bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Intrathecal Midazolam and Fentanyl Added to Bupivacaine for Spinal Anesthesia in Patients Undergoing Appendicectomy
Authors: Thapa Puja , Panta Sunita , Amatya Biswo Ram , Rayamajhi Mallika 
Published: March 2021

Introduction: Hyperbaric Bupivacaine is the extensively used local anesthetic but the major disadvantage is profound sympathetic blockade leading to hypotension and prolonged duration of motor block. The addition of Fentanyl or Midazolam can provide excellent quality and prolong the duration of analgesia. The study aims to compare the effect of intrathecal Fentanyl with that of intrathecal Midazolam in combination with 0.5% hyperbaric Bupivacaine on the duration and quality of spinal anesthesia in patients undergoing appendicectomy.Materials and Methods: This is a prospective, comparative and interventional study where patients were randomized into two equal groups. The study was conducted in a tertiary referral hospital from July 2018 to December 2018 after ethical approval. Group BF received Fentanyl and group BM received Midazolam The outcomes measured were, peak sensory level, quality of intraoperative analgesia and motor block, duration of effective analgesia, intraoperative and postoperative complications.Results: A total of 44 patients were studied with 22 in each arm. The two groups were comparable in terms of age, weight, height, duration of surgery, and ASA status of the patients. Peak sensory level and degree of motor block were not statistically different in the two arms. Duration of effective analgesia was 293.16±35 min in the BF group and 267.80±32 min in the BM group (p=0.01). Increased incidence of pruritus was recorded during the postoperative period in the Fentanyl group.Conclusions: Fentanyl and Midazolam both are equally effi cient adjuvant added to hyperbaric Bupivacaine for intrathecal use to improve the quality of spinal anesthesia in patients undergoing appendicectomy.
Systematic Review of the Role of BCG in the Treatment of Urothelial Carcinoma of the Prostatic Urethra
Authors: Patschan Oliver , Spiess Philippe E. , Thalmann George N. , Redorta Joan Palou , Gakis Georgios 
Published: March 2021

BACKGROUND: In patients with non-invasive urothelial carcinoma of the prostatic urethra (PUC), treatment with Bacillus Calmette-Guérin (BCG) could be beneficial. OBJECTIVE: To assess the response rates to BCG in the different tumor stages, to describe the clinical impact of transurethral resection of the prostate (TURP) before BCG treatment, and to review the side effects of BCG treatment for PUC. METHODS: A systematic search was conducted using the PubMed database to identify original studies between 1977 and 2019 reporting on PUC and BCG. RESULTS: Of a total of 865 studies, ten were considered for evidence synthesis. An indication for BCG treatment was found in non-stromal invasive stages (Tis pu, Tis pd) and in stromal infiltrating cases (T1) of primary and secondary PUC when transitional cell carcinoma was the histology of origin. Studies including patients treated with TURP before BCG showed a better local response in the prostatic urethra with a higher disease free survival (DFS) (80–100% vs. 63–89%) and progression free survival (PFS) (90–100% vs. 75–94%) than patients in studies in which no TURP was performed. However, this difference in recurrence and progression in the prostate neither affected the total PFS (57–75% vs. 58–93%), nor the disease specific survival (70–100% vs. 66–100%). CONCLUSIONS: The use of resection loop biopsies of the prostatic urethra in appropriate cases during the primary work-up for suspected PUC, as well as the use of the current TNM classification for PUC, need to be improved. BCG therapy for non-stromal invasive stages of PUC show a good local response. Local response is further improved by a TURP before BCG therapy, although the overall prognosis does not seem to be affected. Further evidence for BCG treatment in the rare cases of stromal invasive PUC is needed. Specific side effects of BCG treatment for PUC are not reported.
Influence of heart rate and coronary artery calcification on image quality and diagnostic performance of coronary CT angiography: comparison between 96-row detector dual source CT and 256-row multidetector CT
Authors: Qian Wen , Liu Wangyan , Zhu Yinsu , Wang Jun , Chen Yang , Meng Haoyu , Chen Leilei , Xu Yi , Zhu Xiaomei 
Published: March 2021

BACKGROUND: CT-derived fractional flow reserve (FFRCT) and diagnostic accuracy rely on good image quality during coronary CT angiography (CCTA). OBJECTIVE: To investigate whether heart rate (HR) and coronary artery calcium (CAC) score decrease image quality and diagnostic performance of two advanced CT scanners including 96-row detector dual source CT (DSCT) and 256-row multidetector CT (MDCT). METHODS: First, 79 patients who underwent CCTA (42 with DSCT and 37 with MDCT) and invasive coronary angiography (ICA) are enrolled. Next, coronary segments with excellent image quality are evaluated and the percentage is calculated. Then, diagnostic accuracy in detecting significant diameter stenosis is presented with ICA as the reference standard. RESULTS: Compared with the DSCT, the percentage of coronary segments with excellent image quality is lower (P = 0.010) while diagnostic accuracy on per-segment level is improved (P = 0.037) using MDCT. CAC score≥400 is the only independent factor influencing the percentage of coronary segments with excellent image quality [odds ratio (OR): DSCT, 3.096 and MDCT, 1.982] and segmental diagnostic accuracy (OR: DSCT, 2.630 and MDCT, 2.336) for both scanners. HR≥70 bpm (OR: 5.506) is the independent factor influencing the percentage of coronary segments with excellent image quality with MDCT. CONCLULSION: During CCTA, CAC score≥400 still decreases the proportion of coronary segments with excellent image quality and diagnostic accuracy with advanced CT scanners. HR≥70 bpm is another factor causing image quality decreasing with MDCT.
PHYTOCHEMICAL EVALUATION OF INDIGOFERA ASTRAGALINA
Authors: Tailor B. , Singh Y. 
Published: March 2021

The word diabetes is Greek for a draw off, referring to the ejection of a more quantity of urine; and mellitus is Latin used for sugar. Consequently diabetes mellitus means the passage of huge amounts of sweet urine. This is derived from the information that excess glucose in the blood spills over into the urine, absorbing fluids with it. Based on the exhaustive literature survey, the objective of the present work focussed on the search of herb to be proved as more suitable among the reported herbs/ herbal preparations/claimed herbs, towards the control of blood glucose level in hyperglycemic condition. In the present investigation herbs; Indigofera astragalina were considered based on their literature information. In general, there is very little biological knowledge on the specific modes of action in the treatment of diabetes, but most of the plants have been found to contain substances like phenols, glycosides, alkaloids, terpenoids, flavonoids etc., that are normally concerned as having antidiabetic effect.
Keywords: Keywords: Antidiabetic activity, alkaloids, Flavonoid, Phenol and Indigofera Astragalina.
A Correlation between Students’ Rewriting of the Story in Film and Their Vocabulary Mastery
Authors: Sipayung Rohdearni Wati , Matondang Marhaeni K. D. 
Published: March 2021

This research is focused on a correlation between students’ rewriting of the story in film and t heir vocabulary mastery at the second grade of SMP Taman Siswa Pematangsiantar. The problem of this study is: ‘Is there any correlation between students’ rewriting of the story in film and their vocabulary mastery?’ The objective of this study are: 1) To examine whether there is a significant correlation between students’ rewriting of the story in film and their vocabulary mastery; 2) To find out the contribution of watching film in improving students’ rewriting of the story in film and their vocabulary mastery. From the data anlysis it can be concluded that: 1) above it can be concluded that the average score of that students’ rewriting of ¬ the story in film variable (X) is 67, 56 (4054: 60). Six students (10%) get excellent level, 13 students (21,6%) get very good, 13 students (21,6%) get good, 8 students (13,33%) get fair, 11 students (18,33%) get poor and 9 students (15%) get very poor; 2) The average score of the students’ ability in writing recount text is 71, 52 (4291: 60). Five students (8,33%) get excellent level, 11 students (18,33 %) get very good, 20 students ( 33,3 %) get good, 14 students ( 23,3 %) get fair, 7 students ( 11,6 %) get poor and 3 students (5 %) get very poor; 3) There is a significant correlation between students’ rewriting of the story in film variable (X) and the vocabulary mastery variable (Y). This result is obtained from the computation of the correlation between students’ rewriting of the story in film variable (X) and the vocabulary mastery variable (Y) applied to the sample is 0.338 (from the calculation). The critical value of the Pearson r with the 5 % significant level is 0.211 (From the table of statistical book). It means that the result obtained from the computation is greater than its critical value. Therefore, I conclude that the correlation between the two variables above is highly significant.
Recursos tecnológicos para estimular el aprendizaje de los estudiantes de Bachillerato del Colegio Ficoa de Montalvo
Authors: Lema-Dután María , Meza-Mora Mónica 
Published: March 2021

Esta investigación tiene por objetivo diseñar un modelo educativo contentivo de estrategias que constituyan una guía efectiva en la aplicación de recursos tecnológicos que se deberán utilizar para la estimulación del aprendizaje de los estudiantes de bachillerato del colegio fiscal ¨Ficoa de Montalvo”. Se destacan distintas metodologías del nivel teórico y nivel empírico. El método histórico lógico consiente un reconocimiento de los informes históricos que están coherentes con el estudio de la trayectoria real y los avances tecnológicos, el método deductivo nos permite deducir conclusiones lógicas a partir de una serie de premisas o principios y el método holístico ayuda a descomponer el objeto en el campo, es la forma integral de observar un acontecimiento o fenómeno. Por otra parte, esta investigación muestra la formación de los docentes, la construcción que deben tener las aulas y el nivel de administración de herramientas que debe adquirir el educador. La aplicación de las Tecnologías de la Información y Comunicación (TIC) en la práctica educativa es una manera de incentivar a los estudiantes en el aula, por lo que se identificará lo necesario para que los profesores se adapten a esta nueva sociedad tecnológica y guarden una actitud afectiva para desenvolverse en el argumento didáctico. Este tema presenta también conceptualizaciones teóricas, implementaciones prácticas de aprendizaje en el diario vivir y afectaciones por los últimos acontecimientos sanitarios a nivel mundial, que involucran directamente a la forma de educarse considerando la tecnología que es una técnica comprensible. En este artículo se afrontarán acontecimientos de conveniencias y conocimientos de instrucción, empleando los recursos pertinentes. Es necesario señalar que las herramientas técnicas virtuales son de gran ayuda en el período colegial con finalidad de facilitar la adquisición, almacenamiento y utilización del conocimiento, para lograr resultados deseados en el salón de clases y obtener conocimientos significativos en los estudiantes.
CARD-Associated Risk Score Features the Immune Landscape and Predicts the Responsiveness to Anti-PD-1 Therapy in IDH Wild-Type Gliomas
Authors: Li Depei , Hu Wanming , Lin Xiaoping , Zhang Ji , He Zhenqiang , Zhong Sheng , Wen Xia , Zhang Peiyu , Jiang Xiaobing , Duan Hao , Guo Chengcheng , Wang Jian , Zeng Jing , Chen Zhongping , Mou Yonggao , Sai Ke 
Published: March 2021

BackgroundProteins containing the caspase recruitment domain (CARD) play critical roles in cell apoptosis and immunity. However, the impact of CARD genes in tumor immune cell infiltration, responsiveness to checkpoint immunotherapy, and clinical outcomes of gliomas remains unclear. Here, we explore using CARD genes to depict the immune microenvironment and predict the responsiveness of gliomas to anti-PD-1 therapy.MethodsThe genome and transcriptome data of 231 patients with isocitrate dehydrogenase wild-type (IDH-wt) gliomas were retrieved from The Cancer Genome Atlas (TCGA) database to screen CARD genes associated with T lymphocyte infiltration in gliomas. Weighted co-expression network and LASSO penalized regression were employed to generate a CARD-associated risk score (CARS). Two independent and publicly available datasets were used to validate the effectiveness of CARS.ResultsThe CARS divided the 231 glioma patients into high- and low-risk subgroups with distinct immune microenvironment and molecular features. The high-risk group had high CARS and was characterized by enrichment of dysfunctional T lymphocytes in a profound immunosuppressive microenvironment, whereas the low-risk group had low CARS and exhibited an immune exclusion genotype. Moreover, signaling aberrations including upregulation of PI3K/Akt/mTOR, NF-κB, and TGF-β were found in the high-risk group. In contrast, the activated WNT pathway was more evident in the low-risk group. Furthermore, we found that an elevated CARS indicated a decreased overall survival for IDH-wt gliomas under standard care but a clinical benefit from checkpoint immunotherapy.ConclusionThis study developed an immune- and prognosis-relevant risk score, which could be used to enhance our understanding of the heterogeneity of immune microenvironment of gliomas and facilitate to identify patients who will benefit from checkpoint immunotherapy.
Diluted Aqueous Dispersed Systems of 4-Aminopyridine: The Relationship of Self-Organization, Physicochemical Properties, and Influence on the Electrical Characteristics of Neurons
Authors: Ryzhkina Irina , Murtazina Lyaisan , Gainutdinov Khalil , Konovalov Alexander 
Published: March 2021

A variety of physicochemical methods were used to examine the self-organization, physicochemical, UV absorption, and fluorescent properties of diluted aqueous solutions (calculated concentrations from 1·10−20 to 1·10−2 M) of the membrane voltage-dependent potassium channels blocker 4-aminopyridine (4-AP). Using the dynamic light scattering method, it was shown that 4-AP solutions at concentrations in the range of 1·10−20–1·10−6 M are dispersed systems in which domains and nanoassociates of hundreds of nm in size are formed upon dilution. An interrelation between the non-monotonic concentration dependencies of the size of the dispersed phase, the fluorescence intensity (λex 225 nm, λem 340 nm), specific electrical conductivity, and pH has been established. This allows us to predict the bioeffects of the 4-AP systems at low concentrations. The impact of these diluted aqueous systems on the electrical characteristics of identified neurons of Helix lucorum snails was studied. Incubation of neurons in the 4-AP systems for which the formation of domains and nanoassociates had been established lead to a nonmonotonic decrease of the resting potential by 7–13%. An analysis of the obtained results and published data allows for a conclusion that a consistent change in the nature and parameters of the dispersed phase, as well as the pH of the medium, apparently determines the nonmonotonic nature of the effect of the 4-AP systems in a 1·10−20–1·10−6 M concentration range on the resting membrane potential of neurons. It was found that the pre-incubation of neurons in the 4-AP system with a concentration of 1·10−12 M led to a 17.0% synergistic decrease in the membrane potential after a subsequent treatment with 1·10−2 M 4-AP solution. This finding demonstrates a significant modifying effect of self-organized dispersed systems of 4-AP in low concentrations on the neurons’ sensitivity to 4-AP.
Are We Ready for Nosocomial Candida auris Infections? Rapid Identification and Antifungal Resistance Detection Using MALDI-TOF Mass Spectrometry May Be the Answer
Authors: De Carolis Elena , Marchionni Federica , La Rosa Marilisa , Meis Jacques F. , Chowdhary Anuradha , Posteraro Brunella , Sanguinetti Maurizio 
Published: March 2021

The occurrence of multidrug-resistant Candida auris isolates and the increased mortality associated with invasive infections or outbreaks due to this Candida species have been reported in many healthcare settings. Therefore, accurate and rapid identification at the species level of clinical C. auris isolates as well as their timely differentiation as susceptible or resistant to antifungal drugs is mandatory. Aims of the present study were to implement the MALDI-TOF mass spectrometry (MS) Bruker Daltonics Biotyper® database with C. auris spectrum profiles and to develop a fast and reproducible MS assay for detecting anidulafungin (AFG) resistance in C. auris isolates. After creation of main C. auris spectra, a score-oriented dendrogram was generated from hierarchical cluster analysis, including spectra of isolates from C. auris and other Candida (C. glabrata, C. guilliermondii, C. haemulonii, C. lusitaniae, and C. parapsilosis) or non-Candida (Rhodotorula glutinis) species. Cluster analysis allowed to group and classify the isolates according to their species designation. Then, a three-hour incubation antifungal susceptibility testing (AFST) assay was developed. Spectra obtained at null, intermediate, or maximum AFG concentrations were used to create composite correlation index matrices for eighteen C. auris isolates included in the study. All six resistant C. auris isolates were detected as resistant whereas 11 of 12 susceptible C. auris isolates were detected as susceptible by the MS-AFST assay. In conclusion, our MS-based assay offers the possibility of rapidly diagnosing and appropriately treating patients with C. auris infection.
Establishment of a Novel Mouse Model for Atherosclerotic Vulnerable Plaque
Authors: Wang Xueyu , Fu Yahong , Xie Zulong , Cao Muhua , Qu Wenbo , Xi Xiangwen , Zhong Shan , Piao Minghui , Peng Xiang , Jia Ying , Meng Lingbo , Tian Jinwei 
Published: March 2021

Background and Aims:Acute coronary syndrome (ACS) is a group of clinical syndromes characterized by rupture or erosion of atherosclerotic unstable plaques. Effective intervention for vulnerable plaques (VP) is of great significance to reduce adverse cardiovascular events.Methods:Fbn1C1039G+/−mice were crossbred with LDLR−/−mice to obtain a novel model for atherosclerotic VP. After the mice were fed with a high-fat diet (HFD) for 12 or 24 weeks, pathological staining and immunohistochemistry analyses were employed to evaluate atherosclerotic lesions.Results:Compared to control mice, Fbn1C1039G+/−LDLR−/−mice developed more severe atherosclerotic lesions, and the positive area of oil red O staining in the aortic sinus was significantly increased after 12 weeks (21.7 ± 2.0 vs. 6.3 ± 2.1) and 24 weeks (32.6 ± 2.5 vs. 18.7 ± 2.6) on a HFD. Additional vulnerable plaque characteristics, including significantly larger necrotic cores (280 ± 19 vs. 105 ± 7), thinner fiber caps (14.0 ± 2.8 vs. 32.6 ± 2.7), apparent elastin fiber fragmentation and vessel dilation (3,010 ± 67 vs. 1,465 ± 49), a 2-fold increase in macrophage number (8.5 ± 1.0 vs. 5.0 ± 0.6), obviously decreased smooth muscle cell number (0.6 ± 0.1 vs. 2.1 ± 0.2) and an ~25% decrease in total collagen content (33.6 ± 0.3 vs. 44.9 ± 9.1) were observed in Fbn1C1039G+/−LDLR−/−mice compared with control mice after 24 weeks. Furthermore, spontaneous plaque rupture, neovascularization, and intraplaque hemorrhage were detected in the model mouse plaque regions but not in those of the control mice.Conclusions:Plaques in Fbn1C1039G+/−LDLR−/−mice fed a HFD show many features of human advanced atherosclerotic unstable plaques. These results suggest that the Fbn1C1039G+/−LDLR−/−mouse is a novel model for investigating the pathological and physiological mechanisms of advanced atherosclerotic unstable plaques.
Echocardiographic Characteristics and Outcome in Patients With COVID-19 Infection and Underlying Cardiovascular Disease
Authors: Li Yuman , Fang Lingyun , Zhu Shuangshuang , Xie Yuji , Wang Bin , He Lin , Zhang Danqing , Zhang Yongxing , Yuan Hongliang , Wu Chun , Li He , Sun Wei , Zhang Yanting , Li Meng , Cui Li , Cai Yu , Wang Jing , Yang Yali , Lv Qing , Zhang Li , Johri Amer M. , Xie Mingxing 
Published: March 2021

Background: The cardiac manifestations of coronavirus disease 2019 (COVID-19) patients with cardiovascular disease (CVD) remain unclear. We aimed to investigate the prognostic value of echocardiographic parameters in patients with COVID-19 infection and underlying CVD.Methods: One hundred fifty-seven consecutive hospitalized COVID-19 patients were enrolled. The left ventricular (LV) and right ventricular (RV) structure and function were assessed using bedside echocardiography.Results: Eighty-nine of the 157 patients (56.7%) had underlying CVD. Compared with patients without CVD, those with CVD had a higher mortality (22.5 vs. 4.4%, p = 0.002) and experienced more clinical events including acute respiratory distress syndrome, acute heart injury, or deep vein thrombosis. CVD patients presented with poorer LV diastolic and RV systolic function compared to those without CVD. RV dysfunction (30.3%) was the most frequent, followed by LV diastolic dysfunction (9.0%) and LV systolic dysfunction (5.6%) in CVD patients. CVD patients with high-sensitivity troponin I (hs-TNI) elevation or requiring mechanical ventilation therapy demonstrated worsening RV function compared with those with normal hs-TNI or non-intubated patients, whereas LV systolic or diastolic function was similar. Impaired RV function was associated with elevated hs-TNI level. RV function and elevated hs-TNI level were independent predictors of higher mortality in COVID-19 patients with CVD.Conclusions: Patients with COVID-19 infection and underlying CVD displayed impaired LV diastolic and RV function, whereas LV systolic function was normal in most patients. Importantly, RV function parameters are predictive of higher mortality.