bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between alkaline phosphatase and impaired coronary flow in patients with ST-segment elevated myocardial infarction
Authors: Edem Efe 
Published: July 2018

Objective Recent studies have shown that alkaline phosphatase (ALP) might play a negative role in clinical outcomes of patients with peripheral and coronary artery disease. This study aimed to investigate the relationship between serum ALP levels and coronary thrombolysis in myocardial infarction (TIMI) frame counts in patients with ST-segment elevated myocardial infarction undergoing primary percutaneous coronary intervention (PCI). Methods A total of 198 patients were enrolled in the current study. Serum ALP levels were measured in lithium-heparin plasma samples via a standardized, colorimetric enzyme assay. Coronary TIMI flow was evaluated by counting the number of cine frames that were required for contrast to reach a standardized distal coronary landmark in the culprit vessel. Results The Spearman correlation coefficient test showed strong positive relationships between coronary TIMI frame counts after primary PCI and serum ALP levels on admittance for the left anterior descending, circumflex, and right coronary arteries (r = 0.774, r = 0.831, and r = 0.730, respectively). Conclusion Elevated serum ALP levels appear to be a predictor of impaired coronary TIMI frame count in patients suffering from ST-segment elevated myocardial infarction.
Therapeutic measures in a moving ambulance: Qualitative study of professional opinions regarding prehospital emergencies
Authors: Castejón-de la Encina María Elena , Sanjuán Quiles Ángela , del Moral Vicente-Mazariegos Ignacio , García-Aracil Noelia , Morales López Beatriz , Richart Martinez Miguel 
Published: July 2018

Background: current organization of the prehospital emergency teams, decreasing the prehospital times, given the possibility of working during the patient’s transport and, therefore, the consequences that may result from the same improving the prognostic. Objectives: To explore the opinion of professional healthcare experts regarding prehospital emergencies arising when forced to assist a critical patient in a moving vehicle, based on a high-fidelity clinical simulation, as well as the factors influencing them. Methods: An exploratory study of content analysis with qualitative methodology, via semi-structured questionnaires that are self-completed anonymously, before and after the clinical simulation intervention in which participants intubate a mannequin in a moving ambulance. The sample consisted of 36 experts in prehospital emergencies from the province of Alicante (Spain). Codification and assessment of the data obtained was carried out via triangulation, respecting the language and literal expressions of the participants. Results: Thirty-two pre- and post-intervention questionnaires were completed. Four different units of meaning or categories emerged which were organized based on two thematic structures, from the perspective of professional and patient needs. Twenty-three participants had never previously intubated in a moving vehicle. Discussion: Working in a moving vehicle may be yet another aspect to consider in the specialized teaching–learning process of prehospital emergency medicine. Conclusion: Based on the need to decrease prehospital assistance times, a new paradigm has been opened in prehospital emergencies with the possibility of being able to safely assist our patients during their transport on a moving ambulance or helicopter. It will be necessary further research in the future.
Investigating Risk Adjustment Methods for Health Care Provider Profiling When Observations are Scarce or Events Rare
Authors: Brakenhoff Timo B , Moons Karel GM , Kluin Jolanda , Groenwold Rolf HH 
Published: July 2018

Background: When profiling health care providers, adjustment for case-mix is essential. However, conventional risk adjustment methods may perform poorly, especially when provider volumes are small or events rare. Propensity score (PS) methods, commonly used in observational studies of binary treatments, have been shown to perform well when the amount of observations and/or events are low and can be extended to a multiple provider setting. The objective of this study was to evaluate the performance of different risk adjustment methods when profiling multiple health care providers that perform highly protocolized procedures, such as coronary artery bypass grafting. Methods: In a simulation study, provider effects estimated using PS adjustment, PS weighting, PS matching, and multivariable logistic regression were compared in terms of bias, coverage and mean squared error (MSE) when varying the event rate, sample size, provider volumes, and number of providers. An empirical example from the field of cardiac surgery was used to demonstrate the different methods. Results: Overall, PS adjustment, PS weighting, and logistic regression resulted in provider effects with low amounts of bias and good coverage. The PS matching and PS weighting with trimming led to biased effects and high MSE across several scenarios. Moreover, PS matching is not practical to implement when the number of providers surpasses three. Conclusions: None of the PS methods clearly outperformed logistic regression, except when sample sizes were relatively small. Propensity score matching performed worse than the other PS methods considered.
Transition from service to civvy street: the needs of armed forces veterans and their families in the UK
Authors: Fulton E , Wild D , Hancock J , Fernandez E , Linnane J 
Published: July 2018

Aims: Although many veterans make the transition from military to civilian life without difficulty, a small proportion struggle due to an impact on mental and physical wellbeing. Stigma and a reluctance to seek help further exacerbate this problem. The Armed Forces Covenant outlines the importance of ensuring that public services are aware of the specific needs of veterans; however, evidence suggests that knowledge among professional staff may be limited. Methods: This exploratory study included three phases. Phase 1 (questionnaires) explored the needs of veterans and their families in Warwickshire (UK) regarding information about their health and wellbeing and the barriers and facilitators to accessing local public health services. Also in Phase 1, health and public services staff knowledge of veterans’ needs and the Covenant is explored. In Phase 2, both samples attended a related focus group for a more in-depth exploration of the issues identified in Phase 1; in order to inform a Phase 3 workshop to co-develop an intervention. Results: Veterans, their families and friends, wanted more information about what services do, how and when to access them and what to expect. Confusion over when to seek help for mental health ‘symptoms’ was highlighted. More support for families was identified, alongside a need for health and social care staff to have a better understanding of the unique experiences and needs of veterans. Only 35% of staff reported a good understanding of the Armed Forces Covenant and their responsibilities to uphold it. Conclusions: Public health teams within UK local authorities are well placed to ensure veterans have more knowledge about and access to public services. Interventions to address stigma and veterans’ reluctance to seek help were needed. To this end, interventions for local veterans, their loved ones and staff in public services, designed in co-creation with these groups, is discussed.
Fertility outcome after treatment of retained products of conception: a systematic review
Authors: Hamerlynck Tjalina W. O. , Meyers Dora , Van der Veken Hannelore , Bosteels Jan , Weyers Steven 
Published: July 2018

Abstract
Background
Treatment of retained products of conception (RPOC) can be expectant, medical or operative. Surgical removal of RPOC may lead to intrauterine adhesions (IUA) and Asherman’s syndrome.

Objective
To evaluate how treatment options for RPOC affect future fertility by means of a systematic review.

Search strategy
MEDLINE, EMBASE, The Cochrane Library, and clinical trial registers were searched, and reference lists were scanned.

Selection criteria
Randomised controlled trials (RCT) comparing different treatment options for RPOC (conservative, medical or surgical treatment, including curettage and/or hysteroscopic techniques, with or without application of anti-adhesion therapy), in women of reproductive age, were eligible for inclusion.

Data collection and analysis
Reviewers independently performed data extraction and quality of evidence assessment. For dichotomous variables, results were presented as risk ratio (RR) with 95% CI.

Main results
Two studies were included. Nonsignificant differences were observed between the use of an anti-adhesion barrier gel versus no treatment after operative hysteroscopy in IUAs (RR 0.32, 95% CI 0.04 to 2.80, P value = 0.30) and clinical pregnancy (RR 2.22, 95% CI 0.67 to 7.42, P value = 0.19), and between hysteroscopic morcellation versus loop resection in IUAs (RR 0.86, 95% CI 0.06 to 13.12, P value = 0.91).

Conclusion
There is insufficient evidence on how different treatment options for RPOC affect future reproductive outcomes. Results from ongoing RCTs are needed to guide clinicians towards choosing the best treatment.
Proton relative biological effectiveness (RBE): a multiscale problem
Authors: Underwood Tracy SA , McMahon Stephen J 
Published: July 2018

Proton radiotherapy is undergoing rapid expansion both within the UK and internationally, but significant challenges still need to be overcome if maximum benefit is to be realised from this technique. One major limitation is the persistent uncertainty in proton relative biological effectiveness (RBE). While RBE values are needed to link proton radiotherapy to our existing experience with photon radiotherapy, RBE remains poorly understood and is typically incorporated as a constant dose scaling factor of 1.1 in clinical plans. This is in contrast to extensive experimental evidence indicating that RBE is a function of dose, tissue type, and proton linear energy transfer, among other parameters. In this article, we discuss the challenges associated with obtaining clinically relevant values for proton RBE through commonly-used assays, and highlight the wide range of other experimental end points which can inform our understanding of RBE. We propose that accurate and robust optimization of proton radiotherapy ultimately requires a multiscale understanding of RBE, integrating subcellular, cellular, and patient-level processes.
Kisspeptin increases intracellular calcium concentration by protein kinase C-mediated signaling in the primary cultured neurons from rat hippocampus
Authors: Serhatlioglu Ihsan , Yuksel Hande , Kacar Emine , Ozcan Sibel , Canpolat Sinan , Ozcan Mete , Ayar Ahmet , Kelestimur Haluk 
Published: July 2018

In addition to the fact that kisspeptin and its receptor GPR54 are well known to be abundantly expressed in the hypothalamus with suggestive roles in the initiation of puberty and similar reproductive system properties, there is also proof showing that kisspeptin might have influences on hippocampal functions. In our previous study, it was shown that kisspeptin increased free intracellular Ca2+ values ([Ca2+]i) through protein kinase C (PKC) activation in GT1-7 cells. For this reason, we examined the influences of kisspeptin on [Ca2+]i in hippocampal neurons to determine if kisspeptin shows its effects on hippocampus through the same mechanism. Hippocampal neurons were excised from the brains of fetuses on 17th embryonic day from maternal rats. The influences of kisspeptin on [Ca2+]i in hippocampal neurons were examined through in vitro calcium imaging system. The responses of [Ca2+]i to kisspeptin were quantified by the changes in 340nm/380nm ratio. Kisspeptin-10 caused [Ca2+]i transients in hippocampal neurons. The change in [Ca2+]i by 100 nM kisspeptin was prevented by pre-treating the cells in PKC inhibitor chelerythrine chloride. According to the results, kisspeptin activates intracellular calcium signaling in hippocampal neurons via the pathway that depends on PKC. The results of this study suggest that kisspeptin may have a role in hippocampal neuron functions.
Adherence and long-term growth outcomes: results from the easypod™ connect observational study (ECOS) in paediatric patients with growth disorders
Authors: Koledova Ekaterina , Stoyanov George , Ovbude Leroy , Davies Peter S W 
Published: July 2018

Objective
The easypod connect observational study (ECOS) assessed treatment adherence among paediatric patients receiving growth hormone (GH) via the easypod electronic injection device.

Design
ECOS was an open-label, observational, longitudinal study conducted in 24 countries between 2010 and 2016, enrolling children treated with GH.

Methods
The primary endpoint was the rate of treatment adherence during 5 years of follow-up. Impact of adherence on growth outcomes was assessed using Spearman’s product–moment correlations.

Results and conclusions
Overall, 1190 patients had easypod data available for ≥3 months; most patients had GH deficiency (75%); 606 of these patients were GH naïve at baseline. Over the first year of monitoring, the median rate of adherence was 93.7% among patients overall and >93.0% in GH-naïve patients, irrespective of the treatment indication. Clinically meaningful improvements in growth rates were observed after 1 year of treatment across all GH indications. Adherence decreased with increasing treatment duration, but the overall median adherence rate remained high after 3 years of follow-up: 87.2% (n = 409), 75.5% after 4 years (n = 143) and 70.2% after 5 years (n = 43). Statistically significant correlations between adherence and 1-year change in height standard deviation score (P < 0.001 for patients overall) and height velocity (P < 0.001) were observed.

Conclusions
ECOS produced accurate, real-time adherence data in a large population of GH-treated children over 5 years of follow-up. Using the easypod connect system, physicians can potentially identify patients with inadequate adherence and poor response to treatment, enabling them to take appropriate action to help them maximise the benefits of GH treatment.
Clinical Implications of the Revised AAP Pediatric Hypertension Guidelines
Authors: Khoury Michael , Khoury Philip R. , Dolan Lawrence M. , Kimball Thomas R. , Urbina Elaine M. 
Published: July 2018

BACKGROUND AND OBJECTIVES:
New pediatric hypertension definitions were recently published in a clinical practice guideline (CPG). We evaluated the impact of the CPG, compared with the previous guideline ("Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents"), on the prevalence of hypertension and associations with target organ damage (TOD) in high-risk youth.

METHODS:
Participants (10–18 years old) undergoing an evaluation of the cardiovascular effects of obesity and type 2 diabetes mellitus in youth were studied. Blood pressure was categorized according to the 2 guidelines as normal, elevated, and hypertension (stages 1 and 2). Measures of TOD (carotid artery intima-media thickness, pulse wave velocity, left ventricular mass, and diastolic function) were obtained. Associations between blood pressure categories and TOD and the sensitivity of hypertension classification in identifying TOD were evaluated.

RESULTS:
Data were available for 364 participants (65% female sex; 15.1 ± 2.1 years of age). Hypertension was identified in 8% and 13% as defined in the Fourth Report and CPG, respectively (P = .007). The 2 guidelines revealed similar associations with TOD; however, the CPG demonstrated improved sensitivity of TOD detection in hypertensive participants. For example, the proportion of participants with an abnormal left ventricular mass categorized as hypertensive increased from 20% to 31% as defined in the Fourth Report and CPG, respectively (P &lt; .001).

CONCLUSIONS:
Incorporation of the CPG increased the prevalence of pediatric hypertension in a population of high-risk youth and improved the sensitivity of TOD identification in hypertensive participants.
COSTA RICA SIN FRONTERAS #17
Authors: Aragón-Vargas Luis Fernando 
Published: July 2018

En esta sección se publican los resúmenes en español de artículos que han sido publicados por investigadoras/es de universidades costarricenses en otras revistas en el mundo, con su debida referencia al trabajo original, y con una breve explicación de dónde se realizó la investigación. Los artículos originales han sido publicados en otros idiomas; las revistas tienen consejo editorial y manejan un proceso de revisión por pares. Los resúmenes corresponden a estudios relacionados con las ciencias del ejercicio y la salud, que se conforman a los criterios generales de la revista, esto es, se trata de “... estudios experimentales o que hagan recomendaciones concretas para solucionar problemas o preguntas relevantes (...) trabajos originales o de meta-análisis.” Solicitamos a quienes hayan publicado este tipo de trabajos en otros idiomas que no los hagan saber, para incluir sus resúmenes en futuras entregas de esta sección
La parodia a la obra "En busca del tiempo perdido" de Proust y al "Matadero" de Esteban Echeverría en el texto de Alejo Carpentier
Authors: Ortiz María Salvadora 
Published: July 2018

La parodia es uno de los elementos constitutivos más destacados en al escritura Carpenteriana. Este artículo trata de demostrar la importancia de este recurso, utilizado por Carpentier para establecer relaciones más allá tiempo y espacio, entre dos realidades análogas similares, uno de los cuales se explican en términos de su afinidad a la otra, que bien puede haber ocurrido siglos antes.Parody is among the most salient constitutive elements in Carpenterian writing. This article attempts to demonstrate the significance of this resource, used by Capentier to establish relationships beyond time and space, between two similar, analogous realities, one of which is explained in terms of its affinity to the other, which may well have occurred centuries before.
<i>Desire under the Elms</i> as a celebration of life: A view in the light of Nietzsche´s <i>The birth of tragedy</i>
Authors: Sánchez Marta 
Published: July 2018

Eugene O'Neill manifiesta, sobre todo en sus primeras obras, una teoría nietzscheana de la tragedia. En Deseo bajo los olmos, una obra de profundo contenido telúrico, anciano Cabot, el mismo que Dioniso, desafía el tiempo y se convierte, como el tiempo, eterno. En este sentido, Deseo bajo los olmos es una celebración de la vida, un rotundo "¡Sí!" he aquí el destino y para un renacimiento nacido del fracaso y auto -Destrucción. Mito y realidad se pierden en un laberinto de simbolismo para engendrar fiesta y ritual. Por último, en este juego O'Neill transmite un mensaje extraño de la redención que es perceptible sólo a través de la estética de Nietzsche, nunca a través de un punto de vista convencional de la moralidad. Eugene O'Neill manifests, particularly in his early plays, a Nietzschean theory of tragedy. In Desire under the Elms, a work of deep telluric content, old man Cabot, the same as Dionysus, defies time and becomes, like time, eternal. In this sense, Desire under the Elms is a celebration of life, a resounding "Yes !" lo destiny and to a rebirth born of failure and self -destruction. Myth and reality lose themselves in a labyrinth of symbolism to engender celebration and ritual. Finally, in this play O'Neill conveys a bizarre message of redemption which is perceptible only through Nietzschean esthetics, never through a conventional view of morality.
Aspect and the English modal system
Authors: Wilson Jack L. 
Published: July 2018

Se propone que cada frase Inglés no contiene sólo el tiempo (pasado y no pasado), sino también de aspecto (perfectivo y imperfectivo). Mientras que otros idiomas pueden marcar aspecto formal, en Inglés es con frecuencia una categoría encubierta y puede dar lugar a ambigüedades, sobre todo en el lenguaje escrito. La interacción de aspecto y el tiempo con los diferentes modales se muestra en un esfuerzo para describir la forma en que los diferentes modales se han de interpretar semánticamente. It is proposed that every English sentence contains not only time (past and non-past) but also aspect (perfective and imperfective). Whereas other languages may mark aspect formally, in English it is frequently a covert category and may give rise to ambiguities, especially in the written language. The interaction of aspect and time with the different modals is shown in an effort to describe the way the different modals are to be interpreted semantically.
Relaciones intertitulares a partir de <i>Retorno al Kilimajaro</i>
Authors: Chaverri F. Amalia 
Published: July 2018

Las formas en que un texto se inserta en la sociedad se establecen sobre la base de los conceptos teóricos de Leo H. Hoek en ambos títulos y la perspectiva pragmática. Se acepta la simbolica -doble valor y comercial- de la actual literatura. En este artículo se describe cómo, a través de la relación dialógica que se desprende de la intertextualidad, el título Retorno al Kilimanjaro permite el establecimiento de afiliaciones y relaciones simbólicas entre títulos epígrafes y compañeros de textos para los textos a los que se dirige.
Tentatives D´evasion
Authors: Díaz Castro Alfredo 
Published: July 2018

Una aproximación al mundo de la ficción en Epaves por Julien Green: para aclarar las formas de evasión a personajes recurso.Escapar en el tiempo y el espacio para olvidarse de uno mismo o para reafirmar una identidad son dos mecanismos típicos de personajes Greenianos. erótico o contemplativa soñando vivir vidas de otras personas no están ausentes en este trabajo. Algunos terminan en las alucinaciones. La tentación de la muerte como un escape total y definitiva también está sujeto a análisis.Evidentemente, estos intentos de hacer la vuelta a la realidad más amarga. Tarde o temprano, todos los personajes se dan cuenta de que son prisioneros de sí mismos y que sus intentos de escapar son efímeros. An approach to the world of fiction on Epaves by Julien Green -to clarify the ways of evasion to characters resort.Escaping in time and space to forget about oneself or to reaffirm an identity are two typical mechanisms of Greenian characters. Erotic or contemplative day dreaming to live other people's lives are not absent in this work. Some end up in hallucinations. The temptation of death as a total and definitive escape is also subject to analysis.Evidently, these attempts make the return to reality more bitter. Sooner or later, all the characters realize that they are prisoners of themselves and that their attempts to escape are ephemeral.
Índices de los volúmenes I al XXI
Authors: Portilla Chaves Mario 
Published: July 2018

Con motivo del vigésimo aniversario de publicación de la Revista de Filología y Lingüística de la Universidad de Costa Rica, se han elaborado dos tipos de índices: uno de autores y otro temático. El índice de autores aparece ordenado alfabéticamente según el primer apellido del autor y el año de publicación del artículo. Además, cada entrada de este índice incluye una serie de descriptores temáticos, cuyo número promedio oscila entre tres y cuatro. El índice temático ha sido elaborado con base en los descriptores temáticos asignados a cada entrada del índice de autores. Por esta razón, los nombres propios de persona aparencen en este índice ordenados primero por el nombre seguido por el apellido. Por su parte, en el índice de autores, las referencias a los artículos aparecen ordenadas de la siguiente forma: primer apellido del autor, el año de publicación del volumen, título del artículo, volumen, número y páginas que comprende el artlculo.