bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chlamydia infection as a risk factor in ectopic pregnancy: a case control study
Authors: George Angela , S. Shaila 
Published: September 2018

Background: Chlamydia trachomatis has been linked to 30-50% of all ectopic pregnancies, due to irreversible tissue damage. Hence it is pertinent to explore the risk factors pertaining to Chlamydia infection and ectopic pregnancies. The aim is to study whether Chlamydia infection is a risk factor for ectopic pregnancy in comparison with early intrauterine pregnancy, and study other risk factors in ectopic pregnancyMethods: Case-control study conducted at Sree Avittom Thirunal Hospital, Thiruvananthapuram over a period of six months taking 43 subjects in each group, i.e., cases and controls. An interview followed by collection of venous blood sample was done, which was subjected to Enzyme linked immunoassay test to detect Immunoglobulin G antibodies to Chlamydia. Comparison of qualitative variables such as age, socioeconomic status, history of infertility, history of pelvic inflammatory disease, previous history of ectopic pregnancy, use of IUCD, history of IVF, use of OCP or progesterone only pills and presence of Chlamydia IgG antibodies - between two groups was analyzed by chi-square test and the strength of association expressed in terms of Odds Rati. A p-value <0.05 was considered statistically significant.Results: Out of 86 samples 54 were positive for Chlamydia infection. Subjects with Chlamydia infection had an increased risk of developing ectopic pregnancy. Among the other risk factorshistory of pelvic inflammatory disease and history of infertility were the most significant with Odds of 3.46 and 3.98 respectively. History of oral contraceptive use also had a significant risk associated with developing ectopic pregnancy. Other factors with significant association included, age more than 25 years, Upper Socioeconomic Class, previous ectopic pregnancy and history of IUCD use for more than 5 years.Conclusions: The increased number of Chlamydia infection and its increased risk for developing irreversible sequels such as ectopic pregnancy, it is pertinent to vigilantly diagnose, treat and prevent vaginal infection and pelvic inflammatory disease.
Analisis Historis terhadap Corak Kesenian Islam Nusantara
Authors: Nurrohim Nurrohim , Setyorini Fitri Sari 
Published: September 2018

The history of Islamic development in Indonesia has different characteristics compared to other Islamic regions such as Turkey, India, Egypt, Syria, and Morocco. The journey of Islam in Indonesia brings different colors and patterns that distinguish it from other Islamic regions. This happens because Islam is spreaded in the archipelago peacefully and in a gradual long time, unlike the other Islamic regions islamization which is not infrequently through the power of the armed forces. This article will explain the results of Islamic interaction with society who previously embraced Hinduism, Buddhism and animist beliefs dynamism in the form of Islamic Nusantara arts. The analytical method used in this paper is a combination of theories of acculturation and assimilation of Nusantara culture and Islamic culture. The combination of Nusantara culture and Islamic culture produces an Islamic art with the uniqueness of Nusantara without eliminating the elements of the old culture. The form of pre-Islamic Nusantara cultural heritage with the Islamic culture can be found in the architecture of mosques, Arabic Malay script, literary arts, painting and sculpture.
PRÁTICAS TEATRAIS: UM ELEMENTO LÚDICO NO PROCESSO DE ENSINO-APRENDIZAGEM DE LÍNGUA ESTRANGEIRA
Authors: Couto Aldenice De Andrade , Magalhães dos Reis Maria da Glória 
Published: September 2018

<p>Este artigo apresenta algumas reflexões sobre as práticas teatrais no processo de ensino-aprendizagem de uma língua estrangeira, e como a referida prática pode ser um elemento lúdico para ensinar-aprender uma língua estrangeira. O arcabouço teórico utilizado para dar suporte a esta investigação contempla autores que abordam os conceitos de atividades teatrais e atividades lúdicas. Desta forma, a partir dos resultados deste estudo, ressalta-se que o teatro pode ser um real suporte pedagógico para um professor de Língua Estrangeira (LE) que busca desenvolver a expressão oral de seus alunos. Pode-se dizer, ainda, Payet (2010), que o teatro pode não somente auxiliar no que concerne à expressão oral, mas todas as competências que o professor deseja trabalhar nas aulas de LE. Além disso, o teatro pode se mostrar como um verdadeiro meio para favorecer a fala dos sujeitos que aprendem uma língua estrangeira, graças ao seu lado lúdico, que desmistifica o esforço da aprendizagem e determina a motivação e a atitude dos alunos rumo ao objeto da aprendizagem, e que acelera o processo de aquisição. </p>
Current approaches to the morphological diagnosis of pancreatic neuroendocrine tumors and prediction of their clinical course based on the analysis of our own database
Authors: Gurevich L. E. , Kazantseva I. A. 
Published: September 2018

Aim:Combined clinical and morphological analysis of the pancreatic neuroendocrine tumor (pNET) spectrum according to the new World Health Organization classification: patient distribution, hormonal status, morphological grading, somatostatin receptor 2 (SSR2) and 5 (SSR5) expression, the choice of tissue-specific markers for the differential diagnosis of primary NET in the pancreas based on metastases with unknown primary tumor.Materials and methods:The study was performed with 472 tissue samples from pNETs taken from patients. Morphological analysis consisted of histological and immunohistochemical examination with a panel of antibodies to chromogranin A, synaptophysin, CD56, insulin, glucagon, somatostatin, gastrin, calcitonin, adrenocorticotropic hormone (ACTH), serotonin, pancreatic polypeptide, cytokeratins (CK) of a wide spectrum, CK7 and CK19, p53, Ki-67, SSR 2 and SSR5, PDX-1, Isl-1, and NESP-55.Results:In women, the prevalence of pNETS was 2.3 higher than in men (2.3:1). We were able to identify 299 (63.3%) insulinomas, 134 (28.4%) non-functioning NETs, 28 (5.9%) gastrinomas and 1.8% rare tumors (somatostatinomas, “calcitoninomas” and ACTH-producing). Metastatic tumors were found in 16.5% of the cases. Multiple endocrine neoplasia syndrome type 1 was confirmed in 11.9% of the pNET patients, and in 30.8% of those aged below 30 years. Multiple tumors (2 to 10) were found in 32 patients by the time of the diagnosis or occurred at 7 to 18 years after initial surgery. 28.3% of the tumors were CK19-positive, with 54.4% of them being metastatic. Insulinomas were least prone to metastasizing (5.7% of the cases), with 41.2% of them being CK19-positive. Metastases were found in 70.4, 66.7, 100, and 100% of gastrinomas, “calcitoninomas”, ACTH-producing, and somatostatinomas, respectively, with CK19-positivity found in 85.2, 66.7, 66.7, and 100% of these tumors. SSR2 expression was observed in all gastrinomas and “calcitoninomas”, in 90.5% of “glucagonomas”, 85.7% of PPomas, and 66.7% of somatostatinomas. SSR5 expression was significantly less frequent. 86.3% of the studied tumors were PDX-1-positive: all somatostatinomas, 97.4% of insulinomas, 92.3% of gastrinomas, 83.3% of PPomas, 80% of the non-functioning NETs. PDX-1-negativity was identified in all “calcitoninomas” and in 57.1% of the non-functioning “glucagonomas”. 83.3% and 90.9% of the pNETs were Isl-1 and NESP-55-positive, respectively.Conclusion:Combined morphological and immunohistochemical examination of pNETs allows for the correct diagnosis, assessment of their prognosis and choice of the most effective treatment. The malignancy grade of pNETs depends on the cell immunophenotype and is higher in the cases with co-expression of the markers of neuroendocrine and ductal differentiation (CK19), as well as with ectopic hormonal production.
Unfavorable Outcomes Following Surgical Treatment of Hallux Valgus Deformity
Authors: Barg Alexej , Harmer Joshua R. , Presson Angela P. , Zhang Chong , Lackey Mellanye , Saltzman Charles L. 
Published: September 2018

Background:
Surgical correction of deformity plays a central role in the treatment of hallux valgus deformity. However, complications or unintended outcomes are frequently noted in clinical series. There has been no rigorous systematic review of studies reporting outcomes of surgical treatment for hallux valgus deformity, to the best of our knowledge.

Methods:
We performed a systematic review of studies reporting the outcomes of surgical correction for hallux valgus deformity.

Results:
A total of 229 studies met the inclusion criteria. The pooled rates of postoperative patient dissatisfaction and postoperative first metatarsophalangeal pain were 10.6% and 1.5%, respectively. The overall rate of recurrent deformity was 4.9%.

Conclusions:
Hallux valgus surgery has been reported to have fairly consistent results and rates of complications or unfavorable outcomes.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Assessment of Ankle Mortise Instability After Isolated Supination-External Rotation Lateral Malleolar Fractures
Authors: Jeong Bi O. , Kim Tae Yong , Baek Jong Hun , Song Seung Hyun , Park Ji Seon 
Published: September 2018

Background:
The diagnosis of clinically important instability following isolated supination-external rotation (SER) distal fibular fractures is a challenge. The purpose of this study was to investigate the accuracy of clinical findings including medial tenderness, swelling, and ecchymosis, combined with the gravity stress test and magnetic resonance imaging (MRI), in the assessment of ankle mortise stability in association with isolated SER-type lateral malleolar fractures. The external rotation (ER) stress test was used as the reference with which the methods of assessment were compared.

Methods:
Thirty-seven patients were enrolled prospectively. Using the ER stress test as a reference, we evaluated the sensitivity, specificity, likelihood ratio (LR), and post-test probability of instability when using clinical examination, the gravity stress test, and MRI for diagnosing ankle mortise instability after an isolated SER lateral malleolar fracture.

Results:
The positive LR for clinical findings ranged from 1.45 to 2.54, and the negative LR ranged from 0.25 to 0.70, shifting the pre-test probability to a rarely important degree. In contrast, the positive LR for the gravity stress test was 5.71 with a 95% confidence interval (CI) of 1.52 to 21.48, a moderate shift from the pre-test probability, and the negative LR was 0.33 (95% CI = 0.16 to 0.66), indicating a small shift. In cases with a deep deltoid ligament disruption identified on MRI, the positive LR was 3.05 (95% CI = 1.03 to 9.02) and the negative LR was 0.53 (95% CI = 0.31 to 0.91), demonstrating a small but sometimes important shift.

Conclusions:
The gravity stress test is a reliable method for diagnosing ankle mortise instability in patients with an isolated SER lateral malleolar fracture. Nevertheless, this test alone would not qualify as a replacement for the ER stress test. However, when the gravity stress test result is consistent with the clinical or MRI findings, its diagnostic value is almost equivalent to that of the ER stress test.

Level of Evidence:
Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Progressive Autonomy in the Era of Increased Supervision
Authors: Dougherty Paul J. , Cannada Lisa K. , Murray Peter , Osborn Patrick M. 
Published: September 2018

Abstract:
The observation of decreased resident autonomy, ultimately influencing the readiness of a new graduate to practice, has been supported with a number of recent surveys. This perceived lack of autonomy is felt to be due, in part, to many reasons, including duty-hour regulations, increased supervision requirements, patient safety measures, concern for complication rates, and other performance measures. Pressure on faculty members to have increased clinical productivity may not allow for more resident autonomy.
Increased clinical exposure to improve resident independence may come from several suggested areas. First, restructuring the residency program to allow for more clinical time may be one way to improve education. Second, increased use of surgical simulation will allow for more experience to develop technical skills within a controlled environment. Surgical simulators can be used to acquire new skills and also as a means of assessing competence. Third, competency-based education (CBE) has been offered as a way to improve resident education. At its core, CBE offers criterion-based assessments for residents and faculty that allow for more frequent feedback.
Botulinum Toxin Type A Versus Placebo for Idiopathic Clubfoot
Authors: Alvarez Christine M. , Wright James G. , Chhina Harpreet , Howren Alyssa , Law Peggy 
Published: September 2018

Background:
Congenital idiopathic clubfoot is a condition that affects, on average, approximately 1 in 1,000 infants. One broadly adopted method of management, described by Ponseti, is the performance of a percutaneous complete tenotomy when hindfoot stall occurs. The use of onabotulinum toxin A (BTX-A) along with the manipulation and cast protocol described by Ponseti has been previously reported. Our goal was to compare the clinical outcomes between BTX-A and placebo injections into the gastrocnemius-soleus muscle at the time of hindfoot stall in infants with idiopathic clubfoot treated with the Ponseti method of manipulation and cast changes.

Methods:
This was a double-blind, placebo-controlled, parallel-group study with balanced randomization.

Results:
At 6 weeks after the study injection (T1), 66% of the 32 feet in the BTX-A arm and 63% of the 30 in the placebo arm responded to the treatment (i.e., obtained ≥15° of dorsiflexion). Seven of the 11 patients in the BTX-A arm and all of the 11 in the placebo arm who had not responded at T1 responded to a rescue BTX-A injection at 12 weeks after the first injection (T2). The combined response rate at T2, which included the first-time responders as well as the patients who did not respond at T1 but did at T2, was 88% in the BTX-A arm and 100% in the placebo arm, culminating in a 94% response rate at T2. At T3 (2 years of age), 89% of the feet continued to respond and there was an 8% surgical rate.

Conclusions:
There was no difference in outcomes between the BTX-A and placebo groups when the injection was performed at the time of hindfoot stall. Overall, 92% of the clubfeet in this study responded to a manipulation and cast protocol alone, with or without BTX-A injection, by 12 weeks after hindfoot stall, or we can say that 92% of the clubfeet did not require percutaneous Achilles tendon lengthening by 2 years of age. The need for tenotomy is limited to those who have not responded to treatment at this point, and the need for surgery is limited to those for whom all attempts at treatment with sequential casts, BTX-A, and percutaneous Achilles tendon lengthening have failed.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Local Versus Systemic Antibiotics for Surgical Infection Prophylaxis in a Rat Model
Authors: Sweet Fred A. , Forsthoefel Craig W. , Sweet Andrea R. , Dahlberg Ryan K. 
Published: September 2018

Background:
The purpose of this study was to compare the local application of a variety of antimicrobial agents with intravenous (IV) antibiotics for infection prophylaxis in a rat model.

Methods:
A total of 120 adult male Sprague-Dawley rats were implanted with an expanded polytetrafluoroethylene (ePTFE) vascular graft in a submuscular position and challenged with 2 × 107 colony-forming units of methicillin-sensitive Staphylococcus aureus (MSSA). Twenty rats received pretreatment with IV cefazolin and 20 rats were pretreated with IV vancomycin. The remaining 80 rats had application of local antimicrobials in the wound at the conclusion of the procedure: 20 rats received vancomycin powder; 20 rats, cefazolin powder; and 20 rats, tobramycin powder; 20 rats underwent dilute 0.35% Betadine (povidone-iodine) lavage for 3 minutes. One week after surgery, the grafts were retrieved and cultured.

Results:
Twenty (100%) of 20 rats in each of the IV cefazolin, IV vancomycin, and dilute Betadine lavage groups had grossly positive cultures for MSSA (95% confidence interval [CI], 84% to 100%). Eighteen (90%) of 20 rats in the cefazolin local powder group demonstrated positive cultures for MSSA (95% CI, 77% to 100%). Four (20%) of 20 rats in the tobramycin local powder and vancomycin local powder groups demonstrated positive cultures for MSSA (95% CI, 3% to 38%). The infection rates for the local application of vancomycin and tobramycin powder were significantly lower compared with Betadine lavage, IV vancomycin, IV cefazolin, and local cefazolin powder (p < 0.000001).

Conclusions:
Local antimicrobial prophylaxis with vancomycin and tobramycin powder for infections in the rat model was statistically superior to systemic prophylaxis with IV antibiotics, local cefazolin powder, and Betadine lavage.

Clinical Relevance:
This study supports the findings of prior clinical reports that intrawound vancomycin powder reduces the risk of surgical site infection. Local application of tobramycin powder was equivalent to vancomycin powder in this model. Additionally, the superiority of local antibiotic surgical prophylaxis suggests that clinical studies should be considered to determine the relative efficacy of local versus systemic antibiotics for surgical infection prophylaxis in humans.
The Level of Cytokines in the Vitreous Body of Severe Proliferative Diabetic Retinopathy Patients Undergoing Posterior Vitrectomy
Authors: Raczyńska Dorota , Lisowska Katarzyna A. , Pietruczuk Krzysztof , Borucka Joanna , Ślizień Mateusz , Raczyńska Krystyna , Glasner Leopold , Witkowski Jacek M. 
Published: September 2018

Objective: The objective of the study was to compare cytokine levels in the vitreous body of patients
with proliferative diabetic retinopathy (PDR) undergoing posterior vitrectomy.

Patients and methods:

The study included 39 patients (39 eyes) undergoing pars plana vitrectomy (PPV). Patients
were divided into three groups: patients with proliferative diabetic retinopathy (PDR) without aflibercept
injection prior to the surgery, PDR patients administered aflibercept injection prior to the surgery, and patients
without diabetes mellitus (control group). All patients underwent a comprehensive eye examination one day before
and 3 weeks after the surgery, including measurements of: best-corrected visual acuity (BVCA) and intraocular
pressure (IOP), slit-lamp examination and spectral domain optical coherence tomography (SOCT). Concentrations
of cytokines: IL-6, IL-8, IL-12p70, TNF, IL-10, IL-1β were measured in the vitreous body of patients with
BD™ Cytometric Bead Array (CBA) Human Inflammatory Cytokines Kit.

Results:
PDR patients who received pretreatment with aflibercept injection showed significantly lower concentrations
of IL-12p70, TNF, IL-10 and IL-1β in the vitreous body compared to the control group. Meanwhile, patients
without prior aflibercept injection had a significantly higher concentration of IL-8. There was also a significant
positive correlation between IOP before PPV and IL-8 concentration in both PDR patients’ groups.

Conclusion:
Findings of our study suggest an important role of IL-8 in the development of severe PDR. Aflibercept
administration on the day before elective vitrectomy facilitated the surgery.
Cancer Nanotechnology: A New Revolution for Cancer Diagnosis and Therapy
Authors: Chaturvedi Vivek K , Singh Anshuman , Singh Vinay K. , Singh Mohan P. 
Published: September 2018

Background:Nanotechnology is gaining significant attention worldwide for cancer treatment. Nanobiotechnology encourages the combination of diagnostics with therapeutics, which is a vital component of a customized way to deal with the malignancy. Nanoparticles are being used as Nanomedicine which participates in diagnosis and treatment of various diseases including cancer. The unique characteristic of Nanomedicine i.e. their high surface to volume ratio enables them to tie, absorb, and convey small biomolecule like DNA, RNA, drugs, proteins, and other molecules to targeted site and thus enhances the efficacy of therapeutic agents.Objective:The objective of the present article is to provide an insight of several aspect of nanotechnology in cancer therapeutics such as various nanomaterials as drug vehicle, drug release strategies and role of nanotechnology in cancer therapy.Methods:We performed an extensive search on bibliographic database for research article on nanotechnology and cancer therapeutics and further compiled the necessary information from various articles into the present article.Results:Cancer nanotechnology confers a unique technology against cancer through early diagnosis, prevention, personalized therapy by utilizing nanoparticles and quantum dots.Nano-biotechnology plays an important role in the discovery of cancer biomarkers. Quantum dots, gold nanoparticles, magnetic nanoparticles, carbon nanotubes, gold nanowires etc. have been developed as a carrier of biomolecules that can detect cancer biomarkers. Nanoparticle assisted cancer detection and monitoring involves biomolecules like proteins, antibody fragments, DNA fragments, and RNA fragments as the base of cancer biomarkers.Conclusion:This review highlights various approaches of cancer nanotechnology in the advancement of cancer therapy.
Food Components with the Potential to be Used in the Therapeutic Approach of Mental Diseases
Authors: Fernández María J.F. , Valero-Cases Estefanía , Rincon-Frutos Laura 
Published: September 2018

Background:Neurological disorders represent a high influence in our society throughout the world. Although the symptoms arising from those diseases are well known, the causes and mechanisms are complex and depending on multiple factors. Some food components consumed as part of our diet have been studied regarding their incidence in different common neurological diseases such as Alzheimer disease, major depression, Parkinson disease, autism and schizophrenia among others.Objective:In this review, information has been gathered on the main evidences arising from studies on the most promising food components, related to their therapeutic potential, as part of dietary supplements or through the diet, as an alternative or a complement of the traditional drug treatments. Those food components include vitamins, minerals, fatty acids, carotenoids, polyphenols, bioactive peptides, probiotics, creatine and saponins.Results:Many in vitro and in vivo animal studies, randomized and placebo control trials, and systematic reviews on the scientific results published in the literature, have been discussed, highlighting the more recent advances, also with the aim to explore the main research needs. Particular attention has been paid to the mechanisms of action of the compounds regarding their anti-inflammatory, antioxidative properties and neuronal protection.Conclusion:More research is needed to prove the therapeutic potential of the food components based on scientific evidence, also on intervention studies to demonstrate the improvement of neuronal and cognitive impairments.