bluuebunny/crossref_metadata_2025 huggingface dataset:
Participación popular y presidencialismos fuertes en el Nuevo Constitucionalismo Latinoamericano
Authors: Quiroz Villalobos Milton Ebert
Published: August 2019

En Latinoamérica, el contexto de crisis que acompañó a la mayoría de países durante la década de los noventa fue un claro síntoma del divorcio entre Constitución en sentido formal y material, con un evidente correlato en la escasa participación ciudadana en los asuntos públicos. Esto condujo a que en algunos países de la región, específicamente en Venezuela, Ecuador y Bolivia, se dieran situaciones particularmente críticas, las cuales desembocaron en sendas asambleas constituyentes, que dieron lugar a textos constitucionales con elementos y características contradictorias en algunos aspectos y complementarias en otros, que han llevado a hablar de un Nuevo Constitucionalismo Latinoamericano (NCLA). El NCLA, a fin de profundizar la democracia, contiene instrumentos para una mayor participación ciudadana en los asuntos públicos. Sin embargo, la generación de presidencialismos fuertes (con parlamentos que no son contrapesos, sino “socios” del Presidente –los casos de Venezuela y Ecuador atraviesan situaciones confusas–) van en sentido contrario, es decir, debilitan la democracia. Esta tensión es una tarea pendiente de resolver para aquellos que consideran que el NCLA es un estilo que ha llegado para quedarse, trascendiendo el momento histórico y las condiciones que le dieron lugar.
El ius imperium de los tribunales ambientales en Chile
Authors: Retamal Valenzuela Jorge Roberto
Published: August 2019

El trabajo analiza la manera como los tribunales ambientales ejercen su facultad de imperio para hacer cumplir las resoluciones por ellos proferidas, tanto en Chile como en el derecho comparado. Analiza la Ley 20.600 en lo pertinente, y la normativa de la fuerza pública y las fuerzas de orden del Estado. Finaliza acreditando la existencia efectiva de esta facultad de imperio, y plantea la necesidad de adecuar la normativa a la realidad actual del ordenamiento jurídico ambiental chileno.
Antimicrobial Activity Of Silver Nanoparticles Synthesized with Extract of Tomato plant Against Bacterial and Fungal Pathogens
Authors: BARAN Mehmet Fırat , ACAY Hilal
Published: August 2019

Objective:
Silver nanoparticles (AgNPs) have a wide range of
applications. Environmental-friendly synthesis methods for these nanoparticles
are more preferable due to their various advantages. This study aimed to
synthesize AgNPs using the extract of the tomato plant in an easy and
economical way. and testing this AgNPs against some human pathogens.Methods:
Silver nanoparticles were synthesized using aqueous
silver nitrate and reducing tomato plant extract. The characterization of AgNPs
was determined by ultraviolet-visible spectrophotometry (UV-Vis), X-ray
crystallography (XRD) Scanning electron microscopy (SEM), Fourier transform
infrared Spectroscopy (FT-IR), energy dispersive X-ray spectrum (EDAX),
thermogravimetric - differential thermal analysis (TGA-DTA) data. The effects
of the particles on pathogenic microorganisms were determined by minimum
inhibition concentration (MIC).Results:
These data, with a maximum absorbance of 450.51 nm, in
the spherical view, with the peaks and values of 111o, 200o,
220o and 311o (38.08, 44.28, 64.42 and 77.34), AgNPs
showed a cubic crystal structure and, using the Debye-Scherrer equation, it was
determined that they had a crystal size of 21.11 nm AgNPs had an antimicrobial
activity on hospital pathogens gram negative, gram positive and Candida
albicans yeast.

Conclusion:
We found that these particles showed antimicrobial
activity on various microorganisms even at very high concentrations. As a
solution to the antimicrobial search, it can be developed in medical industry.
Do “Interactive” Educational Technologies Promote Interactive Literacy Instruction?
Authors: Lovell-Johnston Meridith Ann
Published: August 2019

This article explores the concept of lesson interactivity within six primary and elementary teachers’ use of whole-class and personal digital devices over multiple lessons including Interactive Whiteboards, data projectors, laptop computers, and others. The analysis focuses on the differences between technical vs pedagogic interactivity (Smith, Higgins, Wall, & Miller, 2005) where technical interactivity refers to direct tactile interaction with technology and pedagogic interactivity refers to the interaction between teachers, students, and lesson content which may occur with or without technology use. Technical interactivity varied in duration between teachers and lessons, but teachers’ use of whole-class devices typically exceeded students’ use. Use of personal devices by students was infrequent, and often supported the content displayed on a whole-class device. In terms of pedagogic interactivity facilitated by technology use, the most frequent activities were teacher-directed questioning and guided practice, during which the teachers had a correct answer or method in mind. Use of deeper pedagogic interaction through discussion, student inquiry, or research were not observed. Teachers expressed that they faced barriers to interactive technology use including program and resource constraints as well as lack of teacher comfort with technology.  This research was conducted following Tri-Council guidelines for the Ethical Conduct of Research Involving Humans. It has passed the research ethics board of two universities and two school districts.
Comparison of the anthocyanins composition of five wine-making grape cultivars cultivated in the Wujiaqu area of Xinjiang, China
Authors: Zhang Ke , Yuan Lin , Li Qian , Wang Rui , Zhang Zhen-Zhen
Published: August 2019

Anthocyanins biosynthesis are essentially determined by grape cultivar genotype. However, specific environmental and vine management conditions could alter the accumulation of anthocyanins. This study selected five wine-making grape cultivars cultivated in the Wujiaqu area of the Xinjiang region of China to investigate the profiles of anthocyanins. Results showed that a total of 15 anthocyanins were identified. Marselan contained 15 anthocyanins, whereas only 14 anthocyanins were present in Cabernet-Sauvignon and Cabernet Franc. Syrah and Petit Verdot were found to only contain 13 anthocyanins. Cabernet-Sauvignon and Cabernet Franc appeared to show the highest and lowest levels of the total anthocyanins, respectively. Cabernet-Sauvignon possessed the highest levels of the total monomeric and acylated anthocyanins, respectively. Malvidin-3-O-glucoside and its acylated derivatives (malvidin-3-O-(6-O-acetyl)-glucoside and malvidin-3-O-(6-O-coumaryl)-glucoside) were the dominant anthocyanins in these grape cultivars. Principal component analysis revealed that the acylated anthocyanins were the major anthocyanins that differentiated these grape cultivars.
AVALIAÇÃO DA QUALIDADE DE JABUTICABAS (CV. SABARÁ), SUBMETIDAS AO ARMAZENAMENTO REFRIGERADO E ACONDICIONADAS EM DIFERENTES EMBALAGENS
Authors: Morgado Cristiane Maria Ascari , Guariglia Bruna Ariel Dias , Trevisan Marcos José , Façanha Rafaela Vieira , Jacomino Angelo Pedro , Corrêa Gilmarcos de Carvalho , Cunha Junior Luis Carlos
Published: August 2019

A jabuticaba [Myrciaria jaboticaba (Vell) Berg] ‘Sabara’ é um fruto muito apreciado in natura, pelo seu sabor adocicado, porém é extremamente perecível. O objetivo deste trabalho foi avaliar embalagens para a conservação dos frutos sob refrigeração. Os frutos foram colhidos no ponto de consumo, lavados, higienizados, acondicionados nas embalagens PET com tampa Neoform N-90©; PVC 12 micras; PD- 900®; PEBD 15 micras; PP 10 micras; Controle (sem embalagem) e armazenados em câmara fria a 12º  1ºC e 85  5%UR. As embalagens reduziram a perda de massa e mantiveram a firmeza das jabuticabas. O filme de PVC proporcionou melhor conservação de ácido ascórbico e luminosidade dos frutos. A atmosfera passiva no interior das embalagens PEBD e PP apresentaram as maiores concentrações de CO2 e menores de O2 do que as outras embalagens, afetando de maneira negativa a conservação das jabuticabas. A embalagem PVC de 12 micras, associada à refrigeração apresentou bons resultados para conservação das jabuticabas ‘Sabará’.

Palavras-chave: Myrciaria jaboticaba (Vell) Berg, embalagem, refrigeração.
ESTUDO DA PREVALÊNCIA DE AFECÇÕES ORAIS EM EQUÍDEOS DE ARAGUAÍNA, TOCANTINS
Authors: Silva Marco Augusto Giannoccaro , Amorim Haiane Arruda Luz , Duarte Claudia Acosta
Published: August 2019

Desde a domesticação, os equinos são empregados no esporte, trabalho e lazer. Para tanto, diferentes dietas foram formuladas e a utilização de embocadura para controle dos animais se fez necessária. Isso, contudo, pode induzir alterações intraorais que, além de promoverem sinais clínicos diversos, prejudicam o consumo de alimentos e o rendimento atlético. Objetivou-se com esse estudo determinar a prevalência de alterações intraorais em equinos de Araguaína, Tocantins. Foram avaliados 72 equinos por meio de exame físico geral e avaliação intraoral com espéculo. Todos os animais avaliados (100%) apresentaram algum tipo de patologia oral. A principal alteração encontrada foi a ponta excessiva de esmalte dentário (100%), seguida do cálculo dentário (59,46%) e dos ganchos (35,13%). Lesões em língua (32,43%) e presença de “dentes de lobo” (33,78%) também foram identificados e estes podem interferir no bem-estar animal, na mastigação e no rendimento atlético. Concluiu-se que os equinos de Araguaína possuem alterações intraorais importantes e que a avaliação oral periódica deve ser inserida nas propriedades, favorecendo a saúde animal e o desempenho satisfatório.
EFEITO DA IMPLANTAÇÃO DE PROGRAMAS DE SINALIZAÇÃO PARA PREVENÇÃO DE ACIDENTES VIÁRIOS NA RODOVIA FEDERAL BR-153/TO
Authors: Marques Jordana Tomaz , Pereira Lilian dos Santos Fontes
Published: August 2019

Tendo em vista a necessidade de um planejamento estratégico para melhorar a segurança viária, alguns programas foram criados pelo Departamento Nacional de Infraestrutura de Transportes (DNIT) a fim de reduzir o número de acidentes nas rodovias. O Programa Nacional de Segurança e Sinalização Rodoviária (BR-Legal) e o Programa de Contratação de Restauração (CREMA) foram criados com a finalidade de assegurar a implantação e manutenção estruturada da sinalização nas rodovias e garantir a manutenção e restauração regular das pistas, auxiliando na  redução da severidade e do número de acidentes de trânsito. O objetivo deste trabalho é avaliar os resultados da implantação do CREMA e do BR Legal na rodovia federal do estado do Tocantins, BR-153, uma importante rodovia do Brasil. Para tanto, foram comparados dados de acidentes entre trechos com e sem implantação dos programas. Foram utilizadas as bases de dados da Polícia Rodoviária Federal (PRF) referente aos anos de 2007 a 2017, para a coleta dos registros dos acidentes. O estudo se concentrou na análise de acidentes com causas relacionadas à sinalização. Após a implantação dos programas, a linha de tendência nos registros de acidentes apresenta uma redução, com queda de 6% na taxa de acidentes no período analisado.
MEMÓRIA URBANA DE PALMAS-TO
Authors: Campos Odisséia Aguiar
Published: August 2019

O presente artigo compõe um dos eixos da pesquisa “Teorias Urbanísticas e Novas Cidades: documentação e pesquisa sobre a concepção do projeto urbanístico de Palmas-TO”, e visa dar continuidade de uma atividade investigativa que teve início em 2011 na UFT. Considerando a escassez de estudos e pesquisas de natureza acadêmica sobre a “última capital planejada do século XX no mundo”, o presente artigo pretende aprofundar-se sobre programas nacionais europeus de criação de novas cidades pós-Brasília, tais como: i) a experiência de Novas Cidades na Inglaterra, “New Town Programme”, em especial o plano para a cidade Milton Keynes, a principal referência urbanística internacional assumida pelos autores do projeto de Palmas, e ii) sobre o Plano de Almere, nova cidade do Programa “Nouvelle Villes” francês, influência não assumida pelos autores, mas sempre lembrada por pesquisadores. Além destas, pesquisou-se ainda sobre a proposta de urbanização de “Coral Ridge”, na Flórida, nos EUA, experiência objeto de visita de campo prévia a elaboração do projeto de Palmas pelos co-autores de Palmas.
Palavras-chave: Urbanismo, Modernidade, Pós-Modernidade e Novas cidades.
ASPECTOS DE QUALIDADE E SEGURANÇA DO TAMBAQUI (COLOSSOMA MACROPOMUM) E PINTADO DA AMAZÔNIA (PSEUDOPLATYSTOMA RETICULATUM X LEIARIUS MARMORATUS)
Authors: Oliveira Maria Olivia dos Santos , Luiz Danielle de Bem , Verdolin dos Santos Viviane Rodrigues , Silva de Oliveira Eduardo Henrique , De Souza Martins Glêndara Aparecida
Published: August 2019

Este trabalho tem como objetivo apresentar uma revisão bibliográfica à cerca de fatores que influenciam na qualidade e segurança de duas espécies nativas de pescado da produção ao processamento, o tambaqui e o surubim. Como o pescado é um alimento altamente perecível, é necessário que haja cuidados durante seu trajeto até o consumidor final e para isso é importante que se conheça a espécie trabalhada e fatores que poderão influenciar na qualidade e segurança da mesma em relação ao consumidor.
MANCHA-BACTERIANA DA MANGUEIRA (XANTHOMONAS CAMPESTRIS PV. MANGIFERAEINDICAE)
Authors: Araujo Mirelle Ribeiro , Leão Geovanka Marcelle Aguiar , Silva Raul da Conceição Alves da , Oliveira Adriana Idalina Torcato , Silva Juliana Fonseca Oliveira da
Published: August 2019

A vida pós-colheita da manga é limitada pela deterioração fisiológica causada pelo excessivo amadurecimento da fruta e pelo desenvolvimento de patógenos que ocasionam podridões. A Mancha angular é provocada pelo microrganismo Xanthomonas campestris PV mangiferaeindicae é uma doença que ataca ramos, folhas, inflorescências e frutos da mangueira, em períodos úmidos prolongado. A crescente preocupação com o conceito de qualidade mercadológica e a preservação do ambiente têm aumentado a procura por frutas saudáveis e sem resíduos de agroquímicos, havendo uma necessidade crescente de estratégias de controle alternativas. A primeira medida de controle é a escolha do local, deve-se evitar locais sob influência de grandes massas de água, como represas das hidroelétricas, pois criam um ambiente favorável ao desenvolvimento da bactéria. A segunda medida é o uso de mudas sadias e de viveiros localizados em regiões onde a doença não ocorra. Várias pesquisas estudam a estrutura química e a atividade antimicrobiana natural de plantas, frutos, hortaliças, grãos e ervas. Os esforços têm-se concentrado na utilização de recursos naturais como extratos e óleos essenciais.

Palavras-chave: Xanthomonas campestris, manga, controle biológico.
MODELAGEM MATEMÁTICA E ANÁLISE DA HIDRATAÇÃO DE GRÃOS DE FEIJÃO E LENTILHA SOB DIFERENTES TEMPERATURAS
Authors: De Moura Bruna Araújo , Morais Romulo Alves , Miranda Lorena Brito , Da Silva Warley Gramacho , Martins Glêndara Aparecida de Souza
Published: August 2019

O feijão e a lentilha são leguminosas de papel importante na alimentação humana e ambas possuem nutrientes essenciais ao organismo. Desta forma faz-se necessário um estudo do comportamento destes grãos quando submetidos ao processo de hidratação, pois a maior parte das leguminosas é consumida na forma cozida. O objetivo deste trabalho foi avaliar a hidratação de duas cultivares de feijão e uma de lentilha, além de aplicar o modelo de Peleg nos dados obtidos. Para validar o modelo, foi realizada análise de umidade dos grãos de feijão branco, caupi e lentilha ao longo do tempo, por meio da imersão das cultivares em água destilada nas temperaturas de 25, 35, 45, 55 e 65ºC. O modelo de Peleg representou de forma mais satisfatória o processo de hidratação em todas as temperaturas estudadas para os grãos de feijão caupi e lentilha utilizando ajustes individuais dos seus parâmetros C1 e C2.
AVALIAÇÃO DO PROCESSO DE DESIDRATAÇÃO OSMÓTICA DE PIMENTA MALAGUETA (Capsicum frutens), VARIEDADE MALAGUETINHA.
Authors: Alves Denise Gomes , Abreu Camila Noleto , Silva Sousa Hermanny Matos , Tenório Pereira Cecília Marques
Published: August 2019

Apreciada há milhares de anos, a pimenta malagueta (Capsicum frutescens) está presente na mesa da população espalhada por todo o mundo, sendo utilizada na maioria das vezes como especiaria. Em consequência desta procura, a área de cultivo de pimentas nos vários estados brasileiros expandiu, com o intuito de atender tanto o mercado interno quanto o externo. Elas abastecem a agroindústria, são consumidas in natura e processadas para serem utilizadas em várias linhas de produtos. Este trabalho teve como objetivo a avaliação do processo de desidratação osmótica de pimenta malagueta (Capsicum frutens). Não houve diferenças significativas entre as soluções desidratantes tanto para a perda de água (PA) como para o ganho de sólidos (GS).
SOBRE A NATUREZA DO ARGUMENTO DE ANSELMO. UMA CRÍTICA À INTERPRETAÇÃO DE JEAN-LUC MARION
Authors: Barreto Marco Heleno
Published: August 2019

Discute-se neste trabalho a interpretação não-metafísica que Jean-Luc Marion propõe da prova da existência de Deus no Proslogion de Santo Ansel­mo. O autor mostra como Marion distorce o objeto sob análise, ao aplicar a ele pressupostos hermenêuticos que são incompatíveis com os fundamentos meta­físicos do argumento de Anselmo. Algumas das contradições e inconsistências que permeiam o raciocínio de Marion são expostas e criticadas. Como resultado, sustenta-se—contra Marion—que a ratio Anselmi indubitavelmente pressupõe o enquadramento metafísico do pensamento de Anselmo, tendo, portanto, uma dimensão ontológica (mesmo que não exatamente no sentido kantiano).
O FIDEÍSMO MÍSTICO DE DEMEA E SUA CRÍTICA AO ANTROPOMORFISMO NOS DIÁLOGOS DE HUME
Authors: Ferraz Marília Côrtes de
Published: August 2019

Hume, nos Diálogos sobre a religião natural, faz com que o persona­gem Demea defenda algumas teses que, a meu ver, podem ser formuladas do seguinte modo: i) a assimilação dos tradicionais atributos divinos depende de argumentos místico-religiosos, pois nossa razão, embora seja potente para pro­var a existência de Deus, não tem poderes para nos dizer qual a sua natureza; ii) o antropomorfismo implicado na tese de Cleanthes é inaceitável; e iii) a existência de Deus pode e deve ser demonstrada por um argumento formal ou prova a priori. Pretendo, neste artigo, examinar conjuntamente as duas primei­ras teses, uma vez que as entendo como teses solidárias, isto é, uma implica a outra. Defendo que o fideísmo místico (ou misticismo religioso) de Demea está circunscrito à sua concepção religiosa cristã e que seu compromisso mais forte em sua crítica ao argumento do desígnio é com a teologia racional subjacente à prova da existência de Deus. Para tanto, faço um exame dos argumentos que Demea oferece contra o antropomorfismo implicado no argumento do desígnio e suas relações com aquilo que chamei de fideísmo místico.
O PAPEL CONSTITUINTE DOS CONFLITOS EM MAQUIAVEL
Authors: Ames José Luiz
Published: August 2019

O objetivo deste estudo é apontar para a “atualidade” de Maquiavel relativamente à função dos conflitos sócio-políticos em cuja origem está o povo como potência constituinte. Procuraremos mostrar que este papel é descrito nos cinco primeiros capítulos do Livro I de Discursos em três momentos prin­cipais. Primeiro, o conflito aparece como única alternativa para a criação de um ordenamento institucional republicano ali onde não existe um sábio legislador (como Licurgo em Esparta) que ad um tratto realize esta obra. Em seguida, o conflito exerce um papel constituinte no surgimento da forma mista de governo da república romana através da relação de confronto/encontro entre grandes e povo. Finalmente, o conflito determina a dinâmica política em geral da vida republicana na medida em que Maquiavel atribui a ele o mérito de todas as medidas jurídico-políticas com as quais a república romana promoveu e con­servou a liberdade.
THE LEFTIST POLITICAL PARTIES IN LIGHT OF SIMONE WEIL’S CRITICISM: THE WORKERS’ PARTY CASE
Authors: Martins Alexandre Andrade
Published: August 2019

Given the socio-political context of Latin American countries and their leftist and center-leftist parties that had governed some countries since the beginning of the 2000’s, this essay will present Simone Weil’s anthropology of a rooted people towards social justice guided by a spirituality of supernatural justice. This anthropology supports her criticism of political parties that this essay will use to examine the Brazilian context and its Workers’ Party that gov­erned the country for over thirteen years and ended its tenure after a process of impeachment. Although Simone Weil seems to be pessimistic as to whether multiparty or monoparty political systems are able to promote and maintain a social order able to lead people to find their rootedness, she develops a critical anthropology that allows us to understand when a political party abandons its commitment to develop social policies for the poor and working class. Conse­quently, the political party assumes an agenda of maintaining power, no matter the means that must be used to achieve this goal.
Pricing to the Scenario: Price-Setting Newsvendor Models for Innovative Products
Authors: Ma Xiuyan
Published: August 2019

In this paper, we consider a manufacturer who produces and sells a kind of innovative product in the monopoly market environment. Because the life cycle of innovative product is usually shorter than its procurement lead time, one unique demand quantity (scenario) will occur in the selling season, thus there is only one chance for the manufacturer to determine both optimal production quantity and optimal sale price. Considering this one-time feature of such a decision problem, a price-setting newsvendor model for innovative products is proposed. Different to the existing price-setting newsvendor models, the proposed models determine the optimal production quantity and sale price based on some specific state (scenario) which is most applicable for the manufacturer. The theoretical analysis provides managerial insights into the manufacturers’ behaviors in a monopoly market of an innovative product and several phenomena in the luxury goods market are well explained.
Low heart rate variability predicts stroke and other complications in the first six postoperative months after a hip fracture operation.
Authors: Ernst Gernot , Watne Leiv Otto , Frihagen Frede , Wyller Torgeir Bruun , Dominik Andreas , Rostrup Morten
Published: August 2019

Background

1-year mortality after hip fractures is underestimated and is reported as 25%. An improved risk stratifying could contribute to a better follow up of these patients. Heart Rate Variability (HRV) is an easy point-of-care investigation and is used in cardiology, endocrinology and perioperative care. This observational study intended to explore relevant associations between HRV parameters and 6-months mortality and morbidity after a hip fracture.

Methods

165 patients admitted to two hospitals were included and short-time HRV measurements were obtained. Mortality data were gathered from the Norwegian central address register. Patients, close relatives of patients and in some cases their general physicians or nursery home physicians were interviewed six months postoperatively regarding the incidence of pneumonia, cardiac events or stroke.

Results

157 (95.2%) patients were followed up after six months. 21 (13%) died during this period. Twenty patients (13%) developed pneumonia, eight (5%) stroke and four (2%) myocardial infarction. No HRV parameter was associated with six-month general mortality. However, patients who developed stroke, had significantly lower High Frequency Power (HF, p< 0.001) and lower Very Low Frequency Power (VLF, p=0.003) at inclusion compared to patients without complications. Patients who developed pneumonia had at inclusion lower root mean square of successive differences (RMSSD, p = 0.044). Patients with a history of coronary heart disease (n = 41) showed a mortality of 7%. Mortality in this group was associated with the standard deviation of the NN intervals (SDNN, p = 0.006), Total Power (TP, p = 0.009), HF (p = 0.026), and Low Frequency Power (LF, p = 0.012). Beta-blocker intake was not associated with differences in HRV parameters.

Conclusions

We present for the first time significant associations between different preoperative HRV parameters and stroke, myocardial infarction and pneumonia during a 6-month period after hip fracture. HRV might be a simple and effective tool to identify patients at risk that would warrant better follow-up.
Systemic treatment of hormone receptor positive, human epidermal growth factor 2 negative metastatic breast cancer: retrospective analysis from Leeds Cancer Centre
Authors: Twelves Chris , Cheeseman Sue , Sopwith Will , Thompson Matthew , Riaz Majid , Ahat-Donker Necibe , Myland Melissa , Lee Adam , Przybysz Raymond , Turner Stuart , Hall Geoff , Perren Tim
Published: August 2019

BACKGROUND Study aimed to characterise treatment and outcomes for patients with hormone receptor positive (HR+), human epidermal growth factor 2 negative (HER2-) metastatic breast cancer (MBC) within a large regional cancer centre, as a benchmark for evaluating real-world impact of novel therapies.METHODS Retrospective longitudinal cohort, using electronic patient records of adult females with a first diagnosis of HR+/HER2- MBC January 2012 - March 2018.RESULTS 196 women were identified with HR+/HER2- MBC. Median age was 67 years, 85.2% were post-menopausal and median time between primary diagnosis and metastasis was 5.4 years. Most (75.1%) patients received endocrine therapy as first line systemic treatment (1st LoT); use of 1st LoT chemotherapy halved between 2012 and 2017. Patients receiving 1st LoT chemotherapy were younger and more likely to have visceral metastasis (p<0.01). Median OS was 29.5 months and significantly greater for patients with exclusively non-visceral metastasis (p<0.01). The adjusted hazard ratio for death of patients with visceral (or CNS) metastasis was 1.91 relative to those with exclusively non-visceral metastasis.CONCLUSIONS Diverse endocrine therapies predominate as 1st LoT for patients with HR+/HER2- MBC, chemotherapy being associated with more aggressive disease in younger patients, emphasising the importance of using effective and tolerable therapies early.
Impact of Cleft lip and Palate on Mother-to-Infant Bonding: a Cross-Sectional Study in the Japan Environment and Children's Study
Authors: Tsuchiya Shinobu , Tsuchiya Masahiro , Momma Haruki , Koseki Takeyoshi , Igarashi Kaoru , Nagatomi Ryoichi , Arima Takahiro , Yaegashi Nobuo
Published: August 2019

Background

Cleft lip and/or palate (CL/P) is among the most prevalent congenital birth defects. They negatively affect maternal psychological status and may consequently result in higher prevalence of child maltreatment. However, the association of CL/P births with bonding disorders still remains unclear. To address this question, we examined the impact of CL/P birth on mother-to-infant bonding, using the nationwide birth cohort study, Japan Environment and Children's Study.

Methods

This study was conducted as a nationwide birth cohort study of the Japan environment and children’s study (JECS), an ongoing nationwide birth cohort study in Japan. 104,065 of foetuses in fifteen regional centres in JECS were enrolled. Finally, the participants consisted of 79,140 mother-infant pairs, of which 211 mothers with CL/P infants were included in our analyses.

Results

First, no increased risk of bonding disorders was observed among all the mothers with CL/P births (odds ratio [95% CI]; 0.97 [0.63-1.48], p = 0.880), and advanced maternal age or multiple parity would adversely affect the associations between bonding disorders and CL/P births, respectively. Thus, after stratification with a combination of maternal age and parity, a significant association of CL/P birth with bonding disorders was found only among advanced-age multiparae (OR [95% CI] = 2.51 [1.17-5.37], p = 0.018), but it was weakened after additional adjustment for maternal depression.

Conclusion

CL/P birth may increase the risk of bonding disorders among advanced-age multiparae possibly through maternal depression. This finding provides valuable information for the provision of multidisciplinary cleft care.
Deep Placement of Nitrogen Fertilizer Affects Grain Yield, Nitrogen Recovery Efficiency, and Root Characteristics in Direct-seeded Rice
Authors: Chen Yunyan , Fan Pingshan , Tian Hua , Ashraf Umair , Mo Zhaowen , Duan Meiyang , Li Lin , Tang Xiangru , Pan Shenggang
Published: August 2019

Background

Deep placement of nitrogen (N) fertilizer has become one of the effective management practices for increasing crop yield and improving N recovery efficiency (NRE). However, the effects of N fertilization depth on direct-seeded rice are not well understood. The objective of this experiment was to evaluate the effects of N fertilization depth at four fertilization depths (0, 4, 8, and 12 cm, D0, D4, D8 and D12, respectively) with a conventional ammonium bicarbonate fertilizer (TN=17.7%) (150 kg N ha-1) and a control (no N fertilizer applied, CK) on grain yield, NRE and root characteristics of direct-seeded rice.

Results

The results indicated that both D8 and D12 increased grain yields by 72.91 and 81.84%, respectively, compared with CK. The main reason was ascribed to the increases of productive panicle and spikelet number. The highest nitrogen agronomic efficiency (NAE) and NRE were found under D12 treatment, which were increased by 165.42 and 129.45% compared to D0, respectively. We also found that deep placement of N fertilizer (both D8 and D12) could also promote rice root growth such as larger root length, root superficial area, and heavier root diameter, increase nitrate reductase (NR), glutamine synthetase (GOGAT), and glutamine synthetase (GS) activities at the heading stage.

Conclusions

The results show that 8 cm is relatively proper fertilizer placement depth when ammonia bicarbonate fertilizer is used in direct-seeded rice production because of requiring less mechanical power input.
HIV-free survival among breastfed infants born to HIV-positive women in post-conflict northern Uganda: a perspective from two tertiary health facilities
Authors: Nyeko Richard , Aguti Irene , Kimbugwe Charles , Apai Patricia , Munyaga Siraji
Published: August 2019

Background
Without interventions, the risk of mother-to-child transmission of HIV is up to 25% during pregnancy, labour and delivery with an additional risk of 5-20% during breastfeeding period, leading to an overall rate of up to 45%. Giving anti-retroviral therapy to the mother and anti-retroviral prophylaxis to the infant has been shown to significantly reduce the risk of HIV transmission through breastfeeding to less than 5%. According to the World Health Organization standard, the effectiveness of interventions towards prevention of mother-to-child transmission of HIV in any setting is measured by its HIV-free survival rate. We therefore carried out a study aimed at determining the HIV-free survival among breastfed infants in a resource poor setting in relation breastfeeding duration.
Methods
A cross-sectional retrospective study using routine clinical data and involving 365 HIV exposed infants followed up in two tertiary facilities in northern Uganda between 2014 and 2016. Data was analysed using Statistical Package for Social Scientists version 16 software package.
Results
Of the three hundred and sixty five (365) infants sampled for this study, 86.8% (317/365) were enrolled within the first 2 months of life, 12.1% (44/365) between 3-12 months of age and 1.1% (4/365) enrolled after 12 months of age. Almost all the infants (98.4%) were initiated on Nevirapine prophylaxis, 97.5% (356/365) of whom were initiated within 72 hours. The overall HIV-free survival rate in the current study was 93.7% (342/365), while 6.3% (23/365) were either HIV-infected (2.7%) or died (3.6%). The infants’ age at enrolment was the single most important factor significantly associated with HIV-free survival. The overall duration of breastfeeding did not significantly affect the HIV-free survival: 98.1% (304/310) for children breastfed > 12 months versus 100% (15/15) for those breastfed ≤12 months, though exclusive breastfeeding for at least 6 months was protective.
Conclusions
Adherence to current approaches to prevention of mother-to-child transmission of HIV with support to breastfeeding in low income countries can greatly enhance HIV-free survival for breastfed infants, and supports the current infant and young child feeding recommendations.
Key words: HIV-free survival, Mother-to-child transmission, Breastfeeding, Antiretroviral therapy
Proenkephalin A 119-159 (penKid) – a novel biomarker for acute kidney injury in sepsis: An observational study.
Authors: Rosenqvist Mari , Bronton Kevin , Hartmann Oliver , Bergmann Andreas , Struck Joachim , Melander Olle
Published: August 2019

Background Sepsis is a leading cause of death worldwide and a major challenge for physicians to predict and manage. Proenkephalin A 119-159 (penKid) is a reliable surrogate marker for the more unstable endogenous opioid peptide enkephalin, which has previously been shown to predict both acute and chronic kidney disease. The aim of this prospective observational study was to assess penKid as a predictor of acute kidney injury (AKI), multi-organ failure and mortality in sepsis among unselected sepsis patients presenting to the emergency department (ED).Method We measured penKid in 588 adult patients with sepsis (≥2SIRS criteria + suspected infection) upon admission to the ED at Skåne University Hospital, Malmö, Sweden. and used logistic regression to relate income levels of penKid to outcomes. Logistic regression models were used to derive odds ratios per 1-SD increment of log-transformed penKid to AKI, multi-organ failure, 28-day mortality as well as to progression of renal SOFA subscore (rSOFA) 0 or 1 to higher rSOFA.Results In age and sex adjusted models, penKid predicted AKI development within 48 hours and 7 days, however, these associations were attenuated after additional adjustment for estimated creatinine-based glomerular filtration rate (eGFR). In models adjusted for age, sex and eGFR, penKid significantly predicted progression from income rSOFA=0 and from rSOFA≤1 to higher rSOFA scores as well as multi-organ failure and mortality. In contrast, eGFR did not predict 28-day mortality.Conclusion PenKid is an effective predictor of renal injury, severe multi-organ failure and mortality in unselected sepsis patients presenting to the emergency department.
Investigation of novel biomarkers of drug-induced kidney injury in renal transplant recipients undergoing graft biopsy
Authors: Michon Arthur , Durrbach Antoine , Gautier Jean-Charles , Benain Xavier , Lunven Catherine , Jagerschmidt Alexandre , Aubert Catherine , Poetz Oliver , Joos Thomas , Gury Thierry , Becquemont Laurent
Published: August 2019

Urinary and blood kidney biomarkers (BM) remain insufficient to detect early kidney injury. Our aim was to compare new kidney BM with histopathological data in kidney allograft recipients.

Blood and urine samples of consecutive adult patients were collected just prior graft biopsy. All kidney samples were classified according to Banff 2007.
The diagnostic performance (area under ROC curve, AUROC) of 16 new BM was compared to those of urinary proteins, blood urea nitrogen, eGFR and serum creatinine to identify histopathological groups.

223 patients were analyzed. Versus slightly modified renal parenchyma (SMRP), microalbuminuria and urinary proteins had the highest diagnostic performance toward glomerular injury. Urinary neutrophil gelatinase associated lipocalin (NGAL) had the best performance values for acute tubular necrosis (ATN) versus SMRP (AUROC 0.93). Others BM reached slightly lower AUROC reaching 0.89. When comparing ATN to acute rejection several new urinary BM (NGAL, cystatin C, and MCP1) and classical BM (eGFR, serum creatinine) reached similar AUROC values ranging from 0.80 to 0.85. Values of urinary NGAL were 10-fold higher in ATN compared to acute rejection (p = 0.0004).

New BM did not outperform classical BM during renal transplantation. Urinary NGAL might be helpful to discriminate ATN and acute rejection.
The role of temporal changes in endometrial blood flow in natural and hormone replacement cycles with vitrified-warmed embryo transfer
Authors: Ota Kuniaki , Takahashi Toshifumi , Shiraishi Satoru , Mizunuma Hideki
Published: August 2019

Background Uterine blood flow promotes endometrial development and subsequent implantation of fertilized eggs. We examined the temporal changes in uterine blood flow during natural and hormone replacement (HRT) cycles and clarified the relationship between uterine blood flow and assisted reproductive technology outcomes for vitrified-warmed embryo transfer (ET). Methods This was a retrospective cohort study. A total of 60 patients with vitrified-warmed ET were assigned to two groups according to the endometrial preparation: natural cycle (28 patients) or HRT cycle (32 patients). The uterine endometrial blood flow was evaluated using measurements of the radial artery resistance index (RA-RI) during the early follicular phase, the days of the human chorionic gonadotropin (hCG) trigger during a natural cycle or the start of progesterone administration during the HRT cycle, and the day of ET. We statistically and longitudinally measured and evaluated the RA-RI values of all individual patients. Results During natural cycles, the RA-RI on the day of ET was significantly higher than that during the early follicular phase. During HRT cycles, the RA-RI on the day of ET was also significantly increased compared to that during the early follicular phase. We validated the efficacy of the RA-RI values for predicting the possibility of pregnancy with vitrified-warmed ET. During natural cycles, the area under the receiver-operating characteristic curves (AUCs) for the early follicular phase, the day of hCG trigger, and the day of ET were 0.75 (95% confidence interval [CI], 0.57–0.93), 0.69 (95% CI, 0.49–0.88), and 0.60 (95% CI, 0.36–0.84), respectively. During HRT cycles, AUCs for the early follicular phase, the day of starting progesterone administration, and the day of ET were 0.60 (95% CI, 0.40–0.81), 0.60 (95% CI, 0.39–0.87), and 0.58 (95% CI, 0.37–0.79), respectively. Conclusions The uterine RA-RI increased at approximately the time of the implantation window compared to that of the early follicular phase during both natural and HRT cycles with vitrified-warmed ET. Our findings suggest that RA-RI during the early follicular phase might be effective and useful for deciding whether to choose the natural or HRT cycle for vitrified-warmed ET.
Health professionals’ experiences of providing care for women survivors of sexual violence in psychiatric inpatient units.
Authors: O'Dwyer Carol , Tarzia Laura , Fernbacher Sabin , Hegarty Kelsey
Published: August 2019

Background Survivors of sexual violence commonly access mental health services. Psychiatric inpatient units in Australia are predominately mixed gender and may further retraumatise these women. Sexual violence is under-recognised by mental health professionals and there is a lack of adequate policy or direction for mental health service services. To date, only a small amount of research has focused on health professionals’ experiences of providing trauma-informed care to women in psychiatric settings, with most studies focused on specific practices or interventions. Qualitative data is particularly lacking on this topic. This is a critical gap in the knowledge given that health professionals are key to detecting and addressing victimisation. The aim of this study was to gain an in-depth understanding of healthcare professionals’ experiences and perceptions in providing care to women who are survivors of sexual violence in psychiatric inpatient units.Methods This qualitative study utilised semi-structured interviews with 40 health professionals recruited from four psychiatric inpatient units within a large Australian public mental health organisation. Data were examined using thematic analysis.Results Three main themes were developed to describe participants’ experiences of the care provided to women; 1) Dismissing and denying; 2) Acknowledging but unprepared; 3) Empathising but despairing. Discussion Gender, professional training, adherence to the biomedical model, and level of experience influenced health professionals’ experiences.Conclusions Health professionals in this study held varying attitudes towards female consumers and responses to sexual violence. Our findings suggest the need to address individual staff perception and promote trauma-informed and gender-sensitive care across all disciplines, genders, and levels of experience.
People living in residential aged care need to BE outside not just SEE outside: associations between quality of life and outdoor access: a cross-sectional study
Authors: Dyer Suzanne Marie , Liu Enwu , Gnanamanickam Emmanuel , Harrison Stephanie Louise , Milte Rachel , Crotty Maria
Published: August 2019

Background

The value of providing access to outdoor areas for people living in residential aged care, including those living with dementia, in terms of mood, behaviour and well-being is increasingly acknowledged. This study examines associations between provision of independent access to outdoor areas and frequency of residents going outdoors with the quality of life (QoL) of nursing home residents and compares use of outdoor areas between alternative models of residential aged care.

Methods

A cross-sectional study was conducted including 541 participants from 17 residential aged care homes in four states in Australia, mean age 85 years, 84% with cognitive impairment. Associations between having independent access to outdoors and the frequency of going outdoors and QoL (EQ-5D-5L) were examined using multi-level models. The odds of going outdoors in a small-scale home-like model of care compared to standard Australian models of care were examined.

Results

After adjustment for potential confounders (including comorbidities and facility level variables), living in an aged care home with independent access to the outdoors was not significantly associated with QoL (β=-0.01, 95% Confidence Interval (CI) -0.09 to 0.07, P=0.80). However, going outdoors daily (β=0.13 95%CI 0.06 to 0.21), but not multiple times a week (β=0.03, 95%CI -0.03 to 0.09), was associated with a better QoL. Residents living in a home-like model of care had greater odds of going outdoors daily (odds ratio 15.1, 95%CI 6.3 to 36.2).

Conclusions

Going outdoors frequently is associated with higher QoL for residents of aged care homes and residents are more likely to get outside daily if they live in a small-scale home-like model of care. However, provision of independent access to outdoor areas alone may be insufficient to achieve these benefits. Increased availability of models of residential aged care with staffing structures, training and design which increases support for residents to venture outdoors frequently is needed to maximise resident quality of life.
Nurse-Patient Interaction and Self-Transcendence: Assets for a Meaningful Life in Nursing Home Residents?
Authors: Haugan Gørill , Kuven Britt Moene , Eide Wenche Mjanger , Tåsen Siw Eriksen , Rinnan Eva , Wu Vivien Xi , Drageset Jorunn , André Beate
Published: August 2019

Background.
Today, we face a shift to an older population worldwide and its consequences; a noteworthy part of older adults will need 24-hours nursing home care at the end of life. Finding new and alternative approaches to increase wellbeing among nursing home residents is highly warranted. Knowledge about nurse-patient-interaction, self-transcendence and meaning-in-life seems vital in order to guide clinical practice in how to best and efficiently boost wellbeing among older adults in nursing homes.

Methods
In a cross-sectional design, 188 (92% response rate) out of 204 long-term NH patients representing 27 NHs responded to the nurse-patient interaction, self-transcendence, and the purpose-and-meaning-in-life scales. Inclusion criteria were: (1) municipality authority’s decision of long-term NH care; (2) residential time three months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed. The hypothesized relations (five hypotheses) between the latent constructs were tested by means of structural equation modelling (SEM) using Stata 15.1.

Results
The SEM-model yielded a good fit (χ2=146.824, p=0.021, df=114, χ2 /df=1.29 RMSEA=0.040, p-close 0.811, CFI=0.97, TLI=0.96, and SRMR=0.063), showing significant relationships between the constructs of nurse-patient interaction, inter- and intra-personal self-transcendence and meaning-in-life. Nurse-patient interaction significantly relates with both inter- and intra-personal self-transcendence and meaning in NH patients. Self-transcendence revealed a fundamental influence on perceived meaning, while nurse-patient interaction demonstrated a significant influence on meaning, mediated by self-transcendence

Conclusion
According to the rapidly growing number of people over 65 in the world, and the growing segment of people 80-100, the present results are significant in their suggestions that nurse-patient-interaction is a crucial resource in relation to nursing home residents’ wellbeing. Knowledge of how nurse-patient-interaction, self-transcendence and meaning relate to each other among older adults in NHs is important for researchers, nurses, caregivers, nursing educators, and clinicians. Health professionals in nursing homes should learn how to competently use the nurse-patient interaction as a health promoting asset for self-transcendence, meaning and thus well-being. Nursing home nurses should be given more time for interacting with the residents, continuity and mutuality in nurse-patient relationships should be prioritized and facilitated.
A Meta-analysis for Major Complications Between Traditional Pacemaker and Leadless Pacemaker
Authors: Cui Diyu , Chen Xiaorui , Wang Lin , Liao Yimeng , He Huan , Chen Yunqing
Published: August 2019

Objectives To compare the major complications between leadless pacemaker (LP) and traditional pacemakers(TP).Background The TP shows some advantages in avoiding pocket- and lead-related complications over the TP and is increasingly used in clinical practice. However, the clinical effect of LP remains controversial.Methods PUBMED、EMBASE、The COCHRANE LIBRARY、CNKI and WANGFANG databases were searched from July 2013 to August 2018. Data concerning the study’s design, patients’ characteristics and outcomes were extracted. The primary end-point is the major complications. The second end-points are elevated pacing threshold, cardiac perforation/effusion, device dislodgement and vascular events.Results A total of 6 studies fulfilled the inclusion criteria. Only 4 of which can provide the data of major complications. The main complications of LP were statistically significantly decreased compared with that of TP(OR 0.41,95%CI:0.29-0.56,P<0.00001,I2=42%).We extracted the data of elevated pacing threshold, cardiac perforation/effusion, device dislodgement and vascular events in 4 other of these 6 studies. There was no significant difference in elevated pacing threshold (OR 0.95, 95%CI:0.24-3.70,P=0.94, I2=31%), cardiac perforation/effusion(OR 1.78,95%CI:0.33-9.58, P=0.50,I2=87%), vascular events (OR1.58, 95%CI:0.45-5.53, P=0.47,I2=47%) and device dislodgement(OR 0.22,95%CI:0.01-5.69,P=0.36,I2=81%) between LP and TP.Conclusion Compared with TP, LP showed a significantly decreased risk in major complications. This indicates that LP has a good prospect to be applicated in clinical practice.