bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study on developmental biochemical characteristics of Leishmania donovani promastigote and inhibitory effect of Achyranthes aspera Linn plant extract on it
Authors: Kumar Srikant , Sinha Puspaa , Parwez Akhtar , Kumar Birendra , Tarun Kumar Lav Kush , Bharti Sudhanshu Kumar 
Published: December 2022

Leishmania donovani is an obligatory intracellular digenetic parasite transmitted by insects, causing serious global health problems as it is endemic to most developing countries. Extensive use of antimony compounds as drugs poses high toxicity and cost; therefore, herbal medicine has identified a position. This study explored the developmental and biochemical characteristics of L. donovani promastigote and the effect of ethanolic extract of Achyranthes aspera Linn (Amaranthaceae) plant on it. The parasites were incubated at 2.5×106 cells/well for 72 h at 23 °C in the presence of various concentrations of extract (µg/mL) dissolved in 1% dimethyl sulfoxide (DMSO) with sterile phosphate-buffered saline and 1% DMSO as negative controls and meglumine antimoniate as positive control. Friedman’s repeated measures analysis showed that 96hr of development is the junction point in promastigotes ontogeny. Post 96hr, it grows with a long stationary phase with higher enzymatic activities of acid phosphatase, superoxide dismutase and glutathione (oxidized and reduced). Total protein estimated showed a linear relationship (R2 = 0.999). Phytochemical screening of the plant extract showed the presence of alkaloid, ﬂavonoid, fixed oil and fats, saponin, tannin and phenolic compounds. It showed an effectual free radical scavenging in the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay with an inhibitory concentration IC50 value of 61.70 µg/ml. At a concentration of 250 µg/mL, the plant extract completely inhibited the promastigotes in vitro while at 50 µg/mL and 100 µg/mL, the survival level declined by 25-50%. These findings corroborate the ethnopharmacological use of this plant for the treatment of leishmaniasis caused by L. donovani.
Impact of total quality management practices on financial performance of commercial banks in Nepal
Authors: Yadav Omprakash Pd. 
Published: December 2022

The main objective of this study is to analyze the impact of TQM practices on the financial performance of commercial banks in Nepal. This study is based on primary as well as secondary data. Quantitative data are collected by survey method consisting of 6 likert scale questionnaires which focus on concern area of Kathmandu valley and analysis with SPSS package. Descriptive and inferential statistics tools have used to identify the relationship between management commitment, Employees involvement, Customer focus and process management with financial performance of commercial banks. In this study management commitment, employee's involvement, customer focus and process management are taken as independent variable and financial performance is taken as dependent variable. Correlation has shown that all the independent variable have significantly positive relationship with dependent variable. Among the
independent variable, Employees involvement & customer focus highly positive effect on financial performance through regression analysis.
Preparation and Evaluation of Oroslippery Tablets Contain Irbesartan and Hydrochlorothiazide Combination for Dysphagia Patients
Authors: Almajidi Yasir Q. , T. Khalaf Yaseen , M. Shalan Naeem , H. Alani Israa , A. Abu Dayyih Wael 
Published: December 2022

Oro slippery tablets (OSTs) is a technique used to improve swallowing of tablets for patients with dysphagia. The aim of this study was to formulate irbesartan and hydrochlorothiazide as Oroslippery tablets (OST) containing 150 mg irbesartan and 25 mg hydrochlorothiazide for dysphagia patients. A simple and rapid method of analysis was developed and validated according to the ICH guideline using HPLC with UV detector. Tablets were prepared by direct compression and then coated with the slippery coat of three different concentrations of the slippering substance “xanthan gum’ (2%, 3% and 4%) in Opadry Colorcone® and evaluated according to USP. Slipperiness test was performed using Albino rabbits. Results showed that 2% xanthan gum gave the shortest swallowing time. Also, disintegration time was increased by the coat significantly with the increase of the gum’s concentration in the coat. The release kinetics study of the tested formulations (uncoated versus coated with 2% gum) gave the highest correlation for the "first-order release model" for both drugs in the absence and presence of the slippering agent which indicates that the coating did not interfere with the release kinetics of both drugs. In a conclusion, 2% xanthan gum as slippering agent the optimum concentration used to promote easy ingestion of this tablet.
A Psycholinguistic Training to Improve Expressive Language Among Children with ASD
Authors: Alshahrani Abdulaziz 
Published: December 2022

Purpose. The purpose was to investigate the effect of a psycholinguistic training to improve expressive language among children with ASD.
Methods. Data were collected from children during the academic year 2021-2022. The participants were 20 children with ASD, aged 7 to 10 years, who were enrolled in a school for children with ID. All children attended the same semester inside the school. Parent consent forms were sent home by the principal and school psychologist to the parents of the prospective participants to inform them about the study and ask them to give permission for their children to participate. Demographic information was obtained from school records and as reported by families. Children were divided randomly into two groups: one experimental (n=10) and other was the control group (n=10). These children were matched as a group with cases on the basis of age, IQ, social class and general level of language ability. A 24 items, six-dimensional Questionnaire was developed in particular for this study. The intention was to identify expressive language skills for children with ASD. The six dimensions are: speaking and questioning skills in correct language (4 items), the ability to verbally express things, needs, and desires (4 items), the skill of pronouncing and imitating words, letters and sounds (4 items), repetition and arranging skill (4 items), the ability to verbally express feelings (4 items), the ability to respond to the speech and questions of others.
Results. Results indicated increased speaking and questioning skills in correct language, the ability to verbally express things, needs, and desires, the skill of pronouncing and imitating words, letters and sounds, repetition and arranging skill, the ability to verbally express feelings and the ability to respond to the speech and questions of others.
Conclusions. Overall, results from this study contribute to the growing literature on the effect of a psycholinguistic training to improve expressive language among children with ASD. The present study lends empirical support to the notion that expressive language of children with ASD can be improved through a psycholinguistic training.
Factors associated with hearing outcomes after a middle fossa approach in 131 consecutive patients with vestibular schwannomas
Authors: Budohoski Karol P. , Rennert Robert C. , Gordon Steven A. , Raheja Amol , Brandon Cameron , Henson J. Curran , Azab Mohammed A. , Patel Neil S. , Karsy Michael , Gurgel Richard K. , Shelton Clough , Couldwell William T. 
Published: December 2022

OBJECTIVE
The middle fossa approach is an effective option for the treatment of small (Koos grade I and II) vestibular schwannomas (VSs) when the goal is hearing preservation. The authors evaluated the rates of hearing preservation and examined the factors associated with improved hearing outcomes after the middle fossa approach for VSs.

METHODS
In this retrospective, single-center cohort study evaluating the clinical outcomes after resection of small VSs using the middle fossa approach, consecutive adult patients (> 18 years) who underwent surgery between January 2000 and December 2021 were included. Clinical and imaging characteristics were analyzed, including baseline hearing status, duration of surgery, anesthetic parameters, and imaging characteristics of the surgically treated tumors.

RESULTS
Among the 131 included patients, 102 had valid and discoverable pre- and postoperative audiology assessments. The mean follow-up was 26 months (range 1–180 months). There were 85 patients with serviceable hearing preoperatively, defined as American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) class A or B, of whom 78% retained class A or B hearing at the last follow-up. Binary logistic regression demonstrated that preoperative hearing AAO-HNS class (OR 0.19, 95% CI 0.05–0.77; p = 0.02), overlap between fundus and cochlea (OR 0.32, 95% CI 0.11–0.96; p = 0.04), and duration of anesthesia (OR 0.98, 95% CI 0.97–0.99; p = 0.03) were independent predictors of hearing outcomes. Additionally, 75% of patients with high diffusion-weighted imaging signal in the tumor (p = 0.009) and 67% of patients with the tumor originating at the modiolus of the cochlea (p = 0.004) had poor hearing outcomes.

CONCLUSIONS
The hearing preservation rates after microsurgical resection of small VSs using the middle fossa approach are high, with 78% of patients maintaining AAO-HNS class A or B hearing. Poor hearing status at baseline, longer duration of anesthesia, and large overlap between the fundus of the internal auditory canal and the cochlea were independently associated with unfavorable hearing outcomes. Imaging characteristics can be used to stratify patients’ risk of hearing loss.
Ictal EEG desynchronization during low-voltage fast activity for prediction of surgical outcomes in focal epilepsy
Authors: Hu Lingli , Xiong Kai , Ye Lingqi , Yang Yuyu , Chen Cong , Wang Shan , Ding Yao , Wang Zhongjin , Ming Wenjie , Zheng Zhe , Jiang Hongjie , Li Hong , Zhu Junming , Xu Cenglin , Wang Yi , Ding Meiping , Chen Zhong , Wu Yingcai , Wang Shuang 
Published: December 2022

OBJECTIVE
The authors investigated alterations in functional connectivity (FC) and EEG power during ictal onset patterns of low-voltage fast activity (LVFA) in drug-resistant focal epilepsy. They hypothesized that such changes would be useful to classify epilepsy surgical outcomes.

METHODS
In a cohort of 79 patients with drug-resistant focal epilepsy who underwent stereoelectroencephalography (SEEG) evaluation as well as resective surgery, FC changes during the peri-LVFA period were measured using nonlinear regression (h2) and power spectral properties within/between three regions: the seizure onset zone (SOZ), early propagation zone (PZ), and noninvolved zone (NIZ). Desynchronization and power desynchronization h2 indices were calculated to assess the degree of EEG desynchronization during LVFA. Multivariate logistic regression was employed to control for confounding factors. Finally, receiver operating characteristic curves were generated to evaluate the performance of desynchronization indices in predicting surgical outcome.

RESULTS
Fifty-three patients showed ictal LVFA and distinct zones of the SOZ, PZ, and NIZ. Among them, 39 patients (73.6%) achieved seizure freedom by the final follow-up. EEG desynchronization, measured by h2 analysis, was found in the seizure-free group during LVFA: FC decreased within the SOZ and between regions compared with the pre-LVFA and post-LVFA periods. In contrast, the non–seizure-free group showed no prominent EEG desynchronization. The h2 desynchronization index, but not the power desynchronization index, enabled classification of seizure-free versus non–seizure-free patients after resective surgery.

CONCLUSIONS
EEG desynchronization during the peri-LVFA period, measured by within-zone and between-zone h2 analysis, may be helpful for identifying patients with favorable postsurgical outcomes and also may potentially improve epileptogenic zone identification in the future.
Development and validation of a machine learning algorithm for predicting diffuse midline glioma, H3 K27–altered, H3 K27 wild-type high-grade glioma, and primary CNS lymphoma of the brain midline in adults
Authors: Lv Kun , Chen Hongyi , Cao Xin , Du Peng , Chen Jiawei , Liu Xiao , Zhu Li , Geng Daoying , Zhang Jun 
Published: December 2022

OBJECTIVE
Preoperative diagnosis of diffuse midline glioma, H3 K27–altered (DMG-A) and midline high-grade glioma without H3 K27 alteration (DMG-W), as well as midline primary CNS lymphoma (PCNSL) in adults, is challenging but crucial. The aim of this study was to develop a model for predicting these three entities using machine learning (ML) algorithms.

METHODS
Thirty-three patients with DMG-A, 35 with DMG-W, and 35 with midline PCNSL were retrospectively enrolled in the study. Radiomics features were extracted from contrast-enhanced T1-weighted MR images. Two radiologists evaluated the conventional MRI features of the tumors, such as shape. Patient age, tumor volume, and conventional MRI features were considered clinical features. The data set was randomly stratified into 70% training and 30% testing cohorts. Predictive models based on the clinical features, radiomics features, and integration of clinical and radiomics features were established through ML. The performances of the models were evaluated by calculating the area under the receiver operating characteristic curve, accuracy, sensitivity, and specificity. Subsequently, 10 patients with DMG-A, 10 with DMG-W, and 12 with PCNSL were enrolled from another institution to validate the established models.

RESULTS
The predictive models based on clinical features, radiomics features, and the integration of clinical and radiomics features through the support vector machine algorithm had the optimal accuracies in the training, testing, and validation cohorts, and the accuracies in the testing cohort were 0.871, 0.892, and 0.903, respectively. Age, 2 radiomics features, and 3 conventional MRI features were the 6 most significant features in the established integrated model.

CONCLUSIONS
The integrated prediction model established by ML provides high discriminatory accuracy for predicting DMG-A, DMG-W, and midline PCNSL in adults.
Effect of long-term anticoagulant therapy on the outcome of chronic subdural hematoma: a propensity score–matched analysis
Authors: Salih Mira , Young Michael , Shutran Max , Stippler Martina , Papavassiliou Efstathios , Alterman Ron L. , Thomas Ajith J. , Taussky Philipp , Moore Justin , Ogilvy Christopher S. 
Published: December 2022

OBJECTIVE
Chronic subdural hematomas (cSDHs) are particularly common in older adults who have increased risk of falls and the conditions that require anticoagulants (ACs). In such cases, clinicians are often left with the dilemma of co-managing the cSDH and the ongoing need for ACs.

METHODS
Patients who underwent surgical management for cSDH at the authors’ institution between January 2006 and June 2022 were identified. Propensity score–matched analysis was used to obtain a balance in patients who were on ACs before the procedure versus those who were not, and in patients who were on ACs postprocedure versus those who were not. Length of hospitalization, periprocedural complications, reintervention rate during the same admission, rebleeding risk, and reintervention rates after discharge were compared.

RESULTS
In total, 104 patients were on long-term ACs before the procedure, whereas 372 were not. After matching, 55 pairs were included in the analysis. Postprocedure, 74 patients were started on long-term ACs; the rest were not. A total of 49 patients in each group were then included in the analysis after matching. Comparing the preprocedure AC group with the non-AC group, no significant differences were found in length of hospitalization (8.5 ± 6.7 days vs 8.1 ± 7.7 days, p = 0.75), periprocedural complications (7.3% vs 7.3%, p > 0.99), or reintervention during the same admission (1.8% vs 5.5%, p = 0.31). In the comparison of postprocedure AC and non-AC groups, no significant differences were seen in recurrence rate (8.2% vs 14.3%, p = 0.52), reintervention rate after discharge (4.1% vs 14.3%, p = 0.16), or disability (i.e., mRS ≤ 2; 83.7% vs 89.8%, p = 0.55).

CONCLUSIONS
Being treated with long-term ACs before cSDH procedures does not affect length of hospitalization, periprocedural complications, or reintervention during the same admission. Similarly, administration of long-term ACs after a procedure for cSDH does not increase rebleeding risk or reintervention rate. Patients who are on long-term ACs can have similar interventions to those who are not on ACs. In addition, it is safe to restart patients on AC agents in a 7- to 14-day window after admission for cSDH with or without acute/subacute components.
Reduced recurrence of chronic subdural hematomas treated with open surgery followed by middle meningeal artery embolization compared to open surgery alone: a propensity score–matched analysis
Authors: Salih Mira , Shutran Max , Young Michael , Vega Rafael A. , Stippler Martina , Papavassiliou Efstathios , Alterman Ron L. , Thomas Ajith , Taussky Philipp , Moore Justin , Ogilvy Christopher S. 
Published: December 2022

OBJECTIVE
Middle meningeal artery embolization (MMAE) is an emerging endovascular treatment technique with proven promising results for chronic subdural hematomas (cSDHs). MMAE as an adjunct to open surgery is being utilized with the goal of preventing the recurrence of cSDH. However, the efficacy of MMAE following surgical evacuation of cSDH has not been clearly demonstrated. The authors sought to compare the outcomes of open surgery followed by MMAE versus open surgery alone.

METHODS
Patients who underwent surgical evacuation alone (open surgery–alone group) or MMAE along with open surgery for cSDH (adjunctive MMAE group) were identified at the authors’ institution. Two balanced groups were obtained through propensity score matching. Primary outcomes included recurrence risk and reintervention rate. Secondary outcomes included decrease in hematoma size and modified Rankin Scale (mRS) score at last follow-up. Variables in the two groups were compared by use of the Mann-Whitney U-test, paired-sample t-test, and Fisher’s exact test.

RESULTS
A total of 345 cases of open surgery alone and 52 cases of open surgery with adjunctive MMAE were identified. After control for subjective confounders, 146 patients treated with open surgery alone and 41 with adjunctive MMAE following open surgery with drain placement were included in the analysis. Before matching, the rebleeding risk and reintervention rate for open surgery trended higher in the open surgery alone than the open surgery plus MMAE group (14.4% vs 7.3%, p = 0.18; and 11.6% vs 4.9%, p = 0.17, respectively). No significant differences were seen in duration of radiographic or clinical follow-ups or decreases in hematoma size and mRS score at last follow-up. After one-to-one nearest neighbor propensity score matching, 26 pairs of cases were compared for outcomes. Rates of recurrence (7.7% vs 30.8%, p = 0.038) and overall reintervention (3.8% vs 23.1%, p = 0.049) after open surgery were found to be significantly lower in the adjunctive MMAE group than the open surgery–alone group. With one-to-many propensity score matching, 76 versus 37 cases were compared for open surgery alone versus adjunctive MMAE following open surgery. Similarly, the adjunctive MMAE group had significantly lower rates of recurrence (5.4% vs 19.7%, p = 0.037) and overall reintervention (2.7% vs 14.5%, p = 0.049).

CONCLUSIONS
Adjunctive MMAE following open surgery can lower the recurrence risks and reintervention rates for cSDH.
The prevalence of central retinal vein occlusion was observed in middle age patients with post-covid syndrome multicenter study
Authors: Ahmed Sanaa , Elmahdy Ahmed , Kenawy Eglal , Abdulrehim Marwa , Shoeir Samar , Elmohaseb Ghada , Youssef Eman , Bayoumy Eman , Byomy Marwa 
Published: December 2022

Background: The World Health Organization pronounced the Coronavirus disease (COVID-19) a pandemic on March 11, 2020. Patients with COVID-19 are more likely to have multisystem thromboembolic events, such as deep vein thrombosis and pulmonary emboli. This study estimates the clinical characteristics of patients with central retinal vein occlusion (CRVO) post-COVID-19 infection in three governorates of Egypt. Methods: A retrospective randomized study was conducted at Al-Azhar University Hospitals. We revised medical records for patients presented to Ophthalmology departments with CRVO. We considered all patients above 30 years old of both sexes without risk factors for central vein occlusion. Results:Central retinal vein occlusion was observed in post-COVID syndrome at younger ages, rather than the ordinary cases. The most presenting symptoms were fever, dyspnea, and a cough with significant hypoxia and elevated D-dimer level. Conclusion:Our study asserts the importance of more investigation into ocular complications associated with COVID-19. Physicians should be vigilant for acute visual symptoms in COVID-19 patients. Patients presenting with thromboembolism should be screened for COVID-19 infection as a presumed etiology. D-dimer may have an important prognostic value for disease severity. Anti-coagulant medications may be required on a long-term basis after COVID-19 infections.Keywords: acute visual symptoms, ophthalmic evaluation, thromboembolism
Development of hemodynamically relevant acquired arterio-venous fistulae in patients with venous malformations
Authors: Schramm D. , Wohlgemuth W.A. , Guntau M. , Wieprecht M. , Deistung A. , Bidakov O. , Wildgruber M. , Brill R. , Cucuruz B. 
Published: December 2022

BACKGROUND: Venous malformations tend to retain their slow-flow behavior, even in progressive disease or regression following therapy. OBJECTIVE: The aim of this study is to analyze the development of acquired hemodynamic relevant arterio-venous fistulae in patients with slow-flow malformations. METHODS: This study is a retrospective analysis based on a consecutive local registry at a tertiary care Interdisciplinary Center for Vascular Anomalies. Patients with venous malformations and development of secondary arterio-venous fistulae were included. Indications for therapy of the vascular malformation were based on patients’ symptoms and complications. The following endpoints were of clinical interest and were assessed: origin of development of arteriovenous fistula, development of secondary comorbidities as a result of the vascular malformation. For analysis we focused on descriptive statistics. RESULTS: Out of 1213 consecutive patients with vascular malformations, in 6 patients perfusion changed from slow flow to arterio-venous fast-flow patterns. Four patients developed the fistula after local trauma in the area of the malformation, the other 2 patients developed the fistula due to progression of the disease and recurrent thrombophlebitis. These 2 patients had no trauma or interventions at the time of arterio-venous fistula development. CONCLUSIONS: Acquired arterio-venous fast-flow fistula in patients with slow flow vascular malformation is very rare and might be a result of local trauma or the progression of the disease with recurrent thrombophlebitis. Specific evidence-based treatment options for these patients do not exist.