bluuebunny/crossref_metadata_2025_split huggingface dataset:
To Correlate the Expression of KRAS and BRAF V600e with Histological Grades and Variants in Tissue Samples of Colorectal Carcinoma
Authors: Wasti Hina , Shawana Sumayyah , Shafique Sehrish , Shahid Yumna , Saleem Kiran , Sidhwani Santosh Kumar 
Published: April 2023

OBJECTIVES
This study aimed to correlate the expression of KRAS and BRAF V600E with histological grades and variants in tissue samples of colorectal carcinoma.METHODOLOGY
In this cross-sectional study total of 51 cases of Colorectal cancer (CRC) were analyzed for immunohistochemical staining using KRAS and BRAF antibodies on representative tissue blocks. Clinical and pathological records were retrieved for the collection of data. The results of the immunohistochemical analysis were correlated with the recorded clinicopathological parameters.RESULTSFifty-one cases of CRC were analyzed for immunoexpression of KRAS and BRAF V600E. The age of the patients ranged from 14 to 85 years, with a mean age of 60.96 years. Among the 51 cases, 37(72.5%) cases were males and 14(27.4%) were females. 37(72.5%) were localized to left side colon and 14(27.4%) were found in the right colon. For KRAS immunostaining, 41(80.3%) out of 51 cases showed overexpression, while the remaining 10(19.6%) cases revealed negative expression. In the case of BRAF V600E, positive expression was seen in 20(39.2%) cases, whereas 31(60.7%) cases showed negative expression of BRAFV600E. A significant association was seen between KRAS overexpression and histological variants, i.e. glandular carcinomas. CONCLUSIONOver-expression of KRAS was observed in advanced tumors. The presence of BRAF V600E mutation in the present study signifies the importance of BRAF V600E inhibitors as a potential alternate therapeutic tool in EGFR inhibitors and chemotherapy-resistant tumors.
Symptom Outcome of Walant Technique for Carpal Tunnel Release – A Prospective Study in the Tertiary Care Hospital, Nowshera
Authors: Hassan Naseer , Hassan Raza , Usman Muhammad , Azam Farooq , Tahir Hamayun , Marwat Zahid Irfan , Saleem Momina 
Published: April 2023

OBJECTIVES
The study aims to determine the outcome of the WALANT technique for Carpal Tunnel Release CTR.METHODOLOGY
A descriptive study was done in the Neurosurgery department at Qazi Hussain Ahmad Medical Complex, Nowshera, from 15th September 2020 to 15th March 2021. A total of 29 consecutive patients of carpal tunnel syndrome (CTS) were undergoing carpal tunnel release (CTR) under wide awake local anaesthesia no tourniquet (WALANT) technique, using a mixture of lidocaine and epinephrine for local anaesthesia, and the outcome was assessed for patient satisfaction by Boston Carpal Tunnel Questionnaire (BCTQ) (symptom severity scales (SSS)) at pre-operatively and six weeks postoperatively.RESULTSWide awake CTR was done in 29 patients; 86.2% were female and 13.8% male. The mean age was 47.3 years. The average time of return to daily activity was three weeks. No complications were noted, like wound infection and dehiscence. BCTQ symptom (BCTQ-S) score significantly improved at six weeks postoperatively. 86% significantly reduced the symptom severity score (SSS). Mean SSS improved from preoperative 3.2 points to 1.7 points postoperatively. There was a significant decrease in distal latencies (p <0.01). CONCLUSIONWide awake surgery is an excellent technique with favourable outcomes and good satisfaction rates for CTR. The study shows that clinical symptoms resolve rapidly after CTR. Without the need for monitored anaesthesia, the cost could decrease dramatically.
ELECTRONIC DOCUMENTS IN PRE-TRIAL CRIMINAL PROCEEDINGS
Authors: Савченко А.Н. 
Published: April 2023

Введение: в статье рассматривается возможность использования в досудебном уголовном произ- водстве электронных документов, предлагаются авторское понятие электронного документа в досу- дебном уголовном производстве и классификация электронных документов. Материалы и методы: методологическую основу исследования составил метод обработки и си- стематизации информации, сравнение, анализ законодательной базы, дедукция и индукция. Матери- альной основой исследования послужили труды ученых-процессуалистов, посвященные проблемам внедрения в уголовный процесс электронных уголовных дел, электронного документооборота и элек- тронных документов. Результаты исследования: автор приходит к выводу о необходимости использования в досудеб- ном уголовном производстве электронных документов, осуществляет их классификацию. Обсуждение и заключение: введение электронного документа в досудебное уголовное производ- ство будет способствовать внедрению электронного производства по уголовным делам в уголовный процесс.
Introduction: the author considers the possibility of the usage of electronic documents in the pre-trial proceedings, gives their own definition of an electronic document in the pre-trial proceedings, and electronic documents classification. Materials and Methods: the methodology of the study were methods of systematization and processing of information, analysis of legislation, deduction and induction. The material basis of the study were works of scientists-processualists devoted to the problems of implementation in the criminal process of electronic criminal cases, electronic document management and electronic documents. Results: the author concludes that it is necessary to use electronic documents in the pre-trial proceedings, classifies them and gives their own definition of electronic documents. Discussion and Conclusions: the introduction of an electronic document in pre-trial criminal proceedings will facilitate the introduction of electronic proceedings in criminal cases.
Myocarditis in Patients With Idiopathic Inflammatory Myopathies: Clinical Presentation and Outcomes
Authors: Chung Melody P. , Lovell Jana , Kelly William , Mecoli Christopher A. , Albayda Jemima , Christopher-Stine Lisa , Gilotra Nisha A. , Paik Julie J. 
Published: April 2023

ObjectiveTo determine the clinical phenotype and outcomes of patients with idiopathic inflammatory myopathies (IIMs) and myocarditis.MethodsUsing the Johns Hopkins Myositis Center Research Registry, we identified 31 adult patients with IIM—out of a total of 3082 with confirmed or suspected muscle disease—with an encounter code of myocarditis from 2004 to 2021. Of these, 14 adult patients with IIM were adjudicated to have clinical myocarditis. Information about demographics, autoantibodies, and clinical outcomes was retrospectively collected and analyzed.ResultsOf 14 patients with IIM with clinical myocarditis, the median age at IIM diagnosis was 49 (IQR 35-56) years, and the median age at myocarditis diagnosis was 54 (IQR 36-61) years. The median duration between IIM diagnosis and myocarditis was 3 (IQR 2-9) years. The majority of patients were female (8/14, 57%) and Black (10/14, 71%). Antisynthetase syndrome was the most common IIM subtype (9/14, 64%). Anti-Jo1 (n = 4) and anti-PL12 (n = 3) were the most frequent autoantibodies. At myocarditis diagnosis, most patients (11/14, 79%) had active myositis, defined as elevated creatine kinase and/or muscle weakness; required hospitalization (13/14, 93%); and had reduced left ventricular ejection fraction (LVEF < 50%; 10/14, 71%). Despite intensification of immunosuppression, the 5-year overall survival rate from IIM diagnosis was 84%, and the 5-year overall survival rate from myocarditis diagnosis was 53%. Systolic dysfunction (LVEF < 40%) at final evaluation was observed in all expired patients (n = 6).ConclusionClinical presentations of myocarditis in this select cohort of patients with IIM were severe and heterogeneous with poor outcomes despite intensification of immunosuppression, potentially reflecting late detection of myocarditis.
App-Based Mindfulness Intervention to Improve Psychological Outcomes in Pretransplant Patients With Heart Failure
Authors: Vandenbogaart Elizabeth , Gawlinski Anna , Grimley Karen A. , Lewis Mary Ann , Pavlish Carol 
Published: April 2023

BackgroundPatients hospitalized with life-threatening conditions experience psychological stressors that can lead to anxiety and poor patient outcomes. Mindfulness stress reduction interventions have been shown to decrease stress and anxiety with sustained effect.Local ProblemIn a single center’s cardiac care units, only pharmacological stress reduction options were embedded in the daily care plan.MethodsThis project evaluated the feasibility and effect of a brief mindfulness intervention on stress, anxiety, and resilience in 20 hospitalized patients with advanced heart failure awaiting transplant. A 1-group, pretest-posttest design over a 4-week period was used. The intervention included a one-on-one mindfulness education session and a 12-minute audio-guided tablet computer app for daily self-practice. Outcome variables measured at baseline and 2 and 4 weeks after implementation included stress (10-item Perceived Stress Scale), anxiety (7-item Generalized Anxiety Disorder instrument), and resilience (10-item Connor-Davidson Resilience Scale). Statistical analysis included descriptive statistics and repeated-measures analysis of variance with Friedman tests, Bonferroni post hoc tests, and Wilcoxon matched-pairs tests.ResultsSignificant reductions in stress and anxiety and increase in resilience occurred from baseline to 2 weeks and 4 weeks after intervention (all P = .001). Feasibility and acceptability were evident from patient experience survey data and focused interview responses.ConclusionsA brief mindfulness intervention holds promise for improving stress, anxiety, and resilience for patients with advanced heart failure awaiting transplant. Nurse-led stress reduction interventions are imperative for best patient outcomes. An evidence-based intervention of mindfulness practice embedded into daily usual patient care may be a feasible option.
Implementing a Unit-Based Alarm Management Bundle for Critical Care Nurses
Authors: Bosma Stephanie , Christopher Roberta 
Published: April 2023

BackgroundClinical alarms are designed to signal an unsatisfactory patient physiological state and alert staff members to malfunctioning medical equipment. Alarm desensitization and fatigue can occur when clinicians are exposed to an overwhelming number of clinical alarms, particularly nonactionable alarms.Local ProblemAlarm fatigue and alarm management competency related to use of Philips monitoring systems were noted to be problematic among nurses working in the 27-bed surgical intensive care unit of a teaching hospital in northeastern Florida.MethodsA quality improvement project was conducted to reduce alarm fatigue and improve nursing competency in managing alarms. The CEASE (Communication, Electrodes, Appropriateness, Setup, and Education) evidence-based alarm management bundle was implemented on the unit, and a representative from the alarm manufacturer conducted in-service training sessions. A clinical alarms survey developed by the Healthcare Technology Foundation was distributed both before and after the intervention to 115 nurses working in the unit. Descriptive and inferential statistics were used to assess for differences between the preintervention and postintervention periods.ResultsNurse participants demonstrated improved alarm management competency, resulting in significant improvements in their perceptions of alarm functionality, settings, response time, and policy adherence. There was a statistically significant decrease in self-reported alarm fatigue, and the CEASE bundle was found to influence nursing practice.ConclusionsThe Joint Commission’s 2022 goal of improving clinical alarm safety remains a top priority nationwide. Implementation of the CEASE alarm management bundle was effective in reducing surgical intensive care unit nurses’ alarm fatigue and improving their alarm management practices.
Performance analysis of the refrigeration system for improving energy efficiency
Authors: Sazanskyi Andrii , Khmelniuk Mykhailo 
Published: April 2023

Refrigeration system holds an important role in many industrial processes. The global industrial refrigeration system market is expected to grow from USD 19.3 billion in 2019 to USD 25.7 billion by 2025, at a CAGR of 4.7%. The traditional systems (cascade/multistage) as well as hybrid system with non-zeotrope refrigerant blends are widely used for processes where more than one temperature level is required. The optimal utilization of energy saving technologies in industrial processes is a key issue for the rational use of energy resources in the process industry. Among the various existing energy saving means, the refrigeration system is a technology area that introduces several degrees of freedom. The goal is to identify the optimal refrigerant/refrigerant mixtures, the optimal temperature levels, and the best cycle's configuration to satisfy the refrigeration requirements of a technological process. It is common that hydrocarbons have great thermodynamic properties, making them efficient refrigerants. The problem is that hydrocarbons are highly flammable, it has restricted their wider adoption for some applications in the refrigeration industry, mostly for applications demanding large refrigerant charges. Targeting to reduce safety as well as regulatory problems getting up from the use of hydrocarbons, the performance of hydrocarbons and carbon dioxide mixtures as refrigerants in a standard vapor-compression cycle has studied. To take into account all energy losses in the compressor, a technique was used that allows one to assess the energy perfection of a hermetically sealed compressor during experimental studies. The given method contains indicators that estimate certain types of energy losses of a hermetic compressor using the electrical efficiency of the compressor.
Loop drainage in Subcutaneous Head and Neck Abscesses: A Minimally Invasive Procedure
Authors: Pakira Titasa , Dubey Arya Brata , Biswas Subhradev 
Published: April 2023

INTRODUCTION: Incision and drainage (I&D) of abscess is the gold standard treatment. The purpose of this study was to compare Loop Drainage Technique (LDT) of subcutaneous Head and Neck abscess with I&D in terms of primary outcome like efficacy and change in abscess diameter and secondary outcome like pain, duration of procedure, duration of healing and patient satisfaction.
MATERIALS AND METHODS: A prospective cohort study was conducted in a tertiary care hospital for one year. Patients were consecutively allocated to I&D and LDT. All patients underwent ultrasonic evaluation of abscess size pre-procedure and 7th day post-procedure. Both groups received antibiotics at discharge and followed up at regular interval.
RESULTS: A total of 70 patients were selected (35 in each group). Mean(sd) change in abscess diameters between I&D and LDT was not significant (p=0.83). In terms of efficacy or healing both procedures were equivalent (p=0.72). The secondary outcome like Pain (VAS score), duration of procedure was significantly lower in LDT than I&D (p<0.0001). The patient satisfaction score measured by Likert scale was significantly better in LDT than I&D (p<0.0001). However duration of healing was same in both groups (p=0.49).
CONCLUSION: Loop drainage is equally efficacious to standard I&D in abscess resolution but the duration of procedure and pain experienced was less, with better compliance.
IgG4 Related Sclerosing Inflammatory Pseudotumor Simulating Cholesteatoma Of The Temporal Bone
Authors: Dahanukar Mrinmayi , Varty Sangeeta , Chitnis Trishna 
Published: April 2023

Introduction
Sclerosing inflammatory pseudotumor of the temporal bone is a rare fibro-inflammatory, benign albeit locally aggressive pathological entity.
Case Report
We report a case of Sclerosing inflammatory pseudotumor of the temporal bone, simulating a cholesteatoma. A 61-year-old female presented with right otalgia, hearing loss, facial pain and imbalance. Ear microscopy revealed a pulsatile mass in the external auditory canal. HRCT temporal bone and MRI reported soft tissue mass in the right middle ear and mastoid air cells, causing attenuation of the ossicles with erosion through the tegmen and mastoid cortex. The patient underwent canal wall down tympanomastoidectomy. The histopathology with immunohistochemistry was consistent with IgG4 related sclerosing inflammatory pseudotumor.
Discussion
This case report explores the similarities as well as the clinical differences between cholesteatoma and IgG4 sclerosing inflammatory pseudotumor of temporal bone, along with the diagnostic and treatment challenges. It is often mistaken for neoplasm or cholesteatoma, hence should be considered as a differential diagnosis.
Tinnitus in COVID-19 Era – A Study on its Association with SARS-CoV-2 and its Outcome
Authors: Mukherjee Paroma , Haque Misbahul , Gure Prasanta Kumar , Azgaonkar Sarvesh Premanand 
Published: April 2023

Introduction
Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) virus mainly affecting the respiratory and circulatory system. In many, neuro-otological changes have been noted – tinnitus being one of the leading clinical manifestations which has skipped the limelight due to the other deadly complications of the disease. The study aims to assess the relation between COVID-19 infection and tinnitus, its relation with vaccination against COVID-19 and to assess the change in intensity of tinnitus at the end of 10 weeks after medical treatment in the patients with and without a positive COVID-19 RTPCR (Reverse Transcription-Polymerase Chain Reaction) report.
Materials and Methods
An institution based prospective comparative study was done in a tertiary hospital in Kolkata, West Bengal between July 2021 to December 2021. All patients aged between 18 and 65 years, with recent onset of subjective tinnitus since March 2020 (COVID-19 1st wave), were included in this study. Intensity of tinnitus was assessed at the end of 10 weeks after medical treatment with the help of Tinnitus Handicap Inventory (THI).
Results
Among the 84 patients with tinnitus - 20 had a history of (H/O) COVID-19 infection, 64 didn’t. Among the 20 patients who developed tinnitus post-COVID-19 infection, 2(10%) had been vaccinated while 39 out of the 64(60.9%) patients without a had been vaccinated against COVID-19 disease. At the end of 10 weeks post-treatment, 6 out of 20(30%) patients with a H/O COVID-19 showed an improvement in THI score– of them, 2 were vaccinated while 33 out of 64(51.56%) patients without a H/O COVID-19 showed improvement in THI score – of them 28 were vaccinated against COVID-19.
Conclusion
Our study concludes that the chances of developing tinnitus is more in those who have not been vaccinated against COVID-19 and post-medication improvement of tinnitus in COVID-19 infected patients was much less than those without a history of COVID-19 infection.
Colonization and Antimicrobial resistance patterns of Potentially Pathogenic Micro-Organisms in tracheostomized patients
Authors: Gure Prasanta Kumar , Ghosh Arunava , Ray Dhrupad , Haque Misbahul , Dutta Manotosh 
Published: April 2023

Introduction: Tracheostomy is one of the most common and ancient surgical procedure performed in the world but it is like a double-edged sword which not only facilitates respiration, but also impairs the natural resistant barrier, therebyaugmenting the colonization of other secondary pathogenic micro-organisms. Hence, it is important to know the patternof microbiological colonizers in tracheostomized patients, so that adequate empiric antimicrobial coverage can preventdevelopment of hospital acquired pneumonia. This study aims to identify various micro-organisms colonizing lower airway in tracheostomized patients.
Materials and Methods: An observational cross-sectional study was conducted in a tertiary based teaching hospital in North Bengal, India during July 2021 to July 2022. A total of 56 patients were included in the study.
Results: Positive Cultures on day 0 were found in 20.8% & 65.6% of patients in wards and ICUs respectively. Out of the positive cultures isolated on day 0, Staphylococcus aureus was the most common organism (80%) obtained from ward patients whereas, Acinetobacter baumannii was most common organism (47.61%) in ICU admitted patients. On day 7, positive cultures were found in 66.6% & 84.4% of admitted patients in wards and ICUs respectively. Staphylococcus aureus was again the most common organism obtained (56.25%) in wards whereas, Pseudomonas aeruginosa was the most common organism (44.44%) obtained in ICU admitted patients followed by Acinetobacter baumannii (33.33%).
Conclusion: Culture positivity rates were higher in patients who were previously intubated in Intensive care unit, which establishes the fact that any procedure which warrants airway manipulations, increases the chance of hospital acquired infections. Antibiotic resistance is very common in ICU admitted patients and has a tendency to increase over time. Hence, upscaling of antibiotics is recommended only after proper sensitivity check of the tracheal aspirates.
AVALIAÇÃO DA INCIDÊNCIA DE TRANSTORNOS ALIMENTARES EM ESTUDANTES DE MEDICINA NO OESTE DO PARANÁ DURANTE O PERÍODO PANDÊMICO DA COVID-19
Authors: Thaiane Mazarro Bortolini Eliana , Miguel Prata Madureira Eduardo 
Published: April 2023

Esta pesquisa teve como objetivo analisar um indicativo de transtornos alimentares durante o período pandêmico em estudantes do curso de medicina em um Centro Universitário particular do interior do Paraná. Estudo transversal, exploratório, descritivo, com foco em levantamento de dados mediante aplicação de questionário semi-estruturado adaptado do EAT-26. Um total de 103 acadêmicos responderam a pesquisa, sendo 66% do sexo feminino e 34% do sexo masculino. Com relação ao peso durante a pandemia, 10,7% da população manteve o peso, 26,2% registraram emagrecimento e 63,1% da população estudada ganhou peso. A incidência de sobrepeso foi de 22%. Houve 7 participantes a mais que passaram a ser classificados como obesidade grau I e 4 passaram a ser portadores de obesidade grau II. Com relação ao EAT-26, no quesito dieta, 10,3% são candidatos para distúrbios alimentares uma vez que, passaram a se preocupar (incidência de 10,3%) com a ingesta de alimentos e com a forma física após o confinamento. A incidência de participantes com sinais de Bulimia ou preocupação com os alimentos foi de 4,9%. A incidência da população que perdeu o controle oral após o confinamento relacionado a COVID-19 foi de 13,3%. Assim o presente estudo encontrou uma parcela dos estudantes como candidatos a distúrbios alimentares, mais estudos devem ser desenvolvidos no sentido de identificar essa população susceptível de modo que, ações preventivas sejam empregadas com o objetivo de evitar o real aparecimento desta condição.
PEMANFAATAN METODE ITIL V3 DOMAIN SERVICE DESIGN DALAM MENGANALISIS MANAJEMEN LAYANAN SHOPEE (STUDI KASUS : MAHASISWA UNIVERSITAS AMIKOM PURWOKERTO)
Authors: Rahma Felinda Aprilia , Ratnawati Maulina Afra , Hidayah Septi Oktaviani Nur , Diniyati Faoziyah Fahiya , Setiawan Ito 
Published: April 2023

Perkembangan industry e-commerce yang cepat di Indonesia dibuktikan dengan banyaknya marketplace dan onlineshop yang muncul secara agresif. Shopee adalah aplikasi e-commerce berbasis mobile yang saat ini sangat berkembang di Indonesia. Tujuan penelitian ini untuk mengetahui dan menganalis kualitas manajemen layanan pada aplikasi Shopee dengan membandingkan tingkat kematangan teknologi informasi kondisi sekarang (current Maturity) dan kondisi yang diharapkan (Expected Maturity), hasil akhir penelitian ini berupa analisis gap serta rekomendasi perbaikan pada kualitas layanan TI dengan menggunakan framework ITIL V3 domain service design dengan sub domain design coordination, service catalog, service level management, availability management, service design process, capacity management, dan information security. Data didapatkan dari penebaran kuesioner dengan responden sebanyak 97 orang, dengan kesimpulan rata-rata nilai maturity 3,57 dan masuk kategori Managed and Measurable. Sedangkan nilai rata-rata gap 0,43. Dari hasil tersebut sistem dapat mengukur dan mengawasi setiap prosedur yang ada serta bisa dengan mudah diatasi jika terjadi kesalahan.