bluuebunny/crossref_metadata_2025_split huggingface dataset:
OPTIMASI Na-CMC SEBAGAI GELLING AGENT DAN PROPILEN GLIKOL SEBAGAI HUMEKTAN PADA SEDIAAN GEL EKSTRAK DAUN JOHAR (Cassia siamea Lam.)
Authors: Putri Vatcha Fitricia , Setiyadi Gunawan 
Published: December 2023

Ekstrak daun johar (Cassia siamea Lam.) sebelumnya telah diteliti mempunyai kemampuan antioksidan yang baik. Ekstrak ini dapat berpotensi untuk dijadikan sebagai komponen bahan aktif dalam pengembangan sediaan topikal seperti gel. Untuk mendapatkan sediaan gel yang sesuai harapan dapat dilakukan dengan optimasi. Tujuan dari penelitian yaitu untuk mengatahui nilai konsentrasi optimal bahan Na-CMC sebagai gelling agent dan propilen glikol sebagai humektan berdasarkan sifat fisik seperti viskositas, daya sebar, daya lekat, pH dan sifat sineresis dari sediaan gel ekstrak daun johar (Cassia siamea Lam.) dan aktivitas antioksidannya. Metode yang digunakan pada optimasi ini yaitu dengan D-optimal design pada level tinggi dan level rendah. Formula optimum dibuat dari pencampuran bahan Na-CMC, propilen glikol, ekstrak daun johar, metil paraben, BHT dan aquadest. Respon yang diukur yaitu viskositas, daya sebar daya lekat, pH serta aktivitas antioksidan pada formula optimal. Percobaan menunjukkan hasil formula optimum gel dengan Na-CMC 3% dan propilen glikol 15%. Hasil respon dari percobaan uji viskositas, uji daya sebar, uji daya lekat dan uji pH dengan rata-rata standar deviasi berturut-turut yaitu 31,92±836,109 cps; 4,25±0,177 cm; 5±10,66 detik; dan 4,64±0,037. Nilai IC50 pada hasil gel ekstrak daun johar yang optimal yaitu 58,98 g/ml, pada formula gel ekstrak daun johar yang optimal terdapat adanya aktivitas antioksidan.
AKTIVITAS ANTIBAKTERI EKSTRAK METANOL DAUN KENIKIR (Cosmos caudatus Kunth.) TERHADAP Staphylococcus epidermidis, Pseudomonas aeruginosa, DAN BIOAUTOGRAFINYA
Authors: Hamka Aminah Fitriana , Muflihah Cita Hanif 
Published: December 2023

Infeksi merupakan penyakit yang paling umum menyebabkan tingginya angka kesakitan dan kematian. Staphylococcus epidermidis dan Pseudomonas aeruginosa merupakan bakteri yang dapat menimbulkan infeksi lokal maupun sistemik. Tujuan dari penelitian untuk menguji aktivitas antibakteri ekstrak metanol daun kenikir terhadap Staphylococcus epidermidis dan Pseudomonas aeruginosa dan mengidentifikasi senyawa aktif yang bertanggung jawab terhadap aktivitas tersebut. Ekstraksi dilakukan dengan menggunakan sokletasi menggunakan metanol pro analisis. Konsentrasi ekstrak yang digunakan adalah 2, 4, 6, dan 8 mg/disk. Uji aktivitas antibakteri dilakukan dengan metode difusi disk. Hasil uji menunjukkan adanya aktivitas antibakteri terhadap bakteri Staphylococcus epidermidis dan Pseudomonas aeruginosa pada konsentrasi 8 mg/disk dengan diameter zona hambat berturut-turut sebesar 16,63 ± 0,50 mm dan 10,5 ± 0,5 mm. Identifikasi golongan senyawa metabolit sekunder daun kenikir menggunakan KLT dengan fase diam silika gel dan fase gerak etil asetat : asam asetat glasial : air (100:11:26 v/v/v), hasil menunjukkan bahwa ekstrak daun kenikir mengandung senyawa fenolik dan flavonoid. Identifikasi senyawa yang berpotensi sebagai antibakteri dengan metode bioautografi kontak tidak menunjukkan adanya potensi antibakteri.
Leading for Sustainable Health Systems
Authors: Avery Mark 
Published: December 2023

A sustainable health system is a cornerstone of any developing society, ensuring the well-being of its citizens and fostering economic development and growth. Emerging healthcare sustainability involves multifaceted aspects of what constitutes a sustainable health system, addressing key components such as accessibility, affordability, quality of care, preventive measures, and the role of technology.
Leaders play are pivotal in healthcare sustainability, yet their impact can be diluted. While some leaders champion innovative practices and resource optimisation, there is need to address systemic issues. Authentic and effective governance, adequate financial stewardship, and strategic foresight affects sustainable healthcare models. Leaders need to beyond significant short-term gains, emphasising long-term ecological and economic viability. Collaboration, transparency, and a commitment to evidence-based policies are essential. Without visionary leadership, healthcare sustainability remains elusive and fragmented, perpetuating challenges that compromise the well-being of both the system and its beneficiaries. We have the systems that we have built and we will get the systems that we build.....
Te Pepe Ao Uri Whāriki: The Development of Pūrākau Analysis Framework
Authors: Black Stella , Kidd Jacquie , Thom Katey 
Published: December 2023

Wairaka was the daughter of the rangatira Toroa, who captained the Mātaatua waka navigating across the Pacific Ocean to Aotearoa, New Zealand. When the Mātaatua waka arrived on the shores of Whakatāne, the men disembarked, but when Wairaka saw that the waka was in danger of drifting out to sea, ignoring the tapu forbidding women from handling the waka. She decisively acted to save the waka, calling out, “Kia Whakatāne au i ahau – I will act the part of a man” to draw on the strength of a man. In doing so, she heroically saved the Mātaatua waka and all those aboard. Indigenous peoples have long preserved their historical accounts using a variety of oral traditions. For Māori, the sharing of pūrākau is one-way oral records have been retained, shared and used to teach or inspire. “He kairangahau waahine, he whaangai ma matou kia kiia he uri nga Wairaka. We have adopted this group of female researchers in order that they emulate our ancestress Wairaka”.These words were included in a letter of support from kaumātua to conduct our rangahau of the te kōti rangatahi o Mātaatua. While we were honoured to be embraced, we were equally mindful of our responsibility to emulate Wairaka. From the outset, our research has been influenced by powerful pūrākau like that of Wairaka. In this article, we outline how we have drawn on personal, iwi, hapū and whānau participant pūrākau together with our observations to analyse and re-present pūrākau as a self-reflection and reflexivity analysis tool in developing a framework.
Development and validation of HPLC-FLD method for aflatoxin M1 determination in milk and dairy products
Authors: Kolarič Lukáš , Šimko Peter 
Published: December 2023

Abstract
Milk and dairy products are the most consumed foods in human diet and their safety is in the attention centre of control authorities. Aflatoxin M1 (AFM1) is a dangerous toxin that can occur in milk and dairy products as a metabolite formed from aflatoxin B1 contained in contaminated animal feed. Therefore, the aim of this study was to develop and validate a reliable method for the determination of AFM1 content in milk and dairy products based on HPLC with fluorescence detection employing immunoaffinity columns (IAC) pre-treatment. Optimal chromatographic separation of AFM1 was achieved using a water/acetonitrile mixture (80/20, v/v) as a mobile phase, column with C18 stationary phase maintained at 25 °C, and fluorescence detection at excitation wavelengths of 360 nm and emission of 440 nm. Efficacy of AFM1 extraction from the samples was found to be influenced by the elution agent composition. The best results were obtained using 1.25 mL of acetonitrile/methanol (3/2, v/v) and 1.25 mL of water. Validation parameters of the proposed method met the criteria set by the European legislation with the limits of detection and quantification at 0.002 and 0.007 µg/kg, respectively. Also, suitability of the method was confirmed by its application for AFM1 determination in certified reference material. Finally, the method was applied for AFM1 determination in 25 milk and dairy products collected in Slovakia; the AFM1 content was below the limit of quantification. It was concluded that the method is suitable for AFM1 content monitoring in milk and dairy products.
Changes in the Cytokine Profile in Patients During COVID-19 Infection
Authors: Ivanov N. , Mihailova S. , Bilyukov R. , Popov C. , Kundurzhiev T. , Naumova E. 
Published: December 2023

Abstract
COVID-19 has proven to be a disease that affects not only the respiratory tract but also leads to a state of generalized systemic hyperinflammation and overall immune dysregulation. An important role in its pathogenesis is the disturbance of many cytokines – a condition which, in its most pronounced form, is also called a „cytokine storm“.

Objective
To evaluate the serum cytokine levels during COVID-19 infection as potential biomarkers for the severity and course of infection.

Materials and methods
By design, the study is a retrospective cross-sectional, in which the serum concentrations of 10 pro- and anti-inflammatory cytokines (IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, TNF-α, and GM-CSF) were investigated in 36 individuals (divided into 3 groups by severity – with a mild form of the infection/presymptomatic, moderately severe and severe/critical) within two periods – before and after the second week from the onset of symptoms of the disease.

Results
In the period up to the 2nd week, the serum concentrations of IFN-γ (p = 0.029), IL-1β (p = 0.017), and IL-5 (p = 0.014) showed a statistically significant correlation with the disease severity, however in the later stage of the disease the cytokine levels did not show any clinical value.

Conclusion
Cytokine testing could be used to predict the severity of COVID-19 infection which could support individual therapeutic decisions. Analysis of a larger group of patients is needed to unfold the full potential of such testing.
Role of Bacterial and Viral Infections and Co-Infections in Miscarriages
Authors: Mesechkova K. , Kavrakova A. , Todorova E. , Georgieva B. , Sigridov I. , Mitev V. , Todorova A. 
Published: December 2023

Abstract

Aim
To investigate the potential role of the following bacterial/viral panel (Chlamydia trachomatis, Ureaplasma urealyticum/parvum, Mycomplasma hominis/genitalium, Gardnerella vaginalis, HSV1/2, EBV, CMV, VZV, HHV6, HHV7, HHV8) as causative factors for miscarriages in women by testing endometrial biopsies. Anaerobic and aerobic microorganisms causing dysbiosis and endometrial bacterial colonization by unbalanced growth were additionally tested.

Materials and methods
In total, 65 patients with a history of early and late miscarriages were analyzed. DNA extractions, real-time qPCR, agarose gel-electrophoresis were applied. Comparative analysis of the current with previously obtained data on the described panel in menstrual tissue samples was performed.

Results
In 64,6% of all tested endometrial biopsies bacterial and/or viral pathogens were detected. In 49,23% of all tested samples we found bacterial, while in 15,3% – viral pathogens. These results are similar to our previous data on menstrual tissue samples of infertile women – 61,1% infected, as 48,8% had bacterial and 22,2% had viral pathogens. Gardnerella vaginalis and Ureaplasma parvum were detected in 31,25% and 3,12% of all bacterial infected endometrial biopsies, significantly lower in comparison to the estimated rate of 69,31% and 61,36% on menstrual tissue. Anaerobic and aerobic dysbiosis were detected in 53,33% and 27% of the bacterial infected endometrial samples. In 13,33% a dysbiosis with a mixed etiology was found, while in 7% a dysbiotic condition with a totally absent findings of targeted bacteria and Lactobacillus was observed. EBV, CMV, HHV6 and HHV7 were detected in 30%, 30%, 20% and 20% of the positive for viral factors endometrial biopsies and in 40%, 7,5%, 10% and 42,5% in menstrual tissue samples. In the current study 62,5% bacterial co-infection and 12,5% bacterial/viral co-infection variants were found. Infections with the rest of the target pathogens were not detected in the endometrial biopsies. In contrast to the endometrial biopsy results, Mycomplasma hominis, Ureaplasma urealyticum and HSV2 were detected in our previous research on menstrual tissue samples.

Conclusions
Our research suggests a possible dysbiosis as a consequence of bacterial/viral endometrial colonization, associated with miscarriages. We prove that menstrual tissue, containing parts of the functional endometrial layer, is a reliable and accurate noninvasive sample for infectious screening of the upper genital tract.
Linguistic Validation, Adaptation, and Reliability of the Liverpool Elbow Score’s Patient-Answered Questionnaire in Bulgarian the Bulgarian Les-Paq Questionnaire
Authors: Tsenkov Ts. , Slavchev S. , Dimitrov N. 
Published: December 2023

Abstract

Background
There is a lack of upper-limb organ specific patient-reported questionnaires that are linguistically validated and culturally adapted for the Bulgarian population. The Liverpool Elbow Score (LES) is a mixed elbow-specific score with excellent psychometric properties of the patient-answered questionnaire (PAQ). There is no Bulgarian version. The aim of this study was to perform a linguistic validation and cultural adaptation of the LES−PAQ in Bulgarian, and to test the validity and reliability of the Bulgarian version.

Materials and Methods
The study was conducted in a single institution. Participant selection criteria were defined – included were mentally healthy adult patients with a diagnosis of osteochondritis dissecans of the radiocapitellar joint, elbow arthritis, lateral epicondylitis and elbow contracture. Excluded were patients with coexisting upper limb conditions, illiterate and non-native Bulgarian speakers. The Bulgarian LES−PAQ was created. The process consisted of forward translation, reconciliation and backward translation. An expert committee agreed upon a pre-final Bulgarian version. A final version was decided after cultural adaptation. The psychometric properties and reliability of the Bulgarian LES−PAQ was tested.

Results
101 patients were included in this study. We did not observe a ceiling or floor effect. Cronbach’s α coefficient was 0.858. Intraclass correlation coefficient was 0.864 (95% CI 0.77 to 0.92; p < 0.05). A moderate negative correlation was revealed between the LES-PAQ and the DASH (r = -0.591, p < 0.05), and a high positive correlation with SF-12 (r = 0.867, p < 0.001).

Conclusion
The Bulgarian LES−PAQ is a reliable and valid instrument for assessing elbow conditions such as osteochondritis dissecans of the radiocapitellar joint, elbow arthritis, lateral epicondylitis and elbow contracture. It may assist Bulgarian healthcare professionals in both research and daily work.
Attitude of Athletes Towards Dietary Supplements
Authors: Miteva I. , Kundurdzhiev T. , Valchev V. 
Published: December 2023

Abstract
At the beginning of 2023 we carried out a survey among active athletes asking about their attitude towards dietary supplements.

Aim
The aim of the study was to evaluate the attitude of athletes towards dietary supplements using a survey method. The objective of the study was to determine whether active athletes use dietary supplements.

Materials and methods
The participants in the study were asked to anonymously complete a survey consisting of 16 questions. In January 2023, we surveyed 50 active athletes from the „Vasil Levski” National Sports Academy (35 men and 15 women). Forty-six of the participants were between 18 and 22 years old and 4 were between 23 and 27 years old.

Results
The majority (94%) of the surveyed athletes trusted the advertisement of a particular dietary supplement. Ninety per cent had complete trust in the pharmacists’ advice. Pharmacists played a significant role in the choice of dietary supplements. A high percentage (60%) of the respondents who used dietary supplements had not sought medical advice prior to their use. Ninety per cent of the respondents used dietary supplements for weight loss in order to fit in a particular category; 78% indicated that they used dietary supplements for improvement of their sports achievements; 72% used supplements to increase their stamina and 46% – to shorten their time for recovery. A campaign should be initiated to encourage the use of dietary supplements only when they are prescribed by physicians.
Comparison of Ultrasonography and Cone-Beam Computed Tomography Accuracy in Measuring the Soft Tissue Thickness of Maxillary and Mandibular Gingiva in a Sheep Model
Authors: Latifi S. , Moudi E. , Abesi F. , Minouei A. , Hozouri M. , Bijani A. 
Published: December 2023

Abstract

Background
To date, few studies have compared the accuracy of cone-beam computed tomography (CBCT) and ultrasonography in measuring the soft tissue thickness of the maxillary and mandibular gingiva.

Aims
To compare the accuracy of ultrasonography and CBCT in measuring the soft tissue thickness of the maxillary and mandibular gingiva in a sheep model.

Materials and Methods
In this study, 38 different landmarks (26 points from the upper jaw and 12 points from the lower jaw) were evaluated. The gingival soft tissue thickness was measured using a digital caliper, ultrasonography, and standard and high-resolution CBCTs. The measurements were finally compared with each other.

Results
Regarding the thicknesses < 2 mm, no significant difference was seen between the measurements of the digital caliper and ultrasonography (mean difference < 0.1 mm, p = 0.140). Conversely, data analysis indicated significant differences between CBCTs measurements and digital caliper and ultrasonography measurements. Regarding thicknesses > 2 mm, digital caliper measurement was not significantly different from ultrasonography and high-resolution CBCT measurements (mean differences < 0.1 mm) but differed from the standard CBCT measurement. Also, a significant difference was observed between ultrasonography and standard CBCT measurements but not between ultrasonography and high-resolution CBCT (mean differences < 0.1 mm). Finally, mean differences between standard and high-resolution CBCT measurements were statistically significant.

Conclusion
According to the results, ultrasonography can be a reliable option for measuring gingival soft tissues regardless of their thickness, while CBCT may be more suitable for thicker gingival tissues. Clinicians should carefully consider the measurement accuracy of different imaging methods when planning dental procedures.
A Rare Case of Adult Precursor B-Cell Lymphoblastic Lymphoma/Leukemia Presenting with Multiple Osteolytic Bone Lesions as Sole Manifestation
Authors: Micheva I. , Dimitrova S. 
Published: December 2023

Abstract
Primary precursor B-lymphoblastic lymphoma/leukemia (B-LBLL) of bone is uncommon neoplasm that accounts for less than 1% of primary bone tumors. It has been commonly reported in pediatric population but is rare in adults. We present a case of a 20-year-old man with multiple osteolytic lesions as sole presentation of acute lymphoblastic leukemia, whose diagnosis was established by bone biopsy. A peripheral blood smear and the bone marrow aspirate showed no blast cells. The patient received treatment according to BFM 99 protocol and achieved complete response confirmed by F-FDG-PET/CT.
Current Therapeutic Options in Active Moderate-to-Severe Thyroid-Associated Ophthalmopathy
Authors: Stoynova M. , Shinkov A. , Kovatcheva R. 
Published: December 2023

Abstract
Active moderate-to-severe TAO is a disease, the treatment of which requires a multidisciplinary team, an individualized approach and strict follow-up, yet it is often suboptimal. Recent knowledge about the pathogenesis of the disease and the randomized controlled trials conducted in recent years made it possible to use new therapeutic combinations and biological agents. The currently recommended first-line therapy for active moderate-to-severe TAO is the combination of intravenous glucocorticoids (GCs) in moderate doses and mycophenolate or, in more severe cases, a high-dose GC treatment alone. There are several options for second-choice therapy, if needed: a new course with GCs, combination of orbital radiotherapy and GCs (preferably intravenous), cyclosporine and oral GCs, azathioprine and oral GCs, rituximab, tocilizumab or teprotumumab. The clinical manifestations of TAO should also be considered when choosing second-line treatment. Thus, for example, teprotumumab best affects diplopia, orbital radiotherapy – visual disturbances and diplopia, while intravenous GCs, mycophenolate, cyclosporine, rituximab and tocilizumab – the inflammatory manifestations of TAO. However, the question of the availability of the new drugs in routine clinical practice remains unsolved.
The Death of Sperm Cells
Authors: Kavaldzhieva K. K. , Dimitrova-Dikanarova D. K. , Mladenova K. S. , Lazarov V. V. , Mladenov N. Y. 
Published: December 2023

Abstract
A major factor affecting male fertility is excessive death of germ cells, both immature germ cells and mature spermatozoa. It can be due to various factors causing testicular and/or post-testicular damage, such as infections, obstructive conditions, toxins, oxidative stress, hormonal imbalance, hyperthermia, and anti-sperm antibodies. Massive death of spermatozoa leads to a high proportion of dead sperm cells in the ejaculate (necrozoospermia or necrospermia) while death of immature germ cells can lead to low sperm count (oligozoospermia or oligospermia). Cell death can occur both by necrosis and by apoptosis; in recent decades, it has been found that apoptosis of mature spermatozoa is not only possible but quite common, and can contribute to infertility. Treatment approaches are primarily directed to the underlying condition, i.e. removing the cause(s) of sperm cell death whenever possible, but include also attempts to bypass the cell death event by intracytoplasmic sperm injection with testicular spermatozoa.
Decentralized Clinical Trials – Current Environment, Potential Barriers and Facilitators for Implementation and Risk Mitigation: A Review of the Literature
Authors: Dimitrova M. , Hristov R. , Djemadan A. , Gaytandzieva I. 
Published: December 2023

Abstract

Introduction
Decentralized clinical trials are a new approach in health technology research and development that take advantage of innovative digital technologies in data collection for clinical trial purposes. Decentralized clinical trials achieve shorter participant recruitment periods, better adherence to assigned therapy, lower drop-out rates and shorter trial duration overall. Participants reported greater convenience compared to traditional clinical trials due to the studies being conducted at home and the removal of transport and time barriers.

Materials and methods
A literature review was conducted using the Scoping Review methodology defined by Arskey and O’Malley in 2005 and further updated in 2010 and 2014. PubMed, Scopus, and Google Scholar scientific databases were searched using predefined inclusion and exclusion criteria and keywords: virtual clinical trials, and/or decentralized clinical trials and barriers and challenges.

Results
The literature review found 40 articles that met the specified inclusion and exclusion criteria. The results of the different studies in this area show that decentralized clinical trials achieve shorter recruitment periods, better adherence to assigned therapy, lower dropout rates from trials, and shorter trial duration overall. Participants reported greater convenience compared to traditional clinical trials due to the studies being conducted at home and the removal of transport and time barriers. Major challenges with this type of trial is the difficulty in conducting physical examinations, invasive therapies by the investigators, and privacy protection.

Conclusion
The adoption of a regulatory framework for digital healthcare, education of medical professionals and patients about innovative technologies are necessary, especially in countries from Central and Eastern Europe.