bluuebunny/crossref_metadata_2025_split huggingface dataset:
Classification of Breast Cancer Tumors Using Mammography Images Processing Based on Machine Learning
Authors: Zahedi Farahnaz , Karimi Moridani Mohammad 
Published: April 2022

Abstract— Using intelligent methods to identify and classify a variety of diseases, in particular cancer, has gained tremendous attention today. Tumor classification plays an important role in medical diagnosis. This study's goal was to classify breast cancer (BC) tumors using software-based numerical techniques. To determine whether breast cancer masses are benign or malignant, we used MATLAB version 2020b to build a neural network. In the first step, the features of the training images and their output classes were used to train the network. Optimal weights were obtained after several repetitions, and the network was trained to produce the best result in the test phase after several repetitions.
Because of using effective and accurate features, the method suggested here, which was based on an artificial neural network, delivered the diagnostic accuracy, specificity, and sensitivity of 100%, 100%, and 100%, respectively, to discern benign from malignant BC tumors, showing a better performance compared to previously proposed methods. One of the challenges for imaging-based diagnostic techniques in medicine is the difficulty of processing dense tissues. Breast cancer is one of the most common progressive diseases among females. Early diagnosis makes treatment easier and more effective. Using AI-based methods for automated diagnosis purposes can be valuable and have a reduced error rate because accurate diagnosis by manual means is time-consuming and error-prone.
Hyponatremia in Melioidosis
Authors: Rao Indu Ramachandra , Shaw Tushar , Prabhu Ravindra Attur , Eshwara Vandana Kalwaje , Nagaraju Shankar Prasad , Rangaswamy Dharshan , Shenoy Srinivas Vinayak , Bhojaraja Mohan Varadanayakanahalli , Mukhopadhyay Chiranjay 
Published: April 2022

Introduction:
Hyponatremia is a frequent finding in hospitalized patients and is associated with poor clinical outcomes. While hyponatremia is known to commonly occur in certain infections, its association with melioidosis has not been studied previously. We studied incidence and impact of hyponatremia on clinical outcomes in melioidosis.

Methods:
This was a retrospective analysis of a single-center hospital registry of culture-positive patients with melioidosis hospitalized during a 10-year period (January 01, 2010, through January 31, 2021). Hyponatremia was defined as serum sodium of <135 mmol/L, and severe hyponatremia as serum sodium <120 mmol/L. The association of hyponatremia with in-hospital mortality, need for intensive care unit (ICU) stay and mechanical ventilation was studied.

Results:
Of 201 patients with melioidosis, 169 (84.1%) had hyponatremia, with severe hyponatremia in 35 (17.4%) patients. Older age (adjusted odds ratios [OR] 1.03, 95% confidence intervals [CI]: 1.00–1.06; P = 0.049) and acute kidney injury (AKI) (adjusted OR 3.30, 95% CI: 1.19-9.19; P = 0.02) were independently associated with hyponatremia. Twenty-two patients had been evaluated for cause of hyponatremia and of these, 11 (50%) had syndrome of inappropriate antidiuresis. Severe hyponatremia was associated with in-hospital mortality (adjusted OR 3.75, 95% CI: 1.37–10.27; P = 0.01), need for ICU stay (adjusted OR 7.04, 95% CI: 2.88–17.19; P < 0.001) and mechanical ventilation (adjusted OR 3.99, 95% CI: 1.54–10.32; P = 0.004).

Conclusion:
Hyponatremia occurs in 84.1% of hospitalized patients with melioidosis. Older age and AKI are associated with a higher incidence of hyponatremia. The presence of severe hyponatremia is an independent predictor of in-hospital mortality, need for mechanical ventilation and ICU stay.
Spectrum of Neurological Complications of Pregnancy on Magnetic Resonance Imaging
Authors: Posh Sheema Ahmad , Rafiq Suhail , Jeelani Beenish , Wani Saima 
Published: April 2022

Introduction:
Catastrophic neurological decline, although exceedingly rare, takes a huge toll on pregnant population. In view of varied symptomatology and risks to the fetus, diagnosis and management of the neurological disorders in pregnancy is always a challenging task. The evaluation and management should be performed in a stepwise fashion and requires a multidisciplinary approach. Radiological imaging, especially magnetic resonance imaging (MRI), has revolutionized the diagnosis of these disorders, thereby exacerbating maternal and fetal outcome.

Aim:
The present study was conducted with the aim to characterize some of the significant neurological disorders complicating pregnancy and puerperium and to study the role of imaging, especially MRI, in differentiation and exclusion of various neurologic conditions, which helps an obstetrician to point to a specific diagnosis and management.

Materials and Methods:
Our study was an observational study conducted in the Department of Obstetrics and Gynecology in collaboration with the Department of Radiodiagnosis of GMC, Srinagar, from June 2018 to January 2020. The images were obtained with MRI and subjected for radiological interpretation.

Results:
A total of 750 patients were included in the study out of which 25 patients had neurological complications. Out of 25 patients, 13 were in the antenatal period and 12 were in the puerperium. There were 10 (40.0%) cases of posterior reversible encephalopathy syndrome (PRES), 6 (24%) cases of cerebral venous thrombosis (CVT), 3 (12.0%) cases of embolic infarcts, 2 (8.0%) cases of status epilepticus, 2 (8.0%) cases of pituitary apoplexy, 1 (4.0%) case of Wernicke encephalopathy, and 1 (4.0%) case of metastasis to brain (choriocarcinoma).

Conclusion:
Diagnosis of neurological complications of pregnancy and postpartum plays a crucial role in reducing fetomaternal morbidity and mortality. MRI stands above all imaging modalities in early diagnosis of these neurological complications, simultaneously taking care of fetal safety as well. The most common neurological complications that cause increased maternal mortality are PRES and CVT. Hence, early imaging can help in early and appropriate management of serious pregnancy-related neurological catastrophes.
“It Helps Me With Everything”: A Qualitative Study of the Importance of Exercise for Individuals With Spinal Cord Injury
Authors: Pebdani Roxanna N. , Leon Jesus , Won Deborah S. , deLeon Ray D. , Dy Christine J. , Forsyth Rowena , Keslacy Stefan 
Published: April 2022

Background
The influence of exercise after spinal cord injury (SCI) is a topic important to both clinicians and researchers. The impact of exercise for individuals with SCI is often studied quantitively, with a large focus on the physiological adaptations to exercise intervention.

Objectives
This study explores individualized experiences of exercise for people with SCI.

Methods
A phenomenological approach was utilized to qualitatively study the experiences of exercise for 16 individuals with SCI.

Results
Participants described multiple benefits of exercise, including increased independence, improved mental health, and increased engagement in social activity.

Conclusion
This study provides novel information about attitudes toward exercise held by individuals with SCI and a more thorough understanding of concepts that are well researched.
Digital Currency Alert System Using IOT
Authors: R DEEPIKA.R , R Keerthika , P Amrutha , K Valarmathi 
Published: April 2022

Assume a client needs to put his cash in Bitcoin market and he/she would be more than once checking for Bitcoin esteem in current market. So rather than customary checking, the python program in this task proves to be useful. In this the program requests that the client enter the money from which he/she need to put resources into bitcoin market, then the program requests his/her ideal selling cost. In the wake of taking the selling value the program stores it and afterward it checks for current bitcoin esteem in the market	in his/her given money. For this the program utilizes the API of worth of bitcoin which we have embedded in our program. Assuming it observes that the current market worth of bitcoin is not exactly the selling value, the program naturally as an indication of caution rings ringer and furthermore the LED as advance notice. Yet, in the event that guess the client not ready to hear alert. This program checks for bitcoin value in every 30 seconds online it also gives the latest transaction of bitcoin which helps the investor to know how many people made a transaction and how much they invest in bitcoin. If people made many transactions between two periods of time, investors may come to a conclusion that the bitcoin price has decreased time.
CICLOFOSFAMIDA COMO DROGA INDUTORA DE REMISSÃO EM PACIENTE LÚPICA: RELATO DE CASO
Authors: Dias Filho Ulisses , Mituiassu Alexandre Mitsuo 
Published: April 2022

Lúpus Eritematoso Sistêmico é definido como uma doença autoimune, de caráter inflamatório crônico, mais frequente em mulheres em idade fértil e que, tipicamente, apresenta acometimento multissistêmico, manifestando-se por períodos de atividade e remissão, com grande variabilidade fenotípica1. Dentre as diversas possibilidades de acometimento renal no LES, a Nefrite Lúpica (NL) é a forma de lesão renal mais comum, acometendo aproximadamente 50% dos pacientes1. Essa manifestação ganha importância impar pelo fato de ser a principal indicação para o uso de altas doses de corticoides e imunossupressores, bem como o principal fator relacionado à mortalidade1. O tratamento de portadores de NL tem como objetivo atingir a resposta clínica completa à terapia imunossupressora, visto que essa é diretamente proporcional à sobrevida renal à longo prazo. Na atualidade, existem diretrizes como a da Sociedade Brasileira de Reumatologia e Sociedade Internacional de Nefrologia que norteiam a prática médica, quanto ao diagnóstico e tratamento da NL. Entretanto, é evidente que o surgimento de novas medicações e novos protocolos terapêuticos abrem espaço para discussões e estudos sobre o manejo destes doentes. O presente estudo tem como objetivo, portanto, discutir a terapia indutora de remissão com o uso de ciclofosfamida em uma paciente de 35 anos, do sexo feminino, com LES grave, associado à NL e acometimento cutâneo, seroso, hematológico e sobreposição com Síndrome do Anticorpo Antifosfolípide (SAAF).
Assessing the Impact of a Physician Resiliency and Wellness Program to Physician Burnout Levels in a Pediatric Department of a Tertiary Hospital: A Pilot Study of the I-CARE Program
Authors: Tan-Lim Carol Stephanie C. , Dumagay Teresita E. , Dahildahil Roy O. , Del Castillo Ronald T. , Carasco Maria Arla Andrea G. 
Published: April 2022

Background. Physician burnout is a growing problem worldwide. Several interventions aimed at lowering burnout rates among physicians have been implemented. To date, there is no established structured program to combat burnout in the Philippine General Hospital. This study evaluated the effectiveness of the I-CARE program, a physician resilience and wellness program which adapted the different components of the international programs for the Philippine setting.
Objective. To evaluate the effectiveness of the I-CARE program in reducing medical residents’ burnout level.
Methods. After key components of the I-CARE program were identified, the program was implemented in 2 phases. The first phase involved training of consultants to hone their facilitation skills. The second phase was a before-and-after study of the I-CARE program. The participants’ burnout level was measured before and after the program using the Maslach Burnout Inventory.
Results. The I-CARE program was implemented in the Department of Pediatrics from March to August 2020. There was no significant change in the overall burnout levels of 59 pediatric residents after the I-CARE implementation (p=0.32). This may be due to several challenges encountered during the implementation, such as time constraints, the increased workload caused by the COVID-19 pandemic, and the lack of physical meetings due to the restrictions of the pandemic. However, the feedback of the administrators, facilitators and residents was generally positive. All the interviewed participants recommended the continuation of the I-CARE program in the Department of Pediatrics.
Conclusion. The I-CARE program shows potential in promoting mental health and emotional wellness among physicians in training.
Functional Outcomes among Geriatric Fragility Hip Fracture Patients in a Developing Country: A Comparative Study between Complete and Incomplete Post-operative Rehabilitation
Authors: Peña Maria Antonia Rosanna G. , Tabu Irewin A. , Ching Bing-Agsaoay Dorothy Dy 
Published: April 2022

Objective. The study compared functional outcomes among post-operative geriatric fragility hip fracture patients who received complete and incomplete rehabilitation.
Methods. This is an ambispective cohort study of 50 acute fragility hip fractures over a 40-month period (October 2017 to November 2020) treated with either arthroplasty or internal fixation under the UP-PGH Orthogeriatric Fracture Liaison Service (FLS). Patients were contacted and interviewed through Telemedicine. They were asked to answer two questionnaires – the Modified Harris Hip Score (MHHS) and the EuroQol-5D-5L (EQ-5D-5L). The scores were tallied and used to describe and compare the post-operative functional outcomes between the two rehabilitation pathways.
Results. Among the 50 patients included in this study, twenty-three (46%) patients underwent complete rehabilitation, while 27 (54%) underwent incomplete rehabilitation. The average corrected MHHS was at 82.5 suggesting good outcomes among all patients, with a higher-than-average outcome of 83.6 among patients who underwent complete rehabilitation, and an outcome of 75.9 among patients who underwent incomplete rehabilitation. Results to the EQ-5D—5L survey showed that a majority of patients who underwent complete rehabilitation reported having ‘no problems’ in terms of self-care, and anxiety or depression. However, the same group had more patients reporting ‘any problems’ in terms of mobility. On the other hand, a bigger proportion of patients from the incomplete rehabilitation group presented with ‘any problems’ in terms of usual activities. Proportions were similar for both groups in terms of pain or discomfort, with neither group having patients who reported extreme pain or discomfort.
Conclusion. In spite of the heterogenous nature of the hip fracture population, functional outcome measures show generally good outcomes of patients under the UP-PGH Orthogeriatric FLS, with no significant difference among patients who receive complete rehabilitation from those who undergo incomplete rehabilitation. Continuing this study may better describe and differentiate the functional outcomes in order to pave the way for evidence-based protocols dedicated to providing the highest quality of care for acute fragility fracture patients.
Rapid versus Slow Feeding Advancement in Preterm Low Birth Weight Neonates: A Systematic Review and Meta-analysis
Authors: Canlas-Gubat Iris G. , Gubat Johannes A. , Gaspi Sally Andrea D. 
Published: April 2022

Objectives. To compare the clinical outcomes of rapid versus slow enteral feeding advancement in preterm low birth weight neonates.
Methods. Searches for randomized controlled trials evaluating the effect of rapid versus slow rate of enteral feeding advancement on the clinical outcomes of preterm, low birth weight neonates were performed in different databases. Two authors screened the articles for inclusion and statistical analysis was done using Review Manager Version 5.3 (RevMan) software.
Results. Six trials with a total of 680 subjects comparing enteral feeding advancement protocols were identified. The number of days to reach full feeds in rapid enteral feeding was shorter by 2.79 days (95% CI 1.39, 4.19) and time to regain weight by 3.72 days (95% CI 2.86, 4.59) compared to slow enteral feeding. There was no significant difference in the incidence of feeding intolerance (OR 0.69, 95% CI 0.42, 1.11) and NEC (OR 0.88, 95% CI 0.45, 1.72) between the two groups.
Conclusions. Rapid enteral feeding protocols reduce the time to establish full enteral feeds and to regain birth weight in preterm low birth weight neonates. Rapid enteral feeding may facilitate early discharge and help reduce hospital costs for the care of these neonates.
Critical Illness-Related Corticosteroid Insufficiency (CIRCI) among Patients with Refractory Shock at a Tertiary Hospital: A Look into Clinical Practices and Patient Outcomes
Authors: Arcellana Anna Elvira S. , Lim Kenneth Wilson O. , Arcegono Marlon S. , Jimeno Cecilia A. 
Published: April 2022

Introduction. A significant number of critically ill patients, as high as 60% among patients with septic shock, suffer from critical illness-related corticosteroid insufficiency (CIRCI), which refers to an inadequate corticosteroid response to the level of stress.
Objectives. This study aimed to determine the strategies employed in managing patients with critical illness-related corticosteroid insufficiency and the outcomes of these patients at a tertiary hospital.
Methods. This was a single-center, mixed-methods study which consisted of a review of charts of patients 19 years old and above admitted for shock or developed refractory hypotension from January 2017-December 2019, and key informant interviews and focus group discussion among clinicians who have experience in managing CIRCI.
Results. A total number of 362 patient charts reviewed showed a relatively low rate of initiation of corticosteroids for patients with refractory shock, at just 28.57% of the entire population. After corticosteroids were initiated, patients were in shock for a median of just one day and the median blood pressure improved to 100/60 mm Hg. In this cohort, patients who were started on steroids had more severe illness, as measured by the Mortality Probability Model (MPM) score, which had a median of 43.65% for the group on steroids and just 25.0% for the non-steroid group (p ≤ 0.0001). Patients who were started on steroids had a statistically significant longer median days on a ventilator, 5 days vs. 3 days for the non-steroid group (p = 0.0297); longer median length of intensive care unit (ICU) stay, 8 days vs. 5 days for the non-steroid group (p = 0.0410), and a higher morbidity and mortality rate. The need for steroids, the presence of septic shock, and a higher MPM score were significant predictors of mortality.
Discussions among clinicians revealed significant variability in practices in the management of CIRCI.
Conclusion. The presence of clinical features of CIRCI is a poor prognostic factor. Timely recognition, work-up, and interventions to address CIRCI are paramount in critical care.
Time Intervals from the First Symptom to Surgery of Ovarian Malignancies in a Tertiary Government Hospital
Authors: Alfabeto Ma. Paula Rhove O. , Toral Jean Anne B. 
Published: April 2022

Objective. This is a cross-sectional study aimed to determine the time intervals from the first symptom to surgery of 37 patients with ovarian malignancies who underwent surgery at a tertiary government hospital from June to October 2019.
Methods. Structured interviews of patients and chart reviews were conducted to identify the intervals and the reasons behind such. The data were analyzed using Stata/SE 14.1, with the time intervals presented as medians and the reasons as frequencies. Multinomial logistic regression analysis established the association of time intervals with the extent of surgery and final stage of ovarian malignancies.
Results. The median Total Time Interval from the first symptom to surgery was 214 days. The longest delay was the Total System Interval (from the first visit at the tertiary hospital to surgery) with a median of 70 days. This was followed closely by Patient Interval (from the first symptom to consult with the initial physician) with a median of 64 days. A distant third was the Initial Physician Interval (from the consult with the initial physician to the first visit at the tertiary hospital) with a median of 29 days. Most common reasons for the delays were the patients not acknowledging the gravity of their condition for the Patient Interval; choice to go to other hospitals, distance and laboratory works or diagnostics for the Initial Physician Interval; waiting for laboratory work-ups for the First System Interval; and waiting for other departments’ clearance for the Second System Interval. The most common first symptom was abdominal enlargement. The length of interval and the final stage (p=0.056 for Stage III and p=0.162 for Stage IV)) as well as extent of surgery (p=0.093) did not show significant association.
Conclusion. The time interval from first symptom to surgery showed a median of 214 days. The greatest delay is contributed by Total System Interval followed by Patient Interval due to varying reasons. Length of time intervals, however, was not found to be significantly associated with the extent of surgery and final stage
Risk Factors and Interventions: Fournier Gangrene in a Tertiary Hospital: A 10-year Experience
Authors: Alip Sylvia Karina L. , Lapitan Marie Carmela M. 
Published: April 2022

Objective. The study aimed to describe the patient demographic characteristics, clinical factors, surgical interventions, and quality of care parameters in non-survivors and survivors of Fournier’s gangrene (FG).
Methods. A total of 131 cases of Fournier’s gangrene (FG) were included in a retrospective chart review in the Philippine General Hospital over 10 years using the Department of Surgery research database. We collected data for various direct and derived variables from the identified population. The primary outcome was mortality rate, while other factors studied were genital and colorectal manipulation, bowel diversion, laboratory parameters (white blood cell count, creatinine, hemoglobin).
Results. The mortality rate was 15%. Diabetes mellitus was common comorbidity among patients with Fournier’s disease. The following were statistically more common in the non-survivor group: female sex, concomitant bowel diversion surgery. Admission data in the non-survivor group showed a lower serum hemoglobin, a higher serum creatinine, and an increased percentage of patients with an abnormal white blood cell count; these did not statistically differ between cohorts, however. The median time to first antibiotic infusion was six hours. The median time to surgery was 13 hours.
Conclusions. Among patients with Fournier’s gangrene, the proportion of women and those undergoing bowel diversion was higher in those who did not survive. The time of infusion of antibiotics or time to surgery did not differ significantly between survivors and non-survivors.