bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reconstrucción de la pared abdominal en pacientes con inmunosupresión: experiencia en una institución de alta complejidad
Authors: Márquez-Duque Juan Manuel , Cabrera-Rivera Paulo Andrés 
Published: August 2021

Introducción. Los pacientes con inmunosupresión llevados a cirugía abdominal convencional tienen un mayor riesgo de desarrollar hernias incisionales en el posoperatorio, y cuando ellas ocurren, es necesario individualizar el procedimiento quirúrgico de elección, según las características anatómicas, fisiológicas y clínicas de cada paciente. Este estudio describe las características demográficas y clínicas de los pacientes con inmunosupresión, llevados a reconstrucción de la pared abdominal, y sus desenlaces después de 30 días del procedimiento quirúrgico.
Métodos. Serie de casos de pacientes con inmunosupresión llevados a reconstrucción de la pared abdominal, en un centro especializado de cuarto nivel de complejidad. Se incluyeron pacientes mayores de 18 años, operados en el período de enero de 2016 a diciembre de 2019.
Resultados. Se presenta una serie de 18 pacientes, cinco (27,7 %) con algún tipo de inmunosupresión primaria y 13 (72,2 %) con algún tipo de inmunosupresión secundaria. La edad promedio fue de 56 años, 11 (61 %) fueron mujeres, el peso promedio de los participantes fue de 73,3 kg. Se encontraron complicaciones en ocho pacientes (44,4 %). Dos pacientes requirieron manejo en la Unidad de Cuidados Intensivos, por un máximo de tres días. Ninguno de los pacientes presentó recidiva de la hernia ni mortalidad.
Discusión. La reconstrucción de la pared abdominal en pacientes inmunosuprimidos representa un reto para cualquier equipo quirúrgico debido a las condiciones especiales de los pacientes y a las variables asociadas al procedimiento. Las tasas de recidiva y de complicaciones de este estudio, se asemejan a las descritas en la literatura.
Adenocarcinoma indiferenciado como factor predictor de metástasis ganglionares en cáncer gástrico
Authors: García Ana María , Sánchez William 
Published: August 2021

Introducción. El grado de diferenciación celular en el estudio histopatológico del adenocarcinoma gástrico está descrito como un factor pronóstico determinante en el comportamiento clínico del tumor. El adenocarcinoma gástrico indiferenciado es considerado una variante agresiva de mal pronóstico, que se correlaciona con una alta tasa de metástasis ganglionares.
Métodos. Estudio prospectivo descriptivo de una serie de casos en el cual se analizan los pacientes con adenocarcinoma gástrico indiferenciado, que fueron llevados a cirugía radical con gastrectomía y linfadenectomía DII y su correlación con la presencia de metástasis ganglionares en un período de dos años.
Resultados. De enero de 2018 a enero de 2020 se recolectaron en la base de datos 113 pacientes con adenocarcinoma gástrico a quienes se les practicó gastrectomía total, disección ganglionar DII y reconstrucción esofagoyeyunal terminolateral con técnica de Orr más Y de Roux. Fueron clasificados histológicamente como adenocarcinoma gástrico indiferenciado 41 pacientes (36,3 %). La edad promedio de este grupo fue de 56 años con un rango entre 28-92 años. De ellos 30 fueron hombres (73 %) y 11 mujeres (27 %). El número promedio de ganglios linfáticos analizados por espécimen fue de 24. De los 41 pacientes con adenocarcinoma gástrico indiferenciado, 35 (85 %) tuvieron metástasis ganglionares, con 382 ganglios positivos en total, con un rango entre 1-38 y un promedio de 11 ganglios linfáticos positivos por espécimen.
Discusión. En esta serie el adenocarcinoma gástrico indiferenciado se presentó en el 36,3 % de los casos y se correlacionó con un 85 % de presencia de metástasis ganglionares en estadios T3-T4.
КОРПОРАТИВНІ ОБЛІГАЦІЇ ЯК ДЖЕРЕЛО РОЗВИТКУ ФІНАНСОВОГО ПОТЕНЦІАЛУ СУБ’ЄКТІВ ГОСПОДАРЮВАННЯ
Authors: Середа Олена Олександрівна 
Published: August 2021

The success of business entities depends on the ability to attract the necessary amount of financial resources to carry out activities. One of the most important issues in raising capital through the issuance of corporate bonds is to identify the factors and trends that affect this process in the context of developing the financial potential of economic entities. The aim of the research is to analyze the current state of the issue activity of business entities and determine the impact of the issue of corporate bonds on the capital formation of business entities. The subject of the research is the formation of capital through the issuance of bonds in the context of the development of the financial potential of economic entities. The methods of the research: generalization, comparison, trend analysis, trend models. The statement of basic materials. The article highlights the features of corporate bonds as an additional source of development of the financial potential of economic entities. The state and dynamics of issue activity of business entities on bond issue and activity on the secondary market of corporate bonds are analyzed. A nonlinear regression model has been formed, which reflects the dynamics of emission activity of economic entities. A polynomial model of capital dependence on bond issues of economic entities has been built. The practical significance of the research lies in the possibility of applying the built models in the process of forming a strategy of financial regulation of the development of economic entities. Conclusions and perspectives of further research. Corporate bonds are a potential source of financing for the development of economic entities. Trend analysis of the issue activity of enterprises on the issue of corporate bonds indicates the underdevelopment of this segment of the stock market. In the process of studying the financial potential of the development of economic entities should take into account the dependence of the formed capital and emission activity, activity in the secondary market of bonds of economic entities. The constructed models of nonlinear regression of the dynamics of bond issues and the polynomial model of the dependence of capital on bond issues of economic entities will increase the objectivity of forecasting.
Efficacy and Safety of Different Aerobic Exercise Intensities in Patients With Heart Failure With Reduced Ejection Fraction: Design of a Multicenter Randomized Controlled Trial (HF-EI Trial)
Authors: Shen Ting , Liu Xiaoling , Zhuang Bo , Luo Qian , Jin Yishan , Li Guanghe , Jiang Yumei , Li Dejie , Chen Xianchuan , Tang Nuo , Xu Zhimin , Wang Lemin , Zheng Liang , Shen Yuqin 
Published: August 2021

Background:Heart failure (HF) is one of the major causes of mortality worldwide, representing the terminal stage of several cardiovascular diseases. Exercise-based rehabilitation is a beneficial therapy for patients with chronic heart failure (CHF). However, there is a lack of specific guidance on clinical decision-making regarding optimal exercise intensity. It is necessary to optimize the clinical recommendations for HF exercises. We will evaluate the efficacy and safety of different aerobic exercise intensities in patients with heart failure with reduced ejection fraction (HFrEF): the HF-EI trial. This trial aims to assess the appropriate exercise intensity for patients with HFrEF.Methods:After a baseline assessment to determine the safety of exercise, 180 patients will be randomly assigned to supervised high-intensity exercise training (ET) group, supervised moderate intensity training (MIT) group, and control group at a ratio of 1:1:1. Patients randomly receiving high intensity training (HIT) undergo supervised ET (3 times/week, 30 min) for aerobic endurance at 70% peak oxygen consumption (peak VO2) intensity for 12 weeks. The MIT patients will perform supervised aerobic ET (3 times/week, 35–42 min) at the anaerobic threshold (AT) intensity for 12 weeks. The control group will continue to maintain their daily activities and will not receive ET. During the baseline and follow-up period, physical examination, laboratory tests, cardiology diagnostic tests, cardiopulmonary exercise tests (CPET), 6-min walk distance (6MWD), scale scores, exercise steps, medications, and clinical events will be monitored. Throughout the research, sport bracelets and patient diaries will be used to monitor and record overall physical activity, training courses, and compliance.Discussion:The HF-EI trial will evaluate the effects of different aerobic exercise intensities on peak VO2, quality of life (QoL), and clinical events among patients with HFrEF. The findings of this trial will provide a basis for formulating exercise prescriptions for patients with HFrEF.Clinical Trial Registration:http://www.chictr.org.cn/, identifier: ChiCTR2000036381.
Combined Algorithm-Based Adaptations of Insulin Dose and Carbohydrate Intake During Exercise in Children With Type 1 Diabetes: Results From the CAR2DIAB Study
Authors: Lysy Philippe Antoine , Absil Hélène , Gasser Emy , Boughaleb Hasnae , Barrea Thierry , Moniotte Stéphane 
Published: August 2021

ObjectivesTo evaluate the evolution of subcutaneous glucose during two sessions of monitored aerobic exercise in children or adolescents with type 1 diabetes after adaptation of insulin doses and carbohydrate intake according to a combined algorithm.MethodsTwelve patients with type 1 diabetes (15.1 ± 2 years; diabetes duration: 9.5 ± 3.1 years) performed two series of exercise sessions after cardiac evaluation. The first series (TE#1) consisted in a monitored exercise of moderate to vigorous intensity coupled with a bout of maximum effort. The second series of exercises (TE#2) was carried out in real life during exercises categorized and monitored by connected watches. TE#2 sessions were performed after adaptation of insulin doses and fast-acting carbohydrates according to decision algorithms.ResultsPatients did not experience episodes of severe hypoglycemia, symptomatic hyperglycemia, or hyperglycemia associated with ketosis. Analysis of CGM data (15 h) during TE#2 sessions revealed an overall improvement in glycemic average [± standard deviation] (104 ± 14 mg/dl vs. 122 ± 17 mg/dl during TE#1; p &lt; 0.001), associated with a decrease in proportion of hyperglycemia in periods ranging from 4 h to 15 h after performing the exercises. The proportion of hypoglycemia was not changed, except during the TE#2 +4–8 h period, where a significant increase in hypoglycemia &lt;60 mg/dl was observed (25% vs. 6.2%; p = 0.04), yet without concurrent complications.ConclusionIn our pediatric series, the application of algorithmic adaptations of insulin doses and carbohydrate intake has globally improved glycemic control during 15 h after real-time exercises performed by children and adolescents with type 1 diabetes.
Drug and Neurofilament Levels in Serum and Breastmilk of Women With Multiple Sclerosis Exposed to Natalizumab During Pregnancy and Lactation
Authors: Proschmann Undine , Haase Rocco , Inojosa Hernan , Akgün Katja , Ziemssen Tjalf 
Published: August 2021

ObjectiveTo determine the transfer of the monoclonal antibody natalizumab into breastmilk and to evaluate drug and serum neurofilament light chain ((s)NfL) levels in natalizumab exposed pregnancies and lactation periods.MethodsEleven women with relapsing remitting multiple sclerosis treated with natalizumab during pregnancy and lactation were included in this study. Breastmilk samples were collected up to 302 days after delivery and analyzed for natalizumab concentration and NfL. Additionally, maternal drug levels and sNfL were determined preconceptually, in each trimester, at delivery and postpartum. Clinical and radiological disease activity was systemically assessed across pregnancy and postpartum period.ResultsThe mean average natalizumab concentration in breast milk was low at 0.06 µg/ml [standard deviation (SD) 0.05] in the eight patients who provided serial breastmilk samples with an estimated mean absolute infant dose of 0.007 mg/kg/d (SD 0.005). The relative infant dose (RID), a metric comparing the infant with maternal drug exposure was low as well with a mean of 0.04% (SD=0.03). Most patients had a maximum concentration in breast milk at one to eight days after infusion. Pregnancy was associated with a non-significant decline of the median natalizumab serum concentration. All patients exposed to natalizumab prior (n=10) and during pregnancy (n=11) kept free of disease activity during gestation. While pregnancy was associated with low sNfL levels in patients treated with natalizumab prior and during pregnancy, the postpartum period was linked to a transient sNfL increase in some patients without any evidence of clinical or radiological disease activity. NfL was detectable in the majority of breastmilk samples with a median concentration of 1.7 pg/ml (range 0.004-18.1).ConclusionWe determined transfer of natalizumab into breastmilk with an RID far below the threshold of concern of 10%. Studies including childhood development assessment are needed in order to gain safety data about natalizumab-exposed breastfeeding. SNfL assessment might be a useful adjunct to monitor silent disease activity and therapeutic response during pregnancy and postpartum period. However, further investigations regarding transient postpartum sNfL increases are required to determine its association to parturition per se or to a silent disease activity in people with multiple sclerosis.
RNA Sequence Profiling Reveals Unique Immune and Metabolic Features of Breast Cancer Brain Metastases
Authors: Xiao Limei , Zhou Jie , Liu Hongyi , Zhou Yuanyuan , Chen Weibin , Cui Wugeng , Zhao Yilin 
Published: August 2021

There is an urgent need to improve our understanding of breast cancer brain metastases (BCBMs). Thus, we obtained transcriptome data of BCBMs, primary breast cancers (BCs), and extracranial metastases (BCEMs) from the Gene Expression Omnibus (GEO) database, including GSE43837, GSE14017, and GSE14018, for immune and metabolic analysis. Firstly, we performed immune and metabolic analysis on BCBMs and primary breast cancers of GSE43837 using RNA sequence. We identified significant immunosuppression and gene signatures associated with immune infiltration in BCBMs; the lower the expression of the signatures, the worse the prognosis of breast cancer patients in the Kaplan–Meier (KM) plotter [Breast cancer] database. We also identified increased oxidative phosphorylation (OXPHOS) utilization in BCBMs compared with BCs and gene signatures associated with increased OXPHOS utilization in BCBMs; the higher the expression of the signatures, the worse the prognosis of breast cancer patients in the KM plotter [Breast cancer] database, which can predict the prognosis of breast cancer patients better, as it can also predict the prognosis of patients with different breast cancer subtypes. In addition, we performed immune and metabolic analysis on BCBMs and extracranial metastases of GSE14017 and GSE14018 using RNA sequence. Compared with extracranial metastases, we identified more significant immunosuppression but no difference in OXPHOS utilization in BCBMs, which may be because OXPHOS was also involved in extracranial metastases. We have proven that OXPHOS was functionally significant in metastasis in vitro assays. Oligomycin, an OXPHOS inhibitor, substantially attenuated the migration and invasion potential of breast cancer cells. Our study provides new insights into the pathogenesis of BCBMs.SignificanceOur study reports the most comprehensive gene expression analysis of BCBMs, BCs and extracranial metastases to date. We identified immunosuppression and OXPHOS enrichment in BCBMs compared with BCs, which provide new insights into the pathogenesis of BCBMs and will facilitate the development of new therapeutic strategies for patients with BCBMs.
Virtual Physical Education During COVID-19: Exploring Future Directions for Equitable Online Learning Tools
Authors: D'Agostino Emily M. , Urtel Mark , Webster Collin A. , McMullen Jaimie , Culp Brian 
Published: August 2021

Introduction: School closures prompted by the COVID-19 pandemic reduced opportunities for US youth to be physically active and disproportionately impacted health disparities in this population. Physical education provides the largest intervention to support the physical activity of school-aged youth, but teachers' opinions about how to maintain quality programming during virtual learning periods remain unexplored. Applying a diversity, equity and inclusion framework, this study explored physical education teachers' perceived significance of different design features for an online teaching tool to promote physical activity equity during school closures.Methods: Previous literature and focus groups informed the development of a survey administered in summer/fall 2020. Survey participants (n = 60) were physical education teachers from 400 randomly selected US preschool-12th grade schools drawing from a national database. Participants rated the significance of four design features in relation to five key attributes of an online supplement to in-person physical education programs. One-way ANOVAs were used to assess differences in teachers' ratings by demographic characteristics.Results: Between-group differences were found in teacher ratings of design features related to the usability, accessibility, equitability, and formal assessment capabilities of an online physical education tool. Differences were based on teacher gender, school level, and geographic location.Conclusions: Future research to promote physical activity equity among preschool-12th grade youth should examine tailored virtual physical education learning tools that address what teachers perceive to be the most significant design features to support equitable physical education among diverse student groups.
The influence of Price, Innovation, and Brand Image on Purchase Decision
Authors: Pascaselnofra Amril Alwa 
Published: August 2021

This study aims to determine how big the influence of price, innovation and brand image partially or jointly on purchasing decisions. The method of data collection was through questionnaires with a sample of 95 students from the Faculty of Economics, Universitas Negeri Padang, Department of Management. The method used is multiple regression analysis. The results of the correlation analysis test show that there is a significant relationship between price, innovation and brand image on purchasing decisions for LENOVO products. The results of the multiple linear regression analysis were obtained: (a) There is a negative and significant effect between price on purchasing decisions, as evidenced by the value of t-statistic < t-table (-2.627 < 1.986). (b) There is a positive and significant influence between innovation on purchasing decisions, as evidenced by the value of t-statistic > t-table (4.494 > 1.986). (c) There is a significant influence between brand image on purchasing decisions, as evidenced by the value of t-statistic > t-table (4.631 > 1.986). Then based on the joint hypothesis test (F test) it can be seen that the value of F-statistic > F-table (21.902 > 2.70). So the author concludes that price, innovation and brand image have a significant effect on purchasing decisions and the result of Determination (R2) the value is 0.419 this shows that the contribution of the influence of the variables studied in this study is 41.9% and the remaining 58.1% is influenced by the variables others outside of this study.
Understanding the Role of Health Workers in the LF Elimination Program in Kenya: Challenges Faced and Suggestions for Improved Program Performance
Authors: Kimani Bridget W , Kibe Lydiah Wanjiku , Okoyo Collins , Omondi Wyckliff P , Sultani Hadley Matendechero , Njomo Doris Wairimu 
Published: August 2021

The Kenyan Ministry of Health and its partners through the Division of Vector-Borne and Neglected Tropical Diseases, is in charge of the Lymphatic Filariasis Mass Drug Administration programme. This is implemented through the national, county, and sub-county neglected tropical diseases coordinators. The current study sought to understand the roles, challenges faced and suggestions of how program performance can be improved by the community health extension workers, county and sub-county neglected tropical diseases coordinators. Two wards of the Kaloleni sub-county; Kilifi County were purposively selected. In 2015, Kaloleni and Kayafungo wards had a treatment coverage of 58% and 54% respectively; 62% and 39% respectively in 2016, all below the recommended minimum treatment coverage of 65%. Qualitative data was collected through sixteen in-depth interviews with community health extension workers and two semi-structured interviews with the county and sub-county neglected tropical diseases coordinators. Data were analysed by QSR NVIVO version 10 according to identified themes. The study results show the various roles in planning and implementation of the program include; supply chain management; health information education communication and records management; health workforce training and management, leadership and governance, and service delivery. Challenges faced included insufficiency of drugs supplied and information education communication materials, the inadequacy of community drug distributors selected and trained, poor facilitation for training and supervision of community drug distributors, limited duration of the mass drug administration, and delayed reporting due to poor network coverage. The results of this study show that the community health extension workers, county and sub-county neglected tropical diseases coordinators are not fully involved in program leadership and governance, a role that is taken up at the national level. They should be involved in all the stages of the mass drug administration program to create ownership to improve the program performance
Suojeluskuntaperinnetyön organisaatiot ja ulottuvuudet 1944–2021
Authors: Kleemola Olli 
Published: August 2021

Suojeluskunnat lakkautettiin syksyllä 1944 Neuvostoliiton vaatimuksesta ja välirauhansopimuksen nojalla. Etenkin suojeluskunnissa toimineet kokivat lakkautuspäätöksen epäoikeudenmukaiseksi, ja syntyi halu ylläpitää suojeluskunta-, lotta- ja suojeluskuntiin kiinteästi liittyneen sotilaspoikajärjestön perinnettä. Tässä tutkimuksessa tarkastellaan suojeluskuntien lakkauttamisen jälkeen tehtyä, suojeluskuntaperheen eri jäseniin liittyvää perinnetyötä eli järjestöihin liittyvän kulttuuriperinnön säilyttämiseen tähtääviä toimenpiteitä.
Tutkimuksen tavoitteena on tarkastella yhtäältä perinnekentän muotoutumista eli perinnetyön organisoitumista eri järjestöihin. Toisaalta tarkastelun kohteena ovat perinnetyön sisällöt eli se, mitä toimia perinnekentällä on tehty kulttuuriperinnön siirtämiseksi. Tutkimuksen kolmantena ulottuvuutena on perinnetyön aineellinen ulottuvuus, eli minkälaista esineistöä tai aineistoa perinnekentän toimijat ovat tuottaneet perinnekentän tarpeisiin. Näiden kolmen ulottuvuuden avulla pyritään luomaan kokonaiskuva perinnetyön kehityksestä sodanjälkeisistä ajoista nykypäivään. Tutkimuksen aikahorisontti ulottuu vuodesta 1944 eli suojeluskunta- ja lottajärjestön lakkauttamisesta nykypäivään.Tutkimus avaa merkittäviä näkökulmia kansallisen maanpuolustushistoriallisen yhdistyskentän muotoutumiseen ja maanpuolustushistoriallisen kiinnostuksen ja perinnetyön merkityksen kasvuun viime vuosikymmeninä sekä yleensä perinnetyön merkitykseen suomalaisessa yhteiskunnassa.