bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suggestion For a New Classification of Postoperative Neurological Complications (CPNC) in Neurosurgery
Authors: Shalamberidze David , Awad Yasar Al , Höpfner Jürgen , Kluge Guido , Benes Ludwig 
Published: March 2021

Abstract
To design a classification concentrating on the art and severity of functional restriction that could include all possible postoperative neurological disturbances and prove its validity to be comparable and easily used in neurosurgery. A seven grade classification was proposed commencing from grade "0" for no neurological disturbances to grade "6" for coma/vegetative state/demise: grade “1”, any remittent neurological disturbances with full improvement spontaneously or as a result of any temporary drug therapy or re-surgery, a single epileptic seizure without the need for anticonvulsant therapy; grade “2”, lasting neurological disturbances resulting in no functional restrictions, no epileptic seizures needing for long-term anticonvulsant therapy; grade “3”, lasting neurological disturbances resulting in slight functional restrictions, rare epileptic seizures despite of anticonvulsant therapy, slight aphasia; grade “4”, lasting neurological disturbances resulting in moderate functional restrictions and partial need of outside help, average frequency of epileptic seizures despite anticonvulsant therapy, moderate aphasia; and grade “5”, lasting neurological disturbances resulting in severe functional restriction and complete need of outside help, high frequency of epileptic seizures despite of anticonvulsant therapy, severe aphasia. The study included a total of 1681 operations at 1530 patients. The postoperative neurological disturbances occurred in 7.7% (n=119) of patients. All postoperative neurological disturbances could be easily classified according to the CPNC. The ranking system was proportional to the length of hospital stay. The CPNC is useful and easily applicable to assess the rates of postoperative neurological disturbances. It can be a comparable instrument in the quality management of neurosurgery.
Mycoremediation of Textile Effluent: A Toxicological Evaluation and its Possible Correlation with COD
Authors: Rajhans Geetanjali , Barik Adyasa , Sen Sudip , Masanta Amrita , Sahoo Naresh , Raut Sangeeta 
Published: March 2021

Abstract
Globally, textile industries are one of the major sectors releasing dye pollutants. This is the first report on the positive correlation between toxicity and COD of textile effluent along with the proposed pathway for enzymatic degradation of acid orange 10 using Geotrichum candidum within a very short stretch of time (18h). Removal efficiency of this mycoremedial approach after 18 h in terms of color, dye concentration as well as reduction of chemical oxygen demand (COD) and biological oxygen demand (BOD) in the treated effluent reached to 89%, 87%, 98.5% and 96.3% respectively. FT-IR analysis of the treated effluent confirmed biodegradation. The LC-MS analysis showed the degradation of acid orange 10, which was confirmed by the formation of two biodegradation products, 7-oxo-8-iminonapthalene-1,3-disulfonate and nitrosobenzene, which subsequently undergoes stepwise hydrogenation and dehydration to form aniline via phenyl hydroxyl amine as intermediate. The X-ray diffraction (XRD) studies showed that heavy metals content in the treated effluent has reduced along with decrease in % crystallinity, indicating biodegradation. The connection between toxicity and COD was also inveterated using Pearson’s correlation coefficient. Further the toxicological studies indicated the toxicity of raw textile effluent and relatively lower toxic nature of metabolites generated after biodegradation by G. candidum.
A case of neck abscess caused by rare hypervirulent Klebsiella pneumoniae, capsular type K20 and sequence type 420.
Authors: McHardy John Alexander , Selvaganeshapillai Vathsalan , Khanna Priya , Whittington Ashley Michael , Turton Jane , Rao Guduru Gopal 
Published: March 2021

Abstract
BackgroundThis case report describes a neck abscess caused by a strain of Hypervirulent Klebsiella pneumoniae in a middle aged man with diabetes without a history of travel to East and South East Asia. This case report is of notable significance as Hypervirulent Klebsiella pneumoniae neck abscesses are rarely seen in the UK and are very infrequently documented in individuals who have not first travelled to the high prevalence areas of East and South East Asia.Case PresentationThis case report describes a 54 year old diabetic man who contracted a Hypervirulent Klebsiella pneumoniae neck abscess which led to the development of sepsis. Klebsiella pneumoniae was cultured from blood cultures and fluid aspirated from the abscess grew the pathogen with same antimicrobial susceptibility. Hypervirulence was demonstrated after the samples were analysed, at the Antimicrobial Resistance and Healthcare Associated Infections Reference Unit Public Health England Colindale, and found to contain the K20 (rmp)A and rmpA2 virulence genes.DiscussionHypervirulent Klebsiella pneumoniae is a gram-negative, encapsulated, non-motile bacillus notable for its ability to metastatically spread and cause potentially life threatening infections in otherwise healthy adults, but especially in those with diabetes. Genes responsible for the production of hyperviscous mucoid polysaccharide capsules and siderophores, such as those isolated in this case, enable the bacteria to more efficiently evade the hosts immune system and disseminate and invade surrounding and distant tissues. Data from Public Health England shows Hypervirulent Klebsiella pneumoniae are rare in the UK. A review of current literature also showed Hypervirulent Klebsiella pneumoniae almost exclusively occur in those who have traveled to East and South East Asia. ConclusionsThis case reported a rare Hypervirulent Klebsiella pneumoniae neck abscess outside of, and without travel to, East and South East Asia. This raises concerns about future, potentially life threatening, Hypervirulent Klebsiella pneumoniae infections becoming more widespread without the need for endemic travel. This concern is further exacerbated by the growing global challenge of antimicrobial resistance.
Combined dural inversion with multiple burr holes for refractory chronic subdural hematoma: A case report.
Authors: Li Tuo , zhu wei , Hao Hongying , Chen Hongguang , Zhang Jianning 
Published: March 2021

Abstract
Background: Chronic subdural hematoma（CSDH） is a common disease in neurosurgery department. Burr-hole drainage is the main surgical treatment. And the recurrence rate is as high as 25%.Case presentation: In this case, a male patient with CSDH in the left frontotemporal parietal region underwent two drilling and drainage operations in the local hospital, but the hematoma recurred after operations. Being unable to bearing the repeated and progressive aggravation of headache, he came to our hospital for treatment. After considering the comprehensive situation, we use a new surgical method, removal of hematoma by drilling multiple holes in the lateral skull, to cure the patient.Conclusions: we get inspirations from the therapy for moyamoya disease, combining dura mater inversion and hole burr, the scalp forms many "meat column" like structures which have powerful capability in absorption through the bone holes, so the scalp could deep into the hematoma, then the CSDH could be cured. This case Provide a new surgical method for the treatment of refractory CSDH. Key words: CSDH R ecur Bone hole Scalp Dural mater inversion
Heme-induced ferroptosis promotes human lumbar disc degeneration analyzed by MALDI-TOF MS
Authors: Shan Liang , Xu Ximing , Zhang Jing , Cai Peng , Gao Han , Lu Yingjie , Shi Jiangang , Guo Yinlong , Su Yue 
Published: March 2021

Abstract
BackgroundNeovasculogenesis is a characteristic of degenerative lumbar discs, which makes extruded tissues exposed to heme-iron cytotoxicity (increased oxidative stress by ferroptosis). However, the present analyses for neovascularization are very complicated, and its mechanism of action is rarely reported.MethodsMatrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was performed to analyze human degenerative lumbar discs. Then, clinical relevance was analyzed between MALDI-TOF MS results and Pfirrmann classification of degenerative discs. In order to explore the mechanism, a heme-induced ferroptosis effect was evaluated both at tissue and cell levels using high-resolution MALDI-TOF MS and molecular biology methods. ResultsThe spectra revealed that hemoglobin (Hb) and heme signals were highly increased, thus serving as biomarkers of vasculogenesis in degenerative tissues. Clinical relevance analysis demonstrated that the intensity of Hb and heme peaks was closely related to Pfirrmann classification of degenerative discs. Mechanically, increased heme catabolism and down-regulation of glutathione peroxidase 4 (GPX4) levels were detected in degenerative discs, reflecting a iron-dependent cell death or ferroptosis. Further, accuracy mass measurements confirmed that the levels of ferroptosis-related metabolites such as glutathione, arachidonic acid (AA), sphinganine, polyunsaturated fatty acid (PUFA), and tricarboxylic acid (TCA) cycle were significantly different between the degenerative and normal tissues, indicating the interior of degenerative tissues was a prooxidant environment. Moreover, the heme-induced ferroptosis was verified in human nucleus pulposus cells, and the underlying mechanism might be associated with the Notch pathway. ConclusionsThe neovascularization in degenerative discs may expose the tissues to high heme toxicity, which further induces the ferroptosis effect within the tissues and accelerates the degeneration progression of discs. This study is beneficial for the pathological mechanism in degenerative discs and facilitate the development of non-operative intervention for lumbar disc herniation (LDH).
Vitamin D level, lipid profile, and vitamin D receptor and transporter gene variants in sickle cell disease patients from Kurdistan of Iraq
Authors: Hama Abdalla Hussein , Shakiba Ebrahim , Rahimi Zohreh , Karimi Mehran , Mozafari Hadi , Abdulkarim Omed Adnan 
Published: March 2021

Abstract
Background. Sickle cell disease patients are susceptible to the development of vitamin D deficiency. Vitamin D through binding to vitamin receptor (VDR) exerts its function and affects gene transcription in target tissues. Also, VDR variants could affect bone mineral density. Methods. In a case-control study 101 sickle cell disease patients including 61 SS, 39 S/β-thalassemia, and 1 SD along with 110 healthy individuals from Kurdistan of Iraq were studied. The lipid profile, vitamin D level, FokI, and TaqI variants of VDR and group-specific component (GC) were detected using the standard enzymatic method, the immunodiagnostic systems limited EIA kit and PCR-RFLP methods, respectively. Results. Around 93 and 82% SS and S/β thalassemia patients, respectively had vitamin D deficiency compared to 83% healthy individuals. Severe vitamin D deficiency (<10 ng/ml) was detected in 78.7% of SS patients. Plasma levels of total cholesterol, HDL-C, and LDL-C in SCD patients were significantly lower compared to controls. Vitamin D levels were negatively correlated to TG and positively correlated to total cholesterol and HDL-C. The frequencies of the C allele of FokI were 81.7 (p=0.003), 80.2 (p=0.034), and 84.6% (p=0.011) in all SCD, SS, and SS/βthal patients, respectively compared to 69.1% in controls. However, no significant difference was detected by comparing the frequencies of VDR TaqI and GC polymorphisms between SCD patients and controls.Conclusion. In the present study we found hypocholesterolemia, high prevalence of VDR FokI C allele, and low vitamin D level among children and adults with SCD patients from Kurdistan of Iraq.
Genotyping-by-sequencing-based identification of Arabidopsis pattern recognition receptor RLP32 recognizing proteobacterial translation initiation factor IF1
Authors: Fan Li , Fröhlich Katja , Melzer Eric , Albert Isabell , Pruitt Rory , Zhang Lisha , Albert Markus , Kim Sang-Tae , Chae Eunyoung , Weigel Detlef , Gust Andrea , Nuernberger Thorsten 
Published: March 2021

Abstract
Pattern-triggered immunity (PTI) is a central component of plant immunity. Activation of PTI relies on the recognition of microbe-derived structures, termed patterns, through plant encoded surface-resident pattern recognition receptors (PRRs). We have identified proteobacterial translation initiation factor 1 (IF1) as an immunogenic pattern that triggers PTI in Arabidopsis thaliana and some related Brassicaceae species. Unlike most other immunogenic patterns identified, IF1 elicitor activity cannot be assigned to a small peptide epitope, suggesting that tertiary fold features are required for IF1 receptor activation. We have deployed natural variation in IF1 sensitivity to identify leucine-rich repeat (LRR) receptor-like protein 32 (RLP32) as the corresponding Arabidopsis receptor using a restriction site-associated DNA sequencing (RAD-seq) approach. Transgenic expression of RLP32 confers IF1 sensitivity to rlp32 mutants, IF1-insensitive Arabidopsis accessions and IF1-insensitive Nicotiana benthamiana. RLP32 binds IF1 specifically and forms complexes with LRR receptor kinases SOBIR1 and BAK1 to mediate signaling. Similar to previously identified PRRs RLP32 confers resistance to Pseudomonas syringae infection, highlighting an unexpectedly complex array of bacterial pattern sensors within a single plant species.
The Role of Pro-fibrotic Myofibroblasts in Systemic Sclerosis: From Origin to Therapeutic Targeting
Authors: Romano Eloisa , Rosa Irene , Fioretto Bianca Saveria , Matucci-Cerinic Marco , Manetti Mirko 
Published: March 2021

:Systemic sclerosis (SSc, scleroderma) is a complex connective tissue disorder characterized by multisystem clinical manifestations resulting from immune dysregulation/autoimmunity, vasculopathy, and, most notably, progressive fibrosis of the skin and internal organs. In recent years, it has been observed that the main drivers of SSc-related tissue fibrosis are myofibroblasts, a type of mesenchymal cells with both the extracellular matrix-synthesizing features of fibroblasts and the cytoskeletal characteristics of contractile smooth muscle cells. The accumulation and persistent activation of pro-fibrotic myofibroblasts during SSc development and progression result in elevated mechanical stress and reduced matrix plasticity within the affected tissues and may be ascribed to a reduced susceptibility of these cells to pro-apoptotic stimuli, as well as their increased formation from tissue-resident fibroblasts or transition from different cell types. Given the crucial role of myofibroblasts in SSc pathogenesis, finding the way to inhibit myofibroblast differentiation and accumulation by targeting their formation, function, and survival may represent an effective approach to hamper the fibrotic process or even halt or reverse established fibrosis. In this review, we discuss the role of myofibroblasts in SSc-related fibrosis, with a special focus on their cellular origin and the signaling pathways implicated in their formation and persistent activation. Furthermore, we provide an overview of potential therapeutic strategies targeting myofibroblasts that may be able to counteract fibrosis in this pathological condition.
Mannosylated Solid Lipid Nanocarriers of Chrysin to Target Gastric Cancer: Optimization and Cell Line Study
Authors: Pandey Sonia S. , Shaikh Farhinbanu I. , Gupta Arti R. , Vaidya Rutvi J. 
Published: March 2021

Background:
Despite significant biological effects, the clinical use of chrysin has been
restricted because of its poor oral bioavailability.

Objective:
The purpose of the present research was to investigate the targeting potential of Mannose
decorated chrysin (5,7- dihydroxyflavone) loaded solid lipid nanocarrier (MC-SLNs) for gastric
cancer.

Methods:
The Chrysin loaded SLNs (C-SLNs) were developed, optimized, characterized and further
mannosylated. The C-SLNs were developed with a high shear homogenizer, optimized with 32
full factorial designs and characterized by Fourier Transform Infrared Spectroscopy (FTIR), Differential
Scanning Calorimetry (DSC), X-Ray Diffraction (XRD) and Scanning Electron Microscope
(SEM) and evaluated for particle size/polydispersity index, zeta-potential, entrapment efficiency,
% release and haemolytic toxicity. The ex-vivo cytotoxicity study was performed on gastric cancer
(ACG) and normal cell lines.

Results:
DSC and XRD data predict the chrysin encapsulation in the lipid core and FTIR results
confirm the mannosylation of C-SLNs. The optimized C-SLNs exhibited a narrow size distribution
with a particle size of 285.65 nm. The % Entrapment Efficiency (%EE) and % controlled release
were found to be 74.43% and 64.83%. Once C-SLNs were coated with mannose, profound change
was observed in a dependent variable - an increase in the particle size of MC-SLNs (307.1 nm) was
observed with 62.87% release and 70.8% entrapment efficiency. Further, the in vitro studies depicted
MC- SLNs to be least hemolytic than pure chrysin and C-SLNs. MC-SLNs were most cytotoxic
and were preferably taken up ACG tumor cells as evaluated against C-SLNs.

Conclusion:
These data suggested that the MC-SLNs demonstrated better biocompatibility and targeting
efficiency to treat gastric cancer.
Teleassistance for Patients With Type 1 Diabetes During the COVID-19 Pandemic: Results of a Pilot Study
Authors: Parise Martina , Tartaglione Linda , Cutruzzolà Antonio , Maiorino Maria Ida , Esposito Katherine , Pitocco Dario , Gnasso Agostino , Irace Concetta 
Published: March 2021

Background
Telemedicine use in chronic disease management has markedly increased during health emergencies due to COVID-19. Diabetes and technologies supporting diabetes care, including glucose monitoring devices, software analyzing glucose data, and insulin delivering systems, would facilitate remote and structured disease management. Indeed, most of the currently available technologies to store and transfer web-based data to be shared with health care providers.

Objective
During the COVID-19 pandemic, we provided our patients the opportunity to manage their diabetes remotely by implementing technology. Therefore, this study aimed to evaluate the effectiveness of 2 virtual visits on glycemic control parameters among patients with type 1 diabetes (T1D) during the lockdown period.

Methods
This prospective observational study included T1D patients who completed 2 virtual visits during the lockdown period. The glucose outcomes that reflected the benefits of the virtual consultation were time in range (TIR), time above range, time below range, mean daily glucose, glucose management indicator (GMI), and glycemic variability. This metric was generated using specific computer programs that automatically upload data from the devices used to monitor blood or interstitial glucose levels. If needed, we changed the ongoing treatment at the first virtual visit.

Results
Among 209 eligible patients with T1D, 166 completed 2 virtual visits, 35 failed to download glucose data, and 8 declined the visit. Among the patients not included in the study, we observed a significantly lower proportion of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) users (n=7/43, 16% vs n=155/166, 93.4% and n=9/43, 21% vs n=128/166, 77.1%, respectively; P<.001) compared to patients who completed the study. TIR significantly increased from the first (62%, SD 18%) to the second (65%, SD 16%) virtual visit (P=.02); this increase was more marked among patients using the traditional meter (n=11; baseline TIR=55%, SD 17% and follow-up TIR=66%, SD 13%; P=.01) than among those using CGM, and in those with a baseline GMI of ≥7.5% (n=46; baseline TIR=45%, SD 15% and follow-up TIR=53%, SD 18%; P<.001) than in those with a GMI of <7.5% (n=120; baseline TIR=68%, SD 15% and follow-up TIR=69%, SD 15%; P=.98). The only variable independently associated with TIR was the change of ongoing therapy. The unstandardized beta coefficient (B) and 95% CI were 5 (95% CI 0.7-8.0) (P=.02). The type of glucose monitoring device and insulin delivery systems did not influence glucometric parameters.

Conclusions
These findings indicate that the structured virtual visits help maintain and improve glycemic control in situations where in-person visits are not feasible.
PRACTICE OF YOGA IN PATIENTS WITH DIABETIC PERIPHERAL NEUROPATHY ATTENDING A TERTIARY CARE HOSPITAL IN NORTHERN INDIA: IMPLICATIONS DURING CORONAVIRUS DISEASE-19 PANDEMIC
Authors: MOR SONIA , SINGH KARAN , WANGNOO SUBHASH KUMAR , BAWA TARUNIKA , DHIKAV VIKAS , ANJUM VARISHA 
Published: March 2021

Objective: The objective of this study was to determine the prevalence of yoga practice in patients with Diabetic Peripheral Neuropathy (DPN) and to compare its acceptance among patients with chronic diseases other than DPN practicing non-yoga physical activities.
Methods: A pre-formed structured questionnaire-based cross-sectional study was conducted with a total of 98 out of 240 patients screened recruited during face to face structured interview, with a diagnosis of DPN. Data on the socio-demographics, age, duration of disease, glycemic controls (hemoglobin A1C [HBA1C] levels), and pain scores, numbness, and physical activity and other comorbid illnesses were collected.
Results: A total of 248 pre-diagnosed diabetic patients were screened; 98 study subjects (M: F=66:32) were enrolled with a mean age found to be 55.28 years. As diagnosed clinically and electrophysiologically, the prevalence of peripheral neuropathy was found to be 39.51%. The mean pain score was 3.27. Risk factors for peripheral neuropathy included male sex, advanced age, higher body mass index (%), higher HbA1C (n=67.34%), having a sedentary lifestyle (38.77%), overweight (43, 44.89%), and obesity (21, 21.42%) and <40% belong to the diabetes of duration group of more than 10 years. A total of 16, male: 9 and female: 5 (22.85%) out of 70 subjects were using yoga as physical activity in peripheral neuropathy group and of the control group (non-peripheral neuropathy group), only 8 (25%) out of 25 were doing yoga. The overall proportions were compared using Chi-square, results were non-significant with p=−0.49; Chi-square statistic −0.47.
Conclusion: This implies that those with DPN are as likely to accept yoga as a physical activity compared to patients with other chronic illnesses practicing non-yoga physical activities.
ORPHAN DRUG POLICY
Authors: GOEL ROSHANI 
Published: March 2021

Pharmaceutical industry is crucial for mankind and contributes in some way in socio economic development of the society through jobs, community welfare, and supply chains. Indian pharmaceutical companies are one of the largest markets in the world, estimated 10% of global production and 2% of world market. The industry is has shown significant growth in infrastructure development, producing wide range of pharmaceutical products with new technical advancements. The country is famous for producing and providing pharmaceutical products at much cheaper prices than the US and EU. However, the country lacks in investment in research on rare disease or orphan drugs. This paper tries to highlight the ways in which the market in orphan drugs can grow in India with the help of international partners.
Objective: The objective of the study was to look at existing orphan drug policies and how we can aim at making it more equitable in India.
Methods: Research is completely based on secondary data from online journals and government data. The study is analytical in its approach and is descriptive in nature.
Results: Pharmaceutical companies invest less in Orphan drugs as they do not mark an assured profit with present investment.
Conclusions: To maintain the interest of Indian pharmaceutical companies it is suggested that, Indian companies should work in collaboration with countries which lead in orphan drug markets.