bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics and Outcomes of COVID-19 Patients Admitted in the Medical ICU of a Tertiary Public Hospital in the Philippines during the First Two Months of being a COVID-19 Referral Center
Authors: Octaviano Aprille Anne O. , Perez Blessie Marie , Benedicto Jubert 
Published: April 2021

Introduction. The University of the Philippines-Philippine General Hospital (UP-PGH) began its operations as a COVID-19 referral center on March 30, 2020. Local studies reporting characteristics of patients in the intensive care units (ICUs) are lacking.
Objectives. 1) To describe the baseline characteristics and outcomes of the initial cohort of COVID-19 patients in the medical ICU. 2) To report the initial situation and strategies in the ICU during the first two months of being a COVID-19 referral center.
Methods. We conducted a review of records of all patients with confirmed COVID-19 admitted to the medical ICU of UP-PGH between April 1 to May 31, 2020. Patient demographics, comorbidities, APACHE-II score, signs and symptoms, laboratory and radiologic results, respiratory and vasopressor support, and outcomes were collected.
Results. Out of 35 patients with confirmed COVID-19, majority were above 60 years old (63%). Hypertension was the most frequent comorbidity (77%). Fever was the most common symptom (51%). The mean duration of symptoms prior admission was 9 ± 7 days. Anemia and leukocytosis with neutrophilia was common. Lactate dehydrogenase (LDH) and high-sensitivity C-reactive protein (HSCRP) were elevated in most patients. Majority of patients (66%) had moderate level of hypoxemia on admission. Bilateral pneumonia on chest radiograph was found in 34 patients. Hydroxychloroquine and chloroquine were the most commonly used drugs. A total of 24 patients (69%) required invasive mechanical ventilation while 15 (43%) needed pressor support. Twenty-two expired (63%) while thirteen (37%) patients were discharged from the medical ICU.
Conclusion. The clinical characteristics in our set of patients are consistent with other studies on critically ill patients. Mortality in the medical ICU was high.
Patient Flow, Health Delivery Processes, and Areas for Improvement in the UP Health Service (UPHS) during May to June 2020 of the COVID-19 Pandemic
Authors: Lavina Shiela Marie , Mejia-Samonte Marishiel , Anuran Geannagail , Villarante Katrina Lenora , Limpoco Anna Guia 
Published: April 2021

Background. Workplace or employees’ clinics play a vital role in disease outbreaks as there could be an influx of sick personnel. Processes and patient flows during pandemics should be documented to identify good practices and sources of operational inefficiencies.
Objective. To describe the patient flow, health delivery processes, and areas for improvement at the UPHS during the early phase of the COVID-19 pandemic from May to June 2020.
Methods. This was a cross-sectional study involving patient flow analysis of processes at the employees’ clinic of the University of the Philippines-Philippine General Hospital. The study was divided into two major components: clinic process time measurement and process flow mapping. Data collection involved time elements and narrative descriptions of good practices and problems in the process flow.
Results. The UPHS staff attended to 1,514 employees’ visits during the 15 working days from May to June 2020. The total UPHS service time from arrival to end of consultation of an employee with a COVID-19-related concern was an average of 1 hour 3 minutes (SD±39 minutes) with a mean total waiting time of 46 minutes (SD±37 minutes). Good practices identified were personnel flexibility in doing other tasks, good communication, and infection control measures. Areas for improvement included symptom screening, implementation of physical distancing, and disinfection practices.
Conclusion. The process flows in the UPHS clinic consisted of COVID-19 related consultations, non-COVID-19 related concerns, and swabbing services. Good communication, staff flexibility, infection control measures, and leadership were identified as good practices. Occasional lapses in symptom screening at triage, physical distancing among employees in queuing lines, and inconsistent disinfection practices were the areas for improvement.
Hospitalization Expenditure of COVID-19 Patients at the University of the Philippines-Philippine General Hospital (UP-PGH) with PhilHealth Coverage
Authors: Tabuñar Scarlett Mia , Dominado Tamara Michelle 
Published: April 2021

Objective. This research aimed to determine the in-patient expenditure of COVID-19 adult patient s and their out-of-pocket (OOP) payments at the University of the Philippines-Philippine General Hospital (UP-PGH) after the new PhilHealth case rate coverage was instituted last 15 April 2020. It also intended to present the preliminary data on the expenses incurred by COVID patients during the initial phase of the pandemic in the country.
Methods. This study was a retrospective chart review of admitted COVID-19 patients aged 19 years old and above from 15 April to 14 August 2020 at UP-PGH that availed of PhilHealth COVID-19 case rate benefits package (C19C1-C4). Data were analyzed to extract overall expenses, out-of-pocket (OOP) charges, cost centers utilization, and other hospitalization expenditure sources.
Results. Of the 691 COVID-19 patients included during the study period, 55.72% were male, mostly belonging to the 61-70 age range with a median age of 58. The average in-hospital stay was 14.20 days, and 76.99% were under charity services, with the moderate (42.84%) and mild (25.33%) pneumonia cases accounting for 68.17% of the admissions. Total hospital expenses clustered around Php51,000 to 200,000 (~USD 1,041 to 4,156), most spending between Php101,000 to 150,000 (~USD 2,078 to 3,118). The top three cost centers and expenditure sources were pharmacies, personal protective equipment (PPE) usage, and laboratory. The average OOP payment for patients less than 60 years old was higher, ranging from Php 25,899 to Php 44,428.63 (USD 538 to USD 924.44) compared to patients older than 60 (Php4,005.60 to Php 32,920.20 ~ USD 83.35 to 684.98). The most OOP charges were for the age group 19-30, amounting to Php 44,428.63 (USD 924.44).
Conclusion. Preliminary findings of this study gave an actual representation of the expenses of COVID-19 patients, which can guide future utilization of the national health insurance during unexpected pandemics. Early price regulation of new therapeutic interventions, diagnostic tests, and medical supplies, e.g., PPEs, disinfectants, air filters, are measures that can be implemented.
Field classes as an improvement strategy for the discipline of Ecology and Conservation
Authors: Almeida PINHEIRO Rodrigo , Dos Santos CABRAL Maria Jéssica , Araujo dos SANTOS Jerffeson , Pessoa de BARROS Rubens 
Published: April 2021

O estudo buscou descrever as metodologias executadas e sua relevância para a disciplina de Ecologia e Conservação para aulas de campo. A disciplina de Ecologia e Conservação é um dos componentes curriculares do curso de licenciatura em ciências biológicas do Campus I, da Universidade Estadual de Alagoas localizada na cidade de Arapiraca – AL. Durante o período em que a disciplina de Ecologia e Conservação foi lecionada, foram realizadas três aulas de campo, que foram: 1º Aula de Campo – Serra da mangabeira, 2º Aula de Campo – Área de cultivo agroecológico: Povoado Bom Jardim e a 3º Aula de Campo – Trilha ecológica Perucaba viva. Após o término das atividades, pôde-se constatar a importância delas para a disciplina de Ecologia e Conservação, onde foram observadas e realizadas práticas que dizem respeito à conservação.
Architecture and transformation in Mexico City’s UNAM University Campus
Authors: Leal Alejandro , Cruz Bruno , Pérez-Duarte Alejandro 
Published: April 2021

<p>Architecture in permanent transformation is the starting point of this article, focused on the interaction between material and social aspects of a case study on modern Mexican housing, observing the building’s life in relation to its inhabitants. The Multifamily Apartment Building for Teachers (Multifamiliar para maestros), a faculty housing building at the UNAM campus, is a mid-twentieth-century experimental housing project, developed at the beginning of Mexico City´s densification. Today it is registered in UNESCO’s World Heritage Sites. The case study sheds some important insights into the transformations of a spatial modern utopia facing inhabitants' needs. Numerous differences were detected between the original idea behind the building’s architecture and the reality of its users today, revealing not only the ambiguous nature of the building but also problems derived from the country’s accelerated modernization. The results show contrasting approaches of the intermediate space between the building’s conception, and the constant process of becoming a home, where the scope of its habitability is negotiated. </p>
Problemas no uso de empatia em investigações sobre o comportamento moral
Authors: Silveira Matheus de Mesquita 
Published: April 2021

Os últimos anos apresentaram grande quantidade de pesquisas conceituais e empíricas sobre a empatia, além de um crescente interesse público pelo tema. Nesse contexto, as esferas acadêmica e pública, diversas vezes, utilizam empatia e moralidade de forma intercambiável. Neste artigo, argumentar-se-á que existe uma relação entre ambas, porém com diferentes níveis de sobreposição. O problema está na amplitude contemporânea do conceito de empatia e sua consequente polissemia. Na construção do argumento, será relevante distinguir as diferentes características do fenômeno de vinculação emocional, em particular a ressonância emocional, a preocupação empática e a tomada de perspectiva. A distinção conceitual seguirá uma linha empírico-materialista: diferentes fenômenos corporificados necessitam de definições conceituais específicas. Afinal, cada um desses processos psicobiológicos influenciam juízos normativos de modo particular, incorrendo em formas de comportamentos sociais variados. A pluralidade de descobertas das ciências cognitivas ilustrará a relação complexa e ambígua acerca da definição de empatia. O ponto central para compreender essa relação consistirá na defesa de maior precisão conceitual acerca dos fenômenos de vinculação emocional associados à moralidade.
Association of serum sialic acid concentration with diabetic complications and cardiovascular risk factors in an Indian population
Authors: Bansal Pankaj , Bansal Puja , Verma Rajesh 
Published: April 2021

IntroductionSialic acid (SA) is an acetylated product of neuraminic acid. It acts as a cofactor of many cell surface receptors (e.g. insulin receptors) and is positively associated with most of the serum acute phase reactants. Sialic acid is an important component of serum, which is elevated in diseases such as diabetes and certain malignancies. Diabetes mellitus (DM) is associated with an increase in SA concentration along with other complications. The present study was undertaken to assess the relationship between serum SA and type 2 diabetes.Material and methodsA total of 200 type 2 DM patients, 145 males and 55 females, were included in the study. Also, 100 healthy individuals served as the control group. Parameters assessed included serum SA, lipid profile, urine microalbumin, LDL-C, lipoprotein(a), and serum fibrinogen. The relationship between serum SA and diabetic complications viz retinopathy, nephropathy, and neuropathy was also assessed.ResultsType 2 DM patients had significantly higher levels (p < 0.01) of SA (77.35 ±4.6 mg%) as compared to the control group (68.23 ±7.9 mg%). Increased levels of serum SA were seen in patients with diabetic nephropathy and retinopathy. No correlation was seen between serum SA and diabetic neuropathy.ConclusionsElevated serum SA concentration is significantly related to type 2 DM and associated cardiovascular risk factors. Further study of acute-phase response markers and mediators as indicators or predictors of diabetic microvascular complications is therefore justified.
Association of atrial fibrillation with outcomes in patients hospitalized with inflammatory bowel disease: an analysis of the National Inpatient Sample
Authors: Ur Rahman Ebad , Gayam Vijay , Garlapati Pavani , Patel Neelkumar , Farah Fatima , El-Hamdani Adee , Khan Arfaat , I. Okhumale Paul , Aronow Wilbert , El-Hamdani Mehiar 
Published: April 2021

IntroductionWe aimed to determine in-hospital outcomes, length of hospital stay (LOS) and resource utilization in a contemporary cohort of patients with inflammatory bowel disease (IBD) and atrial fibrillation (AFIB).Material and methodsThe National Inpatient Sample database October 2015 to December 2017 was utilized for data analysis using the International Classification of Diseases, Tenth Revision codes to identify the patients with the principal diagnosis of IBD.ResultsOf 714,863 IBD patients, 64,599 had a diagnosis of both IBD and AFIB. We found that IBD patients with AFIB had a greater incidence of in-hospital mortality (OR = 1.3; 95% CI: 1.1–1.4), sepsis (OR = 1.2; 95% CI: 1.1–1.3), mechanical ventilation (OR = 1.2; 95% CI: 1.1–1.5), shock requiring vasopressor (OR = 1.4; 95% CI: 1.1–1.9), lower gastrointestinal bleeding (LGIB) (OR = 1.09, 95% CI: 1.04–1.1), and hemorrhage requiring blood transfusion (OR = 1.2, 95% CI: 1.17–1.37). Mean LOS ± SD, mean total charges and total costs were higher in patients with IBD and AFIB.ConclusionsIn this study, IBD with AFIB was associated with increased in-hospital mortality and morbidity, mean LOS and resource utilization.
The cardiovascular burden of light smoking
Authors: Katsi Vasiliki , Maragkoudakis Spyridon , Ioakeimidis Nikolaos , Marketou Maria , Parthenakis Fragkiskos , Vlachopoulos Charalambos , Tsioufis Konstantinos 
Published: April 2021

The assumption that light cigarette smoking, meaning smoking one to five cigarettes per day, is not so harmful has been dissipated by several studies. Regardless of the quantity of tobacco cigarettes, smoking remains a leading risk factor for the development and progression of cardiovascular diseases. Smoke is a mixture of several toxic chemicals, such as nicotine, carbon monoxide, and oxidants, implicated in the pathogenesis of cardiovascular and pulmonary diseases. Despite anti-smoking campaigns, a misconception concerning “safe smoking” still exists. The purpose of this literature review is to highlight the deleterious effect of light cigarette smoking and claim the consensus that there is no safe smoking.
Clinical research of insulin glargine U300 in type 1 diabetes mellitus patients with frequent hypoglycaemia: real-world experience
Authors: Volkan Kişioğlu Savaş , Suat Demir Ahmet , Tufekci Damla , Emur Gunay Yasemin , Coskun Hulya , Ucuncu Ozge , Nuhoglu Irfan , Kocak Mustafa , Karakullukcu Serdar , Onder Ersoz Halil 
Published: April 2021

IntroductionWe aimed to see whether insulin glargine U300 can provide better blood glucose control while reducing hypoglycaemia in a more homogeneous population compared to previous studies.Material and methodsThe retrospective study included type 1 diabetes mellitus (T1DM) patients with frequent hypoglycaemia. For evaluation of fasting blood glucose, haemoglobin glycated (HbA1c) and weight at 6 months and 12 months (final), observation windows of 120–240 days (4–8 months) and 240–480 days (9–16 months) after insulin glargine U300 initiation, respectively, were permitted. Mean follow-up time was 12 months. Hypoglycaemia was defined as blood glucose level < 70 mg/dl, either symptomatic or asymptomatic, measured in hospital or at home.ResultsForty-four patients were included in the study, and 35 patients completed the study – 20 (57.1%) females and 15 (42.9%) males, with a mean age of 24.1 ±6.6 years. Mean body mass index was 24.4 ±7.4 kg/m2. A significant decrease was not found between baseline and HbA1c values at 6 months (p = 0.199), but a significant decrease was found in the final period (between 9–16 months) (p = 0.025). Hypoglycaemic events occurred in all patients (100%) before using insulin glargine U300, while the incidence of hypoglycaemic events gradually decreased to 74.3%, 68.6%, and 68.6% between months 1–3, 3–6, and 6–9, respectively. Of the 26 patients who declared their level of satisfaction, 23 (88.5%) were satisfied, 2 (7.7%) indicated that there was no significant difference, and 1 (3.8%) patient was unsatisfied.ConclusionsOver 9–16 months of follow-up, insulin glargine U300 led to a significant reduction not only of HbA1c levels but also of the frequency of hypoglycaemia, and also yielded high satisfaction rates.
Effect of leptin concentrations and leptin receptor gene polymorphisms on the outcome of renal transplantation
Authors: García-Pino Guadalup , Luna Enrique , Mota-Zamorano Sonia , González Luz María , Tormo María Ángeles , Gervasini Guillermo 
Published: April 2021

IntroductionLeptin is a pro-inflammatory adipocytokine implicated in cardiovascular disease, insulin resistance, obesity and chronic kidney disease.Material and methodsIn a cohort of 236 renal transplant recipients, we aimed to determine whether circulating leptin concentrations and/or three polymorphisms in the leptin receptor (LEPR) gene, namely rs1137100, rs1137101 and rs1805094, were related to clinical outcomes in renal transplantation. Plasma leptin concentrations were measured by ELISA. Genetic variants were determined by conventional real-time PCR assays, and statistical associations with clinical outcomes were obtained by logistic regression modelling.ResultsPatients with elevated leptin levels were at higher risk of acute rejection (OR = 1.03 (1.01–1.05), p = 0.03) and displayed worse renal clearance (p = 0.001) than patients with lower levels. Leptin levels were not significantly affected by any of the three LEPR SNPs. The rs1137101 G variant showed an inverse association with the risk of delayed graft function (DGF) (OR = 0.42 (0.22–0.81), p = 0.009), whilst the homozygous rs1805094 CC genotype was associated with increased risk of acute rejection (OR = 11.38 (2.15–60.16), p = 0.004). A statistically significant association was also observed between the rs1137100 GG genotype and better renal function [mean difference vs. AA/AG = 20.20 (4.91–35.49) ml/min, p = 0.010].ConclusionsOur results show that both leptin plasma concentrations and polymorphisms in the LEPR gene may affect clinical outcomes in renal transplant recipients, suggesting that the determination of these parameters could be useful in predicting post-transplant adverse events.
MicroRNA-126 modulates angiogenesis and tube formation through enhancing epidermal growth factor-like domain 7 expression and phosphorylating PI3K/AKT signaling pathway
Authors: Li Qiang , Wang Zhong-ming , Wang Ai-yue , Xu Qiong-Guan , Fu Zhou-feng , He Shao-yu , Xu Peng-xiang 
Published: April 2021

IntroductionDysregulated angiogenesis is a critical characteristic for endothelial dysfunction disorders. This study aimed to determine functions of microRNA-126 in formation of tube and investigated the potential mechanisms.Material and methodsThe synthesized microRNA-126 control and microRNA-126 inhibitor plasmids were transfected into human umbilical-vein endothelial cells (HUVECs) using lipofectamine 2000 reagent. Cell counting kit-8 (CCK-8) was employed to measure proliferative capability of HUVECs. Transwell analysis was used to evaluate HUVECs invasive ability. Real time PCR (RT-PCR) was utilized to access epidermal growth factor-like domain 7 (EGFL7) and microRNA-126 mRNA transcription. Tube-forming capability in HUVECs was determined. Dual-luciferase assay and linear-regression analysis were conducted to measure interaction between EGFL7 and microRNA-126 molecule. Phosphoinositide-3-kinase/protein kinase-B (PI3K/AKT) signaling pathway associated molecules were evaluated using western blot assay.ResultsSilencing of microRNA-126 significantly enhanced proliferative capability and invasive ability of HUVECs compared to those of microRNA-126 control group (p<0.05). microRNA-126 silencing remarkably promoted tube formation and significantly up-regulated EGFL7 compared to those of microRNA-126 control group (p<0.05). microRNA-126 could interact with EGFL7 molecule. microRNA-126 was also negatively correlated with EGFL7 molecule in HUVECs (p<0.05). Silencing of microRNA-126 significantly enhanced p-PI3K/PI3K ratio compared to that of microRNA-126 control group (p<0.05). microRNA-126 silencing also remarkably increased p-AKT/AKT ratio compared to that of microRNA-126 control group (p<0.05).ConclusionsmicroRNA-126 modulated angiogenesis and tube formation through increasing EGFL7 expression and phosphorylating PI3K/AKT signaling pathway.
Telomere-telomerase system status in patients with acute myocardial infarction with ST-segment elevation – relationship with oxidative stress
Authors: Vukašinović Aleksandra , Ostanek Barbara , Klisic Aleksandra , Kafedžić Srdjan , Zdravković Marija , Ilić Ivan , Sopić Miron , Hinić Saša , Stefanović Milica , Memon Lidija , Gaković Branka , Bogavac-Stanojević Nataša , Spasojević-Kalimanovska Vesna , Marc Janja , Nešković Aleksandar , Kotur-Stevuljević Jelena 
Published: April 2021

IntroductionTelomeres are protective chromosomal ends. Short telomeres are a proven biomarker of biological aging. We aimed to find an association of telomere length and telomerase activity in circulating leukocytes and thromboaspirates of patients with acute myocardial infarction. Furthermore, association of the telomere-telomerase system with oxidative stress markers (as common risk factors for coronary artery disease (CAD)) was tested.Material and methodsPatients were selected from the patients admitted to the intensive care unit with acute myocardial infarction with ST-segment elevation (STEMI), with the following inclusion criteria – STEMI patients between 18 and 80 years old of both genders and candidates for primary percutaneous coronary intervention, with infarction pain present for a maximum of 12 h. In all the patients leukocyte telomere length, telomerase activity and scores related to oxidative-stress status (Protective, Damage and OXY) were evaluated.ResultsPatients were divided into different groups: with stable angina pectoris (AP) (n = 22), acute myocardial infarction with: STEMI (n = 93), non-obstructive coronary arteries (MINOCA) (n = 7), blood vessel rupture (n = 6) at three time points, and compared to the group of 84 healthy subjects. Telomerase activity was significantly higher in all CAD sub-groups compared to the control group (AP = 0.373 (0.355–0.386), STEMI = 0.375 (0.349–0.395), MINOCA = 0.391 (0.366–0.401), blood vessel rupture = 0.360 (0.352–0.385) vs. CG = 0.069 (0.061–0.081), p < 0.001), while telomeres were significantly shorter in STEMI, MINOCA and blood vessel rupture groups compared to the control group (STEMI = 1.179 (0.931–1.376), MINOCA = 1.026 (0.951–1.070), blood vessel rupture = 1.089 (0.842–1.173) vs. CG = 1.329 (1.096–1.624), p = 0.030]. Values of OXY score were significantly higher in STEMI and MINOCA patients compared to the control group and AP patients (5.83 (4.55–7.54) and 10.28 (9.19–10.72) vs. 4.94 (3.29–6.18) and 4.18 (2.58–4.86), p < 0.001). Longer telomeres and higher telomerase activity were found in thromboaspirates, compared to the peripheral blood leukocytes in the same patients (1.25 (1.01–1.84) vs. 1.18 (0.909–1.516), p = 0.036; and 0.366 (0.367–0.379) vs. 0.366 (0.367–0.379), p < 0.001, respectively). In addition, telomere length and telomerase activity had good diagnostic ability to separate STEMI patients from healthy persons.ConclusionsLeukocyte telomere length and telomerase activity can differentiate CAD patients from healthy persons, and relate CAD to oxidative stress.