bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of multimorbidity in community settings: A systematic review and meta-analysis of observational studies
Authors: Nguyen Hai , Manolova Gergana , Daskalopoulou Christina , Vitoratou Silia , Prince Martin , Prina A Matthew
Published: August 2019

Background:

With ageing world populations, multimorbidity (presence of two or more chronic diseases in the same individual) becomes a major concern in public health. Although multimorbidity is associated with age, its prevalence varies. This systematic review aimed to summarise and meta-analyse the prevalence of multimorbidity in high, low- and middle-income countries (HICs and LMICs).

Methods:

Studies were identified by searching electronic databases (Medline, Embase, PsycINFO, Global Health, Web of Science and Cochrane Library). The term ‘multimorbidity’ and its various spellings were used, alongside ‘prevalence’ or ‘epidemiology’. Quality assessment employed the Newcastle-Ottawa scale. Overall and stratified analyses according to multimorbidity operational definitions, HICs/LMICs status, gender and age were performed. A random-effects model for meta-analysis was used.

Results:

Seventy community-based studies (conducted in 18 HICs and 31 LMICs) were included in the final sample. Sample sizes ranged from 264 to 162,464. The overall pooled prevalence of multimorbidity was 33.1% (95% confidence interval (CI): 30.0–36.3%). There was a considerable difference in the pooled estimates between HICs and LMICs, with prevalence being 37.9% (95% CI: 32.5–43.4%) and 29.7% (26.4–33.0%), respectively. Heterogeneity across studies was high for both overall and stratified analyses ( I 2 > 99%). A sensitivity analysis showed that none of the reviewed studies skewed the overall pooled estimates.

Conclusion:

A large proportion of the global population, especially those aged 65+, is affected by multimorbidity. To allow accurate estimations of disease burden, and effective disease management and resources distribution, a standardised operationalisation of multimorbidity is needed.
Adrenal Incidentaloma: Challenges in Diagnosing Adrenal Myelolipoma
Authors: Adapa Sreedhar , Naramala Srikanth , Gayam Vijay , Gavini Frank , Dhingra Hemant , Hazard Florette Kimberly Gray , Aeddula Narothama Reddy , Konala Venu Madhav
Published: August 2019

Adrenal myelolipomas (AMLs) are rare benign adrenal tumors, containing adipose and hematopoietic tissue, a result of reticuloendothelial cell metaplasia. Incidence on autopsy has been reported from 0.08% to 0.4%. AMLs are generally considered nonsecretory. The functional aspect of adrenal incidentaloma should be evaluated. In this article, we report a case of a 40-year-old male, who presented with uncontrolled hypertension and renal failure, with imaging revealing an adrenal incidentaloma. He was started on dialysis for acute fluid overload, and workup for pheochromocytoma revealed an elevated serum norepinephrine level of 1181 pg/mL. Free metanephrine and normetanephrine levels were low when checked pre- and post-dialysis. Complete resection of the encapsulated right adrenal mass was performed. Pathology of the adrenal tumor demonstrates an 11.5 × 9.5 × 7.5 cm well-circumscribed, partially encapsulated proliferation of mature adipose tissue with admixed hemopoietic elements consistent with myelolipoma weighing 29.3 g. This case highlights the inclusion of a full metabolic workup for all adrenal incidentalomas, including AML.
The Effect of Physician Oral Health Services on Dental Use and Expenditures under General Anesthesia
Authors: Meyer B.D. , Wang R. , Steiner M.J. , Preisser J.S.
Published: August 2019

Background:

Despite early evidence touting the effectiveness of physician-provided oral health services (POHS), recent evidence suggests these services might have little impact on caries-related outcomes in children. General anesthesia (GA) is often used to treat early childhood caries and may be considered the most extreme utilization outcome. We sought to assess the impact of POHS utilization on dental GA utilization and expenditures.

Methods:

We used the Medicaid claims of a birth cohort of children born in 2008 in North Carolina ( N = 32,558) to determine the impact of POHS on dental utilization and expenditures under GA for individual children. Children were followed until their eighth birthday. We analyzed the association of the number of prior POHS visits with visit-specific outcomes of dental treatment under GA using population-averaged models fit with generalized estimating equations with exchangeable working correlation structure.

Results:

Children with 2 or more previous POHS visits had reduced odds of GA (odds ratio [OR] = 0.93; confidence interval [CI], 0.87–0.99; P = 0.029) and expenditures ($114; CI,−$152.61 to −$75.19; P < 0.001) compared to those without physician-provided oral health visits, adjusting for age, sex, race/ethnicity, and geographic residence. Dental expenditures did not differ between POHS and non-POHS subjects at non-GA visits.

Conclusions:

POHS decreased the odds of having dental GA treatment and dental expenditures at GA visits. The role of physicians in oral health care can reduce the impact on the most severe outcome—treatment under general anesthesia.

Knowledge Transfer Statement:

The results of this study have important financial implications for state Medicaid programs and disease management programs trying to mitigate the costs of treating early childhood caries under general anesthesia. Children who receive physician oral health care are less likely to use and more likely to save money on general anesthesia to complete dental treatment.
Late Presentation of a Retained Stingray Spine in the Plantar Medial Hindfoot
Authors: Falk David P. , Metikala Sreenivasulu , Lopez Viviana Serra , Stein Matthew , Mahmoud Karim , Chao Wen
Published: August 2019

In the United States, approximately 2000 stingray injuries occur annually. The majority of reports on stingray injuries to the foot and ankle reflect acute injuries. Delayed presentation after stingray injury to the foot and ankle has not been reported. We present a case of a 29-year-old female who sustained a stingray injury to the left plantar medial hindfoot 14 months prior to presenting to our clinic with new-onset posteromedial ankle redness and swelling along the tarsal tunnel. Magnetic resonance imaging (MRI) revealed multiple linear foreign bodies at the quadratus plantae and tarsal tunnel. The patient underwent operative exploration with removal of multiple retained stingray spines. At her most recent follow-up at 3 months, she was able to resume her usual activities.

Level of Evidence:

Level V, case report.
Microvascular endothelial function and primary open angle glaucoma
Authors: Mudassar Imran Bukhari Syed , Yew Kiu Kwong , Thambiraja Rajasunthari , Sulong Sarina , Ghulam Rasool Aida Hanum , Ahmad Tajudin Liza-Sharmini
Published: August 2019

Purpose:

To determine the role of microvascular endothelial dysfunction as risk factor for primary open angle glaucoma.

Methods:

A cross-sectional study was conducted involving 114 Malay patients with POAG seen at the eye clinic of Hospital Universiti Sains Malaysia. Patients aged between 40 and 80 years who were diagnosed with other types of glaucoma, previous glaucoma filtering surgery or other surgeries except uncomplicated cataract surgery and pterygium surgery were excluded. A total of 101 patients who were followed up for dry eyes, age-related cataracts or post cataracts extraction surgery were recruited as control subjects. Those with family history of glaucoma or glaucoma suspect were excluded. Microvascular endothelial function was assessed using laser Doppler fluximetry and the process of iontophoresis. Iontophoresis with acetylcholine (ACh) and sodium nitroprusside (SNP) was used to measure microvascular endothelium-dependent and endothelium-independent vasodilatations, respectively.

Results:

In general, POAG patients demonstrated lower ACh% and AChmax values compared with controls. There was significant difference in microvascular endothelial function [ACh%: mean, 95% confidence interval = 503.1 (378.0, 628.3), and AChmax: mean, 95% confidence interval = 36.8 (30.2, 43.5)] between primary open angle glaucoma cases ( p < 0.001) and controls [ACh%: mean, 95% confidence interval = 1378.4 (1245.4, 1511.3), and AChmax: mean, 95% confidence interval = 79.2 (72.1, 86.2)]; this difference remained significant even after controlling for potential confounders. Similar difference was also found in SNP% and SNPmax between POAG and controls ( p < 0.001). Age and diastolic blood pressure were inversely correlated with microvascular endothelial function.

Conclusion:

There was an impairment of microvascular endothelial function and endothelial-independent vasodilatation in POAG patients. Microvascular endothelial function is a potential risk factor for POAG.
Hippo kinase loss contributes to del(20q) hematologic malignancies through chronic innate immune activation
Authors: Stoner Samuel A. , Yan Ming , Liu Katherine Tin Heng , Arimoto Kei-Ichiro , Shima Takahiro , Wang Huan-You , Johnson Daniel T. , Bejar Rafael , Jamieson Catriona , Guan Kun-Liang , Zhang Dong-Er
Published: August 2019

Deletions of chromosome 20q are frequent abnormalities in myelodysplastic syndrome (MDS) and myeloproliferative neoplasms. Stoner et al identify STK4, which encodes Hippo kinase MST1, as the candidate gene from the deleted region that, when deleted, promotes features of MDS and induces myelofibrosis in the presence of JAK2V617F through modulation of inflammatory pathways.
Tissue factor pathway inhibitor primes monocytes for antiphospholipid antibody-induced thrombosis
Authors: Müller-Calleja Nadine , Hollerbach Anne , Ritter Svenja , Pedrosa Denise G. , Strand Dennis , Graf Claudine , Reinhardt Christoph , Strand Susanne , Poncelet Philippe , Griffin John H. , Lackner Karl J. , Ruf Wolfram
Published: August 2019

Antiphospholipid antibody syndrome is caused by antiphospholipid antibodies (aPLs) that cause thrombosis and pregnancy loss. In a Plenary Paper, Müller-Calleja et al dissect the complex and multifaceted mechanism by which aPLs induce thrombosis through priming of monocytes and disruption of the balance of tissue factor activation and inhibition.
Radiographic lung volumes predict progression to COPD in smokers with preserved spirometry in SPIROMICS
Authors: Arjomandi Mehrdad , Zeng Siyang , Barjaktarevic Igor , Barr R. Graham , Bleecker Eugene R. , Bowler Russell P. , Buhr Russell G. , Criner Gerard J. , Comellas Alejandro P. , Cooper Christopher B. , Couper David J. , Curtis Jeffrey L. , Dransfield Mark T. , Han MeiLan K. , Hansel Nadia N. , Hoffman Eric A. , Kaner Robert J. , Kanner Richard E. , Krishnan Jerry A. , Paine Robert , Peters Stephen P. , Rennard Stephen I. , Woodruff Prescott G.
Published: August 2019

The characteristics that predict progression to overt chronic obstructive pulmonary disease (COPD) in smokers without spirometric airflow obstruction are not clearly defined.

We conducted apost hocanalysis of 849 current and former smokers (≥20 pack–years) with preserved spirometry from the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) cohort who had baseline computed tomography (CT) scans of lungs and serial spirometry. We examined whether CT-derived lung volumes representing air trapping could predict adverse respiratory outcomes and more rapid decline in spirometry to overt COPD using mixed-effect linear modelling.

Among these subjects with normal forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio, CT-measured residual volume (RVCT) to total lung capacity (TLCCT) ratio varied widely, from 21% to 59%. Over 2.5±0.7 years of follow-up, subjects with higher RVCT/TLCCThad a greater differential rate of decline in FEV1/FVC; those in the upper RVCT/TLCCTtertile had a 0.66% (95% CI 0.06%–1.27%) faster rate of decline per year compared with those in the lower tertile (p=0.015) regardless of demographics, baseline spirometry, respiratory symptoms score, smoking status (formerversuscurrent) or smoking burden (pack–years). Accordingly, subjects with higher RVCT/TLCCTwere more likely to develop spirometric COPD (OR 5.7 (95% CI 2.4–13.2) in upperversuslower RVCT/TLCCTtertile; p<0.001). Other CT indices of air trapping showed similar patterns of association with lung function decline; however, when all CT indices of air trapping, emphysema, and airway disease were included in the same model, only RVCT/TLCCTretained its significance.

Increased air trapping based on radiographic lung volumes predicts accelerated spirometry decline and progression to COPD in smokers without obstruction.
Brain ectopic tissue in sacrococcygeal region of a child, clinically mimicking sacrococcygeal teratoma: a case report
Authors: Saadaat Ramin , Abdul-Ghafar Jamshid , Nasir Ahmed , Rahmani Soma , Hamidi Hidayatullah
Published: August 2019

Background

Mature brain heterotopic tissue in sacrococcygeal region is a very rare benign congenital abnormality of newborn. To date, only two cases of mature heterotopic brain tissue in the sacrococcygeal region is reported by literature. Heterotopic brain tissue in other areas such as lung, nose, face and retroperitoneal region are also rarely reported. Meanwhile, rather than brain heterotopic tissue in sacrococcygeal region, a case of adrenal gland heterotopic tissue in sacrococcygeal region also has been reported.

Case presentation

A 3.5 month-old male baby presented with history of sacrococcygeal mass since birth. Clinical examination of the child was good with no other problem. Sacrococcygeal region revealed an elevated round mass with no discharge. Computed tomography reported a large sacrococcygeal teratoma type-III arising from the sacrococcygeal region extending intra-abdominally to the level of L2 vertebral body. The mass was excised by the impression of sacrococcygeal teratoma (SCT). On gross examination, a gray-white irregular tissue fragment with 5 cm in greatest dimension was examined. Cut sections showed homogenous yellowish white appearance. Histological examination revealed solid fragments composed of mature neural tissue comprising glial cells and astrocytes with no other germ cell layer component.

Conclusion

Mature brain heterotopic tissue in sacrococcygeal area is a rare benign disease. Two ectopic brain tissue in sacrococcygeal region were previously also reported. Sacrococcygeal teratoma is the most common congenital tumor, but this current rare case of heterotopic brain tissue in sacrococcygeal region should also be in the differential diagnosis.
Magnetic Resonance Imaging (MRI) reveals high cardiac ejection fractions in red-footed tortoises (Chelonoidis carbonarius)
Authors: Williams Catherine J. A. , Greunz Eva M. , Ringgaard Steffen , Hansen Kasper , Bertelsen Mads F. , Wang Tobias
Published: August 2019

The ejection fraction of the trabeculated cardiac ventricle of reptiles has not previously been measured. Here we use the gold standard clinical methodology – electrocardiogram (ECG) gated flow magnetic resonance imaging (MRI) – to validate stroke volume measurements and end diastolic ventricular blood volumes. This produces an estimate of ejection fraction in the red footed tortoise Chelonoidis carbonaria (n=5) under isoflurane anaesthesia of 88±11%. After elimination of the prevailing right-to-left intraventricular shunt through the action of atropine, the ejection fraction was 96±6%. This methodology opens new avenues for studying the complex hearts of ectotherms, and validating hypotheses on the function of a more highly trabeculated heart than that of endotherms which possess lower ejection fractions.
Structures and Electronic Properties of Diisopropylaminoborane Substituted with Highly Electron-Rich π-Conjugated Systems and Their Oxidized States
Authors: Yoshida Kohei , Suzuki Shuichi , Kozaki Masatoshi , Okada Keiji
Published: August 2019

We have designed and synthesized three kinds of diisopropylaminoboranes substituted with two electron-donating π-conjugated systems, 2a: bis(phenothiazinyl) 2b: bis(N-phenyldihydrophenazinyl), and 2c: bis(phenoxazinyl) derivatives, and investigated their structures and electronic properties including those of oxidized species. The structural analyses of 2a–c and 2a–c•+ indicated that the π-electronic systems composed of boron and three nitrogen atoms showed unique structural deformation by one-electron-oxidation. The structures of the neutral compounds were almost C2-symmetrical, indicating that the two donor π-electronic systems are almost identical. In contrast, the radical cationic compounds were not C2-symmetrical structures because the charges of the radical cations were localized on one of the electron donors. In addition, the B–N bonds directly bound to the radical cations were elongated; also, perpendicular arrangements between the p-orbital of boron and π-conjugated orbitals of the radical cations were observed. We also succeeded in observing the triplet state of 2b2(•+), which was categorized as a heteroatom analogue of the trimethylenemethane (TMM) π-electronic system, by means of electron-spin resonance (ESR) spectroscopy.
Activity Mapping of Children in Play Using Multivariate Analysis of Movement Events
Authors: ROCHA JOANA N. , BARNES CLAIRE M. , REES PAUL , CLARK CAIN T. , STRATTON GARETH , SUMMERS HUW D.
Published: August 2019

Purpose

(i) To develop an automated measurement technique for the assessment of both the form and intensity of physical activity undertaken by children during play. (ii) To profile the varying activity across a cohort of children using a multivariate analysis of their movement patterns.

Methods

Ankle-worn accelerometers were used to record 40 min of activity during a school recess, for 24 children over five consecutive days. Activity events of 1.1 s duration were identified within the acceleration time trace and compared with a reference motif, consisting of a single walking stride acceleration trace, obtained on a treadmill operating at a speed of 4 km h−1. Dynamic time warping of motif and activity events provided metrics of comparative movement duration and intensity, which formed the data set for multivariate mapping of the cohort activity using a principal component analysis (PCA).

Results

The two-dimensional PCA plot provided clear differentiation of children displaying diverse activity profiles and clustering of those with similar movement patterns. The first component of the PCA correlated to the integrated intensity of movement over the 40-min period, whereas the second component informed on the temporal phasing of activity.

Conclusions

By defining movement events and then quantifying them by reference to a motion-standard, meaningful assessment of highly varied activity within free play can be obtained. This allows detailed profiling of individual children’s activity and provides an insight on social aspects of play through identification of matched activity time profiles for children participating in conjoined play.
DIRITTI FONDAMENTALI E DIRITTI UMANI: IL CONTRIBUTO DELLA TEORIA DEI SISTEMI SOCIALI. PROSPETTIVE DI INDAGINE
Authors: Lima Fernando Rister de Sousa , Finco Matteo
Published: August 2019

Il presente articolo analizza la natura e la funzione dei diritti fondamentali e umani dalla prospettiva della teoria dei sistemi sociali, sviluppata dal sociologo Niklas Luhmann alla fi ne del XX secolo. A partire dal contributo dell’autore tedesco e di altri studiosi, verrà messo in evidenza il potenziale che la teoria detiene riguardo al tema in oggetto, avanzando proposte su prospettive di ricerca future. L’ipotesi è che una teoria secondo cui la società è fatta di comunicazione, e non di esseri umani, può aprire spazi di riflessione inediti e mettere il luce la funzione latente dei diritti fondamentali e umani: oltre che valori di ispirazione umanistica, essi rappresenterebbero lo strumento attraverso cui la società stessa costituisce gli esseri umani nella triplice veste di individui, soggetti, persone.
RELAÇÕES LABORAIS E LIMITES JURÍDICOS AO ACESSO E USO DAS INFORMAÇÕES GENÉTICAS DO EMPREGADO
Authors: Araújo Ana Thereza Meirelles , Pessanha Vanessa Vieira
Published: August 2019

Artigo destinado à análise dos limites jurídicos conformadores do uso da informação genética no âmbito das relações laborais. Como premissa, partiu-se de uma análise panorâmica sobre o acesso e o uso da informação contida no DNA conforme os padrões atuais da Ciência, considerando os pretensos benefícios e os riscos agregados. Como objetivo central da pesquisa, buscou-se identifi car as balizas previstas na legislação em vigor que fundamentam a necessidade de contingenciar o uso da informação genética pelo empregador nas relações pré-contratuais, contratuais e pós-contratuais de trabalho. O estudo em voga tem como justificativa a necessidade de sopesar adequadamente a proteção ao trabalhador em condição de vulnerabilidade face à possibilidade de que sua informação genética possa ser arbitrariamente acessada e utilizada, culminando na violação de conteúdos constitucionalmente fundamentais como a igualdade e a intimidade. Optou-se pela perspectiva metodológica hipotético-dedutiva, tendo em vista adequar-se melhor ao objetivo apontado, a partir da construção de pesquisa de natureza bibliográfica.
Role of scalp hypothermia in patients undergoing minimally invasive evacuation of hypertensive cerebral hemorrhage
Authors: Zhang Yueling , Song Ling , Zhao Jianfen
Published: August 2019

Objective: Hypertensive intracerebral hemorrhage (HICH) is one of the common multiple diseases in neurology. Patients with severe HICH have high risk of disability and poor prognosis.

Methods: In order to explore the clinical effect of mild hypothermia combined with micro-traumatic evacuation of cerebral hemorrhage in the treatment of severe HICH, 136 patients with severe HICH were selected and divided into control group and study group using random number table method, 68 each group. The control group was treated with micro-traumatic evacuation of cerebral hemorrhage on the basis of conventional symptomatic treatment, while the study group was treated with mild hypothermia combined with micro-traumatic evacuation of cerebral hemorrhage on the basis of conventional symptomatic treatment. After treatment, the two groups were followed up for eight weeks.

Results: The overall effective rate, residual hematoma volume, rebleeding rate, National Institute of Health stroke scale (NIHSS) score, Barthel index score and incidence of adverse reactions after treatment were observed and compared. The overall effective rate of the study group was 89.7%, which was significantly higher than that of the control group (67.6%). The mortality rate of the study group was 3.0%, which was significantly lower than that of the control group (14.7%, P<0.05). The residual hematoma volume and rebleeding rate of the study group were significantly lower than those of the control group (P<0.05). Before treatment, the NIHSS score and Barthel index score of the two groups had no significant differences (P>0.05). After treatment, they were improved, and the improvement of the study group was more significant (P<0.05). The incidence of adverse reactions in the study group was 10.0%, which was significantly lower than that in the control group (36.0%, P<0.05).

Conclusion: Mild hypothermia in combination with micro-traumatic evacuation of cerebral hemorrhage has significant clinical effect in the treatment of severe HICH. It can significantly improve neurological function and quality of life, causing few adverse reactions. Its clinical application value is high.

doi: https://doi.org/10.12669/pjms.35.5.593

How to cite this:Zhang Y, Song L, Zhao J. Role of scalp hypothermia in patients undergoing minimally invasive evacuation of hypertensive cerebral hemorrhage. Pak J Med Sci. 2019;35(5):1451-1455. doi: https://doi.org/10.12669/pjms.35.5.593

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Recent advances in understanding and managing Paget’s disease
Authors: Reid Ian R
Published: August 2019

Paget’s disease is a condition which continues to challenge and surprise. The dramatic fall in its incidence over the last three decades has been an enormous surprise, as is the capacity of a single infusion of the potent bisphosphonate, zoledronate, to produce biochemical remission in 90% of patients, remissions which usually persist for many years and raise the possibility of a cure in some patients. However, challenges in its management remain. The trials carried out in Paget’s disease have almost always had biochemical indices as their primary endpoints. From these studies, we also know that bone pain is relieved, quality of life improved, bone histology normalised, and radiological lesions healed. Thus, disease progression is halted. Studies have not been powered to assess whether clinically important endpoints such as fracture and the need for joint replacement surgery are diminished, although these complications are well established as part of the natural history of the condition. Since disease progression is prevented by potent bisphosphonates, it is likely that disease complications will also be prevented. Zoledronate also reduces the frequency of follow-up needed and therefore provides a very cost-effective intervention in those who have symptomatic disease or are at risk of complications.
Stage 1 Registered Report: How subtle linguistic cues prevent unethical behaviors
Authors: Guo Wen , Liu Huanxu , Yang Jingwen , Mo Yuqi , Zhong Can , Yamada Yuki
Published: August 2019

Different ways of description can easily influence people’s evaluation and behaviors. A previous study suggested that subtle linguistic differences in ethical reminder instructions can cause differences in preventing readers’ unethical behavior. The present study aims to replicate the previous finding by Bryan and his colleagues (2013) in the Japanese context, additionally exploring the influence of unfamiliar instructions that capture participants’ attention. In two experiments, which are planned to be conducted online, participants are asked to make 10 coin-tosses and report the number of “heads,” indicating the amount of money that could be earned. We will manipulate instructions (“Don’t cheat” vs. “Don’t be a cheater” vs. no instruction as a control) for each participant group including nearly 270 participants (Experiment 1). Next, we will conduct an extended experiment with an additional task in which more attention is directed toward the text (Experiment 2). Through these registered experiments, we examine the credibility of the previous finding that type of instruction affects the occurrence of unethical behaviors.
The Imagination of Criminals in Victorian London in Strange Case of Dr. Jekyll and Mr. Hyde
Authors: Wong Hiu Wai
Published: August 2019

In this article I write about the split of London described in Strange Case of Dr. Jekyll and Mr. Hyde. Dr. Jekyll, decent and belonging to the middle class, fail s to resist the transformation into Mr. Hyde, gross and belonging to the lower class. It represents the fear of the West Enders, who thought that the East Enders were uncivilized and threatening. In order to rationalize their fear, the West Enders imagined the East Enders as criminals, which corresponds to Edward Said’s discussion of Orientalism. In Orientalism, Said discusses how the West represents the Orient as the Other, and produces the category of the Orient grounded on a geographical framework of thinking. In much the same way, the story of Jekyll and Hyde demonstrates a narrative construction of the lower class living in the East End London as criminals. The influence of Cesare Lombroso’s theory of criminology present in the story serves as important evidence of the West Enders’ imagination. In Criminal Man (1876), Lombroso investigates the atavistic criminal, which illustrates the middle-class imagination of the body of the East Enders. Establishing the notion of atavism, Lombroso belittles the lower class by criticizing them as the demonstration of “regression to an earlier stage of evolution.” Examining the details of the geographical demarcation portrayed in the story, this paper hopes to elucidate the cultural imagination of criminals in Victorian London.
Correlates of respiratory admissions frequency in patients with obstructive lung diseases: coping styles, personality and anxiety
Authors: Tabała Klaudia , Wrzesińska Magdalena , Stecz Patryk , Mąkosa Grzegorz , Kocur Józef
Published: August 2019

Cel pracy

Astma oskrzelowa (AO) i przewlekła obturacyjna choroba płuc (POChP) są związane z ogromnym obciążeniem finansowym dla budżetu oraz opieki zdrowotnej na świecie. Cechy osobowości, preferowane sposoby radzenia sobie ze stresem oraz poziom lęku wpływają na funkcjonowanie ludzi chorych. Celem badania była ocena związku pomiędzy tymi zmiennymi a częstością pobytów w szpitalu i wizyt w poradni specjalistycznej u chorych z przewlekłymi chorobami układu oddechowego.

Metoda

Sto osób chorujących na astmę oskrzelową i POChP zostało przebadanych testami psychologicznymi: Inwentarzem Osobowości NEO-FFI, Inwentarzem Stanu i Cechy Lęku (STAI), Inwentarzem do Pomiaru Radzenia Sobie ze Stresem Mini-COPE. Została także wykorzystana ankieta socjodemograficzna.

Wyniki

Wykazano zależność pomiędzy częstością wizyt w szpitalu a neurotycznością (korelacja pozytywna). Liczba wizyt w poradni korelowała dodatnio z poziomem sumienności, korzystaniem ze wsparcia emocjonalnego oraz ujemnie z zaprzestawaniem działań.

Wnioski

Uzyskane wyniki mogą wskazywać na potrzebę objęcia osób z chorobami układu oddechowego działaniami psychoterapeutycznymi służącymi budowaniu bardziej konstruktywnemu funkcjonowaniu, zmniejszeniu niepokoju, zwiększaniu poczucia kontroli.
Upper airway tract complications of endotracheal intubation
Authors: Tikka Theofano , Hilmi Omar J
Published: August 2019

The gold standard in airway maintenance is translaryngeal endotracheal intubation, but this is not without its complications. Trauma to the upper airway as a result of the act of endotracheal intubation is a common event in adults undergoing procedures under general anaesthesia. Sites requiring attention during intubation include the laryngeal apparatus, the pharynx and oral cavity as well as the nasal cavity when nasopharyngeal intubation is performed. Patients can present with a range of symptoms which can make assessment and management challenging. Dysphonia, throat pain and dysphagia are the commonest presenting complaints. Patient-related factors, intubation technique and other anaesthetic-related conditions can be a cause of trauma, if not adequately considered before intubation. All patients should be carefully examined preoperatively and their past medical history obtained. Patient demographics, comorbidities, existing airway pathology and presence of reflux should be noted. Trauma prevention strategies should be in place to eliminate avoidable complications. Potential difficult airway cases should be flagged up and adequately prepared for, in anticipation of intubation difficulties that can lead to trauma. The majority of injuries will resolve spontaneously with conservative management. Persistent symptomatology, usually secondary to laryngeal injuries, requires prompt referral to an ear nose and throat specialist with an interest in laryngology for further assessment and treatment.
Central venous access
Authors: Lockwood Joel , Desai Neel
Published: August 2019

Central venous catheterization is the placement of a catheter in such a manner that its tip is positioned within the proximal third of the superior vena cava, the right atrium or the inferior vena cava. It is indicated when access for administration of drugs or extracorporeal blood circuits and haemodynamic monitoring or interventions is needed. When inserting a central venous catheter, appropriate preparation and asepsis, positioning of the patient, and the use of ultrasound should be considered. Compared to the landmark method of localization, ultrasound can account for anatomical variations, facilitate visualization of venous puncture, and safeguard against inadvertent arterial puncture. In the Seldinger technique, which is the primary mode of central venous catheterization, a needle is passed towards the chosen vessel. Once the needle is in the vein, a guidewire is introduced through the needle into the vessel and the needle is removed. Following a small skin incision at the base of the guidewire, a dilator is advanced over the guidewire and then taken out. Subsequent to this, the central venous catheter is railroaded over the guidewire into the vein and the guidewire is withdrawn. Complications of central venous catheterization can be mechanical, infectious or thrombotic.
The holistic management of fatigue within palliative care
Authors: Dean Antonia
Published: August 2019

Background:

Fatigue is a common symptom experienced by people with cancer and other long-term, non-malignant conditions. It can be disease-related or caused by treatments such as chemotherapy or radiotherapy. Patients frequently report this as a distressing symptom and, while some international guidelines for its management exist, evidence suggests that these are not always implemented.

Method:

This article reviews the evidence basis for fatigue management, looking at exercise, education, psychological interventions, complementary therapies and pharmacological therapy, and finds that a one-size fits all approach to fatigue management is unrealistic.

Findings:

Research appears to support different interventions at various points in the disease trajectory and this is of importance for service design as palliative care is increasingly introduced earlier in the patient's pathway.

Conclusion:

Although the body of research is growing, management of fatigue caused by non-malignant conditions remains poorly evidenced, making comprehensive recommendations for these patient groups even more challenging.
Thinking about strengths in end-of-life nursing practice: the case of intensive care unit nurses
Authors: Vanderspank-Wright Brandi , Wright David Kenneth , McMillan Kim
Published: August 2019

Background:

The intensive care unit (ICU) is a care context that is sometimes described as being unconducive to the values and ideals of a good death in end-of-life care. Such assumptions render the ICU emblematic of a troubling discourse about end-of-life care in this clinical context.

Aim:

To stimulate a reflective examination of intensive care nursing practice with respect to end-of-life care.

Methods:

The work of contemporary nursing scholar Laurie Gottlieb is used to perform a strengths-based relational ethical examination of previously published literature that describes critical care nurses' experiences of providing end-of-life care in the ICU.

Findings:

This literature suggests that the relational ethical value of authentic engagement, which is fundamental to the disciplinary ethos of expert palliative care nursing, is reflected in the everyday practice of intensive care nurses whose patients die while under their care.

Conclusion:

A strengths-based approach can make visible the relational ethical practice of critical care nurses who care for dying patients and their families in the ICU.
Social working without borders: challenging privatisation and complicity with the hostile environment
Authors: Wroe Lauren
Published: August 2019

Social Workers Without Borders is a UK social work charity established in early 2016 to provide direct support to migrant children and families, and to scaffold this through the development of social work education and activism reflecting the principles of human rights and social justice. Reflecting on Social Workers Without Borders’ model of practice, Lauren Wroe, co-founder and trustee of Social Workers Without Borders, discusses the charity’s recent campaign against Capita and the implications of privatisation for asylum-seeking and migrant families, as well as for the ethical value base of the profession. Positioning Social Workers Without Borders as a voluntary network that ‘fills the gap’ in state services, the author discusses campaign strategies to defend the profession, and the families it supports, from the rolling back of state welfare and the rolling out of state hostility through the deregulated outsourcing of social care services.
Towards sustainable family care: using goals to reframe the user-centred design of technologies to support carers
Authors: Leslie Myles , Eales Jacquie , Fast Janet , Mortenson W. Ben , Atoyebi Oladele , Khayatzadeh-Mahani Akram
Published: August 2019

Technology has been identified as an important strategy in making caring sustainable. This article takes the design process for carer support technology as a lens on the divergent definitions that are in play when governments, technology developers and carers contemplate ‘sustainability’. We argue that a central impediment to finding a productive point of overlap among the three perspectives is a predominant focus on carers’ needs. We contrast this needs-based approach, and its focus on doing the tasks of care, with a goal-oriented approach focused on being in relationships. Reframing the conversation around goals is important to achieving truly sustainable caring.
Cómo argumentar con coherencia
Authors: Gascón José Ángel
Published: August 2019

When disagreements arise about the quality of arguments, arguers frequently rely on coherence. Argumentative coherence is mainly manifested in accusations of incoherence and in the production of analogies. With the help of the elements of warrant and of rebuttals in Toulmin's model, it is possible to give a first analysis of this notion.
Química ambiental: monitoramento físico-químico da água de um poço artesiano na cidade de Remígio-PB
Authors: Da Silva Aldeni Barbosa , Da Silva Filho Edmilson Dantas , Câmara John Carlos Silva , Dos Santos Martha Lisboa Oliveira , Dos Santos Daniel Rodrigues , De Freitas Marjorye Lavigne Alves , Dos Santos Joelson Souza Isidro , Da Silveira Pedro Lucas Nunes
Published: August 2019

Esse trabalho teve o objetivo de estudar a qualidade físico-química da água de um poço artesiano localizado na zona urbana da cidade de Remígio-PB. A amostra de água foi coletada em garrafa plástica de 2 litros em um poço artesiano localizado na zona urbana da cidade de Remígio/PB e foi encaminhada ao laboratório de Química do Instituto Federal da Paraíba, campus de Campina Grande, para a realização das análises. Todas as análises foram realizadas em triplicata. Os parâmetros físico-químicos da água foram determinados seguindo-se as metodologias do manual do Instituto Adolfo Lutz. Os parâmetros analisados foram os seguintes: pH, temperatura, cor aparente, alcalinidade, condutividade elétrica, sólidos totais dissolvidos, porcentagem de cinzas, cloreto, turbidez, dureza total, dureza de cálcio e magnésio, cloro total e porcentagem de ferro. A amostra apresentou um valor médio para pH de 6,52 a uma temperatura de 26,3oC, um valor médio de 368 uH para cor aparente, 106,7 uT para turbidez, 42,67 mg/L de CaCO3 para alcalinidade e 104,5 mg/L para cloreto. Com relação a dureza total, o valor médio encontrado foi de 92,67 mg/L de CaCO3, 911,1 µS/cm para condutividade elétrica, 5.957 mg/L para sólidos totais dissolvidos, 0,0165 % de cinzas, 0,24 e 0,94 mg/L para cloro total e ferro, respectivamente. Diante disso, conclui-se que a água é imprópria para o consumo humano, pois os parâmetros cor aparente, turbidez, sólidos totais dissolvidos e porcentagem de ferro estão totalmente fora do que é preconizado pela Portaria de Consolidação no 05/2017 do Ministério da Saúde e da resolução de nº 357/2005 do Conselho Nacional do Meio Ambiente.
La competencia digital docente en formación inicial: Estudio a partir de los casos de Chile y Uruguay
Authors: Silva Juan , Morales María-Julia , Lázaro-Cantabrana José-Luis , Gisbert Mercè , Miranda Paloma , Rivoir Ana , Onetto Alicia
Published: August 2019

Resulta fundamental que el profesorado desarrolle la Competencia Digital Docente (CDD) desde su formación inicial con la finalidad de usar adecuadamente las Tecnologías de Información y Comunicación (TIC) en sus prácticas diarias, además de promover el desarrollo de las competencias digitales en los estudiantes. El presente artículo expone los principales resultados de un estudio comparado de la CDD entre estudiantes de Chile y Uruguay que cursaban último año de Formación Inicial Docente (FID)[1]. Para realizar el estudio se utilizó una metodología mixta para diseñar y validar con expertos un instrumento tipo prueba, en el que se presentaban situaciones contextualizadas del uso de las TIC en la docencia, permitiendo evaluar la CDD a nivel de dimensiones (4) e indicadores (10). El instrumento se aplicó a una muestra representativa estratificada, con un margen de error del 5%, conformada por 568 estudiantes de FID (273 de Chile y 295 de Uruguay). Los resultados muestran un puntaje promedio para los 10 indicadores evaluados (sobre un máximo de 4 puntos) de 2.3 para Chile y 2.2 para Uruguay, un 56,28% y 54,89% de nivel de logro respectivamente. Se espera que estos resultados puedan ser útiles como una base de orientación de las políticas públicas de ambos países con la finalidad de reforzar la inclusión y el tratamiento de la CDD en la FID.
La educación emocional en la educación primaria: Un aprendizaje para la vida
Authors: Sepúlveda Ruiz María del Pilar , Mayorga Fernández María José , Pascual Lacal Rocío
Published: August 2019

En la actualidad, debido a los cambios sociales que se están produciendo es necesario que la escuela atienda de manera directa la formación emocional del alumnado. En este trabajo se presenta un estudio enmarcado en un Proyecto Europeo, cuya finalidad es conocer las condiciones actuales de los sistemas educativos de los socios participantes respecto a las emociones, en este caso concreto se muestran los resultados obtenidos en España (Málaga) en la franja de 6-10 años. Para ello se ha realizado un estudio de corte cualitativo fundamentado en el tópico: la dimensión afectiva de la educación. En total han participado 17 docentes. Los resultados muestran que el currículum está centrado en la dimensión cognitiva, dejando al margen la dimensión emocional, a pesar de que en la actual legislación se contempla explícitamente dicha dimensión. La escuela, hoy día, para poder contemplar su función educativa debe posibilitar el desarrollo integral de su alumnado, para ello los procesos educativos deben diseñarse e implementarse en base al fomento de todas las dimensiones de la persona.
EFFECTS OF E-COMMERCE ON THE SHARIA HOTELS BRAND AWARENESS IN BANDUNG
Authors: Natakusuma Muchyidin , Arifianti Ria , Sukoco Iwan
Published: August 2019

Sharia has become global, including the development of Sharia Hotels. In addition, the development of internet technology in Indonesia can be seen with the existence of e-commerce which benefits in the form of business convenience because the internet is seen as an advertising media that is cheaper, more efficient and effective. Tight business competition has made brand as an important aspect that can be a benchmark for a company. Sharia hotel owners use e-commerce to build strong brands and make consumers acknowledge that their brands are well received by consumers. This study aims to find out how e-commerce influences brand awareness in Narapati Indah Sharia Boutique Hotel and Convention Bandung. Respondents in this study were sampled using the Structural Equation Modeling (SEM) method that allows testing a series of relatively complex relationships simultaneously. The results showed that respondents' responses regarding e-commerce and brand awareness at Narapati Indah Sharia Hotel were in the good category. In addition, there is a significant influence between e-commerce on brand awareness in Narapati Indah Sharia Hotel especially through their own website so that to depend on other parties are no longer needed.
Experimental investigation on the effect of drill quality on the performance of bone drilling
Authors: Alam Khurshid , Piya Sujan , Al-Ghaithi Ahmed , Silberschmidth Vadim
Published: August 2019

Bone drilling is a well-known process in operative fracture treatment and reconstructive surgery. The cutting ability of the drill is lost when used for multiple times. In this study, the effect of different levels of drill wear on bone temperature, drilling force, torque, delamination around the drilling region and surface roughness of the hole was investigated using a series of experiments. Experimental results demonstrated that the wear of the drill is strongly related to the drilling force, torque, temperature and surface roughness of the drilled hole. Statistical analysis was performed to find the effect of various factors on multiple response variables in the bone drilling process. The favorable conditions for bone drilling are obtained when feed rate, drill speed and the roughness of the cutting edge of the drill were fixed at 30 mm, 2000 rpm and up to 2 mm, respectively. Further, analysis of variance (ANOVA) was performed to determine the factor with a significant impact on the response variables. F-test and p-value indicated that the feed rate had the highest effect on grey relational grade followed by the roughness of the drill. This study suggests that the sharp drill along with controlled drilling speed and feed rate may be used for safe and efficient surgical drilling in bone.
The art of narrative – narrative as art: Sameness or difference?
Authors: Skalin Lars-Åke
Published: August 2019

This paper is a critique of narratology’s generality thesis and especially focused on a corollary of that thesis, the “sameness premise”. It says that all objects designated by the noun “narrative”, whether actual, possible, or fictional, are defined by some basic intrinsic properties. This goes for ordinary informative telling of events as well as for literary art, such as novels and short stories. The latter assumption is rejected by me and theorists taking up a “difference premise” instead. Literary art should not be included within a general category of narrative. It would be more correct to regard it as sui generis, since it manifests a system quite different from and incompatible with narrative as this system is defined by standard narratology. For example, ordinary narrative accounts display logically a two-place relation between the denoting signs and the denoted contents (events); while the artistic representations produced by literary art and other art-forms do not denote anything outside themselves– the relation between signs and content is one-place. I discuss this theoretic problem from two sources: modern narratology in conflict with artistic/aesthetic theory and the mimesis-debate in Greek antiquity between Plato and Aristotle, where Plato is advocating a sameness and Aristotle a difference premise.
Biodiesel production from waste cooking oil
Authors: Sarno Maria , Iuliano Mariagrazia
Published: August 2019

Biodiesel production from waste cooking oil was obtained using Thermomyces lanuginosus (TL) lipase (E.C.3.1.1.3) anchored on Fe3O4/Au nanoparticles through physical interactions. A remarkable biodiesel yield of ∼90% was obtained without any pre-treatment and at a lipase concentration of 20%, 45°C reaction temperature, 1:6 oil/methanol molar ratio, after 24 h. The immobilized enzyme showed fast kinetic (the biodiesel yield was already of 34.6% after only 3 h) and activity slightly dependent on the length of the acid chains. The effect of the Au NPs sizes was monitored, to study the role of Au conduction centres in facilitating enzymes favourable orientation. The immobilized lipase activity stays above 74% after the first 3 cycles of use. In particular, the produced biodiesel presents an ester content of 97.8% ± 0.21 and a linolenic methyl ester content of 0.53% ± 0.03, in agreement with EN14214 requirements.