bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatic involvement of infectious origin not related to hepatotropic virus
Authors: Gálvez Fernández RM , Rosales Zábal JM , García Gavilán MC 
Published: March 2020

Resumen

El hígado es un órgano implicado en múltiples funciones orgánicas. Debido a su localización anatómica y sobretodo a su anatomía vascular especial, con llegada a su parénquima de flujo venoso portal proveniente de intestino y bazo principalmente y de flujo arterial a través de la arteria hepática formando parte de la circulación sistémica, hace que el hígado esté especialmente expuesto a diferentes agentes patógenos, principalmente de origen viral, sin poder olvidar a las infecciones bacterianas, parasitarias y fúngicas. La importancia de este hecho hace que el gastroenterólogo cuando está evaluando a un paciente con hipertransaminasemia, además de descartar las principales causas de las misma, en función del contexto clínico y de los datos epidemiológicos, recuerde la necesidad de descartar causas infecciosas menos habituales que podría justificar una alteración del perfil hepático que en ocasiones puede representar cierta gravedad, sobretodo si no se diagnostica y se indica el correcto tratamiento específico que incluso, a veces, requiere de tratamientos invasivos o cirugía. Revisaremos las principales causas infecciosas que pueden producir daño hepático, sin considerar a los virus hepatotropos, es decir, los virus no hepatotropos, bacterias, parásitos y hongos.
Double pylorus: unusual endoscopic finding in peptic disease.
Authors: Díaz Alcázar MM , Ruiz Rodríguez AJ , Martín-Lagos Maldonado A 
Published: March 2020

Resumen

Hombre de 59 años que consulta por melenas y vómitos en posos de café. En tratamiento con heparina desde una semana antes. Se realiza endoscopia digestiva alta objetivando doble píloro y úlcera Forrest IIa de 2 cm en cara anterosuperior de bulbo.

El doble píloro o fístula gastroduodenal es un hallazgo endoscópico raro. Se debe a la formación de una fístula entre el estómago y el duodeno. Su incidencia es menor del 0.4%. Como en el caso presentado, habitualmente se forma en el lado de la curvatura menor. Puede ser congénito o adquirido. El doble píloro congénito es extremadamente raro. El doble píloro adquirido se relaciona con la enfermedad péptica gástrica. En la mayoría de los casos la fístula no cierra aunque cicatrice la úlcera.
Mistakes in chronic constipation treatment in adults
Authors: Pérez Aisa Á 
Published: March 2020

Resumen

El objetivo de este tema es resumir, condensar todos los conocimientos en el enfoque terapéutico y poner en evidencia alguna situación más especial que nos podemos encontrar en el contexto del estreñimiento crónico funcional en el adulto. Para ello utilizaremos el planteamiento de escenarios clínicos con casos habituales en la práctica clínica que nos permitirán insistir en el manejo terapéutico de las diferentes situaciones clínicas.
Sigmoid Schwannoma treated by endoscopic resection
Authors: Carnerero Rodríguez JA , Pérez Luque A , Rivas Rivas M , Iglesias Arrabal M 
Published: March 2020

Resumen

Los schwannomas colorrectales son extremadamente raros y existe poca información sobre el diagnóstico y manejo de esta entidad. Presentamos un nuevo caso de schwannoma sigmoideo y discutimos la forma de presentación clínica, imágenes obtenidas y evolución.
Actitud hacia la investigación en estudiantes de un grupo de instituciones educativas argentinas de nivel medio
Authors: Lavooy Vanina Janet , Berroa Mariano Natanael 
Published: March 2020

Siendo que analizar las actitudes de los estudiantes permite conocer sus ideas previas y diseñar estrategias para fomentar el aprendizaje científico, esta investigación buscó (a) describir el concepto de investigación y la actitud hacia la misma en un grupo de adolescentes de los últimos años del nivel medio de instituciones educativas adventistas argentinas y (b) analizar si el sexo y la participación en feria de ciencias influyen sobre su actitud hacia la investigación. La muestra estuvo compuesta por 267 adolescentes. Se utilizó como instrumento una adaptación de la traducción realizada por Hein y Tumino (en prensa) de la “Escala de Actitudes hacia la Investigación de los Estudiantes”, de Papanastasiou (2005). Se aplicaron las pruebas U de Mann-Whitney y H de Kruskal Wallys para muestras independientes.
Los resultados evidenciaron (a) diferencias estadísticamente significativas entre los rangos promedios del factor dificultad (U = -2,68; p = ,007) en función del sexo de los estudiantes y (b) diferencias estadísticamente significativas en las dimensiones actitud positiva (U = -3,65; p = ,000) y ansiedad (U = -5,23; p = ,000) de la actitud hacia la investigación, según la participación en feria de ciencias. Se pudo observar una mayor percepción de dificultad hacia la investigación en las mujeres evaluadas, que en sus pares varones. Así también, se observó una mayor actitud positiva y una mayor ansiedad ante la investigación, por parte de quienes participaron en ferias de ciencias respecto de quienes nunca lo hicieron.
Modelo de factores predictores de satisfacción estudiantil y lealtad institucional validado con estudiantes universitarios
Authors: Gómez Javier Román 
Published: March 2020

Esta investigación fue de tipo empírica cuantitativa, explicativa, transversal, descriptiva, exploratoria, de campo y multivariante. Pretendió explorar la relación de causalidad entre las variables gestión administrativa, desempeño docente, administración funcional, competencia profesional, satisfacción estudiantil y lealtad institucional de 127 alumnos graduandos de una universidad privada en República Dominicana, según un modelo teórico específico.
Se utilizó la técnica de ecuaciones estructurales, con el método de máxima verosimilitud, para evaluar un modelo y otro alterno. Los dos modelos se probaron con la totalidad de indicadores, sin alcanzar niveles apropiados para los índices utilizados como criterios. También se evaluaron ambos modelos seleccionando las dimensiones y se alcanzaron niveles de ajuste aceptable para ambos modelos. El modelo confirmatorio con las dimensiones de constructo arrojó cuatro de siete medidas de bondad de ajuste aceptables. Estos dos modelos fueron adecuados para explicar las relaciones causales entre las diferentes variables latentes y se encontró una mejor varianza explicada para las variables endógenas con el modelo alterno. Cualquier esfuerzo intencional que hagan los directivos de la institución educativa por mejorar su gestión administrativa influirá positiva y significativamente en el nivel de desempeño docente, así como los programas de buenas prácticas administrativas y el grado de satisfacción de los estudiantes. Lograr esto podrá repercutir en la autopercepción que tienen los alumnos acerca de sus competencias y, por ende, en la satisfacción de los estudiantes, al igual que en su lealtad hacia la institución.
The Dynamics of Interstellar Asteroids and Comets within the Galaxy: An Assessment of Local Candidate Source Regions for 1I/’Oumuamua and 2I/Borisov
Authors: Hallatt Tim , Wiegert Paul 
Published: March 2020

Abstract
The low velocity of interstellar asteroid 1I/’Oumuamua with respect to our galaxy’s local standard of rest implies that it is young. Adopting the young age hypothesis, we assess possible origin systems for this interstellar asteroid and for 2I/Borisov, though the latter’s higher speed means it is unlikely to be young. First, their past trajectories are modeled under gravitational scattering by galactic components (“disk heating”) to assess how far back one can trace them. The stochastic nature of disk heating means that a back integration can only expect to be accurate to within 15 pc and 2 km s−1 at −10 Myr, dropping steeply to 400 pc and 10 km s−1 at −100 Myr, sharply limiting our ability to determine a precise origin. Nevertheless, we show that ’Oumuamua’s origin system likely is currently within 1 kpc of Earth, in the local Orion Arm. Second, we back integrate ’Oumuamua’s trajectory in order to assess source regions, emphasizing young systems and moving groups. Though disk heating allows for only a statistical link to source regions, ’Oumuamua passed through a considerable subset of the Carina and Columba moving groups when those groups were forming. This makes them perhaps the most plausible source region, if ’Oumuamua was ejected during planet formation or via intra-cluster interactions. We find three stars in the Ursa Major group, one brown dwarf, and seven other stars to have plausible encounters with 2I/Borisov, within 2 pc and 30 km s−1. These encounters’ high relative speeds mean none are likely to be the home of 2I/Borisov.
Implications of Abiotic Oxygen Buildup for Earth-like Complex Life
Authors: Lingam Manasvi 
Published: March 2020

Abstract
One of the chief paradoxes of molecular oxygen (O2) is that it is an essential requirement for multicellular eukaryotes on Earth while simultaneously posing a threat to their survival via the formation of reactive oxygen species. In this paper, the constraints imposed by O2 on Earth-like complex life are invoked to explore whether worlds with abiotic O2 inventories can harbor such organisms. By taking the major O2 sources and sinks of Earth-like planets into account using a simple model, it is suggested that worlds that receive time-averaged X-ray and extreme ultraviolet fluxes that are ≳10 times higher than Earth might not be capable of hosting complex lifeforms because the photolysis of molecules such as water may lead to significant O2 buildup. Methods for testing this hypothesis by searching for anticorrelations between biosignatures and indicators of abiotic O2 atmospheres are described. In the event, however, that life successfully adapts to high-oxygen environments, these worlds could permit the evolution of large and complex organisms.
Wave Excitation by Energetic Ring-distributed Electron Beams in the Solar Corona
Authors: Zhou Xiaowei , Muñoz Patricio A. , Büchner Jörg , Liu Siming 
Published: March 2020

Abstract
We analyzed properties of waves excited by mildly relativistic electron beams propagating along the magnetic field with a ring-shape perpendicular momentum distribution in neutral and current-free solar coronal plasmas. These plasmas are subject to both the beam and the electron cyclotron maser instabilities driven by the positive momentum gradients of the ring-beam electron distribution in the directions parallel and perpendicular to the ambient magnetic field, respectively. To explore the related kinetic processes self-consistently, 2.5D fully kinetic particle-in-cell simulations were carried out. To quantify excited wave properties in different coronal conditions, we investigated the dependences of their energy and polarization on the ring-beam electron density and magnetic field. In general, electrostatic waves dominate the energetics of waves, and nonlinear waves are ubiquitous. In weakly magnetized plasmas, where the electron cyclotron frequency ω
ce is lower than the electron plasma frequency ω
pe, it is difficult to produce escaping electromagnetic waves with frequency ω > ω
pe and small refractive index

(k and c are the wavenumber and the light speed, respectively). Highly polarized and anisotropic escaping electromagnetic waves can, however, be effectively excited in strongly magnetized plasmas with ω
ce/ω
pe ≥ 1. The anisotropies of the energy, circular polarization degree (CPD), and spectrogram of these escaping electromagnetic waves strongly depend on the number density ratio of the ring-beam electrons to the background electrons. In particular, their CPDs can vary from left-handed to right-handed with the decrease of the ring-beam density, which may explain some observed properties of solar radio bursts (e.g., radio spikes) from the solar corona.
An Empirical “High-confidence” Candidate Zone for Fermi BL Lacertae Objects
Authors: Kang Shi-Ju , Zhu Kerui , Feng Jianchao , Wu Qingwen , Zhang Bin-Bin , Yin Yue , Wang Fei-Fei , Liu Yu , Zheng Tian-Yuan 
Published: March 2020

Abstract
In the third catalog of active galactic nuclei detected by the Fermi Large Area Telescope Clean (3LAC) sample, there are 402 blazar candidates of uncertain type (BCU). The proposed analysis will help to evaluate the potential optical classification flat spectrum radio quasars (FSRQs) versus BL Lacertae (BL Lac) objects of BCUs, which can help to understand which is the most elusive class of blazar hidden in the Fermi sample. By studying the 3LAC sample, we found some critical values of γ-ray photon spectral index (Γph), variability index (VI), and radio flux (

) of the sources separate known FSRQs and BL Lac objects. We further utilize those values to defined an empirical “high-confidence” candidate zone that can be classified as BCUs. Within such a zone (Γph < 2.187, log F
R < 2.258, and log VI < 1.702), we found that 120 BCUs can be classified as BL Lac object candidates with a higher degree of confidence (with a misjudged rate <1%). Our results suggest that an empirical “high-confidence” diagnosis is possible to distinguish the BL Lac objects from the Fermi observations based on only the direct observational data of Γph, VI, and F
R.
A cross-sectional study of antibiotic misuse among Chinese children in developed and less developed provinces
Authors: Xu Yannan , Lu Jingjing , Sun Chenhui , Wang Xiaomin , Hu Yanhong Jessika , Zhou Xudong 
Published: March 2020

Introduction: Antimicrobial resistance is a global health crisis and primarily caused by antibiotic misuse. Antibiotic misuse among children is particularly concerning, and its prevalence may vary from region to region in China with different development levels.
Methodology: Zhejiang and Shaanxi were selected to represent developed and less developed provinces in China, respectively. Data of 2924 parents in Zhejiang and 3355 parents in Shaanxi whose children were 0-13 years old were collected through multi-stage stratified cluster random sampling and a self-administrated questionnaire. Chi-square tests and logistic regression models were used for statistical analysis.
Results: Compared to parents in Zhejiang, those in Shaanxi were more likely to keep antibiotics for children at home, to engage in self-medication with antibiotics for children, and to make their children take antibiotics prophylactically. While there were no significant provincial differences between parents’ requests for antibiotics during pediatric consultations, parents in Shaanxi province were more likely to receive prescribed antibiotics.
Conclusions: Children in less developed provinces face higher risks of antibiotic misuse at home as well as when attending medical practitioners. Comprehensive educational interventions are required to improve antibiotic use for children all over China but particularly in less developed provinces such as Shaanxi. Furthermore, non-prescription sales and over-prescribing of antibiotics should be reduced by targeted strategies.
L’histoire du paysage à l’épreuve des sources
Authors: Bischoff Georges 
Published: March 2020

Les moyens actuels permettent une lecture archéologique de l’histoire des paysages, de la nature et de son appropriation par les Hommes mais ne dispensent pas de recourir aux sources traditionnelles de l’historien. Les écrits et les documents figurés d’avant 1600 ne sont pas de simples illustrations. Ils peuvent être sollicités d’une manière pertinente, aussi bien pour saisir l’imaginaire de leurs auteurs que pour établir une chronologie plus précise.
Le paysage hydrographique de la province d’Alsace à l’épreuve de la cartographie
Authors: Furst Benjamin 
Published: March 2020

Des premières cartes de la province vantant les conquêtes de Louis XIV en pays rhénan, jusqu’aux plans de cours d’eau produits par les Ponts et Chaussées dans les années 1780, le paysage hydrographique de la province d’Alsace a fait l’objet de nombreuses représentations de la part des cartographes et ingénieurs français. Celles-ci, aussi diverses que pléthoriques, sont utiles à l’historien environnementaliste : qu’il s’agisse du milieu naturel, des usages riverains ou de la manière dont l’espace était compris et pensé par l’administration française, les cartes et plans produits par et pour le pouvoir royal révèlent la réalité environnementale de l’Alsace des XVIIe-XVIIIe siècles. Malgré des limites inhérentes à leurs caractéristiques techniques et graphiques, ils montrent en effet ce qui était, mais aussi ce qui, aux yeux des aménageurs, des administrateurs ou des populations, pouvait ou devait être. Ainsi, les représentations matérielles du paysage hydrographique trahissent les représentations mentales de leurs auteurs, de leurs commanditaires et de leurs destinataires.
Educational Benefits of Allowing Pediatrician Supervision of Emergency Medicine Residents
Authors: Rustici Matthew J. , Moreira Maria , Buchanan Jennie , Rodrigues Kristine Knuti , Roosevelt Genie E. 
Published: March 2020

ABSTRACT

Background
According to the Accreditation Council for Graduate Medical Education emergency medicine (EM) program requirements, EM residents on EM rotations must be supervised by board-certified/board-prepared EM or pediatric EM (PEM) faculty.

Objective
We sought to understand the effect of allowing EM residents to be supervised by attending pediatricians while caring for pediatric urgent care patients.

Methods
The EM residents were permitted to staff pediatric urgent care patients with either an EM/PEM attending or an attending pediatrician from August 2017 to July 2018. Outcomes were assessed through resident focus groups, a mixed-methods survey of EM residents and EM/PEM/pediatrician attendings, and clinical outcomes, including length of stay, best evidence/clinical care guideline adherence, and 48-hour return visits requiring admission. Qualitative data were inductively coded using a phenomenological framework, with themes emerging from consensus discussion.

Results
Ninety percent of residents participated in 1 of 7 focus groups. Four key themes emerged from qualitative analysis of focus group transcripts: (1) pediatricians have unique skills that complement those of EM physicians; (2) EM resident education improved; (3) patients may get better care with dual staffing; and (4) other PEM department and urgent care team members may have benefited from the change. The survey response rate was 72%, and it did not uncover additional themes. Length of stay was shorter for patients supervised by attending pediatricians (114 versus 128 minutes, P &lt; .001); there was no difference in best evidence/clinical care guideline adherence or 48-hour return visits requiring admission.

Conclusions
Physicians' perceived education was improved by adding complementary perspectives without significant negative consequences for learners or patients.
The Current Status of Medical School Clerkship Grades in Residency Applicants
Authors: Vokes Jordan , Greenstein Alexander , Carmody Emily , Gorczyca John T. 
Published: March 2020

ABSTRACT

Background
Two criteria that have been investigated for evaluating orthopedic surgery residency candidates are achieving an “honors” grade during a surgery clerkship and the total number of honors grades received in all clerkships. Unfortunately, the rate of honors grades given and the criteria for earning an honors grade differ between medical schools, making comparison of applicants from different medical schools difficult.

Objective
We measured the rate of honors grades in clerkships at different medical schools in the United States to examine the utility of clerkship grades in evaluating orthopedic surgery residency applicants.

Methods
Adequate data via the Electronic Residency Application Service were available for 86 of 142 Association of American Medical Colleges medical schools from the 2017 Match cycle. Descriptive statistics and Wilcoxon rank sum tests were performed to identify differences in grade distributions within each clerkship and in school ranking for research by U.S. News & World Report.

Results
For the surgery clerkship, the median rate of honors grades given was 32.5% (range 5%–67%). There was a high rate of interinstitutional variability in all clerkships. We were unable to demonstrate a statistically significant relationship between research ranking and percentage honors grades given for individual clerkships.

Conclusions
A standardized method for grading medical students during clinical clerkships does not exist, resulting in a high degree of interinstitutional variability. Surgery clerkship grades are an unreliable measure for comparing orthopedic surgery residency applicants from different medical schools. Standardized measures of applicant evaluation might be helpful in the future.
Spatial Attention Disregard in Children With Hemiplegic Cerebral Palsy
Authors: Wang Tien-Ni , Liang Kai-Jie , Howe Tsu-Hsin , Chen Hao-Ling , Huang Chen-Wei , Wu Chien-Te 
Published: March 2020

Abstract
Importance: Children with hemiplegic cerebral palsy (CP) demonstrate spatial attention disregard, but the rehabilitation approach to CP is traditionally motor oriented.
Objective: To explore spatial attention disregard in children with hemiplegic CP and its relationship to their motor performance in daily activities.
Design: Cross-sectional study.
Setting: Community.
Participants: Twenty-five children with hemiplegic CP and 25 age-matched typically developing children.
Outcomes and Measures: For spatial attention performance, the Random Visual Stimuli Detection Task; for developmental disregard, the Observatory Test of Capacity, Performance, and Developmental Disregard; and for motor performance, the Melbourne Assessment 2.
Results: Children with hemiplegic CP evidenced spatial attention disregard on their more affected sides, and this phenomenon was correlated with developmental disregard.
Conclusions and Relevance: Children with hemiplegic CP demonstrate developmental disregard in both the motor and the visual–spatial attention domains. Including evaluation of and intervention for visual–spatial attention for children with hemiplegic CP in the traditionally motor-oriented rehabilitation approach is recommended.
What This Article Adds: This research provides evidence that children with hemiplegic CP demonstrate disregard in the domain of visual–spatial attention. The findings suggest that evaluation of and intervention for visual–spatial attention should be included in CP rehabilitation in addition to the traditionally motor-oriented approach.