bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psicanálise e prática multidisciplinar: (im)possíveis desdobramentos do trabalho com crianças autistas e pais
Authors: Nicolau Roseane Freitas , Barros Izabella Paiva Monteiro de 
Published: September 2021

Dificuldades costumam estar associadas a sofrimento, mas podem também ser mote para reflexão e cuidado. Nesse artigo trabalhamos alguns desdobramentos da pesquisa desenvolvida ao longo de seis anos em um hospital universitário do norte do país, mais especificamente aqueles que surgiram a partir das intervenções clínicas no serviço que acolhe crianças com autismo, síndromes neurológicas graves, problemas de aprendizagem, hiperatividade, dentre outros diagnósticos. Como analistas no hospital, orientadas pelo método clínico, partimos dos pressupostos freudo-lacanianos que sustentam a suspensão diagnóstica, até que se tenha apreendido, para além das causas orgânicas, as tramas simbólicas imbricadas com o sintoma da criança. Como instrumento de trabalho utilizamos a escuta dos pais e da criança, a transferência e a relação terapêutica como eixos centrais para o tratamento, pois acreditamos que o diagnóstico apressado pode precipitar prescrições medicamentosas cujos efeitos seriam prejudiciais para o desenvolvimento infantil. Problematizamos as dificuldades no trabalho clínico nas instituições as quais, muitas vezes, funcionam na contramão da aposta na saúde psíquica com suas particularidades. Foi possível constatar que há possibilidade de sensibilizar a equipe para a importância de acolher o que é da ordem da experiência, dando alguma possibilidade de amarração para o sujeito do inconsciente. Para tanto, devemos efetivamente sustentar junto à equipe, a possibilidade de emergência do sujeito, este que é dividido e que porta um saber que ele desconhece. Aposta importante, não apenas para o tratamento da criança e seus pais, mas também para o trabalho multidisciplinar, no qual seguimos no exercício (im)possível da intertextualidade.
Infiltração neoplásica em coluna vertebral decorrente de adenocarcinoma mamário: relato de caso
Authors: Silva Pablo José Custódio Bezerra da , Costa Ruth  Silva Lima da 
Published: September 2021

As metástases na coluna vertebral têm por caráter etiológico a disseminação hematogênica, linfática, liquórica ou invasão direta por contiguidade. O carcinoma de mama é o que apresenta maior predileção pelo tecido ósseo, apresentando lesão osteolítica em aproximadamente 80% dos pacientes. O objetivo do estudo foi descrever o relato de caso de uma paciente acometida por uma infiltração neoplásica em coluna vertebral decorrente de adenocarcinoma mamário, com sítio primário ainda desconhecido. Trata-se de um estudo observacional do tipo descritivo, realizado através dos dados clínicos de uma paciente acometida por carcinoma mamário, diagnosticada inicialmente com fibromialgia, sendo transferida para internação e elucidação diagnóstica. Evoluiu com paraplegia súbita, lesões osteolíticas generalizadas, de caráter metastático. Observou-se que mesmo após a realização da anamnese, exame físico, avaliações multidisciplinares e exames de imagem, estes foram incapazes de identificar o foco neoplásico do caso em questão e que somente após a realização do exame de imuno-histoquímica é que foi possível a identificação do foco primário em mama. Sendo assim, é essencial a busca por métodos investigativos, mais especificos, que auxiliem na elucidação do diagnóstico, permitindo assim o estabelecimento da terapéutica adequada e consequentemente um melhor prognóstico para os acometidos.
Six Sigma Analysis as an Approach to Improve Quality of Corrugated Zinc Sheet Product
Authors: Cahya Handy Nur 
Published: September 2021

Every manufacturing company will strive to create the best quality products. This is also done by PT. CMSM, a steel company, is producing corrugated zinc products. In several production periods, the defective product values were still found that exceeded the tolerance limit value set at 0.5% in corrugated zinc products. These problems are, of course, very detrimental to the company, so it’s essential to control the quality of corrugated zinc products. This study aimed to determine the factors that cause product defects, propose plans to improve product quality, and provide managerial recommendations based on Six Sigma analysis. Data collection techniques are carried out through observation, interviews, and documentation. Based on the study results, it is known that DPO is 0.000885 and DPMO is 884.6028. At this time, the company is at the level of 4.64 sigma with CTQ (Critical to Quality) folded zinc sheet, cut size is not according to standard, thickness is not according to standard, uneven coating layer and perforated zinc sheet. Based on the analysis, five factors cause product defects: humans, machines, methods, materials, and the environment. To improve quality, the company should improve their quality control through 5W + 1H analysis, namely by providing training to employees, periodic machine maintenance and ensuring that the SOPs that have been made are implemented correctly and adequately. Keywords: six sigma, DMAIC, product defect, quality control, manufacturing
How does Unified Theory of Acceptance and Use of Technology (UTAUT) Work on Adopting Financial Technology (FinTech) by MSMEs?
Authors: Wismantoro Yohan , Susilowati MG Westri Kekalih Susilowati 
Published: September 2021

Micro Small and Medium Enterprises (MSMEs) have a very significant role in the economy, can even be said to be the backbone of the economy. However, MSMEs are precisely the sector hardest hit by the Covid-19 pandemic. Digitalization creates new opportunities for MSMEs in the pandemic. FinTech, one of the implementations of digitalization should be pursued to be used by MSMEs. Using path analysis processed using Partial Least Square (PLS), this research aims to identify how Unified Theory of Acceptance and Use of Technology (UTAUT) works on Adopting FinTech by MSMEs. The Outer Model and Inner Model reflect that the model work. The outer loading value of ? 0.7, AVE value ? of 0.5, Cronbach's Alpha ? 0,70, a correlation value ? of 0.50; and Composite Reliability ? 0.6, and R-Square 0.716 reflect it. However, regarding the factors that influence intention to use, it is different from previous research that became a reference. There are only four hypotheses proven. Those are Context had a significant positive effect on Perceived Ease of Use and Perceived Usefulness, and Perceived Ease of Use and Perceived Usefulness had a significant positive effect on the intention to use fintech. Keywords: FinTech, MSMEs, Digitalization, UTAUT, Inclusive
Neuron-Glia Crosstalk Plays a Major Role in the Neurotoxic Effects of Ketamine via Extracellular Vesicles
Authors: Penning Donald H. , Cazacu Simona , Brodie Aharon , Jevtovic-Todorovic Vesna , Kalkanis Steve N. , Lewis Michael , Brodie Chaya 
Published: September 2021

Background: There is a compelling evidence from animal models that early exposure to clinically relevant general anesthetics (GAs) interferes with brain development, resulting in long-lasting cognitive impairments. Human studies have been inconclusive and are challenging due to numerous confounding factors. Here, we employed primary human neural cells to analyze ketamine neurotoxic effects focusing on the role of glial cells and their activation state. We also explored the roles of astrocyte-derived extracellular vesicles (EVs) and different components of the brain-derived neurotrophic factor (BDNF) pathway.Methods: Ketamine effects on cell death were analyzed using live/dead assay, caspase 3 activity and PARP-1 cleavage. Astrocytic and microglial cell differentiation was determined using RT-PCR, ELISA and phagocytosis assay. The impact of the neuron-glial cell interactions in the neurotoxic effects of ketamine was analyzed using transwell cultures. In addition, the role of isolated and secreted EVs in this cross-talk were studied. The expression and function of different components of the BDNF pathway were analyzed using ELISA, RT-PCR and gene silencing.Results: Ketamine induced neuronal and oligodendrocytic cell apoptosis and promoted pro-inflammatory astrocyte (A1) and microglia (M1) phenotypes. Astrocytes and microglia enhanced the neurotoxic effects of ketamine on neuronal cells, whereas neurons increased oligodendrocyte cell death. Ketamine modulated different components in the BDNF pathway: decreasing BDNF secretion in neurons and astrocytes while increasing the expression of p75 in neurons and that of BDNF-AS and pro-BDNF secretion in both neurons and astrocytes. We demonstrated an important role of EVs secreted by ketamine-treated astrocytes in neuronal cell death and a role for EV-associated BDNF-AS in this effect.Conclusions: Ketamine exerted a neurotoxic effect on neural cells by impacting both neuronal and non-neuronal cells. The BDNF pathway and astrocyte-derived EVs represent important mediators of ketamine effects. These results contribute to a better understanding of ketamine neurotoxic effects in humans and to the development of potential approaches to decrease its neurodevelopmental impact.
A Novel Pyroptosis-Associated Long Non-coding RNA Signature Predicts Prognosis and Tumor Immune Microenvironment of Patients With Breast Cancer
Authors: Ping Liqin , Zhang Kaiming , Ou Xueqi , Qiu Xingsheng , Xiao Xiangsheng 
Published: September 2021

Background: Pyroptosis, a kind of programmed cell death characterized by the rupture of cell membranes and the release of inflammatory substances, plays an important role in the occurrence and development of cancer. However, few studies focus on the pyroptosis-associated long non-coding RNAs (lncRNAs) in breast cancer (BC). The prognostic value of pyroptosis-associated lncRNAs and their relationship with tumor microenvironment (TME) in BC remain unclear. The purpose of this study was to explore the prognostic role of pyroptosis-associated lncRNAs and their relationship with TME in BC.Methods: The transcriptome data and clinical data of female BC patients were downloaded from The Cancer Genome Atlas (TCGA) database. A total of 937 patients were randomly assigned to either training set or validation set. A pyroptosis-associated lncRNA signature was constructed in the training set and verified in the validation set. Functional analysis and immune microenvironment analysis related to pyroptosis-associated lncRNAs were performed. A nomogram based on the risk score and clinical characteristics was established.Results: A 9-pyroptosis-associated lncRNA signature was constructed to separate BC patients into two risk groups. High-risk patients had poorer prognosis than low-risk patients. The risk score was proven to be an independent prognostic factor by multivariate Cox regression analysis. Function analysis and immune microenvironment analysis showed that low-risk BC tended to be an immunologically “hot” tumor. A nomogram was constructed with risk score and clinical characteristics. Receiver operating characteristic curve (ROC) analysis demonstrated credible predictive power of the nomogram. The area under time-dependent ROC curve (AUC) reached 0.880 at 1 year, 0.804 at 3 years, and 0.769 at 5 years in the training set, and 0.799 at 1 year, 0.794 at 3 years, and 0.728 at 5 years in the validation set.Conclusion: We identified a novel pyroptosis-associated lncRNA signature that was an independent prognostic indicator for BC patients. Pyroptosis-associated lncRNAs had potential relationship with the immune microenvironment and might be therapeutic targets for BC patients.
Association of Digoxin Application Approaches With Long-Term Clinical Outcomes in Rheumatic Heart Disease Patients With Heart Failure: A Retrospective Study
Authors: Liu Cheng , Lai Yanxian , Guan Tianwang , Zeng Qingchun , Pei Jingxian , Zhang Shenghui , Wu Daihong , Wu Deping 
Published: September 2021

Objective: This retrospective, case–control study was executed to assess the effects of digoxin (DGX) use approaches [continuous use of DGX (cDGX) vs. intermittent use of DGX (iDGX)] on the long-term prognosis in rheumatic heart disease (RHD) patients with heart failure (HF).Methods: A total of 642 RHD patients were enrolled to this study after propensity matching. The associations of DGX application approaches with the risks of all-cause mortality, cardiovascular death (CVD), HF re-hospitalization (1-, 3-, and 5-year), and new-onset atrial fibrillation (AF) were analyzed by multivariate Cox proportional hazards or binary logistic regression models, respectively.Results: cDGX was associated with increased risks of all-cause mortality (adjusted HR = 1.84, 95% CI: 1.27–2.65, P = 0.001) and CVD (adjusted HR = 2.23, 95% CI: 1.29–3.83, P = 0.004) in RHD patients with HF compared to iDGX. With exception of 1-year HF re-hospitalization risk, cDGX was associated with increased HF re-hospitalization risk of 3-year (adjusted OR = 1.53, 95% CI: 1.03–2.29, P = 0.037) and 5-year (adjusted OR = 1.61, 95% CI: 1.05–2.50, P = 0.031) as well as new-onset AF (adjusted OR = 2.06, 95% CI: 1.09–3.90, P = 0.027).Conclusion: cDGX was significantly associated with increased risks of all-cause mortality, CVD, medium-/long-term HF re-hospitalization, and new-onset AF in RHD patients with HF.
Delayed Initiation of ECMO Is Associated With Poor Outcomes in Patients With Severe COVID-19: A Multicenter Retrospective Cohort Study
Authors: Li Xuyan , Hu Ming , Zheng Ruiqiang , Wang Yishan , Kang Hanyujie , Jiang Li , Zhong Ming , Sang Ling , Zheng Xia , Pan Chun , Zhang Wei , Qiu Haibo , Du Bin , Tong Zhaohui 
Published: September 2021

Background: Extracorporeal membrane oxygenation (ECMO) is a rapidly evolving therapy for acute lung and/or heart failure. However, the information on the application of ECMO in severe coronavirus disease 2019 (COVID-19) is limited, such as the initiation time. Especially in the period and regions of ECMO instrument shortage, not all the listed patients could be treated with ECMO in time. This study aimed to investigate and clarify the timing of ECMO initiation related to the outcomes of severe patients with COVID-19. The results show that ECMO should be initiated within 24 h after the criteria are met.Methods: In this retrospective, multicenter cohort study, we enrolled all ECMO patients with confirmed COVID-19 at the three hospitals between December 29, 2019 and April 5, 2020. Data on the demographics, clinical presentation, laboratory profile, clinical course, treatments, complications, and outcomes were collected. The primary outcomes were successful ECMO weaning rate and 60-day mortality after ECMO. Successful weaning from ECMO means that the condition of patients improved with adequate oxygenation and gas exchange, as shown by the vital signs, blood gases, and chest X-ray, and the patient was weaned from ECMO for at least 48 h.Results: A total of 31 patients were included in the analysis. The 60-day mortality rate after ECMO was 71%, and the ECMO weaning rate was 26%. Patients were divided into a delayed ECMO group [3 (interquartile range (IQR), 2–5) days] and an early ECMO group [0.5 (IQR, 0–1) days] based on the time between meeting the ECMO criteria and ECMO initiation. In this study, 14 and 17 patients were included in the early and delayed treatment groups, respectively. Early initiation of ECMO was associated with decreased 60-day mortality after ECMO (50 vs. 88%, P = 0.044) and an increased ECMO weaning rate (50 vs. 6%, P = 0.011).Conclusions: In ECMO-supported patients with COVID-19, delayed initiation of ECMO is a risk factor associated with a poorer outcome.Trial Registration: Clinical trial submission: March 19, 2020. Registry name: A medical records-based study for the clinical application of extracorporeal membrane oxygenation in the treatment of severe respiratory failure patients with novel coronavirus pneumonia (COVID-19). Chinese Clinical Trial Registry: https://www.chictr.org.cn/showproj.aspx?proj=51267,identifier:~ChiCTR2000030947.
Angiogenesis Inhibitors in Personalized Combination Regimens for the Treatment of Advanced Refractory Cancers
Authors: Crook Timothy , Patil Darshana , Nagarkar Rajnish , Gaya Andrew , Plowman Nicholas , Limaye Sewanti , Srivastava Navin , Akolkar Dadasaheb , Ranade Anantbhushan , Bhatt Amit , Datta Vineet , Bose Chirantan , Apurwa Sachin , Patil Sanket , Kumar Prashant , Srinivasan Ajay , Datar Rajan 
Published: September 2021

Background: Angiogenic factors are commonly activated in solid tumors and present a viable therapeutic target. However, anticancer treatment with angiogenesis inhibitors (AGI) is limited to a few cancers, mostly as monotherapy and not selected based on molecular indications. We aimed to determine whether patient-specific combination regimens with AGI and other anticancer agents when selected based on multi-analyte tumor interrogation (ETA: Encyclopedic Tumor Analysis) can expand the scope of AGIs in advanced refractory solid organ cancers with improved treatment responses.Methods: We evaluated treatment outcomes in 60 patients with advanced, refractory solid organ cancers who received ETA-guided combination regimens of AGI with other targeted, endocrine or cytotoxic agents. Radiological evaluation of treatment response was followed by determination of Objective Response Rate (ORR), Disease Control Rate (DCR), Progression Free Survival (PFS) and Overall Survival (OS).Results: Among the 60 patients, Partial Response (PR) was observed in 28 cases (46.7%), Stable Disease (SD) was observed in 29 cases (48.3%) and Disease Progression (PD, within 60 days) was observed in 3 cases (5.0%). The ORR was 46.7% and DCR was 95.0%. At the most recent follow-up the median PFS (mPFS) was 5.0 months and median OS (mOS) was 8.9 months. There were no Grade 4 therapy related adverse events or treatment related deaths.Conclusion: ETA-guided patient-specific combination regimens with AGI and other anti-neoplastic agents, can yield improved outcomes over AGI monotherapy. Trial Registration: Details of all trials are available at WHO-ICTRP: https://apps.who.int/trialsearch/. RESILIENT ID CTRI/2018/02/011,808. LIQUID IMPACT ID CTRI/2019/02/017,548.
Abnormalities of Localized Connectivity in Obsessive-Compulsive Disorder: A Voxel-Wise Meta-Analysis
Authors: Qing Xiuli , Gu Li , Li Dehua 
Published: September 2021

Background: A large amount of resting-state functional magnetic resonance imaging (rs-fMRI) studies have revealed abnormalities of regional homogeneity (ReHo, an index of localized intraregional connectivity) in the obsessive-compulsive disorder (OCD) in the past few decades, However, the findings of these ReHo studies have remained inconsistent. Hence, we performed a meta-analysis to investigate the concurrence across ReHo studies for clarifying the most consistent localized connectivity underpinning this disorder.Methods: A systematic review of online databases was conducted for whole-brain rs-fMRI studies comparing ReHo between OCD patients and healthy control subjects (HCS). Anisotropic effect size version of the seed-based d mapping, a voxel-wise meta-analytic approach, was adopted to explore regions of abnormal ReHo alterations in OCD patients relative to HCS. Additionally, meta-regression analyses were conducted to explore the potential effects of clinical features on the reported ReHo abnormalities.Results: Ten datasets comprising 359 OCD patients and 361 HCS were included. Compared with HCS, patients with OCD showed higher ReHo in the bilateral inferior frontal gyri and orbitofrontal cortex (OFC). Meanwhile, lower ReHo was identified in the supplementary motor area (SMA) and bilateral cerebellum in OCD patients. Meta-regression analysis demonstrated that the ReHo in the OFC was negatively correlated with illness duration in OCD patients.Conclusions: Our meta-analysis gave a quantitative overview of ReHo findings in OCD and demonstrated that the most consistent localized connectivity abnormalities in individuals with OCD are in the prefrontal cortex. Meanwhile, our findings provided evidence that the hypo-activation of SMA and cerebellum might be associated with the pathophysiology of OCD.
Long Noncoding RNA NTT Context-Dependently Regulates MYB by Interacting With Activated Complex in Hepatocellular Carcinoma Cells
Authors: Chang Ya-Sian , Lee Ya-Ting , Yen Ju-Chen , Chang Yuli C. , Lin Li-Li , Chan Wen-Ling , Chang Wei-Chiao , Lin Shyr-Yi , Chang Jan-Gowth 
Published: September 2021

BackgroundLong noncoding RNA (lncRNA) mediates the pathogenesis of various diseases, including cancer and cardiovascular, infectious, and metabolic diseases. This study examined the role of lncRNA NTT in the development and progression of cancer.MethodsThe expression of NTT was determined using tissues containing complementary DNA (cDNA) from patients with liver, lung, kidney, oral, and colon cancers. The expression of cis-acting genes adjacent to the NTT locus (CTGF, STX7, MYB, BCLAF1, IFNGR1, TNFAIP3, and HIVEP2) was also assessed. We used knockdown and chromatin immunoprecipitation (ChIP) assays to identify the cis-acting genes that interact with NTT.ResultsNTT was most significantly downregulated in hepatocellular carcinoma (HCC), while a higher NTT level correlated with a shorter survival time of patients with HCC. Multivariate analysis indicated NTT was not an independent predictor for overall survival. MYB was significantly upregulated, and its increased expression was associated with dismal survival in HCC patients, similar to the results for NTT. NTT knockdown significantly decreased cellular migration. ChIP of HCC cell lines revealed that NTT is regulated by the transcription factor ATF3 and binds to the MYB promoter via the activated complex. Additionally, when NTT was knocked down, the expression of MYB target genes such as Bcl-xL, cyclinD1, and VEGF was also downregulated. NTT could play a positive or negative regulator for MYB with a context-dependent manner in both HCC tissues and animal model.ConclusionOur study suggests that NTT plays a key role in HCC progression via MYB-regulated target genes and may serve as a novel therapeutic target.
Combination of Total Psoas Index and Albumin–Globulin Score for the Prognosis Prediction of Bladder Cancer Patients After Radical Cystectomy: A Population-Based Study
Authors: Wang Keyi , Gu Yongzhe , Ni Jinliang , Zhang Houliang , Xie Jinbo , Xu Tianyuan , Geng Jiang , Mao Weipu , Peng Bo 
Published: September 2021

BackgroundSarcopenia as the loss of skeletal muscle mass is related with poor postoperative survival. This work purposed to evaluate the prognostic prediction of the total psoas index (TPI), albumin–globulin score (AGS), and the combination of TPI and AGS (CTA) in bladder cancer (BCa) patients after radical cystectomy.MethodsBCa patients that received radical cystectomy between 2012 and 2020 were retrieved from our medical center. The calculation of TPI was based on the plain computed tomography images. The predictive effects of TPI, AGS, and CTA grade on survival of BCa patients were analyzed and compared with the albumin–globulin ratio (AGR) through the receiver operating characteristic (ROC) curves. A nomogram was further established based on the Cox regression results from CTA grade and clinicopathological characteristics, which are verified by the decision curve analysis (DCA).ResultsA total of 112 eligible patients diagnosed as BCa were included in this study for retrospective analysis. The patients with lower TPI or higher AGS grade (1/2) contained poorer overall survival (OS) and disease-free survival (DFS). Divided by CTA grade, there were 35 (31.25%) patients in grade 1 associated with the best postoperative prognosis, which was accompanied with increased TPI and decreased AGS. The CTA grade could better predict postoperative outcomes compared with TPI, AGR, and AGS for the highest area under the curve (AUC; 0.674 of OS and 0.681 of DFS). The 3- and 5-year OS and DFS nomograms were conducted based on CTA grade and clinical variables, with a higher predictive performance than the TNM stage.ConclusionThis study revealed that the novel index CTA functioned as an effective prognostic predictor for postoperative OS and DFS of BCa patients after radical cystectomy. Preoperative assessment of CTA would contribute to optimizing clinical therapies.