bluuebunny/crossref_metadata_2025_split huggingface dataset:
LEAN HEALTHCARE COMO ESTRATÉGIA DE GESTÃO PARA SERVIÇOS DE ATENÇÃO DOMICILIAR
Authors: Souza Leticia , Bischof dos Santos Christiane 
Published: January 2021

Diante de um cenário competitivo e cada vez mais exigente, os desafios da gestão na saúde especialmente na modalidade de atenção domiciliar são inúmeros, pois além do constante desenvolvimento, estes serviços necessitam avançar, aumentar a performance, reduzir custos para melhorar os resultados finais. Estas incitações foram estímulos que motivaram o desenvolvimento deste estudo. O objetivo da pesquisa está focado em compreender se o Lean Healthcare pode ser uma estratégia para melhorar a Gestão de Serviço de Atenção Domiciliar associado ao desenvolvimento de um questionário estruturado para avaliar quais os principais desperdícios sob a ótica dos gestores dos serviços. Para atingir esse objetivo foi usado como método uma pesquisa exploratória descritiva de abordagem qualitativa e quantitativa, primeiramente uma revisão bibliográfica sobre a metodologia Lean Healthcare, na sequência aplicação de um assessment aos gestores das empresas. Como resultado foi possível encontrar 6 das 8 categorias de desperdícios, classificar a criticidade e atribuir 4 princípios do Lean que são impactados. Em conclusão pode-se notar que relatos dos gestores corroboram com o resultados do questionário possibilitando a sua validação. Como contribuição este estudo sugere ferramentas do Lean Healthcare de acordo com os desperdícios encontrados, possibilitando asim uma gestão com mais valor aos clientes.
Characterization of Glyoxal Modified LDL: Role in the Generation of Circulating Autoantibodies in Type 2 Diabetes Mellitus and Coronary Artery Disease
Authors: Rizwee Md Masum , Abidi Minhal , Habib Safia , Mir Abdul Rouf , Ali Asif , Uddin Moin 
Published: January 2021

Aims:
To investigate role of glyoxal modified LDL in immunopathology of diabetes and cardiovascular disease.

Background:
Glycoxidation of proteins is widely studied in relation to diabetes and cardiovascular disease.

Objective:
This study probed the glyoxal mediated modifications in LDL, analyzed the immunogenicity of the glycated
LDL and ascertained the presence of circulating antibodies against modified LDL in patients with type 2 diabetes mellitus
(T2DM), coronary artery disease (CAD) and patients with both (T2DM+CAD).

Methods:
Glyoxal mediated modifications in LDL were studied by multiple spectroscopic techniques, high performance
liquid chromatography and electron microscopy. Immunization studies were carried in New Zealand rabbits. Presence of
antibodies against glyoxal modified LDL in immunized rabbits and human subjects were analyzed by ELISA.

Results:
Glyoxal altered the structural integrity of LDL and lead to the formation of AGEs. It decreased the alpha helix
content of LDL; increased β sheet formation; increased carbonyl content and decreased free lysine and arginine content.
Modified LDL showed aggregation, generation of of Nε-(Carboxymethyl) lysine and the formation of amorphous type
aggregates. It exhibited high antigenicity and generated specific immune response that shared common antigenic determinants with other glycated proteins. Direct binding data showed the presence of anti- glyoxal modified LDL antibodies in
patients with T2DM, CAD and patients with both T2DM and CAD. Further analysis in competitive binding assay revealed
specific binding characteristics of auto-antibodies. Sera from patients with T2DM+CAD exhibited highest binding with
glyoxal modified LDL.

Conclusion:
Glyoxal modified LDL has neo-antigenic determinants that cause the generation of circulating antibodies in
diabetes and coronary artery disease. The study might have potential relevance in biomarker development.
Rectifying Attenuated Store-Operated Calcium Entry as a Therapeutic Approach for Alzheimer’s Disease
Authors: Huang Alexis S. , Tong Benjamin C.K. , Wu Aston J. , Chen Xiaotong , Sreenivasmurthy Sravan G. , Zhu Zhou , Liu Jia , Su Chengfu , Li Min , Cheung King-Ho 
Published: January 2021

:
Alzheimer’s disease (AD) is the most common neurodegenerative disorder. Although the
pathological hallmarks of AD have been identified, the derived therapies cannot effectively slow down
or stop disease progression; hence, it is likely that other pathogenic mechanisms are involved in AD
pathogenesis. Intracellular calcium (Ca2+) dyshomeostasis has been consistently observed in AD
patients and numerous AD models and may emerge prior to the development of amyloid plaques and
neurofibrillary tangles. Thus, intracellular Ca2+ disruptions are believed to play an important role in
AD development and could serve as promising therapeutic intervention targets.

:
One of the disrupted intracellular Ca2+ signaling pathways manifested in AD is attenuated storeoperated
Ca2+ entry (SOCE). SOCE is an extracellular Ca2+ entry mechanism mainly triggered by intracellular
Ca2+ store depletion. Maintaining normal SOCE function not only provides a means for the cell
to replenish ER Ca2+ stores but also serves as a cellular signal that maintains normal neuronal functions,
including excitability, neurogenesis, neurotransmission, synaptic plasticity, and gene expression.
However, normal SOCE function is diminished in AD, resulting in disrupted neuronal spine stability
and synaptic plasticity and the promotion of amyloidogenesis. Mounting evidence suggests that rectifying
diminished SOCE in neurons may intervene with the progression of AD. In this review, the
mechanisms of SOCE disruption and the associated pathogenic impacts on AD will be discussed. We
will also highlight the potential therapeutic targets or approaches that may help ameliorate SOCE deficits
for AD treatment.
Does Intra-Articular Injection of Platelet-Rich Plasma Have an Effect on Cartilage Thickness in Patients with Primary Knee Osteoarthritis?
Authors: Baki Noha M. Abdel , Nawito Zeinab O. , Abdelsalam Nehal M. S. , Sabry Dina , Elashmawy Hossam , Seleem Nagy A. , Taha Azza Ali Abdel-azeem , El Ghobashy Mohamed 
Published: January 2021

Objectives:
To determine the effect of intra-articular injection of platelet-rich plasma
(PRP) in patients with primary knee osteoarthritis (OA) by clinical evaluation and ultrasonographic
(US) assessment of cartilage thickness.

Patients and Methods:
A total of 100 patients with mild to severe primary knee OA using the Kellgren-
Lawrence (K-L) grading scale were included and divided into two groups. Group I included
50 patients who were given two intra-articular knee injections of PRP, 1 week apart; Group II included
50 patients who received non-steroidal anti-inflammatory drugs (NSAIDs) and chondroprotective
drugs. Functional assessment of all OA patients was done using the basal WOMAC score,
at 2 and 6 months. US assessment of femoral condylar cartilage thickness was conducted basally
and at 6 months.

Results:
Improvement of WOMAC score was observed at 2 and 6 months in Group I following
PRP injection compared to Group II (p values<0.001), The improvement of WOMAC in Group I
occurred in all severity degrees of OA (p<0.001). Moreover, a significant increase in cartilage
thickness was found at the intercondylar area (ICA) at 6 months relative to baseline assessment by
US in Group I (p = 0.041).

Conclusion:
Treatment with PRP injections can reduce pain and improve knee function in patients
with various degrees of articular degeneration. Further studies are needed to clarify the anabolic effect
of PRP on the articular cartilage.
Epidemiological Characteristics of 64 Covid-19 Patients in Errachidia Province (Darâa-Tafilalet region), Morocco: A Retrospective Analysis
Authors: Akdad Mourad , Algharrass Youness , Talha Hafid , Babakhouya Abdelaadim , Ajebli Mohammed , Ech-cherrate Ahlam , Eddouks Mohamed 
Published: January 2021

Background:
At the time of writing this paper, no data was available for the clinical and
epidemiological characteristics of African patients with COVID-19. Herein, we profiled retrospectively
the epidemiological characteristics (clinical, laboratory, radiological, treatment, and clinical
outcomes) of 64 confirmed cases of COVID-19 in the Regional Hospital Center (RHC) of Errachidia
in Morocco. The aim of this study was to analyze the epidemiological characteristics and laboratory
Findings of Covid-19 patients in Errachidia Province, Morocco.

Methods:
This is a retrospective single-center study that included all COVID-19 confirmed patients
(died or discharged) hospitalized in the Regional Center of Errachidia, Morocco, between
March 20, 2020 and May 23, 2020. Patients were confirmed by real-time RT-PCR and epidemiological,
demographic, clinical, laboratory, treatment, and outcomes of patients were extracted manually
from patient’s medical records.

Results:
In a total of 64 patients with COVID-19, 60.9% of patients were men, with a mean age of
41.5 years (SD 18.62). At the admission, 38 patients were asymptomatic (59.4%), and 58 (90.6%)
were clinically classified as being in a benign state. Chronic illnesses were the most comorbidities
observed, including diabetes with 8 cases (12.5%), hypertension 3 cases (4.7%), and hyperlipidemia
1 patient (1.6%). The main symptoms were cough 15 (23.4%), fever 10 (15.6), diarrhea 8
(12.5%), headache 5 (7.8%), and sore throat 5 (7.8%). Only 7 patients (10.9%) had lung lesions,
and lymphopenia was present in only 7 patients (11.1%). The median duration of viral shedding
was 14.5 days (9-22). Concerning deceased cases, they were elderly subjects aged 69.75 years, and
they have presented dyspnea, breathing problems, and respiratory distress as specific symptoms. In
addition, an increase of the medians of serum AST, CRP, and glucose levels was noticed in this
group. During hospitalization, they presented acute respiratory distress syndrome (ARDS), and
they were transferred to intensive care before they died.

Conclusion:
This study revealed that covid-19 infection often appeared in a benign form in the
studied population (90.6% in this study). This finding may incriminate the implication of some protective
parameters such as genetic, nutritional or other factors in the Moroccan population.
Comparison of Wound Infection in Uncomplicated Acute Appendicitis by Subcuticular Suture and Interrupted Suture
Authors: Zarei Farshad , Ahmadinejad Mojtaba 
Published: January 2021

Background:
Postoperative complications such as; wound infection and scaring are some of the major concerns
regarding suturing techniques. This study is designed to evaluate post-operative outcomes of adhering subcuticular sutures
in comparison to interrupted suturing method in patients who underwent appendectomy for uncomplicated acute
appendicitis.

Methods:
240 patients were randomly assigned into two groups; 120 with interrupted and 120 subcuticular sutures after
appendectomy, at Shohada Ashayer hospital, Khorramabad, Iran. The prevalence of wound infection, three days after the
surgery in the hospital and a week after discharged was determined and evaluated statistically.

Results:
No wound infection was seen within three days of hospitalization in subcuticular group whereas, 1 patient reported
infection in interrupted group, however the difference was not statistically significant. A week after discharge, a patient was
reported to have wound infection in subcuticular group and 2 in interrupted group. No significant difference was seen in this
regard either. 55 females and 66 males received subcuticular sutures whereas, 74 males and 46 females were given
interrupted sutures for wound closing. One male in interrupted and 1 male and female subcuticular group was referred for
wound infection, after discharge, respecitvely. Among these groups, no significant differences were seen. In catarrhal
appendicitis, infection was reported in interrupted group only which was not statistically significant.

Conclusions:
Subcuticular sutures provide better cosmetic outcomes without any additional complications in comparison to
interrupted sutures.
Bone Disruption and Environmental Pollutants
Authors: Giannattasio Raffaele , Lisco Giuseppe , Giagulli Vito Angelo , Settembrini Silvio , De Pergola Giovanni , Guastamacchia Edoardo , Lombardi Gaetano , Triggiani Vincenzo 
Published: January 2021

Background:
Endocrine Disrupting Chemicals (EDCs) are ubiquitous and may significantly contribute in
environmental pollution, thus contaminating humans and wildlife. Environmental pollutants could interfere with bone
homeostasis by means of different mechanisms, which include hormonal imbalance, direct osteoblasts toxicity and
enanchment of osteoclasts activity, thus leading to osteopenia or osteoporosis. Among these, bisphenols, dioxins, polycyclic
aromatic hydrocarbons, polychlorobiphenyls, poly- and perfluoroalkyls, phthalates, parabens, organotins and cadmium may
play a role in bone distuption.

Methods:
PubMed/MEDLINE, ISI-web of knowledge and Google scholar databases were searched for medical subject
headings terms and free-text word related to the aforementioned classes of chemicals and bone metabolism and remodelling
for better clarifying and understanding the main mechanisms of bone disruption.

Results:
Several of EDCs act as xenoestrogens. Considering that estrogens play a significant role in regulating bone
remodeling, most of these chemicals generate hormonal imbalance with possible detrimental consequences on bone tissue
structure and its mechanical and non-mechanical properties.

Discussion:
A lot of evidences about bone distruptors came from in vitro studies or animal models, and conduct to
equivocal results. In addition, a few data derived form humans and most of these data focused on the impact of EDCs on
bone mineral density without considering their influence on long-term fracture risk. Moreover, it should be taken into
account that humans are exposed to a mixture of EDCs and the final effect on bone metabolism might be the result of either
a synergism or antagonist effects among them. Age of first exposure, cumulative dose exposure over time, and the usually
observed non-monotonic dose-response curve for EDCs should be considered as other important variable influencing the
final effect on bone metabolism.

Conclusion:
Taking into account these variables, observational studies are needed to better analyze this issue both for
echological purpose and to preserve bone health.
In Vitro Screening for Cytotoxic, Anti-bacterial, Anti-HIV1-RT Activities and Chemical Constituents of Croton fluviatilis, Croton acutifolius, and Croton thorelii
Authors: Worarat Charina , Pompimon Wilart , Udomputtimekakul Phansuang , Sukdee Sukee , Sombutsiri Punchavee , Kuanmuang Natthika , Suwan Issariyaporn , Khamyong Yuttaphong , Suksabai Chuthimon , Artkla Woralak , Meepowpan Puttinan , Nuntasaen Narong 
Published: January 2021

Background:
Although the chemical constituents and biological activities of a large number of plants in the Croton genus have been studied, there are still recently discovered plants to be investigated.

Objective:
1. To investigate the anti-bacterial, anti-HIV1-RT, and cytotoxicity activities of crude extracts from these plants. 2. To investigate the chemical constituents of Croton fluviatilis, Croton acutifolius, and Croton thorelii.

Method:
The anti-bacterial, anti-HIV1-RT, and cytotoxicity of the three plants were evaluated by standard techniques. Extraction, separation, and purification of extracts from the three plants were undertaken.

Results:
The ethyl acetate extract of C. fluviatilis showed low anti-bacterial activity against E. aerogenes, E. coli 0157: H7, and P. mirabilis, together with the ethyl acetate extract of C. acutifolius displayed low anti-bacterial activity against E. aerogenes, while all the crude extracts of C. thorelii were inactive. The ethyl acetate extracts of C. thorelii, and C. fluviatilis showed strong inhibited HIV1-RT, whereas the ethyl acetate extract of C. acutifolius, and the hexane extract of C. fluviatilis displayed moderate inhibited HIV1-RT. Cytotoxic properties of three Croton plants were specific to KKU-M213, MDA-MB-231, A-549, and MMNK-1. Especially, the ethyl acetate extract of C. acutifolius exhibited strong cytotoxic activities against MDA-MB-231, A-549, and MMNK-1. Furthermore, the ethyl acetate extract of C. thorelii showed high cytotoxic activities against KKU-M213, and MDA-MB-231.
Compounds 1, and 4 were found in C. fluviatilis. Compounds 2 and 4 were also found in C. acutifolius. Moreover, compound 3 was only found in C. thorelii.

Conclusion:
The present study revealed that the three Croton species are good sources of flavonoid compounds and further investigation of the chemical constituents from these plants may prove to be fruitful to discover more active compounds to be tested as potential medicines.
Nanomaterials for Targeted Delivery of Anticancer Drugs: An Overview
Authors: Sarmah Pubalee , Choudhary Bhavna 
Published: January 2021

:
Application of nanomaterials in drug delivery is a rapidly developing area of interest. The main intention in the development of these drug delivery vehicles is to successfully know the targeted delivery-related efforts and carrying drugs to the required sites of therapeutic action with reduction in adverse side effects. The task for targeted drug delivery to reach pathological are-as has increased advances in nanomedicine. But the high toxicity of uncoated nanoparticles restricts the use in humans. So, to reduce toxicity, the encapsulation of nanoparticles is done with bio compatible materials. There are many efficient delivery systems thathave been developed in which nanoparticles are loaded with the cancer drug involvingbi-layer molecules. The ﬁelds of nanotechnology has always played a crucial role in electronics, biology and medicine. Its application can be ap-praised, as it involves the materials to be designed at atomic and molecular level.This article reviews different types of nano- materials used as delivery vehicles for chemotherapeutic agents and their mechanism of action that improve the therapeutic efficacy of the drugs. The recent scientiﬁc advances in the area of chemotherapy are also discussed with emphasizingthe fu-ture prospects in cancer treatments.
Knowledge Evaluation of Hand Hygiene and Infectious Diseases in Lebanon
Authors: Taleb Jana , Sankari Najwa , Kassem Maya Alaa Dine , Roufayel Rabih , Kadry Seifedine 
Published: January 2021

Purpose:
Hand washing, also known as hand hygiene, is a simple procedure used
for cleaning and cleansing hands for eliminating soil, dirt, and germs including microorganisms
such are bacterial or viral particles. In the absence of water and soap, cinder can be used as an alternative
method for cleaning hands. Hand hygiene is an essential part that needs to be carefully followed
in the infection control protocols. With the expanding loads of Health-Care Associated Infections
(HCAIs) and the increasing levels of both treatment complexity and severity of illness
synchronized by multi-drug resistant (MDR) pathogen infections, health care practitioners are focusing
on the basic and most essential facts of disease prevention by implementing the basic and
simple cleaning measures including hand hygiene measures. According to healthcare facilities,
many scientific evidences support the observation that hand hygiene or handwashing if properly implemented,
can decrease and eliminate the risk factors of cross-transmission infections.

Method:
The data was collected using a self-administrated survey, which included 10 questions,
constructed using the monkey survey website. The survey was sent by email and collected from
100 participants of different ages.

Results:
Our results indicated that the majority of our population under study is considered
healthy, representing good educational levels.

Conclusion:
The majority revealed advanced knowledge and understanding about the key aspects
for hand washing procedures.
Automating triage and monitoring of 7578 COVID-19 migrant workers in the community: A Narrative Review (Preprint)
Authors: Lim Kheng Sit , Phua Kia-Sheng Jonathan , Chow Sau Yee , Liu Wei Yang Christopher , Tan Hiang Khoon 
Published: January 2021

UNSTRUCTURED

•	Background
The COVID-19 pandemic unmasked how quickly healthcare systems could be overwhelmed. One of the most pressing issues was the lack of hospital and intensive care beds. Attempts to mitigate these addresses both ends of the equation: admissions and bed creation. While it is relatively straightforward to utilize resources in generating more facilities, we were in unchartered waters with regards to refining triage criteria for admission to hospital for patients in the setting of community primary care.
•	Methods
This narrative review shares our journey in determination and revision of triage criteria and effecting a robust self-monitored and reported automated vital sign system in a cohort of 7578 COVID-19 patients managed out-of-hospital.
•	Results:
We present descriptive statistics on our patient cohort’s vital signs, compliance rate to monitoring, percentage of patients triggering medical review, percentage of patients transferred out to hospital and adverse events incidence.
•	Conclusions:
We believe there are lessons and potential applications for the international community from our experience.
Formulation and Evaluation of Ketorolac Tromethamine Mouth Dissolving Tablets
Authors: Bindal Rishabh , Indurkhya Arpna 
Published: January 2021

Due to more versatility and comfort, mouth dissolving tablets are the most advanced type of oral solid dosage forms. Compared to conventional tablets, it increases the effectiveness of APIs by dissolving within a minute in the oral cavity after contact with less saliva, without chewing and without the need for water for administration. Mouth Dissolving Tablets of Ketorolac tromethamine were prepared by direct compression method using various superdisintegrants like crospovidone, Croscarmellose sodium, and Sodium starch glycolate in different concentrations. Prepared tablets were evaluated for hardness, friability, weight variation, disintegration time, wetting time and in vitro drug release. Results of pre-compression and post-compression studies of all formulations were found within the standard limits. The tablets of all the batches were found to release more than 80% of drug in 5 minutes, which is the desired quality of mouth dissolving tablets that helps in faster absorption of the drug and quick onset of therapeutic effect. The the order of dissolution of various disintegrants was found to be Crospovidone˃ SSG˃ CCS. There was no significant variation in drug content of drug during stability studies for selected batch F3 in accelerated conditions over three months. It was concluded from the study that fast release of Ketorolac tromethamine from formulation F3 may reduce onset of drug action with better patient compliance.
Keywords: Crospovidone, Croscarmellose sodium, Ketorolac tromethamine, Mouth dissolving tablets, Sodium starch glycolate, superdisintegrants.