bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cirrhosis as a Comorbidity in Conditions Subject to the Hospital Readmissions Reduction Program
Authors: Rosenblatt Russell , Cohen-Mekelburg Shirley , Shen Nicole , Tafesh Zaid , Lucero Catherine , Kumar Sonal , Fortune Brett , Liu Sze Yan , Brown Robert , Jesudian Arun 
Published: June 2019

INTRODUCTION:
Although the Hospital Readmissions Reduction Program (HRRP) has decreased readmissions in targeted conditions, outcomes in high-risk subgroups are unknown. This study analyzed the impact of cirrhosis as a comorbidity on readmissions in conditions subjected to the HRRP.

METHODS:
Using a longitudinal analysis of the New York, Florida, and Washington State inpatient databases from 2009 to 2013, adult Medicare beneficiaries with a diagnosis-related group of targeted conditions by the HRRP—pneumonia, congestive heart failure (CHF), and myocardial infarction (MI)—were included. Exclusion criteria included inability to assess for readmission, previous liver transplant, or having a readmission not subject to penalty under the HRRP. A sensitivity analysis used the International Classification of Diseases, 9th Revision, Clinical Modification codes to identify pneumonia, CHF, and MI hospitalizations. The primary outcome was 30-day readmission, with secondary outcomes including 90-day readmission, trends, and cirrhosis-specific risk factors for readmission.

RESULTS:
Of the 797,432 patients included, 8,964 (1.1%) had cirrhosis. Patients with cirrhosis had significantly higher 30-day readmissions overall (29.3% vs 23.8%, P < 0.001) and specifically for pneumonia and CHF, but not for MI. Thirty-day readmission rates significantly decreased in patients without cirrhosis (annual percent change −1.8%, P < 0.001), but not in patients with cirrhosis (P = 0.39). Similar findings were present for 90-day readmissions. A sensitivity analysis confirmed these findings. On multivariable analysis, cirrhosis was associated with significantly higher 30-day readmissions (odds ratio 1.13, P < 0.001).

DISCUSSION:
When cirrhosis is comorbid in patients with conditions subjected to the HRRP, readmissions are higher and have not improved. Focused efforts are needed to improve outcomes in cirrhosis and other high-risk comorbidities within the HRRP cohort.
Endoscopic Sinusotomy Using Needle Knife Technique for Treatment of H-Pouch With Leak and Sinus
Authors: Khoudari George , Singh Amandeep , Shen Bo 
Published: June 2019

ABSTRACT
A 62-year-old patient with a history of ulcerative colitis and total colectomy with ileal pouch-anal anastomosis was referred to our pouch center for rectal pain, loose stool, and perianal swelling. He was diagnosed with chronic fistula and anastomotic stricture for which he had excision of J-pouch and creation of H-pouch. Surveillance workup after surgery revealed pouch sinus, which was treated with needle-knife sinusotomy (NKSi). This is the first case in the literature of an H-pouch complicated with anastomotic sinus successfully treated with NKSi. We propose using NKSi as the preferred technique for pouch sinuses.
LA FORMACIÓN INICIAL DEL BIÓLOGO. PRESCRIPCIONES Y SUPUESTOS DADOS EN EL PLAN DE ESTUDIOS
Authors: Flores Miriam Liset , Bar Aníbal Roque 
Published: June 2019

El presente trabajo tiene como objetivo reconocer las prescripciones y supuestos que orientan la formación de los futuros biólogos en una universidad de gestión pública de la República Argentina. La técnica seleccionada para la recolección y tratamiento de la información es la de análisis de contenido de su Plan de Estudios y del sitio web de la facultad donde se inserta la carrera. Los resultados muestran que la formación está orientada en un sentido fuertemente técnico, aunque con un anclaje importante en la actividad de investigación. Se advierte la promoción de estrategias pedagógicas definidas en torno del pensamiento crítico y reflexivo, lo cual tendría ciertas dificultades de implementación en tanto se identifica un plan de estudios atomizado en subdisciplinas que interfieren en la integración del saber biológico. No obstante la actualización y ampliación conceptual referida en los contenidos, éstas se hallan enmarcadas en perspectivas que no logran desanclarse de la vieja tradición mecanicista, encuadre todavía imperante en grandes sectores de formación en la disciplina.
Manajemen Anestesi pada Pasien dengan Kistoma Ovarii Permagna
Authors: Sinantyanta Hadyan , Gde Sujana Ida Bagus 
Published: June 2019

Pendahuluan: Manajemen anestesi pada pasien dengan kistoma ovarium permagna merupakan tantangan karena memerlukan persiapan yang cermat dan memiliki risiko tinggi selama periode perioperatif . Seorang wanita 25 tahun dengan keluhan perut kembung mengganggu aktivitas karena sesak nafas .Tujuan:Melaporkan pengelolaan anestesi pada wanita dengan kistoma ovarium permagna.Metode: Seorang wanita berusia 25 tahun datang dengan keluhan perut membesar sejak 15 bulan sebelum masuk rumah sakit, pasien mengeluhkan kesulitan bernapas. Aktivitas mulai berkurang, terdapat kesulitan berjalan. Pasien memiliki lingkar perut 109 cm. Pemeriksaan USG menunjukkan kistoma besar dengan ascites. CT scan abdomen menunjukkan massa kistik besar dengan ukuran 30,3 x 34,9 x42 ,1 cm dengan komponen padat mendesak usus dan adanya hidronefrosis derajat IV dan III di kiri-kanan, cairan asites minimal intraperitoneal.Hasil: Operasi berlangsung selama 2 jam, kistoma berhasil diangkat secara utuh. Dengan berat massa saat ditimbang 23 kg. Perdarahan intraoperatif sekitar 500 ml, dan produksi urin 1600 ml. Setelah 19 jam pengawasan di unit perawatan intensif, pasien diekstubasi. Setelah hari ketiga pasien dirawat di ruangan. Berat pasien 30 kg diruangan. Aktivitas fisik normal dan tanpa keluhan nyeri dengan skala VAS ( skor analog visual) saat diam dan saat bergerak 2 cm 0 cm. Pasien diijinkan pulang ke rumah setelah hari ke-8 pasca operasi untuk rawat jalan.Ringkasan: Manajemen anestesi telah dilakukan pada wanita dengan kistoma ovarium permagna.Operasi berjalan sukses dan pasien diperbolehkan pulang ke rumah setelah hari ke-8 pasca operasi untuk rawat jalan
Efek Blok Transversus Abdominis Plane Teknik Landmark Terhadap Kebutuhan Analgetik Pascabedah Herniorafi
Authors: Asdarina Nur , Salam Syamsul Hilal , Tanra Husni 
Published: June 2019

Latar Belakang : Blok transversus abdominis plane (TAP) adalah teknik yang aman, mudah, dan efektif untuk memberikan analgesia pascabedah pada operasi yang melibatkan dinding anterior abdomen.Obyektif : Menilai efek blok TAP teknik landmark terhadap kebutuhan analgetik pascabedah herniorafi.Metode : Penelitian ini merupakan uji klinik tersamar tunggal. Penelitian dilakukan pada 44 pasien laki-laki, usia 18-60 tahun, status fisik ASA I-II, dan IMT 18-24 yang menjalani operasi herniorafi elektif dengan anestesi spinal. Pasien dibagi menjadi kelompok TAP (n=22) yang mendapatkan blok TAP dengan bupivakain 0,25% 20 ml ditambahkan epinefrin 1:200.000 setelah operasi selesai; dan kelompok kontrol (n=22) yang tidak mendapatkan blok TAP. Semua pasien diberikan meloksikam suppositoria 15 mg dan tramadol 0,1 mg/kgBB/infus kontinyu pada akhir operasi. Penilaian skala nyeri menggunakan Numeric Rating Scale (NRS), bila NRS mencapai 4 diberikan rescue fentanil 0,5 mcg/kgBB; waktu rescue pertama dan kebutuhan total fentanil selama 24 jam pascabedah dicatat.Hasil : Waktu rescue pertama lebih panjang pada kelompok TAP dibandingkan dengan kelompok kontrol (17,81 ± 7,62 berbanding 9,15 ± 8,12 jam; p<0,001). Kebutuhan total fentanil dalam 24 jam lebih sedikit pada kelompok TAP dibandingkan dengan kelompok kontrol (9,21 ± 13,59 berbanding 30,88 ± 20,39 mcg; p=0,02).Simpulan : Sehingga dari penelitian ini disimpulkan bahwa blok TAP sebagai komponen rejimen analgesia multimodal memberikan analgesia yang efektif dengan durasi analgesia lebih panjang dibanding kontrol dan memiliki opioid sparing effect yang tinggi.
Pengaruh Lidokain Intravena Terhadap Kadar Superoxide Dismutase 1 (Sod-1) Paru Kelinci Dengan Lung Ischemic Reperfusion Injury Model
Authors: Kurniawan Mohammad Arief , Arifin Johan , Nugroho Taufik Eko 
Published: June 2019

Latar belakang : Angka kejadian komplikasi paru paska operasi non jantung dibandingkan dengan komplikasi jantung yaitu 2,7% dan 2,5%. Penyebab hal ini adalah stres oksidatif, ketidakseimbangan radikal oksigen dan endogenous scavenging system.Lidokain menghambat saluran natrium dan, mengurangi masukan kalsium intraseluler, mengurangi produksi Reactive Oxygen Species (ROS) dan modulasi bioenergetika mitokondria, sehingga diharapkan lidokain mampu meningkatkan kadar antioksidan alami di dalam sel.Superoxide Dismutase-1 (SOD-1) adalah salah satu antioksidan alami didalam sel yang berperan dalam melindungi organ dari anion superoksida yang berbahaya dengan mengubah anion yang dihasilkan dari cedera setelah ischaemia-reperfusion.Tujuan : Mengetahui efek lidokain intravena terhadap kadar Superoxide Dismutase 1 (SOD-1) paru kelinci dengan lung ischemic reperfusion injury model.Metode : Desain eksperimental laboratorik, 16 kelinci dibagi menjadi dua kelompok secara acak. Kelompok kontrol mendapat perlakuan lung ischemic reperfusion injury dan kelompok perlakuan dilakukan lung ischemic reperfusion injurydan mendapat injeksi lidokain 1,5mg/kgBB/jam intravena secara kontinyu kemudian diukur kadar SOD-1 jaringan paru kedua kelompok. Uji normalitas menggunakan uji Shapiro Wilk dilanjutkan uji beda Independent T-test.Hasil : Kadar SOD-1 paru kelinci dengan lung ischemic reperfusion injurydan mendapat lidokain lebih tinggi secara signifikan (p=0,01) dibandingkan dengan kadar SOD-1 paru kelinci dengan lung ischemic reperfusion injuryKesimpulan : Pemberian lidokain kontinyu intravena dapat meningkatkan kadar SOD-1 paru kelinci dengan lung ischemic reperfusion injury.
Molecular prognostic factors in small-intestinal neuroendocrine tumours
Authors: Samsom K G , van Veenendaal L M , Valk G D , Vriens M R , Tesselaar M E T , van den Berg J G 
Published: June 2019

Background
Small-intestinal neuroendocrine tumours (SI-NETs) represent a heterogeneous group of rare tumours. In recent years, basic research in SI-NETs has attempted to unravel the molecular events underlying SI-NET tumorigenesis.

Aim
We aim to provide an overview of the current literature regarding prognostic and predictive molecular factors in patients with SI-NETs.

Method
A PubMed search was conducted on (epi)genetic prognostic factors in SI-NETs from 2000 until 2019.

Results
The search yielded 1522 articles of which 20 reviews and 35 original studies were selected for further evaluation. SI-NETs are mutationally quiet tumours with a different genetic make-up compared to pancreatic NETs. Loss of heterozygosity at chromosome 18 is the most frequent genomic aberration (44–100%) followed by mutations of CDKN1B in 8%. Prognostic analyses were performed in 16 studies, of which 8 found a significant (epi)genetic association for survival or progression. Loss of heterozygosity at chromosome 18, gains of chromosome 4, 5, 7, 14 and 20p, copy gain of the SRC gene and low expression of RASSF1A and P16 were associated with poorer survival. In comparison with genetic mutations, epigenetic alterations are significantly more common in SI-NETs and may represent more promising targets in the treatment of SI-NETs.

Conclusion
SI-NETs are mutationally silent tumours. No biomarkers have been identified yet that can easily be adopted into current clinical decision making. SI-NETs may represent a heterogeneous disease and larger international studies are warranted to translate molecular findings into precision oncology.
System for complex exhaust gas cleaning of internal combustion engine with water-fuel emulsion burning
Authors: Kornienko V. S. 
Published: June 2019

The necessity to fulfill all requirements of international organizations in the field of environmental protection, need to reduce heat loss in combustion of organic fuels, increasing economy and reliability of all elements of ship's power plant make it necessary to develop complex technology. The aim of study is to develop system for complex exhaust gas cleaning of internal combustion engine (ICE). For performing tasks in technology of proposed method, providing solutions to problems of improving economic efficiency, improvement of environmental indicators and reliability, it is envisaged 5 stages of technological process. At all stages conditions for appropriate running of physico-chemical processes in the next stage are created. Possibility of solving complex problems in proposed technology is ensured by combustion of water-fuel emulsion (WFE) with specifically recommended value of water content W r = 30%. When WFE is burnt with a water content of 30%, the low-temperature corrosion intensity decreases, which allows to install a condensing heating surfaces in exhaust gas boilers. At these conditions an equimolar ratio of nitrogen oxides NO2:NO in gases is required, which is necessary to activate their absorption properties. When WFE is burnt with water content W r = 30% the metal surface with a temperature below of dew point H2SO4 passivates. Experimental studies performed show that: 1 m2 of condensing surface absorbs 3.4 mg/m3 of NOx and 0.89 mg/m3 of SO2, which makes it possible to decrease the NOx concentration by 1.55 times and SO2 - in 1.5 times. There is a process of precipitation of toxic solid ash and soot particles: from 150...170 mg/m3 (at outlet of ICE when WFE is burnt with W r = 30%) to 70...90 mg/m3 after the condensing surface. Consumption of water with alkaline properties decreases when NOx, SO2, CO2 concentration is reduced in front of scrubbers. Reducing pollution of heating surfaces increases the cleaning period of EGB in 2.5 times. The using of complex system provides efficient exhaust gas cleaning at the level recommended by IMO.
POETIC (Program for Enhanced Training in Cancer): An Initial Experience of Supporting Capacity Building for Oncology Training in Sub-Saharan Africa
Authors: Fish Madeleine , Parkes Jeannette , Dharsee Nazima , Dryden-Peterson Scott , Efstathiou Jason , Schnipper Lowell , Chabner Bruce A. , Parikh Aparna R. 
Published: June 2019

Abstract

Background
Sub-Saharan Africa is simultaneously facing a rising incidence of cancer and a dearth of medical professionals because of insufficient training numbers and emigration, creating a growing shortage of cancer care. To combat this, Massachusetts General Hospital and Beth Israel Deaconess Medical Center partnered with institutions in South Africa, Tanzania, and Rwanda to develop a fellowship exchange program to supplement the training of African oncologists practicing in their home countries.

Methods
In its initial year, 2018, the Program for Enhanced Training in Cancer (POETIC) hosted a pilot cohort of seven fellows for 3-week observerships in their areas of interest. Researchers distributed questionnaires for program evaluation to participants prior to arrival and upon departure; additionally, three participated in semistructured interviews.

Results
Five themes emerged from the qualitative data: expectations of POETIC, differences between oncology in the U.S. and in sub-Saharan Africa, positive elements of the program, areas for improvement, and potential impact. Fellows identified several elements of Western health care that will inform their practice: patient-centered care; clinical trials; and collaboration among medical, radiation, and surgical oncologists. From the quantitative data, feedback was primarily around logistical areas for improvement.

Conclusion
POETIC was found to be feasible and valuable. The results from the pilot year justify the program's continuation in hopes of strengthening global health partnerships to support oncology training in Africa. One weakness is the small number of fellows, which will limit the impact of the study and the relevance of its conclusions. Future research will report on the expansion of the program and follow-up with former participants.

Implications for Practice
This work presents a novel model for fellowship exchange between lower- and higher-resourced areas. The program is a short-term observership with tumor boards and didactic teaching sessions incorporated. By attracting oncologists who aim to practice in their home countries, it facilitates international collaboration without contributing to the preexisting lack of medical professionals in low- and middle-income countries.
Van Gölü seviye değişimlerinin Engil Çayı Deltası jeomorfolojisi üzerine etkisi ve Dilkaya Höyüğü ile ilişkisi
Authors: AKKÖPRÜ Ebru , ALTAN AYDIN Funda , DOĞU Ali Fuat 
Published: June 2019

Van Gölü 3602 km2 lik alanı ve maksimum 451 m derinliği ile Türkiye’nin en büyük gölüdür. Sodalı olan göl denizden 1648 metre yüksekte olup 17.000 km2 lik kapalı bir havzaya sahiptir. Havzanın kapalı olması Nemrut volkanizması ile ilişkilidir. Son yıllarda yapılan sondaj çalışmaları (Paleovan) ile gölün yaşı 600.000 yıl olarak belirlenmiştir. Konu ve inceleme alanına ilişkin literatür araştırmaları yapıldıktan sonra arazi çalışmaları gerçekleştirilmiş ve İnsansız Hava Aracı ile fotoğraf çekimleri yapılmıştır. Engil Deltası ve yakın çevresinin haritalama çalışmalarında ArcGIS 10.3 programı kullanılmıştır. Urartu Medeniyeti tarihi ve kültürünün en önemli kalıntıları ve kayıtlarına da ev sahipliği yapan Van Havzası jeomorfolojik ve jeoarkeolojik anlamda büyük bir zenginliğe sahiptir. Van Gölü’nde geçmişten günümüze önemli ölçüde seviye değişiklikleri meydana gelmiştir. Bu değişimlerin kıyı şekillenmesinde etkileri olmuştur. Özellikle alçak kıyı kesimlerinde seviye değişimlerinin etkileri daha belirgindir. Bu çalışmada göldeki seviye değişikliklerinin Engil Çayı Deltası ve Dilkaya Höyüğü üzerindeki etkileri incelenmiştir. Dilkaya Höyüğü’nün delta gelişimi süreci ve göldeki seviye değişimleri ile olan ilişkisi incelenirken 1986-1998-2016 yıllarına ait Landsat uydu görüntülerinden de faydalanılmıştır. Deltanın eski tortulları üzerinde kurulmuş olan höyük, göl seviyesine göre yüksekte olmakla birlikte göldeki seviye yükselmelerinden tarih boyunca sürekli etkilenmiştir. Höyük tamamen ortadan kalkmamış ve günümüzde bir delta-göl taraçası (Alçak Taraça-Pleistosen Holosen) görünümünü almıştır; ancak bugün yarıya yakınını dalga erozyonu ile kaybetmiştir. İnceleme alanındaki ikinci taraça (Yüksek taraça- Pliyo-Kuvaterner), gölün daha yüksek bir seviyesinde oluşmuş eski delta kalıntısıdır. Engil Çayı, gölün şimdiki seviyesine göre aktüel deltayı oluşturmaktadır. Bu delta alanı gölde sık sık görülen seviye değişimlerinden etkilenerek gelişimini sürdürmektedir.
Investimentos em pesquisa e desenvolvimento agrícola
Authors: Silva Júnior Jaim José da , Silveira José Maria Jardim da , Oliveira Andréa Leda Ramos de , Pereira Caroline Nascimento , Bueno Carolina da Silveira , Pray Carl Esek 
Published: June 2019

O artigo explora mudanças no volume e na composição dos investimentos em pesquisa e desenvolvimento agrícola (P&D) que ocorreram nas últimas décadas. Para isso, é feita uma revisão bibliográfica da experiência internacional e apresentam-se fatos estilizados dos grupos de países desenvolvidos e em desenvolvimento. A partir de uma base inédita de dados primários, o estudo avalia a dinâmica dos investimentos privados em P&D alocados no Brasil por empresas dos setores de insumos agrícolas. O objetivo do trabalho é descrever as transformações recentes no país e contribuir para a tomada de decisões para o progresso tecnológico da agricultura. As conclusões destacam a alta intensidade tecnológica, o crescimento dos investimentos privados e a pequena participação relativa de empresas nacionais no progresso tecnológico de insumos agrícolas.
Linkage to Hepatitis C Care Following Release from Jail: A Prospective, Single Arm Clinical Trial
Authors: Akiyama Matthew Jiro , Columbus Devin , MacDonald Ross , Jordan Alison O , Schwartz Jessie , Litwin Alain H , Eckhardt Benjamin , Carmody Ellie 
Published: June 2019

Abstract
Background: Hepatitis C virus (HCV) is a major public health problem in correctional settings. HCV treatment is often not possible in U.S. jails due to short lengths of stay. Linkage to care is crucial in these settings, but competing priorities complicate community healthcare engagement and retention after incarceration.

Methods: We conducted a single arm clinical trial to assess the rate and factors associated with linkage to HCV care after incarceration associated with a combined transitional care coordination (TCC) and patient navigation intervention.

Results: During the intervention, n=84 participants returned to the community after their index incarceration. Most participants were male and Hispanic, with a history of mental illness and a mean age of 45 years (SD=12). Of those who returned to the community, 26 (31%) linked to HCV care within a mean of 29 days (SD=25); 17 (20%) initiated HCV treatment, 15 (18%) completed treatment, and 7 (8%) had documentation of sustained virologic response. Expressing a preference to be linked to the participant’s existing health system, being on methadone prior to incarceration, and feeling that family or a loved one were concerned about the participant’s wellbeing were associated with linkage to HCV care. Reporting drinking alcohol to intoxication prior to incarceration was negatively associated with linkage to HCV care.

Conclusion: We demonstrate that an integrated strategy with combined TCC and patient navigation may be effective in achieving timely linkage to HCV care. Additional multicomponent interventions aimed at treatment of substance use disorders and increasing social support could lead to further improvement.
The effects of two weeks high-intensity interval training on fasting glucose, glucose tolerance and insulin resistance in adolescent boys; A pilot study
Authors: Cockcroft Emma , Bond Bert , Williams Craig A , Harris Sam , Jackman Sarah R , Armstrong Neil , Barker Alan R 
Published: June 2019

Abstract
Background This study examined whether improvements in fasting and postprandial [insulin], [glucose] and aerobic fitness are possible after two weeks of high-intensity interval training (HIIT) in adolescent boys. Methods Seven boys (14.3 ± 0.3 y) completed 6 sessions of HIIT over two weeks. Homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), fasting glucose:insulin ratio (FGIR) and blood [glucose] and [insulin] responses to a Mixed Meal Tolerance Test (MMTT) were assessed before (PRE), and 20 h and 70 h after (POST) the final HIIT session. Maximal oxygen uptake (VO2 max) was assesed PRE and 70 h POST. Results Compared to PRE, two weeks of HIIT had no effect on fasting plasma [glucose] or [insulin] or HOMA-IR at 20 h and 70 h POST. However, a strong negative correlation was observed between PRE training HOMA-IR, QUICKI and FGIR, and change in HOMA-IR, FGIR and QUICKI at 20 h POST (r =-0.96, 0.969 and 0.826 for HOMA-IR, QUICKI and FGIR respectively all P<0.05). Plasma [insulin] and [glucose] area under the curve in the postprandial period following the MMTT were unchanged 20 h and 70 h POST compared to PRE. Conclusion Two weeks of HIIT did not elicit improvements to fasting or postprandial glucose or insulin health outcomes or aerobic fitness in a group of adolescent boys. Interventions of this type may, however, be effective in adolescents with raised baseline IR.