bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurological complication of pregnancy: An experience from north east India
Authors: Synmon Baiakmenlang , Shullai Wansalan Karu , Sharma Shri Ram , Thakre Mahendra Ram , Lynser Donbok , Jain Ayush , Lyngwa Gareth 
Published: August 2024

: The neurology of pregnancy is usually of two types, those that are pregnancy-specific and those that worsen during pregnancy and the post-partum period. Almost 20% of maternal mortality can be attributed to neurological causes which warrants us to identify the red flag sign for early and proper intervention. : A retrospective study of three years duration in North East India. All demographic, clinical, and neurological findings, routine investigation, and neurological investigation were recorded. Further analysis was done to find out the most common neurological pathology in pregnancy and classify them into pregnancy-specific, incidental, and preexisting neurological conditions. : A total number of 80 patients were included. The age ranged from 18 to 49 years with the maximum number of patients (forty-four) in the 20-30 age group. Guillain barre syndrome (GBS) seen in 21 patients (26%) which was the most common with maternal mortality and stillbirth. Eclampsia was seen in seventeen patients (21%) with three intra-uterine death and one maternal death noted. The other neurological disease was cerebral venous thrombosis (11%), seizure in isolation (six patients), and seizure with post-partum sepsis (five patients). Myelopathy was seen in four patients, carpal tunnel syndrome and cramps in six patients each, multiple sclerosis, tubercular meningitis (proven), thymoma-negative generalized myasthenia gravis, and arteriovenous malformation in one patient each. An in-depth knowledge of the various neurological diseases during pregnancy helps us to recognize them early and provide proper approaches and management to reduce harm to maternal and child health.
Cervical fibroid: A diagnostic dilemma and operative challenge – one year study
Authors: Dahiya Sonia , Dahiya Pushpa , Saini Kirti , Jain Shevata , Bhuria Vandana , Dahiya Krishna 
Published: August 2024

: Cervical fibroids are very rare, with varying clinical presentations, and account for only 1–2% of cases. Cervical fibroids are enigmatic as they present with varying symptoms and simulate several clinical entities, for instance, a large cervical polyp, incarcerated procidentia, chronic uterine inversion, and the Ca cervix. : A two-year retrospective analysis of women diagnosed with cervical leiomyoma was conducted at Obstetrics and Gynaecology department, PGIMS Rohtak (a tertiary care institute in Northern India). A total of 24 cases diagnosed with cervical fibroid (CF) were studied. 75% of the females had vaginal bleeding, 44.6% had heavy menstrual bleeding, 33.3% had irregular bleeding, and one had postmenopausal bleeding. 41.6% had urinary symptoms; 1.5% complained of vaginal discharge; difficulty in stools (16.6%); and leiomyosarcoma (8.3%). We cannot find a clear demarcation of presenting symptoms between anterior and posterior fibroid. It was discovered that the development of malignancy and bladder and intestinal problems was linked to an increase in CF mass, while severe anaemia and vaginal bleeding were not. A cervical fibroid is mostly benign, can be present at extremes of age, and its atypical presenting symptoms pose difficulty in diagnosis. Vaginal bleeding and retention of urine are the most common symptoms. Central and supravaginal fibroids are difficult to operate. Proper pre-operative delineation of altered anatomical structure are essential for choosing the correct modality of treatment. In large cervical fibroids, suspected malignancy before surgery and hidden cervical malignancy can coexist.
Immunohistochemical study of hormone receptors in endometrium with abnormal uterine bleeding
Authors: Soneji Dhairya K , Andola Sainath K , Andola Umadevi S , Andola Shruti S , Masgal Meenakshi , Patil Anuradha G 
Published: August 2024

In the case of AUB, estrogen and progesterone exert their effects by acting on specific nuclei. Receptor proteins such as estrogen receptor (ER) and progesterone receptor (PR). And periodic changes in its expression have been shown in human uterine tissue. Immunohistochemistry (IHC). Immunohistochemistry using specific monoclonal antibodies estimate the content of the receptor at the cellular level and interpret their exact location and distribution.A two-year descriptive study was conducted. There were a total of 50 cases clinically diagnosed with AUB who underwent hysterectomy and endometrial curettage, and 20 non-AUB controls were included in this study. IHC was performed for ER and PR receptors in all cases and controls.The age range was 29 to 65 years and the average age of the patients was 43.21 years. Out of 50 patients, 26 were pre-menopausal and 24 were post-menopausal, and the mean hemoglobin, fertility and bleeding duration were 10.34 g/dL, 2.8 and 8.4 days per cycle. The average thickness of the endometrium was 10.5 mm in the cases and 6.25 mm in the control group. Increasing endometrial thickness was statistically significantly related to AUB and increased ER and PR HSCORE in stroma and glands (p&#60;0.001). In terms of histomorphology, the highest number of cases was endometrial hyperplasia without atypia (27 cases), followed by early proliferative phase (7 cases). ER expression was more abundant in glands and PR expression was more in stroma. In endometrial hyperplasia with atypia, the expression of ER and PR was higher than in other endometrial stages.In addition to pelvic ultrasound and histology, immunohistochemistry. ER and PR have the advantage of allowing these hormone receptors to localize to the tissue.Endometrial aspiration samples and anxiliary tests in patient treatment allong with AUB. Endometrial hyperplasia is more common in patients with AUB. The concentration of estrogen and progesterone receptors is significantly higher. Therefore, the location and concentration of ER and PR receptors increases and this makes it possible for targeted therapies and avoid invasive surgical procedures using selective progesterone receptor modulators and progesterone antagonists in the treatment of patients with AUB and endometrial hyperplasia.
Comapring a lower dose of carbetocin to the standard dose of carbetocin in the prevention of postpartum hemorrhage during elective cesarean delivery: A randomised parallel group trial
Authors: Yaliwal Rajasri G , Patil Neelamma G , Bidri Shailaja R , Soragavi Vijaya 
Published: August 2024

Prophylactic use of uterotonic is a universal practice in vaginal and cesarean delivery. Heat stable carbetocin is a relatively new uterotonic. Lower doses of uterotonics are as effective as standard doses in elective cesarean deliveries. This study aimed to compare the effectiveness and safety of 50 mcg carbetocin (lower dose) to 100mcg carbetocin (standard dose) for the prevention of postpartum hemorrhage during elective cesarean delivery. A total of 212 term pregnant women were randomized to two group. Group I received 50 mcg of carbetocin and Group II received 100 mcg of carbetocin. The blood loss, tone of the uterus, use of additional uterotonics or styptics, requirement of blood transfusions and adverse effects of the drug in both the groups were compared. There were no statistically significant differences in both the groups with respect to blood loss, uterine tone, blood transfusions or additional use of uterotonics or styptics.(p&#62;0.05).: A lower dose of 50 mcg is as effective as the standard dose of 100 mcg of carbetocin in elective caesarean delivery in preventing post-partum hemorrhage.
Identification of fungal agents isolated from burn lesions using mycological and molecular methods in patients admitted to Velayat burn hospital in Rasht city during 2022-2023
Authors: Ardi Pegah , Ghazvini Roshanak Daie , Hashemi Seyed Jamal , Mobayen Mohammadreza , Pourheidari Abolfazl , Khodavaisy Sadegh , Abastabar Mahdi , Rafat Zahra 
Published: August 2024

Background and Objectives: Fungal burn wound infections (FBWIs) are one of the most disastrous complications in burn patients. The present study investigated the incidence and the species distribution of fungal agents isolated from burn lesions and reviewed the feautures, underlying conditions, and outcomes of patients.
Materials and Methods: The wounds were swabbed and cultured on Sabouraud Dextrose Agar with chloramphenicol medi-

Fungal identification was performed using internal transcribed spacer (ITS) and beta-tubulin sequencing.

Results: A total of 380 swab specimens were obtained. Of these, 101 patients (26.75 %) were positive in culture. Among the 101 positive cases, most isolates were from males (n= 68, 67.33%) and most of them were over 30 years old. Flame (n=38, 37.63%) was the predominant cause of burns, and previous history of ICU admission (n=35, 34.66%), presence of central venous catheter (n=25, 24.75%), and diabetes mellitus (n=17, 16.83%) were the main underlying conditions. Candida para- psilosis complex (n=36, 35.64%), and Pichia kudriavzevii (C. krusei) (n=8, 7.92%) represent the most commonly isolated species Also, 2 out of 101 patients (2%) died.
Conclusion: In the present study, non-albicans Candida species were much higher frequent than C. albicans with most cases associated with Candida parapsilosis complex.
Ayurveda and environmental network: Antimicrobial, pharmacological and ecological potential of Swietenia macrophylla Meliaceae (L.) Jacq.
Authors: Dawkar Vishal , Chalwade Anand 
Published: August 2024

To encapsulate the research reports on Swietenia macrophylla compounds to explore their medicinal and ecological importance. The plants of Swietenia genus may be used to recover ecological aspects and importantly to develop drugs to cure many diseases. Many research articles reported through the work that S. macrophylla possesses antidiabetic, antioxidative and antihyperlipidemic activity, antimicrobial and pharmacology potential to ecological recovery property. Herbal drugs prepared from plant extracts have an enormous range of medicinal properties. S. macrophylla species ascertained to have a broad range of medicinal properties and ecological potential to reap up beneficial things. Swietenia macrophylla Meliaceae (L.) Jacq. have immune-modulatory, anticancer, anti-diabetic, antiviral, anti-hypertension and many other curative properties. S. macrophylla gorgeous in flavonoids, tannins, alkaloids, sugars and terpenoids and limonoids, is believed to have vast therapeutic potential. Mahogany can grow in perennial and seasonally dry areas and even flourish in various types of soils. Encapsulation of the research reports on Swietenia macrophylla compounds is essential to explore their medicinal and ecological importance. The plants of Swietenia genus may be used to recover ecological aspects and importantly to develop drugs to cure many diseases. However, more study is needed to categorize, describe and systematize the vital metabolites and plant extracts used in disease treatment. Abundance of limonoids and many other compounds in Swietenia genus brand this plant more noteworthy for in-depth molecular level studies to discover additional potential about its pharmacological, ecological and other possible possessions.
Definition of halal analysis of formulation of kombucha drink from simplicia of malay apple fruit (Syzygium malaccense)
Authors: Lubis Novriyanti , Mubarok Anwar , Junaedi Effan Cahyati , Soni Dang 
Published: August 2024

The wealth of biodiversity and the abundance of native Indonesian germplasm resources have not been optimally utilized domestically. Malay apple, which belongs to the myrtaceae family, has various health benefits. However, its utilization is still limited, thus requiring ideas to increase public interest in this fruit. Therefore, innovation is carried out by transforming malay apple into kombucha fermentation beverages as a step to optimize its utilization. The research aimed to measure the total alcohol content, total acid, and total sugar in the formulation of kombucha beverages derived from malay apple fruit juice, with the goal of developing it into a functional beverage. The research process involved testing alcohol content using gas chromatography, measuring total acid by alkalimetric titration method, and measuring total sugar content by anthrone method. The research results showed that the malay apple kombucha sample the level of alcohol content was 0.0213%, the total acid was 1.38% (<2 g/L), and the total sugar was 0.807 µg. The kombucha malay apple which category halal kombucha.
Adverse Outcomes Following Exposure to Perfluorooctanesulfonamide (PFOSA) in Larval Zebrafish (<em>Danio rerio</em>): A Neurotoxic and Behavioral Perspective
Authors: David Nikita , Ivantsova Emma , Konig Isaac , English Cole , Avidan Lev , Kreychman Mark , Rivera Mario L. , Escobar Camilo , Valle Eliana Maira Agostini , Sultan Amany , Martyniuk Christopher J. 
Published: August 2024

Toxicity mechanisms of per- and polyfluoroalkyl substances (PFAS), a chemical class present in diverse ecosystems, are not well characterized in aquatic species. Perfluorooctanesulfonamide (PFOSA, C8H2F17NO2S) is a common precursor of perfluorooctane sulfonic acid (PFOS), a long-chain PFAS. Here, we assessed sub-lethal endpoints related to development, oxidative stress, locomotor activity, and gene expression in zebrafish embryos and larvae following continuous exposure to PFOSA beginning at 6 hours post fertilization (hpf). PFOSA decreased survival in fish treated with 1 µg/L PFOSA, however the effect was modest relative to the controls (difference of 10%). Exposure up to 10 µg/L PFOSA did not affect hatch rate, nor did it induce reactive oxygen species in 7-day-old larvae fish. However, locomotor activity of larval fish treated with 100 µg/L PFOSA was reduced relative to the solvent control. Transcripts related to oxidative stress response and apoptosis were measured and BCL2 associated X, apoptosis regulator (bax), cytochrome c, somatic (cycs), catalase (cat), superoxide dismutase 2 (sod2) were induced with high concentrations of PFOSA. Genes related to neurotoxicity were also measured and transcript levels of acetylcholinesterase (ache), elav-like RNA binding protein 3 (elavl3), growth associated protein 43 (gap43), synapsin II (syn2a), and tubulin 3 (tubb3) levels were all increased in larval fish with higher PFOSA exposure. This study contributes to our knowledge regarding the relative toxicity of PFOSA to fish and contributes data to future risk assessment strategies of these concerning, persistent environmental pollutants.
Magnetic Resonance Imaging-Guided Single-Fraction Preoperative Radiotherapy for Early Stage Breast Cancer (The RICE Trial): Feasibility Study
Authors: Qadir Ayyaz , Singh Nabita , Dean Jenna , Brown Kerryn , Tacey Mark , Mann Bruce , Kron Tomas , Cahoon Glenn , Lau Eddie , Scot Andrew M , Yeo Belinda , Loh Su-Wen , Uribe Sergio , Moe Aung Aung Kywe , Ireland-Jenkins Kerryn , McAuley Rosly , McDermont Leah , Ooi Wei Ming , Ng Suat , Chao Michael , Foroudi Farshad 
Published: August 2024

Abstract

Background: Over the past decade, the adoption of screening programs, digital mammography, and Magnetic Resonance Imaging (MRI) has increased early-stage breast cancer diagnosis rates. Mortality rates have decreased due to early detection, improved treatments, including personalized therapies. Accelerated partial breast irradiation (APBI) is emerging as a convenient and effective treatment for some patients, with studies exploring its preoperative use. Preoperative APBI, especially with MRI guidance, offers improved tumor targeting and reduced side effects. The RICE trial aims to assess the feasibility and efficacy of MRI-guided single-dose radiotherapy for early-stage breast cancer.
Methods: The RICE study is a prospective, single-arm study evaluating single fraction pre-operative, accelerated partial breast irradiation treatment in patients with early-stage breast cancer using a Magnetic Resonance Imaging Linear Accelerator (MR Linac). Eligible patients enrolled in this study will have a core biopsy to confirm estrogen receptor positive, Her2 negative subtype. Radiotherapy planning will use a planning computed tomography co-registered with a magnetic resonance imaging (MRI) with the patient in either the supine or prone position. For the diagnostic workup, [18] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography ([18]FDG PET/CT) and [18] Fluoroestradiol Positron Emission Tomography/Computed Tomography ([18]FES PET/CT) will be performed prior to treatment. Thirty patients will receive a single ablative RT dose of 21 Gy to the tumor. Pre- and post-treatment MRI scans will be acquired at baseline and 5 weeks post radiotherapy respectively. Breast-conserving surgery will be scheduled for 6 weeks after APBI treatment using the MR- Linac.
The primary study endpoint is the successful administration of a single fraction of preoperative breast radiotherapy under the guidance of an MR-linac. Secondary endpoints include evaluating the utility of MRI, [18F] FDG PET/CT and [18F] FES PET/CT as a non-invasive method for assessing treatment response in patients undergoing single fraction preoperative accelerated partial breast irradiation.
Conclusion: The RICE trial represents a significant step in breast cancer treatment, offering insights that could lead to treatment protocols with minimized radiotherapy and enhanced patient outcomes.
Trial Registration: This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR). Registered 31st of May 2021. Registration number: ACTRN12621000659808 https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621000659808
Genus-targeted markers for the taxonomic identification and monitoring of Coagulase-Positive and Coagulase-Negative Staphylococcus Species
Authors: Jiménez-Velásquez S. , Pacheco-Montealegre M. E. , Torres L. , Uribe-Gutiérrez L. , Burbano-David D. , Dávila-Mora L. L. , Renjifo-Ibáñez C. , Caro-Quintero A. 
Published: August 2024

Abstract

The Staphylococcus genus comprises multiple pathogenic and opportunistic species that represent a risk to public health. Epidemiological studies require accurate taxonomic classification of isolates with enough resolution to distinguish clonal complexes. Unfortunately, 16S rRNA molecular analysis and phenotypic characterization cannot distinguish all species and do not offer enough resolution to assess intraspecific diversity. Other approaches, such as Multilocus Sequence Tagging, provide higher resolution; however, they have been developed for Staphylococcus aureus and a few other species. Here, we developed a set of genus-targeted primers using five orthologous genes (pta, tuf, tpi, groEs, and sarA) to identify all Staphylococcus species within the genus. The primers were initially evaluated using 20 strains from the Collection of Microorganisms of Interest in Animal Health from AGROSAVIA (CMISA), and their amplified sequences were compared to a set of 33 Staphylococcus species. This allowed the taxonomic identification of the strains even on close species and the establishment of intraspecies diversity. To enhance the scope and cost-effectiveness of the proposed strategy, we customized the primer sets for an Illumina paired-end amplicon protocol, enabling gene multiplexing. We assessed five genes across 177 strains, generating 880 paired-end libraries from the CMISA. This approach significantly reduced sequencing costs, as all libraries can be efficiently sequenced in a single MiSeq run at a fraction (one-fourth or less) of the cost associated with Sanger sequencing. In summary, this method can be used for precise identification and diversity analysis of Staphylococcus species, offering an advancement over traditional techniques in both resolution and cost-effectiveness.
Cas3 of type I-Fa CRISPR-Cas system upregulates bacterial biofilm formation and virulence in Acinetobacter baumannii by affecting cilia-related and ompA genes expression
Authors: Li Guocai , Guo Tingting , Yang Jie , Sun Xiaoli , Zhou Na , Huan Changchao , Lin Tao , Bao Guangyu , Hu Jian 
Published: August 2024

Abstract

Acinetobacter baumannii (A.baumannii) is an important pathogen causing various nosocomial infections. CRISPR-Cas system is the adaptive immune system of bacteria, which is also closely related to the drug resistance and virulence of bacteria. In this study, we successfully constructed a cas3 deletion mutant (19606Δcas3) and complemented strain (19606Δcas3/pcas3) to study the regulatory mechanism of type I-Fa cas3 on bacterial virulence. Our results showed that deletion of cas3(type I-Fa) significantly reduced the biofilm formation, virulence and pathogenicity to mice, the organ bacterial load of mice infected with cas3 deletion strain was significantly reduced; the lung inflammation was slightly changed; and the serum cytokine level was also decreased. The results demonstrated that cas3 enhanced the virulence and pathogenicity of A.baumannii. Mechanism analysis shown that deletion of cas3 can lead to the down-regulation of virulence factors such as biofilm formation related factors and outer membrane protein A(ompA). In addition, cas3 was also involved in the regulation of carbon metabolism and oxidative phosphorylation pathway of A.baumannii.
Development of a Weighted-Incidence Syndromic Combination Antibiogram (WISCA) to Guide Empiric Antibiotic Treatment for Ventilator-Associated Pneumonia in a Mexican Tertiary Care University Hospital
Authors: Briseno-Ramírez Jaime , Gómez-Quiroz Adolfo , Avila-Cardenas Brenda Berenice , De Arcos-Jiménez Judith Carolina , Perales-Guerrero Leonardo , Andrade-Villanueva Jaime F , Martínez-Ayala Pedro 
Published: August 2024

Abstract

Background
Ventilator-associated pneumonia (VAP) is a prevalent and serious nosocomial infection among critically ill patients that leads to significant morbidity, mortality, and increased healthcare costs. The heterogeneity in local epidemiology and antibiotic resistance complicates the selection of effective empirical treatments. The weighted-incidence syndromic combination antibiogram (WISCA) tool has been proposed to optimize empirical antibiotic therapy by leveraging local microbiological data.
Objective
This study aimed to develop a WISCA tailored for VAP in a Mexican tertiary care university hospital. The objective is to improve empirical antibiotic coverage by considering the unique pathogen landscape and resistance patterns of the institution.
Methods
This research was conducted from June 2021 to June 2024 using clinical registries and microbiological data from a tertiary hospital in an upper middle-income Latin American country. Data, including demographic and clinical characteristics, were collected from patients who developed VAP. We employed a Bayesian hierarchical logistic regression model to estimate the coverage of various antibiotic regimens. We also analyzed the impact of initial inappropriate empiric treatment on in-hospital mortality and prolonged hospital stays in our population using multivariate logistic regression analysis.
Results
A total of 197 VAP episodes from 129 patients were analyzed. The median age was 44 years (IQR 35–56), and the median Charlson comorbidity index was 1 (IQR 0–2). The most common pathogens were Acinetobacter baumannii and Pseudomonas aeruginosa. Tigecycline-based combined regimens showed greater median coverage (+ 47.97%) than nontigecycline-based combined regimens, particularly against multidrug-resistant Acinetobacter baumannii. Inappropriate initial empirical treatment was associated with prolonged hospital stays but not directly with in-hospital mortality. However, inappropriate treatment during the entire VAP episode was significantly associated with increased mortality.
Conclusions
The tailored WISCA model provided robust coverage estimates. This study demonstrated the potential to optimize empirical antibiotic regimens, especially tigecycline-based combinations. This study highlights the importance of local epidemiological data in guiding empirical therapy and reducing the consequences of inappropriate antibiotic use.