bluuebunny/crossref_metadata_2025_split huggingface dataset:
O risco de dietas veganas em idade gestacional e pediátrica: hipóteses, evidências e recomendações
Authors: Silva Carlos Daniel , Figueiredo Bárbara Queiroz de , Souto Bárbara Oliveira Vasconcelos , Araújo Ana Paula Ferreira , Coury Bruno Faria , Bomfim Karenn Cristina Neves , Sousa Kerolyn Keshyley de , Miranda Luana Damaceno , Gaia Matheus Gontijo Guimarães , Fernandes Sarah Rabelo , Oliveira Rúbia Carla 
Published: August 2021

Introdução: A alimentação onívora é de suma importância para o desenvolvimento das crianças, principalmente até os nove anos de idade, visto que, é por meio de suplementações presentes em artigos animais, majoritariamente, que desenvolvem capacidades cognitivas, motoras, sensitivas e linguísticas do infante. Assim, uma dieta restritiva pode vir a comprometer o natural desenvolvimento da criança, devido a carência calórica-proteica, sinalizada por meio de fadigas, falta de concentração, falhas na memória, alucinações, icterícias e redução nas capacidades cognitivas, deficiências. Objetivo: Rever a bibliografia atual, a mais relevante e disponível em formato online, sobre os riscos hipotéticos e empíricos, bem como recomendações das dietas vegetarianas em idade gestacional e pediátrica. Métodos: Trata-se de uma pesquisa descritiva do tipo revisão integrativa da literatura. Resultados: Crianças que mantém uma dieta restrita ao veganismo, têm maiores riscos de défices fisiológicos. Sob essa perspectiva, deve haver um equilíbrio do aporte de nutrientes, tendo em conta o estado de desenvolvimento da criança, para assegurar um harmonioso crescimento e desenvolvimento. Conclusão: Diante da escolha de inserir uma criança, mesmo nos primeiros anos de vida, numa dieta vegetariana ou vegana, o trabalho do pediatra é respeitar e aconselhar a família, alertando sobre seus riscos. Para isso, a consulta periódica ao pediatra e nutricionista é eminentemente necessária.
Avaliação do uso do agregado reciclado da construção civil como barreira hidráulica em camadas de coberturas de aterros sanitários
Authors: Nascimento Elivelthon Carlos do , Lafayette Kalinny Patricia Vaz , Silva Luciana Cassia Lima da , Bezerra Jonas da Silva , Portela Maria Fernanda de Almeida 
Published: August 2021

As camadas de cobertura de aterro sanitário têm a função de impedir a entrada de líquidos bem como evitar a saída de gases. Geralmente são construídas com solos argilosos compactados e de baixa condutividade hidráulica. Neste sentido, esta pesquisa tem como objetivo avaliar a viabilidade do uso de misturas resíduos da construção e demolição (RCD) com solo, para ser utilizado como barreira hidráulica em cobertura final de aterros sanitários. Para isso, foi utilizado um solo argiloso de uma antiga área de extração de saibro desativada a mais de 30 anos, em uma encosta localizada na Ilha de Itamaracá-PE, Região Metropolitana do Recife (RMR). As misturas utilizadas foram de 10%, 30% e 50 % de solo e RCD. O programa de investigação contou com ensaios de caracterização física, mecânica e mineralógica, além de ensaios de erodibilidade. Nos ensaios de caracterização física, o solo foi classificado com uma argila de alta plasticidade e o RCD como um material arenoso, cuja adição ao solo provocou uma diminuição do teor de finos do solo até chegar numa argila medianamente plástica, resultados esses, confirmados nos ensaios de Limites de Atterberg. As condutividades hidráulicas saturadas dos solos e das misturas foram da ordem de 10-9m/s. Os parâmetros de resistência à compressão simples das misturas foram superiores à resistência máxima do solo, tendo alcançado o seu maior valor na mistura de 30%. Quanto à erodibilidade os ensaios de crumb test e pinhole test indicaram que o solo estudado não apresenta tendência erodível. O acréscimo de RCD diminui a expansibilidade do solo. Desta forma, conclui-se que mistura deste solo específico da região com o RCD é viável para utilização como barreira hidráulica, sendo a mistura de 50% a que apresentou os melhores resultados.
Cuidados de enfermagem ao paciente com úlcera venosa: revisão integrativa
Authors: Vieira Marcos Israel dos Santos , Beheregaray Filipe , Nunes Maurício Rouvel , Silva Kelly de Souza da 
Published: August 2021

Introdução: As úlceras venosas são definidas como lesões crônicas em membros inferiores, sendo mais comum nas pernas. Os indivíduos portadores de úlceras crônicas nos membros inferiores têm um impacto significativo na sua qualidade de vida oriundo da problemática das lesões crônicas. Objetivo: Descrever as evidências científicas disponíveis na literatura sobre os cuidados de enfermagem ao paciente com úlcera venosa. Métodos: Trata-se de uma revisão integrativa da literatura, no período de 2016 a 2021, nas bases de dados Lilacs e BDENF. Foram utilizados os seguintes descritores nas bases: “Úlcera Varicosa”, “Enfermagem”, “Cuidados de Enfermagem”. Para o cruzamento dos descritores, utilizou-se um protocolo com o booleano AND. Como critérios de inclusão foram selecionados artigos disponíveis nas bases de dados e com texto completo e de livre acesso e estudos disponíveis em português. Os critérios de exclusão foram editoriais de revistas, cartas ao editor e estudos que não abordavam a temática do trabalho. Resultados: Após filtragem com base no fluxograma definido, foram selecionados dez artigos conforme critérios estabelecidos. Após a leitura e análise dos artigos, emergiram duas categorias temáticas, os quais foram: “Cuidados de Enfermagem na Úlcera Venosa” e “Gerenciamento do Cuidado de Enfermagem”. Conclusão: conclui-se que o controle das doenças crônicas não transmissíveis associado ao uso de curativos e o manejo da dor são fundamentais no tratamento das úlceras venosas.
A metodologia sociológica contemporânea de Pierre Bourdieu e seus impactos sustentáveis nos modelos de gestão das organizações de saúde do Século XXI
Authors: Alves Joemar Braga , Silvino Zenith Rosa 
Published: August 2021

O presente estudo irá procurar investigar as aplicações da sociologia contemporânea de Bourdieu e seus impactos sustentáveis nos modelos de gestão das organizações de saúde do século XXI. O objetivo deste estudo será apreender sentidos e abordagens na literatura científica acerca do tema, visando contribuir com investigações para melhor aproveitamento das aplicações da sociologia contemporânea de Pierre Bourdieu nos modelos de gestão organizacionais em saúde. Como base de dados serão consultadas as dissertações de mestrado e doutorado, livros e artigos científicos pesquisados nos temas, nas bases Capes, Scielo, e outras, do período em que surge até os tempos atuais do século XXI. No desenvolvimento do estudo irá se realizar os levantamentos, sistematizações e análises do histórico das aplicabilidades da sociologia contemporânea de Bourdieu e seus impactos nos modelos de gestão das organizações da saúde do século XXI, de forma que ao fim desse estudo, permita-se formular propostas de melhoria dos modelos de gestão empregados nas organizações de saúde à luz da análise crítica do que foi produzido, tendo como foco as relações que discutem a sociologia reflexiva de Bourdieu e o mundo organizacional.
Rheumatic diseases and coronavirus infection: levilimab use experience
Authors: Kalinina E. V. , Lekareva I. V. , Zvonorenko M. S. , Emelianova A. L. , Kostryukova I. V. , Scherbinina E. V. , Babaeva A. R. 
Published: August 2021

Background. Rheumatic diseases (RD) of autoimmune origin are considered as an important risk factor for infectious processes due to characteristic native immune system disorder, as well as due to the adverse effect of immunosuppressants and glucocorticoids on the mechanisms of anti-infective protection.Aim. To highlight the problem of RD and concomitant viral infection which becomes critical in the era of COVID‑19.Results. According to the current national guidelines for the management of patients with COVID‑19, patients with RD represent an increased risk group for the adverse course of coronavirus infection. Presented article provides basic information on the use of interleukin‑6 (IL‑6) inhibitors in patients with COVID‑19 focusing on the benefit of this therapeutic option in those with prior RD. The article presents an analysis of two clinical cases demonstrating high efficacy and good tolerability of levilimab (Ilsira®) in the treatment of coronavirus pneumoniae in the setting of autoimmune diseases: polymyositis (PM) and rheumatoid arthritis (RA).Conclusion. Our own clinical experience confirms the feasibility of including an IL‑6 receptor inhibitor in the treatment regimen for coronavirus pneumonia in patients with RD characterized of immune inflammation.
Advances in Biosensors for Continuous Glucose Monitoring Towards Wearables
Authors: Johnston Lucy , Wang Gonglei , Hu Kunhui , Qian Chungen , Liu Guozhen 
Published: August 2021

Continuous glucose monitors (CGMs) for the non-invasive monitoring of diabetes are constantly being developed and improved. Although there are multiple biosensing platforms for monitoring glucose available on the market, there is still a strong need to enhance their precision, repeatability, wearability, and accessibility to end-users. Biosensing technologies are being increasingly explored that use different bodily fluids such as sweat and tear fluid, etc., that can be calibrated to and therefore used to measure blood glucose concentrations accurately. To improve the wearability of these devices, exploring different fluids as testing mediums is essential and opens the door to various implants and wearables that in turn have the potential to be less inhibiting to the wearer. Recent developments have surfaced in the form of contact lenses or mouthguards for instance. Challenges still present themselves in the form of sensitivity, especially at very high or low glucose concentrations, which is critical for a diabetic person to monitor. This review summarises advances in wearable glucose biosensors over the past 5 years, comparing the different types as well as the fluid they use to detect glucose, including the CGMs currently available on the market. Perspectives on the development of wearables for glucose biosensing are discussed.
Time to Detection of Growth for Mycobacterium tuberculosis in a Low Incidence Area
Authors: Vongthilath-Moeung Rechana , Poncet Antoine , Renzi Gesuele , Schrenzel Jacques , Janssens Jean-Paul 
Published: August 2021

BackgroundDiagnosis of Mycobacterium tuberculosis (MTB) infection can be confirmed by Xpert assays within hours. However, when sample size does not allow performing both culture and Xpert, or if Xpert is negative, then formal diagnosis of MTB relies on culture and time to detection of growth (TDG) becomes critical for clinical management.ObjectivesTo determine TDG in Xpert negative samples, or in samples in which Xpert could not be performed, in a low-incidence area for MTB.MethodsRetrospective analysis (2015-2020) of a database including all cultures for mycobacteria in a University Hospital covering approximately 500’000 inhabitants. Analysis was restricted to culture positive (C+) samples for MTB for which 1/Xpert was negative or could not be performed because of limited sample volume, and 2/collected from subjects treated less than 24 hours. TDG was analyzed according to microscopy, origin of sample (pulmonary or not) and presence of cavitation.ResultsAmong 837 C+ samples for MTB, 236 samples (80% of respiratory origin) from 147 patients fulfilled study criteria; 78 samples (49 patients, 33%) were acid-fast bacilli (AFB) positive. Median (IQR) TDG was 25 (17; 40) days for all samples. TDG exceeded 28 days in 43% of samples and was significantly shorter in AFB+ vs AFB- samples, and samples from cavitary vs non cavitary or extra-thoracic disease.ConclusionsIn Xpert negative samples, or samples for which Xpert could not be performed, TDG exceeded 4 weeks in 43% of samples. AFB+ and samples from cavitary lung disease had a significantly shorter TDG.
Preclinical Testing of Living Tissue-Engineered Heart Valves for Pediatric Patients, Challenges and Opportunities
Authors: Movileanu Ionela , Harpa Marius , Al Hussein Hussam , Harceaga Lucian , Chertes Alexandru , Al Hussein Hamida , Lutter Georg , Puehler Thomas , Preda Terezia , Sircuta Carmen , Cotoi Ovidiu , Nistor Dan , Man Adrian , Cordos Bogdan , Deac Radu , Suciu Horatiu , Brinzaniuc Klara , Casco Megan , Sierad Leslie , Bruce Margarita , Simionescu Dan , Simionescu Agneta 
Published: August 2021

Introduction: Pediatric patients with cardiac congenital diseases require heart valve implants that can grow with their natural somatic increase in size. Current artificial valves perform poorly in children and cannot grow; thus, living-tissue-engineered valves capable of sustaining matrix homeostasis could overcome the current drawbacks of artificial prostheses and minimize the need for repeat surgeries.Materials and Methods: To prepare living-tissue-engineered valves, we produced completely acellular ovine pulmonary valves by perfusion. We then collected autologous adipose tissue, isolated stem cells, and differentiated them into fibroblasts and separately into endothelial cells. We seeded the fibroblasts in the cusp interstitium and onto the root adventitia and the endothelial cells inside the lumen, conditioned the living valves in dedicated pulmonary heart valve bioreactors, and pursued orthotopic implantation of autologous cell-seeded valves with 6 months follow-up. Unseeded valves served as controls.Results: Perfusion decellularization yielded acellular pulmonary valves that were stable, no degradable in vivo, cell friendly and biocompatible, had excellent hemodynamics, were not immunogenic or inflammatory, non thrombogenic, did not calcify in juvenile sheep, and served as substrates for cell repopulation. Autologous adipose-derived stem cells were easy to isolate and differentiate into fibroblasts and endothelial-like cells. Cell-seeded valves exhibited preserved viability after progressive bioreactor conditioning and functioned well in vivo for 6 months. At explantation, the implants and anastomoses were intact, and the valve root was well integrated into host tissues; valve leaflets were unchanged in size, non fibrotic, supple, and functional. Numerous cells positive for a-smooth muscle cell actin were found mostly in the sinus, base, and the fibrosa of the leaflets, and most surfaces were covered by endothelial cells, indicating a strong potential for repopulation of the scaffold.Conclusions: Tissue-engineered living valves can be generated in vitro using the approach described here. The technology is not trivial and can provide numerous challenges and opportunities, which are discussed in detail in this paper. Overall, we concluded that cell seeding did not negatively affect tissue-engineered heart valve (TEHV) performance as they exhibited as good hemodynamic performance as acellular valves in this model. Further understanding of cell fate after implantation and the timeline of repopulation of acellular scaffolds will help us evaluate the translational potential of this technology.
Evaluation of the Safety and Efficacy of Coronary Intravascular Lithotripsy for Treatment of Severely Calcified Coronary Stenoses: Evidence From the Serial Disrupt CAD Trials
Authors: Liang Bo , Gu Ning 
Published: August 2021

Background: Previous understanding holds that rotational atherectomy and modified balloons remain the default strategy for severely calcified coronary stenoses. In recent years, coronary intravascular lithotripsy (IVL) provides new ideas. This study was conducted to evaluate the safety and efficacy of IVL for the treatment of severely calcified coronary stenoses.Methods: The serial Disrupt CAD trials (Disrupt CAD I, Disrupt CAD II, Disrupt CAD III, and Disrupt CAD IV) were included in this study. The safety endpoint was freedom from major adverse cardiovascular events (MACE) in hospital, at 30 days, and at 6 months following the index procedure. The efficacy endpoints included procedural success and angiographic success. Optical coherence tomography (OCT) was used to evaluate the mechanism of action of IVL quantifying the coronary artery calcification (CAC) characteristics and calcium plaque fracture.Results: We enrolled a total of 628 patients with a mean age of 71.8 years, 77.1% males. In these patients, the left anterior descending artery and right coronary artery were the most vulnerable vessels. The diameter stenosis was 64.6 ± 11.6% and the lesion length was 24.2 ± 11.4 mm. IVL had a favorable efficacy (93.0% procedural success, 97.5% angiographic success, and 100.0% stent delivery). Among the 628 patients, 568, 568, and 60 reported MACE endpoints in hospital, at 30 days, and at 6 months, respectively. The results showed that 528, 514, and 55 patients were free from MACE in hospital, at 30 days, and at 6 months, respectively. OCT measurements demonstrated that calcium fracture was the underlying mechanism of action for coronary IVL.Conclusions: IVL is safe and efficient for severely calcified coronary stenoses, and, importantly, calcium fracture facilitated increased vessel compliance and favorable stent expansion.
Successful Multi-Level HPV Vaccination Intervention at a Rural Healthcare Center in the Era of COVID-19
Authors: Kepka Deanna , Christini Kaila , McGough Emily , Wagner Anna , Del Fiol Guilherme , Gibson Bryan , Ayres Shauna , Brandt Heather M. , Mann Sara , Petrik Amanda F. , Coronado Gloria D. 
Published: August 2021

Objectives: To develop and test a human papillomavirus (HPV) vaccination intervention that includes healthcare team training activities and patient reminders to reduce missed opportunities and improves the rate of appointment scheduling for HPV vaccination in a rural medical clinic in the United States.Methods: The multi-level and multi-component intervention included healthcare team training activities and the distribution of patient education materials along with technology-based patient HPV vaccination reminders for parents/caregivers and young adult patients. Missed vaccination opportunities were assessed pre- and post-intervention (n = 402 and n = 99, respectively) by retrospective chart review and compared using Pearson χ2. The patient parent/caregiver and young adult patient population (n = 80) was surveyed following the reminder messages and penalized logistic regression quantified unadjusted odds of scheduling a visit.Results: Missed opportunities for HPV vaccination declined significantly from the pre-intervention to the post-intervention period (21.6 vs. 8.1%, respectively, p = 0.002). Participants who recalled receipt of a vaccination reminder had 7.0 (95% CI 2.4–22.8) times higher unadjusted odds of scheduling a visit compared with those who did not recall receiving a reminder. The unadjusted odds of confirming that they had scheduled or were intending to schedule a follow-up appointment to receive the HPV vaccine was 4.9 (95% CI 1.51–20.59) times greater among those who had not received the vaccine for themselves or for their child.Conclusions: Results from this intervention are promising and suggest that vaccination interventions consisting of provider and support staff education and parent/caregiver and patient education materials, and reminders can reduce missed opportunities for vaccinations in rural settings.
The Impact of the Triglyceride-Glucose Index on Poor Prognosis in NonDiabetic Patients Undergoing Percutaneous Coronary Intervention
Authors: Yang Jie , Tang Yi-Da , Zheng Yitian , Li Chen , Zhou Qing , Gao Jun , Meng Xiangbin , Zhang Kuo , Wang Wenyao , Shao Chunli 
Published: August 2021

BackgroundThe triglyceride-glucose index (TyG index) is a valuable marker for predicting adverse cardiovascular events in diabetic patients. However, for nondiabetic patients, whether the TyG index is independently related to poor prognosis remains unclear. This cohort study assessed the association of the TyG index with future cardiovascular risk in nondiabetic subjects who received percutaneous coronary intervention (PCI).MethodsWe consecutively enrolled 5,489 nondiabetic patients who underwent PCI. All experimental subjects were divided into three groups based on their TyG index, which was determined by the equation ln (fasting triglyceride (mg/dl) × fasting blood glucose (mg/dl)/2). The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), including all-cause death, nonfatal myocardial infarction (MI), nonfatal stroke, and target vessel revascularization (TVR).ResultsA total of 386 MACCE were documented during a median 29-month follow-up. The Kaplan–Meier survival results indicated that among the three groups, there was no obvious difference in any endpoints. Further Cox regression analyses suggested that the TyG index was not independently related to adverse cardiovascular outcomes for nondiabetic patients who underwent PCI (HR: 0.77, 95% CI 0.56–1.16, P = 0.210 for MACCE). Subgroup analysis suggested that the TyG index was independently relevant to MACCE for patients with low-density lipoprotein cholesterol (LDL-C) lower than 1.8 mmol/L.ConclusionThe TyG index is not an effective predictive factor for adverse cardiovascular prognosis in nondiabetic patients who underwent PCI. However, in subjects with LDL-C lower than 1.8mmol/L, it may predict future cardiovascular risk.
Obesity Attenuates Ventilator-Induced Lung Injury by Modulating the STAT3–SOCS3 Pathway
Authors: Wu Shih-Wei , Peng Chung-Kan , Wu Shu-Yu , Wang Yu , Yang Sung-Sen , Tang Shih-En , Huang Kun-Lun 
Published: August 2021

BackgroundVentilator-induced lung injury (VILI) is characterized by vascular barrier dysfunction and suppression of alveolar fluid clearance (AFC). Obesity itself leads to chronic inflammation, which may initiate an injurious cascade to the lungs and simultaneously induce a protective feedback. In this study, we investigated the protective mechanism of obesity on VILI in a mouse model.MethodsThe VILI model was set up via 6-h mechanical ventilation with a high tidal volume. Parameters including lung injury score, STAT3/NFκB pathway, and AFC were assessed. Mice with diet-induced obesity were obtained by allowing free access to a high-fat diet since the age of 3 weeks. After a 9-week diet intervention, these mice were sacrificed at the age of 12 weeks. The manipulation of SOCS3 protein was achieved by siRNA knockdown and pharmaceutical stimulation using hesperetin. WNK4 knockin and knockout obese mice were used to clarify the pathway of AFC modulation.ResultsObesity itself attenuated VILI. Knockdown of SOCS3 in obese mice offset the protection against VILI afforded by obesity. Hesperetin stimulated SOCS3 upregulation in nonobese mice and provided protection against VILI. In obese mice, the WNK4 axis was upregulated at the baseline, but was significantly attenuated after VILI compared with nonobese mice. At the baseline, the manipulation of SOCS3 by siRNA and hesperetin also led to the corresponding alteration of WNK4, albeit to a lesser extent. After VILI, WNK4 expression correlated with STAT3/NFκB activation, regardless of SOCS3 status. Obese mice carrying WNK4 knockout had VILI with a severity similar to that of wild-type obese mice. The severity of VILI in WNK4-knockin obese mice was counteracted by obesity, similar to that of wild-type nonobese mice only.ConclusionsObesity protects lungs from VILI by upregulating SOCS3, thus suppressing the STAT3/NFκB inflammatory pathway and enhancing WNK4-related AFC. However, WNK4 activation is mainly from direct NFκB downstreaming, and less from SOCS3 upregulation. Moreover, JAK2–STAT3/NFκB signaling predominates the pathogenesis of VILI. Nevertheless, the interaction between SOCS3 and WNK4 in modulating VILI in obesity warrants further investigation.