bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can we predict relapse in Graves’ disease? Results from a systematic review and meta-analysis
Authors: Struja Tristan , Fehlberg Hannah , Kutz Alexander , Guebelin Larissa , Degen Christian , Mueller Beat , Schuetz Philipp 
Published: October 2016

BackgroundIdentification of pretreatment risk factors predicting relapse in patients with hyperthyroidism of Graves’ disease after stopping anti-thyroid drugs (ATD) is decisive to guide therapeutic options.PurposeWe performed a systematic search and meta-analysis to study predictors for relapse after stopping ATD in patients with Graves’ disease.MethodsBased on a pre-specified protocol, we searched PubMed, EMBASE and Cochrane in July 2015 for case–control, controlled and randomized-controlled trials reporting risk factors for relapse after stopping ATD. The primary endpoint was relapse of disease until follow-up. PRISMA and SIGN statements were used for reviewing the data and assessing the quality of included trials.ResultsWe included 54 trials with a total of 7595 participants. Most trials were small with moderate-to-high risk for bias. Ten trials were assessed only qualitatively (2227 patients), genomic data were reported in 13 trials (2178 patients) and 31 trials (4346 patients) were assessed quantitatively. In total, there were 3696 relapses in 7595 patients (48.7%). By using random-effects meta-analysis, orbitopathy, smoking, thyroid volume measured by sonography, goiter size, fT4, tT3, TRAb and TBII were significantly associated with relapse, whereas male vs female sex, age and initial tT4 level did not show significant associations.ConclusionsThis analysis found several risk factors to predict relapse in Graves’ disease, which can be combined in a risk score. Prospective studies should evaluate the prognostic accuracy of such a score to guide treatment decisions.
Improving Guideline-Based Care of Acute Asthma in a Pediatric Emergency Department
Authors: Gray Matthew P. , Keeney Grant E. , Grahl Michael J. , Gorelick Marc H. , Spahr Christopher D. 
Published: October 2016

BACKGROUND AND OBJECTIVE:
Rapid repetitive administration of short-acting β-agonists (SABA) is the most effective means of reducing acute airflow obstruction in asthma. Little evidence exists that assesses process measures (ie, timeliness) and outcomes for asthma. We used quality improvement (QI) methods to improve emergency department care in accordance with national guidelines including timely SABA administration and use of asthma severity scores.

METHODS:
The Model for Improvement was used and interventions were targeted at 4 key drivers: knowledge, engagement, decision support, and workflow enhancement. Time series analysis was performed and outcomes assessed on statistical process control charts.

RESULTS:
Asthma severity scoring increased from 0% to &gt;95% in triage and to &gt;75% for repeat scores. Time to first SABA (T1) improved by 32.8 minutes (47%). T1 for low severity patients improved by 17.6 minutes (28%). T1 for high severity patients improved by 3.1 minutes to 18.1 minutes (15%). Time to third SABA (T3) improved by 30 minutes (24%). T3 for low severity patients improved by 42.5 minutes (29%) and T3 for high severity patients improved by 21 minutes (23%). Emergency department length of stay for low severity patients discharged to home improved by 29.3 minutes (15%). The number of asthma-related visits between 48-hour return hospitalizations increased from 114 to 261. The admission rate decreased 6.0%.

CONCLUSIONS:
We implemented standardized asthma severity scoring with high rates of compliance, improved timely administration of β-agonist treatments, demonstrated early improvements in Emergency department length of stay, and reduced admission rates without increasing unplanned return admissions.
Therapeutic strategy to prevent acute exacerbations of chronic obstructive pulmonary disease: clinical guidelines of American College of Chest Physicians and Canadian Thoracic Society Guideline (Part 2)
Authors: Article Editorial 
Published: October 2016

Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality worldwide. An acute exacerbation of COPD greatly contributes to worsening lung function, impairment in quality of life, need for urgent care, and use of medical utilities. Last decade, our understanding of the pathogenesis and treatment of COPD has significantly improved. The guideline accumulated recent information about the prevention of acute exacerbations of COPD.Methods. The American College of Chest Physicians and Canadian Thoracic Society developed evidencebased guideline to describe the current knowledge on the prevention of acute exacerbations in a clinically useful manner. The PICO approach (population, intervention, comparator, and outcome) was used which involved nonpharmacologic therapies, inhaled therapies, and oral therapies. To select the most appropriate studies, to extract evidencebased data and to grade the level of evidence, evidencebased document assessment tools were applied.Results. The guideline was designed as a systematic review and critical evaluation of the published literature by clinical experts and researchers in the field of COPD and recommendations were developed to help clinicians in their management of the patient with COPD.Conclusion. This guideline provides an uptodate, rigorous, evidencebased analysis of current randomized controlled trials on the prevention of COPD exacerbations.
Efficacy of prednisolone in patients with pulmonary sarcoidosis: results of a retrospective study
Authors: Vizel’ I. Yu. , Vizel’ A. A. 
Published: October 2016

The purpose of the study was to evaluate efficacy and safety of systemic corticosteroids (SCS) in 245 patients with sarcoidosis in a real clinical practice.Methods. This was a retrospective analysis of outpatients with pulmonary sarcoidosis who visited a pulmonologist in 2000 to 2015. The analysis involved 166 females and 79 males, mean age, 44.9 ± 0.8 years. The diagnosis was verified by biopsy in 74.7% of cases.Results. Prednisolone improved symptoms and objective parameters of sarcoidosis in 90.2% of cases; 55.9% patients had a relapse after treatment. Three"month treatment with SCS was not associated with complete regression of the disease. The stage IV sarcoidosis developed in 8.8% of the patients despite the adequate dose of prednisolone and duration of the treatment; 56.8% of the patients had a relapse at the end of the therapy. Achieving remission of pulmonary disease was not always associated with remission in other involved organs. In some cases, treatment with SCS was complicated by type 2 diabetes mellitus or hypertension.Conclusion. GCS should be prescribed as the first"line therapy only to patients with progressive course of pulmonary sarcoidosis or with involvement of other organs and after assessment of contraindications to this therapy.
Lung hyperinflation and the risk of fractures in patients with chronic obstructive pulmonary disease
Authors: Kochetova E. V. 
Published: October 2016

The purpose of this study was to investigate an association between lung hyperinflation and the risk of bone fracture in patients with chronic obstructive pulmonary disease (COPD).Methods. The study involved 125 smokers with COPD. The patients treated with systemic steroids were excluded from the study. Lung function and bone mineral density were measured in all the patients. The risk of osteoporotic bone fractures was calculated by FRAX tool.Results. Lung hyperinflation increased according to the COPD stage. The highest total lung capacity (TLC) was observed in patients with 4 stage COPD (131.43 ± 38.99%pred.) followed by 126.68 ± 21.58%pred. in 3 stage COPD and 115.39 ± 23.68%pred. in 2 stage COPD (p < 0.05). The highest risk of hip fracture (> 3) was calculated for 24.24% of patients with residual lung volume (RV) < 200%pred. and for 45.71% of patients with RV > 200%pred. Conclusions. The risk of hip fracture was significantly associated with the severity of hyperinflation in COPD patients. The highest risk of fractures was found in patients with 4 stage COPD.
A novel diagnostic principle for alveolar6capillary membrane permeability disorders
Authors: Babarskov E. V. , Mazurik A. P. , Chernyak A. V. , Aysanov Z. R. , Chuchalin A. G. 
Published: October 2016

The aim of this study was to estimate the diffusing capacity of the alveolar"capillary membrane (Dm) and the alveolar volume of the lungs (Va) based on measured CO concentration and basic spirometric parameters.Methods. Previously, we calculated CO concentration in the exhaled air during tidal and forced breathing. Experimental data of a healthy volunteer were analyzed with presumable predicted values of Dm = 60 and Va = 7.0. Then, the real Dm and Va were estimated.Results. We determined an equation for the present case (male; 176 cm of height; 50 years of age). This equation was too intricate for the routine use, so we developed an online calculator to estimate values in the real"time regimen on the basis of DELPHI platform.Conclusion. Our findings could make reasonability for further investigation to develop a new method for Dm and Va estimation that could be more feasible because it do not need test gas mixtures.
Treatment of comorbid chronic obstructive pulmonary disease and cardiovascular disease
Authors: Vatutin N. T. , Smirnova A. S. 
Published: October 2016

This review provided recent information about treatment of patients with comorbid respiratory and cardiovascular disease. Cardiorespiratory comorbidity is associated with cross"deterioration of the disease course given similar pathogenic components. This could decrease effects of treatment, worsen prognosis and actually requires new approaches to diagnosis and therapy. While choosing the treatment strategy for a patient with comorbid chronic obstructive pulmonary disease (COPD) and cardiovascular disease, a physician should be aware of the pooled risk of adverse events. Some agents widely used for treatment of cardiovascular diseases could worsen the course of COPD and, vice versa, bronchodilators that are the essential component of therapy of chronic obstructive bronchitis could adversely affect the cardiovascular system. Therefore, medication choice could be significantly limited due to comorbidity.
A role of melatonin for occurrence of chronic obstructive pulmonary disease
Authors: Budnevskiy A. V. , Tsvetikova L. N. , Ovsyannikov E. S. , Goncharenko O. V. 
Published: October 2016

A growth in prevalence of chronic obstructive pulmonary disease (COPD) is mainly related to continuing exposure of risk factors. COPD is a major and growing global health problem with great economic burden. Therefore, there is an urgent need to study molecular mechanisms of pathogenesis of COPD and to develop a new treatment strategy. Recent studies have revealed geroprotectors which could discover new therapeutic possibilities for COPD. Thus, use of melatonin could be an effective approach to treatment of COPD which could prevent the premature aging of the lungs. Melatonin is a neurohormone which regulates the human’s biological rhythm, metabolism, and immuno"neuroendocrine processes. Melatonin is produced mainly at night. At the same time, there is the peak activity of the immune system. One of the important functions of melatonin is its antioxidant activity. Oxidative stress occurs during acute exacerbations of asthma and COPD, whereas leukocyte number, and antioxidant enzymes and melatonin levels decrease. Exogenous melatonin could improve the oxidative stress and dyspnea and cause 1.6"fold reduction in 8"isoprostane concentration in COPD patients. Melatonin could also inhibit ERK phosphorylation and expression of Sp1 and MUC5AC due to inhibition of MAPK signaling pathway phosphorylation. Melatonin could improve sleep quality in COPD patients with concomitant sleep disorders. Furthermore, melatonin does not cause daytime sleepiness and respiratory disorders compared to conventional hypnotics which may worsen nighttime hypoxemia and respiratory failure in severe cases. Obviously, melatonin could be a potential agent for treatment of chronic airway diseases such as asthma and COPD. However, further long"term large"scale studies are needed to develop recommendations for safe use of melatonin in patients with COPD and sleep disorders.
DEMOCRATIC CONSTITUTIONALISM AND HUMAN RIGHTS GREENING: CHALLENGES AND COMMON CONSTRUCTIONS
Authors: Sampaio José Adércio Leite , Pinto João Batista Moreira 
Published: October 2016

This article aims at analyzing the phenomenon of democratic constitutionalism and human rights greening, listing some of their common challenges and, especially, the possibilities and urgencies of a more integrated performance among them so as to favor full participation and citizenship, and, as a consequence, to strengthen one another. The contradictions of neoliberal globalization are the starting point for the assessment of the position of the constitutional theory - from the perspective of democratic constitutionalism - and of the field of human rights - including the analysis of the different understandings surrounding this concept -, as well as the impacts of its progressive greening. The ambiguities of the international protection of human rights as an indivisible system, characterized by the deficits of effectiveness regarding economic, social and cultural rights, and enlarged by the inclusion of the environmental speech, can only be overcome by their links with the ideas and instruments of the democratic constitutionalism and, especially, through the mobilization of the claiming and fighting energies of the society.
EPIGENETICS AND ENVIRONMENTAL BIOETHICS
Authors: Reis Émilien Vilas Boas , Naves Bruno Torquato de Oliveira 
Published: October 2016

Despite being a new area of scientific knowledge, Bioethics has developed two main references that alternate temporally: a more global Ethics, as the one defended by Potter, and the Georgetown model, which was limited to the issue of Medical Ethics, revitalizing the practical Ethics. In the last decades, a widening of Bioethics is being followed up and it came to be recognized as a new transdisciplinary discipline that is inseparable from concerns about the environment. The advancements of Genetics and the creation of Epigenetics opened new paths to Bioethics. The interaction between the environment and the structure of DNA became known, but modifications that can be passed on to the offspring without affecting the structure of the DNA were also discovered. This paper is dedicated to the analysis of the changes that can hereditarily be passed on to future generations through the interference of the environment, from Rachel Yehuda et al’s recent article: Holocaust exposure induced intergenerational effects on FKBP5 methylation. Yehuda’s study allowed for a glimpse over what unfolds for the future of Bioethics, its new challenges and issues and it also evidenced the fact that health and environment are in constant and inseparable connection.
Estudio comparativo del uso de dos sustratos con inóculos microbiales para el tratamiento de residuos orgánicos sólidos en compostaje doméstico. Análisis Económico
Authors: Borrero-González Gina Paola , Arias-Aguilar Dagoberto , Campos-Rodríguez Rooel , Pacheco-Rodríguez Fabián 
Published: October 2016

<p class="p1">Se realizó un estudio para evaluar técnica y económicamente los efectos de dos sustratos microbiales en la degradación de residuos orgánicos domiciliarios (ROD) en un sistema de compostaje doméstico. Para tal fin se comparó el método del preparado microbial de microorganismos de montaña (MM), usado en el Centro Nacional Especializado en Agricultura Orgánica (CNEAO-INA) de Costa Rica y el método Takakura (TAKA), inoculación con microorganismos fermentativos, de la técnica Japonesa, desarrollada por el Instituto para las Estrategias Globales Ambientales (IGES) de Japón. </p><p class="p1">Se estableció un experimento completamente aleatorio con 20 unidades experimentales, distribuidas en dos tratamientos (MM y TAKA), sus respectivos testigos (MMT y TAKAT), un testigo absoluto (ABST) y 4 repeticiones para cada una. Se utilizaron los ROD de 20 hogares, distribuidos en 7 aportes durante 18 días. </p><p class="p1">Los resultados destacan la calidad del proceso de compostaje y la calidad del compost obtenido por medio del sustrato TAKA en comparación con el compost del sustrato MM. </p><p class="p1">Con respecto al análisis de costos, el sustrato MM es 7% menos costoso que el TAKA, estos costos no sobrepasan los USD17. Ambos tratamientos son bajo costo, comparados con el del actual manejo de residuos en rellenos sanitarios. </p>
Desempeño de turbinas eólicas Magnus de eje horizontal en función de sus variables geométricas y cinemáticas
Authors: Richmond-Navarro Gustavo 
Published: October 2016

<p class="p1">Este estudio presenta el análisis de una turbina eólica de eje horizontal que utiliza cilindros en rotación, en lugar de aspas con perfiles alares. El principio de funcionamiento de este generador eólico es el efecto Magnus, que sucede cuando las aspas cilíndricas empiezan a rotar y se da una interacción entre la corriente de viento incidente y el aire que es arrastrado por las paredes de los cilindros en movimiento. De esta forma, se obtiene la sustentación que pone en movimiento la turbina. </p><p class="p1">El objetivo de la investigación es caracterizar este tipo de turbina mediante modelos numéricos y matemáticos, que permitan determinar el comportamiento de la curva de potencia en función del viento ante variaciones de los parámetros de funcionamiento de la turbina tipo Magnus de eje horizontal, a saber, la geometría del cilindro y las velocidades de rotación tanto de la turbina como del cilindro. </p><p class="p1">Para estudiar el desempeño de la turbina, se propone un método numérico no iterativo, que es implementado en un código que permite predecir el rendimiento de turbinas de eje horizontal, el cual es validado con mediciones experimentales de turbinas convencionales. </p><p class="p1">Posteriormente, se adecúa el código para aplicarlo a turbinas Magnus y con ello se obtiene el comportamiento de la curva de potencia ante variaciones en la geometría y cantidad de cilindros, así como las velocidades angulares de la turbina y del aspa cilíndrica. </p>
Caracterización de defectos y alteraciones nanoestructurales en la superaleación Nimonic 80A por medio de microscopía electrónica de transmisión
Authors: Guillén-Girón Teodolito , León-Salazar José Luis 
Published: October 2016

<p class="p1">En este trabajo se analizaron probetas TEM (Microscopía Electrónica de Transmisión, por sus siglas en ingles) de materiales usados en aplicaciones aeronáuticas. El principal objetivo de este proyecto fue estudiar los defectos intercristalinos presentes en la superaleación Nimonic 80A luego de ser tratada térmicamente y posteriormente someter las probetas a esfuerzos cíclicos. Las probetas TEM fueron probadas previamente bajo fatiga de alta frecuencia (1 000 Hz y 20 000 Hz) en la Universidad de Siegen en Alemania, simulando las condiciones de trabajo de esta aleación en turbinas de avión o en otros tipo de aplicaciones aeronáuticas. Este tipo de esfuerzo mecánico genera muchas deformaciones y defectos nanométricos en este material, que se evidencian por medio de dislocaciones. Estos defectos solo se pueden observar empleando técnicas de microscopía muy potentes, como la TEM. Los resultados obtenidos del análisis TEM revelan precipitados característicos en la muestra de Nimonic 80A al ser sometida a tratamientos térmicos. Además, esta aleación evidencia la formación de dislocaciones producto de los esfuerzos mecánicos que sufrieron estas probetas. Finalmente, se logró evidenciar la influencia de las precipitaciones en el mecanismo de formación, agrupamiento y movimiento de las dislocaciones en la microestructura de las muestras utilizadas. </p>
Aplicación de Cadenas de Markov en un proceso de producción de plantas in vitro
Authors: Sánchez-Brenes Andrés , Alvarado-Ulloa Carlos , Solís-Blanco Ricardo , Chacón-Cerdas Randall , Villalta-Solano Humberto 
Published: October 2016

<p class="p1">La aplicación de la biotecnología incluye una serie de procesos industriales que involucran organismos vivos o partes de ellos. La interacción del genotipo con los demás factores de manipulación industrial, aunque controlables, provoca que el sistema sea estocástico o no determinista, caracterizado por acciones predecibles y con elementos aleatorios. La producción masiva de plantas in vitro es un ejemplo de este tipo de industrias biotecnológicas, en el que se cultivan plantas seleccionadas bajo condiciones controladas de incubación y en medios nutritivos. Durante el proceso se producen pérdidas por contaminación o muerte del material y reprocesos, cuando las plantas se oxidan o deforman, pero una parte de ellas se puede rescatar y reintegrar a la etapa anterior. Tomando como modelo el proceso de producción de vitroplantas de papa (<em>Solanum tuberosum</em>) en la empresa VitroPlant S.A., se aplicó el método de Cadenas de Markov para determinar los requerimientos de material vegetal para cumplir con una demanda determinada de acuerdo con la etapa del proceso de la que se inicia, incluyendo en ese cálculo las pérdidas y reprocesos. Así, el método de Markov es una opción viable en los procesos biológicos productivos que podría aplicarse a otras especies vegetales e incluso a otros sistemas que utilicen diferentes organismos vivos, tales como hongos, bacterias, insectos y microalgas, todos comunes en la industria. </p>
Evolución de los modelos en los procesos de innovación, una revisión de la literatura
Authors: Fonseca-Retana Leonel , Lafuente-Chryssopoulos Raquel , Mora-Esquivel Ronald 
Published: October 2016

<p class="p1">Se considera que la innovación es un factor relevante en el desempeño de las organizaciones, porque implica llevar al mercado ideas novedosas que representan valor para los clientes. Uno de los aspectos que ha llamado la atención es el proceso que llevan a cabo las organizaciones para innovar. </p><p class="p1">Desde la primera mitad del siglo XX se han propuesto varios modelos de procesos de innovación, los cuales han ido evolucionando según el contexto económico prevaleciente en su momento, desde la expansión industrial posterior a la segunda guerra mundial, cuando el desarrollo de innovaciones seguía un proceso lineal secuenciado que se iniciaba con la investigación básica, y que predominó hasta mediados de los años 70. Después se desarrollaron modelos que consideran que el proceso no necesariamente empieza con la investigación, sino que puede provenir de otras áreas de la empresa. Esto significa que el conocimiento no solo reside en la investigación y el desarrollo (I+D), ya que los desarrollos pueden surgir incluso de la demanda de los clientes; además, la secuencia para lograr una innovación no es lineal ni unidireccional. Estos modelos tuvieron su mayor aplicación hasta mediados de los años 80; luego se incorporó el concepto de “etapas y puertas”, según el cual, debe haber una evaluación para que el desarrollo de una innovación pueda pasar de una etapa a otra del proceso.Considerando lo anterior, el presente artículo busca describir las principales características de los modelos que señala la literatura, su evolución y el contexto en el que surgieron </p>