bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospective Evaluation of Opioid Consumption Following Cubital Tunnel Decompression Surgery
Authors: Hozack Bryan A. , Abboudi Jack , Gallant Gregory , Jones Christopher M. , Kirkpatrick William , Liss Frederic E. , Rivlin Michael , Takei T. Robert , Wang Mark L. , Silverman Matthew , Foltz Carol , Ilyas Asif M.
Published: September 2018

Background: Managing postoperative pain is important for patients and surgeons. However, there is concern over opioid dependency. Cubital tunnel decompression is among the most common upper extremity surgeries. Our study aimed to analyze opioid use after cubital tunnel decompression to guide postoperative opioid prescribing. Methods: We prospectively collected opioid consumption for 16 consecutive months (February 2016 to June 2017) for cubital tunnel decompression patients. Data on demographics, insurance type, surgery performed, functional questionnaires (Quick Disabilities of the Arm, Shoulder and Hand [QuickDASH]), and electrodiagnostics (electromyography) were collected. Opioid consumption was reported at first postoperative visits. Results: One hundred patients consumed a mean of 50 morphine equivalent units (MEUs) (range, 0-300), or 7 oxycodone 5-mg pills, postoperatively. Cubital tunnel release (CuTR) patients consumed fewer than ulnar nerve transposition (UNT) patients (40.4 vs 62.5 MEUs or 5.4 vs 8.3 pills, P = .08). Patients undergoing submuscular UNT consumed more than CuTR (115.0 vs 40.4 MEUs or 15.3 vs 5.4 pills, p = 0.003) and more than subcutaneous UNT patients (37.8 MEU or 5.0 pills, p = 0.03). Medicare patients consumed less than privately insured (42.7 vs 54.1 MEUs, 5.7 vs 7.2 pills, P = .02) and less than workers’ compensation patients (76.8 MEU or 10.2 pills, P = .04). Older patients consumed fewer than younger patients ( P = .03). Postoperative QuickDASH score was positively related to opioid intake ( P = .009). Conclusions: Patients consumed 7 oxycodone 5-mg pills after cubital tunnel decompression. Younger, privately insured, and workers’ compensation patients, and those with worse functional scores and those undergoing UNT (specifically the submuscular technique) consumed more opioids.
Proton Pump Inhibitor Use is Associated With Risk of Pancreatic Cancer: A Nested Case–Control Study
Authors: Peng Yen-Chun , Lin Cheng-Li , Hsu Wan-Yun , Lu I-Ta , Yeh Hong-Zen , Chang Chi-Sen , Kao Chia-Hung
Published: October 2018

Purpose:

To investigate the use of proton pump inhibitors (PPIs) and the risk of pancreatic cancer.

Methods:

A nested case–control analysis was conducted. Patients with pancreas cancer were matched with controls by propensity score. Univariate and multivariate logistic regression models were used to determine whether PPIs use affected the risk of pancreas cancer. Dose effect was analyzed based on the cumulative defined daily dose (DDD), which was calculated using the total supply of PPIs to individual patients in terms of days and quantity.

Results:

A total of 1087 patients with pancreas cancer were matched with 1087 control patients from the database. The overall adjusted odds ratio (OR) of PPI use associated with pancreas cancer was 1.69 (95% confidence interval [CI], 1.44-2.05). Dose analysis by cumulative DDD, based on all types of PPI combined, revealed a lower adjusted OR of 0.92 (95% CI, 0.64-1.33) for those on <30 cumulative DDD compared with those on ≥150 cumulative DDD, whose adjusted OR was 2.19 (95% CI, 1.68-2.85). Compared with PPI nonusers, the risks of pancreas cancer were: OR 0.89 (95% CI, 0.62-1.27) for patients using PPI <30 days and 2.22 (95% CI, 1.68-2.94) for ≥150 days.

Conclusions:

Risk of pancreas cancer was associated with PPI use in patients with peptic ulcer diseases or gastroesophageal reflux disease.
MDA as a Research Method of Generic Musical Analysis for the Social Sciences
Authors: Charles Monique
Published: October 2018

Using Grime as a case study, I employ the analytical framework I created, that is, Musicological Discourse Analysis (MDA) as a holistic mode of analysis to contextualize Grime sociologically and musicologically. This method retheorizes genre, providing a more specific, useful, and detailed musical classification system; the sonic footprint timestamp (SFT). The MDA framework provides a generic mode of musical analysis for research projects in sociology, cultural studies, and the social sciences fields. This article evaluates key musical influences in the evolution of Grime as both (i) a musical form and (ii) an analysis of influences in relation to its social context. It evaluates the global, local, historical, technological, political, lyrical themes, and sonic properties (sounds) found in Grime. Significantly, this framework is very much concerned with the voices in the Grime scene, and therefore respondent experiences are central to this analytical method—incorporating in-depth interviews, observation (physical and online), and immersive listening.
My Whole Life in Telephones
Authors: Abildgaard Mette Simonsen
Published: October 2018

In this article, I address a methodological issue that has come into focus after the advent of the “material turn”; the matter of how to study historical, sociomaterial practices. In response, I propose a method for materially oriented qualitative interviews, in which historical artifacts are used as elicitation devices. I focus on three ways in which material devices can aid historical research in interviews: I first emphasize that materiality can aid the qualitative interviewer by providing specificity, as the material presence of historical artifacts can urge participants to remember details, directing the conversation toward the specificity of mundane artifacts whose characteristics can be difficult to recollect. Second, I suggest that such artifacts may be used also to aid narrative structure, guiding and prompting participants to follow the story they infer from a particular setup of artifacts. Third, I propose that the active engagement with historical artifacts in the qualitative interview allows participants to access body memories of using these artifacts, eliciting the particulars of abandoned bodily practices. I end by discussing the possibilities for improving the “materially oriented qualitative interview”—method and applying it in other contexts.
Hong Kong pre-service teachers’ attitudes towards and knowledge of children’s rights
Authors: Lo Yan Lam
Published: October 2018

The Convention on the Rights of the Child emphasizes that the education of the child should be directed to the development of respect for human rights and fundamental freedoms. However, though Hong Kong is a one of the States Parties to the Convention on the Rights of the Child, the government does not put much emphasis on promoting Convention on the Rights of the Child. Children’s rights education is not compulsory in schools or in teacher training institutions in Hong Kong. It is detrimental if teachers do not possess adequate knowledge and positive attitudes towards children’s rights as they hold a crucial role in educating children about their rights and nurturing rights-respecting students. Through modifying Rogers and Wrightsman’s Children’s Rights Attitudes Scale, the present research examined pre-service teachers’ attitudes towards children’s self-determination rights, nurturance rights, and the conflict between self-determination and nurturance rights, and also their knowledge of children’s rights, in order to uncover the areas of improvements.
Does the visual attention span play a role in the morphological processing of orthographic stimuli?
Authors: Antzaka Alexia , Acha Joana , Carreiras Manuel , Lallier Marie
Published: October 2018

We investigated whether the link between visual attention (VA) span and reading is modulated by the presence of morphemes. Second and fourth grade children, with Basque as their first language, named morphologically complex and simple words and pseudowords, and performed a task measuring VA span. The influence of VA span skills on reading was modulated by the presence of morphemes in naming speed measures. In addition, fourth grade children with a larger VA span showed larger lexicality effects (pseudoword-word reading times) only for morphologically simple stimuli. Results are interpreted as support for the notion that both transparency and morphological complexity are important factors modulating the impact of VA span skills on reading.
The experience of dental practices that use automatic washer disinfectors
Authors: Stankiewicz Nikolai
Published: September 2018

Background:

Understanding the collective sociotechnical experiences of the staff in dental practices with automatic washer disinfectors (AWDs) may help shape future strategies that encourage the transition towards best practice in dental instrument decontamination and reprocessing.

Objectives:

To find the emerging themes that reflect the experience of working with an AWD in dental practice. To compare the experience of practice owners to that of the dental nurses.

Methods:

A qualitative semi-structured interview-based methodology was applied using a convenience sample of dentists and dental nurses. Verbatim transcripts of audio recordings underwent thematic analysis.

Results:

Dental practice owners and dental nurses were interviewed. Four themes were common to both groups: impact on daily routine; mundane technology; the decontamination cycle; and safety. Three themes were unique to the dentists: impact on the business; professionalism; and external motivators for change.

Discussion:

AWDs are a mundane form of technology that dental nurses find simple to operate. The extended time it takes to reprocess instruments using an AWD means that dental nurses must adapt their daily working practices to accommodate this. Initial funding to purchase an AWD, especially where there is a professional expert leading a campaign championing their use, can be effective.
The lived experience of motor recovery of elbow flexion following Oberlin nerve transfer: A qualitative analysis
Authors: Brown Hazel , Johnson Kathryn , Gilbert Anthony , Quick Tom J
Published: October 2018

Introduction

Nerve injuries to the upper trunk, lateral cord and musculocutaneous nerve can result in the loss of active biceps contraction. Oberlin nerve transfer surgery is often performed to re-animate the biceps muscle. Outcome studies following this surgery almost exclusively focus on muscle strength. To date, no research has focused on the lived experience of motor recovery following Oberlin nerve transfer.

Methods

A focus group discussion ( n = 6) allowed participants to give their accounts of successful restoration of active elbow flexion. Qualitative analysis of the transcript identified ‘significant statements’ which were used to generate themes and capture participants’ lived experience.

Results

Four main themes were identified as being important components of the lived experience: ‘pain’, ‘patience and positive thought’, ‘functionality and daily lifestyle’ and ‘the biceps muscle’ itself. Each theme was identified to have several subthemes and constituent parts.

Conclusions

The lived experience of motor recovery is complex, multifaceted and individual to the patient. This study has identified areas where clinicians may be able to better tailor their care to the individual and suggested adjuncts to therapy have been included.
The Use of Modern Intramedullary Nailing in Distal Fibula Fracture Fixation
Authors: Tracey Joseph , Vovos Tyler J. , Arora Danny , Adams Samuel , Parekh Selene G.
Published: October 2018

Background. Lateral malleolus (LM) fixation is necessary for unstable ankle fractures. Traditional fixation relies on the use of plates through a lateral incision, wound healing can be an issue for such incisions. A novel intramedullary (IM) fixation device has been developed that can be placed through a minimal incision. The purpose of this study was to demonstrate the clinical efficacy of this device. Methods. A retrospective analysis was performed on patients who received IM fixation for isolated fibula, bimalleolar (BM), and trimalleolar (TM) fractures. Pertinent demographic information, operative factors, complications, and clinical outcomes were recorded. Results. Sixteen patients were included in the study with an average age of 59 years (range 35-86 years). Six patients presented with isolated LM fractures, four patients had a BM fracture with a syndesmotic injury, 2 patients sustained a LM fracture with an associated syndesmotic injury, 2 patients had a BM fracture, and 2 patients had a TM fracture with a syndesmotic injury. There was a 100% healing rate of the lateral malleolus without any cases of malunion or shortening. There were no cases of sural nerve or peroneal tendon injuries, nor any wound complications found. Conclusion. These findings demonstrate the safe and efficacious use of a novel intramedullary fixation device for fibula fractures with lower wound complications compared with published outcomes found with lateral fibular plating. The features of this device allow for reliable fixation of the fibula, maintaining length and minimizing wound issues.

Levels of Evidence: Level IV: Case series
Celiac Disease Awareness: Unraveling the Secrets of Celiac Disease
Authors: Evans Suzanne , Cecere Jennifer
Published: October 2018

School nurses play a major role in the care of students with food-related diversities balancing responsibilities such as providing a safe environment, encouraging leadership and community outreach, giving guidance to family and peers with care coordination, and providing needed accommodations so that all students may thrive in the school setting. It is essential that school nurses share their understanding of what it is like to live with the serious genetic autoimmune disorder known as celiac disease. With improved knowledge, the school education team, nutritional staff, and guidance counselors will have a better understanding of what the student is facing and the unique challenges it presents, because celiac disease is not a food allergy, but much more.
National School Health Data Set: Every Student Counts! Building Capacity for Data Collection
Authors: Johnson Kathleen H. , Meadows Lynne P. , Bergren Martha Dewey , Maughan Erin D.
Published: October 2018

The National Association of School Nurses (NASN) has launched the National School Health Data Set: Every Student Counts! Building on the success of previous school health data collection, this article describes the steps that the Georgia Association of School Nurses takes to promote the collection of data to support the health of Georgia’s school-age children. Building a team, engaging stakeholders, mapping a plan of action, and developing the message are described as ways to build the capacity for data collection. Other states and NASN state affiliates may learn from the ideas presented here.
Asthma Assessment in the School Health Office: Can They Stay or Should They Go?
Authors: Jakubowski Tami L. , Perron Tracy
Published: October 2018

The Assessment Refresher for School Nurses series will review the health assessment and interventions of common complaints of children in the school health setting, making it easier for school nurses to determine whether children should stay in school or be sent home. Initial topics to be covered include asthma and allergies, immunizations, bullying/depression, and diabetes.
Rice hulls pellets as alternate solid fuel for energy generation
Authors: Defonseka Chris
Published: October 2018

Rice is the staple diet of over half the population of the world at an estimated production volume of well over 800 million metric tonnes per month, the second largest produced cereal in the world. Rice grows from tropics to subtropical to warm temperature countries up to 400 S and 500 N of the equator. Four major environments are associated with rice growing as follows: irrigated, rain-fed lowlands, upland and flood prone. Fifty per cent of rice grown are consumed by China and India, and until a few years ago, the rice hulls (husks) resulting from hulling have been considered as agricultural waste and only used in a few small end applications. However, due to diligent research, the full potential of this valuable commodity is being realized and three significant products are being manufactured using this biomass – polymeric composite resins, polymeric lumber as an ideal substitute for natural wood, and more recently, rice hulls solid pellets as an alternative for diesel oil and coal as fuel for energy generation. While the first two are made from combinations of rice hulls flour and polymer resins, the last one is made by compression with suitable small quantities of additives primarily for adhesion. The dimensions and densities of these solid pellets can be varied to suit end applications and also to assist fuel feeding systems. When rice hulls solid pellets are used as fuel, they will generate ash in the combustion chamber and also flue ash which can be easily collected and both items can be successfully recycled. They can be used as filler for bricks, for roofing tiles, extraction of silica (>70%), fertilizer, chemical spill absorbents, filtration mediums and some others. The high content of silica in the ash will provide an enhanced moisture barrier for bricks and roofing tiles. A major end application is its usage as a component for the production of Portland cement. Rice hulls are also an ideal feedstock for producing bio-diesel, and for this purpose, thermochemical processes like pyrolysis and gasification can be used. This research study shows that rice hulls basically consisting of lignin polymer and 20% silica can be made into solid pellets and effectively used as an alternate fuel for petro-based diesel oil and coal for generation of energy. This emerging fuel from renewable sources can even replace the current usage of wooden pellets. Moreover, the resulting ash and flue ash from the combustion of rice hulls will have many viable end uses in industrial, commercial and chemical industries.
Significant aspects of nursing within the process of end-of-life communication in an oncological context
Authors: Rylander Annelie , Fredriksson Stina , Stenwall Ewa , Gustafsson Lena-Karin
Published: October 2018

The complexity of end-of-life communications has previously been described and found to be given late in the patient’s palliative care. There is a need for earlier and more continuous end-of-life-communications throughout the patient’s care to reduce anxiety, confusion, and promote participation. Registered nurses (RNs) have a unique closeness to the patient and the ability to identify early the need for end-of-life communication. The aim of this study was to describe crucial aspects of nursing in end-of-life communication in an oncology context. The study was designed as a qualitative content analysis of in-depth interviews with RNs working in oncology in-patient care units. Two domains were identified: before, and after end-of-life communications, with the categories importance of being well prepared to identify both the patient’s and their family’s needs. Cooperation and interaction between physicians and RNs were crucial to be able to support patients and their relatives around the clock. The presence of RNs encouraged further conversations about the patients’ conditions to gain insight into the new situation. End-of-life communication should not only be medicine oriented and performed by physicians. Involvement of RNs’ expertise enables increased patient/relative participation as well as reduced anxiety and suffering, creating clarity and safety for all involved in care.
Pediatric Meningoencephaloceles Endoscopic Endonasal Repair: Our Experience
Authors: Marfatia Hetal K. , Parelkar Kartik A. , Chakraborty Adhara , Mishra Shampa
Published: October 2018

Background

Pediatric patients presenting with a nasal mass is uncommon and a high index of suspicion for it to be a meningoencephalocele is essential. Majority of these are congenital and require early intervention owing to the risk of meningitis. Surgery in these cases is very challenging because of the risk of anesthesia and limited space.

Objective

This study aimed to describe our technique and experience in managing pediatric meningoencephaloceles.

Methods

A retrospective study of 19 pediatric patients (age ranging from 40-day-old infants to 11.5-year-old children) was conducted at our tertiary care center from January 2012 to February 2017. Patients presenting with an intranasal meningoencephalocele were treated by endoscopic approach, using otological microinstruments. After detailed imaging and clinical evaluation, a tailored repair, using fat/fascia/cartilage, a multilayer closure, was carried out in all cases.

Results

All patients had a successful repair and recovery, except for one death following an episode of convulsion. There was a minor circumferential narrowing of the nasal vestibule and synechia formation in 2 of our cases.

Conclusion

Transnasal endoscopic repair of meningoencephalocele is minimally invasive. It avoids permanent anosmia and is cosmetic. A combination of miniaturized instruments and a 4-mm 0° nasal endoscope gives excellent visual field and an adequate working space. Owing to the larger defects in congenital meningoencephaloceles, a multilayer repair provides excellent outcomes.
Bisphosphonates reduce biomaterial turnover in healing of critical-size rat femoral defects
Authors: Hauser Michel , Siegrist Mark , Denzer Alain , Saulacic Nikola , Grosjean Joël , Bohner Marc , Hofstetter Willy
Published: October 2018

Treatment of osteoporotic patients with bisphosphonates (BPs) preserves bone mass and microarchitecture. The high prescription rate of the drugs brings about increases in the numbers of fractures and bone defects requiring surgical interventions in these patients. Currently, critical-size defects are filled with biomaterials and healing is supported with bone morphogenetic proteins (BMP). It is hypothesized that BPs interfere with biomaterial turnover during BMP-supported repair of defects filled with β-tricalcium phosphate (βTCP) ceramics. To test this hypothesis, retired breeder rats were ovariectomized ( OVX). After 8 weeks, treatment with alendronate (ALN) commenced. Five weeks later, 6 mm diaphyseal femoral defects were applied and stabilized with locking plates. βTCP cylinders loaded with 1 μg and 10 μg BMP2, 10 μg L51P, an inhibitor of BMP antagonists and 1 μg BMP2/10 μg L51P were fitted into the defects. Femora were collected 16 weeks post-implantation. In groups receiving calcium phosphate implants loaded with 10 μg BMP2 and 1 μg BMP2/10 μg L51P, the volume of bone was increased and βTCP was decreased compared to groups receiving implants with 1 μg BMP2 and 10 μg L51P. Treatment of animals with ALN caused a decrease in βTCP turnover. The results corroborate the synergistic effects of BMP2 and L51P on bone augmentation. Administration of ALN caused a reduction in implant turnover, demonstrating the dependence of βTCP removal on osteoclast activity, rather than on chemical solubility. Based on these data, it is suggested that in patients treated with BPs, healing of biomaterial-filled bone defects may be impaired because of the failure to remove the implant and its replacement by authentic bone.
Comparing biomechanical strength of unicortical locking plate versus bicortical compression plate for transverse midshaft metacarpal fracture
Authors: Shanmugam Rukmanikanthan , Jian Chong Yin Chyi@ Chong Shyh , Haseeb Amber , Aik Saw
Published: October 2018

Purpose:

Metacarpal bone fractures constitute 10% of all fractures. Unstable metacarpal fractures require surgical intervention, which poses danger to flexor tendon either due to bicortical drilling or construct of the implant. Unicortical locking plate fixation may be the solution to preventing flexor tendon injury. Studies have compared locking and compression plates. However, in these studies, the biomechanical properties were tested using the static loading method. This study looks into cyclical loading that is more representative of in vivo conditions, particularly for early rehabilitation. We compared the biomechanical strength of the unicortical locking plate and bicortical compression plate system in a transverse metacarpal fracture, tested with cyclical loading and torsion.

Method:

Twenty pieces of fourth-generation, biomechanical testing grade, left third metacarpal composite bones were used. Resin was used to create the holding block at both ends of the bone. An oscillating saw with 0.8 mm thick saw blade was used to osteotomize the metacarpal sawbones to create a midshaft transverse metacarpal fracture model. Ten pieces were fixed with a 2.0 mm titanium locking plate via unicortical screw purchase and 10 were fixed with a 2.0 mm, four holes, titanium dynamic compression plate, bicortical purchase of screws. They were subjected to cyclic load to failure testing three-point bending and torsion.

Results:

There were no significant difference in stiffness and cyclic three-point bending to failure between the unicortical locking plate group and the bicortical compression plate group. The bicortical compression plate group is stiffer and has a higher cyclic bending load to failure as compared to the unicortical locking plate group.

Conclusion:

Unicortical locking plate fixation of metacarpal fracture can be reliably applied clinically to produce a strong and stable construct that allows early mobilization of the joints. This will not only reduce the complication rate of metacarpal plating, but also improve the functional outcome of the hand.
Manipulation under anaesthetic following total knee arthroplasty: Predicting stiffness and outcome
Authors: Cartwright-Terry Matthew , Cohen Daniel R , Polydoros Fotis , Davidson John S , Santini Alasdair JA
Published: October 2018

Purpose:

A stiff total knee replacement can severely limit a patient’s post-operative function, but there remain few prospective trials identifying those patients at risk, nor the efficacy of manipulation. We analysed our prospectively collected database to assess predictors of stiffness and outcomes following manipulation.

Methods:

Using prospectively collected knee arthroplasty data, including preoperative and post-operative range of knee movement, SF-12 (physical and mental) and The Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, patients requiring manipulation were compared to a matched group of patients not requiring manipulation, with a detailed statistical analysis undertaken to assess potential risk factors and the post-manipulation outcome.

Results:

Of the 1313 arthroplasty patients, 69 required manipulation. Patients with less than 80° of flexion at discharge, diabetes or on warfarin were more likely to require manipulation, but flexion at discharge was the overwhelming predictive factor for stiffness. Forty per cent of the range of movement gained during manipulation was maintained at 1 year, with earlier manipulation deriving greater improvements. While the WOMAC scores improved post-manipulation, there was no significant difference in either of the SF12 scores.

Conclusion:

Flexion at discharge is the overwhelming predictive factor for the requirement for manipulation.
Legal and Ethical Implications of Website Accessibility
Authors: Palmer Zsuzsanna Bacsa , Palmer Ralph Henry
Published: October 2018

This article argues that business and professional communication practitioners, instructors, and students, besides becoming better informed about the legal context of website accessibility, should also become more aware of the ethical considerations of creating digital communication products that are inherently accessible for people with disabilities. Through a detailed review of the most important legal cases in the United States and discussion of ethical considerations concerning website accessibility for the disabled, we provide possible entrance points that will help instructors bring ethical considerations into the discussion of website accessibility. We urge instructors to regularly include disability in discussions of accessibility cases.
Geophysics Bright Spots
Authors: Krohn Christine
Published: October 2018

In coordinating this column, I am increasingly impressed with the innovation shown in so many different areas of applied geophysics. Some papers propose a completely new approach and others solve a particularly thorny problem, which limited the use of a previously proposed method. I am also impressed in reading all of the introduction sections of how authors build on the work of others in their fields. Advances in the field of applied geophysics continue to happen at a rapid pace.
The Perioperative Management of Ascending Aortic Dissection
Authors: Gregory Stephen H. , Yalamuri Suraj M. , Bishawi Muath , Swaminathan Madhav
Published: September 2018

Acute aortic syndromes are a distinct group of pathologies involving the wall of the aorta that present acutely and can be potentially fatal unless treated in a timely fashion. The syndrome is dominated by aortic dissections, which comprise ≥95% of all such presentations. Those involving the ascending aorta are particularly lethal and require specific and early surgical treatment compared to dissections involving other parts of the aorta. The surgical repair of an ascending aortic dissection presents multiple challenges to the anesthesiologist. Thoughtful management throughout the perioperative period is critical for minimizing the significant morbidity and mortality associated with this condition. In this narrative review, we provide an overview of the perioperative management of patients presenting for the surgical repair of an ascending aortic dissection. Preoperative discussion focuses on assessment, hemodynamic management, and risk stratification. The intraoperative section includes an overview of anesthetic management, transesophageal echocardiographic assessment, and coagulopathy, as well as surgical considerations that may influence anesthetic management.
Point-of-Care Ultrasound Abnormalities in Late-Onset Severe Preeclampsia: Prevalence and Association With Serum Albumin and Brain Natriuretic Peptide
Authors: Ortner Clemens M. , Krishnamoorthy Vijay , Neethling Elmari , Flint Margot , Swanevelder Justiaan L. , Lombard Carl , Fawcus Susan , Dyer Robert A.
Published: September 2018

BACKGROUND:

Pilot studies applying point-of-care ultrasound (POCUS) in preeclampsia indicate the presence of pulmonary interstitial edema, cerebral edema, and cardiac dysfunction. Laboratory markers of oncotic pressure (albumin) and cardiac dysfunction (brain natriuretic peptide [BNP]) may be abnormal, but the clinical application remains unclear. We investigated the prevalence of pulmonary interstitial syndrome (PIS), cardiac dysfunction, and increased optic nerve sheath diameter (ONSD) in late-onset preeclampsia with severe features. The primary aim was to examine the association between PIS or ONSD and maternal serum albumin level. The secondary aims were to explore the association between cardiac dysfunction and PIS, ONSD, BNP, and serum albumin level and between POCUS-derived parameters and a suspicious or pathological cardiotocograph.

METHODS:

Ninety-five women were enrolled in this prospective observational cohort study. A POCUS examination of lungs, heart, and ONSD was performed. PIS was defined as a bilateral B-line pattern on lung ultrasound and diastolic dysfunction according to an algorithm of the American Society of Echocardiography. ONSD >5.8 mm was interpreted as compatible with raised intracranial pressure (>20 mm Hg). Serum BNP and albumin levels were also measured.

RESULTS:

PIS, diastolic dysfunction, systolic dysfunction, and raised left ventricular end-diastolic pressure (LVEDP) were present in 23 (24%), 31 (33%), 9 (10%), and 20 (25%) women, respectively. ONSD was increased in 27 (28%) women. Concerning the primary outcome, there was no association between albumin level and PIS (P = .4) or ONSD (P = .63). With respect to secondary outcomes, there was no association between albumin level and systolic dysfunction (P = .21) or raised LVEDP (P = .44). PIS was associated with diastolic dysfunction (P = .02) and raised LVEDP (P = .009; negative predictive value, 85%). BNP level was associated with systolic (P < .001) and diastolic dysfunction (P = .003) and LVEDP (P = .007). No association was found between POCUS abnormalities and a suspicious/pathological cardiotocograph (P = .07).

CONCLUSIONS:

PIS, diastolic dysfunction, and increased ONSD were common in preeclampsia with severe features. Cardiac ultrasound abnormalities may be more useful than albumin levels in predicting PIS. The absence of PIS may exclude raised LVEDP. The further clinical relevance of PIS and raised ONSD remains to be established. BNP level was associated with cardiac ultrasound abnormalities. Although this study was not designed to directly influence clinical management, the findings suggest that POCUS may serve as a useful adjunct to clinical examination for the obstetric anesthesiologist managing these complex patients.
Persistent Nociception Facilitates the Extinction of Morphine-Induced Conditioned Place Preference
Authors: You Zerong , Ding Weihua , Doheny Jason T. , Yang Jinsheng , Yang Liuyue , Lim Grewo , Miao Jiamin , Chen Lucy , Shen Shiqian , Mao Jianren
Published: September 2018

BACKGROUND:

As opioid abuse and addiction have developed into a major national health crisis, prescription of opioids for pain management has become more controversial. However, opioids do help some patients by providing pain relief and improving the quality of life. To better understand the addictive properties of opioids under chronic pain conditions, we used a conditioned place preference (CPP) paradigm to examine the rewarding properties of morphine in rats with persistent nociception.

METHODS:

Spared nerve injury (SNI) model was used to induce persistent nociception in rats. Nociceptive behavior was assessed by von Frey test. CPP test was used to examine the rewarding properties of morphine.

RESULTS:

Our findings are as follows: (1) SNI rats did not show a difference compared with sham rats in magnitude of morphine-induced CPP 1 day after last morphine injection (2-way analysis of variance; for SNI versus sham, F[1,42] = 0.014, P = .91; and 95% confidence intervals for difference of means, −5.9 [−58 to 46], 0.76 [−51 to 53], and 0.90 [−51 to 53] for 2.5, 5, and 10 mg/kg, respectively); (2) increasing morphine dosage (2.5, 5, and 10 mg/kg) did not further increase the magnitude of CPP in both sham and SNI rats (for dosage: F[2,42] = 0.94, P = .40); and (3) morphine-induced CPP persisted in sham rats but extinguished in SNI rats when tested at 8 days after last morphine injection (for sham versus SNI: Bonferroni correction, P < .006 for both 5 and 10 mg/kg doses; and 95% confidence intervals for difference of means, 80.3 [19.7–141] and 87.0 [26.3–148] for 5 and 10 mg/kg, respectively).

CONCLUSIONS:

Our data provide new evidence supporting the notion that the brain’s reward circuitry changes in the context of persistent pain. This observational study suggests that future investigation into the neurobiology of opioid reward requires consideration of the circumstances in which opioid analgesics are administered.
Interaction between opposing modes of phospho-regulation of the proneural proteins Ascl1 and Ngn2
Authors: Hardwick Laura J.A. , Philpott Anna
Published: October 2018

From the relatively simple nervous system of Drosophila to the elaborate mammalian cortex, neurogenesis requires exceptional spatial and temporal precision to co-ordinate progenitor cell proliferation and subsequent differentiation to a diverse range of neurons and glia. A limited number of transiently expressed proneural basic-helix-loop-helix (bHLH) transcription factors, for example achaete-scute-complex (as-c) and atonal (ato) in Drosophila and the vertebrate homologues Ascl1 and Neurogenin2 (Ngn2), are able to orchestrate the onset of neuronal determination, context-dependent subtype selection and even influence later aspects of neuronal migration and maturation. Within the last decade, two models have emerged to explain how the temporal activity of proneural determination factors is regulated by phosphorylation at distinct sites. One model describes how cell-cycle associated phosphorylation on multiple sites in the N and C termini of vertebrate proneural proteins limits neuronal differentiation in cycling progenitor cells. A second model describes phosphorylation on a single site in the bHLH domain of Drosophila atonal that acts as a binary switch, where phosphorylation terminates proneural activity. Here we combine activating mutations of phosphorylation sites in the N- and C- termini with an inhibitory phospho-mimetic mutation in the bHLH domain of Ascl1 and Ngn2 proteins, and test their functions in vivo using Xenopus embryos to determine which mode of phospho-regulation dominates. Enhancing activity by preventing N- and C terminal phosphorylation cannot overcome the inhibitory effect of mimicking phosphorylation of the bHLH domain. Thus we have established a hierarchy between these two modes of proneural protein control and suggest a model of temporal regulation for proneural protein activity.
INFORMAÇÕES PARA PLANEJAMENTO E ELABORAÇÃO DE CARDÁPIOS, CONTIDAS EM EDITAIS DE LICITAÇÃO DE RESTAURANTES UNIVERSITÁRIOS EM UNIVERSIDADES FEDERAIS DO SUL DO BRASIL
Authors: Cavaler Samara , Heilman Maiara , Santos Ana Paula , Ferreira Helder , Fatel Elis
Published: October 2018

Objetivo: Avaliar as informações para planejamento e elaboração de cardápios contidas nos editais de licitação dos restaurantes universitários de universidades federais do Sul do Brasil. Métodos: Estudo transversal com avaliação das informações contidas em editais de licitação, sobre o planejamento e a elaboração de cardápios de 35 Restaurantes Universitários das universidades federais do Sul do país, vigentes em 2015. Resultados: Em relação às informações per capita e de frequência, 34,3% dos editais contiveram informações para a realização de um planejamento adequado no que se refere à elaboração de cardápios; mais da metade dos editais não apresentou informações sobre aplicação de procedimentos técnicos apropriados de pré-preparo e preparo dos alimentos (54,29%); a maioria dos editais não manifestou informações de incentivo à aquisição de produtos da Agricultura Familiar (85,71%); nenhum edital exigiu obrigatoriedade da presença de Ficha Técnica de Preparo; mais da metade dos editais não contemplou cardápios para necessidades alimentares especiais (57,14%); menos da metade dos editais determinou que o planejamento de cardápios respeitasse a cultura e o hábito alimentar local dos usuários (45,71%). Foram verificadas diferenças significativas entre os estados da Região Sul do Brasil quanto às pontuações obtidas por meio do levantamento das informações sobre planejamento e elaboração de cardápios contidas nos editais de licitação das instituições de ensino superior. Conclusão: Verificou-se que os editais de licitação para contratação de empresas que forneçam e/ou produzam refeições aos acadêmicos, necessitam de melhor elaboração, abordando claramente itens básicos para um planejamento adequado dos cardápios.DOI: 10.12957/demetra.2018.32140
Desempenho dos serviços de saúde na atenção à tuberculose na estratégia de saúde da família [Health service performance in tuberculosis care in the Family Health Strategy] [Rendimiento de los servicios de salud en la atención a la tuberculosis en la estrategia de salud de la familia]
Authors: Benetti Keidi Vianna , Medeiros Celia Regina Da Silva , Parreira Pedro Miguel Diniz , Mauro Maria yvone Chaves , Souza Maria Helena Do Nascimento , Farias Sheila Nascimento Pereira de
Published: October 2018

Objetivo: avaliar o desempenho dos serviços de saúde na atenção à tuberculose, na percepção das equipes da estratégia saúde da família. Método: estudo transversal de abordagem quantitativa, realizado com 210 profissionais das equipes da estratégia de saúde da família de uma área de planejamento do Rio de Janeiro. Foi aplicado o questionário PCATool – tuberculose, no período de agosto a novembro de 2015. Os dados foram tratados e analisados, no programa epi info versão 7.1.5. Projeto aprovado no comitê de ética em pesquisa da Escola de Enfermagem Anna Nery e da Secretaria Municipal de Saúde. Resultados: observou-se que para o diagnóstico de tuberculose o desempenho das unidades foi razoável e para o tratamento o resultado foi satisfatório. Conclusão: o desempenho dos serviços de saúde apresenta fragilidades e atende parcialmente a clientela.ABSTRACT Objective: to evaluate health service performance in tuberculosis care as perceived by family health strategy teams. Methods: in this quantitative, cross-sectional study, the PCATool-tuberculosis was applied between August and November 2015, to 210 professionals from family health strategy teams in a planning area in Rio de Janeiro. Data were processed and analyzed using Epi Info software, version 7.1.5. The project was approved by the research ethics committees of the Anna Nery School of Nursing and Municipal Health Secretariat. Results: the units’ performance was observed to be reasonable in tuberculosis diagnosis, and satisfactory in treatment. Conclusion: health service performance displays weaknesses and meets client needs partially.RESUMENObjetivo: evaluar el rendimiento de los servicios de salud en la atención a la tuberculosis, bajo la percepción de los equipos de la estrategia de salud de la familia. Método: estudio transversal de abordaje cuantitativo, realizado junto a 210 profesionales de los equipos de la estrategia de salud de la familia de un área de planificación de Río de Janeiro. Fue aplicado el cuestionario PCATool –tuberculosis, en el periodo de agosto a noviembre de 2015. Los dados fueron tratados y analizados en el programa epi info versión 7.1.5. Proyecto aprobado en el comité de ética en investigación de la Escuela de Enfermaría Anna Nery y de la Secretaría Municipal de Salud. Resultados: se verificó que, para el diagnóstico de tuberculosis, el rendimiento de las unidades fue adecuado y, para el tratamiento de los resultados, fue satisfactorio. Conclusión: el rendimiento de los servicios de salud presenta fragilidades y atiende parcialmente la clientela.
TESSITURAS E REINVENÇÕES: (DES)FORMAÇÃO DE PROFESSORES
Authors: Lontra Viviane , Emilião Soymara Vieira
Published: October 2018

Este artigo discute três ideias presentes nas formações: a crença em um conhecimento “potente”, as impossibilidades das políticas serem aplicadas tal como foram pensadas/escritas e o pensamento que abissaliza e invisibiliza saberesfazeres tecidos nas escolas. A abordagem epistemológica teóricometodológica inscreve-se nas pesquisas nos/dos/com os cotidianos à caça do pormenor que provoca entendimentos outros sobre a potência dos encontros de/com professores. O texto traz narrativas e relatos que sugerem que aprendemos a ser professores nas redes que tecemos nos cotidianos das escolas, em movimentos de não-linearidade. Propõe um entendimento da formação de professores na/da/com a prática que nos possibilitam pensá-la como (des)formação para além das lógicas cientificistas e colonialistas.
AS AVALIAÇÕES NACIONAIS, O CURRÍCULO DA ESCOLA BÁSICA E A PRODUÇÃO DO ALUNO COM DISTORÇÃO IDADE X SÉRIE.
Authors: Mesquita Marcelo Ribeiro de , Cardoso Wladirson Ronny Da Silva
Published: October 2018

Este artigo tem a finalidade de discutir a relação entre as avaliações nacionais no Brasil com o currículo da escola básica e a produção do aluno com distorção idade x serie que, no cotidiano escolar, recebe a cunha de fracassado. Buscar-se-á, primeiramente uma abordagem genealógica da escola para evidenciá-la como uma invenção inscrita num imperativo histórico que garantiu sua emergência. Num segundo momento discute-se a avaliação como indutora do currículo e na fabricação do aluno problema a partir da pesquisa realizada em um projeto de aceleração numa escola de periferia em Belém do Pará. Os resultados apontam a necessidade de pensar alternativas às politicas homogeneizantes que negam a singularidade da pessoa humana e as possiblidades de uma educação que valorize as diferenças.
Entrevista com Jussara Hoffmann
Authors: Esteban Maria Teresa
Published: October 2018

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CONSTRUIR CONVIVENCIA EN UN PAIS EN MEDIO DEL CONFLICTO: UNA EXPERIENCIA PEDAGÓGICA ALTERNATIVA
Authors: Pérez Gema Trujillo , Perdomo Milena Trujillo
Published: October 2018

Este artículo expone el origen, fundamentación teórica, así como las estrategias de los procesos de participación y convivencia del proyecto educativo escolar, resume los avances de la Escuela Popular Claretiana, el balance, los factores que han posibilitado la implementación de la propuesta, las dificultades, el impacto y las conclusiones. La experiencia se desarrolla en Neiva-Colombia, a través de un enfoque de la Educación Popular, como respuesta al conflicto político militar, integra aspectos socioculturales, pedagógicos y didácticos; a través de la acción cooperativa, estrategias de participación, autogestión comunitaria y la creación de ambientes pedagógicos. La escuela tiene como propósito construir convivencia, potenciar los liderazgos, reafirmar la identidad cultural y el compromiso de las personas en la construcción de ciudadanía.
Nutraceuticals and skin health: key benefits and protective properties
Authors: Pearson Kim
Published: October 2018

Nutraceuticals are defined as a food, or part of a food, that provides medical or health benefits, including the prevention and/or treatment of a disease. Kim Pearson covers key considerations when recommending nutraceuticals to aesthetic patients, including the importance of choosing well-researched nutrients, provided in bioavailable forms, at a dose proven to be effective
Role of skin-imaging systems in modern aesthetic practice
Authors: Tailor Rekha
Published: October 2018

The world is becoming more technologically advanced on a daily basis, and the aesthetics sector is no exception. One of the most critical advancements over recent years is the increase in use of cutting-edge digital skin-imaging equipment to enhance analysis and provide bespoke patient treatment plans. Rekha Tailor looks at the benefits of using skin-imaging systems
Role of cosmeceutical skincare in the management of acne
Authors: Boxley Sarah
Published: October 2018

There is a growing body of evidence showing the benefit of some common cosmeceutical agents in the various pathogenic stages of acne. Sarah Boxley explains why an understanding of the roles of these products, the evidence to support their use, and their potential side effects, should enable practitioners to effectively and appropriately advise patients on their benefits and limitations
Grandparents of Children With Intellectual and Developmental Disabilities: Navigating Roles and Relationships
Authors: Yang Xueyan , Artman-Meeker Kathleen , Roberts Carly A.
Published: October 2018

Grandparents can play critical roles in the lives of children with intellectual and developmental disabilities and their families. However, current research and understanding around grandparent roles and experiences is limited. The purpose of this qualitative study was to examine the roles and experiences of grandparents supporting children with disabilities. In this article, the voices of grandparents with diverse experiences are presented. Key themes that emerged were the role of the grandparent, boundaries in roles and space, navigating family dynamics, and the general experiences of grandparenting. These findings have implications for the types of supports provided to grandparents and for practitioners working with families who have actively involved grandparents.