bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chick Embryo Chorioallantoic Membrane as a Platform for Assessing the In Vivo Efficacy of Chimeric Antigen Receptor T-cell Therapy in Solid Tumors
Authors: Nipper Allison J , Warren Emilie A K , Liao Kershena S , Liu Hsuan-Chen , Michikawa Chieko , Porter Caroline E , Wells Gabrielle A , Villanueva Mariana , Brasil da Costa Fabio Henrique , Veeramachaneni Ratna , Villanueva Hugo , Suzuki Masataka , Sikora Andrew G 
Published: August 2024

Abstract
The fertilized chicken egg chorioallantoic membrane (CAM), a highly vascularized membrane nourishing the developing embryo, also supports rapid growth of three-dimensional vascularized tumors from engrafted cells and tumor explants. Because murine xenograft models suffer limitations of time, cost, and scalability, we propose CAM tumors as a rapid, efficient screening tool for assessing anti-tumor efficacy of chimeric Ag receptor (CAR) T cells against solid tumors. We tested the efficacy of human epidermal growth factor receptor 2 (HER2)–specific CAR T cells against luminescent, HER2-expressing (FaDu, SCC-47) or HER2-negative (MDA-MB-468) CAM-engrafted tumors. Three days after tumor engraftment, HER2-specific CAR T cells were applied to tumors grown on the CAM. Four days post–CAR T cell treatment, HER2-expressing FaDu and SCC-47 tumors treated with CAR T showed reduced viable cancer cells as assessed by luciferase activity. This reduction in viable tumor cells was confirmed by histology, with lower Ki-67 staining observed in CAR T cell–treated tumors relative to T cell–treated controls. Persistence of CAR T in CAM and tumor tissue 4 days post-treatment was confirmed by CD3 staining. Altogether, our findings support further development of the chick CAM as an in vivo system for rapid, scalable screening of CAR T cell efficacy against human solid tumors.
Efficacy of periodic acid–Schiff stain in the diagnosis of onychomycosis – A cross-sectional study
Authors: Salahudeen Mohamed , Ramdas Anita , Elumalai Arthi , Ravichandran Kandasamy , Kuruvila Sheela 
Published: August 2024

Background:
Onychomycosis is the fungal infection of the nail which needs to be differentiated from other causes of dystrophic nails due to its long-term treatment. Direct microscopic examination with potassium hydroxide (KOH) mount along with fungal culture shows inconsistent sensitivity. Thus, there is a need of more accurate and efficient method to detect onychomycosis.

Aims and Objectives:
This study aims to compare periodic acid–Schiff (PAS) stain with KOH and nail fungal culture in the diagnosis of onychomycosis.

Materials and Methods:
This was a cross-sectional study conducted in the dermatology outpatient department of a tertiary care center in South India from July 2019 to July 2021. A total of 93 patients with clinical suspicion of onychomycosis were included in the study and evaluated for the following three methods: KOH mount, nail fungal culture, and PAS stain.

Results:
Of the 93 patients, PAS was positive in 82 (88%) cases, KOH mount was positive in 32 (34%) cases, and nail fungal culture showed positive results in 49 (53.2%) patients. The percentage of positivity of combined PAS and culture was 89 (95.7%) and combined KOH and culture was 63 (65.7%). The culture yielded growth in 49 patients showing dermatophytes in 2, yeasts in 35, and nondermatophyte molds (NDMs) in 12 specimens The most common isolated species was Candida tropicalis found in 11 (22.4%) followed by Candida species in 8 (16.3%), Candida albicans in 7 (14.2%), and Trichosporon species in 6 (12.2%) specimens. Among the NDMs, Fusarium oxysporum was the most isolated found in 5 (10.2%).

Conclusion:
The importance of this study is to highlight the utility of PAS stain in the diagnosis of onychomycosis which otherwise may be missed with KOH and culture. PAS can be performed as an additional test to KOH mount and nail fungal culture to close the diagnostic gap.
Subcutaneous mycoses in a tertiary care hospital in India
Authors: Muthusamy Rajeshwari Kumaravel , Mehta Sangita S. , Thangaraju Deepak 
Published: August 2024

AbstractBackground:Subcutaneous mycoses, a disease of the tropics, are usually missed or misdiagnosed in immunocompetent individuals unless sought for. The study was designed to explore the experience of diagnosing subcutaneous mycoses by histopathological examination in our institute and to find out the epidemiology, clinical features, and histopathological findings of cases with subcutaneous mycosis.Methodology:We reviewed the cases reported as subcutaneous mycoses in the department of pathology over 6 years (2017–2022). The slides were stained with Hematoxylin and Eosin, Periodic acid Schiff (PAS), and Gomori’s Methenamine silver (GMS) for identification of the fungi. Clinical details were obtained from the medical records.Results:Twenty-seven cases were retrieved from the archives, reported as subcutaneous mycoses from various sites. They presented with varying symptoms ranging from ulcers, discharging sinuses, nodular swellings, and cystic swelling. Histology from these revealed granulomas with suppuration, necrosis of subcutaneous fat, broad aseptate hyphae with angioinvasion, abscesses, and grains.Conclusion:Mycosis, a disease of the tropics, may manifest in immunocompetent individuals with varied clinical presentations and histology. The intact immune status of the individual results in granuloma formation along with suppuration and giant cells. Diagnosis is usually achieved by a meticulous search for fungus in such lesions. PAS and GMS stains help identify the fungus.
Heterotopic gastric mucosa of the umbilicus
Authors: Keloth Thara , Sriram V. , Gandhi Ramya , Ivan Erli Amel 
Published: August 2024

Abstract
Umbilical discharge is a commonly encountered problem in infants, with common causes being omphalitis and umbilical granuloma. Unusual causes of persistent umbilical discharge are remnants of the omphalomesenteric duct and the urachus. Heterotopic or ectopic tissues at the umbilicus are rare events that cause umbilical discharge and these mandate a surgical intervention. Gastric heterotopia at the umbilical region is such an unusual entity causing persistent discharge and chemical dermatitis around the region, which needs surgical intervention. We hereby report a rare case of gastric heterotopia of the umbilicus in an 8-month-old male baby.
Comparative assessment of medicinal plant extract efficacy against plaque and gingivitis: A case–control study
Authors: Agrawal Jyoti , Pant Aditya Bhusan , Agrawal Rajesh Kumar 
Published: August 2024

Abstract

Background:
In the last quarter of the 20th century, dedicated efforts have been made to use phytochemicals in the prevention of periodontal diseases, but the darker side of the coin is that we have hardly encountered studies with a scientific basis to prove the specific role of phytochemicals against dental plaque.

Objective:
This study aimed to assess the antiplaque activity of Curcuma longa, Spilanthes acmella, and Quercus infectoria and to determine the antigingivitis activity of the extract, which shows high antiplaque potential.

Materials and Methods:
Sixteen volunteers were selected as subjects in this biphasic study. In the first phase, 10 volunteers were subjected to topical application of aqueous ethanolic extract (1%) of C. longa, Q. infectoria, and S. acmella on the labial/buccal and lingual/palatal surfaces of 28 teeth. In the second phase, the extract showing the highest efficacy was selected to assess its antigingivitis activity on all the surfaces of six mandibular anterior teeth of six gingivitis patients. The percentage plaque reduction was calculated by dividing the difference of the base and end scores by the baseline scores.

Results:

C. longa demonstrated superior results as it showed the maximum reduction in plaque formation. Antigingivitis activity of long-term topical application of 1% C. longa was depicted in independent clusters in different volunteers selected for the study. Only after 2 weeks, the treatment score was found to be statistically significant to depict optimal results.

Conclusion:

C. longa can be considered the best at reducing plaque. The antigingivitis activity of C. longa ranked reasonably satisfactory and comparable to the existing data for commercially available drugs.
Assessment of Postoperative Venous Thromboembolic Complications
Authors: Aljiffry Murad M. , Alhazmi Mohammed F. 
Published: August 2024

BACKGROUND:
Postoperative venous thromboembolic events (VTEs) are a preventable cause of death. Adherence to available guidelines and prophylactic measures is suboptimal. This study examined postoperative VTEs prevalence, prophylaxis guideline adherence, and VTEs risk factors among surgical patients at King Abdulaziz University Hospital in Saudi Arabia.

METHODOLOGY:
This retrospective study analyzed VTEs patients from August 2020 to November 2022. Medical records collected data on patients, procedures, prevention, guideline adherence, and VTEs diagnosis. The statistical analysis evaluated the link between prophylactic measures and VTEs occurrence.

RESULTS:
Thirty-one (32%) of the 97 VTEs diagnosed in patients were postoperative VTEs. Mortality rates were 18.5%, and for postoperative VTEs patients were 12.9%. Most patients (87.1%) were at high risk (Caprini score ≥ 5) for VTEs. Abdominopelvic procedures were 64.5% of cases. Approximately 60% of patients received postoperative prophylaxis. Enoxaparin was the most frequently used prophylaxis method (63.1%). Mechanical prophylaxis was used in 36.8% of patients who received prophylaxis. Compliance for extended prophylaxis was only 10.5%. Late initiation of prophylactic measures was significantly associated with deep vein thrombosis occurrence.

CONCLUSION:
The study emphasizes the need to follow prophylaxis guidelines. Improving compliance with prophylactic measures, especially for high-risk patients, can potentially reduce postoperative VTEs.
Prognostic Value of ST-segment Deviation in Lead aVR in Electrocardiogram in Acute Myocardial Infarction
Authors: Gandhi Viral , Gandhi Vicky 
Published: August 2024

Background:
Acute myocardial infarction (AMI) remains a significant cause of morbidity and mortality worldwide, necessitating effective risk stratification tools for improved management. ST-segment deviation in lead augmented vector right (aVR) has emerged as a potential prognostic marker in AMI, but its clinical relevance in the Indian context requires further investigation.

Materials and Methods:
We conducted a single-center prospective observational study among patients admitted with AMI to assess the prognostic value of ST-segment deviation in lead aVR. Patients were categorized based on the presence or absence of ST-segment deviation in lead aVR, and demographic, clinical, and angiographic characteristics were compared between groups. Follow-up evaluations were performed to assess left ventricular ejection fraction (LVEF) and the incidence of ventricular tachycardia (VT).

Results:
The study enrolled 110 patients, categorizing them by ST-segment deviation in lead aVR. Patients with ST elevation in lead aVR showed higher moderate LVEF dysfunction (31%–40%) than those with isoelectric ST segments (P = 0.0058). Conversely, patients with ST depression in lead aVR had increased preserved ejection fraction compared to those with an isoelectric ST segment (P = 0.0414). <50% ST-segment resolution postpercutaneous coronary intervention (PCI) was more common among non-ST-segment elevation myocardial infarction (NSTEMI) patients. The incidence of VT was higher in ST elevation in lead aVR (P = 0.0045). Significant differences in ST-segment resolution after PCI (P = 0.0117) between STEMI and NSTEMI patients were noted.

Conclusion:
ST-segment deviation in lead aVR serves as a valuable prognostic marker in AMI, correlating with adverse outcomes such as moderate LVEF dysfunction and increased risk of VT. Furthermore, its association with ST-segment resolution post-PCI highlights its role in assessing reperfusion success and guiding management strategies. These findings underscore the importance of ST-segment deviation in lead aVR for risk stratification and personalized management in AMI patients.
Dapagliflozin in Post-Myocardial Infarction Acute Decompensated Heart Failure: Daffodil Study
Authors: Jariwala Pankaj , Kulkarni Gururaj Pramod , Punjani Arshad , Boorugu Hari Kishan , Madhawar Dilip Babu , Gude Dilip 
Published: August 2024

Background:
Dapagliflozin and sodium–glucose cotransporter 2 inhibitors reduce the risk of cardiac death and hospitalization for heart failure (HF), regardless of the patient’s status with type 2 diabetes mellitus (T2D). Further investigation is required to ascertain the impact of these drugs on patients suffering from acute myocardial infarction (AMI) complicated by acute decompensated heart failure (ADHF).

Methods:
In retrospective research comprising 371 patients with AMI complicated by ADHF of Killip class II–IV and left ventricular ejection fraction ≤40%, the effectiveness of dapagliflozin at a dosage of 10 mg once a day was compared to standard of care alone. The main results consisted of a primary composite outcome, which encompassed either cardiovascular (CV) mortality or hospitalization due to HF. Additional clinical outcomes assessed were CV mortality, hospitalization due to HF, and changes in laboratory measurements, including glycosylated hemoglobin, N-terminal prohormone B-type natriuretic peptide, and estimated glomerular filtration rate (eGFR).

Results:
In the group that received dapagliflozin, 10.7% of patients experienced a primary composite outcome event, while in the group that did not receive dapagliflozin, 24.9% of patients experienced one. The median follow-up period was 12.4 months, and the hazard ratio for CV death or hospitalization for HF was 0.67 (95% confidence interval [CI], 0.65–0.86; P < 0.001). Hazard ratio, 0.68; 95% CI, 0.55–0.69; P < 0.001), the group given dapagliflozin had fewer HF hospitalizations overall than the group given a placebo. Dapagliflozin decreased the likelihood of serious kidney outcomes and decelerated the yearly decline in the eGFR (2.1% vs. 7.6%; P < 0.001).

Conclusions:
Patients with AMI complicated by ADHF who received dapagliflozin had a lower risk of CV death or HF hospitalization, regardless of their T2D status.
A Cross-Sectional Study of Clinical Spectrum and Outcome of Pure Midbrain Strokes
Authors: Sheetal S , Thomas Reji , Byju P , Sasidharan Aswathy , Mathew Finu , Madhusudanan M 
Published: August 2024

Background:
Pure mesencephalic infarcts are uncommon, the main clinical manifestations being oculomotor signs and ataxia.

Objectives:
Primary objective was to determine the incidence of pure midbrain strokes. We also evaluated the clinical spectrum, syndromes, arterial territories involved, risk factors, and outcome at 3 months.

Settings and Design:
This cross-sectional study was conducted at the Neurology department of a tertiary teaching hospital in Kerala.

Methods and Material:
We recorded clinical examination and radiological details of all the patients who presented with isolated midbrain strokes from December 2014 to December 2019. The clinical spectrum and outcomes of the patients at 3 months were analyzed.

Results:
Of the 520 posterior circulation stroke patients, 48 (9.2%) had isolated mesencephalic infarcts. Clinical manifestations included gait ataxia in 40 patients (83.3%), third nerve palsy in 29 (60.41%), fourth nerve palsy in 4 (8.3%), internuclear ophtalmoplegia in 9 (18.8%), upgaze paresis in 3 (6.3%), hemiparesis in 4 (8.3%), and cheiro-oral paraesthesia in 4 (8.3%). Of the 48 patients, 21 (43.8%) had Claude syndrome, 9 (18.8%) had Wernekink commisure syndrome, 6 (12.5%) had ataxic hemiparesis, 3 (6.3%) had Parinaud syndrome, 3 (6.3%) had Weber syndrome, 4 (8.3%) had Nothnagel syndrome, and 1 patient had a pure sensory stroke (2.1%). The anteromedial territory was frequently affected, in 37 (77%), characterized by oculomotor manifestations and ataxia. Posterior lesions were noted in three (6.3%), anterolateral lesions in three (6.3%), and lateral lesion in one (2.1%) patient. Combined lesions in posterior and paramedian territory were seen in four (8.3%). At the end of 3 months, 30 patients (62.5%) had a modified Rankin score of one.

Conclusions:
Our study provides the incidence of midbrain stroke over 5 years. It also highlights the heterogeneity of clinical features of pure midbrain infarcts.
Facial Nerve Preserving Subtotal Excision for Large Vestibular Schwannoma: An Institution-Based Functional Outcome Study
Authors: Annayappa Santhosh K. S. , Prabhuraj A R , Arivazhagan A , Bhat Dhananjaya I , Shukla Dhaval , Srinivas Dwarkanath , Rao K V L N , Vikas V , Devi Indira B 
Published: August 2024

Background:
The ideal goal of treatment for medium to large vestibular schwannoma is complete tumor removal with preservation of all cranial nerves. However, despite the advancements in microsurgery and intraoperative monitoring, the risk of facial nerve dysfunction following total resection varies between 31% and 57%. Currently, the goal of treatment for large tumors is shifting from total excision to facial nerve preservation.

Objective:
To evaluate the facial nerve outcome in patients who underwent subtotal excision with or without subsequent gamma knife radiosurgery for large vestibular schwannomas in our institute.

Methods and Material:
All patients who underwent primary surgery for large vestibular schwannomas between January 2012 and December 2016 were analyzed retrospectively. Cases where total excision was not done and a residue was left behind to prevent facial nerve injury during surgery were included in the study.

Results:
A total of 52 patients who met the inclusion criteria were analyzed. At final follow-up, 70% of patients had good facial nerve function (H-B grade 1 and 2). In patients with normal facial nerve function preoperatively, 81% (25/31) of them had good facial nerve outcomes (H-B grade 1 and 2), whereas in patients with preexisting facial nerve deficits, nearly 62% (13/21) of them either maintained or had improvement in their facial nerve grades.

Conclusion:
Good facial nerve outcomes and tumor control rate is obtained by subtotal excision of VS followed by upfront or delayed GKRS; however, there is a need for long-term follow-up to detect recurrences in these slow-growing tumors.
Clinical outcomes and safety of external beam radiotherapy with extensive intrahepatic targets for advanced hepatocellular carcinoma: A single institutional clinical experience
Authors: Park Sunmin , Rim Chai Hong , Yoon Won Sup 
Published: August 2024

Abstract

Background:
This study observed the clinical outcome of radiotherapy to extensive intrahepatic targets for advanced hepatocellular carcinoma (HCC) in a single institution.

Methods:
From September 2009 to July 2021, patients who underwent fractionated radiotherapy to a planning target volume (PTV) of over 100 ml with biological effective dose >30 Gy10 for advanced HCC were enrolled. Overall survival (OS) and radiation-induced liver toxicity (RILD) were evaluated. RILD was defined as an increase in Child-Pugh (CP) score ≥2 or liver function tests ≥2.5 times at 3 months after the end of radiotherapy.

Results:
A total of 136 patients were evaluated. Eighty-nine patients had portal vein tumor thrombus (PVTT), 37 patients were in CP B stage, and the median radiation dose to PTV was 48.8 Gy10. The median OS was 12.3 months. The factors most affecting OS were PVTT (P = 0.001), PTV (>500 ml, P = 0.001), incomplete coverage of the intrahepatic tumor (P = 0.004), and CP B (P = 0.006) in Cox regression. RILD occurred in 22.4% of the patients and was affected by PVTT (P = 0.003), PTV (P = 0.010), pretreatment bilirubin levels (>1.5 mg/ml, P = 0.016), and the mean normal liver dose (MNLD) (≥ EQD2 18 Gy3, P = 0.021) in binary logistic regression. As the PTV was in excess of >500 ml, RILD developed in 30.2% of patients and the prognostic importance of pretreatment bilirubin levels (P = 0.006) and the MNLD (P = 0.014) increased.

Conclusions:
As PTV is more extensive, the bilirubin level and the MNLD have to be taken into consideration for safe radiotherapy, in addition to the traditional prognostic factors.
Synthesis and toxicity evaluation of a spray consisting of silver nanoparticles, ethylenediaminetetraacetic acid, methylsulfonylmethane, and xylitol on vero cell line
Authors: Hedayatipanah Morad , Niaee Morteza Shakhsi , Torkzaban Parviz , Farmany Abbas , Najafi Rezvan , Farhadian Maryam 
Published: August 2024

Abstract

Introduction:
Dental plaque is a biofilm or an accumulation of bacteria that grows in the internal surfaces of the mouth and can be observed as a white to pale yellow layer over or between teeth. The continuous formation and accumulation of dental plaque lead to oral diseases. As a result, it is necessary to prevent the aggregation of dental plaque and clean it daily. Recently, ethylenediaminetetraacetic acid (EDTA) has been utilized in toothpaste to prevent plaque formation as an EDTA-transporting enhancer, methylsulfonylmethane (MSM) can effectively increase its local effect. Xylitol decreases the Streptococcus mutans count by changing the metabolic pathways.

Aims:
In the present study, we synthesized a solution containing silver nanoparticles, EDTA, MSM, and xylitol and evaluated its toxicity on the Vero cell line through the MTT assay.

Materials and Methods:
To produce silver nanoparticles, we dissolved silver nitrate in sodium citrate. Then we used a solution of distilled water and polyvinylpyrrolidone, which resulted in the encapsulation and stabilization of silver nanoparticles, and the solution was made by mixing other ingredients. We evaluated the cytotoxicity of this spray using the Vero cell line. We cultured the cells in the 10% FBS-containing RPMI culture medium. For performing the cytotoxicity test, we put 10,000 cells in each well of the 96-well plate, and the next day added the synthesized solution to each well at dilutions 0.05%, 0.1%, 0.2%, 0.5%, 1%, 2%, 5%, and 10%. As the control group, we used 4 wells containing live Vero cells without adding the solution. After 24, 48, and 72 h, we added the MTT solution to each well and incubated the plates at 37°C for 4 h. Finally, we evaluated the rate of living cells by reading the absorbance with an ELISA device at 570 nm.

Results and Discussion:
We used the Mann–Whitney nonparametric test to evaluate the cytotoxicity of different concentrations of the synthesized spray solution and compare the cell viability rate of groups with the controls in various periods. According to the cytotoxicity results of different concentrations of the spray solution on the Vero cell line, there was no significant difference in cytotoxicity between the 0.05%, 0.1%, 0.2%, and 0.5%, and control groups at 24, 48, and 72 h (P > 0.05). No significant difference existed in cytotoxicity between 1% and 2% concentrations and the controls 24 h after exposure; this became significant after 48 and 72 h (P = 0.014). However, a significant difference existed in cytotoxicity between 5% concentration and the controls 24, 48, and 72 h after exposure (P = 0.014). The CC50 of the spray solution was calculated at 3.51%.

Conclusion:
The findings of this study showed that the synthesized solution is nontoxic; therefore, this spray solution can be used safely as an oral mouthwash and spray.