bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intervenciones médicas no proporcionales al final de la vida en un hospital de alta complejidad en Colombia
Authors: Gempeler Fritz Eduardo , Torregrosa Almonacid Lilian , Cuadrado Daniela Maria , Barriga Rodríguez Sofía , Sotomayor Londoño Jerónimo , Jassir Acosta María Paula , Filizzola Bermúdez Juan David , Uribe Rueda Daniel 
Published: June 2021

Resumen
Objetivo: Analizar las intervenciones realizadas en una cohorte de pacientes fallecidos en un hospital universitario de alta complejidad y definir la proporcionalidad terapéutica de las mismas, a partir del estudio de la prevalencia de “tratamientos no benéficos”. Metodología Estudio observacional descriptivo retrospectivo, basado en la revisión de historias clínicas de los pacientes fallecidos en el periodo de dos años en un hospital universitario de alta complejidad Resultados: Se analizaron 931 historias de pacientes fallecidos y en la categorización de acuerdo con el criterio de “proporcionalidad terapéutica” se encontró que en el 54,7% de los pacientes se realizaron intervenciones diagnosticas o terapéuticas clasificadas como “desproporcionadas” de acuerdo con la definición aplicada. Conclusión: En la práctica las intervenciones no proporcionales o no benéficas al final de la vida son prevalentes, lo que constituye un problema mayor y persistente, a pesar de sus repercusiones negativas sobre los pacientes, las familias, los profesionales de la salud y el sistema de salud.
Palabras claves
Bioética - Ética médica - Inutilidad Médica (Futilidad) - Humanización de la atención
Número necesario a tratar y número necesario para producir daño: su importancia
Authors: Jassir Acosta Maria Paula , Gómez-Restrepo Carlos 
Published: June 2021

Resumen:
Para lograr una adecuada comprensión de los resultados de un estudio de investigación en salud es importante tener claros ciertos conceptos epidemiológicos y estadísticos. El objetivo de este artículo es abordar, de manera sencilla y clara, los conceptos de número necesario a tratar (NNT) y número necesario para producir daño (NNH), explicar cómo se calculan, aclarar la importancia de su interpretación y aplicación en contextos clínicos a partir de ejemplos, al igual que algunas de las limitaciones de su uso que han sido frecuentemente discutidas en la literatura.
Percepción de los profesores del departamento de morfología acerca del cambio de una modalidad presencial a una remota en el contexto de la crisis generada por la pandemia de Covid-19
Authors: Gutiérrez Gómez María Lucía , Cortes Barré Michelle , Kuhlmann Lüdeke, Angelika , Guillén Olaya Javier Fabricio , Alvarado Valencia Pablo Enrique , Sánchez Zúñiga María Claudia , García Cardona Ananías , Mera Laso Carmen Alicia , González López Luis Fernando , Franco Zuluaga Jorge Andrés 
Published: June 2021

El presente artículo explora la percepción de los profesores del Departamento de Morfología de la Facultad de Medicina de la Universidad Javeriana en Bogotá, Colombia, sobre los ajustes que se requirieron en los procesos de enseñanza- aprendizaje, como consecuencia de un cambio abrupto de modelo presencial a remoto, en respuesta a las nuevas circunstancias que impuso el manejo de la pandemia Covid - 19.
Como metodología, se diseñó un estudio descriptivo de corte transversal mediante la aplicación de una encuesta dirigida a los profesores del departamento. Los resultados del estudio muestran que el tiempo de adaptación de los profesores fue relativamente largo con relación a la inmediatez necesaria para asumir el cambio de modelo, lo que indica cierta dificultad para el proceso. Como problemas se señalaron ruido en las casas, dolores musculares, baja participación de los estudiantes, tiempo insuficiente para abordar temas, mayor tiempo para explicar estructuras tridimensionales, imposibilidad de disecar cadáveres, sonido entrecortado, lenta carga de archivos y falta de contacto espontáneo con los estudiantes en los tiempos entre clases. Se resaltó el uso de canales alternativos de comunicación para resolver dudas, apoyar problemas emocionales o coordinar actividades. Finalmente, los profesores valoraron como positivo la continuación del programa, enriquecido con nuevas tecnologías que llegaron para quedarse.
Performance Evaluation of Hybrid Steam-Solvent Processes in a Post-CHOPS Reservoir With Consideration of Wormhole Network
Authors: Zhao Min , Yang Shikai , Yang Daoyong 
Published: June 2021

Abstract
In this paper, techniques have been developed to evaluate performance of steam, solvents, and hybrid steam-solvent processes in a post-CHOPS reservoir with consideration of wormhole network. With the experimentally determined properties of injected gases and reservoir fluids, history matching is accomplished for the reservoir geological model conditioned to the fluid and sand production profiles together with pressure. Meanwhile, the wormhole network is characterized with the pressure gradient-based (PGB) sand failure criterion. Once the history matching is finished, the calibrated reservoir geological model can be used to quantify the contributions of steam, solvents, and hybrid steam-solvent processes under various conditions. The results show that huff-n-puff processes have a very good performance on oil production and recovery when wormhole network is fully generated and propagated. Among all the solvent-based methods, a pure CO2 huff-n-puff process has been proven to be more efficient than flue gas, while the addition of alkane solvents is also beneficial to oil recovery compared with CO2 only method. Since the addition of C3H8 and n-C4H10 will significantly decrease the heavy oil viscosity and enhance the swelling factor, all hybrid steam-solvent injection achieves high oil recovery by taking the advantage of both hot steam and solvents injection.
Feasibility and Acceptability of Home-Based Exercise Snacking and Tai Chi Snacking Delivered Remotely to Self-Isolating Older Adults During COVID-19
Authors: Liang Ian Ju , Perkin Oliver J. , McGuigan Polly M. , Thompson Dylan , Western Max J. 
Published: June 2021

The purpose of this study was to examine the feasibility and acceptability of remotely delivered, home-based exercise programs on physical function and well-being in self-isolating older adults during the COVID-19 pandemic. In a four-arm randomized controlled trial, 63 participants (aged 65 years and older) were allocated to one of three home-based daily (2 × 10-min) exercise interventions (exercise snacking, tai chi snacking, and combination) or control (UK National Health Service Web pages). Functional assessments were conducted via video call at baseline and 4-week follow-up. A web-based survey assessed the acceptability of each exercise program and secondary psychological/well-being outcomes. Ecological momentary assessment data, collected in Weeks 1 and 4, explored feeling states as antecedents and consequences of exercise. All intervention groups saw increased physical function at follow-up and displayed good adherence with exercise snacking considered the most acceptable program. Multilevel models revealed reciprocal associations between feelings of energy and exercise engagement. Further studies are needed with larger, more diverse demographic samples.
Intracranial hematoma following ruptured anterior communicating artery aneurysms: risk factors, outcome, and prognostic factors after management of coiling first
Authors: Ni Heng , Zhao Lin-Bo , Liu Sheng , Jia Zhen-Yu , Cao Yue-Zhou , Shi Hai-Bin 
Published: June 2021

BackgroundTo determine the risk factors for intracranial hematoma (ICH) development following ruptured anterior communicating artery (AcomA) aneurysms and to determine prognostic factors associated with unfavorable outcomes after coiling first.MethodsFrom March 2014 to February 2020, 235 patients with ruptured AcomA aneurysms underwent endovascular treatment in our department. The clinical and radiographic conditions were collected retrospectively. Modified Rankin Scale (mRS) scores of ≤ 2 were accepted as favorable outcomes. Univariate and multivariate logistic regressions were performed to identify significant factors contributing to the incidence of ICHs and to unfavorable outcomes.ResultsOf these 235 patients, 68 had additional ICHs. A posterior orientation of ruptured AcomA aneurysms was the independent variable associated with the incidence of ICHs (OR 3.675; p<0.001). Furthermore, having preoperative Hunt–Hess grades Ⅳ–Ⅴ was an independent variable associated with unfavorable outcomes for ICH patients (OR 80.000; p<0.001). Among the 68 patients with ICHs, 40% (27/68) had Hunt–Hess grades IV–V. Four percent of patients (3/68) underwent surgical hematoma evacuation after the coiling procedure and 15% of the patients (10/68) underwent external ventricular drainage. A favorable outcome was achieved in 72% (49/68) of patients with ruptured AcomA aneurysms. The mortality rate was 21% (14/68) at 6 months.ConclusionA posterior orientation of ruptured AcomA aneurysms was associated with the incidence of ICHs. Coiling first with surgical management if necessary seems to be an acceptable treatment for ruptured AcomA aneurysms with ICHs. The clinical outcome was associated with the clinical neurological status on admission.
C/EBPβ/AEP Signaling Regulates the Oxidative Stress in Malignant Cancers, Stimulating the Metastasis
Authors: Lei Kecheng , Kang Seong Su , Ahn Eun Hee , Chen Chun , Liao Jianming , Liu Xia , Li Hua , Edgington-Mitchell Laura E. , Jin Lingjing , Ye Keqiang 
Published: June 2021

Abstract
Solid tumors start as a local disease, but some are capable of metastasizing to the lymph nodes and distant organs. The hypoxic microenvironment, which is critical during cancer development, plays a key role in regulating cancer progression and metastasis. However, the molecular mechanisms mediating the disseminated cancer cell metastasis remain incompletely understood. Here, we show that C/EBPβ/AEP signaling that is upregulated in breast cancers mediates oxidative stress and lung metastasis, and inactivation of asparagine endopeptidase (AEP, also known as legumain) robustly regulates breast cancer reactive oxygen species (ROS) and metastasis. AEP, a protease activated in acidic conditions, is overexpressed in numerous types of cancer and promotes metastasis. Employing a breast cancer cell line MDA-MD-231, we show that C/EBPβ, an oxidative stress or inflammation-activated transcription factor, and its downstream target AEP mediate ROS production as well as migration and invasion in cancer cells. Deficiency of AEP in the MMTV-PyMT transgenic breast cancer mouse model significantly regulates oxidative stress and suppresses lung metastasis. Administration of an innovative AEP inhibitor substantially mitigates ROS production and cancer metastasis. Hence, our study demonstrates that pharmacologic inhibition of AEP activity might provide a disease-modifying strategy to suppress cancer metastasis.
SOHLH2 Suppresses Angiogenesis by Downregulating HIF1α Expression in Breast Cancer
Authors: Cui Weiwei , Xiao Yunling , Zhang Ruihong , Zhao Na , Zhang Xianghong , Wang Fuwu , Liu Yang , Zhang Xiaoli , Hao Jing 
Published: June 2021

AbstractSOHLH2 has been demonstrated the downregulation in various cancers and the involvement in tumor growth and metastasis. However, the function of SOHLH2 on tumor angiogenesis and the underlying molecular mechanisms have not been interrogated. IHC staining results revealed that SOHLH2 was negatively associated with microvessel density (MVD), tumor size, histology grade, and metastasis. Overexpression of SOHLH2 inhibited the angiogenic behavior of human umbilical vein endothelial cells (HUVEC) by a tumor cell–mediated paracrine signal, while knockdown of SOHLH2 promoted HUVEC angiogenic behavior. Ectopic SOHLH2 expression remarkably suppressed tumor growth and MVD in xenograft tumors, downregulated the expression of hypoxia inducible factor-1 alpha (HIF1α)-mediated proangiogenic genes in vivo and in vitro, while knockdown of SOHLH2 had an opposite result. Furthermore, we found that upregulation of HIF1α reversed SOHLH2-induced suppression of breast cancer angiogenesis, while KC7F2, the inhibitor of HIF1α, could attenuate the promotion of angiogenesis by SOHLH2 silencing. Using Chromatin immunoprecipitation and luciferase reporter assays, we validated that SOHLH2 could directly bind to HIF1α promoter and repress its transcriptional activity. Collectively, SOHLH2 suppresses breast cancer angiogenesis by downregulating HIF1α transcription and may be a potential biomarker for anti-angiogenesis therapy.Implications:SOHLH2 directly represses HIF1α–mediated angiogenesis and serves as an important inhibitor of angiogenesis in breast cancer.
Nestin Is Required for Spindle Assembly and Cell-Cycle Progression in Glioblastoma Cells
Authors: Wang Qinglin , Wu Hao , Hu Jian , Fu Haijuan , Qu Yanghui , Yang Yijun , Cai Kathy Q. , Efimov Andrey , Wu Minghua , Yen Tim , Wang Yuan , Yang Zeng-Jie 
Published: June 2021

AbstractNestin, a class IV intermediate filament protein, is generally considered as a putative marker of neural stem and progenitor cells in the central nervous system. Glioma is a common type of adult brain tumors, and glioblastoma (GBM) represents the most aggressive form of glioma. Here, we report that Nestin expression is significantly upregulated in human GBM, compared with other types of glioma. Nestin knockdown or deletion in U251 cells and tumor cells from GBM patients derived xenografts resulted in G2–M arrest, finally leading to apoptosis in tumor cells. Using proximity-dependent biotin identification method, we identified βII-tubulin as an interacting protein of Nestin in U251 cells. Nestin stabilized βII-tubulin in U251 cells through physical interaction. Knockdown of Nestin or βII-tubulin disrupted spindle morphology in tumor cells. Our studies further revealed that Nestin deficiency in U251 cells and GBM PDX cells repressed tumor growth upon transplantation. Finally, we found that Nestin deficiency sensitized GBM cells to microtubule-destabilizing drugs such as vinblastine and vincristine. Our studies demonstrate the essential functions and underlying mechanisms of Nestin in the growth and drug response of GBM cells.Implications:Through interaction with βII-tubulin, Nestin facilitates cell-cycle progression and spindle assembly of tumor cells in glioblastoma.
PARP-1 Regulates Estrogen-Dependent Gene Expression in Estrogen Receptor α–Positive Breast Cancer Cells
Authors: Gadad Shrikanth S. , Camacho Cristel V. , Malladi Venkat , Hutti Charles R. , Nagari Anusha , Kraus W. Lee 
Published: June 2021

Abstract

Poly(ADP-ribose) polymerase-1 (PARP-1) has gained considerable attention as a target for therapeutic inhibitors in breast cancers. Previously we showed that PARP-1 localizes to active gene promoters to regulate histone methylation and RNA polymerase II activity (Pol II), altering the expression of various tumor-related genes. Here we report a role for PARP-1 in estrogen-dependent transcription in estrogen receptor alpha (ERα)-positive (ER+) breast cancers. Global nuclear run-on and sequencing analyses functionally linked PARP-1 to the direct control of estrogen-regulated gene expression in ER+ MCF-7 breast cancer cells by promoting transcriptional elongation by Pol II. Furthermore, chromatin immunoprecipitation sequencing analyses revealed that PARP-1 regulates the estrogen-dependent binding of ERα and FoxA1 to a subset of genomic ERα binding sites, promoting active enhancer formation. Moreover, we found that the expression levels of the PARP-1– and estrogen-coregulated gene set are enriched in the luminal subtype of breast cancer, and high PARP-1 expression in ER+ cases correlates with poor survival. Finally, treatment with a PARP inhibitor or a transcriptional elongation inhibitor attenuated estrogen-dependent growth of multiple ER+ breast cancer cell lines. Taken together, our results show that PARP-1 regulates critical molecular pathways that control the estrogen-dependent gene expression program underlying the proliferation of ER+ breast cancer cells.

Implications:
PARP-1 regulates the estrogen-dependent genomic binding of ERα and FoxA1 to regulate critical gene expression programs by RNA Pol II that underlie the proliferation of ER+ breast cancers, providing a potential therapeutic opportunity for PARP inhibitors in estrogen-responsive breast cancers.
Effects of Stimulus Intensity and Frequency on the Force and Timing of Sensorimotor Synchronisation
Authors: Todd Neil P. M. , Keller Peter E. , Govender Sendhil , Colebatch James G. 
Published: June 2021

Abstract
We report an experiment to investigate possible vestibular effects on finger tapping to an auditory anapaest rhythm. In a sample of 10 subjects, index finger acceleration and tapping force were recorded along with extensor/flexor activity and the associated electroencephalographic activity measured at central and cerebellar surface electrodes. In a prior session with a standard short air-conducted 500-Hz pip, vestibular evoked myogenic potential thresholds were measured and subsequently used to set the acoustic intensity. During the main experiment subjects were asked to synchronise tapping to the pips arranged in the anapaest at two different frequencies, 500 Hz vs 5 kHz, so that only the low-frequency high-intensity condition was a vestibular, as well as an auditory stimulus. We hypothesised that a vestibular effect would manifest in an interaction between the frequency and intensity factors for a range of dependent measures of tapping performance. No clear evidence was found for vestibular effects, but this was likely due to the confounding effects of an independent effect of intensity and the relative weakness of the acoustic vestibular stimulus. However, the data did show novel evidence for two distinct timing processes for the flexion and extension stages of a tap cycle and two distinct timing strategies, which we refer to as ‘staccato’ and ‘legato’, characterised by different profiles of force and extension.
Assessment of Preoperative Functional Status Prior to Major Head and Neck Surgery: A Pilot Study
Authors: Miller Ashley L. , Holcomb Andrew J. , Parikh Anuraag S. , Richards Julianne M. , Rathi Vinay K. , Goldfarb Jeremy W. , Remenschneider Aaron K. , Bergmark Regan W. , Annino Donald J. , Goguen Laura A. , Rettig Eleni M. , Deschler Daniel G. , Emerick Kevin S. , Lin Derrick T. , Richmon Jeremy D. , Chan Chiao‐Li , Min Lillian C. , Uppaluri Ravindra , Varvares Mark A. 
Published: June 2021

ObjectiveTo demonstrate feasibility of a recently developed preoperative assessment tool, the Vulnerable Elders Surgical Pathways and Outcomes Analysis (VESPA), to characterize the baseline functional status of patients undergoing major head and neck surgery and to examine the relationship between preoperative functional status and postoperative outcomes.Study DesignCase series with planned data collection.SettingTwo tertiary care academic hospitals.MethodsThe VESPA was administered prospectively in the preoperative setting. Data on patient demographics, ablative and reconstructive procedures, and outcomes including total length of stay, discharge disposition, delay in discharge, or complex discharge planning (delay or change in disposition) were collected via retrospective chart review. VESPA scores were calculated and risk categories were used to estimate risk of adverse postoperative outcomes using multivariate logistic regression for categorical outcomes and linear regression for continuous variables.ResultsFifty‐eight patients met study inclusion criteria. The mean (SD) age was 66.4 (11.9) years, and 58.4% of patients were male. Nearly one‐fourth described preoperative difficulty in either a basic or instrumental activity of daily living, and 17% were classified as low functional status (ie, high risk) according to the VESPA. Low functional status did not independently predict length of stay but was associated with delayed discharge (odds ratio [OR], 5.0; 95% CI, 1.2‐21.3; P =. 030) and complex discharge planning (OR, 5.7; 95% CI, 1.34‐24.2; P =. 018).ConclusionThe VESPA can identify major head and neck surgical patients with low preoperative functional status who may be at risk for delayed or complex discharge planning. These patients may benefit from enhanced preoperative counseling and more comprehensive discharge preparation.
Influence of Age and Sex on Clinical and Therapeutic Features of Laryngopharyngeal Reflux
Authors: Lechien Jerome R. , Carroll Thomas L. , Bobin Francois , Muls Vinciane , Rodriguez Alexandra , Horoi Mihaela , Dequanter Didier , Crevier‐Buchman Lise , Hans Stéphane , Saussez Sven 
Published: June 2021

ObjectiveTo explore the influence of age and sex on the clinical presentation and therapeutic response of patients with laryngopharyngeal reflux (LPR).Study DesignProspective study.SettingProspective multicenter study of 271 patients with a diagnosis of LPR confirmed by impedance‐pH monitoring.MethodsPatients were prescribed 6 months of diet changes and a combination of pantoprazole and/or alginate depending on the results of their impedance‐pH results. The Reflux Symptom Score (RSS) and Reflux Sign Assessment (RSA) were collected at baseline and at 3 and 6 months posttreatment. Data were explored according to sex and age.ResultsA total of 237 patients completed the evaluations (138 females). On the RSS, patients of the oldest group (>60 years) had lower symptom scores (throat pain, ear pain, odynophagia, chest pain, tongue burning, nausea, halitosis, and indigestion) and lower quality‐of‐life scores than younger individuals. RSS and RSA outcomes significantly improved from pretreatment to 3 months posttreatment in all groups. Scores on the RSS and RSA continued to improve from 3 to 6 months posttreatment in the elderly group. Females with LPR had a higher score on the RSS at baseline as compared with males. On the RSS, scores significantly improved after 3 months in males and females; however, they continued to improve from 3 to 6 months in the female group.ConclusionAge and sex may influence the clinical presentation and pre‐ to posttreatment evolution of symptoms and findings. Age and sex differences could be considered in future therapeutic approaches to guide more effective personalized treatment plans for patients with LPR.