bluuebunny/crossref_metadata_2025_split huggingface dataset:
Los bolos epidurales intermitentes programados para mantenimiento de la analgesia de parto. ¿Prolongan los tiempos del trabajo de parto?
Authors: Quispe Pilco Eddisson 
Published: December 2021

Luego de haber leído con mucho interés el articulo “Bolos epidurales intermitentes programados para mantenimiento de la analgesia del trabajo de parto: estudio observacional, analítico de tipo cohorte” por Calderon Lozano Marjorie et al. publicado en el volumen 9 número 3 de la Revista Peruana de la Investigación Materno Perinatal (INMP), considero de suma importancia poder responder la pregunta si realmente esta tecnica de mantenimiento de analgesia prolonga los tiempos del trabajo de parto teniendo en cuenta la información actual.
La analgesia epidural actualmente es la técnica más segura y eficaz con la que contamos para controlar el dolor de parto1. Ya se ha comprobado seguridad materna fetal1,2 y en general no prolonga los tiempos del trabajo de parto, solo se la asocia con un aumento del parto instrumentado en el expulsivo1. El mantenimiento de la analgesia por medio del catéter epidural es hasta hoy un tema de controversia y estudio, se ha comprobado que la técnica de bolos intermitentes produce un mejor bloqueo analgésico y menos complicaciones que la técnica de infusión continua3.
La duración del trabajo de parto es influida por múltiples factores como edad, paridad, grado de distensibilidad de tejidos del canal de parto, uso de oxitocina, variedad de presentación fetal, tamaño fetal, ruptura de membranas fetales, intensidad de dolor, capacidad de pujar adecuadamente, entre otras.
El articulo reporta prolongación de los tiempos de la dilatación y el expulsivo con el uso de bolos epidurales intermitentes programados (BEIP), pero probablemente como la autora refiere existiría un sesgo por tener el grupo de analgesia un mayor numero de nulíparas respecto al grupo de control que tiene una mayor proporción de multiparas, ya que las nulíparas se caracterizan por tener tiempos de parto mas prolongados y dolorosos respecto a las multiparas4,5.
Tampoco se menciona la variedad de presentación fetal que en caso de ser derechas y/o posteriores son consideradas como distócicas y generalmente solicitan más analgesia porque son mas dolorosas y causan tiempos de parto mas prolongados debido a la mayor rotación que deben realizar en el canal de parto4 .
Por tanto se concluye que son necesarios mas estudios respecto a la técnica de BEIP y ser muy rigurosos en los criterios de inclusión y exclusión para uniformizar la comparación de muestras. Solo así podremos determinar si la técnica de BEIP realmente prolonga los tiempos del parto respecto a las gestantes que no reciben analgesia epidural.
Determinación del PH salival en pacientes adultos con diabetes mellitus compensados
Authors: Avellaneda Lopez María Dayan 
Published: December 2021

Objetivo. Determinar el pH salival en pacientes adultos con diabetes mellitus (DM), compensados atendidas en el centro de salud público de Callao. Material y métodos. Fue estudio analítico, observacional, casos y controles. Muestra de 50 personas con rango en edad de 20 a 60 años. Se realizó inducción general sobre el estudio, para obtener el consentimiento informado. Se les indicó que contengan la saliva que se va acumulando en la boca por unos minutos y luego, en cada minuto, la saliva se iba vertiendo en un embudo de vidrio conectado a una probeta desinfectada y limpia, graduada en 10ml, esta actividad se realizó durante un minuto. Una vez recogida la muestra se procedió a colocarla en un lugar fresco y seguro para dejar que pueda reposar durante unos minutos y luego poder proceder a medir su pH con el pH metro digital e inmediatamente colocar los resultados obtenidos en la ficha de datos individual. Resultados. En promedio el pH salival de las personas con diabetes mellitus (pH=6.5) es menor que el de personas que no poseen la enfermedad (pH=8.3), lo que nos indica que poseen un pH salival más ácido. Conclusión. En promedio el pH salival de las personas diabéticas es menor que las personas sanas, lo que nos indica que poseen un pH salival más ácido; asimismo, los pacientes diabéticos presentan un IHOS en promedio mayor que las personas sanas.
“BeDiL” Learning Media Training in The New Normality Era
Authors: Nirmalasari Yohanna , Sitaresmi Dhatu , Jiuangga Vincentius Valiandy 
Published: December 2021

Online learning is a new phenomenon for educators. This requires education actors, such as educators, education staff, governments, students, and even parents of students to be able to work together in building interactive learning. Online learning is a learning method/way that can motivate students to learn more and achieve learning objectives. However, not all educators can adapt quickly, especially for educators who work in the field at the front lines. This can happen because, over the years, educators have been accustomed to face-to-face or offline teaching models instead of a virtually face-to-face or online model. When learning is carried out online, this becomes a challenge for educators where they have to learn many new things such as the media platforms, new presentation methods, or adapted teaching strategies so that learning can be done effectively. Moreover, an educator is a wheel in learning. Therefore, training on the design of a learning media, especially in the face of this new normal era, is crucial to do. This training activity is carried out using the learning-by-doing method. This method was chosen because the training activities were carried out in a guided manner. Based on the training activities two results can be obtained. First, the training related to the BeDiL learning media has been carried out smoothly. Second, participants can make BeDiL learning media in the form of posters that can be classified into two, namely complete BeDiL posters and incomplete BeDiL posters.
Genetic Algorithm-Based Optimization of Curved-Tube Nozzle Parameters for Rotating Spinning
Authors: Li Wenhui , Liu Kang , Guo Qinghua , Zhang Zhiming , Ji Qiaoling , Wu Zijun 
Published: December 2021

This paper proposes an optimization paradigm for structure design of curved-tube nozzle based on genetic algorithm. First, the mathematical model is established to reveal the functional relationship between outlet power and the nozzle structure parameters. Second, genetic algorithms transform the optimization process of curved-tube nozzle into natural evolution and selection. It is found that curved-tube nozzle with bending angle of 10.8°, nozzle diameter of 0.5 mm, and curvature radius of 8 mm yields maximum outlet power. Finally, we compare the optimal result with simulations and experiments of the rotating spinning. It is found that optimized curved-tube nozzle can improve flow field distribution and reduce the jet instability, which is critical to obtain high-quality nanofibers.
Isolation and Characterization of Novel Phages Targeting Pathogenic Klebsiella pneumoniae
Authors: Li Na , Zeng Yigang , Bao Rong , Zhu Tongyu , Tan Demeng , Hu Bijie 
Published: December 2021

Klebsiella pneumoniae is a dominant cause of community-acquired and nosocomial infections, specifically among immunocompromised individuals. The increasing occurrence of multidrug-resistant (MDR) isolates has significantly impacted the effectiveness of antimicrobial agents. As antibiotic resistance is becoming increasingly prevalent worldwide, the use of bacteriophages to treat pathogenic bacterial infections has recently gained attention. Elucidating the details of phage-bacteria interactions will provide insights into phage biology and the better development of phage therapy. In this study, a total of 22 K. pneumoniae isolates were assessed for their genetic and phenotypic relatedness by multi-locus sequence typing (MLST), endonuclease S1 nuclease pulsed-field gel electrophoresis (S1-PFGE), and in vitro antibiotic susceptibility testing. In addition, the beta-lactamase gene (blaKPC) was characterized to determine the spread and outbreak of K. pneumoniae carbapenemase (KPC)-producing enterobacterial pathogens. Using these ST11 carbapenem-resistant K. pneumoniae isolates, three phages (NL_ZS_1, NL_ZS_2, and NL_ZS_3) from the family of Podoviridae were isolated and characterized to evaluate the application of lytic phages against the MDR K. pneumoniae isolates. In vitro inhibition assays with three phages and K. pneumoniae strain ZS15 demonstrated the strong lytic potential of the phages, however, followed by the rapid growth of phage-resistant and phage-sensitive mutants, suggesting several anti-phage mechanisms had developed in the host populations. Together, this data adds more comprehensive knowledge to known phage biology and further emphasizes their complexity and future challenges to overcome prior to using phages for controlling this important MDR bacterium.
Temperature-Driven Hydrocarbon Generation-Expulsion and Structural Transformation of Organic-Rich Shale Assessed by in situ Heating SEM
Authors: Yuan Yuan , Yang Jijin 
Published: December 2021

Mud shale can serve as source or cap rock but also as a reservoir rock, and so the development of pores or cracks in shale has become of great interest in recent years. However, prior work using non-identical samples, varying fields of view and non-continuous heating processes has produced varying data. The unique hydrocarbon generation and expulsion characteristics of shale as a source rock and the relationship with the evolution of pores or cracks in the reservoir are thus not well understood. The present work attempted to monitor detailed structural changes during the continuous heating of shale and to establish possible relationships with hydrocarbon generation and expulsion by heating immature shale samples while performing in situ scanning electron microscopy (SEM) imaging and monitoring the chamber vacuum. Samples were heated at 20°C/min from ambient to 700°C with 30 min holds at 100°C intervals during which SEM images were acquired. The SEM chamber vacuum was found to change during sample heating as a consequence of hydrocarbon generation and expulsion. Two episodic hydrocarbon expulsion stages were observed, at 300 and 500°C. As the temperature was increased from ambient to 700°C, samples exhibited consecutive shrinkage, expansion and shrinkage, and the amount of structural change in the vertical bedding direction was greater than that in the bedding direction. At the same time, the opening, closing and subsequent reopening of microcracks was observed. Hydrocarbon generation and expulsion led to the expansion of existing fractures and the opening of new cracks to produce an effective fracture network allowing fluid migration. The combination of high-resolution SEM and a high-temperature heating stage allowed correlation between the evolution of pores or cracks and hydrocarbon generation and expulsion to be examined.
Interaction Between Animal Burrowing and Loess Cave Formation in the Chinese Loess Plateau
Authors: Geng Haopeng , Liu Ru , Zheng Weishan , Zhang Yunbo , Xie Rong , Guo Yu , Pan Baotian 
Published: December 2021

Although the interactions between biotic and geomorphic processes usually occur on small spatial and short temporal scales, many of the mechanisms remain to be investigated. This study provides the first direct evidence of the interaction between biotic burrowing and loess cave formation in the Chinese Loess Plateau (CLP). The study area is the Qingshui Valley in the western CLP, near Lanzhou. We surveyed the target site (with an area of ∼13,367 m2) four times from Jul 2019 to Dec 2020, using an unmanned aerial vehicle (UAV). High resolution UAV images enabled us to determine the temporal and spatial dynamics of biotic burrowing and loess caves. The results show that loess caves tended to develop down valley below collapses, while animal burrows were preferentially located upslope away from collapses. Despite the distinct “topographic niches” for both biotic and abiotic processes, we observed an interaction between the two processes in space when tracking their temporal dynamics. Three out of seven new loess caves were in the process of formation at typical “topographic niches” of animal burrows and there was a significantly high animal burrow density around these three caves before their initiation. These results indicate that the three caves were directly initiated from animal burrows and/or developed under the influence of biotic activities. Therefore, biotic burrowing promotes the spatial heterogeneity of loess cave distribution. We also found significant decreases in animal burrow density surrounding the newly-formed loess caves after their initiation. This may reflect a risk avoidance strategy of animal burrowing, which causes animals to avoid areas of recent mass movement (i.e., collapses and new caves). The formation and expansion of loess caves can dictate the distribution of active areas of biotic disturbance. Our results demonstrate a clear interaction between biotic burrowing and loess cave formation, and they emphasize the role of biological agents as a mechanism for the formation of loess caves, which enrich the understanding of searching fingerprints of life during landscape evolution.
Obesity-Induced Insulin Resistance Is Mediated by High Uric Acid in Obese Children and Adolescents
Authors: Niu Yang , Tang Qingya , Zhao Xuan , Zhao Xuelin , Mao Xiaomeng , Sheng Jinye , Cai Wei , Feng Yi 
Published: December 2021

ObjectiveThis study aimed to evaluate whether serum uric acid (SUA) plays a mediating role in the development of insulin resistance (IR) in obese children and adolescents.MethodsA total of 369 participants aged 4-17 years with obesity who attended the Nutrition Outpatient Clinic for Obesity at Xinhua Hospital from January 2012 to January 2019 were recruited for this retrospective study. We classified participants into two groups on the basis of HOMA-IR values: the low HOMA-IR group (&lt; 3.16) (n = 222) and the high HOMA-IR group (≥ 3.16) (n = 147).ResultsThe univariate analysis found that the high HOMA-IR group had higher BMI, SUA, and fasting insulin (FINS) (P &lt; 0.05). Multiple linear regression analysis and mediating effect analysis indicated that body mass index (BMI) could directly regulate FINS and HOMA-IR (both P &lt; 0.05). The results from the mediating effect analysis found that UA partially played an indirect role in the link between BMI, FINS and HOMA-IR (both P &lt; 0.05) but had no effect on fasting blood glucose (P &gt; 0.05).ConclusionsSUA should be investigated in obesity and plays a partial mediating role in insulin resistance induced by obesity in obese children and adolescents.
An Integrated Analysis of Tumor Purity of Common Central Nervous System Tumors in Children Based on Machine Learning Methods
Authors: Yang Jian , Wang Jiajia , Tian Shuaiwei , Wang Qinhua , Zhao Yang , Wang Baocheng , Cao Liangliang , Liang Zhuangzhuang , Zhao Heng , Lian Hao , Ma Jie 
Published: December 2021

Background: Tumor purity is defined as the proportion of cancer cells in the tumor tissue, and its effects on molecular genetics, the immune microenvironment, and the prognosis of children’s central nervous system (CNS) tumors are under-researched.Methods: We applied random forest machine learning, the InfiniumPurify algorithm, and the ESTIMATE algorithm to estimate the tumor purity of every child’s CNS tumor sample in several published pediatric CNS tumor sample datasets from Gene Expression Omnibus (GEO), aiming to perform an integrated analysis on the tumor purity of children’s CNS tumors.Results: Only the purity of CNS tumors in children based on the random forest (RF) machine learning method was normally distributed. In addition, the children’s CNS tumor purity was associated with primary clinical pathological and molecular indicators. Enrichment analysis of biological pathways related to the purity of medulloblastoma (MB) revealed some classical signaling pathways associated with MB biology and development-related pathways. According to the correlation analysis between MB purity and the immune microenvironment, three immune-related genes, namely, CD8A, CXCR2, and TNFRSF14, were negatively related to MB purity. In contrast, no significant correlation was detected between immunotherapy-associated markers, such as PD-1, PD-L1, and CTLA4; most infiltrating immune cells; and MB purity. In the tumor purity–related survival analysis of MB, ependymoma (EPN), and children’s high-grade glioma, we discovered a minor effect of tumor purity on the survival of the aforementioned pediatric patients with CNS tumors.Conclusion: Our purity pediatric pan-CNS tumor analysis provides a deeper understanding and helps with the clinical management of pediatric CNS tumors.
Perceptions of Rheumatologists on Diagnosis of Psoriatic Arthritis in China
Authors: Chen Miao , Zhang Hua , Chen Zhiyong , Dai Sheng-Ming 
Published: December 2021

ObjectiveHigh prevalence of undiagnosed psoriatic arthritis (PsA) and prolonged diagnostic delay are key troubles in the appropriate management of PsA. To analyze the possible causes for this phenomenon, a web-based nationwide survey was conducted to investigate rheumatologists’ perceptions on PsA diagnosis in China.MethodsThe electronic questionnaire consisting of 38 questions were designed by an expert panel and distributed with the online survey tool Sojump, which is a professional online survey platform. The completed questionnaires by real-name rheumatologists were collected.ResultsA total of 1594 valid questionnaires were included. More than half of Chinese rheumatologists reported it was challenging to make a diagnosis of PsA. The four major challenges were “Difficulties in identification of atypical or hidden psoriasis”, “Absence of diagnostic biomarkers”, “No active self-report of history or family history of psoriasis” and “Various musculoskeletal manifestations”. In diagnosing PsA, minor participants had incorrect knowledge of inflammatory arthropathy (13.7%), acute phase reactant (23.8%), and rheumatoid factor (28.7%). There were no significant differences in the knowledge of PsA and practice habits in diagnosing PsA between modern western medicine (WM)- and traditional Chinese medicine (TCM)-rheumatologists. The part-time rheumatologists were not as good as full-time rheumatologists in diagnosing PsA.ConclusionsAbout three quarters of Chinese rheumatologists are familiar with the elements in PsA diagnosis and have good practice habits in diagnosing PsA. Four main challenges in making PsA diagnosis are revealed. There was no significant difference in the knowledge of PsA between WM- and TCM-rheumatologists.
Clinical Applicable AI System Based on Deep Learning Algorithm for Differentiation of Pulmonary Infectious Disease
Authors: Zhang Yu-han , Hu Xiao-fei , Ma Jie-chao , Wang Xian-qi , Luo Hao-ran , Wu Zi-feng , Zhang Shu , Shi De-jun , Yu Yi-zhou , Qiu Xiao-ming , Zeng Wen-bing , Chen Wei , Wang Jian 
Published: December 2021

Objective: To assess the performance of a novel deep learning (DL)-based artificial intelligence (AI) system in classifying computed tomography (CT) scans of pneumonia patients into different groups, as well as to present an effective clinically relevant machine learning (ML) system based on medical image identification and clinical feature interpretation to assist radiologists in triage and diagnosis.Methods: The 3,463 CT images of pneumonia used in this multi-center retrospective study were divided into four categories: bacterial pneumonia (n = 507), fungal pneumonia (n = 126), common viral pneumonia (n = 777), and COVID-19 (n = 2,053). We used DL methods based on images to distinguish pulmonary infections. A machine learning (ML) model for risk interpretation was developed using key imaging (learned from the DL methods) and clinical features. The algorithms were evaluated using the areas under the receiver operating characteristic curves (AUCs).Results: The median AUC of DL models for differentiating pulmonary infection was 99.5% (COVID-19), 98.6% (viral pneumonia), 98.4% (bacterial pneumonia), 99.1% (fungal pneumonia), respectively. By combining chest CT results and clinical symptoms, the ML model performed well, with an AUC of 99.7% for SARS-CoV-2, 99.4% for common virus, 98.9% for bacteria, and 99.6% for fungus. Regarding clinical features interpreting, the model revealed distinctive CT characteristics associated with specific pneumonia: in COVID-19, ground-glass opacity (GGO) [92.5%; odds ratio (OR), 1.76; 95% confidence interval (CI): 1.71–1.86]; larger lesions in the right upper lung (75.0%; OR, 1.12; 95% CI: 1.03–1.25) with viral pneumonia; older age (57.0 years ± 14.2, OR, 1.84; 95% CI: 1.73–1.99) with bacterial pneumonia; and consolidation (95.8%, OR, 1.29; 95% CI: 1.05–1.40) with fungal pneumonia.Conclusion: For classifying common types of pneumonia and assessing the influential factors for triage, our AI system has shown promising results. Our ultimate goal is to assist clinicians in making quick and accurate diagnoses, resulting in the potential for early therapeutic intervention.
Effect of Neuromuscular Electrical Stimulation After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Peng Linbo , Wang Kexin , Zeng Yi , Wu Yuangang , Si Haibo , Shen Bin 
Published: December 2021

Background: This systematic review and meta-analysis aimed to evaluate the effect of neuromuscular electrical stimulation (NMES) on quadriceps muscle strength, pain, and function outcomes following total knee arthroplasty (TKA).Methods: PubMed/Medline, Embase, Web of Science, CENTRAL, Scopus, PsycINFO, PEDro, CINAHL, CNKI, and Wanfang were systematically searched for randomized controlled trials (RCTs) from their inception to 18 June 2021.Results: Nine RCTs that involving 691 patients were included in the meta-analysis. Our pooled analysis showed that NMES improved quadriceps muscle strength after TKA within 1 months [standardized mean difference (SMD): 0.81; 95% CI: 0.51–1.11], 1–2 months (SMD: 0.55; 95% CI: 0.13–0.97), 3–4 months (SMD: 0.42; 95% CI: 0.18–0.66), and 12–13 months (SMD: 0.46; 95% CI: 0.18–0.74), pain between 1 and 2 months [mean difference (MD): −0.62; 95% CI: −1.04 to −0.19], pain between 3 and 6 months (MD: −0.44; 95% CI: −0.74 to −0.14) Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) between 3 and 4 months (MD: −0.43; 95% CI: −0.82 to −0.05), timed up and go test (TUG) within 1 month (MD: −2.23; 95% CI: −3.40 to −1.07), 3 minutes walk test between 3 and 6 months (MD: 28.35; 95% CI: 14.55–42.15), and SF-36 MCS between 3 and 6 months after TKA (MD: 4.20, 95% CI: 2.41–5.98).Conclusion: As a supplementary treatment after TKA, postoperative NMES could improve the short-term to long-term quadriceps muscle strength, mid-term pain, and mid-term function following TKA. However, many outcomes failed to achieve statistically meaningful changes and minimal clinically important difference (MCID), thus the clinical benefits remained to be confirmed.Level of Evidence: Therapeutic level I.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021265609.