bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Efficacy of Physical Therapy Rehabilitation Program for Women Following a Modified Radical Mastectomy: A Case Report
Authors: Gaur Vibhuti , Deshpande Shruti , Burhani Tasneem 
Published: July 2021

Background: The most commonly identified cancer is breast cancer. In either the lobules or the breast ducts, the cancer normally grows. Infiltrating ductal carcinoma is the most common subtype. It may appear as a lump or mass; changes in the skin or nipple; breast rash or redness; or lymphadenopathy.
Presenting Complains and Investigations: the patient presented with the complains of swelling and pain in the left breast in lower outer quadrant since 6 months, which was initially small in size and gradually increased and reached up this level 2x2 cm which placed in infra areolar region covering lower inner and outer quadrant. USG and cytology reports showed bilateral breast with axilla. Right breast was normal, enlarged lymph node in the right axilla measuring 15.2 x 4.6 mm with maintained hilum S/O reactive lymphadenopathy. In left breast there is E/O ill-defined taller than wider irregular hypoechoic lesion with spiculated margins, measuring approximately 15.9 x 12.4 mm in lower inner quadrant containing multiple foci of calcification within showing central vascularity OB doppler on elastography lesion is stiff, in left axilla there is E/O on enlarged USG lymph node present measuring 10.2 x 6.7 mm with maintained hilum S/O reactive lymphadenopathy. Impression of F/S/O malignant lesion in the left breast lymphadenopathy.
Diagnosis: Left sided infiltrating ductal carcinoma.
Therapeutic Intervention and Outcomes: Physical therapy intervention involved a variety of range of motion exercises, strengthening exercises, resistance conditioning, breathing exercises, lymphoedema treatment and scar management. This intensive outpatient program is a successful way to enhance the mobility of the shoulder and ROM during the initial 6-week treatment cycle after surgery. Shoulder range of motion was increased, patient was able to do basic activities of daily living like dressing, bathing, combing, etc. Edema was reduced.
Conclusion: Shoulder stiffness after modified radical mastectomy is the commonest complication. Upper limb mobility exercises reduced the shoulder stiffness. Breathing exercises improved the respiration. Strengthening and general aerobic exercises helped the patient to get back on her normal routine.
Caries Prevention in Adults- Knowledge, Attitude and Practices among Indian Dental Professionals
Authors: Sindi Abdulelah Sameer , Jeri Sumaya Yousuf , Sharma Sarika , Nagrale Renuka G. , Kumar Amit , Jawaid Moazzam , Chhabra Kumar Gaurav 
Published: July 2021

Background: Dentists must have accurate knowledge and affirmative attitudes about dental care in order to prevent dental caries. Therefore, the present was conducted with aim to find out knowledge, attitude and actual practices (KAP) for caries prevention in adults on Indian dentist
Material and Methods: This cross-sectional questionnaire study was conducted on private dental practitioners of Ghaziabad city. Knowledge on preventive dentistry was assessed by 16 questions with true/false or multiple choice pattern. A total of 8 questions each were utilized for attitude and practices, respectively on a 5-point likert scale. Student’s t-test and One way ANOVA followed by post hoc test was applied to determine the relationship between mean scores of KAP and demographic variables. The significance level was set at below 0.05.
Results: Slightly better scores for KAP was found in participants belonging to <30 years of age. The total mean KAP scores of dentists were 8.9 ± 2.2, 26.1 ± 1.7, 21.1 ± 1.9, respectively. Approximately 37% dentist agreed or strongly agreed that fluoride application can prevent dental caries in adults. And 31.5% dentist never advised/performed fluoride application in high caries patients.
Conclusion: Strategies to update dentists’ knowledge and practices of primary preventive measures for dental caries may be beneficial in promoting oral health. Findings help in emphasizing the inception and initiation of preventive oral health policies and services in the Indian scenario.
Evaluation of Platelet Counts in the Normal Pregnancy and other Gestational Conditions at Tertiary Care Hospital of Sindh
Authors: Palwasha . , Bhatti Kanwal Abbas , Gul Fahmida , Memon Sameena Gul , Shaikh Pashmina 
Published: July 2021

Background: During gestational period, the most common disorder is hypertension that directly affects the gestation. The frequency of gestational hypertension is increasing day by day and ultimately the pressure is developed on the endothelial wall. Gestational hypertension mostly reduces the platelet counts.
Aim of Study: The major theme of this research is evaluating the count of platelet during pregnancy and other gestational conditions.
Methodology: A Retrospective research was carried out for the period of 06 months at Gynae and Obstetrics ward at tertiary care hospital of Sindh, Pakistan. Total 104 females were selected with different gestational age and trimester. A questionnaire was filled by all participants that were comprised of demographic data and gestational conditions such as preeclampsia, eclampsia, parity and seizure episodes. Females with highest risk factors diseases such as Diabetes, Hepatic disorder, Anemia, renal disorder and cardio vascular disease were not included in our research. Blood samples were collected from all selected participants for proper platelet count and data was compared with normal ranges of platelet count among the pregnant females. Data was analyzed by using statistical software 24.00 versions.
Results: It was observed that 49 patients were having normal pregnancy, 32 had preeclampsia and 23 had eclampsia. 38 participants were first timer & 52 were having second time parity. 58 participants had 2nd trimester of pregnancy. According to condition of anemia, 27 had severe anemic condition whereas 43 had moderate anemic condition. 49 participants had reduced level of platelet count and 17 had very low platelet count. Severity of gestation can be managed through proper management and physician instructions. Hypertension was measured through severity scale, 29 patients had moderate level of hypertension and 22 had severe level of hypertension. 19 participants had very abnormal level of blood count.
Conclusion: It was concluded that proper diagnostic test should be conducted on time for proper management of reduced platelet count and there should be proper mass counseling should be conducted in order to overcome the deficiency of platelet count. There should be proper diet and exercise during pregnancy that can manage the condition of hypertension. Severity of gestation can be managed through proper management and physician instructions.
Frequency and Sensitivity Patterns of Staphylococcus Aureus in a Tertiary Care Setting
Authors: Khawaja Aneela , Ejaz Asma , Abeer . , Arshad Faiqa , Saleem Zaheer , Farooq Umar , Aneela Syeda 
Published: July 2021

Background: Staphylococcus aureus (SA) is a major etiological pathogen causing multiple infections and broadly known as a serious public health challenge faced due to antibiotic resistance. It is the need of time that infection prevention and control strategies; and antibiotic stewardship policies have to be employed conjointly to minimize the extended rise of antibiotic resistance.
Objectives: To determine the frequency and sensitivity patterns of Staphylococcus aureus in tertiary care setting.
Study Design: Descriptive study
Place & Duration of Study: Pathology Laboratory of tertiary care center from 1st March’ 2020 till 28th February’ 2021.
Materials & Methods: A total 643 Staph. aureus isolated from various clinical specimens received in a tertiary care hospital; were processed and identified by culture, staining and bench tests. Sensitivity testing was done by Disc Diffusion method. Resistance to cefoxitin(30µg) was labelled as Methicillin Resistant Staphylococcus aureus (MRSA). Constitutive and Inducible Clindamycin resistance was also evaluated. (CLSI, 2020-21).
Results: During the study period 125 (19.44%) MRSA were recovered. Statistically, gender distribution regarding MRSA was significant, most of SA was recovered from blood (53.68%), while 46.31% from pus and wound swabs. The frequency of MRSA from Surgical and allied wards was higher (52.63%) than Medicine and allied wards (47.36%). Sensitivity to vancomycin, linezolid and tigecycline was noted 100% by all the isolates. Sensitivity to clindamycin and Doxycycline was 68.42% and 64.81% respectively; while resistance to erythromycin, ciprofloxacin and trimethoprim/sulfamethoxazole was 73.68%, 60% and 57.89%, respectively.
Conclusion: The hazardous infections due to Staphylococcus aureus are worrisome in the present therapeutic scenario. A levelheaded prescription of sensitive antibiotics has to be ensured to minimize the rising frequency of resistant strains of SA.
Nuclear PPAR-γ Activation Modulates Inflammation and Oxidative Stress in Attenuating Chemotherapy-Induced Neuropathic Pain in Vivo
Authors: Pasupulati Haritha , Padi Satyanarayana S. V. , Dodoala Sujatha , Koganti Prasad V. S. R. G. 
Published: July 2021

Background: Paclitaxel-induced painful neuropathy is a major dose-limiting side effect and can persist for up to two years after completing treatment that greatly affects both the course of chemotherapy and quality of life in cancer patients. Peroxisome proliferator-activated receptor (PPAR)-γ belongs to a family of nuclear receptors known for their transcriptional and regulatory roles in metabolism, inflammation, and oxidative stress. However, the role of PPAR-γ activation on paclitaxel-induced neuropathic pain is not yet known.
Objective: To investigate whether pioglitazone, a PPAR-γ agonist reduce paclitaxel-induced neuropathic pain and to elucidate underlying mechanisms.
Methodology: Peripheral neuropathy was induced by administration of paclitaxel (2 mg/kg per injection) intraperitoneally on four alternate days (days 0, 2, 4, 6). Thermal hyperalgesia and mechanical allodynia were assessed and the markers of inflammation and nitroso-oxidative stress were estimated.
Results: Pioglitazone did not induce hypoalgesia and had no effect on locomotor activity. Repeated oral administration of pioglitazone (10 and 20 mg/kg,) for 2 weeks started 14 days after paclitaxel injection markedly attenuated paw withdrawal responses to thermal (hyperalgesia) and mechanical (allodynia) stimuli. Further, pioglitazone administration significantly reduced elevated level of pro-inflammatory cytokine, TNF-α, in both the dorsal root ganglia and the spinal cord accompanied by marked decrease in oxidative stress parameters as well as increase in activity of antioxidant defense enzyme, superoxide dismutase, in the spinal cord after paclitaxel injection.
Conclusion: The results of the present study demonstrate that pioglitazone, a PPAR-γ agonist exerted antinociceptive effect in paclitaxel-induced neuropathic pain through inhibiting neuroimmune inflammation in both the periphery and spinal cord and by reducing nitroso-oxidative stress in spinal cord. Our findings strongly suggest pharmacological activation of PPAR-g as a promising therapeutic target in paclitaxel-induced peripheral neuropathy and provide rationale for the clinical evaluation.
A qualitative assessment of emergency medicine residents’ receptivity to feedback
Authors: Fredette Jenna , Michalec Barret , Billet Amber , Auerbach Heather , Dixon Jessica , Poole Christy , Bounds Richard 
Published: July 2021

AbstractBackgroundEffective feedback is the cornerstone of competency‐based education. The emergency department (ED) is a unique learning and feedback environment. Developing our understanding of emergency medicine (EM) residents’ experiences around feedback will improve resident training and inform EM faculty development programs.ObjectiveThis qualitative study explores the feedback culture and practices in EM and resident's experiences and attitudes toward feedback in this specific training environment.MethodsAt a large categorical EM program, 15 residents voluntarily participated in semistructured interviews regarding feedback. These individual interviews were performed by a nonphysician investigator and transcripts underwent an inductive multistep coding process. Transcripts were analyzed to identify common factors influencing feedback and then comparisons were made between residents to explore the interconnectedness of identified factors and further categorize consistent themes.ResultsFactors inherent to the ED environment make the delivery of effective feedback challenging. Residents also revealed that feedback‐seeking/‐avoidant behavior and receptivity to feedback are multifactorial. Residents actively seek feedback when they feel that they performed well but tend to avoid feedback interactions when they expect constructive feedback. Finally, residents filter feedback based on attending personality and perceived practice style as well as their own desired practice style.ConclusionsIt is important for program leaders to understand their residents’ experiences with feedback and engage both faculty and residents in conversations around feedback delivery and receptivity. An improved understanding of these experiences might also reveal barriers to performance assessment and guide efforts to improve the accuracy and reliability of resident evaluations.
Dose‐response relationship between World Trade Center dust exposure and hepatic steatosis
Authors: Jirapatnakul Artit , Yip Rowena , Branch Andrea D. , Lewis Sara , Crane Michael , Yankelevitz David F. , Henschke Claudia I. 
Published: July 2021

AbstractBackgroundThe World Trade Center (WTC) attack exposed thousands of workers to toxic chemicals that have been linked to liver diseases and cancers. This study examined the relationship between the intensity of WTC dust exposure and the risk of hepatic steatosis in the WTC General Responders Cohort (GRC).MethodsAll low‐dose computed tomography (CT) scans of the chest performed on the WTC GRC between September 11, 2001 and December 31, 2018, collected as part of the World Trade Center Health Program, were reviewed. WTC dust exposure was categorized into five groups based on WTC arrival time. CT liver density was estimated using an automated algorithm, statistics‐based liver density estimation from imaging. The relationship between the intensity of WTC dust exposure and the risk of hepatic steatosis was examined using univariate and multivariable regression analyses.ResultsOf the 1788 WTC responders, 258 (14.4%) had liver attenuation less than 40 Hounsfield units (HU < 40) on their earliest CT. Median time after September 11, 2001 and the earliest available CT was 11.3 years (interquartile range: 8.0–14.9 years). Prevalence of liver attenuation less than 40 HU was 17.0% for arrivals on September 11, 2001, 16.0% for arrivals on (September 12, 2001 or September 13, 2001), 10.9% for arrivals on September 14–30, 2001, and 9.0% for arrivals on January 10, 2001 or later (p = 0.0015). A statistically significant trend of increasing liver steatosis was observed with earlier arrival times (p < 0.0001). WTC arrival time remained a significant independent factor for decreased liver attenuation after controlling for other covariates.ConclusionsEarly arrival at the WTC site was significantly associated with increasing hepatic steatosis.
Incidence and timing of biphasic anaphylactic reactions: a retrospective cohort study
Authors: Ichikawa Motohiro , Kuriyama Akira , Urushidani Seigo , Ikegami Tetsunori 
Published: July 2021

AimWe investigated the frequency of overall biphasic reactions, biphasic reactions that met the diagnostic criteria of anaphylaxis, and biphasic reactions that caused a severe abnormality in vital signs in patients who visited the emergency department of a tertiary hospital.MethodsThis retrospective cohort study included patients aged 18 years or over who presented with anaphylaxis at the emergency department of a tertiary care hospital between January 2014 and December 2016. The primary outcome was the incidence of biphasic reactions that caused a severe abnormality in vital signs and developed within 7 days. Secondary outcomes were the frequency of overall biphasic reactions and those that met the diagnostic criteria of anaphylaxis.ResultsIn total, 437 patients aged over 18 years visited the emergency department during the study period. Among them, 202 were enrolled in this study. The proportion of patients who had overall biphasic reactions, those that met the diagnostic criteria of anaphylaxis, and those with a severe abnormality in vital signs was 8.9%, 3.0%, and 1.0%, respectively. Overall, 32.7% of patients were hospitalized, but hospitalization aided in the treatment of severe biphasic reactions at the early stage in only one patient.ConclusionWe found that 8.9% of adult patients with anaphylaxis had a biphasic reaction, but biphasic reactions together with severe abnormalities in vital signs were rare.
Chiral Distorted Hexa‐peri‐hexabenzocoronenes Bearing a Nonagon‐Embedded Carbohelicene
Authors: Medel Miguel A. , Cruz Carlos M. , Miguel Delia , Blanco Victor , Morcillo Sara P. , Campaña Araceli G. 
Published: July 2021

AbstractA new family of chiral saddle‐helix hybrid nanographenes is reported. The first hexa‐peri‐hexabenzocoronene (HBC) analogues bearing a nine‐membered carbocycle are presented. Furthermore, for the first time, π‐extended carbo[n]helicenes containing a nine‐membered ring as part of the helical moiety have been synthesized. The combination of a [5]helicene moiety and a nonagon ring in a single chiral motif induces a tremendous distortion from planarity into the nanographenic structures compared to other saddle‐helix hybrids such as heptagon‐ and octagon‐containing π‐extended carbo[5]helicenes. In fact, the interplanar angle of the two terminal rings reaches the largest angle (134.8°) of a carbohelicene reported to date, thus being by far the most twisted helicene yet prepared. Photophysical properties evaluation showed improved absorption dissymmetry factors (|gabs|=4.2×10−3) in the new family of nonagon‐containing π‐extended carbo[5]helicenes.
Effect of crump rubber on the solid particle erosion response of epoxy composites
Authors: Shahapurkar Kiran , Soudagar Manzoore Elahi M. , Shahapurkar Pavan , Mathapathi Mahantayya , Khan T. M. Yunus , Mujtaba M. A. , Ali M. D. Irfan , Thanaiah Kumara , Siddiqui Md Irfanul Haque , Ali Masood Ashraf 
Published: July 2021

AbstractPresent investigation characterizes solid particle erosion response of neat epoxy and crump rubber filled epoxy composites. Three types of composites were prepared by reinforcing crump rubber particles (10, 20 and 30 vol.%) in epoxy matrix. Neat epoxy samples were also prepared for comparison. Thermo gravimetric analysis revealed crump rubber composites have higher stability as compared with neat epoxy specimen. Differential scanning calorimeter tests reveal higher glass transition temperature for crump rubber composites as compared with neat epoxy specimens. Erosion rate of the samples have been studied for different angles of impingement (30, 45, 60 and 90°) and erodent impact velocity (30, 45 and 60 m/s). 30 vol.% of crump rubber reinforced epoxy composites reveal better resistance to erosion in comparison with other composites and neat epoxy; attributed to the elastic nature of crump rubber particles to absorb impact energy of erodent particles. For all the specimens, maximum erosion is noted at 60° angle of impingement indicating semi‐ductile response to erosion. Erosion efficiency and velocity exponent of samples also substantiate the semi‐ductile behavior. Morphology of the eroded surfaces was analyzed using scanning electron microscope. Property map is used to compare the results available from the literature with the present study.
Fast quasi‐sliding mode control of unknown QUAVs: A data‐driven cascade control approach
Authors: Weng Yongpeng , Nan Dong , Wang Ning 
Published: July 2021

AbstractIn this paper, the fast trajectory tracking of unknown quadrotor unmanned aerial vehicles (QUAVs) in the presence of disturbances and unmodeled dynamics is addressed, whereby a novel fast quasi‐sliding mode control (FQSMC) approach via data‐driven cascade control technique is proposed. Salient contributions include (1) an equivalent data‐based model for unknown QUAV, via data‐driven technique, is innovatively established, thereby contributing to data‐driven sliding‐mode surface which effectively deals with the model‐unavailable problem; (2) within this scheme, quasi‐sliding mode controller and finite‐time quasi‐sliding mode controller in a cascade form, by utilizing the high‐order sliding mode control strategy, virtual control scheme, and finite‐time control technique, are devised for outer‐loop position subsystem and inner‐loop attitude subsystem, respectively, thereby contributing to fast tracking speed and strong robustness to disturbances and unmodeled dynamics; (3) utilizing the Lyapunov approach and finite‐time theory, the finite‐time asymptotic tracking of the attitude subsystem and thereafter the asymptotic tracking of the position subsystem can be guaranteed. Simulation studies are finally conducted to testify the efficacy and superiority of the devised FQSMC scheme.
Effect of Nigella sativa oil on pharmacokinetics and pharmacodynamics of gliclazide in rats
Authors: Adiwidjaja Jeffry , Sasongko Lucy 
Published: July 2021

AbstractNigella sativa oil (NSO) has been used widely for its putative anti‐hyperglycemic activity. However, little is known about its potential effect on the pharmacokinetics and pharmacodynamics of antidiabetic drugs, including gliclazide. This study aimed to investigate herb–drug interactions between gliclazide and NSO in rats. Plasma concentrations of gliclazide (single oral and intravenous dose of 33 and 26.4 mg/kg, respectively) in the presence and absence of co‐administration with NSO (52 mg/kg per oral) were quantified in healthy and insulin resistant rats (n = 5 for each group). Physiological and treatment‐related factors were evaluated as potential influential covariates using a population pharmacokinetic modeling approach (NONMEM version 7.4). Clearance, volume of distribution and bioavailability of gliclazide were unaffected by disease state (healthy or insulin resistant). The concomitant administration of NSO resulted in higher systemic exposures of gliclazide by modulating bioavailability (29% increase) and clearance (20% decrease) of the drug. A model‐independent analysis highlighted that pre‐treatment with NSO in healthy rats was associated with a higher glucose lowering effect by up to 50% compared with that of gliclazide monotherapy, but not of insulin resistant rats. Although a similar trend in glucose reductions was not observed in insulin resistant rats, co‐administration of NSO improved the sensitivity to insulin of this rat population. Natural product–drug interaction between gliclazide and NSO merits further evaluation of its clinical importance.