bluuebunny/crossref_metadata_2025 huggingface dataset:
Fundamentos da Deteção Automática de Incêndios em Edifícios Parte 1
Authors: Gomes António Augusto Araújo
Published: October 2017

O fogo, grande elemento de evolução humana, é também, em potencial, um dos seus maiores inimigos. Muitos são os fogos florestais e urbanos, que ocorrem diariamente, provocando mortes, avultados prejuízos materiais, perda de valor patrimonial, assim como perda de valor simbólico.As causas principais dos incêndios em edifícios são a deficiência nas canalizações elétricas, a má utilização de equipamentos elétricos, nomeadamente ferros, fogões, fornos e aquecedores elétricos, bem como a negligência na utilização do fogo.Os Sistemas Automáticos de Deteção de Incêndio (SADI) são hoje encarados um sistema integrante e imprescindível dos edifícios, como elemento de garantia da segurança e do bem-estar das pessoas, e da preservação dos seus bens.Um SADI é uma instalação técnica capaz de registar um princípio de incêndio, sem a intervenção humana, transmitir as informações correspondentes a uma central de sinalização e comando (CDI - central de deteção de incêndios), dar o alarme automaticamente, quer local e restrito, quer geral, quer à distância (alerta) e acionar todos os comandos (imediatos ou temporizados) necessários à segurança contra incêndios dos ocupantes e do edifício onde está instalado: fechar portas corta-fogo, parar elevadores, fechar registos corta-fogo, comandar sistemas automáticos de extinção de incêndios (SAEI), parar/ligar ventiladores, desligar energia elétrica, etc.
DESAIN PENDEKATAN KONTEKSTUAL PADA PEMBELAJARAN STATISTIK MATEMATIKA
Authors: Indriani Ari
Published: October 2017

Masalah yang ingin diteliti dalam penelitian ini adalah bagaimanakah rancangan pendekatan kontekstual pada pembelajaran statistik matematika? Adapun tujuan penelitian ini adalah untuk merancang/mendesain pendekatan kontekstual pada pembelajaran statistik matematika. Penelitian ini menggunakan metode penelitian dan pengembangan (Research and Development/R&D). Pada penelitian ini baru disajikan tahapan yang pertama yaitu perancangan model pembelajaran yaitu penyusunan kegiatan-kegiatan pembelajaran statistik matematika dengan menggunakan pendekatan kontekstual. Langkah-langkah pendekatan kontekstual pada pembelajaran Statistik Matematika ada tujuh prinsip yaitu 1) Konstruktivisme/Constructivism; 2) Menemukan/Inqury; 3) Bertanya/Questioning; 4) Masyarakat Belajar/ Learning Comunity; 5) Pemodelan/Modelling; 6) Refleksi/Reflection; dan 7) Penilaian Sebenarnya/Authentic Assesment. Setelah diadakan ujicoba, untuk mengetahui efektifitas pendekatan yang dihasilkan perlu dilakukan penerapan pendekatan di kelas. Kata kunci: Pendekatan Kontekstual, Statistik Matematika
ANALISIS JENIS KESALAHAN SISWA MENYELESAIKAN MASALAH FAKTORISISASI SUKU ALJABAR KELAS VIII SMP NEGERI 35 SEMARANG TAHUN AJARAN 2016/2017
Authors: Saputri Septiyana Dwi
Published: October 2017

Penelitian ini bertujuan untuk mendeskripsikan jenis-jenis kesalahan yang dilakukan siswa dalam menyelesaikan masalah faktorisasi aljabar. Jenis penelitian ini merupakan penelitian deskriptif kualitatif. Subjek dari penelitian ini adalah siswa-siswi kelas VIII SMP Negeri 35 Semarang. Data-data pada penelitian ini diperoleh dari hasil observasi, tes tertulis dan wawancara. Berdasarkan hasil analisis dan triangulasi data bahwa dari 27 subjek penelitian, sebanyak 3 dari 27 siswa melakukan jenis kesalahan reading errors,  17 dari 27 siswa melakukan jenis kesalahan planning errors, 23 dari 27 siswa melakukan jenis kesalahan skill errors dan 25 dari 27 siswa melakukan jenis kesalahan finishing errors. Adapun penyebab dari banyaknya kesalahan yang dilakukan siswa adalah kurang terbiasanya siswa mengerjakan masalah-masalah yang disajikan berupa masalah atau sol non rutin. Kata kunci : Jenis Kesalahan, Penyelesaian masalah, Faktorisasi Aljabar.
BENTUK ORNAMEN MASJID KERAMAT LEMPUR KERINCI
Authors: Alipuddin Alipuddin , Yulimarni Yulimarni
Published: October 2017

Bentuk ornamen yang diterapkan di Masjid Keramat Lempur sebagai penggubahan bentuk-bentuk figuratif sehingga menjadi tersamarkan ini dipandang sebagai upaya jalan keluar untuk menghindari larangan menggambarkan makhluk hidup dan dianggap pula sebagai strategi adaptasi penyebarluasan agama Islam pada waktu itu. Ornamen yang diterapkan pada umumnya berbentuk tumbuh-tumbuhan, geometris. Ornamen diterapkan pada bagian  luar maupun bagian dalam masjid, meliputi  hiasan pada tiang, dinding, alang, papan pengunci sudut, mimbar, dan tempat azan. Di samping itu, ornamen tersebut terlihat adanya pengaruh ornamen yang terdapat pada benda prasejarah. Ornamen tersebut ditata atau disusun berdasarkan prinsip komposisi, meliputi: pertimbangan keseimbangan, keserasian, irama, kesatuan, proporsi, dan disusun secara vertikal maupun horizontal. Menggunakan data kualitatif, penelitian ini dianalisis secara deskriptif. Ornamen tidak hanya semata-mata sebagai penghias melainkan juga mengandung maksud-maksud simbolis.
BELU: SEBUAH EKSPLORASI MUSIK NUSA TENGGARA TIMUR DI DAERAH ISTIMEWA YOGYAKARTA
Authors: Putra Leo Pradana
Published: October 2017

Belu merupakan sebuah komposisi musik etnis sasando yang di dalamnya terdapat penggabungan instrumen-instrumen musik dari budaya lain. Pembuatan musik tersebut dengan cara meniru bentuk asli yang masih terkesan tradisi, bervariasi, dan singkat tidak menggunakan durasi yang lama. Sehingga, masuknya instrumen-instrumen tersebut dalam komposisi ini menjadi sebuah inovasi baru mengikuti selera penonton dalam penyajiannya. Selain itu, faktor-faktor yang mempengaruhi pembuatan komposisi Belu ialahadaptasi terhadap lingkungan sekitar, perubahan cara pandang, dan kontak dengan orang-orang sekitar, sehingga memunculkan ide-ide baru dalam sebuah penggarapan musik tradisi menjadi kemasan masa kini. Dengan demikian, perubahan dan perkembangan budaya akan sangat tergantung pada kreator seni serta apresiasi masyarakat pendukungnya untuk menyajikan musik dengan inovasi baru yang tetap mempertahankan nuansa tradisional budaya Nusa Tenggara Timur. Penelitian ini menelaah tentang proses pengolahan komponen musikal yang berasal dari unsur-unsur musik Jawa dan Timur dalam komposisi musik Belu.
ANALISIS KITAB BATU KARYA MUSIK GATOT DANAR SULISTIYANTO
Authors: Lituhayu Iwang Prasiddha
Published: October 2017

Kitab Batu adalah sebuah music karya komponis muda Gatot Danar Sulistiyanto. Karya ini dikarang pada 2011 dan telah mendapatkan beberapa kesempatan pementasan bergengsi, antara lain di Belanda dan di Indonesia. Dalam karya untuk tujuh instrument dan satu vocal perempuan ini Gatot menggunakan mantra sebagai salah-satu idiom pada struktur komposisinya. Pengalaman kebudayaannya sebagai orang Jawa sangat mempengaruhi laku kekaryaannya sebagai komponis. Dalam penelitian ini diteliti lebih jauh bagaimana latarbelakang budaya Jawa komponis berpengaruh pada ekspresi kekaryaan; bagaimana pertautan antara hal-hal teknis seputar kaidah komposisi music dalam hubungannya dengan pandangan spiritualitas individu (komponis). Secara umum penelitian ini jugamelihat konteks lebih luas yaitu music kontemporer Indonesia dan audiens. Digunakan pendekatan kualitatif dengan mengutamakan penggalian subjek melalui wawancara untuk menemukan metodologi individu dalam kaitannya dengan proses penciptaan musik.
MENDOBRAK NILAI-NILAI PATRIARKI MELALUI KARYA SENI: ANALISIS TERHADAP LUKISAN CITRA SASMITA
Authors: Putri Aninda Dyah Hayu Pinasti , Bahari Nooryan , Wahyuningsih Novita , Sasmita Citra
Published: October 2017

Patriarki merupakan simbol dari kekuasaan, perangkap, dan hegemoni yang menciptakan wacana-wacana meminggirkan keberadaan perempuan. Dalam dunia seni rupa, subaltern perempuan membutuhkan upaya mengungkapkan di bagian mana perempuan berbicara dan tidak berbicara. Perupa perempuan menarik untuk diungkap sebagai subaltern. Partisipasi perempuan sebagai perupa diharapkan menghilangkan gambaran perempuan yang selama ini diciptakan oleh perupa laki-laki. Dominasi perupa laki-laki menunjukkan minimnya perempuan perupa, seolah dunia perupa tidak memberi tempat bagi perempuan. Metode yang digunakan dalam penelitian ini adalah metode kualitatif, yaitu, dengan wawancara terstruktur, observasi, mengkaji dokumen dan arsip. Hasil yang dicapai dari karya Citra Sasmita adalah lukisan dengan figur perempuan dan simbol- simbol yang berkaitan dengan konsep purusa dan pradanapada budaya Hindu Bali, misalnya seperti tumbuhan kaktus sebagai simbol purusa. Warna-warna yang sering digunakan yaitu warna hijau, biru, hitam, putih, coklat, merah.
KATURANGGANING KUTUT
Authors: Sanjaya Abda Lucky , Purwantoro Agus , Wahyuningsih Novita
Published: October 2017

Karya Seni Lukis berjudul Katurangganing Kutut terinspirasi dari pengalaman memelihara burung perkutut dan legenda Falsafah Jawa tentang Katuranggan burung Perkutut. Permasalahannya dibahas melalui pendekatan; Apa yang menjadi dasar ” Katuranggan burung Perkutut “ diangkat menjadi sumber ide dan konsep penciptaankarya seni ? Bagaimana merumuskan konsep karya seni berdasarkan gagasan “ Katuranggan burung Perkutut ” dalam implementasinya, Karakteristik dan figure burung Perkutut sesuai dengan Katuranggannya, diolah kembali secara kreatif dan memunculkan nuansa yang sesuai dengan imajinasi penulis, dengan menggunakan media kayu yang dipahat, karena dalam menggunakan media ini penulis merasa nyaman dan lebih berekplorasi pada proses berkarya. Karya ini dipahat menyerupai ukiran dengan finishing menggunakan polytur untuk penyajian akhirnya menciptakan suasana kejawen dengan membuat sangkar burung sebagai tempat karya dengan bahan kayu.
Surgical management of incidentally discovered diffusely infiltrating low-grade glioma
Authors: Opoku-Darko Michael , Lang Stefan T. , Artindale James , Cairncross J. Gregory , Sevick Robert J. , Kelly John J. P.
Published: October 2017

OBJECTIVE

Occasionally, diffusely infiltrating low-grade gliomas (LGGs) are identified as incidental findings in patients who have no signs or symptoms that can be ascribed to the tumors. The diagnosis of incidental, asymptomatic LGGs has become more frequent due to the vast increase in access to medical imaging technology. While management of these lesions remains controversial, early surgery has been suggested to improve outcome. The authors set out to identify and review the characteristics and surgical outcomes of patients who underwent surgical intervention for incidental LGG.

METHODS

All cases of LGG surgically treated between 2004 and 2016 at the authors’ institution were analyzed to identify those that were discovered incidentally. Patients with incidentally discovered LGGs were identified, and their cases were retrospectively reviewed. An “incidental” finding was defined as an abnormality on imaging that was obtained for a reason not attributable to the glioma, such as trauma, headache, screening, or research participation. Kaplan-Meier analysis was performed to determine actuarial rates of overall survival, progression-free survival, and malignant progression–free survival.

RESULTS

In 34 (6.8%) of 501 adult patients who underwent surgery for LGG, the tumors were discovered incidentally. Headache (26%, n = 9) and screening (21%, n = 7) were the most common indications for brain imaging in this group. Four of these 34 patients had initial biopsy after the tumor was identified on imaging. In 5 cases, the patients opted for immediate resection; the remaining cases were managed with a “watch-and-wait” approach, with intervention undertaken only after radiological or clinical evidence of disease progression. The mean duration of follow-up for all 34 cases was 5 years. Twelve patients (35.3%) had disease progression, with an average time to progression of 43.8 months (range 3–105 months). There were 5 cases (14.7%) of malignant progression and 4 deaths (11.8%). Oligodendroglioma was diagnosed in 16 cases (47%) and astrocytoma in 15 (44%). Twenty-five patients (74%) had IDH1 mutation and demonstrated prolonged survival. Only 2 patients had mild surgery-related complications, and 16 patients (47%) developed epilepsy during the course of the disease.

CONCLUSIONS

In this retrospective analysis of cases of incidentally discovered LGGs, the tumors were surgically removed with minimal surgical risk. In patients with incidental LGGs there is improved overall survival relative to median survival for patients with symptomatic LGGS, which is likely attributable to the underlying favorable biology of the disease indicated by the presence of IDH1 mutation in 74% of the cases.
Idiopathic intracranial hypertension: 120-day clinical, radiological, and manometric outcomes after stent insertion into the dural venous sinus
Authors: Asif Hasan , Craven Claudia L. , Siddiqui Almas H. , Shah Syed N. , Matloob Samir A. , Thorne Lewis , Robertson Fergus , Watkins Laurence D. , Toma Ahmed K.
Published: October 2017

OBJECTIVE

Idiopathic intracranial hypertension (IIH) is commonly associated with venous sinus stenosis. In recent years, transvenous dural venous sinus stent (DVSS) insertion has emerged as a potential therapy for resistant cases. However, there remains considerable uncertainty over the safety and efficacy of this procedure, in particular the incidence of intraprocedural and delayed complications and in the longevity of sinus patency, pressure gradient obliteration, and therapeutic clinical outcome. The aim of this study was to determine clinical, radiological, and manometric outcomes at 3–4 months after DVSS in this treated IIH cohort.

METHODS

Clinical, radiographic, and manometric data before and 3–4 months after DVSS were reviewed in this single-center case series. All venographic and manometric procedures were performed under local anesthesia with the patient supine.

RESULTS

Forty-one patients underwent DVSS venography/manometry within 120 days. Sinus pressure reduction of between 11 and 15 mm Hg was achieved 3–4 months after DVSS compared with pre-stent baseline, regardless of whether the procedure was primary or secondary (after shunt surgery). Radiographic obliteration of anatomical stenosis correlating with reduction in pressure gradients was observed. The complication rate after DVSS was 4.9% and stent survival was 87.8% at 120 days. At least 20% of patients developed restenosis following DVSS and only 63.3% demonstrated an improvement or resolution of papilledema.

CONCLUSIONS

Reduced venous sinus pressures were observed at 120 days after the procedure. DVSS showed lower complication rates than shunts, but the clinical outcome data were less convincing. To definitively compare the outcomes between DVSS and shunts in IIH, a randomized prospective study is needed.
Prediction of BRAF mutation status of craniopharyngioma using magnetic resonance imaging features
Authors: Yue Qi , Yu Yang , Shi Zhifeng , Wang Yongfei , Zhu Wei , Du Zunguo , Yao Zhenwei , Chen Liang , Mao Ying
Published: October 2017

OBJECTIVE

Treatment with a BRAF mutation inhibitor might shrink otherwise refractory craniopharyngiomas and is a promising preoperative treatment to facilitate tumor resection. The aim of this study was to investigate the noninvasive diagnosis of BRAF-mutated craniopharyngiomas based on MRI characteristics.

METHODS

Fifty-two patients with pathologically diagnosed craniopharyngioma were included in this study. Polymerase chain reaction was performed on tumor tissue specimens to detect BRAF and CTNNB1 mutations. MRI manifestations—including tumor location, size, shape, and composition; signal intensity of cysts; enhancement pattern; pituitary stalk morphology; and encasement of the internal carotid artery—were analyzed by 2 neuroradiologists blinded to patient identity and clinical characteristics, including BRAF mutation status. Results were compared between the BRAF-mutated and wild-type (WT) groups. Characteristics that were significantly more prevalent (p < 0.05) in the BRAF-mutated craniopharyngiomas were defined as diagnostic features. The minimum number of diagnostic features needed to make a diagnosis was determined by analyzing the receiver operating characteristic (ROC) curve.

RESULTS

Eight of the 52 patients had BRAF-mutated craniopharyngiomas, and the remaining 44 had BRAF WT tumors. The clinical characteristics did not differ significantly between the 2 groups. Interobserver agreement for MRI data analysis was relatively reliable, with values of Cohen κ ranging from 0.65 to 0.97 (p < 0.001). A comparison of findings in the 2 patient groups showed that BRAF-mutated craniopharyngiomas tended to be suprasellar (p < 0.001), spherical (p = 0.005), predominantly solid (p = 0.003), and homogeneously enhancing (p < 0.001), and that patients with these tumors tended to have a thickened pituitary stalk (p = 0.014). When at least 3 of these 5 features were present, a tumor might be identified as BRAF mutated with a sensitivity of 1.00 and a specificity of 0.91. The area under the ROC curve for the sum of all 5 diagnostic criteria was 0.989 (p < 0.001).

CONCLUSIONS

The BRAF mutation status of craniopharyngiomas might be predicted using certain MRI features with relatively high sensitivity and specificity, thus offering potential guidance for the preoperative administration of BRAF mutation inhibitors.
Interbody distraction and vertebral body reconstruction with polymethylmethacrylate for the treatment of pathological fractures
Authors: Zuckerman Scott L. , Rao Ganesh , Rhines Laurence D. , McCutcheon Ian E. , Everson Richard G. , Tatsui Claudio E.
Published: October 2017

OBJECTIVE

Treatment of epidural spinal cord compression (ESCC) caused by tumor includes surgical decompression and stabilization followed by postoperative radiation. In the case of severe axial loading impairment, anterior column reconstruction is indicated. The authors describe the use of interbody distraction to restore vertebral body height and correct kyphotic angulation prior to reconstruction with polymethylmethacrylate (PMMA), and report the long-term durability of such reconstruction.

METHODS

A single institution, prospective series of patients with ESCC undergoing single-stage decompression, anterior column reconstruction, and posterior instrumentation from 2013 to 2016 was retrospectively analyzed. Several demographic, perioperative, and radiographic measurements were collected. Descriptive statistics were compiled, in addition to postoperative changes in anterior height, posterior height, and kyphosis. Paired Student t-tests were performed for each variable. Overall survival was calculated using the techniques described by Kaplan and Meier.

RESULTS

Twenty-one patients underwent single-stage posterior decompression with interbody distraction and anterior column reconstruction using PMMA. The median age and Karnofsky Performance Scale score were 61 years and 70, respectively. Primary tumors included renal cell (n = 8), lung (n = 4), multiple myeloma (n = 2), prostate (n = 2), and other (n = 5). Eighteen patients underwent a single-level vertebral body reconstruction and 3 underwent multilevel transpedicular corpectomies. The median survival duration was 13.3 months. In the immediate postoperative setting, statistically significant improvement was noted in anterior body height (p = 0.0017, 95% confidence interval [CI] −4.15 to −1.11) and posterior body height (p = 0.0116, 95% CI −3.14 to −0.45) in all patients, and improved kyphosis was observed in those with oblique endplates (p = 0.0002, 95% CI 11.16–20.27). In the median follow-up duration of 13.9 months, the authors observed 3 cases of asymptomatic PMMA subsidence. One patient required reoperation in the form of extension of fusion.

CONCLUSIONS

In situ interbody distraction allows safe and durable reconstruction with PMMA, restores vertebral height, and corrects kyphotic deformities associated with severe pathological fractures caused by tumor. This is accomplished with minimal manipulation of the thecal sac and avoiding an extensive 360° surgical approach in patients who cannot tolerate extensive surgery.
Inpatient costs and blood transfusion rates of sarcopenic patients following thoracolumbar spine surgery
Authors: Bokshan Steven L. , Han Alex , DePasse J. Mason , Marcaccio Stephen E. , Eltorai Adam E. M. , Daniels Alan H.
Published: October 2017

OBJECTIVE

Sarcopenia, the muscle atrophy associated with aging and disease progression, accounts for nearly $18.5 billion in health care expenditures annually. Given the high prevalence of sarcopenia in patients undergoing orthopedic surgery, the goal of this study was to assess the impact of sarcopenia on inpatient costs following thoracolumbar spine surgery.

METHODS

Patients older than 55 years undergoing thoracolumbar spine surgery from 2003 to 2015 were retrospectively analyzed. Sarcopenia was measured using total psoas area at the L-4 vertebra on perioperative CT scans. Hospital billing data were used to compare inpatient costs, transfusion rate, and rate of advanced imaging utilization.

RESULTS

Of the 50 patients assessed, 16 were sarcopenic. Mean total hospital costs were 1.75-fold greater for sarcopenic patients compared with nonsarcopenic patients ($53,128 vs $30,292, p = 0.04). Sarcopenic patients were 2.1 times as likely to require a blood transfusion (43.8% vs 20.6%, p = 0.04). Sarcopenic patients had a 2.6-fold greater usage of advanced imaging (68.8% vs 26.5%, p = 0.002) with associated higher diagnostic imaging costs ($2452 vs $801, p = 0.01). Sarcopenic patients also had greater pharmacy, laboratory, respiratory care, and emergency department costs.

CONCLUSIONS

This study is the first to show that sarcopenia is associated with higher postoperative costs and rates of blood transfusion following thoracolumbar spine surgery. Measuring the psoas area may represent a strategy for predicting perioperative costs in spine surgery patients.
Isolated optic nerve gliomas: a multicenter historical cohort study
Authors: Shofty Ben , Ben-Sira Liat , Kesler Anat , Jallo George , Groves Mari L. , Iyer Rajiv R. , Lassaletta Alvaro , Tabori Uri , Bouffet Eric , Thomale Ulrich-Wilhelm , Hernáiz Driever Pablo , Constantini Shlomi , _ _
Published: October 2017

OBJECTIVE

Isolated optic nerve gliomas (IONGs) constitute a rare subgroup of optic pathway gliomas (OPGs). Due to the rarity of this condition and the difficulty in differentiating IONGs from other types of OPGs in most clinical series, little is known about these tumors. Currently, due to lack of evidence, they are managed the same as any other OPG.

METHODS

The authors conducted a multicenter retrospective cohort study aimed at determining the natural history of IONGs. Included were patients with clear-cut glioma of the optic nerve without posterior (chiasmatic/hypothalamic) involvement. At least 1 year of follow-up, 2 MRI studies, and 2 neuro-ophthalmological examinations were required for inclusion.

RESULTS

Thirty-six patients with 39 tumors were included in this study. Age at diagnosis ranged between 6 months and 16 years (average 6 years). The mean follow-up time was 5.6 years. Twenty-five patients had neurofibromatosis Type 1. During the follow-up period, 59% of the tumors progressed, 23% remained stable, and 18% (all with neurofibromatosis Type 1) displayed some degree of spontaneous regression. Fifty-one percent of the patients presented with visual decline, of whom 90% experienced further deterioration. Nine patients were treated with chemotherapy, 5 of whom improved visually. Ten patients underwent operation, and no local or distal recurrence was noted.

CONCLUSIONS

Isolated optic nerve gliomas are highly dynamic tumors. Radiological progression and visual deterioration occur in greater percentages than in the general population of patients with OPGs. Response to chemotherapy may be better in this group, and its use should be considered early in the course of the disease.
Lessons learned from administration of high-dose methylprednisolone sodium succinate for acute pediatric spinal cord injuries
Authors: Caruso Michelle C. , Daugherty Margot C. , Moody Suzanne M. , Falcone Richard A. , Bierbrauer Karin S. , Geis Gary L.
Published: October 2017

OBJECTIVE

Methylprednisolone sodium succinate (MPSS) has been studied as a pharmacological adjunct that may be given to patients with acute spinal cord injury (ASCI) to improve neurological recovery. MPSS treatment became the standard of care in adults despite a lack of evidence supporting clinical benefit. More recently, new guidelines from neurological surgeon groups recommended no longer using MPSS for ASCI, due to questionable clinical benefit and known complications. However, little information exists in the pediatric population regarding MPSS use in the setting of ASCI. The aim of this paper was to describe steroid use and side effects in patients with ASCI at the authors’ Level 1 pediatric trauma center in order to inform other hospitals that may still use this therapy.

METHODS

A retrospective chart review was conducted to determine adherence in ordering and delivery according to the guideline of the authors’ institution and to determine types and frequency of complications. Inclusion criteria included age < 17 years, blunt trauma, physician concern for ASCI, and admission for ≥ 24 hours or treatment with high-dose intravenous MPSS. Exclusion criteria included penetrating trauma, no documentation of ASCI, and incomplete medical records. Charts were reviewed for a predetermined list of complications.

RESULTS

A total of 602 patient charts were reviewed; 354 patients were included in the study. MPSS was administered in 59 cases. In 34 (57.5%) the order was placed correctly. In 13 (38.2%) of these 34 cases, MPSS was administered according to the recommended timeline protocol. Overall, only 13 (22%) of 59 patients received the therapy according to protocol with regard to accurate ordering and administration.

Among the patients with ASCI, 20 (55.6%) of the 36 who received steroids had complications, which was a significantly higher rate than in those who did not receive steroids (8 [24.2%] of 33, p = 0.008). Among the patients without ASCI, 10 (43.5%) of the 23 who received steroids also experienced significantly more complications than patients who did not receive steroids (50 [19.1%] of 262, p = 0.006).

CONCLUSIONS

High-dose MPSS for ASCI was not delivered to pediatric patients according to protocol with a high degree of reliability. Patients receiving steroids for pediatric ASCI were significantly more likely to experience complications than patients not receiving steroids. The findings presented, including complications of steroid use, support removal of high-dose MPSS as a treatment option for pediatric ASCI.
Phytochemical characterization, and evaluation of rheological and antioxidant properties of commercially available juices of berries
Authors: Luís Ângelo , Sousa Sónia , Duarte Ana Paula , Pereira Luísa , Domingues Fernanda
Published: October 2017

The consumption of berries and their contribution to improving the human health is a subject of considerable interest, have already resulted in several research projects and numerous clinical trials in humans. The main goal of this study was to evaluate the phytochemical composition (total reducing sugars, total phenolics, flavonoids, and anthocyanins) of some commercially-available juices of berries and associating it to their physicochemical (pH, density, and total solids), rheological and antioxidant properties. It was observed that in general, the juices analysed presented great concentrations of polyphenols and anthocyanins; and, in what concerns to their rheological properties, non-Newtonian pseudoplastic fluid characteristics (n <  1) were observed. The antioxidant properties of the juices were evaluated using both the DPPH free radical scavenging assay and the β-carotene bleaching test. Overall, the results of the % Inhibition of DPPH free radical by the tested juices indicate that they possess considerable capacity to scavenge free radicals, resulting in good antioxidant properties. This study demonstrated that the physicochemical properties of the juices influence their rheological behavior; and the phytochemical composition impacts their antioxidant properties. Due to their antioxidant capacities, juices of berries could be considered functional foods.
Progression of Duchenne Cardiomyopathy Presenting with Chest Pain and Troponin Elevation
Authors: Hor Kan N. , Johnston Pace , Kinnett Kathi , Mah May Ling , Stiver Corey , Markham Larry , Cripe Linda
Published: October 2017

Background:

Improved neuromuscular and respiratory therapies have altered the natural history of Duchenne muscular dystrophy (DMD) such that the most common cause of mortality is progressive cardiomyopathy. Despite imaging evidence of progressive cardiomyopathy, troponin I (cTn) is not significantly elevated in asymptomatic DMD patients.

Results:

We describe eight boys with DMD evaluated for acute chest pain (ACP) and found to have acute cTn elevation with depressed left ventricular ejection fraction (LVEF). Of our eight patients, five presented with a primary complaint of ACP, while three presented with secondary myocardial injury in the context of systemic illness requiring hospitalization. Electrocardiograms showed diffuse ST changes and mean peak cTn level was 44±15.4 ng/mL (reference range <0.03 ng/mL). cTn levels normalized with only supportive care. Cardiac magnetic resonance imaging (CMR) was performed during the event on all but one patient, demonstrating increased late gadolinium enhancement (LGE) from 12.4±11.4% to 36.5±10.3% with associated deterioration of LVEF from 61±4.4% to 47.6±6.6% which remained depressed on follow-up CMR study (49.1±7.8%). All viral studies were negative. Additional investigations varied among patients, but no causative findings were demonstrated.

Conclusions:

ACP with cTn elevation occurs in DMD boys and may be indicative of cardiomyopathy progression as evidenced by acute left ventricular dysfunction and development or progression of myocardial fibrosis. This clinical presentation is under recognized. These events may represent an important pathophysiological mechanism in cardiomyopathy progression.
Initiation of Levodopa-Carbidopa Intestinal Gel Infusion Using Telemedicine (Video Communication System) Facilitates Efficient and Well-Accepted Home Titration in Patients with Advanced Parkinson’s Disease
Authors: Willows Thomas , Dizdar Nil , Nyholm Dag , Widner Håkan , Grenholm Peter , Schmiauke Ursula , Urbom Anna , Groth Kristina , Larsson Jörgen , Permert Johan , Kjellander Susanna
Published: October 2017

Background:

Levodopa-carbidopa intestinal gel (LCIG; Duodopa®) is used for continuous infusion in advanced Parkinson’s disease. To achieve optimal effect, the LCIG dose is individually titrated, traditionally conducted during hospitalization in Sweden. However, dose adjustment depends on surrounding conditions, physical activity, and emotional stress, which is why titration at home could be beneficial. Telemedicine (TM) using a video communication system offers alternative titration procedures, allowing LCIG initiation at home.

Objective:

Study objectives were to show the feasibility of TM for LCIG home titration, evaluate resource use, and assess patient, neurologist, and nurse satisfaction.

Methods:

Four clinics enrolled 15 patients to observe efficiency and feasibility of TM-based monitoring.

Results:

Patient median (range) age was 67 (52–73) years and time since diagnosis was 10 (7–23) years. Median time between LCIG initiation and end of TM-assisted titration was 2.8 (2.0–13.8) days. Median time required for home titration by neurologists, nurses, and patients was (hours:minutes) 1 : 14 (0 : 29–1 : 52), 5 : 49 (2 : 46–10 : 3), and 8 : 53 (4 : 11–14 : 11), respectively. Neurologists and nurses considered this to be less time than required for hospital titration. TM allowed patients 92% free time from start to end of titration. Technical problems associated with TM contacts were rare, mostly related to digital link, and quickly resolved. Patients, neurologists, and nurses were satisfied using TM. No serious adverse events were reported; there was one device complaint (tube occlusion).

Conclusions:

In this study, TM-assisted LCIG titration at home was resource-efficient, technically feasible, well-accepted and was deemed satisfactory by patients, neurologists, and nurses.
The Role of Vitamin D in Disease Progression in Early Parkinson’s Disease
Authors: Sleeman Isobel , Aspray Terry , Lawson Rachael , Coleman Shirley , Duncan Gordon , Khoo Tien K. , Schoenmakers Inez , Rochester Lynn , Burn David , Yarnall Alison
Published: October 2017

Background:

Previous cross-sectional studies have shown that Parkinson’s disease (PD) patients have lower serum 25-hydroxy vitamin D (25(OH)D) concentrations than controls. Vitamin D deficiency was associated with increased disease severity and cognitive impairment in prevalent PD patients.

Objective:

The aim of the study was to determine 25(OH)D in newly diagnosed PD and age-matched controls and to assess if there was an association with clinical outcomes (disease severity, cognition and falls) over the 36-month follow up period.

Methods:

A prospective observational study of newly diagnosed PD patients in the North East of England with age-matched controls (PD, n = 145; control, n = 94). Serum 25(OH)D was assessed at baseline and 18 months. Participants underwent clinical assessment at baseline, 18 and 36 months. One hundred and ten participants with PD also took part in a prospective falls study.

Results:

Mean serum 25(OH)D concentrations were lower in PD than control participants at baseline (44.1±21.7 vs. 52.2±22.1 nmol/L, p < 0.05) and 18 months (44.2±23.6 vs. 55.7±28.8 nmol/L, p < 0.05). Baseline serum 25(OH)D concentration, age, motor score and dosage of dopaminergic medication were significant predictors of variance of motor severity at 36 months (( ΔR2 = 0.039, F = 6.6, p < 0.01). Serum 25(OH)D was not associated with cognition or falls during the follow up period.

Conclusions:

Patients with incident PD had significantly lower serum 25(OH)D concentrations than age-matched controls, which may have implications in terms of bone health and fracture risk. There was a small but significant association between vitamin D status at baseline and disease motor severity at 36 months.
The therapeutic use of non-invasive brain stimulation in multiple sclerosis – a review
Authors: Iodice Rosa , Manganelli Fiore , Dubbioso Raffaele
Published: October 2017

Background:

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system and a leading cause of disability in young adults. Many disabling symptoms in MS, such as spasticity, pain, depression and cognitive deficits are not fully controlled by drug treatment. Non-invasive brain stimulation (NIBS) techniques can be used as tools for modulating altered cortical excitability and plasticity MS patients, providing an improvement in disabling symptoms affecting such patients.

Objective:

This review reported and summarized some of the most interesting and promising recent achievements regarding the therapeutic use of NIBS in MS patients.

Methods:

We reviewed the clinical application of transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), emphasizing their effect on clinical symptoms and signs that are commonly involved in MS patients. In addition, we shortly described new NIBS protocols, such as transcranial alternating current stimulation and transcranial focused ultrasound stimulation as potential and innovative therapeutic options to be applied in future studies in MS patients.

Results:

We reviewed twenty-one studies covering six main clinical domains. Most of such studies focused on fatigues (33.3%), motor performance (19%) and spasticity (19%), sparse results were about pain (9.5%), cognitive abilities (9.5%), sensory deficit (4.8%) and bladder function (4.8%). The most promising results have been published for the improvement of motor (i.e. hand dexterity) and cognitive performances (i.e. attention and working memory) by applying rTMS or tDCS alone or in association with motor/cognitive training, for pain’s treatment by using tDCS.

Conclusion:

There are still no official recommendations for the therapeutic use of tDCS or rTMS in MS. The huge inter-individual variability of NIBS efficacy is still a big challenge which needs to be solved. However, well-designed studies, deeper knowledge about pathomechanisms underlying MS, and the combination of such techniques with motor and cognitive rehabilitation might results in higher effectiveness of NIBS.
Making if-then plans counteracts learned non-use in stroke patients: A proof-of-principle study
Authors: Marquardt Michael K. , Cohen Anna-Lisa , Gollwitzer Peter M. , Gilbert Sam J. , Dettmers Christian
Published: October 2017

Background:

After stroke, the learned non-use of a paretic arm is a major obstacle to the improvement of hand function.

Objective:

We examined whether patients with a central paresis could profit from applying the self-regulation strategy of making if-then plans that specify situational triggers to using the paretic arm.

Method:

Seventeen stroke patients with a mild to moderate hand paresis were asked to perform a Simon task which is commonly used to study the enhanced executive control needed when there is a mismatch between stimulus (e.g., color) and response (e.g., location) features. We examined whether patients with hemiparesis would be able to reduce the Simon effect (i.e., responding slower to mismatched as compared to matched stimulus and response features) by creating new stimulus-response associations via if-then plans.

Results:

A significant Simon effect was observed in both the affected and the non-affected arm for control trials. However, there was no longer a significant Simon effect for the critical trials prepared by forming if-then plans. This led to a significant stimulus×compatibility interaction effect for the affected arm and a marginally significant interaction effect for the non-affected arm. Making if-then plans was effective for eliminating or at least reducing the Simon effect for the affected and the non-affected arm, respectively.

Conclusion:

This observation opens a potential new route to improving stroke rehabilitation. If-then plans may qualify as a viable strategy to overcome the learned non-use of the affected arm. Further research is now required to develop and test therapeutic measures based on this proof-of-principle.
The Greater Wonder of God's Subjection in John Donne's Holy Sonnet “Why are wee by all Creatures waited on?”
Authors: Terranova Michael D.
Published: October 2017

In his deceptively simple, but really extremely rich, sonnet, “Why are wee by all Creatures waited on?”, John Donne uses all the tools of prosody available to him and plays with the English and Italian forms of the sonnet to give a rich meditation on the order of creation, the history of salvation, and the relationship of nature and grace. He begins with what seems an irenic scholastic discussion, asking why humans are able to subjugate elements and animals which are purer and stronger than they. In the third quatrain, however, he shifts to a deep moral plaint. At the same time, he interweaves the philosophical idea of the Great Chain of Being with the theological distinction between nature and grace. He does so by employing both the Italian and the English sonnet forms simultaneously. The Italian sonnet poses and then resolves the question about the order of nature, while the English sonnet takes the question of the order of nature up into the question of the order of redemption. In the final couplet, he goes beyond both the metaphysical question and the moral plaint by turning the reader's attention to the Incarnation, in which God subjects Himself to both that which is lower and that which is worse than Himself. In doing so Donne transforms the images he evokes in a poem surprisingly devoid of his typical metaphysical conceits into one sustained conceit which elicits in the reader a humble awe before the Divine condescension.
Oliver Parker's Filmed Othello: Desdemona and Design
Authors: Evans Robert C.
Published: October 2017

This essay examines the 1995 filmed version of Shakespeare's Othello, directed by Oliver Parker and starring Laurence Fishburne. For the first time in a big-budget movie, Othello was played by a black man – an astonishing fact when one considers that this development did not occur until almost the very end of the twentieth century. This essay briefly surveys the often highly divergent responses the film received. It concludes by defending various aspects of the film, including its tightly knit structure and also the performance by Irène Jacob as Desdemona. Because Jacob's presence in the film was often severely criticized, it seems worthwhile, in attempting to defend the film in general, to examine several scenes prominently featuring her contributions to the production.
Valuing Species: The Continuities between Non-Market and Market Valuations in Biodiversity Conservation
Authors: Fredriksen Aurora
Published: October 2017

This article explores how the rise of new markets for biodiversity has been facilitated by existing, non-market-based valuation practices within the field of biodiversity conservation. Where others have considered biodiversity markets in terms of capitalist and/or neoliberal expansion, I argue that the abstraction of the value of living things in markets is made easier by the existing valuation practices of species-based biodiversity conservation. After briefly contextualising the terms ‘species’ and ‘biodiversity’ within the history of Western conservation, the article shows how biodiversity conservation - as science, policy and practice - subordinates the value of individual living organisms and emplaced ecologies to the abstract categories of species and habitat types. This conceptual move performs a condition of ethical commensurability between individual organisms and places, thereby prefiguring the equivalence of value between units of the same category needed to establish new markets for biodiversity. The article considers this link between the valuation practices of species-based biodiversity conservation and new markets for biodiversity as an instance of performative continuity. The article concludes by reflecting on the critical use of attending to the links between existing valuation practices in biodiversity conservation and new biodiversity markets.
From Valuation to Instauration: On the Double Pluralism of Values
Authors: Hennion Antoine
Published: October 2017

At the request of Valuation Studies, Antoine Hennion reflects on his own investigative trajectory as a way to explore the ways in which the sociology of attachment, which lies at the heart of his pragmatist approach, can refine our understanding of a number of recurring problems with which the sociology of valuation is confronted.
Measuring Welfare Beyond GDP
Authors: Kullenberg Christopher , Nelhans Gustaf
Published: October 2017

This article analyses a series of negotiations of how to measure welfare and quality of life in Sweden beyond economic indicators. It departs from a 2015 Government Official Report that advanced a strong recommendation to measure only objective indicators, rather than relying on subjective indicators such as life satisfaction and happiness. The assertion of strictly objective indicators falls back on a sociological perspective developed in the 1970s, which conceived of welfare as being measurable as 'levels of living', a framework that came to be called the 'Scandinavian model' of welfare research. However, in the early 2000s, objective indicators were challenged scientifically by the emerging field of 'happiness studies', which also found political advocates in Sweden who argued that subjective indicators should be an integral part of measuring welfare. This tension between subjective and objective measurements resulted in a controversy between several actors about what should count as a valuable measurement of welfare. As a consequence, we argue that these negotiations can be understood as the creation of valuemeters, devices that both measure and value various aspects of society.
Membrane Engineering for Sustainable Development: A Perspective
Authors: Ali Aamer , Drioli Enrico , Macedonio Francesca
Published: October 2017

Membrane engineering can offer an important contribution in realizing sustainable industrial development. It provides opportunities to redesign the conventional process of engineering in the logic of Process Intensification. Relatively new and less exploited membrane operations offer innovative solutions to the scarcity of raw materials, freshwater and energy. Here, we identify the most interesting aspects of membrane engineering in some strategic industrial sectors. Several cases of either successful or innovative membrane technologies are discussed.
Optimal Tilt Angle and Orientation of Photovoltaic Modules Using HS Algorithm in Different Climates of China
Authors: Guo Mian , Zang Haixiang , Gao Shengyu , Chen Tingji , Xiao Jing , Cheng Lexiang , Wei Zhinong , Sun Guoqiang
Published: October 2017

Solar energy technologies play an important role in shaping a sustainable energy future, and generating clean, renewable, and widely distributed energy sources. This paper determines the optimum tilt angle and optimum azimuth angle of photovoltaic (PV) panels, employing the harmony search (HS) meta-heuristic algorithm. In this study, the ergodic method is first conducted to obtain the optimum tilt angle and the optimum azimuth angle in several cities of China based on the model of Julian dating. Next, the HS algorithm is applied to search for the optimum solution. The purpose of this research is to maximize the extraterrestrial radiation on the collector surface for a specific period. The sun’s position is predicted by the proposed model at different times, and then solar radiation is obtained on various inclined planes with different orientations in each city. The performance of the HS method is compared with that of the ergodic method and other optimization algorithms. The results demonstrate that the tilt angle should be changed once a month, and the best orientation is usually due south in the selected cities. In addition, the HS algorithm is a practical and reliable alternative for estimating the optimum tilt angle and optimum azimuth angle of PV panels.
Can Intensity-Modulated-Radiotherapy Reduce Toxicity in Head and Neck Squamous Cell Carcinoma?
Authors: Van der Veen Julie , Nuyts Sandra
Published: October 2017

Intensity modulated radiotherapy (IMRT) is a modern radiotherapy technique that was implemented in the mid-1990s. It allows closer shaping of dose, to target volumes, thereby sparing organs at risk (OARs). Before the IMRT-era, two-dimensional radiotherapy (2DRT) and later three-dimensional conformal radiotherapy (3DCRT) were the techniques of choice, but this robust way of irradiating caused more normal tissue to receive a higher dose. Radiation of cancers in the head and neck region is complex because of close proximity to critical normal tissue and the large target volumes that need to be treated at high doses. IMRT offers an elegant solution compared with 3DCRT and surgery because it allows organ preservation and improved function preservation. In this manuscript, we review the rationales for IMRT, with an emphasis on toxicity outcomes compared with 3DCRT. We performed a review of the literature and looked at the most important randomised controlled trials comparing IMRT with 3DCRT. We conclude that IMRT is safe in regard to disease outcome, and that it allows better sparing of normal tissue, thereby causing less toxicity, resulting in a smaller impact on quality of life compared with conventional radiotherapy in the treatment of head and neck cancer.