bluuebunny/crossref_metadata_2025_split huggingface dataset:
Valencene-rich fraction from Vetiveria zizanioides exerts immunostimulatory effects in vitro and in mice
Authors: Sunitha V.S. , Midhun Sebastian Jose , Sunil M.A. , Radhakrishnan E.K. , Mathew Jyothis 
Published: July 2021

Objective:
To decipher the responsible compound present in the aqueous root extract of Vetiveria zizanioides which has tremendous immunomodulatory activity.

Methods:
Different fractions of the water extract were collected and analyzed for immunomodulatory activity by analyzing in vitro phagocytic activity and nitric oxide production. One fraction VF3 was selected and further analyzed for possible compounds by high performance liquid chromatography and gas chromatography coupled with a mass spectrometer. The in vitro immunomodulatory parameters such as phagocytic index, nitrite content, and tumor necrosis factor-α production in murine macrophages were analyzed. In vivo studies, sheep red blood cell induced haemagglutination titer, the number of antibody-producing cells, and sheep red blood cell induced delayed-type hypersensitivity were analyzed. Cytotoxic studies in L929 normal fibroblasts were also performed.

Results:
One of the fractions, VF3, was selected and confirmed the presence of an active compound valencene. The in vitro immunomodulatory parameters were significantly (P<0.05) increased by valencene treatment. In vivo studies in Swiss albino mice showed that valencene could significantly (P<0.05) increase haemagglutination titer, the number of antibody-producing cells, and delayed-type hypersensitivity. Cytotoxic studies also showed that valencene did not cause any morphological changes and DNA damage in normal fibroblasts.

Conclusions:
Valencene possesses immunomodulatory activities and can be commercially exploited for its immunostimulatory potentials.
Bitter gourd extract improves glucose homeostasis and lipid profile via enhancing insulin signaling in the liver and skeletal muscles of diabetic rats
Authors: Eweda Saber Mohamed , Ali Mennatallah Ahmed , Abd El-Bary Hala Mohamed , El-Sokkary Nahed Hussein , Helmy Madiha Hassan , Kamel Maher Abdel-Nabi 
Published: July 2021

Objective:
To investigate the modulatory effects of bitter gourd extract on the insulin signaling pathway in the liver and skeletal muscle tissues of diabetic rats.

Methods:
The ethanolic extract of bitter gourd was prepared and its contents of total polyphenols and flavonoids were assayed. A neonatal streptozotocin-induced diabetic rat model was established and the diabetic rats were assigned into different groups and were treated with different doses of bitter gourd extract (100, 200, 400, or 600 mg/kg) or with glibenclamide (0.1 mg/kg) for 30 d. Fasting blood glucose, insulin, and lipid profile were evaluated and the insulin signaling pathway in the liver and skeletal muscle of rats was investigated. The correlations between homeostasis model assessment (HOMA) and the components of insulin signaling pathway were also evaluated.

Results:
Different doses of bitter gourd extract significantly ameliorated fasting blood glucose level and HOMA index for insulin resistance. Moreover, bitter gourd extract increased serum insulin and improved disrupted serum lipid profile. The levels of insulin receptor substrate-1 (IRS-1), p-insulin receptor β (p-IR-β), protein kinase C (PKC), GLUT2, and GLUT4 were improved by treatment with bitter gourd extract. The best results were obtained with 400 mg/kg dose of the extract, the effect of which was equivalent to that of glibenclamide. HOMA in the bitter gourd treated rats was negatively correlated with p-IR-β, IRS-1 and PKC in hepatic and skeletal muscle. HOMA was also negatively correlated with skeletal muscle GLUT4.

Conclusions:
Bitter gourd extract improves glucose homeostasis and lipid profile in diabetic rats via enhancement of insulin secretion and sensitivity. Therefore, bitter gourd can be used as a potential pharmacological agent for the treatment of type 2 diabetes mellitus.
Guillian--Barre' Syndrome in Patients with SARS-CoV-2
Authors: Dhamne Megha C. , Benny Rajesh , Singh Rakesh , Pande Amitkumar , Agarwal Pankaj , Wagh Satish , Oak Pradyumna , Lakhotia Akshay , Godge Yogesh , Bolegave Vyankatesh , Doshi Darshan , Patidar Yogesh , Venkatachalam Anil , Pujara Bhavin , Borse Sandeep , Makhija Prashant , Khadilkar Satish 
Published: July 2021

Background:
Guillian--Barre' Syndrome (GBS) has been shown to be associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The aim of our study was to study the clinical profile and outcomes of GBS in COVID-19 from the Western region of India, the State of Maharashtra.

Methods:
This was a retrospective, multicenter observation study from different hospitals in Maharashtra beginning from March 2020 until November 2020.

Results:
We report 42 patients with COVID-19 GBS. Mean age was 59 years (range, 24--85 years). 31/42 (73.8%) were men. GBS was the presenting symptom in 14/42 (33%), while six of them remained asymptomatic for COVID-19 despite positive SARS-CoV-2 on nasopharyngeal swab reverse transcriptase polymerase chain reaction. The median interval between COVID-19 and GBS was 14 days (SD + 11), with minimum of 1 and maximum 40 days. Clinical presentation was like that of typical GBS. Electrophysiological studies showed a predominant demyelinating pattern in 25/42 (59.5%). Inflammatory markers were elevated in 35/42 (83.3%) and 38/42 (90.5%) had an Abnormal high-resolution CT (HRCT) chest. 14/42 (33.3%) patients required a ventilator, with nine deaths. Intravenous immunoglobulin was the mainstay of treatment for GBS. Majority had a good outcome and were walking independently or with minimal support at discharge. In subgroup analysis, the postinfectious group had a better outcome than the parainfectious group.

Conclusion:
GBS in COVID-19 occurs as both parainfectious and postinfectious GBS. Parainfectious GBS needs more rigorous monitoring and may benefit from COVID-19 specific treatment. Routine screening for SARS-CoV-2 should be implemented in patients with GBS in view of the ongoing pandemic.
A Study of Prothrombotic Factors in Human Immunodeficiency Virus-Infected Patients
Authors: Lanjiwar Meena , Kumari Pushpa , Khunger Jitendra Mohan , Negi Narender Singh 
Published: July 2021

Introduction:
Human immunodeficiency virus (HIV) infection has been described as a hypercoagulable state. Some studies suggest that thrombotic events may be 2–10 times more prevalent in this group than in the general population. Subjects

and Methods:
This was a single-center, cross-sectional case–control study. Thirty confirmed HIV cases of age group 20–60 years were enrolled. A similar number of age- and sex-matched healthy volunteers were taken as controls. CD4 cell count, protein C, protein S, antithrombin III (AT III), anticardiolipin antibody, and highly sensitivity C-reactive protein (hs-CRP) estimation was done and correlated with the CD4 counts.

Results:
Among HIV cases, 40% were protein C deficient, while 10% were deficient in control group (P = 0.015). One-third (33%) were AT III deficient in HIV-infected group, while none were observed AT III deficient in control group (P < 0.001). Protein C and antithrombin levels did not correlate with CD4 count. Protein S levels were normal in all the HIV-infected cases. Anticardiolipin antibody was not detected in any patient among HIV group. Mean hs-CRP levels in cases and controls were 20.18 ± 12 mg/dl and 3.32 ± 5.13 mg/dl, respectively (P < 0.0005). Conclusion:Protein C deficiency and AT III deficiency were found to be significantly associated with HIV infection. The hs-CRP levels were significantly elevated in HIV-infected patients' protein C deficiency, increased level of hs-CRP, and AT III deficiency did not correlate with CD4 cell count.
Benign pathologies results from lung nodule percutaneous biopsies
Authors: Li Lei , Xu Xiao-Liang , Feng Kai , Liu Xin-Qiang , Yang Jing 
Published: July 2021

Objectives:
The objective was to identify predictors of true negatives in lung nodules (LNs) with computed tomography-guided percutaneous biopsy (CTPB)-based benign pathological results.

Materials and Methods:
We included 90 total patients between January 2013 and December 2017 that had CTPB-based nonspecific benign pathologies and used these patients as a training group to accurately identify true-negative predictors. A validation group of 50 patients from January 2018 to June 2019 to confirm predictor reliability.

Results:
CTPB was conducted on 90 LNs from the training group. True-negative and false-negative CTPB-based pathologies were obtained for 79 and 11 LNs, respectively. CTPB-based benign results had a negative predictive value of 87.8% (79/90). Univariate and multivariate analyses revealed younger age (P = 0.019) and CTPB-based chronic inflammation with fibroplasia (P = 0.010) to be true-negative predictors. A predictive model was made by combining these two prognostic values as follows: score = −7.975 + 0.112 × age −2.883 × CTPB-based chronic inflammation with fibroplasia (0: no present; 1: present). The area under receiver operator characteristic (ROC) curve was 0.854 (P < 0.001). To maximize sensitivity and specificity, we selected a cutoff risk score of −0.1759. The application of this model to the validation group yielded an area under the ROC curve of 0.912 (P < 0.001).

Conclusions:
Our predictive model showed good predictive ability for identifying true negatives among CTPB-based benign pathological results.
Factors influencing postembolization syndrome in patients with hepatocellular carcinoma undergoing first transcatheter arterial chemoembolization
Authors: He Jing-Jing , Yin Xi-Xi , Wang Ting , Chen Min-Ying , Li Xi-Long , Yang Xin-Jing , Shao Hong-Yan 
Published: July 2021

Context:
Postembolization syndrome (PES) is the most common complication in patients with hepatocellular carcinoma (HCC) who had undergone transcatheter arterial chemoembolization (TACE). PES was defined as fever, nausea and/or vomiting, and abdominal pain and these symptoms develop within 1–3 days after TACE. However, few studies have explored the factors influencing PES in patients with TACE for the first time.

Aims:
We explored the factors influencing PES in patients with HCC undergoing TACE for the first time.

Settings and Design:
The present study was a hospital-based study conducted in the tertiary care hospital of Guangzhou with a retrospective study design.

Subjects and Methods:
In this single-center retrospective study, a total of 242 patients with HCC were included in the first TACE program between November 1, 2018 and November 31, 2019.

Statistical Analysis Used:
T-test and Chi-square test revealed the factors affecting the occurrence of PES. Correlation analysis (Spearman) explored the relationship between these factors and PES. Binary logistics analyzed the predictive factors of PES.

Results:
The probability of PES in patients with HCC undergoing TACE for the first time was 55.45%. Types of embolic agents (r = 0.296), types of microspheres (r = 0.510), number of microspheres (r = 0.130), maximum diameter of microspheres used (r = 0.429), type of drug (r = 0.406), and drug loading (r = 0.433) were positively correlated with PES (P < 0.05). Serum albumin was negatively correlated with PES (P = 0.008, r = −0.170). Binary logistic regression analysis revealed that drug loading microspheres (odds ratio [OR] = 0.075, 95% confidence interval [CI] = 0.031–0.180) and serum albumin (OR = 0.182, 95% CI = 0.068–0.487) were the protective factors influencing PES, while drug loading was the risk factor of PES (OR = 1.407, 95% CI = 1.144–1.173).

Conclusions:
Drug loading microspheres, serum albumin, and drug loading were the predictors of PES after the first TACE.
Prognostic role of programmed cell death ligand-1 expression in head and neck cancer treated with programmed cell death protein-1/programmed cell death ligand-1 inhibitors
Authors: Huang Zilu , Zheng Shuohan , Ding Shirong , Wei Yinghong , Chen Chen , Liu Xing , Li He , Xia Yunfei 
Published: July 2021

Purpose:
The purpose of our meta-analysis is to clarify whether the biomarker of programmed cell death ligand-1 (PD-L1) could predict the treatment efficacy and prognosis of programmed cell death protein-1 (PD-1)/PD-L1 immune-checkpoint inhibitors (ICIs) in head and neck cancer (HNC) patients.

Materials and Methods:
We performed the article search in four main online databases. The search deadline was September 8, 2020. To elucidate whether a positive or negative PD-L1 expression correlates with different efficacy and prognosis of PD-1/PD-L1–related therapy in HNC, the relative risk (RR) and 95% confidence interval (95% CI) were pooled. Our meta-analysis assigned the overall survival (OS) at 6 and 12 months and the objective response rate (ORR) for the primary end points.

Results:
The present meta-analysis included 11 relevant studies, which have 1663 HNC cases who received the treatment of PD-1/PD-L1 ICIs. The pooled results revealed that the high or positive expression of PD-L1 predicted better 6- and 12-month OS in head and neck squamous cell carcinoma (HNSCC) (RR 1.30, 95% CI: 1.02–1.65, P = 0.03; and RR 1.31, 95% CI: 1.05–1.62, P = 0.01). PD-L1 expressors were also relevant with higher ORR in HNC patients who had treatment of PD-1/PD-L1 inhibitors compared to PD-L1 nonexpressors (RR 1.84, 95% CI: 1.41–2.41, P < 0.00001).

Conclusions:
In summary, PD-L1–positive HNSCC patients portend favorable OS at 6 and 12 months from PD-1/PD-L1 ICIs. Increased ORR also favored to appear in PD-L1 expressors of HNC or recurrent/metastatic HNSCC who received PD-1/PD-L1 ICIs. Therefore, PD-L1 proved to be an appropriate biomarker to predict the clinical efficacy and prognosis of PD-1/PD-L1 ICIs in HNC.
Combination of thermal ablation and activated functional killer cells immunotherapy for cancer
Authors: Li Yunfang , Li Yuanming , Bie Zhixin , Li Bin , Ma Jie , Li Xiaoguang 
Published: July 2021

Purpose:
The purpose was to evaluate the effect of thermal ablation combined with activated functional killer (AFK) cells immunotherapy for patients with malignant tumors.

Materials and Methods:
A cohort of 10 patients with malignancies received thermal ablation combined with AFK cells immunotherapy. Progression-free survival (PFS), overall survival, laboratory test, and postoperative complications were assessed.

Results:
The success rate of the combination therapy was 100% and no severe complications occurred. Five patients maintained in PFS (50%) during the follow-up. The median PFS was 11 months (range 3.5–16.75 months). The hemoglobin (P = 0.023), hematocrit (P = 0.034), and lymphocyte ratio (P = 0.023); neutrophil-to-lymphocyte ratio (P = 0.038), neutrophil ratio (P = 0.016), albumin (P = 0.006), and alkaline phosphatase (P = 0.029); CA-125 (P = 0.033); and D-dimer (P = 0.011) changed significant after ablation. Whereas the white blood cell count (P = 0.003), neutrophil count (P = 0.024), lymphocyte count (P =0.003), monocyte ratio (P = 0.008), and eosinophil ratio (P = 0.005) changed significantly after combination therapy. The lymphocytes (P = 0.001) in the surviving patients increased more significantly after treatment. After the combination therapy, the percentage of CD3+ cells (P = 0.016) and CD3+ CD8+ cells (P = 0.002) increased, while CD3- CD16+ CD56+ (P = 0.002) and CD4+/CD8+ (P = 0.016) decreased.

Conclusion:
Combination of thermal ablation and AFK cells immunotherapy is a safe and effective method for patients with malignancy. And adoptive immunotherapy with AFK cells may be helpful to prevent recurrence after thermal ablation in patients with advanced cancer.
Overexpression of replication protein A3 is associated with unfavorable outcome in bladder urothelial carcinoma
Authors: Sun Dingqi , Zhang Keqin , Fu Qiang , Zhang Hui , Liu Shuai , Wang Haoran , Xu Zhen , Wang Jinhua 
Published: July 2021

Purpose:
The replication protein A3 (RPA3) is a subunit of the RPA protein complex, which plays an essential role in multiple processes of DNA metabolism. However, the involvement of RPA3 bladder urothelial carcinoma (UC) prognosis has not yet been elucidated. The aim of our study is to investigate the prognostic role of RPA3 expression in patients with bladder UC.

Materials and Methods:
Bladder UC tissue specimens from 155 consecutively treated patients who underwent surgery between 2013 and 2018 were evaluated. The RPA3 expression was determined by immunohistochemistry, Western blot, and correlated with clinicopathological parameters. The prognostic significance of RPA3 expression was explored using the univariate and multivariate survival analysis of 155 patients who were followed.

Results:
A total of 155 tissue specimens “of patients” who were regularly followed with the mean 39.6 months (from 4 to 71 months). The expression of RPA3 was significantly associated with tumor grade (P = 0.031) and stage (P = 0.021), as well as tumor size (P = 0.034). In univariate analysis, RPA3 overexpression showed an unfavorable influence on recurrence-free survival with statistical significance (P < 0.01). TNM stage and grade also showed strong statistical relation with adverse recurrence-free survival (P < 0.01, P = 0.030). Multivariate analysis revealed that grade, stage, and RPA3 reactivity (P = 0.025, P < 0.01, P = 0.016) were identified as independent prognostic factors for recurrence-free survival in patients with bladder UC.

Conclusions:
These results of this study proved that elevated expression of RPA3 was associated with worse clinical outcome in bladder UC patients. This finding suggested that RPA3 served as a potential prognostic biomarker, which could be useful to predict cancer evolution and may represent a novel therapeutic target for the intervention of bladder UC patients.
Detection significance of miR-3662, miR-146a, and miR-1290 in serum exosomes of breast cancer patients
Authors: Li Sha , Zhang Meng , Xu Feng , Wang Ying , Leng Dong 
Published: July 2021

Context:
The potential relationship between exosomal microRNAs (miRNAs) and clinical symptoms in breast cancer patients and the expression levels of exosomal miRNAs in patients undergoing surgery and chemotherapy are still unclear.

Aims:
The aim of this study was to explore the correlation among exosomal miRNAs and clinical features and treatment in breast cancer patients.

Materials and Methods:
First, exosomes were isolated from the serum of patients with breast cancer and healthy controls. Next, the features of exosomes were identified by transmission electron microscopy, nanoparticle tracking analysis, and Western blot assays. Then, we detected the expression of the top-ranked miRNAs (miR-3662, miR-16-1, miR-146a, miR-1290, and miR-29c) in sixty breast cancer patients and twenty healthy controls using quantitative real-time polymerase chain reaction.

Statistical Analysis Used:
The differential expression was measured by the Mann–Whitney U-test.

Results:
The relative expression of miR-3662, miR-146a, and miR-1290 in serum exosomes was significantly higher in patients than healthy controls. Moreover, significant differences were found in the lymph node metastasis and clinical stage of breast cancer as the miRNA levels changed, but their expression levels in exosomes and sera were not correlated. In addition, exosomal miR-3662, miR-146a, and miR-1290 were shown to be valuable biomarkers to monitor patient condition in the course of surgery and chemotherapy.

Conclusions:
Exosomal miR-3662, miR-146a, and miR-1290 may have promising predictive value and could be utilized as biomarkers for diagnosis and preventative strategy development.
Trans-jugular intrahepatic portosystemic shunt in patients with hepatic cellular carcinoma
Authors: Dong Hong , Zhang Cunjing , Li Zheng , Yang Haiyan , Wang Yongzheng , Liu Jibing , Liu Bin , Mao Shuzhi 
Published: July 2021

Purpose:
To analyze the effects of trans-jugular intrahepatic portosystemic shunt (TIPS) on portal hypertension and liver function in patients with hepatocellular carcinoma (HCC).

Materials and Methods:
Thirteen patients with hemorrhage caused by portal hypertension and HCC who received TIPS and antitumor treatment were retrospectively analyzed. Trans-arterial chemoembolization, microwave ablation, target therapy, and immunetherapy or combined therapy were performed to treat HCC. Child-Pugh score was applied to estimate liver functions before and after TIPS. Shunting patency, overall survival (OS), and progression-free survival were analyzed.

Results:
The median age was 58 (interquartile range: 52.5–62.5) years. The ratio with ascites before and after TIPS was 84.6% (11/13) and 7.7% (1/13), with P < 0.001. The ratio with Child-Pugh A before and after TIPS were 61.5% (8/13) and 84.6% (11/13) respectively, with P = 0.179. Mean portal vein pressure before and after TIPS was 27.85 ± 7.02 mmHg and 16.23 ± 6.61 mmHg, respectively, with P = 0.001. Two-year shunting patency rate was 61.5%. Median OS was 29.8 ± 11.5 months (95% confidence interval [CI] 22.8–36.7), and median progression-free survival was 20.2 ± 13.2 months (95% CI 12.2–28.1).

Conclusion:
TIPS could reduce ascites, down-regulate the Child-Pugh score, and give a chance for further anti-tumor therapy.
The Outcome of the Online Virtual Classes During COVID-19 Pandemic
Authors: Albeladi Fatma Ibrahim , Yousof Shimaa Mohammad , Omar Nesreen Nabil , Tash Reham Fathy 
Published: July 2021

Background:
COVID-19 pandemic has affected the educational process greatly in the academic year 2019–2020. Therefore, this warranted an urgent and effective shift and intervention toward the online teaching practice.

Aim:
We have aimed in this study to assess the impact of the necessary shift of the educational process of the basic sciences toward the online distant learning in the female campus; Faculty of Medicine in Rabigh, King Abdulaziz University.

Subjects and Methods:
Promptly shift toward the online teaching practice through virtual classrooms for the 2nd and 3rd year students was accomplished during the second term of the academic year 2019–2020. Following that, we analyzed the efficacy of this shift qualitatively through focus group discussions with the students and the staff members. For objective assessment, we analyzed and compared the students' results of the second term of the academic years 2018–2019 and 2019–2020 regarding the same modules.

Results:
The results of the students were not negatively affected during the pandemic hit. Conversely, the results improved in the basic science modules, and no significant difference was found in the clinically-oriented genetic module.

Conclusion:
The significant move toward the online virtual classrooms did not affect the teaching and learning process negatively. Contrarily, the online teaching and learning practice have proved to be a decent alternative if applied on a sound basis during emergencies and thus is promising as an adjuvant method in the educational process in the ordinary circumstances.