bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spectrum of Diseases among Neurosurgical Patients in a Tertiary Care Hospital of Nepal: A Descriptive Cross-sectional Study
Authors: Devkota Harihar , Khadka Nilam Kumar , Rokaya Poojan Kumar , Giri Pravin Kumar 
Published: March 2021

Introduction: The number of neurosurgical cases, especially traumatic injuries, are increasing in remote settings. This study aims to determine neurosurgical cases in a tertiary care center teaching hospital situated in a remote area of Nepal.
Methods: It was a descriptive cross-sectional study among 138 neurosurgical patients at Karnali Academy of Health Sciences from 2019 August to 2020 July. A convenient sampling technique was used. The demographic data, the diagnosis, and management offered were recorded, reviewed, and analyzed using Statistical Package for Social Sciences version 16 and Microsoft Excel.
Results: Out of 138 cases, trauma was the main finding in 102 (73.91%) cases, and fall injury was the most frequent mechanism of injury in 64 (46.38%) cases. Traumatic brain injury was the most common disease in 85 (61.6%) cases followed by prolapsed intervertebral disc in 11 (8%), Spine fracture/dislocation in 11 (8%), stroke in 7 (5.1%), spondylosis in 6 (4.3%) and so on. Among the Traumatic Brain Injuries, normal findings were noted in 28 (20.3%) cases, extra dural hemorrhage in 12 (8.7%), contusion 11 (8%), and skull base fracture in 7 (5.1%). With a mean age of 29.8 years, a maximum number of the cases were 30 (21.74%) from the age group 31-40.
Conclusions: Trauma was seen in a majority of neurosurgical cases. Hematoma, depressed skull fracture, and spinal fractures were the main findings of neurosurgical cases. The burden of neurosurgical cases in this part of the world is quite high, so necessary step should be taken to increase such services.
Prevalence of Gastritis in a Tertiary Care Centre: A Descriptive Cross-sectional Study
Authors: Dhunghana Durga , REgmi Yukta Narayan 
Published: March 2021

Introduction: Endoscopic examination is one of the commonest procedures done in day-to-day practice in evaluating gastrointestinal problems. Esophagogastroduodenoscopy provides an excellent view of mucosal surfaces of the esophagus, stomach, and proximal duodenum. Upper gastrointestinal endoscopy is utilized for various diagnostic and therapeutic reasons. This study aimed to study the prevalence of gastritis in a tertiary health care center in Pokhara.
Methods: A descriptive cross-sectional study was conducted at Gandaki Medical College Teaching Hospital, Pokhara. After ethical approval from the institutional review board with Ref No: 070/2077/2078, endoscopic records of 889 patients undergoing upper gastrointestinal endoscopy from May 2018 to April 2019 were retrospectively reviewed. The convenience sampling method was used. Data entry and descriptive analysis were done in SPSS version 21.0. Descriptive statistics were performed.
Results: A total of 889 patients undergoing upper gastrointestinal endoscopy during a period of 12 months period were studied. Among them, females were 472 (53.1%) and males were 417 (46.9%). The mean age of the study population was 45.6 years (SD, 16.86). The majority of the patients belonged to the age group 30 to 50 years. Gastritis was the most common finding in 452 (50.8%) cases.
Conclusions: Gastritis was the most common finding in the patients undergoing upper gastrointestinal endoscopy. A significant proportion of people had normal endoscopy findings. Optimal selection of cases is needed to avoid overuse in younger and encourage use in older populations.
OPTIMALISASI RUTE DISTRIBUSI PRODUK TANGKI BAHAN BAKAR DENGAN ANALISIS BULLWHIP EFFECT METODE NEAREST INSERT DAN NEAREST NEIGHBOR DI PT XYZ
Authors: Firjatullah Rafi Fadlurrahman , Ernawati Dira 
Published: March 2021

Sepeda motor memiliki berbagai komponen yang disematkan agar dapat berkerja dengan baik. PT. XYZ merupakan salah satu distributor komponen sepeda motor yang diperoleh dari berbagai produsen dan pengrajin yang mulai berdiri sejak tahun 2012 di Kota Surabaya dan telah memiliki tiga cabang di wilayah Jawa Timur. Salah satu komponen sepeda motor yang disediakan adalah tangki bahan bakar khususnya untuk sepeda motor CB. Dalam perkembangannya permintaan produk tangki bahan bakar CB terus meningkat yang menimbulkan permasalahan rute pendistribusian produk ke cabang yang dimiliki oleh PT. XYZ. Usulan solusi yang digunakan dalam pemecahan masalah distribusi dengan metode Nearest Insert dan Nearest Neighbor serta menggunakan metode analisis Bullwhip Effect. Metode Nearest Insert dan Nearest Neighbor digunakan untuk menambahkan konsumen terdekat untuk melengkapi rute dari titik terdekat hingga titik akhir distribusi. Analisis Bullwhip Effect digunakan untuk mengetahui cabang yang harus dilakukan pengawasan lebih. Dengan dilakukannya penelitian tentang pendistribusian produk tangki CB diharapkan permasalahan tentang jarak dan biaya pengiriman dapat diminimalkan sehingga proses pendistribusian produk tangki CB menjadi lebih efisien dan optimal. Rute paling optimal yang didapatkan pada penelitian ini adalah rute 1 C0-C11-C12-10-C9-C0, rute 2 C0-C2-C7-C8-C0 dan rute 3 C0-C5-C4-C3-C1-C6-C0 dengan total jarak 822.5 km dengan total biaya sebesar Rp. 193.865.965,-. Dengan hasil tersebut didapatkan penghematan jarak 359,7 km atau 30,42% per tahun dari rute awal yaitu 1182.2 km dan didapatkan penghematan biaya sebesar Rp. 44.768.868,- atau 18.76% per tahun dari rute awal yaitu Rp.238.654.833,- per tahun.
Kata kunci : Analisa Bullwhip Effect, Nearest Insert dan Nearest Neigbor, Rute Distribusi.
Clinical Safety and Efficacy of Ablation for Atrial Fibrillation Patients With a History of Stroke
Authors: Song Zi-liang , Wu Shao-hui , Zhang Dao-liang , Jiang Wei-feng , Qin Mu , Liu Xu 
Published: March 2021

Objectives: To evaluate the clinical safety and efficacy of radiofrequency catheter ablation for atrial fibrillation patients with a history of stroke.Methods and Results: A total of 116 symptomatic, drug-refractory AF patients with a history of stroke, and 1:2 matched patients without a history of stroke were enrolled. Of these, 28 cases occurred stroke within 3 months (Group 1), 88 cases with stroke history longer than 3 months (Group 2), and 232 cases without stroke (Group 3). PVI was performed in all patients, extended to ablation of linear lesions ablation. The periprocedural stroke rates and other procedure-related in-hospital complications did not differ significantly among the three groups. The maintenance rate of SR after the procedure showed no significant difference (p = 0.333), 52.7, 66.4, and 70.7% in Group 1, 2, and 3, respectively. Furthermore, the comparison between a history of stroke and those without it were also shown no significant difference (p = 0.351).Conclusions: Radiofrequency ablation for AF patients occurred stroke, even within 3 months is safe and effective, without higher periprocedural complication rate and recurrence rate.
The Impact of Down-Regulation on Obstetrics and Perinatal Outcomes in Singleton Pregnancies After In Vitro Fertilization
Authors: Jin Lei , Ai Jihui , Zheng Yu , Chen Biao , Wang Lan , Dong Xiyuan 
Published: March 2021

Backgrounddown-regulation has been widely used in IVF treatment; however, it lacks reports on the impact of down-regulation on obstetrics and perinatal outcomes. The purpose of this study was to compare the obstetrics and perinatal outcomes among different down-regulation conditions.Methodsthis is a retrospective cohort study on 3578 patients achieving cumulative singleton clinical pregnancy after their first oocytes retrieval cycle. Patients were grouped according to the serum estradiol after down-regulation (E2D) into three groups: &lt;30, 30-55, &gt;55 pg/ml. The obstetrics and perinatal outcomes, and live-birth rate per clinical pregnancy were main outcome measures. In the subgroup analysis, patients were further divided according to the mode of transfer. ANOVA, chi-square test, multivariate logistic regression, and multivariate general linear model were performed for statistical analysis.Resultsthe patients with E2D &lt;30, 30-55, &gt;55 pg/ml had similar live-birth rates. The patients with E2D &lt;30 pg/ml had a lower risk of hypertension disorders than those with E2D 30-55 pg/ml. No difference was found in the risks of placenta previa, placenta abruption, premature rupture of membrane, hemorrhage, gestational diabetes mellitus, or intrauterine growth restriction. The newborns in the group with E2D &lt;30 pg/ml had a lower risk of PICU admission than those in the group with E2D &gt;55 pg/ml. There was no difference in the risks of congenital anomalies or mortality among the three groups. No differences were found in the gestational week, percentages of preterm birth and very preterm birth, birth weight, percentages of low birth weight and very low birth weight, delivery mode, or sex of newborn. Subgroup analysis showed that E2D 30-55 pg/ml was associated with a higher risk of low birth weight in patients with one fresh transfer + frozen transfer(s).ConclusionDown-regulation has no effect on the live-birth rate per clinical pregnancy. Patients with E2D &lt;30 pg/ml may have advantages regarding lower risks of both maternal hypertension and newborn PICU admission. E2D 30-55 pg/ml may be associated with low birth weight in patients with relatively low quality embryos.
IRX3 Overexpression Enhances Ucp1 Expression In Vivo
Authors: Zhang Zhiyin , Wu Qihan , He Yang , Lu Peng , Li Danjie , Yang Minglan , Gu Weiqiong , Liu Ruixin , Hong Jie , Wang Jiqiu 
Published: March 2021

ObjectiveThe Iroquois homeobox 3 (IRX3) gene was recently reported to be a functional downstream target of a common polymorphism in the FTO gene, which encodes an obesity-associated protein; however, the role of IRX3 in energy expenditure remains unclear. Studies have revealed that the overexpression of a dominant–negative form of IRX3 in the mouse hypothalamus and adipose tissue promoted energy expenditure by enhancing brown/browning activities. Meanwhile, we and others recently demonstrated that IRX3 knockdown impaired the browning program of primary preadipocytes in vitro. In this study, we aimed to further clarify the effects of overexpressing human IRX3 (hIRX3) on brown/beige adipose tissues in vivo.MethodsBrown/beige adipocyte-specific hIRX3-overexpressing mice were generated and the browning program of white adipose tissues was induced by both chronic cold stimulation and CL316,243 injection. Body weight, fat mass, lean mass, and energy expenditure were measured, while morphological changes and the expression of thermogenesis-related genes in adipose tissue were analyzed. Moreover, the browning capacity of primary preadipocytes derived from hIRX3-overexpressing mice was assessed. RNA sequencing was also employed to investigate the effect of hIRX3 on the expression of thermogenesis-related genes.ResultshIRX3 overexpression in embryonic brown/beige adipose tissues (Rosa26hIRX3;Ucp1-Cre) led to increased energy expenditure, decreased fat mass, and a lean body phenotype. After acute cold exposure or CL316,243 stimulation, brown/beige tissue hIRX3-overexpressing mice showed an increase in Ucp1 expression. Consistent with this, induced hIRX3 overexpression in adult mice (Rosa26hIRX3;Ucp1-CreERT2) also promoted a moderate increase in Ucp1 expression. Ex vitro experiments further revealed that hIRX3 overexpression induced by Ucp1-driven Cre recombinase activity upregulated brown/beige adipocytes Ucp1 expression and oxygen consumption rate (OCR). RNA sequencing analyses indicated that hIRX3 overexpression in brown adipocytes enhanced brown fat cell differentiation, glycolysis, and gluconeogenesis.ConclusionConsistent with the in vitro findings, brown/beige adipocyte-specific overexpression of hIRX3 promoted Ucp1 expression and thermogenesis, while reducing fat mass.
Deciphering the Prognostic Implications of the Components and Signatures in the Immune Microenvironment of Pancreatic Ductal Adenocarcinoma
Authors: Tang Rong , Liu Xiaomeng , Liang Chen , Hua Jie , Xu Jin , Wang Wei , Meng Qingcai , Liu Jiang , Zhang Bo , Yu Xianjun , Shi Si 
Published: March 2021

Background: The treatment modalities for pancreatic ductal adenocarcinoma (PDAC) are limited and unsatisfactory. Although many novel drugs targeting the tumor microenvironment, such as immune checkpoint inhibitors, have shown promising efficacy for some tumors, few of them significantly prolong the survival of patients with PDAC due to insufficient knowledge on the tumor microenvironment.Methods: A single-cell RNA sequencing (scRNA-seq) dataset and seven PDAC cohorts with complete clinical and bulk sequencing data were collected for bioinformatics analysis. The relative proportions of each cell type were estimated using the gene set variation analysis (GSVA) algorithm based on the signatures identified by scRNA-seq or previous literature.Results: A meta-analysis of 883 PDAC patients showed that neutrophils are associated with worse overall survival (OS) for PDAC, while CD8+ T cells, CD4+ T cells, and B cells are related to prolonged OS for PDAC, with marginal statistical significance. Seventeen cell categories were identified by clustering analysis based on single-cell sequencing. Among them, CD8+ T cells and NKT cells were universally exhausted by expressing exhaustion-associated molecular markers. Interestingly, signatures of CD8+ T cells and NKT cells predicted prolonged OS for PDAC only in the presence of “targets” for pyroptosis and ferroptosis induction. Moreover, a specific state of T cells with overexpression of ribosome-related proteins was associated with a good prognosis. In addition, the hematopoietic stem cell (HSC)-like signature predicted prolonged OS in PDAC. Weighted gene co-expression network analysis identified 5 hub genes whose downregulation may mediate the observed survival benefits of the HSC-like signature. Moreover, trajectory analysis revealed that myeloid cells evolutionarily consisted of 7 states, and antigen-presenting molecules and complement-associated genes were lost along the pseudotime flow. Consensus clustering based on the differentially expressed genes between two states harboring the longest pseudotime span identified two PDAC groups with prognostic differences, and more infiltrated immune cells and activated immune signatures may account for the survival benefits.Conclusion: This study systematically investigated the prognostic implications of the components of the PDAC tumor microenvironment by integrating single-cell sequencing and bulk sequencing, and future studies are expected to develop novel targeted agents for PDAC treatment.
Case Report: Premature Ventricular Beats-Induced Chronic Cough and Cough Syncope
Authors: Hu Yue , Hua Wen , Li Na , Huang Huaqiong 
Published: March 2021

Background: Chronic cough is a common complaint that in rare cases can be caused by premature ventricular beats (PVCs).Materials and Methods: In this report, we present the case of a healthy 44-year-old female who presented persistent cough and cough syncope that was attributed to PVCs.Results: The cough disappeared after radiofrequency ablation, and no recurrence of arrhythmia or cough was observed.Conclusion: PVCs should be considered a probable cause of chronic cough and cough syncope in differential diagnosis.
Eye Movement Technique to Improve Executive Function in Patients With Stroke: A Randomized Controlled Trial
Authors: He Wen , Ji Yazheng , Wei Xiating , Wang Fan , Xu Feng , Lu Chengyi , Ma Qianqian , Wang Kai 
Published: March 2021

Objective: To investigate the efficacy of eye movement technique for the treatment of executive dysfunction of patients with stroke.Methods: This was a prospective, single-blinded, randomized, controlled, single-center clinical trial conducted from June 2018 to December 2019 in patients with stroke. The patients were randomized 1:1 to the routine (conventional management) and eye-move group (routine management plus eye movement technique: 5-min goal management training, 5-min computer-aided working memory, and 10 min of inhibitory control training and set conversion training). The intervention lasted 6 weeks, followed by a 4-week follow-up. The primary endpoint was the Behavioral Assessment of the Dysexecutive Syndrome (BADS) score. The secondary endpoints mainly included the Montreal Cognitive Assessment (MoCA), Wisconsin Card Sorting Test (WCST), and modified Barthel Index (MBI) scores.Results: Sixty-four patients were enrolled (32/group). After the 6-week intervention, the BADS and WCST scores of the eye-move group were significantly improved than those of the routine group (all P &lt; 0.05), but the effects were attenuated in certain subscores after follow-up (all P &gt; 0.05). The MoCA and MBI scores of the eye-move group were significantly higher, and the reaction time was significantly lower than those of the routine group at 4 weeks after the intervention (all P &lt; 0.05). After follow-up, the MBI scores of the eye-move group were still higher than that of the routine group (P &lt; 0.001), but there were no differences for MoCA scores and reaction time (both P &gt; 0.05).Conclusion: The eye movement technique could improve the executive function of patients with stroke. These results have to be confirmed.This was a prospective, single-blinded, randomized, controlled, single-center clinical trial (ChiCTR2000036393).Clinical Trial Registration: [www.chictr.org.cn], identifier [ChiCTR2000036393].
Clinical and VNG Features in Anterior Canal BPPV—An Analysis of 13 Cases
Authors: Porwal Prateek , V. R. Ananthu , Pawar Vishal , Dorasala Srinivas , Bijlani Avinash , Nair Prem , Nayar Ravi 
Published: March 2021

Objective: To define diagnostic VNG features in anterior canal BPPV during positional testing (Dix-Hallpike, supine head hanging, and McClure Pagnini tests).Study Design: A retrospective study of patients diagnosed with anterior canal BPPV across four referral centers in New Delhi, Kochi, Bangalore, and Dubai.Subjects and Methods: Clinical records of 13 patients with AC BPPV out of 1,350 cases, during a 3-years period, were reviewed and analyzed by four specialists.Results: Four patients had positional down beating nystagmus with symptoms of vertigo during the bilateral DHP maneuver. Seven cases had positional down beating nystagmus only on one side of DHP. Typical down beating nystagmus was seen in 10 out of 13 cases during the straight head hanging maneuver. Down beating torsional nystagmus was seen in 6 out of 13 cases. Down beating with horizontal nystagmus was seen in three cases (in DHP and MCP mainly) while pure down beating nystagmus during SHH was only seen in four cases.Conclusion: We conclude that anterior canal BPPV is a rare but definite entity. It may not be apparent on positional testing the first time, so repeated testing may be needed. The most consistent diagnostic maneuver is SHH though there were patients in which findings could only be elicited using DHP testing. We recommend a testing protocol that includes DHP testing on both sides and SHH. MCP testing may also evoke DBN with or without the torsional component. Reversal of nystagmus on reversal of testing position is unusual but can occur. The Yacovino maneuver is effective in resolving AC BPPV. We also propose a hypothesis that explains why DHP testing is sensitive to AC BPPV on either side, whereas MCP lateral position on one side is only sensitive to AC BPPV on one side. We have explained a possible role for the McClure Pagnini test in side determination and therapeutic implications.
A Case–Control Study of the Effects of Chimarrão (Ilex paraguariensis) and Coffee on Parkinson's Disease
Authors: Medeiros Márcio Schneider , Schumacher-Schuh Artur Francisco , Altmann Vivian , Rieder Carlos Roberto de Mello 
Published: March 2021

Introduction: Coffee has been inversely associated with Parkinson's disease (PD) in many studies, and caffeine is the leading candidate to mediate this effect. Mate (Ilex paraguariensis, IP), a caffeinated beverage rich in antioxidants consumed in South America, was also inversely associated with PD in one study from Argentina. Other varieties of IP infusion, such as chimarrão, were never studied in PD. Chimarrão is a common caffeinated beverage consumed in Brazil made with the leaves and stems of IP.Methods: A case–control study was conducted to evaluate the relationship between chimarrão ingestion and PD in southern Brazil. All subjects answered a questionnaire about the frequency of chimarrão and coffee intake. A multiple regression analysis adjusted for age and sex was performed to assess the association between PD and chimarrão consumption.Results: We included 200 PD patients and 200 healthy controls. High consumption of chimarrão was inversely associated with PD (OR = 0.44, 95% CI = 0.24–0.81, P = 0.008). High consumption of coffee was also inversely associated with PD, as expected. Chimarrão remained associated when adjusted for coffee consumption, smoking history, and age (OR 0.46, 95% CI = 0.25–0.86, P = 0.014). These two exposures showed an additive effect.Conclusion:Chimarrão consumption was inversely associated with PD, even after adjusting for coffee intake, suggesting a possible protective role. IP's effect can be mediated by caffeine and through its antioxidant components. Chimarrão has a lower concentration of caffeine compared with coffee and has numerous substances with antioxidative effects that may be important to PD protection. Further studies are needed to test this hypothesis.
Severe Vitamin D Deficiency Is Associated With Increased Expression of Inflammatory Cytokines in Painful Diabetic Peripheral Neuropathy
Authors: Xiaohua Gong , Dongdong Luo , Xiaoting Niu , Shuoping Chen , Feixia Shen , Huajun Yang , Qi Zhou , Zimiao Chen 
Published: March 2021

Background: The exact pathogenic mechanism of the painful diabetic peripheral neuropathy (DPN) is poorly understood. Our study aimed to evaluate the association amongst vitamin D status, inflammatory cytokines, and painful DPN.Methods: A total of 483 patients were divided into three groups, i.e., diabetes without DPN (no-DPN, n = 86), diabetes with painless DPN (painless DPN, n = 176) and diabetes with painful DPN (painful DPN, n = 221) groups. Basic information and laboratory results were collected. The concentrations of vitamin D (25-hydroxyvitamin D), high-sensitivity C-reactive protein, interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) were also measured.Results: The prevalence of severe vitamin D deficiency (&lt;10 ng/mL) was more common in the painful DPN group than in the painless DPN and no-DPN groups (25.8,12.5, and 8.1%, respectively, P &lt; 0.01). Cases in the painful DPN group had significantly higher concentrations of IL-6 (P &lt; 0.01) and TNF-α (P &lt; 0.01) than those in the two other groups. The multivariate logistic analysis showed that severe vitamin D deficiency, IL-6, and TNF-α were independent risks for painful DPN after adjusting for confounding factors. Furthermore, the vitamin D status had significantly negative correlations with IL-6 (r = −0.56, P &lt; 0.01) and TNF-α (r = −0.47, P &lt; 0.01) levels.Conclusion: Severe vitamin D deficiency was an independent risk factor for the painful DPN. Severe vitamin D deficiency status may play a role in the painful DPN pathogenesis through elevated IL-6 and TNF-α levels.