bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Pulmonary Hypertension during Pregnancy
Authors: Matusov Yuri , Khan Adnan , Levian Candace , Ozimek John , Tapson Victor F. 
Published: February 2024

:
Pregnancy in patients with pulmonary arterial hypertension (PAH) is a high-risk condition
associated with high morbidity and mortality. Patients with severe PAH are often advised
against pregnancy. Still, those patients who pursue pregnancy require a dedicated and multidisciplinary
approach since the progression of fetal growth will accompany significant hemodynamic
changes, which can be challenging for patients with a poorly functioning right ventricle. In this article,
we describe the approach to the unique cardiovascular, respiratory, hematologic, and social
challenges that pregnant patients with PAH face throughout pregnancy. We discuss the impact of
these physiologic changes on diagnostic studies commonly used in PAH and how to incorporate
diagnostic data in making the diagnosis and risk stratifying pregnant patients with PAH. The pharmacologic
challenges of pulmonary vasodilators in pregnancy are discussed as well. Pregnant patients
with PAH are at particularly high risk of mortality around the time of delivery, and we discuss
the multidisciplinary approach to the management of these patients, including the use of anesthesia,
inotropic support, type of delivery, and postpartum care, providing clinicians with a practical
approach to the management of this difficult condition.
Comparative Effectiveness of Oral Hypoglycemic Agents for Glycemic Control and Glycemic Variability in Patients with Type 2 Diabetes Mellitus: Using Flash Glucose Monitoring
Authors: Venkatachalapathy Poongothai , Mohandoss Karthik Kumar Dos Alagarswamy , Munisamy Murali , Sellappan Mohan 
Published: February 2024

Aim:
The study aimed to compare the effectiveness of oral hypoglycemic agents
(OHAs) as monotherapy, dual and quadruple therapy for glycemic control (GC) and glycemic
variability (GV) in patients with type-2 diabetes (T2DM) using flash glucose monitoring system
(FGM).

Background:
Diabetes management largely relies on HbA1c monitoring. Glycemic variability
(GV) has been an evolving glycemic target for preventing complications related to type 2 diabetes
mellitus (T2DM).

Objective:
The purpose of the study was to compare glycemic control (GC) measures and glycemic
variability (GV) measures among study groups and to study the relationships between
GC and GV indices.

Methods:
Retrospectively, FGM data were collected from 50 T2DM patients. The patients were
classified based on prescribed number of OHAs as monotherapy [group 1: dipeptidyl peptidase-
4 (DPP-4) inhibitors (n=10), group 2: sodium-glucose co-transporter-2 (SGLT2) inhibitors
(n=10), group 3: sulphonylureas (n=10), group 4: dual therapy (n=10), and group 5: quadruple
therapy (n=10)]. Measures of GC and GV were evaluated.

Results:
Significant differences between study groups were observed in GC and GV measurements.
The SGLT2 inhibitors monotherapy group demonstrated optimal GC [eA1c (%): 6.5 ±
2.2; MBG: 140.80 ± 63.94; TIR: 60.60 ± 19.96] and GV (SD: 42.38 ± 34.57; CV: 27.85 ± 6.68;
MAGE: 96.76 ± 52.47; MODD: 33.96 ± 22.91) in comparison to other study groups. On using
Pearson correlation analysis, mean blood glucose (MBG) and mean amplitude of glycemic excursion
(MAGE) showed moderate correlation (r = 0.742)(r2 = 0.551), depicting distinct glucose
variabilities at the same mean blood glucose levels.

Conclusion:
The monotherapy group of SGLT2 inhibitors demonstrated glucose-lowering effects
with reduced glycemic variability. Hence, optimum glycemic control is associated with
decreased glycemic variability.
Therapeutic Interventions to Improve Static Balance in Type 2 Diabetes
Mellitus: A Systematic Review and Meta-Analysis
Authors: Marques Pedro Ana Cristina , Diógenes Campelo Bruna Larysse , Costa Souza Wellington , da Silva Sousa Fernanda Mello , da Rocha Rebeca Barbosa , Saura Cardoso Vinicius 
Published: February 2024

Introduction:
Diabetes mellitus (DM) is a metabolic disorder characterized by an abnormal
increase in blood glucose levels resulting from insulin secretion and/or dysfunctional activity
that can lead to several serious complications in addition to decreased postural balance.

Objective:
This study aimed to identify and analyze the main interventions used to improve static
balance in patients with DM.

Methods:
For the selection of articles, a bibliographic search was performed using PubMed,
Scopus, Web of Science, Embase, and Cochrane databases. Only clinical trials that investigated
the effect of training on static balance in adults with type 2 DM were selected, and 34 studies
were included.

Results:
The search resulted in the identification of 2681 articles, and of these, 31 were eligible
for the study. The identified interventions were proprioceptive, aerobic, resistance training on
platforms, in virtual reality, and Tai Chi. The main results obtained were an increase in time in
the one-leg stance, Romberg test, and tandem position, a significant increase in the Berg Balance
Scale score and balance index, and a reduction in the variables of postural sway.

Conclusion:
There are a variety of effective training methods for improving static balance, and
the choice of intervention to be applied goes beyond proven effectiveness, depending on reproducibility
and/or financial cost.
Glycemic Control in Patients with Type 1 Diabetes: Comparison of Holidays
versus Schooldays
Authors: Al Hayek Ayman , Alwin Robert Asirvatham , Almonea Khuloud Ibrahim , Al Dawish Mohamed Abdulaziz 
Published: February 2024

Background and Aims:
To examine the influence of school life in children and adolescents
with type 1 diabetes (T1D) by comparing the glycemic control and Ambulatory Glucose
Profile (AGP) between the holidays and schooldays.

Methods:
This is a retrospective study conducted on 147 patients with T1D (14-19 years) who
used an intermittently scanned Continuous Glucose Monitoring (isCGM) system to self-test their
glucose levels during the periods of school time and holiday time. A record was maintained of the
Continuous Glucose Monitoring (CGM) metrics i.e., Glucose Variability (GV) (%), mean Time in
Range (TIR), Time above Range (TAR), Time below Range (TBR), and average time period of
the hypoglycemic events during schooldays and the holidays.

Results:
The study revealed differences between the recorded values during the holidays and
schooldays, in % in target 70-180 mg/dL (38.2 vs 49.5; p = 0.039), mean glucose (194 vs 185; p =
0.048), frequency of low glucose events (9.2 vs 5.1; p = 0.036), mean duration of low glucose
levels (117 vs 65; p = 0.021), % TBR below 70 mg/dL (2.9 vs 1.45; p = 0.023), % TBR below 54
mg/dL (1.1 vs 0.51; p = 0.031), TAR 181-250 mg/dL (21.1 vs 16.5; p = 0.037) and TAR >250
mg/dL (8.9 vs 6.5; p=0.043). On comparing the HbA1c levels of the study population recorded
during the holidays (8.34%) with those recorded during the schooldays (8.13%), the HbA1c values
during the school days were observed to be lower; however, no significant changes were noted in
the HbA1c level between the holidays and schooldays. Concerning the FreeStyle Libre (FSL) scanning,
the frequency during the holidays (n=6.2) was significantly lower than during the schooldays
(n=9.5) (p=0.042).

Conclusion:
From the findings, it appears that children with T1D have good diabetes control during
schooldays rather than during the holidays. To improve their glucose control during the holidays,
these patients may also benefit from receiving greater attention and guidance.

result:
The study revealed crucial differences between the recorded values during the holidays and schooldays, in % in target 70-180 mg/dL (38.2 vs 49.5; p = 0.039), mean glucose (194 vs 185; p = 0.048), frequency of low glucose events (9.2 vs 5.1; p = 0.036), mean duration of low glucose levels (117 vs 65; p = 0.021),

conclusion:
From the findings, it appears that children with T1D have good diabetes control during schooldays rather than during the holidays. In order to improve their glucose control during the holidays, these patients may also benefit from receiving greater attention and guidance.
Progress in Cardiac Magnetic Resonance Feature Tracking for Evaluating
Myocardial Strain in Type-2 Diabetes Mellitus
Authors: Shen Li-Ting , Shi Rui , Yang Zhi-Gang , Gao Yue , Jiang Yi-Ning , Fang Han , Min Chen-Yan , Li Yuan 
Published: February 2024

Abstract:
The global prevalence of type-2 diabetes mellitus (T2DM) has caused harm to human
health and economies. Cardiovascular disease is one main cause of T2DM mortality. Increased
prevalence of diabetes and associated heart failure (HF) is common in older populations, so accurately
evaluating heart-related injury and T2DM risk factors and conducting early intervention
are important. Quantitative cardiovascular system imaging assessments, including functional imaging
during cardiovascular disease treatment, are also important. The left-ventricular ejection
fraction (LVEF) has been traditionally used to monitor cardiac function; it is often preserved or
increased in early T2DM, but subclinical heart deformation and dysfunction can occur. Myocardial
strains are sensitive to global and regional heart dysfunction in subclinical T2DM. Cardiac
magnetic resonance feature-tracking technology (CMR-FT) can visualize and quantify strain and
identify subclinical myocardial injury for early management, especially with preserved LVEF.
Meanwhile, CMR-FT can be used to evaluate the multiple cardiac chambers involvement mediated
by T2DM and the coexistence of complications. This review discusses CMR-FT principles,
clinical applications, and research progress in the evaluation of myocardial strain in T2DM.
Psychosocial Facilitators and Barriers to Type 2 Diabetes Management in
Adults: A Meta-Synthesis
Authors: Lekha P. Padma Sri , Abdul Azeez E.P. 
Published: February 2024

Background::
Globally, the cases of type 2 diabetes are increasing, and this is largely
attributed to lifestyle changes. Though diabetes is primarily a metabolic disease determined by
biological factors, psychosocial aspects play a crucial role in its progression and management.
However, the literature on psychosocial dimensions of diabetes management is minuscule and
scattered.

Objective::
This synthesis sought to understand the psychosocial facilitators and barriers to type 2
diabetes management and coping among adults.

Methods::
We have adopted a meta-synthesis to review available qualitative studies using Pub-
Med and Scopus databases. Based on inclusion criteria, we have chosen 24 studies published between
2010 and 2023. We have considered studies across countries, among which 63% of the
studies included were from Western countries, and most have employed qualitative descriptive
design. The selected studies were analyzed thematically using a deductive framework.

Results::
Six themes emerged as the psychosocial barriers and facilitators of managing and coping
with type 2 diabetes: 1) cognitive-emotional factors, 2) faith, 3) constraints to behavioural
change, 4) social constraints and support, 5) healthcare provider-patient relationship, and 6)
awareness. Further, a conceptual framework was developed from the synthesis.

Conclusion::
The patients' experiences evident from this synthesis signify the crucial role of psychosocial
factors in diabetes management and coping. This evidence emphasizes the need for integrated
care so that psychosocial aspects are addressed by healthcare providers and behavioural
health professionals, which may lead to the promotion of facilitators and the minimization of barriers.
Dietary Effects of Fasting on the Lipid Panel
Authors: Hourizadeh Jason , Munshi Rezwan , Zeltser Roman , Makaryus Amgad N. 
Published: February 2024

Introduction::
Dietary habits, such as the Mediterranean diet and the Dietary Approaches
to Stop Hypertension (DASH), have been shown to improve cardiac health.

Methods:
Another more recent popular form of dieting incorporates periods of fasting known as
intermittent fasting. The two main forms are alternate-day fasting and time-restricted eating.

Results:
There have been studies that have shown that intermittent fasting does provide a benefit
in cardiovascular health, weight loss, and hypertension. However, the effect on cholesterol and
triglyceride levels during intermittent fasting is in question.

Conclusion::
This review evaluates the current literature regarding the effects of this dietary
model and other types of fasting on the lipid panel.
Emerging Strategies and Effective Prevention Measures for Investigating
the Association Between Stroke and Sudden Cardiac Fatality
Authors: H. Nithesh Kumar , S. Jeevanandham , Ganesh M. Shankar , M. Ashmi Sabana , P. Manivasakam 
Published: February 2024

Abstract::
Stroke-related cardiac death is a significant concern for patients with stroke and their
healthcare providers. It is a complex and multifaceted condition that requires careful management
of both modifiable and non-modifiable risk factors. This review provides an overview of
the pathophysiology, risk factors, and prevention strategies for stroke-related cardiac death. The
review highlights the importance of identifying and managing modifiable risk factors such as
hypertension, diabetes, and lifestyle factors, as well as non-modifiable risk factors such as age
and genetics. Additionally, the review explores emerging strategies for prevention, including the
use of wearable devices and genetic testing to identify patients at risk, stem cell therapy and
gene therapy for cardiac dysfunction, and precision medicine for personalized treatment plans.
Despite some limitations to this review, it provides valuable insights into the current understanding
of stroke-related cardiac death and identifies important areas for future research. Ultimately,
the implementation of evidence-based prevention strategies and personalized treatment
plans has the potential to improve outcomes for patients with stroke and reduce the burden of
stroke-related cardiac death in the population.
Modular Edge Analysis Reveals Chemotherapy-induced Brain Network
Changes in Lung Cancer Patients
Authors: You Jia , Wang Zhengqian , Hu Lanyue , Zhang Yujie , Chen Feifei , Yin Xindao , Chen Yu-Chen , Yong Xiaomin 
Published: February 2024

Background::
Lung cancer patients with post-chemotherapy may have disconnected or weakened function connections within brain networks.

Objective::
This study aimed to explore the abnormality of brain functional networks in lung cancer patients with post-chemotherapy by modular edge
analysis.

Methods::
Resting-state functional magnetic resonance imaging (rs-fMRI) scans were performed on 40 patients after chemotherapy, 40 patients before
chemotherapy and 40 normal controls. Patients in all three groups were age and sex well-matched. Then, modular edge analysis was applied to
assess brain functional network alterations.

Results::
Post-chemotherapy patients had the worst MoCA scores among the three groups (p < 0.001). In intra-modular connections, compared with normal
controls, the patients after chemotherapy had decreased connection strengths in the occipital lobe module (p < 0.05). Compared with the nonchemotherapy
group, the patients after chemotherapy had decreased connection strengths in the subcortical module (p < 0.05). In inter-modular
connections, compared with normal controls, the patients after chemotherapy had decreased connection strength in the frontal-temporal lobe
modules (p < 0.05). Compared with the non-chemotherapy group, the patients after chemotherapy had decreased connection strength in the
subcortical-temporal lobe modules (p < 0.05).

Conclusion::
The results reveal that chemotherapy can disrupt connections in brain functional networks. As far as we know, the use of modular edge analysis to
report changes in brain functional brain networks associated with chemotherapy was rarely reported. Modular edge analysis may play a crucial part
in predicting the clinical outcome for the patients after chemotherapy.
Optimization and Transfollicular Delivery of Finasteride Loaded PLGA
Nanoparticles Laden Carbopol Gel for Treatment of Hair Growth
Stimulation
Authors: Kuchukuntla Mounika , Palanivel Venkatesan , Ananthula Madhubabu 
Published: February 2024

Background:
One of the frequent side effects of cancer treatment is chemotherapyinduced alopecia (CIA). The psychological discomfort of hair loss may cause patients to stop receiving chemotherapy, lowering the therapy's effectiveness. Finasteride (FNS), a JAK inhibitor, has
shown tremendous promise in therapeutic uses for treating baldness. Still, systemic side effects constrained its broad use in alopecia from oral treatment and a low absorption rate at the target site—
PLGA-loaded nanoparticles (NPs) for topical delivery of FNS—to overcome these issues.

Methods:
The nano-precipitation process was used to make FNS-NPs. The independent variables
(stabiliser and polymer) were PLGA (X1), P407 (X2), and sonication time (X3). Based on the
point prediction method obtainable by the Box Behnken design software, the best FNS-NPs composition was selected. Entrapment efficiency, particle size, zeta potential, and polydispersity index were used to characterize the nanoparticles. Using Carbopol as a polymer, the ideal FNS-NPs
composition was further transformed into a gel formulation. The prepared topical gel formulation
(FNS-NPs gel) included gel characterization, Dynamic Light Scattering (DLS), Scanning Electron Microscopy (SEM), Powder X-ray Diffraction (PXRD), Differential Scanning Calorimetry
(DSC), Fourier Transform Infrared Spectroscopy (FTIR), invitro and in vivo studies.

Results:
Optimized FNS-NPs (F13) had particle sizes of 175.26±3.85 nm, 0.241±0.11 PDI,
71.04±1.35 % EE, and -33.27±0.39 surface charges. There is no interaction between the drug and
the excipients, according to FTIR studies. The FNS were visible in the X-ray diffractogram enclosed in a polymer matrix. The developed FNS-NPs gel formulation shows ideal drug content,
viscosity, pH, and spreadability. According to the release and permeation investigation findings,
FNS released slowly (68.73±0.94%) but significantly permeated the membrane more than before.
In a dose- and time-dependent manner, the produced nanoparticles considerably (p≤0.05) increased FNS delivery compared to the FNS solution. The FNS-NPs gel therapy significantly increases the quantity and size of hair follicles dose-dependently. The effectiveness of the 1% FNSNPs gel and the 2% minoxidil solution were comparable. After 72 hours, the FNS-NPs gel
showed no signs of skin irritation. The outcomes, therefore, showed that the trans follicular delivery mechanism of the FNS-NPs gel might stimulate hair growth.

Conclusion:
These findings imply that the innovative formulation that has been developed has several
beneficial properties that make it suitable for FNS dermal delivery in the treatment of alopecia areata
Insights to Design New Drugs against Human African Trypanosomiasis Targeting Rhodesain using Covalent Docking, Molecular Dynamics Simulations, and MM-PBSA Calculations
Authors: dos Santos Nascimento Igor José , Santos Mirelly Barbosa , De Jesus Marinho Washley Phyama , de Moura Ricardo Olimpio 
Published: February 2024

Background:
Neglected tropical diseases (NTDs) are parasitic and bacterial diseases
that affect approximately 149 countries, mainly the poor population without basic sanitation.
Among these, Human African Trypanosomiasis (HAT), known as sleeping sickness, shows
alarming data, with treatment based on suramin and pentamidine in the initial phase and melarsoprol
and eflornithine in the chronic phase. Thus, to discover new drugs, several studies
point to rhodesain as a promising drug target due to the function of protein degradation and intracellular
transport of proteins between the insect and host cells and is present in all cycle phases
of the parasite.

Methods:
Here, based on the previous studies by Nascimento et al. (2021) [5], that show the
main rhodesain inhibitors development in the last decade, molecular docking and dynamics
were applied in these inhibitors datasets to reveal crucial information that can be into drug
design.

Results:
Also, our findings using MD simulations and MM-PBSA calculations confirmed Gly19,
Gly23, Gly65, Asp161, and Trp184, showing high binding energy (ΔGbind between -72.782 to
-124.477 kJ.mol-1). In addition, Van der Waals interactions have a better contribution (-140,930
to -96,988 kJ.mol-1) than electrostatic forces (-43,270 to -6,854 kJ.mol-1), indicating Van der
Waals interactions are the leading forces in forming and maintaining ligand-rhodesain complexes.
Thus, conventional and covalent docking was employed and highlighted the presence of Michael
acceptors in the ligands in a peptidomimetics scaffold, and interaction with Gly19, Gly23,
Gly65, Asp161, and Trp184 is essential to the inhibiting activity. Furthermore, the Dynamic
Cross-Correlation Maps (DCCM) show more correlated movements for all complexes than the
free rhodesain and strong interactions in the regions of the aforementioned residues. Principal
Component Analysis (PCA) demonstrates complex stability corroborating with RMSF and
RMSD.

Conclusion:
This study can provide valuable insights that can guide researchers worldwide to
discover a new promising drug against HAT.
Mechanism of the Effect of Scopolamine on Breast Cancer: Determination by Network Pharmacology and Bioinformatics
Authors: Xiao Yang , Guo Qiang , Li Yichen , Ma Mengcong , Sun Yu , Gu Qing , Xiao Yunfeng 
Published: February 2024

Background:
To a certain extent, traditional Chinese medicine (TCM)-based anesthesia
has replaced opiate administration in recent years. Preliminary drug screening has revealed
that scopolamine may affect breast cancer (BC) metastasis by an unknown mechanism.

Methods:
Network pharmacology, bioinformatics, and protein-protein interaction (PPI) topological
analysis were implemented to identify the core genes linking scopolamine and BC. The core
genes were then subjected to gene expression profiling interactive analysis (GEPIA). The top
ten pathways were detected by gene ontology (GO) enrichment and Kyoto Encyclopedia of
Genes and Genomes (KEGG) pathway analyses. The impact of immune infiltration on the core
gene difference and survival analyses was then determined. Molecular docking was then performed
on the core genes and the main active components.

Results:
Protein kinase 1 (AKT1), epidermal growth factor receptor (EGFR), heat shock protein
90 alpha class A (HSP90AA1), caspase 3 (CASP3), and estrogen receptor 1 (ESR1) were the
key genes in the interaction between scopolamine and BC cells. The KEGG enrichment analysis
disclosed that the top ten pathways significantly associated with the scopolamine response in
BC included "protein glycosylation," "phosphoinositide 3-kinase (PI3K)-Akt signaling," "mitogen-
activated protein kinase (MAPK) signaling" and others. The AKT1, EGFR, and especially
the HSP90AA1 expression levels were correlated with survival in patients with BC. Immune
infiltration also influenced the survival outcome. Molecular docking demonstrated that scopolamine
bound and formed stable complexes with the protein products of all five aforementioned
genes.

Conclusion:
Scopolamine has multiple targets regulating BC cell function and may increase the
risk of metastasis during treatment. Therefore, it should be preoperatively administered with
caution to patients with BC.

result:
AKT1, EGFR, HSP90AA1, CASP3, and ESR1 were revealed as the five key genes. Find the top ten pathways with possible effects by GO enrichment analysis and KEGG pathway analysis, and get the results of core gene difference analysis and survival analyses and explore the effect of immune infiltration only on them. Finally, molecular docking between the core genes and the main active components was performed for verification.