bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Rare Cause of Obstructive Jaundice and Pancreatitis; Lemmel's Syndrome
Authors: Aslan Serdar , Önder Ramazan Orkun 
Published: March 2023

Introduction::
Lemmel’s syndrome is defined as obstructive jaundice due to a PDD in the absence of choledocholithiasis or a neoplasm. The most common cause
is the presence of PDD which arise within 2-3 cm from the ampulla of Vater. Currently, there are very few case reports of this condition, which
was first named in 1934 after Dr. Gerhard Lemmel.

Case Presentation:
A 74-year-old female patient presented to the emergency department with complaints of abdominal pain and jaundice, and also had signs of
pancreatitis, with laboratory results showing elevated liver and pancreatic enzymes and hyperbilirubinemia. We present a case of a patient who was
diagnosed with Lemmel’s syndrome after abdominal CT, MRCP, and ERCP.

Conclusion:
Although rare, it is imperative for physicians to recognize this syndrome in order to deliver prompt care. Because making the correct diagnosis in
these patients is very important for correct treatment and preventing the development of complications.
Standardization of Breast Dynamic Contrast-enhanced MRI Signal with
Application to the Assessment of Background Parenchymal Enhancement Rate
Authors: Medved Milica , Tsuchiya Keiko , Fan Xiaobing , Karczmar Gregory S. , Abe Hiroyuki 
Published: March 2023

Background:
There is currently no clinically accepted method for quantifying background parenchymal enhancement (BPE), though a sensitive method might
allow individualized risk management based on the response to cancer-preventative hormonal therapy.

Objective:
The objective of this pilot study is to demonstrate the utility of linear modeling of standardized dynamic contrast-enhanced MRI (DCEMRI) signal
for quantifying changes in BPE rates.

Methods:
On a retrospective database search, 14 women with DCEMRI examinations pre- and post-treatment with tamoxifen were identified. DCEMRI
signal was averaged over the parenchymal ROIs to obtain time-dependent signal curves S(t). The gradient echo signal equation was used to
standardize scale S(t) to values of FA = 10° and TR = 5.5 ms, and obtain the standardized DCE-MRI signaSP(t)l. Relative signal enhancement RSEp
was calculated from Sp, and the reference tissue method for T1 calculation was used to standardize RSEp to gadodiamide as the contrast agent,
obtaining RSE. RSE in the first 6 minutes post-contrast administration was fit to a linear model with the slope αRSE denoting the standardized rate
relative BPE.

Results:
Changes in αRSE were not found to be significantly correlated with the average duration of tamoxifen treatment, age at the initiation of preventative
treatment, or pre-treatment BIRADS breast density category. The average change in αRSE showed a large effect size of -1.12, significantly higher
than -0.86 observed without signal standardization (p < 0.01).

Conclusion:
Linear modeling of BPE in standardized DCEMRI can provide quantitative measurements of BPE rates, improving sensitivity to changes due to
tamoxifen treatment.
Non-Alkaloidal Compounds from Tubers of Gloriosa superba and their In
vitro and In silico Antibacterial and Antioxidant Activities
Authors: Kiros Tsegu , Eswaramoorthy Rajalakshmanan , Mohammed Seid , Dekebo Aman , Melaku Yadessa 
Published: March 2023

Background:
The tubers of Gloriosa superba L. (Colchicaceae) are previously well known for their alkaloidal constituents. The present work aimed to investigate the non-alkaloidal constituents and evaluate their in vitro and in silico antibacterial and antioxidant activities from the tuber.

Methods:
The chloroform: methanol (1:1) tuber extract was fractionated over silica gel column chromatography, and isolated compounds were characterized by NMR spectroscopy. Various extracts and isolated compounds were evaluated for their antibacterial and antioxidant activities against certain pathogenic strains and oxidants. The in silico drug-likeness properties of isolated compounds were also studied against 6F86 antibacterial and 1HD2 antioxidant protein models.

Results:
Three non-alkaloidal compounds, β-sitosterol (1), 3-(cyclopenta-2,4-dienyloxy) β-
sitosterol (2) and 1,2-n-dipropyl phthalate (3), were reported herein. The n-hexane and chloroform
extracts displayed better antibacterial activity against E. coli (9.83 ± 0.28 mm) and P. aeruginosa
(10.65 ± 0.79 mm), and S. aureus (10.33 ± 0.3 mm), respectively, at 100,000 μg/mL concentration.
Compound 3 established a better activity against all bacterial strains (9.78 ± 0.63-11.07 ± 0.09 mm)
at 1000 μg/mL (IC50 values of 1.5-3.2 μg/mL). All the extracts exhibited a DPPH free radical scavenging
activity comparable to ascorbic acid (IC50 value of 1.2 μg/mL), whereas isolated compounds
were found with negligible DPPH scavenging activity and weak ferric ion reduction power up to
500 μg/mL dose. The docking study revealed that all the compounds fulfilled Lipinski’s rule of five
by contravening no more than one rule with strong binding affinity shown by compound 1 (-8.2
kcal/mol) and compound 3 (-4.5 kcal/mol) to the 6F86 bacterial and 1HD2 antioxidant protein
models, respectively, which are comparable to the ciprofloxacin (-7.2 kcal/mol) and ascorbic acid (-
4.5 kcal/mol) drugs. All the compounds also did not show any cytotoxicity properties. Whereas
compound 1 showed an immunotoxicity and mutagenicity properties; and compounds 2 and 3 were
found as immunotoxic and carcinogenic isolates, respectively.

Conclusion:
The promising antioxidant activity result of the various tubers extracts may highlight the potential use of Gloriosa superba as a source of foods by conducting further phytochemical investigation and additional bioassay evaluation, including the cytotoxicity effect of the whole part of the plant.
Investigating the Protective Effect of Leaves of Calotropis procera (Aiton)
for In-vivo Anti-oxidant and Antiulcer Activity using Pylorus Ligation
Method
Authors: Singh Sonia , Semwal Bhupesh Chander , Shukla Alok 
Published: March 2023

Background:
Calotropis procera (Aiton) (Apocynaceae) is a traditional Indian medicinal
plant and used in folk medicine for the past decade for the treatment of gastrointestinal disorders.
Therefore the current investigation was undertaken to explore the gastroprotective effect of
C. procera (Aiton) leaves extract using pylorus ligation-induced gastric ulcer in rats.

Methods:
The crude powder material was successively extracted with different solvents and concentrated
at reduced pressure in a rotary evaporator. The current investigation was carried out by a
pylorus ligation-induced gastric ulcer model in rats. Omeprazole, 20 mg/kg and 100, 250, and 500
mg/kg ethanol extract of C. procera (Aiton) leaves were administered orally for 15 consecutive
days, on the last day six hours after pylorus ligation animals were sacrificed and the amount of
gastric juice, pH, total and free acidity, ulcer index, and pro-inflammatory cytokines along with
antioxidant parameters and total protein were also studied.

Results:
Pretreatment of C. procera (Aiton) leaf extract at the doses 250 and 500 mg/kg, significantly
(p < 0.001) decrease the volume of gastric juice, free and total acidity as well as gastric
lesions, and secretion of pro-inflammatory cytokine. On the other hand, the pH of gastric juice,
mucin content, and total protein was also significantly decreased. Moreover, pretreatment of C.
procera (Aiton) significantly (p < 0.001) boost the enzymatic activity and level of different antioxidant
markers and attenuated the pylorus ligation-induced level of MDA (p < 0.05) in experimental
animals.

Conclusion:
From this study, it is concluded that the ethanol leaf extract of C. procera (Aiton)
extract possess considerable antiulcer and antioxidant potential. For further research findings, it is
necessary to explore the mechanism of action for anti-ulcer activity.
Computer Simulation for Effective Pharmaceutical Kinetics and Dynamics:
A Review
Authors: Tiwari Gaurav , Shukla Anuja , Singh Anju , Tiwari Ruchi 
Published: March 2023

Abstract:
Computer-based modelling and simulation are developing as effective tools for supplementing
biological data processing and interpretation. It helps to accelerate the creation of dosage
forms at a lower cost and with the less human effort required to conduct the work. This paper
aims to provide a comprehensive description of the different computer simulation models for various
drugs along with their outcomes. The data used are taken from different sources, including review
papers from Science Direct, Elsevier, NCBI, and Web of Science from 1995-2020. Keywords
like - pharmacokinetic, pharmacodynamics, computer simulation, whole-cell model, and cell simulation,
were used for the search process. The use of computer simulation helps speed up the creation of
new dosage forms at a lower cost and less human effort required to complete the work. It is also
widely used as a technique for researching the structure and dynamics of lipids and proteins found in
membranes. It also facilitates both the diagnosis and prevention of illness. Conventional data analysis
methods cannot assess and comprehend the huge amount, size, and complexity of data collected by
in vitro, in vivo, and ex vivo experiments. As a result, numerous in silico computational e-resources,
databases, and simulation software are employed to determine pharmacokinetic (PK) and pharmacodynamic
(PD) parameters for illness management. These techniques aid in the provision of multiscale
representations of biological processes, beginning with proteins and genes and progressing
through cells, isolated tissues and organs, and the whole organism.
The Metabolism of Portulacatone B from Portulaca oleracea L. in Rats by
UHPLC-ESI-Q-TOF/MS
Authors: Cui Xinyu , Lan Xiujuan , Leng Aijing , Ying Xixiang 
Published: March 2023

Objective:
This study aims to investigate the main metabolites and metabolic pathways
of Portulacatone B in rats, which is an alkaloid isolated from Portulaca oleracea L.

Methods:
Portulacatone B was administered through the tail vein of the rat, and the orbital blood
at 10 and 30 min and urine and feces within 24 h were collected. The metabolites and metabolic
pathways in the rat were researched by ultra-high performance liquid chromatographyelectrospray
coupled with quadrupole-time of flight mass spectrometry (UHPLC-ESI-QTOF/
MS).

Results:
The research results of the metabolites and metabolic pathways of Portulacatone B
showed that after administration through the tail vein of rats, 3 metabolites were found in the
plasma sample, 2 metabolites in the urine sample, and one metabolite in the feces sample. The
main metabolic pathways were found to be oxidation, hydrolysis, methylation, glucuronidation,
and sulfonation.

Conclusion:
Six metabolites were found in the rat’s plasma, urine, and feces samples, and the
metabolic pathways included oxidation, hydrolysis, methylation, glucuronidation, and sulfonation
process.
Knowledge, Perception, and Practices on the Labelling of Dispensed
Medicine among Community Pharmacists and General Practitioners in the
State of Sarawak, Malaysia
Authors: Bin Said Luqman Nulhakim , Chyi Loo Shing , Anak Talin Benodict Apok , Foo Khiong Augustine Law , Mohamad Rosli Izzah Alia Binti , Pei Sze Jessica Low , Abdul Razak Ridhwan bin 
Published: March 2023

Background:
The labelling of dispensed medicines (LDM) ensures that optimum therapeutic
treatment levels are achieved, and medication errors are prevented. In Malaysia, LDM is
enforced under the Poisons Act 1952.

Objective:
To explore the knowledge, perception, and practices of community pharmacists (CP)
and general practitioners (GP) on LDM.

Methods:
A cross-sectional study was conducted from April 2019 until March 2020 among CP and
GP practising in Sarawak, Malaysia. Sample sizes were 90 and 150 for CP and GP, respectively.
Proportionate stratified random sampling was employed. A self-administered structured questionnaire
pre-tested and pilot-tested was used to explore knowledge and perception. Practices were assessed
by having participants prepare dispensed medicine labels (DML) using simulated prescriptions.

Results:
250 participants; 96 CP and 154 GP participated. While most of them perceived that they
knew the requirements of LDM (n = 244; 97.6%), their median knowledge score was poor
(57.1%). The mean knowledge score of CP (62.0%) was significantly higher (P = 0.002) than GP
(51.0%). The majority of participants perceived that LDM is important (n = 237; 94.8%) and necessary
(n = 239; 95.6%) and perceived that poor compliance with the requirements would lead to
medication errors (n = 243; 97.2%). Although their knowledge was poor, their median practice
score (100.0%) was excellent. There was no correlation between knowledge and perception with
the practice of LDM.

Conclusion:
The majority of CP and GP perceived that LDM is important. Interestingly, although
their knowledge of the requirements of LDM was poor, their practices were sound.
Detection of Stage-wise Biomarkers in Lung Adenocarcinoma Using Multiplex
Analysis
Authors: K Athira , P V Sunil Kumar , M Manju , G Gopakumar 
Published: March 2023

Introduction:
Lung cancer is the leading cancer in terms of morbidity and mortality rate. Its
prevalence has been steadily increasing over the world in recent years. An integrated study is unavoidable
to analyse the cascading interrelationships between molecular cell components at multiple levels resulting
in hidden biological events in cancer.

Methods:
Multiplex network modeling is a unique methodology that could be used as an integrative
method for dealing with diverse interactions. Here, we have employed a multiplex framework to model
the lung adenocarcinoma (LUAD) network by incorporating co-expression correlations, methylation relations,
and protein physical binding interactions as network layers. Hub nodes identified from the multiplex
network utilizing centrality measures, including degree, eigenvector, and random walk with a
random jump technique, are considered as biomarker genes. These stage-wise biomarker genes identified
for LUAD are investigated using GO enrichment analysis, pathway analysis, and literature evidence
to determine their significance in tumor progression.

Results:
The study has identified a set of stage-specific biomarkers in LUAD. The 31 genes identified
from the results of multiple centrality analysis can be targeted as novel diagnostic biomarkers in LUAD.
Multiple signaling pathways identified here may be considered as potential targets of interest.

Conclusion:
Based on the analysis results, patients may be identified by their stage of cancer progression,
which can aid in treatment decision-making.
Effects of Arctigenin in Proliferation, Migration, and Invasion of Nasopharyngeal
Carcinoma 5-8F Cells
Authors: Huang Dongdong , Lu Rui , Cai Mingjing , Meng Jie , He Shuangba , Zhang Qingxiang , Meng Wei 
Published: March 2023

Background:
Nasopharyngeal carcinoma (NPC) is a malignant tumor of the nasopharynx.

Objective:
Here, we aimed to understand better the molecular basis for arctigenin (ARG)’s ability to promote NPC 5-8F cell invasion.

Methods:
We tested the effects of several doses of ARG on 5-8F cells that had been cultured in vitro. We estimated the
metabolic activity of cells by The MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) tetrazolium
assay. We examined the influence on cell invasion, and migration using Transwell Evaluation. Real-time polymerase
chain reaction analysis was used to determine the relative amounts of epidermal growth factor receptor (EGFR), Janus
kinase 2 (JAK2) , and transcriptional activator 3 (STAT 3) mRNA expression. Using western blotting, we looked at the
level of phosphorylation of specific proteins like EGFR, phosphorylated EGFR, JAK2, and STAT 3.

Results:
Our findings revealed that ARG inhibited NPC 5-8F cell development in a dose-and time-dependent manner.
The invasiveness and mobility of 5-8F cells were significantly suppressed when ARG was overexpressed in a tumor
development model. Expression levels of EGFR, JAK2, and STAT 3 mRNA were considerably low in the experimental
group. As a consequence of being treated with ARG, lower levels of EGFR, p-EGFR, p-JAK2, and p-STAT3
expression were observed.

Conclusion:
These results suggest that ARG may prevent NPC 5-8F cells from proliferating, migrating, and invading
other tissues. There are a few potential molecular pathways, two of which are the inhibition of EGFR phosphorylation
and the reduction of levels of phospho-JAK2 and phospho-STAT3.
Garcinia livingstonei T. Anderson: A Potential Source for Bioactive Constituents
Authors: Nossier Fatma H.M. , Ashour Rehab M.S. , Abdel-Monem Azza R. , Elsayed Ali M.A. 
Published: March 2023

Abstract:
Garcinia livingstonei T. Anderson (African mangosteen) is a member of family Clusiaceae and is native to South Africa. It is distributed from Malaysia to the Philippines, Burma and India. The plant is used traditionally in the treatment of diarrhea. It contains various chemical constituents belonging to biflavonoids, benzophenones and xanthones. Garcinia livingstonei is reported to possess beneficial pharmacological activities as anti-oxidant, anti-bacterial, anti-viral and cytotoxicity. This review aims at summarizing the available literature on the botanical features, phytochemical, ethnomedicinal and pharmacological activities of Garcinia livingstonei.
Rethinking the Difficult Patient: Formative Qualitative Study Using Participatory Theater to Improve Physician-Patient Communication in Rheumatology
Authors: Leung Jerik , Som Avira , McMorrow Lily , Zickuhr Lisa , Wolbers John , Bain Karen , Flood Julia , Baker Elizabeth A 
Published: March 2023

Background
Effective physician-patient communication is crucial for positive health outcomes for patients with chronic diseases. However, current methods of physician education in communication are often insufficient to help physicians understand how patients’ actions are influenced by the contexts within which they live. An arts-based participatory theater approach can provide the necessary health equity framing to address this deficiency.

Objective
The aim of this study was to develop, pilot, and conduct a formative evaluation of an interactive arts-based communication skills intervention for graduate-level medical trainees grounded in a narrative representative of the experience of patients with systemic lupus erythematosus.

Methods
We hypothesized that the delivery of interactive communication modules through a participatory theater approach would lead to changes in both attitudes and the capacity to act on those attitudes among participants in 4 conceptual categories related to patient communication (understanding social determinants of health, expressing empathy, shared decision-making, and concordance). We developed a participatory, arts-based intervention to pilot this conceptual framework with the intended audience (rheumatology trainees). The intervention was delivered through routine educational conferences at a single institution. We conducted a formative evaluation by collecting qualitative focus group feedback to evaluate the implementation of the modules.

Results
Our formative data suggest that the participatory theater approach and the design of the modules added value to the participants’ learning experience by facilitating interconnection of the 4 communication concepts (eg, participants were able to gain insight into both what physicians and patients were thinking about on the same topic). Participants also provided several suggestions for improving the intervention such as ensuring that the didactic material had more active engagement and considering additional ways to acknowledge real-world constraints (eg, limited time with patients) in implementing communication strategies.

Conclusions
Our findings from this formative evaluation of communication modules suggest that participatory theater is an effective method for framing physician education with a health equity lens, although considerations in the realms of functional demands of health care providers and use of structural competency as a framing concept are needed. The integration of social and structural contexts into the delivery of this communication skills intervention may be important for the uptake of these skills by intervention participants. Participatory theater provided an opportunity for dynamic interactivity among participants and facilitated greater engagement with the communication module content.
LEGAL REVIEW OF MEDICAL EMERGENCY THAT HAPPENED AFTER A FAILED ABORTION ATTEMPT
Authors: Winoto Elfan 
Published: March 2023

ABSTRAK

Aborsi adalah penyebab tertinggi kelima angka kematian ibu. Aborsi dibenarkan atau legal disebut abortus provokatus medisinalis dan yang kriminal atau ilegal disebut abortus provokatus kriminalis. Hukum Indonesia melarang melakukan aborsi kecuali indikasi kegawatdaruratan medis dan akibat pemerkosaan. Tujuan penelitian, mengetahui akibat hukum seseorang yang gagal melakukan aborsi dan perlindungan hukum dokter yang merawatnya. Jenis penelitian, menggunakan yuridis normatif dengan pendekatan konseptual dan perundangan. Para pelaku dan mereka yang membantu aborsi yang menyebabkan kedaruratan medis terancam dengan KUHP Pasal 53. Mereka tidak dapat dihukum jika sesuai dengan standar profesional dan prosedur operasi standar. Kesimpulan dan sarannya ialah dokter tidak dapat dihukum sebagai pelaku kejahatan atau sebagai pembantu untuk kejahatan aborsi jika dapat dibuktikan bahwa aborsi dilakukan dalam kondisi darurat untuk menyelamatkan ibu atau janin dan mencegah kecacatan. Pemerintah perlu membuat undang-undang yang mengatur siapa yang akan melakukan aborsi yang aman, kualitatif dan bertanggung jawab.