bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retinopathy of Prematurity Screening Examination and Changes in Vital Signs
Authors: Lahoti Sejal , Jones Richard , Beck Kinley D. , Padidam Sneha , Apple Daniel , Lin Xihui , Quiram Polly , Young Ryan C. , Desireddi Jennifer , Harper C. Armitage 
Published: August 2021

BACKGROUND AND OBJECTIVE:
Dilation and examination during retinopathy of prematurity (ROP) screening can cause systemic complications and even life-threatening adverse events (AEs). The main objective of this study is to assess the prevalence and significance of AEs and changes in vital signs during ROP screenings, and to correlate birth weight, gestational age, and length of exam as possible predictors of these changes.

PATIENTS AND METHODS:
This is a prospective, observational study that includes 1,360 screening exams from 680 premature infants in two neonatal intensive care units. Systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, and oxygen saturation were monitored from the time that dilating drops were administered until 4 hours after the examination was completed. Any clinical deterioration or complication was documented.

RESULTS:
Of 1,360 infant screening exams, 153 (11%) screening exams resulted in at least one change in vital sign that alerted the monitor. There was one serious AE requiring bag valve mask resuscitation 30 minutes after dilating drops were placed. Gestational age, birth weight, and length of ROP exam were not significant predictors of AEs. There were statistically significant changes when comparing pre- and post-vital signs following dilation and funduscopy exam.

CONCLUSIONS:
Although ROP screening exams are essential for at-risk neonates, mydriatic drops and retinal exams can result in changes to vital signs and AEs. It is important to closely monitor neonates during these examinations.

[
Ophthalmic Surg Lasers Imaging Retina
. 2021;52:458–463.]
Synthesis and cytotoxic evaluation of some novel 3-[2-(2-phenyl-thiazol-4-yl)-ethyl]-3H-pyrido[2,3-d]pyrimidin-4-one derivatives
Authors: Rahmani Khajouei Marzieh , Khodarahmi Ghadamali , Ghaderi Aram 
Published: August 2021

Background and purpose:
Pyridopyrimidine and its derivatives have a variety of chemical and biological significances. Thiazole-containing compounds have also been reported to have a wide range of biological activities. Due to the valuable cytotoxic effects of both thiazole and pyridopyrimidinone derivatives, a series of pyridopyrimidinone-thiazole hybrids were synthesized in the present study.

Experimental approach:
Briefly, different acyl chlorides were reacted with 2-amino nicotinic acid followed by anhydride acetic to give the corresponding pyridobenzoxazinones. The aminothiazole derivative G was also prepared via a multistep procedure and incorporated into the benzoxazinones to furnish the target pyridopyrimidinone, K1-K5. Furthermore, the cytotoxic activity of the final compounds was determined against MCF-7 and HeLa cell lines using MTT assay.

Findings/Results:
The results indicated that aromatic substitution on C2 of pyridopyrimidine nucleus was in favor of cytotoxic activity on both cell lines, of which, compound K5 bearing a chlorophenyl group showed the highest cytotoxicity.

Conclusion and implications:
The results of the present study are valuable in terms of synthesis of hybrid molecules and also cytotoxic evaluations which can be useful for future investigations about the design of novel pyridopyrimidinone-thiazole hybrids possessing better cytotoxic activities.
Quinazoline analogues as cytotoxic agents; QSAR, docking, and in silico studies
Authors: Emami Leila , Sabet Razieh , Khabnadideh Soghra , Faghih Zeinab , Thayori Parvin 
Published: August 2021

Background and purpose:
Synthesis and investigation of pharmacological activity of novel compounds are time and money-consuming. However, computational techniques, docking, and in silico studies have facilitated drug discovery research to design pharmacologically effective compounds.

Experimental approach:
In this study, a series of quinazoline derivatives were applied to quantitative structure-activity relationship (QSAR) analysis. A collection of chemometric methods were conducted to provide relations between structural features and cytotoxic activity of a variety of quinazoline derivatives against breast cancer cell line. An in silico-screening was accomplished and new impressive lead compounds were designed to target the epidermal growth factor receptor (EGFR)-active site based on a new structural pattern. Molecular docking was performed to delve into the interactions, free binding energy, and molecular binding mode of the compounds against the EGFR target.

Findings/Results:
A comparison between different methods significantly indicated that genetic algorithm-partial least-squares were selected as the best model for quinazoline derivatives. In the current study, constitutional, functional, chemical, resource description framework, 2D autocorrelation, and charge descriptors were considered as significant parameters for the prediction of anticancer activity of quinazoline derivatives. In silico screening was employed to discover new compounds with good potential as anticancer agents and suggested to be synthesized. Also, the binding energy of docking simulation showed desired correlation with QSAR and experimental data.

Conclusion and implications:
The results showed good accordance between binding energy and QSAR results. Compounds Q1-Q30 are desired to be synthesized and applied to in vitro evaluation.
Duchenne Muscular Dystrophy
Authors: Goyal Manisha , Gupta Ashok , Agarwal Kamlesh , Kapoor Seema , Kumar Somesh 
Published: August 2021

Background:
Duchenne Muscular Dystrophy (DMD) is an X-linked recessive muscular dystrophy that affects young boys and is caused by mutation of the dystrophin gene located over X chromosome.

Materials and Methods:
In this prospective study, 120 clinically diagnosed DMD patients were tested for exon deletions, duplication or point mutation.

Results:
Of the 120 clinically suspected DMD patients, the diagnosis of DMD was confirmed by the genetic study or muscle biopsy in 116 patients. The mean age of onset was 3.2 years and the mean age at presentation was 7.2 years. 110/120 cases were confirmed by genetic testing and six were by absence of staining for dystrophin on muscle biopsy. DMD gene deletion was present in 78.5%, duplication in 5.3% and point mutation in 11.2% cases. 70.3% of patients had deletion located at a distal hot spot region. Single exon deletion was found in 16.5%. Distal hotspot exons 47, 48 and 50 were the commonly deleted exons.

Conclusions:
In our study, 94.8% cases showed genetic change in the DMD gene. Muscle biopsy was the choice of investigation in earlier days. Detection of DMD by DNA based method eliminates the need to do an invasive procedure for diagnosis. Hence the genetic testing should be the investigation of choice in suspected cases of DMD. The pattern of deletion, obtained in the population of Rajasthan was similar when compared with other ethnic groups of the Indian population. It would be helpful for researchers to develop drugs specific to exons or for ongoing mutation-specific therapies.
Factors Affecting Adherence to Pharmacotherapy in Parkinson's Disease
Authors: Aggarwal Shivaansh , Paul Gunchan , Paul Birinder S. , Mahendru Diksha , Goyal Shriya 
Published: August 2021

Background:
The goal of dopaminergic replacement therapy to achieve good clinical outcome in Parkinson's disease (PD) patients largely depends on the pattern of adherence to the pharmacological treatment. This study aims to find the factors affecting medication adherence in patients with PD keeping in mind the cultural, economic, and social diversities so that preventive steps can be taken to fill these gaps.

Methods:
Demographic data, disease parameters, treatment-related factors, family characteristics, educational, and employment status were assessed for relationship with the medication adherence pattern in a cohort of non-demented PD patients. Medication adherence was measured by MMAS-8; depression, and socioeconomic status were assessed by GDS-SF and Kuppuswamy scales respectively.

Results:
From 134 PD subjects, high adherence was observed in 43.2%, 18.2% had moderate, and 38.6% reported low adherence level to their pharmacotherapy. The sub-optimal level of adherence was significantly correlated to compliance of follow up with the physician (p 0.03), presence of adverse events related to drugs (p 0.03), and depressive symptoms (p < 0.0001). Also, there was significant negative co-relationship between poor adherence and depression on Spearman's rank coefficient (0.702). There was no effect of demographic factors, living conditions, family type, educational qualification, associated comorbid conditions, and socioeconomic status on adherence to dopaminergic treatment in patients with PD.

Conclusion:
Poor adherence to prescribed medication is a menace that is more than just oversimplification of forgetfulness which should be evaluated at each visit to improve efficacy of the prescribed regimen to achieve better treatment result and thus quality of life of PD patients.
Conflict Management Styles of Nurses at All India Institute of Medical Sciences, New Delhi, India
Authors: Sharma Tarika , Bhatia Manisha , Andrews Gaddam Rachel , Mahesh R. 
Published: August 2021

Background:
Conflict is an inevitable and integral part of any work environment including nursing. Unresolved conflicts among nurses may lead to increased errors in patient care, affect their morale, and even increase turnover.

Objective:
The objective of the study is to determine the conflict-handling styles practiced by newly joined nursing staff working in a tertiary care hospital.

Materials and Methods:
This descriptive cross-sectional study was conducted on newly joined 297 nurses. Standardized Thomas-Kilmann Conflict Mode Instrument was used to collect the data. Nurses were asked to give answers that characterized their dominant response in a conflict situation.

Results:
A total of 34.7% nurses used accommodating style for conflict management whereas 30.3% used collaborating style. It was followed by compromising, competing, and avoiding styles of conflict management.

Conclusion:
There is a need to enhance nurses' conflict management skills which in long run may lead to improvement in the quality of work as well as job satisfaction among nurses.
Hook Plate Fixation with and Without Coracoclavicular Ligament Augmentation with Suture Anchors for Acute Acromioclavicular Joint Dislocation
Authors: Shih Jen-Ta , Yeh Tsu-Te , Wu Chia-Chun , Shen Pei-Hung , Wang Chih-Chien , Chien Wu-Chien , Chung Chi-Hsiang , Wang Sheng-Hao 
Published: August 2021

Purpose:
The purpose of this study was to evaluate the radiographic and clinical outcomes of hook plate fixation with and without coracoclavicular (CC) ligament augmentation with suture anchors for acute acromioclavicular (AC) joint dislocation.

Methods:
The study included 67 patients (48 males and 19 females; average age: 45.5 years) with acute AC joint dislocation (Rockwood types III and V) treated with hook plate fixation. The patients were divided into two groups: those treated with hook plate fixation with or without CC ligament augmentation with suture anchors. We used the CC distance and ratio as radiographic outcomes. We evaluated the American Shoulder and Elbow Surgeons (ASES) score and the Constant Shoulder Score as functional outcomes. The following were considered major complications: symptomatic acromial osteolysis, peri-implant fracture, acromial cut-out, and hook plate disengagement.

Results:
Among the Rockwood type III patients, there was no significant difference between the two subgroups in terms of the functional outcome after adjusting for sex and age. However, among the type V patients, treatment with CC ligament augmentation with suture anchors revealed a superior outcome in terms of the ASES score (P = 0.01). There was no difference in the risk of developing major complications between the two subgroups among type III and type V patients. The risk of residual subluxation of the AC joint was significantly lower in the CC augmentation subgroup among the type III patients (P = 0.04), and a similar result was obtained among the type V patients with borderline significance (P = 0.06).

Conclusions:
Hook plate fixation with CC suture anchor augmentation provided radiographic benefits in both type III and type V patients and yielded better functional outcomes in type V patients after implant removal but had no significant influence on the complication rate. Additional CC suture anchor augmentation may prevent residual subluxation and yield better functional outcomes.
Outcomes of Intramedullary Steinmann Pin Fixation for Concurrent Fibula Fracture in Comminuted Tibia Shaft or Distal Metaphyseal Tibia Fractures
Authors: Lee Po-Yu , Chen Chiu-Ming , Tseng Hui-Sen , Yang Jui-Jung 
Published: August 2021

Background:
Fracture of the tibia shaft accounts for 17% of lower extremity fractures, with concurrent fibula fracture in about 78% of these cases. Intramedullary fixation for fibula fractures can restore fibula alignment and thus facilitate fracture reduction, especially in cases with comminuted shaft or distal metaphyseal tibia fractures.

Methods:
Patients who had internal fixation of comminuted tibia shaft or distal metaphyseal tibia fracture and a concurrent fibular fracture treated with intramedullary Steinman pin fixation were included in this study. Patients' demographic data and fracture patterns were analyzed retrospectively. Postoperative X-rays were used for fracture union evaluation and alignment analysis.

Results:
Nine males and one female were included in the present study. Tibia fractures were classified as four OTA42 and as six OTA43, including one type I, two type II, one type IIIA, and three type IIIB open fractures. Intramedullary nail and locking plate were used as definitive fixation in four and six cases, respectively. Complications required additional surgeries including wound debridement for one patient, bone graft for three patients, and revision surgery from a broken plate to an intramedullary nail for one patient. A total of 14 fibula fractures were identified in ten patients due to four segmental fractures. Eight were Weber type C, one was Weber type B, and five were midshaft fractures. The mean duration of fibula fracture healing according to radiographs was 6.9 months.

Conclusions:
This study suggests that intramedullary Steinmann pin fixation for concurrent fibula fracture is a critical procedure when dealing with comminuted shaft or distal metaphyseal tibia fractures.
Relationship between Maternal and Infants’ Serum 25-Hydroxyvitamin D, Calcium, and Phosphates in an Exclusively Breastfeeding Population
Authors: Adebiyi Lateefat Oluwakemi , Kuti Bankole Peter , Adegbola Adebanjo Jonathan , Odekunle Jelil , Onuchukwu Chuma , Oyelami Oyeku Akibu 
Published: August 2021

Background:
Maternal nutrition is linked to nutrient supply to breastfeeding infants.

Aim:
This study aimed to determine how maternal serum Vitamin D relates to serum calcium, phosphate, and Vitamin D of exclusively breastfeeding young infants.

Methods:
Mother–infant pairs practicing exclusive breastfeeding at a Nigerian tertiary hospital were recruited and characterized. Their serum 25-hydroxyvitamin D (25-OHD), calcium, and phosphate were analyzed and compared.

Results:
A total of 110 mother–infant pairs were recruited. Mean (standard deviation) ages for mothers and infants were 27.4 (5.0) years and 3.0 (1.4) months, respectively. Thirty-four (30.9%) mothers and 26 (23.6%) infants were Vitamin D deficient. Serum 25-OHD (39.5 [25.0] vs. 33.4 [19.5] ng/ml; P = 0.045) and phosphate (4.9 [1.6] vs. 4.4 [1.8] mg/dl; P = 0.031) were lower in mothers than infants. Maternal 25-OHD correlated positively with infants’ 25-OHD but not with infants’ serum calcium and phosphate.

Conclusion:
Unlike serum calcium and phosphate, optimal maternal serum Vitamin D is necessary to maintain appropriate amount of serum Vitamin D in exclusively breastfeeding infants.
Clinical Characteristics, Etiology, and Outcome of Patients with Adrenal Crisis
Authors: Nabi Tauseef , Rafiq Nadeema , Ur Rahman Mohammad Hifz , Bhat Nikhil 
Published: August 2021

Background:
Adrenal crisis is a life-threatening medical emergency associated with high mortality unless it is recognized early and treated.

Aims:
The aim of this study was to evaluate the clinical characteristics, etiology, and outcomes of patients with adrenal crisis.

Methods:
This was a hospital-based, prospective study of 35 adult patients, age >18 years diagnosed with the adrenal crisis. Patients were studied for clinical, etiological, laboratory parameters, comorbidities, and outcome.

Results:
The mean age of patients with the adrenal crisis was 47.2 ± 16.8 years, and there was female (68.6%) preponderance. The most common mode of presentation was hypotension (100%), shock (94.3%), altered sensorium (28.6%), hyponatremia (45.7%), hypoglycemia (17.1%), and sepsis (37.1%). Hypoglycemia and hyperlactatemia were predominantly found in patients without known adrenal insufficiency before the presentation. Secondary adrenal failure (57.1%) followed by sepsis-related adrenal failure (34.3%) and primary adrenal failure (8.1%) was the most common cause of admission. Secondary adrenal failure comprised of withdrawal of exogenous glucocorticoid therapy (25%), Sheehan syndrome (30%), pituitary surgery (15%), and pituitary tumor (15%). Overall mortality was 17.1%, with the highest mortality for sepsis-related adrenal failure (33.3%). Elderly (age >60 years), altered sensorium, serum sodium <120 mEq/L, hypoglycemia, multiorgan dysfunction syndrome (MODS), and lactic acidosis significantly increase the mortality in adrenal crisis.

Conclusions:
Patients with adrenal crisis carry significant morbidity and mortality with particular emphasis on sepsis-related adrenal failure. The factors predicting mortality in adrenal crisis are elderly, altered sensorium at presentation, severe hyponatremia, hypoglycemia, MODS, and lactic acidosis.
Inertial Measurement Unit-Based Functional Evaluation for Adhesive Capsulitis Assessment
Authors: Chang Chih-Ya , Wu Yung-Tsan , Lin Ching-Yueh , Liu Te-Jung , Ho Tsung-Yen , Shen Yu-Ping , Liu Kai-Chun , Lu Ting-Yang , Chou Li-Wei 
Published: August 2021

Aims:
The inertial measurement unit (IMU), as a sensor-based assessment tool, could provide objective and quantitative data for evaluating a patient with adhesive capsulitis (AC). The IMUs have advantages in simplification of implementation, cost, and computation complexity. We aimed to propose an IMU-based approach to extract statistical features for the assessment of AC in daily activity.

Methods:
Nine healthy subjects and nine AC patients participate in this experiment. The accelerometers are placed on the wrist and arm to measure the movement performance. Each subject is asked to perform three basic shoulder motions, including flexion, extension, and abduction. Eight types of features are extracted from the norm of accelerometer signals, including mean, standard deviation (SD), variation, maximum, minimum, range, kurtosis, and skewness. These features are explored to distinguish the differences in the movement performance between healthy subjects and AC patients.

Statistical Analysis Used:
Student's t-test and effect size (Cohen's d) are calculated to assess the reliability of the proposed evaluation approach.

Results:
The results show that the feature of SD extracted from the wrist can achieve significant differences and large effect sizes between healthy subjects and AC patients.

Conclusion:
We demonstrate the feasibility of the proposed IMU-based functional evaluation for the AC assessment using statistical features.
Suspected Compartment Syndrome and Rhabdomyolysis after “Pseudoephedrine” Use: A Case Report
Authors: Eric Medrano  , Jake Goliver  
Published: August 2021

Acute compartment syndrome and rhabdomyolysis are two life threatening diagnoses that cannot be missed in the emergency room. The increased pressure in the closed compartments of extremities can eventually lead to loss of peripheral pulses, decreased tissue perfusion, and ultimately muscle necrosis. This breakdown of muscle byproducts will ultimately lead to kidney damage and rhabdomyolysis.
Although the most common cause of compartment syndromes are secondary orthopedic causes such as lower extremity fractures there are known documented toxicological causes. (1,2)
Pseudoephedrine, a sympathomimetic amine, is commonly used in the treatment of nasal congestion. Its primary mechanism directly acts on the adrenergic receptor system which stimulates release of stored norepinephrine from neurons. Its alpha-adrenergic effect is believed to be the cause of vasoconstriction in the body (3)
Clinically, intoxication from sympathomimetic drugs have produced toxidromes with prominent features such as tachycardia, hypertension, hyperthermia, agitation, and delirium. However, it is incredibly rare to see an association with pseudoephedrine overdose and rhabdomyolysis and compartment syndrome. There are documented cases where sympathomimetic drugs have been associated with compartment syndrome (2,4,5)
This case of a 29-year-old male with suspected pseudoephedrine abuse highlights the need for consideration of rhabdomyolysis and compartment syndrome being a possible complication from pseudoephedrine overdose.
METODOLOGIA DA UNIDADE PADRÃO DE TEMPO (UP) EM UMA INDÚSTRIA DE CONFECÇÕES
Authors: Santos Valdemar Dias dos 
Published: August 2021

Diante da realidade vivida pelas empresas, em virtude da abertura do mercado e consequentemente da concorrência por ela imposta, os controles de quantidade produzida, custo da produção, ociosidade, capacidade produtiva e tudo mais relacionado à eficiência, se tornaram questão de sobrevivência para quem quer se manter no mercado. No setor de confecções essa realidade não é diferente. Produtos de diversas origens e características se apresentam no mercado e pressionam preços e critérios de desempenho. Especialmente na região Norte do Estado do Paraná. Em comum observa-se a preocupação dessas em estabelecer o preço adequado e competitivo para gerar sobrevivência e capacidade de crescimento. Para isso, a busca da identificação do quanto se gasta para produzir concentra uma vasta gama dos esforços.