bluuebunny/crossref_metadata_2025_split huggingface dataset:
Precipitation of Soluble Uric Acid Is Necessary forIn VitroActivation of the NLRP3 Inflammasome in Primary Human Monocytes
Authors: Alberts Ben M. , Barber James S. , Sacre Sandra M. , Davies Kevin A. , Ghezzi Pietro , Mullen Lisa M. 
Published: March 2019

Objective.To investigate the effects of soluble uric acid (UA) on expression and activation of the NOD-like receptor (NLR) pyrin domain containing protein 3 (NLRP3) inflammasome in human monocytes to elucidate the role of hyperuricemia in the pathogenesis of gout.Methods.Primary human monocytes and the THP-1 human monocyte cell line were used to determine the effects of short- and longterm exposure to UA on activation of the NLRP3 inflammasome and subsequent interleukin 1β (IL-1β) secretion by ELISA and cell-based assays. Expression of key NLRP3 components in monocytes from patients with a history of gout were analyzed by quantitative PCR.Results.Precipitation of UA was required for activation of the NLRP3 inflammasome and subsequent release of IL-1β in human monocytes. Neither monosodium urate (MSU) crystals nor soluble UA had any effect on activation of the transcription factor, nuclear factor-κB. Prolonged exposure of monocytes to soluble UA did not alter these responses. However, both MSU crystals and soluble UA did result in a 2-fold increase in reactive oxygen species. Patients with gout (n = 15) had significantly elevated serum UA concentrations compared to healthy individuals (n = 16), yet secretion of IL-1β and expression of NLRP3 inflammasome components in monocytes isolated from these patients were not different from those of healthy controls.Conclusion.Despite reports indicating that soluble UA can prime and activate the NLRP3 inflammasome in human peripheral blood mononuclear cells, precipitation of soluble UA into MSU crystals is essential forin vitroNLRP3 signaling in primary human monocytes.
Investigating the Association of Giant Cell Arteritis with Varicella Zoster Virus in Temporal Artery Biopsies or Ascending Aortic Resections
Authors: Solomon Isaac H. , Docken William P. , Padera Robert F. 
Published: March 2019

Objective.A variety of infectious agents, including varicella zoster virus (VZV), have been hypothesized to play a role in the pathogenesis of giant cell arteritis (GCA). The detectability of the virus in patients with GCA is debatable. To further investigate an association between GCA and VZV infection, 10 years of GCA cases were evaluated for VZV by immunohistochemistry (IHC).Methods.All temporal artery biopsies and ascending aortic resections positive for GCA from 2007 to 2017 at Brigham and Women’s Hospital were immunostained using a VZV antibody cocktail (SG1-1, SG1-SG4, NCP-1, and IE-62).Results.Forty-one temporal artery biopsies and 47 ascending aortic resections positive for GCA were identified, all of which were found to be negative for VZV by IHC. Twelve temporal artery biopsies in this cohort were previously analyzed by unbiased metagenomics sequencing and were negative for VZV DNA.Conclusion.These results argue against a clinically relevant association between VZV infection and GCA, and support neither routine testing for VZV nor treatment with antiviral drugs.
Radiographic Progression According to Baseline C-reactive Protein Levels and Other Risk Factors in Psoriatic Arthritis Treated with Tofacitinib or Adalimumab
Authors: van der Heijde Désirée , Gladman Dafna D. , FitzGerald Oliver , Kavanaugh Arthur , Graham Daniela , Wang Cunshan , Fallon Lara 
Published: March 2019

Objective.To evaluate the effect of baseline risk factors on radiographic progression in patients with active psoriatic arthritis (PsA) who had an inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARD) and were treated with tofacitinib or adalimumab (ADA).Methods.Tofacitinib is an oral Janus kinase inhibitor for the treatment of PsA. OPAL Broaden was a 12-month, double-blind phase III trial. Patients received tofacitinib 5 mg twice daily (BID; n = 107), tofacitinib 10 mg BID (n = 104), or ADA 40 mg once every 2 weeks (n = 106), all with 1 background csDMARD. Radiographs (baseline and Month 12) were scored using the van der Heijde-modified total Sharp score (mTSS) for PsA. Radiographic nonprogression was defined as an increase from baseline in mTSS ≤ 0.5, ≤ 0, or ≤ 0.66. Changes from baseline in mTSS and nonprogression (≤ 0.5 increase from baseline in mTSS) were analyzed by baseline C-reactive protein (CRP) > 2.87 or ≤ 2.87 mg/l. Baseline predictors of radiographic progression were analyzed.Results.At Month 12, > 90% of patients receiving tofacitinib or ADA met all radiographic nonprogression criteria. Mean changes from baseline through Month 12 in mTSS, erosion, and joint space narrowing scores were close to 0. Changes in radiographic outcomes were minimal, irrespective of baseline CRP levels > 2.87 or ≤ 2.87 mg/l, with a small numerical difference observed for tofacitinib 5 mg BID. A significant relationship was observed between baseline CRP level and increases from baseline in mTSS > 0.5 at Month 12.Conclusion.Elevated CRP levels at baseline were associated with greater structural progression. Changes in radiographic outcomes were minimal regardless of CRP levels. [Clinical trial registration number (www.ClinicalTrials.gov):NCT01877668]
Assessment of the perception of service recipients about the quality of work in health care professionals in the Children Emergency Room of a Tertiary Hospital in Nigeria
Authors: Osuorah Chidiebere DI. , Ndu Ikenna Kingsley , Amadi Ogechukwu F. , Ekwochi Uchenna , Nduagubam Obinna C. , Ozoemena Onukwuli V. , Maduabuchi Chinawa J. , Azionu Ogechukwu H. 
Published: March 2019

The children emergency room (ER) is regarded as an essential section of hospitals and other healthcare settings where immediate medical and surgical care is given to children in need of urgent care. The conditions of the emergency room and the quality of service by the emergency room staff has been described as a major determinant of the socio-medical outcome of patients and their relatives. This is a hospital based cross-sectional carried out in the Children Emergency Room (CHER) of the Enugu State University Teaching Hospital, Enugu Nigeria. Parents and care-givers that presented with their sick children to the ER department were successively enrolled after obtaining consent. Information on their assessment of certain aspects of the emergency room environment and quality of service received from medical and administrative personnel working in the emergency room was obtained using a 5-point Likert assessment scale. Results were reported using frequencies, percentages and chisquare were applicable. Statistical significance was set at P≤0.05. Over half (59%) of the 83 respondents that presented to the emergency room during the study period were self-referrals and all (95.2%), but four respondents noted a significant improvement in the condition of their sick children following management in the emergency room. In all parameters assessed, most respondents rated the emergency room conditions as moderate in noise level 69 (83.1), crowdedness 65 (78.3), comfort 49 (59.0) and cleanliness 41 (49.4) with an overall point score of 2.97±0.33 out of a possible five. Doctors were on average rated better than nurses and record clerk staff in politeness (P=0.001), patience (P=0.002), efficiency (P=0.002), and adequate explanation of procedures (P=0.001) while nurses were rated better than record staff in explanation of procedures to their patient (P=0.05) but not in politeness (P=0.894), patience (P=0.505) and efficiency (P=0.982). The rating of record clerks was significantly affected by the socio-economic class of respondents (P=0.036) but not by gender (P=0.252) or age of respondents (P=0.123). None of the respondents’ socio-demographic factors significantly determined their rating for the emergency room conditions and the quality of service by doctors or nurses. There is a need for a continued review of emergency room conditions in addition to training and re-training of staff in the children emergency room. This not only helps improve health outcomes but may also significantly reduce the duration of stay in the emergency room that in turn reduces congestion and the burden on the healthcare system.
Athletic Trainers' Influence on National Collegiate Athletic Association Division I Athletes' Basic Psychological Needs During Sport Injury Rehabilitation
Authors: Bejar Matthew P. , Raabe Johannes , Zakrajsek Rebecca A. , Fisher Leslee A. , Clement Damien 
Published: March 2019

Context
Athletic trainers (ATs) have indicated a desire to better understand the motivations of athletes during rehabilitation. Self-determination theory offers an ideal lens for conceptualizing the antecedents, mediators, and consequences of motivated behavior.

Objective
To explore athletes' perceptions of ATs' influence on their basic psychological needs as well as their motivation during sport injury rehabilitation.

Design
Qualitative study.

Setting
National Collegiate Athletic Association Division I universities in the northwestern and southeastern United States.

Patients or Other Participants
A total of 10 injured and previously injured athletes (7 women, 3 men; mean age = 20.9 ± 2.0 years) active in a variety of sports.

Data Collection and Analysis
Participants completed semistructured interviews, which were transcribed verbatim. The data were analyzed using consensual qualitative research methods. Trustworthiness techniques (eg, bracketing interview, discussion of biases, member checking, external auditor) were used throughout the process.

Results
Four domains were constructed: (a) athletes' concerns about injury and rehabilitation, (b) ATs' feedback and athletes' perceptions of competence, (c) a person-centered approach from ATs and athletes' perceptions of autonomy, and (d) a connection between ATs' and athletes' perceptions of relatedness. Athletes' experiences were largely influenced by the degree to which they perceived that ATs satisfied their 3 basic psychological needs, which, in turn, was determined by the presence or absence of particular AT behaviors, such as providing encouragement (competence), soliciting input (autonomy), and building rapport (relatedness). Furthermore, the degree to which they perceived these basic psychological needs were fulfilled (or thwarted) affected their overall motivation during sport injury rehabilitation.

Conclusions
Self-determination theory is a promising framework for ATs to consider when addressing motivational challenges among injured athletes.
Body Mass Index and Type 2 Collagen Turnover in Individuals After Anterior Cruciate Ligament Reconstruction
Authors: Lane Amy R. , Harkey Matthew S. , Davis Hope C. , Luc-Harkey Brittney A. , Stanley Laura , Hackney Anthony C. , Blackburn J. Troy , Pietrosimone Brian 
Published: March 2019

ContextIndividuals with an anterior cruciate ligament reconstruction (ACLR) are at an increased risk of developing posttraumatic osteoarthritis. How osteoarthritis risk factors, such as increased body mass index (BMI), may influence early changes in joint tissue metabolism is unknown.ObjectiveTo determine the association between BMI and type 2 cartilage turnover in individuals with an ACLR.DesignCross-sectional study.SettingResearch laboratory.Patients or Other ParticipantsForty-five individuals (31 women, 14 men) with unilateral ACLR at least 6 months earlier who were cleared for unrestricted physical activity.Main Outcome Measure(s)Body mass index (kg/m2) and type 2 collagen turnover were the primary outcomes. Body mass index was calculated from objectively measured height and mass. Serum was obtained to measure type 2 collagen turnover, quantified as the ratio of degradation (collagen type 2 cleavage product [C2C]) to synthesis (collagen type 2 C-propeptide [CP2]; C2C : CP2). Covariate measures were physical activity level before ACLR (Tegner score) and current level of disability (International Knee Documentation Committee Index score). Associations of primary outcomes were analyzed for the group as a whole and then separately for males and females.ResultsOverall, greater BMI was associated with greater C2C : CP2 (r = 0.32, P = .030). After controlling for covariates (Tegner and International Knee Documentation Committee Index scores), we identified a similar association between BMI and C2C : CP2 (partial r = 0.42, P = .009). Among women, greater BMI was associated with greater C2C : CP2 before (r = 0.47, P = .008) and after (partial r = 0.50, P = .008) controlling for covariates. No such association occurred in men.ConclusionsGreater BMI may influence greater type 2 collagen turnover in those with ACLR. Individuals, especially women, who maintain or reduce BMI may be less likely to demonstrate greater type 2 collagen turnover ratios after ACLR.
LA TRANSICIÓN DEMOGRÁFICA Y EPIDEMIOLÓGICA Y SU REPERCUSIÓN EN LA DIABETES MELLITUS, CUBA. 1970-2015
Authors: Álvarez Vázquez Luisa , Dominguez Yuri Arnold , Rodríguez Cabrera Aida 
Published: March 2019

La transición demográfica (TD) cubana se refleja en muy marcado envejecimiento poblacional, mientras que la transición epidemiológica (TE) ha llevado a un aumento acelerado de las enfermedades no transmisibles, entre ellas la diabetes mellitus (DM). Objetivo: Identificar la relación entre la transición demográfica y epidemiológica, y su efecto en la DM. Metodología: Se utilizaron registros y estimacio- nes de la Oficina Nacional de Estadística, los datos de población e indicadores del registro nacional de dispensarización de la DM en el país, desde el año 1970 al 2015. Resultados: En Cuba la natalidad ha descendido de 18.0 por cada mil habitantes en 1985 a 10.9 en el 2015 y la tasa de mortalidad ascendió de 6.4 a 8.9 por cada mil habitantes, mostrando una TD acelerada con disminución del crecimiento natural de 81.0%, cambios de fecundidad y de esperanza de vida, están entre los más rápidos de América Latina. Como efecto de la TE la DM se encuentra entre las 10 primeras causas de muerte en el 2015, lo que ha conducido a programas y campañas de salud. Según datos de dispensarización la DM tipo 1 y tipo 2 han tenido cambios relacionados con la estructura poblacional. Conclusiones: 1-El envejecimiento poblacional unido al predominio de las enfermedades no transmisibles muestra el efecto conjunto de ambos procesos transicionales. 2.-La diabetes Mellitus se incrementa dado el monto elevado de la personas de mayor edad y muestra el efecto de ambas transiciones en la necesidad de servicios de salud.

Palabras clave
Transición Demografica, Epidemiologia, Diabetes Mellitus
CATEGORIZACION DE RIESGO CARDIOVASCULAR EN EMPLEADOS DE UNIVERSIDAD NACIONAL AUTONOMA DE HONDURAS, VALLE DE SULA
Authors: Zúniga Rosa Elena , Arita Chávez José Raúl , Elvir Patricia Monserrath , Ochoa Lesly Altenida , Arita Ledezna Lizeth , Rostran Virginia Odili , Girón Ana Lourdes , Quiroz Obed Jeovany 
Published: March 2019

Las enfermedades cardiovasculares (ECV) engloban afectaciones tanto del corazón como del cerebro, siendo el problema subyacente la ateroesclerosis como responsable de las enfermedad coronaria y eventos cerebrovasculares, las ECV constituyen la principal causa de morbi-mortalidad a nivel mundial, en su origen se involucran diversos factores, que van desde el estilo de vida y otros que pueden ser modificables como también aquellos que no pueden modificarse como la edad, herencia, entre otros. Objetivo: Identificar riesgo cardiovascular (RCV) mediante Índice de Masa Corporal (IMC)/ índice cintura-cadera y tablas de Framinghan en empleados de la Universidad Nacional Autónoma de Honduras-Valle de Sula, (UNAH-VS) de febrero a octubre, 2016. Pacientes y Métodos: Se realizó investigación cuantitativa, alcance descriptivo y diseño no experimental. La población 210 emplea- dos permanentes, muestra 137 empleados. Muestreo probabilístico estratificado según actividad desempeñada en la Institución. La evaluación fue mediante Instrumento creado por OMS: STEP 3; se midió riesgo cardiovascular por Tabla IMC/índice cintura-cadera y Tablas de Framingham. Los datos se analiza- ron mediante paquete estadístico SPSS versión 22. Resultados: La categorización de RCV según IMC/índice cintura-cadera fue: muy leve 11 (8.05%), leve 27 (19.71%), moderado 49 (35.76%), alto 26 (18.97%) y muy alto 24 (17.51%). Según Tablas de Framingham: el riesgo de presentar un evento cardiovascular en los próximos 10 años fue: 131 (95.62%) bajo, 5 (3.65%) moderado, y 1 (0.73%) alto. Conclusión: El riesgo cardiovascular en empleados de UNAH-VS es alto según la categorización IMC/ índice cintura-cadera, la cual estimula a tomar medidas preventivas más temprana- mente, en cambio, según Framinghan el riesgo cardiovascular fue menor, esto debido a que incorpora condiciones como diabetes, hipertensión, fumar, niveles de colesterol en sangre.

Palabras clave
Enfermedades cardiovasculares, Factores de riesgo, Prevalencia
TIEMPO Y NATURALEZA DE USO DEL MÓVIL EN ESTUDIANTES DE LA CARRERA DE MEDICINA
Authors: Andrade Mancías Lourdes Azucena , Ortega José , Santos Jose M. , Rivas Luis F. , Banegas Nestor R. , Gámez Sofía M. 
Published: March 2019

Antecedentes: Diversas investigaciones se realizan sobre el tiempo y naturaleza de uso del móvil en estudiantes universitarios pero escasas en el área de la medicina en el siglo de la tecnología. Objetivo: Establecer el tiempo y naturaleza de uso del teléfono móvil en estudiantes de cuarto año de medicina de cuarto año A en la Escuela Universitaria de Ciencias de la Salud de la Universidad Nacional Autónoma de Honduras en el Valle de Sula (EUCS/UNAH-VS) en el primer semestre académico del 2017. Pacientes y Métodos: Estudio exploratorio-descriptivo. Población fue de 78, muestra no probabilística por conveniencia de 38 estudiantes, instrumento de recolección de datos se realizó a través del programa App Usage® que generó los resultados, se evaluaron los datos de frecuencias, porcentajes y medidas de tendencia central en Excel®. Resultados: Los datos reflejaron que el tiempo promedio de uso del móvil por los estudiantes fue de 5 horas 9 minutos (21.5%) del día. El uso se centró en aplicaciones móviles reactivas (distractor) con 4 horas 47 minutos (93%) y en aplicaciones móviles proactivas solo 22 minutos (7%). Conclusiones: Los datos de esta investigación indican que el patrón de uso del teléfono móvil es del 21.5% al día y la naturaleza del uso de los teléfonos celulares por parte del estudiante de Medicina de cuarto año A de la UNAH-VS es de carácter reactivo o sea como distractor

Palabras clave
Aplicaciones Móviles, Estudiantes de medicina, Teléfonos celulares
Doação de óvulos no Brasil: regulamentações e legislações
Authors: Alvarenga Raquel De Lima Leite Soares , Zuculo Jaqueline Verceze Bortolieiro , Guimarães Fernando Marques 
Published: March 2019

Num tratamento de Reprodução Assistida a doação de óvulos é o processo no qual uma mulher fértil permite que seus óvulos sejam coletados após estimulação ovariana, e que sejam utilizados para que outra mulher, infértil, denominada receptora, possa engravidar. A prática da doação de óvulos no mundo está diretamente ligada à cultura e regulamentação local. O Brasil não possui leis que regem a RA. A regulamentação nacional desta prática se dá pela deontologia médica desde 1992, com a primeira Resolução do CFM sobre normas éticas para utilização das técnicas de RA. Tramitam no Congresso Nacional vários projetos. A ANVISA determina, através de resoluções, as diretivas para o funcionamento dos BCTGs e doação de gametas. Visam principalmente o controle sanitário destas doações. A utilização de óvulos de doadoras é uma opção clinicamente viável para mulheres que não possuem óvulos adequados para a obtenção de uma gestação saudável e a termo. As questões éticas, legais e políticas apresentadas pela doação de óvulos surgem da separação do vínculo genético e gestacional feminino e da relativa escassez e inacessibilidade aos óvulos, quando comparados aos espermatozóides. Nenhuma destas questões torna ilegal ou moralmente inaceitável a ovodoação como uma forma de tratamento de infertilidade.
Linear Maps Preserving Rank-additivity and Rank-sum-minimal on Tensor Products of Matrix Spaces
Authors: Gao Lele , Zhang Yang , Xu Jinli 
Published: March 2019

The problems of characterizing maps that preserve certain invariant on given sets are called the preserving problems, which have become one of the core research areas in matrix theory. If for any a linear map, , as established, there is we say that preserves the rank-additivity. If for any , and a linear map, established, there is we say that rank-sum-miminal. In this paper, we characterize the form of linear mapping .
Reasons of Non-Guideline-Concordant Treatment in Patients with Multivessel Coronary Artery Disease Regret -One Trial
Authors: Çakır Çayan , Ökten Mehmet Şefa , Epçaçan Serdar , Ayaz Ahmet , Oğuz Mustafa 
Published: March 2019

Objective: We aimed to find the prevalence and the reasons for receiving non-guideline-concordant treatment in patients with multivessel coronary artery disease (mv-CAD), at a single centre.
Methods: All consecutive patients who underwent coronary angiography, due to stable angina pectoris or non-ST-elevation acute coronary syndrome (NSTE-ACS), and were diagnosed with mv-CAD at our hospital between August 2017 and February 2018 were included in this study. Stand-alone medical treatment, percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), or hybrid revascularization is recommended treatment methods by The European Society of Cardiology (ESC) and The European Association for Cardio-Thoracic Surgery Guidelines (EACTS) on Myocardial Revascularisation. Stabilised NSTE-ACS patients were assessed as stable angina pectoris patient
Results: A total of 140 patients (96 male, 68.6% and 111 NSTE-ACS, 79.3%) were included in this study, of which 65 (46.4%) received non-guideline-concordant treatment and 75 patients (53.6%) received guideline-concordant treatment. Sociodemographic and clinical characteristics did not differ statistically between patients who received guideline-concordant treatment and non-guideline-concordant treatment. Patients that received non-guideline-concordant treatment did so for the following reasons: patient’s preference and/or cardiologist’s decision of PCI over CABG (42, 64.6%), patient’s refusal of the revascularization method (14, 21.5 %), refusal by the surgery team to perform surgery due to advanced patient age or low left ventricular ejection fraction (5, 7.7%),unavailability of the surgery team (1, 1.5%) and developing ischaemia/myocardial infarction during the waiting period (3, 4.6 %). There was no inappropriate CABG decision.
Conclusions: In our study, the prevalence of non-guideline-concordant treatment was high and associated primarily with the preferences of the interventional cardiologists and patients.