bluuebunny/crossref_metadata_2025 huggingface dataset:
Combination of Serum C-reactive Protein and D-lactate: Predictors of Strangulation in Intestinal Obstruction
Authors: Pal Ajay K , Ansari Maulana M , Islam Najmul
Published: January 2017

Introduction

Serum C-reactive protein (CRP) and D-lactate have been proposed as markers of intestinal ischemia. The purpose of this prospective observational study is to find whether serum CRP and serum D-lactate can help in predicting strangulation in cases of acute intestinal obstruction.

Materials and methods

A total of 50 consecutive patients were included in the study after excluding patients of comorbid medical illness and patients with findings other than obstruction or strangulation. The serum values of CRP and D-lactate were measured and compared between obstruction with strangulation and obstruction without strangulation. Receiver operating characteristic (ROC) curve was drawn and cutoff values for the diagnosis of strangulation were calculated along with calculation of sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs).

Results

A total of 14 patients who were diagnosed with strangulated bowel obstruction had significantly higher values of serum CRP and D-lactate when compared with 36 patients with simple bowel obstruction (116vs40 mg/L and 5.4vs2.7 mmol/L respectively, p < 0.05). Using ROC analysis, the area under the curve of serum CRP and D-lactate was found to be 0.785 and 0.775 respectively, for bowel strangulation. Using a cutoff value of 60 mg/L for CRP, the sensitivity, specificity, PPV, and NPV were 87.5, 58.3, 48.3, 91.3% respectively. Using a cutoff value of 4.5 mmol/L for D-lactate, the sensitivity, specificity, PPV, and NPV were 75.0, 69.4, 52.7, 86.2% respectively.

Conclusion

Serum CRP and D-lactate can be useful and reasonable markers for predicting strangulation in cases of acute intestinal obstruction in an emergency setting.

How to cite this article

Pal AK, Ansari MM, Islam N. Combination of Serum C-reactive Protein and D-lactate: Predictors of Strangulation in Intestinal Obstruction. Panam J Trauma Crit Care Emerg Surg 2016;5(3):134-139.
Object impaled in the Thorax: Review Study
Authors: Botelho-Filho Fabio , Drumond Domingos AF , Starling Sizenando V , Peixoto Leonardo C , Zille Diego P , Constantino Gabriela DC
Published: January 2017

Aim

The aim of this study is to describe the management of a patient who presents with a penetrating chest trauma due to impalement by an offending object, be it a knife, metal structure, or other type of object.

Background

Until today, many institutions have treated this type of injury with urgent thoracotomy, despite advances in thoracoscopy and radiologic studies. A review was performed principally to discuss the use of nonoperative treatment, thoracoscopy, and thoracotomy. Thirty-two patients described as case reports in 27 articles were reviewed to carry out this descriptive study. For each patient, the following variables were studied: Age, gender, trauma mechanism, hemodynamic stability upon admission, treatment type, injuries encountered and associated with the condition, complications, and the final disposition of death vs survival.

Review results

Twenty-one patients were treated with thoracotomy or sternotomy, seven patients with removal of the impaling object without surgery, and five patients with removal of the object using thoracoscopic assistance (one patient was treated with the assistance of thoracoscopy on the right side and with direct removal on the left side). A summary of the evidence reviewed is provided in a flowchart.

Conclusion

With technological advancements, especially in thoracoscopy and computed tomography, many of these injuries are responsive to less invasive treatment. Thoracotomy, considered the standard of care in many trauma centers, can be reserved for specific cases.

Clinical significance

Pursuant to some of the criteria listed in this study, as occurs in our institution, the thoracotomy rate can be reduced, thereby reducing mortality and benefiting patients.

How to cite this article

Botelho-Filho F, Drumond DAF, Starling SV, Peixoto LC, Zille DP, Constantino GDC. Object impaled in the Thorax: Review Study. Panam J Trauma Crit Care Emerg Surg 2016;5(3):148-154.
Hérnias Diafragmáticas Traumáticas com Lesão Pericárdica: Apresentação e Complicaçōes Específicas
Authors: Netto Fernando Spencer , Mierzwa Tiago Cesar , Silva Mariana Thalita Bertolin , Oliveira Luan Geraldo Ocaña de , Santos Djoney Rafael dos , Barbosa Jean Carlo
Published: January 2017

Introducción

Hernia diafragmática traumática (HDT) se puede evolucionar con diversas complicaciones. Pacientes con lesión asociada al pericárdico, presentan risco de evolucionar con complicaciones específicas que se pueden llevar al óbito.

Objetivo

Este estudio tiene como objetivo dos casos de HDT con extensión pericárdico, con presentación o complicación grave e específica.

Casos clínicos

Primer caso: Paciente masculino de 34 años fue víctima de una caída de nivel de 8 metros de altura. Tomografía computadorizada (TC) mostró herniación del estómago para la cavidad torácica, líquido intraperitoneal y fracturas de la pelvis y acetabular. Fue sometido a laparotomía exploratoria por inestabilidad hemodinámica. En el postoperatorio inmediato, se observó la saída de alto flujo sanguíneo por tubo torácico, necesitando acercamiento por toracotomía, siendo realizado ligación del vaso sangrante del pericárdico. Presentó Buena evolución postoperatorio y sigue en la asistencia. Segundo caso: Paciente masculino de 54 años fue víctima de atropellamiento por motocicleta. Tomografía computadorizada mostró herniación del estómago para el saco pericárdico. Desarrollo un cuadro clínico de tamponamiento cardíaco y fue sujeto a laparotomía, que mostró hernia diafragmática intrapericárdica, la cual fue reducida, con mejora hemodinámica inmediata. Sin embargo, el paciente evolucionó con disfunción de múltiple órganos y sistemas, y falleció, dos días después de la admisión.

Conclusiones

La HDT con extensión pericárdica puede tener presentación o complicaciones específicas, como tamponamiento pericárdico por vísceras abdominales y sangría del pericárdico, que pueden llevar a óbito si no identificado y tratada rápidamente.

Importancia clínica

Debido la alta morbilidad y mortalidad, el diagnóstico precoz de la lesión pericárdica asociada a la hernia diafragmática a través de imagen y mientras la cirugía es de gran importancia, permitiendo un enfoque dirigido, que se pueda mejorar el desenlace clínico del paciente.

How to cite this article

Netto FS, Mierzwa TC, Bertolin Silva MT, de Oliveira LGO, dos Santos DR, Barbosa JC. Hernias Diafragmaticas Traumaticas com Lesao Pericardica: Apresentacao e Complicacōes Especifiçãs. Panam J Trauma Crit Care Emerg Surg 2016;5(3):161-165.
Endovascular Stenting for Traumatic Common Iliac Pseudoaneurysm as an Adjunct following Exploratory Laparotomy in a Stab Injury Patient
Authors: Biswas Saptarshi , Nagarakanti Nishaan
Published: January 2017

Traumatic iliac vessel injuries, especially secondary to penetrating wounds, are often associated with a very high mortality rate. The patients usually present to the trauma bay in profound hemorrhagic shock, which, in turn, triggers the vicious cycle of hypothermia, coagulopathy, and acidosis. Iliac artery injuries should be managed promptly because of the high incidence of late complications of pseudoaneurysm and arteriovenous fistulae and risks of subsequent arterial thrombosis and distal ischemia.

We report a case of a 17-year-old female who was brought in following a stab wound in the right lower quadrant (RLQ). A postlaparotomy computed tomography (CT) scan performed revealed a pseudoaneurysm on the right common iliac. A pelvic angiography was performed, which was followed by an endovascular placement of a covered stent on the right common iliac artery.

We discuss an interesting case along with discussion of relevant literature.

How to cite this article

Biswas S, Nagarakanti N. Endovascular Stenting for Traumatic Common Iliac Pseudoaneurysm as an Adjunct following Exploratory Laparotomy in a Stab Injury Patient. Panam J Trauma Crit Care Emerg Surg 2016;5(3):172-176.
Impact of dust size parameterizations on aerosol burden and radiative forcing in RegCM4
Authors: Tsikerdekis Athanasios , Zanis Prodromos , Steiner Allison L. , Solmon Fabien , Amiridis Vassilis , Marinou Eleni , Katragkou Eleni , Karacostas Theodoros , Foret Gilles
Published: January 2017

Abstract. We investigate the sensitivity of aerosol representation in the regional climate model RegCM4 for two dust parameterizations for the period 2007–2014 over the Sahara and the Mediterranean. We apply two discretization methods of the dust size distribution keeping the total mass constant: (1) the default RegCM4 4-bin approach, where the size range of each bin is calculated using an equal, logarithmic separation of the total size range of dust, using the diameter of dust particles, and (2) a newly implemented 12-bin approach with each bin defined according to an isogradient method where the size ranges are dependent on the dry deposition velocity of dust particles. Increasing the number of transported dust size bins theoretically improves the representation of the physical properties of dust particles within the same size bin. Thus, more size bins improve the simulation of atmospheric processes. The radiative effects of dust over the area are discussed and evaluated with the CALIPSO dust optical depth (DOD). This study is among the first studies evaluating the vertical profile of simulated dust with a pure dust product. Reanalysis winds from ERA-Interim and the total precipitation flux from the Climate Research Unit (CRU) observational gridded database are used to evaluate and explain the discrepancies between model and observations. The new dust binning approach increases the dust column burden by 4 and 3 % for fine and coarse particles, respectively, which increases DOD by 10 % over the desert and the Mediterranean. Consequently, negative shortwave radiative forcing (RF) is enhanced by more than 10 % at the top of the atmosphere and by 1 to 5 % on the surface. Positive longwave RF locally increases by more than 0.1 W m−2 in a large portion of the Sahara, the northern part of the Arabian Peninsula and the Middle East. The four-bin isolog method is to some extent numerically efficient, nevertheless our work highlights that the simplified representation of the four-bin approach produces less dust optical depth and RF, a fact that should be taken into account by future studies of the same region.
Temporal evolution of main ambient PM2.5 sources in Santiago, Chile, from 1998 to 2012
Authors: Barraza Francisco , Lambert Fabrice , Jorquera Héctor , Villalobos Ana María , Gallardo Laura
Published: January 2017

Abstract. The inhabitants of Santiago in Chile have been exposed to harmful levels of air pollutants for decades. The city's poor air quality is a result of sustained emissions and stable atmospheric conditions, averse to mixing and ventilation and favorable for the formation of oxidants and secondary aerosols. Identifying and quantifying the sources that contribute to the ambient levels of pollutants is key for designing adequate mitigation measures. Knowledge about the temporal evolution of the contribution of each source to ambient pollution levels is also paramount to evaluate the effectiveness of pollution reduction measures that have been implemented in the past decades. Here, we quantify the main sources that have contributed to fine particulate matter (PM2.5) between 1998 and 2012 in Santiago's center by using two different source-receptor models (PMF 5.0 and Unmix 6.0), that re applied to elemental measurements on 1243 24-hour filter samples of ambient PM2.5 collected between April-1998 to August-2012. Both models resolve six sources that contribute to ambient PM2.5: motor vehicles (37 %), industrial sources (19 %), copper smelters (14 %), wood burning (12 %), coastal sources (10 %), and urban dust (3 %). Our results show that over the 15 years analyzed here, the emissions from motor vehicles, industrial sources, copper smelters, and coastal sources declined by about 21, 39, 81, 59, and 59 % respectively, while wood burning didn’t change and urban dust increase by 72 %. These changes are consistent with emission reduction measures, such as improved vehicle and smelting technology, introduction of low sulfur fuel for vehicles and natural gas for industrial processes, emission controls for vehicles, public transport improvements etc. However, it is also apparent that the mitigation expected from improved public transport, vehicle technology, and fuel has been largely nullified by the ever-rising number of private vehicle journeys in the past decade. As a consequence, Santiago still experiences PM2.5 levels above the annual and 24-hours Chilean and World Health Organization standards.
Modelling the genesis of equatorial podzols: age and implications on carbon fluxes
Authors: Doupoux Cédric , Merdy Patricia , Montes Célia Régina , Nunan Naoise , Melfi Adolpho José , Pereira Osvaldo José Ribeiro , Lucas Yves
Published: January 2017

Abstract. Amazonian podzols store huge amounts of carbon and play a key role in transferring organic matter to the Amazon river. In order to better understand their C dynamics, we modelled the formation of representative Amazonian podzol profiles by constraining both total carbon and radiocarbon. We determined the relationships between total carbon and radiocarbon in organic C pools numerically by setting constant C and 14C inputs over time. The model was an effective tool for determining the order of magnitude of the carbon fluxes and the time of genesis of the main carbon-containing horizons, i.e. the topsoil and deep Bh. We performed retro calculations to take in account the bomb carbon in the young topsoil horizons (14C age from 62 to 109 y). We modelled four profiles representative of Amazonian podzols, two profiles with an old Bh (14C age 6.8 × 103 and 8.4 × 103 y) and two profiles with a very old Bh (14C age 23.2 × 103 and 25.1 × 103 y). The calculated fluxes from the topsoil to the perched water-table indicates that the most waterlogged zones of the podzolized areas are the main source of dissolved organic matter found in the river network. It was necessary to consider two Bh carbon pools to accurately represent the carbon fluxes leaving the Bh as observed in previous studies. We found that the genesis time of the studied soils was necessarily longer than 15 × 103 and 130 × 103 y for the two younger and the two older Bhs, respectively, and that the genesis time calculated considering the more likely settings runs to around 15 × 103–25 × 103 and 150 × 103–250 × 103 y, respectively.
Accurate simulation of transient landscape evolution by eliminating numerical diffusion: the TTLEM 1.0 model
Authors: Campforts Benjamin , Schwanghart Wolfgang , Govers Gerard
Published: January 2017

Abstract. Landscape evolution models (LEMs) allow the study of earth surface responses to changing climatic and tectonic forcings. While much effort has been devoted to the development of LEMs that simulate a wide range of processes, the numerical accuracy of these models has received less attention. Most LEMs use first-order accurate numerical methods that suffer from substantial numerical diffusion. Numerical diffusion particularly affects the solution of the advection equation and thus the simulation of retreating landforms such as cliffs and river knickpoints. This has potential consequences for the integrated response of the simulated landscape. Here we test a higher-order flux-limiting finite volume method that is total variation diminishing (TVD-FVM) to solve the partial differential equations of river incision and tectonic displacement. We show that using the TVD-FVM to simulate river incision significantly influences the evolution of simulated landscapes and the spatial and temporal variability of catchment-wide erosion rates. Furthermore, a two-dimensional TVD-FVM accurately simulates the evolution of landscapes affected by lateral tectonic displacement, a process whose simulation was hitherto largely limited to LEMs with flexible spatial discretization. We implement the scheme in TTLEM (TopoToolbox Landscape Evolution Model), a spatially explicit, raster-based LEM for the study of fluvially eroding landscapes in TopoToolbox 2.
Resistance to a First-Time Online Training Course for Sport Technicians
Authors: Alvarez Isabel , Dulsat Carles
Published: January 2017

Decreasing enrollment at The Royal Spanish Skating Federation for Training SportTechnicians compelled the adoption of an online version of a training course. This paperidentifies the resistance experienced by participants and explores the relations among fourpower variables: communication and participation, daily routines, flexibility of the courses,and training programs. Participants included students and instructors who completed aquestionnaire. The results indicated that the students felt that they lack contact and interaction,leading to a feeling of apprehension. In addition, they had limited Internet access, whichaggravated their lack of participation, isolating them and leaving them feeling inadequatelyinformed. In contrast, the instructors focused their attention on the training programs. Thispaper proposes solutions and improvements for future versions of the course for redressingimbalances in power relationships among the participants.
Chivalric Men and Good(?) Women: Chaucer, Gender, and John Bossewell's Workes of Armorie
Authors: Warren Nancy Bradley
Published: January 2017

This article considers the ways in which John Bossewell draws upon Chaucer's Wife of Bath's Tale, Book of the Duchess, and Legend of Good Women in his Workes of Armorie to examine complex questions about the construction and maintenance of English masculine identity. The ways in which Bossewell uses the Legend in dialogue with the Wife of Bath's Tale and the Book of the Duchess serve, at least superficially, to promote a subordinated, passive model of femininity that works as an enhancing foil for chivalric English masculinity. However, the Chaucerian material he includes works in ways almost inexorably contrary to his aims.
GESTÃO SISTÊMICA DE ENERGIA E SUA CONTRIBUIÇÃO PARA A REDUÇÃO DOS GASES DE EFEITO ESTUFA – ABORDAGEM INTEGRADA DAS NORMAS ISO 50001:2011 E ISO 14064:2007
Authors: Celupi Nicole , Corte Ana Paula Dalla
Published: January 2017

A crescente demanda por soluções sustentáveis para conter as mudanças climáticas tem exercido forte pressão sobre os setores públicos e privados. A norma ISO 50001, lançada em 2011, é uma das mais aguardadas nos últimos tempos, pois tem o propósito de habilitar organizações a estabelecerem sistemas e processos para a melhoria do desempenho energético, que consiste em eficiência energética, uso e consumo de energia. Se for amplamente aplicada pelos setores econômicos nacionais, estima-se que a norma possa influenciar até 60% do uso de energia do mundo, levando, consequentemente, à redução do custo de energia, das emissões de gases de efeito estufa e de outros impactos ambientais. Para demonstrar que a ISO 50001:2011 é uma importante ferramenta para as organizações com interesse na gestão ambiental e de energia, este trabalho tem como resultado a apresentação de um modelo de sistema de gestão de energia integrado à ISO 14064:2007. A metodologia empregada foi baseada num estudo de caso no qual se elaborou o diagnóstico inicial do sistema de gestão de energia de uma organização e o inventário das emissões de gases de efeito estufa de acordo com os requisitos normativos. Foram propostas oportunidades de melhoria à organização em estudo que servem não somente para melhorar seu desempenho energético, como também para reduzir as emissões de gases de efeito estufa.
EMISSÕES DE CO2 E GERAÇÃO DE RESÍDUOS PELO CONSUMO DE CIGARROS NO BRASIL NO PERÍODO 2006-2012
Authors: Sanquetta Carlos Roberto , Anater Mônica Joelma do Nascimento
Published: January 2017

São escassos os trabalhos que versam sobre os impactos ambientais do consumo de cigarros no Brasil, como a emissão de gases de efeito estufa e a geração de resíduos sólidos. Assim, este estudo visou quantificar as emissões em dióxido de carbono equivalente da queima do cigarro consumido no Brasil, no período 2006 a 2012, e a consequente geração de resíduo sólido pelo descarte das bitucas. Dados oficiais da população brasileira e resultados de um estudo publicado pela UNIFESP sobre consumo de tabaco no Brasil foram usados para embasar as análises. Além disso, dados de teores de carbono determinados em laboratório, volume e peso do filtro em cigarros de cinco marcas foram empregados para os cálculos. A interpolação linear foi empregada para os cálculos anuais no período, cujos resultados apontaram para o consumo de 900 bilhões de cigarros no período, acarretando na emissão de 818 mil Mg de CO2 e geração de 135 mil Mg ou 1,1 milhão de m3 de resíduos. Essa emissão correspondeu ao desmatamento de cerca de 1.500 hectares de Floresta Amazônica, ao passo que o volume de resíduos equivaleu ao tamanho do Empire State Building, um dos edifícios mais altos do mundo. Desta forma, o tabagismo contribui negativamente para as mudanças climáticas e para o meio ambiente em geral.
Feel, think, teach – Emotional Underpinnings of Approaches to Teaching in Higher Education
Authors: Kordts-Freudinger Robert
Published: January 2017

The paper investigates relations between higher education teachers’ approaches to teaching and their emotions during teaching, as well as their emotion regulation strategies. Based on the assumption that the approaches hinge on emotional experiences with higher education teaching and learning, three studies assessed teachers’ emotions, their emotion regulation strategies and their approaches to teaching with questionnaires. Study 1, with n = 145 German university teachers and teaching assistants, found relations between positive emotions and the student-oriented approach to teaching, but not with negative emotions. In addition, cognitive reappraisal and expressive suppression were related to the student-oriented approach. Study 2, with n = 198 German teachers, replicated these findings and, in addition, found relations between perspective taking, empathic concern and personal distress, and the student-oriented approach. Study 3, with n = 76 Australian and New Zealand teachers, again replicated and extended the findings by establishing a relation between negative emotions and the content-oriented approach to teaching. The results of all studies together indicate a significant emotional component of the approaches to teaching. Positive emotions are not only directly related to the student-oriented approach, but also partially mediate the relation between cognitive reappraisal and the student-oriented approach. This link seems to generalize to emotional components of empathy. In addition, the cultural-educational context seems to moderate the relations between negative emotions and the content-oriented approach to teaching. Limitations and directions for future research and educational practice are discussed.
Além das Aparências: Um Estudo sobre a Identidade de Idade de Mulheres na Terceira Idade
Authors: Cordeiro Ruane Pereira , Nunes Pereira Severino Joaquim
Published: January 2017

O Brasil tem apresentado um grande aumento no nmero de pessoas na terceira idade, em 2011 j eram contabilizados 23,5 milhes de indivduos nessa faixa etria (IBGE, 2014). Apesar destes nmeros significativos, os indivduos que chegam a esta faixa etria so ainda estigmatizados pela sociedade. Um exemplo disso est no mercado brasileiro segmentado para este pblico, que na sua maioria oferece produtos quase unicamente associados s limitaes da condio fsica inerentes idade (BALLSTAEDT, 2007). No entanto, por meio dos significados atribudos as atividades de consumo possvel negar o julgamento social sobre a identidade de idade construda socialmente (BARNHART PEALOZA, 2013). Sendo assim, essa pesquisa teve como objetivo analisar como mulheres entre 65 e 75 anos utilizam os significados atribudos ao consumo de produtos e servios para construrem e negociarem sua identidade de idade. A pesquisa de campo foi realizada com onze mulheres moradoras da regio metropolitana da cidade do Rio de Janeiro no ano de 2015. A partir da anlise dos dados foi possvel identificar que: i) A demarcao simblica da identidade de idade das mulheres na terceira idade ocorre pelo enfrentamento do esteretipo negativo associado ao envelhecimento; ii) O consumo exerce um papel central para a socializao e construo de uma identidade de idade mais positiva; e iii) o significado cultural do corpo e seu consumo so utilizados pelas mulheres como forma de construo de uma identidade de idade na terceira idade.
Consumo Colaborativo e Valores Pessoais: O Caso da Bicicleta Compartilhada
Authors: De Arruda Hanna Rocha , Bandeira Emanuella Lustosa , Da Silva Áurio Lúcio Leocádio , Rebouças Silvia Maria Dias Pedro
Published: January 2017

O consumo colaborativo uma tendncia global e em crescimento alavancado por motivaes individuais e questes ambientais, sociais e econmicas presentes no cotidiano das pessoas, como uma forma de fomentar um consumo mais consciente e sustentvel. Dentre as prticas de consumo colaborativo, o compartilhamento de bicicletas o mais praticado mundialmente. Considerando a influncia dos valores pessoais no comportamento do consumidor, essa pesquisa tem por objetivo analisar as relaes entre os valores pessoais dos consumidores e o consumo colaborativo de bicicletas compartilhadas. Para tanto, em relao aos consumidores de bicicletas compartilhadas, identificam-se seus valores pessoais; suas motivaes; e seus perfis, bem como se investiga a relao entre valores pessoais e consumo colaborativo. Trata-se de uma pesquisa quantitativa, descritiva, realizada por meio de uma survey com 172 usurios do sistema de compartilhamento de bicicletas de Fortaleza, o Bicicletar. Para tal, utiliza-se anlise fatorial exploratria, anlise de clusters e regresso linear. Os resultados indicam que os valores pessoais preponderantes dos usurios so autodeterminao e estimulao; a principal motivao para o uso do sistema compartilhado a economia de custos e tempo; h 3 perfis de consumidores, porm, de forma geral, a bicicleta compartilhada utilizada prioritariamente para fins de lazer aos finais de semana, por pessoas jovens, com faixa de renda intermediria e com alto nvel de escolaridade, ratificando estudos anteriores. Os valores pessoais dos consumidores de bicicleta compartilhada influenciam de forma pouco significativa o consumo colaborativo. Sugere-se ao governo o desenvolvimento de polticas pblicas que fomente essa forma de mobilidade sustentvel.
Validity, Reliability and Acceptability of the Team Standardized Assessment of Clinical Encounter Report*
Authors: Wong Camilla L. , Norris Mireille , Sinha Samir S. , Zorzitto Maria L. , Madala Sushma , Hamid Jemila S.
Published: January 2017

BackgroundThe Team Standardized Assessment of a Clinical Encounter Report (StACER) was designed for use in Geriatric Medicine residency programs to evaluate Communicator and Collaborator competencies.MethodsThe Team StACER was completed by two geriatricians and interdisciplinary team members based on observations during a geriatric medicine team meeting. Postgraduate trainees were recruited from July 2010–November 2013. Inter-rater reliability between two geriatricians and between all team members was determined. Internal consistency of items for the constructs Communicator and Collaborator competencies was calculated. Raters completed a survey previously administered to Canadian geriatricians to assess face validity. Trainees completed a survey to determine the usefulness of this instrument as a feedback tool.ResultsThirty postgraduate trainees participated. The prevalence adjusted bias-adjusted kappa range inter-rater reliability for Communicator and Collaborator items were 0.87–1.00 and 0.86–1.00, respectively. The Cronbach’s alpha coefficient for Communicator and Collaborator items was 0.997 (95% CI: 0.993–1.00) and 0.997 (95% CI: 0.997–1.00), respectively. The instrument lacked discriminatory power, as all trainees scored “meets requirements” in the overall assessment. Niney-three per cent and 86% of trainees found feedback useful for developing Communicator and Collaborator competencies, respectively.ConclusionsThe Team StACER has adequate inter-rater reliability and internal consistency. Poor discriminatory power and face validity challenge the merit of using this evaluation tool. Trainees felt the tool provided useful feedback on Collaborator and Communicator competencies.
Geriatric Homelessness: Association with Emergency Department Utilization
Authors: Hategan Ana , Tisi Daniel , Abdurrahman Mariam , Bourgeois James A.
Published: January 2017

BackgroundHomeless adults frequently use emergency departments (EDs), yet previous studies investigating ED utilization by the older segment received little attention. This study sought to characterize older homeless adults who utilized local urban EDs.MethodsED encounters at three hospitals in Hamilton (Ont.) were analyzed, and demographic and clinical characteristics of the older homeless (age > 50) vs. younger counterparts (age ≤ 50) were compared during a 24-month period.ResultsOf all adults, 1,330 were homeless, of whom 66% were above age 50. Older homeless adults sought less acute care within 30 days from an index visit compared with their younger counterparts. Non-acute illnesses constituted only 18% of triaged cases. Older homeless women with access to a primary care physician (PCP) were 3.3 times more likely to return to ED within 30 days, whereas older homeless men (irrespective of PCP access) were less likely to return to ED.ConclusionsDespite high homeless patient acuity, a lesser number of ED visits with increasing age remains concerning because of previously reported high morbidity and mortality rates. Access to primary care may not be enough to reduce ED utilization. Further research is needed to evaluate acute care interventions and their effectiveness in ED, and to identify homeless patients requiring more targeted services.
Falls & Fall-related Injuries Special Interest Group: a Call to Action
Authors: Montero-Odasso Manuel , Hogan David
Published: January 2017

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Last Issue, 2016
Authors: Madden Ken , Rapoport Mark , Maxwell Colleen
Published: January 2017

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Recovering a "Disfigured" Face
Authors: Yaron Gili , Widdershoven Guy , Slatman Jenny ,   Philosophy Documentation Center
Published: January 2017

Prosthetic devices that replace an absent body part are generally considered to be either cosmetic or functional. Functional prostheses aim to restore (some degree of) lost physical functioning. Cosmetic prostheses attempt to restore a “normal” appearance to bodies that lack (one or more) limbs by emulating the absent body part’s looks. In this article, we investigate how cosmetic prostheses establish a normal appearance by drawing on the stories of the users of a specific type of artificial limb: the facial prosthesis. Given that prostheses are first and foremost devices worn upon the body, such an analysis requires an understanding of the ways in which bodies and technologies interact. We thus interpret users’ stories by critically engaging with the work of disability researcher and Actor-Network theorist Myriam Winance, as well as with the postphenomenological scholarship of Don Ihde and Peter-Paul Verbeek. Using this framework, we explore users’ attempts to achieve a proper fit between their faces and their prostheses, the technological transparency such a fit enables, and the ways in which transparency mediates users’ everyday exchanges with others. We conclude that a normal appearance, when it is achieved by means of prosthetics, enables the device’s user to navigate a precarious social environment as they encounter and interact with others in public.
Vandens motyvas Liūnės Sutemos ir Astridos Ivaskos poezijoje
Authors: Stepukonienė Inga
Published: January 2017

Straipsnyje pasitelkus fenomenologinės analizės principus siekiama apžvelgti vandens motyvo svarbą dviejų baltų tautų poečių – Liūnės Sutemos ir Astridos Ivaskos kūryboje. Reikšmingas Liūnės Sutemos ir Astridos Ivaskos poetinio pasaulėvaizdžio elementas yra vanduo, savitai ženklinantis pasaulio ritmus ir žmogaus egzistenciją, glaudžiai susijęs su asmenybės saviidentifikacija.
Liūnės Sutemos ir Astridos Ivaskos poezijoje vandens stichija dažniausia įprasminama lietaus, sniego, ledo, ežero, jūros struktūra, kuria liudijama stipri gyvenimo manifestacija, viename lygmenyje simboliškai susiejant realybę ir iliuziją, realų ir anapusinį pasaulį.
Vanduo Liūnės Sutemos ir Astridos Ivaskos poezijoje yra ir mirties, ir gyvybės simbolis. Poečių kūrybą artina ryškios individo pastangos išsaugoti savą dvasinį pasaulį, savą kultūrinį „ego“  –  etninę atmintį subrandinusį gimtosios aplinkos, kalbos, žmonių santykių lauką; jūros banga, lietus, sniegas, lašas  –  dažniausios vandens formos, eilėraščio poetinėje erdvėje įprasminančios šias gyvybės išlaikymo, sielos atgijimo, pabudimo semas. Liūnės Sutemos ir Astridos Ivaskos kūrybą artina ir saviidentifikacijos paieškos: pasiaukojančios, atnašaujančios moters savastis.
Darbo metodai: analitinis interpretacinis, aprašomasis, fenomenologinis, lyginamasis.
Multi-Scalar Trade Unionism: Lessons from Maritime Unions
Authors: Fairbrother Peter , Gekara Victor Oyaro
Published: January 2017

Union approaches in relation to the global recalibration of work and employment relations and practices over the last three decades are being worked out in practice. The question for unions is by which means they either have leverage or the potential to exercise power in relation to state and corporate decisions and strategies. Unions thus face challenging questions about the ways they organize, exercise their capacities and attempt to meet their purposes. With reference to the Australian maritime sector, the study examines the ways the main union, the Maritime Union of Australia, developed multi-scalar approaches to localized events. The problem unions face is to defend and advance workers’ interests. The task is to organize, to realize their capacities to defend and advance maritime workers’ interests, increasingly in multi-scalar ways.

The argument is that leaderships and activity that ‘bridge’ scalar relationships are an important condition in this process. There appears to be a complex set of cross-connections between the local, the national and the international. While transnational connectivity increasingly defines contemporary forms of trade unionism, these scalar relations are defined in relation to the workplace, the everyday world, and by the ways that transport is a defining characteristic of the global world. These relations constitute contemporary class struggle where work and employment relations are always in a process of change and development. Trade unionism, thus, remains a collective expression of power relations, in an increasingly internationalized world of work and employment.

Thus, this research presents important lessons for multi-scalar organization and campaigning by unions to realize their capacities and purpose. Nonetheless, this study is only a beginning. While it indicates the processes of bridging, the next step is to investigate the variety of ways that bridging may take place and with what outcomes for the development of multi-scalar activity.
What’s Next after Psychological Contract Violation?
Authors: Guerrero Sylvie , Naulleau Mickael
Published: January 2017

This article adopts an in-depth clinical perspective based on the theoretical framework of grief in order to examine individuals’ reactions following psychological contract violation over a period of 12 months. By focusing on emotional intra-psychic phenomena our study provides evidence of the enduring effects of psychological contract violation on individuals and the employment relationship.

We conducted a total of 60 interviews among 11 managers of a temporary employment agency that has implemented a series of organizational changes, mainly related to restructuring and downsizing decisions. The 11 managers interviewed have been chosen after having reported in a short survey that they experienced a psychological contract violation at work.

Our results indicate that psychological contract violation triggers the subject into a grief process only when violation deprives the individual from a highly invested object at work. In these circumstances, the grief process lasts longer than we originally expected since, over 12 months, we were unable to observe the grief process in its entirety among our participants. We also find that the grief process may be accelerated or stopped according to the capacity of the organization and the individual to offer new objects that satisfy the individual’s needs and thus may help the person mourn the loss experienced as a result of the violation. Finally, our results show that the grief process deeply alters the employment relationship and modifies the amount and intensity of energy that the participants of our study devote to their work.
Genetic defects in β-spectrin and tau sensitize C. elegans axons to movement-induced damage via torque-tension coupling
Authors: Krieg Michael , Stühmer Jan , Cueva Juan G , Fetter Richard , Spilker Kerri , Cremers Daniel , Shen Kang , Dunn Alexander R , Goodman Miriam B
Published: January 2017

Our bodies are in constant motion and so are the neurons that invade each tissue. Motion-induced neuron deformation and damage are associated with several neurodegenerative conditions. Here, we investigated the question of how the neuronal cytoskeleton protects axons and dendrites from mechanical stress, exploiting mutations in UNC-70 β-spectrin, PTL-1 tau/MAP2-like and MEC-7 β-tubulin proteins in Caenorhabditis elegans. We found that mechanical stress induces supercoils and plectonemes in the sensory axons of spectrin and tau double mutants. Biophysical measurements, super-resolution, and electron microscopy, as well as numerical simulations of neurons as discrete, elastic rods provide evidence that a balance of torque, tension, and elasticity stabilizes neurons against mechanical deformation. We conclude that the spectrin and microtubule cytoskeletons work in combination to protect axons and dendrites from mechanical stress and propose that defects in β-spectrin and tau may sensitize neurons to damage.
Platelet-derived growth factor (PDGF) signaling directs cardiomyocyte movement toward the midline during heart tube assembly
Authors: Bloomekatz Joshua , Singh Reena , Prall Owen WJ , Dunn Ariel C , Vaughan Megan , Loo Chin-San , Harvey Richard P , Yelon Deborah
Published: January 2017

Communication between neighboring tissues plays a central role in guiding organ morphogenesis. During heart tube assembly, interactions with the adjacent endoderm control the medial movement of cardiomyocytes, a process referred to as cardiac fusion. However, the molecular underpinnings of this endodermal-myocardial relationship remain unclear. Here, we show an essential role for platelet-derived growth factor receptor alpha (Pdgfra) in directing cardiac fusion. Mutation of pdgfra disrupts heart tube assembly in both zebrafish and mouse. Timelapse analysis of individual cardiomyocyte trajectories reveals misdirected cells in zebrafish pdgfra mutants, suggesting that PDGF signaling steers cardiomyocytes toward the midline during cardiac fusion. Intriguingly, the ligand pdgfaa is expressed in the endoderm medial to the pdgfra-expressing myocardial precursors. Ectopic expression of pdgfaa interferes with cardiac fusion, consistent with an instructive role for PDGF signaling. Together, these data uncover a novel mechanism through which endodermal-myocardial communication can guide the cell movements that initiate cardiac morphogenesis.
Mitochondrial respiratory gene expression is suppressed in many cancers
Authors: Reznik Ed , Wang Qingguo , La Konnor , Schultz Nikolaus , Sander Chris
Published: January 2017

The fundamental metabolic decision of a cell, the balance between respiration and fermentation, rests in part on expression of the mitochondrial genome (mtDNA) and coordination with expression of the nuclear genome (nuDNA). Previously we described mtDNA copy number depletion across many solid tumor types (Reznik et al., 2016). Here, we use orthogonal RNA-sequencing data to quantify mtDNA expression (mtRNA), and report analogously lower expression of mtRNA in tumors (relative to normal tissue) across a majority of cancer types. Several cancers exhibit a trio of mutually consistent evidence suggesting a drop in respiratory activity: depletion of mtDNA copy number, decreases in mtRNA levels, and decreases in expression of nuDNA-encoded respiratory proteins. Intriguingly, a minority of cancer types exhibit a drop in mtDNA expression but an increase in nuDNA expression of respiratory proteins, with unknown implications for respiratory activity. Our results indicate suppression of respiratory gene expression across many cancer types.
Comparison of different sample preparation methods for platinum determination in cultured cells by graphite furnace atomic absorption spectrometry
Authors: Xiao Man , Huang Zaiju , Cai Jing , Jia Jinghui , Zhang Yuzeng , Dong Weihong , Wang Zehua
Published: January 2017

Background

Platinum-based agents are widely used in chemotherapy against solid tumors and insufficient intracellular drug accumulation is one of the leading causes of platinum resistance which is associated with poor survival of tumor patients. Thus, the detection of intracellular platinum is pivotal for studies aiming to overcome platinum resistance. In the present study, we aimed to establish a reliable graphite furnace atomic absorption spectrometry (GFAAS)-based assay to quantify the intracellular platinum content for cultured cells.

Methods

Several most commonly applied cell preparation methods, including 0.2% HNO3, 0.2% Triton X-100, concentrated nitric acid, RIPA combined with concentrated nitric acid and hydroxide, followed by GFAAS for platinum detection were compared in ovarian, cervical and liver cancer cell lines to obtain the optimal one, and parameters regarding linearity, accuracy, precision and sensitivity were evaluated. Influence of other metals on platinum detection and the storage conditions of samples were also determined.

Results

The treatment of cells with 0.2% HNO3was superior to other approaches with fewer platinum loss and better repeatability. The recovery rate and precision of this method were 97.3%–103.0% and 1.4%–3.8%, respectively. The average recoveries in the presence of other metals were 95.1%–103.1%. The detection limit was 13.23 ug/L. The recovery rate of platinum remained acceptable even in cell samples stored in −20 °C or −80 °C for two months.

Discussion

After comparison, we found that 0.2% HNO3was optimal for intracellular platinum quantification based on GFAAS, which presented values compatible with that of inductively-coupled plasma mass-spectrometry (ICP-MS), and this is partially attributed to the simplicity of this method. Moreover, the assay was proved to be accurate, sensitive, cost-effective and suitable for the research of platinum-based antitumor therapy.
The helical domain of the EcoR124I motor subunit participates in ATPase activity and dsDNA translocation
Authors: Bialevich Vitali , Sinha Dhiraj , Shamayeva Katsiaryna , Guzanova Alena , Řeha David , Csefalvay Eva , Carey Jannette , Weiserova Marie , Ettrich Rüdiger H.
Published: January 2017

Type I restriction-modification enzymes are multisubunit, multifunctional molecular machines that recognize specific DNA target sequences, and their multisubunit organization underlies their multifunctionality. EcoR124I is the archetype of Type I restriction-modification family IC and is composed of three subunit types: HsdS, HsdM, and HsdR. DNA cleavage and ATP-dependent DNA translocation activities are housed in the distinct domains of the endonuclease/motor subunit HsdR. Because the multiple functions are integrated in this large subunit of 1,038 residues, a large number of interdomain contacts might be expected. The crystal structure of EcoR124I HsdR reveals a surprisingly sparse number of contacts between helicase domain 2 and the C-terminal helical domain that is thought to be involved in assembly with HsdM. Only two potential hydrogen-bonding contacts are found in a very small contact region. In the present work, the relevance of these two potential hydrogen-bonding interactions for the multiple activities of EcoR124I is evaluated by analysing mutant enzymes usingin vivoandin vitroexperiments. Molecular dynamics simulations are employed to provide structural interpretation of the functional data. The results indicate that the helical C-terminal domain is involved in the DNA translocation, cleavage, and ATPase activities of HsdR, and a role in controlling those activities is suggested.
Tratamiento periodístico de la Responsabilidad Social Empresarial del sector de alimentos en Colombia
Authors:   Universidad de la Sabana, Chía, Colombia, Pinzón-Rios Cindy Paola , Ocampo-Villegas María Cristina ,   Universidad de la Sabana, Chía, Colombia, Gutiérrez-Coba Liliana María ,   Universidad de la Sabana, Chía, Colombia
Published: January 2017

Se realiza un análisis del tratamiento que dan los medios impresos de comunicación colombianos a los temas de Responsabilidad Social Empresarial en el sector de alimentos, en empresas como Ingenios Riopaila-Castilla, Ingenio La Cabaña y Colombina S.A. Se trata de un estudio descriptivo en el cual se utiliza un método de calificación binaria para categorías como datos de identificación, temas de interés, escala de Budd, calidad de la información y el enfoque de la información. Los resultados muestran que los medios colombianos no generan un número significativo de publicaciones referidas a empresas con temas relacionados con la Responsabilidad Social Empresarial, sino que tienen un interés marcado por temas económicos.
Santiago no es Chile: brechas, prácticas y percepciones de la representación medial en las audiencias chilenas
Authors:   Universidad Diego Portales, Santiago, Chile, Arriagada Arturo , Correa Teresa ,   Universidad Diego Portales, Santiago, Chile, Scherman Andrés ,   Universidad Diego Portales, Santiago, Chile, Abarzúa Josefina ,   Universidad Diego Portales, Santiago, Chile
Published: January 2017

Este estudio explora las prácticas de apropiación de distintos medios de comunicación por parte de las audiencias y las percepciones de representación a través de sus discursos. A través de una metodología cualitativa -que combinó el registro de diarios de vida con entrevistas en profundidad (N= 36)- este estudio reveló una brecha centro-periferia: las audiencias definen de forma diferente lo “local” según estén en el centro (Santiago) o en la periferia (regiones). A su vez, las audiencias de la periferia se sienten poco representadas y cubiertas de una manera estereotípica por los medios nacionales, los cuales se concentran en las audiencias del centro.
Fragilidad masculina en la ficción televisiva peruana: el caso de La reina de las carretillas
Authors:   Pontificia Universidad Católica del Perú, Dettleff James A.
Published: January 2017

Analizamos las representaciones masculinas en la ficción televisiva, concentrándonos en la miniserie peruana La Reina de las carretillas. A partir de una matriz de análisis y de trabajo cualitativo sobre las formas de representación, reconocemos una propuesta de diversas masculinidades, que se contraponen a las representaciones femeninas: mujeres empoderadas, con agencia. Los personajes masculinos se alejan del modelo hegemónico patriarcal, y muestran variaciones que responden a masculinidades alineadas al discurso políticamente correcto de la sociedad actual. La contribución de este trabajo está en la matriz de análisis, y la propuesta de una representación masculina alejada del relato latinoamericano clásico.