bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma ferritin concentration is positively associated with in vivo fatty acid mobilization and insulin resistance in obese women
Authors: Ryan Benjamin J. , Van Pelt Douglas W. , Guth Lisa M. , Ludzki Alison C. , Gioscia‐Ryan Rachel A. , Ahn Chiwoon , Foug Katherine L. , Horowitz Jeffrey F. 
Published: September 2018

New Findings
What is the central question of this study?Do obese women with relatively high whole‐body iron stores exhibit elevated in vivo rates of fatty acid (FA) release from adipose tissue compared with a well‐matched cohort of obese women with relatively low iron stores?
What is the main finding and its importance?Obese women with high plasma [ferritin] (a marker of whole‐body iron stores) had greater FA mobilization, lipolytic activation in adipose tissue and insulin resistance (IR) compared with obese women with lower plasma [ferritin]. Given that elevated FA mobilization is intimately linked with the development of IR, these findings suggest that elevated iron stores might contribute to IR in obesity by increasing systemic FA availability.
AbstractHigh rates of fatty acid (FA) mobilization from adipose tissue are associated with insulin resistance (IR) in obesity. In vitro evidence suggests that iron stimulates lipolysis in adipocytes, but whether iron is related to in vivo FA mobilization is unknown. We hypothesized that plasma ferritin concentration ([ferritin]), a marker of body iron stores, would be positively associated with FA mobilization. We measured [ferritin], the rate of appearance of FA in the systemic circulation (FA Ra; stable isotope dilution), key adipose tissue lipolytic proteins and IR (hyperinsulinaemic–euglycaemic clamp) in 20 obese, premenopausal women. [Ferritin] was correlated with FA Ra (r = 0.65; P = 0.002) and IR (r = 0.57; P = 0.008); these relationships remained significant after controlling for body mass index and plasma [C‐reactive protein] (a marker of systemic inflammation) in multiple regression analyses. We then stratified subjects into tertiles based on [ferritin] to compare subjects with ‘High‐ferritin’ versus ‘Low‐ferritin’. Plasma [hepcidin] was more than fivefold greater (P < 0.05) in the High‐ferritin versus Low‐ferritin group, but there was no difference in plasma [C‐reactive protein] between groups, indicating that the large difference in plasma [ferritin] reflects a difference in iron stores, not systemic inflammation. We found that FA Ra, adipose protein abundance of hormone‐sensitive lipase and adipose triglyceride lipase, and IR were significantly greater in subjects with High‐ferritin versus Low‐ferritin (all P < 0.05). These data provide the first evidence linking iron and in vivo FA mobilization and suggest that elevated iron stores might contribute to IR in obesity by increasing systemic FA availability.
Dinámica de una red integral de prestadores de servicios de salud (RIPSS)
Authors: Tabarquino Muñoz Raúl Andrés , Pulgarin Henao Dora Marcela , Giraldo Varón Albert Ferney 
Published: September 2018

La Política Pública de Atención Integral en Salud del año 2016 en Colombia establece el esquema de redes integrales de prestadores de servicios de salud (RIPSS), el cual dinamiza demandas y recursos proyectados, personal calificado e infraestructura en red. El análisis de este nuevo esquema de prestación de servicios de salud parte de un enfoque metodológico mixto con aplicación de análisis de redes, apropiando el caso de la red de salud del oriente del municipio de Santiago de Cali, por la existencia de avances y aportes en la aplicación del concepto de redes integradas de servicios de salud (RISS) y logística integral. Los resultados de lainvestigación aportan teórica, analítica y metodológicamente que la interdependencia, interrelación y coordinación entre actores en una red integral de prestadores de servicios de salud (RIPSS) puede ser simulada de manera estructural y posicional.
Evaluación de la estructura del componente regular de los programas departamentales de hábitos y estilos de vida saludable, Colombia, 2014-2015
Authors: Torres Moya Oscar Ricardo , Prieto Alvarado Franklyn Edwin 
Published: September 2018

Los programas comunitarios de actividad física son una estrategia prometedora para combatir el sedentarismo. En Colombia existe el Programa Nacional de Hábitos y Estilos de Vida Saludable. Establecer la estructura en su propósito de evaluación general es fundamental para conocer su relevancia y coherencia. El objetivo del estudio fue evaluar la estructura y la variabilidad del componente regular de los programas departamentales de hábitos y estilos de vida saludable, Colombia 2014-2015. La investigación contó con un análisis documental, una valoración de los modelos lógicos y una entrevista semiestructurada. La racionalidad presentó diferencias en lo que se reere al diagnóstico y se encontró consenso en el establecimiento de objetivos; estos responden a las necesidades y problemas de la población y son tratados a través de estrategias que varían muy poco. Las metas que sugieren los programas, en próximos desarrollos, deberán tener en cuenta las conductas y el contexto de los usuarios.
Factores asociados al grado de satisfacción del usuario del consultorio externo de gastroenterología del Hospital Central de la Fuerza Aérea del Perú. Mayo, 2014
Authors: La Torre Mantilla Angello Rafael , Oyola García Alfredo Enrique , Quispe Ilanzo Melisa Pamela 
Published: September 2018

Se desarrolló un estudio observacional, descriptivo y transversal para determinar los factores asociados al grado de satisfacción del usuario del consultorio externo de gastroenterología del Hospital Central de la Fuerza Aérea del Perú, debido a que la insatisfacción del paciente se asocia con el nivel de excelencia profesional, uso eficiente de los recursos y mínimo riesgo para el paciente. La muestra incluyó 221 pacientes. Se halló que 21.3% de pacientes estaban satisfechos con la atención, 26,7% en el componente fiabilidad, 31.2% en el componente responsabilidad, 48% en el componente seguridad, 38.9% en el componente empatía y 32.6% en el componente tangibles. La insatisfacción se observó en 75 (70.8%) de los varones, 99 (86.1%) de las mujeres (p=0.005), en 65 (70.7%) de los beneficiarios directos y 109 (84.5%) de los familiares (p=0.013). Asimismo, conforme aumentaba el tiempo de espera para la atención, disminuía la satisfacción del paciente (r=-0.316; p=0.000).
Instrumentos para evaluar la calidad percibida por los usuarios en los servicios de salud
Authors: Henao Nieto Daniel Eduardo , Giraldo Villa Adriana , Yepes Delgado Carlos Enrique 
Published: September 2018

La calidad es considerada un factor clave en la diferenciación y en la excelencia de los ser vicios de salud, y la percepción de un paciente sobre la prestación del ser vicio determina en forma definitiva su nivel de calidad. Se han descrito indicadores que ayudan a evaluar la calidad de los ser vicios de salud, entre estos, indicadores de efectividad, de oportunidad y de adhesión. Sin embargo, la evaluación integral de la calidad percibida en los ser vicios de salud es aún compleja. Se realizó una búsqueda en Medline, Embase, OVID, Lilacs, Ebsco, Scielo y The Cochrane Library para identificar instrumentos de tipo cualitativo o cuantitativo que permitieran medir la calidad de los ser vicios de salud percibida por los pacientes. Se encontraron estudios que validaron y aplicaron la escala Ser vqual y Ser vqhos en el ámbito hospitalario. Adicionalmente, en nuestro país se intentó validar escalas diferentes a estas, pero no contaron con un rigor estadístico importante.
La insoportable levedad de la política nacional de salud mental para Colombia : reflexiones a propósito de la propuesta de ajuste en 2014
Authors: Parales Quenza Carlos José , Urrego Mendoza Zulma Consuelo , Herazo Acevedo Edwin 
Published: September 2018

La salud mental es una problemática de interés para muchos gobiernos. En los últimos veinte años, en Colombia se han hecho varios intentos de formular una política nacional, cuya recepción por la sociedad y sus instituciones ha sido fútil. Desde la perspectiva del equipo consultor para el ajuste de la Política Nacional de Salud Mental Colombiana en 2014, se elaboró un recuento de tales iniciativas desde 1994 hasta 2015, con énfasis en lo sucedido en 2014, y se analizaron diversos antecedentes que considerar para comprender las dicultades en la implementación de una política pública al respecto. Entre las dificultades afrontadas se encontraron la diversidad de conceptualizaciones sobre salud mental, la falta de voluntad política, las características propias de los sistemas de salud y el estigma social que rodea a los padecimientos mentales. Tales aspectos, entre otros, han hecho ardua y compleja la tarea de formular e implementar políticas nacionales de salud mental
Carcinoma escamocelular de labio superior en paciente con síndrome nevoide basocelular. Reporte de caso clínico / Upper Lip Squamous Cell Carcinoma in Patient with Basal Cell Nevus Syndrome. Case Report
Authors: López Muñoz Nathalia , Ordóñez Ropero Paula Andrea , Vargas Rico Leonardo 
Published: September 2018

RESUMEN. Antecedentes: El síndrome de Gorlin-Goltz, o síndrome nevoide de células basales (SNCB), es un trastorno autosómico dominante de baja incidencia. Su etiología está relacionada con una mutación en el gen PTCH y afecta los sistemas esquelético, oftalmológico y neurológico. Su prevalencia es de 1:60.000 y las mutaciones de novo se presentan aproximadamente en un 20 % a 30 % de los casos. Objetivo: Describir el proceso diagnóstico y manejo de un caso de esporádica presentación de una paciente con SNCB con carcinoma escamocelular (CEC) en labio superior. Descripción del caso: Se trató de una paciente de 58 años, quien asistió a consulta odontológica por motivos estéticos y funcionales. Se encontró un CEC (confirmado por inmunohistoquímica) asintomático delimitado en el lado izquierdo del labio superior, con erosiones de color rojizo y costra. No se encontraron linfoadenopatías asociadas. También presentó fisuras palmoplantares y múltiples carcinomas basocelulares en la espalda y el dorso de la mano izquierda (con antecedentes familiares similares). Radiográficamente, no se observaron queratoquistes mandibulares que usualmente se asocian con el síndrome de Gorlin-Goltz. Conclusiones: La paciente fue diagnosticada con SNCB, pues presentaba dos criterios mayores (dos o más CBC y piqueteado palmoplantar) y dos menores (calcificación laminar de la hoz del cerebro y antecedente de fibromas ováricos). El tratamiento odontológico se planeó y se remitió a la paciente a la institución pertinente para manejar su condición sistémica.ABSTRACT. Background: Gorlin-Goltz syndrome, or basal cell nevus syndrome (BCNS), is a rare autosomal dominant disorder caused by mutations in the Patched (PTCH) gene. BCNS affects about 1:60,000 people and de novo mutations represent approximately 20 % to 30 % of all cases. Purpose: To describe the diagnostic process and management of a rare case of a female patient with BCNS and squamous cell carcinoma (SCC) in upper lip. Case description: The patient was a 58-year-old woman who attended the dental office seeking aesthetic and functional treatment. An asymptomatic, delimited SCC with red erosions and scab in left upper lip was diagnosed (confirmed through immunohistochemistry). Associated lymph adenopathy was not observed. The patient also presented palmoplantar pits and multiple basal cell carcinomas (BCC) in back and left-hand back (and similar family history). X-rays did not show mandible keratocysts often associated to the Gorlin-Goltz syndrome. Conclusions: The patient was diagnosed with BCNS because she met two major (two or more BCCs and palmoplantar pits) and two minor criteria (lamellar calcification of brain sickle and history of ovary fibromas). Dental treatment was planned and the patient was referred to another institution to address her systemic condition.
Evaluation of in-office tooth whitening treatment with violet LED: protocol for a randomised controlled clinical trial
Authors: Santos Ana Eliza Castanho Garrini dos , Bussadori Sandra Kalil , Pinto Marcelo Mendes , Pantano Junior Dácio Antonio , Brugnera Jr Aldo , Zanin Fátima Antonia Aparecida , Rodrigues Maria Fernanda Setúbal Destro , Motta Lara Jansiski , Horliana Anna Carolina Ratto Tempestini 
Published: September 2018

IntroductionIn-office tooth whitening treatment using violet light emited diode (LED) (405 nm) is a novel bleaching method that causes less sensitivity while offering the same effectiveness as the gold standard (35% hydrogen peroxide, H2O2). This study describes a protocol for the first randomised controlled clinical trial to compare the effects of the two methods.Methods and analysisEighty patients will be divided into four groups: G1 violet LED; G2 violet LED +35% carbamide peroxide; G3 35% H2O2and G4 violet LED +gingivoplasty. Colour will be measured at baseline, immediately after the first session and at the 15 and 180 days follow-up using the Vita Classical and the digital Easyshade V spectrophotometer (Vita, Zahnfabrik, Germany). Sensitivity after whitening will be measured using the Visual Analogue Scale at baseline and at each session in all groups and in all follow-ups. The tissue removed during gingivoplasty (G4) will be submitted to immunohistochemical analysis for the determination of inflammatory changes caused by violet LED. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) will be evaluated before, as well as at established time point controls. The results will be expressed as mean and SD values. After determining the normality of the data, a one-way repeated-measures analysis of variance will be used for the comparison of data with normal distribution and the Kruskal-Wallis test will be used for data with non-normal distribution. A p<0.05 will be considered indicative of statistical significance. After determining the normality of the data, the Kruskal-Wallis test will be used for non-parametric data. Multivariate analysis of variance (MANOVA) and the Wilcoxon test will be used for comparing data from the PIDAQ.Ethics and disseminationThis protocol has been approved by the Human Research Ethics Committee of UniversidadeNove de Julho (certificate: 2.034.518). The findings will be published in a peer-reviewed journal.Trial registration numberNCT03192852; Pre-results.
‘CPR for Feet’ care bundle to improve foot assessment in inpatient diabetes
Authors: O’Regan Rhea , MacDonald Ross , Boyle James G , Hughes Katherine A , McKenzie Joyce 
Published: September 2018

AimsThe Scottish Inpatient Diabetes Foot Audit conducted in 2013 revealed that 57% of inpatients had not had their feet checked on admission, 60% of those at risk did not have pressure relief in place and 2.4% developed a new foot lesion. In response, the Scottish Diabetes Foot Action Group launched the ‘CPR for Feet’ campaign. The aim of this project was to raise awareness of the ‘Check, Protect and Refer’ (CPR) campaign as well as improve the assessment and management of inpatients with diabetes.MethodsA quality improvement project underpinned by Plan-Do-Study-Act (PDSA) methodology was undertaken. The first and second cycles focused on staff education and the implementation of a ‘CPR for Feet’ assessment checklist using campaign guidelines, training manuals and modules. The third and fourth cycles focused on staff feedback and the implementation of a ‘CPR for Feet’ care bundle.ResultsBaseline measurements revealed 28% of patients had evidence of foot assessment. Medical and nursing staff reported to be largely unaware of the ‘CPR for Feet’ campaign (13%). Fifty-two per cent of inpatients with diabetes had their feet assessed and managed correctly following the second PDSA cycle. After completion of the third and fourth PDSA this number improved further to 72% and all staff reported to be aware of the campaign.ConclusionsThe introduction of a ‘CPR for Feet’ care bundle improved the assessment of inpatients with diabetes.
Pirfenidone in patients with unclassifiable progressive fibrosing interstitial lung disease: design of a double-blind, randomised, placebo-controlled phase II trial
Authors: Maher Toby M , Corte Tamera J , Fischer Aryeh , Kreuter Michael , Lederer David J , Molina-Molina Maria , Axmann Judit , Kirchgaessler Klaus-Uwe , Cottin Vincent 
Published: September 2018

IntroductionDespite extensive multidisciplinary team (MDT) assessment, some patients have interstitial lung disease (ILD) that is considered unclassifiable (uILD), for which there are currently no approved treatments. This study will assess the efficacy and safety of the antifibrotic pirfenidone in treating uILD.Methods and analysisThis double-blind, randomised, placebo-controlled phase II trial is enrolling adults with fibrosing ILD, including uILD that fulfils proposed research criteria for interstitial pneumonia with autoimmune features (IPAF), that cannot be classified with moderate or high confidence to any category of ILD following MDT discussion. Study participants must have >10% fibrosis on high-resolution CT scan within the previous 12 months, forced vital capacity (FVC) ≥45% and diffusing capacity of the lung for carbon monoxide ≥30% of predicted values. Study participants will be randomised to receive 801 mg pirfenidone or placebo three times daily for 24 weeks. The efficacy of pirfenidone vs placebo will be assessed by daily measurement of FVC using a handheld spirometer over the treatment period. Other functional parameters, patient-reported outcomes, samples for biomarker analysis and safety endpoints will be collected. Additionally, the study will assess the efficacy and safety of pirfenidone with and without concomitant mycophenolate mofetil treatment and in study participants with or without IPAF.Ethics and disseminationThis trial is being conducted in accordance with the International Conference on Harmonisation E6 guideline for Good Clinical Practice, Declaration of Helsinki and local laws for countries in which the research is conducted.Trial registration numberNCT03099187.
Effectiveness of tobacco cessation pharmacotherapy in the Veterans Health Administration
Authors: Duffy Sonia A , Ignacio Rosalinda V , Kim Hyungjin Myra , Geraci Mark C , Essenmacher Carol A , Hall Stephanie V , Chow Adam , Pfeiffer Paul N , Sherman Scott E , Bohnert Kipling M , Zivin Kara , Barnett Paul George 
Published: September 2018

IntroductionIn 2003, the Veterans Health Administration (VHA) implemented a directive that cessation pharmacotherapy be made available to all who use tobacco and are interested in quitting. Despite the efficacy of cessation pharmacotherapy shown in clinical trials, the generalisability of the results in real-world settings has been challenged. Hence, the specific aim of this study was to determine the effectiveness of cessation pharmacotherapies in the VHA.MethodsThis retrospective cohort study used VHA’s electronic medical record data to compare quit rates among those who use tobacco and who did vs. did not receive any type of cessation pharmacotherapy. Included were 589 862 Veterans identified as current tobacco users during fiscal year 2011 who had not received cessation pharmacotherapy in the prior 12 months. Following a 6-month period to assess treatment, quit rates among those who were treated versus untreated were compared during the 7–18 months (12 months) post-treatment follow-up period. The estimated treatment effect was calculated from a logistic regression model adjusting for inverse probability of treatment weights (IPTWs) and covariates. Marginal probabilities of quitting were also obtained among those treated versus untreated.ResultsAdjusting for IPTWs and covariates, the odds of quitting were 24% higher among those treated versus untreated (OR=1.24, 95% CI 1.23 to 1.25, p<0.001). The marginal probabilities of quitting were 16.7% for the untreated versus 19.8% for the treated based on the weighted model.ConclusionThe increased quit rates among Veterans treated support the effectiveness and continuation of the VHA tobacco cessation pharmacotherapy policy.
Treg Destabilization and Reprogramming: Implications for Cancer Immunotherapy
Authors: Munn David H. , Sharma Madhav D. , Johnson Theodore S. 
Published: September 2018

Abstract
Regulatory T cells (Tregs) are an important contributor to the immunosuppressive tumor microenvironment. To date, however, they have been difficult to target for therapy. One emerging new aspect of Treg biology is their apparent functional instability in the face of certain acute proinflammatory signals such as IL6 and IFNγ. Under the right conditions, these signals can cause a rapid loss of suppressor activity and reprogramming of the Tregs into a proinflammatory phenotype. In this review, we propose the hypothesis that this phenotypic modulation does not reflect infidelity to the Treg lineage, but rather represents a natural, physiologic response of Tregs during beneficial inflammation. In tumors, however, this inflammation-induced Treg destabilization is actively opposed by dominant stabilizing factors such as indoleamine 2,3-dioxygenase and the PTEN phosphatase pathway in Tregs. Under such conditions, tumor-associated Tregs remain highly suppressive and inhibit cross-presentation of tumor antigens released by dying tumor cells. Interrupting these Treg stabilizing pathways can render tumor-associated Tregs sensitive to rapid destabilization during immunotherapy, or during the wave of cell death following chemotherapy or radiation, thus enhancing antitumor immune responses. Understanding the emerging pathways of Treg stabilization and destabilization may reveal new molecular targets for therapy. Cancer Res; 78(18); 5191–9. ©2018 AACR.
p63-Dependent Dickkopf3 Expression Promotes Esophageal Cancer Cell Proliferation via CKAP4
Authors: Kajiwara Chihiro , Fumoto Katsumi , Kimura Hirokazu , Nojima Satoshi , Asano Keita , Odagiri Kazuki , Yamasaki Makoto , Hikita Hayato , Takehara Tetsuo , Doki Yuichiro , Morii Eiichi , Kikuchi Akira 
Published: September 2018

Abstract
Dickkopf3 (DKK3) is a secretory protein that belongs to the DKK family, but exhibits structural divergence from other family members, and its corresponding receptors remain to be identified. Although DKK3 has been shown to have oncogenic functions in certain cancer types, the underlying mechanism by which DKK3 promotes tumorigenesis remains to be clarified. We show here that DKK3 stimulates esophageal cancer cell proliferation via cytoskeleton-associated protein 4 (CKAP4), which acts as a receptor for DKK3. DKK3 was expressed in approximately 50% of tumor lesions of esophageal squamous cell carcinoma (ESCC) cases; simultaneous expression of DKK3 and CKAP4 was associated with poor prognosis. Anti-CKAP4 antibody inhibited both binding of DKK3 to CKAP4 and xenograft tumor formation induced by ESCC cells. p63, a p53-related transcriptional factor frequently amplified in ESCC, bound to the upstream region of the DKK3 gene. Knockdown of p63 decreased DKK3 expression in ESCC cells, and reexpression of DKK3 partially rescued cell proliferation in p63-depleted ESCC cells. Expression of ΔNp63α and DKK3 increased the size of tumor-like esophageal organoids, and anti-CKAP4 antibody inhibited growth of esophageal organoids. Taken together, these results suggest that the DKK3-CKAP4 axis might serve as a novel molecular target for ESCC.
Significance: In esophageal cancer, findings identify DKK3 as a poor prognostic indicator and demonstrate CKAP4 inhibition as an effective therapeutic strategy. Cancer Res; 78(21); 6107–20. ©2018 AACR.