bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk and Predictors of Patients Receiving Neoadjuvant Chemotherapy Followed by Radical Cystectomy or Transurethral Resection Alone for Muscle-Invasive Bladder Cancer
Authors: Chiang Pei-Jhang , Ko Kai-Hsiung , Meng En , Cha Tai-Lung , Sun Guang-Haun , Yu Dah-Shyong , Kao Chien-Chang 
Published: August 2021

Background:
Upper urinary tract urothelial carcinoma and muscle-invasive bladder cancer (MIBC) incidence rates are high in Taiwan. Our patients with MIBC are commonly managed with a radical cystectomy (RC); however, recurrence rates remain high.

Aim:
We aimed to establish a protocol regarding neoadjuvant chemotherapy (NAC) followed by RC or transurethral resection (TUR) alone from 2008 to 2013. We outline the efficacy and prognosis of NAC followed by RC.

Methods:
This was a retrospective study. The clinical data of 38 patients who underwent NAC from 2008 to 2013 at a single institution were retrospectively reviewed. Patients were divided into Group 1 (NAC with RC) and Group 2 (NAC with TUR alone). Age, sex, tumor size, prechemotherapy characteristics, and oncological outcomes were analyzed.

Results:
Group 1 had worse chemotherapy responses than Group 2 (48% vs. 71%, P = 0.0002). There were no significant differences in the 3-year progression-free survival and overall survival (OS) between the groups. High-risk patients were defined as having a tumor size >5 cm, concurrent hydronephrosis, and adverse pathological features. High-risk Group 1 patients had a better 3-year OS than high-risk Group 2 patients (13/17, 76%; and 3/5, 63%; respectively).

Conclusion:
In high-risk patients or patients with poor chemotherapy responses, NAC followed by RC with pelvic lymph node dissection resulted in a significantly increased 3-year OS. NAC with TUR alone was suitable only for low-risk patients with good chemotherapy responses.
Risk Factors for Early and Late Recurrence in Hepatocellular Carcinoma after Liver Transplantation
Authors: Hsiu-Lung Fan , Chung-Bao Hsieh , Shih-Ming Kuo , Teng-Wei Chen 
Published: August 2021

Background:
Risk factors of early and late recurrence in hepatocellular carcinoma (HCC) after liver transplantation (LT) remain unclear.

Aim:
To identify factors that affect, both early and late recurrence in this setting.

Methods:
We retrospectively analyzed outcomes of 220 patients with HCC who received LT. Two patients who underwent re-transplantation were excluded. Early, late, and very late recurrence were defined as recurrence in the 1st year, 1–5 years, and >5 years after LT, respectively. Kaplan–Meier survival curves were generated, and log-rank tests were performed to compare survival between these groups. Univariate and multivariate Cox proportional-hazard models for risks of early and late recurrence were established.

Results:
Twenty and 19 patients experienced HCC recurrence in the 1st year and between 1 and 5 years, respectively, after undergoing LT. The groups differed significantly in cumulative postrecurrence survival rate. The hazard ratio of early recurrence for tumor size >3 cm was 1.766 (P = 0.046) and that for tumor number >3 was 1.929 (P = 0.027). Alpha-fetoprotein >20 ng/mL was a predictor of early recurrence in multivariate analysis (P = 0.077). The hazard ratio of late recurrence for HCC with microvascular invasion was 1.891 (P = 0.047).

Conclusion:
The recurrence rate of HCC was high in the 1st year after LT. Patients with early recurrence had a poorer survival rate than those with late recurrence. Tumor size >3 cm and tumor number >3 were risk factors of early recurrence. Microvascular invasion was a risk factor for late recurrence. Close individual surveillance is needed in patients with these risk factors.
Clinical Analysis for Osmotic Demyelination Syndrome in Patients with Chronic Hyponatremia
Authors: Chen Hsi-Chih , Sung Chih-Chien , Lin Yi-Chang , Chan Lin-Chien , Lin Shih-Hua 
Published: August 2021

Background:
Although osmotic demyelination syndrome (ODS) has been well known to be associated with a rapid correction of sodium (Na+) in patients with chronic hyponatremia, its risk factors and clinical outcomes have not been examined in Taiwan.

Aim:
The aim of the study was to analyze the underlying causes and overlooked risk factors in patients with ODS.

Methods:
We retrospectively collected chronic hyponatremic patients developing ODS and analyzed their clinical characteristics.

Results:
Fourteen patients (7 males and 7 females) with a mean age of 62.7 ± 17.9 years old were enrolled. Their underlying causes included gastrointestinal illness with poor intake (n = 7), chronic use of diuretics (n = 2), syndrome of inappropriate antidiuretic hormone (n = 2), pneumonia (n = 2), and hypopituitarism (n = 1). Their serum Na+ was 107.2 ± 1.2 mmol/L with mild hypokalemia (potassium 3.1 ± 7 mmol/L), hypoalbuminemia (albumin, 3.4 ± 0.6 g/dL), and hypophosphatemia (phosphorus, 2.3 ± 1.0 mg/dL). Their mean Na+ correction rate was 8.4 ± 9 mmol/L/day and most patients (60%) developed ODS in first 3 days. Their manifestations included delirium, seizures, unstable gait, aphasia, and drowsy consciousness. Brain magnetic resonance imaging demonstrated that 42.8% had isolated central pontine myelinolysis. Totally, 43% of ODS patients had unfavorable outcome with death and disability. In addition, patients with rapid Na+ correction rate (>12 mmol/L/day, n = 4) usually exhibited significant hypokalemia (2.5 ± 0.4 vs. 3.5 ± 0.7 mmol/L, P < 0.05) as compared with those without.

Conclusion:
Nutritional status and concurrent electrolyte deficiencies such as hypokalemia are major risk factors in patients with ODS. Clinicians should timely recognize these potential risks of ODS and reduce Na+ correction rate to avoid catastrophic outcomes.
A Cross-Sectional Study to Compare Anesthesia Techniques Employed for the Conduct of Upper Gastrointestinal Endoscopic Procedures in a Gastroenterology Suite of a Tertiary Care Hospital
Authors: Sud Saurabh , Dwivedi Deepak , Dudeja Puja , Hooda Bhavna , Singh Shalendra , Aggarwal Manish 
Published: August 2021

Background:
Endoscopic procedures in gastroenterology (GE) imaging suite are conducted primarily under moderate sedation (MS) and general anesthesia (GA). Various factors determine the choice of the technique such as the physical status of the patient, an anticipated difficult procedure, or an unanticipated complication.

Aims:
The aim was to study various factors affecting the selection of anesthesia techniques in patients undergoing endoscopy. This was a cross-sectional descriptive study in a tertiary care hospital.

Methods:
All patients who underwent upper gastrointestinal endoscopic procedures (n = 373) from January 2017 to December 2018 were included in the study. Patients were divided into groups on the basis of the anesthesia technique employed as MS – Group I (n = 343) and GA – Group II (n = 30). Data were collected for patient related and procedure related factors such as age, sex, physical status of the patient, complexity of the endoscopic procedures, anesthesia duration, drugs used, complications and recovery profile, which were analyzed for the two groups as per the entries made in the GE suite and central anesthesia registry. Statistical analysis was done using SPSS software Version 22.0 (IBM Corp., Armonk, NY, USA). Categorical variables were tested using Chi-square test and means were compared using t-test.

Conclusions:
MS was preferred in patients with lesser grades of physical status and in less complex GE procedures as compared to GA.
A Comparison of Facial Profiles between the General Populations of Taiwan and Fiji
Authors: Sun Wan-Hsuan , Hsu Su-Yi 
Published: August 2021

Background:
Comprehensive facial assessment can be attained by analyzing population facial profiles and comparing racial variations. To date, there are no databases of Taiwanese facial profiles. Furthermore, facial profiles vary widely among different countries and races. Understanding these differences may facilitate facial profile analyses and surgical planning for facial plastic surgeons. Therefore, in this study, we collected the facial profile parameters of Taiwanese and Fijian people and then analyzed the differences between the two populations.

Methods:
We recruited 94 Taiwanese individuals at Fu Jen University from December 2014 to November 2015. During a volunteer medical mission to Fiji in November 2017, we enrolled 13 Fijians. Right lateral standard facial photographs were taken to analyze facial profile parameters, including nasofrontal angle (NFA), nasolabial angle, nasofacial angle (NfA), nasomental angle (NMA), mentocervical angle (MCA), glabella-subnasale-pogonion angle, glabella-nasal tip-pogonion angle, superior labial angle, inferior labial angle, and pogonial angle. These parameters were compared between both males and females in Taiwan and Fiji.

Results:
We observed no significant difference in any of the facial profile parameters between males and females in both Taiwan and Fiji. Compared with Fijian individuals, Taiwanese females have a sharper NfA, and Taiwanese males have a more obtuse NFA, NMA, and MCA, as well as a sharper NfA.

Conclusion:
Fijian females may have a more outstanding nose than Taiwanese females. Meanwhile, Fijian males may feature a more prominent glabella, a more outstanding nose, and a sharper chin compared with Taiwanese males. In conclusion, the Fijian population has more prominent facial convexity than the Taiwanese population.
Scaling up self- regulatory ability in childhood education as correlate of creative mindset
Authors: Sunday Maria Ofie , Obogo Godwin Obogo , Adie Rose Unwanung 
Published: August 2021

The study is on the need to scale up self – regulatory abilities in learners towards more sustainable national development in Nigeria. This study was instigated by the poor nature of children that need to create a background on purposeful activities in the learning environment. Three research questions raised which were translated into correspondent null hypotheses to guide the study. Some related literatures were reviewed accordingly. The study adopted a Survey research design with 218 samples selected through simple random sampling technique from primary school Pupils in Ogoja Education Zone of Cross River State. A four points likert scale questionnaire with eighteen items was adapted and validated and used for data collection. The reliability estimate was established for the instrument using the Cronbach alpha reliability method, the values were between o.76 and 0.81. Pearson product moment correlation method of analysis was employed to analyze the data. All hypotheses were tested at 0.05 level of significance. The result of the analysis revealed that all hypotheses were significant. Based on the findings, the researcher concluded that there was a relationship between self-regulatory learning ability and pupils’ creative mindset. The use of SRL strategy by pupils significantly correlates with pupils’ creative mindset. It was recommended among others that schools should organize sensitive educational programmes to develop children’s creative mindset. Parents, teachers and caregivers should encourage the values of managing emotions, behaviour and learning in children.
Keywords: Self-regulatory ability, Early childhood education, creative mindset
Evaluación del Médico Interno de Pregrado a través de Competencias Profesionales en Medicina Familiar
Authors: De Hoyos Perla Patricia Abarca , Calvo María Dolores Martínez , Cortés Gerardo Muñoz , Calvo María Dolores Martínez , Andrade María Elena Estrada , Estrada Yurixhi Cancino , Flores Laura Miriam Pérez , Alonso Carlos Gómez 
Published: August 2021

Introducción: Los métodos de evaluación aplicados al área de la salud continúan siendo tradicionales, donde se evalúan conocimientos sin captar habilidades, actitudes y aptitudes. Es necesario buscar una estrategia para evaluar la competencia profesional en los médicos internos de pregrado (MIP) por medio de un examen clínico objetivo estructurado (ECOE)
Objetivo: Evaluar las competencias profesionales de los médicos internos de pregrado que egresan de su rotación por medicina familiar.
Material y métodos: Estudio cuasiexperimental, prospectivo, longitudinal realizado a los médicos internos de pregrado que cursaron medicina familiar en la Unidad de Medicina Familiar No. 80 en los bimestres: Enero-Febrero, Marzo-Abril y Julio-Agosto del 2020. Se llevó a cabo una evaluación diagnóstica y de acuerdo al resultado se estableció un programa académico y se realizó una evaluación posterior de las competencias profesionales, mediante un examen clínico objetivo estructurado. Se utilizó estadística descriptiva, para comparación de medias: t de student, significancia p <0.05. Registro SIRELCIS R-201-1602-023.
Resultados: Se evaluaron 23 médicos internos de pregrado, 65.2% mujeres; con 23.34 ± 0.48 años. Nivel de competencia al inicio 21.7% y 100% al final de la evaluación. Media de conocimientos al iniciar 5.6 y al finalizar 5.8 (p 0.06). Excelencia en conocimientos 2.1%, en habilidades 92.7%; en actitud y aptitud 100% al finalizar la rotación.
Conclusión: Los médicos internos de pregrado son competentes al egresar de su rotación de medicina familiar.
CULTURAL COMPETENCE OF HEALTH CARE WORKERS ON MATERNAL HEALTH CARE SERVICE UTILIZATION AMONG MOTHERS OF MOUNT ELGON CONSTITUENCY BUNGOMA, KENYA
Authors: Kisiangani Pascalia , Arudo John , Sakwa Gregory , Okoit Florence 
Published: August 2021

Purpose: To determine cultural competence of health care workers on maternal health care service utilization among mothers of Mt. Elgon Constituency in Bungoma County.
Methodology: A descriptive-analytical cross-sectional study design was adopted using mixed methods for data collection. Cultural competence tool was used to assess health care workers cultural competence. Qualitative data was collected using key informant interviews (KII) and focus group discussion (FGD). Data entry and analysis was done using SPSS Version 25 software. Descriptive and inferential statistical analyses were used. Bivariate and multivariate logistic regressions were applied and odds ratio used to determine the strength of association. A p-value of ≤ 0.05 was considered as statistical significance threshold.
Findings: Unemployment (OR: 0.6; 95% CI: 0.4 – 0.9; p = 0.02); lack of mobile clinic (OR: 0.7; 95% CI: 0.4 – 1.0; p = 0.06 ); use of interpreter (OR: 0.2; 95% CI: 0.01 – 0.81; p = 0.02); service provided in public facilities (OR: 0.5; 95% CI: 0.3 – 0.8; p = 0.004); being too busy (OR: 0.5; 95% CI: 0.3 – 0.9; p = 0.02); consulting health care workers (OR: 0.5; 95% CI: 0.2 – 0.9; p = 0.03); not consulting elders (OR: 0.7; 95% CI: 0.4 – 1.0; p = 0.08) and culturally incompetent ( 100%) were significantly associated with utilization of maternal and child health services. The determinants of maternal health care service utilization in Mt. Elgon Sub-County are women who are employed (OR: 2.8; 95% CI: 1.1 – 7.3; p=0.03) and cultural incompetence of health care workers (100%).
A unique contribution to theory, practice, and policy: The study findings have identified cultural competence gaps among health care workers which need to be addressed by policy makers to increase utilization in the study area and other similar environment
ASCRIBING CAUSES OF MATERNAL MORTALITY IN HOMA BAY COUNTY KENYA
Authors: Athmani Tamima , Kipmerewo Dr. Mary , Arudo John 
Published: August 2021

Purpose: The study sought to ascribe cause of maternal mortality in Homa Bay County Kenya.
Materials and Method: Data was collected by 40 trained community health workers who were residents of each sub county. Data for the retrospective study was collected using a standardized WHO verbal autopsy questionnaire. All maternal deaths which occurred between 2015 and 2019 in the county were identified. Data was analyzed using SPSS software version 20. Descriptive statistics, bivariate and multiple logistic regression were used in data analysis. Odds ratios with 95% confidence interval were calculated. P value of less than 0.05 was used to establish statistical significance.
Results: The results show that 73.6% of the deaths occurred in a health facility with 20.7% occurring at home. Majority (70.7%) of the mothers visited health facilities during the last illness preceding death. 13.6% received treatment at home while 9.3% were seen by traditional healers. Expert review of the 140 reported deaths reported the leading causes of maternal deaths as obstetric haemorrhage (31.4%), HIV/AIDS (10.7% and abortion (10%). Although the results were not statistically significant, a higher proportion of community deaths attributed to obstetric hemorrhage (31.8%) and abortion-related causes (35.7%). A higher proportion of housewives in Homa Bay died at home, though all the socio-demographic and health-related variables analyzed were not significantly correlated with community deaths.
Unique Contribution to Theory, Practice and Policy: The need for improving the quality of care offered in different health care facilities, the department should also create an enabling environment and ensure a fully functional referral pathway between health facilities in the county. There is therefore need of increasing age of marriage through the practice of family planning methods and avoidance of home treatment and traditional healers. Further research can be done on causes of maternal deaths with a larger sample size.
Fala de mim
Authors: Anderson Gustavo , De Souza Luana Maria , Zarpellon Mariana , Fausto Carlos 
Published: August 2021

Obra: Fala de mim Autores: Gustavo Anderson, Luana Maria de Souza e Mariana Zarpellon
Comentário: Um filme pra se falar Comentarista; Carlos Fausto
Narradores Urbanos com Antônio A. Arantes
Authors: Schons Marize , Eckert Cornelia , Rocha Ana Luiza Carvalho da , Tamaso Izabela Maria 
Published: August 2021

Obra: Narradores Urbanos com Antonio a. Arantes Autoras: Marize Schons, Cornelia Eckert e Ana Luiza Carvalho da Rocha
Comentário: Narrando paisagens paulistanas e patrimônios Comentarista: Izabela Tamaso
Saberes e sabores da colônia - Schimier de melancia de porco
Authors: Schneider Maurício , Zanini Maria Catarina Chitolina 
Published: August 2021

Obra: Saberes e sabores da colônia: schmier de melancia de porco Autor: Maurício Schneider
Comentário: Saberes e sabores da colônia: schmier de melancia de porco Comentarista: Maria Catarina Chitolina Zanini
Um fio da meada, artesãs indígenas tecendo vidas no Amazonas
Authors: Santos Jenniffer Simpson dos , Athias Renato 
Published: August 2021

Obra: Um fio da meada - artesãs indígenas tecendo vidas no Amazonas Autora: Jenniffer Simpson dos Santos Comentário: Tecendo arte no Amazonas! Comentarista: Renato Athias
A ovelha não foge porque o lobo não é belo, mas porque é seu inimigo natural: os fracassos de Kant e as fronteiras entre o estético e o metafísico-religioso
Authors: Grupillo Arthur 
Published: August 2021

Acreditamos que Kant se equivocou na dedução do princípio de universalidade do que é produzido no simples ajuizamento, cujo paradigma é o juízo de gosto puro, sobre o belo. Isto é, Kant não consegue provar, com um argumento transcendental, o direito de pressupor a priori um “sentido comum” (sensus communis), e com ele a possibilidade de uma validade universal intersubjetiva não-objetiva. Mas, parece, o fracasso de Kant é mais iluminador do que teria sido seu “sucesso”. O tipo de princípio que ele realmente procurava tem, na verdade, uma longa história. Encontramos indicações bastante instrutivas na psicologia do animal perfeito elaborada por São Tomás de Aquino (por exemplo, Suma Teológica I, q.78, a.4 e Questões Disputadas sobre a Alma, q. XIII), mas que merecem ajustes diante de sua vasta e complexa filosofia. Algumas características da abordagem tomista podem ajudar a entender porque o sensus communis não poderia ser deduzido por uma prova idealista, baseada na objetividade do conhecimento, mas somente numa “prova realista”, que parte da complexidade observada dos fenômenos naturais e psíquicos, no homem quanto em outros animais.
CONTEXTO SÓCIO HISTÓRICO DE CONSTRUÇÃO DOS CONCEITOS DE QUALIDADE E QUALIDADE DA EDUCAÇÃO: DA PERSPECTIVA EMPRESARIAL A EDUCACIONAL COMO DIREITO DE TODOS
Authors: De Lima Wanessa Maria , Saraiva Joseana Maria 
Published: August 2021

O estudo trata do contexto sócio histórico e cultural de construção do conceito de qualidade, sobremodo, de qualidade da educação, apresentado por estudiosos da área, clássicos e contemporâneos, a partir de diferentes perspectivas e situações. Trata-se de uma pesquisa bibliográfica, através da qual se buscou referências em livros, artigos publicados em periódicos científicos e em dissertações e teses que tratam dos respectivos fenômenos. Priorizou-se a perspectiva histórico crítica, a partir das sociedades ágrafas a contemporânea. O percurso percorrido pelo debate mostrou que o conceito de qualidade e de qualidade da educação, é histórico, socialmente construído e, portanto, reflete em cada conjuntura um significado, imbuído de contradições e controvérsias.
DESAIN PEMBELAJARAN PENDIDIKAN DASAR BERBASIS PERKEMBANGAN INTELEKTUAL
Authors: Fauziah Irma 
Published: August 2021

Pada proses penyelenggaraan pendidikan Sekolah Dasar (SD) atau Madrasah Ibtidaiyah (MI), pemahaman tentang perkembangan intelektual anak usia dasar penting untuk menjadi acuan dalam rangka mendidik dan mengajar. Kegiatan belajar mengajar akan maksimal apabila materi ajar yang disampaikan dapat dipahami oleh anak. Hal tersebut dapat terjadi ketika tingkat kesukaran materi sesuai dengan taraf kemampuan berfikir anak. Maka pengetahuan tentang perkembangan kemampuan berpikir atau perkembangan intelektual peserta didik usia dasar merupakan hal yang harus dikaji. Tujuan penelitian ini adalah untuk menganalisis perkembangan intelektual peserta didik usia dasar yang dapat digunakan oleh guru dan praktisi pendidikan sebagai pedoman dalam mendesain pembelajaran yang efektif. Penelitian ini menggunakan metode penelitian kualitatif dengan jenis penelitian pustaka/literature. Sumber data yang digunakan dalam penelitian ini yaitu buku, jurnal, artikel, dan karya ilmiah lainnya yang relevan. Data dikumpulkan untuk kemudian dilakukan analisis deskriptif. Hasil penelitian ini adalah bahwa kemampuan intelektual adalah kemampuan untuk memperoleh berbagai informasi, berpikir abstrak, menalar, serta bertindak secara efisien dan efektif . adapun perkembangan intelektual dipengaruhi oleh dua factor utama yaitu hereditas/keturunan dan lingkungan, Dalam proses penyelenggaraan pendidikan, penting untuk mempertimbangkan perkembangan intelektual peserta didik pada masing-masing tingkat sebagai dasar dalam merancang pembelajaran. Hal ini mengingat bahawa proses pembelajaran dapat berlangsung secara maksimal serta penyerapan materi oleh peserta didik akan maksimal apabila materi, media, strategi, model dan metode pembelajaran yang digunakan sesuai dengan kemampuan inteletual peserta didik.