bluuebunny/crossref_metadata_2025 huggingface dataset:
Revisiting positionality and the thesis of situated knowledge
Authors: Simandan Dragos
Published: June 2019

Feminist and queer epistemologies have been influential throughout the social sciences by means of the development of a set of interrelated approaches involving positionality, partiality, reflexivity, intersectionality, and the highly politicized thesis of situated knowledge. This article aims to operationalize these approaches by introducing an anti-humanist, politically attuned, and historically contextualized framework, which postulates that one’s knowledge is inevitably incomplete and situated because information about the world always reaches one through a channel that is constituted by four epistemic gaps: (1) ‘possible worlds versus realized world’, (2) ‘realized world versus witnessed situation’, (3) ‘witnessed situation versus remembered situation’, and (4) ‘remembered situation versus confessed situation’.
Comparison of Pulmonary Function After Selective Anterior Versus Posterior Fusion for the Correction of Thoracolumbar and Lumbar Adolescent Idiopathic Scoliosis
Authors: Demura Satoru , Watanabe Kota , Suzuki Teppei , Saito Toshiki , Yamamoto Takuya , Kotani Toshiaki , Nohara Ayato , Tsuji Taichi , Ogura Yoji , Tsuchiya Hiroyuki , Uno Koki , Matsumoto Morio , Kawakami Noriaki ,   Japan Spinal Deformity Institute
Published: June 2019

Study Design:

Retrospective multicenter study.

Objectives:

To compare the selective anterior spinal fusion (ASF) versus posterior spinal fusion (PSF) on postoperative pulmonary function testing (PFT) whether thoracotomy with separation of the diaphragm by anterior approach influences the PFT in thoracolumbar and lumbar adolescent idiopathic scoliosis (AIS).

Methods:

A multicenter series of AIS patients who underwent selective spinal fusion were retrospectively reviewed. Seventy-nine female patients were included (mean 15.8 years). There were 35 patients in the ASF group and 44 patients in the PSF group. Patient demographics, radiographic measurements, and PFT data from preoperative to 2-year follow-up were analyzed.

Results:

Preoperatively, there were no significant differences in PFTs between the groups. The ASF group patients were more likely to undergo shorter fusions (4.5 instrumented vertebral levels) than those in the PSF group (5.2 levels). At 2-year follow-up, forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) in ASF group were statistically lower than those in PSF group. When comparing preoperative and 2-year changes on each procedure, only %FVC showed significant difference in ASF while FVC, FEV1, and %FEV1 did not. Meanwhile, the ASF group showed a significant decrease in FVC at 6 and 12 months compared to preoperative values. In PSF group, there was a decrease at 6 months, returned to preoperative value at 1-year follow-up.

Conclusions:

Pulmonary function after ASF and PSF was similar at 2 years; however, anterior group did not return to the baseline at 6 months and 1 year suggesting anterior approach may affect early postoperative pulmonary function.
Multiple Subscapularis Tendon Sign: A New Risk Factor for Recurrence After Arthroscopic Anterior Shoulder Instability Surgery
Authors: Kanatli Ulunay , Özer Mustafa , Gem Mehmet , Öztürk Burak Yağmur , Ataoğlu Muhammet Baybars , Çetinkaya Mehmet , Ayanoğlu Tacettin
Published: June 2019

Background:

Being able to predict recurrence after the treatment of shoulder instability would be helpful in planning the appropriate treatment.

Purpose:

To define the multiple subscapularis tendon sign (MSTS) as a novel anatomic variant and a possible risk factor for the recurrence of shoulder instability after anterior stabilization and to evaluate it, together with the other risk factors as described in the literature.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A total of 87 patients met the study criteria and underwent arthroscopic stabilization for anterior shoulder instability. The MSTS was evaluated in this study group. Age, sex, hand dominance, number of preoperative shoulder dislocations, history of overhead or contact sports participation, type of labral lesion, number of anchors used in surgery, presence of the drive-through sign, presence of the MSTS, Oxford Shoulder Score results, and the association of these parameters with recurrence were assessed. The mean follow-up time was 81.0 ± 27.9 months (range, 48-139 months).

Results:

Nine (10.3%) patients experienced recurrent instability. The presence of the MSTS ( P = .009), existence of an anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion ( P = .04), and history of overhead or contact sports participation ( P = .04) were significant risk factors for recurrence. The recurrence rates were as follows: 30.7% with the MSTS; 40% with the MSTS and an ALPSA lesion; and 75% with the MSTS, an ALPSA lesion, and a history of overhead or contact sports participation.

Conclusion:

The MSTS is a variation of the anterior shoulder joint capsule. It is a sign of capsular insufficiency or thinning, which may be a risk factor for recurrence after anterior stabilization. Considering the low success rates of anterior capsulolabral repair in patients participating in overhead or contact sports, especially when an ALPSA lesion is present, encountering the MSTS during surgery in this at-risk group may be an indicator for the surgeon to choose the surgical procedure more carefully.
Arthroscopic Diagnosis and Treatment of Chronic Hip Pain After Total Hip Arthroplasty and the Role of Anterior Capsule Disruption in Iliopsoas Tendinopathy
Authors: Nazal Mark R. , Parsa Ali , Martin Scott D.
Published: June 2019

Background:

The use of hip arthroscopic surgery in patients suffering from chronic hip pain after total hip arthroplasty (THA) has a limited presence in the literature, with most studies having limited follow-up.

Purpose:

The first goal of this study was to evaluate hip arthroscopic surgery in the diagnosis and management of patients with chronic hip pain after THA. The second goal was to describe a new cause of iliopsoas tendinopathy (IPT) involving disruption of the anterior capsule.

Study Design:

Case series; Level of evidence, 4.

Methods:

We conducted a retrospective analysis with prospectively collected clinical outcomes of patients after THA who underwent hip arthroscopic surgery for chronic hip pain without an identifiable cause. The patients were at least 18 years old and had a minimum follow-up of 24 months.

Results:

The retrospective analysis found that hip arthroscopic surgery led to new diagnostic information in 8 patients (80%). Of the 10 patients diagnosed with IPT, 4 (40%) lacked an anatomic cause; however, these patients had a history of difficult exposure of the anterior capsule and/or a lack of capsular repair during index THA. The mean modified Harris Hip Score (mHHS) was 71.9 ± 15.6, and the mean 6-month postoperative visual analog scale (VAS) pain score was 0.8 ± 2.2, which was significantly lower than preoperatively ( P = .0055). There was also significantly improved forward flexion range of motion ( P = .0183) and straight leg raise (SLR) strength test results ( P = .0263). Hip arthroscopic surgery resulted in 8 patients (80%) continuing to be pain-free at a mean follow-up of 6.8 ± 1.4 years, while 2 patients (20%) progressed to revision arthroplasty. There were no major or minor complications.

Conclusion:

Hip arthroscopic surgery was found to have an important role in the diagnostic and therapeutic management of patients with chronic hip pain after THA, with good clinical outcomes at a mean follow-up of 6.8 years and no complications. We believe that disruption of the anterosuperior acetabular capsule, including the reflected head of the rectus femoris, can allow the iliopsoas tendon to move intra-articularly and precipitate IPT. This disruption may be appreciated on the SLR strength test. Although this study presents a small sample size that cannot substantiate a cause-effect relationship, orthopaedic surgeons performing THA should consider minimizing disruption and/or ensuring repair of the anterior capsule to decrease this potential cause of IPT.
Validating the SEDA Measures of District Educational Opportunities via a Common Assessment
Authors: Kuhfeld Megan , Domina Thurston , Hanselman Paul
Published: June 2019

The Stanford Educational Data Archive (SEDA) is the first data set to allow comparisons of district academic achievement and growth from Grades 3 to 8 across the United States, shining a light on the distribution of educational opportunities. This study describes a convergent validity analysis of the SEDA growth estimates in mathematics and English Language Arts (ELA) by comparing the SEDA estimates against estimates derived from NWEA’s MAP Growth assessments. We find strong precision-adjusted correlations between growth estimates from SEDA and MAP Growth in math (.90) and ELA (.82). We also find that the discrepancy between the growth estimates in ELA is slightly more pronounced in high socioeconomic districts. Our analyses indicate a high degree of congruence between the SEDA estimates and estimates derived from the vertically scaled MAP Growth assessment. However, small systematic discrepancies imply that the SEDA growth estimates are less likely to generalize to estimates obtained through MAP Growth in some states.
General Well-Being in Adult Black Males With Chronic Illness
Authors: Esiaka Darlingtina , Naemi Pegah , Kuofie Araba , Hess Riley
Published: June 2019

As individuals age, they witness a decline in physical health and functional capacities. The presence of one or more chronic illnesses challenges their quality of life and general well-being, thus, impacting their abilities to function physically, psychologically, and socially. We investigated reports of general well-being in older Black males with chronic illness(es) in a study of N = 145 participants, aged 35 to 63, and identified as Black/African American male. Participants responded to items assessing general well-being; ethnic identity; self-esteem; active coping; the presence of chronic illness(es); and additional demographic, social and ecological characteristics. Analyses of responses indicated that marital status (β = –.17, p < .05), ethnic identity (β = –.34, p = .00), self-esteem (β = .22, p = .03) are significant determinants of general well-being in Black males with chronic illness(es). Data further showed active coping ( β = –.41 p = .09) to be negatively correlated with well-being. We discuss the implications of results for the understanding of health outcomes among this marginalized population.
Closing the Gap in Hospice Utilization for the Minority Medicare Population
Authors: Hughes M. Courtney , Vernon Erin
Published: June 2019

Background: Medicare spends about 20% more on the last year of life for Black and Hispanic people than White people. With lower hospice utilization rates, racial/ethnic minorities receive fewer hospice-related benefits such as lesser symptoms, lower costs, and improved quality of life. For-profit hospices have higher dropout rates than nonprofit hospices, yet target racial/ethnic minority communities more through community outreach. This analysis examined the relationship between hospice utilization and for-profit hospice status and conducted an economic analysis of racial/ethnic minority utilization. Method: Cross-sectional analysis of 2014 Centers for Medicare & Medicaid Services (CMS), U.S. Census, and Hospice Analytics data. Measures included Medicare racial/ethnic minority hospice utilization, for-profit hospice status, estimated cost savings, and several demographic and socioeconomic variables. Results: The prevalence of for-profit hospices was associated with significantly increased hospice utilization among racial/ethnic minorities. With savings of about $2,105 per Medicare hospice enrollee, closing the gap between the White and racial/ethnic minority populations would result in nearly $270 million in annual cost savings. Discussion: Significant disparities in hospice use related to hospice for-profit status exist among the racial/ethnic minority Medicare population. CMS and state policymakers should consider lower racial/ethnic minority hospice utilization and foster better community outreach at all hospices to decrease patient costs and improve quality of life.
Prevalence and Incidence of Atrial Fibrillation and Other Arrhythmias in the General Older Population: Findings From the Swedish National Study on Aging and Care
Authors: Lindberg Terese , Wimo Anders , Elmståhl Sölve , Qiu Chengxuan , Bohman Doris M. , Sanmartin Berglund Johan
Published: June 2019

Aim: To study the prevalence and cumulative incidence of arrhythmias in the general population of adults aged 60 and older over a 6-year period. Study Design and Setting: Data were taken from the Swedish National Study on Aging and Care (SNAC), a national, longitudinal, multidisciplinary study of the general elderly population (defined as 60 years of age or older). A 12-lead resting electrocardiography (ECG) was performed at baseline and 6-year follow-up. Results: The baseline prevalence of atrial fibrillation (AF) was 4.9% (95% confidence interval [CI] = [4.5%, 5.5%]), and other arrhythmias including ventricular premature complexes (VPCs), supraventricular tachycardia (SVT), and supraventricular extrasystole (SVES) were seen in 8.4% (7.7%, 9.0%) of the population. A first- or second-degree atrioventricular (AV) block was found in 7.1% of the population (95% CI = [6.5%, 7.7%]), and there were no significant differences between men and women in baseline arrhythmia prevalence. The 6-year cumulative incidence of AF was 4.1% (95% CI = [3.5%, 4.9%]), or 6.9/1,000 person-years (py; 95% CI = [5.7, 8.0]). The incidence of AF, other arrhythmias, AV block, and pacemaker-induced rhythm was significantly higher in men in all cohorts except for the oldest. Conclusion: Our data highlight the prevalence and incidence of arrhythmias, which rapidly increase with advancing age in the general population.
Cellular effects of diquat dibromide exposure: Interference with Wnt signaling and cytoskeletal development
Authors: Jalil Amaris S , Reddy Sneha B , Plautz Carol Zygar
Published: June 2019

The herbicidal action of diquat dibromide (DD) on plant cells is due primarily to the initiation of reactive oxygen species (ROS) formation, lipoperoxidation, and apoptotic cell death. It has been demonstrated that oxidative stress also occurs in animal cells exposed to high concentrations of DD; however, observations of DD’s effects on animal cells at concentrations below the reported ROS-initiation threshold suggest that some of these effects may not be attributable to ROS-induced cell death. Our results suggest that DD causes disruption of the Wnt pathway, calcium dysregulation, and cytoskeletal damage during development. Using embryos of the pond snail Lymnaea palustris as our model organism, we observed increased mortality, developmental delay and abnormality, altered motility, calcium dysregulation, decreased heart rate, and arrhythmia in embryos exposed to DD. Sperm extracted from adult snails that were exposed to DD exhibit altered motility, increased abundance, and high mortality. Effects were quantified via real-time imaging, heart rate assessment, flow cytometry, and mortality scoring. We propose that there are two models for the mechanism of DD’s action in animal cells: at low concentrations (≤28 µg/L), apoptotic cell death does not occur, but cytoskeletal elements, calcium regulation, and Wnt signaling are compromised, causing irreversible damage in L. palustris embryos; such damage is partially remediated with antioxidants or lithium chloride. At high concentrations of DD (≥44.4 µg/L), calcium dysregulation may be triggered, leading to the establishment of an intracellular positive feedback loop of ROS formation in the mitochondria, calcium release from the endoplasmic reticulum, calcium efflux, and apoptotic cell death. Permanent cellular damage occurring from exposure to sublethal concentrations of this widespread herbicide underscores the importance of research that elucidates the mechanism of DD on nontarget organisms.
Altered neural activity in brain cough suppression networks in cigarette smokers
Authors: Ando Ayaka , Mazzone Stuart B. , Farrell Michael J.
Published: June 2019

Cough is important for airway defence, and studies in healthy animals and humans have revealed multiple brain networks intimately involved in the perception of airway irritation, cough induction and cough suppression. Changes in cough sensitivity and/or the ability to suppress cough accompany pulmonary pathologies, suggesting a level of plasticity is possible in these central neural circuits. However, little is known about how persistent inputs from the lung might modify the brain processes regulating cough.

In the present study, we used human functional brain imaging to investigate the central neural responses that accompany an altered cough sensitivity in cigarette smokers.

In nonsmokers, inhalation of the airway irritant capsaicin induced a transient urge-to-cough associated with the activation of a distributed brain network that included sensory, prefrontal and motor cortical regions. Cigarette smokers demonstrated significantly higher thresholds for capsaicin-induced urge-to-cough, consistent with a reduced sensitivity to airway irritation. Intriguingly, this was accompanied by increased activation in brain regions known to be involved in both cough sensory processing (primary sensorimotor cortex) and cough suppression (dorsolateral prefrontal cortex and the midbrain nucleus cuneiformis). Activations in the prefrontal cortex were highest among participants with the least severe smoking behaviour, whereas those in the midbrain correlated with more severe smoking behaviour.

These outcomes suggest that smoking-induced sensitisation of central cough neural circuits is offset by concurrently enhanced central suppression. Furthermore, central suppression mechanisms may evolve with the severity of smoke exposure, changing from initial prefrontal inhibition to more primitive midbrain processes as exposure increases.
In vivoobservations provide insight into roles of eosinophils and epithelial cells in asthma
Authors: Persson Carl
Published: June 2019

Observationsin vivoin patients, supported by guinea-pigin vivodata, take centre stage in this perspective. Its objective is to highlight dichotomies between asthma features observedin vivoand accepted views involving cell/molecular biology research paradigms. For example, increased bronchial epithelial permeability is now considered a major paradigm and trait of asthma, yet, absorption of inhaled tracers has not been increasedin vivoin asthma. Such maintained barrier function in exudative asthma reflectsin vivoasymmetry of the epithelial lining as barrier between outside and inside world of molecules and cells. In desquamatory asthma, maintained epithelial tightness may be explained byin vivodemonstrations of exceedingly patchy epithelial loss, prompt creation of plasma-derived provisional barriers, and high-speed epithelial regeneration. Acknowledged protein/peptide secretion by epithelial cellsin vitrois contrasted here with a dominant, unidirectional movementin vivoof plasma-derived proteins/peptides (including antimicrobial peptides) to the surface of an intact epithelial lining. Furthermore, longstanding claims that epithelium-produced adenosine is a mediator of asthma are eroded by observationsin vivoin asthmatics. Notions concerning activation/fate of mucosal tissue eosinophils illustrate additional distinctions between accepted views andin vivopatient observations. Finally,in vitro-based paradigms preaching defect epithelial regeneration and increased permeability in pathogenesis of asthma are contrasted with experimentalin vivoobservations of exaggerated epithelial regeneration, which is multipathogenic in its own right. In conclusion, unexpected and challengingin vivoobservations in recent decades underpin novel insights into mucosal mechanisms in asthma.
The microbiology of pleural infection in adults: a systematic review
Authors: Hassan Maged , Cargill Tamsin , Harriss Elinor , Asciak Rachelle , Mercer Rachel M. , Bedawi Eihab O. , McCracken David J. , Psallidas Ioannis , Corcoran John P. , Rahman Najib M.
Published: June 2019

Background and objectives

Pleural infection is a major cause of morbidity and mortality among adults. Identification of the offending organism is key to appropriate antimicrobial therapy. It is not known whether the microbiological pattern of pleural infection is variable temporally or geographically. This systematic review aimed to investigate available literature to understand the worldwide pattern of microbiology and the factors that might affect such pattern.

Data sources and eligibility criteria

Ovid MEDLINE and Embase were searched between 2000 and 2018 for publications that reported on the microbiology of pleural infection in adults. Both observational and interventional studies were included. Studies were excluded if the main focus of the report was paediatric population, tuberculous empyema or post-operative empyema.

Study appraisal and synthesis methods

Studies of ≥20 patients with clear reporting of microbial isolates were included. The numbers of isolates of each specific organism/group were collated from the included studies. Besides the overall presentation of data, subgroup analyses by geographical distribution, infection setting (communityversushospital) and time of the report were performed.

Results

From 20 980 reports returned by the initial search, 75 articles reporting on 10 241 patients were included in the data synthesis. The most common organism reported worldwide wasStaphylococcus aureus. Geographically, pneumococci and viridans streptococci were the most commonly reported isolates from tropical and temperate regions, respectively. The microbiological pattern was considerably different between community- and hospital-acquired infections, where more Gram-negative and drug-resistant isolates were reported in the hospital-acquired infections. The main limitations of this systematic review were the heterogeneity in the method of reporting of certain bacteria and the predominance of reports from Europe and South East Asia.

Conclusions

In pleural infection, the geographical location and the setting of infection have considerable bearing on the expected causative organisms. This should be reflected in the choice of empirical antimicrobial treatment.
How Providing Cervical Cancer Screening Results via Cell Phone Affects Patient Follow-Up Rates in Western Kenya
Authors: Huchko Megan J. , Saduma Ibrahim , Blat Cinthia , Oketch Sandra , Bukusi Elizabeth A.
Published: June 2019

Purpose

Human papillomavirus (HPV) testing is being more widely used in simplified cervical cancer screening protocols in low-resource settings. One challenge to successful implementation is the multiple visits necessary to provide results and follow-up. mHealth strategies may reduce visit burden by providing information through text message.

Methods

As part of a cluster-randomized trial to compare HPV testing in clinics and community health campaigns in western Kenya, we carried out a mixed-methods study to assess women’s preferences and experiences with different strategies to receive their results. Women could opt to receive their HPV results via text message, cell phone call, home visit, or return clinic visit. We examined overall receipt of results, follow-up rates, and acceptability by notification method.

Results

Among the 4,947 women who underwent HPV-based cervical cancer screening, 1,596 (32%) received results via text message, 1,181 (24%) via cell phone call, 1,563 (32%) via clinic visit, and 605 (12%) via home visit. Women opting for texts or calls were younger and had higher rates of prior cervical cancer screening, HIV testing, and modern contraceptive use ( P < .001 for all). Home visits were associated with a significantly higher rate of treatment acquisition (45%) than texts (38%), cell phone calls (38%), and clinic visits (23%; P < .001). In a model controlling for age, prior screening, HIV testing, and contraceptive use, clinic visits remained significantly associated with decreased odds of treatment (adjusted odds ratio, 0.45; 95% CI, 0.29 to 0.69) compared with texts. Among treated women, there was no difference in time to treatment by notification method.

Conclusion

Cell phone–based results notification strategies were preferred by women with greater health-seeking behavior; however, HPV-positive women who received results via home visit were more likely to pursue for treatment.
Association of Inpatient Glucose Measurements With Amputations in Patients Hospitalized With Acute Diabetic Foot
Authors: Peled Shahar , Pollack Rena , Elishoov Ofer , Haze Amir , Cahn Avivit
Published: June 2019

Context

The association of inpatient glucose measurements with amputations in patients admitted with acute diabetic foot has not been described.

Objective

To evaluate the relationship of hyperglycemia, hypoglycemia, and glucose variability during hospitalization with amputations in patients hospitalized with acute diabetic foot.

Design

Retrospective cohort study.

Setting

Academic tertiary hospital.

Patients

We reviewed demographic, clinical, laboratory, and point-of-care glucose data in patients hospitalized with acute diabetic foot in the Diabetic Foot Unit during 2015 through 2017.

Main Outcome Measures

The primary outcomes were any or major amputations during hospitalization. Secondary outcomes included length of hospitalization and in-hospital mortality.

Results

During the study period, 418 patients were hospitalized in the Diabetic Foot Unit and 45,496 glucose measurements were taken. Patients experiencing any hyperglycemia and any or severe hypoglycemia were more likely to undergo any or major amputations during hospitalization. High glycemic variability was associated with major amputations. Peripheral vascular disease (PVD), high Wagner score, and hypoglycemia were independent predictors of amputations. Older age, PVD, previous amputation, elevated white blood cell level, high Wagner score, and hypoglycemia were independent predictors of major amputations.

Conclusions

In-patient hypoglycemia emerged as an independent risk factor for any and major amputations. Although it is unclear whether hypoglycemia directly contributes to adverse outcomes or is simply a biomarker of disease severity, efforts to minimize in-hospital hypoglycemic events are warranted.
Medium- and Long-Term Educational Consequences of Alternative Conditional Cash Transfer Designs: Experimental Evidence from Colombia
Authors: Barrera-Osorio Felipe , Linden Leigh L. , Saavedra Juan E.
Published: June 2019

In 2005 the city of Bogota, Colombia, introduced three conditional cash transfer programs for secondary schooling, randomly assigning socioeconomically disadvantaged students to different payment structures. We show, through administrative data, that forcing families to save one-third of the transfer increases long-term human capital accumulation by means of additional tertiary education—which is not incentivized—, casting doubt on conditionalities as a driving mechanism. Directly incentivizing on-time tertiary enrollment does no better than forcing families to save a portion of the transfer. Whereas forcing families to save increases enrollment in four-year universities, incentivizing tertiary enrollment only increases enrollment in low-quality colleges. (JEL D14, H75, I21, I22, I26, J24, O15)
Do Women Give Up Competing More Easily? Evidence from the Lab and the Dutch Math Olympiad
Authors: Buser Thomas , Yuan Huaiping
Published: June 2019

We use lab experiments and field data from the Dutch Math Olympiad to show that women are more likely than men to stop competing if they lose. In a math competition in the lab, women are much less likely than men to choose competition again after losing in the first round. In the Math Olympiad, girls, but not boys, who fail to make the second round are less likely to compete again one year later. This gender difference in the reaction to competition outcomes may help to explain why fewer women make it to the top in business and academia. (JEL C90, D82, D91, J16)
Assessment rate of true dorsogluteal intramuscular drug injection using ultrasonography
Authors: Ozen Ozkan , Gunaydın Mucahit , Tosun Alptekin , Coskun Zafer Unsal , Aytekin Kursad , Takir Selcuk
Published: June 2019

Objective: Medications are generally administered by either the enteric or parenteral route. With parenteral administration, intramuscular (IM) is the preferred approach because it increases the bioavailability of the drug, acts more quickly than the enteric route. The aim of this study was to determine the rate of true dorsogluteal intramuscular drug injection and to determine the causes for application failures in practice by ultrasonography (US).

Methods: The study was conducted from May 1 to May 30, 2017 in Giresun University Education and Research Hospital, Giresun, Turkey. We examined 60 patients who were administered dorsogluteal IM injection with a 38.1mm length needle. After the injection, localization of medications (whether intramuscular or subcutaneous adipose tissue [SAT]) was evaluated by Ultrasound.

Results: Female/male ratio of the patients was 27/33, with a mean age of 39.78±2.16 years. Obese/normal weight ratio was 20/40. The mean dorsogluteal area SAT thickness of obese and normal weight patients were 32.34±2.17 mm and 20.85±1.20 mm, respectively. In 23 of the patients, IM injected drug was observed in the SAT, while it was observed in the IM area in 37 patients. Medication was observed in IM area in 37 of 50 patients who dorsogluteal region SAT thickness was appropriate (SAT thickness lower than 33.1mm) for IM injection while it was seen in SAT area in 13 patients.

Conclusions: SAT thickness values are important if IM drug injection is to be administered correctly. Unsuccessful IM injections may be seen even in patients with appropriate SAT thicknesses.

doi: https://doi.org/10.12669/pjms.35.4.313

How to cite this:Ozen O, Gunaydin M, Tosun A, Coskun ZU, Aytekin K, Takir S. Assessment rate of true dorsogluteal intramuscular drug injection using ultrasonography. Pak J Med Sci. 2019;35(4):1132-1137. doi: https://doi.org/10.12669/pjms.35.4.313

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Impaired renal functions in Pakistani cohort of rheumatoid arthritis
Authors: Wagan Dr Abrar Ahmed , Nasir Dr Sadia , Rahim Dr Abdul , Khan Dr Daim
Published: June 2019

Objective: To determine the frequency of impaired renal functions and hypertension in rheumatoid arthritis.

Methods: This study was conducted between May 1st 2018 to February 1st 2019 at Rheumatology Division, Department of Medicine Central Park Medical College Lahore, total 260 study participants were selected, demographic detail were asked in detail, disease duration of RA and hypertension, DMARD’s, self-use NSAID’s,/hakeem medications, smoking were asked in detail, BMI and blood pressure were measured,5 ml of blood was taken by trained phlebotomist, and sent for the estimation of serum urea and creatinine on (COBAS-III) machine, after availability of results each individuals eGFR (creatinine clearance) was calculated by Cockroft Gualt (CG) and Modification in diet in renal disease method (MDRD).

Results: In this study the mean age of study participants was 42.4 (± 9.5) years with disease duration of 7.7(±4.8) years, prevalence of Impaired renal functions of 14.6% (n=38) and hypertension in 53.5% (n=139).Regression analysis shows there is significant association between hypertension, smoking and self/hakeem medications with impaired renal functions (p-0.5). Kappa analysis shows both (MDRD & CG methods) had uniformity in picking up cases of impaired renal functions 75.6% (p-0.05).

Conclusion: In RA decline in renal functions is seen with self-use NSAID’s/hakeem medications along with other modifiable factors like smoking and hypertension, while conventional DMARD’s don’t show association with decline. There is very high prevalence of hypertension in rheumatoid arthritis.

doi: https://doi.org/10.12669/pjms.35.4.564

How to cite this:Wagan AA, Nasir S, Rahim A, Khan D. Impaired renal functions in Pakistani cohort of rheumatoid arthritis. Pak J Med Sci. 2019;35(4):905-910. doi: https://doi.org/10.12669/pjms.35.4.564

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Some features of professional law enforcement communications
Authors: Хаврак Александр , Khavrak Aleksandr , Николаева (Зайцева) Наталья , Nicolaeva (Zaytseva) Natalya
Published: June 2019

The article describes the main specific features of the organizational component of the processes of communication and communication in the field of law enforcement agencies, due to their specific activity. The concepts of communication and communication are compared in a semantic context, an analysis has been made and in a functional informational and communicative aspect in relation to the activities of specialists of various police departments, whose activities significantly differ not only in subject-object structure, but also in functional, subordinate and other differences. In connection with the diverse specificities of various aspects of the communicative process of law enforcement officers, the authors used general scientific (general logical) methods: analysis, synthesis, comparison, description, studied in scientific literature and generalized communication models of subjects of communication, the formation of personal and professional potential in various professional environments law enforcement practices, indicating which models in which professional environments will produce the most effective result. Knowledge of these features of building communicative interaction will generally improve the communicative culture of law enforcement officers.
Philosophy for lawyers
Authors: Канке Виктор , Kankye Viktor
Published: June 2019

Questions of philosophy of science and history of philosophy, ontology, epistemology, ethics and aesthetics are stated. The course is based on the achievements of analytical philosophy, critical rationalism, phenomenology, hermeneutics, structuralism.
Special attention is paid to the connection between philosophy and law. The textbook includes questions and tasks, tests, references, recommendations to students.
For students of higher education, especially future lawyers, as well as for a wide range of readers.
NOTAS SOBRE O CONCEITO DE GATTUNGSWESEN EM MARX
Authors: Dos Santos Vinícius
Published: June 2019

O objetivo deste artigo, em primeiro lugar, é demarcar o uso que Marx faz da noção de ser genérico (Gattungswesen) enquanto um conceito filosófico expressivo de sua visão materialista de mundo. Trata-se, com efeito, de apontar paro o fato de que a referida noção permite apreender alguns aspectos primordiais da compreensão marxiana acerca da sociabilidade vigente sob a égide do capital, cujo eixo se encontra no fenômeno do trabalho alienado ou estranhado (entfremdete Arbeit). Segundo Marx, o estranhamento cinde o indivíduo entre uma abstrata “força de trabalho” e seu ser concreto, criando uma relação de apartamento do indivíduo em relação: 1) à natureza, seu meio sensível; 2) a seu próprio corpo, reificado em favor do capital; e 3) aos outros indivíduos, esvaziando a dimensão social da existência; logo, a possibilidade de construção de seu respectivo sentido. Se isto é verdade, como se tentará apontar ao final, os novos mecanismos de produção e captura das subjetividades no capitalismo contemporâneo, neoliberal, em face de um indivíduo vivendo em um estado de crescente desamparo e dilaceramento, viriam reforçar os apontamentos de Marx.
FASCISMO DE ESTADO E MICROFASCISMO
Authors: Rocha Jorge Alberto Da Costa , Sales Deivisson Warlla Miranda
Published: June 2019

No século XX iríamos assistir ao advento de uma terceira alternativa política entre o capitalismo e o marxismo: o fascismo. Mussolini buscará soerguer a Itália em meio a crises profundas, ao mesmo tempo mostrando a viabilidade teórica da sua posição, denunciando as falhas dos sistemas anteriores. Mas só poderíamos ficar restritos a uma abordagem política do termo “Fascismo”? Por um lado, esse artigo tentará mostrar um pouco o nascimento histórico deste movimento político, concentrando-se nos fundamentos teóricos da sua proposta através do entendimento do próprio Mussolini. Por outro, buscamos mostrar que houve uma apropriação filosófica interessante do termo “Fascismo”, alargando o seu conceito através das perspectivas de Deleuze e Guattari. Esses autores vão trabalhar com o conceito de microfascismo, não mais tomando o Estado como foco principal, mas os sujeitos e a constituição de sua subjetividade.
The (music) educator as producer
Authors: King Andrew
Published: June 2019

Music technology has been an active part of the Higher Education (HE) curricula for several decades but it is perhaps the last few decades that have witnessed the proliferation of courses at tertiary level, or at least certainly in the United Kingdom. The recently formed Office for Students (OfS) in the United Kingdom replaces HEFCE (Higher Education Funding Council for England) although the remit is somewhat different for this new entity. The OfS is very much a regulator working on behalf of the consumers (students) and not the universities; education is probably the last of the sectors in the United Kingdom to fall into line with this practice since utility and other companies which have had such regulation for years. This brings into sharp focus the view of education as a service industry and the position of education more generally in HE in the United Kingdom. This takes place in the suggested context of a falling number of students engaging with music at schools, sixth form, and further education colleges as a consequence of changes to government policy and the content of the curricula. This article begins by examining music in education and highlighting the current issues. It draws upon recent reports about music in schools before examining the value of music, and especially music technology, in the curriculum. Questions around employability are set out and some key findings from a phenomenological study are presented to educators. Finally, some signposts are set out for future work in this area.
The discipline that ‘became’: Developments in Music Technology in British higher education between 2007 and 2018
Authors: Boehm Carola , Hepworth-Sawyer Russ , Hughes Nick , Ziemba Dawid
Published: June 2019

In 2007 Carola Boehm published the introductory article within the first volume of the Journal of Music, Technology and Education entitled ‘The discipline that never was: Current developments in Music Technology in higher education in Britain’. Boehm identified the higher education (HE) offerings in Music Technology at that time. In the ten or so years that have passed since those findings, we have witnessed both incredible growth in the HE sector and significant shift in the flavour of programmes on offer. This shift has been seen primarily in the growth of the creative practice-led title of ‘Music Production’, but not at the expense of traditional ‘Music Technology’. Boehm’s paper also explored the wider range of subject matters that could be considered within the then term ‘Music Technology’, whether by an ever-expanding technological backdrop, or through interdisciplinarity. In this article, we report on the significant changes since then, with some analysis for the future whilst considering the current political challenges for British HE.
Estructuras en el Tiempo. La ruina en la obra de Aires Mateus
Authors: Blázquez Jesús Pablo
Published: June 2019

El recorrido trazado a lo largo de este artículo se inicia en la célebre intervención de Manuel y Francisco Aires Mateus de Alenquer realizada en el año 1998 para comprobar que, después de veinte años de obras y proyectos, es posible vislumbrar una transferencia conceptual en torno a la idea del tiempo y la ruina que podrían estar apuntando hacia un asentamiento de ciertas estrategias ligadas al proyecto arquitectónico. Desde esta perspectiva podríamos observar algunas de sus construcciones como estructuras expuestas deliberadamente a recibir las huellas, inscripciones e incluso destrucciones acaecidas por el paso del tiempo.
Yahudi Dualarında Kudüs
Authors: Özcan Şevket
Published: June 2019

Yahudilik, özellikle Kral Davut
döneminden itibaren Kudüs ile kimlik bulan, yaşanılabilen ve özdeşleştirilen
bir dindir. Yahudilere göre Kudüs’te Davut ve oğlu Süleyman zamanında yaşanılan
dini ve siyasi hayat, belleklerinde unutulmaması ve yeniden yaşanılması gereken
bir idealdir. Yahudilerin dinî hayatının vazgeçilmez bir parçası olan ve
özellikle II. Mabed’in yıkılmasıyla dinin odağına yerleşen dualar, Kudüs’ün
onlar için ifade ettiği anlamı açık bir şekilde ortaya koymakta ve Yahudi inanç
tarihinin birer özeti olarak kabul edilmektedir. Düzenli olarak, bayramlarda ve
geçiş dönemleri ve bazı özel durumlarda yapılan Yahudi dualarında Kudüs’e
yönelik vurgular, Tanrı’nın yüceltilerek kendisinden barışın ve kurtuluşun
istenildiği, kurtuluşun Mesih’in gelişi, Mabed’in inşası ve Kudüs’e barışın
hâkim olmasıyla gerçekleşeceğine işaret eden bir görünüm arz etmektedir. Bu
bağlamda Amida duası, Mesih’in gelişi, Yahudilerin Kudüs’te toplanması ve
adaletin sağlanması neticesinde kurtuluşun gerçekleşmesine yönelik vurguları
nedeniyle Kudüs vatandaşlığının yani Yahudi olmanın bir simgesi olarak kabul
edilmektedir. Dolayısıyla Yahudilerin belleğinde Kudüs unutulmaması gereken
olarak tezahür etmekte ve dillerinde “Kudüs’ü yeniden inşa et” şeklinde yer
alan bir “Yahudi Ümidi” olarak her zaman önemini ve değerini korumaktadır. Bu çalışmada
çeşitli zamanlarda ve şekillerde yapılan Yahudi dualarına odaklanmak suretiyle,
Kudüs’ün Yahudi dualarında ne şekilde yer aldığı ve onlar için ne anlam ifade
ettiği fenomenolojik yöntem aracılığıyla anlaşılmaya ve ortaya konulmaya gayret
edilmektedir.
Kader İnancının Savunma Mekanizması ve Dini Başa Çıkma Kavramları Açısından Değerlendirilmesi
Authors: AYDIN Cüneyd
Published: June 2019

ÖzModern psikoloji ile din psikolojisinin önemli kavramlarından olan savunma mekanizmaları ve (dini) başa çıkma ile dini inanç ve pratikler arasındaki ilişkilere yönelik teorik ve ilişkisel çalışmalar artarak devam etmektedir. Ancak dini inanç ve uygulamaların inanan bireyler nezdinde bir tür savunma mekanizması mı yoksa (dini) başa çıkma stratejisi mi olduğunun tespit edilmesi gerekmektedir. Çünkü dini inançlar söz konusu olduğunda adı geçen kavramların tanımları ve kapsamları dikkate alınmaksızın, bazı işlevsel benzerlikleri dolayısıyla, birbirlerinin yerine kullanılmalarının din psikolojisi bilimi çerçevesinde uygun olup olmayacağının belirlenmesinin olası bir kavram kargaşasının önlenmesi ve bu konularda yapılan çalışmaların doğru yönde ilerlemesi için önem arz ettiği düşünülmektedir. Bu makalede, İslam dininin önemli inanç esaslarından sayılan kader inancının bireyler tarafından ne şekilde kullanıldığında savunma mekanizması hangi şekilde ise dini başa çıkma yolu olduğu yapılan çalışmalar ışığında değerlendirilmeye çalışılmıştır. Yapılan değerlendirmelerin sonucunda, kader inancının aslına uygun anlaşılmadığında bir tür savunma mekanizması ve duygu odaklı başa çıkma stratejisi; doğru bir kader inancı geliştirilmesi halinde ise, problem çözmeye dayalı başa çıkma stratejisi ile işbirliğine dayalı ve kendi kendine yeten dini başa çıkma yolu olarak kullanıldığı tespit edilmiştir.
Evaluation Criteria and Approach to Voyage Planning in Ice. Verification on the Example of German Ship Activity During the Second World War
Authors: Pastusiak Tadeusz
Published: June 2019

Vessels designed for navigation in ice can perform voyage with the assistance of icebreaker in the navigation season in case an ice cover area is less than 20%. Whereas the same vessels could carry out successfully completed voyage through the NSR with intensive icebreaker help at the ice-covered area lower than 42%. Navigation of the same vessel at ice covered area above 80% is possible with intensive icebreaker help, but it threatens to damage the hull, rudder or propeller.

Excessive generalization of data analyzed may cause to wrong, even opposite conclusions. Using only basic statistical information in the form of average values and standard deviation may be not sufficient for the purpose of vessel’s voyage planning in areas covered with ice. Much more opportunities for the assessment of navigation in ice covered regions provides cumulative distribution, which should be related to the time and geographical space distribution. It allows to determine the duration of time window for given area covered with ice in a particular region and predetermined probability of its occurrence. It is thus possible to plan approximate date of departure and duration of voyage for assumed safety criteria. Also, it is possible to plan a number of consecutive voyages in a navigation season.

Mathematical approach to voyage planning in ice based on a cumulative distribution is presented in the paper. It allows creation of an advisory computer application to support decision-making by the commander of a vessel. It will reduce the human factor in data processing and reduce possibility of making a mistake. By this way, can be enhanced the safety of maritime transport. Novell approach is verified on the example of historical data about the German Navy ship activity during the Second World War.
The Risk of Collision Assessment with Graphic Forms of Target Data Presentation Use
Authors: Juszkiewicz Wiesław
Published: June 2019

Guarantee of the ship safety is the primary task posed for modern navigation systems. This concerns monitoring the proper ship position as well as providing accurate information about the collision threat. The proper interpretation of this information belongs to the navigator. He must take into account many variables affecting the assessment of the situation and then make the right decision regarding anti-collision manoeuvres. This assessment could be made easier for him with use some form of graphic target data presentation methods other than currently required and described in IMO performance standards. Other possible graphic presentation methods of collision information are described in the article along with the concept of their usage.
Determination of the Risk of Location the Quay for Large Steel Components Handling in Vicinity of the Fairway Using the Fast-Time Simulation Method
Authors: Marcjan Krzysztof , Gucma Lucjan
Published: June 2019

The paper presents the use of the Fast-Time navigational simulator to verify the location of designed elements of navigational infrastructure in vicinity of a high traffic fairway. The aim of the study is to perform the analysis of navigational safety in vicinity of newly constructed quay placed to the east of the island Ostrow Brdowski. The Quay is intended handling of large steel structures. The Fast-Time simulation is performed to evaluate the safety of the navigation passage through the fairway along the quay for the future use of vessels which length may exceed 260 m. This kind of simulation method has been implemented to make a statistical analysis based on a large amount of data, the collection of which would be very expensive and time consuming using a Real-Time simulator.