bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of thrombocytapheresis in the management of extreme thrombocytosis: a 6 years’ experience from a tertiary care center
Authors: Chenna Deepika , Polavarapu Isha , Kandasamy Dhivya , Mohan Ganesh , Shastry Shamee
Published: October 2021

Background. According to the American Society for Apheresis (ASFA) guidelines, thrombocytapheresis is a Category II indication in symptomatic patients and is a Category III indication when used as secondary or prophylactic treatment. The role of thrombocytapheresis is to prevent untoward complications that might occur even before the cytoreductive agents can exert their action.

Methods. A retrospective analysis of patients who underwent thrombocytapheresis between 2012 to 2018 was conducted. Demographic details, complete blood counts, diagnosis and indication for thrombocytapheresis were noted.

Results. A total of 12 patients with thrombocytosis were included in the study. The cause of thrombocytosis was primary in 3 (25%) patients and secondary in 9 (75%) patients. The average percentage reduction in platelet count was 47.1% (range 12.3%-65.64%). There was a significant decrease in platelet count, platelet crit, and mean platelet volume after the procedure when compared to pre-procedure.

Conclusion. Thrombocytapheresis selectively reduces platelet counts with no effect on other cellular and plasma components. The role of thrombocytapheresis in extreme thrombocytosis is to be considered for an immediate decrease in platelet count and to minimize the risks associated with thrombocytosis.
Dentoskeletal effects of Twin Block appliance in patients with Class II malocclusion
Authors: Khan Mahamad Irfanulla , Neela Praveen Kumar , Unnisa Nayeem , Jaiswal Ajit Kumar , Ahmed Nadeem , Purkayastha Abhik
Published: October 2021

Background and aim. Class II malocclusions are most commonly seen in orthodontic practice and in the recent times Twin Block appliance has been the most popular and widely used among removable functional appliances for the correction of Class II malocclusion in growing patients. The aim of this retrospective study was to evaluate the dentoskeletal effects produced by the Twin Block appliance for the correction of Class II division 1 malocclusion with retrognathic mandible.
Methods. Pre-treatment (T1) and post-treatment (T2) lateral cephalograms of 30 patients treated with Twin Block appliance (mean age  =  10.8 ± 1.2 years) for the correction of class II division 1 malocclusion were compared with the 30 untreated class II control patients (mean age 11.2 ± 0.8 years) who did not undergo any treatment during this period. Both the groups were evaluated for the dentoskeletal changes using 24 angular and linear cephalometric measurements. The differences between the pre and post-treatment were calculated using a paired t-test.
Results. The cephalometric analysis revealed that the Twin Block appliance stimulated mandibular growth and statistically significant differences were found between the two groups. Twin Block patients showed a statistically very high significant (p<0.001) increase in mandibular length (6.02 mm) compared with the control group (0.3 mm). ‘Headgear effect’ on the maxilla, increase in lower anterior facial height, significant reduction of overjet, overbite and Class I molar relationship was achieved in the Twin Block group. However, no significant changes appeared in the control group.
Conclusion: The results of the present study conclude that the Twin Block appliance is effective in the treatment of Class II malocclusion and this is due to a combination of skeletal and dentoalveolar changes in both the arches.
Implants displaced into the maxillary sinus, an endoscopic approach - a report of two cases
Authors: Berberi Antoine , Aoun Georges , Hjeij Bouchra , AboulHosn Maissa , Hallak Roy , Azar Elie
Published: October 2021

Accidental implant displacement into the maxillary sinuses and accompanying complications are well documented in the literature. Two surgical approaches have been suggested to remove the displaced implants and to handle the related complications: an intraoral approach and the nasal endoscopy. The intraoral approach is preferred in cases of absence of local infection, ostium obstruction, and oroantral communication needing to be closed.

The nasal approach, besides retrieval of displaced implants, allows the treatment of any associated pathology and reestablishment of the mucociliary clearance as well as the natural ventilation through the ostium.

This article reports two clinical cases of implant displacement in the maxillary sinus treated with a nasal endoscopy through the middle meatal meatotomy.

This article reports two clinical cases of implant displacement in the maxillary sinus treated with a nasal endoscopy through the middle meatal meatotomy.

Implants accidentally displaced can be avoided by a proper exploration of the preoperative x-ray, selecting an appropriate treatment plan, and esteeming the surgical skills. The most appropriate approach to handle these complications is close cooperation between oral surgeons and otolaryngologists.
Artistic Research: A Cuckoo’s Egg in Other Bird’s Nest or an Epistemologically Justified Strategy of Research?
Authors: Gedutis Aldis , Michelkevičius Vytautas
Published: October 2021

In the broader context of other types of research, the authors of this article seek to analyse the epistemological status of artistic research. Because of its transdisciplinary character, artistic research is interpreted ambiguously: on the one hand, it might be treated as an unjustified and illicit intervention into the scientific field, on the other hand, despite its peculiarities artistic research still might be capable of creating knowledge commensurable with the knowledge produced in other (scientific) disciplines. The major question the article seeks to answer is the following: is it possible to justify artistic research applying ready-made arguments in the philosophy of science?
Forgotten Theorists of Lithuanian Romanticism: Priest Ignotas Dembinsky
Authors: Viliūnas Dalius
Published: October 2021

The sluggish development of romantic philosophy research suggests looking back at new sources that have been ignored so far. Priest Ignacy Dembinsky (1800–1869) is a forgotten romantic theorist. He is not only Wilhelm Schlegel’s translator, but also his promoter, commentator, who formulated authentic insights of romantic philosophy. The article focuses on the circumstances of Schlegel’s two-dimensional publication of “Philosophy of Life” (1840), which remained on the subscriber list, raises the hypothesis that the subscription of the work was a large-scale quasi-political patriotic campaign. The direction represented by Dembinsky is attributable to legal catholic romanticism. The latter sought to establish a positive alternative to Enlightenment’s scientism, naturalism, sensualism, one-sided rationalism, based on ideas of compatibility between science and philosophy, philosophy and Revelation. A person should realize freedom in a moral life and strive for the fullness of life – these ideas had refreshing sociopolitical implications in a depressing tsarist reality. Dembinsky polemicized with his local competitor, Florian Bochvic, a representative of a similar direction. The latter episode raises the question of the compatibility of his catholic theological doctrine and his maxims of a romantic philosopher: it is left open. It is hypothesized that the works translated, commented and creatively supplemented by Dembinsky could function as a bridge between the old Polish-speaking philosophy of Lithuania and the beginnings of the current Lithuanian theorization.
Aristotle and Johnston on Hylomorphism and the Character of Objects
Authors: Panayides Christos Y.
Published: October 2021

As M. Loux has recently reminded us, there are two basic strategies for explaining the character of particular objects, the ‘relational approach’ and the ‘constituent approach’. The prime example of a constituent approach would be Aristotelian hylomorphism. This article reveals three things. First, it gives a roadmap towards what the author considers to be the exegetically correct reconstruction of Aristotle’s hylomorphic theory. Second, it provides a presentation of the basic claims of a neo-Aristotelian hylomorphic theory, the one argued for by M. Johnston. Finally, it argues that regardless of whatever shortcomings it may have, Aristotle’s theory has an advantage over that proposed by Johnston. Unlike Johnston’s theory, it may give us a complete account of the character of a particular object.
Anos Achmatovos kūrybos recepcija Lietuvoje
Authors:   , Ivinskaja Aliona Sofija
Published: October 2021

The Reception of Anna Akhmatova's works in Lithuania
Reflexões sobre Educação Ambiental a partir da análise dos trabalhos de conclusão do Curso Técnico em Meio Ambiente nos anos de 2015 até 2018
Authors: Duarte Luiza da Cruz , Roso Luciana , Galli Leonardo , Da Silva Franciélen Teixeira
Published: October 2021

A pesquisa abordou sobre as reflexões da educação ambiental presentes nos Relatórios de Conclusão do Curso Técnico em Meio Ambiente do Instituto Federal Sul Rio-Grandense, Campus Pelotas - Visconde da Graça, durante os anos de 2015 a 2018. Com este objetivo esta pesquisa analisou a presença ou ausência de concepções de educação ambiental, que estão vinculadas à ética. Pesquisou-se em que medida as concepções acadêmicas conferem a educação ambiental reflexões significativas e quais suas articulações com relação à ética considerando os conceitos ambientais formulados por pesquisadores que contribuíram para a nossa compreensão de ser-estar no mundo. A metodologia de pesquisa bibliográfica utilizada possuiu uma abordagem quali-quantitativa observando-se como resultados que, nos trabalhos analisados, 37 possuíam conceitos de educação ambiental enquanto que 17 não apresentaram estes conceitos, ou seja, 68,51% dos trabalhos continham concepções de educação ambiental, com temas diversos como questões sobre o comportamento humano, conscientização, cuidado e a qualidade de vida, conjunto de processos educativos, impactos ambientais, controle social, os recursos naturais, os resíduos sólidos e desmatamento.
Palavras-chave: Ética; aprendizagem; socioambiental; concepção ambiental.
DAMAGES OF THE KEEL BONE IN LAYING HENS – OVERVIEW OF THE ETIOLOGICAL ASPECTS
Authors: Uzunova K. , Lazarov L.
Published: October 2021

The damages of the locomotor system and the skeletal system, in particular, are one of the major problems in the industrial poultry farming. The topic for the pathological changes in the keel bone in oviparous birds has become especially popular among scientists and researchers in recent years. The high incidence of keel bone damage (KBD) of laying hens in industrial complexes is one of the biggest welfare problems facing the industry. They lead to disturbance of the animal welfare, causing pain, limiting the ability to move and to perform the characteristic behaviour of the species. This in turn causes a decrease in productivity and unacceptably large losses not only for the individual producer but also for the whole sector. The problem with the KBD is widespread in Switzerland, Great Britain, the Nederland, Belgium, Germany, and Canada. Different genetic lines of laying hens are affected, as well as all types of breeding systems. In general, the etiological factors are reduced to three main groups – genetic predisposition, unbalanced diet and imperfections in housing systems. The causes and influencing factors of KBD remain unknown to the research community - a circumstance that seriously complicates the development of effective strategies to reduce their occurrence and severity.
RISK ASSESSMENT FOR OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN
Authors: Shukerova Z.
Published: October 2021

PURPOSE: Risk factors for osteoporotic fractures include parental history of hip fractures, smoking, excessive alcohol consumption, low body weight and menopause.
Postmenopausal women under 65 years with at least one risk factor should be evaluated with a risk assessment tool to decide if they need to undergo osteodensitometry. There is an evidence of a significantly greater sensitivity of the SCORE test for detection of osteoporosis in women with age between 50 to 64 years compared to the FRAX tool.
METHODS: We conducted a survey to evaluate the risk of osteoporosis in 64 postmenopausal women using SCORE tool. The assessed women were with mean age of 50 years. A total score of more than 6 points is considered to determine a possible risk of osteoporosis.
RESULTS: 50% of the women showed moderate risk and 25% of the women had very high risk for osteoporosis. 75% of all evaluated subjects were detected to need bone mineral density (BMD) assessment with a dual-energy X-ray absorptiometry (DXA).
CONCLUSIONS: The results of the current study are evidence of the high sensitivity of the SCORE tool and of the significant prevalence of osteoporosis among Bulgarian postmenopausal women.
The role of cultural psychological orientations for flexibility in coping with stress in Polish adolescents
Authors: Kruczek Agnieszka , Grzankowska Izabela , A. Basińska Małgorzata
Published: October 2021

Aim: The aim of the study was to assess the dominant cultural psychological orientation among Polish youth, the role of individualism and collectivism for flexibility in coping, and the assessment of the modifying role of gender and age of the studied youth for the relationship between the included cultural psychological orientations and the flexibility in coping with stress. Materials and methods: A total of 367 adolescents (131 boys and 236 girls) aged between 13 and 20 participated in the study. The following methods were used: the Individualism–Collectivist Questionnaire by Harry Triandis and Michele Gelfand, Flexibility in Coping with Stress Questionnaire by Basińska et al., and a personal survey. Results: Polish adolescents obtained the highest average score in the psychological orientation of vertical collectivism. There were statistically significant positive correlations between horizontal individualism, horizontal collectivism, vertical collectivism and flexibility in coping and its dimensions. Moreover, Polish adolescents’ psychological orientation – horizontal individualism – was a predictor of flexibility in coping with stress and its dimensions. The analysis revealed that the model for the relationship between horizontal individualism and coping competences with the modifying role of age was statistically significant. Younger adolescents (from 13 to 17 years of age) were more individually oriented horizontally, and had higher coping competences, whereas in the group of older adolescents (>17.4) this effect was not observed. Conclusions: The results of the study are an important contribution to the recognition of flexibility in coping, but also answer numerous questions about its relationships with cultural psychological orientation.
Fibromyalgia from a psychiatric point of view
Authors:   Studenckie Koło Naukowe Psychiatrii, Wydział Nauk Medycznych w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach, Tarnowskie Góry, Polska, Hasterok Maja , Piegza Magdalena ,   Katedra i Oddział Kliniczny Psychiatrii w Tarnowskich Górach, Wydział Nauk Medycznych w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach, Tarnowskie Góry, Polska, Dębski Paweł ,   Studenckie Koło Naukowe Psychiatrii, Wydział Nauk Medycznych w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach, Tarnowskie Góry, Polska
Published: October 2021

Fibromyalgia is a disorder bordering on rheumatology and psychiatry, which was included in the ICD-10 (M79.7) classification in the 1990s. It is characterised by a triad of symptoms including chronic widespread pain, sleep disturbances, and mental or physical exhaustion. According to various estimates, fibromyalgia affects from 2 to 4% of the population, particularly individuals between 50 and 60 years of age. There is a lack of consistent data in the available literature on the prevalence of the disorder between sexes. Depending on the criteria used, the female/male ratio is reported to be 13.7:1, 4.8:1 or 2.3:1. Despite nearly three decades of fibromyalgia presence in the ICD classification system, the nature and treatment of the disease have not been sufficiently recognized and arouse a lively discussion among researchers of various medical specialties. The paper attempts to systematise selected issues related to fibromyalgia which seem particularly important from the point of view of psychiatry. The introduction presents the history of the debate on the concept of fibromyalgia, problems relating to the definition and classification of the condition and, finally, symptomatology. The article focuses on the psychiatric aspect of fibromyalgia and reviews reports of the association of fibromyalgia with mental disorders, as well as issues relating to pathophysiological and therapeutic concepts that may be useful to both psychiatrists and other specialists who may encounter the disorder in their practice.
Evolving Patterns of Metastasis in Renal Cell Carcinoma
Authors: Lin Justin , Zhang Yue , Hou Wei , Qin Qian , Galsky Matthew , Oh William , Tsao Che-Kai
Published: October 2021

Advance diagnostic and treatment modalities have improved outcomes for renal cell carcinoma (RCC) patients, but the prognosis for those with metastatic disease (mRCC) remains poor. As given metastatic distribution is critical in guiding treatment decisions for mRCC patients, we evaluated evolving metastatic patterns to assess if our current practice standards effectively address patient needs. A systematic literature review was performed to identify all publicly available prospective clinical trials in metastatic renal cell carcinoma (mRCC) from 1990 to 2018. A total of 16,899 mRCC patients from 127 qualified phase I–III clinical trials with metastatic site documentations were included for analysis for incidence of metastases to lung, liver, bone, and lymph nodes (LNs) over time. Studies were categorized into three treatment eras based on the timing of regulatory approval: Cytokine Era (1990-2004), vascular endothelial growth factor/tyrosine kinase inhibitor (TKI) Era (2005-2016), and immune checkpoint inhibitor/TKI Era (ICI-TKI, 2017-2018) and also classified as first-line only (FLO) or second-line and beyond (SLB). Overall, an increase in the incidence of bone and LNs metastases in FLO and SLB, and lung metastases in FLO, was seen over the three treatment eras. Generally, the burden of disease is higher in SLB when compared with FLO. Importantly, in the ICI-TKI era, the incidences of bone metastasis are 28% in FLO and 29% in SLB settings. The disease burden in patients with mRCC has increased steadily over the past three decades. Given the unexpectedly high rate of bone metastasis, routine dedicated bone imaging should be considered in all patients with mRCC.
The effect of attenuation from fish on long-range active and passive acoustic sensing in the ocean
Authors:   , Duane Daniel M.
Published: October 2021

Attenuation from fish can reduce the intensity of acoustic signals and significantly decrease detection range for long-range active and passive sensing in the ocean. This makes it important to understand the relevant mechanisms and accurately predict attenuation from fish in underwater acoustic sensing. Formulations for predicting attenuation from fish, however, depend on the accurate characterization of population density and spatial distribution of fish groups along long-range propagation paths, which is difficult to achieve using conventional survey methods. In previous investigations of attenuation from fish, population densities were inferred from reductions in the intensity of long-range acoustic signals caused by diel or seasonal shoaling patterns of fish groups. Here, Ocean Acoustic Waveguide Remote Sensing (OAWRS) is used to instantaneously image massive Norwegian herring shoals that stretch for thousands of square kilometers and simultaneously measure attenuation from these shoals within the active OAWRS transmissions, as well as attenuation to ship-radiated tonals detected by Passive Ocean Acoustic Waveguide Remote Sensing (POAWRS). Reductions in signal intensity are predicted using a normal-mode-based analytical theory derived from first principles for acoustic propagation and scattering through inhomogeneities in an ocean waveguide. The predictions of the waveguide attenuation formulation are in agreement with measured reductions from attenuation, where the position, size, and population density of the fish groups are characterized using OAWRS imagery as well as in situ echosounder measurements of the specific shoals occluding the propagation path. Common heuristic formulations that employ free space scattering assumptions for attenuation from fish groups are not in agreement with measurements here, and waveguide scattering theory is found to be necessary for accurate predictions. It is experimentally and theoretically shown that attenuation can be significant when the sensing frequency is near the resonance frequency of the shoaling fish, where scattering losses from the fish swimbladders and damping from fish flesh is most significant. Negligible attenuation was observed in previous OAWRS and POAWRS surveys because the frequency of the acoustic signals was sufficiently far from the swimbladder resonance peak of the shoaling fish or the packing densities of the fish shoals were not sufficiently high.
Immune recovery after antiretroviral therapy initiation: a challenge for people living with HIV in Brazil
Authors: Mendicino Cássia C. P. , Moodie Erica E. M. , Guimarães Mark Drew Crosland , Pádua Cristiane A. Menezes de
Published: October 2021

Immune recovery reflects health conditions. Our goal was to estimate the time it takes to achieve immune recovery and its associated factors, in people living with HIV (PLHIV), after antiretroviral therapy (ART) initiation. A historical cohort study was performed among PLHIV (> 18 years-old) in Minas Gerais State, Brazil, using data from healthcare databases. Patients initiating ART between 2009-2018, with T-CD4+ lymphocytes and viral load recorded before and after antiretroviral therapy were included. The outcome is achievement of immune recovery, defined as the first T-CD4+ > 500 cells/µL after ART initiation. Explanatory variables were age, gender, place of residence, year of ART initiation, baseline viral load and T-CD4+, viral load status, and adherence to ART at follow-up. Descriptive analysis, cumulative, and person-time incidences of immune recovery were estimated. Median-time to immune recovery was estimated using Kaplan-Meier method. Factors associated with immune recovery were assessed by Cox regression. Among 26,430 PLHIV, 8,014 (30%) were eligible. Most were male (67%), mean age 38.7 years, resided in non-central region, median-baseline T-CD4+ = 228 cells/µL (< 200 cells/µL = 43%) and viral load median-baseline = 4.7 log10 copies/mL (detectable viral load = 99%). Follow-up time = 15,872 person-years. Cumulative and incidence rate were 58% (95%CI: 57-58) (n = 4,678) and 29.47 cases/100 person-years, respectively. Median-time to immune recovery was of 22.8 months (95%CI: 21.9-24.0). Women living with HIV, younger than 38 years of age, with T-CD4+ baseline > 200 cells/µL, detectable viral load (baseline), antiretroviral therapy-adherence and undetectable viral load (follow-up) were independently associated with immune recovery. Time to immune recovery remains long and depends on early treatment and antiretroviral therapy-adherence.
Social position and anthropometric status among adults in the ELSA-Brasil study: a latent class analysis
Authors: Matos Sheila Maria Alvim , Amorim Leila Denise Alves Ferreira , Pitanga Francisco José Gondim , Patrão Ana Luísa , Barreto Sandhi M. , Chor Dora , Cardoso Letícia de Oliveira , Molina Maria del Carmen Bisi , Barreto Mauricio Lima , Aquino Estela M. L.
Published: October 2021

Abstract: The objective of the present study was to evaluate the association between social position and anthropometric status in women and men Brazilian adult. This was a cross-sectional study that used baseline data collected from 2008 to 2010 for the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil, in Portuguese), in the six major Brazilian state capital cities. A total of 15,105 active and retired civil servants aged from 35 to 74 years. Two latent variables were defined by latent class analysis, social position and anthropometric status. Both constructs and the analyses were separately evaluated by sex. Associations were assessed using multivariate logistic regression analysis with adjustment for age, self-reported skin color/race, and marital status. Around 44% of the women and 26% of the men were classified as overweight or obese. Social position tended to be lower in women (43.2%) and higher among men (40.4%). Heavier women were more likely to be black and brown-skinned, whereas slimmer women were more likely to be white. After adjustment, women’s weight increased as social position decreased (OR = 1.52; 95%CI: 1.36-1.70), whereas in men weight decreased as social position decreased (OR = 0.87; 95%CI: 0.76-0.99). Social position affected the anthropometric status of women and men differently, with body patterns also being affected by ethnicity/skin color, showing the potentiality of taking the intersectional perspective when investigating the possible social determinants of the phenomenon.
Mortalidade e causas de óbitos nas prisões do Rio de Janeiro, Brasil
Authors: Sánchez Alexandra , Toledo Celina Roma Sánchez de , Camacho Luiz Antônio Bastos , Larouze Bernard
Published: October 2021

Resumo: A mortalidade nas prisões, indicador fundamental do direito à saúde das pessoas privadas de liberdade (PPL), nunca foi estudada de maneira aprofundada no Brasil. A avaliação da mortalidade global e por causas entre PPL encarceradas em 2016-2017 no Estado do Rio de Janeiro, foi realizada a partir de dados do Sistema de Informações sobre Mortalidade e da Administração Penitenciária. Taxas de mortalidade entre PPL e população geral do estado foram comparadas após padronização. As principais causas de morte entre PPL foram doenças infecciosas (30%), doenças do aparelho circulatório (22%) e causas externas (12%). Dentre as causas infecciosas, destacam-se HIV/aids (43%) e tuberculose (TB) (52% se considerados todos os óbitos com menção de TB). Somente 0,7% das PPL que faleceram tiveram acesso a serviço de saúde extramuros. A taxa global de mortalidade foi maior entre as PPL comparadas à população geral do estado, com mortalidade por doenças infecciosas 5 vezes superior, por TB 15 vezes e por doenças endócrinas, especialmente diabetes, e doenças circulatórias (1,5 e 1,3 vez, respectivamente), enquanto mortes por causa externa foram menos frequentes entre PPL. Este estudo mostra um expressivo excesso de mortes potencialmente evitáveis nas prisões, o que traduz importante desassistência e exclusão dessa população do Sistema Único de Saúde. Evidencia a necessidade de um sistema de monitoramento, em tempo real, dos óbitos, preciso e sustentável, além da reestruturação da saúde prisional por meio da efetivação da Política Nacional de Atenção Integral à Saúde das Pessoas Privadas de Liberdade no Sistema Prisional para que as PPL usufruam do direito constitucional à saúde em sua integralidade, com a mesma qualidade e tempestividade oferecida à população geral.
The positive association between serum uric acid, impaired fasting glucose, impaired glucose tolerance, and diabetes mellitus in the ELSA-Brasil study
Authors: Galvão Aline Isabel Rodrigues , Beleigoli Alline Maria R. , Vidigal Pedro Guatimosim , Duncan Bruce Bartholow , Schmidt Maria Inês , Appleton Sarah L. , Barreto Sandhi Maria , Diniz Maria de Fátima Haueisen Sander
Published: October 2021

Abstract: There is a conflict in the literature regarding the association between serum uric acid (SUA) levels and glycemic status. Therefore, we evaluated the association between SUA level and glycemic status - impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes mellitus - and insulin resistance, in a large Brazilian study. This is a cross-sectional, observational study with 13,207 participants aged 35-74 years, at baseline (2008-2010) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). A multinomial regression analysis was performed to test the association between SUA and glycemic status (IFG, IGT, and newly diagnosed type 2 diabetes at the cohort baseline) after adjustments by age, sex, skin color, body mass index, physical activity, smoking, alcohol consumption, comorbidities, and medicines use. Logistic regression model was used to evaluate the association between SUA and insulin resistance by HOMA-IR. Stratified analyses by sex were performed. The mean age (standard deviation) was 51.4 (8.9) years, 55.2% of participants were women. There were 1,439 newly diagnosed diabetes. After all adjustments, higher SUA was associated with IFG, IGT, and diabetes, with odds ratio (OR) = 1.15 (95%CI: 1.06; 1.25), 1.23 (95%CI: 1.14; 1.33), and 1.37 (95%CI: 1.24; 1.51), respectively. There was association between SUA levels and insulin resistance with OR = 1.24 (95%CI: 1.13; 1.36). In analysis stratified by sex, higher SUA persisted independently associated with impaired glycemic status. Our results suggest that a higher SUA levels were significantly associated with glycemic status in a large Latin American population, mainly among women.
Ser estudante de enfermagem em tempos de COVID-19
Authors: Baixinho Cristina Lavareda , Ferreira Óscar Ramos
Published: October 2021

Resumo Objetivo Compreender como a pandemia afetou os estudantes de enfermagem nos contextos de Ensino Clínico. Método Este é um estudo de abordagem qualitativa, exploratória, transversal e descritiva. Os participantes foram 5 enfermeiros recém-licenciados que realizaram o último estágio clínico da sua licenciatura durante a pandemia de COVID-19. A análise de conteúdo ocorreu por meio da técnica para a análise dos achados das narrativas. Resultados Emergiram 5 categorias: Dificuldades sentidas na integração; Dificuldades na concretização do ensino clínico; Influência da pandemia nas expectativas dos estudantes ante o ensino clínico de integração à vida profissional; Receios, relacionadas com a COVID 19; e Sugestões para a formação dos licenciados em enfermagem, com vista a capacitá-los para a gestão de situações de pandemia. Conclusões e implicações para a prática O ensino clínico, cujo objetivo é atingir as competências exigidas para o exercício profissional, foi vivenciado com ansiedade, medo e pressão, porém com o suporte possível por parte dos supervisores clínicos, eles próprios também sob pressão, dado o aumento da sobrecarga de trabalho provocada pela pandemia. O estudo permite fazer recomendações para a educação e investigação em enfermagem.
Perfil clínico-epidemiológico de crianças hospitalizadas: um recorte do período pandêmico e não pandêmico
Authors: Santos Robson Gomes dos , Cardoso Érika Leite da Silva , Marques Laísa de Sousa , França Ludymilla Linéia Almeida de , Xavier Thaís Grilo Moreira , Leon Pollyana Amorim Ponce de , Souza Luciana Ferreira de
Published: October 2021

RESUMO Objetivo Analisar o perfil clínico-epidemiológico de crianças e adolescentes hospitalizadas na clínica médica de um hospital pediátrico, referente aos períodos não pandêmico e pandêmico por COVID-19. Método Trata-se de estudo comparativo de natureza quantitativa, com delineamento transversal. A coleta de dados foi realizada em 219 prontuários do Serviço de Arquivo Médico e Estatística de um complexo pediátrico, no município de João Pessoa-PB. Quanto à análise dos dados, utilizou-se a estatística descritiva e testes estatísticos para comparar os grupos. Resultados O perfil das crianças e dos adolescentes hospitalizados teve predominância do sexo masculino, e de lactentes para o período não pandêmico e pandêmico, igualmente. A mãe foi a principal responsável e acompanhante da criança. As variáveis, natureza do benefício social, diagnóstico segundo especialidade médica e tempo de internação apresentaram diferenças estatísticas significativas entre os períodos não pandêmico e pandêmico por COVID-19. Conclusão Os dados encontrados apontam que não ocorreram mudanças expressivas no perfil sociodemográfico de crianças internadas. A pandemia por COVID-19 resultou em maior mudança no perfil clínico das internações. Implicações para a prática: Conhecer o perfil das crianças e adolescentes em processo de hospitalização, em um período pandêmico por COVID-19, auxiliará na elaboração de fluxos assistenciais e estratégias que atendam às reais demandas com propriedade.
Study of the multidimensional academic ranking “U-Multirank”
Authors: Prado Antonio
Published: October 2021

The present paper studies the Dimensions and Indicators of the academic international multidimensional ranking “U-Multirank”. The study of this ranking is important in Brazil nowadays, because the new evaluation of the graduate programmes in Brazil is using many aspects of multidimensional evaluation, including some concepts used by the U-Multirank. This ranking shows the weaknesses and strengths of each Academic Institution, using five Dimensions that are composed by 36 Indicators. This large number of Dimensions and Indicators gives a more complete view of the Universities, but raise questions about their independence and data availability. The top 300 European Academic Institutions listed in the 2020 edition are analyzed, explaining the Dimensions and Indicators and making statistical correlations between them.
Infidelidad: pasar del abismo a la grieta luego del acompañamiento terapéutico
Authors: Salazar-Franco Natalia , Muñoz-Santrich Diana , Builes-Correa María Victoria
Published: October 2021

Objetivo. Reconocer los significados y las vivencias de la infidelidad antes y después del proceso terapéutico. Metodología. Investigación cualitativa, fenomenológica hermenéutica. Se realizaron dos entrevistas semiestructuradas a tres parejas y una participante; triangulación de la información a través de un grupo de discusión con terapeutas. Resultados. La terapia facilitó la transformación de los significados; en infieles al pasar de una “ética del infiel” en tanto minimiza la infidelidad, a una postura crítica de sus actos; en infidelizados, pasó de una postura del blindaje e idealización de la pareja a comprenderla desde la fragilidad humana; ambos logran responsabilizarse, lo que permitió el tránsito de la vivencia inicial enmarcada en dolor y sensación del final de la relación, a la recuperación personal y relacional. Conclusión. La terapia es un escenario que facilita transformar el “abismo” de la infidelidad a una “grieta”, para así construir un presente y futuro más estético para ambos.
Organización familiar durante el confinamiento en familias mexicanas
Authors: Valle-Morfín María Esther , Obregón-Patiño Jessica Paola , Torres-Velázquez Laura Evelia
Published: October 2021

Objetivo. Analizar el trabajo doméstico en familias mexicanas durante el confinamiento por Covid-19, específicamente en las actividades de limpieza, alimentación, escolares y de ocio. Metodología. El enfoque fue cualitativo con perspectiva de género desde el construccionismo social. Participaron tres madres de familia a quienes se les realizaron entrevistas semiestructuradas. Resultados y conclusión. Se encontró que en este periodo de confinamiento las madres de familia experimentan una sobrecarga de actividades de cuidado en la organización familiar, la cual se asume y se justifica por la condición de género. No obstante, ellas están involucrando a sus familias en algunas de las actividades domésticas. Se concluyó que es necesaria la desconstrucción de los estereotipos de género que se han legitimado en las dinámicas familiares; y se reconozca a la familia extensa, entre otras personas, como una red de apoyo desde la cual las mujeres buscan construir lazos de bienestar.
Perspectiva de género en la violencia filio-parental
Authors: Correa-Agudelo Sara Melisa , Botero-Arango Yesica , Valoyes-Arenas Jenifer Vanesa , Rodríguez-Bustamante Alexánder
Published: October 2021

La violencia filio-parental es una manifestación de la violencia intrafamiliar que se caracteriza por la acción violenta, intencionada y sistemática de hijos hacia los progenitores o quien ejerce el rol de adulto significativo; el daño ocasionado a las víctimas puede comprender dimensiones físicas, psicológicas, emocionales y financieras. Objetivo. Reconocer las cualidades de la víctima y victimario de la violencia filio-parental en las dinámicas familiares desde una perspectiva de género. Metodología. Esta investigación se realizó bajo un enfoque cualitativo con una metodología hermenéutica en la modalidad de estado del arte; se tuvieron en cuenta 56 referencias bibliográficas privilegiando los artículos de revista con un margen de antigüedad de 10 años. Resultados y conclusiones. La perspectiva de género se convierte en un enfoque necesario para la intervención del fenómeno de la violencia filio-parental desde la prevención, en tanto contribuye a la democratización de las funciones y roles en las dinámicas familiares como la afectividad y la autoridad; de tal manera que padres, madres y cuidadores puedan asumir estilos parentales democráticos y de disciplina inductiva en función de la crianza de seres humano más prosociales.
Bicameralism in Lesotho: A review of the powers and composition of the second chamber
Authors: 'Nyane Hoolo
Published: October 2021

ABSTRACT Lesotho has a bicameral parliamentary system based on the British model. While the National Assembly is clearly a representative House elected by the citizenry, the purpose, structure and legislative powers of the Senate as the Second Chamber have been a matter of considerable controversy throughout the history of parliamentary democracy in the country. The National Assembly generally has the upper hand not only in the legislative process but also in the broader parliamentary system - it chooses the Prime Minister, it places its confidence in the government and it can withdraw such confidence. The fact that the model generally gives the National Assembly the upper hand is a matter of common cause. What is in question, though, is the nature and extent of the limitation of the powers of the Senate in terms of the Constitution. This article investigates this question and contends that the composition of, and restrictions on, the Senate need to be reviewed in order to enable the Chamber to play a meaningful role in Lesotho's parliamentary democracy . Key words: Constitution of Lesotho, Bicameralism, Senate, National Assembly, Powers of the Second Chamber
Does the exclusion of a right to basic sanitation in international law impede its legal enforcement?
Authors: Heleba Siyambonga
Published: October 2021

ABSTRACT Despite expressly providing for a number of rights, the International Covenant on Economic, Social and Cultural Rights (ICESCR) sadly omits the right to basic sanitation. This is a matter of concern as figures released by United Nations agencies and other international organisations paint a bleak picture of the levels of provision (or lack thereof) of basic sanitation around the world. They demonstrate huge and growing disparities in relation to the provision of basic sanitation facilities between urban and rural populations. International law has certainly not helped the situation by omitting this important right in key human rights instruments such as the ICESCR This is also manifested in the tendency by many governments to separate basic sanitation from the right to water. The article argues, however, that this fact alone should not hinder the legal enforcement of this right. Keywords: Basic sanitation, global picture, international law, human rights, legal enforcement
Four years following South Africa's declaration upon the ratification of the ICESCR and jurisprudence on the right to basic education: A step in the right direction?
Authors: Nanima Robert Doya , Durojaye Ebenezer
Published: October 2021

ABSTRACT Education empowers individuals to develop the skills needed for economic success in order to contribute to nation-building and reconciliation. Following South Africa's ratification of the International Covenant on Economic, Social and Cultural Rights, there were mixed reactions on account of the much-anticipated ratification, on the one hand, and the declaration that subjected the right to basic education to the National Education Policy Framework and the available resources, on the other. This article interrogates the efficacy of this declaration in the realisation of the right to basic education in South Africa. It utilises a three-step approach. First, it contextualises the right to education and evaluates the declaration. Secondly, it evaluates selected decisions of the South African courts to establish the trend on the right to basic education. The third step juxtaposes the executive's and the courts' approaches from the ratification to date. A conclusion and recommendations inform the way forward. Keywords: Best interests principle, Eviction of schools, Immediate realisation, National policy, Provision of textbooks, Right to basic education, Staffing.
COVID-19 and elections in Ethiopia: exploring constitutional interpretation by the House of the Federation as an exit strategy
Authors: Mengie Legesse Tigabu
Published: October 2021

ABSTRACT Over 60 countries have postponed their elections due to COVID-19. As an election is the primary means by which government power is assumed in constitutional democracies, the postponement of elections has posed this question: what exit mechanisms do constitutional systems have to address a power vacuum caused by unforeseen circumstances like COVID-19? In other words, how can a legitimate government that adheres to the rule of law, a constitution more specifically, be ensured when elections cannot be held? While some countries held elections amid COVID-19 with precautions, others postponed them. Ethiopia is one of those countries which have postponed their elections. The postponement of Ethiopia's general elections sparked a debate about how the power vacuum caused by the pandemic should be addressed. After deliberating on the matter, Ethiopia's lower house approved constitutional interpretation by the upper house as the best solution. The upper house, through interpreting the Constitution, extended the term limits of the federal and regional governments. This article intends to address the question posed above by examining constitutional interpretation by the upper house as an exit strategy. It explores constitutional interpretation by this house and its implications for the rule of law and legitimacy of government. I conclude that comprehensive understanding of the Constitution offers an answer to the conundrum. The upper house has adopted a holistic interpretation approach and that is commendable. However, the ruling that allows the government to stay in power for an unknown time and the partiality inherent in the house compromise the merit of its interpretation. Keywords: COVID-19; election; constitution; the rule of law; legitimacy; Ethiopia.
Failure to recognise a third gender option: unfair discrimination or justified limitation?
Authors: Sloth-Nielsen Rachel
Published: October 2021

ABSTRACT This article seeks to answer the question of whether the State's failure to recognise a third gender option for transgender non-binary individuals amounts to unfair discrimination or whether this limitation could be justified. After a brief conceptual framework is discussed, the article looks at the right to equality as found in section 9 of the Constitution of the Republic of South Africa, 1996. Thereafter the article explores whether the non-recognition of a third gender option could be found to be discrimination on a ground listed in the Constitution, as well as whether it could be found to amount to an analogous ground. It is opined that non-recognition of a third gender option does amount to discrimination on the analogous ground of gender identity. It is further submitted that no justification for this limitation of the right to equality would be upheld by a competent court. Keywords: Transgender; discrimination; unfair discrimination; third gender option; justified limitation; equality.
The exhaustion of local judicial remedies in investor-state dispute settlement: a proposal for the African Continental Free Trade Agreement on Investment Protocol
Authors: Qumba Mmiselo Freedom
Published: October 2021

ABSTRACT Over the past few years, the international Investor-State Dispute Settlement (ISDS) mechanisms have been confronted with an unprecedented level of scrutiny, and the system's legitimacy is being questioned by both developed and developing countries alike. This article presents a proposal for the adoption of the old customary international law rule of exhaustion of local remedies in the upcoming Investment Protocol of the African Contin en tal Free Trade Agreement (AfCFTA). It observes that the ISDS mechanism that will be developed under the AfCFTA framework is likely to be shaped by the legitimacy crisis in investment treaty arbitration and ongoing global debates about the reform of the ISDS mechanisms. In particular, the ISDS debate in the African region will continue to characterise and potentially derail the negotiations of the AfCFTA Protocol on Investment. The main contention is that adopting the exhaustion of local remedies under the AfCFTA Protocol on Investment before recourse is had to the ISDS is arguably the single reform with the greatest potential to foster a balanced investment dispute resolution mechanism and reduce political opposition to ISDS while still providing investors with access to ISDS when domestic remedies are inadequate. The article finally proposes a drafting suggestion for the adoption of the exhaustion of local remedies rule into the ISDS provision of the AfCFTA Protocol on Investment. Keywords: Exhaustion of local remedies; African Continental Free Trade Area; Investment Protocol; ISDS; African courts.
Creating and Implementing a Protocol for the Management of Patients in Skeletal Traction: A Quality Improvement Project
Authors: Cline Justin , Nolte Jack , Mendez Gregory , Willis Jordan , Bachinskas Andrew , Benge Clint , Dart Bradley
Published: October 2021

Introduction.Skeletal traction use generally has decreased over generations and is used most often for temporary fracture stabilization. Proper nursing management of patients in skeletal traction is crucial. A hospital protocol was created and implemented to educate and direct registered nurses (RNs) in the care of patients requiring skeletal traction.
Method.A skeletal traction management protocol was drafted and implemented as hospital policy. Twenty-nine RNs from an orthopaedic unit at a level 1 trauma center attended a financially compensated, 45-minute, in-person, off-shift educational session. An anonymous pre-test utilizing a 5-point Likert scale was completed to assess RN knowledge and comfort regarding the following topics of traction care: pin care, manual traction, frame assembly, weight application and removal, skin evaluation, neurovascular checks, and reporting issues. The RNs were provided with a copy of the new hospital policy and key points were highlighted and demonstrated. After the demonstration, the RNs were given a post-test to assess their perceived knowledge and comfort with traction care.
Results.Statistically significant improvements in RN knowledge and comfort were seen in six of the seven evaluated topics. The greatest increase was seen in the manual traction topic. No significant change regarding neurovascular checks was observed with this topic having the highest pre-test scores.
Conclusion. A hospital protocol was created successfully and implemented that significantly improved the level of RN knowledge and comfort with the management of patients requiring skeletal traction. Future studies should assess the effectiveness of annual education regarding the traction policy.