bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hormonal contraceptive use and subjective sleep reports in women: An online survey
Authors: Bezerra Andréia Gomes , Andersen Monica Levy , Pires Gabriel Natan , Banzoli Carolina V. , Polesel Daniel Ninelo , Tufik Sergio , Hachul Helena 
Published: January 2020

AbstractFemale sexual hormones have known hypnogenic effects and the use of hormonal replacement therapy in postmenopausal women leads to improvement in sleep quality. However, the effects of hormonal contraceptives in women of reproductive age are still scarcely understood. This study sought to evaluate the impact of hormonal contraceptive use on subjective self‐reports of sleep through a web‐based cross‐sectional survey. A total of 2,055 women between 18 and 40 years old participated by answering an online questionnaire evaluating hormonal contraceptive use, sleep‐related characteristics and related features. Sleep assessment tools comprised the Epworth Sleepiness Scale (ESS) and the Insomnia Severity Index (ISI). Statistical comparisons were performed between hormonal contraceptive users and those who reported no current use. Analyses were repeated to compare users of combined contraceptives with users of progestagens only, as well as to compare users of different generations of contraceptives. Among the total sample, 1,286 participants met the inclusion criteria (918 of them were currently taking a hormonal contraceptive). Contraceptive users reported more frequent sleep complaints and had higher scores on ESS and ISI, which means increased excessive daytime sleepiness and more insomnia symptoms. Women using progestagen‐only therapies reported lower total sleep duration compared with combined therapy. Users of third‐generation contraceptives showed lower total sleep time and higher ISI score when compared with non‐users. In conclusion, contraceptive users have more insomnia symptoms and increased excessive daytime sleepiness when compared with women who do not use any hormonal contraceptive method, and progestagen‐only therapy was associated with lower sleep duration.
Smaller does not mean worse: variation of roe deer antlers from two distant populations in their mechanical and structural properties and mineral profile
Authors: Cappelli J. , Ceacero F. , Landete‐Castillejos T. , Gallego L. , García A. 
Published: January 2020

AbstractAntler size, structure, composition and mechanics have been shown to reflect nutrition, climate and body effects in red deer, but studies have only assessed effects on size in the roe deer (Capreolus capreolus). Roe deer show little sexual dimorphism, lower inter‐male fighting and could form groups during part of the year but does not form harems, in contrast to red deer. Thus, it is interesting to assess how nutrition and habitat affects investment in antlers as compared to red deer. Antlers were collected from adult males of two game estates differing in location, climate and management: 13 from the south‐east of Spain (mild winter, hot summer, dry habitat and rich supplementary feeding), and 10 specimens came from central‐southern part of the Czech Republic (snowy winter, mild summer, humid habitat and limited supplementary feeding). After measuring whole‐antler parameters, a destructive sampling was performed to obtain a full‐transversal section and cortical bone samples from two sampling position along the main beam. Then bone structure, mechanical properties (three‐point bending test, impact test) and the mineral profile were studied. Roe deer from Spain had heavier and longer antlers than Czech roe deer. Their bone material had a higher mechanical quality, although Czech roe deer compensated by developing antlers with thicker walls. Mineral composition also differs, particularly by greater contents in Czech antlers in 3 minerals associated with nutrient stress: Fe, K and Zn. We concluded that the differences found between populations may be caused by differences in habitat quality and diet, in a similar way as reported for red deer, despite interspecific differences. Our study suggests that habitat affects antler parameters and, as previous results in red deer, suggests that improving diet quality may affect size, composition and mechanical quality of antler material. Certainly, antlers of roe deer provide information useful for population management.
Marine stepping‐stones: Connectivity of Mytilus edulis populations between offshore energy installations
Authors: Coolen Joop W. P. , Boon Arjen R. , Crooijmans Richard , van Pelt Hilde , Kleissen Frank , Gerla Daan , Beermann Jan , Birchenough Silvana N. R. , Becking Leontine E. , Luttikhuizen Pieternella C. 
Published: January 2020

AbstractRecent papers have suggested that epifaunal organisms use artificial structures as stepping‐stones to spread to areas that are too distant to reach in a single generation. With thousands of artificial structures present in the North Sea, we test the hypothesis that these structures are connected by water currents and act as an interconnected reef. Population genetic structure of the blue mussel, Mytilus edulis, was expected to follow a pattern predicted by a particle tracking model (PTM). Correlation between population genetic differentiation, based on microsatellite markers, and particle exchange was tested. Specimens of M. edulis were found at each location, although the PTM indicated that locations >85 km offshore were isolated from coastal subpopulations. The fixation coefficient FST correlated with the number of arrivals in the PTM. However, the number of effective migrants per generation as inferred from coalescent simulations did not show a strong correlation with the arriving particles. Isolation by distance analysis showed no increase in isolation with increasing distance and we did not find clear structure among the populations. The marine stepping‐stone effect is obviously important for the distribution of M. edulis in the North Sea and it may influence ecologically comparable species in a similar way. In the absence of artificial shallow hard substrates, M. edulis would be unlikely to survive in offshore North Sea waters.
Beyond summative decision making: Illuminating the broader roles of competence committees
Authors: Pack Rachael , Lingard Lorelei , Watling Christopher , Cristancho Sayra 
Published: January 2020

AbstractContextAlthough competence committees (CCs) are most often conceptualised as group decision‐making bodies, policy documents forward a more ambitious vision and outline several additional roles for CCs that support the continuous quality improvement of education programmes and promote formative feedback. However, whether these functions are encompassed in the everyday work of CCs is currently unknown.MethodsThis constructivist grounded theory study elaborates the range of roles taken up by CCs and illuminates the processes through which these roles are actualised. Two investigators observed 27 CC meetings (>80 hours) across seven diverse postgraduate programmes at a single Canadian institution. Following each observation, a semi‐structured interview was conducted with one CC member. Data collection and analysis unfolded iteratively.ResultsIn this study, CCs did much more than make summative decisions about progression and entrustment; they identified a variety of problems that arose at the levels of both the individual learner and the programme, and leveraged their knowledge of assessment data to develop solutions. The problem‐solving work of CCs was enabled by the in‐depth data review, synthesis and analysis work that occurred before scheduled meetings, outside protected academic or administrative time. Although this work often appeared invisible to those outside the committee, the insights gleaned from data review provided committee members with essential information about how their programme of assessment was unfolding in practice.ConclusionsCompetence committees may be an untapped resource that can support assessment for learning, local evaluation of competency‐based medical education (CBME) implementation and continuous quality improvement for programmes of assessment. However, the ability of CCs to engage in this work is fragile and is currently sustained by the willingness of faculty members to devote their time and energy to it. The resourcing of CCs may have profound implications for translation of the theory of programmatic assessment and CBME into practice.
Visualization of the human enteric nervous system by confocal laser endomicroscopy in Hirschsprung's disease: An alternative to intraoperative histopathological diagnosis?
Authors: Shimojima Naoki , Kobayashi Masakuni , Kamba Shunsuke , Harada Atsushi , Hirobe Seiichi , Ieiri Satoshi , Kuroda Tatsuo , Sumiyama Kazuki 
Published: January 2020

AbstractBackgroundHirschsprung's disease is a congenital abnormality of the enteric nervous system (ENS) presenting severe constipation soon after birth due to the lack of ganglion cells in the distal gut. Surgery for Hirschsprung's disease requires an intraoperative histopathological diagnosis to assess the extent of aganglionosis. Confocal laser endomicroscopy (CLE) is a novel endoscopic technique allowing real‐time, in vivo analysis of cellular details during ongoing endoscopy. In this study, we evaluated the possibility of a new application of CLE to provide real‐time observations of the ENS in patients with Hirschsprung's disease. In this preclinical feasibility study, we assessed the visualization of the ENS by CLE using surgically resected intestines.MethodsThe subjects were nine patients who underwent pull‐through surgery for Hirschsprung's disease between September 2014 and March 2016. The colon specimens were stained with 0.1% cresyl violet and evaluated using CLE. We compared the CLE findings with those of the histopathological examination.Key ResultsThe ENS was clearly visualized as a ladder‐like structure in the ganglionic segment but was not observed in the aganglionic segment. Of the 69 samples, corresponding positive and negative results for both CLE and the histopathology were obtained in 61 (88%). In addition, CLE was able to visualize unique, wavy structures comprising thick nerve bundles characteristic of the aganglionic/transition zone in Hirschsprung's disease.Conclusions and InferencesAs a novel tool for visualizing the human ENS, CLE has the potential to revolutionize how pediatric surgeons identify the level of ganglionosis during surgery for Hirschsprung's disease and may be a superior alternative to intraoperative histopathological diagnosis.
Mycobacterium tuberculosis, antimicrobials, immunity, and lung–gut microbiota crosstalk: current updates and emerging advances
Authors: Osei Sekyere John , Maningi Nontuthuko E. , Fourie Petrus B. 
Published: January 2020

AbstractIncreasingly, gut microbiota distortions are being implicated in the pathogenesis of several infectious and noninfectious diseases. Specifically, in the absence of an eubiotic microbiota, mice are more prone to colonization and infection by Mycobacterium tuberculosis (Mtb). In this qualitative analysis, the following were observed: (1) antimicrobials cause long‐term gut microbiota perturbations; (2) Mtb causes limited and transient disturbances to the lung–gut microbiota; (3) pathogens (e.g., Helicobacter hepaticus) affect microbiota integrity and reduce resistance to Mtb; (4) dysbiosis depletes bacterial species regulating proper immune functioning, reducing resistance to Mtb; (5) dysregulated immune cells fail to express important pathogen‐recognition receptors (e.g., macrophage‐inducible C‐type lectin; MINCLE) and Mtb‐killing cytokines (e.g., IFN‐γ, TNF‐α, and IL‐17), with hampered phagocytic capability; (6) autophagy is central to the immune system's clearance of Mtb, control of inflammation, and immunity–microbiome balance; (7) microbiota‐produced short‐chain fatty acids, which are reduced by dysbiosis, affect immune cells and increase Mtb proliferation; (8) commensal species (e.g., Lactobacillus plantarum) and microbiota metabolites (e.g., indole propionic acid) reduce tuberculosis progression; and (9) fecal transplants mostly restored eubiosis, increased immune resistance to Mtb, restricted dissemination of Mtb, and reduced tuberculosis‐associated organ pathologies. Overuse of antimicrobials, as shown in mice, is a risk factor for reactivating latent or treated tuberculosis.
Uncertain Risk Assessment and Management: Case Studies of the Application of the Precautionary Principle in Portugal
Authors: Gonçalves Vasco Barroso 
Published: January 2020

AbstractThis study intends to clarify how the precautionary principle (PP) has been interpreted and applied by the courts in Portugal in the analysis of conflicts associated with uncertain and serious potential risks to human health and the environment. It also aims to contribute to the debate of when and how to apply precautionary measures. To this end, recent court cases in the areas of waste incineration, high‐voltage power lines, as well as dam and wind farm construction were considered. The degree of consistency in the courts’ decisions and their reasons in the different judicial bodies was analyzed with the support of a theoretical framework based on three attributes: the level of seriousness of potential hazards, level of evidence required, and the severity of precautionary actions taken. Different positions among courts were observed, with contradictory arguments in the same case or in similar cases. A greater propensity for favorable decisions in the acceptance of restraining orders was verified in the courts of lower instances, where human health could be threatened. However, the decisions of the Supreme Administrative Court, which were always unfavorable to the restraining orders, seem to reflect the priority given to national economic and political interests over local or regional environmental interests. They may also reflect the Supreme Court's reluctancy to apply the PP in the absence of a firm legally binding PP in national legislation. To address this situation, more explicit legal requirements and criteria for the analysis of uncertain risks and the weighting of interests by area of activity are needed.
Sparse Principal Component Analysis via Axis-Aligned Random Projections
Authors: Gataric Milana , Wang Tengyao , Samworth Richard J. 
Published: January 2020

SummaryWe introduce a new method for sparse principal component analysis, based on the aggregation of eigenvector information from carefully selected axis-aligned random projections of the sample covariance matrix. Unlike most alternative approaches, our algorithm is non-iterative, so it is not vulnerable to a bad choice of initialization. We provide theoretical guarantees under which our principal subspace estimator can attain the minimax optimal rate of convergence in polynomial time. In addition, our theory provides a more refined understanding of the statistical and computational trade-off in the problem of sparse principal component estimation, revealing a subtle interplay between the effective sample size and the number of random projections that are required to achieve the minimax optimal rate. Numerical studies provide further insight into the procedure and confirm its highly competitive finite sample performance.
Agenesia pulmonar
Authors: Oyola Mercedes , Gordillo Gisel , García Carlos A. , Torres David 
Published: January 2020

La agenesia pulmonar es una alteración poco frecuente, con predominio en el sexo femenino y sin preferencia por la lateralidad. Reportamos el caso de un recién nacido masculino con diagnóstico prenatal de hernia diafragmática. Al nacer, se descartó esta patología y se hizo una impresión diagnóstica de malformación adenomatoide quística (malformación congénita de la vía aérea pulmonar) vs. agenesia pulmonar. El paciente falleció a los seis días de vida y la necropsia confirmó una agenesia pulmonar.
Deterioro cognitivo y envejecimiento: no hay evidencia de deterioro gradual de la memoria de trabajo, dependiente de la edad, en la rata Wistar
Authors: Bríñez José Arturo , Velásquez Silvio , Gómez Juan Daniel 
Published: January 2020

La memoria de trabajo es un sistema neuro-conductual en el que participan la memoria a corto y a largo plazo, la orientación espacial, la planeación y la ejecución de tareas espaciales y lingüísticas, la adaptación social, las operaciones cognitivas complejas y los logros académicos, y que se ha utilizado para estudiar los cambios cognitivos asociados al envejecimiento.
De Gregor Mendel y la docencia sin licencia
Authors: Suárez Fernando , Ordóñez Adriana 
Published: January 2020

Gregor Mendel, padre de la genética, fracasó en su intento por obtener la licenciatura que lo acreditara como profesor, pero su fracaso fue el origen de su posterior triunfo histórico. La fidelidad de Mendel hacia la defensa del preformismo fue la base de los experimentos en Pisum sativum. Su historia demuestra que la licencia no necesariamente certifica al verdadero maestro y que el buen maestro no requiere de licencia.
Linfoma nasal de células T asesinas naturales
Authors: Chavarriaga María Claudia , Moreno Ximena 
Published: January 2020

El linfoma nasal de células T asesinas naturales, también conocido como granuloma letal de la línea media, es una entidad poco frecuente. Se trata de un linfoma extraganglionar de comportamiento agresivo que, usualmente, se origina en la cavidad nasal, prevalente en países orientales y en hombres en la tercera década de la vida. Su asociación con infección por el virus de Epstein-Barr actualmente está bien documentada. Su tratamiento es aún controvertido; la tendencia actual está a favor de la radioterapia.A continuación se presenta un caso de linfoma nasal de células T asesinas naturales y la revisión de la literatura, con el fin de proveer un mayor entendimiento de la enfermedad.
Evaluación del sistema de navegación magnética intracardiaca Niobe®, revisión sistemática de la literatura científica
Authors: Ruiz-Aragón Jesús , Molina-Linde Juan Máximo , Márquez-Pelaéz Sergio , Rodríguez-López Rocío 
Published: January 2020

Introducción y objetivos. Los métodos actuales de ablación conllevan sistemas de navegación manual y ablación cardiaca, y presentan ciertas limitaciones. El objetivo de este trabajo ha sido evaluar la eficacia y seguridad de los nuevos sistemas de navegación magnética intracardiaca.Métodos. Se hizo una revisión sistemática en las bases MedLine, Embase, Cochrane Library, CRD, ECRI, Hayes y bases de datos de HTA. Como términos Mesh se usaron: “electrophisiologic techniques”, “magnetics”, “stereotaxic techniques”, “heart catheterization” y “catheter ablation”. Los criterios de inclusión fueron estudios con adultos y lesiones cardíacas. La intervención fue el sistema de navegación magnética intracardiaca Niobe®. Los resultados medidos fueron: tiempos totales de procedimiento, tiempo de fluoroscopia, tiempo de colocación del catéter, tiempo de mapeo y tiempo de ablación. La calidad se evaluó con los cuestionarios CASPe y STROBE.Resultados. Se localizaron 467 referencias y se incluyeron 14. Hubo dos ensayos clínicos de calidad moderada y 10 estudios observacionales con calidad baja a moderada. Los ensayos presentaron un tiempo total de procedimiento mediante la intervención, igual o superior al comparador (151 y 113 vs. 151 y 77,2 minutos), mientras que los tiempos de fluoroscopia fueron inferiores (17,8 y 10,6 vs. 27,1 y 15,0 minutos). En los estudios observacionales, el tiempo total de intervención osciló entre 59 y 243 minutos para los sistemas magnéticos, frente a 57 a 332 minutos empleando técnicas convencionales. Los trabajos reflejaron la técnica magnética como segura, sin efectos secundarios graves.Conclusiones. No se ha logrado obtener información de calidad para afirmar que los sistemas de navegación magnética intracardiaca superen con claridad a los sistemas convencionales.
Encefalitis de Bickerstaff, síndrome o espectro de Fisher Bickerstaff, reporte de dos casos
Authors: Pérez Juan Carlos , Mateus Sergio Andrés , Mosquera Juan Manuel 
Published: January 2020

La encefalitis de Bickerstaff es una entidad infrecuente de origen posinfeccioso, de presentación grave y con un curso clínico generalmente benigno, cuya diferenciación con el síndrome de Fisher aún no es clara y su asociación con el síndrome de Guillain - Barré está ya establecida. Presentamos dos casos atendidos en el Hospital Universitario San Ignacio.
Resonancia magnética cerebral: secuencias básicas e interpretación
Authors: Rivera Diego Miguel , Puentes Sofía , Caballero Ligia 
Published: January 2020

La resonancia magnética cerebral se ha establecido como una herramienta muy valiosa para el diagnóstico de enfermedades neurológicas, debido a su capacidad de proveer excelente detalle y caracterización de los tejidos.En este artículo se explican las bases físicas de la resonancia magnética y las diferentes secuencias usadas en el protocolo de imágenes cerebrales, con el objetivo de proporcionar al lector las herramientas básicas para comprender las imágenes del cerebro.
Profilaxis antibiótica en quemaduras
Authors: Nieto Luis Eduardo , Acosta Luis Manuel Alejandro , Bedoya Miguel Andrés , Tapias Vanesa 
Published: January 2020

Introducción. Las quemaduras son un importante problema de salud, en especial en los países en vía de desarrollo, y presentan múltiples condiciones de morbilidad con altos porcentajes de mortalidad por procesos infecciosos.Desarrollo. Se hizo una búsqueda de la literatura médica disponible, con el objetivo de llegar a conclusiones acerca de la profilaxis antibiótica en el paciente con quemaduras.Conclusiones. Los antibióticos profilácticos reducen todas las causas de mortalidad en pacientes de la unidad de cuidado intensivo y en pacientes con quemaduras; administrados en las primeras dos semanas, reducen la mortalidad cerca a la mitad. Infortunadamente, la información disponible es insuficiente y estas medidas no se pueden generalizar. La profilaxis perioperatoria reduce la infección de las áreas quemadas, pero no la mortalidad, y los antibióticos tópicos aplicados en las lesiones disminuyen las tasas de infección y colonización bacteriana en algunos grupos etarios. Es necesario aportar nuevos y sólidos datos.
Simple, Mobile-based Artificial Intelligence Algorithm in the detection of Diabetic Retinopathy (SMART) study
Authors: Sosale Bhavana , Aravind Sosale Ramachandra , Murthy Hemanth , Narayana Srikanth , Sharma Usha , Gowda Sahana G V , Naveenam Muralidhar 
Published: January 2020

IntroductionThe aim of this study is to evaluate the performance of the offline smart phone-based Medios artificial intelligence (AI) algorithm in the diagnosis of diabetic retinopathy (DR) using non-mydriatic (NM) retinal images.MethodsThis cross-sectional study prospectively enrolled 922 individuals with diabetes mellitus. NM retinal images (disc and macula centered) from each eye were captured using the Remidio NM fundus-on-phone (FOP) camera. The images were run offline and the diagnosis of the AI was recorded (DR present or absent). The diagnosis of the AI was compared with the image diagnosis of five retina specialists (majority diagnosis considered as ground truth).ResultsAnalysis included images from 900 individuals (252 had DR). For any DR, the sensitivity and specificity of the AI algorithm was found to be 83.3% (95% CI 80.9% to 85.7%) and 95.5% (95% CI 94.1% to 96.8%). The sensitivity and specificity of the AI algorithm in detecting referable DR (RDR) was 93% (95% CI 91.3% to 94.7%) and 92.5% (95% CI 90.8% to 94.2%).ConclusionThe Medios AI has a high sensitivity and specificity in the detection of RDR using NM retinal images.