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Risk Factors Associated with Unsuccessful Vaginal Birth after One Cesarean (VBAC-1) in Puerto Rico

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Open Journal of Obstetrics and Gynecology 2024年第6期14卷 888-902页

作者： Irazú Guinan Marjorie Suárez Fabiola Angulo luis Mayol Paula Suárez Lisandris Dominicci Nathalie Chang Saribel Torres Antonio Rodríguez Raymond L. Tremblay Maricarmen Colón-Díaz Department of Physiology and Pathology San Juan Bautista School of Medicine Caguas USA

Background: Cesarean section (CS) has increased steadily over the last decade, with an estimated one-third of women delivering by cesarean section worldwide. Objective: Our study aimed to investigate the demographic and associated factors influencing vaginal birth after one cesarean (VBAC-1) success focusing on variables like pre-pregnancy BMI, diabetes, hypertension, education, and smoking. Study Design and Methods: In this retrospective study, we analyzed 285 cases (81 unsuccessful VBAC-1, 204 successful VBAC-1) from San juan City Hospital (Puerto Rico) between January 1, 2019, and December 31, 2020. We used odds ratios and model selection comparison to assess the impact of variables on successful VBAC-1, using a significance threshold of 95% CI. Model selection assessed binomial model combinations using a generalized linear approach to identify key risk factors. Results: Unsuccessful VBAC-1 (a repeat cesarean), was associated with diabetes (OR: 0.376, p = 0.086), hypertension (OR: 0.23, p = 0.006), and university-educated women (OR: 1.372, p = 0.711). High school-educated women had an OR of 3.966 (p = 0.105), while overweight women were 0.481 times more likely to have unsuccessful VBAC-1 (p = 0.041). Significant associations were not found with obesity (OR: 0.574, p = 0.122), underweight/normal (OR: 1.01, p = 0.810), or smoking (OR: 1.227, p = 0.990). Conclusion: Results revealed women with higher education levels, hypertension, or diabetes are less likely to have a successful VBAC-1. Understanding the complex interactions affecting these outcomes is aimed at establishing guidelines for healthcare professionals to conduct systematic risk/benefit assessments. This study lays a foundation for evidence-based practices and policies, offering initial insights into VBAC-1 success factors in Puerto Rico.

关键词： Diabetes Hypertension Obesity Trial of Labor Vaginal Birth after Cesarean

Diagnosis and management of bacterial infections in decompensated cirrhosis

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World Journal of Hepatology 2013年第1期5卷 16-25页

作者： Maria Pleguezuelo Jose Manuel Benitez juan Jurado Jose luis Montero Manuel De la Mata Liver Research Unit Reina Sofia University HospitalAvda Menendez Pidal s/n14004 CordobaSpain

Bacterial infections are one of the most frequent complications in cirrhosis and result in high mortality *** with cirrhosis have altered and impaired immunity,which favours bacterial *** of infections are more frequent in patients with decompensated cirrhosis than those with compensated liver *** most common and life-threatening infection in cirrhosis is spontaneous bacterial peritonitis followed by urinary tract infections,pneumonia,endocarditis and skin and soft-tissue *** with decompensated cirrhosis have increased risk of developing sepsis,multiple organ failure and *** factors associated with the development of infections are severe liver failure,variceal bleeding,low ascitic protein level and prior episodes of spontaneous bacterial peritonitis (SBP).The prognosis of these patients is closely related to a prompt and accurate *** appropriate treatment decreases the mortality *** strategies are the mainstay of the management of these *** antibiotics should be started immediately following the diagnosis of SBP and the first-line antibiotic treatment is third-generation ***,the efficacy of currently recommended empirical antibiotic therapy is very low in nosocomial infections including SBP,compared to community-acquired *** may be associated with the emergence of infections caused by Enterococcus faecium and extended-spectrum β-lactamaseproducing Enterobacteriaceae,which are resistant to the first line antimicrobial agents used for *** emergence of resistant bacteria,underlines the need to restrict the use of prophylactic antibiotics to patients with the greatest risk of *** infections should be treated with wide spectrum *** studies of early diagnosis,prevention and treatment are needed to improve the outcomes in patients with decompensated cirrhosis.

关键词： Cirrhosis Infections Spontaneous bacterial peritonitis Ascites Antibiotics

Thermodynamic and Dynamic of Chromium Biosorption by Pectic and Lignocellulocic Biowastes

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Journal of Water Resource and Protection 2010年第10期2卷 888-897页

作者： luis Sala juan González 不详

Orange peel (OP) and rice husk (RH) were tested as low-cost biosorbents for Cr(III) removal from aqueous solutions. Dynamics of the biosorption process indicated that intraparticle mass transfer represents the rate-limiting step in the system that attained equilibrium at 120 min. While the OP sorbent material was capable of taking up 39.11 mg Cr(III)/g at the optimum pH 4.4, RH immobilized 3.20 mg Cr(III)/g at the optimum pH 3.0. The fitting of different sorption isotherms models resulted in the best fit with the Langmuir isotherm model. The mean free energy of the metal sorption process was in the range of 8-16 kJ/M. Abiotic Cr(VI) reduction was observed at various contact times and Cr-laden biomass was characterized by XPS, XAFS and EPR spectroscopy. These instrumental analyses confirmed that Cr(VI) removed from the solution was reduced and bound to the biomass as Cr(III). Results indicated that OP and RH materials are efficient biosorbents for eliminating Chromium from aqueous solutions.

关键词： Chromium Adsorption Orange Peel Rice Husk

T_3-induced liver AMP-activated protein kinase signaling:Redox dependency and upregulation of downstream targets

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World Journal of Gastroenterology 2014年第46期20卷 17416-17425页

作者： luis A Videla Virginia Fernández Pamela Cornejo Romina Vargas Paula Morales juan Ceballo Alvaro Fischer Nicolás Escudero Oscar Escobar Molecular and Clinical Pharmacology Program Institute of Biomedical SciencesFaculty of MedicineUniversity of ChileIndependencia 1027SantiagoChile School of Medical technology Faculty of MedicineDiego Portales UniversityEjército 141SantiagoChile

AIM: To investigate the redox dependency and promotion of downstream targets in thyroid hormone (T3)-induced AMP-activated protein kinase (AMPK) signaling as cellular energy sensor to limit metabolic stresses in the l... 详细信息

关键词： Liver Thyroid hormone N-acetylcysteine AMP-activated protein kinase Fatty acid oxidation

Patterns of local recurrence in rectal cancer after a multidisciplinary approach

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World Journal of Gastroenterology 2011年第13期17卷 1674-1684页

作者： Jose M Enríquez-Navascués Nerea Borda Aintzane Liz-erazu Carlos Placer Jose L Elosegui juan P Ciria Adelaida Lacasta luis Bujanda Colorectal Cancer Multidisciplinary Unit Donostia Hospital University of the Basque CountryCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas 20010 San Sebastian Spain

Improvements in surgery and the application of combined approaches to fight rectal cancer have succeeded in reducing the local recurrence (LR) rate and when there is LR it tends to appear later and less often in isolation. Moreover, a subtle change in the distribution of LRs with respect to the pelvis has been observed. In general terms, prior to total mesorectal excision the most common LRs were central types (perianastomotic and anterior) while lateral and posterior forms (presa-cral) have become more common since the growth in the use of combined treatments. No differences have been reported in the current pattern of LRs as a function of the type of approach used, that is, neo-adjuvant therapies (short-term or long-course radiotherapy, orchemoradiotherapy versus extended lymphadenectomy, though there is a trend towards posterior or presacral LR in patients in the Western world and lateral LR in Asia. Nevertheless, both may arise from the same mechanism. Moreover, as well as the mode of treatment, the type of LR is related to the height of the initial tumor. Nowadays most LRs are related to the advanced nature of the disease. Involvement of the circumferential radial margin and spillage of residual tumor cells from lymphatic leakage in the pelvic side wall are two plausible mechanisms for the genesis of LR. The patterns of pelvic recurrence itself (pelvic subsites) also have important implications for prognosis and are related to the potential success of salvage curative approach. The re-operability for cure and prognosis are generally better for anastomotic and anterior types than for presacral and lateral recurrences. Overall survival after LR diagnosis is lower with radio or chemoradiotherapy plus optimal surgery approaches, compared to optimal surgery alone.

关键词： Rectal cancer Local neoplasm recurrence pelvis Pattern of recurrence multidisciplinary approach

IBD5 polymorphisms in inflammatory bowel disease: Association with response to infliximab

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World Journal of Gastroenterology 2005年第8期11卷 1187-1192页

作者： Elena Urcelay juan luis Mendoza Alfonso Martínez Laura Fernández Carlos Taxonera Manuel Díaz-Rubio Emilio G.de la Concha Immunology Department Gastroenterology Department

AIM: Inflammatory bowel diseases (IBD) are multifactorial pathologies of unknown etiology. One susceptibility locus, IBD5, has been mapped to chromosome 5q31. We analyzed our Spanish cohorts of Crohn's disease (CD) and ulcerative colitis (DC) patients to determine whether this locus is associated with IBD, and to ascertain the main clinical phenotype influenced by this risk factor. The kind of interaction, either genetic heterogeneity or epistasis, between this IBD5 susceptibility region and the NOD2/CARD15 gene mutations was studied as well. Finally, we assessed whether this locus can predict response to infliximab therapy. METHODS: A case control study was performed with 274 CD and 211 UC patients recruited from a single center and 511 healthy ethnically matched controls. Two polymorphisms were genotyped in the IBD5 locus and three in the CARD15/NOD2 gene. RESULTS: Our results evidence association only with CD especially with the fistulizing phenotype and in the absence of NOD2/CARD15 variants (mutant allele frequency in patients vs controls: OR = 2.03, 95% CI = 1.35-3.06, Pted suggest the potential role of the 5q31 polymorphisms as markers of response to infliximab.

关键词： Crohn's disease Ulcerative colitis 5q31 polymorphisms Infliximab

Software Project Management Approaches for Global Software Development： A Systematic Mapping Study

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Tsinghua Science and technology 2018年第6期23卷 690-714页

作者： Manal El Bajta Ali Idri Joaquín Nicolás Ros José luis Fernández-Alemán juan Manuel Carrillo de Gea Félix García Ambrosio Toval Software Project Management Research team Ecole Nationale SuperieuredInformatique et d'Analyse des Systemes (ENSIAS)Mohammed V University Rabat 713 Morocco Department of Informaticay Sistemas University of Murcia Murcia 30100 Spain ALARCOS Research GroupDepartment of Information Systems and technologies University of Castilla-La Mancha (UCLM) Ciudad Real13071 Spain

Global Software Development （GSD） is a well established field of software engineering with the benefits of a global environment. Software Project Management （SPM） plays a key role in the success of GSD. As a result, the need has arisen to study and evaluate the downsides of SPM for GSD, to thereby pave the way for the development of new methods, techniques, and tools with which to tackle them. This paper aims to identify and classify research on SPM approaches for GSD that are available in the literature, to identify their current weaknesses and strengths, and to analyze their applications in industry. We performed a Systematic Mapping Study （SMS） based on six classification criteria. Eighty-four papers were selected and analyzed. The results indicate that interest in SPM for GSD has been increasing since 2006. As a class of approaches, the most frequently reported methods （40%） are those used for coordination, planning, and monitoring, along with estimation techniques that can be used to better match a distributed project. SPM for GSD requires further investigation by researchers and practitioners, particularly with respect to cost and time estimations. These findings will help overcome the challenges that must to be considered in future SPM research for GSD, especially regarding collaboration and time-zone differences.

关键词： Software Project Management (SPM) Global Software Development (GSD) SPM approaches Systematic Mapping Study (SMS)

Artificial Triterpenoid Fatty Acid Ester Isolated From the Leaves of Phytolacca icosandra L

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Natural Products and Bioprospecting 2020年第4期10卷 221-225页

作者： Elier Galarraga Andersson Mavares Neudo Urdaneta Rafael ERodríguez-Lugo juan Manuel Amaro-luis Departamento de Química.Edificio de Química Y Procesos Universidad Simón Bolívar(USB)Apartado 89000.Caracas-1080AVenezuelaUSA Laboratorio de Química Bioinorgánica Centro de QuímicaInstituto Venezolano de Investigaciones Científicas(IVIC)VenezuelaCaracas 1020-AUSA Laboratorio de Productos Naturales Departamento de Química.Facultad de CienciasUniversidad de Los Andes(ULA)MéridaVenezuela-5101USA

The methanol extract form the leaves of Phytolacca icosandra L.,afforded the unprecedented artificial triterpenoid fatty acid ester 1 derived from the new natural triterpenoid phytolaccagenic acid 3-O-myristate(1a),along with the three known triterpenoids serjanic,acinosolic and phytolaccagenic acid(2-4).Their structures were stablished by HR-EI-MS,1D and 2D NMR *** possible mechanistic formation of 1 is proposed,and the in vitro toxicity of all compounds was assessed using the brine shrimp lethality assay(BSLA).

关键词： Phytolacca icosandra.triterpenoid fatty acid ester NMR artificial products BSLA

A comparative pattern of lectin-binding in the endometrial glands of the uterus and placenta of healthy buffaloes and bovines at early gestation

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BIOCELL 2021年第2期45卷 331-337页

作者： SERGIO GASTÓN CASPE JOSÉluis KONRAD DADIN PRANDO MOORE juan MANUEL SALA LILIAN LISCHINSKY CARLOS MANUEL CAMPERO CLAUDIO GUSTAVO BARBEITO Laboratory of Pathology Experimental Station MercedesInstituto Nacional de Tecnología AgropecuariaCorrientes3470Argentina Laboratory of Theriogenology School of Veterinary SciencesUniversidad Nacional del NordesteCorrientesW3402BKGArgentina Animal Health Group Experimental Station BalcarceInstituto Nacional de Tecnología AgropecuariaBalcarceB7620EMAArgentina Laboratory of Histology and Embryology School of Veterinary SciencesUniversidad Nacional de La PlataLa Plata1900Argentina

Water buffalo(Bubalus bubalis)and domestic cattle(Bos taurus)are closely related ***,embryo transfer interspecies has been attempted without any *** failure in hybrid embryo-implantation is associated with the glycocode in the maternal-fetal *** patterns have been studied in different species of ruminants;however,in ***,only the binucleated cells(BNC)have been *** glycocode is essential for a successful embryo-implantation and can be defined by Lectin-Histochemistry(LHC).The aim of this study is to compare the glycosylation pattern of placenta and uterus in water buffaloes and cattle by *** samples of placenta and uterus from pregnant Mediterranean female water buffaloes(Buf1)and Angus cows(Bov1)were *** animals were euthanized at 98 days of *** was carried out using twelve lectins(Con A,LCA,PSA,sWGA,PHA-e,SBA,UEA-1,WGA,RCA-1,PNA,DBA,BSA-1).The intensity of lectin binding was semiquantitatively scored using a scale of 0(negative)to 3(strongly positive).Difference between species was found in trophoblast layer by PSA,SWGA,PNA and BSA-1,in BNC,and in the mononuclear cells by LCA,PSA,PHA-e,DBA,BSA-1,*** utero,differences in the apical cellular membrane and the secretion of glands were identified by DBA and RCA-1,and in the cytoplasm of those glandular epithelial cells by PHA-e,BSA-1,WGA,and *** both species,BNC presented a strong positive reaction with DBA and SBA,a moderate response by LCA,PHA-e,BSA-1 and PNA lectin,and a low reaction by PSA,UEA-1,SWGA,WGA,Con A and *** results found in this study suggest that although both species are closely related,glycosylation patterns in the placenta and uterus are different,thus providing a possible reason for embryo transfer not being possible between these species.

关键词： Lectin-histochemistry Water buffalo Placenta Glycosylation pattern