bluuebunny/crossref_metadata_2025_split huggingface dataset:
6 voces en 10 minutos: Estrategias para prevenir reganancia de peso
Authors: Ackerman Marianela 
Published: November 2020

6 voces en 10 minutos: Estrategias para el descenso de peso en personas con diabetes mellitus tipo 2 Estrategias para prevenir reganancia de pesoEl éxito a largo plazo de los procedimientos bariátricos depende tanto de factores técnicos como de factores clínicos, motivacionales y comportamentales.Si bien la cirugía bariátrica-metabólica es una herramienta eficaz en el arsenal terapéutico de la obesidad, la diabetes y de otras enfermedades crónicas, el 20-30% de los pacientes muestran resultados subóptimos, que incluyen no alcanzar la pérdida de peso deseada o recuperar peso. El mayor desafío es adoptar los cambios requeridos en el estilo de vida. El mantenimiento exitoso del peso se asocia con un ritmo regular de comidas, incluyendo el desayuno, un estilo de vida físicamente activo y mayor autocontrol de los comportamientos.
Simposio 1: Diabetes secundaria a diferentes tipos de trasplante
Authors: Bottino Rita 
Published: November 2020

Simposio 1: Cuando la diabetes no es autoinmune Diabetes secundaria a diferentes tipos de trasplanteLa diabetes mellitus postrasplante (DMPT) es una complicación ampliamente informada que ocurre después del trasplante de órganos. La incidencia de DMPT se estima entre el 10-20% en los receptores de riñón y entre el 30-40% en los receptores de órganos sólidos, aunque se ha informado una variabilidad significativa (1). Se ha señalado de forma variable que se asocia con una mayor morbilidad y mortalidad.La incidencia de DMPT está afectada por factores de riesgo asociados directa e indirectamente al trasplante. Los factores predisponentes como la edad, el estilo de vida, la genética, los antecedentes familiares y la obesidad contribuyen a aumentar la incidencia de DMPT, sin embargo, los factores relacionados con el entorno del trasplante también deben considerarse como factores causales.
6 voces en 10 minutos: ¿Cuándo elegimos un iSGLT-2 o un arGLP-1?
Authors: Faingold Cristina 
Published: November 2020

6 voces en 10 minutos: Estrategias para reducir el riesgo cardiovascular del paciente con diabetes mellitus¿Cuándo elegimos un iSGLT-2 o un arGLP-1?En los últimos años hubo un cambio en el paradigma de los objetivos del tratamiento de la diabetes pasando de la glucocentricidad a la evaluación de la reducción de mortalidad y riesgo cardiovascular (RCV)Tres diferentes clases de fármacos para la diabetes se sometieron a estudios para evaluar resultados CV; la mayoría de ellos se focalizó en poblaciones de alto riesgo CV y todos demostraron NO aumento de riesgo con la utilización de los mismos y notablemente algunos incluso demostraron beneficios y también se encontraron algunos beneficios inesperados como por ejemplo protección renal.
6 voces en 10 minutos: Retinopatía
Authors: Issa Claudia 
Published: November 2020

6 voces en 10 minutos: Actualización en complicaciones crónicasRetinopatíaLa retinopatía diabética (RD) es la causa más frecuente de nuevos casos de ceguera evitable en adultos entre 20 y 74 años; se estima que más de un tercio de los pacientes con diabetes mellitus (DM) tiene algún grado de RD y la misma correlaciona con el tiempo de duración de la diabetes y el control glucémico. La complicación ocular relacionada con diabetes representa a nivel mundial el 35,6% en alguna de sus manifestaciones, siendo 7,24% formas proliferativas (PDR), 7,48% edema macular diabético (EMD) y 11,72% compromiso grave de pérdida de agudeza visual.
Simposio 5: Manejo de fármacos en diabetes y enfermedad renal crónica
Authors: Wassermann Alfredo 
Published: November 2020

Simposio 5: El compromiso renal en la diabetes: más allá del riñónManejo de fármacos en diabetes y enfermedad renal crónicaLa circulación renal representa el 25% del volumen sistólico, por cuanto los riñones reciben una cantidad de droga circulante superior a cualquier otro órgano. Esta carga podría aumentar en hiperfiltración, pero no disminuye en la misma proporción que la disminución de la función renal, incrementando la cantidad de droga por nefrón funcionante durante la enfermedad renal crónica (ERC). La ERC modifica la farmacodinamia en formas diversas a través de la alteración de: 1) la composición de los compartimientos de distribución del líquido corporal; 2) de las proteínas plasmáticas sintetizadas en un ambiente que no depura tóxicos sumando la carbamilación a la glicosilación de la diabetes; 3) el ambiente en el cual se produce la unión droga-receptor; y 4) las alteraciones metabólicas sistémicas. La disminución de la depuración renal incrementa la carga metabólica hepática y enzimática, alterando la vida media de drogas y metabolitos.
Simposio 10: Hígado
Authors: Re Matías 
Published: November 2020

Simposio 10: Resistencia a la insulina: de la fisiopatología al tratamientoHígadoEl hígado juega un papel central en la regulación del metabolismo de glucosa y de los lípidos. El exceso de nutrientes en la dieta y la obesidad generan un estado de insulinorresistencia donde la insulina no logra regular adecuadamente el metabolismo hepático, lo que conlleva a un exceso de producción de glucosa. El aumento de la producción de glucosa y la lipogénesis de novo están bien documentados en seres humanos resistentes a la insulina. La combinación de glucotoxicidad y lipotoxicidad produce un estado inflamatorio crónico que incrementa aún más la IR.
6 voces en 10 minutos: Tratamiento quirúrgico conservador en el pie diabético
Authors: Ravaschio Mario 
Published: November 2020

6 voces en 10 minutos: Pie diabéticoTratamiento quirúrgico conservador en el pie diabéticoEs remarcable el avance del tratamiento del pie diabético en estas últimas décadas. Trabajo multidisciplinario donde antes había derivaciones “ad eternum”, y amputaciones casi como primera elección. Antes de comenzar con las amputaciones describiremos cómo la evolución de la patología conduce a cambios anatómicos que alteran la marcha por generación de un pie rígido. Éstos son hipotrofia muscular, debilidad tendinosa, engrosamiento de la fascia plantar y tendón de Aquiles, limitación de la flexo-extensión de la primera articulación metatarso-falángica. Este pie rígido le genera un patrón de marcha al que le llamamos “conservador”. Esto incluye: reducción de la velocidad, longitud de paso menor, mayor amplitud de la base de sustentación (anchura del paso), se alarga el tiempo de doble apoyo y reducción del rango de movilidad del tobillo (afecta la propulsión).
Importância atribuída no fitness segundo o rendimento líquido mensal dos praticantes (The importance given in fitness according to the participants income)
Authors: Campos Francisco , Martins Fernando , Gomes Ricardo , Zylberberg Tomás , Mendes Stefan , Damásio António 
Published: November 2020

A participação em health clubs e academias de fitness tem ganho prevalência nos índices de prática desportiva em Portugal ao longo dos últimos anos, e os proprietários dos ginásios e health clubs competem, para atrair para as suas instalações, cada vez mais clientes. O conhecimento acerca do que os clientes esperam do serviço desempenha um papel-chave na adequação do serviço prestado em função do público-alvo. O objetivo deste estudo é caracterizar e comparar a importância atribuída à qualidade dos instrutores, qualidade dos serviços e motivos para a prática, segundo o rendimento líquido mensal. Participaram no estudo 560 praticantes de atividades de fitness, divididos em 7 grupos. Foi utilizado o questionário “Importância Atribuída no Fitness - Motivos de Prática, Qualidade do Serviço e Qualidade do Instrutor”. Em termos gerais, os resultados mostram que os praticantes com maior rendimento apresentam valores mais altos de importância atribuída, nas três dimensões do questionário, particularmente nos Motivos de Prática. “Para melhorar a minha saúde em termos gerais” é mais importante para os clientes com rendimento superior (F = 2.440; p = 0.025; η2 = 0.027), como “para relaxar em termos mentais” (F = 3.815; p = 0.001; η2 = 0.042). Na dimensão Qualidade do Instrutor, “empatia” é mais relevante para clientes com maior rendimento (F = 2.196; p = 0.042; η2 = 0.024). Os proprietários de ginásios e health clubs podem utilizar estes resultados para adaptar o serviço às necessidades e expectativas dos clientes.
Abstract: Participation in health clubs and fitness centres have gained prevalence in the overall Portuguese sport participation ratios over the past years, and gym and health club owners compete to attract even more clients to their facilities. Knowledge about what clients expect from fitness services plays a key role in adjusting fitness services to their target population. The aim of this study is to characterise and compare the importance given to the quality of instructors, the quality of services and reasons for practice of fitness clients, according to income. 560 fitness clients participated in this study, divided in 7 income groups. The questionnaire “Importance given in Fitness - Reasons for Practice, Service Quality and Quality of Instructors” was used. Overall results show that clients with higher income show higher values in all three dimensions of the questionnaire, particularly in Reasons for Practice. “To stay or improve health or wellbeing” is regarded as more important for higher income clients (F = 2.440; p = 0.025; η2 = 0.027), as it is “to mentally relax” (F = 3.815; p = 0.001; η2 = 0.042). In the dimension Instructor Quality, “empathy” is more relevant for higher income clients (F = 2.196; p = 0.042; η2 = 0.024). Gym and health club owners may use these results to adapt their services to the clients’ needs and expectations.
ESTRATÉGIAS PARA O DESENVOLVIMENTO DO USO PÚBLICO DAS APAs DOS MORROS DA BABILÔNIA E SÃO JOÃO, DO LEME E URUBU E PARQUE ESTADUAL DA CHACRINHA, RJ
Authors: De Barros Pena Ingrid Almeida , Santos Celso Junius Ferreira , Sinay Laura 
Published: November 2020

Este trabalho apresenta os principais resultados de um estudo técnico executado pela Universidade Federal do Estado do Rio de Janeiro (UNIRIO) com o objetivo desenvolver uma proposta estratégica para o uso público de três Unidades de Conservação (UCs) de baixa visitação e alto potencial turístico na zona sul da cidade do Rio de Janeiro. Espera-se, assim, apoiar a implantação do Parque Natural Municipal Paisagem Carioca e chamar atenção para a importância das parcerias entre a gestão de UCs e as Universidades.
OPERAÇÃO LIMPAOCA- SUBSÍDIOS PARA A POLÍTICA NACIONAL DE RESÍDUOS SÓLIDOS NA ESTAÇÃO ECOLÓGICA (ESEC) DA GUANABARA, RJ
Authors: Bispo Maria das Graças Silveira , De Miranda Rodrigo Gaião Brault 
Published: November 2020

Aliada à necessidade de conservação de áreas de manguezal em Unidades de Conservação (UCs) e de integração com diferentes setores da sociedade, em especial com as comunidades de pescadores e catadores de caranguejo, foi realizada a OPERAÇÃO LIMPAOCA de coleta de resíduos sólidos em área de manguezal. Participaram das atividades 13 pecadores e catadores de caranguejo, sendo coletados2.850 kg de resíduos totais (2.266 kgde plásticos,324 kgde isopor,167 kgde vidros,77 kgde couro e afins e16 kgde metais), num período de 22 horas. Todo esse material estava sendo carreado pelas águas do Rio Guaxindiba para a Baía de Guanabara. Sem levar em conta a extensão da área de atuação, a coleta diária foi de 129,5 kg/hora/13 participantes e média de 9,9 kg/coletor. Materiais plásticos predominaram, assim como citado em outras referências. Resíduos de isopor vieram em seguida, mas devido ao seu grande volume e baixo peso, sua presença foi significativa. Vidro (100 % de lâmpadas) foi o terceiro colocado seguido do grupo mais heterogêneo (couro e afins) e, por fim, o de metais. O material coletado foi avaliado em R$ 4.425,75. Foram desperdiçados no ambiente2.590 kgde petróleo e217 kgde areia, respectivamente, porque os plásticos e vidro não voltaram à cadeia produtiva, via reciclagem. A Operação LIMPAOCA tem um caráter inovador, por se tratar de ação de Política Pública, com abordagem socioeducativa (PNEA) em área de UCs.
O APARATO LEGAL BRASILEIRO E A TEMÁTICA DA PARTICIPAÇÃO EM ÁREAS PROTEGIDAS
Authors: De Souza Renata , Barros Maciel Tânia Maria de Freitas 
Published: November 2020

Estratégias políticas vinculadas à inclusão da sociedade nas tomadas de decisão são cada vez mais discutidas e adotadas pelo Estado brasileiro. O debate relacionado ao tema abarca questões benéficas tanto para o Estado quanto para a população, pois as práticas participativas podem ser de grande valia para o Estado – visto que este deixa de ser o único responsável pelas políticas sociais – e para a população – pois, a ampliação da participação em instâncias políticas e decisórias é de relevância para garantir autonomia, empoderamento, diminuição das injustiças, além de gerar benefícios sociais e econômicos. Quando se trata de áreas protegidas, muitos autores são categóricos em afirmar que a incorporação de práticas participativas nas estratégias de gestão dessas áreas é de grande importância não apenas para a população, como também para efetivar e consolidar a política de proteção e conservação da natureza. Portanto, devido à relevância da questão da participação para a conservação de áreas protegidas o presente trabalho vislumbra analisar o aparato legal brasileiro relacionado às áreas protegidas, no intuito de compreender como a temática da participação é inserida nesses documentos.
PENANAMAN NILAI–NILAI ISLAM BERUPA INTEGRASI AL-QURAN DALAM PENGAJARAN ILMU KAUNIYAH MELALUI RPP
Authors: Nurjannah Amalia 
Published: November 2020

The aim of planting the islamic values is to realize generation with noble caracter that has strong faith and knowledge. Integrating Islam with the studies in kauniyah is an idea that is based on the assumption that the development of the studies in kauniyah in the Islamic context is a necessity for the continuation of human civilization harmony in the future. Integration of Al-Quran in the teaching of the studies in kauniyah through the lesson plan is one way to implanting the islamic values in students . The way that is done is also prepared lesson plan of the studies in kauniyah developed by integrating the verses of the Al-Quran that are relevant to the material being taught.
T&T Clark Companion to Atonement
Authors: Johnson Adam J. 
Published: November 2020

The T&T Clark Companion to Atonement establishes a vision for the doctrine of the atonement as a unified yet extraordinarily rich event calling for the church's full appropriation. Most edited volumes on this doctrine focus on one aspect of the work of Christ (for example, Girard, Feminist thought, Penal Substitution or divine violence). The Companion is unique in that every essay seeks to both appropriate and stimulate the church's understanding of the manifold nature of Christ's death and resurrection.
The essays are divided into four main sections: 1) dogmatic location, 2) chapters on the Old and New Testaments, 3) major theologians and 4) contemporary developments. The first set of essays explore the inter-relationship between the atonement and other Christian doctrines (for example Trinity, Christology and Pneumatology), opening up yet further avenues of inquiry. Essays on key theologians eschew reductionism, striving to bring out the nuances and breadth of the contribution. The same is true of the biblical essays. The final section explores more recent developments within the doctrine (for example the work of Rene Girard, and the ongoing reflection on “Holy Saturday”).
The book is comprised of 18 major essays, and an A-Z section containing shorter dictionary-length entries on a much broader range of topics. The result is a combination of in-depth analysis and breadth of scope, making this a benchmark work for further studies in the doctrine.
Simulated Selves
Authors: Spira Andrew 
Published: November 2020

The notion of a personal self took centuries to evolve, reaching the pinnacle of autonomy with Descartes’ ‘I think, therefore I am’ in the seventeenth century. This ‘personalisation’ of identity thrived for another hundred years before it began to be questioned, subject to the emergence of broader, more inclusive forms of agency. Simulated Selves: Undoing Personal Identity in the Modern World addresses the ‘constructed’ notion of personal identity in the West and how it has been eclipsed by the development of new technological, social, art historical and psychological infrastructures over the last two centuries.
While the provisional nature of the self-sense has been increasingly accepted in recent years, Simulated Selves addresses it in a new way – not by challenging it directly, but by observing changes to the environments and cultural conventions that have traditionally supported it. By narrating both its dismantling and its incapacitation in this way, it records its undoing.
Like The Invention of the Self: Personal Identity in the Age of Art (to which it forms a companion volume), Simulated Selves straddles cultural history and philosophy. Firstly, it identifies hitherto neglected forces that inform the course of cultural history. Secondly, it highlights how the self is not the self-authenticating abstraction, only accessible to introspection, that it seems to be; it is also a cultural and historical phenomenon. Arguing that it is by engaging in cultural conventions that we subscribe to the process of identity-formation, the book also suggests that it is in these conventions that we see our self-sense – and its transience – best reflected.
By examining the traces that the trajectory of the self-sense has left in its environment, Simulated Selves offers a radically new approach to the question of personal identity, asking not only ‘how and why is it under threat?’ but also ‘given that we understand the self-sense to be a constructed phenomenon, why do we cling to it?’.
Queering the “Modern Bride”: Lessons fromVogue
Authors: Parkins Ilya 
Published: November 2020

ABSTRACTThis article traces the distinctive figuration of the fashionable bride in Vogue (New York) as a variant of broader discourses of the white modern woman in the interwar period. The bride in Vogue constellates multiple times, as the frequent vehicle of “tradition” in a periodical generally saturated with claims of newness. And in embodying a third temporal register—the timeless—she temporarily sidesteps the constraints that the magazine implies are created for women by the aftermath of the wedding: the marriage. In her suspension in the moment of anticipation before the wedding, she suggests an alternative to the deadening force of marriage. As she does so, she mirrors the complex temporal structure of the magazine in which she is represented. Vogue's bride demands that we examine the potentially challenging quality of a frequently trivialized and even derided feminine figure.
Evaluation of Key Pointers of Physical, Emotional and Mental Health among Medical Students: A Cross Sectional Study to Understand the Lifestyle Areas Needing Improvement
Authors: Mishra Anil , Sharma Vinod Kumar , Dixit Anil K 
Published: November 2020

Introduction: Medical schools are the places where students learn the art of allaying people’s sufferings in ill health and of saving their lives. Various studies have shown that medical training and education are stressful and require remedial approaches for benefitting medical students.
Objectives: To understand the prevailing life style related health pointers, having potential adverse effect physical, emotional and mental health, among the MBBS students.
Methods: A questionnaire-based cross-sectional assessment involving 82 respondents.
Results: Average age of the study group was 21.61 years, with a majority (89%) belonging to urban areas, around 44% belonging to business family background. The average BMI for the group was 23.02, with 15.85% having BMI 25 or more (overweight). Only 31.71% respondents considered themselves healthy and fit, 53% were doing regular physical activities in any form. Questions related to inability to concentrate in the classroom, losing interest in hobbies, managing studies, feeling sad, depressed, anxious and worried, getting irritated on minor issues, language barrier, ability to express clearly etc. also revealed some valuable findings.
Conclusion: The study findings indicate the need for developing institutional approaches for bringing necessary lifestyle changes to address the issue.
Bupivacaine-induced myotoxicity during a continuous perineural femoral block: case report
Authors: Dorado-Velasco Fabián Camilo , Loaiza-Ruiz Diana Marcela , Llinás-Hernández Paulo José , Herrera Huependo Gilberto Antonio 
Published: November 2020

Introduction: Regional anesthesia is widely used for postoperative analgesia in total knee arthroplasty (TKA). Although it is a safe and effective procedure, serious complications may still develop. In the event of an unusual or torpid evolution, the possibility of local anesthetic-induced myotoxicity should be suspected.
Case presentation: A 54-year old patient, American Society of Anesthesiologists (ASA) II, underwent TKA due to primary gonarthrosis. The analgesic technique used was a femoral nerve block associated with continuous perineural infusion. 24hours later, the patient’s medical condition deteriorated presenting pain, edema, and functional limitation of the thigh of the operated extremity. The symptoms were suggestive of myotoxicity, confirmed with diagnostic images leading to the removal of the catheter. The patient experienced then a significant improvement and was discharged 5 days after surgery.
Conclusion: The diagnosis of myotoxicity from local anesthetics is rare, since its manifestations may be masked by the usual symptoms of the postoperative period. Early identification of the condition is fundamental to reduce its negative impact on the patient’s recovery and satisfaction. Since the scope of the damage depends particularly on the concentration and duration of the exposure to the local anesthetic agent, there is a need to implement protocols that enable an effective block with the lowest concentration and volume of the medication.
HER2 Immunohistochemistry in Invasive Micropapillary Breast Carcinoma: Complete Assessment of an Incomplete Pattern
Authors: Perron Marjorie , Wen Hannah Y. , Hanna Matthew G. , Brogi Edi , Ross Dara S. 
Published: November 2020

Context.—
Invasive micropapillary carcinoma (IMPC) is a rare variant of breast carcinoma, composed of avascular morula-like tumor clusters surrounded by stromal spaces, which can affect the HER2 immunohistochemical (IHC) staining pattern. The 2013 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) HER2 testing guideline suggests moderate to intense but incomplete (basolateral) staining be considered equivocal.

Objectives.—
To perform a detailed assessment of HER2 IHC staining patterns in IMPC.

Design.—
Hematoxylin-eosin and HER2 IHC slides were retrospectively reviewed to assess the morphology and HER2 IHC characteristics of IMPC. The 2018 ASCO/CAP guideline was applied.

Results.—
The cohort consisted of 187 IMPCs from 181 patients with median age of 58 years. Homogeneous (≥90%) micropapillary component was found in 40% (75 of 187) of cases. Receptor profile was as follows: 75% (140 of 187) ER+ HER2−, 19% (37 of 187) ER+ HER2+, 4% (7 of 187) ER− HER2+, and 2% (3 of 187) ER− HER2−. Of 26 cases with HER2 IHC 3+, 65% (17 of 26) showed a basolateral staining pattern with strong intensity. HER2 fluorescence in situ hybridization (FISH) showed amplification in 26% (17 of 66) of HER2 IHC equivocal cases: 76% (13 of 17) showed basolateral staining pattern and 24% (4 of 17) complete staining, with weak to moderate (2), moderate (14), or moderate to strong (1) intensity.

Conclusions.—
The most frequent staining pattern was basolateral, seen in 49% of cases, including 65% HER2 IHC positive and 76% HER2 IHC equivocal/FISH amplified. If a basolateral pattern and weak to moderate staining is observed in IMPC, alternative testing should be performed to confirm the HER2 status.