bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal cutoff for the evaluation of insulin resistance through triglyceride-glucose index: A cross-sectional study in a Venezuelan population
Authors: Salazar Juan , Bermúdez Valmore , Calvo María , Olivar Luis Carlos , Luzardo Eliana , Navarro Carla , Mencia Heysa , Martínez María , Rivas-Ríos José , Wilches-Durán Sandra , Cerda Marcos , Graterol Modesto , Graterol Rosemily , Garicano Carlos , Hernández Juan , Rojas Joselyn
Published: January 2018

Background: Insulin resistance (IR) evaluation is a fundamental goal in clinical and epidemiological research. However, the most widely used methods are difficult to apply to populations with low incomes. The triglyceride-glucose index (TGI) emerges as an alternative to use in daily clinical practice. Therefore the objective of this study was to determine an optimal cutoff point for the TGI in an adult population from Maracaibo, Venezuela.

Methods: This is a sub-study of Maracaibo City Metabolic Syndrome Prevalence Study, a descriptive, cross-sectional study with random and multi-stage sampling. For this analysis, 2004 individuals of both genders ≥18 years old with basal insulin determination and triglycerides < 500 mg/dl were evaluated.. A reference population was selected according to clinical and metabolic criteria to plot ROC Curves specific for gender and age groups to determine the optimal cutoff point according to sensitivity and specificity.The TGI was calculated according to the equation: ln [Fasting triglyceride (mg / dl) x Fasting glucose (mg / dl)] / 2.

Results: The TGI in the general population was 4.6±0.3 (male: 4.66±0.34 vs. female: 4.56±0.33, p=8.93x10-10). The optimal cutoff point was 4.49, with a sensitivity of 82.6% and specificity of 82.1% (AUC=0.889, 95% CI: 0.854-0.924). There were no significant differences in the predictive capacity of the index when evaluated according to gender and age groups. Those individuals with TGI≥4.5 had higher HOMA2-IR averages than those with TGI <4.5 (2.48 vs 1.74, respectively, p<0.001).

Conclusions: The TGI is a measure of interest to identify IR in the general population. We propose a single cutoff point of 4.5 to classify individuals with IR. Future studies should evaluate the predictive capacity of this index to determine atypical metabolic phenotypes, type 2 diabetes mellitus and even cardiovascular risk in our population.
Blinding in trials of interventional procedures is possible and worthwhile
Authors: Wartolowska Karolina , Beard David , Carr Andrew
Published: January 2018

In this paper, we use evidence from our earlier review of surgical randomised controlled trials with a placebo arm to show that blinding in trials of interventional procedures is feasible. We give examples of ingenious strategies that have been used to simulate the active procedure and to make the placebo control indistinguishable from the active treatment. We discuss why it is important to blind of patients, assessors, and caregivers and what types of bias that may occur in interventional trials. Finally, we describe the benefits of blinding, from the obvious ones such as avoiding bias, as well as less evident benefits such as avoiding patient drop out in the control arm.
Using the Technology of Blended Learning in a Modern School: Overview of Domestic and Foreign Models
Authors: Чернобай Елена , Chernobay Elena , Давлатова М. , Davlatova M.
Published: January 2018

The article reviews the domestic and foreign blended learning models which are used in contemporary schools. The history of blended learning development in foreign, in particular, American and Russian educational environments is considered. Moreover, the authors examine the main existed approaches to determining the concept of blended learning, the developed classifi cations of blended learning models, as well as the activities devoted to its development and expansion.
Therapeutic interventions
Authors: Cook Tim
Published: January 2018

Introducing a range of therapeutic provision in his disadvantaged primary school was at the heart of Dr Tim Cook's school improvement strategy
We've explored… London
Authors: Rawstrone Annette
Published: January 2018

How one setting used its own resources to explore the capital and bring it to life. By Annette Rawstrone
Face value
Authors: Vollans Caroline
Published: January 2018

Face blindness – not being able to recognise familiar people's faces – is a very misunderstood condition, explains Caroline Vollans
The role and contribution of an intermediary organisation in the implementation of an interactive knowledge transfer model
Authors: Gagnon Stephanie , Mailhot Chantale , Ziam Saliha
Published: January 2018

Despite enthusiasm for the use of intermediation as a knowledge transfer strategy, there is little research documenting the conditions for its success. This article addresses the role of the intermediary in a collaborative research project. The focus is on how the intermediary facilitates the implementation of an interactive knowledge transfer model. Using a case study as part of a research strategy, we demonstrate that the success of a collaborative research project rests on the credibility and legitimacy of the intermediary, as well as its ability to encourage the involvement of all stakeholders. In fact, the collaborative leadership demonstrated by the intermediary helped to reconcile the various motivations of the project’s stakeholders as well as their views of the project’s usefulness.
Urban Tattoos for new Landscape narratives. Explorando el papel del arte urbano en el contexto de la ciudad contemporánea.
Authors: García-Mayor Clara
Published: January 2018

El estudio de la ciudad contemporánea ha evolucionado en las últimas décadas, incorporando a la descripción morfológica de datos objetivos y elementos que configuran la escena urbana, otros factores subjetivos como son el comportamiento, la experiencia y las preferencias de los usuarios. En el espacio público urbano se contextualizan y suceden los procesos sociales, multiculturales e intergeneracionales, que conciernen a una colectividad. De todas las posibles formas de expresión pública, la práctica ancestral de escribir en las paredes —hoy denominado graffiti— ha sido el modo de expresión libre, reivindicativo y anónimo que, combinado con las técnicas de diseño gráfico, difundía de forma transgresora y espontánea un mensaje a la vista de todos. Asimilable a la manera en que los tatuajes se imprimen en la piel, el graffiti lo hace sobre la envolvente del espacio público —Urban Tattoo—; y aunque no modifica la geometría del lugar incide en la percepción espacial; se establece, así, un diálogo con el observador activando nuevas narrativas, comparable al efecto que puede tener un tatuaje como proyección de la personalidad de quien lo lleva. El presente artículo analiza cómo el graffiti y su evolución en imagen mural de arte urbano transforman la interpretación del espacio público contemporáneo; muestra las diferencias entre las iniciativas de carácter individual y las que están organizadas a través de instituciones públicas o privadas; y, finalmente, reflexiona sobre alguno de los efectos derivados de la instrumentalización de la técnica por intereses ajenos a la libre expresión creativa.
Análise do Conhecimento dos Agentes Comunitários de Saúde da Unidade de Saúde da Família de uma cidade do interior da Bahia sobre Hipertensão Arterial
Authors: Santos Elenito Bitencorth , Mares Filho Almir Santos , Fernandes Mayline Alcântara
Published: January 2018

O aumento de óbitos relacionado direta ou indiretamente a Hipertensão Arterial vem caracterizando a população mundial como um problema relevante de saúde pública evidenciado dentro da modalidade das doenças não transmissíveis, onde 10-20% dos adultos são acometidos de tal enfermidade. Conceituada como síndrome hipertensiva, ela é diagnosticada através da aferição dos níveis pressóricos com base na força exercida nos vasos sanguíneos, a mesma, identificada pela contração cardíaca sistólica e diastólica elevadas. O presente trabalho tem como objetivo analisar o conhecimento dos Agentes Comunitários de Saúde sobre hipertensão arterial, por se tratar de profissionais que realizam diretamente um trabalho de mediação entre a comunidade e a Estratégia de Saúde da Família. Eles surgiram no Brasil como um instrumento útil para a redução alarmante dos indicadores de morbimortalidade, sendo capaz de mitigar os fatores de risco para a doença com ações e medidas preventivas informacionais. Como estratégia metodológica, optou-se por um estudo qualiquantitativo do tipo exploratório, o que permite um específico enfoque de uma dada realidade, realizado através de questionário com 15 Agentes Comunitários de Saúde pertencentes a Unidade de Saúde da Família de uma cidade do interior da Bahia em janeiro de 2012. O estudo permitiu identificar que apesar de 100% dos Agentes Comunitários de Saúde já terem participado de alguma capacitação sobre Hipertensão e se considerarem aptos a passar informações à comunidade, identificou-se algumas dificuldades destes trabalhadores referente à patologia, tornando-se uma situação estarrecedora, apesar de ser considerados como parte fundamental e reorganizadora da atenção básica, podendo atuar em diversos contextos da promoção à saúde e minimização dos agravos. Palavras-chave: Agente Comunitário de Saúde. Hipertensão Arterial Sistêmica. Comunidade.
Ensino de Filosofia Fé-Razão no Pensamento de Kierkegaard
Authors: Castro Roberto Menezes de
Published: January 2018

O artigo quer mostrar a importância da filosofia e do ensino-aprendizagem em sala de aula e na vida cotidiana de cada discente, a partir de uma reflexão diante da fé e da razão e a luz do existencialismo trazido pelo filósofo dinamarquês Soren Aabye Kierkegaard que trabalhou majestosamente esse tema. É notório que a Filosofia segue a regra da racionalidade, dessa forma, porque não refleti-la também dentro do contexto da fé? Dessa maneira queremos apresentar esse embate da fé e da razão como indicadores para nos levar a trilhar o caminho do conhecimento de novas descobertas.
O Uso dos Jogos no Ensino da Matemática
Authors: Barros Marcelo Lopes Leão , Angelim Clenilson Panta
Published: January 2018

Esse artigo tem como objetividade difundir o jogo matemático como uma das principais alternativa para tornar o ensino da matemática mais dignificante e acolhedor, aumentando assim a motivação e o despertar do discente pela Matemática. O uso do jogo traz um aprendizado com grandes perspectivas no desenvolvimento da capacidade mental e intelectual do discente tornando gratificante, satisfatório e significativo o ensino da matemática, promovendo assim o cálculo mental, indução pela a busca de estratégias, dominar o uso das operações fundamentais, o construtivismo dos conceitos e o aperfeiçoamento do raciocínio lógico. Além de desenvolver o gosto e o prazer pela a matemática.
O Papel do Cuidador na Identificação dos Fatores Relacionados ao Suicídio de Idosos
Authors: Alcântara Maria Raquel De Oliveira , Maranhão Thércia Lucena Grangeiro , Marinho Ana Olívia De Oliveira , Macedo Leonarda Carvalho de
Published: January 2018

O artigo teve como objetivo identificar o papel do cuidador na identificação dos possíveis fatores que levam pessoas idosas a cometerem suicídio dentro do seu contexto familiar e social, tendo como objetivos específicos: identificar, quais fatores estão relacionados a tentativas de suicídio no idoso; analisar de que forma os fatores de risco do suicídio podem ser amenizados da vida do idoso e compreender a importância do acolhimento familiar e psicológico no processo de envelhecimento saudável. Foi realizada uma pesquisa bibliográfica em artigos científicos e livros, utilizando a abordagem qualitativa. Assim, conclui-se que a presença da família e de um cuidador é de suma importância no processo de envelhecimento e na identificação dos comportamentos suicidas, onde a falta de atenção e amor dos familiares, são os fatores mais comuns para o desencadeamento de ideações, comportamentos e suicídios em idosos. A pesquisa não pretende esgotar o tema, mas contribuir para o desenvolvimento de novas pesquisas dentro dos fatores de riscos encontrados.
Automedicação em Universitários do curso de Graduação da área de Saúde em uma Instituição de Ensino Superior Privada em Vitória da Conquista
Authors: Freitas Valéria Pires , Marques Matheus Santos , Duarte Stênio Fernando Pimentel
Published: January 2018

A automedicação pode ser conceituada como a utilização de fármacos por iniciativa e indicação do próprio paciente, gerando assim graves riscos à sua saúde. Este tipo de consumo tem como principal objetivo a diminuição dos sintomas e a cura de determinada doença, independentemente do medicamento ter sido prescrito ou não por um profissional habilitado. A fiscalização das autoridades sanitárias é ineficaz e constantemente burlada. Isso porque mesmo diante da obrigação legal da permanência constante de um profissional capacitado no estabelecimento farmacêutico e da exigência de receita médica para venda de vários medicamentos, temos dados que demonstram que a automedicação ainda tem um índice muito alto no Brasil e no mundo. Além da falta de fiscalização, são várias as razões que contribuem para isso, tais como o uso de medicamentos para curar qualquer tipo de patologia e as táticas de motivação e persuasão utilizadas pela indústria farmacêutica, as quais podem contribuir para instigar o desejo de consumo de algumas medicações, bem como propiciar vontades “irracionais” direcionadas para o uso de medicamentos por indivíduos ou populações. Trata-se de um estudo transversal de abordagem quantitativa sobre a ocorrência de automedicação entre universitários do primeiro (1º) e décimo (10º) semestres dos cursos de saúde de uma instituição particular de ensino superior em Vitória da Conquista/BA, no ano de 2017. Foram aplicados 189 questionários nos meses de Agosto e Setembro. Sobre fazer o uso ou comprar medicamentos sem receita 181 (95,8%) relatam fazer essa prática, quando somente 8 (4,2%) dos entrevistados afirmou que não. Já em relação a fazer reutilização de receitas antigas 66 (34,9%) afirmam fazer o uso e 123 (65,1%) não se aplica essa prática, dos 66 que afirmaram reutilizar receitas 65 (98,5%) relataram ser próprias e 1 (1,5%) relatou ser da mãe e tias.
A Importância do Curso de Operações Rurais, no âmbito organizacional e pedagógico, da Companhia Independente de Policiamento Especializado – Caatinga da Polícia Militar do Estado da Bahia: Um Estudo de Caso
Authors: Ferreira Fábio Jorge Nascimento , Souza Nadjane Gonçalves de , Silva Wilton Panta da
Published: January 2018

O objetivo principal deste trabalho é validar a importância do Curso de Operações Rurais,  no âmbito da Polícia Militar do Estado da Bahia, enquanto pratica pedagógica-organizacional, tendo como seu principal agente, a CIPE/Caatinga, unidade responsável pela implantação do modelo de atuação operacional adotado junto às Companhias Independentes de Policiamento Especializado – CIPE’s. Desenvolvido através de estudos sobre gestão de competências, processos de ensino-aprendizagem, educação corporativa, gestão de pessoas, docência, prática pedagógica e treinamento policial militar, evidenciando-se como um artigo original, e complementado com livros e pesquisas correlacionadas à realidade da profissão policial militar, o citado trabalho preocupou-se, basicamente, em realizar uma análise concisa e bastante didática, verificando a história, a realidade e a relevância da CIPE/Caatinga e, num segundo momento, o fomento gerado pela realização do VIII Curso de Operações Rurais e as suas repercussões no plano intitucional.
Os Sistemas Florestais na Preservação das APP
Authors: Ribeiro Fernanda Teixeira , Ribeiro Mariana Emídio Oliveira , Antoniolli Bianca Inêz , Silva José Marcos Santos da , Venturin Edileuza Valeriana De Farias
Published: January 2018

O atual item sobrepuja relatos que podem incidir os códigos florestais na recuperação de Áreas de Preservação Permanente (APP). Nos estudos sobre princípios florestais, múltiplos fatores são aliados, não somente aos pequenos agricultores, mas também para aqueles que possuem nas propriedades áreas que precisam de preservação. Os métodos de estudos que foram compostos pela presente pesquisa bibliográfica qualitativa e exploratória, foram estudos situados nas linguagens dos vários autores citados na mesma. Os objetivos elencados nesse estudo possuem confirmação pelo papel importante do equilíbrio ecológico das propriedades que torna uma opção que pode ser adotada em propriedades que tenham produção da agricultura familiar. Os benefícios dos sistemas florestais, estão na diversidade citar a de espécies utilizadas nas formas de plantio; melhoria e a capacidade produtiva do solo ;reduzido a utilização dos recursos naturais disponíveis; adaptando-se as condições ecológicas que trazem vantagens sutis em curto tempo.
Os efeitos da massagem terapêutica manual em pacientes com a síndrome da fibromialgia
Authors: Gondim Sarah Santos , Almeida Maria Antonieta Pereira Tigre
Published: January 2018

A síndrome da fibromialgia (SFM), possui origem desconhecida e diagnóstico incerto, acomete milhares de pessoas principalmente mulheres, tendo como características principais: dores musculoesqueléticas associadas a distúrbio do sono e psíquicos, rigidez matinal, cefaleia crônica e alterações de humor. Fatores psicológicos e biológicos simultaneamente fazem com que o indivíduo diminua sua capacidade de saber lidar com a dor e como decorrência disso muitos apresentam sintomas de ansiedade e depressão. O objetivo desse trabalho de revisão da literatura é de reunir referências recentes sobre a fibromialgia e informar aos leitores sobre a importância de tratamentos alternativos como a massagem terapêutica e seus efeitos sendo esta conceituada como técnicas de manobras para alívio de dores em pacientes com fibromialgia, para que haja melhora na qualidade de vida dos mesmos.
Análise de clima organizacional e ações de endomarketing em uma empresa do campo: um estudo de caso na empresa GrandValle
Authors: Caffé Filho Hesler Piedade , Andrade Ludimilla Macedo de , Theotonio Paula Nely Vasconcelos
Published: January 2018

Este estudo tem como objetivo identificar as percepções dos colaboradores de campo em relação às ações de endomarketing realizadas pela fazenda GrandValle Agrícola, de Casa Nova (BA). A escolha da fazenda em questão se deu pela importância do negócio para a região e pela massiva contratação de trabalhadores rurais por ela e em todo o Vale do São Francisco. Para tanto, partimos de um pesquisa exploratória com estudo de caso de abordagem qualitativa. No intuito de avaliar o clima organizacional, foi aplicado um questionário estruturado, com amostra aleatória simples, a 20 trabalhadores do setor de manga e 46 colaboradores atuantes do segmento de uva. As dimensões contempladas foram: condições de trabalho, segurança, comunicação, liderança, relacionamento interpessoal, compensação e reconhecimento. Após identificar problemas como absenteísmo e falhas na comunicação entre trabalhadores e gestores, são sugeridas três ações que podem vir a sanar os problemas encontrados, bem como possíveis desdobramentos deste artigo científico.
Reestruturação no Layout: Otimizando tempo e reduzindo custos
Authors: Silva Louriano Santana da , Vale Júnior João Sotero Do
Published: January 2018

O presente artigo tem como objetivo avaliar a importância de uma boa estrutura de layout em centros de distribuição, com foco em descargas (recebimento) e cargas (expedição) de mercadorias, de modo a analisar sua movimentação e armazenagem, bem como os custos atrelados ao processo. Foi realizado um estudo de caso em uma empresa do ramo atacadista de alimentos e bebidas na cidade de Cruz das Almas-BA. Os dados foram analisados a partir da Análise Proposicional Quantitativa. Os resultados revelaram que um bom layout na estrutura física leva ao aumento da produção e reduz custos, tornando a uma maior competitividade no mercado.
Parada e Reanimação Cardiopulmonar em Criança: atuação da equipe de enfermagem da Unidade de Terapia Intensiva Pediátrica em hospital público de Vitória da Conquista – Bahia
Authors: Santos Elenito Bitencorth
Published: January 2018

Objetivo: avaliar o conhecimento da equipe de enfermagem em relação à técnica de Reanimação Cardiopulmonar e medicações utilizadas em crianças internadas na Unidade de Terapia Intensiva Pediátrica do Hospital Geral de Vitória da Conquista, Bahia. Métodos: quanto à natureza a pesquisa é quantitativa descritiva com paradigma positivista, sendo, quanto aos procedimentos técnicos uma pesquisa de campo participante, visando alcançar os objetivos propostos através de estatísticas obtidas pelos questionários. Resultados: os dados estabeleceram o perfil da população estudada; identificação da Parada Cardiopulmonar; os conhecimentos técnico-científicos dos profissionais: manobras e uso de medicações relevantes na parada cardiorrespiratória; a periodicidade dos treinamentos de Reanimação Cardiopulmonar, onde, dos 25 profissionais de enfermagem da Unidade de Terapia Intensiva Pediátrica, 20% foram treinados após a admissão e 36% não receberam treinamento, tendo que aprender o serviço no cotidiano ao exercer suas funções. A equipe pesquisada consegue perceber com êxito a insuficiência respiratória no menor, porém, ao tentar identificar uma parada cardiopulmonar não conseguiram demonstrar seu conhecimento técnico-científico satisfatoriamente, pois revelam respostas incompletas relacionadas a todos os sinais e sintomas do seu início. Um ponto importante a ser trabalhado nos funcionários em questão seria o uso das drogas, direcionando para causa/efeito no organismo da criança com parada cardiorrespiratória. Conclusão: a metodologia utilizada permitiu conhecer a dificuldade enfrentada pela equipe de enfermagem no seu setor de trabalho devido à quantidade reduzida de treinamento e atualização adequada. Um ponto importante a ser trabalhado nos funcionários em questão seria o uso das drogas, direcionando para causa/efeito no organismo da criança com parada cardiorrespiratória.
Estimation of inferior alveolar nerve proximitytothe root api-ces : A CBVI analysis
Authors: Pagare Sandeep , Roy Christine , Vahanwala Sonal , Gavand Kapil , Waghmare Mandavi , Goyal Saurabh
Published: January 2018

A sound knowledge of the relative three dimensional (3D) approximations to the inferior alveolar nerve (IAN) to the root apices of the mandibular premolars and molars and their significance to gender and age is imperative for any dental procedure. Utilization of Cone Beam Computed Tomography (CBCT) has facilitated increased accuracy, higher resolution, and scan time and dose reduction. Literature reveals that various procedures in endodontics and oral surgery may lead to IAN injury, a rare but serious treatment complication. It can result from over instrumentation, periapical surgery and over filling by root canal obturation materials. Surgical endodontic procedures require a thorough knowledge of anatomic structures that might be traumatized. What better view than CBCT, where it gives a thorough knowledge about the 3D position of the IAN, allowing 3D reconstruction in true 1:1 anatomic representation. Majority of IAN injury cases reported were in relation to the mandibular second molars hence before undertaking procedures with potential damage to the IAN, it is essential to know the location of the IAN with respect to the surrounding structures to avoid injury or harm. A study was undertaken with an aim to assess the distance between the apical tips of the mesial roots of the first, second molars and second premolars to the superior border of the IAN. The findings of which could be used to prevent injuries to the inferior alveolar nerve.
Transformaciones del derecho y del estado un espacio de reflexión de Novum Jus.
Authors: Carvajal Martinez Jorge Enrique
Published: January 2018

A lo largo de la evolución del Estado moderno, este se ha esforzado por establecer una separación de poderes y un control jurídico que permitan el cumplimiento de los derechos; adicionalmente, a través de la historia de la modernidad se ha presentado un incremento considerable de titularidades, particularmente en el campo de los derechos humanos, derechos que han sido reflejados en el ordenamiento jurídico interno y en los innumerables tratados que en el ámbito del derecho internacional público se han producido, particularmente desde las Naciones Unidas.
When Does Market Share Matter? New Empirical Generalizations from a Meta-Analysis of the Market Share–Performance Relationship
Authors: Edeling Alexander , Himme Alexander
Published: January 2018

The impact of market share on financial firm performance is one of the most widely studied relationships in marketing strategy research. However, since the meta-analysis by Szymanski, Bharadwaj, and Varadarajan (1993) , substantial environmental (e.g., digitization) and methodological (e.g., accounting for endogeneity) developments have occurred. The current work presents an updated and extended meta-analysis based on all available 863 elasticities drawn from 89 studies and provides the following new empirical generalizations: (1) The average raw market share–financial performance elasticity is .132, which is substantially lower than the effectiveness of other intermediate marketing metrics. This result challenges a widely used strategy that solely focuses on increasing market share. (2) Elasticities differ significantly between contextual settings. For example, they are lower for business-to-business firms than for business-to-consumer firms, for service firms than for manufacturing firms, and for U.S. markets than for emerging and Western European markets. The authors also observe differences between countries with respect to a general time trend (e.g., lower elasticities in recent times for Western European markets) and recessionary periods (e.g., lower elasticities in the United States, higher elasticities in non-Western economies).
Neural Profiling of Brands: Mapping Brand Image in Consumers’ Brains with Visual Templates
Authors: Chan Hang-Yee , Boksem Maarten , Smidts Ale
Published: January 2018

The authors demonstrate a novel template-based approach to profiling brand image using functional magnetic resonance imaging. They compare consumers’ brain responses during passive viewing of visual templates (photos depicting various social scenarios) and brain responses during active visualizing of a brand's image, and then they generate individual neural profiles of brand image that correlate with the participant's own self-report perception of those consumer brands. In aggregate, these neural profiles of brand image are associated with perceived cobranding suitability and reflect brand image strength rated by a separate and bigger sample of consumers. This neural profiling approach offers a customizable tool for inspecting and comparing brand-specific mental associations, both across brands and across consumers. It also demonstrates the potential of using pattern analysis of neuroimaging data to study multisensory, nonverbal consumer knowledge and experience.
Social Sustainability as Buying Local: Effects of Soft Policy, Meso-Level Actors, and Social Influences on Purchase Intentions
Authors: Testa Francesco , Russo Michael V. , Cornwell T. Bettina , McDonald Aaron , Reich Brandon
Published: January 2018

Recently issued United Nations Sustainable Development Goals call for people to make extensive behavioral changes, including consuming food more sustainably. The authors explore the role that meso-level retailers play in local purchasing, an activity that the United Nations recognizes as a contributor to sustainability. In so doing, the authors promote more balance within the marketing literature, which has focused more on the environmental component of products and purchasing and less on the local dimension. This article spotlights “soft” policies, those that use persuasion and encourage voluntary action, rather than direct methods, such as subsidies and regulations. The authors develop a core hypothesis about how social norm messages and attitudes toward local food affect consumer purchase intentions. They test this hypothesis across national contexts via online surveys of 316 Italian consumers (Study 1) and 186 U.S. consumers (Study 2). The analysis reveals that in both countries, the effectiveness of social norm messages increases with unfavorable attitudes toward local buying. The study concludes with thoughts for researchers and policy makers about how meso-level actors, such as retailers, can elicit more local purchasing.
Universal Liver Extraction Algorithm: An Improved Chan–Vese Model
Authors: Siri Sangeeta K. , Latte Mrityunjaya V.
Published: January 2018

Liver segmentation is important to speed up liver disease diagnosis. It is also useful for detection, recognition, and measurement of objects in liver images. Sufficient work has been carried out until now, but common methodology for segmenting liver image from CT scan, MRI scan, PET scan, etc., is not available. The proposed methodology is an effort toward developing a general algorithm to segment liver image from abdominal computerized tomography (CT) scan and magnetic resonance imaging (MRI) scan images. In the proposed algorithm, pixel intensity range of the liver portion is obtained by cropping a random section of the liver. Using its histogram, threshold values are calculated. Further, threshold-based segmentation is performed, which separates liver from abdominal CT scan image/abdominal MRI scan image. Noise in the liver image is reduced using median filter, and the quality of the image is improved by sigmoidal function. The image is then converted into binary image. The Chan–Vese (C–V) model demands an initial contour, which evolves outward. A novel algorithm is proposed to identify the initial contour inside the liver without user intervention. This initial contour propagates outward and continues until the boundary of the liver is identified accurately. This process terminates by itself when the entire boundary of the liver is detected. The method has been validated on CT images and MRI images. Results on the variety of images are compared with existing algorithms, which reveal its robustness, effectiveness, and efficiency.
Professionally responsible management of gynecologic cancer in pregnancy when clinical resources are unavoidably limited
Authors: Božanović Tatjana , Pejović Tanja , Chervenak Frank A. , McCullough Laurence , Ljubić Aleksandar
Published: January 2018

General ethical principles such as respect for autonomy and justice could probably be unique around the world but there is an enormous diversity of medical care possibilities that are provided for patients around the globe, and therefore different approaches should be considered depending on the level of health care provided.
DMF-promoted reductive functionalization of CO2 with secondary amines and phenylsilane to methylamines
Authors: Liu Xiao-Fang , Qiao Chang , Li Xiao-Ya , He Liang-Nian
Published: January 2018

An amide-promoted protocol was developed for the reductive functionalization of CO2 with amines/imine and phenylsilane to produce methylamine. Secondary amines and an imine were methylated successfully to methylamines with up to 98% yield under atmospheric pressure of CO2 and 80°C. Furthermore, a tentative mechanism involving amide-promoted CO2 reduction to the silyl acetal species was proposed. Striking features of this metal-free protocol are selective six-electron reduction of CO2 with hydrosilane as a reductant in the presence of amine.
Selected data from the Polish National Prenatal Cardiac Pathology Registry from the year 2016
Authors: Kordjalik Paulina , Tobota Zdzisław , Respondek-Liberska Maria
Published: January 2018

Introduction: Analysis have been subjected to evaluate standard data reports from the Polish National Prenatal Cardiac Pathology Registry from the year 2016, compared to previous years. Material and methods: The methodology of this work was comparison of the data from previous years that have been published in the Prenatal Cardiology and records generated in www. orpkp.pl from the year 2016. The total number of records entered in the Registry in the year 2016 was n=774. Results: Top 10 most common prenatal CHD in 2016 were such as follow: HLHS, AVSD, VSD, d-TGA, TOF, AvS, muscular VSD, Aberrant origin R subclavian artery, RAA, CoA. In the centers Lodz and Krakow the most common prenatal congenital heart defects were severe CHD requiring surgery in 1 st month of life. In the contrast, in Warsaw the first place was taken by a “critical heart defects” regardless whether cardiac surgery was planned in first week (contemporary definition of prenatal critical heart defects) or first month - contemporary definition of severe planned heart defects of postnatal life. Conclusion: The fact that in 2016 most common cause of referrals to targeted the fetal chocardiography was abnormal, large vessels view and not the abnormal 4 chamber view of the heart, suggests more and better training of hysicians performing the screening or basic study of fetal heart in Poland.
Single Fetal Cardiac Tumors and Follow-Up Based on 13 Cases from the Fetal Cardiac Referral Center in 1993-2017
Authors: Żalińska Agnieszka , Korabiewska Sara , Krekora Michał , Michalak Krzystof , Kopala Marek , Cichos Ewa , Romanowicz Anna , Słodki Maciej , Respondek-Liberska Maria
Published: January 2018

Introduction: Fetal cardiac tumors are anomalies, that occur rarely: from Nationwide Register of Fetal Cardiological Problems in Poland in years 2004-2016 amongst 8112 fetuses with cardiological problems, there were 85 fetuses with cardiac tumors, including 52 cases of multiple cardiac tumors (0,64%) and 33 of single anomalies (0,4%). Material: This analysis included 13 cases from single tertiary fetal cardiac center Lodz in years 1993-2017. Results: Ten out of 13 fetuses with single cardiac tumors (SFCT) had cardiomegaly: on average HA/CA was 0,49. The size of the tumor was different: the smallest one - 6 x 6 mm, the biggest 47 x 47 mm. The way of the delivery: in 10 cases there was CS and in 3 cases natural delivery. Birth weight was from 2000-3950 g (average 2989,2 g). Cardiosurgical resection of the tumor was performed on 4 newborns: at 2nd, 4th, 8th and 16th day of life (average 7,5 day). Four neonatal deaths were registered (31%): in 1st 2nd and 11th day (before surgery) and in the 28th day after the operation. Conclusions: Single fetal cardiac tumors (SFCT) can be diagnosed at 20 weeks of pregnancy, which allows to start echocardiographic monitoring, taking into consideration the potential risk of hemodynamic progression. SFCT can be the first sign of tuberous sclerosis complex in later prenatal or postnatal life. SFCT other than rhabdomyoma can be asymptomatic in newborn, but may require an early cardiosurgical resection.
The Prognosis for Fetuses with Vein of Galen Malformation and Symptoms of Heart Failure
Authors: Nawara-Baran Agnieszka
Published: January 2018

Vein of Galen Malformation (VGM) it is the most common cerebral arteriovenus malformation in fetuses and children. Usually VGM causes volume overload of the heart and can induce mass effect in the brain, causing progressive neurological impairment. Modern treatment allow on earlier therapy (before the 5th monthof life). This gives the newborn with isolated VGM and heart failure a chance of survival. This work presents case of isolated vein of Galen malformation with diagnosed cardiomegaly, monophasic flow through the tricuspid valve, large right heart, pericardiac effusion, dilatation of SVC and abnormal doppler exam. Postnatal management included aggressive medical treatment of cardiac failure and early transarterial embolization of the selected vessels feeding the aneurysm at 6 days of age. The newborn is 6 month old, growing normally without neurological deficits or developmental retardation and waiting of next stage therapy. New techniques of treatment give fetuses with VGM and prenatal signs of cardiac insufficiency a chance of survival and healthy life, in a group of selected cases. The analysis of the cardiovascular system in fetuses with VGM according to uniform criteria is essential in order to assess the influence of these malformations on the survivability of newborns.
Authentic Science with Live Organisms Can Improve Evolution Education
Authors: Broder E. Dale , Angeloni Lisa M. , Simmons Stephanie , Warren Sarah , Knudson Kaitlin D. , Ghalambor Cameron K.
Published: January 2018

Evolution education in the United States remains controversial and challenging. This is in part due to the difficulty educators face when trying to overcome students' preexisting beliefs about evolution, which can bias assimilation of information and inhibit learning. We propose that the most effective way to overcome such belief persistence is through an engaging, hands-on inquiry approach that mimics the scientific process used to study evolution. Although this teaching approach, known as authentic science, has gained recognition for its effectiveness in the classroom, it has not been widely applied to teach evolution. We describe how an authentic science approach can be used to teach evolution by natural selection, and provide a formula for the development of such programs. Following this blueprint, we developed a program using Trinidadian guppies and implemented it in 7th grade classrooms in Colorado. Pre- and post-program assessments revealed significant increases in both the understanding and acceptance of evolution among participants. Authentic science experiments using locally adapted populations of live organisms may be able to overcome belief persistence and improve student understanding of evolution.
The Ongoing Challenges to Evolution Education: Schools, the Law, and Classroom Instruction
Authors: Hall Gordon Emmett , Woika Shirley Andrea
Published: January 2018

There are forces at the local, state, and national levels that have worked to delegitimize the teaching of evolution and, in some cases, to legitimize the teaching of religious theory. Despite scientific evidence, public opinion, and even legislation, these forces have continued to influence, and in some cases block, the teaching of evolution in public schools. Proponents for the teaching of religious theory in schools have been defeated in the courts many times but have continued to find new ways to insert their ideology into the U.S. education system. Strategies for avoiding controversy, confronting misinformation, and distinguishing science from faith are provided at the end of this article.
IAPP and type 1 diabetes: implications for immunity, metabolism and islet transplants
Authors: Denroche Heather C , Verchere C Bruce
Published: January 2018

Islet amyloid polypeptide (IAPP), the main component of islet amyloid in type 2 diabetes and islet transplants, is now recognized as a contributor to beta cell dysfunction. Increasingly, evidence warrants its investigation in type 1 diabetes owing to both its immunomodulatory and metabolic actions. Autoreactive T cells to IAPP-derived epitopes have been described in humans, suggesting that IAPP is an islet autoantigen in type 1 diabetes. In addition, although aggregates of IAPP have not been implicated in type 1 diabetes, they are potent pro-inflammatory stimuli to innate immune cells, and thus, could influence autoimmunity. IAPP aggregates also occur rapidly in transplanted islets and likely contribute to islet transplant failure in type 1 diabetes through sterile inflammation. In addition, since type 1 diabetes is a disease of both insulin and IAPP deficiency, clinical trials have examined the potential benefits of IAPP replacement in type 1 diabetes with the injectable IAPP analogue, pramlintide. Pramlintide limits postprandial hyperglycemia by delaying gastric emptying and suppressing hyperglucagonemia, underlining the possible role of IAPP in postprandial glucose metabolism. Here, we review IAPP in the context of type 1 diabetes: from its potential involvement in type 1 diabetes pathogenesis, through its role in glucose metabolism and use of IAPP analogues as therapeutics, to its potential role in clinical islet transplant failure and considerations in this regard for future beta cell replacement strategies.
Prognostic importance of acute heart failure persistence in patients with ST-elevation myocardial infarction
Authors: Kozhukhov Sergey , Parkhomenko Alexander , Dovganych Nataliia
Published: January 2018

Introduction: Acute heart failure (AHF) is one of the most frequent complication of acute myocardial infarction (AMI). It is not only associated with a several-fold increase of in-hospital mortality but also, worsens the long-term survival in comparison to those without AHF. The AHF is observed to be more in AMI patients whose in-hospital stay is more than 3 days. The clinical implications and prognostic accuracy of the AHF term in the setting of AMI are yet unknown.

Methods: We observed 1,104 consecutive cardiac care patients, who were admitted with ST-elevation AMI (STEMI). They were divided into groups according to the AHF presence {AHF(+) n=334 and AHF(-) n=764}. Among 334 AHF(+) patients: 252 patients were found to have a transient AHFt(+), whereas 82 of AHF(+) patients had persistent AHFp(+) during in-hospital period.  Patients' baseline characteristics, blood analysis, left ventricle (LV) and renal function data were assessed and analyzed on the admission day and 10th day post-admission. The follow-up was conducted on the 30th day and after 2 years.

Results. STEMI patients accompanied by AHF(+) were older, presented mostly with anterior AMI (p<0.01), had lower LV ejection fraction (EF) (p<0.01) and a higher heart rate (p<0.05). Their rates of comorbidities and of in-hospital complications such as recurrent angina, reinfarction, LV aneurism were higher in comparision to AHF(-) patients. AHFp(+) patients had the shortest time from symptoms onset before thrombolysis in comparision to AHFt(+) and AHF(-) groups. Partial recovery of cardiac function according to Left ventricular ejection fraction (LVEF) and end-systolic volume index, occurred mainly in AHF(-) and AHFt(+) patients on the 10th day post-admission, but not in AHFp(+).

STEMI patients with AHFp(+) demonstrated a larger infarct size, higher C-reactive protein and VGEF level, fasting glucose and heart rate on admission, higher erythrocyte sedimentation rate, absence of heart rate normalization on the 10th day post-admission. All of these markers were the signs of severe myocardial damage and inflammation, which can reflect worse recovery in AHF patients despite optimal management. Patients with AHF(+) had renal dysfunction on admission while its creatinine clearance (CrCl) decreased during the in-hospital period which is the reflection of a poor prognosis.

Сardiovascular mortality and non-fatal MI were significantly higher in the AHFp(+) group as compared to the AHFt(+) and the AHF(–) groups during the 30 days and 2 years of follow-up.

Conclusion: The AHF is a frequent STEMI complication. AHF lasting >3 days had worse short- and long-term prognosis. Therefore, an aggressive strategy should be recommended particularly in patients who have clinical signs and symptoms of persistent AHF.

Keywords: myocardial infarction, acute heart failure, infarct size, survival.
Editors and Reviewers Acknowledgement, 2(1), January-June, 2018
Authors: Team Editorial
Published: January 2018

The Journal of Medical Research and Innovation would like to thank each and every one who has helped us to review and edit the articles. As a small token of appreciation, we would like to mention the names of all the editors and reviewers in random order here who have edited or reviewed the articles for the January-June, 2018 issue. The list will be updated as when more reviewers review the articles.

Editors

1) Varshil Mehta2) Shakti Goel3) Surya Parajuli4) Nikhil Nalluri5) Vitaliy Bezsheiko

Reviewers

1) Shakti Goel

2) Assad Mughal

3) Harsha Makwana

4) Megha Patel

5) Ishpreet Biji

6) Surya Parajuli

7) Varshil Mehta

8) Heera KC

9) Prem Bhattarai

10) Tushar Kunder

11) Akshay Avula

12) Mykola Khaitovych

13) K Bedmutha

14) Mayank Jain

15) Joseph Bell

16) Vitaliy Bezsheiko

17) Ahmad Farrokhi

18) Shaunak Ajinkya

19) N. Kumar
Dinámica de la concentración y acumulación de nutrimentos en los componentes de la biomasa aérea de Cedrela odorata l. en costa rica
Authors: Ramírez Daniel , Alvarado Alfredo , Ávila Carlos , Camacho Manuel E. , Fernández Jesús , Murillo Rafael , Salazar Luis , Sandí Carlos L.
Published: January 2018

Se planteó el presente estudio con el objetivo de estudiar la dinámica de la concentración y la acumulación de nutrimentos en árboles de Cedrela odorata L. (Meliaceae), para mejorar el conocimiento y la gestión de las plantaciones forestales tropicales. Mediante una serie falsa de tiempo (crono secuencia) compuesta por 15 plantaciones en bosque Muy Húmedo Tropical de Costa Rica, se determinó la biomasa aérea, la concentración de nutrimentos y se estimó su acumulación en los componentes de la biomasa en árboles seleccionados. Como resultado se obtuvo que la concentración de los nutrimentos presentó tendencia a disminuir en el orden: nitrógeno > potasio > magnesio > calcio > azufre > fósforo para los macro nutrimentos, mientras que los micro elementos siguen la secuencia hierro > boro > zinc > manganeso > cobre > aluminio.Destacaron los altos valores de concentración de potasio medidos en los pecíolos (1,46 ± 0,48%) en contraste con contenidos más bajos de este elemento en el follaje (1,09 ± 0,21%). Se desarrolló modelos de regresión lineal para evaluar el comportamiento de la concentración de nutrimentos y se observó tendencia a la disminución de la concentración nitrógeno, fósforo, potasio y magnesio con el incremento de la edad, al ser este comportamiento más evidente en el potasio del fuste. Por otro lado, los modelos de regresión generados para evaluar el comportamiento de la acumulación de nutrimentos en los distintos componentes de la biomasa presentaron un comportamiento exponencial, con significancia estadística principalmente en el fuste y en el total acumulado. Dichos modelos permiten estimar posibles salidas de nutrimentos del sitio de plantación durante la cosecha, así como el reciclaje de cantidades de nutrimentos en componentes de la biomasa que permanecen en el sitio de plantación.
PENGEMBANGAN POTENSI DIRI MELALUI METODE DZIKIR DAN OLAH NAPAS (PENELITIAN PADEPOKAN PERISAI BATHIN DAN SILAT LADUNI DI KAB. BANDUNG BARAT)
Authors: Supenawinata Anwar
Published: January 2018

Every human being has potencies that needs to be empowered, which is the element of earth, fire, water, and air. Basically these elements consist of two aspects, namely, inner aspects what we called the soul and outer aspects that is the body. Elements of the inner aspects which are water, fire and air, while an element of the outer aspect is land. To process the four elements, it’s required struggle and continuous training so that it could benefit themselves, especially in the implementation of worship, as well as beneficial to others.
CHARACTER BUILDING PADA MANUSIA (Analisis Terhadap Budaya Suku Dayak Losarang Indramayu)
Authors: Tarsono Tarsono
Published: January 2018

Humans are unique creatures because they have a different character each other. The character is a strong trait of a man that its formation is influenced by their culture. The tribe of Dayak Losarang in Indramayu district is one of unique custom that located in urban area. Their uniqueness is including how to dress, how to communicate, how to worship and make sense of life. Push factors and pull factors that make them survive in indigenous communities are some rituals which are: a) kungkum, b) pepe, c) ngaula ning anak rabbi, d) ruatan putri keraton, e) pemurnian diri (self-purification), and f) Kliwon Friday night.