bluuebunny/crossref_metadata_2025 huggingface dataset:
A importância da liga acadêmica na promoção do envelhecimento saudável
Authors: Vasconcelos Wu Shaumin , Alcântara Fernandes Camila , Cereja Ferreira da Silva Dayane , Raissa Siqueira do Nascimento Elissa , Silva Campos Jamylle , de Sousa Oliveira João Sérgio
Published: November 2020

Objetivo: Relatar a experiência de discentes de uma liga acadêmica de Fisioterapia em gerontologia em uma ação para promoção do envelhecimento saudável. Síntese dos dados: Trata-se da descrição da experiência de discentes de Fisioterapia em uma ação organizada pela Liga Acadêmica de Fisioterapia em Gerontologia (LAFIGE), vinculada à Universidade do Estado do Pará, na IV ação de extensão da liga, intitulada “Promoção do envelhecimento saudável”, vivenciada em uma praça pública de Belém, Pará, Brasil. Nessa ação, participaram da organização: 13 membros da LAFIGE, sendo 12 acadêmicos e um orientador, e 50 participantes com idade igual ou superior a 20 anos. Antes da ação, o coordenador repassou as orientações aos discentes acerca de orientações (sob supervisão profissional) de condicionantes do envelhecimento saudável, avaliações físico-funcionais, exercícios físicos e incentivo à alimentação saudável. Tal experiência da ação possibilitou a troca de informações entre a comunidade e a academia, além de favorecer a educação em saúde da população acerca do processo de envelhecimento e da importância de preservar a capacidade funcional. Ademais, incentivou-se a construção de aprendizados científicos e interpessoais de forma bidirecional, entre os acadêmicos e participantes, enfatizando a importância da inserção da fisioterapia em gerontologia na promoção da saúde no envelhecimento. Conclusão: Observou-se a essencialidade da prática de educação em saúde em busca de uma velhice saudável, com a conscientização da população sobre o processo de envelhecimento, além de uma adequada capacitação dos ligantes envolvidos, incentivando ações que visem à promoção da saúde dos idosos.
Ideas and perspectives: enhancing the impact of the FLUXNET network of eddy covariance sites
Authors: Papale Dario
Published: November 2020

Abstract. In the last 20 years, the FLUXNET network provided unique
measurements of CO2, energy and other greenhouse gas exchanges between
ecosystems and atmosphere measured with the eddy covariance technique. These
data have been widely used in different and heterogeneous applications, and
FLUXNET became a reference source of information not only for ecological
studies but also in modeling and remote sensing applications. The data are, in general, collected, processed and shared by regional networks or by single
sites, and for this reason it is difficult for users interested in analyses
involving multiple sites to easily access a coherent and standardized
dataset. For this reason, periodic FLUXNET collections have been released in
the last 15 years, every 5 to 10 years, with data standardized and shared
under the same data use policy. However, the new tools available for data
analysis and the need to constantly monitor the relations between ecosystem
behavior and climate change require a reorganization of FLUXNET in order
to increase the data interoperability, reduce the delay in the data sharing
and facilitate the data use, all this while keeping in mind the great effort made
by the site teams to collect these unique data and respecting the different
regional and national network organizations and data policies. Here a
proposal for a new organization of FLUXNET is presented with the aim of
stimulating a discussion for the needed developments. In this new scheme, the
regional and national networks become the pillars of the global initiative,
organizing clusters and becoming responsible for the processing, preparation
and distribution of datasets that users will be able to access in real time and
with a machine-to-machine tool, obtaining always the most updated collection
possible but keeping a high standardization and common data policy. This will
also lead to an increase in the FAIRness (Findability, Accessibility,
Interoperability and Reusability) of the FLUXNET data that will ensure a
larger impact of the unique data produced and a proper data management and
traceability.
Simulating the evolution of the topography-climate coupled system
Authors: Paik Kyungrock , Kim Won
Published: November 2020

Abstract. Landscape evolution models simulate the long-term variation of topography under given rainfall scenarios. In reality, local rainfall is largely affected by topography, implying that surface topography and local climate evolve together. Herein, we develop a numerical simulation model for the evolution of the topography-climate coupled system. We investigate how simulated topography and rain field vary between no-feedback and co-evolution simulations. Co-evolution simulations produced results significantly different from those of no-feedback simulations, as illustrated by transects and time evolution in rainfall excess among others. We show that the evolving system keeps climatic and geomorphic footprints in asymmetric transects and local relief. We investigate the roles of the wind speed and the time lags between hydrometeor formation and rainfall (called the delay time) in the co-evolution. While effects of the wind speed and delay time were thought to compensate each other in the evolving morphology, we demonstrate that the evolution of the coupled system can be more complicated than previously thought. The channel concavity on the windward side becomes lower as the imposed wind speed or the delay time grows. This tendency is explained with the effect of generated spatial rainfall distribution on the area-runoff relationship.
Preface: Advances in post-processing and blending of deterministic and ensemble forecasts
Authors: Hemri Stephan , Lerch Sebastian , Taillardat Maxime , Vannitsem Stéphane , Wilks Daniel S.
Published: November 2020

Abstract. The special issue on advances in post-processing and blending of deterministic and ensemble forecasts is the outcome of several successful successive sessions organized at the General Assembly of the European Geosciences Union. Statistical post-processing and blending of forecasts are currently topics of important attention and development in many countries to produce optimal forecasts. Ten contributions have been received, covering key aspects of current concerns on statistical post-processing, namely the restoration of inter-variable dependences, the impact of model changes on the statistical relationships and how to cope with it, the operational implementation at forecasting centers, the development of appropriate metrics for forecast verification, and finally two specific applications to snow forecasts and seasonal forecasts of the North Atlantic Oscillation.
Social-cultural impacts of China-Pakistan Economic Corridor on the well-being of local community
Authors: Sun Yunpeng , Ghani Usman , Pitafi Abdul Hameed , Islam Tahir
Published: November 2020

In this research, the impact of infrastructure improvement as a result of the China-Pakistan Economic Corridor (CPEC) initiative on the well-being and quality of life (QOL) of residents has been studied. Using the primary data collected from the local population of the Baluchistan province of Pakistan, a link between the socio-cultural effects of CPEC development and the subjective well-being of local citizens has been established. A total of 495 relevant responses were used to assess the well-being of the population through structural equation modeling. Results have shown that the social, cultural, and educational benefits of local communities are significant predictors of the well-being of citizens, and QOL issues have shown to have a major impact on the well-being of citizens. However, findings have also shown that the community resource has an important link with the subjective well-being of citizens. Furthermore, the results also give the local community perceptions of the CPEC initiative; hence the officials of the province can use the findings of this study to create prospective approaches based on the local community perceptions toward better exploitation of CPEC as an opportunity.
Evaluación de la estructura de capital de las Sociedades Cooperativas de Ahorro y Préstamo de México
Authors: Cruz Lázaro Luis Miguel , Pérez Sosa Felipe Abelardo
Published: November 2020

El objetivo del trabajo es determinar si las Sociedades Cooperativas de Ahorro y Préstamo de México (SOCAPS) obedecen a la teoría de la jerarquización financiera, cómo toman sus decisiones de financiamiento y cuáles son las posibles consecuencias de ello. Para este fin, se propuso un modelo hipotético, basado en la teoría de la jerarquización financiera y tomando en consideración las restricciones que tienen las SOCAPS; el cual, se contrastó con las decisiones de financiamiento de una muestra de 34 Sociedades Cooperativas de Ahorro y Préstamo de México, a través de la interpretación de las betas estandarizadas obtenidas mediante el análisis de regresión múltiple. De esta forma, se hallaron en las SOCAPS once distintos criterios de financiamiento, de los cuales, uno obedece a la teoría de la jerarquización. Asimismo, se encontró que la fuente de financiamiento principal de las SOCAPS son los fondos internos, seguida de los préstamos bancarios y de otros organismos. Con esto, se concluyó que los criterios de financiamiento de las entidades analizadas las protege de varios riesgos, como el exceso de apalancamiento, pero, al mismo tiempo, limitan sus posibilidades de crecimiento.
Presentación N°155
Authors: Editor El
Published: November 2020

Realidad: Revista de Ciencias Sociales y Humanidades No. 155, 2020: 1-2
Presentación del Dossier
Authors: Samour Héctor
Published: November 2020

No abstracts available
Realidad: Revista de Ciencias Sociales y Humanidades No. 155, 2020: 3-16
Ignacio Ellacuría y la "civilización de la pobreza". Apuntes para el siglo XXI
Authors: Sermeño Quezada Ángel
Published: November 2020

This article offers a reconstruction of the category of "civilization of poverty" in the thought of Ignacio Ellacuría. For such category, we understand the proposal of the construction of a global arder of human cohabitation that emerges in opposition and as a response to the serious civilizatory crisis we currently suffer. If thirty years ago, the emergence of such crisis was evident. now it is impossible not to recognize that we live in times that face us with complex challenges of all sorts: financial economic, environmental climatic, food-related, demographical, energetic etc. Thus with such a notion Ellacuría already underscored the urgent need of constructing a radically different future for humanity. In his conception of civilization of poverty, Ellacuría insisted in searching for a way of establishing a viable system of life, characterized by articulating an appropriate link between humankind and nature, Thus, the new axis of articulation of the notion of civilization would be the intimate connection between civilization and sustainability. Achieving this ecological sustainable balance is not an easy task and, for Ellacuría, its viability starts with a radical critique of the current capitalist civilizatory model.
Realidad: Revista de Ciencias Sociales y Humanidades No. 155, 2020: 87-104
The times they are a-changin’: The evolution of prostate cancer screening practices and beliefs among primary care physicians in Victoria, British Columbia
Authors: Spooner Jesse , Birk Manjot , Espionsa Victor , Hoag Nathan
Published: November 2020

Introduction: Prostate cancer screening practices remain controversial among primary care practitioners (PCPs). Inconsistent guidelines and publication of large prostate cancer screening trials have failed to provide definitive guidance. This study investigates the evolution of prostate cancer screening practices and beliefs over 12 years, in Victoria, British Columbia.

Methods: Questionnaires were delivered to 119 randomly selected PCPs in 2019. Descriptive analysis together with exploratory graphs and Pearson Chi-squared test for independence was calculated. The 2008 data was compared by determining if their value fell within the 2019 data’s 95% confidence interval.

Results: Response rate was 69.8% (83/119); 30.1% of PCPs reported regularly screening asymptomatic men with prostate-specific antigen (PSA) testing and 37.3% reported regularly performing digital rectal exam (DRE). The combination of PSA and DRE was the most commonly used (48.2 %) screening modality. Most (73.5%) reported that guidelines influence their screening practices, with the most popular choice being those published by The Canadian Task Force on Preventive Health Care (CTF) (32.5%).

Conclusions: The results demonstrate a movement away from prostate cancer screening among PCPs when compared to 2008. PCPs believe that DRE and PSA are less valuable as screening tools and that there is insufficient evidence to support their use. The most used initial screening modality was the combination of PSA/DRE, however, we found a decrease in their use between the two study periods. Clinical guidelines continue to influence PCPs screening practices, but the shift of more PCPs following the CTF guidelines since 2008 has likely led to the reciprocal decrease in prostate cancer screening.
Oncological outcomes in the management of cT1-T2 cN0 penile squamous cell carcinoma
Authors: Garisto Juan , Nayan Madhur , Fadaak Kamel , Li Kathy , Pandya Advait , Leao Ricardo , Chung Peter , Shridar Srikala S. , Helou Joelle , Kulkarni Girish S.
Published: November 2020

Introduction: Squamous cell carcinoma (SCC) of the penis is a rare disease comprising 1% of all male cancer. Options for the management of cT1-T2 cN0 penile SCC include partial penectomy (PP), considered the standard, and brachytherapy (BT), which offers acceptable local disease control and organ preservation. The purpose of our study was to assess and describe the oncological outcome for both treatments in a tertiary care center.

Methods: We performed a contemporary retrospective study of patients with early-stage penile cancer treated surgically or by BT at a tertiary center between 2000 and 2016. Demographic, management, and followup data were obtained from an institutional database. Descriptive statistics and survival analysis using Kaplan-Meier plots were calculated. Local and regional recurrences were compared in both groups (BT vs. PP).

Results: A total of 51 patients with cT1-T2N0 penile SCC treated with BT (35) and PP (16) were analyzed. Median followup was 37.1 (13.9–68) and 25.4 months (18–52.3) for the BT and PP group, respectively. Recurrence developed in seven (20%) patients treated with BT. Median time to recurrence was 35.2 months (range 2.9–95.8). No recurrences were reported in patients treated with PP. Forty-four (86.2%) patients were alive with no evidence of disease at the last followup. Overall survival was 62.7%. Complications after primary tumor treatment were urethral stenosis (15.7%), penile necrosis (7.8%), and local infection (2%).

Conclusions: PP provides acceptable local control with organ preservation in early-stage penile SCC. BT was able to offer organ preservation in 69% of men. Future prospective studies are needed to compare other organ-conserving treatment modalities with PP.
Canadian trends in testosterone therapy
Authors: Ory Jesse , White Joshua Theodore , Moore Jonathan , Grantmyre John
Published: November 2020

Introduction: Rates of testosterone therapy (TT) prescribing dropped dramatically following the FDA and Health Canada warning regarding potential cardiovascular morbidity in 2014. Since then, prescription rates appear to be increasing in the U.S., however, data on TT use in Canada is lacking. Current database studies suffer from incomplete prescription capture, lack of information on continued use, and confounding from concurrent population growth. Nova Scotia (NS) is a Canadian province with minimal population growth over the past decade. NS tracks every testosterone prescription and refill through their prescription monitoring program (NSPMP). All testosterone prescriptions must be written on triplicate forms, allowing for comprehensive tracking. The purpose of this study is to describe the long-term prescription trends of testosterone in a mid-sized Canadian province, using a database that captures 100% of all TT prescriptions written and filled.

Methods: Data were extracted from the NSPMP database on all prescriptions and prescription refills of androgens for men over 18 years of age from 2007–2019. Population statistics were gained using publicly available data from Statistics Canada. Analysis of patterns on individual years and over time were examined for number of patients, prescriptions, and prescribers, as well as formulation.

Results: The male population of Nova Scotia remained relatively stable throughout the study period (2007: 455 064; 2019: 475 478; population increase of 4.3%). A total of 7883 men (1.7% of the male population) received a prescription for TT during the study period; 1673 men received only one prescription in the entire study period and 5446 men remained on TT for longer than six months. Of the 1730 men under 45 who were prescribed TT, 75% (n=1298) of them stayed on it for more than six months; 1856 men (24%) switched the type of testosterone they were on during the study period. The number of men receiving TT yearly increased by 98%, from 1235 in 2007 to 2448 in 2019. The number of men receiving TT plateaued in 2014, except for men under age 35, in whom it has steadily increased every year since 2007. Interestingly, primary care providers (PCPs) wrote 92% of all prescriptions on average (interquartile range 90–93).

Conclusions: In a mid-sized Canadian province with stable population growth, prescriptions of testosterone increased until 2014, and then either stabilized or decreased. TT prescriptions in young men have continued to increase yearly. Injectable and gel-based formulations have increased in popularity over the past decade. Future efforts to educate prescribers, especially surrounding the effects on fertility in young men, should be largely focused on PCPs.
Optimization of Nitric Acid Leaching of Rare Earth Elements From Moroccan Natural Phosphate
Authors: Amine Marouane , Asafar Fatima , Bilali Latifa , Nadifiyine Mehdi
Published: November 2020

Phosphate is a very important natural resource in Morocco and one of the secondary resources of rare earth elements. Our study is particularly interested in Youssoufia phosphate, which contains 228.77 ppm of rare earth elements (ΣREEs). The purpose of our work is to study the influence of different parameters (acid concentration, solid/liquid ratio and temperature) in order to determine the optimal conditions for the leaching of rare earths. An experimental design (Doehlert matrix) has been drawn up to optimize the experimental conditions of the leaching. All tests were made with nitric acid at different concentrations varying between 1.5M and 4.5M with a solid/liquid ratio of 1/12 to 1/6; reaction temperature and duration are respectively 20°C to 80 °C and 60 min. The optimal conditions are obtained when using 69 °C as temperature, 4.1 M as acid concentration and 1/9 as solid/liquid ratio.
Systemic Risk for Financial Institutions in the Major Petroleum-based Economies: The Role of Oil
Authors: Khalif Ahmed , Caporin Massimiliano , Costola Michele , Hammoudeh Shawkat
Published: November 2020

We examine the relationship between oil returns and systemic risk of financial institutions in major petroleum-based economies. By estimating ACoVaR, we observe the presence of remarkable increases in risk levels during the financial crises and achieve a better risk measurement when oil returns are included in the risk functions. Moreover, the estimated spread between the CoVaR without and with oil returns is absorbed in a time range that is longer than the duration of the oil shocks. This indicates that drops in oil prices which have a longer effect on risk and financial institutions require more time to account for their impact. Policy implications are also provided.
La cultura participativa de Star Wars como experiencia transmedia
Authors: Álvarez Rodríguez Víctor
Published: November 2020

Este artículo es una investigación sobre la figura de la cultura participativa en relación con una marca de ficción. El estudio busca conocer en detalle los procesos y decisiones tomadas por la organización de fans de Star Wars la Legión 501 para traer el mundo real parte de este relato desde una perspectiva física y de comportamiento. Este análisis se fundamenta a través de la herramienta publicitaria de product placement inverso desarrollando una metodología exploratorio-descriptiva dividida en fases. Como resultado, se obtiene un trabajo que reflexiona sobre las dimensiones relacionadas con esta técnica y la experiencia transmedia generada.
Preparation of National
Infrastructure for Performing
Defensive Tasks in the Light
of Applicable Laws
Authors: Ryczkowski Dariusz
Published: November 2020

The article gathers synthesized information on infrastructure for defense use. It is the research query
of accessible acts of common law on the subject. Based on general system recommendations,
conclusions have been drawn on the development of defense infrastructure at the national level, and
at the level of specific sections of public administration. The article is a critical analysis of existing
organizational and legal solutions introduced in the period between the time of system transformation
in the 1990s and 2018.
ZNACZENIE WYBRANYCH PODMIOTÓW PAŃSTWOWYCH DLA BEZPIECZEŃSTWA MILITARNEGO RP
Authors: Denysiuk Irmina , Majchrzak Dariusz
Published: November 2020

W artykule autorzy zbadali znaczenie wybranych państw da bezpieczeństwa militarnego RP. Zaproponowana metodyka tej oceny jest podejściem nowatorskim, niestosowanym do tej pory w materiałach analitycznych, co stanowi interesujący głos w piśmiennictwie związanym z bezpieczeństwem. Analizie poddano czynniki materialne i niematerialne, militarne i niemilitarne. Analiza wybranych państw z otoczenia RP pozwoliła na stworzenie rankingu państw (wg siła oddziaływania na arenie międzynarodowej). Ponadto wykazano, że przewaga militarna i materialna nie jest gwarantem silnej pozycji państwa a obecnie to strategiczna wola polityczna odgrywa decydującą rolę w zapewnieniu bezpieczeństwa militarnego.
Crisis management in the European Air Traffic Management Network
Authors: Markiewicz Telesfor Marek
Published: November 2020

The article presents the genesis and evolution of Network Manager (NM) activities in terms of responding to disturbances and crisis situations and mitigating their effects on the European air traffic management network. The objective of these activities, carried out in coordination with the operational stakeholders and other relevant stakeholders, is to ensure maximum continuity and safety of air navigation services for aircraft operators and airports. The review, analysis and evaluation of how to respond to extraordinary and unforeseen events with a negative impact on the functioning of the air transport sector in Europe covers the period 2010-2018.
The Legal Limbo of Counter-Terrorism Criminal Law and Armed Conflict Anti-Regime and Anti-IS (Foreign) Fighters Before European Courts
Authors: Geneuss Julia
Published: November 2020

The Syrian conflict has reached public prosecution offices and courts in numerous European states with full force. Criminal investigations and proceedings against so-called foreign fighters returning from Syria as well as against persons who arrived as refugees or migrants and were involved in the conflict as members of non-state armed groups have rapidly increased in recent years. Most of the fighters returning or arriving from Syria to Europe are members of the so-called Islamic State or comparable jihadist groups and are being prosecuted for counter-terrorism crimes. In this contribution, however, the focus will be on those groups for which classification as “terrorist organization” is less clear. This paper takes a closer look at the criminal investigations and proceedings that are being conducted in several European states against anti-regime and anti-IS (foreign) fighters. Do members of these groups also face prosecution under counter-terrorism criminal law after their return to or their entry into the country? Or does counter-terrorism criminal law differentiate between the groups involved in the Syrian conflict? Is this differentiation a legal or a political matter? Who is responsible for the decision? What criteria apply?
Kindeswohlgefährdung vor Gericht – Zum Zusammenwirken von Jugendamt, Gericht und Verfahrensbeistandschaft in familiengerichtlichen Verfahren
Authors: Bindel-Kögel Gabriele , Schone Reinhold
Published: November 2020

In den zurückliegenden 20 Jahren hat der Gesetzgeber eine Reihe von Gesetzen zum Kinderschutz novelliert oder neu geschaffen. Im Zentrum stand dabei der Versuch, den Schutz von Kindern und Jugendlichen vor Gefahren nachhaltig zu verbessern. Dabei ging es immer wieder auch um das Zusammenwirken von Jugendämtern und Familiengerichten. Zudem wurde der Aufgabenbereich der Verfahrensbeistandschaft als weiterer Akteur in Kindeswohlverfahren neu geschaffen und gesetzlich eindeutiger fixiert. Diese Veränderungen und ihre Auswirkungen wurden im Zeitraum von 2014 bis 2016 im Rahmen eines bundesweiten Praxisforschungsprojektes zum „Kindeswohl zwischen Jugendhilfe und Justiz“ untersucht und analysiert. Der hier vorgelegte Beitrag beschäftigt sich auf der Grundlage der Ergebnisse aus diesem Projekt mit eben diesem Zusammenwirken der oben genannten Akteure im Kinderschutz.
Ruptured Ectopic Pregnancy with an Intrauterine Device: Case Report and Sonographic Considerations
Authors: Jones Derick , Kummer Tobias , Schoen Jessica
Published: November 2020

Introduction: Ectopic pregnancy carries a high morbidity and mortality; patients are at risk for rupture and life-threatening hemorrhage.

Case Report: We present a rare case of ruptured abdominal ectopic pregnancy in a patient with a well-positioned intrauterine device (IUD) and discuss the diagnostic utility that transabdominal point-of-care ultrasound (POCUS) can have when performed at the bedside.

Conclusion: While pregnancy with an IUD in place is rare, when it is encountered the emergency provider should maintain a high degree of suspicion for extrauterine pregnancy and perform prompt evaluation for hemorrhagic shock using diagnostic POCUS.
Palmoplantar Pustulosis: A Case Report
Authors: Dulski Anne , Varamo Vince
Published: November 2020

Introduction: Dermatology complaints account for 3.3% of emergency department (ED) visits per year. Most rashes are benign, but there are a select few that emergency physicians must be familiar with as delay in treatment could be life threatening. Case Report: A well-appearing, 76-year-old male presented to the ED with multiple coalescing pustules to his palms and soles and was transferred to the nearest tertiary care hospital for dermatology consult. He was diagnosed with palmoplantar pustulosis and discharged home with a five-day course of clobetasol propionate 0.05% cream twice daily and outpatient dermatology follow-up. Conclusion: Palmoplantar pustulosis is an uncommon skin condition characterized by recurrent eruptions of sterile pustules localized to the palms and soles. Emergency physician awareness of this rare diagnosis may help prevent hospital admissions and lead to earlier initiation of treatment with outpatient dermatology follow-up.
Miller-Fisher Syndrome: A Case Report and Review of the Literature
Authors: Truong Justina , Conley Jeff , Ashurst John
Published: November 2020

Introduction: Neurological complaints are a common presenting symptom seen by the emergency physician. However, the Miller-Fisher variant of Guillain-Barré syndrome is a rare cause of neurological complaints seen in the emergency department.

Case Report: A 26-year-old male presented with dysphonia and bilateral hand and feet paresthesia after a recent diarrheal illness. Examination revealed the absence of tricep, brachioradialis, patellar and Achilles tendon reflexes bilaterally, and difficulty with phonation. Lumbar puncture revealed the presence of anti-GQ1b antibodies, and the patient was diagnosed with Miller-Fisher variant of Guillain-Barré.

Discussion: Miller-Fisher syndrome is an acute, autoimmune response that typically follows either an upper respiratory or diarrheal illness. Typically associated with dysfunction of cranial nerves three, four, and six, Miller-Fisher syndrome may present with facial paralysis, opthalmoplegia, arefexia, or ataxia. Lumbar puncture with the presence of anti-GQ1b antibodies is indicative. Treatment could include supportive respiratory care, intravenous immunoglobulin therapy, or plasmapheresis.

Conclusion: Miller-Fisher syndrome is a rare form of Guillain-Barré syndrome that the emergency provider should include in the differential when faced with a patient with cranial nerve dysfunction.
A 61-year-old Female with Right Upper Abdominal Pain
Authors: Long Drew , Long Brit
Published: November 2020

Case Presentation: A 61-year-old female presented to the emergency department with right upper quadrant abdominal pain following a cholecystectomy 18 days prior. Computed tomography (CT) of her abdomen demonstrated a large abscess in her post-hepatic fossa. She was admitted to the general surgery service and received an image-guided percutaneous drain placement with interventional radiology with immediate return of purulent material. She was discharged home after a three-day hospital course with outpatient antibiotics and follow-up.

Discussion: Patients may have multiple complications following cholecystectomy, including infection, bleeding, biliary injury, bowel injury, or dropped stone. The emergency clinician must consider cholecystectomy complications including gallbladder fossa abscess in patients presenting with abdominal pain in the days to weeks following cholecystectomy, especially if they present with signs of sepsis. Critical actions include obtaining CT and/or ultrasonography, initiating broad spectrum antibiotics, and obtaining definitive source control by either surgery or interventional radiology.
Inhaled Tranexamic Acid for Massive Hemoptysis in the Setting of Oral Anticoagulation: A Case Report
Authors: Dempsey Jacqueline , Jones Mandy , Bronner Jonathan , Greer Connor , Howington Gavin
Published: November 2020

Introduction: We discuss a case of massive hemoptysis in the setting of a direct-acting oral anticoagulant (DOAC) successfully managed with nebulized tranexamic acid (TXA).

Case Report: Per the American College of Cardiology and the American Society of Hematology, it is recommended that significant bleeding associated with a DOAC be treated with either 4-factor prothrombin complex concentrate or andexanet alfa. However, our patient was at high risk for thrombotic complications given a recent pulmonary embolism.

Conclusion: We demonstrate that it is reasonable to trial nebulized TXA given its low cost, ease of administration, and safety profile. Additionally, this report discusses a unique dosing strategy and a previously unreported complication associated with nebulization of undiluted TXA.
Extensive Upper Airway Hematoma Secondary to Supratherapeutic Warfarin Anticoagulation
Authors: Oyedokun Taofiq , Durr Kevin
Published: November 2020

Case Presentation: A 63-year-old female presented to the emergency department complaining of cough, neck swelling, dysphagia, and dysphonia for two days, with a past medical history of atrial fibrillation managed with warfarin. Investigations revealed a supratherapeutic international normalised ratio (greater than 10). Imaging and endoscopic examination showed an extensive retropharyngeal hematoma with significant mass effect on the airway.

Discussion: A rare but potentially fatal complication of warfarin anticoagulation is upper airway hematoma, with violent coughing described as an inciting cause. Signs of airway compromise necessitate specialist consultation and definitive airway management, while mild cases without airway concerns can be managed conservatively with medical anticoagulation reversal.
Pharmacologically-induced Recreational Priapism: Case Report and Review
Authors: Kunas Grace , Smereck Janet , Ladkany Diana , Davis Jonathan
Published: November 2020

Introduction: Priapism, a time-sensitive urologic emergency, is associated with hematologic disorders, malignancies, trauma, pharmaceuticals, and recreational drugs.

Case Report: A 51-year-old male presented with 36 hours of priapism after recreational use of nonprescribed pharmaceuticals including an oral phosphodiesterase inhibitor and intracorporally injected erectile medications, together with unspecified quantities of cocaine and alcohol. Venous blood gas confirmed ischemic priapism. Detumescence was achieved with intracavernosal phenylephrine injection, aspiration, and irrigation.

Conclusion: This case highlights the risk that recreational use of vasoactive medications by patients who seek to prolong sexual activity may lead to delayed presentation for ischemic priapism.
Case Report of Traumatic Uterine Rupture in a Multigravida Woman with Emergency Department Cesarean Section
Authors: Wiese Krista , Ernest Stacey , Dukes W. Seth
Published: November 2020

Introduction: Uterine ruptures in blunt trauma are an extremely rare complication. Furthermore, while perimortem cesarean sections in cardiac arrest patients are a well-established practice in emergency medicine, cesarean sections in the emergency department are rarely performed on non-arresting patients.

Case Report: A multigravida woman at approximately 24 weeks gestation presented as a transfer from an outside hospital after a motor vehicle collision. Upon arriving to our facility, she underwent an emergency cesarean section in the trauma bay and was found to have a uterine rupture with the fetus free floating in the right upper quadrant of the abdomen.

Conclusion: Uterine rupture is a rare but important complication of blunt abdominal trauma in pregnant patients. Resuscitative cesarean sections may be necessary for favorable outcomes. A well prepared and diversified team was essential to maternal survival.
One Notable Complication of Nasopharyngeal Airway: A Case Report
Authors: Briggs Blake , Countryman Chase , McGinnis Henderson
Published: November 2020

Introduction: The nasopharyngeal airway (NPA) is used by emergency providers and first responders to assist with oxygenation in obtunded, critically ill patients. There are few recorded NPA complications.

Case Report: We describe a unique case in which a patient went multiple days with recurrent symptoms of upper airway obstruction secondary to retained NPA.
Discussion: Nasopharyngeal airways may be uniquely prone to being displaced and retained due to their use in emergent situations, their small size, and time of insertion in the field prior to emergency department (ED) contact where handoff is not often standardized.

Conclusion: The use of large-flanged NPAs might reduce incidences of displacement into the nasal cavity. This case highlights the need for improved handoff communication between emergency medical services and ED staff, especially to account for all inserted devices to prevent foreign body retention.
Clinicopathological Conference: 54-year-old with Facial Swelling for One Month
Authors: Pile Justin , Dawson Adam , Maxa Lynn
Published: November 2020

A 54-year-old female with facial swelling for one month who had repeatedly been treated for allergic reaction during multiple emergency department (ED) visits, presented to the ED for the same complaint of facial swelling. Maintaining a broad differential diagnosis was of critical importance to appropriately evaluating the patient and arriving at the correct conclusion for the etiology of the patient’s symptoms. Upon establishing the correct diagnosis, a multidisciplinary approach was used to intervene to provide early treatment without delay.
Fundamentals Of Interactive Storytelling
Authors: BOSTAN Barboros , MARSH Tim
Published: November 2020

The focus of interactive storytelling should not only be on the attributes of the technology or characteristics of the medium, such as the AI techniques, planning formalisms, story representations, etc. but also on the computer-mediated communication processes, such as the relatedness of transmitted messages with previous exchanges of information, the number of attributes to be manipulated by the player, or the level of player control on the messages. It is argued that an approach to maximize player enjoyment in a computer game is to customize/personalize the gaming experience and the associated computer-mediated communication processes. To this aim and to provide answers to “how” and “what” should be customized, the article first explores the problematic notions of interactivity and then frame the discussion in the context of interactive storytelling systems. Secondly, it analyses table-top role-playing games RPGs - the live counterpart of computerized interactive storytelling systems – in an attempt to find “what” to customize. In particular, it focuses on the Dungeon Master whose role in co-ordinating human-to-human communication process of interactive storytelling provides valuable insights into how to handle the human-to-machine/game communication process. Finally, the article proposes a framework to explain “how” to customize for maximum player enjoyment and optimal game experience within an interactive storytelling system.
An unrealistic story of a realistic dream: A dream as 'another reality' in the story 'Funeral in Sušić' by Petar Sarić
Authors: Jeftimijević-Mihajlović Marija
Published: November 2020

Although his life is tied to the Kosovo-Metohian environment, the greatest living writer from Serbia's southern province, Petar Saric, with his thematic motifs, stayed faithful to the Banians, that have almost a mythical appearance in his novels. After immense suffering and pogrom of Serbs from Kosovo and Metohy in 1999, Saric has stayed faithful to the spiritual space, and his exile from Prishtina, where he has lived and worked for years, didn't mean an exile from the southern Serbian province. Finding refuge in a seemingly more quiet and safer place, in Strpce, on Brezovica, Saric practically chooses not to be defeated in his personal life and literature. It is witnessed by his works published after the ominous year at the end of the millennium. But life in a hostile environment, a constant fear of revenge and death, has made Saric turn to "realistic prose." However, it has been realistic only when the tragic everyday life has become a subject of the art process, where another layer has been added, typical for Saric's narrative act, and it can be described as magical, enigmatic, and phantasmagoric, as an intertwining of realistic and unrealistic, physics and metaphysics. The story "Funeral in Sushic" (2015) is, above all, characterized by a moral lesson of a story about a dream that is more horrifying than reality and reality that is more horrifying than a dream; other words, it is characterized by a function of a dream in the story. On the one hand, it enabled the writer to present the readers with everyday life reality through a different "reality" - the reality of a dream (since most vivid dreams are often more persuasive than the moments of "reality"); it enabled him to involve a reader into the magical world of storytelling and narration through a story of the evil that was spread through spaces of reality and spaces of dreams. On the other hand, "Funeral in Sushic" is realized as a universal story of man's suffering, that is a suffering of any man in any time, where a dream of one's own death was used as a "base" for a story about "a man in adversity and a soul in agony" (Goethe). The most profound meaning of the story is in its narrative rhetorical question "is it possible that I will give a eulogy to myself!" with this question, Saric not only opened new dimensions of meaning and values of his mainly realistic prose, but he raised the following question: Isn't it that we deliver the eulogies for ourselves and to ourselves, where the spaces of evil in his prose become hopeless distances of life, especially in a place of an ordeal and in a time of ordeal like the one that the writer brings into his story: 2015, Strbac, Brezovica (Kosovo and Metohy).
Cholecystitis after Placement of Covered Self-Expandable Metallic Stents in Patients with Distal Malignant Biliary Obstructions
Authors: Watanabe Masafumi , Okuwaki Kosuke , Woo Jun , Kida Mitsuhiro , Imaizumi Hiroshi , Iwai Tomohisa , Yamauchi Hiroshi , Kaneko Toru , Hasegawa Rikiya , Kurosu Takahiro , Minato Naoki , Haradome Hiroki , Koizumi Wasaburo
Published: November 2020

Background/Aims: Cholecystitis can occur after the placement of covered self-expandable metallic stents for distal malignant biliary obstructions. We aimed to identify risk factors for cholecystitis following covered self-expandable metallic stent placement.Methods: We investigated risk factors related to cholecystitis following covered self-expandable metallic stent placement in 118 patients with distal malignant biliary obstructions between January 1, 2015 and April 30, 2019. Endoscopic assessments and tumor invasion to the arteries feeding the gallbladder were determined by a pancreaticobiliary endoscopist and a radiologist, respectively.Results: The median patient age was 72 years (men, 61.0%). The flow of the contrast agent into the gallbladder and tumor involvement in the orifice of the cystic duct were observed in 35 (29.7%) and 35 (29.7%) patients, respectively. During the observation period (median, 179 days), cholecystitis occurred in 18 (15.3%) patients. Multivariate analysis revealed the flow of the contrast agent into the gallbladder (p=0.023) and tumor involvement in the orifice of the cystic duct (p=0.005) as significant independent risk factors associated with cholecystitis.Conclusions: The flow of the contrast agent into the gallbladder and tumor involvement in the orifice of the cystic duct are potential independent risk factors for cholecystitis following the placement of covered self-expandable metallic stents. A follow-up prospective study is warranted to validate their influence.
Public opinion monitoring on the activity of the bodies of internal affairs for the purpose of formation positive image of a police officer
Authors: Kostin Sergei Gennad'evich
Published: November 2020

The subject of this research is the criteria for extradepartmental assessment of police performance, and the mechanism for conducting public opinion monitoring. The goal consists in the analysis of the impact of public opinion upon the performance efficiency of the bodies of internal affairs, as well as in determination of the factors affecting the formation of positive image of a police officer. The application of systemic approach in the course of this research allowed outlining the group of factors that impact the effectiveness of the bodies of internal affairs. Structural-functional analysis was used for studying the role of public opinion, identification of its development trends and conditions for the purpose of improving performance efficiency of the bodies of internal affairs. It is noted that the results of studying public opinion are an essential criterion for assessing the work of law enforcement agencies along with determination of deficiencies in their work, as well as allow make organizational and administrative decisions for their elimination. The author substantiates the growing influence of public opinion upon the current socially-oriented model of state administration. The main conclusions of this research consist in the analysis of theoretical aspects of the impact of public opinion upon the operational police activity, as well as in proposal of recommendations  on the forms of implementation of results of public opinion monitoring, which may enhance public confidence in the police, and form positive image of the employee of internal affairs agencies.
Peculiarities of adjudication of tax disputes by the United States Tax Court
Authors: Osina Dina
Published: November 2020

Currently, the United States has three judicial instances that are authorizes to contest the fact of bringing to responsibility for violation of tax legislation: Tax Court, Court of Claim, and district courts. The United States Tax Court is the most demanded authority among taxpayers that adjudicates over 95% of all tax disputes, which is substantiated by the fact that it is the only instance where a taxpayer can apply prior to paying taxes, penalties and fines. This article using the general scientific and special legal methods examines the previously uncovered in Russian legal literature peculiarities of adjudication of tax disputes by the United States Tax Court. Including the questions of formation of precedents in tax cases. As a result of the conducted research the author formulates the following conclusions: 1) a mandatory conditions of jurisdiction of the Tax Court is the notification on uncollected tax; if it is absent, the tax payer cannot appeal to the Tax Court; 2) only a small number of cases is considered by the Tax Court substantively, namely due to the fact that the parties listen to the verbal opinion of the judge, based on which formulate the settlement offer and submit for approval of the judge; 3) the opinion and decisions of the Tax Court should be differentiated, only certain categories of opinions are of precedent nature; 4) since the decisions of the Tax Court are subject to appeal to the thirteen Courts of Appeal, potentially there occurs a problem related to controversial case law on the same issues; 5) cases with an insignificant sum in dispute qualify under simplified procedure, which contributes to procedural efficiency; however, the opinion formed based on the results of such consideration would not be of precedential value.
Lymphangiogenic therapy prevents cardiac dysfunction by ameliorating inflammation and hypertension
Authors: Song LouJin , Chen Xian , Swanson Terri A , LaViolette Brianna , Pang Jincheng , Cunio Teresa , Nagle Michael W , Asano Shoh , Hales Katherine , Shipstone Arun , Sobon Hanna , Al-Harthy Sabra D , Ahn Youngwook , Kreuser Steven , Robertson Andrew , Ritenour Casey , Voigt Frank , Boucher Magalie , Sun Furong , Sessa William C , Roth Flach Rachel J
Published: November 2020

The lymphatic vasculature is involved in the pathogenesis of acute cardiac injuries, but little is known about its role in chronic cardiac dysfunction. Here, we demonstrate that angiotensin II infusion induced cardiac inflammation and fibrosis at 1 week and caused cardiac dysfunction and impaired lymphatic transport at 6 weeks in mice, while co-administration of VEGFCc156s improved these parameters. To identify novel mechanisms underlying this protection, RNA sequencing analysis in distinct cell populations revealed that VEGFCc156s specifically modulated angiotensin II-induced inflammatory responses in cardiac and peripheral lymphatic endothelial cells. Furthermore, telemetry studies showed that while angiotensin II increased blood pressure acutely in all animals, VEGFCc156s-treated animals displayed a delayed systemic reduction in blood pressure independent of alterations in angiotensin II-mediated aortic stiffness. Overall, these results demonstrate that VEGFCc156s had a multifaceted therapeutic effect to prevent angiotensin II-induced cardiac dysfunction by improving cardiac lymphatic function, alleviating fibrosis and inflammation, and ameliorating hypertension.