bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac rehabilitation outcome after transcatheter aortic valve implantation
Authors: Penati Chiara , Incorvaia Cristoforo , Mollo Valentina , Lietti Federica , Gatto Gemma , Stefanelli Marco , Centeleghe Paola , Talarico Giuseppe , Mori Ileana , Franzelli Cristina , Ratti Fosco , Ponticelli Maria Paola , Ridolo Ermina , Febo Oreste Carlo 
Published: April 2021

Patients with severe aortic stenosis are increasingly treated with transcatheter aortic valve implantation (TAVI) as a safer option to surgical aortic valve replacement (sAVR). Similar to many other heart diseases, after the specific therapeutic intervention patients are eligible for cardiac rehabilitation (CR) for the purpose of functional recovery. Thus far, CR after both sAVR and TAVI has been used to a limited extent, as shown by the availability of only two meta-analyses including 5 studies and 6 studies, respectively. Recent observational studies reported a significant improvement in functional indexes such as the Barthel scale and the 6-minute walk test (6MWT). We evaluated the outcome of CR in patients after TAVI treatment by measuring changes in the commonly used Barthel scale and 6MWT and adding the short physical performance battery (SPPB) scale as an index to assess lower extremity function. All indexes demonstrated a significant improvement, namely p<0.001 with the Barthel scale, p=0.043 for the 6MWT, and p=0.002 for SPPB. These results confirm the significant improvement of the Barthel scale and 6MWT reported in the previous meta-analysis and suggest the utility of SPPB as a further index of efficacy of CR in patients with severe aortic stenosis treated with TAVI.
Pattern of Social Media use and Social Anxiety among the Undergraduate Health Professionals with Social Media Addiction
Authors: Kadavala Bhavin Naranbhai , Tiwari Deepak Sachidanand , Patel Vishal Kanaiyalal , Chanpa Nirav Bhupendrabhai , Patel Niranjan L. , Shah Viral 
Published: April 2021

Background:
There has been a significant surge in the usage of smartphones, Internet, social media platforms, and also the growing concern about the impact of Internet, gaming, and social media addiction (SMA) on mental health in the community since the last decade.

Aim:
This study is aimed to know the pattern of social media use and social anxiety (SA) among medical undergraduates with SMA.

Materials and Methods:
This was a 12-month cross-sectional, observational study of 640 medical undergraduates. Social media disorder scale was used to detect SMA and Liebowitz social anxiety scale was used to detect SA. Descriptive statistics, independent t-test, and Chi-square test were used for the analysis of data.

Results:
According to our findings, 11.04% of the participants had SMA. More than 60% of the participants with SMA spent 2 h or more time on social media in a day. About 29.41% of students with SMA spent more money compared to 11.86% of nonaddicted ones. About 47.05% of students with SMA reported fear of missing out (FoMO) as compared to 34.12% of nonaddicted students. Participants with SMA reported a significantly higher level (P < 0.05) of SA (SA score 67.63) compared to social media nonaddicts (SA score 49.43).

Conclusion:
Medical undergraduates with SMA spent more time and money on Internet, reported FoMO, frequently checked notifications, and reported regular substance use. They also had high SA; vice versa is also true.
Dadima (Punica granatum L.), as an Aushadha (medicine), depicted in Ayurveda
Authors: Patel Vivek Kumar , Acharya Rabinarayan 
Published: April 2021

Introduction:
The description of plants used in Ayurveda can be traced from hundreds of written texts. Dadima (Punica granatum L.), of family Lytheraceae, is one among the plants described under Phala Varga, a classification of Aahara Varga mentioned by ancient scriptures of Ayurveda; it is highlighted for its wide range of use as an Aahara (diet) and Aushadha (drug) in different diseased conditions. Single-hand information about this plant is still lacking.

Aim:
To obtain comprehensive information on Dadima (as an aushadha) different classical texts of Ayurveda.

Results:
Thirty-two names, known as Paryaya (synonyms), have been attributed, highlighting its morphological characteristics and pharmacological properties and actions. Dadima, as an ingredient, is included in 634 formulations. Among 530 Aushadha Kalpana (a drug), 433 were indicated for its internal use, 93 for its external use, and 4 for its external as well as internal use. Dadima is indicated in 80 different diseased conditions; among them, the maximum formulations have been found to be used in Atisara (76). Various research activities, such as antidiarrheal, cardioprotective, nephroprotective, antiarthritic, analgesic, and anti-inflammatory, have been reported to validate Dadima as an ingredient of various Ayurveda indications.

Conclusion:

Dadima as a single drug or as an ingredient in 530 formulations have been indicated for its use as an Aushadha in 80 different diseased conditions. Dadima, a drug of Phala Varga, is a very important fruit and has a wide range of clinical indications.
An anatomical study of vascular foramina of radius and its clinical insinuation
Authors: Rangasubhe Pramod Pundalik , Bhusaraddi P. S. , Khona Pratik Pradeep , Havaldar Pavan Prahlad 
Published: April 2021

Introduction:
Different segments of radius present numerous vascular foramina (VF). The objective of the study was to quantify VF and note their size and direction.

Methodology:
One hundred dry human radii bones in our anatomy department were divided into various segments for studying VF. The number and direction of VF were evaluated in upper end (UE), shaft, and lower end (LE) separately. VF were categorized into three groups based on size, namely small (which admitted 25-gauge needle): 0.5–0.7 mm, medium (22-gauge needle): 0.71 mm to 1.10 mm, and large (19-gauge needle): >1.10 mm. The direction of foramina in each segment was noted. They were categorized into three types: horizontal, upper oblique, and lower oblique.

Results:
Significantly, a greater number of VF in the UE of radius were observed in the neck (average: 9.3 foramina) than in the radial tuberosity (average: 1.3 foramina). In the shaft, the maximum number of VF was observed in the anterior surface and minimum was found in the lateral surface. In the LE, the maximum number of VF was observed in the posterior surface (average 7.2 foramina) and minimum was found in the medial surface (average 1.6 foramina). In the UE of radius, 81.8% of VF were small sized. In the UE of radius, 62.8% of VF were directed horizontally. In the shaft, almost all (99%) VF were directed upper oblique.

Conclusion:
The present study concludes that different segments of radius have different densities of VF. The LE of radius has got more VF compared to UE indicating its rich vascularity.
Osteological Study of Morphometric Analysis of Acromion Process and Its Implication in Impingement Syndrome
Authors: Hafezji Hamzah Muzammil 
Published: April 2021

Background:
Acromial morphology along with its position (slope/tilt) has a role in shoulder impingement. Acromioplasty is an important step in rotator cuff repair. Thus, knowledge of morphometric variations of the acromion is necessary. The aim of the study was to determine acromion morphometry and to correlate the morphometry of acromion with the dimensions of the scapula.

Methodology:
The study was performed on 150 dried adult human scapulae, for which age and sex were not known. The shape of the acromion was observed from posterior and lateral view and different dimensions were measured.

Results:
The acromial curvature (as per Bigliani classification) was found to be flat (Category I) in 23.33%, curved (Category II) in 49.33%, and hooked (Category III) in 27.34% of scapulae. The acromial shape (from posterior view) was found to be quadrangular in 22%, triangular in 31.33%, and tubular in 46.67% of scapulae. The mean values of length, breadth, and thickness of acromion were 41.14 mm, 24.89 mm, and 6.95 mm, respectively. The acromion thickness was <8 mm in 87.33% and >8 mm in 12.67%. The mean of acromion slope and tilt were 28.23° and 42.47°, respectively.

Conclusions:
From the study, it may be concluded that a small proportion of the population (12.67%) may be prone to develop impingement due to more acromial thickness (>8 mm). The acromion slope and tilt are larger in our population which suggests lesser predisposition to impingement syndrome.
Taxation of Micronuclei Frequency as a Prognostic Marker in Oral and Oropharyngeal Carcinoma
Authors: Ravi Kumar Satish , Pushpa N. B. , Kishore Sanjeev , Kaur Sohinder , Mehta Vandana , Reddy K. S. 
Published: April 2021

Background:
Oral and oropharyngeal carcinoma are one among the most common cancers in the world. India shares about one-fourth of incidences of oral and oropharyngeal cancers and death due to the same is also of significant number. Micronucleus resulting from aberrant mitosis, chromatin fragmentation, or aberrant chromosome is considered as a hall mark for genotoxicity, also oral cancer risk and is useful in chemopreventive studies. Hence, the determination of micronuclei frequency serves as better prognostic marker.

Methodology:
A total of 60 patients with a mean age of 53 (56 males and 4 females) years, who were histopathologically confirmed cases of oral and oropharyngeal carcinoma with different degree of differentiation were included in the study. Patients were solely treated by radiotherapy with radiation dose plan of 4 Gy, 14 Gy, 24 Gy, and 60 Gy on the 2nd, 7th, 12th, and 30th days, respectively. The mucosal scapings stained with Giemsa and May-Grunwald's stain were studied to assess the micronuclei at each interval.

Results:
Although there was no significant association between site of lesion and tumor differentiation with micronuclei index, there was statistically significant difference in the micronuclei index at each interval. Percentage of relative increment in micronuclei also showed promising significance.

Conclusion:
Hence, micronuclear assay could be used as an efficient tool to determine the radiosensitivity and prognosis in oral and oropharyngeal carcinoma patients treated by radiotherapy.
Empleo del Cierre Primario sobre la Línea Media Libre de Tensión para el Tratamiento de la Enfermedad Pilonidal Sacrococcígea: Experiencia y Resultados
Authors: FERRARI LUIS CARLOS 
Published: April 2021

Introducción: En la actualidad el tratamiento quirúrgico de la enfermedad pilonidal sacrococcígea (EPSC) se basa en una amplia resección de la lesión con o sin el cierre primario de la misma. La práctica del cierre primario sobre la línea media es sencilla y ampliamente difundida pero con índices de infección, dehiscencia y recidiva elevados. Los cierres primarios alejados de la línea media como propone Karydakis o mediante el empleo de colgajos como la técnica de Limberg muestran mejores resultados. Sin embargo, cuando el cierre primario sobre la línea media se lleva a cabo libre de tensión, los resultados pueden ser equivalentes a los alcanzados por estas técnicas por lo que debería ser considerado.
Objetivo: Evaluar prospectivamente la técnica de cierre primario sobre la línea media libre de tensión y los resultados obtenidos con ella en el tratamiento de la EPSC.
Diseño: Prospectivo observacional.
Pacientes y Método: 49 pacientes consecutivos intervenidos quirúrgicamente por el mismo cirujano entre el 01.10.2010 y el 30.11.2019 por EPSC a quienes se les practicó un cierre primario sobre línea media libre de tensión.
Resultados: Fueron intervenidos quirúrgicamente 49 pacientes consecutivos; la edad promedio fue de 20,9 años (entre 14 y 37 años), de los cuales el 69,38% (34 de 49) fueron hombres. Entre las complicaciones postoperatorias, el sangrado se evidenció en un paciente (2,04%); la apertura parcial del cierre primario en 16 (32,65%). La recidiva fue constatada en dos (4,08%) casos con un porcentaje de curación del 95,91% (47/49). Un solo paciente presentó infección de herida quirúrgica (2,04%). La estadía sanatorial fue de un día en todos los casos. No hubo necesidad de reintervenir ningún paciente en el postoperatorio inmediato. El tiempo de curación fue de 31,06 días (mínimo 19/ máximo 52). La anatomía patológica informó en todos los casos quiste pilonidal, sin malignidad y con márgenes de resección libres de lesión. Todos los pacientes expresaron plena conformidad con el procedimiento realizado.
Conclusiones: El cierre primario sobre la línea media libre de tensión es una procedimiento sencillo, con estadía sanatorial breve y bajo índice de recurrencia y de complicaciones por lo que a nuestro parecer debería ser tenido en cuenta a la hora de escoger la técnica quirúrgica a emplear para resolver esta patología.
Palabras Claves: Enfermedad pilonidal - Cierre libre de tensión
Designing and Validating Performance Standards for Clinical Instructors at Technical Institutes of Nursing
Authors: Abd El-Fatah Fatma A. , El-Shimy Harisa M. A. , Ibrahim Sanaa A. , Abd El-Aleem Marwa M. 
Published: April 2021

Context: The nursing program's success depends to a great extent on effective clinical learning experience. Clinical instructors can utilize professional standards to identify areas for improvement in clinical practice. The importance of content validity of the developed standards and its relevance with reliability, have made it an essential step in the standards development.
Aim: This study aims to design and validate performance standards for clinical instructors at the Technical Institutes of Nursing. Methods: The methodological design was utilized. This study was conducted in two sectors: Technical Institutes of Nursing at Port Said and Ismailia City, and their practical training settings. Two groups of participants were included in the study: clinical instructors and experts’ group. The data was collected using two tools: An observational checklist and an expert opinion sheet.
Results: The proposed performance standards had an appropriate level of content validity. The overall value of scale-content validity/universal agreement (S-CVI/UA) was equal to 0.852, and the overall value of scale-content validity/average (S-CVI/AVE) was equal to 0.988. The overall interrater reliability value of the proposed standards was 0.852. There were statistically significant differences between pre and post dissemination of the proposed standards in the total mean percentages in all standards (p<0.001).
Conclusions: This study concluded that the proposed developed standards are acceptable for use in the Technical Institutes of Nursing. The study recommended that the developed standards be applied and communicated to all clinical instructors in the Technical Institutes of Nursing, with clinical instructors' training on its implementation.
Epstein - Barr virus epidemiology in HIV infected transsexuals
Authors: Sadia Salahuddin  , Joharia Azhar  , Hasham Akhtar  , Jabbar Khan  , Noor Muhammad  
Published: April 2021

Abstract
Objectives: To molecularly characterise the relationship between Epstein-Barr virus genotypes and Pashtun ethnicity.
Method: The cross-sectional study was conducted from November 2018 to December 2019 after approval from the Gomal University, Dera Ismail Khan, Pakistan, and comprised blood samples from transgender sex workers who were seropositive for human immunodeficiency virus-1 and seronegative for human immunodeficiency virus residing in two cities of Khyber Pakhtunkhwa province and Islamabad, the federal capital. Formalin-fixed paraffin-embedded samples were collected retrospectively, but collection of blood samples from the study subjects was purely on the basis of physical availability. ?-globin gene and EBER-1 were amplified for qualitative assessment and existence of Epstein-Barr virus. Characterisation of EBNA-2 was done through nested polymerase chain reaction.
Results: Of the 80 subjects, 40(50%) each were seropositive and seronegative individuals. The overall mean age was 28±6.917 years. Among the seropositive group, 38(95%) were homosexual and 2(5%) were heterosexual. Among the seropositive group, 16(40%) had Epstein-Barr virus genotype 1 and 6(15%) had genotype 2, while co-infections were found in 2(5%) subjects. In the seronegative group, 36(90%) subjects had Epstein-Barr virus genotype 1, while there was no case of genotype 2 or co-infection. EBV-2 genotypes with HIV seropositivity showed strong association (p=0.005). Amplification for the EBER-1 gene was done in all the 80(100%) samples.
Conclusion: Epstein-Barr virus EBV genotype 1 was found to be the most frequent type, while genotype 2 and co-infections were detected only seropositive samples.
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Maternal near miss, mortality and their correlates at tertiary care hospital
Authors: Tayyiba Wasim  , Gul e Raana  , Mustafa Wasim  , Javeria Mushtaq  , Zeenish Amin  , Saman Asghar  
Published: April 2021

ABSTRACT
OBJECTIVE: To determine the frequency and causes of maternal near miss and mortality among pregnant women.
METHODS: This cross-sectional study was conducted Jan 2016 - Dec 2018. All near miss cases, admitted in Gynecology department of Services Hospital Lahore during the study period, were prospectively recruited. WHO criteria was used to identify maternal near miss cases. Primary outcome measures were frequency and causes of near miss and maternal mortality to near miss ratio. Secondary outcome measures were delays, need for massive blood transfusion, ICU admission, obstetric hysterectomy and hospital stay> 7 days.
RESULTS: During the study period, there were 10,739 live births, 305 near miss cases and 29 maternal deaths. Frequency of near miss was 28.4/ 1000 live births and maternal mortality to near miss ratio was 1:10.5. There were 215(70.4%) unbooked patients and 23(79.3%) of them died (p<0.001). Hemorrhage accounted for 150 (49.18%), hypertensive disorders 102 (33.44%),cardiac disease 25 (8.28%) and infection for 12 (3.97%) near miss cases respectively. Maternal mortality was significantly low for hemorrhage, hypertension, sepsis and cardiac disease; 6 vs 150, 8 vs102, 3vs 12 and 10 vs 25 respectively (p<0.001). Massive blood transfusion was given to 20.98%patients, 15.74% underwent hysterectomy, 32.13% required ICU admission. First and second delay was seen in 78.6% of patients with 86.2% deaths (p<0.001)
CONCLUSION: Hemorrhage and hypertension are major reasons for near miss but timely intervention can prevent mortality. Strengthening care at primary and secondary level can reduce the burden of maternal morbidity.
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Identification and comparison of factors related to academic failure in medical colleges; A Bi-center, comparative study
Authors: Faiza kiran  , Syed Moyn Aly  , Al Shehri Abdullah 
Published: April 2021

Abstract
Objectives: The objectives of our study were to identify the student’s perceptions related to their academic failure and compare these perceptions with their nationality.
Methods: A, non-interventional, bi national, comparative study was conducted in medical colleges of Pakistan and Saudi Arabia, in year 2015-2018, by taking a purposive sample of 210 students. All those who gave consent and scored less than fifty percent in their professional examinations were included. Data was analyzed using SPSS version 23. Frequencies and percentages were calculated, and Man Whitney U was applied to calculate p value.
Results: According to the respondents, common reasons of failure identified were information overload (n=114,50%), difficult examination (n=101, 48%), poor teaching skills of teachers (n=82, 39%), system of education (n=75,36%) and unfair examination (n=78,37%). Eleven items in nationality group were found significant.
Conclusion: Regardless of few cultural and environmental differences in factors contributing towards failure in students of different countries, the risk factors are common to all students. Moreover, most students tend to blame external factors more than internal ones.
Keywords: Risk, factors, Perceived, academic, failure, students, medical, Saudi Arabia, nationality, Pakistan, perceptions
CircRNA LRIG3 knockdown inhibits hepatocellular carcinoma progression by regulating miR-223-3p and MAPK/ERK pathway
Authors: Sun Hui , Zhai Junwei , Zhang Li , Chen Yingnan 
Published: April 2021

IntroductionEmerging evidence suggests that circular RNAs (circRNAs) play critical roles in tumorigenesis. However, the roles and molecular mechanisms of circRNA leucine-rich repeat immunoglobulin domain-containing protein 3 (circ_LRIG3) in hepatocellular carcinoma (HCC) has not been investigated.Material and methodsThe expression levels of circ_LRIG3, miR-223-3p, and mitogen-activated protein kinase kinase 6 (MAP2K6) were determined by qRT-PCR. Flow cytometry was applied to determine the cell cycle distribution and apoptosis. Cell proliferation, migration and invasion were assessed by MTT, colony formation, and transwell assays. Western blot assay was employed to measure the protein levels of the snail, E-cadherin, MAP2K6, mitogen-activated protein kinase (MAPK), phospho-MAPK (p-MAPK), extracellular signal-regulated kinases (ERKs), and phospho-ERKs (p- ERKs). The relationship between miR-223-3p and circ_LRIG3 or MAP2K6 was predicted by bioinformatics tools and verified by dual-luciferase reporter assay. A xenograft tumor model was established to confirm the functions of circ_LRIG3 in vivo.ResultsCirc_LRIG3 and MAP2K6 expression were enhanced while miR-223-3p abundance was reduced in HCC tissues and cells. Knockdown of circ_LRIG3 inhibited cell proliferation, metastasis, and increasing apoptosis. MiR-223-3p was a target of circ_LRIG3, and its downregulation reversed the inhibitory effect of circ_LRIG3 knockdown on the progression of HCC cells. Moreover, MAP2K6 could bind to miR-223-3p, and MAP2K6 upregulation also abolished the suppressive impact of circ_LRIG3 interference on progression of HCC cells. Additionally, the silence of circ_LRIG3 suppressed the activation of the MAPK/ERK pathway and tumor growth by upregulating miR-223-3p and downregulating MAP2K6.ConclusionsCirc_LRIG3 knockdown inhibited HCC progression through regulating miR-223-3p/MAP2K6 axis and inactivating MAPK/ERK pathway.
Urine flora imbalance and new biomarkers in prostate cancer and benign prostatic hyperplasia
Authors: Yin Shuiping , Xu Dandan , Zhang Meng , Zhang Peiyu , Guan Yu , Kzhyshkowska Julia , Liang Chaozhao 
Published: April 2021

IntroductionMicrobial structure is closely associated with the initiation
and development of various diseases. However, the roles of urine flora in
prostate diseases, including prostate cancer (PCa) and benign prostatic hyperplasia (BPH), are still unclear.Material and methodsIn this study, clinical samples were collected from
PCa (n = 21) and BPH (n = 19) patients and healthy people (n = 12). The
analysis of urine flora DNA sequencing and hematological testing results between groups was performed using bioinformatic methods, including alpha
and beta diversity analysis, and functional PICRUSt analysis.ResultsThe results showed that the microbial structure in PCa and BPH
differed from the healthy control. Abundance of Escherichia coli was higher
in PCa and BPH patients, while probiotics, such as Lactobacillus helveticus
and Lactobacillus iners, were lower. Moreover, beta diversity in the PCa group
was significantly different from the control group, while alpha diversity was
not. Spearman analysis showed that Escherichia coli was negatively correlated with Lactobacillus helveticus and Lactobacillus iners. Functional analysis
showed that microbial imbalance was associated with energy metabolism
in PCa, and with cell motility, energy metabolism, and intracellular trafficking, secretion, and vesicular transport in BPH. Moreover, microbial imbalance
was associated with nervous disorders and infectious diseases in PCa, and
with metabolic system, infectious diseases, and signal transduction in BPH.ConclusionsTaken together, microbial imbalance may be associated with PCa
and BPH. The increase of Escherichia coli was accompanied by the decrease of
probiotics, such as Lactobacillus helveticus and Lactobacillus iners. These may
be biomarkers for risk prediction and early treatment for prostate disease.