bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of a Holistic School Improvement Model in Enhancing School Effectiveness in Oman
Authors: Al-Mekhlafi Abdo Mohamed , Tahir Osman Mohamed El 
Published: April 2021

Purpose - This study examined the impact of a holistic school improvement model on overall school effectiveness, More specifically, it attempted to answer two questions: 1) Are there any significant differences in school performance between the control group and the experimental group before and after the experiment? 2) Is there any significant improvement in the experimental group school effectiveness before and after the experiment? Methodology - As a part of a four-year longitudinal research project, the study used a quasi experimental research design to examine the impact of a holistic school improvement model on enhancing overall school effectiveness in Oman. The sample consisted of 16 intact classes selected from 8 schools (4 experimental and 4 control groups), with a total of 2378 students (1157 from grade nine classes and 1221 from grade seven classes). The experimental group schools were exposed to a wide range of school improvement activities within a four-year period. A series of workshops on activating the 13 elements of the Innovation Sustainability Wheel (ISW) were delivered to all administrators and teachers at the target experimental group schools, in addition to empowering students through enrichment programs in five subject areas. Data was collected from the Omani Ministry of Education school performance indicators, which included five subject matter achievement tests aggregated over three years. Findings - The study revealed significant differences in overall school performance across the four years between the control and experimental schools, in favour of the experimental group. Moreover, a significant progression of school effectiveness was observed in the two grade levels of the experimental group. Significance - The findings are significant in terms of providing educational systems with a workable mechanism for identifying key areas of weaknesses and means of improvement; establishing a chain of actions for activating all interrelated elements that act as driving forces for sustainable change; ensuring that the indicators of school improvement should include both operational processes and studentsâ€™ learning outcomes; and contributing to the knowledge base in the area of school improvement in terms of a research-based model that has potential implications for practitioners and policy makers.
A case of unsuspected chronic lithium toxicity presenting with neurological symptoms
Authors: Chy Umme Kulsum , Sultana Amina , Faruq Mohammad Omar 
Published: April 2021

Lithium Carbonate is the first line treatment for bipolar depressive disorder. It also has beneficial effects on prophylactic use in Acute manic episodes to prevent recurrence and reduces rate of suicide associated with affective disorder. Low therapeutic index of Lithium (0.8-1.2meq/l) mandates regular and frequent measurement of Serum lithium level in patients taking this drug. Here we present a 59 years Indian male who is a known diabetic, chronic alcoholic and a case of bipolar disorder. He was on Lithium tablet off and on for last 4 years and was also on oral antidiabetic agent. He was admitted in ICU through emergency with complaints of altered level of consciousness for 2 days with H/O recurrent hypoglycemia associated with nausea, reduced food intake, vertigo, tremor of all four limbs with weakness of both lower limbs for approximately last 2 months. Admission serum lithium level was 2.24meq/l. Hemodialysis was started. Neurological symptoms improved and serum Lithium level returned to normal (0.79meq/l) after 2 session of hemodialysis.
Bangladesh Crit Care J March 2021; 9(1): 46-48
Association of Hyperhomocysteinemia with Early Onset Atherosclerotic Peripheral Arterial Occlusive Diseases
Authors: Reza Md Shamim , Rahim AM Asif , Bashar AHM , Islam M Shahidul , Alam SAN 
Published: April 2021

Background: Homocysteine is increasingly recognized as an independent risk factor for vascular disease specially peripheral arterial occlusive diseases. In the present study, an attempt was made to find out the association between the raised fasting plasma total homocysteine level and early onset atherosclerotic peripheral arterial occlusive diseases (PAOD).
Methods: In this prospective observational study a total of 50 study subjects were included. All patients were clinically and angiographically documented for atherosclerotic PAOD. All patients underwent surgical intervention as well as estimation of serum total homocysteine level. Arterial segment was sent for histopathological examination to find out whether atherosclerosis was present or not. Patients were divided into two groups- Group-1 included patients of 20-40 years of age and group-II included those of 41-60 years of age. The groups were compared to see association between elevated level of plasma homocysteine and atherosclerotic peripheral arterial occlusive diseases in elderly as well as in early age.
Results: 41 (82%) patients were male and 9 (18%) patients were female. Serum homocysteine level was higher in group I than group II (71.4% vs. 40.9%). Besides, the level of mean serum homocysteine level was significantly (p=0.02) higher in group I than group II (21.18±9.53 vs. 17.24±8.92 μmol/L).
Conclusion: In conclusion, this study suggests that serum homocysteine has an association with early onset atherosclerotic PAOD. Therefore, a raised serum homocysteine level can be used as an independent biochemical predictor of early onset atherosclerotic PAOD.
Cardiovasc. j. 2021; 13(2): 120-127
Cardioprotection with Adenosine during Coronary Revascularization
Authors: Idris M Rumman , Rahim AM Asif , Hasan M Kamrul , Karim M Rezaul , Jahan Nusrat , Quashem MA 
Published: April 2021

Background: Postoperative cardiac dysfunction is a common cause of mortality and morbidity associated with CABG Surgery. Adenosine enhances tolerance of the myocardium to ischemic arrest. Therefore, the study on adenosine pre-treatment as an adjunct to cardioplegia in patients undergoing CABG will definitely help to provide better myocardial protection for better postoperative outcome.
Methods: Quasi experimental study was done in the Department of Cardiac Surgery, NICVD during July 2012 to June 2014 with patients who underwent conventional CABG surgery. Patients were divided in two groups. Group A: Patients received at regular institutional high-potassium ([K+] = 20 mol/ l) cold (12 °C) blood cardioplegia. and Group B: Patients received 250 μg /kg bolus dose of adenosine pre-treatment, which was immediately followed by high-potassium cold (12 °C) blood cardioplegia after clamp-on. Patients were followed up to evaluate the degree of myocardial damage by measuring perioperative Troponin I, amount of inotropic support, time of assisted ventilation, arrhythmia and mortality.
Results: Most of the patients in each group belongs to 51-60 years of age range. There was no difference regarding operative parameters in two groups. Time to arrest was significantly shorter in group B compared to group A, indicating that adenosine has the potential to enhance the efficacy of cardioplegic arrest. Plasma level markers of myocardial damage: cardiac Troponin I (cTnI) obtained from serial venous blood samples post-operatively were significantly lower in group B than group A (p<0.05). There was significantly decreased requirement of inotrope in group B during first 24 hrs (p <0.05).
Conclusion: Decreased level of cardiac enzymes and lower inotropic requirement suggests that an optimal myocardial protection with less cellular damage is obtained with adenosine pre-treatment as adjunct to cold blood cardioplegia.
Cardiovasc. j. 2021; 13(2): 128-134
Primary Percutaneous Coronary Intervention of ST-segment Elevated Myocardial Infarction- Experiences in a Tertiary Care Hospital
Authors: Islam AHM Waliul , Munwar Shams , Talukder Shahabuddin , Reza AQM , Bhuiyan Azfar H , Ahmed Tamzeed , Rahman Kazi Atiqur , Ali M Atahar , Alam Shamsul , Rahman Zia Ur , Yusuf Intekhab , Islam Nighat , Hasan Mahmud , Siddique Atique Bin , Bala Poppy , Haque Md Zahidul , Alam Md Asiful , Tanvir Hossain A 
Published: April 2021

Background: Primary percutaneous coronary intervention (pPCI) is the preferred and established mode of treatment in ST elevated myocardial infarction (STEMI). Exact data on procedural outcome in patient undergoing primary PCI in our population is not well documented. Therefore, we have carried out this study to see the prognosis, in-hospital, and 12-month survival outcome of our patients.
Methods: Patients were enrolled in the observational non-randomized prospective cohort between November 2017-Mar 2020, who were presented into our emergency department with acute onset of severe chest pain or angina with ECG evidenced acute ST elevated myocardial infarction. Total 182 patient (F 14; Male 168) were enrolled in this study.
Results: Out of 182 patients, female :14 (7.7%) vs. Male: 168 (92.3%). Among, these patient females were more obese (BMI: Female 27.1 ± 2.1 vs. male 25.8 ± 4.1) and developed CAD in advance age (Female 59.1 ± 13.5 vs. Male 53.7 ± 10.5). Anterior MI were 47.8% (n=87) and Inferior MI 50.5% (n=92) and Lateral MI 1.6% (n=3). At presentation 10.4% (n=19) patents were in cardiogenic shock with STEMI, 42.1%(n=8) patients with Ant MI, 57.9%(n=11) in Inf MI group. Total, 15 (8.2%) patients died; 93.3%(n=14) within 1 week of pPCI due shock and poor LV function and subsequent development of LVF with arrhythmia and 6.7%(n=1) patient died 6 months after pPCI due to other cause. Death was more in Ant Wall STEMI than Inferior wall STEMI, though Cardiogenic shock at presentation were more in Inf MI STEMI than Ant wall STEMI.
Conclusion: We may conclude from our observational study on STEMI PCI that the territory wise involvement of myocardium, baseline serum Troponin-I level, infarcted vessel, time to presentation, duration of anginal chest pain and door to balloon time may be the key determinant of better in hospital outcome.
Cardiovasc. j. 2021; 13(2): 154-163
Short Term Outcome of Double Valve Replacement vs. Aortic Valve Replacement with Mitral Valve Repair in Bangladesh: A Comparison
Authors: Mohammad Rokonujjaman - , Ahmad Syed Tanvir , Islam Shaheedul , Khalilullah Md Ibrahim , Faruquee ZA , Rahman Md Atiqur , Ghafoor Nusrat , Siraj Nawshin , Shoyeb Abdullah Al 
Published: April 2021

Background: Although all mitral valves are not repairable, most non rheumatic valves and a substantial proportion of rheumatic valves are amenable to repair. Repair preserves the normal valvular tissue, so the left ventricular function is well maintained post-operatively. Combined aortic and mitral valve surgery is associated with increased mortality and morbidity. Several studies have shown the superiority of DVR (Double valve replacement) in this entity to prevent reoperation. Some other data suggested superiority of aortic valve replacement combined with mitral valve repair in double valve disease. No study had been done over Bangladeshi population. Our aim was to compare the short-term outcome of mitral valve repair and aortic valve replacement with double valve replacement.
Methods: It was a prospective non-randomized observational study took place in the Department of Cardiac Surgery of National Institute of Cardiovascular Disease. In this study post-operative result of double valve replacement was compared with aortic valve replacement and mitral valve repair. Total 60 patients under went aortic valve replacement with either mitral valve replacement (n=30) marked as group A or (n=30) repair marked as Group B.
Results: Aortic cross clamp time and cardiopulmonary bypass time was higher in group B than group A but it was well tolerated without any short-term measurable consequences. Required inotrope support was 49.8±2.3 hours in group B and 87.2±3.5 hours in group A (p<0.05). Duration of ICU stay were 91.1±3.2 hours in group A and 60.3±2.9 hours in group B (p<0.05). Development of postoperative low output syndrome was significantly higher (23.33%) in group A versus 3.33% in group B. Patients of group A suffered more from CHF in the follow up period than the group B. But the result was statistically insignificant. There was an early post-operative fall of ejection fraction in both groups but it was recovered after 3 months. Post-operative thromboembolism was 13.79% in group A and 3.33% in group B. There was no early death in repair group though total three (10%) cases died after DVR. There was no valve failure, re-stenosis or regurgitation in any group in this limited follow up period. Higher dose of warfarin was required in group A to maintain INR. Consequently, post-operative major bleeding occurred in 24.14% patients of group A. On the contrary, no patient of repair group suffered from this catastrophe.
Conclusion: This study reveals that the result of mitral valve repair with aortic valve replacement is equally comparable or in some cases superior to that of double valve replacement. Therefore, in feasible cases, mitral valve repair should be attempted who need concomitant aortic valve replacement.
Cardiovasc. j. 2021; 13(2): 164-171
Óleo essencial de Lippia origanoides (Verbenaceae) na higienização de tetos de vacas leiteiras
Authors: Almeida Anna Christina de , Mourão Rodrigo Pereira , Mourthé Mário Henrique França , Faraco André Augusto Gomes , Fonseca Francine Souza Alves , Martins Ernane Ronie , Silva Livia Mara Vitorino , Souza Cintya Neves de , Marcelo Natalia Arantes , Vieira Lucas Gomes , Porto Raphael  Rodrigues , Lima Marcelo Dourado de , Lopes Idael Matheus Góes , Santos Eliane Macedo Sobrinho 
Published: April 2021

O presente estudo teve como objetivo avaliar a eficácia de um novo produto elaborado a base de óleo essencial de alecrim pimenta sob a redução da contagem de microrganismos presentes na pele de tetos de vacas leiteiras. Para o teste in vivo, avaliou-se a eficácia do novo produto sob a antissepsia de negativos para mastite clínica (192 tetos), em comparação ao tratamento que continha produtos comerciais (192 tetos), durante um período de 42 dias. Os tetos foram diariamente acompanhados clinicamente, havendo semanalmente avaliação da microbiota presente na pele dos mesmos quanto à redução na contagem de Staphylococcus aureus, Estafilococos coagulase negativo (ECN), Echerichia coli e aeróbios mesófilos. Os dois produtos mantiveram a integridade dos tetos, sendo observado ausência de mastite clínica durante o período experimental. Não observou-se diferença significativa na ocorrência de mastite subclínica e de microrganismos nos tetos dos dois grupos em estudo pelo teste de Fisher em nível de significância de 5%. Ao comparar a redução Log da contagem em UFC.mL-1 dos microrganismos para o grupo tratado com produto convencional e com produto experimental para aeróbios mesófilos, E. coli, S. aureus e Estafilococos coagulase negativa, obtidos com o processo de higienização dos tetos foi observada diferença estatística(p>0,05), na contagem de microrganismos, evidenciando que ambos apresentaram efeito semelhante ao controle de microrganismos presentes na pele dos tetos. Sendo assim, o novo produto contendo óleo essencial de alecrim pimenta apresentou eficácia semelhante ao produto convencional clorexidine e iodo para antissepsia dos tetos de vacas leiteiras sem promover reações locais na pele, podendo este vir a ser utilizado como produto alternativo no manejo de ordenha.
Alelopatia de espécies da Caatinga
Authors: Silva Monalisa Alves Diniz da , Silva Joyce Naiara da , Alves Rafael Mateus , Gonçalves Edilma Pereira , Viana Jeandson da Silva 
Published: April 2021

Para que a implementação de sistemas agroflorestais na Caatinga e de projetos de recuperação de áreas degradadas sejam práticas exitosas, devem ser considerados os efeitos alelopáticos que estarão envolvidos no sistema, pois os mesmos determinam a composição florística e a predominância das espécies vegetais. Esta revisão narrativa de caráter qualitativo foi realizada para obter melhor conhecimento sobre a alelopatia das espécies da Caatinga. Considerou-se: (a) Fatores que influenciam o efeito alelopático: constituintes químicos; pH e potencial osmótico; solvente de extração; órgão vegetal; preparação física das partes vegetais; temperatura de extração do extrato; sinergismo; concentração do extrato; avaliação do efeito alelopático; (b) Fatores que influenciam na quantidade e qualidade de metabólitos secundários: domesticação da espécie vegetal; características físicas e fisiológicas das sementes da espécie alvo; época do ano; horário de coleta; estresse e local de coleta; interações entre a planta e os microrganismos presentes no solo; substâncias alelopáticas (Inibição ou estímulo?). Entre as possibilidades de investigações destaca-se o desenvolvimento de estudos de processos alelopáticos com espécies arbóreas nativas com o objetivo de determinar quais são as espécies sinérgicas entre si, com capacidade de favorecerem o sucesso na recuperação de áreas degradadas e no manejo sustentável. Averiguar de quais maneiras as condições de estresses (hídrico, salino, térmico, luminoso e nutricional) afetam a quantidade e a qualidade dos metabólitos secundários. Pesquisas podem simular o efeito da serapilheira das diferentes espécies da Caatinga sobre a germinação e desenvolvimento de outras espécies a serem usadas em programas de reflorestamento e em sistemas agrosilvipastoris.
Clinical Characteristics, Prognosis, and Nomogram for Esophageal Cancer Based on Adenosquamous Carcinoma: A SEER Database Analysis
Authors: Qian Haisheng , Ji Xiaofeng , Liu Chang , Dang Yini , Li Xuan , Zhang Guoxin 
Published: April 2021

Objective: Esophageal adenosquamous carcinoma (ASC) is a rare pathological type of cancer. Its clinical features and prognosis is poorly understood. The purpose of this study was to identify the characteristics of ASC patients and analyze the risk factors of esophageal carcinoma.Methods: Patients with esophageal cancer in the SEER database diagnosed from 1975–2016 were obtained. The epidemiology, clinical characteristics, and outcomes between these three groups were compared. The nomogram and online dynamic nomogram were constructed according to the Cox proportional hazard model.Results: The age-adjusted incidences of AC (1975–1999), AC (1999–2016), and ASC (1975–1989) increased over time (p &lt; 0.05). Age-adjusted incidences of SqCC (1986–2012) and ASC (1989–2016) decreased (p &lt; 0.05). Survival of patients with ASC was significantly worse when compared to AC and SqCC (ASC vs. AC, p &lt; 0.001, ASC vs. SqCC, p = 0.01). ASC, older age, black race, male, overlapping site, higher tumor grade, lymph node metastasis, and a higher summary stage or AJCC stage were considered to be risk factors for a poor survival in the multivariate Cox analysis. The ROC curves and AUC indicated that the model has a good discrimination ability (AUC were 0.774 for a 3-year OS and 0.782 for a 5-year OS). An online dynamic nomogram was built based on the Cox proportional hazard model for convenient clinical use.Conclusions: ASC is somewhat closer to AC rather than SqCC in terms of the demographics and tumor site, but has a worse OS than both AC and SqCC.
CT Texture Analysis for Differentiating Bronchiolar Adenoma, Adenocarcinoma In Situ, and Minimally Invasive Adenocarcinoma of the Lung
Authors: Sun Jinju , Liu Kaijun , Tong Haipeng , Liu Huan , Li Xiaoguang , Luo Yi , Li Yang , Yao Yun , Jin Rongbing , Fang Jingqin , Chen Xiao 
Published: April 2021

Purpose: This study aimed to investigate the potential of computed tomography (CT) imaging features and texture analysis to distinguish bronchiolar adenoma (BA) from adenocarcinoma in situ (AIS)/minimally invasive adenocarcinoma (MIA).Materials and Methods: Fifteen patients with BA, 38 patients with AIS, and 36 patients with MIA were included in this study. Clinical data and CT imaging features of the three lesions were evaluated. Texture features were extracted from the thin-section unenhanced CT images using Artificial Intelligence Kit software. Then, multivariate logistic regression analysis based on selected texture features was employed to distinguish BA from AIS/MIA. Receiver operating characteristics curves were performed to determine the diagnostic performance of the features.Results: By comparison with AIS/MIA, significantly different CT imaging features of BA included nodule type, tumor size, and pseudo-cavitation sign. Among them, pseudo-cavitation sign had a moderate diagnostic value for distinguishing BA and AIS/MIA (AUC: 0.741 and 0.708, respectively). Further, a total of 396 quantitative texture features were extracted. After comparation, the top six texture features showing the most significant difference between BA and AIS or MIA were chosen. The ROC results showed that these key texture features had a high diagnostic value for differentiating BA from AIS or MIA, among which the value of a comprehensive model with six selected texture features was the highest (AUC: 0.977 or 0.976, respectively) for BA and AIS or MIA. These results indicated that texture analyses can effectively improve the efficacy of thin-section unenhanced CT for discriminating BA from AIS/MIA.Conclusion: CT texture analysis can effectively improve the efficacy of thin-section unenhanced CT for discriminating BA from AIS/MIA, which has a potential clinical value and helps pathologist and clinicians to make diagnostic and therapeutic strategies.
Effects of Different Training Interventions on Heart Rate Variability and Cardiovascular Health and Risk Factors in Young and Middle-Aged Adults: A Systematic Review
Authors: Grässler Bernhard , Thielmann Beatrice , Böckelmann Irina , Hökelmann Anita 
Published: April 2021

Introduction: Heart rate variability (HRV), the beat-to-beat variation of adjacent heartbeats, is an indicator of the function of the autonomic nervous system (ANS). Increased HRV reflects well-functioning of autonomic control mechanism and cardiovascular health. The aim of this systematic review is to provide a systematic overview of the effects of different physical training modalities on resting HRV and cardiovascular health and risk factors (i.e., baroreflex sensitivity, body fat, body mass, body mass index, blood pressure, heart rate recovery, VO2 max, and VO2 peak) in young and middle-aged (mean age of the studies samples up to 44 years), healthy adults.Methods: A systematic review in accordance with the PRISMA guidelines was performed. Studies investigating the effects of different physical interventions (endurance, resistance, high-intensity, coordinative, or multimodal training) on HRV were included. Trials were considered eligible if the intervention lasted for at least 4 weeks and participants were regarded as general healthy. Five electronic databases were searched from 2005 to September 8th, 2020. The methodological quality of eligible studies was assessed by two study quality and reporting assessment scales (TESTEX and STARDHRV). PROSPERO registration number: CRD42020206606.Results: Of 3,991 retrieved records, 26 were considered eligible and analyzed. Twelve studies used an endurance training (of which three included high-intensity sessions), six studies resistance training, four studies coordinative training, two studies high-intensity training, and two studies used a multimodal intervention. Overall, the results showed for all types of intervention an improvement in linear and non-linear HRV parameters and cardiovascular health and risk factors. However, quality assessment revealed some methodological and reporting deficits.Conclusion: This systematic review highlights the benefits of different types of physical training interventions on autonomic function and health parameters in young and middle-aged, healthy adults. In conclusion, higher training intensities and frequencies are more likely to improve HRV. For future studies, we recommend adhering to the criteria of methodological standards of exercise interventions and HRV measurements and encourage the use of non-linear HRV parameters.