bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of the central venous pressure in trauma patients on the basis of non-invasive parameters using artificial neural network
Authors: Moinadini Shiva , Tajoddini Shahrad , Hedayat Amir Ahmad 
Published: June 2019

Background: Generally, in traumatic patients, uncontrolled bleeding leads to shock and ultimately death. So, any early detection of shock can reduce the likelihood of a patient’s death. At present, the precise method for estimating the body’s need for fluids is to measure central venous pressure (CVP). However, this method is invasive and time consuming. Objective: This study aimed to predict the central venous pressure value and range of trauma patients through non-invasive parameters such as caval index, lactate clearance, base excess and shock index. Methods: A prospective observational study was performed in 100 trauma patients. Written informed consent was obtained from patient(s) or relatives for their anonymized information to be published in any article. Results: It indicated that parameters such as caval index (at a proposed cutoff point of 35%), lactate clearance (at a cutoff point of 6%) and base excess (at a proposed cutoff point of 6 mmol/L) are approximately of the same level of accuracy for estimating the central venous pressure range, while parameter shock index (at a cutoff point of 1.25) is of the least level of accuracy to predict the central venous pressure range. Results also showed that among all proposed predictive models for estimating the central venous pressure value, which were on the basis of either non-linear regression or artificial neural network, the most accurate model was the one on the basis of the artificial neural network. Among parameters lactate clearance, base excess and shock index used to form the artificial neural network-based model, parameters base excess and lactate clearance were of the highest and lowest level of importance, respectively. Conclusion: Among all proposed models and non-invasive parameters to predict the central venous pressure range, CVPLC model (at a cutoff point of 9), which is a non-linear regression model and is in terms of parameter lactate clearance, was the most accurate model.
Adaptive correction of craniofacial defects in pre-metamorphic Xenopus laevis tadpoles involves thyroid hormone-independent tissue remodeling
Authors: Pinet Kaylinnette , Deolankar Manas , Leung Brian , McLaughlin Kelly A. 
Published: June 2019

ABSTRACT
Although it is well established that some organisms can regenerate lost structures, the ability to remodel existing malformed structures has been less well studied. Therefore, in this study we examined the ability of pre-metamorphic Xenopus laevis tadpoles to self-correct malformed craniofacial tissues. We found that tadpoles can adaptively improve and normalize abnormal craniofacial morphology caused by numerous developmental perturbations. We then investigated the tissue-level and molecular mechanisms that mediate the self-correction of craniofacial defects in pre-metamorphic X. laevis tadpoles. Our studies revealed that this adaptive response involves morphological changes and the remodeling of cartilage tissue, prior to metamorphosis. RT-qPCR and RNA-seq analysis of gene expression suggests a thyroid hormone-independent endocrine signaling pathway as the potential mechanism responsible for triggering the adaptive and corrective remodeling response in these larvae that involves mmp1 and mmp13 upregulation. Thus, investigating how malformed craniofacial tissues are naturally corrected in X. laevis tadpoles has provided valuable insights into the maintenance and manipulation of craniofacial morphology in a vertebrate system. These insights may help in the development of novel therapies for developmental craniofacial anomalies in humans.
Comparison of effects of propofol versus sevoflurane for patients undergoing cardiopulmonary bypass cardiac surgery
Authors: Tang Shaoqun , Huang Wei , Zhang Kun , Chen Wei , Xie Tao 
Published: June 2019

Objective: To compare the effects of propofol versus sevoflurane on the outcomes of patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
Methods: A total of 110 patients undergoing cardiac surgery with CPB in our hospital from January 2015 to June 2017 were randomly divided into 2 groups (n=55): Group A, in which anesthesia was maintained with sevoflurane, and Group B, in which anesthesia was maintained with propofol. The MMSE score before and after operation, perioperative laboratory index, incidence of postoperative cognitive dysfunction (POCD) and incidence of adverse events between the two groups were compared.
Results: The MMSE score was significantly higher in Group B than in Group A after anesthesia (p<0.05). Serum levels of the brain injury markers neuron-specific enolase, S100β and matrix metalloproteinase 9 were significantly lower in Group B than in Group A (p<0.05). POCD incidence at 12 hour and 24 hour after operation was significantly lower in Group B than in Group A (p<0.05). There were no significant differences in the incidence of low cardiac output and thoracotomy bleeding between two groups.
Conclusion: Compared with sevoflurane, the use of propofol during cardiac surgery with CPB can efficiently improve postoperative cognitive function without increasing the risk of adverse reactions.
doi: https://doi.org/10.12669/pjms.35.4.1279
How to cite this:Tang S, Huang W, Zhang K, Chen W, Xie T. Comparison of effects of propofol versus sevoflurane for patients undergoing cardiopulmonary bypass cardiac surgery. Pak J Med Sci. 2019;35(4):1072-1075. doi: https://doi.org/10.12669/pjms.35.4.1279
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Evaluation of kidney injury molecule-1 as a disease progression biomarker in diabetic nephropathy
Authors: Abid Khan Fatima , Fatima Syeda Sadia , Khan Ghulam Mustafa , Shahid Sana 
Published: June 2019

Background & Objective: Kidney Injury Molecule-1 (KIM-1) is a peptide whose release into circulation is specific to tubular injury. This study aimed to estimate levels of kidney injury molecule-1 in diabetic patients with and without kidney disease. And evaluate the role of KIM-1 as an early screening marker of progressive kidney injury.
Methods: This follow-up study included n=85 subjects from the diabetic clinic of Jinnah Post Graduate Medical Center (JPMC) in collaboration with Aga Khan University from November 2016 till September 2017 They were divided as: i) Group A1 (n=30) participants with diabetes for <5 years without microalbuminuria ii) Group A2 (n= 30) subjects with diabetes for 6-10 years with microalbuminuria; iii) Group B (n=25) subjects as healthy control group. All study participants were followed for 6 months and their blood glucose, urea, creatinine, electrolytes, albuminuria and serum KIM-1 were assayed.
Results: High KIM-1 at baseline was present in group A2 patients as compared to controls and group A1 (p<0.001). Higher levels were seen after six months in group A1 along with the presence of micro albuminuria (p<0.001) suggesting kidney damage. Moderate positive association were seen for KIM1 with creatinine levels (r=0.530; p<0.001), and HbA1c (r=0.576; p<0.001) in all patients. While a strong positive association was seen for blood urea nitrogen as a marker for kidney function both at baseline (r= 0.728; p=0.000) and follow up (r=0.747; p=0.001). Multiple logistic regression controlling for age showed that KIM1 was independently associated with BUN (r=0.727; p<0.001), creatinine (r=0.510; p<0.001) and HbA1c (r=0.401; p=0.008) in all groups.
Conclusion: Rising KIM-1 levels with progressive kidney damage with or without derangement of kidney function is reported in this study. This finding may pave a way towards identifying KIM1 as a prognostic marker for kidney injury.
doi: https://doi.org/10.12669/pjms.35.4.154
How to cite this:Khan FA, Fatima SS, Khan GM, Shahid S. Evaluation of kidney injury molecule-1 as a disease progression biomarker in diabetic nephropathy. Pak J Med Sci. 2019;35(4):992-996. doi: https://doi.org/10.12669/pjms.35.4.154
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effects of topical Vancomycin Dressing on Methicillin-Resistant Staphylococcus Aureus (MRSA) positive diabetic foot ulcers
Authors: Saif Anas bin , Jabbar Sohail , Akhtar Muhammad Saeed , Mushtaq Ahmed , Tariq Mansoor 
Published: June 2019

Objective: To compare the effects of simple saline dressings versus topical vancomycin dressings on Methicillin-resistant Staphylococcus Aureus positive chronic diabetic foot ulcers.
Methods: It was quasi experimental study conducted in Combined Military Hospital Kohat and PNS-Shifa Hospital Karachi from 01 January 2017 to 31 December 2017. A total of 23 patients were included based on non-probability convenient sampling who had diabetes and presented with foot ulcers for more than two weeks showing positive growth of Methicillin-Resistant Staphylococcus Aureus. The patients were treated with simple saline soaked dressings and debridement at first for three weeks followed by three weeks of topical vancomycin dressings with debridement. Thus patients served as their own controls
Results: The average change in surface area with saline dressing was +1.73 ±1.53cm2 per week whereas with vancomycin soaked dressing it was --0.06±1.60 cm2 per week (p <0.05). The average exudate also decreased from 1.78±1.23 to 0.99±0.72 (p<0.05) and same trend was observed in percentage of slough covering the ulcer from 45% ± 22.3% to 24.3% ±12.90% (p<0.05) with vancomycin dressing. Moreover, fifteen patients had negative culture for MRSA within 2 weeks.
Conclusion: Vancomycin impregnated dressing in MRSA positive Diabetic foot may help achieve early healing as compared to simple conventional dressings with no systemic toxicity.
doi: https://doi.org/10.12669/pjms.35.4.368
How to cite this:Saif AB, Jabbar S, Akhtar MS, Mushtaq A, Tariq M. Effects of topical Vancomycin Dressing on Methicillin-Resistant Staphylococcus Aureus (MRSA) positive diabetic foot ulcers. Pak J Med Sci. 2019;35(4):1099-1103. doi: https://doi.org/10.12669/pjms.35.4.368
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Seasonal and plant-part isotopic and biochemical variation in Posidonia oceanica
Authors: CRESSON PIERRE , BOUDOURESQUE CHARLES FRANÇOIS , RUITTON SANDRINE , CASALOT LAURIE , VERLAQUE MARC , HARMELIN-VIVIEN MIREILLE 
Published: June 2019

Posidonia oceanica is an iconic and highly productive Mediterranean seagrass. As most studies focused on the fate of this production, temporal and plant part-specific variations of isotopic composition and biochemical content were overlooked. Combined seasonal and plant-part stable isotope composition and biochemical concentrations were measured at the lower depth limit of a P. oceanica meadow (~ 25 meter depth), and explained by previous knowledge of the specific metabolic functioning of each part. The predominance of compounds with complex chemical structure was reflected by the high concentrations of insoluble carbohydrates, high C/N ratios, and high δ13C values. Plant parts clustered in 3 groups with similar isotopic or biochemical features and metabolism: rhizomes and juvenile leaves, intermediate and adult leaves, senescent and drifting leaves. This result agrees with the vegetative phenology of the plant. The biochemical composition and the isotopic composition of the plant parts were consistent with previous knowledge about the photosynthetic activity and its seasonal variation. Correlations were found between N-linked descriptors (δ15N and protein content), and between δ13C and insoluble carbohydrate concentration. Epibiont values differed considerably from those of the leaf, as this community is taxonomically diverse and seasonally variable. Biochemical and isotopic composition measured confirmed that the current complex metabolism of P. oceanica results from adaptations to the specific life in a marine oligotrophic environment.
Documentation of Clinical Reasoning in Admission Notes of Hospitalists: Validation of the CRANAPL Assessment Rubric
Authors: Kotwal Susrutha , Klimpl David , Tackett Sean , Kauffman Regina , Wright Scott 
Published: June 2019

BACKGROUNDHigh‐quality documentation of clinical reasoning is a professional responsibility and is essential for patient safety. Accepted standards for assessing the documentation of clinical reasoning do not exist.OBJECTIVETo establish a metric for evaluating hospitalists' documentation of clinical reasoning in admission notes.STUDY DESIGNRetrospective study.SETTINGAdmissions from 2014 to 2017 at three hospitals in Maryland.PARTICIPANTSHospitalist physicians.MEASUREMENTSA subset of patients admitted with fever, syncope/dizziness, or abdominal pain were randomly selected. The nine‐item Clinical Reasoning in Admission Note Assessment & Plan (CRANAPL) tool was developed to assess the comprehensiveness of clinical reasoning documented in the assessment and plans (A&Ps) of admission notes. Two authors scored all A&Ps by using this tool. A&Ps with global clinical reasoning and global readability/clarity measures were also scored. All data were deidentified prior to scoring.RESULTSThe 285 admission notes that were evaluated were authored by 120 hospitalists. The mean total CRANAPL score given by both raters was 6.4 (standard deviation [SD] 2.2). The intraclass correlation measuring interrater reliability for the total CRANAPL score was 0.83 (95% CI, 0.76‐0.87). Associations between the CRANAPL total score and global clinical reasoning score and global readability/clarity measures were statistically significant (P < .001). Notes from academic hospitals had higher CRANAPL scores (7.4 [SD 2.0] and 6.6 [SD 2.1]) than those from the community hospital (5.2 [SD 1.9]), P < .001.CONCLUSIONSThis study represents the first step to characterizing clinical reasoning documentation in hospital medicine. With some validity evidence established for the CRANAPL tool, it may be possible to assess the documentation of clinical reasoning by hospitalists.
A Crise Ética na Pós-Modernidade e sua Relação com o Projeto Iluminista / The Ethical Crisis in Postmodernity and its Relation with the Illuminist Project
Authors: Morais Allan Richards De Melo Nunes , Ramos Júlio Cezar Costa , Silva Andrey Tavares da , Nascimento Fernanda Coelho de Figueiredo Soares , Nascimento Tiago Gama do , Duarte Francisco Ricardo 
Published: June 2019

O ideário iluminista, mormente referenciado no pensamento kantiano, instaura a premissa de que autêntica moralidade somente o será se originada na plena autonomia da vontade e do entendimento. Sobre esse alicerce conceitual, foi edificado um período civilizacional e cultural de grande otimismo e autoconfiança humana. Diante do exposto, foi possível depreender que o ser humano tem a necessidade dos outros, no sentido de discutir com os demais a compreensão de sua própria situação particular. Portanto, a concepção ética da pós-modernidade tenderá a lograr êxito na medida em que conduzir o homem contemporâneo a compreender sua responsabilidade para consigo e para com os outros, o que demanda um aguçado senso de autocrítica e sentimento de coletividade.
Duodenal Perforation With Transplant Hepatic Artery Pseudoaneurysm
Authors: Votta Kaitlyn , Dhanekula Raja K. , Frank Adam M. , Sass David A. , Shah Ashesh P. 
Published: June 2019

ABSTRACT
A transplant hepatic artery pseudoaneurysm is a rare postorthotopic liver transplant complication. Bleeding is a common complication of posterior duodenal ulcer secondary to erosion into the gastroduodenal artery. We report the case of a post-transplant patient who presented with massive upper gastrointestinal hemorrhage in the setting of nonsteroidal anti-inflammatory drug use. Endoscopy demonstrated a duodenal ulcer with high-risk stigmata not amenable to hemostasis. Subsequently, an arteriogram revealed a hepatic artery pseudoaneurysm. Transplant professionals should be aware of the possibility of an ulcer eroding into the liver vasculature and in the differential diagnosis for bleeding and pseudoaneurysms in post-transplant patients.
Strongyloides Infection Presenting as Proximal Small Intestinal Obstruction
Authors: Patra Ananya Apurba , Nath Preetam , Pati Girish Kumar , Panigrahi Sarat Chandra , Mallick Bipadabhanjan , Acharya Jyotiprakash C.K. , Adhya Amit 
Published: June 2019

ABSTRACT
Duodenal obstruction is an infrequent but potentially fatal complication of strongyloidiasis infection. Strongyloides stercoralis can clinically manifest in a broad variety of ways and lacks a classic clinical syndrome, which makes the diagnosis of strongyloidiasis difficult. The diagnosis is usually delayed and made by duodenal aspirate, duodenal biopsy, and/or postoperative biopsy specimen of the resection stricture segment. We present a case of partial duodenal obstruction caused by S. stercoralis. A 46-year-old man had presented with repeated bilious vomiting for 12 days. Upper gastrointestinal endoscopy showed ulceronodular mucosa with luminal compromise at the second part of the duodenum. Abdominal computed tomography scan also showed a wall thickening with luminal narrowing of the second and third part of the duodenum. Duodenal mucosal biopsy revealed larval forms of S. stercoralis.
El currículo oculto en los libros de historia de México en el Bachillerato mexicano
Authors: Magaña Hidalgo José Orestes 
Published: June 2019

Esta investigación analiza el contenido didáctico de los libros de texto de Historia de México a nivel bachillerato. Se empleó una metodología cualitativa de tipo descriptivo. El uso del Análisis del Discurso (AD) permitió identificar el contexto político, económico y educativo bajo el cual se definen los contenidos de los libros de texto, así como de la participación de editoriales extranjeras que forman parte en este proceso y cuya intervención en la creación de contenidos es también fundamental. Se concluye que, los libros de texto de la asignatura, representan un discurso nacionalista más que didáctico. Con base en la información analizada, se propone un currículo que desarrolle en el alumno las habilidades necesarias para lograr una empatía histórica y un conocimiento significativo.
Reseña/ Universidad en Diálogo: Revista de Extensión
Authors: Restrepo Salazar María Eugenia 
Published: June 2019

La revista Universidad en Diálogo nace en 2011 —con carácter institucional— como un espacio bidireccional para compartir prácticas, conocimientos, experiencias, visiones, propuestas y resultados del compromiso de la universidad pública con la sociedad.
Citizen participation at the level of local rural communities – tentative analysis
Authors: Lubik-Reczek Natasza 
Published: June 2019

Partycypacja obywatelska jest istotnym elementem współczesnej demokracji. Traktowana jest jako ratunek wobec stałego obniżania udziału obywateli w życiu politycznym i publicznym. Partycypację można podejmować z bardzo rożnych powodów. Istotne jest to, iż sprzyja ona rozwojowi demokracji lokalnej, chociażby poprzez wzmocnienie oddolnych inicjatyw obywatelskich; pobudza integracje środowisk lokalnych dzięki podejmowaniu wspólnych działań. Jest również skutecznym sposobem na rozwiązanie problemów: daje możliwość wysłuchania opinii wszystkich zainteresowanych osób, rozwiązania lokalnych konfliktów i wypracowania kompromisu. W niniejszym tekście podjęto próbę przeanalizowania zagadnienia partycypacji obywatelskiej na przykładzie konkretnej grupy społecznej, jaką jest wiejska społeczność lokalna. Skoncentrowano się na różnych teoretycznych ujęciach tych dwóch zagadnień. Celem tekstu jest przede wszystkim odpowiedź na pytanie o formy zaangażowania wiejskich społeczności lokalnych w działania partycypacyjne; ukazanie przykładowych instrumentów, które umożliwiają członkom tej wspólnoty uzewnętrznienie ich aktywności i postaw obywatelskich.
Change, Continuity and Partisan Sorting on Moral Issues
Authors: Ridenour Joshua , Schmitt Elizabeth , Norrander Barbara 
Published: June 2019

Abstract
Is public opinion on moral issues basically stable or does it change over time? Evidence from the late 20th century indicated contrary patterns for public opinion on abortion, where attitudes were mostly stable, versus views toward gay rights, where public opinion was moving quickly in the liberal direction. This article examines whether public opinion trends on abortion and gay rights from the 20th century remain the same at the beginning of the 21st century. Second, we explore whether change or continuity better describes public attitudes on a host of moral issues. Finally, we investigate the contribution of partisan sorting to contemporary attitudes on moral issues.
Computational Study of Photonic Crystal Resonator for Biosensor Application
Authors: Benmerkhi A. , Bouchemat M. , Bouchemat T. 
Published: June 2019

AbstractA two dimensional photonic crystal biosensor with high quality factor, transmission and sensitivity has been theoretically investigated using two dimensional finite difference time domain method (FDTD) and plane-wave expansion (PWE) approach. The studied biosensor consisted of two waveguide couplers and one microcavity formed by removing one air pore. Following analyte injection into the sensing holes and binding, the refractive index changes inducing a possible shift in the resonant wavelength. For the optimized structure, the biosensor quality factor is found to be over 49,767 and the obtained sensitivity is of order 15.2 nm/fg. Also, we investigated this structure in case of all air holes are applied as the functionalized holes with a sensitivity was found to be approximately equal to 292.46 nm∕RIU (refractive index units). According to the resonance cavity characteristics, the demultiplexing of different wavelengths can be achieved by regulating the radius of defects “r” inside the cavity. For this, A new design with 2D PCs for two-channel demultiplexer optofluidic biosensor has been proposed. The analysis shows that the response of each channel has a different resonant cavity wavelength and the filling of analyte in the selected holes cause resonant wavelength shifting, independently.
The use of humor in Spanish and English compliment responses: A cross-cultural analysis
Authors: Mir Montserrat , Cots Josep Maria 
Published: June 2019

AbstractCompliments and compliment responses (CRs) are face threatening acts which may jeopardize the interlocutor’s positive and negative face. Compliment responses are especially challenging because of the need to balance accepting the compliment with saving face for not sounding arrogant. The use of humor in responding to a compliment can serve as a mitigating factor to respond to a compliment gracefully but with amusement to balance out the loss of face. The present study seeks to analyze humorous CRs in Spanish and English in order to establish cross-cultural comparisons. The results suggest some distinct cultural tendencies. American English speakers prefer self-denigrating humor whereas Peninsular Spanish use teasing and ironic upgrades. Spanish speakers also rely on a wider variety of linguistic resources to add humor to their CRs. Both language groups use humor as a tool to save face. Teasing among Peninsular Spanish is used to strengthen familiarity and closeness ties between interlocutors, a trait often associated with the positive politeness nature of Spanish culture. Self-denigrating humor in English CRs is described as ambiguous from a politeness perspective because it can preserve negative face by directing the humor to the speaker or it may be interpreted as an imposition to reiterate the compliment.