bluuebunny/crossref_metadata_2025_split huggingface dataset:
Active Surveillance of Small Renal Masses: A Systematic Review
Authors: Ellis Elizabeth E. , Messing Edward 
Published: June 2021

BACKGROUND: Our goal is to review current literature regarding active surveillance (AS) of small renal masses (SRMs) and identify trends in survival outcomes, factors that predict the need for further intervention, and quality of life (QOL). METHODS: We performed a comprehensive literature search in PubMed and EMBASE and identified 194 articles. A narrative summary was performed in lieu of a meta-analysis due to the heterogeneity of selected studies. RESULTS: Seventeen articles were chosen to be featured in this review. Growth rate (GR) was not an accurate predictor of malignancy, although it was the characteristic most commonly used to trigger delayed intervention (DI). The mean 5-year overall survival (OS) of all studies was 73.6% ±1.7% for AS groups. The combined cancer specific survival (CSS) for AS is 97.1% ±0.6%, compared to 98.6% ±0.4% for the primary intervention (PI) groups, ( p = 0.038). CONCLUSIONS: Short and intermediate-term data demonstrate that AS with the option for DI is a management approach whose efficacy (in terms of CSS) approaches that of PI at 5 years, is cost effective, and prevents overtreatment, especially in patients with significant comorbidities.
A COMPARATIVE STUDY OF KETOFOL (KETAMINE AND PROPOFOL) WITH PROPOFOL ALONE FOR RECOVERY IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY
Authors: Thakur Priyanka , Negi Prteet , Sood Ajay , Sharma Aparna 
Published: June 2021

Background: To compare the recovery in ketofol (ketamine and propofol) with propofol alone for vas in patients undergoing laparoscopic cholecystectomy
Methods: Prospective, randomized, double blinded controlled trial. After approval by the research ethics committee and written informed valid consent of the patients, the proposed study was carried out for a period of one year in 60 patients , in ASA-I and ASA-II patients, aged between 19 to 60 years of either sex, who were posted for laproscopic cholecystectomy surgery at Indira Gandhi Medical College, Shimla.
Results: Recovery profile was statistically significant for two groups. In group P after stopping infusion ,mean time for eye opening was 8.27 ± 1.28 which was less than group K ( 12.53 ± 1.48). Mean time of response to verbal command in group P(8.4 ± 1.19) was less than group K (12.5 ± 1.46) and mean time of extubation in group P (9.5 ± 1.25) was also less than group K (14.33 ± 1.52).
Conclusion- Patients of Group P after stopping of infusion took less time for eye opening, obeying verbal command and also less time for extubation in comparison to group K .
Keywords: Recovery, Propofol, Ketamine
A PROSPECTIVE CLINICO- BACTERIOLOGICAL STUDY OF SURGICAL SITE INFECTION AT PBM HOSITAL
Authors: Shukla Satyam , Lohar Naveen 
Published: June 2021

Background: This study aims at determining the risk factors and incidence of surgical site infections.
Methods: The material for the present study was obtained from patient’s undergone surgery in Department of General Surgery, SPMC and PBM Hospital, Bikaner, Rajasthan from 1st Jan 2019 to 31th December, 2019. Surgical site were considered to be infected according to the definition by NNIS. The wounds were classified according to the wound contamination class system proposed by U.S. National Research Council.
Results: A study of 400 operated cases was carried out of which 39 were diagnosed to be having surgical site infection as per the CDC criteria. Thus the incidence of SSI in this study is 9.75%.
Conclusion: Incidence of surgical site infection was more in emergency surgery case as compare to elective.
Keywords: SSI, Emergency, Elective
ANALYSIS OF BLUNT ABDOMINAL TRAUMA CASES AT TERTIARY CARE HOSPITAL BIKANER (RAJASTHAN)
Authors: Panwar Deepak Singh , Kumar Ashok 
Published: June 2021

Background: In view of increasing number of vehicles and consequently road traffic accidents, this dissertation has been chosen to study the cases of blunt abdominal trauma with reference to the patients presenting at P.B.M. hospital, attached to S.P. Medical College, Bikaner.
Methods: Prospective hospital-based study was conducted on all the patients of blunt abdominal injury admitted in the department of surgery, S.P. Medical College and P.B.M. Hospital, Bikaner.
Results: Majority of the patients presented with abdominal pain (86%) and abdominal tenderness (81%).
Conclusion: We concluded that young Males are predominantly affected. Road traffic accident forms the most common mode of injury. Though conservative management is successful in carefully selected patients, operative management remains the main stay of treatment.
Keywords: Blunt trauma, Age, Sex
Design of antigen synthesis and identification of its artificial antigen for zearalenone
Authors: Wang Yanan , Fotina Hanna , Fotin Alexsey 
Published: June 2021

Background: study aimed to modify the ZEN molecule and conjugate the carrier protein to prepare a complete antigen. To lay the foundation for the preparation of ZEN monoclonal antibodies. Methods: The carbonyl group at the 7 position of ZEN molecule was modified by deuteration reaction. The immunogen and antigen were synthesized by EDC method and mixed acid anhydride method, and the complete antigen was identified by UV, IR and electrophoresis. Antisera were obtained after immunization of animals, and an antiserum was designed by ELISA. Results: The immunogens were identified by UV, IR and electrophoresis, ZEN-BSA was successfully synthesized. The ratio of ZEN-BAS to ZEN was calculated to be 1 : 13. When the antibody serum was detected, the titer of the antibody reached 1:(6.4×103). Conclusion: This study demonstrated that the OAE method is preferable in preparing the ZEN. These findings lay the material and technical foundation for the preparation of anti-ZEN monoclonal antibody
Perfil epidemiológico de nascidos vivos: Uma análise comparativa em um território marcada por mosaicos geográficos
Authors: Lopes Elida Borges , Silva Aline Cerqueira Santos Santana da , Nicol Alcina Frederica , Padilha Giúlia Kamille de Medeiros , Batista Walesca Carvalho Amaral , Knupp Virginia Maria Azevedo Oliveira 
Published: June 2021

Objetivo: analisar o perfil epidemiológico dos nascidos vivos e comparar entre cinco áreas de planejamento em saúde de uma mesma região geográfica. Métodos: estudo epidemiológico, do tipo ecológico, observacional, descritivo, quantitativo, elaborado com base nos dados contidos no Sistema de Informação sobre Nascidos Vivos. Os dados foram processados nos programas Tab para Windows e analisados no LibreOffice Excel versão 5.4. Os resultados descritivos foram exibidos em frequência absoluta e relativa e os indicadores em proporções de acordo com AP de residência da mãe. Resultados: Foram analisadas 82.780 declarações de Nascidos vivos. A maioria apresentou-se a termo, o peso adequado, Apgar no primeiro e quinto minutos entre 7 a 10 pontos. As mães foram em sua maioria pardas, solteiras, com 8 a 11 anos de estudo e idade entre 20 a 34. O tipo de parto mais frequente foi à cesárea. Considerações finais: A avaliação do perfil epidemiológico dos nascidos vivos deve fazer parte dos serviços de saúde para que as ações estratégicas sejam direcionadas, com vistas a intervir nos agravos de saúde que levam a situação de prematuridade, a desigualdade do acesso ao pré-natal, e cesarianas sem critério. Logo, os serviços de saúde devem dispor de Plano de ações locais.
Etnobotânica das plantas medicinais utilizadas no tratamento de ferimentos na pele em duas comunidades rurais da região do Baixo Tocantins, Amazônia, Brasil
Authors: Sousa Ronaldo Lopes de , Silva Edson Costa da , Silva Adriana Franco da , Mesquita Silviene dos Santos , Sousa Denise Ribeiro de , Sousa Ana Clara Ribeiro de , Maia Ana Aurea Barreto , Silva Sebastião Gomes , Costa Jeferson Miranda , Fonseca Dyana Joy dos Santos , Pereira Maria das Graças da Silva , Cordeiro Yvens Ely Martins 
Published: June 2021

Levantamentos etnobotânicos de plantas medicinais com potencial para sarar ferimentos de pele podem ser uma alternativa no auxílio desses cuidados ou acelerar o processo de cura e para indústria farmacêutica são importantes na escolha de espécies para investir em testes laboratoriais. Nesse contexto, a pesquisa visou fazer um levantamento etnobotânico de plantas medicinais usadas pelos moradores de duas comunidades rurais da Amazônia brasileira para o tratamento de ferimentos cutâneos, além de registrar as indicações, usos e as formas de preparo das formulações caseiras. Adotou-se a bola de neve como metodologia para selecionar os colaboradores e técnicas de etnobotânica para coleta dos dados. A importância de cada espécie foi determinada calculando a frequência relativa de citação (RFC). No total participaram 17 colaboradores e foi registrado o conhecimento sobre 16 etnoespécies usadas no processo de cicatrização de feridas de pele. Os maiores de valores da CRF registrados foram para as espécies de andiroba (Carapa guianensis Aubl.), copaíba de planta (Escobedia sp.) e malvarisco (Piper umbellatum L.). Dessa foram, destaca-se que as plantas medicinais usadas nessas comunidades contribuem para melhorar a qualidade de vida e são importantes para o tratamento de ferimentos de pele.
Estresse e comportamento alimentar
Authors: Matos Suamily Maria Rodrigues de , Ferreira José Carlos de Sales 
Published: June 2021

Introdução: podemos definir como um breve conceito de estresse o entendimento como sequências de reações, que transformam a integridade física e psicológica, que aterrorizam o equilíbrio do organismo (homeostase). O estresse é um fator importante no desenvolvimento do vício e na recaída do vício e pode contribuir para um maior risco de obesidade e outras doenças metabólicas. O estresse incontrolável muda os padrões de alimentação e a saliência e o consumo de alimentos hiper palatáveis; com o tempo, isso poderia levar a mudanças na carga alostática e desencadear adaptações neurobiológicas que promovem um comportamento cada vez mais compulsivo. Metodologia: Optou-se pela pesquisa bibliográfica, desenvolvida a partir de material já elaborado, constituído principalmente de livros e artigos científicos. Resultados: Neste trabalho, demonstrou-se que o estresse tem sido considerado um fator de risco crítico no desenvolvimento de transtornos aditivos e recaída para comportamentos aditivos. No entanto, poucos estudos revisaram as ligações entre o estresse e a ingestão de alimentos, particularmente de alimentos hiper palatáveis ​​ou “confortáveis” que podem ser consumidos para reduzir o estresse. Conclusão: Podemos analisar que realmente a percepção e a avaliação do estresse dependem de aspectos específicos da apresentação de estímulos externos ou internos e podem ser moderados ou mediados por traços de personalidade, estado emocional e respostas fisiológicas que, juntos, contribuem para a experiência de sofrimento.
Elastogenesis Correlates With Pigment Production in Murine Aortic Valve Leaflets
Authors: Hutcheson Joshua D. , Schlotter Florian , Creager Michael D. , Li Xiaoshuang , Pham Tan , Vyas Payal , Higashi Hideyuki , Body Simon C. , Aikawa Masanori , Singh Sasha A. , Kos Lidia , Aikawa Elena 
Published: June 2021

Objective: Aortic valve (AV) leaflets rely on a precise extracellular matrix (ECM) microarchitecture for appropriate biomechanical performance. The ECM structure is maintained by valvular interstitial cells (VICs), which reside within the leaflets. The presence of pigment produced by a melanocytic population of VICs in mice with dark coats has been generally regarded as a nuisance, as it interferes with histological analysis of the AV leaflets. However, our previous studies have shown that the presence of pigment correlates with increased mechanical stiffness within the leaflets as measured by nanoindentation analyses. In the current study, we seek to better characterize the phenotype of understudied melanocytic VICs, explore the role of these VICs in ECM patterning, and assess the presence of these VICs in human aortic valve tissues.Approach and Results: Immunofluorescence and immunohistochemistry revealed that melanocytes within murine AV leaflets express phenotypic markers of either neuronal or glial cells. These VIC subpopulations exhibited regional patterns that corresponded to the distribution of elastin and glycosaminoglycan ECM proteins, respectively. VICs with neuronal and glial phenotypes were also found in human AV leaflets and showed ECM associations similar to those observed in murine leaflets. A subset of VICs within human AV leaflets also expressed dopachrome tautomerase, a common melanocyte marker. A spontaneous mouse mutant with no aortic valve pigmentation lacked elastic fibers and had reduced elastin gene expression within AV leaflets. A hyperpigmented transgenic mouse exhibited increased AV leaflet elastic fibers and elastin gene expression.Conclusions: Melanocytic VIC subpopulations appear critical for appropriate elastogenesis in mouse AVs, providing new insight into the regulation of AV ECM homeostasis. The identification of a similar VIC population in human AVs suggests conservation across species.
Differential Organic Carbon Mineralization Responses to Soil Moisture in Three Different Soil Orders Under Mixed Forested System
Authors: Singh Shikha , Jagadamma Sindhu , Liang Junyi , Kivlin Stephanie N. , Wood Jeffrey D. , Wang Gangsheng , Schadt Christopher W. , DuPont Jesse I. , Gowda Prasanna , Mayes Melanie A. 
Published: June 2021

Soil microbial respiration is one of the largest sources of carbon (C) emissions to the atmosphere in terrestrial ecosystems, which is strongly dependent on multiple environmental variables including soil moisture. Soil moisture content is strongly dependent on soil texture, and the combined effects of texture and moisture on microbial respiration are complex and less explored. Therefore, this study examines the effects of soil moisture on the mineralization of soil organic C Soil organic carbon in three different soils, Ultisol, Alfisol and Vertisol, collected from mixed forests of Georgia, Missouri, and Texas, United States , respectively. A laboratory microcosm experiment was conducted for 90 days under different moisture regimes. Soil respiration was measured weekly, and destructive harvests were conducted at 1, 15, 60, and 90 days after incubation to determine extractable organic C (EOC), phospholipid fatty acid based microbial community, and C-acquiring hydrolytic extracellular enzyme activities (EEA). The highest cumulative respiration in Ultisol was observed at 50% water holding capacity (WHC), in Alfisol at 100% water holding capacity, and in Vertisol at 175% WHC. The trends in Extractable Organic Carbon were opposite to that of cumulative microbial respiration as the moisture levels showing the highest respiration showed the lowest EOC concentration in all soil types. Also, extracellular enzyme activities increased with increase in soil moisture in all soils, however, respiration and EEA showed a decoupled relationship in Ultisol and Alfisol soils. Soil moisture differences did not influence microbial community composition.
Higher Serum Brain-Derived Neurotrophic Factor Levels Are Associated With a Lower Risk of Cognitive Decline: A 2-Year Follow Up Study in Community-Dwelling Older Adults
Authors: Fujiwara Yoshinori , Ihara Kazushige , Hachisu Mitsugu , Suzuki Hiroyuki , Kawai Hisashi , Sakurai Ryota , Hirano Hirohiko , Chaves Paulo H. M. , Hashizume Masahiro , Obuchi Shuichi 
Published: June 2021

ObjectiveTo assess the relationship of serum brain-derived neurotrophic factor (BDNF) levels with the subsequent short-term decline in cognitive functioning in community-dwelling older adults.DesignTwo-year prospective, observational study.Setting and ParticipantsThe study included 405 adults aged 65–84 years, initially free of a dementia diagnosis who were living in Tokyo, Japan.MethodsParticipants underwent health assessments at baseline (2011) and follow-up (2013). Serum BDNF levels and scores from the Montreal Cognitive Assessment-Japanese version (MoCA-J) were systematically measured. Logistic regression was used to estimate the odds of cognitive decline between baseline and follow-up assessments in the full MoCA-J scale (operationally defined as a decrease of two or more points), as well as in MoCA-J subscales (decline of one or more points in a specific subscale), as a function of serum BDNF level, adjusting for baseline demographics, prevalent chronic diseases, and baseline cognitive scores.ResultsAmong individuals who performed worse on the full MoCA-J at baseline (i.e., scores in the bottom quartile [≤21], which is consistent with a mild cognitive impairment status), but not among those who performed better (top 3 quartiles), those with highest baseline serum BDNF levels (top quartile) had lower odds of subsequent decline in the full MoCA-J scale than those with lowest (bottom quartile); i.e., odds ratio (OR): 0.10 (95% confidence interval [CI]: 0.02–0.62; p = 0.013). Regarding MoCA-J subscales, adjusted odds of decline in the executive function subscale, but not in the other five subscales, were substantially low among those with highest baseline serum BDNF levels (top quartile), as compared to those with the lowest (bottom quartile), i.e., OR: 0.27 (95% CI:0.13–0.60; p &lt; 0.001).Conclusion and ImplicationsHigher serum BDNF levels were associated with a lower risk of decline in cognitive function in a sample of community-dwelling older Japanese adults. Risk varied across cognitive subdomains and according to baseline cognition. This warrants further research to evaluate the added-value of serum BDNF in health promotion initiatives directed toward cognitive decline prevention in community-dwelling older adults.
Impact of Left Atrial Appendage Morphology on Recurrence in Embolic Stroke of Undetermined Source and Atrial Cardiopathy
Authors: Gwak Dong-Seok , Choi WooChan , Kim Yong-Won , Kim Yong-Sun , Hwang Yang-Ha 
Published: June 2021

Background: The left atrial appendage (LAA) is a major source of thrombus and non-chicken wing (CW). LAA morphology is a risk factor for embolic events in atrial fibrillation. However, the association of non-CW morphology with embolic stroke recurrence is unknown in patients with embolic stroke of undetermined source (ESUS) and atrial cardiopathy.Methods: We conducted retrospective analyses using a prospective institutional stroke registry (2013–2017). Patients with ESUS and atrial cardiopathy were enrolled. Atrial cardiopathy was diagnosed if an increased left atrial diameter (&gt;40 mm, men; &gt;38 mm, women), supraventricular tachycardia, or LAA filling defect on computed tomography (CT) were present. Patients admitted &gt;24 h after onset were excluded. LAA morphology was evaluated using CT and categorized into CW vs. non-CW types. The primary outcome was embolic stroke recurrence. Multivariable Cox proportional hazards models were used to examine the independent association between LAA morphology and outcome.Results: Of 157 patients, 81 (51.6%) had CW LAA morphology. The median follow-up was 41.5 (interquartile range 12.3–58.5) months corresponding to 509.8 patient years. In total, 18 participants experienced embolic stroke recurrences (3.80 per 100 patient-years). Non-CW morphology was more associated with embolic stroke recurrence than CW morphology (hazard ratio (HR), 3.17; 95% confidence interval (CI), 1.13–8.91; p = 0.029). After adjusting for CHA2DS2-VASc score and number of potential embolic sources, non-CW morphology showed an independent association with outcome (adjusted HR, 2.90; 95% CI, 1.02–8.23; p = 0.045).Conclusions: The LAA morphology types may help identify high risk of embolic stroke recurrence in ESUS with atrial cardiopathy. LAA morphology in atrial cardiopathy may provide clues for developing therapies tailored to specific mechanisms.
Yoga of Immortals Intervention Reduces Symptoms of Depression, Insomnia and Anxiety
Authors: Verma Sadhna , Donovan James , Tunuguntla Hari S. , Tunuguntla Renuka , Gupta Babu V. , Nandi Ayon , Shivanand Ishan 
Published: June 2021

Background: Depression, anxiety, and disordered sleep are some common symptoms associated with sub-optimal mental health. During the COVID-19 pandemic, mental health issues have grown increasingly more prevalent in the population. Due to social distancing and other limitations during the pandemic, there is a need for home-based, flexible interventions that can improve mental health. The Yoga of Immortals (YOI) mobile application provides a structured intervention that can be used on any mobile device and applied from the user's home.Methods: A total of 1,505 participants were enrolled in the study and used the YOI app for an 8-week period. Participants were asked to fill out three questionnaires: The Patient Health Questionnaire, 8 items (PHQ-8), the Generalized Anxiety Disorder questionnaire (GAD-7) and the Insomnia Severity Index (ISI). These three items were completed by 1,297 participants a total of four times: before starting YOI, two more times during use, and a fourth time after the 8-week usage period. Changes in PHQ8, GAD7 and ISI in participants were compared to a control group, who did not use the YOI app but completed all questionnaires (590 controls finished all questionnaires).Results: Participants reported significant decreases in depression and anxiety-related symptoms. Compared to baseline, PHQ-8 scores decreased 50% on average after the 8-week period. GAD-7 scores also decreased by 40–50% on average, and ISI scores decreased by 50%. These changes were significantly greater (p &lt; 0.05) than that observed in the control group. Participants who reported a previous diagnosis of depression and generalized anxiety reported significantly larger decreases in PHQ-8 and GAD-7 as compared to participants with no prior diagnosis (p &lt; 0.05).Conclusions: Regular use of the YOI intervention over an 8-week period led to significant decreases in symptoms of both depression and anxiety, as well as alleviation of insomnia.
Genomic Investigation of Carbapenem-Resistant Klebsiella pneumonia Colonization in an Intensive Care Unit in South Africa
Authors: Madni Osama , Amoako Daniel G. , Abia Akebe Luther King , Rout Joan , Essack Sabiha Yusuf 
Published: June 2021

The study investigated carbapenemase-producing Klebsiella pneumoniae (CPKP) isolates of patients in an intensive care unit (ICU) in a public hospital in the KwaZulu-Natal province, South Africa using whole-genome sequencing (WGS). Ninety-seven rectal swabs, collected from all consenting adult patients (n = 31) on days 1, 3, and 7 and then weekly, were screened for carbapenemase-production using Chrome-ID selective media. Antibiotic susceptibility was determined for the fourteen positive CPKP isolates obtained using the VITEK 2 automated system. All isolates (100%) were resistant to ertapenem and meropenem, and 71.4% (n = 10) were resistant to imipenem. All CPKP isolates were subjected to ERIC/PCR, and a sub-sample of isolates was selected for WGS based on their antibiograms and clonality. All sequenced isolates harbored the blaOXA-181 carbapenemase (100%) and co-carried other β-lactamase genes such as blaOXA-1, blaCTX-M-15, blaTEM-1B, and blaSHV-1. IncF, IncX3, and Col plasmid replicons groups and class I integrons (ln191 and ln27) were detected. All isolates belonged to the same sequence type ST307 and capsular serotypes (K102, O2v2). All the isolates carried the same virulence repertoire, reflecting the epidemiological relationship between isolates. blaOXA-181 was located on a multi-replicon plasmid similar to that of E. coli p010_B-OXA181, and isolates were aligned with several South African and international clades, demonstrating horizontal and vertical transboundary distribution. The findings suggest that blaOXA-181 producing K. pneumoniae is endemic in this ICU, colonizing the patients. CRE screening and enhanced infection prevention and control measures are urgently required.