bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disseminated Tuberculosis Associated Hemophagocytic Lymphohistiocytosis in a Pregnant Woman With Evans syndrome: A Case Report and Literature Review
Authors: Shi Yun-Feng , Shi Xiao-Han , Zhang Yuan , Chen Jun-Xian , Lai Wen-Xing , Luo Jin-Mei , Ba Jun-Hui , Wang Yan-Hong , Chen Jian-Ning , Wu Ben-Quan 
Published: June 2021

BackgroundTuberculosis (TB) is a leading cause of morbidity and mortality in underdeveloped and developing countries. Disseminated TB may induce uncommon and potentially fatal secondary hemophagocytic lymphohistiocytosis (HLH). Timely treatment with anti-tuberculosis therapy (ATT) and downmodulation of the immune response is critical. However, corticosteroid treatment for TB-associated HLH remains controversial. Herein, we report a successful case of disseminated TB-associated HLH in a pregnant woman with Evans syndrome accompanied by a literature review.Case PresentationA 26-year-old pregnant woman with Evans syndrome was transferred to the Third Affiliated Hospital of Sun Yat-Sen University because of severe pneumonia. She presented with cough, fever, and aggravated dyspnea. Nested polymerase chain reaction for Mycobacterium tuberculosis (M. tuberculosis) complex in sputum was positive. Sputum smear sample for acid-fast bacilli was also positive. Metagenome next-generation sequencing (mNGS) of the bronchoalveolar lavage fluid identified 926 DNA sequence reads and 195 RNA sequence reads corresponding to M. tuberculosis complex, respectively. mNGS of blood identified 48 DNA sequence reads corresponding to M. tuberculosis. There was no sequence read corresponding to other potential pathogens. She was initially administered standard ATT together with a low dose of methylprednisolone (40 mg/day). However, her condition deteriorated rapidly with high fever, acute respiratory distress syndrome, pancytopenia, and hyperferritinemia. Bone marrow smears showed hemophagocytosis. And caseating tuberculous granulomas were found in the placenta. A diagnosis of disseminated TB-associated HLH was made. Along with the continuation of four drug ATT regimen, therapy with a higher dose of methylprednisolone (160 mg/day) combined with immunoglobulin and plasma exchange was managed. The patient’s condition improved, and she was discharged on day 19. Her condition was good at follow-up with the continuation of the ATT.ConclusionsClinicians encountering patients with suspected TB accompanied by unexplainable inflammation not responding to ATT should consider complications with HLH. Timely administration of ATT combined with corticosteroids may result in a favorable outcome.
The Inhibitory Effect of Lysophosphatidylcholine on Proangiogenesis of Human CD34+ Cells Derived Endothelial Progenitor Cells
Authors: Zhao Haijun , He Yanhui 
Published: June 2021

Increasing evidence reveals that lysophosphatidylcholine (LPC) is closely related to endothelial dysfunction. The present study aimed to investigate the mechanism of LPC in inhibiting the proangiogenesis and vascular inflammation of human endothelial progenitor cells (EPCs) derived from CD34+ cells. The early EPCs were derived from CD34+ hematopoietic stem cells whose purity was identified using flow cytometry analysis. The surface markers (CD34, KDR, CD31; VE-cadherin, vWF, eNOS) of EPCs were examined by flow cytometry analysis and immunofluorescence. RT-qPCR was used to detect the mRNA expression of inflammatory cytokines (CCL2, IL-8, CCL4) and genes associated with angiogenesis (VEGF, ANG-1, ANG-2) in early EPCs after treatment of LPC (10 μg/ml) or phosphatidylcholine (PC, 10 μg/ml, control). The angiogenesis of human umbilical vein endothelial cells (HUVECs) incubated with the supernatants of early EPCs was detected by a tube formation assay. The mRNA and protein levels of key factors on the PKC pathway (phosphorylated PKC, TGF-β1) were measured by RT-qPCR and western blot. The localization of PKC-β1 in EPCs was determined by immunofluorescence staining. We found that LPC suppressed the expression of CCL2, CCL4, ANG-1, ANG-2, promoted IL-8 expression and had no significant effects on VEGF expression in EPCs. EPCs promoted the angiogenesis of HUVECs, which was significantly inhibited by LPC treatment. Moreover, LPC was demonstrated to promote the activation of the PKC signaling pathway in EPCs. In conclusion, LPC inhibits proangiogenesis of human endothelial progenitor cells derived from CD34+ hematopoietic stem cells.
Selective Reporting of Outcomes in Tinnitus Trials: Comparison of Trial Registries With Corresponding Publications
Authors: Beurden Isabeau van , Beek Megan J. van de , Heteren Jan A. A. van , Smit Adriana L. , Stegeman Inge 
Published: June 2021

Objectives: We aimed to study the prevalence of selective reporting of primary and secondary outcomes in tinnitus trials and to examine if selective reporting of outcome measures is influenced by the nature and direction of its results.Background: Selective reporting of outcome measures has been reported in several biomedical fields and can influence the clinical usefulness and implementation of outcomes of clinical trials. It is reported as one of the obstacles in finding an effective intervention for tinnitus.Methods: ClinicalTrials.gov (CT.gov) was used to identify all registered interventional tinnitus trials up to December 2015. A standardized search was used to find corresponding publications up to March 2018. The prespecified outcomes in CT.gov were compared with the outcomes reported in corresponding publication(s). The effects of the (lack of) statistical significance of trial results and the effects of funding source on record adherence were evaluated. Changes in registration elements were assessed with the Archive site of CT.gov.Results: We found corresponding publications for 60 (64.5%) of 93 eligible tinnitus trials registered in CT.gov. Of all the publications, five (7.5%) fully reported outcome measures entirely in line with the prespecified outcome measures. Discrepancies between the prespecified and reported outcomes were found in a total of 51 (76.1%) of the studies for primary outcomes, whereas 62 (92.5%) of the studies had discrepancies in secondary outcomes. In secondary outcomes, statistical significance of trial results influenced CT.gov record adherence. In addition, there was a statistically significant difference in the rate of discrepancy in industry-funded [n = 98 (87.5%) discrepant outcomes] and non-industry funded trials [n = 172 (74.5%) discrepant outcomes] (p = 0.01). Finally, 15 (25.9%) trialists made modifications in registered outcome measures during or after the trial period.Conclusion: Tinnitus trials suffer from substantial outcome reporting bias. Awareness of its presence must be raised to limit the obstacles of finding an effective intervention for tinnitus.
A Novel Variation in the Mitochondrial Complex I Assembly Factor NDUFAF5 Causes Isolated Bilateral Striatal Necrosis in Childhood
Authors: Bi Hongyan , Guo Hui , Wang Qianfei , Zhang Xiao , Zhao Yaming , Li Jimei , Zhao Weiqin , Tuo Houzhen , Zhang Yongbo 
Published: June 2021

Background: Bilateral striatal necrosis (BSN) is characterized by symmetrical degeneration, predominantly of the caudate and putamen nucleus, in the basal ganglia. It is associated with numerous acquired and hereditary neuro-developmental and motor dysfunction-related pathological conditions. BSN results in high morbidity and mortality among infants and children, and its diagnosis is clinically challenging due to several overlapping disease phenotypes. Therefore, a precise genetic diagnosis is urgently needed for accurate genetic counseling and improved prognostic outcomes as well.Objective: To identify novel missense mutations in the NDUFAF5 gene as a cause of childhood BSN in members of a Chinese family and summarize the clinical characteristics of patients with the NDUFAF5 gene mutations.Methods: This study included a large family living in a remote northwestern area of China. Three siblings developed a neurological disorder characterized by generalized dystonia within the first decade of their lives. Cerebral computed tomography (CT) and magnetic resonance imaging (MRI) showed bilateral lesions of the putamen. Biochemical and genetic approaches were used to identify the cause of BSN.Results: Sequence analysis showed no pathogenic variation in PANK2, SLC25A19, SLC19A3, and NUP62 genes and in the entire mitochondrial genome as well. Whole-exome sequencing revealed compound heterozygous mutations consisting of NDUFAF5:c.425A &gt; C(p.E142A) and c.836T &gt; G (p.M279R). The father, a healthy sister, and a healthy brother of the affected siblings carried the c.836T &gt; G mutation, and the mother carried the c.425A &gt; C mutation. These variants were absent in 100 ethnically matched non-BSN controls. In silico analysis demonstrated that the E142A and M279R mutations in NDUFAF5 protein significantly perturbed the normal conformation of the protein due to alterations in the hydrogen bonding patterns around the evolutionarily conserved catalytic domains, leading to its loss of function in the early stage of mitochondrial complex I assembly.Conclusions: We identified a novel compound heterozygous mutation (c.425A &gt; C and c.836T &gt; G) in the NDUFAF5 gene as the potential cause of autosomal recessive childhood BSN, which extended the pathogenic variation spectrum of the NDUFAF5 gene. This study provides substantial evidence for further improvement of genetic counseling and better clinical management of BSN affected individuals.
LLGL2 Increases Ca2+ Influx and Exerts Oncogenic Activities via PI3K/AKT Signaling Pathway in Hepatocellular Carcinoma
Authors: Leng Shusheng , Xie Fei , Liu Junyi , Shen Junyi , Quan Guangqian , Wen Tianfu 
Published: June 2021

BackgroundLethal giant larvae (Lgl), scaffolding proteins, regulate the epithelial cell apicobasal polarity in Drosophila. They play important roles in asymmetric cell division, cell migration, and progenitor cells self-renewal as tumor suppressors. One of Lgl mammalian homologues proteins, LLGL2 overexpression has been reported in ER+ breast cancer and promotes tumor proliferation through regulating leucine uptake. Nonetheless, the role of LLGL2 in hepatocellular carcinoma (HCC) is still unknown.MethodsTCGA dataset mining, qRT-PCR, Western blot along with immunohistochemistry assays were employed to explore LLGL2 expression in human HCC samples and cell lines. Moreover, the clinical value of LLGL2 was investigated in 156 HCC patients. Furthermore, the role as well as the molecular mechanism of LLGL2 in the progression of HCC was explored through a series of in vitro and in vivo experiments.ResultsLLGL2 was up-regulated in HCC tissues, which was related with certain clinicopathological features including tumor number, vascular invasion as well as advanced stage. High expression of LLGL2 predicted poor prognosis after hepatectomy. LLGL2 promoted HCC cells proliferation, migration and invasion through PI3K/ATK signaling by promoting calcium ion influx.ConclusionOur study identified that LLGL2 is a tumor promoter in HCC for the first time, which could potentially be utilized as a new biomarker and a therapeutic target for HCC.
Evaluation of Epigallocatechin-3-Gallate as a Radioprotective Agent During Radiotherapy of Lung Cancer Patients: A 5-Year Survival Analysis of a Phase 2 Study
Authors: Zhu Wanqi , Zhao Yalan , Zhang Shuyu , Li Xiaolin , Xing Ligang , Zhao Hanxi , Yu Jinming 
Published: June 2021

BackgroundPrevious analysis of the study (NCT02577393) had demonstrated the application of epigallocatechin-3-gallate (EGCG) could be safe and effective in the prevention and treatment of acute radiation esophagitis in patients with advanced lung cancer. EGCG seemed to improve the response rate of small cell lung cancer (SCLC) to radiotherapy in a subgroup analysis. This research continued to analyze the impact of EGCG application on cancer-radiation efficacy and patient survival.MethodsAll patients with SCLC in the NCT02577393 study were included. Patients were randomized into EGCG group or conventional therapy group as protocol. The primary endpoints of the study were radiation response rate and progression-free survival (PFS). Overall survival (OS) and the efficacy of EGCG in the treatment of esophagitis were assessed as secondary endpoints.ResultsA total of 83 patients with lung cancer in the NCT02577393 study were screened, and all 38 patients with SCLC were eligible for analysis. No significant differences with regard to baseline demographic and clinical characteristics were observed between the two groups. The objective response rate (ORR) was higher than that of conventionally treated patients (84.6 vs 50%, P = 0.045), while the median PFS and OS were not significantly prolonged. At data cut-off (1 January 2021), 5-year PFS was 33% with EGCG versus 9.3% with conventional treatment, and 5-year OS was 30.3% versus 33.3%, respectively. The mean adjusted esophagitis index and pain index of patients with EGCG application were lower than conventional treatment (5.15 ± 2.75 vs 7.17 ± 1.99, P = 0.030; 8.62 ± 5.04 vs 15.42 ± 5.04, P &lt; 0.001).ConclusionThe study indicates EGCG may alleviate some esophagitis-related indexes in SCLC patients exposed to ionizing radiation without reducing survival. However, this conclusion should be confirmed by further studies with large sample size.
Self-Nanoemulsifying Drug Delivery System Loaded with Psiadia punctulata Major Metabolites for Hypertensive Emergencies: Effect on Hemodynamics and Cardiac Conductance
Authors: Abdallah Hossam M. , El-Bassossy Hany M. , El-Halawany Ali M. , Ahmed Tarek A. , Mohamed Gamal A. , Malebari Azizah M. , Hassan Noura A. 
Published: June 2021

Vasodilators are an important class of antihypertensive agents. However, they have limited clinical use due to the reflex tachycardia associated with their use which masks most of its antihypertensive effect and raises cardiac risk. Chemical investigation of Psiadia punctulata afforded five major methoxylated flavonoids (1–5) three of which (1, 4, and 5) showed vasodilator activity. Linoleic acid-based self-nanoemulsifying drug delivery system (SNEDDS) was utilized to develop intravenous (IV) formulations that contain compounds 1, 4, or 5. The antihypertensive effect of the prepared SNEDDS formulations, loaded with each of the vasodilator compounds, was tested in the angiotensin-induced rat model of hypertension. Rats were subjected to real-time recording of blood hemodynamics and surface Electrocardiogram (ECG) while the pharmaceutical formulations were individually slowly injected in cumulative doses. Among the tested formulations, only that contains umuhengerin (1) and 5,3′-dihydroxy-6,7,4′,5′-tetramethoxyflavone (5) showed potent antihypertensive effects. Low IV doses, from the prepared SNEDDS, containing either compound 1 or 5 showed a marked reduction in the elevated systolic blood pressure by 10 mmHg at 12 μg/kg and by more than 20 mmHg at 36 μg/kg. The developed SNEDDS formulation containing either compound 1 or 5 significantly reduced the elevated diastolic, pulse pressure, dicrotic notch pressure, and the systolic–dicrotic notch pressure difference. Moreover, both formulations decreased the ejection duration and increased the non-ejection duration while they did not affect the time to peak. Both formulations did not affect the AV conduction as appear from the lack of effect on p duration and PR intervals. Similarly, they did not affect the ventricular repolarization as no effect on QTc or JT interval. Both formulations decreased the R wave amplitude but increased the T wave amplitude. In conclusion, the careful selection of linoleic acid for the development of SNEDDS formulation rescues the vasodilating effect of P. punctulata compounds from being masked by the reflex tachycardia that is commonly associated with the decrease in peripheral resistance by most vasodilators. The prepared SNEDDS formulation could be suggested as an effective medication in the treatment of hypertensive emergencies, after clinical evaluation.
Del comportamiento organizacional a la práctica de producción del sentido
Authors: García Tamayo Galo Hernán 
Published: June 2021

El presente ensayo tiene como propósito presentar algunas reflexiones sobre la práctica en la producción del sentido que se atribuyen a las organizaciones, producto del tránsito de las mismas, de la modernidad a la posmodernidad.
El trabajo consistió en hacer una revisión documental con un recorrido por la literatura respecto de la temática planteada, con el fin de entender desde un punto de vista teórico, cuáles han sido los cambios que ha soportado la sociedad desde la modernidad hasta la posmodernidad.
El estudio se basó en la lectura crítica del tema presentado; para ello se consiguieron artículos científicos, mismos que fueron analizados a profundidad con la finalidad de relevar los datos pertinentes. La comprensión de la información se complementó con métodos de análisis de contenido y de frecuencia.
Se concluye que, a lo largo de la historia, la marcada incertidumbre característica de dicha época, abre la posibilidad a una nueva vía que se dirige a la búsqueda de sentido en las personas.
Análisis de la importancia de los modelos de gestión como estrategia de mejora continua en los Gobiernos Autónomos Descentralizados Municipales de la Provincia de Cotopaxi
Authors: Choloquinga Escobar Carmen Marlene 
Published: June 2021

Desde el año 2009, con la implementación del Sistema Nacional de Información pública, coordinado por la Secretaría Técnica de Planificación "Planifica Ecuador" que abarca un conjunto organizado en elementos que permiten a la planificación cumplir con las metas en el desarrollo y las finanzas públicas, resulta importante en los Gobiernos Autónomos Descentralizados Municipales que apliquen un modelo de gestión como un instrumento innovador con la visión de reflejar eficiencia y eficacia a la gestión pública por procesos relacionada a resultados; de esta manera, el presente trabajo de tiene como objetivo analizar la importancia de los modelos de gestión como estrategia de mejora continua en los Gobiernos Autónomos Descentralizados Municipales de la Provincia de Cotopaxi.
Se consideraron puntos importantes que afectan al resultado eficiente en la administración pública y la forma que el indicador de las Necesidades Básicas Insatisfechas territoriales tiene un impacto directo con la ejecución de los presupuestos, eje central en atender la demanda de los habitantes. El trabajo se desarrolló mediante la recolección de datos con encuestas aplicadas a los funcionarios responsables del área/unidad de planificación de los gobiernos municipales y documental, el impacto de la aplicación de un modelo de gestión por procesos permite a los municipios enmarquen su acción en estrategias de mejora continua que lleguen a cumplir con el objetivo que adopten una administración publica eficiente con resultados.
GAMBARAN TINGKAT PENGETAHUAN PERAWAT INSTALASI GAWAT DARURAT (IGD) TENTANG MANAJEMEN KLINIS PASIEN COVID–19 DI RSUD SANJIWANI GIANYAR
Authors: Yundari Hana 
Published: June 2021

Manajemen klinis COVID-19 adalah serangkaian kegiatan yang dilakukan oleh tenaga medis dan tenaga kesehatan untuk menegakkan diagnosis, melaksanakan tata laksana pengobatan dan tindakan terhadap pasien COVID-19. Perawat menjadi petugas kesehatan pertama yang kontak dengan pasien yang terinfeksi SARS-CoV-2, Oleh karena itu perlu memahami tanda dan gejala penyakit secara sistematis untuk memastikan penerapan segera tindakan pencegahan tambahan untuk menghentikan transmisi penularan. Penelitian ini bertujuan untuk mengetahui tentang tingkat pengetahuan perawat IGD RSUD Sanjiwani Gianyar tentang manajemen klinis pasien COVID-19. Penelitian ini menggunakan desain deskriptif, pada 30 sampel melalui teknik total sampling. Instrumen yang digunakan berupa tes kuesioner diolah secara univariat. Pendekatan pengambilan data dengan digital karena pandemi. Penelitian dilakukan tanggal 16 November 2020 sampai 30 November 2020 di IGD RSUD Sanjiwani Gianyar. Hasil penelitian menunjukkan bahwa terdapat 27 responden atau 90% memiliki pengetahuan baik, 1 responden atau 3,3% memiliki pengetahuan cukup dan 2 responden atau 6,7% memiliki pengetahuan kurang. Diharapkan penelitian ini dapat bermanfaat bagi semua tenaga kesehatan untuk meningkatakan perkembangan pengetahuan tentang COVID-19 dan dapat memberikan kontribusi dalam mengevaluai program pelayanan kesehatan.
PENGARUH TUI NA MASSAGE TERHADAP PICKY EATER PADA BALITA USIA 1 s.d 5 TAHUN DI BPM LILIS SURYAWATI JOMBANG
Authors: Meinawati Lusianah 
Published: June 2021

Introduction: Feeding difficulties in children are at high risk of becoming malnourished with age. Parents overcome children's feeding difficulties by giving them a multivitamin without paying attention to the cause. Recently it has been developed from a baby massage technique, namely the Tui Na massage. Objective: To analyze the effect of Tui Na massage on picky eaters. Purpose: Analyzing the effect of Tui Na massage on picky eaters. Method: Quasi experimental research design design. In this study, the experimental group was treated by giving tui na massage and for the control group by giving a multivitamin. The population of this study were all children under five in the working area of ​​the practicing midwife, Lilis Suryawati, totaling 286 children under five. Samples were taken by consecutive sampling method and obtained a total sample size of 50 respondents with a ratio of 1: 1 where the Tuina massage group was 25 people, and the group that was given multivitamins was 25 people. Result: Based on the results of the Wilcoxon statistical test, the p-Value is 0,000. From the p-value of 0.000 (<0.005), it shows that there is an effect of Tui Na massage on increasing appetite for children aged 1 to 5 years. Conclusion: Giving Tui Na massage to toddlers aged 1 to 5 years is more effective in overcoming feeding difficulties than giving multivitamins with a p-value (p = 0.000). Discuss: Parents, especially mothers, can apply Tui Na massage to their toddlers in order to avoid eating difficulties, and toddlers can grow and develop optimally.

Key Word: Tui Na Massage, Picky Eater, Toddler
MODEL PENGEMBANGAN USAHA KESEHATAN GIGI SEKOLAH BINAAN SEBAGAI LAHAN PRAKTIK KERJA LAPANGAN
Authors: Harapan I Ketut , Raule Jean Henry , Kasihani Ni Nyoman 
Published: June 2021

Latar Belakang: Program pemeliharaan kesehatan gigi yang dilaksanakan di sekolah melalui Usaha Kesehatan Gigi Sekolah (UKGS) belum dapat merubah perilaku menggosok gigi siswa menjadi lebih baik dan benar, karena hanya dilaksanakan satu kali dalam satu tahun. Kebiasaan dalam memelihara kesehatan gigi dan mulut dapat diawali melalui pembentukan perilaku sejak dini, dimana masa yang paling tepat untuk menanamkan nilai nilai guna membentuk perilaku positif adalah di sekolah. Tujuan: Menghasilkan Model Pengembangan UKGS Binaan Sebagai Lahan Praktik Kerja Lapangan Jurusan Kesehatan Gigi Poltekkes Kemenkes Manado. Metode : Metode Research and Development merupakan salah satu proses penelitian dalam mengembangkan suatu produk baru atau menyempurnakan produk yang telah ada dan dapat dipertanggung jawabkan. Jenis penelitian deskriptif analitik pretest dan posttest dengan teknik purposive sampling di SD Katolik St. Theresia Manado sebagai sekolah binaan dan SD GMIM 20 Manado sebagai sekolah kelompok control. Hasil : Revitalisasi UKGS dapat dilakukan melalui upaya inovatif dengan Kegiatan UKGS penjaringan kesehatan gigi dan mulut, dilanjutkan dengan penanganan kasus sesuai kompetensi dan rujukan ke kampus JKG atau ke Puskesmas, serta pelatihan dokter kecil. uji statistik menggunakan uji Wilcoxon didapatkan nilai Asymp. Sig(2 tailed) < 0,000 berarti ada pengaruh dengan metode sekolah binaan terhadap indeks kebersihan gigi dan mulut (OHI-S) siswa. Kesimpulan : Implementasi model pengembangan isntitusi melalui UKGS efektif meningkatkan kesehatan gigi dan mulut siswa SD.
Kata Kunci : Model, Pengembangan, UKGS Binaan