of virtual classes, while teachers noted challenges in maintaining student engagement. The study also shows that overall 55.52% of students and 56.13% of teachers did not agree to continue the virtual education.

Conclusion:
Ayurveda students generally embraced the flexibility offered by online learning, and teachers faced challenges in sustaining student engagement. Addressing these differences in perception and bridging technological gaps is crucial for the continued success of virtual education in Ayurveda. Understanding these variations in perception and attitudes can guide in the development of effective blended learning strategies in Ayurveda education, catering to the needs and concerns of both students and teachers.
Atreya virachita sarasamgraha and its contribution to Ayurveda – A critical analysis of an unpublished manuscript
Authors: Vadhel Manisha V. , Vyas Hitesh A. , Raval Suhag D. 
Published: December 2024

Introduction:
Enormous literature on healthcare is available in ancient texts of Indian civilization, however, much of it is still limited to the libraries in the form of unpublished manuscripts. “Atreya virachita sarasamgraha” is an available manuscript on Ayurveda in Sanskrit language and Devanagari script, but is unpublished.

Materials and Methods:
A total of 27 manuscripts were collected from different libraries across the country, out of which eight manuscripts were included in the study following the inclusion criteria. Manuscripts were studied with the method of lower and higher criticism.

Observations:
There are differences in the number of folios and verses in these manuscripts. The predominant poetic meter used in the verses is the Anusthupa chhanda. Almost all the subjects of Ayurveda such as Nadi pariksha (~pulse diagnosis), Mutra pariksha (~urine examination), Ritucharya (~seasonal regimen), Annapana guna (~classification and attribute of food and beverages), Roga ganana (~enlisting diseases), and Vayoyojana (~information about patient examinations including age) have been described in this work. According to a verse found in the manuscript, the author has summarized the essence of other treatises of Ayurveda in this work. These concepts are distinct from the Brihattrayi, indicating unique insights and contributions within the manuscript. The critical analysis on the manuscripts deals with the preliminary information as well as description of the themes of some of the initial chapters.

Conclusion:
Many of the verses of Atreya virachita sarasamgraha are analogs to the Harita samhita and other Ayurveda texts, but a distinctive aspect lies in the lingering content, suggesting the unique contribution by the author.
Pterygium extended removal followed by minor ipsilateral simple limbal epithelial transplantation (PERMISLET): An innovative technique for recurrent pterygium
Authors: Sati Alok , Mishra Sanjay Kumar , Shukla Sarvadarshi , Unni Deepesh , Kumar Sonali V. , Dhar Sanjay Kumar , Kaushik Jaya , Sharma Vijay Kumar , Pannu Anju 
Published: December 2024

Abstract
We describe a novel technique for recurrent pterygium and assess the advantage of properties of extended tenonectomy, amniotic membrane transplantation, and limbal epithelial transplantation in terms of recurrence rate, postoperative symptoms, postoperative orthoptics, and other complications. A total of nine eyes with recurrent pterygium underwent PERMISLET, i.e., pterygium extended removal (PER) (removal of tenon capsule with fibrovascular tissue around medial rectus from limbus till medial canthus) followed by minor ipsilateral limbal epithelial transplantation (coverage of bare sclera with amniotic membrane graft and placement of ipsilateral limbal pieces at the affected limbus). The patients were reviewed on day 1, day 7, and day 30 and at third, sixth, and twelfth month after surgery, and none of the eyes (0/9) showed recurrence of pterygium on to the cornea. Time taken for surgery was 53.88 ± 8.74 minutes (range, 45 to 75 minutes). Postoperative discomfort (pain, irritation, foreign body sensation, and lacrimation) persisted mainly for day 1 after the surgery. However, lacrimation persisted till day 7 in two of the patients. Intraoperative complications were seen in none of the eyes. A total of 1/9 patients had granuloma formation, and 1/9 had dellen formation in postoperative period with successful management. Moreover, none of the eyes (0/9) developed ocular motility restrictions in postoperative period. PERMISLET, an innovative surgical technique for recurrent pterygium, is a viable option with zero rate of recurrence and minimal complications, a boon for patients with limited healthy conjunctiva or a potential for future glaucoma drainage procedures.
Ectopic Bronchial Arteries – Incidental Findings on Multi-detector Computed Tomography
Authors: Babu C. S. Ramesh , Sharma Vinay , Gupta Om Prakash 
Published: December 2024

Introduction:
Orthotopic bronchial arteries (BAs) arise from the descending aorta between T5 and T6 vertebral levels and those emanating from the aortic arch, distal descending aorta, and subclavian arteries are called ectopic and are present in about one-third of cases.

Study Design:
Rare and unreported origin of ectopic BAs incidentally detected while analyzing 710 multi-detector computed tomography (MDCT) scans are presented.

Observations:
Ectopic BAs of subclavian origin supplying ipsilateral lungs are seen in two cases. Ectopic common bronchial trunk arising from the left subclavian and dividing into right and left branches was observed in two cases. Bilateral subclavian origin of both BAs is a rare presentation. Till now, an unreported variant is the common trunk of the left bronchial and left vertebral (bronchovertebral trunk) arising from the left subclavian close to its root from the aortic arch. Another rare variant of right bronchial arising from the left subclavian (Contralateral origin) is also noted.

Discussion and Conclusion:
The number of BAs varies. At least one ectopic BA is present in 36% of cases and in nearly half of these cases, ectopic arteries are the only supply. BAs are embolized to control severe hemoptysis and are used for infusion chemotherapy for lung neoplasms. A prerequisite for successful interventional and surgical procedures on BA is precise anatomical knowledge and preprocedural MDCT can provide accurate anatomical information to prevent complications following BA embolization to control hemoptysis.