bluuebunny/crossref_metadata_2025 huggingface dataset:
Business travel decisions and high-speed trains: an ordered logit approach
Authors: Rossi Federica , Maggi Rico
Published: December 2019

The paper studies the potential impact on business travel of the new high-speed railway line project, called AlpTransit, which will link Lugano, the small economic hub of the southern part of Switzerland, with Zurich, one of the major Swiss economic centres, situated north of the Alps. Thanks to this infrastructure, travel time between the two cities will decrease considerably from about three hours to less than two hours by the end of 2020.

The question that we pose in this paper is what impact high-speed trains could have, in the short to medium term, on business travel between the two hubs (ex-ante evaluation). Indeed, given the travel time, firms could increase their business-to-business one-day trips, boosting face-to-face interactions within and among enterprises. Our curiosity more specifically regards the potential impact of the change in travel time on the propensity to travel of employees with different functions in various types of firms.

An on-line survey was conducted among firms located in Ticino, the Swiss Canton that includes Lugano. The data are analysed using four ordered logit models, one for each employee category (CEO, administrative staff, sales personnel, specialists), since hierarchical position and professional status influence business travel characteristics. Results show that internal firm characteristics, such as sector, frequency and destination of current business travels significantly influence the propensity to travel to Zurich more often thanks to AlpTransit.
Snap-through Buckling of Shallow Spherical Shells under Ring Loads
Authors: KARATAŞ Esra Eylem , YÜKSELER Receb Faruk
Published: December 2019

Snap-through buckling behaviour of rigid vinyl polyethylene shallow spherical shells, undergoing large displacements, subjected to static ring loads is investigated by using finite difference and the Newton-Raphson Method. The load-deflection diagrams corresponding to various values of thickness, depth and ring diameter of the shell with simply supported and clamped edges are sketched and compared. The accuracy of the used algorithm and the prepared computer program are tested by comparing some of the numerical results obtained in this study with those obtained by an experimental study, available in the relevant literature. Further steps on the concerning subject are achieved.
Spatial Analysis over the Impact of Fiscal Decentralization on the Mortality Rate in Iranian Provinces
Authors: Golkhandan Abolghasem
Published: December 2019

Background: Many previous empirical studies indicated appropriate implementation of the fiscal decentralization and transfer of resources and expenses from the central government to local governments was an important factor to improve health outcomes in developing countries. Accordingly, the major purpose of this study was to evaluate the impact of fiscal decentralization indicators on the mortality rate (as an indicators of health measurement) in Iranian provinces.
Methods: This study uses the statistical data of variables affecting the mortality rate in provinces of Iran to study the spatial effects of fiscal decentralization indicators on the mortality rate during 2006-2015. To this end, the spatial econometric approach was used. Furthermore, the statistical analyses were performed using the Matlab software.
Results: Findings of the model's estimation indicate that indicators of the fiscal decentralization and mortality rate had a negative and significant relationship. In this regard, 1 % increase in fiscal decentralization indicators of income and expenditure decreased  the mortality rate by 0.19 % and 0.10 % in provinces of Iran, respectively. Other results showed that the spatial proximity effect between provinces of Iran had a positive and significant effect on the mortality rate.
Conclusion: By providing the necessary conditions for expansion of fiscal decentralization, the health level can be promoted in provinces of Iran.
Technical Efficiency Evaluation of Ardabil Hospitals Affiliated to University of Medical Sciences using Artificial Neural Network Method
Authors: Rezapour Aziz , Alipour Vahid , Bagheri Faradonbeh Saeed , Gholami Somarin Arsalan , Sedaghi Zahra
Published: December 2019

Background: The optimal management of hospitals as the most important centers for providing health services has always been the focus of decision makers and policymakers. The present study aimed to evaluate the technical efficiency of hospitals affiliated to Ardebil University of Medical Sciences using Artificial Neural Network (ANN) method.
Methods: The present descriptive, applied, and cross-sectional study was conducted in 2017. The study population consisted of 8 educational and therapeutic centers affiliated to Ardabil University of Medical Sciences and Health Services. Census sampling method was applied to select the participants and researcher-made checklists were used to collect the data. The artificial neural network method was also used to investigate the study objectives. The applied network was a multi-layer prospectron with a Levenberg Marquardt optimization function, a sigmoid tangent transfer function in the middle layer, and a linear function in the output layer. For processing and preparing data, Excel spreadsheet was used and Matlab software were used for analyzing and designing the network.
Results: The results showed that the average technical efficiency of the studied hospitals was 0.75. Ardabil Bou Ali, Khalkhal Imam Khomeini, and Meshkinshahr Valiasr hospitals had the highest technical efficiency (1.00). With regard to the hospital bed occupancy rate, Germi Velayat hospital had the lowest efficiency rate (0.75). Furthermore, Parsabad Imam Khomeini hospital had the lowest efficiency in the number of discharged healthy patients (0.69) in 2017. Finally, the improvement space of each variable was calculated to achieve the total technical efficiency.
Conclusion: According to the results, one of the factors that decreases  the technical efficiency of the educational centers is the low rate of hospital beds' utilization and occupancy rate. In other words, lack of full-capacity operation by the hospital centers and the low rates of active hospital bed imposed costs and consequently reduced the hospitals' performance.
The Adoption Rate of Isfahan University of Medical Sciences with Components of the Learning Organization from the Perspective of Senior and Middle University Managers
Authors: Sadeqi Jabali Monireh , Tadayon Hamidreza , Monemian Sharifeh
Published: December 2019

Background: Universities of Medical Sciences are required to take steps to implement dimensions of the learning organization due to their wide-range of activities and their role in maintaining and improving the community health. This study was conducted to determine the compliance of Isfahan University of Medical Sciences with the components of learning organization. 
Methods: This descriptive-analytic study was conducted among all senior and middle managers of Isfahan University of Medical Sciences at the Central headquarters, colleges, and hospitals. For data collection, the standard Neife Learning Organization Questionnaire (2001) was applied .Validity of the questionnaire was evaluated in terms of content validity based on the experts' opinion and the questionnaire's reliability was confirmed by calculating the Cronbach's alpha coefficient of 0.89. Data were analyzed using descriptive and analytical statistics such as Pearson correlation coefficient, t-test, and Spearman correlation coefficient through SPSS 20.
Results: The compliance rate of Isfahan University of Medical Sciences with components of the learning organization was 72.60 from the viewpoint of the senior and middle managers of this university in total. The highest mean score was attributed to the individual skills (77.60) and the lowest mean scores were related to the components of mental models (67.03), team learning (70.70), and shared vision (72.20), respectively. Independent t-tests showed that the total mean score of adoption with the learning organization and scores of the shared vision, team learning, and systematic thinking components were significantly higher in male than female managers (p < 0.05).
Conclusion: The Isfahan University of Medical Sciences' compliance with characteristics of the learning organization is at a desirable level. Managers and authorities can achieve the highest level of learning organization by improving all components of the learning organization, especially the mental model, team learning, and shared vision.
Effective Factors of the Entrepreneurship Development in Isfahan University of Medical Sciences: A qualitative study
Authors: Ferdosi Masoud , Molavi Taleghani Yasamin
Published: December 2019

Background: Promotion and institutionalization of the entrepreneurial culture in the health system is one of the most important components of entrepreneurship development and economic success of countries. Thus, the present study was conducted with the aim of identifying the factors affecting the development of entrepreneurship in the health area, Isfahan University of Medical Sciences in 2017.
Methods: This applied qualitative study was conducted in 2017. First, 10 health experts in Isfahan University of Medical Sciences were selected using semi-structured interviews based on the purposeful sampling method. The Delphi method was used to prioritize the factors. To analyze the qualitative data, the framework analysis method of Max QDA 10 software was used. Furthermore, descriptive statistics were used by SPSS 22 for analyzing the Delphi phase data.
Results: In the initial phase, 3 themes (contextualizing, operational, consolidation and institutionalization) and 15 classes were extracted. Then, in the Delphi phase, 12 factors were determined as the effective factors on the entrepreneurship development in the health area. The most important factors in the development of entrepreneurship included empowerment of work forces, customers and stakeholders, as well as attracting internal and external capitals for initiating business with a mean of 4.73.
Conclusion: In strategies of entrepreneurship development in the health area, policymakers are recommended to base their measures and decisions on differentiating the identified factors. In other words, this differentiation improves the entrepreneurship opportunities and outcomes based on the environmental conditions and current resources.
INVESTIGATING THE EFFECT OF BUSINESS STRATEGY AND INTERNAL CONTROL ON AUDIT QUALITY
Authors: Vahdani Mohammad , Rashedi Rozhan , Mohammadi Mehr Javad
Published: December 2019

Purpose: Auditing will improve the quality of financial information. However, in today's audit quality affected by the environment. The purpose of this study to investigate the effect of business strategy and internal control on audit quality in listed companies in the Tehran Stock Exchange.

Methodology: This is applied research in terms of its purpose and in terms of its method is correlation analysis with the regression approach. For this inference method, this research is descriptive-analytic. For this important statistical society, companies listed in the Tehran Stock Exchange during the years 2010-2017 for 8 years have the necessary conditions. According to the constraints defined in the research, companies with qualifying conditions of 107 companies and 856 years-company of observation were collected. To test the hypotheses, the multivariate regression technique was used using panel data.

Main Findings: The business strategy modifies the relationship between the auditor's specialty in the industry and the internal control of audit quality.

Implications: The control structure can provide an understanding of the difference between the business strategy and its diversion, which is necessary for the auditor's expertise in the industry. It is proposed to combine business strategy and audit planning, we can identify the weakness of the internal control of the system in order to improve the quality of the audit and create value for the stakeholders.

Novelty: The study considered the effects of business strategy on the relationship between internal control and audit quality.
ENSINO BASEADO EM EQUIVALÊNCIA E PRODUÇÃO DE SENTENÇAS EM CRIANÇAS COM IMPLANTE COCLEAR
Authors: Das Neves Anderson Jonas , Almeida-Verdu Ana Claudia Moreira , Silva Leandra Tabanez do Nascimento , Moret Adriana Lima Mortari
Published: December 2019

O ensino baseado em equivalência pode integrar repertórios verbais distintos e promover a precisão da fala em crianças com implante coclear, fato que tem sido observado com palavras e estendido recentemente para sentenças. O presente estudo replicou um estudo prévio e verificou os efeitos do ensino baseado em equivalência sobre a precisão da fala na nomeação de figuras de cenas e a produtividade oral de sentenças (nomear novas figuras relacionadas às sentenças recombinadas), em cinco crianças com implante coclear e leitoras. Os estímulos foram organizados em uma matriz que produziu nove sentenças de três termos, com estrutura sujeito-verbo-objeto (SVO) e o objeto comum; as três sentenças da diagonal da matriz foram ensinadas e as demais testadas. O ensino consistiu em selecionar figuras de cenas (por emparelhamento de acordo com o modelo, MTS) e construir sentenças impressas (por emparelhamento de acordo com o modelo com resposta construída, CRMTS), condicionalmente às sentenças ditadas. Pós-testes de leitura de sentenças impressas e de nomeação de figuras de cenas ocorreram para as sentenças ensinadas e recombinadas. Todos os participantes aprenderam as relações ensinadas, demonstraram relações de equivalência, aumentaram a precisão da fala diante das figuras de cenas e foram capazes de nomear figuras usando as sentenças recombinadas. Nossos resultados replicaram estudos prévios e aumentaram a generalidade dos achados com mais participantes. O aumento na precisão da linguagem oral em crianças com implante coclear e leitoras pode ser obtida por meio de ensino baseado em equivalência e ensino por matrizes.Palavras chave: Ensino baseado em equivalência, matriz, produção oral, sentenças, implante coclear.
Marco jurídico de las cooperativas en Cuba. Tracto histórico y realidad actual
Authors: Rodríguez Musa Orestes
Published: December 2019

En el presente trabajo se valora el tracto histórico por el que ha transitado el marco jurídico de las cooperativas en Cuba, identificando las limitaciones y potencialidades ofrecidas a estas formas asociativas en cada período. Se hará especial énfasis en la realidad actual, iniciada con el perfeccionamiento del modelo económico cubano, donde se constata un proceso de expansión de las cooperativas hacia otros sectores de la economía nacional además del agropecuario. Las perspectivas jurídicas de este proceso experimental en curso también serán objeto de una valoración general, teniendo en cuenta las últimas novedades legislativas en la materia cooperativa, en especial la letra de la nueva Constitución de la República de Cuba de 2019.Recibido: 25 octubre 2019Aceptado: 18 noviembre 2019Publicación en línea: 20 diciembre 2019
RELATIONSHIP BETWEEN THE ALLOY FREQUENCY OF THE T102C POLYMORPHISM OF THE 5HT2A GENE WITH ANTHROPOMETRIC AND CARDIOMETABOLIC MEASURES
Authors: Mallmanna BLK , Tonini CRA , Chielle EO , Chielle Eduardo Ottobelli
Published: December 2019

Obesity is a disease characterized by excessive body fat. Among the neurobiological factors associated with obesity, the serotonergic system stands out. The neurotransmitter of these circuits is serotonin (5-HT). Decreased levels of 5-HT have been linked to increased desire to ingest sweets and carbohydrates. This study aims to verify the relationship of the 5HT2A T102C gene polymorphism with obesity and anthropometric parameters. Blood samples and anthropometric data were collected from 150 volunteers, divided between the control and obese groups. The results showed that for individuals with diastolic pressure (p = 0.3681), Estimated Mean Glycemia (GMe) (p = 0.0228) and Homeostatic Model Assessment (HOMA-IR-IR) (p = 0.001) all altered, a higher frequency of C alleles was observed. For normal GMe (p = 0.0270), a higher frequency of the T allele was observed. There was no difference for the allele distribution between the normal and altered groups for the parameters of Triglycerides, HDL cholesterol, total cholesterol, glycated hemoglobin and Insulin. The distribution of the alleles between the groups, normal diastolic pressure (p = 0.3681) and HOMA-IR (p = 0.9203) groups presented no difference. From the genotypic analyzes of the T102C polymorphism of the 5HT2A gene, it was possible to demonstrate a relationship between the presence of the C allele with biochemical and anthropometric markers related to obesity and hypertension.
A NEW METHODOLOGY FOR DIAGNOSIS OF FANCONI ANEMIA BASED ON BIOLOGICAL DOSIMETRY
Authors: Amaral Ademir , De Lima SC , Silva LMB , Lemos-Pinto M , Lucena LRF , Marques-Salles T , Silva EB , Magnata SP
Published: December 2019

Fanconi Anemia (FA) is a syndrome associated with chromosomal fragility. Current laboratory tests to diagnose this disease are based on the scoring of chromosomal aberrations induced in peripheral blood lymphocytes by clastogenic chemical agents, mainly: diepoxybutane (DEB) or mitomycin C (MMC). This study evaluated an alternative test for the diagnosis of FA, in which ionizing radiation replaces DEB/MMC. Two groups were studied: normal and DEB-sensitive individuals. From each individual, samples of peripheral blood were irradiated using an electron linear accelerator. Following lymphocyte cultures, and slide preparation, metaphases were scored based on the same methodology for biological dosimetry, according to recommendations of the International Atomic Energy Agency. Our results emphasized a pattern of distribution of dicentrics, fragments, as well as abnormal chromosomal arrangements. The methodology of analysis here proposed permitted to distinguish normal from DEB-sensitive subjects.
Hepatocellular Carcinoma with Increased AFP Levels and Extrahepatic Manifestation after Liver Transplantation: A Case of Late-Onset Recurrence
Authors: TOKMAK Salih
Published: December 2019

Liver transplantation is the best treatment modality in patients with hepatocellular carcinoma. The major concern after liver transplantation for hepatocellular carcinoma treatment is recurrence, because it’s the most important factor for the long term survival. There are two forms of recurrence; early-onset (within 2 years of liver transplantation) and late-onset (after 2 years of liver transplantation). A lot of factors have been reported in the literature to foresee recurrence after liver transplantation and one of them is alpha-fetoprotein. Many studies have shown that high levels of pre-transplant alpha-fetoprotein is related to early-onset recurrence and worse outcomes in the long term. In this case report, we report a case of late-onset recurrence, despite having high levels of pre-transplant alpha-fetoprotein in contrary to the literature, and still survive with a high quality of life 6 years after transplantation.
O constitucionalismo espectral: presença, tempo e narrativa à luz de Roque Larraquy
Authors: Pinheiro Douglas Antônio Rocha
Published: December 2019

O presente artigo questiona o constitucionalismo crononormativo que, ao se caracterizar por uma temporalidade linear, homogênea, abstrata e direcional, nega o reconhecimento de ritmos sociais distintos do padrão hegemônico do presente. Valendo-se da metodologia do direito através da literatura, em especial das intuições presentes na obra de Roque Larraquy, o texto faz uma reflexão interdisciplinar das categorias de presença/ausência, tempo e narrativa. Ao final, propõe-se um constitucionalismo espectral fundado na perda como constitutiva da modernidade, na simultaneidade dos tempos não-simultâneos e no poder narrativo das experiências sociais invisibilizadas.
Constitucionalismo de ficções: ressentimento e romances de formação do Brasil
Authors: Trindade Andre Karam , Alcântara Guilherme Gonçalves
Published: December 2019

Trata-se de ensaio, circunscrito aos estudos e pesquisas em Direito e Literatura, especificamente Direito através da Literatura, que expõe o potencial dos textos literários para a reflexão do constitucionalismo. A premissa adotada é de que certas ficções, sobretudo as que tematizam o ressentimento, permitem acessar o contexto histórico, social e cultural em que vigoraram as constituições brasileiras ao longo da história. Conclui que, na companhia de Machado de Assis, Graciliano Ramos e Guimarães Rosa, é possível não somente compreender o passado, mas também antecipar momentos em que a cultura jurídica nacional cederia a processos de retrocesso na separação dos poderes e garantia dos direitos fundamentais.
Interpretação, integridade, império da lei: o direito como romance em cadeia
Authors: Streck Lenio Luiz , Morbach Júnior Gilberto
Published: December 2019

Este artigo pretende analisar a proposta teórica, articulada por Ronald Dworkin, que oferece uma explicação do fenômeno jurídico a partir da analogia com a construção literária de um romance em cadeia. Nesse sentido, por intermédio de uma revisão bibliográfica pautada sob o método fenomenológico, pretendemos abordar o ideal maior de integridade subjacente à metáfora de Dworkin e, a partir daí, investigar as possíveis contribuições dessa ideia ao direito brasileiro à luz do império da lei.
Agua para consumo humano y saneamiento en Centros Educativos de Costa Rica al año 2017
Authors: Mora-Alvarado Darner A. , Rivera-Navarro Pablo C. , Acuña-Cubero Flora , Portuguez Carlos Felipe
Published: December 2019

Este estudio retrospectivo tiene como objetivo principal “estimar la cobertura del agua para consumo humano y saneamiento en aguas residuales, en los centros educativos de Costa Rica al año 2017, con el propósito de establecer la línea base y las metas para la Agenda 2030, en el marco de los Objetivos de Desarrollo Sostenible”. Para su cumplimiento, la metodología consistió en el análisis de datos de acceso a agua por mecanismo de abastecimiento, mediante el aporte del Ministerio de Educación Pública con su documento “Infraestructura en las Escuelas y Colegios Públicos del 2017”. Los datos de la calidad microbiológica del agua y las determinaciones de cloro residual, se obtuvieron del Programa de Vigilancia y Control de Calidad del Agua del Laboratorio Nacional de Aguas, en el marco del “Programa Bandera Azul Ecológica”. Los resultados obtenidos en los años 2016 y 2017 se compararon con los datos iniciales del 2004. Posteriormente, con información de calidad del agua del 2017 y sobre infraestructura del Ministerio de Educación Pública, se aplicó la “Escalera de Agua Potable” de la UNICEF y la OMS para los centros educativos de Costa Rica. Con respecto al saneamiento o disposición de excretas de los centros educativos, también se utilizó información del Ministerio de Educación Pública, de donde se identificó el porcentaje de escuelas y colegios que usaron alcantarillado, tanques sépticos, letrinas o pozos negros y otros; además, se cuantificó el uso de inodoros y lavatorios en buenas condiciones. Los resultados indican que el acceso a agua en los centros educativos públicos lo suministran los acueductos rurales en un 52,9%, los municipios 5,6%, las cooperativas y/o empresas 2,2%, el AyA 21,5%; por su parte, otras fuentes utilizadas fueron pozos en 6,7%, ríos 9,0%, otras fuentes 0,3% y no respondieron la encuesta 0,8%. La calidad microbiológica del agua indica que, en el 2016, la cobertura fue de 94,2% de calidad potable y en el 2017 fue de 95,9%. La comparación o evolución de la calidad del agua -desde el punto de vista microbiológico- entre el 2004, el 2016 y 2017, demuestra un gran avance de 18,5 puntos porcentuales. La estimación de la aplicación de la “Escalera del Agua Potable”, sugiere que el 86,0% de los centros educativos se ubican en el eslabón de “Servicio avanzado”, 4,1% en “Servicio Básico”, en “Servicio Limitado” 6,7% y “Sin servicio” 11,1%.
A REVIEW OF TPACK AND SAMR MODELS: HOW SHOULD LANGUAGE TEACHERS ADOPT TECHNOLOGY?
Authors: Sindi Alivi Justsinta
Published: December 2019

This paper primarily aims at reviewing the idea of Technological Pedagogical and Content Knowledge (TPACK) as well as the application of Substitution, Augmentation, Modification, and Redefinition (SAMR) frameworks in teaching practices. In particular, this paper is expected to provide insight for language teachers interested in Information and Communication Technology (ICT) incorporation to teaching as regards TPACK and SAMR understanding. Accordingly, the language teachers are expected to be able to incorporate technology into teaching in appropriate ways reflecting to the frameworks. Further, description about how TPACK and SAMR carried out in teaching is presented to provide teachers with a clear definition of the frameworks. Additionally, some views concerning challenges of the application are also discussed as an evaluation.
INVESTIGATING THE ARCHITECTURAL ORIGIN OF THE GAYEBI MOSQUE IN OSMANPUR, SYLHET, BANGLADESH
Authors: Chowdhury Shubhajit , Saha Kawshik , Arefin Mohammad Samsul , Haque Mahinul
Published: December 2019

This study aimed to investigate the architectural origin, style, and legacy of the Gayebi Masjid (Divine Mosque), which is located as a witness of time in Osmanpur, Balaganj, Sylhet, Bangladesh. The origin of the mosque is shrouded in mystery, as the actual construction period and the patronizing builder is unknown to the people. On the other hand, based on the characteristics and features, it can be generally assumed that the mosque was constructed either in the Sultanate or the Mughal period of Muslim rule in Bengal. The mosque has prominent architectural features that can also be found in other Sultanate and Mughal mosques in the surrounding region. However, the real-time period of construction of the mosque remains uncertain, as no other evidence, document, or argumentation can be found except the existing mosque’s architectural features. For this study, the attributions and characteristics will be critically examined to form a comparative analysis to determine the mosque’s origin and architectural style. The method of this research was a critical review and descriptive analysis of all the collected information, and the interpretation of some physical evidence from the field survey, as well as comparative analysis of the data with some other case studies. However, through this research and careful investigation, we conclude that the most convincing assumption is the original structure of the mosque resembles the architecture of the Sultanate period. On the contrast, more than a few additional architectural features were added during the later Mughal period.
Ethical Concerns and Clinical Judgments Related to the Use of Psychometric Assessments for Rehabilitation Counselors
Authors: Beveridge Scott , DiNardo Jeff , France Kharod , Chan Christian D. , Glickman Courtney
Published: December 2019

This study investigated how rehabilitation counselors integrated their use of psychometric instruments into clinical practice. The primary aim was to determine how psychometric instruments interact with clinical judgment during assessment as well as what ethical concerns practitioners have. The sample consisted of 228 participants from the International Association for Rehabilitation Professionals (IARP) and the American Board of Vocational Experts (ABVE), whom responded to an electronic survey distributed through listservs. Participants responded to a quantitative section regarding overall assessment use, followed-up by a qualitative section with open response prompts. Results provided a preliminary investigation into the selection of psychometric assessments utilized by rehabilitation counselors and the degree to which this process affects ethical and clinical judgment. These findings, in consideration with previous literature, highlight the need for improved training on the selection and utilization of psychometric assessments.
IMPACTO SOCIAL DA MINERAÇÃO: UMA COMPARAÇÃO ENTRE A PERCEPÇÃO DA EMPRESA E A DA COMUNIDADE
Authors: Gerotto Maria Gisela , Pisano Viviane , Demajorovic Jacques , Aledo Antonio , Santiago Ana Lucia
Published: December 2019

O objetivo desta pesquisa é comparar a percepção de uma comunidade sobre os impactos sociais de um projeto minerário e a percepção da empresa responsável pelo projeto. Os instrumentos para alcançar este objetivo foram a Avaliação de Impacto Social proposto por Aledo e Domínguez-Gómez (2018) e a proposta de categorização de impactos da mineração de Mancini e Sala (2018). A metodologia incluiu a realização de entrevistas e de duas oficinas com representantes da mineradora e da comunidade. Os resultados da pesquisa mostram que o processo de seleção de impactos por parte da empresa foca nos mais imediatos, muitas vezes com viés dos riscos para o negócio, associados à ausência e ineficiência do poder público em apoiar projetos de desenvolvimento local. Já o olhar da comunidade avança além dos impactos mais imediatos, como oferta e qualidade da água e queda na produção agrícola, para questões subjetivas e culturais associadas aos processos de mudança. Infere-se que a visão parcial dos impactos por parte da empresa fragiliza a estratégia de projetos sociais compensatórios. As questões mais profundas associadas aos impactos, como a perda do sentimento de coletividade e o impacto do processo migratório no esgarçamento dos laços familiares, são desconsideradas na escolha e implementação de projetos na comunidade.
Guía de Práctica Clínica para el Diagnóstico y Tratamiento de Esclerosis Múltiple en Adultos.
Authors: Vizcarra Darwin R. , Cruz Ana G. , Rojas Edgar , Mori Nicanor , Caparó César , Castañeda Carlos C. , Castro Sheila , Gavidia Jorge M. , González Oscar , Huertas Marco , Meza María , Montalván Víctor , Rivara Alda , Adrianzén Fiorella , Duque Kevin , Serván Sebastián A. , Villafuerte Brian J. , Vizcarra Joaquín A. , Zamudio Rodrigo , Neira Elsa R. , Carrá Adriana , Fernández Oscar , Rivera Víctor
Published: December 2019

La Esclerosis Múltiple (EM) es una enfermedad crónica del sistema nervioso central, para la cual aún no hay una cura definitiva; sin embargo, existe una diversa variedad de terapias con el objetivo de modificar el curso natural de la enfermedad, que promueve la inclusión constante de nuevas estrategias terapéuticas. Objetivo: La Sociedad Peruana de Neurología, por encargo del Ministerio de Salud, convocó a un comité de expertos con el objetivo de elaborar una guía de práctica clínica para el diagnóstico y tratamiento de EM. Método: Se realizó una búsqueda y evaluación de guías de práctica clínica bajo la metodología AGREE II, escogiendo como modelo la Guía de Práctica Clínica Catalana. Las preguntas clínicas no concernientes al tratamiento fueron resueltas a través de revisión sistemática. Las preguntas clínicas de tratamiento se diseñaron bajo el formato PICO y se resolvieron con un meta-análisis de ensayos clínicos disponibles hasta agosto del 2017, tomando en consideración las terapias aprobadas por DIGEMID hasta enero del 2017. Las recomendaciones finales fueron elaboradas mediante el método Delphi modificado con un consenso de al menos 80% de los miembros de su comité. Finalmente se realizó una revisión externa del manuscrito por expertos internacionales en EM.   Resultados: Se formularon 18 preguntas clínicas y 21 recomendaciones para el manejo, incluyendo algoritmos terapéuticos.
Síndrome neuroléptico maligno inducido por risperidona y facilitado por sepsis de origen urinario: clínica y fisiopatología.
Authors: Muñoz Omar H. , Vargas-Rodríguez Ledmar J. , Benavidez-Jiménez Hernando A. , Vega-Sepúlveda Ana C.
Published: December 2019

La risperidona es un antagonista selectivo monoaminérgico, con una elevada afinidad por receptores dopaminérgicos, que puede producir síndrome neuroléptico maligno (SNM), considerado una emergencia médica con alto riesgo de muerte. Tiene una incidencia de hasta el 3% y su mortalidad está entre el 10 y 20%. Se reporta el caso de una paciente de 56 años, que reunía los criterios clínicos del SNM, inducido por el uso de risperidona y facilitado por una sepsis de origen urinario. El tratamiento se condujo con un agente agonista dopaminérgico y cambio del antipsicótico, procedimientos que resultaron en una adecuada evolución clínica. El SNM es una entidad de baja prevalencia, para la cual existen criterios diagnósticos con especificidad y sensibilidad mayor del 90%, por lo que debe diferenciarse claramente de otras patologías. Se discute el mecanismo mediante el cual la infección urinaria facilitaría la ocurrencia de esta enfermedad. El diagnóstico precoz mejora la respuesta al manejo adecuado que se establezca en cada caso.
Desarrollo de la colaboración en revistas de psiquiatría y salud mental en el mundo.
Authors: Atencio-Paulino Joel I. , Alcala Jhonatan , Castañeda Elmer , Gala Miguel
Published: December 2019

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Réflexions sur le développement du secteur laitier et sa durabilité dans différentes parties du monde
Authors: SRAÏRI Mohamed Taher , CHATELLIER Vincent , CORNIAUX Christian , FAYE Bernard , AUBRON Claire , HOSTIOU Nathalie , SAFA Alejandra , BOUHALLAB Saïd , LORTAL Sylvie
Published: December 2019

La filière laitière occupe une place importante à l’échelle mondiale, en termes de contribution à l’occupation des surfaces agricoles, aux emplois et à la création de richesse. La production laitière, qui résulte de modèles productifs très variés d’un pays à l’autre et qui relève d’espèces animales aux caractéristiques différentes, a considérablement augmenté au cours des dernières décennies. Le développement futur de la production laitière est soumis à différentes contraintes qui interrogent sur les voies à privilégier dans une optique de durabilité. Dans ce cadre, la première partie de cet article présente la dynamique du secteur laitier, en termes de consommation et de production, et ce, pour différentes grandes zones géographiques ; la seconde traite de la durabilité du secteur laitier, principalement dans les pays en développement, au travers d’une sélection de trois thèmes : la dimension sociale (souvent oubliée) et la nécessité d’intégrer les questions de genre ; l’usage durable des ressources hydriques en l’illustrant au travers de deux situations contrastées, celle du Maroc et de l’Inde ; la biodiversité et l’importance de la contribution des laits non bovins au développement local. La troisième partie rappelle que les échanges internationaux permettent, pour de nombreux pays déficitaires en lait, de satisfaire la demande intérieure.
L’ovulation chez les mammifères
Authors: DEROUIN-TOCHON Flavie , BELTRAMO Massimiliano , DECOURT Caroline , FLEUROT Renaud , GÉRARD Nadine , PINET-CHARVET Caroline , MARTINET Stéphanie , ROBERT Vincent , TARAGNAT Catherine , TILLET Yves , DUITTOZ Anne
Published: December 2019

Le déclenchement de l’ovulation peut se faire selon deux modes chez les mammifères : spontané et provoqué. L’ovulation spontanée intervient au cours du cycle œstral sous l’effet de facteurs internes hormonaux. L’ovulation provoquée est déclenchée par l’accouplement avec un mâle. Dans les deux cas, c’est une augmentation de la sécrétion de GnRH qui conduit à l’augmentation de LH qui provoque l’ovulation. Les facteurs qui conduisent à l’augmentation de sécrétion de GnRH sont différents selon les deux modalités : principalement la kisspeptine (ovulation spontanée) et le b-NGF (ovulation provoquée). Les protocoles d’induction de l’ovulation actuels reposent sur une action directe sur l’ovaire, grâce à l’utilisation de gonadotropines hétérologues, ou bien par une action sur l’hypophyse grâce aux agonistes du GnRH. Ces protocoles présentent différents inconvénients : perte d’efficacité dans le temps, stimulation supra-physiologique qui peut être délétère, problème éthique posé par l’obtention de certaines molécules. De nouveaux paradigmes d’induction de l’ovulation ciblant l’hypothalamus, et favorisant un déclenchement physiologique de l’ovulation sans supplémentation en hormones sont en cours de développement. Cette revue a pour objectif de présenter au lecteur les mécanismes intimes impliqués dans la régulation et le déclenchement de l’ovulation ainsi que deux approches nouvelles respectueuses de la physiologie de l’animal et de l’environnement.
Déterminants techniques et sociologiques du maintien des prairies dans les élevages bovins laitiers de plaine
Authors: COUVREUR Sébastien , PETIT Timothée , LE GUEN Roger , BEN ARFA Nejla , JACQUERIE Valérie , SIGWALT Annie , HAIMOUD-LEKHAL Djamila Ali , CHAIB Karim , DEFOIS Justine , MARTEL Gilles
Published: December 2019

Malgré de multiples services rendus aux territoires et aux élevages reconnus et soutenus, les surfaces en prairie s’érodent depuis plusieurs décennies, en particulier en zone d’élevage bovin laitier de plaine. Partant du constat qu’il existe localement des situations de maintien voire d’augmentation de ces surfaces durant les 15 dernières années, cet article fait la synthèse de travaux portant sur les déterminants de ces dynamiques de maintien. À l’échelle territoriale, les conditions favorables au maintien, pouvant dépasser l’échelle locale et agissant sur un temps long, conjuguent i) une spécialisation laitière assurant une diversité de débouchés dont certains valorisant la prairie, ii) une offre riche de conseil technique sur la prairie adapté à une diversité de profils d’éleveurs, iii) une situation locale favorable en termes de politique publique et de relations sociales. Lorsque cela est réuni, une diversité de systèmes où la place de la prairie est très variable émerge. À l’échelle de l’exploitation, le maintien des prairies peut s’opérer via des ruptures de pratiques permettant d’évoluer vers des systèmes alternatifs, mais aussi via des recompositions lentes dans des systèmes plus conventionnels. Celles-ci sont permises par des processus d’hybridation des pratiques favorisés par la coexistence de systèmes fourragers et l’interaction dans des réseaux de dialogue de façons de concevoir les prairies au service de la stratégie de production contrastées. Ainsi, plus la multifonctionnalité des prairies est partagée par des acteurs aux profils variés (éleveurs, conseillers…) au sein de plusieurs réseaux de dialogues, et plus la probabilité de voir les prairies se maintenir dans les élevages et les territoires est forte.
Analyse génétique de la « fromageabilité » du lait de vache prédite par spectrométrie dans le moyen infrarouge en race Montbéliarde
Authors: SANCHEZ Marie-Pierre , WOLF Valérie , LAITHIER Cécile , EL JABRI Mohammed , BEUVIER Éric , ROLET-RÉPÉCAUD Odile , GAUDILLIÈRE Nicolas , MINÉRY Stéphanie , RAMAYO-CALDAS Yuliaxis , TRIBOUT Thierry , MICHENET Alexis , BOUSSAHA Mekki , TAUSSAT Sébastien , FRITZ Sébastien , DELACROIX-BUCHET Agnès , GROSPERRIN Philippe , BROCHARD Mickaël , BOICHARD Didier
Published: December 2019

Les aptitudes du lait à la transformation en fromage sont étroitement liées à sa composition. Ces caractères, difficiles à mesurer directement, ont été prédits à partir des spectres dans le moyen infrarouge (MIR) du lait en race Montbéliarde (projet From’MIR). Cet article rassemble les résultats de l’analyse du déterminisme génétique des aptitudes fromagères et de la composition fine du lait, prédites à partir de six millions de spectres MIR de 400 000 vaches. Ces caractères sont modérément à fortement héritables et les corrélations génétiques entre caractères fromagers (rendements et coagulation) et avec la composition du lait (protéines, acides gras et minéraux) sont élevées et favorables. Des analyses d’association (GWAS) et de réseaux de gènes, réalisées à partir des génotypes imputés pour l’ensemble des variations du génome de 20 000 vaches, permettent d’identifier des gènes et des variants candidats ainsi qu’un réseau de 736 gènes impliqués dans des voies métaboliques et des gènes régulateurs fonctionnellement liés à la composition du lait. Enfin, l’estimation de la précision d’une évaluation génomique montre qu’un modèle de type contrôles élémentaires, incluant les variants détectés par les GWAS et présumés causaux, permet de prédire des valeurs génomiques précises. Nous avons par ailleurs simulé une sélection incluant les aptitudes fromagères qui montre les possibilités de sélectionner efficacement les vaches pour qu’elles produisent un lait plus « fromageable », avec un impact limité sur le gain génétique des caractères actuellement sélectionnés. Ces résultats ont conduit à la mise en place d’un prototype d’évaluation génomique en race Montbéliarde dans la zone AOP Comté en 2019
An outbreak of norovirus-related acute gastroenteritis associated with delivery food in Guangzhou, southern China
Authors: Lu Ying , Ma Mengmeng , Wang Hui , Wang Dahu , Chen Chun , Jing Qinlong , Geng Jinmei , Li Tiegang , Zhang Zhoubin , Yang Zhicong
Published: December 2019

Background
A large number of students at a school in Guangzhou city developed a sudden onset of symptoms of diarrhea and vomiting. To help control the outbreak, we conducted an epidemiological investigation to determine the causative agent, sources, role of transmission and risk factors of the infections.
Methods
The study population consisted of probable and confirmed cases. An active search was conducted for cases among all students, teachers and other school staff members. A case control study was carried out using standardized online questionnaires. Data were obtained regarding demographic characteristics, gastrointestinal symptoms, personal hygiene habits, history of contact with a person who had diarrhea and/or vomiting and dining locations during the past 3 days. Rectal swabs or stool samples of the cases and, food handlers, as well as environmental samples were collected to detect potential intestinal viruses and bacteria. We calculated odds ratios and 95% confidence intervals (CIs).
Results
A total of 157 individuals fit the definition of a probable case, including 46 with laboratory-confirmed norovirus infection between March 8 and March 22, 2018. The proportion of students who had eaten delivery food 3 days before the onset of illness in the case group was 2.69 times that in the control group (95% CI: 1.88-3.85 ). Intake of take-out food 3 days earlier, and exposure to similar cases 72 hours before onset and case in the same dormitory were risk factors. A total of 20 rectal swab samples from students, 10 rectal swabs from food handlers and 2 environmental swab samples from the out-campus restauranttested positive for norovirus (G Ⅱ , genogroup Ⅱ strain ).
Conclusions
We investigated an outbreak of norovirus infectious diarrhea. Food handling practices carry potential risk of acute gastroenteritis outbreaks owing to a lack of surveillance and supervision. Greater attention should be paid to the monitoring and supervision of food handlers in off campus restaurant to reduce the incidence of norovirus-related acute gastroenteritis associated with delivery food.
Stakeholder views on the acceptability of Human Infection Studies in Malawi
Authors: Kapumba Blessings M. , Jambo Kondwani , Rylance Jamie , Gmeiner Markus , Sambakunsi Rodrick , Parker Michael , Gordon Stephen B. , Gooding Kate
Published: December 2019

Background: Human infection studies (HIS) are valuable in vaccine development. Deliberate infection, however, creates challenging questions, particularly in low and middle-income countries (LMIC) where HIS are new and ethical challenges may be heightened. Consultation with stakeholders is needed to support contextually appropriate and acceptable study design. We examined stakeholder perceptions about the acceptability and ethics of HIS in Malawi, to inform decisions about planned pneumococcal challenge research and wider understanding of HIS ethics in LMIC.
Methods: We conducted 6 deliberative focus groups and 15 follow-up interviews with research staff, medical students, and community representatives from rural and urban Blantyre. We also conducted 5 key informant interviews with clinicians, ethics committee members and district health government officials.
Findings: Stakeholders perceived HIS research to have potential population health benefits, but they also had concerns, particularly related to safety of volunteers and negative community reactions. Acceptability depended on a range of conditions related to procedures for voluntary and informed consent, inclusion criteria, medical care or support, compensation, regulation, and robust community engagement. These conditions largely mirror those in existing guidelines for HIS and biomedical research in LMICs. Stakeholder perceptions pointed to potential tensions, for example balancing equity, safety and relevance in inclusion criteria.
Conclusions: Our findings suggest HIS research could be acceptable in Malawi, provided certain conditions are in place. Ongoing assessment of participant experiences and stakeholder perceptions will be required to strengthen HIS research during development and roll-out.
Key words: Human Infection Studies, pneumococcal, Malawi, acceptability, ethics
Feasibility cluster randomised controlled trial evaluating a theory-driven group-based complex intervention versus usual physiotherapy to support self-management of osteoarthritis and low back pain (SOLAS)
Authors: Hurley Deirdre , Jeffares Isabelle , Hall Amanda M , Keogh Alison , Toomey Elaine , McArdle Danielle , McDonough Suzanne M , Guerin Suzanne , Segurado Ricardo , Matthews James
Published: December 2019

Background The Self-management of Osteoarthritis (OA) and Low back pain (LBP) through Activity and Skills (SOLAS) theory-driven group-based complex intervention was developed primarily for the evaluation of its acceptability to patients and physiotherapists and the feasibility of trial procedures, to inform the potential for a definitive trial. Methods This assessor-blinded multicentre two-arm parallel cluster randomised controlled feasibility trial compared the SOLAS intervention to usual individual physiotherapy (UP; pragmatic control group). Patients with OA of the hip, knee, lumbar spine and/or chronic LBP were recruited in primary care physiotherapy clinics (i.e. clusters) in Dublin, Ireland between September 2014 and November 2015. The primary feasibility objectives were evaluated using quantitative methods and individual telephone interviews with purposive samples of participants and physiotherapists. A range of secondary outcomes were collected at baseline, 6 weeks (behaviour change only), 2 months and 6 months to explore the preliminary effects of the intervention. Analysis was by intention-to-treat according to participants’ cluster allocation and involved descriptive analysis of the quantitative data and inductive thematic analysis of the qualitative interviews. A linear mixed model was used to contrast change over time in participant secondary outcomes between treatment arms, while adjusting for study waves and clusters. Results 14 clusters were recruited (7 per trial arm), each cluster participated in two waves of recruitment, with the average cluster size below the target of six participants (Intervention: mean (SD) =4.92 (1.31), range 2-7; UP: mean (SD) =5.08 (2.43), range 1-9). 120 participants (83.3% of n=144 expected) were recruited (Intervention n=59; UP n=61), with follow up data obtained from 80.8% (n=97) at 6 weeks, 84.2% (n=101) at 2 months and 71.7% (n=86) at 6 months. Most participants received treatment as allocated (Intervention n=49; UP n=54). The qualitative interviews (12 participants; 10 PTs) found the Intervention and trial procedures acceptable and appropriate, with minimal feasible adaptations required. Linear mixed methods showed improvements in most secondary outcomes at 2 and 6 months with small between group effects. Conclusions While the SOLAS intervention and trial procedures were acceptable to participants and PTs, the recruitment of enough participants is the biggest obstacle to a definitive trial. Trial Registration: ISRCTN Registry, ISRCTN49875385, Registered 26 March 2014. https://doi.org/10.1186/ISRCTN49875385