bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of the combination of metformin and exercise on glycated hemoglobin, functional capacity, lipid profile, quality of life, and body weight
Authors: Eltonsy Sherif , Dufour Doiron Monique , Simard Patrice , Jose Caroline , Sénéchal Martin , Bouchard Danielle R. , LeBlanc Rémi , Bélanger Mathieu 
Published: January 2019

Objective To evaluate the impact of the combination of metformin and exercise on changes in glycated hemoglobin (HbA1c), functional capacity, the lipid profile, quality of life, and weight. Methods Data from a 12-week cardiovascular rehabilitation program (2014–2016) were retrospectively evaluated. Metformin exposure was determined through recorded prescriptions, and average minutes of exercise per week were computed from exercise logs. The primary outcomes were changes in HbA1c and functional capacity (6-minute walk test [6MWT]) over 12 weeks. The secondary outcomes were changes in the lipid profile, quality of life, and weight. Directed acyclic graphs were used to identify potential confounders, accounted for with multiple linear regression. Results The cohort comprised 403 patients (85 metformin users, 318 non-users). The average amount of exercise was 102.7±48.7 minutes/week among metformin users and 107.7±58.1 minutes/week among non-users. Although changes in HbA1c were similar for both groups, the coefficient for the metformin–exercise interaction indicated significantly greater improvements in the 6MWT among metformin users. There were no between-group differences in any secondary outcomes. Conclusions The combination of metformin and exercise led to greater gains in functional capacity than exercise alone. This combination did not appear to influence the effects of either treatment on other outcomes.
Spatially Detailed 3D Quantification of Improved Facial Symmetry After Surgery in Children With Unicoronal Synostosis
Authors: Öwall Louise , Darvann Tron A. , Hove Hanne B. , Bøgeskov Lars , Kreiborg Sven , Hermann Nuno V. 
Published: January 2019

Objective: To assess improvement of soft-tissue facial symmetry in children surgically treated for unicoronal synostosis (UCS) in infancy, to correlate pre- and postsurgical facial asymmetry and to evaluate whether the improvement was visually recognizable. Design: Case–controlled follow-up. Patients/Settings: Eleven Danish children diagnosed with UCS were included, 3 of whom had tested positive for Muenke mutation. Preoperative computed tomography scans and postoperative 3dMD surfaces were available for measurements. A control group of healthy children matched for age and sex was employed. Main Outcome Measures: Pre- and postsurgical facial asymmetry was analyzed using a computerized method capable of objective and spatially detailed quantification in 3-dimension (transverse, vertical, and sagittal directions). Asymmetry was evaluated in the facial region and 6 subregions (forehead, mouth, eyes, nose, cheek, and chin). Results: The largest significant improvement was seen in the sagittal direction of the facial (1.9 mm), forehead (2.0 mm), and cheek (3.4 mm) regions. Small but significant improvements were also seen in the mouth, chin, and eye regions. No significant improvement was seen in the nose region. Significant correlations were found between the pre- and postsurgically calculated facial asymmetry and between calculated asymmetry and clinical validation scores. Conclusions: All patients presented with improved facial symmetry after surgery and the improvements were visually recognizable. However, only 1 (9.1%) of the 11 patients reached a level of facial asymmetry as low as that seen in the control group. The best outcome was, in general, seen in cases with mild facial asymmetry presurgically.
The nursing of skin metastasis on the puncture site of peripherally inserted central catheter in a patient with lung cancer
Authors: Xie Ling L , Pu Dan , Xiang Fen Q , Li Ying J 
Published: January 2019

Objective: To report a case of lung cancer metastasizing to skin from peripherally inserted central catheter puncture and to analyze the causes and treatment of this event. Methods: In August 2016, one patient with lung cancer developed a nodule on the puncture site of peripherally inserted central catheter. The nodule was 1 cm × 1 cm in size and soft in texture, whose color was similar to that of the skin; the surface was smooth and integral without tenderness, bleeding, or exudates. After removing the catheter, the nodule ruptured and was liable to bleeding on touching and grew up gradually ever since. Cytological examination of the nodule revealed tumor cells infiltration, after which nodule resection was performed. Result: The patient’s wound healed up well, and no other masses were found on the skin surface around the whole body. The pathological examination of the surgical specimen suggested metastatic pulmonary adenocarcinoma. Conclusion: The case of lung cancer metastasizing to skin from peripherally inserted central catheter puncture is rare and may be attributed to the aggressiveness of tumor, the age of the patient, and the duration and location of peripherally inserted central catheter. Active treatment of distant metastasis could improve the life quality and prolong the survival of the patients.
Overcoming data scarcity in flood hazard assessment using remote sensing and artificial neural network
Authors: Kim Dong-Eon , Gourbesville Philippe , Liong Shie-Yui 
Published: January 2019

AbstractMany urban cities in Southeast Asia are vulnerable to climate change. However, these cities are unable to take effective countermeasures to address vulnerabilities and adaptation due to insufficient data for flood analysis. Two important inputs required in flood analysis are high accuracy Digital Elevation Model (DEM), and long term rainfall record. This paper presents an innovative and cost-effective flood hazard assessment using remote sensing technology and Artificial Neural Network (ANN) to overcome such lack of data. Shuttle Radar Topography Mission (SRTM) and multispectral imagery of Sentinel-2 are used to derive a high-accuracy DEM using ANN. The improvement of SRTM’s DEM is significant with a 42.3% of reduction on Root Mean Square Error (RMSE) which allows the flood modelling to proceed with confidence. The Intensity Duration Frequency (IDF) curves that were constructed from precipitation outputs from a Regional Climate Model (RCM) Weather Research and Forecasting (WRF) were used in this study. Design storms, calculated from these IDF curves with different return periods were then applied to numerical flood simulations to identify flood prone areas. The approach is demonstrated in a flood hazard study in Kendal Regency, Indonesia. Flood map scenarios were generated using improved SRTM and design storms of 10-, 50- and 100-year re-turn periods were constructed using the MIKE 21 hydrodynamic model. This novel approach is innovative and cost-effective for flood hazard assessment using remote sensing and ANN to overcome lack of data. The results are useful for policy makers to understand the flood issues and to proceed flood mitigation adaptation/measures in addressing the impacts of climate change.
Influence of providing information to participants about development of trial outcomes on response rates and attitudes to questionnaire completion: Protocol for a study within a trial
Authors: Griffin Charlotte , Toomey Elaine , Queally Michelle , Hayes Catherine , Kearney Patricia M. , Matvienko-Sikar Karen 
Published: January 2019

Background: Issues with questionnaire completion introduce bias and limit examinations in trials. Improving communication with participants about trial processes, such as outcome and questionnaire development, may improve questionnaire completion and response rates. Providing information about the involvement of stakeholders in the development of core outcome sets (COS) measured in trials may improve responding by tapping into subjective norms and behaviour change mechanisms. The aim of this Study Within a Trial (SWAT) is to examine if questionnaire response rates and participants’ attitudes towards questionnaire completion are impacted by providing information about COS use in a trial of a complex intervention. Methods: This is a randomised, single-blinded, parallel group intervention SWAT, embedded within a feasibility trial of an infant feeding intervention to prevent childhood obesity. The SWAT intervention consisting of a brief written description and explanation about the development and use of a COS of infant feeding outcomes to prevent childhood obesity, used in the trial. Participants are parents or caregivers of infants aged two months at questionnaire completion. Participants will be randomly assigned to receive the SWAT intervention prior to questionnaire completion (I1 condition), or to receive the information following completion of all questionnaires (I2 condition). The SWAT will be assessed using closed-ended and an open-ended question to evaluate participants’ attitudes about questionnaire completion. Response rates will be measured as proportion of full questionnaire completion and individual item response rates. Discussion: We hypothesise that providing information about development and use of a COS will increase questionnaire response rates and attitudes toward questionnaire completion relative to the control condition. Findings will indicate the potential usefulness of this strategy for improving participant attitudes and response rates in trials. Trial Registration: This SWAT is registered on the Northern Ireland Hub for Trials Methodology: Research SWAT Repository (SWAT57).
The effects of obesity on asthma control and management
Authors: Marsh Viv 
Published: January 2019

Obesity is a well-known risk factor for many chronic conditions but its link to asthma is still poorly understood. As phenotyping continues to develop, Viv Marsh explains the link between obesity and asthma as well as useful support strategies to aid patients in weight loss Although not fully understood, obesity is a known risk factor for the development of asthma, and also for poor asthma control and increased severity of asthma attacks; therefore, it is an important issue in asthma management. This article explores these issues and focuses on the impact of obesity on asthma control and management strategies for primary care health professionals.
Perfil da Prescrição de Fitoterápicos em uma Farmácia de Manipulação de Vitória da Conquista-BA entre 2014 a 2018
Authors: Moraes Marcelo Batista , Marques Matheus Santos , Soares Érika Chuluk Silva , Damascena Rodrigo Santos 
Published: January 2019

Os fitoterápicos são medicamentos obtidos através de uma planta medicinal, ou dos seus derivados, com exceção das substâncias isoladas, tendo o objetivo profilático, curativa ou paliativa. O presente trabalho teve como foco verificar o perfil da prescrição de fitoterápico em uma farmácia de manipulação de Vitória da Conquista-Ba entre 2014 a 2018, conhecer o público que mais utiliza dessa terapia, as especialidades dos prescritores desses medicamentos e avaliar a evolução das vendas nos últimos cinco anos. A pesquisa foi do tipo documental/ digital, retrospectiva e descritiva, utilizando o programa Fórmula Certa como fonte de pesquisa, tendo como base de análise as prescrições de medicamentos fitoterápicos referentes ao período de Julho de 2014 a julho de 2018. Os resultados foram verificados utilizando análise percentual e expressos em gráficos e tabelas. Após análise viu-se que todas as prescrições (17.078) apresentavam o nome do usuário; e destas 13.320,84 foram prescritas para mulheres (78%) e 3.757,16 (22%) para homens. A área profissional que mais apresentaram prescritores foram nutricionistas com (202), seguido por clínico geral (142), ginecologista (36), cardiologista (19), dermatologista (18), pediatra (16) gastroenterologista (10), endocrinologista (09). Os fitoterápicos com maior frequência foram: Aesculus hippocastanum, Vitis vinífera,Tribullus terrestres, Carapa guaianesis Aubl, Equisetum arvense L. A forma farmacêutica com maior volume de prescrição foi de cápsulas que pertence ao laboratório de sólidos. Verificou- se nos últimos cinco anos uma redução nas vendas dos fitoterápicos.
O Brincar e o Aprender na Educação Infantil
Authors: Rodrigues Eliza Naiane , Alves Maria do Socorro Januário , Sobral Maria do Socorro Cecílio 
Published: January 2019

Brincar é uma necessidade para o desenvolvimento da criança. Sendo assim, é o direito que ela tem, inclusive consta no Estatuto da Criança e do Adolescente, no Artigo nº16. Muitos pensam que a criança brinca apenas para se distrair e por prazer, mas a brincadeira é uma grande necessidade, porque de acordo com a idade da criança, a brincadeira evolui e a própria relação da criança com o adulto se modifica. O presente artigo trata de uma pesquisa bibliográfica que busca identificar as bases teóricas que sustentam o brincar e o aprender no ensino aprendizagem de crianças na educação infantil, fundamentada na reflexão de leituras autores renomados como Andrade (2013), Antunes (2013), Ramos, (2012), Raul (2007), Rolim, (2014) e RCNEI (2001), os quais discutem com precisão a temática aqui abordada. O objetivo deste estudo é demonstrar de que forma o brincar contribui com o ensino aprendizagem nas crianças na educação infantil. Os dados foram obtidos por meio de análises de textos de dos quais nos dá embasamento da importância da prática do brincar para a concretização do aprender. É preciso repensar em uma prática pedagógica que privilegie as brincadeiras na formação integral da criança.
Análise do Conhecimento e Atitudes dos Profissionais das USFs da Zona Urbana sobre Notificação de Reações Adversas
Authors: Flores Alana Ferraz , Damascena Rodrigo Santos 
Published: January 2019

Os medicamentos são instrumentos indispensáveis no esquema terapêutico de diversas doenças, no qual, auxiliam na prevenção e progressão da mesma. As reações adversas aos medicamentos (RAM) são eventos imprevisíveis, de intensidade leve ou grave (como hospitalização, incapacidade e óbito) e que pode acometer qualquer pessoa quando administrar um medicamento em dose terapêutica. Objetivo: O presente estudo tem por objetivo analisar o conhecimento e atitudes dos profissionais das USFS da zona urbana sobre notificação de reações adversas. Materiais e Métodos: Trata-se de um estudo seccional descritivo conduzido no município de Vitória da Conquista por meio de um questionário estruturado e auto preenchido. A pesquisa envolveu 41 entrevistados de 3 categorias profissionais: 21 enfermeiros (51,22%), 12 médicos (29,27%) e 8 odontólogos (19,51%). Resultados e discussão: Observou-se predominância do gênero feminino (75,61%), bem como das faixas etárias de 36-40 (26,83%) e 41-45 anos (21,95%). A maioria dos entrevistados tinham acima de seis anos de formação (40%), a maioria (80%) porta títulos de especialização. A compreensão quanto ao nível de conhecimento acerca de RAM, apenas 46,34%(n=19) dos profissionais o classificaram como razoável e 41,46%(n=17) de forma satisfatória. Os profissionais de Saúde da Família que participaram do presente estudo caracterizaram o conhecimento limitado sobre as notificações de reações adversas, o que evidencia a necessidade de ações estratégicas (palestras; distribuição de informativos e folhetos; capacitações) voltadas para a educação continuada da equipe multiprofissional. Conclusão: De acordo com os dados obtidos nesse estudo, conclui-se que o incentivo à notificação de RAM é considerado elemento chave para o fortalecimento dos sistemas de monitorização, utilizado pela farmacovigilância, sendo de suma importância para a melhoria da qualidade e do uso racional dos medicamentos. Porém, enfatiza-se a necessidade de capacitação como estratégia de preparação do profissional para notificação espontânea.
Reflexões Éticas Suscitadas pelos Avanços Tecnológicos
Authors: Silva Andrey Tavares da , Morais Allan Richards De Melo Nunes , Nascimento Fernanda Coelho de Figueiredo Soares , Ramos Júlio Cezar Costa , Nascimento Tiago Gama do , Duarte Francisco Ricardo 
Published: January 2019

Este artigo faz uma análise das transformações que o uso das novas tecnologias, que surgiram na sociedade pós-moderna e contemporânea, sobre a conduta moral dos indivíduos e suas implicações éticas. Dessa forma buscou-se identificar na literatura a fundamentação teórica dos conceitos. O método de pesquisa constituiu no levantamento bibliográfico dos conceitos, juntamente com análise de artigos e acontecimentos relevantes sobre a utilização das tecnologias. É destacado quatro tecnologias que se desenvolveram no último século – data mining, manipulação genética, energia nuclear, redes sociais – para analisar as transformações e reflexões éticas que essas tecnologias trouxeram para o comportamento moral dos indivíduos. Essas reflexões são elencadas e discutidas a luz dos conceitos levantados na pesquisa bibliográfica. Por fim nas considerações finais é ponderado as reflexões éticas colocadas no texto.
Hubungan Asupan Zat Gizi Makro dan Status Gizi Ibu Menyusui dengan Kandungan Zat Gizi Makro pada Air Susu Ibu (ASI) di Kelurahan Bandarharjo Semarang
Authors: Wardana Ruliansyah Kusuma , Widyastuti Nurmasari , Pramono Adriyan 
Published: January 2019

Latar Belakang : Peningkatan Angka kematian Bayi (AKB) salah satunya dapat disebabkan karena gizi buruk. Gizi buruk di Kota Semarang pada Kelurahan Bandaharjo ada >2 kasus. Masalah gizi buruk dapat dilakukan dengan memperhatikan asupan zat gizi makro, banyak sedikitnya asupan ibu berdasarkan status gizi memberikan pengaruh terhadap kualitas air susu ibu (ASI). Jika asupan makanan pada ibu menyusui tidak tercukupi energi, karbohidrat, lemak, dan protein akan beresiko mengalami penurunan kualitas. Metode : Penelitian dilakukan Kelurahan Bandaharjo, Semarang dengan metode Cross-Sectional, subjek 42 orang ibu menyusui dengan bayi usia 1-12 bulan. Pemilihan subjek secara purposive dan memenuhi kriteria inklusi. Data kandungan ASI sebanyak 100ml yang diujikan pada laboratorium patologi RSUP Kariadi. Asupan energi, karbohidrat, lemak, dan protein dengan recall 24 jam. Data status gizi didapat dengan pengukuran tinggi dan berat badan kemudian dihitung IMTnya. Analisis data menggunakan program statistik, uji normalitas menggunakan uji Shapiro-Wilk dilanjutkan uji korelasi Pearson. Hasil : Rentang usia subjek 17-40 tahun. Sebagian besar subjek memiliki status gizi lebih (64,4%). Sebanyak 64% asupan lemak kategori lebih, asupan energi dengan kategori kurang (50%), asupan karbohidrat dengan kategori kurang 90% dan asupan protein dengan kategori kurang (45%). Status Gizi tidak berhubungan dengan kandungan energi ASI (p=0,540) karbohidrat ASI (p=0,742), lemak ASI (p=0,472), protein ASI (p=0,296), dan terdapat hubungan asupan energy ibu dengan energi ASI (p=0,021) karbohidrat ASI (p=0,040), lemak ASI (p=0,043), dan protein ASI (p=0,031), asupan karbohidrat dengan karbohidrat ASI (p=0,000), asupan lemak dengan lemak ASI (p=0,000), asupan protein dengan protein ASI (p=0,000). Simpulan : Terdapat hubungan pada asupan zat gizi makro ibu menyusui dengan kandungan zat gizi makro pada ASI. Tidak ada hubungan status gizi ibu dengan kandungan zat gizi makro pada ASI.
“Her-story”: contemporary female film directors in post-Yugoslav cinema
Authors: Durić Dejan 
Published: January 2019

The subject of this paper is a new generation of female directors in former Yugoslav (Croatia, Serbia, Bosnia and Herzegovina) cinematography. It considers the stylistic, narrative and representational strategies in the films Clip (Klip, 2012) by Maja Miloš, Sonja and the Bull (Sonja i bik, 2012) by Vlatka Vorkapić, Our Everyday Life (Naša svakodnevna priča, 2015) by Ines Tanović, Zagreb Cappuccino (2014) by Vanja Sviličić, Trampoline (Trampolin, 2016) by Zrinka Katarina Matijević, You Carry Me (Ti mene nosiš, 2015) by Ivona Juka, and Quit Staring at My Plate (Ne gledaj mi u pijat, 2016) by Hana Jušić. The movies are related through conceptual, thematic and/or stylistic features. They examine the position of female protagonists in a patriarchal society and their daily experiences, wherein they dissect gender, economic and social problems that exist in countries in the territory of former Yugoslavia.
Glycemic control, medication adherence, and injection practices among diabetic patients treated in the 3 tertiary referral hospitals in Bhutan: a call for more action
Authors: Dorji Thinley , Lhamo Pempa , Tshering Tshering , Zangmo Lungten , Choden Kencho , Choden Deki , Namgyal Kesang 
Published: January 2019

Abstract

Background
The burden of diabetes has increased rapidly with an increasing cost of treatment.

Objectives
To describe the glycemic control, injection practices, and treatment adherence among diabetic patients treated with insulin.

Methods
This cross-sectional study was conducted using a convenience sampling method at the 3 tertiary referral hospitals in Bhutan. Sociodemographic, injection practices, and clinical details were collected. Good glycemic control was defined as glycated hemoglobin A (HbA1c) <7% if available or fasting blood sugar 70–130 mg/dL and 2 h postprandial blood sugar <180 mg/dL if HbA1c values were unavailable. Medication adherence was assessed using the Morisky, Green and Levine (MGL) scale. The injection technique was assessed using a 10-item checklist.

Results
We studied 207 patients. Good glycemic control was achieved by only 58 (28.0%) of patients. Using the MGL scale score, the objective adherence with insulin therapy was mostly low to medium and a gross discordance was with self-declared adherence (P < 0.001). The injection technique was fair to poor in half of the participants. Those with good injection techniques also had good adherence to medication (P = 0.025, adjusted odds ratio = 4.4, 95% confidence interval 1.2–16.4). The majority (154, 74.4%) had self-injected insulin, while the remaining were dependent on their home caregivers. Forty percent of the participants used storage practices that were not recommended. The disposal of the used insulin needles was generally unsafe.

Conclusions
Glycemic control and adherence to insulin administration recommendations were poor. The injection technique needs to be improved and standardized, and methods of safe disposal of sharps need to be developed.