bluuebunny/crossref_metadata_2025 huggingface dataset:
Political struggles for a universal health system in Brazil: successes and limits in the reduction of inequalities
Authors: Machado Cristiani Vieira , Silva Gulnar Azevedo e
Published: November 2019

Background

Brazil is a populous high/middle-income country, characterized by deep economic and social inequalities. Like most other Latin American nations, Brazil constructed a health system that included, on the one hand, public health programs and, on the other, social insurance healthcare for those working in the formal sector. This study analyzes the political struggles surrounding the implementation of a universal health system from the mid-1980s to the present, and their effects on selected health indicators, focusing on the relevant international and national contexts, political agendas, government orientations and actors.

Main text

In the 1980s, against the backdrop of economic crisis and democratization, Brazil’s health reform movement proposed a Unified Health System (SUS), which was incorporated into the 1988 Constitution. The combination of a democratic system with opportunities for interaction between various developmental and social agendas and actors has played a key role in shaping health policy since then. However, the expansion of public services has been hampered by insufficient public funding and by the strengthening of the private sector, subsidized by the state. Private enterprises have expanded their markets and political influence, in a process that has accelerated in recent years. Despite these obstacles, SUS has produced significant health-status improvements and some (although incomplete) reductions in Brazil’s vast health inequalities.

Conclusions

We find that a combination of long-term structural and contingent factors, international agendas and interests, as well as domestic political struggles, explains the advances and obstacles to building a universal system in an economically important yet unequal peripheral country. Further consolidation of SUS and reduction of health inequalities hinge on the uncertain prospects for democracy and national development, on enlarging the political coalition to support a public and universal health system, and on strengthening the state’s ability to regulate the private sector.
A clinical series of packing the wound tract for arresting traumatic hemorrhage from injuries of the lung parenchyma as a feasible damage control technique
Authors: Garcia Alberto F. , Manzano-Nunez Ramiro , Bayona Juan Gabriel , Millan Mauricio , Puyana Juan C.
Published: November 2019

Background

Tractotomy has become the standard of care for transfixing through-and-through lung injuries as it can be performed quickly with little blood loss and a low risk of complications. However, packing with laparotomy pads could be a feasible alternative to tractotomy on selected patients. We describe a series of four patients with lung trauma in which packing of the pulmonary wound tract was used as the primary and unique surgical strategy for arresting hemorrhage from injuries of the lung parenchyma.

Methods

Packing of the traumatic tract is achieved by gently pulling a laparotomy pad with a Rochester clamp and adjusting it to the cavity to stop the bleeding. The pack is removed in a subsequent surgery by moistening and tractioning it softly to avoid additional damage. The operation is completed by manual compression of the wounded lobe. We present a case series of our experience with this approach.

Results

From 2012 to 2016, we treated four patients with the described method. The mechanism was penetrating in all them. The clinical condition was of exsanguinations with multiple sources of hemorrhage. There were three patients with peripheral injuries to the lung and one with a central injury to the pulmonary parenchyma. Bleeding was stopped in all the cases. Three patients survived. A patient had recurrent pneumothorax which was resolved with a second chest tube.

Conclusion

Packing of the traumatic tract allowed rapid and safe treatment of transfixing through-and-through pulmonary wounds in exsanguinating patients under damage control from several bleeding sources.
Autologous stem cell-derived chondrocyte implantation with bio-targeted microspheres for the treatment of osteochondral defects
Authors: Bozkurt Murat , Aşık Mehmet Doğan , Gürsoy Safa , Türk Mustafa , Karahan Siyami , Gümüşkaya Berrak , Akkaya Mustafa , Şimşek Mehmet Emin , Cay Nurdan , Doğan Metin
Published: November 2019

Background

Chondral injury is a common problem around the world. Currently, there are several treatment strategies for these types of injuries. The possible complications and problems associated with conventional techniques lead us to investigate a minimally invasive and biotechnological alternative treatment. Combining tissue-engineering and microencapsulation technologies provide new direction for the development of biotechnological solutions. The aim of this study is to develop a minimal invasive tissue-engineering approach, using bio-targeted microspheres including autologous cells, for the treatment of the cartilage lesions.

Method

In this study, a total of 28 sheeps of Akkaraman breed were randomly assigned to one of the following groups: control (group 1), microfracture (group 2), scaffold (group 3), and microsphere (group 4). Microspheres and scaffold group animals underwent adipose tissue collection prior to the treatment surgery. Mesenchymal cells collected from adipose tissue were differentiated into chondrocytes and encapsulated with scaffolds and microspheres. Osteochondral damage was conducted in the right knee joint of the sheep to create an animal model and all animals treated according to study groups.

Results

Both macroscopic and radiologic examination showed that groups 3 and 4 have resulted better compared to the control and microfracture groups. Moreover, histologic assessments indicate hyaline-like cartilage formations in groups 3 and 4.

Conclusion

In conclusion, we believe that the bio-targeted microspheres can be a more effective, easier, and safer approach for cartilage tissue engineering compared to previous alternatives.
Comparative analysis of the complete chloroplast genome sequences of six species of Pulsatilla Miller, Ranunculaceae
Authors: Zhang Tingting , Xing Yanping , Xu Liang , Bao Guihua , Zhan Zhilai , Yang Yanyun , Wang Jiahao , Li Shengnan , Zhang Dachuan , Kang Tingguo
Published: November 2019

Background

Baitouweng is a traditional Chinese medicine with a long history of different applications. Although referred to as a single medicine, Baitouweng is actually comprised of many closely related species. It is therefore critically important to identify the different species that are utilized in these medicinal applications. Knowledge about their phylogenetic relationships can be derived from their chloroplast genomes and may provide additional insights into development of molecular markers.

Methods

Genomic DNA was extracted from six species of Pulsatilla and then sequenced on an Illumina HiSeq 4000. Sequences were assembled into contigs by SOAPdenovo 2.04, aligned to the reference genome using BLAST, and then manually corrected. Genome annotation was performed by the online DOGMA tool. General characteristics of the cp genomes of the six species were analyzed and compared with closely related species. Additionally, phylogenetic trees were constructed, based on single nucleotide polymorphisms (SNPs) and 51 shared protein-coding gene sequences in the cp genome among all 31 species via maximum likelihood.

Results

The size of cp genomes of P. chinensis (Bge.) Regel, P. chinensis (Bge.) Regel var. kissii (Mandl) S. H. Li et Y. H. Huang, P. cernua (Thunb.) Bercht. et Opiz f. plumbea J. X. Ji et Y. T. zhao, P. dahurica (Fisch.) Spreng, P. turczaninovii Kryl. et Serg, and P. cernua (Thunb.) Bercht. et Opiz. were 163,851 bp, 163,756 bp, 162,481 bp, 162,450 bp, 162,795 bp, and 162,924 bp, respectively. Each species included two inverted repeat regions, a small single-copy region, and a large single-copy region. A total of 134 genes were annotated, including 90 protein-coding genes, 36 tRNAs, and eight rRNAs across all species. In simple sequence repeat analysis, only P. dahurica was found to contain hexanucleotide repeats. A total of 26, 39, 32, 37, 32 and 43 large repeat sequences were identified in the genic regions of the six Pulsatilla species. Nucleotide diversity analysis revealed that the rpl36 gene and ccsA-ndhD region have the highest Pi value. In addition, two phylogenetic trees of the cp genomes were constructed, which laced all Pulsatilla species into one branch within Ranunculaceae.

Conclusions

We identified and analyzed the cp genome features of six species of P. Miller, with implications for species identification and phylogenetic analysis.
Poor prognostic factors in patients with newly diagnosed intestinal Adamantiades-Behçet’s disease in the Shanghai Adamantiades-Behçet’s disease database: a prospective cohort study
Authors: Zhang Liang , Tian Yun , Ye Jing-Fen , Lin Chen-Hong , Guan Jian-Long
Published: November 2019

Background

Adamantiades-Behçet’s Disease (ABD) is an immunological recurrent systemic vasculitis with a chronic course. We investigated the predictors of long-term flare-ups, poor outcomes and event-free survival in Chinese non-surgical patients with intestinal ABD.

Methods

This was a prospective cohort study of 109 intestinal ABD patients seen in our institution between October 2012 and January 2019 who met the international criteria for ABD and had intestinal ulcers confirmed on colonoscopy. Predictors of relapses and poor outcomes, event-free survival were calculated using logistic regression models and Cox proportional hazard regression models, respectively.

Results

Sixty-six intestinal ABD patients (60.55%) had ileocecal ulcers; 19 patients (17.43%) presented with colorectum ulcers; 24 patients (22.02%) showed both ileocecal and colorectum ulcers. 7 patients (6.42%) experienced at least 1 flare-up of intestinal ulcers. 38 patients (34.86%) complained of non-healing intestinal ulcers. In multivariate analysis, location of intestinal ulcers (ileocecal and colorectum) (odd ratio (OR) 7.498 [95% confidence interval [95% CI] 1.844–30.480]), erythrocyte sedimentation rate (ESR) > 24 mm/h (OR 5.966 [95% CI 1.734–20.528]), treatment with infliximab (IFX) (OR 0.130 [95% CI 0.024–0.715]), and poor compliance (OR 11.730 [95% CI 2.341–58.781]) were independently correlated with a poor outcome. After a median follow-up of 28 months, 45 intestinal ABD patients (41.28%) underwent adverse events. Factors independently associated with shorter event-free survival were early onset of ABD (< 7 years) (hazard ratio (HR) 2.431 [95% CI 1.240–4.764]) and poor compliance (HR 3.058 [95% CI 1.612–5.800]).

Conclusion

Distribution of intestinal ulcers (ileocecal and colorectum), ESR > 24 mm/h, treatment without IFX, and poor compliance were independent risk factors for poor outcomes in non-surgical intestinal ABD patients.
Hemodynamic response to familiar faces in children with ADHD
Authors: Shimamura Keiichi , Inoue Takeshi , Ichikawa Hiroko , Nakato Emi , Sakuta Yuiko , Kanazawa So , Yamaguchi Masami K. , Kakigi Ryusuke , Sakuta Ryoichi
Published: November 2019

Background

School-age children with attention deficit hyperactivity disorder (ADHD) have difficulties in interpersonal relationships, in addition to impaired facial expression perception and recognition. For successful social interactions, the ability to discriminate between familiar and unfamiliar faces is critical. However, there are no published reports on the recognition of familiar and unfamiliar faces by children with ADHD.

Methods

We evaluated the neural correlates of familiar and unfamiliar facial recognition in children with ADHD compared to typically developing (TD) children. We used functional near-infrared spectroscopy (fNIRS) to measure hemodynamic responses on the bilateral temporal regions while participants looked at photographs of familiar and unfamiliar faces. Nine boys with ADHD and 14 age-matched TD boys participated in the study. fNIRS data were Z-scored prior to analysis.

Results

During familiar face processing, TD children only showed significant activity in the late phase, while ADHD children showed significant activity in both the early and late phases. Additionally, the boys with ADHD did not show right hemispheric lateralization to familiar faces.

Conclusions

This study is the first to assess brain activity during familiar face processing in boys with ADHD using fNIRS. These findings of atypical patterns of brain activity in boys with ADHD may be related to social cognitive impairments from ADHD.
Measuring children’s emotional and behavioural problems: are SDQ parent reports from native and immigrant parents comparable?
Authors: Runge Ronja A. , Soellner Renate
Published: November 2019

Background

The number of immigrants worldwide is growing and migration might be a risk factor for the mental health of children. A reliable instrument is needed to measure immigrants' childrens mental health. The aim of the study was to test the measurement invariance of the parent version of the Strengths and Difficulties Questionnaire (SDQ) between German native, Turkish origin and Russian origin immigrant parents in Germany. The SDQ is one of the most frequently used screening instruments for mental health disorders in children.

Methods

Differential Item Functioning (DIF) was tested in samples matched by socio-economic status, age and gender of the child. A logistic regression/item response theory hybrid method and a multiple indicators- multiple causes model (MIMIC) was used to test for DIF. Multi Group Confirmatory Factor analysis (MGCFA) was used to test for configural invariance. Parent reports of 10610 German native, 534 Russian origin and 668 Turkish origin parents of children aged 3–17 years were analysed.

Results

DIF items were found in both groups and with both methods. We did not find an adequate fit of the original five factor model of the SDQ for the Turkish origin group, but for the Russian origin group. An analysis of functional equivalence indicated that the SDQ is equally useful for the screening of mental health disorders in all three groups.

Conclusion

Using the SDQ in order to compare the parent reports of native and immigrant parents should be done cautiously. Thus, the use of the SDQ in epidemiological studies and for prevention planning is questionable. However, the SDQ turns out to be a valid instrument for screening purposes in parents of native and immigrant children.
CRIMoClo plasmids for modular assembly and orthogonal chromosomal integration of synthetic circuits in Escherichia coli
Authors: Vecchione Stefano , Fritz Georg
Published: November 2019

Background

Synthetic biology heavily depends on rapid and simple techniques for DNA engineering, such as Ligase Cycling Reaction (LCR), Gibson assembly and Golden Gate assembly, all of which allow for fast, multi-fragment DNA assembly. A major enhancement of Golden Gate assembly is represented by the Modular Cloning (MoClo) system that allows for simple library propagation and combinatorial construction of genetic circuits from reusable parts. Yet, one limitation of the MoClo system is that all circuits are assembled in low- and medium copy plasmids, while a rapid route to chromosomal integration is lacking. To overcome this bottleneck, here we took advantage of the conditional-replication, integration, and modular (CRIM) plasmids, which can be integrated in single copies into the chromosome of Escherichia coli and related bacteria by site-specific recombination at different phage attachment (att) sites.

Results

By combining the modularity of the MoClo system with the CRIM plasmids features we created a set of 32 novel CRIMoClo plasmids and benchmarked their suitability for synthetic biology applications. Using CRIMoClo plasmids we assembled and integrated a given genetic circuit into four selected phage attachment sites. Analyzing the behavior of these circuits we found essentially identical expression levels, indicating orthogonality of the loci. Using CRIMoClo plasmids and four different reporter systems, we illustrated a framework that allows for a fast and reliable sequential integration at the four selected att sites. Taking advantage of four resistance cassettes the procedure did not require recombination events between each round of integration. Finally, we assembled and genomically integrated synthetic ECF σ factor/anti-σ switches with high efficiency, showing that the growth defects observed for circuits encoded on medium-copy plasmids were alleviated.

Conclusions

The CRIMoClo system enables the generation of genetic circuits from reusable, MoClo-compatible parts and their integration into 4 orthogonal att sites into the genome of E. coli. Utilizing four different resistance modules the CRIMoClo system allows for easy, fast, and reliable multiple integrations. Moreover, utilizing CRIMoClo plasmids and MoClo reusable parts, we efficiently integrated and alleviated the toxicity of plasmid-borne circuits. Finally, since CRIMoClo framework allows for high flexibility, it is possible to utilize plasmid-borne and chromosomally integrated circuits simultaneously. This increases our ability to permute multiple genetic modules and allows for an easier design of complex synthetic metabolic pathways in E. coli.
Improved metagenomic analysis with Kraken 2
Authors: Wood Derrick E. , Lu Jennifer , Langmead Ben
Published: November 2019

Although Kraken’s k-mer-based approach provides a fast taxonomic classification of metagenomic sequence data, its large memory requirements can be limiting for some applications. Kraken 2 improves upon Kraken 1 by reducing memory usage by 85%, allowing greater amounts of reference genomic data to be used, while maintaining high accuracy and increasing speed fivefold. Kraken 2 also introduces a translated search mode, providing increased sensitivity in viral metagenomics analysis.
Efficiency and safety of renal denervation via cryoablation (Cryo-RDN) in Chinese patients with uncontrolled hypertension: study protocol for a randomized controlled trial
Authors: Chen Han , Ji Meng , Zhang Yi , Xu Yawei , Qiao Lingjuan , Shen Li , Ge Junbo
Published: November 2019

Background

Clinical data show that due to the limited effects of lifestyle regulation and unsatisfactory drug adherence, only half of the hypertensive population have their blood pressure (BP) under control. In recent years, catheter-based renal denervation (RDN) has been used as a novel approach for treating uncontrolled hypertension. The safety and efficacy of catheter-based RDN have been confirmed by a number of studies and trials in which the participants were all non-Chinese and RDN was conducted via radiofrequency or ultrasound.

Methods/design

This study is a prospective multicenter randomized sham-controlled trial that aims to investigate the safety and efficacy of cryoablation RDN (cryo-RDN) using a novel dedicated cryoablation balloon catheter (Cryofocus, China). A total of 200 Chinese patients who have uncontrolled hypertension despite standard medical treatment will be enrolled. With drug standardization, eligible participants will be randomized in a 1:1 ratio to undergo cryo-RDN treatment or renal angiography alone as a sham treatment.

The primary endpoint is defined as the change in 24-h ambulatory systolic blood pressure from baseline to 6 months. Office BP and other 24-h ambulatory BP are included as secondary endpoints. Safety endpoints primarily include any adverse effects.

Discussion

This study was designed to verify the safety and efficacy of cryo-RDN with Cryofocus balloon catheters in uncontrolled hypertensive patients on polypharmacy. The aim is to provide a new way to improve the control of hypertension in China as a complement to drug therapy.

Trial registration

ChiCTR, ChiCTR1800017707. Registered on 10 August 2018.
Chimney Trial: study protocol for a randomized controlled trial
Authors: Mäkäräinen-Uhlbäck Elisa , Wiik Heikki , Kössi Jyrki , Nikberg Maziar , Ohtonen Pasi , Rautio Tero
Published: November 2019

Background

Parastomal hernias (PSHs) are common, troubling the lives of people with permanent colostomy. In previous studies, retromuscular keyhole mesh placement has been the most-used technique for PSH prevention but results have been controversial. Additionally, surgical treatment of PSHs is associated with a high rate of complications and recurrences. Therefore, it is crucial to find the most effective way to prevent PSHs in the first place without an increased risk of complications. Due to a lack of adequate research, there is no clear evidence or recommendations on which mesh or technique is best to prevent PSHs.

Methods/design

The Chimney Trial is a Nordic, prospective, randomized controlled, multicenter trial designed to compare the feasibility and the potential benefits of specifically designed, intra-abdominal onlay mesh (DynaMesh®-Parastomal, FEG Textiltechnik GmbH, Aachen, Germany) against controls with permanent colostomy without mesh.

The primary outcome of the Chimney Trial is the incidence of a PSH detected by a computerized tomography (CT) scan at 12-month follow-up. Secondary outcomes are the rate of clinically detected PSHs, surgical-site infection as defined by the Centers for Disease Control and Prevention (CDC), complications as defined by the Clavien-Dindo classification, the reoperation rate, operative time, length of stay, quality of life as measured by the RAND-36 survey and colostomy impact score, and both direct and indirect costs. For each group, 102 patients were enrolled at attending hospitals and randomized at a ratio of 1:1 by browser-based software to receive a preventive mesh or a conventional colostomy without a mesh. Patients will be followed for 1 month and at 1, 3, and 5 years after the operation for long-term results and complications.

Discussion

The Chimney Trial aims to provide level-I evidence on PSH prevention.

Trial registration

ClinicalTrials.gov, ID: NCT03799939. Registered on 10 January 2019
Teaching and learning nature of scientific knowledge: Is it Déjà vu all over again?
Authors: Lederman Norman G. , Lederman Judith S.
Published: November 2019

This review traces the history of research on the teaching and learning of nature of scientific knowledge (NOSK), and its implications for curriculum and instruction. Initially, the complex rubric of NOSK is clearly conceptualized, while recognizing that there is no singularly accepted definition. As part of this conceptualization NOSK is distinguished from the body of scientific knowledge and science practices/inquiry, the latter of which is often conflated with NOSK. The empirical research on NOSK related to teaching, learning, and assessment is briefly reviewed, followed by a discussion of the challenges that teachers face and a delineation of research foci that can help alleviate teachers’ challenges. Finally, a variety of important questions yet to be answered are delineated and explained.
No Association Between Bone Mineral Density and Breast Arterial Calcification Among Postmenopausal Women
Authors: Iribarren Carlos , Chandra Malini , Molloi Sabee , Sam Danny , Sanchez Gabriela , Bidgoli Fatemeh Azamian , Cho Hyo-Min , Ding Huanjun , Lo Joan C
Published: November 2019

Context

The association between bone mineral density (BMD) and breast arterial calcification (BAC) remains poorly understood and controversial.

Objective

The objective of this article is to examine the association between BMD and BAC in a large cohort of postmenopausal women undergoing routine mammography.

Design

A cross-sectional analysis of baseline data from a multiethnic cohort was performed.

Setting

The setting for this analysis is an integrated health care delivery system in Northern California in the United States.

Patients

A total of 1273 women age 60 to 79 years (mean age, 67 years) were recruited within 12 months of screening mammography.

Main outcome measure

A BAC score (mg) was obtained from digital mammograms using a novel densitometry method. BAC presence was defined as a BAC score greater than 0 mg, and severe BAC as a BAC score greater than 20 mg.

Results

Overall, 53% of women had osteopenia and 21% had osteoporosis. The prevalence of BAC greater than 0 mg was 29%, 30%, and 29% among women with normal BMD, osteopenia, and osteoporosis, respectively (P = 0.98). The prevalence of BAC greater than 20 mg was 5%, 3%, and 5% among women with normal BMD, osteopenia and osteoporosis, respectively (P = .65). The odds ratios (ORs) of BAC greater than 0 mg vs BAC = 0 mg after multivariable adjustment were 1.09 (95% CI, 0.81-1.48; P = .54) for osteopenia and 0.99 (95% CI, 0.69-1.48; P = .98) for osteoporosis. The adjusted ORs for BAC greater than 20 mg vs BAC 20 mg or less were 1.03 (95% CI, 0.52-2.01; P = .93) for osteopenia and 1.89 (95 CI, 0.81-4.47; P = .14) for osteoporosis.

Conclusion

Our findings do not support an association of either osteopenia or osteoporosis with BAC presence or severity among postmenopausal women.
Quantification of plan robustness against different uncertainty sources for classical and anatomical robust optimized treatment plans in head and neck cancer proton therapy
Authors: Cubillos-Mesías Macarena , Troost Esther G C , Lohaus Fabian , Agolli Linda , Rehm Maximilian , Richter Christian , Stützer Kristin
Published: November 2019

Objective:

Classical robust optimization (cRO) in intensity-modulated proton therapy (IMPT) considers isocenter position and particle range uncertainties; anatomical robust optimization (aRO) aims to consider additional non-rigid positioning variations. This work compares the influence of different uncertainty sources on the robustness of cRO and aRO IMPT plans for head and neck squamous cell carcinoma (HNSCC).

Methods:

Two IMPT plans were optimized for 20 HNSCC patients who received weekly control CTs (cCT): cRO, using solely the planning CT, and aRO, including 2 additional cCTs. The robustness of the plans in terms of clinical target volume (CTV) coverage and organ at risk (OAR) sparing was analyzed considering stepwise the influence of (1) non-rigid anatomical variations given by the weekly cCT, (2) with fraction-wise added rigid random setup errors and (3) additional systematic proton range uncertainties.

Results:

cRO plans presented significantly higher nominal CTV coverage but are outperformed by aRO plans when considering non-rigid anatomical variations only, as cRO and aRO plans presented a median target coverage (D  98%) decrease for the low-risk/high-risk CTV of 1.8/1.1 percentage points (pp) and −0.2 pp/−0.3 pp, respectively. Setup and range uncertainties had larger influence on cRO CTV coverage, but led to similar OAR dose changes in both plans. Considering all error sources, 10/2 cRO/aRO patients missed the CTV coverage and a limited number exceeded some OAR constraints in both plans.

Conclusion:

Non-rigid anatomical variations are mainly responsible for critical target coverage loss of cRO plans, whereas the aRO approach was robust against such variations. Both plans provide similar robustness of OAR parameters.

Advances in knowledge:

The influence of different uncertainty sources was quantified for robust IMPT HNSCC plans.
Response evaluation after stereotactic ablative radiotherapy for localised non-small-cell lung cancer: an equipoise of available resource and accuracy
Authors: Gouveia Andre G , Zalay Osbert C , Chua Kevin LM , Moraes Fabio Ynoe
Published: November 2019

There is growing evidence supporting the use of stereotactic ablative radiotherapy (SABR) on the treatment of localised stage non-small-cell lung cancer (NSCLC). Distinctive imaging challenges are posed post-SABR treatment. Thus, it is imperative to provide guidance on assessing treatment response, especially for new adopters. This commentary is about filling a gap in response evaluation after SABR for localised NSCLC.
Study of Ballet Dancers During Cou-De-Pied Derrière with Demi-Plié to Piqué Arabesque
Authors: Mira Natali Olaya , Marulanda Andrés Felipe Hernández , Peña Adriana Carmen Guerrero , Torres Daniela Cuartas , Orrego Juliana Correa
Published: November 2019

Dancers are highly trained athletes who are at significant risk of injury due to the repetitive nature of their movement patterns. Most ballet injuries result from overuse and occur in the lower limbs. Therefore, the behavior of the lower limbs during a basic ballet movement should
be studied in order to identify and subsequently correct mechanical factors that may contribute to injuries. This study analyzed a cou-de-pied derrière with demi-plié to piqué arabesque gesture executed by 18 ballet dancers identified in two groups: experienced dancers
(EDs) and beginner dancers (BDs). Kinematic, baropodometric, and electromyographic analyses enabled the observation of differences between these study groups with regard to joint angles, velocities, foot pressure behavior, and muscle activation during execution of the gesture. Experienced
dancers reached greater hip and lumbar spine hyperextension and demonstrated less forward torso flexion, which enables better execution of the gesture compared to BDs. The highest foot pressure in both groups was found in the first metatarsal, with a tendency toward the great toe. In terms
of muscular activation, BDs exhibited lower electrical activity than EDs. It is concluded that: 1. ankle and knee angles in demi-plié are not defined by dancers' expertise; 2. the faster the leg is raised during piqué-arabesque the better the gesture; 3. special attention to
the metatarsal heads is required due to the high pressures found in this study; and 4. activation of different muscle groups depends on the complexity of the gesture and dancer's expertise.
Skin changes in a therapeutic patient
Authors: Хазова Елена , Hazova Elena , Ослопов Владимир , Oslopov Vladimir , Ослопова Юлия , Oslopova Yuliya , Хасанов Нияз , Hasanov Niyaz , Булашова Ольга , Bulashova Ol'ga
Published: November 2019

The manual contains new knowledge on the diagnosis of diseases of internal organs from the position of a thorough, systematic study of the skin. Includes a large illustrative material that provides a visual perception of therapeutic diseases in fact at a glance at the patient.
Compiled in accordance with the working program of the discipline "Propaedeutics of internal diseases".
Meets the requirements of the Federal state educational standards of higher education of the last generation.
For students of medical universities implementing educational programs in the areas of training 31.05.01 "Medical business", 31.05.02 "Pediatrics", 32.05.01 "Medical-preventive business".
Introduction to programming in Visual Basic for Applications (VBA)
Authors: Гуриков Сергей , Gurikov Sergey
Published: November 2019

The tutorial discusses the basics of algorithmization and programming in Visual Basic for Applications (VBA), describes the action of linear, branching and cyclic structures. Much attention is paid to programming based on functions and procedures, processing one-dimensional and two-dimensional arrays, working with files. Examples of mathematical data processing, the use of spreadsheets for charting are given. In addition, the methods of creating macros, the principles of developing test programs based on various controls are considered. At the end of each Chapter there is a set of control questions and tasks.
It has an applied orientation and meets the requirements of the Federal state educational standards of higher education of the last generation.
It is intended for students of higher educational institutions studying under the programs of bachelor of technical specialties, it will also be useful for students of secondary professional educational institutions and schoolchildren in preparation for the Unified state exam on the discipline "Informatics and ICT".
Methodological problems of modern pedagogy
Authors: Vasianovych Hryhoriy , Muszkieta Radosław
Published: November 2019

The article analyzes the nature and the content of the term “methodology”, and concludes that so far tere  is no clear approach to the notion definition. Much attention is paid to determine the relationship between methodology and science, and to reveal dialectical aspects of this relationship.The author studies the main factors of methodology influence on improving teaching reality and pedagogical activity, and defines the role of methodology in forming the content of pedagogical education. It is proved that the improvement of the educational process and study of its main components depends on methodological culture of a teacher.
The problem of training of future teachers of physical education for organization of competitive activities in the field of professional education
Authors: Kashuba Anatolii
Published: November 2019

Using theoretical analysis of scientific and methodological literature on the problem of a study, it has been revealed and reasoned in the article certain factors which affect the training process of future teachers of physical education for professional work and stated that the present requirements for professional competence of a teacher, its theoretical and practical training become more expressed and must be aimed at the development of a teacher’s personality with such qualities that would meet the current requirements of the present time and ensure success of practical activity. It has been revealed and described abilities that must be mastered by the future teachers of physical education for the successful implementation of their professional activity, and skills required for the successful organization of competitive activities on sport games. It has been defined that the future teacher of physical education must be prepared for teaching, educational, scientific an methodological, organizational and supervisory activities in the system of secondary education according to the obtained specialty, where the typical kinds of its activities are as follows: educational, health and fitness, sports, organizational, recreation and preventive activities and include: planning physical education process; organizing and conducting physical education lessons; conducting educational and training lessons, organizing sports classes work, training school teams for competitive activities; promoting healthy lifestyles and monitoring the level of health and physical fitness of students; development of own professional level, summing up and implementing advanced experience of work.
Influence of the emotionally positive attitude on forming the communicative competences of technology teachers
Authors: Hevko I.
Published: November 2019

The article reveals the influence of an emotionally positive attitude on the formation of communicative competences of technology teachers. In the article under communicative competence, the author considers the quality of a person characterized by certain properties, in particular by properties that necessary for perceptual activity, personal-communicative and communicative-operational activities. It is proved that the creation of an emotionally positive mood in the learning environment acts as one of the factors of pedagogical stimulation in our study and the formation of the communicative competence of the future specialist in the technological profile.
Conceptual approaches to the organization of a modern model of a consultative and diagnostic center on the principles of public-private partnership
Authors: Kravchenko V. V.
Published: November 2019

Background The transition to progressive development models is an actual problem of the Ukrainian health care system. Objective: to substantiate conceptual approaches to the formation of a modern functional-organizational model of consultative-diagnostic centers (CDC) on the basis of public-private partnership (PPP).Materials and methods. General scientific methods of analysis, synthesis, generalization, interpretation of scientific data, as well as systemic and structural-functional approaches were used in the study.Results The article presents conceptual approaches to the organization of a consultative and diagnostic center on the principles of PPP, which include three components: the concept and methodological approaches to the restructuring of the CDC system, as well as the rationale for the organizational and economic formation of the CDC model on the principles of PPP.Conclusions Presented in the article the conceptual approaches to the organization of a modern model of a consultative and diagnostic center on the principles of PPPs are the way of adaptation of the communal CDC system to the conditions of a market economy.
The quality of life of people with spinal cord injury
Authors: Stocka Joanna , Simińska Joanna , Ratuszek-Sadowska Dorota , Miszewska Agnieszka , Świątkowska Anna , Głowacka-Mrotek Iwona , Nowacka Krystyna , Hagner Wojciech
Published: November 2019

Spinal injuries are the most common cause of formation of spinal subsequently they may be formed as a result of inflammation, tumors or other diseases. Among the consequences of spinal cord injury can be distinguished numbness, paralysis or paresis as well as restrictions within the urinary tract and sexual performance. There is also the increased chance of bedsores. The appearance of abnormal muscle tone and spasticity in the form of periarticular ossification. These problems make it difficult to "normal" functioning in society. Rehabilitation for patients with spinal cord injury is aimed at reducing symptoms and finding methods that most effectively compensated by the quality of deficiencies in the functioning of society.
JACQUES CHESSEX: O ESCRITOR-VAMPIRO DE ROPRAZ
Authors: Costa Ana Amelia Gonçalves da
Published: November 2019

Em Le vampire de Ropraz (2007), livro do escritor suíço de língua francesa Jacques Chessex (1934-2009), a condição da falência da memória enquanto lugar da expiação histórica é construída através da imortalidade do vampiro, que expressa, por outro lado, uma crise perene do fazer literário, crise essa que deve ser compreendida no sentido positivo de renovação. O questionamento, em Jacques Chessex, é sinônimo de ironia, traço marcante em muitos de seus escritos. No caso de Le vampire de Ropraz é parodiando o estilo romântico que Jacques Chessex tece sua crítica à hipocrisia e ao não-dito, mergulhando a paisagem helvética em uma imagem lúgubre e escamoteada. O vampiro da obra chessexiana não tem o arquétipo do personagem folclórico, distanciando o romance de uma obra de literatura fantástica. É a simbologia da exclusão, entretanto, que transfigura o protagonista no perfeito vampiro, no jogo simbólico de uma ambiguidade traduzida, pelo autor, em ruptura e transcendência identitárias.
“O INTRUSO”, DE H. P. LOVECRAFT: O UNHEIMLICH NO ESPELHO
Authors: Dos Santos de Souza Carla Larissa , Giroldo Ramiro
Published: November 2019

Este texto toma como objeto o conto “O intruso”, de H. P. Lovecraft, e tem como objetivo a leitura do personagem que dá nome ao título como uma peculiar figura do unheimlich, que só compreende a sua natureza no confronto com o outro. Embasa-se em noções formuladas por Sigmund Freud em “O inquietante” e, também, em formulações de Noel Carroll acerca do monstro, em A filosofia do horror ou os paradoxos do coração. O texto contempla, ainda, o olhar cunhado por Lovecraft na obra O horror sobrenatural na literatura. A articulação aqui apresentada busca discutir como a ambientação gótica e a atmosfera dela decorrente se relacionam no conto com o efeito unheimlich, bem como o jogo ficcional travado entre o familiar e o desconhecido.
ENTREVISTA COM FLÁVIO CARNEIRO
Authors: Garcia Flavio , Monteiro Lena Hauer do Rego
Published: November 2019

Recebido em 31 Ago 2019Aprovado em 10 Set 2019
LITERATURA FANTÁSTICA & CONTOS DE FADAS (2018), DE ANDRÉ DE SENA (ORG.)
Authors: França Eduardo Melo
Published: November 2019

Recebido em 04 Set 2019Aprovado em 11 Set 2019
A PERSONAGEM FRACASSADA NO ROMANCE DE 30 EM ALGUMAS NARRATIVAS DO DESLOCAMENTO
Authors: Furtado Pedro Barbosa Rudge
Published: November 2019

O nosso artigo intenciona analisar a relação dialética do deslocamento espacio-temporal em quatro narrativas do decênio de 30: O anjo, de Jorge de Lima, Maleita, de Lúcio Cardoso, Angústia, de Graciliano Ramos e O amanuense Belmiro, de Cyro dos Anjos, lançadas, respectivamente, em 1933, 1934, 1936 e 1937. O nosso fito é mostrar como a ocorrência dos movimentos espacio-temporais concorrem para o realce da representação do sentimento de fracasso. O aparecimento da personagem fracassada foi notado, primeiramente, por Mário de Andrade (2002) em “Elegia de abril”, publicado em 1941. Cabe indicar que, mesmo no subtexto das narrativas, há tensões animadas na relação com outro como ser – a alteridade – e o outro como espaço-tempo, cada um carregando os seus correspondentes valores. Por meio de estudos de Tim Cresswell (2006), sobre a espacialidade e suas representações, de Sérgio Miceli (2011) e de Antonio Candido (1989) sobre o sentimento de negatividade presente nos romances de 30, de Luís Bueno (2015), versando sobre as narrativas do período em questão, e textos críticos acerca delas, procuramos demonstrar como a sua forma/conteúdo oferece pertinentes discussões a respeito do deslocamento interligado à lógica do poder e da noção de não-pertencimento das personagens derrotadas.
NOMADISMO, DESLOCAMENTOS E TRAJETÓRIAS ERRANTES: IDENTIDADES EM JOGO NA NARRATIVA DE CAROLINA MARIA DE JESUS
Authors: Sá Janaína Da Silva
Published: November 2019

A cultura contemporânea recuperou a figura do passageiro, do caminheiro, do passeador, do errante, reinventando a ideia de localização e deslocamento. Para Paul Ricoeur (2007), entre as alternâncias de repouso e movimento está instituído o ato de habitar, o fato de um corpo estar compreendido entre um aqui e um acolá. Diante dessa compreensão, acredito que a construção do universo narrado da escritora mineira Carolina Maria de Jesus concretiza-se por essa procura incessante pelo ato de habitar, que se manifesta por meio dos constantes agenciamentos que a narradora irá empreender pelos caminhos por onde circula. No discurso de Carolina Maria de Jesus, existe uma inquietante busca por fazer parte de um lugar que não foi reservado a ela, sendo que, nessa busca por sobrevivência, em uma sociedade excludente, verifico outro ângulo de visada de onde se sobressai um novo tipo de escritura. Nessa trajetória, encontram-se indivíduos considerados à margem, estando reservado a eles apenas um sentimento assombroso de busca por agenciamento, prevalecendo, ou estando imposto a ele, o reinado do vazio. Ser errante, nômade, caminheiro, transeunte serão possíveis nomenclaturas para designar esse percurso insólito de quem ousa narrar as adversidades de um mundo contemporâneo hostil, não acostumado a lidar com outras identidades.
O PAPEL DAS UNIVERSIDADES EM SISTEMAS DE INOVAÇÃO EM CUBA E URUGUAI: REFLEXÕES PARA O CASO BRASILEIRO
Authors: Marcellino Israel Sanches , Borin Elaine Cavalcante Peixoto
Published: November 2019

Resumo: Reconhecendo a importância das especificidades de cada local, o objetivo deste trabalho é analisar o papel das universidades nos Sistemas de Inovação (SI), tendo os casos de Cuba e do Uruguai como estudo. A partir dessa análise, será possível destilar conceitos que proporcionem perspectivas úteis para a compreensão do caso brasileiro. O período atual traz novas dinâmicas ao sistema capitalista com desdobramentos para as lógicas da produção de conhecimento e da inovação. Logo, a emergência de um paradigma baseado em conhecimento e ciência, além das contradições impostas pelo processo de financeirização, tem posto em xeque o padrão tradicional de inserção das universidades nos SI. O avanço da financeirização sobre os orçamentos públicos em países como os da América Latina suscita questões relacionadas ao financiamento das universidades públicas. No esteio da lógica custo-benefício, surgem questões adicionais relacionadas ao impacto social e econômico efetivo das atividades universitárias. As universidades encontram-se compelidas a uma fase de transição em nível global. Essa transição, contudo, é um processo em andamento, pleno de incertezas e sem rumos únicos definidos.Palavras-chave: Sistema de Inovação. Universidade. América Latina.Abstract: Recognizing the importance of the specificities of each location, the aim of this paper is to analyze the role of universities in innovation systems (IS), taking as a study the case of Cuba and Uruguay. From this analysis, it will be possible to distill concepts that provide useful perspectives for understanding the Brazilian case. The present period brings new dynamics to the capitalist system with consequences for the logic of knowledge production and innovation. Thus, the emergence of a knowledge-based and science-based paradigm and the contradictions imposed by the financialization process have challenged the traditional pattern of insertion of universities in IS. The advancement of financialization over public budgets in countries such as Latin America raises questions related to the financing of public universities. Underlying the cost-benefit logic, additional questions arise regarding the effective social and economic impact of university activities. Universities are compelled to undergo a transitional phase at the global level. This transition, however, is an ongoing process, full of uncertainties and with no single defined directions. Keywords: Innovation System. University. Latin America.
Factors influencing nurses' knowledge and skills in the prevention and management of postpartum haemorrhage
Authors: Angelina Joho A. , Kibusi Stephen M. , Mwampagatwa Ipyana
Published: November 2019

Background:

Postpartum haemorrhage (PPH) is one of the main causes of maternal death. In Tanzania, 25% of maternal deaths are the result of PPH. Gaps in practitioner knowledge in the prevention and management of this issue may lead to severe maternal complications and death. Little has been documented about nurses' knowledge and skills regarding PPH prevention and management.

Objective:

To determine the factors influencing nurses' knowledge and skill in the prevention and management of PPH in the Dodoma Region, Central Tanzania.

Method:

A cross-sectional study was conducted involving 172 nurses working in Dodoma, Tanzania. Data on the sociodemographic characteristics of the nurses was collected using a structured questionnaire. Knowledge on PPH was assessed using a validated questionnaire and skills were assessed using an observational checklist. The chi-squared test was used to find associations between sociodemographic characteristics and knowledge and skills. Binary logistic regression (both reduced and full models) was used to identify significant predictors of knowledge and skills.

Results:

The findings indicated that being ≥40 years old (OR=2.87, P=0.004), being a registered nurse (OR=2.73, P=0.002), having >3 years of professional training (OR=2.38, P=0.01), and having ≥5 years of experience in a maternity unit (OR=3.06, P<0.00) were significant predictors for knowledge in the prevention and management of PPH in a reduced model of binary logistic regression. Being ≥40 years old (OR=11.5, P=0.00), having >3 years of professional training (OR=4.58, P<0.00), and having ≥5 years of experience in a maternity unit (OR=9.14, P<0.00) were significant predictors for skills in the reduced model. After adjusting to control for possible confounders, being a registered nurse was the only significant predictor of nurses' knowledge (AOR=3.35, P=0.001), while having ≥5 years experience in a maternity unit was the only significant predictor of nurses' skills (AOR=3.89, P=0.01).

Conclusion:

Professional qualification and experience in a maternity unit are significant factors influencing nurses' knowledge and skills, respectively, in the prevention and management of PPH.