bluuebunny/crossref_metadata_2025 huggingface dataset:
Canabinoides na dor crónica: uma revisão baseada na evidência
Authors:   Médico de Família, Silva Ricardo Garcia , Remtula Sofia Piarali ,   Médico de Família, Gonçalves Tiago Castelar ,   Médico de Família
Published: May 2021

Objetivo: Avaliar a evidência existente relativa à eficácia de canabinoides no tratamento da dor crónica. Fontes de dados: MEDLINE/PubMed, Cochrane Library, TRIP Database, National Guideline Clearing House, Canadian Medical Association Practice Guidelines. Métodos de revisão: Utilizando os termos MeSH cannabis e chronic pain fez-se, em agosto de 2019, uma pesquisa de meta-análises (MA), revisões sistemáticas (RS), estudos observacionais (EO), ensaios clínicos (EC) e guidelines, publicados em português e inglês, sem limite temporal. Incluíram-se estudos realizados em adultos com dor crónica, independentemente da causa, submetidos a terapêutica com canabinoides, excluindo-se aqueles com intervenção em dor aguda. Utilizou-se a escala Strength of Recommendation Taxonomy, da American Academy of Family Physicians, para atribuir níveis de evidência (NE) e força de recomendação (FR). Resultados: Dos 244 artigos encontrados, 16 cumpriram os critérios de inclusão: nove RS, quatro EC duplo-cegos aleatorizados e controlados com placebo, dois estudos retrospetivos de série de casos e um estudo prospetivo de série de casos. Todos os estudos selecionados abordavam dor crónica, mas de etiologia diversa (oncológica, neuropática, reumatológica, visceral). Os resultados entre os estudos não foram consistentes. Parece haver algum benefício na dor neuropática e na dor oncológica, embora haja consenso pelas revisões de que serão necessários estudos de maior dimensão e duração para que a utilização de canabinoides tenha evidência robusta. Podem verificar-se efeitos adversos gastrointestinais e nas funções cognitiva e motora, sobretudo com as preparações contendo maior dosagem de tetrahidrocanabinol. Não há evidência para utilização em dor de origem reumatológica ou visceral. Não se atribuiu NE 1 a qualquer estudo. Conclusões: A utilização de canabinoides, embora promissora e com eventual benefício identificado em pequenos estudos para alguns tipos de dor crónica (sobretudo a neuropática), tem evidência limitada (FR B) e requer a realização de ensaios de maior qualidade e dimensão. Devem ser considerados a eficácia e os possíveis efeitos secundários a longo prazo em estudos de maior duração, algo que poderá ser alcançado com a crescente utilização dos fármacos na prática clínica. Com base na evidência disponível, os canabinoides poderão ser uma solução de última linha em casos de dor refratária neuropática e oncológica.
Avaliação de conhecimentos e hábitos de proteção solar de crianças e adolescentes
Authors:   Médico de Família, Ferreira Cátia Alexandra Granja , Cunha Filipa Inês de Sousa Vela ,   Médico de Família
Published: May 2021

Objetivo: Avaliar e descrever os conhecimentos e hábitos de proteção solar em idade pediátrica. Tipo de estudo: Estudo observacional transversal analítico. Local: Consulta externa e serviço de urgência de pediatria de um hospital nível II e consulta de saúde infantil de uma Unidade de Saúde Familiar (USF) local. População: Crianças com idade inferior a 18 anos e respetivos acompanhantes que frequentaram as unidades referidas. Métodos: Aplicação de um questionário sobre conhecimentos e hábitos sobre proteção solar de resposta voluntária e confidencial. O tratamento estatístico dos dados foi realizado através do programa Statistical Package for the Social Sciences – SPSS®. Considerou-se existir significância estatística para valores de p<0,05. Resultados: Amostra de 295 questionários, 63,7% respondidos por cuidadores de crianças com idade inferior a nove anos e 36,3% por adolescentes entre os 10 e os 17 anos. O período do dia de maior exposição solar foi antes das 11 horas e após as 16 horas (77%). Usam protetor solar 93% dos adolescentes e 90,6% das crianças; no entanto, a maioria da população usa-o apenas na praia (61%) (p<0,05). Quanto à frequência de renovação de protetor solar, 40,2% dos adolescentes renovam duas vezes e 52,6% das crianças apenas uma vez (p<0,05). É o sexo feminino que usa mais o guarda-sol (76,2%) (p<0,05) e que utiliza fator de proteção solar (FPS) 30 (59%) e 50+ (73,7%), enquanto mais rapazes utilizam o FPS <15 (76,9%) (p<0,05). Os questionados referiram obter mais informação sobre proteção solar através da comunicação social (46,8%). Discussão/Conclusão: Este estudo demonstrou hábitos inadequados de proteção solar, resultados concordantes com outros estudos. Alerta-se para a necessidade de divulgação mais ampla de conhecimentos adequados que consolide práticas saudáveis em relação à exposição solar. A multidisciplinaridade entre os cuidados de saúde primários e a pediatria torna-se fulcral.
Depois da tempestade... Relato de um período de pandemia que abalou a bonança
Authors:   Médico de Família, Aires Ana , Oliveira Cátia Almeida ,   Médico de Família
Published: May 2021

No final do ano de 2019 surgiram na China os primeiros casos de uma infeção respiratória provocada por um vírus que viria a designar-se SARS-CoV-2 pela homologia com o coronavírus da síndroma respiratória aguda grave (SARS-CoV). A patologia causada pelo mesmo seria nomeada de COVID-19 (“COronaVirus Disease identified in 2019”), sendo que cerca de 80% dos doentes infetados apenas apresentava sintomatologia ligeira. No entanto, pela sua infecciosidade, a doença rapidamente se disseminou por todos os continentes, apresentando uma mortalidade global de 5%. Desta forma, dado o aumento exponencial do número de doentes com COVID-19 por todo o mundo, em março de 2020 foi decretado o nível de pandemia, altura em que Portugal registou os primeiros casos. Pela imprevisibilidade e infecciosidade da doença, as autoridades políticas e de saúde do País foram obrigadas a implementar diversas medidas, tendo-se decretado inclusivamente uma cerca sanitária em Ovar após constatar-se a presença de transmissão comunitária ativa. O presente relato de prática pretende refletir sobre o exercício da atividade clínica em período de pandemia por COVID-19. Trata-se de um relato de duas internas de medicina geral e familiar de uma Unidade de Saúde Familiar da zona de Ovar, com o intuito de, de algum modo, plasmar aquilo que terá sido a sua atividade assistencial neste período, em que a maioria dos contactos com utentes ocorreram de forma indireta. Com esta publicação pretende-se pensar sobre as dificuldades sentidas e o esforço realizado pela equipa de profissionais de saúde, à semelhança de tantas outras unidades de saúde de Portugal, com o objetivo de promover a manutenção da saúde, prevenção e gestão da doença de uma comunidade, em que os problemas, relativos ou não ao COVID-19, tivessem todos lugar num momento onde a pandemia era aparentemente a prioridade.
Pengaruh Stres Kerja Dan Konflik Kerja Terhadap Kepuasan Kerja Pada PT. Sinarartha Bali Money Changer Kabupaten Badung
Authors: Andika Ary Wira , Irmayanti Ni Putu
Published: May 2021

Tujuan  penelitian ini adalah untuk mengetahui pengaruh secara simultan dan parsial stres kerja dan konflik kerja terhadap kepuasan kerja pada PT. Sinarartha Bali Money Changer. Metode penelitian ini yaitu dengan cara observasi,wawancara, dan kuisioner. Kuisioner diberikan kepada 35 orang responden, alat analisis yang digunakan dalam penelitian ini adalah analisis regresi linier berganda, analisis korelasi berganda, analisis determinasi, F-test dan t-test. Hasil analisis diperoleh analisis regresi linier berganda Y=42,221 - 0,276X1 - 0,484X2. Ini menunjukkan bahwa pola pengaruh stres kerja, konflik kerja terhadap kepuasan kerja adalah negatif. Artinya apabila stres kerja dan konflik kerja meningkat maka kepuasan kerja karyawan karyawan pada PT. Sinarartha Bali Money Changer akan menurun. Hasil analisis korelasi R sebesar 0,847, yang berarti terdapat hubungan yang sangat kuat antara stres kerja dan konflik kerja dengan kepuasan kerja karyawan. Hasil analisis determinasi diperoleh koefisien determinasi sebesar 71,7%,  ini berarti pengaruh stress kerja dan kepuasan kerja terhadap kepuasan kerja PT. Sinarartha Bali Money Changer sebesar 71,7% sedangkan sisanya sebesar 28,3 % dipengaruhi oleh faktor lain diluar penelitian ini.4) Dari hasil analisis F test diperoleh nilai signifikasi F\= hitung 0,000 < 0,05, ini berarti bahwa stres kerja dan kepuasan kerja berpengaruh signifikan secara simultan terhadap kepuasan kerja karyawan. 5) Hasil uji t-test stres kerja diperoleh nilai signifikan sebesar 0,005 < 0,05, maka dapat disimpulkan bahawa stres kerja berpengaruh negatif dan  signifikan terhadap kepuasan kerja karyawan. Demikian juga konflik kerja berpengaruh negatif dan signifikan terhadap kepuasan kerja karyawan pada PT. Sinarartha Bali Money Changer.
Risk Factors for Congenital Deafness in Pediatric Patients Who Underwent Otoaccoustic Emission (OAE) and Auditory Brainstem Response (ABR) Examinations in General Hospital Mohammad Hoesin Palembang, Indonesia
Authors: Fiona Widyasari  , Paulina Fani , Ahmad Hifni  , Abla Ghanie  , Erial Bahar
Published: May 2021

Introduction: Congenital deafness is a hearing loss that occurs at birth. Congenital deafness in neonates can be caused by risk factors during pregnancy and during the birth process. The tests carried out for hearing screening for neonates in hospital up to 1 month old are Otoaccoustic Emission (OAE) and Auditory Brainstem Response (ABR) examinations.

Objective: Determining the relationship between family history of deafness, syndromes associated with sensorineural hearing loss, TORCH infection and prenatal syphilis, use of ototoxic drugs during pregnancy, prematurity, low birth weight, asphyxia, and hyperbilirubinemia with the incidence of congenital deafness in children

Methods: This cross-sectional study was conducted based on medical record datas from children who underwent OAE and ABR examinations at Dr. Mohammad Hoesin Palembang hospital from January 2019 to February 2021.

Results: From the 349 children, 180 (51.6%) had bilateral OAE and ABR pass results, 161 (46.1%) had bilateral referrals and 8 (2.3%) children received unilateral refer results. From 122 children with risk factors, 38 (31.1%) children with bilateral passes, 81 (66.4%) children with bilateral referrals and 3 (2.5 %) children with unilateral refer. From 227 children without risk factors, 142 (62.6 %) children with a bilateral pass, 80 (35.2 %) children with bilateral referrals and 5 (2.2%) children with unilateral refer. The most common risk factor was LBW of 41 (11.7%) children. Chi square test and logistic regression analysis results showed a significant relationship between ototoxic drugs during pregnancy and congenital deafness (p = 0.001) with referral results, the value of Odd Ratio (OR) 9.651.

Conclusions: There is a significant relationship between risk factors for ototoxic drugs during pregnancy, TORCH and syphilis infection during pregnancy, asphyxia, congenital syndrome, LBWand hyperbilirubinemia with congenital deafness.
THE HOMING TRIAL: A RETROSPECTIVE PILOT STUDY ON THE EFFICACY OF PERSONALIZED BIOIDENTICAL HORMONE, DIETARY SUPPLEMENT AND NUTRITION CARE PLANS FOR AGE-RELATED MACULAR DEGENERATION (AMD)
Authors: Rozakis George W. , Bakke Brian A.
Published: May 2021

The objective of the Hormones, Oxidative stress, Methylation, Inflammation and Gene expression (HOMING) trial was to assess the efficacy of personalized bio identical hormone, dietary supplement and nutritional care plans on dry and wet Age-related Macular Degeneration (AMD) outcomes.  We evaluated 220 Age-related Macular Degeneration (AMD) patients that followed a personalized clinical care plan for up to 9 months.   The care plans consisted of bio identical hormones, dietary supplements and nutrition recommendations with the objective to improve lab and clinical measurements linked to oxidative stress, inflammation and gene expression.  Serum concentrations of CRP, HbA1c and homocysteine responded favorably to the HOMING protocol with full program compliance.

Sixty percent (42/70) of wet AMD patients reported improvement in visual acuity and/or a reduction in the frequency of anti-VEGF injections during the study period.  Forty eight percent (44/92) of dry AMD patients reported improvement in visual acuity during the study period.  Nine percent (4/45) patients reported improvement in visual acuity in the dry AMD control group and no (0/13) wet AMD patients in the control group reported improvement.  Six percent (4/70) of wet AMD patients reported that their vision declined and/or that their F frequency increased during the study period.  Five percent (4/92) of dry AMD patients reported that their vision was worse. 

Keywords:  Bio identical Hormones, Oxidative stress, Methylation, Inflammation, Gene Expression, Nutrition and AMD.
Parametric Design Optimisation of Planetary Hub Reduction Equipped in Rigid Frame Dump Truck
Authors: P R Suresh , Patnala Raghu Vamsi
Published: May 2021

Even though the information is not leveraged in the contemporary environment, still designing the planetary hub reduction for the off-highway dump truck application without the benchmarking is a sophisticated and exceptional one, because of robust design criteria, including dynamic and maximum loads under different load spectrum. Adopting the conventional planetary gearbox/transmission design used on On/off-highway applications can cater to adequate information. However, in terms of accuracy, it substantially lags, especially for off-highway planetary hub reduction application. The primary objective of this paper is to describe the most viable and reliable procedure of designing, as well as optimizing the planetary hub reduction for off-highway dump truck in the preliminary design stage, which is suitable for industrial application with the help of gear design and simulation software called KISSsoft/KISSsys in rapid manner. Further, this paper describes designers input factors based on benchmarked and ascertained data which significantly reduces iterative steps economically. This design methodology for designing from scratch with a required reduction ratio of 7.235:1 in a short space constraint carried out for 100-ton dump truck, with the gradeability which suits the design requirements and the results of optimised design compared with existing design used for similar tonnage BEML dump truck with the same reduction ratio in higher constructive volume. The compared results found to be in very well accordance concerning the safety factor, life cycle and also the system-level weight of the planetary gear train reduced by 17% in a diminished constructive volume for the optimized new design. This design approach is versatile and time saving and can also be used as an integral approach which is suitable from the conceptual design stage to proto development for industrial application.
A Modified Fault Detection Bayesian Learning Model For Inter Connected Vehicle Networks
Authors: Umar Syed , Deressa Tadele Debisa , Terfa Bodena
Published: May 2021

Currently an important worldwide web, The IoT represents the biggest connected vehicle network of all, but will evolve into a much larger network of connected vehicles. Though a concept promising, the combination of different enabling frequencies does pose various intrinsic and defining challenges in the form of communication systems like privacy and protection. It is also important to establish an effective and dependable strategy to access information for solutions which emerge from increasingly complex vehicle and data systems because of the proliferation of wireless medium. In this article, we provide and improve a new algorithm known as Advanced Fault Detection and Management with Bayesian Network techniques, in which we intend to locate and adjust spatial vehicle faults in real time. Often, we apply measurement method to discover the most effective fault detection methodology, which is the turning point. A sequence of recent studies illustrated findings shows that the suggested approaches include fault detection and correction utilizing tools accessible previously.
Investigate the Effect of Cutting Parameters on Surface Roughness When Milling X12m Steel
Authors: Lien Do Thi Kim , Dinh Man Nguyen , Tran Dinh Phung
Published: May 2021

In this paper, an experimental study on the effect of cutting parameters on surface roughness was conducted when milling X12M steel. The cutting tool used in this study is a face milling cutter. The material that is used to make the insert is the hard alloy T15K6. The cutting parameters covered in this study include the cutting speed, the feed rate and depth of cut. The experiments are performed in the form of a rotating center composite design. The analysis shows that for both Ra and Rz: (1) the feed rate has the greatest influence on the surface roughness while the depth of cut, the cutting speed has a negligible effect on the surface roughness. (2) only the interaction between the feed rate and the depth of the cut has a significant effect on both Ra and Rz while the interaction between the cutting speed and the feed rate, the interaction between the cutting speed and the depth of cut have a negligible effect on surface roughness. A regression equation showing the relationship between Ra, Rz, and cutting parameters has also been built in this study.
A Review on Wind Analysis of a Multi Storied Structure
Authors: Khiratkar Saurabh S , Dabhekar K. R. , Pitale N. H.
Published: May 2021

Due to growing population and less availability of land, multistoried buildings are constructed which can serve many people in less area. Main aim of this project is to analyse and design a (G+16) multistory building using E-TABS. Aims to give proper awareness regarding right design and details of the building. Planning is done using AutoCAD. Design involves load calculations manually and the structure is analyzed using E-TABS. Codes refer for this project are NBC IS (456-2000). Concrete mix use is M30. The steel strength for all members are of grade Fe-415. For analyzing the structure, the loads are very important which are calculated using IS (875). The LIMIT STATE METHOD is the method which has been adopted. The manual design is a difficult process and consumes more time. The project purpose is to give the complete experience in the field of design and to gain the knowledge in a practical way.
COVID-19 and Adoption of Webinars: Empirical Perspectives from Nigerian Small and Medium Enterprises
Authors: Bello O. , Yahaya O. A.
Published: May 2021

This study examines the factors driving the adoption of webinars among small and medium enterprises (SMEs) in the midst COVID-19 pandemic to hold meetings, training events and sharing business ideas and information. The study used survey questionnaires to obtain data from respondents based on a modified Unified Theory of Acceptance and Use of Technology (UTAUT) model. Results of the regression analysis show that performance expectancy is the most important determinant of webinar adoption during the COVID-19 pandemic. Based on the findings of the study, it is deduced that SMEs adopted webinars due to their perception that it improves their performance, increases their social status, adapts easily with their existing infrastructures and gives them positive feelings of pleasure and achievements.
Preparation and Performance Analysis of Graphite Nanoparticle in Domestic Refrigerator
Authors: Maurya Vijay Kumar , Arya Mayank , Tripathi Awnish Kumar
Published: May 2021

This article examines experimentally the performance of domestic refrigerators with isobutene (R600a) and graphite nano-lubricants as working fluids. Graphene has an extremely thin layer structure that fills the friction surfaces and reduces friction losses quickly. However, there is a lower coefficient of friction (COF) and higher thermal conductivity of nano-fluids generated using graphite in the base fluid. The graphite nanoparticles modified in the surface are verified to continuously suspend for a long period of time in the form of clusters. The refrigeration test examined the application of the graphite nano-lubricants in the domestic refrigerator with a volume concentration of 0.1%, 0.3%, and 0.5%. The findings show that nano-refrigerants in the refrigeration system work safely and normally. And also compressor and refrigerator output have been analyzed. Moreover, refrigerator energy usage decreased by 15.26%, 17.10%, and 21.16% with graphite nano-lubricant as a concentration of 0.1%, 0.3% and 0.5%, respectively.
O Negócio das Escolas de Negócios
Authors: Torquato Paola Regazoni , Araujo Fernando Oliveira de
Published: May 2021

Este artigo busca comparar as entregas prometidas pelas principais Escolas de Negócio com aquelas esperadas pelos alunos, a fim de aperfeiçoar os processos administrativos em uso pelas Instituições. Trata-se de revisão sistemática da literatura, acompanhada de pesquisa empírica exploratória, que descreve o estado da arte e o potencial de inovação no que se refere aos processos de gestão das Escolas de Negócio em relação à expectativa de mercado. Foram identificados cinco atributos relevantes para o sucesso das Escolas de Negócio, a saber: provimento de aprendizagem gerencial; flexibilidade organizacional; medida de desempenho estratégico; impacto e resultado. trata-se de um estudo inédito, em âmbito nacional, orientado ao aperfeiçoamento de processos gerenciais das Escolas de Negócios do Rio de Janeiro. Os resultados estão limitados ao caso em estudo.
Percepção sobre mercado de trabalho em enfermagem entre acadêmicos ingressantes e formados
Authors: Silva Junior Manoelito Ferreira , Martinelli Anna Laura , Euzébio Maria Emanoelly , Mello Ellen De Souza , Fadel Cristina Berger
Published: May 2021

O objetivo do estudo foi analisar a percepção sobre o mercado de trabalho entre ingressantes e formandos do curso de Enfermagem de uma universidade pública. O estudo qualitativo foi realizado com ingressantes (2019) e formandos (2018) do curso de Enfermagem da Universidade Estadual de Ponta Grossa. A amostra foi definida pelo método de saturação, a coleta de dados gravada com roteiro-guia. O material transcrito recebeu análise temática de conteúdo. Sobre o mercado de trabalho foram identificadas as categorias: amplo, saturado, exigente e desvalorizado. O mercado amplo deriva da percepção de diversidade no campo de atuação, porém houve sentimento de saturação, e por isto, exige experiência e maior formação profissional, tornando-o desvalorizado, principalmente no retorno financeiro. Houve uma percepção aproximada entre ingressantes e formandos sobre o mercado de trabalho em Enfermagem. Sendo assim, ao escolher o curso, o estudante tem ciência das dificuldades enfrentadas no mercado de trabalho relacionado à profissão.
Morfología de la profesión académica en la Universidad Nacional de San Juan
Authors: Algañaraz Soria Victor Hugo
Published: May 2021

El artículo presenta los resultados de un estudio de caso sobre el devenir y configuración reciente de la “profesión académica” en una institución que, por sus características histórico-estructurales, puede considerarse como periférica en el sistema universitario argentino: la Universidad Nacional de San Juan. Se abordan, específicamente, dos dimensiones analíticas: su estructura académica (esto es las “posiciones” del cuerpo docente según cargos, categorías y dedicaciones y su relación con la función de investigación) y el régimen de carrera docente vigente, dando cuenta de su devenir, particularidades y mecanismos de evaluación previstos para el ingreso/permanencia/promoción docentes, a partir de visibilizar diversas “tomas de posición” del profesorado universitario. La metodología incluye un acceso documental (examinando estadísticas públicas y marcos normativos específicos) y otro etnográfico (recuperando diversas voces docentes y, particularmente, las opiniones de referentes sindicales). Los hallazgos principales indican que, aunque la Universidad asume una estructura académica segmentada, manifestándose una alta concentración de cargos en su base, el nuevo régimen de carrera docente ha promovido mayores márgenes de estabilidad y crecimiento profesional.
The Use of Mixed-Income Housing Development to Address Poverty and Inequality, Based on Delphi Empirical Approach: A Case of South Africa
Authors: Onatu George , Baloyi Vutivi Kay
Published: May 2021

Since the dawn of democracy in 1994, the Republic of South Africa (RSA) has been trying to address the aftermath and consequences of the apartheid regime. This comprises of the socio-economic, spatial, and political challenges that have persisted over the decades. These have had far reaching repercussions in the society to the extent that 25 years later after apartheid, the country finds itself with alarming rates of poverty, social exclusion, unemployment, and inequality. Literature has revealed that there is a direct relationship between poverty and inequality as well as access to socio-economic services / opportunities. Poor access to these services perpetuates exclusivity and thus inequality and marginalisation in all form and character. The purpose of this study is to investigate how housing developments have been used in South Africa to address poverty and inequality. The aim is to understand how to plan for better and more socially and economically thriving communities through housing development, focusing specifically on aspects of development that contributes to addressing poverty and inequality.

Using a Delphi three round method of Inquiry of 20 experts, perceptions from a diverse panel of experts about mixed-income housing development were uncovered. In comparison to previous housing models, the study uncovered a significant paradigm shift in housing development and what a housing intervention should achieve. Since 2004 after the introduction of the Breaking New Ground Policy (BNG), the housing development approaches, and interventions have shifted away from just providing roof over once head to providing social asset to the poor and a whole range economic opportunities. The conclusion is that housing development by virtue of location, diverse housing typologies and tenure options is now part and parcel of integrated planning and the pro poor development agenda.
Estratégias individuais e coletivas de gestão dos serviços de higienização e limpeza no setor de hemodiálise de um hospital de referência macrorregional
Authors: Fonseca Maria Luíza Fernandes , Mendes Juliana Cristina de Lima , Moraes Geraldo Fabiano de Souza , Mendes Davidson Passos
Published: May 2021

Setores de Hemodiálise são locais de alta complexidade de tratamentos e atividades de trabalho, apresentam grande demanda de trabalhadores e pacientes e, consequentemente, elevado grau de risco e de carga de trabalho. Os Serviços de Higienização e Limpeza Hospitalar têm um papel importante para a efetividade dos serviços prestados no setor, bem como para a gestão da saúde e da segurança individual e coletiva. Ao desvelar o real do trabalho a partir das abordagens ergonômica e ergológica, este estudo buscou compreender a atividade das funcionárias dos serviços de higienização e limpeza, a (in)visibilidade dos riscos presentes no setor e a importância do (re)conhecimento das estratégias de regulação diante das variabilidades presentes em um ambiente de trabalho tão complexo. Por meio de um estudo qualitativo descritivo, foi possível levantar a percepção de trabalho dos participantes da pesquisa bem como a importância de sua atuação para a qualidade e segurança no setor. Foi evidenciado que a atuação das trabalhadoras para a gestão local é de extrema importância, mesmo que cotidianamente o trabalho que realizam e os riscos com os quais vivenciam não sejam percebidos pela maior parte dos usuários ali inseridos.
Cultivo de Kalanchoe blossfeldiana em diferentes substratos contendo resíduos de erva-mate
Authors: Monteiro Daniela Machado , Girardi Leonita Beatriz , Menegaes Janine Farias , Steffens Cristian José , Pereira Jackson Vinícius Rodrigues , Reinehr Tarik Ian
Published: May 2021

Em busca de uma agricultura de baixo impacto ambiental, o objetivo com este trabalho foi avaliar o cultivo de Kalanchoe blossfeldiana Poelln. (calandivas) cultivar Amora, submetidas a diferentes substratos contendo na sua composição resíduos de erva-mate. O experimento foi conduzido em delineamento inteiramente casualizado, com cinco tratamentos compostos pelas diferentes misturas do substrato comercial e o resíduo de erva-mate compostada, obtendo as composições: S1: 100% substrato comercial (SC); S2: 50% SC + 50% resíduo de erva-mate (REM); S3: 25% SC + 75% REM; S4: 75% SC + 25% REM e S5: 100% REM, com cinco repetições, cada unidade experimental foi constituída por um vaso de planta.  Analisou-se as variáveis quanto à altura das plantas e comprimento radicular, diâmetro das inflorescências, número de flores e folhas e massa fresca radicular. Observou-se que o desenvolvimento das plantas de calandivas foi similar com as diferentes combinações contendo o substrato comercial e o resíduo de erva-mate. No entanto, o substrato contendo apenas com os resíduos de erva-mate não é recomendado para esse cultivo. Por fim, recomenda-se para o cultivo de calandivas em vasos o uso do substrato composto de 50% substrato comercial + 50% resíduo de erva-mate (S2).
Prevalência das doenças metabólicas em recém-nascidos de Unidade de Terapia Intensiva neonatal submetidos ao teste do pezinho
Authors: Floriano Teresa Virgínia Neves , Andrade Renata Hellen Silva , Lopes Izailza Matos Dantas , Vieira Caroline Cordeiro , Melo Leonardo Santos , Matias Lais Costa , Menezes Lorenna Oliveira , Farias Mariana Guimarães Nolasco
Published: May 2021

Objetivos: Descrever a prevalência das doenças metabólicas em recém-nascidos de unidade de terapia intensiva neonatal submetidos ao teste do pezinho. Método: Trata-se de um estudo transversal, retrospectivo e analítico, por meio da análise de 261 prontuários de recém-nascidos de maternidade de referência em Sergipe com recém-nascidos que necessitaram de internação em unidade de terapia intensiva neonatal e que faziam seguimento no ambulatório de especialidades da maternidade. Resultados: Dos 261 prontuários avaliados, 105 apresentaram resultado do teste do pezinho. Dentre as doenças triadas nota-se que a dosagem de Fenilalanina se situou dentro da normalidade em todos os pacientes; a positividade para o Hipotireoidismo Congênito foi de 3,8%, para Fibrose Cística foi de 2%, para Hiperplasia Adrenal Congênita foi de 1%, para Deficiência de Biotinidase foi de 4,2% e para as Hemoglobinopatias foi de 9,5%. Conclusão: A doença metabólica de maior prevalência nesse estudo foi o grupo que compreende as Hemoglobinopatias triadas pelo teste do pezinho, que correspondem a 9,5% de resultados positivos. Tal achado corrobora com o perfil de prevalência de doença metabólica no Brasil, com ênfase para a Anemia Falciforme, na triagem neonatal.
Qualidade de vida de pacientes com Diabetes mellitus na Atenção Primária
Authors: Marques Victor Guilherme Pereira da Silva , Barreto Eveline Bittencourt , Sousa Júnior Célio Pereira de , Lima Mariel Wágner Holanda , Melo Ana Carla Almeida de , Santos Marks Passos , Carvalho Millena Raimunda Martins de Almeida , Costa Roberto de Sousa , Silva Estefany de Jesus , Veras Roseane Oliveira , Bandeira Larissa de Lima Machado , Matos Laisa Garcia , Silva Eryson Lira da
Published: May 2021

O presente estudo tem como objetivo realizar um levantamento bibliográfico acerca da qualidade de vida de pacientes com diabetes mellitus na atenção primária. Trata-se de uma revisão integrativa da literatura, que fez as buscas na Biblioteca Virtual em Saúde (BVS), com o auxílio das bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scientific Electronic Library Online (SciELO), Base de Dados de Enfermagem (BDENF) e PUBMED. Os artigos foram coletados no período de janeiro a fevereiro de 2021. Foram utilizados os descritores: Atenção primária à saúde, Diabetes mellitus, Educação em saúde, Promoção da saúde e Qualidade de vida. Após a aplicação dos critérios de inclusão, restaram 25 estudos. Diversos meios são utilizados para a redução de complicações graves aos pacientes com diabetes, como: tratamento medicamentoso, atividade física dentre outros meios que possam fazer com que esse paciente tenha uma boa qualidade de vida, que não afete tanto sua rotina.
Increasing the effectiveness of mobile speed cameras on rural roads in Victoria based on crash reductions from operations in Queensland
Authors: Cameron Max , Newstead Stuart
Published: May 2021

Mobile speed cameras on Victoria’s rural roads are not as effective as they could be due to the site selection criteria, the limited number of sites, and the visibility and predictability of their enforcement operations. Queensland’s overt mobile speed cameras achieve substantial crash reductions up to 4 km from rural camera sites due to site selection based only on crash history and randomised scheduling of operations to those sites. New sites in Victoria should be selected as in Queensland and camera visits should be randomly-scheduled. The Victorian Government’s announcement to increase mobile speed camera hours by 75% should take the form of at least 75% increase of rural sites. The new sites should be selected on the basis of a serious crash history within 2.5 km. Mobile speed cameras operated at these new rural sites could be expected to save 22.5 fatal crashes and 172 serious injury crashes per year.
Backward trajectory analysis of southern California atmospheric rivers
Authors: Harris SM , Carvalho LMV
Published: May 2021

Atmospheric rivers (ARs) are filamentary channels of high water vapor flux that transfer moisture horizontally through the atmosphere at low levels. ARs are often responsible for large annual rainfall totals as well as high-intensity storms due to orographic forcing. ARs are important features when predicting hazardous events such as flooding and are vital components of many regional water budgets. This is especially true for drought-prone areas such as southern California (SCA), which experiences relatively few storms per season, many from AR events. Here, we use a Lagrangian model to create backward air parcel trajectories of 159 AR events that made landfall on the US west coast from December 2004 to December 2015. Trajectories are used to examine the lifecycles and movements of these ARs and to differentiate ARs that made landfall in different regions. Prior to landfall, SCA ARs share similarities to but also have distinct differences from other ARs. At 1000 m above mean sea level (MSL), SCA AR trajectories travel shorter distances over the same 72 h time frame than trajectories for ARs that made landfall farther north. Additionally, along-trajectory measurements for SCA ARs tend to be warmer and have higher specific humidity values. This applies to both the 1000 and 2000 m MSL levels. These results imply that SCA ARs move slower and have the potential to produce higher intensity storms at landfall. An analysis of a case study event of an extreme AR that made landfall in SCA on 17 February 2017 confirms these results.
Kamu İhale Kurumu'nun İhale Sürecindeki Kararları ve Yargısal Denetimi
Authors: YILDIZ Hayrettin
Published: May 2021

İhale sürecinde idare tarafından yapılan eylem ve işlemlere karşı idareye şikâyet, Kamu İhale Kurumu’na ise itirazen şikâyet yollarıyla başvuruda bulunulabilir. İtirazen şikâyet yoluyla yapılan başvurular üzerine Kurum’un karar organı olan Kamu İhale Kurulu karar vermektedir. Kurul’un yapılan başvurular üzerine üç tür karar verme yetkisi bulunmaktadır. Bunlar, itirazen şikâyet konusu idari tasarruf hakkında verilen iptal, düzeltici işlem belirlenmesi ve ret kararlarıdır. Bununla beraber, Kurul’un bazı kararlarında bu üç karar türü dışında da bazı kararlar verdiğine rastlanabilmektedir. Bu çalışmada hem Kamu İhale Kurumunca ihale sürecinde verilebilecek karar türleri detaylı bir biçimde ele alınmakta hem de Kurum’un verdiği farklı türdeki kararlar da incelemeye dahil edilmektedir. Bunun dışında, hukuk devletinde en etkili denetim yolunun yargısal denetim yolu olduğu dikkate alınarak, incelemeye Kurum kararlarının yargısal denetiminin de eklenmesinden yarar görülmüştür.
Political Surveys Bias Self-Reported Economic Perceptions
Authors: Bailey Jack
Published: May 2021

If voters are to hold governments to account for the state of the economy, they must know how it has changed. Indeed, this is a prerequisite for democratic accountability. Yet the perceptions that voters report often show signs of clear partisan bias. At present, we do not know if this bias is real or instead due to priming in political surveys. To test this, I assign subjects at random to either a political or non-political survey. I then record their economic perceptions and compare the results for each group. I show that political surveys do worsen partisan bias, though only among supporters of the incumbent party. Still, much partisan bias remains unexplained, even in the non-political condition. So, while economic perception items remain biased, we can at least be sure that most people respond to them in a similar way no matter the survey context.
The Wrong Practice Of Anointing Oil In The Church According To James 5:14 A Theological study
Authors: Laia Sayangi , Laia Harman Ziduhu , Wibowo Daniel Ari
Published: May 2021

The practice of anointing with oil has been done in the church since the first century to the present. On the other hand, there are also churches which have refused to do this. The practice of anointing with oil has essentially lifted from James 5:14. This text has become one of one text in the New Testament which is quite difficult to understand and bring a variety of views. Not a few denominations of the church understand James 5:14 is wrong, even the Catholic church including in it. The increasingly incorrect practice of anointing in the church today, that can be believed can heal disease physically and a variety of other functions push back the author to check the text of James 5:14 in the exegesis. Studies the exegesis of the deep, which focuses on the contextual, grammatical-structural,
Presence of Extra-Criteria Antiphospholipid Antibodies Is an Independent Risk Factor for Ischemic Stroke
Authors: Naranjo Laura , Ostos Fernando , Gil-Etayo Francisco Javier , Hernández-Gallego Jesús , Cabrera-Marante Óscar , Pleguezuelo Daniel Enrique , Díaz-Simón Raquel , Cerro Mercedes , Lora David , Martínez-Salio Antonio , Serrano Antonio
Published: May 2021

Background: Ischemic stroke is the most common and severe arterial thrombotic event in Antiphospholipid syndrome (APS). APS is an autoimmune disease characterized by the presence of thrombosis and antiphospholipid antibodies (aPL), which provide a pro-coagulant state. The aPL included in the classification criteria are lupus anticoagulant, anti-cardiolipin (aCL) and anti-β2-glycoprotein-I antibodies (aB2GPI) of IgG and IgM isotypes. Extra-criteria aPL, especially IgA aB2GPI and IgG/IgM anti-phosphatidylserine/prothrombin antibodies (aPS/PT), have been strongly associated with thrombosis. However, their role in the general population suffering from stroke is unknown. We aim (1) to evaluate the aPL prevalence in ischemic stroke patients, (2) to determine the role of aPL as a risk factor for stroke, and (3) to create an easy-to-use tool to stratify the risk of ischemic stroke occurrence considering the presence of aPL and other risk factors.

Materials and Methods: A cohort of 245 consecutive ischemic stroke patients was evaluated in the first 24 h after the acute event for the presence of classic aPL, extra-criteria aPL (IgA aB2GPI, IgG, and IgM aPS/PT) and conventional cardiovascular risk factors. These patients were followed-up for 2-years. A group of 121 healthy volunteers of the same age range and representative of the general population was used as reference population. The study was approved by the Ethics Committee for Clinical Research (Reference numbers CEIC-14/354 and CEIC-18/182).

Results: The overall aPL prevalence in stroke patients was 28% and IgA aB2GPI were the most prevalent (20%). In the multivariant analysis, the presence of IgA aB2GPI (OR 2.40, 95% CI: 1.03–5.53), dyslipidemia (OR 1.70, 95% CI: 1.01–2.84), arterial hypertension (OR 1.82, 95% CI: 1.03–3.22), atrial fibrillation (OR 4.31, 95% CI: 1.90–9.78), and active smoking (OR 3.47, 95% CI: 1.72–6.99) were identified as independent risk factors for ischemic stroke. A risk stratification tool for stroke was created based on these factors (AUC: 0.75).

Conclusions: IgA aB2GPI are an important independent risk factor for ischemic stroke. Evaluation of aPL (including extra-criteria) in cardiovascular risk factor assessment for stroke can potentially increase the identification of patients at risk of thrombotic event, facilitating a decision on preventive treatments.
Students’ Civic Engagement Self-Efficacy Varies Across Socioscientific Issues Contexts
Authors: Dauer Jenny M. , Sorensen Amanda E. , Wilson Jena
Published: May 2021

In STEM learning focused on science literacy, socioscientific issues instruction is often proposed as a way to bolster students’ civic engagement, however few studies in science education have explicitly examined this connection. We define civic engagement as the work of influencing legitimately public matters using means within the existing political structure. In this work we investigate students’ feelings of self-efficacy for this type of civic engagement in the context of four socioscientific issues (prairie dog conservation, food insecurity, biofuels and water conservation). This study was in the context of a large enrollment introductory science college course, where students used a structured decision-making process to examine alternative policy solutions to complex socioscientific issues. We qualitatively examined students’ response about their perception of the importance of the issue, their self-efficacy in exploring actions they could take to impact the issue, and the effectiveness of those actions. We found that students’ ideas about impact and effectiveness varied across the four different issues contexts due to students’ sense of the issues’ importance and scale. Generally, students’ ideas about actions they could take to impact the issue were narrow and rarely included political actions like voting. We also found post instruction increases in students’ civic engagement attitudes and skills related to social justice, interpersonal and problem-solving skills and political awareness. Finally, we suggest that socioscientific instruction must have an explicit connection to policy-level decisions and reveal how individual actions can influence the societal system. Our course using a structured decision-making process in the context of socioscientific issues is one model to help students make these connections.
Implementation of the PIERS on the Move mHealth Application From the Perspective of Community Health Workers and Nurses in Rural Mozambique
Authors: Boene Helena , Valá Anifa , Kinshella Mai-Lei Woo , La Michelle , Sharma Sumedha , Vidler Marianne , Magee Laura A. , von Dadelszen Peter , Sevene Esperança , Munguambe Khátia , Payne Beth A. ,   the CLIP Mozambique Working Group
Published: May 2021

Background:mHealth is increasingly regarded as having the potential to support service delivery by health workers in low-resource settings. PIERS on the Move (POM) is a mobile health application developed to support community health workers identification and management of women at risk of adverse outcomes from pre-eclampsia. The objective of this study was to evaluate the impact of using POM in Mozambique on community health care workers' knowledge and self-efficacy related to caring for women with pre-eclampsia, and their perception of usefulness of the tool to inform implementation.

Method: An evaluation was conducted for health care workers in the Mozambique Community Level Intervention for Pre-eclampsia (CLIP) cluster randomized trial from 2014 to 2016 in Maputo and Gaza provinces (NCT01911494). A structured survey was designed using themes from the Technology Acceptance Model, which describes the likelihood of adopting the technology based on perceived usefulness and perceived ease of use. Surveys were conducted in Portuguese and translated verbatim to English for analysis. Preliminary analysis of open-ended responses was conducted to develop a coding framework for full qualitative analysis, which was completed using NVivo12 (QSR International, Melbourne, Australia).

Results: Overall, 118 community health workers (44 intervention; 74 control) and 55 nurses (23 intervention; 32 control) were surveyed regarding their experiences. Many community health workers found the POM app easy to use (80%; 35/44), useful in guiding their activities (68%; 30/44) and pregnant women received their counseling more seriously because of the POM app (75%; 33/44). Almost a third CHWs reported some challenges using the POM app (30%; 13/44), including battery depletion after a full day's activity. Community health workers reported increases in knowledge about pre-eclampsia and other pregnancy complications and increases in confidence, comfort and capacity to advise women on health conditions and deliver services. Nurses recognized the increased capacity of community health workers and were more confident in their clinical and technological skills to identify women at risk of obstetric complications.

Conclusions: Many of the community health workers reported that POM improved knowledge, self-efficacy and strengthened relationships with the communities they serve and local nurses. This helped to strengthen the link between community and health facility. However, findings highlight the need to consider program and systematic challenges to implementation.
Expression of Nutrient Transporters on NK Cells During Murine Cytomegalovirus Infection Is MyD88-Dependent
Authors: Khan Abrar Ul Haq , Almutairi Saeedah Musaed , Ali Alaa Kassim , Salcedo Rosalba , Stewart C. Andrew , Wang Lisheng , Lee Seung-Hwan
Published: May 2021

Natural killer (NK) cells are the predominant innate lymphocytes that provide early defense against infections. In the inflammatory milieu, NK cells modify their metabolism to support high energy demands required for their proliferation, activation, and functional plasticity. This metabolic reprogramming is usually accompanied by the upregulation of nutrient transporter expression on the cell surface, leading to increased nutrient uptake required for intense proliferation. The interleukin-1 family members of inflammatory cytokines are critical in activating NK cells during infection; however, their underlying mechanism in NK cell metabolism is not fully elucidated. Previously, we have shown that IL-18 upregulates the expression of solute carrier transmembrane proteins and thereby induces a robust metabolic boost in NK cells. Unexpectedly, we found that IL-18 signaling is dispensable during viral infectionin vivo, while the upregulation of nutrient transporters is primarily MyD88-dependent. NK cells fromMyd88-/-mice displayed significantly reduced surface expression of nutrient receptors and mTOR activity during MCMV infection. We also identified that IL-33, another cytokine employing MyD88 signaling, induces the expression of nutrient transporters but requires a pre-exposure to IL-12. Moreover, signaling through the NK cell activating receptor, Ly49H, can also promote the expression of nutrient transporters. Collectively, our findings revealed multiple pathways that can induce the expression of nutrient transporters on NK cells while highlighting the imperative role of MyD88 in NK cell metabolism during infection.