bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonpharmacological interventions and outcomes in the management of complications of human T-cell lymphotropic virus type 1-related myelopathy/tropical spastic paraparesis: A systematic review
Authors: Davoudi Malihe , Boostani Reza , Manzari Zahra Sadat 
Published: February 2024

Background:
Human T-cell lymph tropic virus type 1 (HTLV-I)-related myelopathy/tropical spastic paraparesis (TSP) is a progressive inflammatory process affecting the spinal cord that occurs as a result of HTLV 1. The use of nonpharmacological approaches has always been one of the treatment strategies in these patients, but disagreement about these interventions and their results has led to their limited use. Therefore, this study aimed to identify nonpharmacological interventions and their consequences in these patients.

Materials and Methods:
We followed the Cochrane Handbook for systematic reviews of interventions. The present report is organized according to the preferred reporting items for systematic reviews and meta-analyses. This study was conducted at PubMed, Cochrane Library, Web of Science, and Scopus, among all published studies by December 30, 2021. Keywords were: HTLV-1, Human T-lymph tropic virus 1, HTLV-I-associated myelopathy, HAM/TSP, tropical spastic paraparesis, nonpharmacological intervention, nonpharmacological treatment, massage, physiotherapy, acupuncture, acupressure, and exercise. The quality of the studies was assessed using JADAD.

Results:
Of 288 articles, 11 were eligible for data extraction published between 2014 and 2021. 90/9% of studies were randomized clinical trials. 81/8% of articles were of high quality. The total sample size was 253 people, of which 137 (54/15%) were women. Approaches such as exercise and motion therapy, electrotherapy, behavioral therapy, and virtual reality can be used for these patients. With these interventions, results such as improved mobility and balance, physical condition, pain, quality of life, muscle spasticity, maximum inspiratory pressure, and urinary symptoms can be achieved.

Conclusion:
The most common physical therapy method used in studies was active and passive body movements, which are associated with positive results for patients. Due to the small sample size in this group of studies, it is necessary to conduct more clinical trials for more accurate conclusions. Furthermore, due to the limited number of studies that have used electrical stimulation or combined intervention packages, it is not possible to say with certainty what effect these methods have on patients. It is necessary to conduct more clinical trials.
Sonographic estimation of fetal heart rate in healthy pregnant women in Umuahia South East Nigeria
Authors: Obiozor Anthony Ayaegbunam , Imo Augustine Onuegbuchi C. 
Published: February 2024

Abstract

Introduction:
There are various methods of estimating fetal heart rate (FHR) in pregnancy such as the use of fetoscope, sonicaid, and others. Of all these methods, Doppler ultrasound evaluation of FHR is preferred because it is real in time, readily available, does not involve the use of ionizing radiation, is cheap, reproducible and is not observer dependent. It does not have any deleterious effect on the fetus, it also shows the fetal cardiac tracing and rhythm such that FHR and heart sound can be heard and calculated. This can help in determining abnormal fetal heart sound.[1,2] There is not much previous work on the ultrasound estimation of FHR in pregnant women in Umuahia and hence the need for this study.

Aim:
The aim of the study is to establish normal ranges of FHR in healthy pregnant women using Doppler-guided ultrasound estimation, to correlate it with the gestational age (GA) and estimated fetal weight (EFW).

Materials and Methods:
This is a randomized prospective study of 110 healthy singleton pregnant women on their routine antenatal visit. Data on GA were obtained using the crown-rump length in the first trimester and biparietal diameter (BPD) and femur length (FL) in the second and third trimesters. FHR was obtained using Doppler interrogation of the heart while the weight of the fetus was obtained using three parameters; the FL, abdominal circumference, and the BPD.

Results:
The result obtained from the data was analyzed using Statistical Package for Social Sciences (SPSS) version 21. Mean, minimum, and maximum values were obtained. The relationship between the FHR, EFW, and GA was correlated. The minimum GA was n = 10 weeks while the maximum GA was n = 40 weeks with a mean value of 30. The minimum fetal weight was observed to be n = 35 g while the maximum fetal weight was n = 4402 g and the mean value was 1923.8 the minimum FHR obtained from this research was n = 125 bpm and the maximum = 176 bpm while the mean was observed to be 143.4.

Conclusions:
In summary, the FHR is affected by the EFW and the GA in such a manner that as the fetal weight and GA increase, the FHR decreases and vice versa. The FHR ranges from 125 bpm to 176 bpm in a healthy pregnant woman.
Analysis of External Factors Based on Porter's Five Forces Method at PT Gipan Metal Teknik Indonesia
Authors: Pranoto Ari , Indradewa Rhian 
Published: February 2024

The industrial company providing and fabricating abrasion-resistant steel PT Gipan Metal Teknik Indonesia (PT GMTI) will face competition in the business, so the company must increase efficiency and optimize its potential. This study aims to determine the competitive advantage strategy of PT GMTI based on Porter's Five Forces method. Analysis of external factors as a planning strategy to find out opportunities and threats in running business processes so that they can affect the sustainability of the company. Michael A. Porter describes the five forces module as an analytical tool in industrial competition. The results of this analysis are in the form of external factors of the company in facing the Competitive Force used by the company in facing business competition. External factors faced by PT GMTI in running its business based on Porter's Five Forces method are a) Threat of New Entrans namely the need for company capital and government regulations, b) Rivalry Among Existing Competitors namely the quality of products offered and marketed, c) Bargaining Power of Buyers namely the number of similar competitors, d) Bargaining Power of Suppliers namely the price of raw materials from suppliers, e) Threat of Subtitute Products, namely the quality of substitute products. The results of this study show that the strategy that can be developed by PT GMTI is to increase business capital and training employees so that the company can develop and maintain the quality of services and products for business continuity. The determination of variables used in Porter's Five Forces analysis is based on the experience of one of our members who works as a supplier of abrasion-resistant materials and also works in one of the heavy equipment companies in Indonesia.
Fortalezas y debilidades para una lactancia materna exclusiva exitosa en madres que asisten al Hospital General Docente Riobamba, Ecuador
Authors: Santillán Mancero Eulalia Terecita , Rosero Arévalo Pablo Gregorio , Yaulema Brito Lorena Patricia , Gavidia Castillo Mayra Alejandra 
Published: February 2024

Introducción: la leche materna es la mejor fuente alimentaria para el niño menor de seis meses, aporta los nutrientes para un crecimiento y desarrollo óptimo, sin embargo en las últimas décadas se han reportado una disminución. Objetivo: identificar las fortalezas y debilidades de una lactancia materna exclusiva (LME) exitosa, en madres que asisten al Hospital General Docente Riobamba (HGDR). Métodos: se investigó a 331 binomios madre – hijo de 6 a 24 meses de edad, en diseño observacional, descriptivo, transversal y mediante. Resultados: las madres son residentes de Riobamba, el 14% tienen trabajo estable, la mayoría son amas de casa o estudiantes, con edad promedio de 25 años y el 23% son solteras. El 72% ha mantenido LME, lo que difiere significativamente (p < 0.05) con lo reportado en la Encuesta Nacional de Salud, Alimentación y Nutrición (ENSANUT), 2011-2013. Además se observó que existe una disminución de LME en madres menores de 19 años. Son fortalezas, el apoyo de los profesionales de salud, la convicción de dar a su hijo/ja la mejor alimentación para evitar las enfermedades y tengan un crecimiento óptimo y el apoyo familiar. La principales debilidades son el ingreso de la madre al trabajo y la disminución en la producción de leche. Conclusión: hay necesidad de motivar, educar y brindar asesoría alimentaria nutricional para una LME exitosa en especial a madres menores de 19 años.
Utilización de apps móviles en el control de la salud
Authors: Avalos Pérez Miguel Angel , Piñas Morales María Bélen , Avalos Pérez Martha Cecilia 
Published: February 2024

Introducción: actualmente muchas personas se benefician de las ventajas que proveen las apps móviles (mHealth) para la medición de datos y controlar su salud, pero en nuestro medio aún no se refleja una tendencia sobre el uso de apps para mejorar la calidad de vida. Objetivo: el propósito del estudio es conocer el uso de dispositivos y apps móviles en el ámbito de la salud, en jóvenes estudiantes de la Carrera de Medicina de la ESPOCH. Métodos: se realizó un estudio descriptivo transversal para determinar la prevalencia en el manejo y aprobación de las TICs a través de un muestreo de conveniencia aleatorio, seleccionando de esta manera a 245 estudiantes cuyas edades fluctúan entre los 18 y 23 años. Resultados: 93.88% (n = 230) de estudiantes poseen un teléfono del tipo Smartphone, mientras que el 6.12% (n = 15) no poseen teléfonos inteligentes, pero utilizan otros dispositivos móviles en el caso de que se requiera instalar y usar apps para diferentes necesidades. Del conjunto efecto de estudio, apenas el 5.3% (n = 13) utilizan con frecuencia apps destinados al control de su salud. Conclusión: a pesar de la evidente revolución de las tecnologías móviles y apps orientadas a la salud, se puede comprobar que aún existe una baja predisposición al uso de este tipo de herramientas debido básicamente a la falta de conocimiento de su funcionalidad, a las dudas en la fiabilidad con respecto a la información mostrada, a la seguridad y confidencialidad de los datos de salud.
Enfermedades crónicas: Un reto en la salud de la comunidad San Francisco de Cununguachay, Chimborazo
Authors: Matías Panchana Dollys , Pineda Grillo Indira José , Baltodano Ardon Franklin 
Published: February 2024

Introducción: Las enfermedades crónicas siguen siendo un reto en atención primaria. Las intervenciones para prevenirlas están orientadas principalmente a la educación y prevención de complicaciones. Objetivo: Caracterizar el comportamiento de las enfermedades crónicas en adultos mayores en la comunidad de San Francisco de Cunuguachay, provincia de Chimborazo. Metodología: Se realizó un estudio descriptivo, transversal, con datos recolectados retrospectivamente. El estudio incluyó 399 familias, todas ellas afiliadas al Seguro Social Campesino en el periodo 2019. La muestra estuvo compuesta por 328 adultos mayores con diagnóstico de enfermedad crónica no transmisible. Resultados: Predominó el sexo masculino, las enfermedades crónicas más frecuentes fueron la dislipidemia en un total de 159, hipertensión en 123 pacientes, seguida de diabetes mellitus tipo 2. Los factores de riesgo relacionados al diagnóstico de enfermedad crónica no transmisible incluyeron malos hábitos alimenticios, sedentarismo y tabaquismo. Conclusión: Las enfermedades crónicas no transmisibles constituyen un problema de salud en los pacientes adultos mayores de la comunidad de San Francisco de Cunuguachay donde prevaleció la dislipidemia, hipertensión y diabetes tipo 2.
Attitudes of health science students on English learning
Authors: Carpio Salas José Gabriel , Guambo Enrique , Mancero Washington , Medina Rea Jazmín Marisol , Cando María Liliana 
Published: February 2024

Introducción: El aprendizaje del idioma inglés es una herramienta básica para la permanente actualización profesional y científica, con mayor razón, en las ciencias de la salud. Objetivo: Evaluar las actitudes de estudiantes de ciencias de la salud en relación al aprendizaje del idioma inglés. Métodos: Estudio transversal n = 400 estudiantes de carreras de salud (Medicina, Nutrición y Dietética, Gastronomía, Promoción, Cuidados para la salud, Bioquímica y Farmacia). Se recopilaron sobre la comprensión del idioma, las cuatro habilidades del inglés (escuchar, leer, escribir, hablar) y el ambiente pedagógico. Se consideró como variables independientes al sexo, el nivel de estudio de los estudiantes y la última calificación obtenida, se realizó un análisis utilizando la prueba Chi2 elaborada usando Stata 14.0. Resultados: 57.5% de la muestra de estudio fueron mujeres, edad promedio 23.4 ± 11.5 años y el 46.75% de los sujetos fueron de la escuela de medicina. Las actitudes de los estudiantes hacia el aprendizaje del inglés fueron estadísticamente diferentes en las distintas dimensiones del aprendizaje del inglés respecto al sexo (los hombres presentan actitudes más positivas que las mujeres), el nivel de estudio (los estudiantes de niveles superiores tienen un auto concepto académico de hablar en nivel medio-alto mayor que los de niveles inferiores) y la última calificación (los estudiantes que tenían mejores calificaciones tenían mejor auto percepción de sus habilidades para entender, escribir, hablar y leer en inglés). Conclusiones: Las actitudes hacia el aprendizaje del inglés pueden varias dependiendo de factores como sexo, nivel de estudio y calificaciones obtenidas
Manejo de animales de laboratorio. Revisión bibliográfica
Authors: Rodríguez Duque Raisa , Valdés Cabodevilla Regla Cristina , Pino Burgos Susana del Pilar 
Published: February 2024

Introducción: La utilización de animales de laboratorio ha ido en paralelo al desarrollo de la biomedicina. Conocer su manejo es indispensable para el desarrollo de la investigación. Objetivo: Describir el uso y manejo correcto de los animales de laboratorio. Métodología: El presente trabajo es una revisión narrativa de la literatura. Los recursos se recuperaron en las bases de datos, lo que incluye PubMed, ScienceDirect, WOS, ProQuest e IEEE. Resultados: Se incluyeron 30 estudios, los cuales abordan distintos temas en cuanto al uso y manejo de animales de laboratorio. Discusión: El desarrollo de la medicina, veterinaria, odontología ha ido de la mano con el empleo de los animales en el laboratorio. En contraposición de lo que ocurre en otras zonas geográficas donde se incentiva el uso de alternativas a la experimentación animal, en países latinoamericanos la utilización de animales de es cada vez mayor. Si se usan animales de experimentación, deben manejarse con principios éticos. Debe constituir una prioridad que los animales sean bien cuidados en cada una de las etapas iniciando desde el nacimiento hasta su muerte, se les debe asegurar el bienestar durante el proceso de crianza, subsistencia y en el de la experimentación. Conclusiones: La utilización de animales de experimentación de hacerse de manera ética y siempre y cuando no exista otra alternativa y la intención de su uso esté asociada a la consecución de un bien mayor.
Micobacteriosis pulmonar por Mycobacterium kansasii
Authors: Chuquizala Chafla Segundo Julián , Cuzco Macias Leslie Gricel , Atencio Trujillo Karina Andrea , Moreno Sailema Rubén Israel , Muquinche Olovacha Ivonne Amparo 
Published: February 2024

Micobacterias no tuberculosas (MNT) es una designación utilizada para referirse a un gran número de especies de micobacterias ambientales potencialmente patógenas y no patógenas, distintas de la Mycobacterium tuberculosis y Mycobacterium leprae. Mycobacterium kansasii (M. Kansasii) es una MNT oportunista causante de infecciones pulmonares, cutáneas, entre otras, cuya tasa de incidencia ha ido incrementando en los últimos años a nivel mundial. A través de presentar el siguiente caso se pretende aportar al conocimiento con respecto al abordaje de pacientes con infección por MNT a nivel pulmonar, dirigido a médicos que trabajan en atención primaria de salud (APS). Se trata del caso de una paciente de 46 años de edad que acude al Hospital Provincial General Docente de Riobamba (HPGDR) con infección por MNT a nivel pulmonar. En el examen microscópico se detectaron Bacilos‐Ácido‐Alcohol‐Resistentes (BAAR) mientras en el cultivo de esputo más antibiograma se aisló M. kansasii resistente a los antibióticos utilizados para la terapia convencional de tuberculosis. Se trata de un caso raro en la práctica clínica. Es crucial saber cómo manejar una infección con M. kansasii debido a su implicación para la salud del paciente y el sistema de salud nacional. El médico de APS debe reconocer su papel fundamental y la importancia que tiene un diagnóstico oportuno y tratamiento adecuado.
Recent advances in rectal cancer treatment – are we on the right track?
Authors: Glimelius Bengt 
Published: February 2024

Background: Staging and treatment of rectal cancer have evolved over several decades with considerably fewer locoregional recurrences but no marked improved survival since systemic recurrence risks remain virtually unchanged. This development will briefly be summarised followed by a thorough discussion of two recent developments.
Methods: A systematic approach towards the literature is aimed at focusing on organ preservation and the delivery of all non-surgical treatments prior to surgery or total neoadjuvant treatment (TNT).
Results: Organ preservation, that is to defer surgery if the tumour happens to disappear completely after any pre-treatment given to locally advanced tumours to decrease recurrence risks has increased in popularity and is, if not universally, widely accepted. To give neo-adjuvant treatment to intentionally obtain a clinically complete remission to avoid surgery is practised in some environments but is mostly still experimental. TNT, that is to provide both radiotherapy and chemotherapy aimed at killing microscopic disease in the pelvis or elsewhere has been subject to several trials. Collectively, they show that the chance of achieving a complete response, pathologically or clinically, has approximately doubled, increasing the chance for organ preservation, and the risk of distant metastasis has decreased at least in some trials. The best schedule remains to be established.
Conclusions: To obtain substantial progress and also improve survival, the systemic treatments need to be improved even if preoperative delivery is more effective and better tolerated than postoperative. The locoregional treatment may be further optimised through better risk prediction.
Tennessee Williams
Authors: Kolin Philip 
Published: February 2024

The plays of Tennessee Williams are some of the greatest triumphs of the American theatre. If Williams is not the most important American playwright, he surely is one of the two or three most celebrated, rivaled only by Eugene O’Neill and Arthur Miller. In a career that spanned almost five decades, he created an extensive canon of more than 70 plays. His contributions to the American theatre are inestimable and revolutionary. The Glass Menagerie (1945) introduced poetic realism to the American stage; A Streetcar Named Desire (1947) explored sexual and psychological issues that had never before been portrayed in American culture; Cat on a Hot Tin Roof (1955) dared to challenge the political and sexual mores of the Eisenhower era; and his plays of the 1970s are among the most innovative works produced on the American stage. But Williams was far more than a gifted and prolific playwright. He created two collections of poetry, two novels, four collections of stories, memoirs, and scores of essays.
Because of his towering presence in American drama, Williams has attracted the attention of some of the most insightful scholars and critics of the twentieth century. The 1990s in particular ushered in a renaissance of Williams research, including a definitive biography, a descriptive bibliography, and numerous books and scholarly articles. This reference book synthesizes the vast body of research on Tennessee Williams and offers a performance history of his works. Under the guidance of one of the leading authorities on Williams, expert contributors have written chapters on each of Williams’ works or clusters of works. Each chapter includes a discussion of the biographical context of a work or group of writings; a survey of the bibliographic history; an analysis of major critical approaches, which looks at themes, characters, symbols, and plots; a consideration of the major critical problems posed by the work; an overview of chief productions and film and television versions; a concluding interpretation; and a bibliography of secondary sources. The volume concludes with a selected, general bibliography and a comprehensive index.
Term Paper Resource Guide to Nineteenth-Century World History
Authors: Walker William T. 
Published: February 2024

With this guide, major help for nineteenth-century World History term papers has arrived to enrich and stimulate students in challenging and enjoyable ways.
Show students an exciting and easy path to a deep learning experience through original term paper suggestions in standard and alternative formats, including recommended books, websites, and multimedia. Students from high school age to undergraduate can get a jumpstart on assignments with the hundreds of term paper suggestions and research information offered here in an easy-to-use format. Users can quickly choose from the 100 important events, spanning the period from the Haitian Revolution that ended in 1804 to the Boer War of 1899-1902.
With this book, the research experience is transformed and elevated. Term Paper Resource Guide to Nineteenth-Century World History is a superb source with which to motivate and educate students who have a wide range of interests and talents. Coverage includes key wars and revolts, independence movements, and theories that continue to have tremendous impact.
Thematic Guide to World Mythology
Authors: Stookey Lorena Laura 
Published: February 2024

All around the world, myths address questions that humans have always posed about their origins, their environments, their ultimate destinies, and the meanings of their lives. This book examines 30 common motifs that thread their way through mythological tales across history and around the globe. The themes are presented in alphabetical order, moving from The Afterlife and Animals in Myth to The Underworld, World Tree, and Ymir Motif. Each thematic section defines and discusses a single recognizable motif, compares a number of different mythological traditions, and traces the repeated occurrences of one of these patterns through several different categories of narratives.
The discussion of The Afterlife, for example, examines the theme's earliest known occurrences in ancient Mesopotamia and compares them with those in Greek, Aztec, Norse, and other ancient cultures, as well as with contemporary views from Innuit and Polynesian cultures. A glossary provides concise definitions of recurring terms. A list of suggested readings on these topics will further aid students who desire to deepen their knowledge of world mythology.