bluuebunny/crossref_metadata_2025 huggingface dataset:
Community Informatics in Chongqing: A Case Study of the Real-Name and ID Requirement Policy in the Chinese Railway System
Authors: Huo Ran 霍然 , Wei Qunyi 魏群义
Published: November 2013

This study discusses strategies for narrowing the digital divide by examining the real-name and ID requirement policy that governs online purchases of train tickets in China. Using a case study, the authors of this study asks what factors influence online ticket purchasing by railway passengers and examines how Chinese public libraries offer online ticket-purchasing assistance as a strategy for bridging the digital divide. Deploying both quantitative and qualitative methods—including questionnaires and semistructured interviews—the authors found that four factors—gender, age, social status, and privacy concerns—were most important in influencing passengers' online ticket purchasing, and that Chinese public libraries do facilitate access to the digital world.
Moral Distress and Moral Disempowerment
Authors: Carse Alisa
Published: November 2013

Moral distress can consist in anxiety or concern about one’s capacity to meet challenges to one’s integrity; it can also consist in the sense that one has failed to meet these challenges, betraying fundamental moral values or commitments. When the sense of moral failure is compounded by feelings of frustration or impotence, of being constrained or impeded in one’s ability to act as one believes one ought, one experiences moral disempowerment. Drawing on narratives of moral distress emerging from work in the clinical context, this essay explores a distinction between cases in which moral distress does, and does not, center around the experience of moral disempowerment. When moral distress is tied to moral disempowerment, the acute personal toll is joined with broader moral costs, for effective moral agency is stymied. If we are to support individuals’ resilience and effectiveness in working constructively with moral distress, we need to understand and redress the social, systemic, and institutional factors contributing to moral disempowerment.
The Content of Hope in Ambulatory Patients with Colon Cancer
Authors: Beckman Emily S. , Helft Paul R. , Torke Alexia M.
Published: November 2013

Although hope is a pervasive concept in cancer treatment, we know little about how ambulatory patients with cancer define or experience hope. We explored hope through semistructured interviews with ten patients with advanced (some curable, some incurable) colon cancer at one Midwestern, university–based cancer center. We conducted a thematic analysis to identify key concepts related to patient perceptions of hope. Although we did ask specifically about hope, patients also often revealed their hopes in response to indirect questions or by telling stories about their cancer experience. We identified four major themes related to hope: 1) hope is essential, 2) a change in perspective, 3) the content of hope, and 4) communicating about hope. The third theme, the content of hope, included three subthemes: a) the desire for normalcy, b) future plans, and c) hope for a cure. We conclude that hope is an essential concept for patients undergoing treatment for cancer as it pertains to their psychological well–being and quality of life, and hope for a cure is not and should not be the only consideration. In a clinical context, the exploration of patients’ hopes and aspirations in light of their cancer diagnosis is important because it provides a frame for understanding their goals for treatment. Exploration of the content of patients’ hope can not only help to illuminate misunderstandings but also clarify how potential treatments may or may not contribute to achieving patients’ goals.
Analyzing Reflective Narratives to Assess the Ethical Reasoning of Pediatric Residents
Authors: Moon Margaret , Taylor Holly A. , McDonald Erin L. , Hughes Mark T. , Beach Mary Catherine , Carrese Joseph A.
Published: November 2013

A limiting factor in ethics education in medical training has been difficulty in assessing competence in ethics. This study was conducted to test the concept that content analysis of pediatric residents’ personal reflections about ethics experiences can identify changes in ethical sensitivity and reasoning over time. Analysis of written narratives focused on two of our ethics curriculum’s goals: 1) To raise sensitivity to ethical issues in everyday clinical practice and 2) to enhance critical reflection on personal and professional values as they affect patient care. Content analysis of written reflections was guided by a tool developed to identify and assess the level of ethical reasoning in eight domains determined to be important aspects of ethical competence. Based on the assessment of narratives written at two times (12 to 16 months/apart) during their training, residents showed significant progress in two specific domains: use of professional values, and use of personal values. Residents did not show decline in ethical reasoning in any domain. This study demonstrates that content analysis of personal narratives may provide a useful method for assessment of developing ethical sensitivity and reasoning.
A Case of Deceptive Mastectomy
Authors: Volpe Rebecca , Baker Maria , Blackall George F. , Kauffman Gordon , Green Michael J.
Published: November 2013

This paper poses the question, “what are providers’ obligations to patients who lie?” This question is explored through the lens of a specific case: a 26–year–old woman who requests prophylactic bilateral mastectomy with reconstruction reports a significant and dramatic family history, but does not want to undergo genetic testing. Using a conversational–style discussion, the case is explored by a breast surgeon, genetic counselor/medical geneticist, clinical psychologist, chair of a hospital ethics committee and director of a clinical ethics consultation service.
The Many Faces of Moral Distress Among Clinicians: Introduction
Authors: Rushton Cynda Hylton , Boss Renee
Published: November 2013

This narrative symposium illuminates the problem of clinician moral distress. NIB editorial staff and narrative symposium editors, Cynda Rushton, PhD, RN, FAAN and Renee Boss, MD, MHS, developed a call for stories, which was sent to several list serves and posted on Narrative Inquiry in Bioethics’ website. The request for personal stories from inter–professional healthcare providers asked them to: identify specific clinical situations that give rise to moral distress; discuss the sources of this distress; reflect on how they experienced moral distress—physically, psychologically, socially, or spiritually; assess how they managed their situations; and offer suggestions for avoiding future problems of a similar nature. Twelve stories are found in the print version of the journal and an additional eight supplemental stories are published online only through Project MUSE. The clinicians describe a wide range of experiences with patients, other clinicians, and their own professional and personal identities. Embedded in each of the narratives are deeply felt emotions that accompany their experiences of moral distress. Katherine Brown-Saltzman (a nurse), Alisa Carse (a philosopher), Zhanna Bagdasarov and Shane Connelly (industrial–organizational psychologists), and Nancy Berlinger (a bioethicist) provided commentaries.
Emotional Labor among Healthcare Professionals: The Effects are Undeniable
Authors: Bagdasarov Zhanna , Connelly Shane
Published: November 2013

Healthcare professionals encounter a variety of emotion-laden events involving ethical implications and choices. These events may trigger deeply felt negative emotions, which can limit an individual’s ability to make ethical decisions, and result in emotional labor. The topic of emotional labor, though studied extensively with customer service workers, has recently been investigated with regard to healthcare professionals, including nurses, clinical psychologists, and physicians. Studies focused on these populations have revealed widespread instances of emotional labor, commonly accompanied by various negative physical and psychological health consequences. Accordingly, emotion regulation strategies are important to explore in order to counteract the negative health outcomes. Recommendations for ways to cope with emotional demands for healthcare employees are provided.
Writing Wrongs: On Narratives of Moral Distress
Authors: Berlinger Nancy
Published: November 2013

The perception that one is being forced to do wrong, or being prevented from doing the right thing, is often described in the most brutal terms, as a situation that feels like participating in the torture of another human being. The emotional force of the experience of moral distress, and the perception that one is powerless to do anything to change the situation producing moral distress, can make it hard to look at these experiences critically, and to imagine a different reality. Writing about the experience of moral distress is a way to look critically at this experience. This commentary discusses how these narratives explore moral distress in relation to the formation of professional identity, as a “dirty” experience, as a potential consequence of unrelieved moral uncertainty, in the care of “difficult” patients, and as a response to systemic problems.
The Gift of Voice
Authors: Brown-Saltzman Katherine
Published: November 2013

Initial writings and moral distress research focused on nursing, however, it soon became clear that others in healthcare also experienced moral distress. The narratives discussed in this commentary show this variation not only in the authors’ multiplicity of disciplines (psychologists, nurses, an ethicist, and physicians), but also in their workplace environments (prisons, hospitals, and homecare) and their roles, from students to well accomplished professionals. In other words no one is immune. By looking through the lens of time the author shows that the experience of moral distress is not isolated in time, but in fact continues to be lived over time. Other important themes drawn out here are: isolation, powerlessness, failure, regret, undermined potential and the way feelings are experienced. It is also noted that despite the pain and angst, there is a sense of gratitude in these stories. They touch our own woundedness, remind us of our own resiliency and give us hope for the redemptive power of the experience and reflection
A New Kind of Northerner: Initial Song Perceptions of the Mongols
Authors: Garcia Chad D.
Published: November 2013

In the final days of the Mongol conquest of the Jin, the Song Empire chose to ally itself with the Mongols and together besieged the last strongholds of Jin resistance. In the years following the destruction of the Jin, Song-Mongol relations deteriorated into open hostility and a prolonged campaign of conquest. This paper investigates the initial Song perception and representation of the Mongols in the years prior to and immediately after the fall of the Jin. By analyzing topical and thematic elements of two key texts of the period, Mengda beilu (1221) and Heida shilüe (1237) certain hallmarks of Mongol image become apparent. Additionally, the historical context of the texts provides possible motives behind the formation and modification of Mongol image within the Song. The results of this study show that the Mongols may have been initially perceived in a positive light, and that this positive Mongol image served varying functions within Song society.
Maternal Mosaicism Is a Significant Contributor to Discordant Sex Chromosomal Aneuploidies Associated with Noninvasive Prenatal Testing
Authors: Wang Yanlin , Chen Yan , Tian Feng , Zhang Jianguang , Song Zhuo , Wu Yi , Han Xu , Hu Wenjing , Ma Duan , Cram David , Cheng Weiwei
Published: November 2013

BACKGROUND

In the human fetus, sex chromosome aneuploidies (SCAs) are as prevalent as the common autosomal trisomies 21, 18, and 13. Currently, most noninvasive prenatal tests (NIPTs) offer screening only for chromosomes 21, 18, and 13, because the sensitivity and specificity are markedly higher than for the sex chromosomes. Limited studies suggest that the reduced accuracy associated with detecting SCAs is due to confined placental, placental, or true fetal mosaicism. We hypothesized that an altered maternal karyotype may also be an important contributor to discordant SCA NIPT results.

METHODS

We developed a rapid karyotyping method that uses massively parallel sequencing to measure the degree of chromosome mosaicism. The method was validated with DNA models mimicking XXX and XO mosaicism and then applied to maternal white blood cell (WBC) DNA from patients with discordant SCA NIPT results.

RESULTS

Sequencing karyotyping detected chromosome X (ChrX) mosaicism as low as 5%, allowing an accurate assignment of the maternal X karyotype. In a prospective NIPT study, we showed that 16 (8.6%) of 181 positive SCAs were due to an abnormal maternal ChrX karyotype that masked the true contribution of the fetal ChrX DNA fraction.

CONCLUSIONS

The accuracy of NIPT for ChrX and ChrY can be improved substantially by integrating the results of maternal-plasma sequencing with those for maternal-WBC sequencing. The relatively high frequency of maternal mosaicism warrants mandatory WBC testing in both shotgun sequencing– and single-nucleotide polymorphism–based clinical NIPT after the finding of a potential fetal SCA.
Supporting arts and health evaluation: Report of a UK knowledge transfer partnership
Authors: Daykin Norma , Attwood Megan , Willis Jane
Published: November 2013

Despite increasing calls for a robust evidence base, there is no clear consensus surrounding appropriate methodologies for evaluation of the impact of arts on health and well-being. Commissioners and stakeholders often require evidence of measurable outcomes, but quantitative evaluation does not provide a complete picture of impact, neither can it explain the effects of arts. Further, outcomes and impact evaluation must be balanced with process evaluation to guide the development of practice. Practitioners face significant challenges in responding to these issues, including evaluation capacity, knowledge, skills and resources. This article reports on a project that supported the arts and health field by generating knowledge, resources and support for evaluation. A two-year Knowledge Transfer Partnership (KTP) between an Arts and Health consultancy and a University explored evaluation issues and developed strategies with practitioners. A guided evaluation model, in which external evaluators worked alongside practitioners in an iterative process, was developed. While resourcing such partnerships is challenging, our project demonstrates that they can strengthen sustainable evaluation, generating evidence for local commissioning as well as contributing to longer-term research agendas.
Evaluación espacio-temporal de vegetación y uso de suelo de la Cuenca Río Caliente, Jalisco, México
Authors: Ramírez-Sánchez Hermes Ulises , García-Guadalupe Mario Enrique , Villalpando-Piña Gilberto
Published: November 2013

El territorio mexicano ha sufrido un proceso acelerado de degradación de bosques con transformación en áreas de uso agropecuario o urbano. Los estudios de procesos dinámicos del uso del suelo son importantes y necesarios, ya que proporcionan información de la degradación producto de factores antrópicos. El objetivo de este trabajo fue identificar y cuantificar la variación espacial de los tipos de vegetación y usos de suelo en la Cuenca Río Caliente del Área de Protección de Flora y Fauna La Primavera de 1990 a 1999. Se clasificaron escenas del satélite Landsat TM 1990 y Landsat ETM 1999. Se generaron mapas de vegetación y uso del suelo y se sobrepusieron para obtener un mapa de cambios entre 1990 y 1999. Las clases que perdieron área en 1999 con respecto a 1990 fueron el bosque de encino-pino 58 %, bosque de pino-encino 51 %, pastizal inducido 23 % y vegetación secundaria 8%. Las clases que ganaron superficie en 1999 con respecto a 1990 fueron suelo desnudo 119 %, zona agrícola 83 %, encino 70 % y pino 50 %. Esto muestra la tendencia hacia la consolidación de rodales puros desplazando a las mezclas. La tasa de cambio anual para encino fue de 6.27 %, pino 4.83 %, pino-encino -7.51 %, encino-pino -8.92 %, vegetación secundaria -0.75 %, pastizal inducido -2.65 %, zona agrícola 7.20 % y suelo desnudo 9.30 %. Los cambios pueden atribuirse a diversas causas como: incendios, apertura de caminos, sobreexplotación de recursos, expansión ganadera, extracción de madera y quema intencional para cambio de uso de suelo; esto debido a los problemas de tenencia de la tierra.
Diseño de un itinerario turístico en Tivissa a partir de la estación meteorológica
Authors: Saladié Òscar , Salvat Salvat Jaume , Anton Clavé Salvador
Published: November 2013

La existencia de estaciones meteorológicas convencionales, que empezaron su andadura durante la segunda mitad del siglo XIX e inicios del siglo XX, ha hecho posible analizar las variaciones y las tendencias seculares de las diferentes variables meteorológicas a partir de la generación de series regionales. Estas estaciones, que a lo largo de los años han sufrido cambios de emplazamiento, de instrumentos y de observadores, forman parte del patrimonio material de un territorio, pudiéndose convertir en un atractivo turístico. Esta transformación es aún más factible si en los orígenes de la estación se encuentra la figura de un personaje de relevancia histórica, natural de la población donde está localizada la estación o bien una institución que justificó la creación de la estación. En este estudio se exponen los atributos que debería tener una estación para convertirse en un atractivo turístico y se propone un itinerario entorno a la estación meteorológica de Tivissa (Tarragona). Esta estación cuenta con datos desde el año 1911 y sus orígenes están ligados a la figura de Ramon Jardí (Tivissa 1881 - Barcelona 1972), profesor de la Universidad de Barcelona y que, entre otras cosas, diseñó y construyó el prototipo de pluviógrafo de intensidades que lleva su nombre.
Highlights on Artificial Insemination (AI) Technology in the Pigs
Authors: Khalifa Tarek , Rekkas Constantinos , Samartzi Foteini , Lymberopoulos Aristotelis , Kousenidis Kostas , Dovenski Toni
Published: November 2013

Over the past decade, there has been a tremendous increase in the development of field AI services in the majority of countries concerned with pig production. The objective of this paper is to review: (a) the current status of swine AI in the world, (b) significance and limitation of AI with liquid and frozen semen, (c) the biological traits of porcine semen in relation to in vitro sperm storage, (d) the criteria used for selection of a boar stud as a semen supplier, (e) how to process boar semen for liquid and frozen storage in the commercial settings and (f) how to improve fertility and prolificacy of boar semen. More than 99% of the inseminations conducted worldwide are made with liquid-stored semen. AI with frozen semen is used only for upgrading the genetic base in a particular country or herd. Determining the initial quality of semen ejaculates along with the selection of the optimum storage extender has a profound effect on the quality and fertility of AI doses. Different procedures have been used for improving the fertility of preserved spermatozoa including colloidal centrifugation of the semen, intrauterine insemination and modulation of the uterine defense mechanism after AI. Development of an efficient protocol for synchronizing the time of ovulation in sows and gilts coupled with improving uterine horn insemination technique will make a breakthrough in the commercial use of frozen boar semen.
Beneficial effect of melatonin treatment on age-related insulin resistance and on the development of type 2 diabetes
Authors: Tresguerres Jesus A.F. , Cuesta Sara , Kireev Roman A. , Garcia Cruz , Acuña-Castroviejo Dario , Vara Elena
Published: November 2013

This paper will review the effect of aging on glucose metabolism and insulin resistance in pancreas and in peripheral tissues and how melatonin administration could affect these parameters. In SAMP8 mice insulin levels in plasma were found to be increased together with enhanced HOMA-IR values, whereas insulin content in pancreas showed a decrease with aging. Aging in SAMP8 mice was also associated with a significant increase in the relative expression of both protein and mRNA of different pro-inflammatory mediators. Furthermore, aging was associated with a decrease in the expression of Pdx-1, FoxO 1 and FoxO 3A and Sirt 1 in pancreas SAMP8 samples. Melatonin administration was able to reduce these age-related alterations, decreasing plasma insulin levels and increasing its pancreatic content in SAMP8 mice. HOMA-IR was decreased with melatonin treatment in all animals. Conversely, in SAMP8 mice, melatonin treatment decreased the expression of glucagon, GLUT2, somatostatin and insulin. Furthermore it was also able to increase the expression of Sirt 1, Pdx-1 and FoxO 3A. The present study has shown that aging is associated with significant alterations in the relative expression of pancreatic genes involved in both insulin secretion and glucose metabolism and that these are associated with an increase in inflammation and oxidative stress. Melatonin administration was able to reduce oxidative stress and inflammation and thus to improve pancreatic function in old mice. By doing so, insulin resistance is diminished and plasma insulin is reduced, enhancing insulin pancreatic content and reducing plasma glucose levels and HOMA index.
Axonal Sprouting and Formation of Terminals in the Adult Cerebellum during Associative Motor Learning
Authors: Boele Henk-Jan , Koekkoek Sebastiaan K. E. , De Zeeuw Chris I. , Ruigrok Tom J. H.
Published: November 2013

Plastic changes in the efficacy of synapses are widely regarded to represent mechanisms underlying memory formation. So far, evidence for learning-dependent, new neuronal wiring is limited. In this study, we demonstrate that pavlovian eyeblink conditioning in adult mice can induce robust axonal growth and synapse formation in the cerebellar nuclei. Thisde novowiring is both condition specific and region specific because it does not occur in pseudoconditioned animals and is particularly observed in those parts of the cerebellar nuclei that have been implicated to be involved in this form of motor learning. Moreover, the number of new mossy fiber varicosities in these parts of the cerebellar nuclei is positively correlated with the amplitude of conditioned eyelid responses. These results indicate that outgrowth of axons and concomitant occurrence of new terminals may, in addition to plasticity of synaptic efficacy, contribute to the formation of memory.
How Do Immune Cells Support and Shape the Brain in Health, Disease, and Aging?
Authors: Schwartz Michal , Kipnis Jonathan , Rivest Serge , Prat Alexandre
Published: November 2013

For decades, several axioms have prevailed with respect to the relationships between the CNS and circulating immune cells. Specifically, immune cell entry was largely considered to be pathological or to mark the beginning of pathology within the brain. Moreover, local inflammation associated with neurodegenerative diseases such Alzheimer's disease or amyotrophic lateral sclerosis, were considered similar in their etiology to inflammatory diseases, such as remitting relapsing-multiple sclerosis. The ensuing confusion reflected a lack of awareness that the etiology of the disease as well as the origin of the immune cells determines the nature of the inflammatory response, and that inflammation resolution is an active cellular process. The last two decades have seen a revolution in these prevailing dogmas, with a significant contribution made by the authors. Microglia and infiltrating monocyte-derived macrophages are now known to be functionally distinct and of separate origin. Innate and adaptive immune cells are now known to have protective/healing properties in the CNS, as long as their activity is regulated, and their recruitment is well controlled; their role is appreciated in maintenance of brain plasticity in health, aging, and chronic neurodevelopmental and neurodegenerative diseases. Moreover, it is now understood that the barriers of the brain are not uniform in their interactions with the circulating immune cells. The implications of these new findings to the basic understanding of CNS repair processes, brain aging, and a wide spectrum of CNS disorders, including acute injuries, Rett syndrome, Alzheimer's disease, and multiple sclerosis, will be discussed.
Retrograde BMP Signaling at the Synapse: A Permissive Signal for Synapse Maturation and Activity-Dependent Plasticity
Authors: Berke Brett , Wittnam Jessica , McNeill Elizabeth , Van Vactor David L. , Keshishian Haig
Published: November 2013

At theDrosophilaneuromuscular junction (NMJ), the loss of retrograde, trans-synaptic BMP signaling causes motoneuron terminals to have fewer synaptic boutons, whereas increased neuronal activity results in a larger synapse with more boutons. Here, we show that an early and transient BMP signal is necessary and sufficient for NMJ growth as well as for activity-dependent synaptic plasticity. This early critical period was revealed by the temporally controlled suppression of Mad, the SMAD1 transcriptional regulator. Similar results were found by genetic rescue tests involving the BMP4/5/6 ligand Glass bottom boat (Gbb) in muscle, and alternatively the type II BMP receptor Wishful Thinking (Wit) in the motoneuron. These observations support a model where the muscle signals back to the innervating motoneuron's nucleus to activate presynaptic programs necessary for synaptic growth and activity-dependent plasticity. Molecular genetic gain- and loss-of-function studies show that genes involved in NMJ growth and plasticity, including the adenylyl cyclase Rutabaga, the Ig-CAM Fasciclin II, the transcription factor AP-1 (Fos/Jun), and the adhesion protein Neurexin, all depend critically on the canonical BMP pathway for their effects. By contrast, elevated expression of Lar, a receptor protein tyrosine phosphatase found to be necessary for activity-dependent plasticity, rescued the phenotypes associated with the loss of Mad signaling. We also find that synaptic structure and function develop using genetically separable, BMP-dependent mechanisms. Although synaptic growth depended on Lar and the early, transient BMP signal, the maturation of neurotransmitter release was independent of Lar and required later, ongoing BMP signaling.
Lipocalin 2 induces the epithelial–mesenchymal transition in stressed endometrial epithelial cells: possible correlation with endometriosis development in a mouse model
Authors: Liao Chi-Jr , Li Pei-Tzu , Lee Ying-Chu , Li Sheng-Hsiang , Chu Sin Tak
Published: November 2013

Lipocalin 2 (LCN2) is an induced stressor that promotes the epithelial–mesenchymal transition (EMT). We previously demonstrated that the development of endometriosis in mice correlates with the secretion of LCN2 in the uterus. Here, we sought to clarify the relationship between LCN2 and EMT in endometrial epithelial cells and to determine whether LCN2 plays a role in endometriosis. Antibodies that functionally inhibit LCN2 slowed the growth of ectopic endometrial tissue in a mouse model of endometriosis, suggesting that LCN2 promotes the formation of endometriotic lesions. Using nutrient deprivation as a stressor, LCN2 expression was induced in cultured primary endometrial epithelial cells. As LCN2 levels increased, the cells transitioned from a round to a spindle-like morphology and dispersed. Immunochemical analyses revealed decreased levels of cytokeratin and increased levels of fibronectin in these endometrial cells, adhesive changes that correlate with induction of cell migration and invasion.Lcn2knockdown also indicated that LCN2 promotes EMT and migration of endometrial epithelial cells. Our results suggest that stressful cellular microenvironments cause uterine tissues to secrete LCN2 and that this results in EMT of endometrial epithelial cells, which may correlate with the development of ectopic endometriosis. These findings shed light on the role of LCN2 in the pathology of endometrial disorders.
Singular features of fertilization and their impact on the male reproductive system in eutherian mammals
Authors: Bedford J Michael
Published: November 2013

Therian (marsupial and eutherian) mammals have evolved a suite of novel reproductive features – seen variously in their gametes, the steps of fertilization and the male reproductive tract – whose adaptive significance remains unclear. Present evidence for the better-understood eutherian mammals suggests that the ‘prime mover’ in their evolution has been the character of the egg coat, with other such features being adaptations to the consequences of this. Its elastic thickness allows the zona pellucida to stretch to a variable degree and yet remain around the blastocyst during much or all of its expansion before implantation, but its character represents an unusual challenge for spermatozoa. Novel aspects of the acrosome related to this challenge enable it to maintain a relatively prolonged binding after the onset of the acrosome reaction, and the structure, shape and behaviour of the sperm head point to physical thrust as a major element of zona penetration – with the unique configuration of gamete fusion as asequelaof this strategy. In the male, such adaptations are reflected in sperm head formation in the testis and in sperm maturation in the epididymis involving at least the sperm head's structure, plasmalemma and acrosome. This complexity allied to a slow epididymal sperm transport, a relatively modest sperm production and the brief life span of mature spermatozoa kept above the cauda epididymidis could account for the evolution of the sperm storage function – a development seemingly linked, in turn, to the need for sperm capacitation and scrotal evolution.
Contact lens-related keratitis
Authors: Steiber Zita , Berta András , Módis László
Published: November 2013

Nowadays, keratitis, corneal infection due to wearing contact lens means an increasingly serious problem. Neglected cases may lead to corneal damage that can cause blindness in cases of otherwise healthy eyes. Early diagnosis based on the clinical picture and the typical patient history is an important way of prevention. Prophylaxis is substantial to avoid bacterial and viral infection that is highly essential in this group of diseases. Teaching contact lens wearers the proper contact lens care, storage, sterility, and hygiene regulations is of great importance. In case of corneal inflammation early accurate diagnosis supported by microbiological culture from contact lenses, storage boxes or cornea is very useful. Thereafter, targeted drug therapy or in therapy-resistant cases surgical treatment may even be necessary in order to sustain suitable visual acuity. Orv. Hetil., 154(45), 1781–1789.
Hypertension-related eye abnormalities
Authors: Resch Miklós , Süveges Ildikó , Németh János
Published: November 2013

Hypertension affects a significant proportion of the population, however, it is often diagnosed with a delay. The aim of this article is to review the well known and less known eye abnormalities related to hypertension, and place them in the context of population based studies. Hypertension affects various parts of the eye. The originally classified hypertensive retinopathy (retinal microvascular changes) is still relevant, but new features are visible in cases of controlled hypertension. Signs of mild hypertensive retinopathy are more common than expected occurring in nearly 10–15% of the adult non-diabetic population. Hypertensive retinopathy can be an indicator of other hypertensive complications such as neurologic and cardiac complications. Microvascular changes are reversible in well controlled hypertension. Proper treatment of hypertension can reduce the development and progression of diabetic retinopathy and, thus, visual loss due to severe retinal diseases such as retinal vascular occlusion (artery and vein), retinal arteriolar emboli, macroaneurysm, ischemic optic neuropathy and age-related macular degeneration.Orv. Hetil., 154(45), 1773–1780.
Uveitis in sarcoidosis
Authors: Szepessy Zsuzsanna
Published: November 2013

This case report demonstrates signs of uveitis and difficulties of the differential diagnosis of sarcoidosis as the cause of uveitis. A 57-year-old woman, who had visual loss in her both eyes, developed bilateral panuveitis: bilateral precipitates on the cornea with posterior synechia and infiltrates in the vitreous, and multifocal, peripheral retinochoroiditis. Chest X-ray revealed an infiltrate and numerous smaller granulomas in both lungs. The presumptive diagnosis was tuberculosis, however, biopsy of the pulmonal lesion showed sarcoidosis. Pulmonary and ophthalmologic findings rapidly disappeared with corticosteroid therapy. The author concludes that sarcoidosis may present with different signs of uveitis. Histopathology is of great importance for the differentiation between sarcoidosis and tuberculosis, which is very important for the therapy. Orv. Hetil., 154(45), 1798–1801.
Long term intravitreal ranibizumab treatment for exsudative age-related macular degeneration
Authors: Lukács Regina , Resch Miklós , Papp András , Szabó Antal , Borbándy Ágnes , Menkens Hanna , Kiss Huba , Németh János
Published: November 2013

Introduction: The results of intravitreal ranibizumab treatment for exsudative age-related macular degeneration have been favourable until this time. Aim: To evaluate the two-year functional and anatomic results of intravitreal ranibizumab treatment. Method: 46 patients (age: 75±9.1 years) were included in a prospective single center study. Treatment regimen was the following: monthly 0.5 mg ranibizumab was administered in the first 3 months, and later as required (pro re nata). The change of best corrected visual acuity and central retinal thickness was followed. Results: The visus change at the end of the follow-up time was not statistically significant compared to baseline (p = 0.760) and the at the end of the first year (p = 0.154). Central retinal thickness decreased significantly compared to baseline (p = 0.000001), but the change was not statistically significant compared to the end of the first year (p = 0.875). Conclusions: Patients with neovascular macular degeneration treated with intravitreal ranibizumab using pro re nata regimen have stable visus for long term, and the exsudation could be reduced efficiently. Orv. Hetil., 154(45), 1790–1797.
History of cataract operations in Hungary
Authors: Marsovszky László
Published: November 2013

The history of the cataract operations dates back to thousands of years ago. Initially, surgery was carried out using rudimentary operating techniques resulting in the loss of many eyes. Cataract surgery has evolved immersely and now it is a highly refined surgical practice. Evolution of the cataract surgery was closely linked to broadening of anatomical-pathological knowledge and to the development of the instruments applied. Although Daviel performed the first intentional cataract removal in 1747, almost one hundred years passed before the extracapsular cataract extraction method finally replaced the old couching technique. By the middle of the 20th century, with the progression of the operation techniques and instruments, different forms of intracapsular cataract extraction methods became prevalent. Introduction and widespread use of the artificial intraocular lenses from the second half of the 20th century led to the rediscovery and further perfection of the extracapsular cataract extraction technique. Today, phacoemulsification through small incision, along with the foldable intraocular lenses is the gold standard of cataract surgery. The aim of this study is to present the different cataract surgery methods applied throughout the centuries, as well as the difficulties encountered. It discusses pioneering steps of each era, in order to give a closer look at the most frequently performed surgical intervention in ophthalmology. Orv. Hetil., 154(45), 1802–1805.
Relação entre bem-estar espiritual, características sociodemográficas e consumo de álcool e outras drogas por estudantes
Authors: Silva Roberta de Paiva , Souza Priscila de , Nogueira Denismar Alves , Moreira Denis da Silva , Chaves Erika de Cássia Lopes
Published: November 2013

OBJETIVOS: O estudo objetivou avaliar o consumo de álcool e de outras drogas por estudantes de Enfermagem e investigar a relação entre esse consumo e o bem-estar espiritual e as características sociodemográficas/religiosas dos estudantes. MÉTODOS: Trata-se de um estudo epidemiológico, observacional e seccional, realizado com 100 graduandos do curso de Enfermagem de uma universidade do sul de Minas Gerais. A coleta de dados foi realizada no segundo semestre de 2011 e utilizou um questionário sociodemográfico, a Escala de Bem-estar Espiritual e o Teste de Triagem do Envolvimento com Álcool, Tabaco e outras Substâncias. O tratamento estatístico dos dados foi realizado utilizando-se a análise univariada, por meio do teste qui-quadrado e análise múltipla, por meio da regressão logística dicotômica. RESULTADOS: O álcool demonstrou ser a substância mais utilizada pelos estudantes (84%), o que, por sua vez, apresentou relação significativa com a espiritualidade deles, visto que possuir bem-estar espiritual negativo (OR: 3,325; IC95%: 1,059-10,441) e não ter prática religiosa frequente (OR: 3,392; IC95%: 1,064-10,811) aumenta as chances de consumo abusivo dessa substância. CONCLUSÃO: Iniciativas preventivas ao consumo de drogas psicoativas, vinculadas à prática de atividades espirituais, podem ser utilizadas como estratégias para a promoção de hábitos saudáveis e para a manutenção da saúde e também como recurso na formação profissional de estudantes de Enfermagem
Estrutura da vegetação de mangue associada ao gradiente de inundação no litoral norte do Espírito Santo, Brasil
Authors: Londe Vinícius , Salles Débora Mello , Leite Mariangela Garcia Praça , Antonini Yasmine
Published: November 2013

O manguezal é um ecossistema de grande complexidade que ocorre na interface entre os ambientes marinhos e terrestres, mas que apresenta baixa riqueza de espécies vegetais adaptadas às suas condições diferenciadas. Avaliar a estrutura e distribuição da vegetação no manguezal do rio Piraquê-Açu, ES, associando-as com parâmetros abióticos ao longo de um gradiente, foi o objetivo deste estudo. Em seis parcelas de 100 m² cada, foram registrados 306 indivíduos vivos e um morto, pertencentes às espécies Laguncularia racemosa, Rhizophora mangle, Avicennia schaueriana, Terminalia catappa e outras quatro indeterminadas, sendo L. racemosa de maior densidade, dominância, área basal e IVI. A altura média das árvores foi de 4,2 m (DP±1,9) e a CAP, de 12,4 cm (DP±9,5), estando a maioria dos indivíduos em classes de CAP até 10 cm. O manguezal encontrava-se em estado juvenil e pouco desenvolvido estruturalmente, e houve distinção na distribuição das espécies na área, com espécies associadas ocorrendo na parcela mais elevada e menos úmida. As variáveis abióticas diferiram entre as parcelas, contudo apenas a umidade do substrato apresentou relação significativa com a abundância de indivíduos e circunferência dos troncos.
Estudo nutricional da canafístula (I): crescimento e qualidade de mudas em resposta à adubação com nitrogênio e fósforo
Authors: Souza Natália Hilgert de , Marchetti Marlene Estevão , Carnevali Thiago de Oliveira , Ramos Diovany Doffinger , Scalon Silvana de Paula Quintão , Silva Eulene Francisco da
Published: November 2013

A canafístula é uma importante espécie florestal nativa, encontrada em áreas de Cerrado, que ainda carece de informações nutricionais e de obtenção de mudas de qualidade. Sendo assim, objetivou-se neste trabalho avaliar os efeitos da adição de N e P sobre o crescimento inicial e qualidade de mudas de canafístula em Latossolo Vermelho distroférrico. O experimento foi desenvolvido em vasos de 4 dm³, com os tratamentos dispostos em fatorial 4x4, sendo quatro doses de N (0; 20,82; 41,64 e 62,46 mg kg-1 de N) e quatro doses de P (0; 41,72; 83,44 e 125,16 mg kg-1 de P2O5), em delineamento experimental de blocos casualizados, com três repetições. Foram avaliadas características de crescimento (altura, diâmetro de caule e massa seca da parte aérea e radicular) e parâmetros de qualidade de mudas (relação altura/diâmetro - RAD; relação massa seca da parte aérea/massa seca de raiz - RPAR, e Índice de Dickson). Houve interação significativa entre as doses de N e P para todas as características de crescimento e parâmetros de qualidade avaliados. As maiores doses de N e P proporcionaram maior crescimento de mudas, no entanto, com relação à qualidade das mudas, o índice de Dickson indicou o fósforo como elemento mais importante.
Avaliação qualitativa de impactos ambientais considerando as etapas de limpeza e preparo do terreno em plantios florestais no Nordeste paraense
Authors: Krag Márcia Nágem , Vale Rodrigo Silva do , Silva Elias , Oliveira Francisco de Assis , Gama Marcos André Piedade , Silva Paulo de Tarso Eremita da
Published: November 2013

Este trabalho apresenta os resultados da avaliação qualitativa de impactos ambientais na etapa de implantação florestal, considerando-se as atividades de limpeza e preparo do terreno, por meio da aplicação dos métodos de matriz de identificação e interação de impactos, da lista descritiva (checklist) e da combinação/ponderação de atributos. Tal avaliação foi feita com base na identificação e caracterização qualitativa dos impactos ambientais, cujas metodologias possibilitaram a visualização rápida e hierarquizada dos impactos. Através dessa matriz, evidenciaram-se 348 possíveis relações de impactos (capacidade total da matriz), das quais 304 (87,6%) foram identificadas, em que 209 impactos (60,05%) recaíram sobre o meio biofísico e 95 (27,31%) sobre o meio socioeconômico. Dos 209 impactos no meio biofísico, todos apresentaram valor negativo, evidenciando-se ser esse o compartimento ambiental mais impactado negativamente quando da realização das atividades de limpeza e preparo do terreno. Já, dos 95 impactos no meio socioeconômico, 72 (75,78%) foram de valor positivo e 23 (24,21%) de valor negativo, demonstrando que o meio socioeconômico é o compartimento ambiental mais afetado positivamente por ocasião da realização das atividades. Foram identificados os impactos ambientais positivos e negativos mais significantes que, com a combinação/ponderação de atributos, mostraram ser, em sua maioria, de significância média local e regional. Todos os impactos evidenciados apresentaram temporalidade no curto prazo, evidenciando estarem sobre o alcance quanto ao diagnóstico e gestão ambiental adequados. Os resultados contribuem e reafirmam a necessidade de se instituir o processo de avaliação de impactos ambientais na rotina técnico-administrativa da empresa como instrumento de gestão ambiental.
Estabelecimento inicial de plântulas de Myracrodruon urundeuva Allemão em diferentes substrato
Authors: Andrade Alexandro Pereira , Brito Camilla de Carvalho de , Silva Júnior Jorge da , Cocozza Fábio Del Monte , Silva Marcos Antônio Vanderlei
Published: November 2013

Objetivou-se com este trabalho avaliar o crescimento inicial de plântulas de M. urundeuva estabelecidas em diferentes substratos. O trabalho foi realizado no Laboratório de Sementes e no Viveiro de Mudas da Universidade Estadual da Bahia (UNEB), Barreiras, BA. As sementes foram coletadas de árvores daquela universidade. Foi utilizado o delineamento inteiramente casualizado com seis tratamentos e quatro repetições, sendo os tratamentos T1: solo; T2: areia; T3: solo + areia + esterco; T4: casca de madeira; T5: bagaço de cana-de-açúcar + esterco; e T6: bagaço de cana-de-açúcar + esterco + cinzas. A semeadura foi realizada em bandejas plásticas, com diferentes substratos, utilizando-se 20 sementes, colocadas a uma profundidade de 1,0 cm. Foram avaliados o índice de velocidade de emergência (%), a altura da parte aérea e da radícula, o comprimento das plântulas e das folhas, o número de folhas e as massas verde e seca da parte aérea e da radícula. Plântulas estabelecidas utilizando casca de madeira como substratos obtiveram melhores resultados quanto ao número e comprimento das folhas, altura da parte aérea e massa verde e seca da parte aérea. Em contraste, os percentuais de índice de velocidade de emergência obtiveram os piores resultados em plântulas estabelecidas em substratos com casca de madeira. Os resultados de radículas não diferiram entre as plântulas estabelecidas com os diferentes substratos. Os substratos contendo composto de casca de madeira ou bagaço de cana + esterco forneceram as melhores condições para o crescimento inicial de plântulas de M. urundeuva.
Brazilian mothers' description of their children: dimensions of autonomy and relatedness
Authors: Seidl-de-Moura Maria Lucia , Mendes Deise Maria Leal Fernandes , Vieira Mauro Luis , Korbarg Ana Paula , Pessôa Luciana Fontes , Bandeira Tatiana Targino Alves
Published: November 2013

Development of the self is oriented according to cultural models, such as: interdependent, independent, and autonomous-related. This study aimed to investigate how Brazilian mothers describe their children and the presence of autonomy and relatedness in their descriptions. Ninety-four mothers with children with ages ranging from 17 to 22 months were interviewed. The results indicate that mothers valued children being intelligent, active, loving and caring. Children were described with more positive than negative temperament characteristics. No significant difference was observed between the proportion of descriptors in the Independence and Relatedness category. This indicates a tendency towards an autonomous-related model, corroborating evidence of previous Brazilian studies. The present study brings evidence to socialization trajectories of Brazilian mothers and contributes to the literature on parental beliefs.
Transplante de intestino delgado
Authors: Pécora Rafael Antonio Arruda , David André Ibrahim , Lee André Dong , Galvão Flávio Henrique , Cruz-Junior Ruy Jorge , D'Albuquerque Luiz Augusto Carneiro
Published: November 2013

INTRODUÇÃO: O transplante de intestino delgado, em razão de sua complexidade, apresentou evolução mais lenta que os demais órgãos sólidos. Diversos avanços permitiram sua aplicação clínica. OBJETIVO: Revisão da evolução do transplante de intestino delgado e seu estado atual. MÉTODO: levantamento bibliográfico nas bases de dados MEDLINE e ScIELO. Os termos usados como descritores foram: intestinal failure, intestinal transplant, small bowel transplant, multivisceral transplant. Foram analisados dados sobre evolução histórica, centros, indicações, tipos de enxertos, seleção e captação de órgãos, manejo pós-operatório, complicações e resultados. CONCLUSÃO: Apesar de desenvolvimento mais lento, o transplante intestinal é hoje a terapia para pacientes portadores de falência intestinal irreversível que apresentam complicações da nutrição parenteral. Envolve algumas modalidades: intestino delgado isolado, fígado-intestino, multivisceral e multivisceral modificado. Atualmente a sobrevida é semelhante aos demais órgãos sólidos. A maioria dos pacientes fica livre da nutrição parenteral.