bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastroenterologists Adherence to Tumor Necrosis Factor Antagonist Combination Therapy in Inflammatory Bowel Disease
Authors: Abdullah Israa , Alhendi Ghadeer , Alhadab Anwar , Alasfour Hajer , Shehab Mohammad 
Published: September 2021

Introduction: Tumor necrosis factor antagonists (anti-TNF) therapies are used for the management of moderate to severe inflammatory bowel disease (IBD). Anti-TNF combination therapy, with immunomodulators, has been shown to reduce immunogenicity, especially for infliximab, improve treatment success rate and patient outcomes. We evaluated factors associated with gastroenterologists adherence to anti-TNF combination therapy.Methods: A retrospective cohort study was performed to evaluate the adherence of gastroenterologists (n = 14), at an inflammatory bowel disease center, to anti-TNF combination therapy. Records of patients who received Infliximab (n = 137) or adalimumab (n = 152) were obtained and their ordering physicians' data was analyzed. Gastroenterologists were divided into six groups according to their age and interest in IBD. The baseline characteristics of their patients were also obtained.Results: The proportion of patients on combination therapy in the young gastroenterologists group was higher than those in the senior gastroenterologists group for both infliximab (83.2 vs. 55.6%, respectively, P &lt; 0.001) and adalimumab (59 vs. 30.8%, respectively, P &lt; 0.001). Gastroenterologists with interest in inflammatory bowel disease (IBD interest group) had also more proportion of patients on adalimumab combination therapy compared to gastroenterologists with no interest in IBD (non-IBD interest group) (61.7 vs. 35.2%, respectively, P &lt; 0.001). Gastroenterologists who were both young and have interest in IBD had more proportion of patients on combination therapy than those who were senior or had no interest in IBD for both infliximab (89.4 vs. 63.4%, respectively, P &lt; 0.001) and adalimumab (75.9 vs. 33%, P &lt; 0.001). The IBD interest group was also requesting more antidrug antibody level tests than those in the non-IBD interest group (41.4 vs. 12.3 tests, respectively, P &lt; 0.001).Conclusion: Young gastroenterologists are more likely to prescribe anti-TNF infliximab and adalimumab combination therapy than senior gastroenterologists. In addition, gastroenterologists with IBD interest are more likely to prescribe adalimumab combination therapy than gastroenterologists with no IBD interest. Moreover, young gastroenterologists who have interest in IBD are more likely to prescribe both infliximab and adalimumab combination therapy than senior gastroenterologists or those with no IBD interest. In addition, gastroenterologists with IBD interest requested more anti-TNF serum drug concentrations and antidrug antibody level tests than those with no IBD interest.
Acute Angle of Multilobulated Contours Improves the Risk Classification of Thymomas
Authors: Han Xiaowei , Luo Song , Liu Bing , Chen Yue , Gao Wenwen , Wang Yige , Liu Xiuxiu , Yu Hongwei , Zhang Longjiang , Ma Guolin 
Published: September 2021

Background: Computed tomography plays an important role in the identification and characterization of thymomas. It has been mainly used during preoperative evaluation for clinical staging. However, the reliable prediction of histological risk types of thymomas based on CT imaging features requires further study. In this study, we developed and validated a nomogram based on CT imaging and included new indices for individualized preoperative prediction of the risk classification of thymomas.Methods: We conducted a retrospective, multicenter study that included 229 patients from two Chinese medical centers. All the patients underwent cross-sectional CT imaging within 2 weeks before surgery. The results of pathological assessments were retrieved from existing reports of the excised lesions. The tumor perimeter that contacted the lung (TPCL) was evaluated and a new quantitative indicator, the acute angle (AA) formed by adjacent lobulations, was measured. Two predictive models of risk classification were created using the least absolute shrinkage and selection operator (LASSO) method in a training cohort for features selection. The model with a smaller Akaike information criterion was then used to create an individualized imaging nomogram, which we evaluated regarding its prediction ability and clinical utility.Results: A new CT imaging-based model incorporating AA was developed and validated, which had improved predictive performance during risk classification of thymomas when compared with a model using traditional imaging predictors. The new imaging nomogram with AA demonstrated its clinical utility by decision curve analysis.Conclusions: Acute angle can improve the performance of a CT-based predictive model during the preoperative risk classification of thymomas and should be considered a new imaging marker for the evaluation and treatment of patients with thymomas. On the contrary, TPCL is not useful as a predictor for the risk classification of thymomas in this study.
Genetic and Phenotypic Characterization of the Novel Metallo-β-Lactamase NDM-29 From Escherichia coli
Authors: Zhu Ying , Jia Xinmiao , Jia Peiyao , Li Xue , Yang Qiwen 
Published: September 2021

Objectives: The New Delhi metallo-β-lactamase (NDM) can hydrolyze almost all clinically available β-lactam antibiotics and has widely spread all over the world. NDM-29, a novel carbapenemase, was discovered in an Escherichia coli (19NC225) isolated from a patient with biliary tract infection in 2019 in China.Methods: Conjugation, transformation, cloning test, fitness cost, PacBio Sequel, and Illumina sequencing were performed to analyze the genetic and phenotypic characterization of blaNDM–29.Results: The susceptibility testing results showed 19NC225 was resistant to cephalosporins, carbapenems, combinations of β-lactam and β-lactamase inhibitors, and levofloxacin. Conjugation and transformation were performed to verify the transferability of NDM-29-encoding plasmid, and cloning test was conducted to prove the function of blaNDM–29 to increase carbapenem resistance. Furthermore, fitness cost test confirmed that the presence of NDM-29 exerts no survival pressure on bacteria. PacBio Sequel and Illumina sequencing were performed to analyze the genetic characterization of 19NC225, which contains two plasmids (pNC225-TEM1B and pNC225-NDM-29). pNC225-NDM-29, exhibiting 99.96% identity and 100% coverage with pNDM-BTR (an IncN1 plasmid from an E. coli in urine specimen from Beijing in 2013), showed responsibility for the multidrug-resistant (MDR) phenotype. Compared with blaNDM–1, blaNDM–29, located on pNC225-NDM-29, carries a G388A (D130N) mutation. The region harboring blaNDM–29 is located in an ISKpn19-based transposon, and two Tn6292 remnants are symmetrically located upstream and downstream of the transposon. The sequence results also indicated several important virulence genes.Conclusion: The findings of the novel carbapenemase NDM-29 could pose a threat to the control of antimicrobial resistance and arouse attention about the mutation of bacteria.
Trevo 6 × 25mm vs. 4 × 30mm in Mechanical Thrombectomy of M1 LVO
Authors: Oliver Marion John , Brereton Emily , Khan Muhib A. , Davis Alan , Singer Justin 
Published: September 2021

Objectives: Our primary objective was to determine the successful rate of recanalization of M1 large vessel occlusion using either the Trevo 4 × 30 mm or 6 × 25 mm stent during mechanical thrombectomy. Our secondary objectives were to determine differences between the use of these two stent retrievers regarding first-pass effect, periprocedural complications, and mortality in the first 90 days.Methods: This is a retrospective cohort study. Data regarding the stent used, recanalization, number of passes, periprocedural complications, and mortality were determined via our mechanical thrombectomy database along with chart review.Conclusion: When comparing Trevo 4 × 30 mm to 6 × 25 mm stent retrievers used in mechanical thrombectomy for middle cerebral artery large-vessel occlusion causing stroke, there is no statistically significant difference in successful recanalization rates, first-pass effect, perioperative complications, or mortality at 90 days. Studies like this will hopefully lead to further prospective, randomized controlled trials that will help show experts in the field an additional way to perform this procedure effectively and safely.
Development and Validation of a Nomogram to Predict Survival in Pancreatic Head Ductal Adenocarcinoma After Pancreaticoduodenectomy
Authors: Peng Feng , Qin Tingting , Wang Min , Wang Hebin , Dang Chao , Wu Chien-Hui , Tien Yu-Wen , Qin Renyi 
Published: September 2021

BackgroundPancreatic head ductal adenocarcinoma (PHDAC) patients with the same tumor-node-metastasis (TNM) stage may share different outcomes after pancreaticoduodenectomy (PD). Therefore, a novel method to identify patients with poor prognosis after PD is urgently needed. We aimed to develop a nomogram to estimate survival in PHDAC after PD.MethodsTo estimate survival after PD, a nomogram was developed using the Tongji Pancreatic cancer cohort comprising 355 PHDAC patients who underwent PD. The nomogram was validated under the same conditions in another cohort (N = 161) from the National Taiwan University Hospital. Prognostic factors were assessed using LASSO and multivariate Cox regression models. The nomogram was internally validated using bootstrap resampling and then externally validated. Performance was assessed using concordance index (c-index) and calibration curve. Clinical utility was evaluated using decision curve analysis (DCA), X-tile program, and Kaplan–Meier curve in both training and validation cohorts.ResultsOverall, the median follow-up duration was 32.17 months, with 199 deaths (64.82%) in the training cohort. Variables included in the nomogram were age, preoperative CA 19-9 levels, adjuvant chemotherapy, Tongji classification, T stage, N stage, and differentiation degree. Harrell’s c-indices in the internal and external validation cohorts were 0.79 (95% confidence interval [CI], 0.76–0.82) and 0.83 (95% CI, 0.78–0.87), respectively, which were higher than those in other staging systems. DCA showed better clinical utility.ConclusionThe nomogram was better than TNM stage and Tongji classification in predicting PHDAC patients’ prognosis and may improve prognosis-based selection of patients who would benefit from PD.
Public Policy Responses to Address the Mental Health Consequences of the COVID-19 Pandemic: Evidence From Chile
Authors: Irarrazaval Matias , Norambuena Pablo , Montenegro Cristian , Toro-Devia Olga , Vargas Belen , Caqueo-Urízar Alejandra 
Published: September 2021

Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context of countries' responses. Even before the start of the pandemic, there were significant barriers to access mental health services in Chile, coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis.Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics.Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19.Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic.
Education as a Predictor Factor for Knowledge of COVID-19 in Portugal
Authors: Gomes da Silva Joana , Silva Carla Sofia , Alexandre Bárbara , Morgado Pedro 
Published: September 2021

Introduction/Objective: Pandemic of COVID-19 is a major public health problem. At the time of development of this study, no specific medication/vaccine for this disease was approved. Therefore, preventive measures were the main key to control this pandemic. Health literacy (HL) is the ability to obtain, understand and use the information to make free and informed decisions about the health of an individual and to promote community empowerment. Thus, the HL of COVID-19 is important for community empowerment and the adoption of preventive measures. This article aims to understand possible predictors of HL of COVID-19, functional domain.Material and Methods: A cross-sectional study was designed, applying the Questionnaire of COVID-19 (previously designed and submitted to a preliminary pilot testing) through an online platform from April 23 to June 23, 2020. An Index of Health Knowledge of COVID-19 Questionnaire (IHK-COV19) was constructed. Associations between independent variables (“Gender,” “Age,” “Education,” and “Risk Factor” for COVID-19 codified by ICPC-2) and HL were assessed using multivariate analyses (mixed effects models). The level of significance was set at p &lt; 0.05.Results: Our sample includes 864 subjects (median age, 44.33 years), mostly women (n = 619; 71.76%), undergraduate (n = 392; 45.37%) and with at least one risk factor for COVID-19 (n = 266; 30.79%). Univariate and multivariate analyses demonstrated “Age” as a negative predictor of IHK-COV19 and “Education” and “Risk Factor” as positive predictors of IHK-COV19.Conclusions: Health knowledge regarding COVID-19 is associated with the level of education. Future interventions should consider including HL mechanisms in interventions designed to improve communication.
Estudio de la identidad profesional en estudiantes de Marxismo-Historia de la Universidad de Holguín, Cuba
Authors: Rodríguez D´Agostini Katia , Palomo Alemán Adalys Grisell , Medina Carballosa Emma 
Published: September 2021

El objetivo del artículo consistió en presentar los resultados de un diagnóstico, que permitió evaluar la concepción del trabajo para el desarrollo de la identidad profesional pedagógica, en el proceso de formación inicial de los estudiantes de la carrera Licenciatura en Educación Marxismo Leninismo e Historia en la Universidad de Holguín. La metodología utilizada, combinó los enfoques cualitativo y cuantitativo de la investigación. Se alcanzó como resultado, corroborar la existencia de insuficiencias que inciden en la identificación de los estudiantes con la profesión y la carrera y, con ello, demostrar la necesidad de perfeccionar la preparación de los futuros profesores, de manera que logren una participación activa en la transformación de la sociedad, desde la asunción del significado social de su misión.
Do Cues Facilitate Retrieval of Verbs in Persons with Bilingual Aphasia?
Authors: K.S Girish , B.P Abhishek , P Deepak 
Published: September 2021

Word retrieval difficulty is commonly seen in persons with aphasia. The cues would repair word retrieval difficulty. The effect of cues during verb retrieval was gauged via Action Naming Test (ANT) in Kannada and English languages in persons with aphasia (PWAs). A total of eight persons with bilingual Aphasia (Broca's, conduction, and isolation type) were recruited for the study. The participants were expected to have a minimum quantum of verbal output were considered for the study. Specifically, the study used phonemic, semantic, and verbal contextual cues to assess verb retrieval abilities. The result of the study manifested that all participants of the study were able to perform better with phonemic cues followed by semantic and verbal contextual cues in both Kannada and English languages.
Pengaruh Likuiditas, Struktur Modal dan Earning Per Share terhadap Kinerja Keuangan dengan Corporate Social Responsibility sebagai Variabel Intervening
Authors: Mardiana Nana , Hadi Hamdy , Zefriyeni Z 
Published: September 2021

Penelitian ini bertujuan untuk mengetahui seberapa besar Pengaruh Likuiditas, Struktur Modal dan Earning Per Share terhadap Kinerja Keuangan dengan Corporate Social Responsibility sebagai variabel intervening. Penelitian ini menggunakan populasi seluruh perusahaan manufaktur yang terdaftar di Bursa Efek Indonesia periode 2015-2019 dengan 55 sampel perusahaan yang didapat melalui metode purposive sampling. Penelitian ini menggunakan analisis regresi linear berganda. Hasil penelitian menunjukkan bahwasannya Likuiditas (QR) berpengaruh signifikan terhadap CSR, Struktur Modal (DER) berpengaruh signifikan terhadap CSR, Earning Per Share (EPS) tidak berpengaruh signifikan terhadap CSR, QR, DER dan EPS, berpengaruh signifikan terhadap CSR, Likuiditas (QR) berpengaruh signifikan terhadap ROA, Struktur Modal (DER) tidak berpengaruh signifikan terhadap ROA, Earning Per Share (EPS) berpengaruh signifikan terhadap ROA, Corporate Social Responsibility (CSR) berpengaruh signifikan terhadap ROA, QR, DER, EPS melalui CSR tidak berpengaruh signifikan terhadap ROA, Likuiditas (QR) melalui Corporate Social Responsibility (CSR) tidak berpengaruh signifikan terhadap Kinerja keuangan (ROA), Struktur Modal (DER) melalui Corporate Social Responsibility (CSR) tidak berpengaruh signifikan terhadap Kinerja keuangan (ROA), Earning per Share melalui Corporate Social Responsibility (CSR) tidak berpengaruh signifikan terhadap Kinerja keuangan (ROA), Kontribusi QR, DER dan EPS terhadap Corporate Social Responsibility (CSR) sebesar 25%, sedangkan sisanya 75% dipengaruhi oleh variabel lain yang tidak diteliti, Kontribusi QR, DER dan EPS terhadap Kinerja Keuangan (ROA) sebesar 16%, sedangkan sisanya 84% dipengaruhi oleh variabel lain yang tidak diteliti.
Akhir dari penulis menyarankan bahwa Kinerja Keuangan dapat mempengaruhi Likuiditas, Struktur Modal dan Earning Per Share yang dimediasi dengan Corporate Social Responsibility (CSR).
Estudio observacional prospectivo que evalúa la carga de enfermedad del HZ en Colombia
Authors: Rampakakis Emmanouil , Stutz Melissa , Monsanto Homero , Mejía Gonzalo , Zapata-Cárdenas Andrés , Rico Carillo Andrés Eduardo , Molina de Salazar Dora Inés , Pradilla Vesga Oscar Enrique , Johnson Kelly 
Published: September 2021

Introducción: el herpes zóster (HZ) es una enfermedad debilitante que afecta negativamente la calidad de vida (CV). Este estudio buscó describir la carga de la enfermedad por el HZ en Colombia.
Métodos: estudio prospectivo, observacional, de cohorte única realizado en 10 centros clínicos colombianos. Para ser elegibles, los pacientes tenían que ser inmunocompetentes, ≥50 años de edad, y tener un diagnóstico confirmado de HZ en fase aguda o dolor posherpético. Los resultados del estudio incluyeron el inventario breve del dolor por zóster (ZBPI), la CV evaluada con el cuestionario EQ-5D y la utilización de recursos de atención médica (URAM) debido a HZ. El seguimiento fue de 180 días.
Resultados: se incluyeron 154 pacientes con una media (DE) de la edad de 64.6 (9.6) años. La media (DE) del peor dolor agudo fue 8.2 (2.1), mientras la neuralgia posherpética (dolor por HZ ≥3 que persistió ≥90 días) fue reportado por 36.5% de los pacientes. Los predictores significativos del aumento de la carga de dolor fueron la edad avanzada y puntuaciones de peor dolor más altas desde el inicio de la erupción. El aumento en el dolor asociado a HZ estuvo acompañado con reducción significativa en CV, la cual duró aproximadamente 60 días. En términos de la URAM, medicamentos para el HZ y que fueron recetados a 98.7% de los pacientes, incluyendo aciclovir en 85.1% de los pacientes, 79.2% tuvieron un seguimiento por un médico general, 38.2% visitó una sala de emergencia y 29.2% visitó un especialista.
Conclusión: HZ está asociado a carga de enfermedad significativa en Colombia, incluyendo dolor, impacto en la CV y URAM. A medida que la población colombiana envejece, se deben implementar estrategias para manejar y/o prevenir de manera más efectiva la carga asociada
Aféresis terapéutica
Authors: Torres Serrano Rodolfo Eduardo , Roselli-Sanmartín Carlos , Olivares-Algarín Carlos Roberto , Montero-Cetina Camilo , Zambrano-González Diana Marcela , Suárez-Martínez Arnoldo José , Madariaga-Carocci Carlos 
Published: September 2021

Introducción: la aféresis plasmática, ampliamente utilizada, con indicaciones renales y no renales, así mismo con diferentes niveles de evidencia descritos por la Sociedad Americana de Aféresis, siendo un tratamiento antiguo y muy utilizado, en la literatura se disponen de escasos estudios que comparen el uso de las diferentes soluciones de reposición (cristaloides, coloides, plasma, albumina) en cuanto a su respuesta clínica y paraclínica, específicamente en resultados de la función renal.
Objetivo: describir la experiencia de pacientes llevados a aféresis plasmática en una institución de cuarto nivel, haciendo énfasis en los desenlaces de función renal y seguridad, con una nueva estrategia de solución de reposición con voluven.
Métodos: estudio tipo serie de casos, se incluyeron pacientes tratados con plasmaféresis, quienes ingresaron entre enero 2012 y abril 2019 al servicio de nefrología del Hospital San José. Se realizó un análisis descriptivo.
Resultados: se realizaron 608 sesiones de plasmaféresis. La indicación más frecuente el rechazo humoral agudo en el trasplante renal. Al final del periodo de tratamiento, los pacientes en plasma e hidroxietil almidón (hydroxyethyl starch, HES por sus siglas en inglés) presentaron similar proporción de hipocalcemia y trombocitopenia, las pruebas de función renal se conservan normales después del tratamiento.
Conclusión: los efectos secundarios de la aféresis terapéutica como los trastornos hematológicos (alteración de los factores de coagulación, trombocitopenia o anemia), además de hipocalcemia, o posibles alteraciones de la función renal comparados entre los diferentes líquidos de reemplazo plasmático, albúmina o HES, en nuestro trabajo demostró que las alteraciones no son mayores y la función renal se mantiene conservada durante la terapia, además, se encontró que el uso de HES no generó lesión renal aguda, al contrario, se observa estabilidad de la función renal, por lo tanto se debe considerar su uso, siendo un producto de bajo costo, con excelentes resultados clínicos
Nicolai Hartmann’ın Yeni Ontoloji Perspektifinden Ahlâkî Özgürlük Yorumu ve Kant Eleştirisi
Authors: YAVUZ Ziya 
Published: September 2021

Hartmann ahlâkî özgürlüğün açıklanmasında Kant’ın irade özgürlüğü hakkındaki görüşlerini eleştirirken aynı doğrultuda benzer bir yaklaşımla pozitif özgürlüğü (belirlenmemişlik/undeterminiert), negatif özgürlükten (özel tipte belirlenmişlik/plus determination) ayırmak suretiyle yeni bir özgürlük yorumuna ulaşmak istemiştir. O, aksiyolojik belirlenimin değer ilişkisinden yola çıkarak insanın, ontolojik belirlenmişliğini aksiyolojik açıdan aşabileceğini ve buna bağlı olarak da aşkın bir determinasyon formu içinde değer duygusuna dayalı olarak kendisine amaçlar koyabileceğini ve böylece özgür olabileceğini savunmuştur. Ayrıca o, Alman idealistlerinin özgürlük hakkındaki mutlak tinin sonsuz etkinliği şeklindeki özgürlüğü bir geist varlığına bağlayan görüşlerine karşı özgürlüğü, hukuksal özgürlük, ahlaki özgürlük, bireysel özgürlük, içsel ve dışsal özgürlük, eylem ve irade özgürlüğü gibi farklı boyutlarda ele alarak onu insana ait bir değer olarak görmüştür.