bluuebunny/crossref_metadata_2025 huggingface dataset:
Skin manifestations of hematologic malignancies
Authors: Haque AKM Rejaul , Zakaria ASM , Sultana Abida , Khan Md Rafiquzzaman
Published: January 2016

Hematologic malignancies can present with various cutaneous manifestations. These include specific cutaneous diseases & non-specific cutaneous lesions. Non-specific skin lesions are more common in patients with hodgkins diseases. Generalized severe pruritus may precede other findings of Hodgkins disease by many months . So an evaluation for underlying lymphoma should be considered in patient with severe itching. Leukemia cutis (specific skin lesions of Leukemia) most commonly occurs concomitant with or following the diagnosis of leukemia. The skin may also be the site of relapse of leukemia after chemotherapy. Uncommonly leukemia cutis may be identified while the bone marrow & peripheral blood are normal. Those patients are classified as aleukemic leukemia cutis. This cross sectional observational study was carried out in the Hematology department of Bangabandhu Sheikh Mujib Medical University from January 2012 to January 2013 with the intention to know the prevalence of skin manifestations of hematologic malignancies & to help diagnose and manage hematologic malignancies in some extent. Total 127 consecutive patients who were already diagnosed as haematological malignancies & hospitalized were evaluated at the period of one year. Different types of cutaneous lesions were found in our study population, Infections were the highest number, 32(25.19%) patients suffering from various infections. Other findings includemalignant infiltration, 10(7.87%); hemorrhagic 121 lesions (petechia and ecchymosis), 17(13.38%); drug reaction, 5(3.93%); gingival hyperplasia, 3(2.36%); pruritus, 23(18.11%); pigmentation, 20(15.74%); prurigo, 8(6.29%) and ichthyosiform lesion, 19(14.96%).Bangladesh Med J. 2014 Sep; 43 (3): 121-124
Diseases pattern in the department of physical medicine & rehabilitation in a tertiary level hospital
Authors: Hossain Md Shahadat , Chakraborty Prasanta Kumar , Rahman Sohely , Islam Md Jahidul , Amin Md Ruhul , Saha Ripon Kumer , Khan Moinuddin Hossain , Yasmin Nahid
Published: January 2016

This is a retrospective study carried out at the department of Physical Medicine and Rehabilitation in Dhaka Medical College Hospital (DMCH), Dhaka for the period of one year from 1st January, 2012 to 31st December, 2012. The purpose of the study was to observe the disease pattern and demographic characteristics of patients attending the department of Physical Medicine and Rehabilitation in a tertiary care hospital. Total sixteen thousand two hundred ninety seven (n=16297) patients were studied, of which 48% were male and 52% were female. The mean age was 43.64 ± 5.12 years, maximum patients (27.96%) belong to 41-50 years of age. Maximum patients (51%) were come from Dhaka city and most of the studied patients were housewife (36.73%). Largest disease group was non-specific low back 130 pain (16.42%). Regarding disease pattern, 44.07% of patients rheumatological, 17.25% neurological, 25.11% orthopaedic condition. Among leading diseases, 16.77% were non-specific low back pain, 10.13% osteoarthritis of knee joints, 8.15% stroke, 7.56% lumbar spondylosis, 7.05% cervical spondylosis, 6.43% adhesive Capsulitis, 3.84% neck sprain/strain 3.57% Facial palsy, 3.18% fibromyalgia and 3.12% tennis elbow.Bangladesh Med J. 2014 Sep; 43 (3): 130-133
A case of acute pancreatitis with normal serum lipase
Authors: Alam Afroja , Rahman Mohammad Ferdous Ur , Rahman Mahbubur , Khan Abed Hussain , Chowdhury Mohammad Mainul Hasan , Chowdhury MA Jalil
Published: January 2016

Patients with acute pancreatitis typically present with epigastric pain. In such patients, demonstration of elevated pancreatic enzymes and swollen pancreas by radiological investigations are sufficient to confirm the diagnosis. Here we present case history of a middle aged man who had epigastric pain, fever and swollen pancreas but enzyme levels were normal. He responded to conventional conservative treatment.Bangladesh Med J. 2014 Sep; 43 (3): 162-164
L’être père à la Réunion : réflexions théoriques. Approche éthno-psychanalytique
Authors: Goulois David
Published: January 2016

Nous questionnons ici la fonction paternelle à l’île de la Réunion. Nous pensons que le contexte sociétal d’hier et d’aujourd’hui a façonné un « être père » qui n’est pas sans conséquences psychopathologiques sur la vie de famille : une absence du père et de sa loi, à la fois cause et conséquence d’une matrifocalité et d’un climat intra-familial incestuel, transmis trans-générationnellement. Nous proposons une lecture de la problématique sous l’angle ethno-psychanalytique.
Hypnothérapie en famille
Authors: Salem Gérard , Auberjonois Katharina
Published: January 2016

Les auteurs, tous deux psychiatres, thérapeutes de famille et hypnothérapeutes, présentent dans cet article diverses combinaisons possibles entre thérapies systémiques et hypnothérapie. Leurs observations et réflexions se fondent sur nombre d’expérimentations thérapeutiques en milieu ambulatoire ou hospitalier, auprès de familles qui ont accepté d’utiliser l’hypnose intégrée à la thérapie familiale. Ce type d’intégration s’avère bénéfique sur le plan thérapeutique du fait que les procédés hypnotiques fonctionnent comme des amplificateurs significatifs des processus attentionnels mutuels au sein du système familial.
« Je suis le seigneur du château ». L’apport de l’approche ericksonienne et de l’hypnose à la thérapie familiale
Authors: Marteaux Alain
Published: January 2016

L’objet de cet article est d’interroger l’hypnose comme mode de communication, et ses éventuelles connections avec la thérapie familiale. Au lieu de (se) poser la question de la compatibilité ou de l’incompatibilité des deux disciplines, il s’agira de montrer que la communication Ericksonienne est une et qu’elle peut s’utiliser en thérapie individuelle, conjugale ou familiale. Nous poserons également la question de l’accordage relationnel entre thérapeute et patient(s) et de la nécessaire empathie, créativité, co-création d’images et de langage commun circulant entre eux par l’utilisation de métaphores thérapeutiques.
Systémique et psychotraumatologie : une expérience intégrative face à la souffrance complexe
Authors: Jobin Catherine , Philippe Isabelle , Stern Daniel N.
Published: January 2016

Les auteurs vous invitent à partager le récit du déroulement d’un processus thérapeutique familial et individuel réalisé par trois thérapeutes dans une situation complexe de maltraitance intrafamiliale avec inceste, ayant provoqué de graves troubles psychotraumatiques et relationnels. Nous examinons ensuite de quelle manière articuler, dans une perspective intégrative, les aspects systémiques et psychotraumatiques, les différents temps familiaux et individuels ; comment également coordonner les divers axes thérapeutiques individuel, systémique et EMDR, et enfin, ce qu’une telle expérience amène à vivre en tant qu’équipe thérapeutique.
Thérapie EMDR et thérapie familiale avec les enfants, un exemple d’intégration de deux paradigmes différents
Authors: Silvestre Michel
Published: January 2016

Le travail avec les situations complexes d’enfants et de familles en souffrance nous amène à penser l’articulation du regard individuel et du regard familial comme proposition de réponse thérapeutique. L’intégration des deux dimensions diachronique et synchronique doit être organisée dans un ensemble thérapeutique congruent et fonctionnel.
La création des UHSA : une nouvelle régulation de l’enfermement ?
Authors: Contrast Collectif
Published: January 2016

En 2010, à l’ouverture de la première UHSA, destinée à hospitaliser en psychiatrie des personnes détenues, critiques sécuritaires et défenseurs d’un outil d’égal accès aux soins s’opposent. Notre analyse interdisciplinaire de ce développement controversé croise la force normative des règles autorisant l’enfermement, le contexte de leur élaboration et leurs usages sociaux. À partir de textes juridiques et administratifs et d’entretiens avec les acteurs, nous montrons que la régulation dichotomique issue du XIX e siècle et l’essor des services psychiatriques en prison éclairent comment les règles élaborées pour les UHSA participent aux recompositions contemporaines du sens de l’enfermement.
The Relationship between Current Account Deficits and Unemployment in Turkey
Authors: Ozer Mustafa , Yeldan A. Erinç
Published: January 2016

In this chapter, we test the nature of the variety of empirical relationships between current account deficits and unemployment in Turkey over 2000Q1–2012Q1. Our working hypothesis in this paper is that the meager job creation in Turkey over 2000s is the direct symptom of a speculative-led growth environment (Grabel, 1995) together with an excessively open and unregulated capital account in the age of relatively cheap and abundant global finance. Based on the vector error correction model (VECM), we found that there is a unidirectional causality running from current account deficits to unemployment. Both Impulse Response and Variance Decomposition analyses are quite consistent with results of VECM. We interpret these findings as evidence of the structural characteristics of unemployment, reflected in output elasticities, being embedded under the deepening external fragility of the Turkish economy over the 2000s.
Study of Noise Removal Techniques for Digital Images
Authors: Patel Punyaban , Jena Bibekananda , Sahoo Bibhudatta , Patel Pritam , Majhi Banshidhar
Published: January 2016

Images very often get contaminated by different types of noise like impulse noise, Gaussian noise, spackle noise etc. due to malfunctioning of camera sensors during acquisition or transmission using the channel. The noise in the channel affects processing of images in various ways. Hence, the image has to be restored by applying filtration process before the high level image processing. In general the restoration techniques for images are based up on the mathematical and the statistical models of image degradation. Denoising and deblurring are used to recover the image from degraded observations. The researchers have proposed verity of linear and non-linear filters for removal of noise from images. The filtering technique has been used to remove noisy pixels, without changing the uncorrupted pixel values. This chapter presents the metrics used for measurement of noise, and the various schemes for removing of noise from the images.
Multi-Modal Fusion Schemes for Image Retrieval Systems to Bridge the Semantic Gap
Authors: Goel Nidhi , Sehgal Priti
Published: January 2016

Image retrieval (IR) systems are used for searching of images by means of diverse modes such as text, sample image, or both. They suffer with the problem of semantic gap which is the mismatch between the user requirement and the capabilities of the IR system. The image data is generally stored in the form of statistics of the value of the pixels which has very little to do with the semantic interpretation of the image. Therefore, it is necessary to understand the mapping between the two modalities i.e. content and context. Research indicates that the combination of the two can be a worthwhile approach to improve the quality of image search results. Hence, multimodal retrieval (MMR) is an expected way of searching which attracts substantial research consideration. The main challenges include discriminatory feature extraction and selection, redundancy identification and elimination, information preserving fusion and computational complexity. Based on these challenges, in this chapter, authors focus on comparison of various MMR systems that have been used to improve the retrieval results.
Fingerprint Iris Palmprint Multimodal Biometric Watermarking System Using Genetic Algorithm-Based Bacterial Foraging Optimization Algorithm
Authors: Nair S. Anu H. , Aruna P.
Published: January 2016

With the wide spread utilization of Biometric identification systems, establishing the authenticity of biometric data itself has emerged as an important issue. In this chapter, a novel approach for creating a multimodal biometric system has been suggested. The multimodal biometric system is implemented using the different fusion schemes such as Average Fusion, Minimum Fusion, Maximum Fusion, Principal Component Analysis Fusion, Discrete Wavelet Transform Fusion, Stationary Wavelet Transform Fusion, Intensity Hue Saturation Fusion, Laplacian Gradient Fusion, Pyramid Gradient Fusion and Sparse Representation Fusion. In modality extraction level, the information extracted from different modalities is stored in vectors on the basis of their modality. These are then blended to produce a joint template which is the basis for the watermarking system. The fused image is applied as input along with the cover image to the Genetic Algorithm based Bacterial Foraging Optimization Algorithm watermarking system. The standard images are used as cover images and performance was compared.
A PhysX-Based Framework to Develop Rehabilitation Systems Using Haptics and Virtual Reality
Authors: Agostini Michela , D'Andrea Antonio , Daud Omar Andres , Oboe Roberto , Pilastro Davide , Reggiani Monica , Turolla Andrea
Published: January 2016

The use of Virtual Reality (VR), in combination with haptic devices (i.e. robotic manipulators capable of generating forces that stimulate the tactile and/or proprioceptive system of the users) is becoming very popular in the field of rehabilitation. As matter of fact, different rehabilitation requirements, related to various pathologies, are usually addressed by developing specialized haptic devices, together with specific VR worlds and exercises to be performed within. This, in turn, usually brings a tremendous effort when new exercises must be designed and/or new haptic devices, with their mechanical model and hardware (HW) interfaces, must be embedded into an existing environment. To cope with the required flexibility and adaptability, while reducing the development cost, we propose in this chapter a software framework that aims at reducing the development time and cost of new VR+haptics systems, through the use of well-known software design patterns (Model/View/Controller, Strategy, Observer) and freely available technologies (XML, PhysX).
Effective Physical Rehabilitation System
Authors: Aung Yee Mon , Al-Jumaily Adel
Published: January 2016

Physical disability due to any neurological disorder such as Traumatic Brain Injury (TBI), Spinal Cord Injury (SCI) or Cerebrovascular Accident (CVA) leads to motor deficit which will result in loss of control over whole body or one side of the body depending on which part of the brain is affected. In this case, physical rehabilitation is required to perform for restoration of lost functions to promote the patient's quality of life. However, traditional rehabilitation therapy requires one-to-one attention between patient and therapist. Furthermore, patients feel mundane after long term training with traditional exercises in repetitive manners. Therefore, this chapter presents the Effective Physical Rehabilitation System (EPRS) for upper limb rehabilitation by combination of augmented reality based rehabilitation exercises and biofeedback for fast recovery of motor deficit with motivational approach over traditional upper limb rehabilitation therapy which requires minimum supervision of physiotherapist. The main objective of EPRs is to restore the range of motions of upper limb and to prevent from muscle spasticity, muscle atrophy and osteoporosis in effective and motivated way. To meet this objective, augmented reality based pick and place rehabilitation exercises are developed for reaching movements. The effectiveness of the proposed system is evaluated by the experiments and questionnaires results.
Addressing Accessibility of MOOCs for Blind Users
Authors: Álvarez Robles Teresita de Jesús , González Alfredo Mendoza , Gaona Alma Rosa García , Rodríguez Francisco Alvarez
Published: January 2016

The concept of universal access to information society stands for the guaranteed access for all people in the world to internet services, online learning including. Blind users have been benefited by accessible tools such as screen readers, auditory interfaces, etc., nevertheless this kind of external software would not be required if the blind user's requirements were taking into account since the design process. This chapter presents a set of guidelines for designing hearing messages that help blind students to navigate in a MOOC's interface.
Use of Augmented Reality a New Vision on the Massive Open Online Courses
Authors: Ponce Julio , Ornelas Francisco , Álvarez Francisco , Toscano Beatriz
Published: January 2016

This study explains the importance of use Augmented Reality in education and how it can be used on the Massive Open Online Courses (MOOCs) in order to improve specific advantages. Augmented reality (AR) is an area that mixes real-world images, whose elements are augmented by computer-generated sensory input such as sound, video, graphics or GPS data. This study further shows the development tools, application areas, and results obtained through augmented reality in the education, as a support tool to achieve the primary objective of education, which is learning through the use of MOOCs, making it a more attractive with the use of information and communication technologies. Currently there is a great variety of applications that use the augmented reality in areas such as medicine, military, education, among others.
Failure-Avoidance in the Implementation of Tourism and Hospitality Strategies
Authors: Aboutalebi Reza
Published: January 2016

One of the key factors for the effectiveness and success of tourism promotional methods is having the right strategy for each promotional technique and implementing those strategies properly. The problem with current tourism and hospitality literature is a lack of wide-scope and strategic perspective on the reasons for strategy fatality that can compile and categorize all major causes of strategy failure. A meta-analysis technique is used to systematically analyze existing related literature in the top eight related journals and all Amazon books that include one or more of the six strategy failure related keywords. The taxonomy of causes of strategy failure has emerged after systematic combination of the principal causes of strategy failure (absent, present, incompatible) and approximation of influential environments that contribute to failure of strategies (near, middle, far). The taxonomy of causes of strategy failure has nine sets of strategy-crashing factors.
Web Analytics for Web Site Quality Improvement
Authors: Prasad A.V. Krishna , M Varaprasad Rao
Published: January 2016

Web plays an important role in running business organizations, governments, societies, education sector, scientific organizations, social networks etc. As soon as web application has been deployed into the production environment, some or all of its features are available to the users. Web analytics is used to understand the usage pattern and its behaviour of users. The Web analytics is a procedure of measuring, collecting, analyzing and reporting of Internet data to optimize the business processes and maximize their revenue. Web Analytics is processes of inspecting, analyzing, tracking, measuring and reporting of web data for the purpose of discovering useful information, understanding web site quality, assess and improve the effectiveness of a website.
Web Analytics
Authors: Singal Himani , Kohli Shruti
Published: January 2016

There is a remarkable association between an organization's analytics intricacy and its competitive enactment. The biggest problem to adopting analytics is the lack of knowledge of using it to improve business performance. A website is believed and considered as ‘face' of the company. In present era, there are more than 200 million people who buy goods online across the globe. Business Analytics helps companies to find the most profitable customer and allows them to justify their marketing effort, especially when the competition is very high. Predictive analytics helps organizations to predict churn, default in loan payment, brand switch, insurance loss and even the outcome in a football match. There is ample evidence from the corporate world that the ability to make better decisions (by management executives) improves with analytical skills. This chapter will provide an in-depth knowledge of business analytic techniques and their applications in improving business processes and decision-making.
Taxonomy of the New World Pseudichnea complex (Coleoptera: Cleridae: Peloniinae)
Authors: Opitz Weston
Published: January 2016

The Pseudichnea complex involves the genera Ambitus, new genus, Ampleris, new genus, Sirpa, new genus, and Pseudichnea Schenkling. Ambitus includes one species, A. anticus Opitz, new species. Ampleris includes A. achira Opitz, new species, A. angustata Opitz, new species, A. cava Opitz, new species, A. orosi Opitz, new species, A. primitura Opitz, new species,A. rufocapilla Opitz, new species, and A. buenavista Opitz, new species.Pseudichnea includes P. acia Opitz, new species, P. arima Opitz, new species, P. eliminata Schenkling, and P. gracila Opitz, new species. Sirpa includes S. cauda Opitz, new species, S. flavoapiculis Opitz, new species, and S. skelleyi Opitz, new species. Morphological observations, particularly those based on mouthpart structure, suggest that these beetles are predatory. Their leg construction, especially development of the tarsal pads and ungues, suggest that they are lignicolous beetles that inhabit the woody components of arboreal vegetation, a niche in which they presumably pursue bark-beetle prey. Besides descriptions, this treatise includes a key to genera and species, 72 line drawings, eight electron micrographs, 16 habitus illustrations, and two distribution maps.
Phosphatidylinositol 3-Kinase p110δ Isoform Regulates CD8+ T Cell Responses during Acute Viral and Intracellular Bacterial Infections
Authors: Gracias Donald T. , Boesteanu Alina C. , Fraietta Joseph A. , Hope Jennifer L. , Carey Alison J. , Mueller Yvonne M. , Kawalekar Omkar U. , Fike Adam J. , June Carl H. , Katsikis Peter D.
Published: January 2016

The p110δ isoform of PI3K is known to play an important role in immunity, yet its contribution to CTL responses has not been fully elucidated. Using murine p110δ-deficient CD8+ T cells, we demonstrated a critical role for the p110δ subunit in the generation of optimal primary and memory CD8+ T cell responses. This was demonstrated in both acute viral and intracellular bacterial infections in mice. We show that p110δ signaling is required for CD8+ T cell activation, proliferation and effector cytokine production. We provide evidence that the effects of p110δ signaling are mediated via Akt activation and through the regulation of TCR-activated oxidative phosphorylation and aerobic glycolysis. In light of recent clinical trials that employ drugs targeting p110δ in certain cancers and other diseases, our study suggests caution in using these drugs in patients, as they could potentially increase susceptibility to infectious diseases. These studies therefore reveal a novel and direct role for p110δ signaling in in vivo CD8+ T cell immunity to microbial pathogens.
Exploración en tiempo real de la reconstrucción virtual de los instrumentos del Pórtico de la Gloria
Authors: Méndez Roi , Otero Antonio , Jarque Samuel , Flores Julián
Published: January 2016

This article presents the development of a system to perform the interactive visualization of the virtual reconstruction of the instruments of the Portico de la Gloria.
We describe the process followed for creating a specific set of hardware and software centered on the user that, through a tangible interface, allows interaction with highly realistic 3D views of the instruments of the Portico. The system, using computer vision techniques to control human-computer interaction, allows a user to interact with 3D models in an intuitive and easy way. This will make these models accessible to non-experts, making the system an ideal choice for its exhibition in museums.
Computer Tool for Automatically Generated 3D Illustration in Real Time from Archaeological Scanned Pieces
Authors: López Luis , Arroyo Germán , Martín Domingo
Published: January 2016

The graphical documentation process of archaeological pieces requires the active involvement of a professional artist to recreate beautiful illustrations using a wide variety of expressive techniques. Frequently, the artist’s work is limited by the inconvenience of working only with the photographs of the pieces he is going to illustrate. This paper presents a software tool that allows the easy generation of illustrations in real time from 3D scanned models. The developed interface allows the user to simulate very elaborate artistic styles through the creation of diagrams by using the available virtual lights. The software processes the diagrams to render an illustration from any given angle or position. Among the available virtual lights, there are well known techniques as silhouettes enhancement, hatching or toon shading.
Los estudiantes tras las cámaras: el recurso de la novela para la historia
Authors: Lopez Martinez Andres Rodrigo
Published: January 2016

Aquí se exploran las representaciones colectivas, el escenario familiar, cotidiano y afectivo de los estudiantes de mediados de 1960 en la Universidad Nacional (UN) en Bogotá, y de los primeros años de 1970 en la Universidad de Antioquia (UdeA), en Medellín. El objetivo: acercarse a la historia transcurrida tras las cámaras de la historiografía político-social tradicionalmente encargada del sujeto en cuestión, la cual creo un acervo, pero también un objeto desde una mirada particular. Las fuentes: dos novelas, Compañeros de viaje (1991) de Luis Fayad y El dedo índice de Mao (1993) de Juan Diego Mejía. El ejercicio permitió aproximarse a la escena privada y domestica estudiantil, reflexionar sobre el vínculo de esta con la vida pública y social y sobre la injerencia de las razones afectivas en los motivos de la vinculación o la militancia, así como interpretar la manera como significaron y enfrentaron el mundo en que vivieron, a partir de indicios y datos tipificados encontrados en las novelas. Finalmente, el artículo es una forma de demostrar y corroborar la eficacia del uso de la novela como fuente, que parece depender más de las capacidades del investigador que de las cualidades del material.
Las movilizaciones populares de los años 30, la oligarquía cristiana y la prensa francófona en el Líbano bajo el Mandato
Authors: Di Ricco Massimo
Published: January 2016

El fermento político de la década de los años 30 en Líbano representa un importante momento histórico de consolidación nacional que llevará a la formal independencia del país con el Pacto Nacional de 1943. En esta fase, con el país bajo el Mandato francés, se distingue la presencia de una burguesía nacional que empieza a mirar con recelo las prerrogativas de las empresas francesas. La prensa francófona libanesa, directamente relacionada con la oligarquía cristiana, se vuelve en esta coyuntura una herramienta en sus manos para criticar el Mandato y atacar el adversario político en la lucha para el poder con mira al futuro Líbano independiente. El artículo destaca la estricta relación entre la agenda política y económica de una parte de las elites cristianas con las movilizaciones populares y el uso de los medios de comunicación por parte de estas oligarquías.
El uso de Facebook y Twitter de las Fuerzas de Defensa de Israel en la operación “Margen Protector”.
Authors: Rodríguez Fernández Leticia
Published: January 2016

Las redes sociales se han convertido en una potente herramienta en el impulso del activismo y la movilización desde las bases de la sociedad. En consecuencia, los gobiernos y sus instituciones se han adaptado a esta nueva realidad con la intención de formar parte de estas conversaciones, persuadir a los ciudadanos y generar corrientes de opinión a su favor. ¿Se aplica también esta circunstancia cuando los gobiernos participan en conflictos armados? ¿Utilizan los gobiernos las redes sociales para escuchar a sus ciudadanos o son solamente instrumentos propagandísticos para sus fines? El presente artículo analiza el uso de las redes sociales (cuentas oficiales de Twitter y Facebook) realizado por las Fuerzas de Defensa Israelí (FDI) durante los primeros 15 días de la operación Margen Protector (julio, 2014). Para ello, se realizó un doble análisis, cuantitativo y cualitativo, con la intención de conocer el tipo de mensajes utilizados, la frecuencia de los mismos, su repercusión y su relación con los argumentos utilizados en la operación militar Pilar Defensivo, desarrollada por las FDI en 2012.
AVALIAÇÃO DA FREQUÊNCIA DE INTERAÇÕES MEDICAMENTOSAS OCORRIDAS COM PACIENTES INTERNADOS EM CLÍNICA CIRÚRGICA EM UM HOSPITAL PÚBLICO DE JOINVILLE.
Authors: Pinto Luciano Henrique , Souza Helena De , Carneiro Tamara Kassandra
Published: January 2016

Interações medicamentosas são definidas como alteração no efeito esperado de certos medicamentos se administrados junto com outros fármacos. Implica em prejuízo nas respostas terapêuticas esperadas, devido a alterações tanto no ponto de vista farmacocinético quanto farmacodinâmico, o que pode vir a ocasionar em prejuízos clínicos no tratamento estabelecido. O presente estudo teve como objetivo verificar a ocorrência de interações medicamentosas clinicamente relevantes no setor de clínica cirúrgica do Hospital Regional Hans Dieter Schmidt. Foram analisados neste estudo o prontuário contendo prescrições de 50 pacientes internados na clinica cirúrgica. As interações medicamentosas clinicamente relevantes foram classificadas em graves e moderadas tendo como fonte de dados o site Drugs.com®. Foram investigadas 434 prescrições, e identificadas 376 interações, sendo estas 312 moderadas e 64 graves. Dentre as interações classificadas como graves, a que ocorreu com maior frequência foi entre Tramadol e Metoclopramida com 54% do total de interações graves. A ocorrência de interações medicamentosas é freqüente nos hospitais brasileiros e necessita de maior atenção devido aos riscos em que o paciente é exposto. A criação e implantação de mecanismos que visam diminuir estas ocorrências se fazem necessário e trazem benefícios não somente ao paciente e ao seu respectivo tratamento, mas também aos hospitais, resultando em diminuição de gastos excessivos e desnecessários.
Gestão do desempenho integrando Balanced Scorecard e FMEA: uma aplicação no laboratório de gestão
Authors: Silva Sheila Serafim da , Oliveira Ualison Rebula de , Oliveira Murilo Alvarenga
Published: January 2016

O uso de indicadores para mensurar o desempenho é de grande importância nas organizações. Diversos estudos (ZOUAIN & SILVEIRA, 2006; FREIRE et al., 2007; FRAGA & SILVA, 2010; ANDRADE & FRAZÃO, 2011) propõem a avaliação de desempenho em organizações públicas, privadas e do terceiro setor. Todavia, este estudo propõe uma aplicação num laboratório de gestão, que consiste num programa integrado de educação e produção científica. O estudo tem como objetivo descrever uma proposta de integração da técnica de avaliação de desempenho Balanced Scorecard (BSC) e o Método de Análise de Efeitos e Falhas (FMEA). O estudo realizou uma revisão conceitual de BSC, FMEA e laboratório de gestão. O estudo de natureza exploratória teve os dados coletados por meio de pesquisa documental no programa analisado. Como resultados, pode-se destacar a importância de se realizar a avaliação de desempenho de programas e grupos de pesquisa como o laboratório de gestão. Como resultados mais interessantes, pode-se destacar a capacidade da análise integrada promover os alvos de melhorias. A análise combinada BSC/FMEA sinalizou que os indicadores “atividades de extensão” e “publicação de pesquisas” apresentaram problemas no caso analisado, enquanto os indicadores “captação de recursos” e “captação de bolsas” corresponderam às expectativas do laboratório. Embora a produção de pesquisas atenda às metas do laboratório, em geral, estas não são revisadas e publicadas.
Lean Startup e Canvas: uma proposta de metodologia para startups
Authors: Nardes Felipe Bruno Souza , Miranda Roberto Campos da Rocha
Published: January 2016

Apresenta o uso da metodologia Lean Startup e da modelagem de negócios, por meio da ferramenta Canvas, em empresas nascentes, denominadas startups. Trata-se de uma nova forma de empreender, em que se verifica a prevalência da experimentação em oposição ao planejamento minucioso. Atualmente, alguns estudiosos e empreendedores defendem a ideia de que não é possível abordar de maneira tradicional, com o auxílio de um plano de negócios, a criação de startups. Por meio de pesquisa bibliográfica sobre o tema, o presente trabalho apresentou de que forma a metodologia Lean Startup consegue lidar melhor com o dinamismo e incertezas presentes na criação e desenvolvimento de uma startup do que a abordagem tradicional, que sustenta a confecção de um plano de negócio. Entretanto, a título comparativo, também foram abordadas nesse estudo as principais características de um plano de negócios, examinando os prós e contras dessa ferramenta. Como resultado, buscou-se contribuir para o sucesso dos empreendedores envolvidos com startups.
Significados sobre genética transmitidos por el cine y la educación formal
Authors: Abril Gallego Ana María , Muela García Francisco Javier
Published: January 2016

La genética es uno de los temas científicos que más impacto tienen en la actual sociedad del conocimiento. Pero a su vez el aprendizaje de estos contenidos se configura como uno de los problemas más generalizados en la educación formal. El objetivo de este trabajo es comprobar si las ideas sobre genética transmitidas por las películas que los estudiantes ven podrían generar o fomentar sus ideas previas sobre el tema. Para ello se contrastan tres fuentes de significados: los personales de los estudiantes, los implementados, y los transmitidos por las películas. Tras este estudio proponemos que los significados transmitidos por las películas pueden reforzar, o incluso generar, las ideas erróneas de los estudiantes, convirtiéndose así en obstáculos de aprendizaje.
Comprensión del modelo hereditario de Mendel tras la enseñanza habitual en alumnos de educación secundaria obligatoria
Authors: García Lillo José Antonio , Quinto Medrano Patricia , Martínez Torregrosa Joaquín
Published: January 2016

Mostrar que una nueva propuesta de enseñanza produce mejores actitudes y aprendizajes en los alumnos requiere disponer de un análisis de lo que se hace y se consigue con la enseñanza habitual. Para realizar dicho análisis se ha efectuado un estudio histórico y epistemológico de la evolución de las ideas en genética clásica, identificando los problemas que están en su origen, las ideas que permitieron avanzar y los obstáculos que hubo que superar. Como resultado de dicho estudio se han seleccionado un conjunto de indicadores de aprendizaje que deberían manifestarse en aquellas personas que hubieran comprendido los aspectos esenciales del modelo de herencia mendeliana, que se imparte en  4º de ESO. Dichos indicadores se han utilizado para analizar el aprendizaje tras la enseñanza convencional del tema. En este trabajo se presentan los resultados obtenidos que muestran las deficiencias más comunes y justifican la necesidad de una propuesta diferente.
Crystal structures of chitin binding domains of chitinase from Thermococcus kodakarensis KOD1
Authors: Hanazono Yuya , Takeda Kazuki , Niwa Satomi , Hibi Masahito , Takahashi Naoya , Kanai Tamotsu , Atomi Haruyuki , Miki Kunio
Published: January 2016

Chitinase from T. kodakarensis (TkChiA) catalyzes the hydrolysis of chitin. The enzyme consists of two catalytic and three binding domains (ChBD1, ChBD2 and ChBD3). ChBD2 and ChBD3 can bind to not only chitin but also cellulose. In both domains, the intervals of the side chains of the three tryptophan residues, which are located on the molecular surface, correspond to twice the length of the lattice of the chitin. A binding model with crystalline chitin implies that the tryptophan residues and a glutamate residue interact with the hexose ring by CH‐π interactions and the amide group by a hydrogen bond, respectively.
Influence of the construction process and nonstructural components on the modal properties of a five‐story building
Authors: Astroza Rodrigo , Ebrahimian Hamed , Conte Joel P. , Restrepo José I. , Hutchinson Tara C.
Published: January 2016

A full‐scale five‐story reinforced concrete building was built and tested on the NEES‐UCSD shake table during the period from May 2011 to May 2012. The purpose of this test program was to study the response of the structure and nonstructural components and systems (NCSs) and their dynamic interaction during seismic base excitation of different intensities. The building specimen was tested first under a base‐isolated condition and then under a fixed‐based condition. As the building was being erected, an accelerometer array was deployed on the specimen to study the evolution of its modal parameters during the construction process and placement of major NCSs. A sequence of dynamic tests, including daily ambient vibration, shock (free vibration) and forced vibration tests (low‐amplitude white noise and seismic base excitations), were performed on the building at different stages of construction. Different state‐of‐the‐art system identification methods, including three output‐only and two input‐output methods, were used to estimate the modal properties of the building. The obtained results allow to investigate in detail the effects of the construction process and NCSs on the dynamic parameters of this building system and to compare the modal properties obtained from different methods, as well as the performance of these methods. Copyright © 2015 John Wiley & Sons, Ltd.
Associations between attending physician workload, teaching effectiveness, and patient safety
Authors: Wingo Majken T. , Halvorsen Andrew J. , Beckman Thomas J. , Johnson Matthew G. , Reed Darcy A.
Published: January 2016

BACKGROUND

Prior studies suggest that high workload among attending physicians may be associated with reduced teaching effectiveness and poor patient outcomes, but these relationships have not been investigated using objective measures of workload and safety.

OBJECTIVE

To examine associations between attending workload, teaching effectiveness, and patient safety, hypothesizing that higher workload would be associated with lower teaching effectiveness and negative patient outcomes.

DESIGN, SETTING, AND PARTICIPANTS

We conducted a retrospective study of 69,386 teaching evaluation items submitted by 543 internal medicine residents for 107 attending physicians who supervised inpatient teaching services from July 2, 2005 to July 1, 2011.

MEASUREMENTS

Attending workload measures included hospital service census, patient length of stay, daily admissions, daily discharges, and concurrent outpatient duties. Teaching effectiveness was measured using residents' evaluations of attendings. Patient outcomes considered were applicable patient safety indicators (PSIs), intensive care unit transfers, cardiopulmonary resuscitation/rapid response team calls, and patient deaths. Mixed linear models and generalized linear regression models were used for statistical analysis.

RESULTS

Workload measures of midnight census and daily discharges were associated with lower teaching evaluation scores (both β = −0.026, P < 0.0001). The number of daily admissions was associated with higher teaching scores (β = 0.021, P = 0.001) and increased PSIs (odds ratio = 1.81, P = 0.0001).

CONCLUSION

Several measures of attending physician workload were associated with slightly lower teaching effectiveness, and patient safety may be compromised when teams are managing new admissions. Ongoing efforts by residency programs to optimize the learning environment should include strategies to manage the workload of supervising attendings. Journal of Hospital Medicine 2016;11:169–173. © 2016 Society of Hospital Medicine
Cannabinoid receptor‐2 agonist inhibits macrophage induced EMT in non‐small cell lung cancer by downregulation of EGFR pathway
Authors: Ravi Janani , Elbaz Mohamad , Wani Nissar A. , Nasser Mohd W. , Ganju Ramesh K.
Published: January 2016

JWH‐015, a cannabinoid receptor 2 (CB2) agonist has tumor regressive property in various cancer types. However, the underlying mechanism by which it acts in lung cancer is still unknown. Tumor associated macrophage (TAM) intensity has positive correlation with tumor progression. Also, macrophages recruited at the tumor site promote tumor growth by enhancing epithelial to mesenchymal (EMT) progression. In this study, we analyzed the role of JWH‐015 on EMT and macrophage infiltration by regulation of EGFR signaling. JWH‐015 inhibited EMT in NSCLC cells A549 and also reversed the mesenchymal nature of CALU‐1 cells by downregulation of EGFR signaling targets like ERK and STAT3. Also, in vitro co‐culture experiments of A549 with M2 polarized macrophages provided evidence that JWH‐015 decreased migratory and invasive abilities which was proved by reduced expression of FAK, VCAM1, and MMP2. Furthermore, it decreased macrophage induced EMT in A549 by attenuating the mesenchymal character by downregulating EGFR and its targets. These results were confirmed in an in vivo subcutaneous syngenic mouse model where JWH‐015 blocks tumor growth and also inhibits macrophage recruitment and EMT at the tumor site which was regulated by EGFR pathway. Finally, JWH‐015 reduced lung tumor lesions in an in vivo tumorigenicity mouse model. These data confer the impact of this cannabinoid on anti‐proliferative and anti‐tumorigenic effects, thus enhancing our understanding of its therapeutic efficacy in NSCLC. Our findings open new avenues for cannabinoid receptor CB2 agonist‐JWH‐015 as a novel and potential therapeutic target based on EGFR downregulation mechanisms in NSCLC. © 2016 Wiley Periodicals, Inc.
The efficacy of acupuncture in managing patients with chronic prostatitis/chronic pelvic pain syndrome: A systemic review and meta‐analysis
Authors: Chang Shang‐Chih , Hsu Chung‐Hua , Hsu Chun‐Kai , Yang Stephen Shei‐Dei , Chang Shang‐Jen
Published: January 2016

Objectives

This study aimed to systemically review published randomized control trials that compared the efficacy of acupuncture with sham acupuncture or standard medical treatment as management for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

Methods

A systemic search of the PubMED®, Embase, Airiti Library, and China Journal Net was done for all randomized controlled trials that compared the efficacy of acupuncture with sham acupuncture, alpha‐blockers, antibiotics, or anti‐inflammatory drugs in patients with CP/CPPS. Two investigators conducted the literature search, quality assessment, and data extraction. The data were then analyzed using the Cochrane Collaboration Review Manager (RevMan®, version 5.3). The study endpoints were response rate, the National Institute of Health‐Chronic Prostatitis Index (NIH‐CPSI), and the International Prostate symptom score (IPSS) reduction.

Results

Three and four randomized controlled trials compared acupuncture with sham acupuncture (n = 101 vs. 103) and medical treatment (n = 156 vs. 138), respectively. The results revealed that acupuncture was superior to sham acupuncture as regards response rate (OR: 5.15, 95%CI: 2.72–9.75; P < 0.01), NIH‐CPSI (WMD: −6.09, 95%CI: −7.85 to −4.33), and IPSS (WMD: −2.44, 95%CI: −4.86 to −0.03; P = 0.05) reductions, therefore, excluding the placebo effect. Compared to standard medical treatments, acupuncture had a significantly higher response rate (OR: 3.57, 95%CI: 1.78–7.15; P < 0.01).

Conclusions

Acupuncture has promising efficacy for patients with CP/CPPS. Compared to standard medical treatment, it has better efficacy. Thus, it may also serve as a standard treatment option when available. Neurourol. Urodynam. 36:474–481, 2017. © 2016 Wiley Periodicals, Inc.
Quality of Life in Survivors of Pediatric Cancer and Their Siblings: The Consensus Between Parent‐Proxy and Self‐Reports
Authors: Schulte Fiona , Wurz Amanda , Reynolds Kathleen , Strother Douglas , Dewey Deborah
Published: January 2016

Objectives

To examine the discrepancy between survivor–parent and sibling–parent reports of health‐related quality of life (HRQL) and the level of agreement (i.e., correlation) between child reports (i.e., survivor and sibling) and parent‐proxy reports of HRQL.

Methods

Fifty‐one families participated. Pediatric cancer survivors (49% male; 6–18 years of age) and one sibling (47% male; 9–18 years of age) completed a measure of their HRQL. As well, one parent (14% male; 27–65 years of age) from each family completed a proxy report of their children's (i.e., survivor and sibling) HRQL. Consensus was determined through discrepancy and agreement scores, between parent‐proxy and children's (i.e., survivors and siblings) self‐reports of total HRQL, and physical, emotional, social, and school functioning subscales.

Results

Repeated‐measures analysis of variance (ANOVA) revealed significant group differences for total HRQL (F = 6.79, P ≤ 0.01). Repeated‐measure ANOVAs of subscale discrepancy scores revealed significant group differences for physical functioning scores (F = 6.39, P < 0.01). A significant interaction was also found for social functioning when age at diagnosis was considered as a covariate (F = 10.30, P < 0.01). Zero‐order and intraclass correlation coefficients revealed different levels of agreement between parent and child reports. Specifically, there was poorer agreement between parent‐proxy and sibling's self‐reports, particularly on social and emotional subscales.

Conclusions

Discrepancy and agreement are both important indices to consider when examining consensus between parent‐proxy and child self‐reports. The findings from this study have important implications for future research and suggest that the impact of cancer on siblings should be further investigated.
Two‐year outcomes after diagnostic and therapeutic fetal cystoscopy for lower urinary tract obstruction
Authors: Sananes Nicolas , Cruz‐Martinez Rogelio , Favre Romain , Ordorica‐Flores Ricardo , Moog Raphaël , Zaloszy Ariane , Giron Amilcar Martins , Ruano Rodrigo
Published: January 2016

Objectives

Our objective is to report long‐term outcome after fetal cystoscopy for lower urinary tract obstruction (LUTO), as well as to investigate the accuracy of fetal cystoscopy in diagnosing the cause of bladder outlet obstruction.

Methods

This is a retrospective cohort study of all fetuses who underwent cystoscopy for prenatal diagnosis of LUTO in three tertiary referral centers. Fetal diagnostic cystoscopy was performed to determine prenatally the cause of LUTO and to ablate the posterior urethral valves (PUV).

Results

A total of 50 fetal cystoscopies were performed, revealing PUV in 31 (62%) fetuses, urethral atresia (UA) in 14 (28%) fetuses, and urethral stenosis (US) in 5 (10%) fetuses. Two fetuses had trisomy 18 diagnosed after fetal cystoscopy and were excluded from the present analysis. Fetal cystoscopy was accurate in the diagnosis of the etiology of LUTO in 32/35 (91.4%). There were no survivors in the UA group. One fetus with US underwent urethral stenting and survived with normal renal function at 2 years of life. Among the infants with PUV, 17/30 (56.7%) infants survived, and 13/17 (76.5%) had normal renal function at 1 year of life; 15/28 (53.6%) infants survived, and 11/15 (73.3%) had normal renal function at 2 years.

Conclusions

Fetal cystoscopy is accurate in the diagnosis of the etiology of LUTO and serves as a guide to the specific prenatal treatment. This procedure is associated with modest long‐term survival (54%) but with adequate preserved normal renal function in two thirds of the infants among fetuses with PUV. © 2016 John Wiley & Sons, Ltd.