bluuebunny/crossref_metadata_2025 huggingface dataset:
YEREL YÖNETİMLERDE MÜKEMMELLİK MODELİ ve YENİ KAMU YÖNETİMİ ANLAYIŞI
Authors: ATEŞ Hamza
Published: January 2020

This article takes a comparative view on the models of ‘New Public Management’ and ‘Excellence for Local Government’. As NPM has become a dominant movement in the theory and practice of public administration worldwide, it has been in application in local governments as well as central government. However, the Excellence Model for Local Government, which has been created by a generalisation of innovation efforts in such cities as Tilburg and Christchurch, is a different model, although it has a number of similarities with NPM. The former aims at creating an indigenous model for local government by major adjustments in NPM.
OPTİMAL VERGİLENDİRME MARJLARINDA SORUNLAR ve BÜTÇE AÇIKLARININ REFAH ETKİSİ
Authors: ÖZKER A. Niyazi
Published: January 2020

In this study, we analyze that the matters of the optimal taxation in current period are brought up by a fall in the world rate of interest raises foreign wealth and a rise in foreign spending on a present goods in the scales of the interest’s rate therefore, the deficits result from a reduction in domestic taxes raises the world interest rate and thus the domestic budget deficit raises the equilibrium value of domestic consumption. The phenomenon lowers the corresponding value of foreign consumption and be effected by demographic station and the current saving rate. As may be seen in the last period of Turkey with γ<1, budget deficits exert real welfare and current effects.
Passive Klimatisierung in einem Magazinneubau. Zwischenbilanz des Magdeburger Modells
Authors: Heiden Detlev
Published: January 2020

Anforderungsgerecht klimatisierte Archivmagazine sind das Fundament aller Bestandserhaltungsmaßnahmen. Der Magdeburger Magazinneubau des Landesarchivs Sachsen-Anhalt zeigt die Machbarkeit einer technikarmen passiven Klimatisierung. Die jährlichen Temperaturverläufe zeichnen sich bei durchschnittlichen Temperaturen zwischen 16 und 18° Celsius durch mäßige Schwankungen innerhalb eines gleichförmigen Musters aus. Der Gesamtdurchschnitt von 17,2° Celsius setzt den Zielwert von 16–18° Celsius um. Die relativen Feuchten bewegen sich zwischen 42 und 50 % (mit einem Gesamtdurchschnitt von 45 % bei einem Zielwert von 40–50 %), womit die hygrische Stabilität uneingeschränkt erreicht wird.
Mitochondrial Dysfunction Combined with High Calcium Load Leads to Impaired Antioxidant Defense Underlying the Selective Loss of Nigral Dopaminergic Neurons
Authors: Ricke Konrad M. , Paß Thomas , Kimoloi Sammy , Fährmann Kai , Jüngst Christian , Schauss Astrid , Baris Olivier R. , Aradjanski Marijana , Trifunovic Aleksandra , Eriksson Faelker Therese M. , Bergami Matteo , Wiesner Rudolf J.
Published: January 2020

Mitochondrial dysfunction is critically involved in Parkinson's disease, characterized by loss of dopaminergic neurons (DaNs) in the substantia nigra (SNc), whereas DaNs in the neighboring ventral tegmental area (VTA) are much less affected. In contrast to VTA, SNc DaNs engage calcium channels to generate action potentials, which lead to oxidant stress by yet unknown pathways. To determine the molecular mechanisms linking calcium load with selective cell death in the presence of mitochondrial deficiency, we analyzed the mitochondrial redox state and the mitochondrial membrane potential in mice of both sexes with genetically induced, severe mitochondrial dysfunction in DaNs (MitoPark mice), at the same time expressing a redox-sensitive GFP targeted to the mitochondrial matrix. Despite mitochondrial insufficiency in all DaNs, exclusively SNc neurons showed an oxidized redox-system, i.e., a low reduced/oxidized glutathione (GSH-GSSG) ratio. This was mimicked by cyanide, but not by rotenone or antimycin A, making the involvement of reactive oxygen species rather unlikely. Surprisingly, a high mitochondrial inner membrane potential was maintained in MitoPark SNc DaNs. Antagonizing calcium influx into the cell and into mitochondria, respectively, rescued the disturbed redox ratio and induced further hyperpolarization of the inner mitochondrial membrane. Our data therefore show that the constant calcium load in SNc DaNs is counterbalanced by a high mitochondrial inner membrane potential, even under conditions of severe mitochondrial dysfunction, but triggers a detrimental imbalance in the mitochondrial redox system, which will lead to neuron death. Our findings thus reveal a new mechanism, redox imbalance, which underlies the differential vulnerability of DaNs to mitochondrial defects.

SIGNIFICANCE STATEMENTParkinson's disease is characterized by the preferential degeneration of dopaminergic neurons (DaNs) of the substantia nigra pars compacta (SNc), resulting in the characteristic hypokinesia in patients. Ubiquitous pathological triggers cannot be responsible for the selective neuron loss. Here we show that mitochondrial impairment together with elevated calcium burden destabilize the mitochondrial antioxidant defense only in SNc DaNs, and thus promote the increased vulnerability of this neuron population.
Cholecystokinin-Expressing Interneurons of the Medial Prefrontal Cortex Mediate Working Memory Retrieval
Authors: Nguyen Robin , Venkatesan Sridevi , Binko Mary , Bang Jee Yoon , Cajanding Janine D. , Briggs Chloe , Sargin Derya , Imayoshi Itaru , Lambe Evelyn K. , Kim Jun Chul
Published: January 2020

Distinct components of working memory are coordinated by different classes of inhibitory interneurons in the PFC, but the role of cholecystokinin (CCK)-positive interneurons remains enigmatic. In humans, this major population of interneurons shows histological abnormalities in schizophrenia, an illness in which deficient working memory is a core defining symptom and the best predictor of long-term functional outcome. Yet, CCK interneurons as a molecularly distinct class have proved intractable to examination by typical molecular methods due to widespread expression of CCK in the pyramidal neuron population. Using an intersectional approach in mice of both sexes, we have succeeded in labeling, interrogating, and manipulating CCK interneurons in the mPFC. Here, we describe the anatomical distribution, electrophysiological properties, and postsynaptic connectivity of CCK interneurons, and evaluate their role in cognition. We found that CCK interneurons comprise a larger proportion of the mPFC interneurons compared with parvalbumin interneurons, targeting a wide range of neuronal subtypes with a distinct connectivity pattern. Phase-specific optogenetic inhibition revealed that CCK, but not parvalbumin, interneurons play a critical role in the retrieval of working memory. These findings shine new light on the relationship between cortical CCK interneurons and cognition and offer a new set of tools to investigate interneuron dysfunction and cognitive impairments associated with schizophrenia.

SIGNIFICANCE STATEMENTCholecystokinin-expressing interneurons outnumber other interneuron populations in key brain areas involved in cognition and memory, including the mPFC. However, they have proved intractable to examination as experimental techniques have lacked the necessary selectivity. To the best of our knowledge, the present study is the first to report detailed properties of cortical cholecystokinin interneurons, revealing their anatomical organization, electrophysiological properties, postsynaptic connectivity, and behavioral function in working memory.
Evaluation of maxillary anterior teeth proportion with Chu’s Gauge in a population of Central India: an in-vivo study
Authors: Wagh Sukhada Arun , Mantri Sneha S. , Bhasin Abhilasha
Published: January 2020

Aim. To evaluate the width/height proportions in maxillary anterior natural dentition and its correlation with Chu’s esthetic proportion Gauge.

Settings and Design. Observational cross-sectional study with the inclusion criteria of well aligned maxillary anterior teeth.

Purpose. The present study attempts to perceive the application of Chu’s Esthetic Proportion Gauge in a group of the central Indian population .

Methods. A total number of 150 participants within the age group 18- 30 years were screened, out of which 80 participants were selected, who fulfilled the inclusion criteria of well aligned maxillary anterior teeth with pleasing smile, unrestored, periodontally sound, no fracture, no missing, absence of diastema teeth and no H/O orthodontic treatment. The selected participants were seated on the dental chair with the Frankforts horizontal plane parallel to the floor. The participants were observed for height and width proportions using the Chu’s esthetic proportion gauge and measured using digital vernier  calliper. The proportion and measured height and width ratios were then compared .

Results. The recorded data was compiled and entered in a spreadsheet computer program (Microsoft Excel 2007) and then exported to data editor page of SPSS version 20.0 (SPSS Inc., Chicago, Illinois, USA). Intergroup comparison between gauge and vernier caliper was done using Chi- square test for proportions percentages (Qualitative data) and Mann-Whitney U test of width and height and then categorized into esthetic and unesthetic anterior teeth. Level of significance was set at 0.05.

Conclusions. Within the limitations of the study, it was concluded that maxillary anterior teeth did show similarity with Chu’s esthetic proportion scale.
Mandibular symphysis morphology and lower incisor angulation in different anteroposterior jaw relationships and skeletal growth patterns – a cephalometric study
Authors: Jain Sandhya , Puniyani Prateek , Saifee Arwa
Published: January 2020

Objective. The purpose of the present study was to assess the symphyseal morphology and lower incisor angulation in different anteroposterior relationship and in different growth patterns and to investigate whether the symphyseal morphology had any correlation with dentofacial parameters.

Method. Random Sampling method and lateral cephalograms of 90 subjects, age group 16-30 years, were divided into 30 in each group, i.e. Class I, Class II & Class III after calculating the following parameters (ANB angle, wits appraisal). After that, groups were again divided into 10 in each subgroup i.e. Average, Horizontal and Vertical growers.

Results. Results showed the increase in actual symphysis width, inclination of the alveolar part, total height of symphysis and reduction in overall width along with retroclination of lower incisors in class III subjects as compared to class I and class II. Similarly actual and overall width of the symphysis were decreased and inclination of the alveolar part, symphyseal height and symphyseal ratio were increased in vertical growers.

Conclusion. The dimensions and configuration of Mandibular Symphysis in class III was found to be different than those in Class I and Class II relationships; the alveolar part of Mandibular Symphyseal compensated for the skeletal relationship in the Class III pattern. Mandibualr Symphysis dimensions were strongly correlated to anterior facial dimensions. Similarly the dimensions and configuration of Mandibular Symphysis was also different in vertical growers as compared to horizontal and average growers, moreover symphyseal morphology and lower incisor angulation had a correlation with dentofacial parameters.
A People’s Writer for Peasant Readers: The Early Reception of Žemaitė’s Writings (1895–1915)
Authors: Bleizgienė Ramunė
Published: January 2020

This article investigates the rise of the peasantry as new readers and Lithuanian intellectuals’ reactions to this phenomenon as they took the initiative in directing the peasants’ cultivation as readers. These intellectuals were concerned with the development of the peasants and sought to form their reading habits, influence the readers’ choices as to reading material, and so on. This article goes on to analyze how Žemaitė’s status as a peasant writer was established during her early reception, and how the evaluation of her work depended on the imagined addressee. By analyzing the reviews and broader studies of Žemaitė’s published works in the Lithuanian press from 1895 to 1915, this article aims to show that the formation of the common people as a potential and especially important national reading public was an integral part of her canonization process. Yet another important aim of this research is to reveal how the reception of Žemaitė’s works brought ordinary village peasant onto the horizon of modern Lithuanian culture, and how this became the foundation of one of the new literary styles in Lithuania, namely realism. In this way, by canonizing Žemaitė’s works, the life of village folk became not only visible and recognizable to the Lithuanian reading public, but also came to be regarded as a credible topic for realistic prose.
Between the tropes and pragmatics: the rhetorical aspect of Rozmowa polaka z litwinem
Authors: Knieža Skirmantas
Published: January 2020

This paper presents rhetorical aspects of a sixteenth century Lithuanian polemical treatise “Rozmowa polaka z litwinem” (“Pasikalbėjimas lenko su lietuviu”). This anonymous work is often labeled as “humanist”. Even though many scholars analyse its contents and emphasize references to the Classical Antiquity, formal aspects and their pragmatic implications remain unevaluated. Scholars have mainly focused on the issue of it authorship and quoted it illustrating cultural and political sixteenth century changes in the Grand Duchy of Lithuania. The main aim of this article is to reveal rhetorical tropes and figures employed by the author of the treatise and discuss the possible motivation of their selection. “Rozmowa” responds to, “Quincunx”, written in 1564 by a Polish polemist Stanisław Orzechowski (1513–1566). It is a part of a prolonged polemic between the later and Lithuanian Chancellor, Palatine of Vilnius Mikalojus Radvila “The Black”. The details and the course of their dispute is reconstructed by Orzechowski himself in the letter to Piotr Miscovius, which also is titled “Apologia pro Quincunce”. He refers to the “Rozmowa” without mentioning its title or particular author. Historiography attributes it to the Vilnius mayor (wójt) Augustyn Rotundus (c. 1520–1582). Both Orzechowski and Rotundus studied abroad and had spent some time in Italy. Not only curricula of their studies of artes liberales were influenced by Classical Antiquity, they also undoubtedly got familiar with humanist culture of the contemporary Europe.“Rozmowa” consists of two main parts, which are separated by a verse. The treatise is written in a form of a dialogue, and allows to portray a vivid discussion and multiple points of view. The first part of “Rozmowa” focuses on the questions of the political theory, whereas the second one is dedicated to the history of Lithuania, its dynasty and the issue of the Polish-Lithuanian Union. While the first part is polemical, the second one has epideictic character. The author employs personification, paradiastole and antithesis. The latter two allow changing the normative contents of political concepts, and irony highlights the absurdities in the Polish political practices. The Lithuanian, one of the characters, uses deprecation and interpellation, addresses the absent participants of a dialogue (e. g. Orzechowski himself). The author quotes Ancient authors, Scripture, Church Fathers and contemporary thinkers (e. g. Machiavelli and Erasmus), whose ideas provide him with literary topoi. Merged with the rhetorical techniques, they constitute the political arguments of the treatise and allows the author to express one’s political ideas.
Hyperglycemia in Extremely Preterm Infants
Authors: Ramel Sara , Rao Raghavendra
Published: January 2020

Hyperglycemia after birth is common in extremely preterm infants (<28 weeks of gestation). Lower gestational age, lower birthweight, presence of severe illness, and higher parenteral glucose intake increase the risk for hyperglycemia, while provision of higher amounts of amino acids and lipids in parenteral nutrition and early initiation and faster achievement of full enteral feeding decrease the risk. Hyperglycemia is associated with increased mortality and morbidity in the neonatal period. Limited data show an association with long-term adverse effects on growth, neurodevelopment, and cardiovascular and metabolic health. Lowering the glucose infusion rate and administration of insulin are the 2 treatment options. Lowering the glucose infusion could lead to calorie deficits and long-term adverse effects on growth and neurodevelopment. Conversely, insulin use increases the risk for hypoglycemia and requires close blood glucose monitoring and frequent adjustments to glucose infusion and insulin dosage. Randomized trials of varying strategies of nutrient provision and/or insulin therapy and long-term follow-up are needed to improve clinical care and overall health of extremely preterm infants with hyperglycemia.
Subacute Neuropsychiatric Syndrome in Girls WithSHANK3Mutations Responds to Immunomodulation
Authors: Bey Alexandra L. , Gorman Mark P. , Gallentine William , Kohlenberg Teresa M. , Frankovich Jennifer , Jiang Yong-hui , Van Haren Keith
Published: January 2020

Phenotypic and biological characterization of rare monogenic disorders represents 1 of the most important avenues toward understanding the mechanisms of human disease. Among patients with SH3 and multiple ankyrin repeat domains 3 (SHANK3) mutations, a subset will manifest neurologic regression, psychosis, and mood disorders. However, which patients will be affected, when, and why are important unresolved questions. Authors of recent studies suggest neuronal SHANK3 expression is modulated by both inflammatory and hormonal stimuli. In this case series, we describe 4 independent clinical observations of an immunotherapy responsive phenotype of peripubertal-onset neuropsychiatric regression in 4 girls with pathogenic SHANK3 mutations. Each child exhibited a history of stable, mild-to-moderate lifelong developmental disability until 12 to 14 years of age, at which time each manifested a similar, subacute-onset neurobehavioral syndrome. Symptoms included mutism, hallucinations, insomnia, inconsolable crying, obsessive-compulsive behaviors, loss of self-care, and urinary retention and/or incontinence. Symptoms were relatively refractory to antipsychotic medication but improved after immunomodulatory treatment. All 4 patients exhibited chronic relapsing courses during a period of treatment and follow-up ranging from 3 to 6 years. Two of the 4 girls recovered their premorbid level of functioning. We briefly review the scientific literature to offer a conceptual and molecular framework for understanding these clinical observations. Future clinical and translational investigations in this realm may offer insights into mechanisms and therapies bridging immune function and human behavior.
MOODLE PLUGINS CODERUNNER FOR ASSESSMENT CODE IN TRAINING PROGRAMMING
Authors: Nedeva Veselina , Kiryakova Gabriela
Published: January 2020

The report presents Moodle's capabilities in teaching programming through the implementation of the CodeRunner and connect with him Adaptive adapter for CodeRunner plugins. In the beginning, Moodle's virtual learning environment is briefly introduced, its characteristics that make it so popular and preferred. Plug-ins are also given as an opportunity to evolve according to user needs. The specifics of the installation in the Moodle environment of CodeRunner is described. The use of executed servers, their role, setup and functions are explained. CodeRunner plugin is discussed as a question type with options for evaluating programming code in different programming languages. In conclusion, it was stated that the implementation of CodeRunner in the Faculty of Engineering and Technology - Yambol have to be analyzed.
MULTIPARAMETRIC OPTIMIZATION FOR THE SELECTION AND IMPLEMENTATION OF TECHNOLOGICAL SOLUTIONS FOR THE PRODUCTION OF BIODIESEL FROM WASTE OIL-CONTAINING MATERIALS
Authors: Ganev Evgeniy , Dzhelil Yunzile , Ivanov Boyan , Dobrudzhaliev Dragomir
Published: January 2020

In this work, a multi-parameter, multi-criteria parameter optimization of the mathematical model we have developed is performed. The use of reasonable parameter limits, determined through extensive statistical observations and analyses, enables the generation of optimal technological and logistical solutions for the use of biodiesel. Based on the selection of suitable oil-containing raw materials and such wastes, it allows the construction of optimum technological-logistical chains, providing the necessary amount of biodiesel in a certain territorial unit.
PREDICTION OF THE WEIGHT OF QUAIL EGGS THROUGH SHAPE FEATURES AND SPECTRAL INDICES
Authors: Georgieva-Nikolova Mariya , Zlatev Zlatin
Published: January 2020

In the present work, a method for indirect determination of the weight of Japanese quail eggs is proposed, taking into account changes in their internal properties. Visual data and transmission spectra is used. Shape features and spectral indices are selected and applied. It has been found that egg weight M can be predicted by the volume V of eggs and the spectral index GLI, M=f(V,GLI). The resulting model has a coefficient of determination R2=0,89, low error values, up to 3%. Mean square error MSE=0,03 and root mean square error RMSE=0,2. The results obtained can be used to indirect determination the weight of Japanese quail eggs when incubated, packaged.
THE BRAIN-COMPUTER INTERFACE
Authors: Büyükgöze Selma
Published: January 2020

The Brain-Computer Interface (BCI), defined as systems that allow people to use a computer, an electromechanical arm or various neuroprostheses without the use of motor nervous systems, is a communication pathway used to establish direct communication between the brain and a peripheral interface. The brain-computer interface is often used to help or repair human cognitive or sensory motor functions. However, with today's developing technology, it hasn’t only been used for this purpose and has started to be used in many different areas from advertising, to smart peripheral systems, to games, even authentication and security applications. The increase in access to BCI devices, together with the increase in their usage, has led to an increase in the number of applications that have been developed in health, engineering, and education. We hope that in the near future BCI devices will allow us to communicate without talking and will understand our thoughts and act accordingly.
Perjuangan Kh.Choer Affandi Pendiri Pesantren Miftahul Huda Manonjaya
Authors: Prayoga Dian
Published: January 2020

Pesantren Miftahul Huda yang didirikan oleh Almarhum K.H. Choer Affandi, dan merupakan Pesantren Salafiyah terbesar yang berada di wilayah Kabupaten Tasikmalaya, yang masih mempertahankan sistem Salafiyah dengan sedikit mengadopsi sistem pembelajaran dari Pesantren Modern sehingga dengan hal ini mengakibatkan tingkat kemajuan dalam bidang pendidikan bagi santrinya itu sendiri. Pesantren ini lahir berkat kesabaran dan keinginan serta kepatuhan pendiri terhadap gurunya. Menggunakan pendekatan kualitatif dengan melakukan studi serajah dan cara mendapatkan data dilakukan dengan wawancara,studi literature dan turun langsung kelapangan. Perkembangan pesantren juga bisa dikatakan berkembang dengan pesat, ini terbukti dengan luas pesantren yang semakin luas walaupun tidak secara keseluruhan dijadikan bangunan pesantren namun kepemilikan lahan pesantren yang luas membuktikan pesantren tersebut bisa mandiri dan berkembang tanpa tergantung dari uluran tangan dermawan-dermawan, luas lahan pesantren ini mencapai 8,5 Ha dengan luas 5 Ha di tempai bangunan dan rumah serta asrama pesantren, sedangkan sisanya dijadiakan lahan pertanian, peternakan, kolam ikan. Dengan jumlah santri secara keseluruhan mencapai 2.085 jiwa.
Kehidupan Masyarakat Bima Pada Masa Kepemimpinan Sultan Muhammad Salahuddin Tahun 1915-1951
Authors: Pratama M Al Qautsar
Published: January 2020

Penelitian ini bertujuan untuk mengungkapkan tentang peranan Sultan Muhammad Salahuddin dalam perkembangan Islam di daerah Bima. Masalah yang diteliti dalam tulisan ini difokuskan pada Bagaimana kondisi Bima pra Sultan Muhammad Salahuddin, Bagaimana Usaha-usaha Sultan Muhammad Salahuddin dalam mengembangkan Islam di Bima dan Bagaimana tantangan dan peluang yang dihadapi Sultan Muhammad Salahuddin dalam mengembangkan Islam di Bima. peneliti menggunakan metode sejarah, untuk mengungkapkan fakta sejarah tentang biografi Sultan Muhammad Salahuddin dan peranannya dalam perkembangan Islam di daerah Bima. Untuk menganalisis fakta tersebut peneliti menggunakan pendekatan yang sering digunakan dalam penelitian sejarah, yaitu pendekatan politik, sosiologi, antropologi, agama dan pendidikan. Penelitian ini menemukan Muhammad Salahuddin lahir dalam lingkungan istana dan dibesarkan oleh para ulama. Dari didikan ulama inilah sehingga membentuk kepribadian sultan sampai tumbuh dewasa. Muhammad Salahuddin di nobatkan menjadi Sultan setelah kematian saudaranya Abdul Azis dan mendapatkan pelajaran dari ulama di daerah dan luar daerahnya sehingga pada masa kepemimpinanya Islam di Bima mengalami perkembangan, dalam mengembangan Islam di daerah Bima Sultan melakukan pembaharuan sehingga pada masanya Islam di derah Bima mengalami kejayaan. Adapun hal-hal yang dilakukan oleh Sultan adalah membagun lembaga-lembaga pendidikan baik formal maupun non formal, dan masjid-masjid dan dalam menunjang kemajuan daerah Bima Sultan membiayai dan memberikan beasiswa kepada remaja yang sekolah di timur tengah dan bagi mereka yang memiliki kemampuan dalam bidang agama.
Dynamics of Mediterranean Africa, ca. 9600–1000 bc
Authors: Broodbank Cyprian , Lucarini Giulio
Published: January 2020

Mediterranean Africa forms a crucial junction between the wider Saharan zone and the rest of the Mediterranean.In contrast to its well-investigated history from the first millennium BC onward, its antecedentdynamics are very poorly understood, and deeper archaeological histories of the Mediterranean thereforeremain unbalanced and incomplete. This paper draws on a new surge in data to present the first up-todateinterpretative synthesis of this region's archaeology from the start of the Holocene until the threshold ofthe Iron Age (9600-1000 bc). It presents the evidence for climatic, environmental and sea-level change,followed by analysis of the chronological and spatial patterning of all radiocarbon dates from MediterraneanAfrica, brought together for the first time. The principal exploration then divides into three phases.During Phase 1 (9600-6200 bc) diverse forms of hunting, gathering and foraging were ubiquitous.Phase 2 (6200-4000 bc) witnessed more continuity than elsewhere in the Mediterranean, but also thewidespread uptake of domesticated livestock and gradual evolution of herding societies, as well as limitedenclaves of farming. Phase 3 (4000-1000 bc) has been least explored, outside developments in Egypt; inthe east this phase witnessed the emergence of fully nomadic and transhumant pastoralism, with politicalsuperstructures, while trajectories in the west remain obscure, but in parts of the Maghreb suggest complexpossibilities. Contacts with the Mediterranean maritime world grew during the third and second millenniabc, while interaction to the south was transformed by desertification. Understanding how the southernMediterranean shore was drawn into Iron Age networks will require much better knowledge of its indigenoussocieties. The present constitutes a pivotal moment, in terms of accumulated knowledge, pathways forfuture investigation and engagement with a challenging current geopolitical situation.
Brainstem auditory pathway of children with acute lymphoid leukemia on chemotherapy with methotrexate
Authors: LEITE Renata Aparecida , VOSGRAU Jéssica Sales , CORTEZ NETO Leticia , SANTOS Nayara Pereira , MATAS Sandro Luiz de Andrade , ODONE FILHO Vicente , MATAS Carla Gentile
Published: January 2020

Abstract Objective: Investigate the auditory pathway in the brainstem of children with acute lymphoblastic leukemia submitted to chemotherapy (by intravenous or intrathecal infusion). Methods: Fourteen children aged between 2 and 12 years with diagnosis of acute lymphoid leukemia were evaluated. The following procedures were used: meatoscopy, acoustic immitance measurements, tonal audiometry, vocal audiometry, transient otoacoustic emissions, and auditory brainstem response. Results: From the 14 children with normal auditory thresholds, 35.71% showed an alteration in auditory brainstem response, with a predominance of hearing impairment in the lower brainstem. It was found that 80% of the children with alteration had used intrathecal methotrexate less than 30 days and that 40% had the highest cumulative intravenous methotrexate doses. Conclusion: Children with acute lymphoblastic leukemia submitted to chemotherapy, present auditory pathway impairment in the brainstem, with a predominance of a low brainstem.
Avaliação ortopédica e ultrassonográfica da estabilidade dos quadris de recém-nascidos encaminhados por pediatras, com suspeita de Displasia Típica do Desenvolvimento.
Authors: Cruz Mário Augusto Ferreira , Volpon José Batista
Published: January 2020

RESUMO Objetivo: avaliar recém-nascidos com suspeita de instabilidade do quadril, encaminhados por pediatras a um serviço ortopédico terciário. Métodos: recém-nascidos de uma maternidade pública universitária, com suspeita de instabilidade ou fatores de risco para displasia do quadril, eram encaminhados ao Departamento de Ortopedia e Anestesiologia, Ribeirão Preto/SP, onde eram avaliados clinicamente e através de exames ultrassonográficos dos quadris. Constatada a displasia, iniciava-se o tratamento, e em casos em que havia apenas imaturidade do quadril e exame clínico normal, procedia-se à observação e re-exame clinico e ultrassonográfico com dois ou três meses de vida. Resultados: foram examinados 448 recém-nascidos, com predominância feminina e média de idade na primeira avaliação de 27 dias. A principal causa do encaminhamento foi apresentação pélvica. Em 8% havia sinal de Ortolani positivo e em 12,5% estalido no quadril. No exame ortopédico, 405 (90,5%) pacientes eram normais, 8,5% apresentavam estalido no quadril e 1,1% apresentavam teste de Ortolani positivo. À ultrassonografia, 368 (89,5%) apresentavam imaturidade, 26 (6,3%) tinham displasia moderada e em 17 (4,1%) pacientes os quadris eram francamente displásicos. Todos os casos com sinal de Ortolani positivo apresentavam quadro ultrassonográfico de displasia. Conclusão: houve excesso de diagnóstico de instabilidade do quadril na avaliação do pediatra, o que, no entanto, permitiu ao paciente uma segunda avaliação, em ambiente mais especializado e com mais recursos tecnológicos.
Proposta de escore preditor de desfechos para abdome agudo.
Authors: Cacciatori Felipe Antônio , Ronchi Arthur Dajori , Sasso Sérgio Emerson
Published: January 2020

RESUMO Objetivo: estabelecer a correlação entre dados objetivos coletados na avaliação inicial e os desfechos nos casos de dor abdominal aguda. Métodos: estudo retrospectivo, de caso controle, em que foram revisados prontuários de pacientes atendidos em um serviço de urgência e emergência no ano de 2016, diagnosticados com dor abdominal e pélvica. Resultados: de 2.352 prontuários avaliados, 330 foram considerados válidos para o estudo. Destes pacientes, 235 (71,2%) receberam alta e os 95 (28,8%) restantes foram internados, submetidos à cirurgia ou morreram. A análise estatística demonstrou que sexo masculino, idade ≥50 anos, temperatura axilar >37,3ºC, anemia, leucocitose >10.000/mm3, neutrocitose acima de 7.700/mm3, linfopenia <2.000/mm3 e hiperamilasemia são variáveis isoladamente associadas a pior desfecho. Conclusão: a presença de três ou mais das variáveis avaliadas aumenta fortemente a chance de um paciente sofrer os desfechos de cirurgia ou morte, sendo a chance de óbito tanto maior quanto maior o número de variáveis presentes.
Efeitos da arginina na reparação cicatricial da parede abdominal em ratos Wistar.
Authors: Caron Filipe Carlos , Repka João Carlos Domingues , Milgioransa Viviane Gomes , Timi Jorge Rufino Ribas
Published: January 2020

RESUMO Objetivo: avaliar os efeitos da arginina na cicatrização da parede abdominal de ratos Wistar. Métodos: vinte ratos Wistar foram submetidos à laparotomia e separados em dois grupos (arginina e controle), que receberam tratamento diário por via intraperitoneal com arginina (300mg/kg/dia) e solução tampão fosfato em dose equivalente ao peso, respectivamente, durante cinco dias. No sétimo dia pós-operatório, coletaram-se amostras de sangue e da cicatriz da parede abdominal de ambos os grupos. Avaliaram-se o nível sérico de nitratos e nitritos, a evolução cicatricial pelas dosagens de hidroxiprolina tecidual, formação de tecido de granulação, determinação da porcentagem de colágeno maduro e imaturo, densidade de miofibroblastos e angiogênese. Empregaram-se os testes de ANOVA e t de Student com p=0,05 para as comparações entre os grupos. Resultados: não ocorreram diferenças significantes entre os grupos estudados para dosagens de nitratos e nitritos (p=0,9903), hidroxiprolina tecidual (p=0,1315) e densidade de miofibroblastos (p=0,0511). O grupo arginina apresentou maior densidade microvascular (p=0,0008), maior porcentagem de colágeno tipo I (p=0,0064) e melhora na formação do tecido de granulação, com melhores índices de proliferação angiofibroblástica (p=0,0007) e re-epitelização das bordas (p=0,0074). Conclusão: na avaliação cicatricial da parede abdominal de ratos Wistar sob tratamento com arginina, não houve alteração do nível sérico de nitratos e nitritos, da deposição de colágeno total e da densidade de miofibroblastos. Verificaram-se aumento da maturação de colágeno do tipo I, da densidade microvascular e melhora na formação do tecido de granulação cicatricial pelas melhores re-epitelização de bordas e proliferação angiofibroblástica.
Síndrome da ressecção anterior do reto: fatores preditivos.
Authors: Miacci Fernanda Letícia Cavalcante , Guetter Camila Roginski , Moreira Paula Heroso , Sartor Maria Cristina , Savio Mariane Christina , Baldin Júnior Antonio , Nóbrega Norton Luiz
Published: January 2020

RESUMO Objetivo: identificar fatores preditivos da síndrome da ressecção anterior do reto (SRAR) que podem contribuir para o seu diagnóstico e tratamento precoces. Métodos: estudo de coorte retrospectivo de pacientes submetidos à ressecção anterior do reto entre 2007 e 2017 no Serviço de Coloproctologia do Hospital de Clínicas da Universidade Federal do Paraná. Foram realizadas análises de curva ROC (Receiver Operating Characteristic Curve Analysis) ou COR (Característica de Operação do Receptor) para identificar os fatores preditivos da SRAR. Resultados: foram incluídos 64 pacientes com dados completos. A idade dos homens foi de 60,1±11,4 anos e 37,10% eram do sexo masculino. Vinte pacientes (32,26%) apresentaram SRAR. Os sintomas mais relatados foram evacuação incompleta (60%) e urgência (55%). Na análise univariada, a distância da anastomose à margem anal (p<0,001), terapia neoadjuvante (p=0,0014) e confecção de ileostomia no momento da ressecção (p=0,0023) foram preditivos da SRAR. Análise da curva ROC mostrou um ponto de corte de 6,5cm na distância da anastomose à margem anal como preditor da SRAR. Conclusão: distância entre anastomose e margem anal, história de terapia neoajuvante e confecção de estoma são condições que podem ajudar a predizer o desenvolvimento da SRAR. A orientação e o envolvimento na educação do paciente, bem como, o manejo precoce podem reduzir potencialmente o impacto desses sintomas na qualidade de vida dos pacientes.
Incidência comparativa de câncer incidental de vesícula biliar em colecistectomias de urgência versus colecistectomias eletivas.
Authors: Figueiredo Welligton Ribeiro , Santos Rute Rocha , Paula Marlon Moreno da Rocha Caminha de
Published: January 2020

RESUMO Objetivo: analisar, comparativamente, a incidência de câncer incidental de vesícula biliar em colecistectomias de urgência versus colecistectomias eletivas realizadas em hospitais públicos de Teresina-PI. Métodos: estudo observacional descritivo, quantitativo, com delineamento transversal, cujo cenário foram dois hospitais públicos de Teresina-PI. Foram analisados 6.329 prontuários de pacientes submetidos à colecistectomia, entre janeiro de 2011 e dezembro de 2017. Os dados coletados foram divididos em dois grupos e confrontados estatisticamente através do teste Z para diferença entre proporções. Resultados: detectou-se câncer incidental da vesícula biliar em 6,53% das colecistectomias de urgência e em 0,38% das eletivas. Quanto ao sexo, observou-se que, na cirurgia de urgência, 69% eram mulheres e 31%, homens, enquanto no procedimento eletivo, 78% eram mulheres e 22%, homens. Quanto à idade, a maioria dos pacientes possuía mais de 60 anos e, entre estes, 69,3% submetidos à colecistectomias de urgência e 82,6%, à eletivas. O tipo histopatológico "adenocarcinoma" foi encontrado em 84,6% das cirurgias de urgência e 100% das eletivas. Conclusão: câncer incidental de vesícula biliar foi mais frequente em colecistectomias de urgência em comparação às eletivas. O perfil dos pacientes com essa doença maligna nos dois tipos de procedimento foi do sexo feminino, maiores de 60 anos de idade e com diagnóstico histopatológico de adenocarcinoma.
Consumo alimentar e sua associação com estado nutricional, atividade física e fatores sociodemográficos de candidatos à cirurgia bariátrica.
Authors: Vieira Renata Adrielle Lima , Rabelo Filho Lucio Vilar , Burgos Maria Goretti Pessoa de Araújo
Published: January 2020

RESUMO Objetivo: avaliar a associação do consumo alimentar com estado nutricional, atividade física e fatores sociodemográficos no pré-operatório de cirurgia bariátrica. Métodos: estudo transversal, realizado no período de 2018 a 2019, com pacientes internados para a cirurgia bariátrica no Hospital Universitário Oswaldo Cruz da Universidade Federal de Pernambuco. Foram obtidos dados sociodemográficos, estado nutricional pelo índice de massa corporal (IMC), circunferência da cintura, maior peso e peso pré-cirúrgico, consumo alimentar obtido pelo questionário de frequência alimentar baseado na pirâmide alimentar adaptada para o paciente bariátrico e atividade física. Resultados: participaram do estudo 60 pacientes, sendo 78,3% do sexo feminino, com idades de 38,8±9,6 anos, 53,3% casados e 70% dos indivíduos com mais de 12 anos de estudo. Na prática de atividade física, 31,7% eram sedentários. Sobre o estado nutricional, a média de IMC observada foi de 47,3±6,96kg/m2. O peso pré-operatório, maior peso atingido antes da cirurgia e circunferência da cintura foi maior no sexo masculino (p<0,05). Houve associação entre atividade física e consumo alimentar, sendo que indivíduos sedentários consumiam mais carboidratos (p=0,041). Por outro lado, dados sociodemográficos e estado nutricional não apresentaram associações com o consumo. Conclusão: o nível de atividade física evidenciou associação significativa apenas com o consumo de carboidratos.
Impacto do escore MELD na sobrevida de pacientes portadores de carcinoma hepatocelular, transplantados no Brasil: revisão sistemática.
Authors: Vasconcellos Marcel , Zamith Luíza Magalhães
Published: January 2020

RESUMO O objetivo do estudo foi o de analisar o valor preditivo do escore MELD (Model for End-Stage Liver Disease) na sobrevida de médio e longo prazo em pacientes portadores de carcinoma hepatocelular (CHC), transplantados no Brasil. O estudo foi registrado no PROSPERO (International Prospective Register of Systematic Reviews), sob o nº 152.363. Os critérios de inclusão basearam-se nas recomendações PRISMA. A pesquisa foi realizada nos bancos de dados indexados do Lilacs, SciELO, Pubmed e Cochrane Library, e utilizou como estratégia de busca os termos MeSH: ((("Meld Score") OR "Model for End-Stage Liver Disease") AND "Hepatocellular Carcinoma") AND ("Brazil"). Foram incluídos artigos com texto completo, publicados a partir de janeiro de 2006 até outubro de 2019. A busca inicial encontrou 162 artigos. Após a leitura dos resumos e textos completos disponíveis, foram excluídos 156 artigos, totalizando seis artigos para análise qualitativa. Embora o número reduzido de artigos elegíveis tenha sido um fator limitante do estudo, nossos resultados corroboraram parcialmente aos encontrados nos EUA, Reino Unido e Irlanda. Nestes países, ao contrário do Brasil, o modelo prognóstico MELD mostrou forte associação com a sobrevida pós-transplante hepático. No entanto, a baixa capacidade preditiva do modelo em médio e longo prazo, foi similar ao nosso estudo. Configura-se a premência do desenvolvimento e validação de um modelo de sobrevida pós-transplante aos portadores de CHC, aperfeiçoando o sistema de alocação de órgãos no Brasil.
Factors associated with time interval between the onset of symptoms and first medical visit in women with breast cancer
Authors: Barros Ângela Ferreira , Murta-Nascimento Cristiane , Abdon Carlos Henrique de , Nogueira Daniela Nunes , Lopes Emenny Line Cardoso , Dias Adriano
Published: January 2020

Women presenting with advanced breast cancer tumors are common in Brazil. Little is known about factors contributing to the delay in seeking care. The aim of this study was to identify factors associated with longer time intervals between the onset of breast cancer symptoms and the first medical visit in the Federal District, Brazil. The analysis included 444 symptomatic women with incident breast cancer, interviewed between September, 2012 and September, 2014, during their admission for breast cancer treatment in nine public hospitals in the Federal District. Patients with metastatic disease at diagnosis were not included in this study. The outcome was time interval between symptom onset and the first medical visit, whether > 90 (34% of patients) or ≤ 90 days. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI). In the multivariate analysis, the > 90 day interval was significantly associated with patients not performing mammography and/or breast ultrasound in the two years prior to breast cancer diagnosis (OR = 1.97; 95%CI: 1.26-3.08), and with more advanced stages (OR = 1.72; 95%CI: 1.10-2.72). Furthermore, there was a lower chance of delay in patients with higher levels of education (OR = 0.95; 95%CI: 0.91-0.99). A relatively high proportion of breast cancer patients in the Brazilian Federal District experienced delay to attend the first medical consultation after the symptoms onset. Increasing breast cancer awareness, especially among women with low educational levels and those not participating in mammography screening programs could contribute to reduce this delay.
Cost-effectiveness analysis is a mandatory strategy for health systems: evidence from a study involving therapies for hepatitis C
Authors: Rodrigues João Paulo Vilela , Cazarim Maurílio de Souza , Chachá Silvana Gama Florencio , Martinelli Ana de Lourdes Candolo , Pereira Leonardo Régis Leira
Published: January 2020

Abstract: Cost-effectiveness analysis is essential in health decision making. Several countries use it as synthesis of evidence to incorporate health technologies. The protease inhibitors (PI) boceprevir (BOC) and telaprevir (TVR) are indicated for chronic hepatitis C treatment and were incorporated in guidelines worldwide. Pre-marketing clinical trials showed higher sustained virological response rates in relation to previous therapies, but the incorporation of PIs generated a significant financial impact. The aim of this study was to discuss the relevance of cost-effectiveness analysis through a study that involved the inclusion of PIs in a clinical protocol. The analysis was part of a real-life study that included patients infected with hepatitis C virus genotype 1 treated in a tertiary university hospital in Brazil. Triple therapies (TT) with ribavirin (RBV), peginterferon α-2a (Peg-INF α-2a) and BOC or TVR were compared to dual therapy with RBV and Peg-INF α-2a. Sensitivity analysis of the cost-effectiveness ratio indicated an 88.2% chance of TTs presenting a higher cost per cure. The incremental cost-effectiveness ratios (ICER) exceeded the Brazilian gross domestic product (GDP) per capita by three times in all proposed scenarios. The sensitivity of ICER showed an 88.4% chance of TT not being cost-effective. The impact of PI incorporation was negative and the conduct about this could have been different if a previous cost-effectiveness analysis had been conducted.
ARTIGO - JOGOS COMO RECURSOS DIDÁTICOS NA ALFABETIZAÇÃO: O QUE DIZEM E FAZEM AS PROFESSORAS
Authors: ARAUJO LIANE CASTRO de
Published: January 2020

RESUMO: O artigo apresenta resultados parciais de uma pesquisa que visa a investigar práticas alfabetizadoras que circulam em escolas da rede municipal de Salvador quanto ao uso de jogos voltados à apropriação da língua escrita. A metodologia qualitativa, de perspectiva colaborativa, propõe o levantamento de acervos, práticas e discursos envolvendo jogos e outros materiais para a alfabetização, bem como uma intervenção junto a escolas, visando a construir conhecimentos partilhados sobre esses recursos, articulando função lúdica e função didática. Resultados da primeira fase da pesquisa, a partir de entrevistas e observação, revelam que as professoras reconhecem o valor dos jogos na alfabetização, mas sua baixa frequência nas rotinas e no planejamento indica que esse uso é incipiente, sendo muitas as justificativas dadas para essa ausência. Os resultados sugerem que é preciso investir, na formação docente, em ações para fortalecer estratégias didáticas que abordam o ensino da escrita de modo reflexivo, não mecânico.
ARTIGO - PRÁTICAS DE LEITURA, GÊNEROS E SUPORTES TEXTUAIS DO CONTEXTO FAMILIAR NA PERSPECTIVA DE CRIANÇAS EM CLASSE DE ALFABETIZAÇÃO
Authors: PICCOLI LUCIANA , ZEN MARIA ISABEL HABCKOST DALLA
Published: January 2020

RESUMO: Neste artigo analisam-se práticas de leitura vinculadas ao contexto familiar de crianças de segundo ano do Ensino Fundamental de escola municipal de Porto Alegre/RS, bem como textos e materiais utilizados por elas em tais práticas. Situa-se nos campos do letramento, alfabetização e leitura, vistos sob os enfoques social, cultural, linguístico e pedagógico. Para geração dos dados, foram realizadas discussões com crianças em grupos focais, sendo os encontros registrados em diário de campo. A partir da análise dos dados, buscou-se identificar as práticas de leitura mais recorrentes apresentadas nos eixos: variedade de materiais e práticas de leitura apontada pelos participantes, protagonismo da criança-leitora em seu contexto familiar, perspectiva das crianças sobre gêneros e suportes de leitura. Constatou-se que as crianças fizeram mais referência ao suporte do que ao gênero, sendo tal resultado significativo para o planejamento de práticas escolares de alfabetização e leitura, as quais são inventariadas ao final do texto.
ARTIGO - COMO CRIANÇAS ALFABETIZADAS COM O MÉTODO FÔNICO RESOLVEM TAREFAS QUE AVALIAM A CONSCIÊNCIA FONÊMICA?
Authors: ARAGÃO SILVIA DE SOUSA AZEVEDO , MORAIS ARTUR GOMES DE
Published: January 2020

RESUMO: A pesquisa discute a relação entre várias habilidades de consciência fonêmica e os desempenhos de leitura apresentados por 20 crianças concluintes do primeiro ano, que tinham alcançado uma hipótese alfabética e eram ensinadas em escolas públicas com um método fônico. Elas foram submetidas a nove tarefas de consciência fonêmica e a três tarefas de leitura (de palavras, de frases e de texto). Na maioria das tarefas de consciência fonêmica houve um desempenho médio inferior ou igual a 60%. Ao lerem, os aprendizes revelaram um bom desempenho apenas na leitura de palavras, que apresentou correlação com poucas habilidades de consciência fonêmica. As análises qualitativas revelaram que as crianças pensavam predominantemente sobre letras ou sílabas e quase não verbalizavam fonemas. Nossas evidências levam a questionar a relevância de um ensino que priorize o treino isolado da pronúncia de fonemas como requisito para a aprendizagem da leitura e da escrita em Português.