bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Programmed Cell Death Ligand-1 Expression in Non-small Cell Lung Carcinomas by Immunohistochemistry
Authors: Mani Sandeep , Lakshmanan Archana , Subramanyan Annapurneswari 
Published: August 2023

Background: Non-small cell lung carcinomas (NSCLCs) expressing programmed cell death ligand-1 (PD-L1), a transmembrane protein, are more likely to respond to immunotherapy drugs. All advanced NSCLC samples should be examined with PD-L1 immunohistochemistry (IHC). PD-L1 is now the only approved predictive biomarker of immunotherapy response in NSCLC patients. This study evaluates the expression of PD-L1 in NSCLC by IHC and assesses the morphological and clinical correlation of PD-L1 expression. Materials and Methods: All patients with histologically proven NSCLC with needle core biopsies and resected specimens were analyzed in the department of pathology. The correlation of PD-L1 expression with morphological and clinical parameters was analyzed. Results: On evaluating PD-L1 expression in 97 cases of NSCLC, 61.85% ( n = 60) had positive PD-L1 staining. Among patients with a positive tumor proportion score, 22 had a history of smoking, 51 were ≥50 years old, 43 were male patients, 24 were in Stage IV, 44 had a history of chemotherapy or radiotherapy, 47 had adenocarcinoma, and 33 had Grade II tumors. The association of PD-L1 expression with various clinicopathological parameters such as gender, smoking status, histological type, histological grade, clinical tumor stage, previous treatment history, site and type of biopsy, necrosis, and peritumoral lymphoid response was not statistically significant. Conclusion: Our study indicated that PD-L1 expression was not associated with various clinicopathological variables in NSCLC. More research is needed to look into the probable factors that influence the PD-L1-positive distribution. Since expression of the PD-L1 protein is proven to be of therapeutic and prognostic significance, we recommend that testing for PD-L1 should be done at least in cases of advanced-stage NSCLC.
Persistent Postural-perceptual Dizziness: A Review
Authors: Swain Santosh Kumar 
Published: August 2023

Introduction: Persistent postural-perceptual dizziness (PPPD) is characterized by chronic subjective dizziness, phobic postural vertigo, and related disorders. For at least 3 months, it exhibits varying symptoms of vertigo, unsteadiness, or dizziness. Methods: Research articles regarding PPPD were searched by viewing the Scopus, PubMed, Medline, and Google Scholar databases online. A search strategy using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis was used. Results: It presents a typical chronic vestibular system and brain malfunction that result in persistent dizziness, nonspinning vertigo, and/or unsteadiness. Persistent nonvertiginous dizziness and hypersensitivity to motion and visual stimuli are the main signs and symptoms of PPPD. These symptoms appeared either when there were no active neuro-otologic illnesses or when an episodic vestibular condition was present but could not completely account for the symptoms. Psychological mechanisms that resemble cognitive models of health anxiety and panic disorder are involved in the PPPDs development and maintenance. Conclusion: Since PPPDs diagnostic criteria only involve symptoms, the patient's clinical history is crucial in making the diagnosis. Once diagnosed, effective communication and personalized treatment plans, such as serotonergic medicines, cognitive behavioral therapy, and specialized physical therapy (vestibular rehabilitation), help manage PPPD. Since PPPD is a relatively recent clinical diagnosis, many medical practitioners who treat patients who feel dizzy are unfamiliar with it.
Epidemiology, Clinical Characteristics, and Outcomes of Culture-negative Sepsis
Authors: Byrappa Varun , Venkataraman Ramesh , Ramakrishnan Nagarajan , Mani Ashwin Kumar 
Published: August 2023

Aim: Culture-negative sepsis (CNS) is a common but understudied entity. The objective of this study was to compare the incidence, characteristics, and outcomes of CNS with culture-positive sepsis (CPS). Methods: This was a prospective observational study of patients admitted to the medical intensive care unit (ICU) of a tertiary hospital from January to December 2015 with clinical suspicion of severe sepsis as defined by Consensus Conference Criteria 2001. Results: Patients with severe sepsis ( n = 122) were studied of whom 66 (54%) were CPS and 56 (46%) were CNS. Patients with CNS had fewer comorbidities (0.7 ± 0.70 vs. 2 ± 0.8, P < 0.01). At presentation, CNS patients had less tachycardia (heart rate 92.5 ± 10.5 vs. 105.9 ± 13.2, P < 0.01), lower white blood cell counts (11859 ± 4791 vs. 14224 ± 3898, P = 0.003), lower need for vasopressors (38% vs. 68%, P < 0.01), and mechanical ventilation (23% vs. 53%, P < 0.01) compared to patients with CPS. The number of antibiotics on admission was similar between the groups (1.5 ± 0.6 vs. 1.6 ± 0.6, P = 0.36) but the duration of antibiotics was less in CNS (7.6 ± 1.7 days vs. 10.4 ± 2.6 days, P < 0.01). CNS had lower duration of ICU stay (6 ± 2.1 days vs. 7.8 ± 3.7 days, P < 0.01) and lower ICU mortality (7.1% vs. 22.7%, P = 0.02). Conclusion: CNS is very common in ICU. CNS patients compared to CPS tend to be less sick at presentation utilizing less resources but were initiated on a similar number of antibiotics on admission although for a shorter duration. Patients with CNS had a lower mortality in comparison to those with CPS.
Prevalence of Mental Health Problems among School-going Adolescents in Melmaruvathur: An Observational Study
Authors: Chandrasekar Sashidharan 
Published: August 2023

Introduction: Around 2.2 billion of the world's population are children and adolescents. Ninety percentage live in low-and middle-income countries, where they make up 30%–50% of the population. This study examines mental health issues and their association with gender in Melmaruvathur, teenage school children. Materials and Methods: After receiving approval from the Ethics Committee, a descriptive cross-sectional questionnaire-based study was carried out on adolescents who were attending school in Melmaruvathur. The participants in the study filled out the questionnaires. The power of the study was set at 80%, and the significance level was set at 0.05. The estimated size of the sample was 500. The duration of the study was approximately 1 ½ years, beginning on June 1, 2021, and ending on December 30, 2022. The age range was anywhere between 11 and 17 years, participants had to be adolescents who attended school. Those who had participated in mental health training programs in the past were not allowed to participate. Results: There were about 43.4% of females and 56.6% of males among the study participants. About 3.0% had very high conduct problems, 5.80% had high conduct problems, 1.4% had very high hyperactivity, around 1.80% had very high emotional problems, around 7.40% had very high peer problems, and 6.80% had very low prosocial. There was no statistically significant difference between the genders regarding conduct problems, hyperactivity problems, emotional problems, peer problems, and prosocial. In the case of females, 77.52% had a total difficulty score that was quite close to the average and in males, 81.53% received a total difficulty score that was quite close to the average. Conclusion: The findings are significant for several reasons, including the understanding of gender-specific vulnerabilities, the creation of youth mental health interventions that are more specifically focused on youth, and the peculiarities of the home setting.
Effect of Oral Clonidine and Gabapentin as Premedication on Intraoperative Hemodynamic Responses and Postoperative Analgesia Requirement in Laparoscopic Cholecystectomy
Authors: Tyagi Megha , Kour Arvin Preet , Singh Ajaydeep , Gupta Ritu , Prasad Ram Nandan 
Published: August 2023

Background: Laparoscopic cholecystectomy pain is a sensory and emotional experience connected with actual or potential tissue damage. Effective pain control is quite important, with around 70% of patients still complaining of moderate-to-severe pain postoperatively. Uncontrolled perioperative pain may raise patient morbidity and mortality rates. Both gabapentin and clonidine as premeditated can be easily administered have minimal side effects, are easily available at a low price, both them have a sedative effect that can decrease anxiety and they can blunt the stress response. Moreover, both drugs have anti-nociceptive effects that may be beneficial for controlling postoperating pain which is the basis of our current study. Aims: This study aims to compare the efficacy of oral clonidine with gabapentin before induction of anesthesia in attenuating hemodynamic stress response to laryngoscopy, intubation, and carbon dioxide pneumoperitoneum in laparoscopic cholecystectomy and to compare the efficacy of oral clonidine with oral gabapentin for postoperative pain control. Materials and Methods: Hundred patients undergoing laparoscopic surgery and qualifying inclusion criteria were randomly allocated into two groups each containing 50 patients. Group I patients were given Tab. Clonidine (300 μg) and Group II patients were given tablet Gabapentin (600 mg) orally 60 min before induction of general anesthesia. Hemodynamic changes and the incidence of postoperative pain in both groups were measured and compared. Results: Hemodynamic blunting to pressor stress of laryngoscopy and intubation was seen in both groups with better results obtained in the group receiving clonidine in the form of lesser variations in heart rate, systolic blood pressure, and diastolic blood pressure. Postoperative analgesia was achieved in both groups but gabapentin showed a better analgesic profile in the form of lesser Visual Analog Scale scoring and decreased utilization of rescue analgesia. Conclusion: Clonidine (300 μg) cause a greater attenuation of intraoperative hemodynamic stress responses, whereas gabapentin (600 mg) provides superior postoperative analgesia.
Impact of Pulmonary Rehabilitation on Recuperation of Moderate-to-Severe Coronavirus Disease 2019 Patients in Western India
Authors: Singh Manoj K , Annamalai K M 
Published: August 2023

Background: Coronavirus disease 2019 (COVID-19) virus has caused widespread Acute Respiratory Disease globally since 2020. Patients with evidence of lower respiratory illness either clinically or radiologically had moderate-to-severe illness. COVID respiratory and nonrespiratory symptoms (psychological and cognitive) noticed after 4–8 weeks of primary disease were called long COVID syndrome. Survivors of moderate-to-severe disease had a poor quality of life. The main objective of this retrospective study was to assess the role of outpatient pulmonary rehabilitation (PR) done in moderate-severe COVID-19 survivors who had symptoms after 4–8 weeks at Shaivam Lung Rehabilitation Centre, Ahmedabad. Methods: We analyzed the impact of PR on 30 patients' post-COVID-19 who were willing to participate during the ongoing pandemic. It was an outpatient 6–8 weeks of program designed to target respiratory and general muscle training, relaxation technique, nutritional counseling, occupational and psychological support. Patients were tested with of combination of self-assessment quality of life scale (adapted from short form 36 questionnaire), muscle training, dyspnea scale, and physical assessment. The standard objective assessment included oxygenation index (SpO2/FiO2 ratio), 6 min walk distance (6 MWD), Modified Medical Research Council (MMRC) score, manual muscle testing (MMT) along with pulmonary function testing. All these subjective and objective variables were tested pre- and post-PR program to assess the impact on defined parameters. Results: From December 2020 to March 2022, we studied the impact of PR on 30 out of 55 patients fitting into the inclusion criteria. Significant benefit was noted in subjective Short Form 36 (SF 36) score and objective (6 MWD, MMRC, oxygenation, MMT) quality of life post-PR program ( P < 0.001). Improvement in spirometry was not statistically significant, indicating structural chronicity of COVID pulmonary fibrosis. Conclusion: PR is safe, effective, and feasible on an outpatient basis in COVID-19 survivors of illness with poor quality of life. Further research is required to prove its widespread benefit in such patients.
Do histone deacetylase 1 (HDAC1) and retinoblastoma-associated protein have a synergistic role in the determination of prognosis in renal cell carcinoma? An immunohistochemical study
Authors: Al-Sharaky Dalia R. , Abdou Asmaa G. , El Maged Moselhy Aliaa A. , Aziz Reham A.A. , El-Dien Marwa M. Serag 
Published: August 2023

Background
Renal cell carcinoma (RCC) is the most common solid tumor of the kidney and the most lethal of all urological malignancies. Poor prognosis of RCC is caused by that third of patients presented by metastasis and half of them die due to disease. More research is needed to identify molecular markers that could lead to advances in personalized medicine.

Aim
We aimed to evaluate the protein expression of histone deacetylase 1 (HDAC1) and retinoblastoma-associated protein (RbAp48) in RCC and their relation to the clinicopathological parameters including survival.

Materials and methods
Fifty-one RCC cases were included in five tissue microarray blocks. Histopathological, clinical, and survival data were collected from patients’ records in Pathology, Clinical Oncology, and Nuclear Medicine Departments, Faculty of Medicine, Menoufia University. All cases were subjected to immunostaining by HDAC1 and RbAp48 antibodies. Expression of both was evaluated by different methods, including percentage, H score, and immunoreactivity score.

Results
No significant associations were noticed between neither HDAC1 nor RbAp48 expression and the studied clinicopathological variables. High expression of RbAp48 is significantly associated with shorter overall survival. Moreover, RbAp48 percentage of expression is an independent bad prognostic factor (beta=−0.634, P=0.001).

Conclusion
RbAp48 percentage of expression may be a promising independent bad prognostic factor in RCC. RbAp48 could play an essential role in RCC prognosis independent of HDAC1. Further studies are needed to identify specific HDAC isoforms essential in RCC tumorigenesis to be targeted by specific HDAC inhibitors. Also, molecular research will be helpful to clarify the pathways that help RbAp48 executing its bad prognostic effect in the scarcity of HDAC1.
Evaluation of the role of tight junction molecules
Authors: El-Fattah Ghada A. Abd , Said Eman M. , Roshdy Rania G. 
Published: August 2023

Background
According to the results of the National Population-based Cancer Registry Program, bladder cancer is the second most common cancer after liver cancer that is prevalent among Egyptian males. About 70% of bladder cancers are diagnosed as nonmuscle invasive cancers with high risk of recurrence, besides the risk of progression to muscularis propria invasion. The challenge is to identify noninvasive cancers using a reliable method for accurate diagnosis as well as for predicting the prognosis.

Aim
We aimed to evaluate the immuno-histochemical expression of claudin-1 (CLDN-1) and CLDN-4 in invasive and noninvasive urothelial lesions and correlate them with clinicopathological findings.

Patients and methods
This retrospective study included 36 different cases of urinary bladder lesions: 30 cases of urothelial carcinomas (UCs) and six papillary urothelial neoplasms of low malignant potential in addition to six normal control cases. Cases were graded according to the WHO classification and staged according to the TNM pathological staging system. Slides were subjected to immunohistochemical staining by CLDN-1 and CLDN-4.

Results
CLDN-1 showed the highest level of expression among carcinoma cases, while CLDN-4 showed the highest expression among control cases (P<0.000 for both). Increased CLDN-1 expression was significantly related to muscle invasion (P=0.000), advanced T stage (P=0.000), and high tumor grade (P=0.012). CLDN-4 expression showed a statistically significant difference in UCs without muscle invasion (P=0.000), earlier T stage, and low tumor grade (P=0.006).

Conclusion
CLDN-1 and CLDN-4 could be used as potential markers to differentiate invasive from noninvasive and low grade from high grade UC. They can predict the clinical outcome and play a role in the assessment of patients with UC.
Evaluation of the expression and role of adenosine receptor and programmed death ligand-1 in bladder urothelial carcinoma
Authors: Abd El-Fattah Ghada A. , Shalan Naglaa H. , El Sawi Rasha M. 
Published: August 2023

Background
Immune-checkpoint molecules are important regulators of physiologic inflammatory responses, and are highly effective in behavior of many cancers. They are involved in production of antitumor immune response. This study aims to evaluate the expression and role of both programmed death ligand-1 (PDL-1) and adenosine receptor (A2aR) antibodies in bladder urothelial cancer.

Materials and methods
This was a retrospective study on 45 bladder urothelial cancers obtained from archives of Pathology Department, Faculty of Medicine, Benha University and from International Medical Center Hospital (IMC) during the period from January 2015 to December 2019. Immunohistochemical expression of A2aR was evaluated and compared with those of PDL-1. A2aR expression was also correlated with tumor-infiltrating CD8+T cells. Relations to demographic data of the patients were evaluated.

Results
PDL-1 expression was detected in 24.4% of tumor cells±immune cells. PDL-1 was significantly related to advanced PT stage (P<0.01), detrusor muscle invasion (P<0.05), and nonpapillary tumor histology (P<0.05). High expression of A2aR was detected in 40% of tumor specimens in tumor cells±immune cells. Higher A2aR expression was statistically significant related to higher tumor grade (P<0.05), advanced PT stage (P<0.01), detrusor muscle invasion (P<0.01), and nonpapillary tumor histology (P<0.01). The expression of A2aR was statistically significant related to PDL-1 expression (P<0.01). Higher A2aR expression was statistically related to lower the density of tumor-infiltrating CD8+T lymphocytes (P<0.01). Using receiver operating characteristic curve, A2aR was more accurate than PDL-1 as area under the curve (0.648 and 0.565, respectively). The specificity of A2aR is higher than PDL-1 (51.9 and 29.6, respectively).

Conclusion
Both PDL-1 and A2aR markers could be useful in monitoring urothelial bladder cancer immunotherapy. A2aR is higher to and more specific than PDL-1 in predicting tumor lymphocytic infiltrate. A2aR antagonists could have a positive role in cases that are resistant to anti-PDL-1 immunotherapy.
E-cadherin immunohistochemical expression in gastric carcinoma in relation to different clinicopathological parameters
Authors: Edin Hala S.E. Alaa , El Sayed Salah M. , Bakheet Rafaat A. , Allithy Amal N.A. 
Published: August 2023

Background
Gastric cancer (GC) is an aggressive malignancy and a common cause of cancer-related deaths worldwide. E-cadherin is a transmembrane calcium-dependent epithelial cell adhesion molecule. Loss of E-cadherin-mediated cell–cell adhesion is needed for tumor cell invasion and metastasis. Cells with mutated E-cadherin demonstrate increased motility, show altered organization of their actin cytoskeleton, and are associated with metastases, thereby providing evidence for its role as an invasion suppressor.

Objectives
To assess the prognostic value of E-cadherin expression in GC and to evaluate its correlations with other prognostic parameters.

Materials and methods
Immunohistochemical E-cadherin expression was studied in 36 cases of GC (24 cases of endoscopic biopsies and 12 cases of total gastrectomy), and the results were correlated with clinicopathological parameters.

Results
E-cadherin was positive in 15/36 (41.7%) cases of GC. A significant inverse correlation was found between E-cadherin expression and tumor grade, number of lymph nodes involved by metastasis, and Helicobacter pylori positivity, with P values of 0.02, 0.04, and 0.03, respectively.

Conclusion
E-cadherin loss plays an important role in invasion and metastasis potential in GC, and decrease or loss of its expression is predictive of poor prognosis. H. pylori plays an important role in gastric carcinogenesis, and it induces a statistically significant decrease in E-cadherin expression, so eradication of H. pylori infection can stop or decrease the progression of carcinogenesis.
Clinicopathological relation of CD10 and cyclooxygenase-2 expression in invasive breast cancer no special type
Authors: Sayed Rasha M.S. , Ghanam Walaa Abd El Gawad , Bebars Shaimaa M.M. 
Published: August 2023

Background
In breast cancer, which is the most frequent female cancer, new histopathologic parameters, such as tumor-infiltrating lymphocytes and stromal factors, are now introduced for prognosis and new strategies of therapy. This study was designed to explore CD10 and cyclooxygenase-2 (COX2) expression levels in invasive duct carcinoma (IDC) no special type (NST) and their relations with clinicopathological data.

Methods
This work was conducted on 40 cases of IDC of NST that were collected as paraffin-embedded blocks. For each case, sections of paraffin-embedded blocks were submitted to be stained with routine hematoxylin and eosin and other sections were stained using the immunohistochemistry technique with CD10 and COX2 antibodies and then evaluated and scored.

Results
CD10 was expressed in nearly half of the cases (45%), whereas COX2 was detected in all of the cases (100%). COX2 was strongly expressed in more than two-thirds of the cases. A significant association was detected between CD10 and lymph node status (P=0.017). Although no significant association could be detected, about one-fourth and one-third of cases with marked estrogen receptor and progesterone receptor expressions, respectively, had strong CD10. No significant association could be detected between COX2 and all studied clinical and histological data, including CD10 expression. However, COX2 was expressed more frequently in negative human epidermal growth factor receptor 2/neu and high Ki-67 cases. Cases with associated carcinoma in situ, detected vascular emboli, and lymph node positivity expressed COX2 score 4.

Conclusion
A significant association was found between CD10 and lymph node staging. COX2 was detected in all studied cases, with tendency to be associated with bad prognostic indicators. These findings suggest that CD10 and COX2 could contribute to tumor aggressiveness and progression in IDC NST.