bluuebunny/crossref_metadata_2025 huggingface dataset:
Nutcracker Syndrome Masquerading as Renal Colic in an Adolescent Athlete: A Case Report
Authors: Waldrop Ron , Henning Paul
Published: November 2021

Introduction: Abdominal pain and flank pain cause a significant proportion of emergency department (ED) visits. The diagnosis often remains unclear and is frequently associated with repeat visits to the ED for the same complaint. A rare cause of left upper abdominal and flank pain is compression of the left renal vein between the aorta and the superior mesenteric artery known as nutcracker syndrome. Diagnostic findings on ultrasound include increased left renal vein diameter proximal and peak blood flow velocity increase distal to the superior mesenteric artery. We describe such a patient presenting to an ED repeatedly with severe pain mimicking renal colic before the final diagnosis and intervention occurred.
Case Report: A 16-year-old female, long-distance runner presented four times complaining of intractable left upper quadrant abdominal pain radiating to the left flank after exercise. On each visit urinalysis revealed proteinuria and hematuria, and on two visits abdominal computed tomography revealed no kidney stone or dilatation of the collecting system. Ultimately, she was referred to vascular surgery where Doppler ultrasonography was used to diagnose left renal vein compression. Transposition of the left renal vein improved Doppler diameter and flow measurements and eliminated symptoms.
Conclusion: Emergency physicians must maintain a large list of possible diagnoses during the evaluation of abdominal and flank pain with a repetitive and uncertain etiology. Nutcracker syndrome may mimic other causes of abdominal and flank pain such as renal colic and requires appropriate referral.
Acute Myocardial Infarction in a Patient with Twin Pregnancy: A Case Report
Authors: Michaelis Tony , Gunaga Satheesh , McKechnie Tyson , Shafiq Qaiser
Published: November 2021

Introduction: Acute myocardial infarction (AMI) rarely occurs during pregnancy and presents unique challenges in diagnosis and management. Traditionally, pregnancy has not readily been considered a risk factor for AMI in the emergency department despite the potential for adverse impacts on maternal and fetal health. As cardiovascular risk factors and advanced maternal age become more prevalent in society over time, the incidence will continue to increase. Prior cases with singular gestation have been reported; however, only one previous case during a twin pregnancy was identified in the medical literature. Case Report: We describe a rare case of acute ST-segment elevation myocardial infarction in a 37-year-old woman at 24 weeks gestation with a dichorionic diamniotic twin pregnancy. Conclusion: It is important for the emergency physician to recognize acute coronary syndrome as a part of the differential diagnosis of chest pain in pregnant patients and be familiar with the diagnostic and management options available for this special population.
SAPHO Syndrome: An Unusual Cause of Dysphagia
Authors: Hoffer Megan , Salvo Michaela , Batra Sonal
Published: November 2021

Case Presentation: This case describes a 51-year-old male who presented to the emergency department with a complaint of two weeks of progressively worsening dysphagia as well as the emergence of superficial fluid collections on the anterior chest and leg during the same period. Computed tomography showed retropharyngeal and paratracheal fluid collections with adjacent vertebral osteitis; however, biopsies were negative for any infectious or mycobacterial source, and instead showed chronic inflammatory changes.
Discussion: Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome is a rare rheumatic disorder that presents with multifocal osteitis and sterile neutrophilia. SAPHO syndrome may be easily mistaken for a diffuse infectious process on initial evaluation and imaging; however, it is treated with anti-inflammatory medications, including non-steroidal anti-inflammatory drugs and corticosteroids. Although most patients achieve remission of symptoms with treatment, the location of the fluid collections and resultant bony destruction may be life-threatening if undiagnosed.
A Case Report of Opisthotonos Associated with Administration of Intramuscular Ketamine
Authors: Morgan Matthew , Dore Ellen
Published: November 2021

Introduction: Ketamine, a commonly used medication to treat agitation, has known adverse effects such as emergence reactions, vomiting, and laryngospasm. Opisthotonos has not been a commonly reported adverse reaction.
Case Report: We report a case of opisthotonos brought on by administration of ketamine. A 24-year-old male with a history of schizophrenia was brought in by emergency medical services with opisthotonos shortly after treatment with 250 milligrams intramuscular ketamine by paramedics. He had become increasingly paranoid after being off his aripiprazole for a few weeks, and his family had become afraid for his and their safety. Paramedics administered ketamine to control his combative agitation, per protocol. The patient’s extreme neck and back extension rapidly resolved with the administration of midazolam. Further history and workup did not reveal another cause for opisthotonos.
Conclusion: This is the first reported case to our knowledge of ketamine-associated opisthotonos in the emergency setting. Emergency care providers should be aware of this potential side effect.
Pacemaker Lead Migration and Ventricular Perforation in a Patient Presenting with Chest Pain
Authors: Cañizares-Otero Maria , Danckers Mauricio
Published: November 2021

Case Presentation: We describe a middle-age male with a past medical history of second-degree atrioventricular block type II status post permanent pacemaker placement the day prior who presented to the emergency department complaining of chest pain. Electrocardiography showed a non-paced ventricular rhythm. Chest radiograph showed the ventricular pacemaker lead located distally overlying the right ventricle apical area. On further investigation, chest computed tomography showed a perforation of the ventricular wall by the pacemaker lead prompting urgent intervention by the cardiothoracic surgery team for lead replacement and right ventricular repair.
Discussion: Our case illustrates the importance of timely recognition of a perforated pacemaker lead in a patient presenting with chest pain after device implantation. We additionally describe the risk factors for ventricular perforation, initial clinical presentation, and management approach.
Traumatic Anterior Dislocation of Ocular Cataract Lens
Authors: Shirke Tanvi , Wilcox Kyle , Luong Thuyvi
Published: November 2021

Case presentation: A 33-year-old male presented to the emergency department following a motor vehicle collision with complaints of right eye pain after hitting his head on the steering wheel. Point-of-care ultrasound (POCUS) revealed retinal detachment and an anterior lens dislocation.
Discussion: Lens dislocations following blunt head trauma can often be diagnosed using POCUS. Anterior ocular lens dislocation is a rare but vision-threatening result of head trauma. This case highlights how POCUS can facilitate early detection of ocular pathology, such as lens dislocation, and improves patient outcomes.
Computed Tomography Appearance of the “Whirlpool Sign” in Ovarian Torsion
Authors: Livingston Joshua , Gonzales Savannah , Langdorf Mark
Published: November 2021

Case Presentation: A 28-year-old female presented to the emergency department complaining of right lower abdominal pain. A contrast-enhanced computed tomography (CT) was done, which showed a 15-centimeter right adnexal cyst with adjacent “whirlpool sign” concerning for right ovarian torsion. Transvaginal pelvic ultrasound (US) revealed a hemorrhagic cyst in the right adnexa, with duplex Doppler identifying arterial and venous flow in both ovaries. Laparoscopic surgery confirmed right ovarian torsion with an attached cystic mass, and a right salpingo-oophorectomy was performed given the mass was suspicious for malignancy.
Discussion: Ultrasound is the test of choice for diagnosis of torsion due to its ability to evaluate anatomy and perfusion. When ovarian pathology is on the patient’s right, appendicitis is high in the differential diagnosis, and CT may be obtained first. Here we describe a case where CT first accurately diagnosed ovarian torsion by demonstrating the whirlpool sign, despite an US that showed arterial flow to the ovary. Future studies should determine whether CT alone is sufficient to diagnose or exclude ovarian torsion.
73-year-old Female with Syncope and Motor Vehicle Collision
Authors: Flanagan Kevin , Dezman Zachary , Dachroeden Karl , Bontempo Laura
Published: November 2021

Introduction: Patients with traumatic injuries can be difficult to assess, and their evaluation often evolves in the emergency department (ED). We describe how an ED attending physician member developed a differential diagnosis for this presentation, arrived at a suspected diagnosis, and what test he proposed to prove his hypothesis.
Case Presentation: This clinicopathological case presentation details the initial assessment and management of a 73-year-old female who presented to the ED following a motor vehicle collision precipitated by a syncopal episode.
Conclusion: The final surprising diagnosis is then revealed.
Atypical Presentation of Aseptic Meningitis Due to Varicella Zoster: A Case Report
Authors: Jia Sharon , Luong Thuyvi
Published: November 2021

Introduction: Varicella zoster virus (VZV) meningitis is primarily an infection of the immuno-compromised. However, it can also affect immunocompetent individuals. Reactivation of VZV typically presents with a distinct dermatomal rash suggestive of varicella zoster, but there have also been reports of VZV meningitis presenting without a rash.
Case Report: We describe a case of VZV meningitis in a healthy, 30-year-old male presenting to the emergency department shortly after receiving his first coronavirus disease 2019 vaccination. He was treated with intravenous acyclovir and then discharged home on oral valacyclovir.
Conclusion: Emergency physicians should consider aseptic meningitis in immunocompetent patients presenting with atypical headaches in this population.
Needle Decompression of Tension Pneumoperitoneum: A Case Report
Authors: Ray Joseph , Exantus Nadin
Published: November 2021

Introduction: Tension pneumoperitoneum is rarely encountered in the emergency department but can have disastrous effects on the body when it is. However, an emergency physician has skills that can be readily applied to needle decompress the abdomen for rapid stabilization.
Case Report: A 42-year-old male arrived via ambulance after a likely overdose with mental status improvement following naloxone administration. He was found to be in respiratory distress due to a rigid, distended abdomen that required intubation for stabilization. Computed tomography imaging showed significant pneumoperitoneum with tension physiology. Surgery consultation was unable to intervene immediately, and needle decompression with an angiocatheter was performed at the bedside with immediate ventilatory improvement.
Conclusion: Tension pneumoperitoneum is a rare but potentially disastrous consequence of overdose secondary to emesis and rupture of the gastric wall. Needle decompression is a skillset already in the emergency physician’s toolbox and can be applied for emergency stabilization of a tension pneumoperitoneum with proper forethought and technique.
Atypical Presentation of Haemophilus influenzae Septic Arthritis: A Case Report
Authors: Tadych Andrew , Catano David , Brill April
Published: November 2021

Introduction: Septic arthritis is a destructive form of acute arthritis that requires expeditious recognition. as delayed treatment yields significant morbidity and mortality.
Case Report: A 40-year-old male presented to the emergency department with right elbow pain. Examination revealed tachycardia, swelling, redness, tenderness, and decreased range of motion of the right humeroulnar joint. Synovial fluid analysis was consistent with an inflammatory etiology, but blood and joint cultures ultimately revealed Haemophilus influenzae.
Discussion: This case highlights the importance of trusting clinical findings over laboratory evidence in patients with suspected septic arthritis.
El teocentrismo de la jerarquía de los bienes en al doctrina de san Agustín
Authors: Kowalczyk Stalislaw ,   Order of Augustinian Recollects
Published: November 2021

Al centrar su atención en Dios y en el hombre, con frecuencia Agustín nos ofrece su relación recíproca al nivel axiológico. La teoría agustiniana de los valores comporta un razonamiento filosófico y teológico a la vez. En la intersección de estos dos elementos se encuentra el problema de la jerarquía de los bienes y en el fondo podemos descubrir el teocentrismo agustiniano. En el pensamiento del obispo de Hipona, podemos distinguir un triple teocentrismo teleológico, que se completan y explican recíprocamente.
Diverse Populations are Conflated with Heterogeneous Collectives
Authors: Shavit Ayelet , Ellison Aaron M. ,   Journal of Philosophy Inc.
Published: November 2021

The concept of difference has a long and important research tradition. We identify and explicate a heretofore overlooked distinction in the meaning and measurement of two different meanings of 'difference': 'diversity' and 'heterogeneity'. We argue that ‘diversity’ can describe a population well enough but does not describe a collective well. In contrast, ‘heterogeneity’ describes a collective better than a population and therefore ought to describe a collective. We argue that ignoring these distinctions can lead to a surprising and disturbing conflict between diversity and heterogeneity. In particular, focusing on the 'diversity' of human communities can be self-defeating for those who truly care about the importance of diversity, inclusion, and belonging.
Aboutness Paradox
Authors: Sbardolini Giorgio ,   Journal of Philosophy Inc.
Published: November 2021

The present work outlines a logical and philosophical conception of propositions in relation to a group of puzzles that arise by quantifying over them: the Russell-Myhill paradox, the Prior-Kaplan paradox, and Prior's Theorem. I begin by motivating an interpretation of Russell-Myhill as depending on aboutness, which constrains the notion of propositional identity. I discuss two formalizations of of the paradox, showing that it does not depend on the syntax of propositional variables. I then extend to propositions a modal predicative response to the paradoxes articulated by an abstraction principle for propositions. On this conception, propositions are “shadows” of the sentences that express them. Modal operators are used to uncover the implicit relation of dependence that characterizes propositions that are about propositions. The benefits of this approach are shown by application to other intensional puzzles. The resulting view is an alternative to the plenitudinous metaphysics of impredicative comprehension principles.
Team and teamwork in the function of effective management
Authors: Stojadinović-Jovanović Sandra , Bojović Ivana , Dašić Boban
Published: November 2021

An unavoidable part of organizational life and management is teamwork. The goal of forming and using teams is to realize certain jobs and work tasks, to achieve or contribute to the achievement of certain results and thus the effective achievement of defined organizational goals. Only an effective team can contribute to the effectiveness of management. For these reasons, the subject of the paper is to consider the characteristics of the team and teamwork, the advantages and disadvantages of the use of teams and the effectiveness issue of the team itself. The aim of the paper is to point out the possibilities that the use of the team can provide, and also the obstacles it can bring, in order to recognize the ways of achieving and improving the effectiveness of the team.
Effect of post-weld tempering treatment on performance of DP600 spot welded joint
Authors: Hong Li , Xusheng Liu , Bing Wang , Zhuoxin Li
Published: November 2021

In order to meet the increasing requirements of the automotive industry for material strength grades and performance, the application of advanced highstrength steel automotive panels, represented by dual-phase steel, in lightweight vehicle bodies is increasing. Resistance spot welding is the main joining process for vehicle body manufacturing. How to improve the tensile strength and fatigue performance of dual-phase steel resistance spot welding joints is of great significance to the welding structure of the body. In this paper, resistance spot welding of cold rolled DP600 dual phase steel in the welding current range of 9000A-12000A was carried out. The effects of post-weld tempering treatment on microstructure, microhardness, shearing and fatigue of joints were compared. The results show that the microstructure transformation occurs in the weld nugget area after post-weld tempering, and the tempered martensite appears to reduce the microhardness of the weld nugget area; the nugget diameters, tensile-shear strength and failure energy are all higher than those without tempering treatment; tempering improves the fatigue strength of the spot joints, and regardless of whether the welded joints are tempered, cracks are all generated near the heat affected zone of the joint after fatigue test.
Crisis del paradigma representativo y propuestas de impulso de la democracia directa
Authors: Garrido López Carlos
Published: November 2021

La democracia representativa padece una seria crisis de legitimidad. La recesión económica y la ola de indignación generada por la incapacidad del Estado para enfrentarla han cuestionado el paradigma representativo. Y ello ha reabierto el debate sobre la incorporación de nuevas vías de participación de los ciudadanos en las decisiones colectivas, sobre su funcionalidad y sobre su compatibilidad con la democracia representativa. En este contexto, las formas de participación directa han recobrado protagonismo porque, reguladas con las garantías precisas, pueden contribuir a completar la democracia de elección con una mayor implicación e intervención de los ciudadanos en el proceso de formación de la voluntad general. En España, la regulación de estas formas de participación es muy restrictiva y su balance práctico resulta muy limitado. La situación es muy distinta en otras democracias occidentales, donde la iniciativa popular y, especialmente, el referéndum son instrumentos frecuentes de participación política que operan como complemento y contrapeso de la democracia representativa. La regulación y la práctica de la democracia directa en estos países, que en este trabajo analizamos junto a las insuficiencias de la regulación española, pueden servir de modelo para una regulación más incisiva y generosa de estas formas de participación política en una futura, y cada vez más necesaria, reforma de nuestra Constitución.
La incorporación de la justicia restaurativa en la delincuencia socioeconómica
Authors: Rebollo Vargas Rafael
Published: November 2021

La vía procesal para la tutela de los delitos socioeconómicos, en la hipótesis de víctimas de carácter colectivo o difuso, no es la acción particular, ni la acción popular, sino que el mecanismo para la tutela de esos derechos e intereses es el dispuesto en el art. 7.3 LOPJ. A pesar de que el Anteproyecto de Ley de Enjuiciamiento Criminal no prevé los instrumentos idóneos para su defensa, ni dispone de vías específicas para la Justicia Restaurativa en esos delitos, la Secretaría General de Instituciones Penitenciarias ha puesto en marcha el Programa PIDECO donde se regulan fórmulas de esa naturaleza.
Personality predictors of emergency department post-discharge outcomes
Authors: Atherton Olivia E. , Willroth Emily C. , Schwaba Ted , Goktan Ayla J. , Graham Eileen K. , Condon David M. , Rao Mitesh B. , Mroczek Daniel K.
Published: November 2021

Personality traits are important predictors of health behaviors, healthcare utilization, and health outcomes. However, we know little about the role of personality traits for emergency department outcomes. The present study used data from 200 patients (effective Ns range from 84 to 191), who were being discharged from the emergency department at an urban hospital, to investigate whether the Big Five personality traits were associated with post-discharge outcomes (i.e., filling prescriptions, following up with primary care physician, making an unscheduled return to the emergency department). Using logistic regression, we found few associations among the broad Big Five domains and post-discharge outcomes. However, results showed statistically significant associations between specific Big Five items (e.g., “responsible”) and the three post-discharge outcomes. This study demonstrates the feasibility of assessing personality traits in an emergency medicine setting and highlights the utility of having information about patients’ personality tendencies for predicting post-discharge compliance.
Przegląd ekonomiczno-przestrzennych badań rynku samochodów osobowych = A review of economic and spatial research on the market for passenger cars
Authors: Stryjakiewicz Tadeusz , Kołsut Bartłomiej , Doszczeczko Bartosz , Dyba Wojciech , Kisiała Wojciech , Kudłak Robert , Wojtyra Bartosz
Published: November 2021

Rynek samochodów osobowych – ze względu na skalę, dynamikę i konsekwencje jego rozwoju – staje się w coraz większym zakresie przedmiotem badań wielu dyscyplin naukowych, w tym geografii. Przemiany tego rynku są uzależnione w szczególności od dochodów i preferencji mieszkańców, polityki państw i organizacji międzynarodowych oraz poziomu rozwoju gospodarek, w szczególności rozwoju przemysłu motoryzacyjnego. Z drugiej strony, wielkość oraz struktura rynku samochodów osobowych w istotny sposób wpływają na poziom PKB wielu państw rozwiniętych, na eksport samochodów używanych do krajów peryferyjnych oraz na jakość środowiska przyrodniczego. Wpływ ten zaznacza się również na poziomie regionalnym i lokalnym (np. kwestia dostępności przestrzennej dóbr i usług). Dlatego w badania rynku samochodów osobowych włączają się coraz częściej specjaliści zajmujący się geografią ekonomiczną oraz geografią rozwoju regionalnego. Celem artykułu jest przedstawienie wybranych kierunków, a także wyników badań rynku samochodów osobowych, ze szczególnym wyeksponowaniem ich wymiaru geograficznego. Koncentrują się one wokół czterech głównych grup zagadnień: (1) poziomu motoryzacji i modelowania popytu na samochody, (2) relacji między rynkiem aut nowych i używanych w krajach rozwijających się, (3) roli czynników przestrzennych i transportu publicznego w funkcjonowaniu rynku samochodowego oraz (4) skutków środowiskowych upowszechnienia motoryzacji i sposobów ich ograniczania, takich jak elektromobilność oraz ekonomia współdzielenia.
Lasy wybranych dużych obszarów leśnych = The forests in selected examples of Poland’s Large Forest Areas
Authors: Zielony Roman
Published: November 2021

Key issues for spatial planning and development, nature protection and forestry in Poland relate to the problems encountered in determining the area of forests included within – and the boundaries of – what are known as the Large Forest Areas (LFAs) in Poland. Even as overall forest cover in the country has increased steadily – by about 2.5 million ha overall – since 1945, the data available for the LFAs relate to measurements made as long ago as in the 1960s and 1970s. Even then, it is often unclear whether it is total areas or areas of forest that are being referred to in relation to the LFAs. There is thus an urgent need for meas-urements to be updated, with a view to the present-day boundaries of the Areas being delim-ited. Some 80‑100 LFAs are in fact distinguished in Poland, in line with definitions relating to total area exceeding 10,000 ha (100 km2) and forest cover exceeding 35%. While many of the LFAs received Proper-Noun names at one point or another in their histories, as used locally in a given region, and in guides and publications, there are also less culturall-defined areas that still await naming. Efforts to determine the boundaries of the LFAs at this point allow, not only for renewed or de novo determination of their overall areas and areas of forest, but also for an advancement of our knowledge regarding any items of cultural heritage that may be present within LFAs. Such data will be useful or essential as new physiographic, economic and tourist guide-studies are developed; and they will encourage and facilitate the more-detailed analysis and assess-ment of forest management taking place within the limits of the LFAs. In line with the effort made to achieve the above goals, this article details selected problems encountered with the delimitation of forest boundaries and areas, as these are exemplified by the Polish LFAs of the Białowieża, Bolimów, Borki, Knyszyn, Kampinos, Noteć, Romincka, Tuchola, Łuków and Chojnów Forests. Figures for overall area and area of forest were indeed obtained and are presented here for the selected examples of LFAs, which are also augmented by the so-called Dobrzejewice and Lubniewice Forests not distinguished in this way before now.
RAZLOZI ZA KASNO OTKRIVANJE NEETIČNOSTI I ZLOUPOTREBA U BANKAMA
Authors: Slijepčević Vitomir
Published: November 2021

Savremeno svjetsko, a i nacionalno bankarstvo Republike Srpske, odnosno Bosne i Hercegovine, svakodnevno se suočava sa raznim oblicima ugrožavanja imovine svojih akcionara i deponenata. Bez obzira na sve zakonske odredbe, interne i eksterne procedure, standarde i kontrole, neetičko ponašanje, zloupotrebe, pa i kriminalne radnje i dalje značajno ugrožavaju imovinu banke. Pored eksternih počinilaca, veliki broj njih dolazi iz samih banaka, zaposlenih iz svih sfera rada, te raznih nivoa obrazovanja i odgovornosti. Sprovedeno istraživanje među bankarskim radnicima sa područja gradova Doboj i Teslić imalo je cilj dobijanje odgovora na pitanje: „Koji su to razlozi koji dovode do kasnog otkrivanja neetičnosti u bankama povezanih sa zloupotrebama, pa i kriminalnim radnjama od strane zaposlenih?“ U radu su korišćene osnovne metode naučnog istraživanja čijom primjenom se vršila obrada, analiza, sinteza, apstrahovanje i provjera dobijenih podataka. Rezultati istraživanja su pokazali da kod ispitanika postoji visok nivo tolerancije za neregularnosti u radu kada su u pitanju radne kolege, bliski prijatelji, rodbina i rukovodioci. Veliki broj ispitanika pokazuje prisustvo fenomena dobrog prijatelja. Da bi se spriječila neetičnost u radu, prevare, zloupotrebe i kriminalne radnje od strane zaposlenih u bankama neophodno je s posebnom pažnjom voditi računa o prijemu i upravljanju kadrovskim resursima u banci. Neophodno je kontinuirano sprovoditi edukacije zaposlenih kroz širenje značaja moralnih normi i decidnog upoznavanja sa etičkim kodeksom rada bankarskih službenika. Provjera primjene normi etičkog kodeksa, organizovanje sistema interne i eksterne kontrole i vršenje nadzora nad primjenom bankarskih standarda, procedura i kodeksa, je obaveza menadžmenta u banci.
ETIČKI ARGUMENT ZA UVOĐENJE KONCEPTA DRUŠTVENO ODGOVORNOG POSLOVANJA KOMPANIJA
Authors: Bradić Dubravka , Gligorijević Jasmina , Kostić Duško
Published: November 2021

Socijalne posledice koje je izazvala finansijska i ekonomska kriza doprinele su da dođe do smanjenja poverenja potrošača u poslovanje kompanija, tako da se ispred njih nameće ne samo problem ostvarenja profita, već i njihovo uključivanje u rešavanje određenih problema u samom društvu. U tom smislu, kompanije sve više rade na uvođenju i primeni koncepta društveno odgovornog poslovanja, kojim se socijalni i opšteljudski problemi, sprečavanje i rešavanje ekoloških problema kao i druga pitanja u vezi sa unapređenjem zajednice i brigom za životnu sredinu integrišu u poslovanje same kompanije. Jedan od tradicionalnih argumenata za uvođenje društveno odgovornog poslovanja jeste moralni odnosno etički argument, na osnovu kog kompanije u svoje poslovanje sve više uvode skup ličnih i kolektivnih moralnih postupaka a koje se definišu kao poslovna etika. Koncepti društveno odgovornog poslovanja i poslovne etike su veoma usko povezani i prožimaju se. Društveno odgovorno poslovanje zahteva od kompanija da posluju transparentno, odgovorno i da svojim aktivnostima podrže rešavanje određenih problema u društvu, a poslovna etika omogućava da se načela etike i društvene odgovornosti uključe u koncept društveno odgovornog poslovanja.
Peculiarities of the formation and transformation of cultural landscape of the historical settlements of Onezhskoye Pomorye
Authors: Usov Aleksei Aleksandrovich
Published: November 2021

The object of this research is the historical,-cultural and natural environment of historical settlements of the Russian North. The subject of this research is the traditional dwelling as a factor of formation and transformation of the cultural landscape of Onezhskoye Pomorye. The goal lies in studying the peculiarities of formation and transformation of cultural landscape of the rural settlements Onezhskoye Pomorye based on the material of traditional dwelling. The research relies on the empirical data acquired in the course of expedition of the Scientific Center for Traditional Culture and Museum Practices of the Ural Branch of the Russian Academy of Sciences to Onezhsky District of Arkhangelsk Region (2018–2021);archival sources of A.V. Shchusev State Museum of Architecture (Moscow), experience of exploring the monuments of wooden architecture of the open-air museum “Malye Korely” (Arkhangelsk Region). The data were obtained by photofixation of the architectural monuments, schematic measurements, and ethnographic survey conducted among local residents using the method of interview. The research employs the original methodology developed by the Doctor of Culturology A. B. Permilovskaya on the architectural-ethnographic exploration of the sites of wooden architecture. Cultural landscape of Onezhskoye Pomorye (and the Russian North overall) primarily is the landscape of rural historical settlements. Northern settlements emerged in close connection with the natural landscape and transformed it into a cultural one. Special role in this process was played by the local population – the Pomors, who were guided by the principles of creating compact settlements, with closed type of dwelling to due to the harsh climate. The adaptive capabilities of traditional dwelling, reflected in its architectural design, allowed the people to survive in the severe conditions of the North. The dwelling is a reflection of natural space of the Russian North and the Arctic, passed through the “prism” of local mentality and carpenter's culture, coexistence of man and the surrounding natural environment, special marker of the North Russian identity, and intrinsic part of the North Russian cultural landscape.
Review of Understanding Consciousness by Max Velmans
Authors: Beshara Robert
Published: November 2021

Understanding Consciousness can almost be said to have a plot/narrative, or a dramatic structure similar to the ‘three-act structure’ model used by numerous screenwriters. In Part I—the Setup—Velmans surveys “mind-body theories and their problems”, in part II—the Confrontation—he reconstructs “a new analysis: how to marry science with experience”, and in part III—the Resolution—he shares with us “a new synthesis: reflexive monism” (v-vi). Velmans starts off in the first chapter with perhaps one of the most basic, nevertheless hard, questions in the field of consciousness studies: “what is consciousness?”
Syntactic model-based human body 3D reconstruction and event classification via association based features mining and deep learning
Authors: Ghadi Yazeed , Akhter Israr , Alarfaj Mohammed , Jalal Ahmad , Kim Kibum
Published: November 2021

The study of human posture analysis and gait event detection from various types of inputs is a key contribution to the human life log. With the help of this research and technologies humans can save costs in terms of time and utility resources. In this paper we present a robust approach to human posture analysis and gait event detection from complex video-based data. For this, initially posture information, landmark information are extracted, and human 2D skeleton mesh are extracted, using this information set we reconstruct the human 2D to 3D model. Contextual features, namely, degrees of freedom over detected body parts, joint angle information, periodic and non-periodic motion, and human motion direction flow, are extracted. For features mining, we applied the rule-based features mining technique and, for gait event detection and classification, the deep learning-based CNN technique is applied over the mpii-video pose, the COCO, and the pose track datasets. For the mpii-video pose dataset, we achieved a human landmark detection mean accuracy of 87.09% and a gait event recognition mean accuracy of 90.90%. For the COCO dataset, we achieved a human landmark detection mean accuracy of 87.36% and a gait event recognition mean accuracy of 89.09%. For the pose track dataset, we achieved a human landmark detection mean accuracy of 87.72% and a gait event recognition mean accuracy of 88.18%. The proposed system performance shows a significant improvement compared to existing state-of-the-art frameworks.
Brixia Chest X-ray Scoring System in Critically Ill Patients with COVID-19 Pneumonia for Determining Outcomes
Authors: Agrawal Nishant , Chougale Samruddhi Dhanaji , Jedge Prashant , Iyer Shivakumar , Dsouza John
Published: November 2021

Introduction: In early stage of disease of Coronavirus Disease 2019 (COVID-19) infection chest Computed Tomography (CT) imaging is considered as the most effective method for detecting lung abnormalities. A Brixia Chest X-ray (CXR) scoring system which uses an 18-point severity scale to grade lung abnormalities due to COVID-19 was developed to improve the risk stratification for infected patients. Aim: To ascertain the validity of Brixia scoring system and to measure the outcome in COVID-19 patients. Materials and Methods: A retrospective study was conducted from 1st April 2020 to 31st July 2020, at a tertiary care hospital in India. Baseline CXR of COVID-19 patients were scored based on Brixia scoring system. The lungs were divided into six equal zones. Subsequently, scores (from 0-3) were assigned to each zone, based on lung abnormalities. A group comparison was implemented using Chi-Square test for categorical variables. Whereas an independent t-test was applied for continuous variables that followed normal distribution. Results: The study included 130 patients. The mean age was 57.09±13.73 years, 70.8% patients included were males. Out of 130 patients, 79 patients died. Among patients who died the mean CXR score was calculated to be 12.13±2.50. The mean CXR score was calculated to be 11.18±2.30 in patients who recovered and got discharged. During the process of comparison of CXR scores with the outcomes, the t-value came out to be 2.20 and the resulting p-value was 0.03 (statistically significant). Conclusion: Brixia score more than 12 was associated with increased mortality due to COVID-19, with p-value of 0.03.
Prescription Claims for Immunomodulator and Antiinflammatory Drugs Among Persons With Ehlers‐Danlos Syndromes
Authors: Dhingra Radha , Hakim Alan , Bascom Rebecca , Francomano Clair A. , Schubart Jane R.
Published: November 2021

Objective

Joint hypermobility in Ehlers‐Danlos Syndromes (EDS) predisposes persons with EDS to frequent subluxations and dislocations, chronic arthralgia, and soft‐tissue rheumatism. Epidemiologic trends of rheumatologic conditions among persons with EDS are lacking. Prescription claims databases can reflect underlying disease burdens by using medication claims as disease proxies. We examined the prevalence of prescription claims for commonly prescribed immunomodulator and antiinflammatory (IMD) drugs among persons with EDS compared with their matched control person, and hypothesized peripubertal increases among female persons with EDS.

Methods

We compared the percentages of IMD drug prescription claims among 3,484 persons with EDS (ages 5–62 years) against their age‐, sex‐, state of residence‐, and earliest claim date–matched control persons using 10 years (2005–2014) of private prescription claims data and a minimum 2‐year enrollment inclusion criterion.

Results

Our cohort comprised 70% adults and 74% female persons. At least 1 IMD medication was prescribed to 65.4% of persons with EDS compared with 47.4% of control persons. We observed 1.3 to 4.2 times higher odds (P < 0.0001) for 5 out of 6 IMD drug classes among persons with EDS compared with matched control persons, except for biologic agents (conditional odds ratio 1.3, 95% confidence interval 0.8–2.0). Peripubertal increases were observed for nonsteroidal antiinflammatory drugs, oral, and injectable steroids.

Conclusions

To our knowledge, our study is the first to examine the full range of IMD drug prescription claim trends among persons with EDS. We believe our research findings can have notable diagnostic and management implications for EDS patients who present with multiple comorbidities and generally require a more granular assessment of their medical conditions.
All‐Cause and Cause‐Specific Mortality in Psoriatic Arthritis and Ankylosing Spondylitis: A Systematic Review and Meta‐Analysis
Authors: Chaudhary Haseeb , Bohra Nidrit , Syed Khezar , Donato Anthony , Murad M. Hassan , Karmacharya Paras
Published: November 2021

Objective

Psoriatic arthritis (PsA) and ankylosing spondylitis (AS) are chronic inflammatory diseases associated with a higher risk of cardiometabolic comorbidities compared to the general population. Individual studies examining mortality in these patients have produced conflicting results. The present study was undertaken to perform a systematic review and meta‐analysis to analyze the all‐cause and cause‐specific mortality in PsA and AS from the available literature.

Methods

A comprehensive database search was performed for studies reporting all‐cause or cause‐specific mortality in patients with PsA and AS compared with the general population. Pooled relative risks (RRs) were calculated using a random‐effects model.

Results

We included 19 studies (11 of PsA, 7 of AS, 1 of both). In PsA studies, there was no increased mortality compared to the general population (RR 1.12 [95% confidence interval (95% CI) 0.96–1.30]; n = 10 studies). We found a higher all‐cause mortality in female (RR 1.19 [95% CI 1.04–1.36]) but not in male (RR 1.02 [95% CI 0.66–1.59]) PsA patients. Cardiovascular‐, respiratory‐, and infection‐specific mortality risks were significantly higher for PsA patients (RR 1.21 [95% CI 1.06–1.38], RR 3.37 [95% CI 1.30–8.72], and RR 2.43 [95% CI 1.01–5.84], respectively), but not cancer‐related mortality (RR 1.01 [95% CI 0.91–1.11]). In AS, we found a higher risk of death from all causes (RR 1.64 [95% CI 1.49–1.80]; n = 6 studies) and cardiovascular causes (RR 1.35 [95% CI 1.01–1.81]; n = 3 studies) compared to the general population. All‐cause mortality was high in both male (RR 1.56 [95% CI 1.43–1.71]) and female (RR 1.85 [95% CI 1.56–2.18]) AS patients. The included AS studies did not report mortality data for non‐cardiovascular causes.

Conclusion

This systematic review and meta‐analysis showed a significantly increased risk of overall mortality in AS but not PsA. Cardiovascular‐specific mortality was higher for both PsA and AS, which emphasizes the importance of early screening and management of cardiovascular risk factors.
Optimization of Human Mesenchymal Stem Cells for Rheumatoid Arthritis: Implications for Improved Therapeutic Outcomes
Authors: Breitman Maya , Bonfield Tracey L. , Caplan Arnold I. , Lazarus Hillard M. , Haghiac Maricela , LaSalvia Susan , Reese‐Koc Jane , Singer Nora G.
Published: November 2021

Objective

Seropositive rheumatoid arthritis (RA) is a chronic autoimmune disease that is rarely “cured.” Human mesenchymal stem cells (hMSCs) are known to reduce inflammation and restore immune homeostasis. However, methods for predicting therapeutic hMSC potency have not been established. The goal of these studies was to use and refine an ex vivo functional assay that determines potency of hMSCs and can then be validated in clinical trials as a potency measure of hMSCs used therapeutically to treat RA.

Methods

Allogeneic hMSCs were cytokine‐stimulated, and a conditioned medium (CM) was harvested. The CM was tested for the potential to attenuate RA CD4+ T cell proliferation using suppression assays. Indoleamine 2, 3‐dioxygenase (IDO) mRNA, and protein were quantified in hMSCs as a measure to compare hMSCs across (prior) studies.

Results

To mimic a proinflammatory environment that resembles that in RA, interleukin‐1(IL1β), tumor necrosis factor α (TNFα), and interferon γ (IFNγ) (alone or in combination) were used to precondition hMSCs. Treating hMSCs with a combination of these cytokines generated a CM “secretome” that suppressed T cell proliferation between 70 and 83%. Forty‐eight hours of cytokine preconditioning hMSCs was required to maximize this effect. T cell suppression positively correlated with increases in hMSC cellular IDO mRNA and protein.

Conclusion

By standardizing assays to measure hMSC effects, their potency on T cell suppression can be quantified. These studies demonstrate that hMSCs can be compared functionally to identify optimal preparation(s) for therapeutic use in RA and that the potency of hMSC‐dependent T cell suppression may differ between hMSC donors. Clinical studies are warranted to validate the hypothesis that ex vivo potency in suppressing T cells will positively correlate with a reduction in RA disease activity and increase in immunological quiescence.
Free‐Standing Nanofilm Electrode Arrays for Long‐Term Stable Neural Interfacings
Authors: Gao Lei , Wang Jinfen , Zhao Yan , Li Hongbian , Liu Mengcheng , Ding Jianfei , Tian Huihui , Guan Shouliang , Fang Ying
Published: November 2021

Flexible neural electrodes integrated on micrometer‐thick polymer substrates offer important opportunities for improving the stability of neuronal activity recordings during cognitive processes. However, the bending stiffness of micrometer‐thick polymer substrates is typically two orders of magnitude higher than that of nanofilm electrodes, making it a limiting factor in electrode‐tissue interfacings. Here, this limitation is overcome by developing self‐assembled nanofilm electrode arrays (NEAs) that consist of high‐density, free‐standing gold nanofilm electrodes. Chronically implanted NEAs can form intimate and innervated interfaces with neural tissue, enabling stable neuronal activity recordings across multiple brain regions over several months. As an application example, the activities of the same neuronal populations are tracked across odor discrimination reversal learning and it is illustrated how dorsal striatal neurons represent and update stimulus‐outcome associations across multiple timescales. The results underscore the potential of free‐standing nanoscale materials for interfacing biological systems over long terms.
Ferromagnetic Enhancement in LaMnO3 Films with Release and Flexure
Authors: Yao Hongbao , Jin Kuijuan , Yang Zhen , Zhang Qinghua , Ren Wenning , Xu Shuai , Yang Mingwei , Gu Lin , Guo Er‐Jia , Ge Chen , Wang Can , Xu Xiulai , Zhang Dongxiang , Yang Guozhen
Published: November 2021

A variety of novel phenomena and functionalities emerge from lowering the dimensionality of materials and enriching the degrees of freedom in modulation. In this work, it is found that the saturation magnetization of LaMnO3 (LMO) films is largely enhanced by 56% after releasing from a brand‐new phase of tetragonal strontium aluminate buffer layer, and is significantly increased by 92% with bending films to a curvature of 1 mm−1 using a water‐assisted direct‐transferring method. Meanwhile, the Curie temperature of LMO films has been improved by 13 K. High‐resolution spherical aberration‐corrected scanning transmission electron microscopy and first‐principles calculations unambiguously demonstrate that the enhanced ferromagnetism is attributed to the strengthened Mn–O–Mn super‐exchange interactions from the augmented characteristics of the unconventional P21/n structure caused by the out‐of‐plane lattice shrinking after strain releasing and increased flexure degree of freestanding LMO films. This work paves a way to achieve large‐scale and crack‐and‐wrinkle‐free freestanding films of oxides with largely improved functionalities.
Vacuum‐Assisted Layer‐by‐Layer Carbon Nanotube/Ti3C2TX MXene Films for Detecting Human Movements
Authors: Wang Jing‐Qi , Qian Peng‐Fei , Lou Tian‐Jiao , Wang Wenyi , Geng Wen‐Hao , Jing Li‐Chao , Bao Ze‐Long , Wang Tao , Geng Hong‐Zhang
Published: November 2021

The rapid development of the Internet of Things has promoted the application of wearable devices in human's daily life and industrialization. Strain sensors play an indispensable role as a member of wearable devices. Here, a strain film sensor with multi‐walled carbon nanotubes (MWCNTs) and Ti3C2TX MXene, which is obtained by vacuum‐assisted filtration and integrated onto a thermoplastic polyurethane substrate, is developed. Since the MWCNTs and Ti3C2TX MXene composite sensor has a characteristic ‘mud‐brick’ microstructure. The sensor has the ability to detect various human movements, such as, bending of finger joints, wrists, elbow joints, and shoulder. The sensors show excellent mechanical property and can be folded more than 2000 times without failure. It also exhibits short response time, low detection limit, and wide range of use. In addition, the sensor shows excellent electrical heating performance. The temperature of the composite film can rise to 96.6 °C in a short period of time even under low voltage power supply (25 V). It likewise proves its excellent performance in terms of cyclability and long‐time heating capability. The film has low production cost, easy preparation method, and simple operation. The MWCNT/Ti3C2TX MXene film can be integrated into wearable devices and shows great potential for future applications.
Regional variation in growth status. The Peruvian health and optimist growth study
Authors: Bustamante Alcibíades , Santos Carla , Pereira Sara , Freitas Duarte , Katzmarzyk Peter T. , Maia José
Published: November 2021

Objective

This study aims to (1) investigate differences in weight, body mass index (BMI), and waist circumference (WC) among Peruvian children and adolescents living in three areas located at different altitudes; (2) compare age‐ and sex‐specific height, weight, and BMI within each site with US reference data.

Methods

We sampled 8753 subjects (4130 boys), aged 4 to 17 years from sea level, rainforest, and high‐altitude. Height, weight, and WC were measured and BMI was calculated. Analysis of variance was used to compare variables across geographic regions, and the Hoff and Blackburn procedure was used to compare the Peruvian results with US reference data.

Results

Participants living at sea level were taller, heavier, had greater BMI and WC relative to those living at high‐altitude and in the rainforest. Peruvian schoolchildren of both sexes from the three geographical areas were shorter and lighter than their American peers. Boys and girls living in the rainforest and at high‐altitude had lower BMI, whereas WC values of American schoolchildren are higher than those of the Peruvian children by age and gender.

Conclusions

Peruvians living at different altitudes differ in their growth indicators (height, weight, BMI, and WC), with significant differences between those living at sea level relative to their peers from other regions. Further, Peruvian schoolchildren of both sexes from the three geographical areas significantly differ from their US counterparts.