bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Is dangling of the lower leg after a free flap reconstruction necessary? A study protocol for a large multicenter randomized controlled study.”
Authors: Krijgh David D. , Teunis Teun , Schellekens Pascal P.A. , Mureau Marc M.A. , Luijsterburg Antonius J.M. , Tempelman Tallechien M.T. , Beek Eva S.J. van der , Maarse Wiesje , Coert J. Henk 
Published: October 2019

Abstract
Background: Within the field of plastic surgery free tissue transfer is common practice for knee and lower leg defects. Usually, after such free flap reconstruction patients undergo a dangling protocol in the postoperative phase. A dangling protocol is designed to gradually subject the free flap to increased venous pressure resulting from gravitational forces. Worldwide there are multiple variations of dangling protocols. However, there is no evidence available in the literature that supports the use of a dangling protocol. Methods: This is a multicenter randomized controlled trial that includes patients with a free flap lower leg reconstruction. The primary outcome is to assess whether a no-dangling protocol is not inferior to a dangling protocol in terms of proportion of partial flap loss, six months after surgery. Secondary objectives are to identify differences in major and minor complications, length of stay, costs, and to objectify blood gaseous changes during dangling. Furthermore, at 2 years we will assess difference in physical function, infection rates and osseous union rates. Discussion: The primary outcome of this study will give a more decisive answer to the question whether a dangling protocol is necessary after a free flap reconstruction of the lower leg. The secondary outcomes of this study will provide a better insight into the physical functions, infection rates and union rates in these patients. Trial registration: Registered at the CCMO (Dutch Medical Research Ethics Commission) in the Netherlands on 11 July 2018: NL63146.041.17. Registered with the Dutch Trial Register (registration number NTR 7545).
Analgesic effect of the ultrasound-guided subcostal approach to transmuscular quadratus lumborum block in patients undergoing laparoscopic nephrectomy: a randomized controlled trial
Authors: Zhu Manhua , Qi Yong , He Huijuan , Lou Jinfeng , Pei Qingqing , Mei Yuliu 
Published: October 2019

Abstract
Background: Quadratus lumborum block (QLB) is an effective analgesia that lowers opioid consumption after lower abdominal and hip surgeries. The subcostal approach to transmuscular QLB is a novel technique that can provide postoperative analgesia by blocking more dermatomes. The aim of this study is to evaluate the efficacy and viability of subcostal approach to QLB after laparoscopic nephrectomy. Methods: Sixty patients who underwent laparoscopic nephrectomy were randomly divided into the subcostal approach to QLB group (QLB group, n=30) and the control group (C group, n=30). All patients underwent ultrasound-guided subcostal approach to QLB in an ipsilateral parasagittal oblique plane at the L1–L2 level. The QLB group received 0.4 cc/kg of 0.3% ropivacaine, and the C group received 0.4 cc/kg of 0.9% saline. Postoperatively, a patient-controlled intravenous analgesic pump with sufentanil was attached to all the patients. The primary outcome was sufentanil consumption within the first 24 h after surgery. The secondary outcomes included the Ramsey sedation scale (RSS) scores and Bruggemann comfort scale (BCS) scores 6 h (T1), 12 h (T2), and 24 h (T3) after surgery, intraoperative remifentanil consumption, number of patients requiring rescue analgesia, time to recovery of intestinal function, mobilization time after surgery, and presence of side effects. Results: Sufentanil consumption within the first 24 h after surgery was significantly lower in the QLB group than in the C group (mean [standard deviation]: 34.1 [9.9] μg vs 42.1 [11.6] μg, P=.006). The RSS scores did not differ between the two groups, and the BCS scores of the QLB group at T1 and T2 time points was significantly higher than those of the C group(P＜0.05). The consumption of remifentanil intraoperatively and the number of patients requiring rescue analgesia were significantly lower in the QLB group (P＜0.05). Time to recovery of intestinal function and mobilization time after surgery were significantly earlier in the QLB group (P＜0.05). The incidence of postoperative nausea and vomiting was significantly lower in the QLB group (P＜0.05). Conclusions: The ultrasound-guided subcostal approach to QLB is an effective analgesic technique in patients undergoing laparoscopic nephrectomy as it reduces the consumption of sufentanil postoperatively.
Transcriptomic and microstructural analyses in Liriodendron tulipifera Linn. reveal candidate genes involved in nectary development and nectar secretion
Authors: Liu Huanhuan , Ma Jikai , Li Huogen 
Published: October 2019

Abstract
Background Nectar is a major flower attractant and reward for insects for pollination. Liriodendron , a genus of the Magnoliaceae family, has only two relict species, L. chinense and L. tulipifera , that are considered “basal angiosperms” according to plant evolutionary history. The flowers of Liriodendron plants are insect pollinated and secrete nectar to attract pollinators. To date, the morphology and anatomy of the nectary, the mechanism of nectar secretion and the molecular mechanism involved in nectary development in Liriodendron remain poorly understood. Methods In this study, we examined the nectary surface cells and the change in starch in L. tulipifera by using scanning electron microscopy and periodic acid-Schiff techniques to select definitive samples for next research. Transcriptome sequencing was performed on the top and middle parts of the immature nectary and the middle parts of the mature nectary and the postsecreted nectary in L. tulipifera . We evaluated the expression profiles of 21 DEGs that were closely related to nectary development and nectar secretion for real-time quantitative PCR analysis. Results The L. tulipifera nectary is a starch-storing nectary and is located in the top and middle parts of L . tulipifera petals. After analyzing the RNA-seq data, we obtained 115.26 Gb clean data in 12 libraries and mapped the results to the L. chinense reference genome with 71.02%-79.77% efficiency. In total, 26,955 DEGs were identified by analyzing six different pairwise comparisons. The flavonoid biosynthesis, phenylpropanoid biosynthesis, anthocyanin biosynthesis and starch and sucrose metabolism pathways were enriched and related to nectar secretion and pigment change. We identified 56 transcription factor families, and members of the TCP, Trihelix, C2H2, ERF, and MADS families changed dynamically during nectary development. Moreover, to further verify the accuracy of the RNA-seq results, we validated the expression profiles of 21 candidate genes. Conclusions We evaluated the nectary development and secretion process comprehensively and identified many related candidate genes in L. tulipifera . These findings suggest that the nectary may play important roles in flavonoid synthesis and petal color presentation.
Transcriptomics analysis revealing candidate genes and networks for sex differentiation of Yesso scallop(Patinopecten yessoensis)
Authors: Zhou Liqing , Liu Zhihong , Dong Yinghui , Sun Xiujun , Wu Biao , Yu Tao , Zheng Yanxin , Yang Aiguo , Zhao Qing , Zhao Dan 
Published: October 2019

Abstract
Background:The Yesso scallop, Patinopecten (Mizuhopecten) yessoensis, is a commercially important bivalve in the coastal countries of Northeast Asia. It has complex modes of sex differentiation, but knowledge of the mechanisms underlying this sex determination and differentiation is limited. Results:In this study, the gonad tissues from females and males at three developmental stages were used to investigate candidate genes and networks for sex differentiation via RNA-Req. A total of 901,980,606 high quality clean reads were obtained from 18 libraries, of which 417 expressed male-specific genes and 754 expressed female-specific genes. Totally, 10,074 genes differentially expressed in females and males were identified. Weighted gene co-expression network analysis (WGCNA) revealed that turquoise and green gene modules were significantly positively correlated with male gonads, while coral1 and black modules were significantly associated with female gonads. The most important gene for sex determination and differentiation was Pydmrt1, which was the only gene discovered that determined the male sex phenotype during early gonadal differentiation. Enrichment analyses of GO terms and KEGG pathways revealed that genes involved in metabolism, genetic and environmental information processes or pathways are sex-biased. Forty-nine genes in the five modules involved in sex differentiation or determination were identified and selected to construct a gene co-expression network and a hypothesized sex differentiation pathway. Conclusions: The current study focused on screening genes of sex differentiation in Yesso scallop, highlighting the potential regulatory mechanisms of gonadal development in P. yessoensis. Our data suggested that WCGNA can facilitate identification of key genes for sex differentiation and determination. Using this method, a hypothesized P. yessoensis sex determination and differentiation pathway was constructed. In this pathway, Pydmrt1 may have a leading function.
Panic Disorder and Chronic Caffeine Use: A Case-control Study
Authors: Santos Veruska Andrea , Hoirisch-Clapauch Silvia , Nardi Antonio E. , Freire Rafael Christophe 
Published: October 2019

Background:
Acute administration of caffeine produces panic attacks in most Panic Disorder (PD) patients, but little is known about chronic caffeine use in these patients.

Objective:
To assess caffeine use in patients with PD and to ascertain if caffeine consumption is associated with sociodemographic or clinical features.

Methods:
65 adults with PD and 66 healthy controls were included in the current study. Their caffeine intake within the previous week was quantified with a questionnaire and compared. Harmful caffeine use was defined as consumption above 400 mg/day of caffeine. We tested for correlations between caffeine intake, demographic and clinical features.

Results:
Patients consumed significantly more caffeine than controls (P < 0.001). 14% (N = 9) of the PD patients made harmful use of caffeine. The use of caffeine-containing medications was observed in 40% (N = 26) of the PD patients and 6% (N = 4) of controls. Consumption of energy drinks was observed in 11% (N = 7) of PD patients and in none of the healthy subjects. Patients reported sleeping significantly less than controls (P < 0.001). In PD patients, caffeine consumption was not correlated with the presence of panic attacks or comorbidity with depression. The use of benzodiazepines or sedative medications was not correlated with caffeine intake.

Conclusion:
High caffeine consumption in PD patients could be explained by the development of tolerance with regular use of this substance. Subtypes of sensitive and non-sensitive PD patients could also explain why some of these patients are able to tolerate high doses of caffeine.
Analysis of four-year management of the waiting list for liver transplantation in Rostov region: prospects for reducing mortality of candidates listed for liver transplantation
Authors: Korobka V. L. , Pak E. S. , Shapovalov A. M. , Kostrykin M. U. , Tkachev A. V. 
Published: October 2019

Purpose: analysis of various clinical results in patients registered in the liver transplantation waiting list (LTWL).Materials and methods: the study was carried at the Center of Surgery and Donor Coordination of the Rostov Regional Clinical Hospital using clinical, laboratory and instrumental data of 198 patients from the LTWL. 99 men and 99 women were enrolled into this study. The men age ranged from 21 to 70 years (47.8 ± 10.4 years), women age - from 18 to 66 years (49.2 ± 10.9 years). At the time of analysis of the LTWL, the average follow-up period was 14.8 ± 11.2 months. All patients were examined according to the list required for inclusion in the LTWL.Results: depending on the outcome, 198 patients from TLWL were grouped into 4 groups. The first group (delisting group) — 19 patients (9.6 %) with clinical and laboratory indicators that allowed them to be excluded from WL. The second group — 67 patients (33.8 %) who had positive clinical dynamics following therapy. The third group — 39 patients (19.7 %) who underwent liver transplantation. The fourth group — 73 patients (36.9 %) who had negative dynamics following therapy, including patients with a fatal outcome. While keeping LTWL for 4 years, 61 (30.81 %) of 198 listed patients died. The majority (40 patients) died of bleeding from varicose veins and OPPN, 17 patients died of hepatic coma and SPB. Each group represents the distribution of patients according to the MELD-Na scale, the severity of portal hypertension and hepatic encephalopathy.Conclusion: the following factors are indispensable for successful work of the transplant center: systematic work with the territories in order to expand the donor base; defining the patient priority criteria in the LTWL in order to reduce the death rate in the list; detailed examination of the patient before entering the list; forming the observation base; systematic patient observation during the pre- and postoperative period, at the rehabilitation stage, as well as at long-term periods in order to develop an effective algorithm of management of the recipient of a solid organ.
Analysis of the incidence of community-acquired pneumonia and acute otitis media in children during the first four years of life in different age groups vaccinated with pneumococcal 13-valent vaccine Prevenar
Authors: Pyrkova S. A. , Voronina L. P. , Kuzin M. E. , Cherepova V. V. , Polunina E. A. 
Published: October 2019

Objective: to analyze the incidence of community-acquired pneumonia and acute otitis media in children during the first four years of life in different age groups vaccinated with pneumococcal 13-valent vaccine Prevenar.Materials and methods: medical records of 590 children aged 1 to 5 years were analyzed. All subjects were divided into 2 groups. The first group consisted of vaccinated children (n = 490), born in 2014, and vaccinated against pneumococcal 13-valent vaccine Prevenar. The second group consisted of unvaccinated children (n = 100) born in 2013 and not vaccinated. Each group was divided into subgroups depending on the age period (1—2 years, 2—3 years, 3—4 years, 4—5 years).Results: it is established that the conduct of specific prophylaxis of pneumococcal infection vaccine Prevenar-13 in children during the first 4 years of life effectively reduces the incidence of community-acquired pneumonia (in 7,6 times) and acute otitis media (in 8,5 times). The effectiveness of the vaccine was observed in all age groups. In cases of development of an inoculated child acute otitis reduces the risk of severe forms and complications of the disease. Analysis of the course of the post-vaccination period indicates a high level of safety and good tolerability of the vaccine.Conclusion: Implementation of specific prophylaxis of pneumococcal 13-valent vaccine Prevenar in children during the first four years of life according to the calendar of vaccination effectively reduces the incidence of community-acquired pneumonia (87 %) and acute otitis media (42,8 %) in all age subgroups. In cases of development of an inoculated child acute otitis reduces the risk of severe forms and complications of the disease. Analysis of the course of the post-vaccination period indicates a high level of safety and good tolerability of the vaccine.
Pharmacogenetic aspects of vildagliptin treatment in patients with newly diagnosed type 2 diabetes mellitus
Authors: Shorokhova P. B. , Baranov V. L. , Vorokhobina N. V. , Matezius I. Yu. , Bashnina E. B. , Jakovenko K. A. 
Published: October 2019

Objective: to study a role of the rs5219 polymorphism in KCNJ11 in the formation of the response variability to vildagliptin therapy in patients with newly diagnosed type 2 diabetes mellitus (T2DM).Materials and methods: 48 patients with newly diagnosed T2DM were examined. For all patients vildagliptin in a dose of 50 mg/day was prescribed. If necessary, dose titration was carried out or other glucose-lowering therapy was prescribed for 6 months of observation. Dynamics of the main indicators of glycemic control and body mass index were studied, presence of the rs5219 polymorphism in KCNJ11 gene was also determined.Results: all patients-carriers the T allele had achieved the target values of glycated hemoglobin (HbA1c) in 3 months of vildagliptin monotherapy, compared to patients with wild-type gene who achieved target values of HbA1c in only 44,4% of cases. Increasing the dose to 100 mg/day required 35% of patients with wild-type gene and 17.9% of patients with rs5219 polymorphism. The appointment of a combination of glucose-lowering therapy was necessary in 40% of patients with the wild-type gene and no one with polymorphism.Conclusion: the presence of the polymorphic allele T rs5219 in KCNJ11 gene makes it possible to predict the high efficacy of vildagliptin monotherapy in patients with newly diagnosed T2DM.
Mediators of a Physical Activity Intervention on Cognition in Breast Cancer Survivors: Evidence From a Randomized Controlled Trial
Authors: Hartman Sheri J , Weiner Lauren S , Nelson Sandahl H , Natarajan Loki , Patterson Ruth E , Palmer Barton W , Parker Barbara A , Sears Dorothy D 
Published: October 2019

BackgroundEmerging research suggests that increasing physical activity can help improve cognition among breast cancer survivors. However, little is known about the mechanism through which physical activity impacts cancer survivors’ cognition.ObjectiveThe objective of this secondary analysis examined physical and psychological function potentially linking physical activity with changes in cognition among breast cancer survivors in a randomized controlled trial where the exercise arm had greater improvements in cognition than the control arm.MethodsA total of 87 sedentary breast cancer survivors were randomized to a 12-week physical activity intervention (n=43) or control condition (n=44). Objectively measured processing speed (National Institutes of Health Toolbox Oral Symbol Digit), self-reported cognition (patient-reported outcomes measurement information system [PROMIS] cognitive abilities), PROMIS measures of physical and psychological function (depression, anxiety, fatigue, and physical functioning), and plasma biomarkers (brain-derived neurotrophic factor, homeostatic model assessment 2 of insulin resistance, and C-reactive protein [CRP]) were collected at baseline and 12 weeks. Linear mixed-effects models tested intervention effects on changes in physical and psychological function variables and biomarkers. Bootstrapping was used to assess mediation. Exploratory analyses examined self-reported cognitive abilities and processing speed as mediators of the intervention effect on physical functioning.ResultsParticipants in the exercise arm had significantly greater improvements in physical functioning (beta=1.23; 95% CI 2.42 to 0.03; P=.049) and reductions in anxiety (beta=−1.50; 95% CI −0.07 to −2.94; P=.04) than those in the control arm. Anxiety significantly mediated the intervention effect on cognitive abilities (bootstrap 95% CI −1.96 to −0.06), whereas physical functioning did not (bootstrap 95% CI −1.12 to 0.10). Neither anxiety (bootstrap 95% CI −1.18 to 0.74) nor physical functioning (bootstrap 95% CI −2.34 to 0.15) mediated the intervention effect on processing speed. Of the biomarkers, only CRP had greater changes in the exercise arm than the control arm (beta=.253; 95% CI −0.04 to 0.57; P=.09), but CRP was not associated with cognition; therefore, none of the biomarker measures mediated the intervention effect on cognition. Neither cognitive abilities (bootstrap 95% CI −0.06 to 0.68) nor processing speed (bootstrap 95% CI −0.15 to 0.63) mediated the intervention effect on physical function.ConclusionsPhysical activity interventions may improve self-reported cognition by decreasing anxiety. If supported by larger studies, reducing anxiety may be an important target for improving self-reported cognition among cancer survivors.Trial RegistrationClinicalTrials.gov NCT02332876; https://clinicaltrials.gov/ct2/show/NCT02332876
Procesos de gestión humana en universidades públicas de Villavicencio
Authors: Leal-Céspedes Juan Carlos , Lozano Pernett Laura Fernanda , Orozco Castro Ginna Paola 
Published: October 2019

La globalización económica bajo el precepto de la competitividad ha generado la exigencia de elevar sus estándares de calidad a todas las organizaciones que asumen el reto de prevalecer en su entorno. Las instituciones de educación públicas no han sido ajenas a este escenario de la economía mundial, por lo que deben realizar ajustes a sus factores estratégicos y la gestión humana es uno de ellos.
La Universidad de los llanos ha emprendido desde la década pasada, un proceso de reforma a fin de fortalecer sus elementos estratégico ajustando procesos de gestión tales como la administración de personal, el reclutamiento y la selección, y la evaluación de desempeño. En este proceso se encuentran aciertos y recomendaciones para cada uno a fin de lograr los estándares solicitados por el nuevo escenario nacional y mundial.
Crisis en la política socio-comercial presidencialista norteamericana y sus efectos para la economía mexicana
Authors: Soto Aguilar Adriana Patricia 
Published: October 2019

Durante los últimos 10 años se ha observado un incremento de las contradicciones en la política económica comercial de la presencia de los Estados Unidos hacia México teniendo como resultado una inestabilidad en la relación comercial entre ambos países, hoy en día llama la atención las propuestas de los dos candidatos presidenciales a la Casa Blanca especialmente la política comercial y un escaso seguimiento por parte del Gobierno Federal Mexicano. El trabajo presentado pone énfasis en las propuestas comerciales de Donald Trump y en segunda instancia en los intereses ocultos de Hillary Clinton.
El reto de análisis es mayor dadas las crisis recurrentes de la Economía Norteamericana en materia inmobiliaria y crisis financiera especialmente el incremento de su deuda interna y cartera vencida, así como el incremento de las remesas hacia nuestro país. Se pretende Identificar las contradicciones de la política económica-comercial presidencialista norteamericana y sus efectos para México en torno a la crisis económica y financiera de ambos países, objetivo concluido, bajo la línea de investigación Crisis económica y financiera Internacional, como resultado relevante la política socio-comercial de Estados Unidos ha agudizado las contradicciones de las crisis recurrentes en Estados Unidos y en los Estados Unidos Mexicanos, generando nuevos procesos de acumulación de capital, y como conclusión apremiante se presenta en que la política socioeconómica del gobierno norteamericano y sus presidenciales aumenta los factores de crisis económica y financiera.
JEL A:13, D:60, F:18, N:35