bluuebunny/crossref_metadata_2025_split huggingface dataset:
HUBUNGAN FAKTOR-FAKTOR PERILAKU SEHAT DENGAN KETIDAKPATUHAN DIET PADA PENDERITA DIABETES MELLITUS DI POLIKLINIK PENYAKIT DALAM RSUD DR. M. YUNUS KOTA BENGKULU TAHUN 2013
Authors: Taurustya Hernita 
Published: March 2021

ABSTRAKLatar Belakang: Diabetes Mellitus (DM) merupakan salah satu masalah kesehatan khususnya di Propinsi Bengkulu yang masih tinggi. Keberhasilan perencanaan makanan tergantung pada perilaku penderita DM dalam menjalani anjuran makan yang diberikan. Perilaku kesehatan di pengaruhi oleh tiga teori penyebab masalah kesehatan yaitu faktor predisposisi, faktor pemungkin, dan faktor penguat. Tujuan penelitian ini adalah untuk mengetahui hubungan faktor-faktor dengan ketidakpatuhan diet pada penderita DM.Metode: Penelitian ini menggunakan metode deskriptif analitik dengan desain penelitian cross sectional. Tehnik pengambilan sampel pada penelitian ini dengan sample random sampling. Sampel pada penelitian ini berjumlah 97 orang yang keseluruhannya adalah penderita DM yang berobat di Poliklinik Penyakit Dalam RSUD Dr. M.Yunus Kota Bengkulu. Pengambilan data dilakukan dengan menggunakan kuesioner dan wawancara secara langsung dengan responden. Data penelitian dianalisa dengan menggunakan tabel distribusi dan uji chi-square, yang hasilnya disajikan dalam bentuk tabel dan narasi.Hasil: Hasil analisis univariat, distribusi frekuensi faktor predisposisi (pengetahuan mengenai DM) dari 97 responden, sebagian besar responden yaitu 59 orang (60,8%) tidak baik. Distribusi frekuensi faktor pemungkin (perilaku kesehatan) dari 97 responden, sebagian besar responden yaitu 61 orang (62,89%) tidak baik. Distribusi frekuensi faktor penguat (dukungan keluarga) dari 97 responden, hampir sebagian dari responden yaitu 36 orang (37,11%) tidak baik. Distribusi frekuensi ketidakpatuhan diet dari 97 responden, sebagian besar responden yaitu 68 orang (70,10%) tidak patuh terhadap diet DM. Hasil analisis bivariat, ada hubungan faktor predisposisi dengan ketidakpatuhan diet pada penderita DM dengan nilai ? = 0,000, ada hubungan faktor pemungkin dengan ketidakpatuhan diet pada penderita DM dengan nilai ? = 0,000 dan ada hubungan faktor penguat dengan ketidakpatuhan diet pada penderita DM di Poliklinik Penyakit Dalam RSUD Dr. M.Yunus Kota Bengkulu tahun 2013 dengan nilai ? = 0,000.Kesimpulan: Adanya hubungan faktor-faktor perilaku kesehatan (faktor predisposisi, faktor pemungkin, dan faktor penguat) dengan ketidakpatuhan diet pada penderita DM di Poliklinik Penyakit Dalam RSUD Dr. M. Yunus Kota Bengkulu Tahun 2013.
Anestesia general para cesárea en paciente con paraparesia espástica asociada al virus linfotrópico de las células T humanas tipo 1
Authors: Calderón Marjorie Lisseth , Tejada Chacón Deisy Mirella , Quispe Gómez María Victoria , Onton Reynaga Victor Wilfredo 
Published: March 2021

Introducción: La paraparesia espástica es una infección causada por el virus linfotrópico de células T humanas (HTLV-1). Se caracteriza por una mielopatía de lenta instauración que compromete principalmente los miembros inferiores. Afecta más a mujeres que a varones y las principales vías de transmisión son: sanguínea, sexual y vertical (principalmente durante la lactancia).
Presentación del caso: Gestante de 28 años de edad, y 38 semanas de gestación, con diagnóstico de paraparesia espástica asociada a HTLV-1; programada para cesárea; en quién se empleó una técnica anestésica general balanceada.
Conclusiones: La anestesia general balanceada fue una opción segura para el manejo anestésico de la cesárea en esta paciente, brindando una adecuada relajación muscular durante la cirugía, con mínimos cambios hemodinámicos, además de una rápida recuperación del bloqueo neuromuscular.
¿Es el Score SOFA un predictor adecuado para evaluar la mortalidad materna?
Authors: Alburqueque Melgarejo Joseph , Roque Quezada Juan Carlos 
Published: March 2021

Estimado señor editor:
Luego de haber leído con interés el artículo “Utilidad del score SOFA en la predicción de muerte materna en la UCI materna del INMP” por De la Peña Meniz Walter et al. publicado en el Volumen 9 número 3 de la Revista Peruana de Investigación Materno Perinatal, el cual consideramos un estudio de suma relevancia en el campo de la Gineco-Obstetricia y la Medicina Intensivista; y teniendo en cuenta la alta tasa de mortalidad materna en el Perú; quisiéramos mencionar algunos aspectos que deberían considerarse para posteriores estudios.
Actualmente no existe un score específico para predecir la mortalidad materna en pacientes obstétricas en la UCI. Sin embargo, a pesar de que no hay muchos estudios al respecto, el score SOFA es el que ha presentado los mejores resultados en contraste con otros scores para valorar mortalidad. Esto puede verse ilustrado en el hecho de que otros scores como el APACHE II o el SAPS II sobreestiman la mortalidad materna, este no es el caso del score SOFA 1-3 .
Por otro lado, es de relevancia señalar las características del score SOFA que hacen que sea un score confiable para la estimación de la variable mortalidad materna, en comparación con otros scores de mortalidad. Una de ellas reside en el hecho de las variables que evalúa el score SOFA que, a diferencia de otros scores, no presentan modificaciones considerables en el estado fisiológico del embarazo. Sin embargo, el score SOFA también algunas variables que si podrían modificarse con este estado fisiológico, estas son las siguientes: presión arterial media, niveles de creatinina sérica y conteo de plaquetas. Además, el score SOFA considera variables que pueden ser evaluadas en estancias de escasos recursos, a diferencia de otros scores1,4 .
Aunque existen varios subtipos de score SOFA, que tienen diferentes utilidades. En el presente estudio se valoró el score SOFA en la admisión y a las 48h del ingreso. Con la presencia de estas dos mediciones hubiera sido interesante el cálculo del delta SOFA, el cual se obtiene del cambio entre el score SOFA total en la admisión y en un punto definido en el tiempo. Esta sugerencia se sustenta en el hecho de que el delta SOFA tiene más confiabilidad para la evaluación de mortalidad en los ensayos clínicos 4,5 .Es importante también mencionar que la medida del score SOFA debe ser adecuada, puesto que errores al momento de su medición pueden conllevar a variabilidad en los resultados entre diferentes autores 4.
Finalmente, mencionar que el score SOFA es un instrumento útil para evaluar la mortalidad materna, dada su superioridad en relación a otros scores previamente mencionados.
OPTIMIZATION ACTIVITIES IN A CONTAINER TERMINAL TO REDUCE IDLE TIME IN LOADING-UNLOADING OPERATION
Authors: Andromeda Vega F , Purwantini Sri 
Published: March 2021

<p><em>In line with the implementation of development in Indonesia, whose main target is in the field of economic development, trade activities are one of the sectors of economic development, constantly developing their role. Therefore, it is necessary to have adequate transportation facilities, both by land, sea, and air. The dynamics of the construction can be seen clearly both in terms of the number of high-rise buildings, vehicles, activity facilities, residential areas, and other infrastructure. This condition requires careful, fast, and precise anticipation from the Regional Governent and various policies in a spatial structure feasibility plan that considers the ability of transportation support as one of the main supports. This study seeks to study and analyze the related handling of idle time at PT Samudera Indonesia Jakarta by optimizing loading and unloading activities on container ships. By using descriptive qualitative methods and samples taken from PT Samudera Indonesia Jakarta, the following results are obtained: Problems in the system The cargodoring are: Difficult to direct the location of container dropping from the ship, The slow process of container dropping from the ship, Limited number of cranes, The occurrence of transportation queues, Limited ability to carry containers for each transport, Required trucks in large quantities, There was a clash between trucks that carry out the process of loading and unloading containers, the difficulty of directing the location of containers if it must be stacked with other containers, the development idea is to make a cargodoring handling system using a headless semi-automatic train, which utilizes seawater power and the conveyor system.</em><em></em></p><p> </p><em>Keywords : <strong>Idle time,</strong><strong>Optimization, Loading, Container, Samudra Indonesia</strong></em>
Big Data Analysis of a Dedicated YouTube Channel as an Open Educational Resource in Hand Surgery
Authors: Rahman Norana Abdul , Ng Hannah Jia Hui , Rajaratnam Vaikunthan 
Published: March 2021

Background: Educationally designed videos have the advantage of explaining difficult concepts via graphic diagrams and dynamic illustrations. The benefits of videos will be enhanced if videos are well-designed, concise, explore scientifically correct content, and have a clear presentation.Aims: Video as an open educational resource (OER) is the cornerstone for online learning. YouTube has been widely used as a distribution platform for OER. The aim of this study was to evaluate the engagement of hand surgery videos on a dedicated education channel on YouTube.Methods: The senior author has been utilizing a YouTube channel dedicated to the education of clinicians in Hand Surgery, surgical education, and management since 2008. The degree of engagement was evaluated using YouTube Analytics, providing up-to-date metrics and reports.Results: Since 2008, there have been 6521 subscribers with 1,360,680 views, a total view time of 35,033 h and an average view time of 1.72 min. The channel views averaged 1000 views per day. There were 4,324,724 impressions with a 7.32% click-through rate, with the United States of America accounting for 23.5% of the audience. YouTube search accounted for 33.3% of the traffic source and suggested videos by others were 19.4%, and external links were 19%. Playback location was through mobile devices in 76.7%, while 16% was through the computer. The two popular playlists were “flaps in hand surgery” (50.2%) and “basic hand surgery workshop” (21.9%). Sharing by WhatsApp was most popular (27.9%) in embedded websites and apps. Overall there were 488 comments on the channel.Conclusion: This paper confirms the phenomenon of micro-learning by online learners. It is recommended that educational videos as OER should be confined to 2 min, made compatible for the mobile device, and be optimized for sharing on social media. These can be used as resources for blended learning, allowing better utilization of time for deliberate practice in surgical training.
MiR-29a Knockout Aggravates Neurological Damage by Pre-polarizing M1 Microglia in Experimental Rat Models of Acute Stroke
Authors: Zhao Fangfang , Zhao Haiping , Fan Junfen , Wang Rongliang , Han Ziping , Tao Zhen , Zheng Yangmin , Yan Feng , Huang Yuyou , Yu Lei , Zhang Xu , Qi Xiaolong , Zhang Lianfeng , Luo Yumin , Ma Yuanwu 
Published: March 2021

ObjectiveBy exploring the effects of miR-29a-5p knockout on neurological damage after acute ischemic stroke, we aim to deepen understanding of the molecular mechanisms of post-ischemic injury and thus provide new ideas for the treatment of ischemic brain injury.MethodsmiR-29a-5p knockout rats and wild-type SD rats were subjected to transient middle cerebral artery occlusion (MCAO). miR-29a levels in plasma, cortex, and basal ganglia of ischemic rats, and in plasma and neutrophils of ischemic stroke patients, as well as hypoxic glial cells were detected by real-time PCR. The infarct volume was detected by TTC staining and the activation of astrocytes and microglia was detected by western blotting.ResultsThe expression of miR-29a-5p was decreased in parallel in blood and brain tissue of rat MCAO models. Besides, miR-29a-5p levels were reduced in the peripheral blood of acute stroke patients. Knockout of miR-29a enhanced infarct volume of the MCAO rat model, and miR-29a knockout showed M1 polarization of microglia in the MCAO rat brain. miR-29a knockout in rats after MCAO promoted astrocyte proliferation and increased glutamate release.ConclusionKnockout of miR-29a in rats promoted M1 microglial polarization and increased glutamate release, thereby aggravating neurological damage in experimental stroke rat models.
A Neuromotor to Acoustical Jaw-Tongue Projection Model With Application in Parkinson’s Disease Hypokinetic Dysarthria
Authors: Gómez Andrés , Gómez Pedro , Palacios Daniel , Rodellar Victoria , Nieto Víctor , Álvarez Agustín , Tsanas Athanasios 
Published: March 2021

AimThe present work proposes the study of the neuromotor activity of the masseter-jaw-tongue articulation during diadochokinetic exercising to establish functional statistical relationships between surface Electromyography (sEMG), 3D Accelerometry (3DAcc), and acoustic features extracted from the speech signal, with the aim of characterizing Hypokinetic Dysarthria (HD). A database of multi-trait signals of recordings from an age-matched control and PD participants are used in the experimental study.Hypothesis:The main assumption is that information between sEMG and 3D acceleration, and acoustic features may be quantified using linear regression methods.MethodsRecordings from a cohort of eight age-matched control participants (4 males, 4 females) and eight PD participants (4 males, 4 females) were collected during the utterance of a diadochokinetic exercise (the fast repetition of diphthong [aI]). The dynamic and acoustic absolute kinematic velocities produced during the exercises were estimated by acoustic filter inversion and numerical integration and differentiation of the speech signal. The amplitude distributions of the absolute kinematic and acoustic velocities (AKV and AFV) are estimated to allow comparisons in terms of Mutual Information.ResultsThe regression results show the relationships between sEMG and dynamic and acoustic estimates. The projection methodology may help in understanding the basic neuromotor muscle activity regarding neurodegenerative speech in remote monitoring neuromotor and neurocognitive diseases using speech as the vehicular tool, and in the study of other speech-related disorders. The study also showed strong and significant cross-correlations between articulation kinematics, both for the control and the PD cohorts. The absolute kinematic variables presents an observable difference for the PD participants compared to the control group.ConclusionKinematic distributions derived from acoustic analysis may be useful biomarkers toward characterizing HD in neuromotor disorders providing new insights into PD.
Brain–Heart Interaction During Transcutaneous Auricular Vagus Nerve Stimulation
Authors: Machetanz Kathrin , Berelidze Levan , Guggenberger Robert , Gharabaghi Alireza 
Published: March 2021

ObjectivesTranscutaneous auricular vagus nerve stimulation (taVNS) modulates brain activity and heart function. The induced parasympathetic predominance leads to an increase of heart rate variability (HRV). Knowledge on the corresponding cortical activation pattern is, however, scarce. We hypothesized taVNS-induced HRV increases to be related to modulation of cortical activity that regulates the autonomic outflow to the heart.Materials and MethodsIn thirteen healthy subjects, we simultaneously recorded 64-channel electroencephalography and electrocardiography during taVNS. Two taVNS stimulation targets were investigated, i.e., the cymba conchae and inner tragus, and compared to active control stimulation in the anatomical vicinity, i.e., at the crus helicis and outer tragus. We used intermitted stimulation bursts of 25 Hz applied at a periodicity of 1 Hz. HRV was estimated with different time-domain methodologies: standard deviation of RR (SDNN), the root mean squares of successive differences (RMSSD), the percentage of RR-intervals with at least 50 ms deviation from the preceding RR-interval (pNN50), and the difference of consecutive RR intervals weighted by their mean (rrHRV).ResultsThe stimulation-induced HRV increases corresponded to frequency-specific oscillatory modulation of different cortical areas. All stimulation targets induced power modulations that were proportional to the HRV elevation. The most prominent changes that corresponded to HRV increases across all parameters and stimulation locations were frontal elevations in the theta-band. In the delta-band, there were frontal increases (RMSSD, pNN50, rrHRV, SDNN) and decreases (SDNN) across stimulation sites. In higher frequencies, there was a more divers activity pattern: Outer tragus/crus helicis stimulation increased oscillatory activity with the most prominent changes for the SDNN in frontal (alpha-band, beta-band) and fronto-parietal (gamma-band) areas. During inner tragus/cymba conchae stimulation the predominant pattern was a distributed power decrease, particularly in the fronto-parietal gamma-band.ConclusionNeuro–cardiac interactions can be modulated by electrical stimulation at different auricular locations. Increased HRV during stimulation is correlated with frequency-specific increases and decreases of oscillatory activity in different brain areas. When applying specific HRV measures, cortical patterns related to parasympathetic (RMSSD, pNN50, rrHRV) and sympathetic (SDNN) modulation can be identified. Thus, cortical oscillations may be used to define stimulation locations and parameters for research and therapeutic purposes.
Interdisciplinary Radical “En-Bloc” Resection of Ewing Sarcoma of the Chest Wall and Simultaneous Chest Wall Repair Achieves Excellent Long-Term Survival in Children and Adolescents
Authors: Basharkhah Alireza , Lackner Herwig , Karastaneva Anna , Bergovec Marko , Spendel Stephan , Castellani Christoph , Sorantin Erich , Benesch Martin , Liegl-Atzwanger Bernadette , Smolle-Jüttner Freyja-Maria , Urban Christian , Höllwarth Michael , Singer Georg , Till Holger 
Published: March 2021

Introduction: Ewing sarcomas of the chest wall, historically known as “Askin tumors” represent highly aggressive pediatric malignancies with a reported 5-year survival ranging only between 40 and 60% in most studies. Multimodal oncological treatment according to specific Ewing sarcoma protocols and radical “en-bloc” resection with simultaneous chest wall repair are key factors for long-term survival. However, the surgical complexity depends on tumor location and volume and potential infiltrations into lung, pericardium, diaphragm, esophagus, spine and major vessels. Thus, the question arises, which surgical specialties should join their comprehensive skills when approaching a child with Ewing sarcoma of the chest wall.Patients and Methods: All pediatric patients with Ewing sarcomas of the chest wall treated between 1990 and 2020 were analyzed focusing on complete resection, chest wall reconstruction, surgical complications according to Clavien-Dindo (CD) and survival. Patients received neo-adjuvant chemotherapy according to the respective Ewing sarcoma protocols. Depending on tumor location and organ infiltration, a multi-disciplinary surgical team was orchestrated to perform radical en-bloc resection and simultaneous chest wall repair.Results: Thirteen consecutive patients (seven boys and six girls) were included. Median age at presentation was 10.9 years (range 2.2–21 years). Neo-adjuvant chemotherapy (n = 13) and irradiation (n = 3) achieved significant reduction of the median tumor volume (305.6 vs. 44 ml, p &lt; 0.05). En-bloc resection and simultaneous chest wall reconstruction was achieved without major complications despite multi-organ involvement. Postoperatively, one patient with infiltration of the costovertebral joint and laminectomy required surgical re-intervention (CD IIIb). 11/13 patients were treated with clear resections margins (R1 resection in one patient with infiltration of the costovertebral joint and marginal resection &lt;1 mm in one child with multiple pulmonary metastases). All patients underwent postoperative chemotherapy; irradiation was performed in four children. Two deaths occurred 18 months and 7.5 years after diagnosis, respectively. Median follow-up for the remaining patients was 8.8 years (range: 0.9–30.7 years). The 5-year survival rate was 89% and the overall survival 85%.Conclusion: EWING specific oncological treatment and multi-disciplinary surgery performing radical en-bloc resections and simultaneous chest wall repair contribute to an improved survival of children with Ewing sarcoma of the chest wall.
Associations of Vascular Risk Factors, APOE and TOMM40 Polymorphisms With Cognitive Function in Dementia-Free Chinese Older Adults: A Community-Based Study
Authors: Gui Wenjun , Qiu Chengxuan , Shao Qi , Li Juan 
Published: March 2021

Objective: The associations of vascular risk factors (VRFs), apolipoprotein E (APOE), and translocase of outer mitochondrial membrane 40 (TOMM40) with cognitive function have been investigated mostly in western societies. In the present study, we sought to examine the associations of VRFs [i.e., current smoking, current drinking, physical inactivity, obesity, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), diabetes, and hypertension] and variants located in APOE (ε2/3/4) and TOMM40 (rs2075650) with global cognitive function in Chinese older adults, with a focus on their potential interactions.Methods: This is a cross-sectional study that included 422 permanent residents (mean age 69.2 years, 54.3% female) living in Beijing, who were free of dementia. Data were collected through interviews, clinical examinations, and laboratory tests. The two genetic polymorphisms were genotyped, and participants were dichotomized as carriers vs. non-carriers of APOE ε4 or TOMM40 G. Global cognitive function was assessed with the Mini-Mental State Examination (MMSE). Data were analyzed with multivariable linear regression models.Results: Physical inactivity and diabetes were independently associated with a lower MMSE score (all p &lt; 0.05). When four putative VRFs (i.e., current smoking, physical inactivity, high LDL-C, and diabetes) were aggregated, an increasing number of having these factors was associated with a decreasing MMSE score in a dose–response manner (p = 0.001). TOMM40 polymorphisms, independent of the APOE ε4 allele, interacted with aggregated VRFs to influence cognitive performance, such that having one or more of these VRFs was particularly detrimental to the cognition of TOMM40 carriers. Further analyses revealed interactions of the TOMM40 polymorphism with (i) physical inactivity and (ii) diabetes, such that having either physical inactivity or diabetes in combination with carrying a TOMM40 G allele, compared to having neither, was significantly associated with a markedly lower MMSE score (all p &lt; 0.05).Conclusion: This study provides some evidence supporting the association of vascular risk factors with poor cognitive performance among dementia-free Chinese older adults and further revealed their interactions with the TOMM40 polymorphism. The results underscore the vulnerability of global cognitive function to VRFs, which could be reinforced by carrying the TOMM40 rs2075650 G allele. These findings have potential implications for developing tailored intervention programs to maintain cognitive function.