bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and Hormonal Profile of Polycystic Ovary Syndrome Phenotypes
Authors: Hossain Mohammad Afjal , Pathan Md Faruque , Afsana Faria , Sharifuzzaman Mirza , Amin Farzana , Kabir Md Lutful , Mahmud Nusrat , Saifuddin Mohammad , Qureshi Nazmul Kabir , Selim Shahjada , Kamrul-Hasan A. B. M. 
Published: June 2023

Background:
Polycystic ovary syndrome (PCOS) is a heterogeneous androgen-excess disorder with varying degrees of reproductive and metabolic abnormalities, whose diagnosis is based on anthropometric, biochemical, and radiological abnormalities. This study was conducted to observe the frequency of different phenotypes of PCOS and to observe the pattern of clinical profile and hormonal changes among them.

Methods:
This cross-sectional observational study was conducted at the Endocrinology and Obstetrics and Gynecology Outpatient Department of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine, and Metabolic Disorders over the period of 13 months, dated from April 2016 to April 2017. Eighty patients clinically diagnosed as a case of PCOS were included in this study as per inclusion and exclusion criteria. Patients were categorized into four different phenotypes based on the presence of oligo-anovulation (O), hyperandrogenism (H), and polycystic ovarian morphology (P): (i) Phenotype A (O + H + P), (ii) Phenotype B (O + H), (iii) Phenotype C (H + P), and (iv) Phenotype D (O + P). Demographic, clinical, anthropometric, and hormonal profiles were recorded and compared among phenotypes of PCOS by ANOVA and Chi-square test.

Results:
Most prevalent phenotype in the study population was Phenotype A (55%), followed by Phenotype D (22.5%), Phenotype B (15%), and Phenotype C (7.5%). Hirsutism, acne, acanthosis nigricans, and family history of diabetes mellitus were more common in Phenotype A and Phenotype B than in Phenotype C and Phenotype D (P < 0.001, P = 0.029, P = 0.008, and P = 0.048, respectively). Relatively, higher body mass index, waist circumference, and waist–hip ratio were found in Phenotypes A and B than in other phenotypes (P < 0.001, P < 0.001, and P < 0.001, respectively). Phenotypes A and B had higher serum total testosterone, luteinizing hormone (LH), free androgen index, and lower sex hormone-binding globulin than other phenotypes (P = 0.003, P = 0.007, P = 0.001, and P < 0.001, respectively). Follicle-stimulating hormone (FSH), LH/FSH ratio, prolactin, and thyroid-stimulating hormone were comparable in all phenotypes (P 0.445, 0.204, 0.748, and 0.811, respectively).

Conclusions:
The PCOS in certain subgroups such as Phenotypes A and B had higher hyperandrogenism and was associated with adverse anthropometric and clinical parameters. Clinical and hormonal findings are different in different phenotypes.
Small Pancreas Neuroendocrine Tumors: How Small is Small?
Authors: Chen Ming-Huang , Hsieh Chia Hsun , Yang Ching-Yao , Tsai Hui-Jen , Chen Li-Tzong ,   On Behalf of Taiwan Neuroendocrine Tumor Society
Published: June 2023

Objective:
The current study aimed to investigate the issues in contemporary management strategies that focus on small pancreatic neuroendocrine tumors (PNETs).

Data Sources and Study Selection:
We searched various scientific databases using specific keywords.

Results:
Surveillance-only strategies were considered for selected patients. The exact cut-off value of small neuroendocrine tumors for surveillance-only strategies needs to be verified with additional high-level evidence.

Conclusion:
There is no consensus on the size and treatment strategy for small PNETs currently. Patients with small nonfunctioning PNETs require individualized recommendations for surgery versus active surveillance based on tumor size, radiographic characteristics, and patient characteristics, such as age and comorbidities and also patient references.
Adjuvant Chemotherapy in Patients with Low-Risk Epithelial Ovarian Cancer: A Taiwanese Cohort Study
Authors: Lo Yuan-Ting C. , Ku Hsiu-Ying , Chang Cheng-Shyong , Ch’ang Hui-Ju , Ho Chih-Ming , Liu Tsang-Wu , Lin Shih-Min 
Published: June 2023

Background:
Whether or not patients with stage I epithelial ovarian cancer (EOC) benefit from postoperative chemotherapy in the Asian population remains unclear. This retrospective cohort study was aimed at investigating the use of adjuvant chemotherapy in clinical practice to treat patients with early-stage EOC considering clinical factors.

Materials and Methods:
A total of 414 patients with the International Federation of Gynecology and Obstetrics (FIGO) stage IA–IC and grade 1 EOC were enrolled from the Taiwan Cancer Registry. We used multivariable Cox proportional-hazards models to control for clinical factors. The overall survival (OS) and disease-free survival (DFS) were estimated with the Kaplan–Meier method.

Results:
DFS did not improve significantly for patients with FIGO stage IA/IB EOC receiving adjuvant chemotherapy, with a 10-year DFS rate of 98% and 88% for those with and without adjuvant chemotherapy, respectively (hazard ratio [HR] = 0.41, 95% confidence interval [CI]: 0.05–3.36). OS did not improve significantly for patients with FIGO stage IA/IB EOC with adjuvant chemotherapy (HR = 0.86, 95% CI: 0.18–4.22) or stage IC (HR = 0.50, 95% CI: 0.10–2.45). OS did not differ significantly for patients with optimal (10-year OS: 92% with chemotherapy and 86% without chemotherapy in the log-rank test, P = 0.629) or nonoptimal staging (10-year OS: 73% with chemotherapy and 90% without chemotherapy in the log-rank test, P = 0.959).

Conclusion:
Adjuvant chemotherapy did not improve the prognosis of patients with low to intermediate-risk EOC and optimal/nonoptimal surgery. This result should be considered in clinical practice.
Predictive Value of Global Longitudinal Strain Imaging in Detecting Significant Coronary Artery Disease in Patients with Non-ST-segment Elevation Myocardial Infarction
Authors: Prasad Ravi Vishnu , Manikrao Gutte Rahul , Singh B. P. , Kumar Nirav , Kumar Goutam , Chandan Chandra Bhanu 
Published: June 2023

Background:
Two-dimensional speckle-tracking echocardiography (2D-STE) is a newer method for assessing left ventricular (LV) systolic function. The aim of this study was to assess the predictive value of 2D global longitudinal strain (GLS) in the detection of longitudinal LV systolic dysfunction and the identification of significant coronary artery disease (CAD) in non-ST-segment elevation myocardial infarction (NSTEMI) patients without wall motion abnormalities.

Materials and Methods:
We enrolled 100 patients who were suspected cases of NSTEMI with echocardiography showing LV ejection fraction >50% and no regional wall motion abnormality. LV myocardial function was assessed using conventional echocardiographic measurements and myocardial deformation analysis with 2D-STE. The patients found to have significant CAD on coronary angiography were included in the cases group and those without significant CAD were considered as controls.

Results:
Mean age of the patients was 58.36 ± 11.21 years versus 56.54 ± 8.10 years in controls. Male preponderance was found in both case and control groups, with 66% (n = 33) and 56% (n = 28) males, respectively. The patients had significantly lower GLS as compared to the controls (-16.31 ± 1.34% vs -19.17 ± 1.63%, P < 0.001). The patients with positive troponin assay had a lower mean GLS −16.49 ± 1.5% as compared to those with negative troponin assay (−19.32 ± 1.54%, P < 0.001). Multivariate analyses indicated that GLS was an independent predictor of CAD in those with NSTEMI (GLS odds ratio = 0.024, P < 0.001).

Conclusions:
The present study demonstrates that 2D-STE is superior to conventional echocardiography in excluding significant CAD. It is a promising, easy to perform, bedside tool for diagnosis and prognostication in patients with NSTEMI. GLS has a potential to be used in conjugation with other risk stratification strategies to identify patients at high risk.
Effects of Graded Doses of Sildenafil Citrate on Liver Microanatomy in Male Albino Rats
Authors: Bashir Sameena , Bhat Ghulam Mohammad , Khanday Shabir Ahmad , Wani Lateef Ahmad 
Published: June 2023

Background:
Sildenafil citrate (SC) is a vasoerectile drug used to treat impotence caused by erectile dysfunction by inhibiting phosphodiesterase type 5 enzyme. The drug is widely used and may have adverse effects on the liver as it is metabolized mainly in the liver. Therefore, the present research aimed to study the effect of graded doses of SC on the histological structure of the liver in albino rats.

Methodology:
The present prospective interventional experimental study was conducted on 30 albino rats. The rats were given SC in different doses and for different periods. Rats were sacrificed, and the liver was extracted and processed for histopathological examination. The slides were stained with hematoxylin and eosin and observed under a compound light microscope.

Results:
SC administrated in graded doses in male albino rats caused central venous congestion, sinusoidal dilatation, and fatty infiltration in the liver. These changes were more pronounced in rats that received the drug in higher doses and for a longer duration. The effects of SC on the rat liver microanatomy were dose and time dependent.

Conclusion:
SC is relatively safe in low doses, but at higher doses and longer duration, there can be adverse effects on the liver.
Early Clinical Exposure – Effectiveness and Attitude among MBBS Students
Authors: Mathew Dini , Kantha B. M. Lakshmi , Dhanasekar P. Durai 
Published: June 2023

Background:
In the traditional method, students learn theory without contacting patients in the initial part of MBBS. Early clinical exposure creates a scope for students to correlate basic science and clinical application. Hence, there is a need to study the effectiveness of different forms of early clinical exposure (ECE). The objectives of the study were to compare the knowledge acquired and attitude toward ECE by the students after different forms of ECE.

Methodology:
An observational study was done with 1st-year MBBS (n = 150) students. Based on the National Medical Council (Then Medical Council of India) II ECE document for undergraduate medical education programs, 10 topics were selected. The first six ECE sessions were conducted in the classroom, the next two at the hospital, and the last two virtually. Phase-validated structured multiple-choice questions (MCQs) and feedback were given to students before and after every ECE. The MCQ scores and feedback conducted in three forms were statistically analyzed.

Results:
There was a notable disparity in the mean between pre- and posttest. The mean scores of the virtual mode were better than the other two forms. As per the feedback analysis, most of the students observed ECE aid to clear conceptualization, critical thinking, and correlate anatomical basis in clinical cases. However, students also felt that it is too early to understand the topic in such detail in 1st year.

Conclusion:
This longitudinal study on ECE showed there is an increase in the knowledge and analytical skills of students. Hence, we recommend continuing ECE and to have a blended learning environment along with limited content to be included for a better outcome.
A study of antenatal, intranatal, and postnatal care of mothers in index pregnancy
Authors: Srivastava Shubhangi , Agarwal Monika , Nawaz Zaidi Syed Hasan , Agrawal Deepika 
Published: June 2023

Background:
Most newborn deaths are preventable by improving quality of care during antenatal period and at delivery. Optimum maternal healthcare utilization, such as antenatal care (ANC) visits, skilled birth attendants or intranatal care, and postnatal care (PNC) services are associated with maternal health outcomes.

Objectives:
To study antenatal, intranatal, and PNC of mothers in index pregnancy.

Materials and Methods:
A descriptive cross sectional study was carried out among mothers of 360 neonates. Study was conducted in three government Sick newborn care units (SNCUs) of Lucknow district, which were randomly selected. The schedule was pretested on 10% of the total sample of mothers of neonates admitted to SNCU in Lok Bandhu Shri Raj Narayan Combined Hospital, Lucknow, to see for the accuracy of responses and to estimate the time needed. Three days a week were selected randomly for data collection. These 3 days were randomly allocated to collect data from three different SNCUs. One day was dedicated to collect data from one SNCU.

Results:
95.8% mothers had at least one ANC checkup during index pregnancy. Majority (62%) of the mothers had more than 4 ANC visits during index pregnancy. Majority (69%) of mothers had their first ANC checkup in 1st trimester, 25.8% in 2nd trimester, only 5.2% had their first ANC checkup in 3rd trimester. Only 28.3% mothers received counseling on newborn care during index pregnancy. Majority (92.5%) of the deliveries were attended by doctor. It was seen that 72.8% mothers got counseling on newborn care in postnatal period.
Conclusion: Extra efforts are needed to sensitize ASHA to counsel women regarding early registration, birth preparedness, adequate ANC, safe delivery, PNC, immunization of children etc and to mobilize the community and facilitate them in accessing these services.
Dietary pattern in brochial asthma control
Authors: Chandra Eshutosh , Mahendran C. S. , Das Pooja , Pandey Ankit , Saini Mukul 
Published: June 2023

Background:
Asthma is a noncurable but preventable disease, responsible for higher morbidity worldwide. Approximately, in every fifth asthmatic patient, the possible role of food allergy should be taken into account.

Materials and Methods:
This was a descriptive study of dietary pattern in asthma control in 1 year, between 2021 and 2022 with 100 asthma and 100 healthy controls. Asthma was diagnosed as per Global Initiative for Asthma 2021. The control group had no respiratory ailments in their entire life span. Diabetes and hypertension were excluded from the study. Dietary habits were documented in both groups in a food diary, and five parameters were given thrust in order to simplify the study.

Results:
There is a positive correlation between consumption of fast food, packed chips, carbonated drinks and worsening of asthma in 36 patients. Low consumption of cereals has a positive correlation with asthma severity in 38 patients and greater than three times a week sugar intake associated with poor asthma control which is found in 26 patients.

Conclusion:
The correlation between asthma and the consumption of fast food, salted snacks, fried snacks, fats and oils nuts, dry fruits, and carbonated drinks has been observed in India. Consequently, it becomes crucial to lower the intake of these items and enhance public awareness regarding the impact of fast food on asthma through the implementation of effective public health policies.
Knowledge, attitudes, and practices in transport workers and gym-goers toward COVID-19
Authors: Das Pooja , Singh Prekshy , Dhandayuthapani Sivanesan , Tomo Sojit , Mahendran C. S. 
Published: June 2023

Background:
Researchers in the field of public health frequently employ knowledge, attitude, and practice models to examine individuals' health-related behaviors. Hence, the primary objective of this study was to investigate the correlations between two groups with different sociodemographic status toward COVID-19 knowledge, affective attitudes, and preventive behaviors.

Method:
A cross-sectional comparative offline survey was conducted through questionnaire in a total of 166 population in and around Ghaziabad where 93 were active gym-goers and 73 were transport worker. Data collection was done from January to March 2022 that was included in statistical data analysis.

Results:
The difference of knowledge and practice was found when both groups were compared which was statically significant.

Conclusion:
The presence of sufficient COVID-19 knowledge demonstrates a direct association with increased engagement in precautionary behaviors. However, attitudes toward COVID-19 did not appear to have a significant role in motivating individuals to adopt preventive behaviors. Furthermore, COVID-appropriate behavior was associated with more educated and health-conscious groups.
Resident Research Mentoring Teams: A Support Program to Increase Resident Research Productivity
Authors: Haas David M. , Hadaie Bachar , Ramirez Mirian , Shanks Anthony L. , Scott Nicole P. 
Published: June 2023

ABSTRACT

Background
Scholarly activity is a requirement for most graduate medical education training programs. However, barriers exist for residents to accomplish projects.

Objective
To evaluate the correlation between a resident research mentoring team (RRMT) program and meeting presentations and publications of resident research projects. We further plan to report feasibility of the RRMT.

Methods
We performed a before-and-after study of meeting presentations and/or publication of resident research projects before institution of the RRMT (2004-2011) and post-RRMT implementation (2016-2019). The RRMT is a diverse group of faculty, statisticians, and research staff who meet regularly with residents to provide guidance for their research studies. It is part of overall research support from the department, which also includes biostatistics, database and regulatory help, travel funds, and project budget funds. Data on meeting presentations and publications were collected from Google Scholar, PubMed, Scopus, and the IUPUI ScholarWorks institutional repository, using resident and faculty names and titles of projects. Comparisons of pre- and post-RRMT groups were made.

Results
Seventy-four residents were in the pre-RRMT group and 40 were in the post-RRMT group. Post-RRMT residents published, presented, and combined published or presented their projects more frequently than those in pre-RRMT group (57.5% vs 28.4%, P=.002; 50% vs 16.2%, P=.001; 67.5% vs 37.8%, P=.002). Controlling for winning a Research Day award and pursuing a fellowship, being in the post-RRMT group was independently associated with presentation or publication of the resident research project (OR 3.62, 95% CI 1.57-8.83).

Conclusions
Support of resident scholarly activity, such as thorough implementation of a program like the RRMT, is associated with increased presentations and publications of research projects.
Estimating Soil Erosion to Highlight Potential Areas for Conservation Priority in Rukarara Catchment, South-western Rwanda
Authors: Rizinjirabake Fabien , Nyiramana Aisha , Kamizikunze Théoneste , Mukamugema Jane 
Published: June 2023

Soil erosion is one of the major environmental problems in tropical ecosystems; however, the lack of information on the amount of eroded soils in Rwandan mountainous watersheds hinders effective decision-making toward sustainable soil management. This study aimed at predicting soil erosion in the Rukarara River watershed, one of the mountainous watersheds in Rwanda, and identifying potential areas of high erosion risk using the revised universal soil loss equation (RUSLE) implemented in a GIS environment. The annual soil loss was estimated by computing and performing a spatial overlay analysis of relevant layers including rainfall erosivity (R), soil erodability (K), slope length and steepness (LS), cover management (C), and conservation practice (P) factors. The results indicate that the annual soil erosion varies from 54 to 134 t ha−1 year−1 (95% confidence interval) with a mean of 39.96 t ha−1 year−1. The study area is generally characterized by very low and low soil erosion classes and the mean erosion correlated with literature results in the tropics. Agricultural lands are the hotspots of soil erosion with a mean of soil loss of 61.29 t ha−1 year−1. The produced maps and soil loss estimates can facilitate informed decision-making toward sustainable soil management in mountainous areas of Rwanda, especially in the Rukarara River watershed.
Knowledge, attitude and practices of small ruminant butchers on tuberculosis in selected areas of Katsina State, Nigeria
Authors: Dahiru M.H. , Saidu S.N.A. , Tekdek L.B. , Buhari H.U. , Kaltungo B.Y. , Babashani M. , Baba A.Y. 
Published: June 2023

A questionnaire survey was conducted on the knowledge, attitude and practices of butchers on tuberculosis in small ruminants in selected areas of Katsina State, Nigeria. All respondents had some level of formal education. Animals slaughtered included cattle (18.0%), sheep (34.0%), goats (53.0%) and camels (4.0%). Animals were slaughtered in the countryside (23.0%), within the village (24.0%) and in community areas (57.0%). The butchers knew small ruminants could acquire tuberculosis and that tuberculosis could infect humans along with its signs and modes of transmission in animals and humans. Eighteen percent knew small ruminants could acquire tuberculosis from humans while 80.0% knew humans could acquire tuberculosis from animals. Thirty percent of respondents knew people with tuberculosis, while 10.0% each reported their family members having tuberculosis and living with tuberculosis-infected persons respectively. The butchers handled their tuberculosis-infected animals by taking such animals to Veterinary Clinic (52.0%), selling (21.0%) or leaving them in the flock (15.0%). The butchers reported socializing at night with friends (44.0%), brothers (14.0%), sisters (8.0%) and wives (34.0%). The butchers allowed dogs into the slaughter facilities and this was highly significant. Some of the butchers (62.0%) accepted childhood vaccination which included BCG (40.0%), Polio (28.0%) and Measles (27.0%). The study concluded that the butchers were aware of tuberculosis in both humans and animals, the signs and symptoms of the disease as well as its mode of transmission. The study has demonstrated poor attitudes and practices among the butchers about tuberculosis. The study recommends the need for greater education of butchers to enhance better practices and attitudes towards the disease to control it in themselves and the public they serve.
Embryonated eggs as an alternative to animals in the determination of median lethal dose (LD50) in bitis venom
Authors: Yusuf P.O. , Dahiru S. , Ameh M.P. , Oyetunde J.S. , Ada G. , Idoga E.S. , Akefe I.O. , Attah C.U. , Ajagun E. 
Published: June 2023

Determination of median lethal dose (LD50) is a vital tool adopted by the World Health Organization for pre-clinical assessment of products for use in the management of snakebite envenoming, a condition which is now included among the list of Neglected Tropical Diseases in 2017. The current trend in the determination of LD50 involves the use of laboratory animals, tens or even hundreds of animals are sacrificed to achieve this goal. This study aimed to find reliable alternatives to this sacrificing of laboratory animals for research purposes. This study investigated the comparative similarities or differences in results obtained from the use of laboratory animals and embryonated eggs in the determination of LD50 in snake venom research. The median lethal dose (LD50) was determined using female mice using the up and down method and Probit method as well as embryonated eggs. There was no statistical difference in the LD50 of the venom of Bitis arietans obtained by the up and down method and that of the conventional probit analysis (p≤0.05) (0.325 mg/kg [probit] and 0.351 mg/kg [up and down] respectively). There was also no statistical difference in the LD50 of the venom of Bitis arietans by the up and down method, conventional probit method, and by the use of embryonated eggs (p≤0.05) (0.325 mg/kg [probit], 0.351 mg/kg [up and down], and 0.392 mg/kg [embryonated eggs). The three methods used produced values of LD50 that were within the range reported on the Australian snake and venom database of 2007. The results suggest embryonated eggs can conveniently replace the use of laboratory animals in the determination of LD50 in snake venom research to ease the ethical challenges posed by excessive use of laboratory animals in snake venom research.