bluuebunny/crossref_metadata_2025 huggingface dataset:
Near-Infrared Photoimmunotherapy for Cancers of the Gastrointestinal Tract
Authors: Nagaya Tadanobu , Choyke Peter L. , Kobayashi Hisataka
Published: December 2020

Background: Cancers of the gastrointestinal (GI) tract are the common leading cause of cancer-related death in the world. Recent advances in cancer therapies such as intensive multidrug chemotherapy and molecular targeted treatment have improved therapeutic efficacy; however, the outcomes are not satisfied. Moreover, these therapies also cause severe side effects. New type of cancer therapies is urgently needed to improve the outcomes and to reduce side effects of GI tract cancers. Summary: This account is a comprehensive review article on the newly developed, photochemistry-based cancer therapy named as near-infrared photoimmunotherapy (NIR-PIT). NIR-PIT is a highly selective tumor treatment that employs an antibody-photoabsorber conjugate, which is activated by near-infrared light. A world-wide phase 3 clinical trial of NIR-PIT against recurrent head and neck cancer patients is currently underway. NIR-PIT differs from conventional cancer therapies such as surgery, chemotherapy, and radiation in its selectivity for killing cancer cells and cells treated with NIR-PIT leading to immunogenic cell death. Preclinical research in animals with combining cancer-targeting NIR-PIT and other cancer immunotherapies could lead to responses not only in local tumor but also in distant metastases. NIR-PIT also leads to an immediate and dramatic increase in vascular permeability after therapy. From these aspects, NIR-PIT appears to be a promising new form of cancer therapy. NIR-PIT could be readily translated into clinical use for virtually any cancers in the near future provided suitable humanized antibodies are available. Here, we describe the specific advantages and applications of NIR-PIT in the GI tract. Key Messages: We believe that NIR-PIT with NIR excitation light, which can be delivered via a fiber optic diffuser through endoscopes, is a promising method for a new treatment of GI cancers.
Thromboembolische Erkrankung bei COVID-19-Patienten: Eine kurze narrative Übersichtsarbeit
Authors: Mondal Samhati , Quintili Ashley L. , Karamchandani Kunal , Bose Somnath
Published: December 2020

Die Infektion mit dem Coronavirus 2 (SARS-CoV2, severe acute respiratory syndrome corona virus 2) hat sich zu einer globalen Gesundheitskrise entwickelt. Berichten zufolge ist die Inzidenz von thromboembolischen Erkrankungen bei der SARS-CoV2-Krankheit hoch und betrifft ein breites Spektrum an Organsystemen, von Hautthrombosen bis zu Lungenembolien, Schlaganfall oder Koronarthrombose, bisweilen mit katastrophalen Folgen. Es liegen Hinweise vor, nach denen Thromboembolien, Hyperkoagulabilität und eine Überproduktion proinflammatorischer Zytokine, die einen Zytokinsturm nachahmen, der zu Multiorganversagen führt, eine Schlüsselrolle dabei spielen. Die vorliegende kurze narrative Übersichtsarbeit beleuchtet die Pathophysiologie und die Risikofaktoren der thromboembolischen Erkrankung und liefert einen Rahmen für das Antikoagulationsmanagement auf Grundlage der aktuellen Evidenzlage.
Nacionalismo como lógica de partilha
Authors: Carvalho Bruno Sciberras de
Published: December 2020

Com base na análise de obras, entrevistas e posicionamentos políticos de Edward Said sobre as relações Israel-Palestina, o artigo discute como inflexões no ativismo do autor se articulam com a evolução de suas reflexões teóricas. Argumenta-se que mudanças de posição de Said sobre os conflitos da questão palestina refletem movimentos contínuos de sua produção teórica, particularmente o desenvolvimento de teses críticas a formas e práticas de filiação identitária. Conquanto Said mude algumas opiniões ao longo dos anos, sustenta-se que a crítica teórica a lógicas identitárias, em especial o que denomina “modelo de partilha” do nacionalismo, assim como o elogio de uma postura universalista se apresentam desde sempre em sua obra.
Violência de gênero e telenovelas nacionais
Authors: Caminhas Lorena Rúbia Pereira
Published: December 2020

O artigo apresenta um diagnóstico dos últimos dezenove anos de representação da violência de gênero em telenovelas nacionais, pensando essas produções ficcionais em consonância com o contexto sociojurídico brasileiro de combate às violações de mulheres. Trata-se de um balanço crítico composto por um corpus de 21 novelas, que investiga as representações de agressões contra mulheres para além da fachada do merchandising social, isto é, dos núcleos dramáticos que pretenderam debater e educar sobre esse problema público. Ao fim, demonstram-se os sofisticados mecanismos narrativos que edificam e sustentam imagens dissidentes da violência de gênero, ora interpretada como sofrimento, ora como castigo necessário.
Caminho sem volta? Faces da expansão do PCC a Minas Gerais
Authors: Duarte Thais Lemos , De Araújo Isabela Cristina Alves
Published: December 2020

Com base nos recursos analíticos empregados pela literatura a respeito das faces bélica, empresarial e fraternal sobre a organização criminal do Primeiro Comando da Capital (PCC), este artigo analisa distintos relatos sobre o grupo em sua expansão por Minas Gerais. São analisadas perspectivas de funcionários estaduais e de pessoas custodiadas na Penitenciária Nelson Hungria da Região Metropolitana de Belo Horizonte, as quais teriam algum tipo de vinculação ao PCC. Os atores públicos mobilizaram, em especial, as faces bélica e empresarial não só para caracterizar o grupo criminal, como também para justificar as ações de controle empregadas para contê-lo. Por sua vez, embora os presos tenham reforçado a face fraternal da organização, não ignoraram a importância dos seus traços bélicos e empresariais no processo de expansão pelo território mineiro.
Laços à brasileira: desigualdades e vínculos sociais
Authors: Guimarães Nadya Araújo , Paugam Serge , Prates Ian
Published: December 2020

Ao longo da vida os indivíduos se envolvem num processo permanente de (re)construir laços (familiares, comunitários, profissionais, de cidadania) que lhes assegurem a proteção frente a riscos e o reconhecimento de sua própria existência e identidade. Embora, em cada sociedade, as várias modalidades de laço se façam presentes, há sempre um tipo preeminente, cujos valores e princípios influem sobre os demais, regulando-os e assentando as bases para uma economia moral particular, para um “regime de vinculação”. Neste artigo trataremos o tema a partir do caso brasileiro. Usaremos a comparação para identificar suas singularidades. Inicialmente compararemos os dados para o Brasil com aqueles produzidos em estudo anterior sobre uma amostra de dezesseis países europeus. Em seguida, analisaremos suas heterogeneidades internas, observando mudanças no tempo e entre regiões do país.
Distribution and composition of Dragonfly and Damselfly species (Odonata) of the upper Rio das Velhas, Ouro Preto, Minas Gerais State, Brazil
Authors: Ávila Júnior Walter Francisco de , Machado Gustavo Lisboa Vieira , Lencioni Frederico Augusto de Atayde , Carneiro Marco Antônio Alves
Published: December 2020

This paper describes the composition and distribution of Anisoptera and Zygoptera (Odonata) species of the upper Rio das Velhas in the municipality of Ouro Preto, Minas Gerais State, Brazil. A total of 727 specimens of 40 species were collected near water bodies over a period of 23 months between 2015 and 2017. The families with greatest species richness were Libellulidae (13 species), Coenagrionidae (12 species) and Heteragrionidae and Aeshnidae (4 species each). Notable among the species collected were Perilestes fragilis Hagen in Selys, 1862, inhabiting well-preserved forests, Minagrion waltheri Santos, 1965, pertaining a endemic genus of Brazil and the recently described Heteragrion cauei Ávila-Júnior et al., 2017, and three species recorded for the first time for the state: Elasmothemis alcebiadesi (Santos, 1945); Erythrodiplax melanica Borror, 1942 and Erythrodiplax acantha Borror, 1942, the latter is considered Critically Endangered (CR) by the International Union for Conservation of Nature's (IUCN) Red List.
Catarata morganiana bilateral em paciente com aniridia congênita - relato de caso
Authors: Scarpini Lara Picanço , Valbon Lucas Siegle , Silva Rafael Fernandes , Valbon Bruno de Freitas
Published: December 2020

A diminuição da visão devido à importante opacidade de meios é comum em aniridia, porém existem poucos relatos de cirurgia combinada nesta condição. A cirurgia de catarata com implante de lente intra-ocular de polimetilmetacrilato continua sendo um desafio para os cirurgiões, devido ao maior peso desse material e à diálise zonular apresentada por esses pacientes. O presente estudo, tem como objetivo relatar um caso de aniridia em uma paciente jovem, apresentando catarata hipermadura.
A reformulação da rede federal de ensino profissional como estratégia geopolítica para produzir inovação tecnológica no Brasil
Authors: Souza Mauro Sergio Pinheiro dos Santos
Published: December 2020

Este artigo propõe uma reflexão sobre a política de reformulação da rede federal de ensino como estratégia geopolítica do governo federal para a educação profissional e as decorrentes imbricações territoriais da produção de inovações. Trata-se do estudo das transformações na educação profissional da rede federal de ensino para a melhora da educação nacional e para a competição econômica nacional e internacional, a partir da prospecção das potencialidades territoriais para a inovação. Com base numa revisão da bibliografia e a partir da pesquisa da produção de inovações patenteadas, investiga-se a correlação entre a educação profissional e a produção de inovações. O resultado da análise aponta que a educação profissional tem ensejado a produção de inovações técnicas e tecnológicas, evidenciado a correlação dessa produção com as características dos territórios onde ficam as unidades dos Institutos Federais.
Tendências das séries temporais de precipitação no estado do Paraná
Authors: Siqueira Beatriz , Nery Jonas Teixeira
Published: December 2020

O objetivo deste trabalho é avaliar a presença de tendências nas séries temporais de precipitação no estado do Paraná. Foram analisadas séries do índice de concentração (IC) e do índice de concentração da precipitação (IPC) e os totais anuais, além do período úmido e do período seco de 38 séries pluviométricas. Para tanto, aplicou-se o teste estatístico não paramétrico de Mann-Kendall. Os resultados obtidos apresentaram tendências significativas em todas as análises, podendo-se destacar que, das 38 séries pluviométricas, 18 apresentaram tendências, correspondendo a 47% do total.
Vulnerabilidade territorial do agronegócio globalizado no Brasil: crise do setor sucroenergético e implicações locais
Authors: Santos Henrique Faria dos , Castillo Ricardo
Published: December 2020

O artigo discute a especialização regional produtiva e a vulnerabilidade territorial do agronegócio globalizado no Brasil, a partir do estudo da recente crise econômica do setor sucroenergético. Desde 2008, mais de 100 Unidades Agroindustriais Sucroenergéticas (UAS) suspenderam suas atividades de processamento no país, em função de diversos fatores conjunturais e estruturais que elevaram o endividamento e os prejuízos de vários grupos empresariais. Em razão do processo de especialização produtiva provocada pelo padrão de ocupação da agroindústria sucroenergética e da dificuldade do setor, vários municípios, especialmente os de baixo patamar demográfico e reduzido dinamismo urbano-industrial, estão vulneráveis aos casos de recuperação judicial e falências de UAS.
Urbanização, discursos e relações de poder: turismo e planejamento urbano em Florianópolis (1950-1980)
Authors: Lenzi Maria Helena , Gonçalves Tiago Cargnin
Published: December 2020

Este artigo analisa como o planejamento urbano incorpora um discurso pautado em atributos turísticos que orienta a urbanização de Florianópolis e consolida um projeto hegemônico de cidade, sobretudo entre as décadas de 1950 e 1980. A avaliação de sucessivos planos diretores e turísticos indica que o turismo passa de atividade acessória da cidade, conforme seu primeiro plano diretor, da década de 1950, para uma política institucional de planejamento urbano na virada da década de 1960 para a de 1970. Já na década de 1980, o planejamento urbano incorpora a ideia de vocação turística de Florianópolis, pautando-se na retórica ambiental para justificar suas ações. A instituição de Florianópolis como cidade turística surge de articulações entre relações de poder e formas de saber, como o planejamento urbano.
Ação, Conhecimento e Relações Sociais do Espaço
Authors: Werlen Benno
Published: December 2020

Ao contrário de entendimento ainda bem estabelecido, as condições geográficas das ações humanas devem ser vistas do ponto de vista sociogeográfico, ou seja, principalmente como um produto social e apenas secundariamente como uma condição biofísica. Esse status ontológico da era do antropoceno significa que as transformações sociais geográficas são altamente importantes para todas as formas de fazer geografia, que, por sua vez, são fundamentais para a mudança e as transformações sociais.
Glauber Rocha e Hiroshima mon amour: notas sobre um amor eclipsado
Authors: Silva Mateus Araújo
Published: December 2020

O artigo reexamina a recepção crítica de Hiroshima mon amour por Glauber Rocha, que lhe consagrou dois artigos específicos em 1960-61, e deixou uma série considerável de referências ao filme ou a Resnais em uma trintena de outros textos (sobre outros filmes e cineastas), basicamente na década de 1960, mas também, em número menor, na seguinte. Neste percurso, discute o entusiasmo com o qual Glauber acolhe o filme no calor da hora, mas que parece refluir com o passar dos anos, num eclipse gradual do qual o sintoma mais significativo é a ausência daqueles dois artigos no sumário d’O Século do Cinema, seu livro preparado antes da morte sobre o cinema mundial.
O Tanztheater e suas imagens
Authors: Sertori Rafael Henrique Viana
Published: December 2020

A escrita desse artigo tem por objetivo discutir a produção de imagens a partir da linguagem da dança, tomando como objeto de análise geral a Dança Moderna alemã e, em específico, a obra da bailarina e coreógrafa alemã Pina Bausch (1940-2009), à frente da companhia Tanztheater Wuppertal-Pina Bausch. As observações aqui descritas caminham na direção de tentar evidenciar em que medida a experiência estética em dança pode contribuir com o campo compreendido pela reflexão estética acerca das imagens na contemporaneidade.
The Rusty-spotted Cat Prionailurus rubiginosus (I. Geoffroy Saint-Hillaire, 1831) (Mammalia: Carnivora: Felidae) in Rajasthan, India – a compilation of two decades
Authors: Sharma Satish Kumar , Dhakad Meenu
Published: December 2020

In Rajasthan, the presence of the Rusty-spotted Cat Prionailurus rubiginosus was first reported in 1994 in Udaipur District, the southernmost district of Rajasthan.  Since then, it was also recorded in four more districts scattered over an area of about 86,205km2.  We compiled information about the occurrence of the Rusty-spotted Cat in Rajasthan based on direct sightings, road kills, rescued kittens, and camera trap images.  Our data set shows that the Rusty-spotted Cat is also present in eight more districts of Rajasthan that form part of the Aravalli Hills and Vindhyan Hills in the semi-arid zone of eastern Rajasthan.  The area encompassed by these records amounts to 71,586km2.  Kittens were rescued in six instances.  Adult cats were recorded in 45 instances including 41 live cats and four roadkills.  Ten adult live Rusty-spotted Cats were sighted in the mornings, and 31 were recorded after dark between late evenings and early mornings.  They were recorded in eight habitat types including foremost thorny and dry deciduous forests, but also ravines and agricultural fields adjacent to forests, and in forest patches in the vicinity of human settlements.  The preservation of forests is of utmost importance for the long-term viability of the Rusty-spotted Cat.  We strongly recommend surveys outside protected areas to determine the connectivity between Rusty-spotted Cat population units in Rajasthan.
Updating records of a threatened felid species of the Argentinian Patagonia: the Guigna Leopardus guigna (Molina, 1782) (Mammalia: Carnivora: Felidae) in Los Alerces National Park
Authors: Guerisoli Maria de las Mercedes , Schiaffini Mauro Ignacio , Bauer Gabriel
Published: December 2020

The Guigna Leopardus guigna is an endemic felid of the Valdivian Temperate Forests in Argentina and Chile, and of the Chilean Matorral ecoregion.  It is a small-sized felid (1.6–2.5 kg), one of the least known wild felids, and categorized as Vulnerable to extinction.  Here, we present two new reliable records in Los Alerces National Park, Chubut Province, Argentina, the southernmost protected area, in which the species is present. The first record is an individual found dead on 6 June 2019 on the bank of Frey River near Amutui Quimei Lake.  The second record was an individual casually captured in an American Mink Neovison vison cage on 7 December 2019 near Menéndez Lake.  Both records were in forested Nothofagus sites very nearby to watercourses.  In order to maintain viable long-term Guigna populations, corridors between protected areas should be established, particularly in habitat dominated by human presence and activities.  We strongly recommend further fieldwork in protected areas and between them to increase the knowledge about the distribution, habitat use, and ecology of the Guigna.
Prediction of Cardiovascular Events by Type I Central Systolic Blood Pressure
Authors: Lamarche Florence , Agharazii Mohsen , Madore François , Goupil Rémi
Published: December 2020

Compared with brachial blood pressure (BP), central systolic BP (SBP) can provide a better indication of the hemodynamic strain inflicted on target organs, but it is unclear whether this translates into improved cardiovascular risk stratification. We aimed to assess which of central or brachial BP best predicts cardiovascular risk and to identify the central SBP threshold associated with increased risk of future cardiovascular events. This study included 13 461 participants of CARTaGENE with available central BP and follow-up data from administrative databases but without cardiovascular disease or antihypertensive medication. Central BP was estimated by radial artery tonometry, calibrated for brachial SBP and diastolic BP (type I), and a generalized transfer function (SphygmoCor). The outcome was major adverse cardiovascular events. Cox proportional-hazards models, differences in areas under the curves, net reclassification indices, and integrated discrimination indices were calculated. Youden index was used to identify SBP thresholds. Over a median follow-up of 8.75 years, 1327 major adverse cardiovascular events occurred. The differences in areas under the curves, net reclassification indices, and integrated discrimination indices were of 0.2% ([95% CI, 0.1–0.3]
P
<0.01), 0.11 ([95% CI, 0.03–0.20]
P
=0.01), and 0.0004 ([95% CI, −0.0001 to 0.0014]
P
=0.3), all likely not clinically significant. Central and brachial SBPs of 112 mm Hg (95% CI, 111.2–114.1) and 121 mm Hg (95% CI, 120.2–121.9) were identified as optimal BP thresholds. In conclusion, central BP measured with a type I device is statistically but likely not clinically superior to brachial BP in a general population without prior cardiovascular disease. Based on the risk of major adverse cardiovascular events, the optimal type I central SBP appears to be 112 mm Hg.
Checklist of ciliates (Alveolata: Ciliophora) that inhabit in bromeliads from the Neotropical Region
Authors: DURÁN-RAMÍREZ CARLOS ALBERTO , DIAS ROBERTO JÚNIO PEDROSO , MAYÉN-ESTRADA ROSAURA
Published: December 2020

Species from almost all classes of ciliates are prone to be found inhabiting bromeliads in the Neotropics, from Mexico to Brazil, and the Antilles. Studies of ciliates recorded from bromeliads have been carried out from few bromeliad species, mainly in tropical forest. We compiled all available data of free living and sessile ciliates from bromeliads, including their geographic distribution and bromeliad identity. We provide a list of 170 ciliate species that have been recorded in 52 epiphytic and terrestrial bromeliad species, distributed in ten Neotropical countries . Most of the species belong to the Classes Oligohymenophorea, Colpodea and Spirotrichea. The largest number of ciliate species has been recorded in Brazil and Mexico. Bromeliothrix metopoides and Glaucomides bromelicola were the two species with the widest geographical distribution, 19 species have been recorded only in Mexico, 11 in the Antillean islands, and 89 only in Southamerica. Free living species prevailed over sessile species, and both represent 2% of the total ciliate species number. Sixteen ciliate species have been recorded only inhabiting in bromeliads. Although bromeliads show a high endemicity, their specificity is low in relation to ciliates.
A new genus and three new species of leafhopper tribe Scaphoideini (Hemiptera: Cicadellidae: Deltocephalinae) from India with a note on Gunghuyana cingalensis Distant
Authors: VIRAKTAMATH C.A. , YESHWANTH H.M.
Published: December 2020

Advikus gen. nov. and three new species, Advikus siddappaji sp. nov. (type species, India: Karnataka), A. andamanicus sp. nov. (India: Andaman & Nicobar Islands) and A. radhamaniae sp. nov. (India: Karnataka) are described and illustrated. A key to the known genera of the tribe Scaphoideini from the Indian subcontinent and also the three new species are provided. A lectotype for Gunghuyana cingalensis Distant is designated and the female type is redescribed and illustrated.
Megarthrus of China. Part 2. Megarthrus basicornis Fauvel, 1904 with description of a new species from Mount Emei (Coleoptera: Staphylinidae: Proteininae)
Authors: LIU ZHIPING , CUCCODORO GIULIO
Published: December 2020

Megarthrus budai Liu and Cuccodoro sp. nov. from Sichuan province in China is described. It is the first record of the genus from Mount Emei, a temperate biodiversity-rich mountain to which this new species seems to be endemic. Megarthrus basicornis Fauvel, 1904, known so far only from India and Nepal, is reported from China for the first time.These two species have many features found mainly in members of the predominantly Holarctic and African M. depressus supergroup of species.
Utilization of Percentage of Predicted Forced Vital Capacity to Stratify Rib Fracture Patients: An Updated Clinical Practice Guideline
Authors: Khan Abid D. , Marlor Derek R. , Billings Joshua D. , Rodriguez Joe , Leininger Brian E. , Douville Alyssa A. , Clement Lesley Paige , Schroeppel Thomas J.
Published: December 2020

Background

Rib fractures are the most common injuries diagnosed after blunt thoracic trauma and are a source of significant morbidity and mortality. Early identification of at-risk patients and initiation of effective analgesia are keys to mitigating complications from these injuries. Multiple tools exist to predict pulmonary decompensation after rib fractures; however, none has found a widespread acceptance. A clinical practice guideline (CPG) utilizing Forced vital capacity (FVC) has been in place at a single institution. The goal of this study is to update the CPG to use percentage of predicted FVC (FVC%) instead of FVC to triage patients with rib fractures.

Materials and Methods

A retrospective study of 266 patients with rib fractures was conducted. Patients were divided into 3 groups based on FVC of <1000 mL, 1001-1500 mL, or >1500 mL for analysis. Data were analyzed with analysis of variance, and Youden’s J Index was used to identify inflection points.

Results

Patients in the high-risk category were more likely to be women, older than 65 years, admitted to the intensive care unit (ICU), transferred to the ICU, require intubation, and have overall longer hospital and ICU stays. The updated CPG triage cutoffs for admission to ICU, stepdown, and floor were redefined as FVC% values of <25%, 25-45%, and >45%, respectively.

Discussion

The updated CPG using FVC% may more accurately identify patients with compromised physiology and be a better tool to help predict patients who are at risk for decompensation following rib fractures. A validation study for the updated CPG is in progress.
Palliative Care in Emergency General Surgery Patients: Reduced Inpatient Mortality And Increased Discharge to Hospice
Authors: Baimas-George Maria , Yelverton Sam , Ross Samuel W. , Rozario Nigel , Matthews Brent D. , Reinke Caroline E.
Published: December 2020

Background

Admissions due to emergency general surgery (EGS) are on the rise, and patients who undergo emergency surgery are at increased risk of mortality. We hypothesized that utilization of palliative care and discharge to hospice in the EGS population have increased over time and that this is associated with a decrease in inpatient mortality.

Methods

Using the 2002-2011 nationwide inpatient sample and American Association for the Surgery of Trauma-defined EGS diagnosis codes, we identified patients ≥18 years old with an EGS admission. Demographics, hospitalization characteristics, mortality, use of palliative care services, and discharge to hospice were queried. All Patient Refined-Diagnosis Related Group risk of mortality was used to categorize those with an extreme likelihood of dying (ELD). Multivariable logistic regression was used to investigate the association between palliative care consult and discharge to hospice.

Results

Of the included patients, 0.3% received palliative care and 0.2% were discharged to hospice. Over time, rates of palliative care and hospice discharge increased while inpatient mortality decreased. In the 4% of patients with ELD, 3% received palliative care, 5% were transitioned to hospice care, and 22% suffered inpatient mortality. Controlling for patient characteristics, utilization of palliative care services was associated with increased odds of discharge to hospice compared to inpatient mortality (OR = 1.78 all patients and OR = 2.04 for ELD).

Conclusions

Despite the known increased risks associated with emergency surgical diagnoses, palliative care services remain infrequently utilized in the EGS population. This may be an opportunity for lessening suffering, improving patient-concordant care and outcomes, and reducing nonbeneficial and unwanted care.
National Health Burden of Aspiration Pneumonia on Clinical and Operational Outcomes in Patients With Small Bowel Obstruction Requiring Nasogastric Decompression
Authors: Mehta Amit , Martin Tracey , Demiralp Berna , Steele-Adjognon Marie , Agarwal Aishwarya , Mahadev Srihari , Sharaiha Reem Z.
Published: December 2020

Background

Nasogastric tubes (NGTs) are used for decompression in patients with acute small bowel obstruction (SBO); however, their role remains controversial. There is evidence that NGT use is still associated with high incidence of aspiration pneumonia. The aims of this study were to define the prevalence of aspiration pneumonia in patients with SBO managed with an NGT and estimate the association of aspiration pneumonia with 30-day mortality rates, length of stay (LOS), and hospital costs.

Materials and Methods

A retrospective cohort study was done using Medicare Inpatient Standard Analytic Files from 2016 to 2018. Patients hospitalized with SBO and managed with NGT were identified using an algorithm of ICD-10-CM codes. The key exposure was aspiration pneumonia. Outcome measures included 30-day mortality rates, LOS, and hospital costs.

Results

53 715 patients hospitalized with SBO and managed with an NGT were identified and included in the analysis. We observed a prevalence of aspiration pneumonia of 7.3%. The 30-day mortality rate was 31% for those who developed aspiration pneumonia vs. 10% for those without pneumonia ( P < .001). Those with aspiration pneumonia, on average, were hospitalized 7.0 days longer ( P < .001) and accrued $20,543 greater hospitalization costs ( P < .001) than those without pneumonia. Controlling for hospital size and hospital teaching status, we noted a significant association between aspiration pneumonia and increased mortality ( P < .001), longer length of stay ( P < .001), and higher hospital costs ( P < .001).

Discussion

Among patients hospitalized for SBO who required an NGT, aspiration pneumonia was associated with a higher mortality rate, longer hospital LOS, and higher total hospital costs. vv
Comparing Activity Trackers With vs. Without Alarms to Increase Postoperative Ambulation: A Randomized Control Trial
Authors: Waller Giacomo C. , Kim Tesia G. , Perez Sebastian , Esper Gregory J. , Srinivasan Jahnavi K. , Shaffer Virginia O. , Staley Charles A. , Sullivan Patrick S.
Published: December 2020

Early ambulation is a key component to postoperative recovery; however, measuring steps taken is often inconsistent and nonstandardized. This study aimed to determine whether an activity tracker with alarms would increase postoperative ambulation in patients after elective colorectal procedures. Forty-eight patients were randomly assigned to either trackers with 5 daily alarms or activity trackers alone. Over 223 total patient days, the trackers recorded a complete data set for 216 patient days (96.9%). Increasing the postoperative day significantly affected the number of steps taken, while age, sex, Risk Analysis Index score, and approach (laparoscopic versus open) did not show a significant effect. The mean steps per day in the intervention group were 1468 (median 495; interquartile range (IQR) 1345) and in the control group was 1645 (median 1014; IQR 2498). The use of trackers with alarms did not significantly affect the number of daily steps compared to trackers alone (ANOVA, P = .93). Although activity trackers with alarms did not increase postoperative ambulation compared with trackers with no alarms, we demonstrated a strategy to operationalize the use of trackers into postoperative care to provide a quantitative value for ambulation. This enables quantification of a key component in the Enhanced Recovery After Surgery protocol.
An Enduring Lesson from the History of Peacemaking in Afghanistan
Authors: Andisha Nasir A.
Published: December 2020

Peace processes offer opportune moments for social and political transformation in embattled nations. There is no perfect formula or peace recipe. As per the existing literature, the ‘ripeness’ of circumstances and timing of a peace process and pertinence of the ‘substance’ of settlements to the root causes of conflict are the main components of a viable peace agreement. In the past 30 years, Afghanistan experienced two unsuccessful peacemaking episodes: first after the Soviet withdrawal in 1989 and the second following the removal of the Taliban in 2001. While failure of the former is primarily attributed to the complexities of circumstance at the time, ineptness of the latter is linked to the primacy of imposed deadlines over inclusive consultations and inadequacy of contents of the Bonn Agreement. By briefly examining substantive characteristics of peacemaking processes in the context of Najibullah’s National Reconciliation Policy and the Bonn process, this article argues that meaningful structural change in favour of an inclusive and participatory political system and institutionalization of a regional balance of interests in foreign relations remain central to enduring peace in Afghanistan.
The Irish Churches Peace Project: A Catalyst for Peace
Authors: McDowell Peter
Published: December 2020

The Irish Churches Peace Project was an EU funded project undertaken collaboratively by the four biggest denominations in Northern Ireland and the Irish Council of Churches. Over two years it engaged with hundreds of church leaders and church members to stimulate good relations and community engagement, particularly in areas where churches had not previously engaged across community divisions. This article records the methodology developed by the project to encourage and deepen cross-community engagement, explores the operant and espoused theologies of reconciliation associated with the project, and highlights key insights as to utilizing the potential within religious traditions for overcoming conflict and division. ICCP’s experience is applicable to future projects in Northern Ireland and other contexts in which divisions within communities are sustained by religious difference.
Between Violence, Racism and Reform: São Tomé e Príncipe in the Great Depression Years, 1930–7
Authors: Valverde Contreras Beatriz , Keese Alexander
Published: December 2020

The effects of the Great Depression on the important cocoa plantation sector of the archipelago of São Tomé e Príncipe – a Portuguese colonial laboratory for social change in plantation agriculture shifting between coercive practices and attempts at accommodation – were drastic: initially backed by a right-wing authoritarian government, plantation managements lowered workers’ wages and made already repressive conditions of worker exploitation worse. This article highlights the processes of degradation in plantation workers' life. However, in ways that might seem paradox at first glance, the crisis years of the 1930s also opened the ways to changes in social experiences in the plantations.

Labour inspectors were increasingly called upon to scrutinize existing abuses on the plantations, and although this might have been in the first phase simply lip service to certain international debates on good standards in colonialism, inspectors internalized the need for reform and turned out to be critical observers. At the same time, the workers expanded their repertoire of responses – from individual resistance to ever better-organized escape strategies and the manipulation of offers of settlement schemes for small groups of workers. By 1937, these trends were important precursors to changes that would achieve their full impact in the 1950s.
Homicide concentration and retaliatory homicide near repeats: An examination in a Latin American urban setting
Authors: Chainey Spencer , Muggah Robert
Published: December 2020

Despite numerous attempts to decrease homicides in the Latin American region, high homicide levels have persisted. Examining four cities in Rio de Janeiro, the research reveals the intense geographic concentration of homicides in each city, but illustrates differences in the extent of homicide concentration when using a variety of crime concentration measures. Single events involving multiple homicides and a homicide near repeat pattern are observed, with almost all these incidents taking place in areas of homicide concentration. The findings suggest that programmes targeted to areas of homicide concentration, including interventions that suppress the likelihood of future incidents, could decrease homicides.
Class Reimagined? Intersectionality and Industrial Action – the British Airways Dispute of 2009–2011
Authors: Moore Sian , Taylor Phil
Published: December 2020

This article explores the inter-relationship of gender, sexuality, race and class among cabin crew, members of trade union BASSA, in the British Airways dispute of 2009–2011. It evaluates the utility of intersectional analysis in the context of industrial action, investigating the ways crew mobilised intersectional identities and class interests. In their narratives, crew evoked the 1984–1985 miners’ strike, but rejected a version of class and militancy based on a perceived historical legacy of class as white, heterosexual and male. Engaging with debates in Sociology on class, the article restores work as the key site of class formation and identifies BASSA as providing the organisational and ideological resources to legitimate an inclusive worker interest that transcended sectional identities and generated a reimagined and reconfigured class identity.
Social Media as an (Un)Supportive Resource for Military Partners Coping With Military Lifestyle Challenges
Authors: Rossetto Kelly R. , Owlett Jennifer S.
Published: December 2020

The current study explored how romantic partners of active-duty service members perceived social media as (un)supportive when dealing with military lifestyle challenges. This study also explored coping and support paradoxes as they play out when military partners are using social media to help them cope. Twenty-four partners (female, n = 22; male, n = 2) participated in interviews. Participants reported mostly using Facebook (e.g., spouse groups) for dealing with military lifestyle challenges. Supportive functions included seeking and providing support and relational maintenance and development. Unsupportive functions included reinforced boundaries and support breakdowns. Findings are discussed with a focus on communal coping and coping and support paradoxes.
The Teacher Behavior Checklist: The Mediation Role of Teacher Behaviors in the Relationship Between the Students’ Importance of Teacher Behaviors and Students’ Effort
Authors: Geier Michael T.
Published: December 2020

Background:

Previous research suggests a relationship between teacher behaviors and students’ effort. However, it is not clear what role the students’ expectations (i.e., importance of teacher behaviors) play in this relationship.

Objective:

Utilizing the teacher behavior checklist, this study sought to investigate whether teacher behaviors mediate the relationship between the importance students set on teacher behaviors and students’ effort. Further, the study explored which specific behaviors influence students’ effort.

Method:

Cross-sectional survey data were analyzed ( N = 159) using mediation analysis and stepwise multiple linear regression.

Results:

There was evidence that teacher behaviors mediate the relationship between the importance students set on teacher behaviors and students’ effort. Four of the 28 teacher behaviors had a significant relationship to students’ effort: creative and interesting, enthusiastic about teaching, happy/positive/humorous, and promotes critical thinking.

Conclusion:

Knowing students’ expectations (i.e., the importance of teacher behaviors) is essential to increasing students’ effort.

Teaching Implications:

Happy/positive/humorous had a negative relationship with students’ effort, while creative and interesting, enthusiastic about teaching, and promotes critical thinking showed a positive relationship with students’ effort.
Robust sliding model control-based adaptive tracker for a class of nonlinear systems with input nonlinearities and uncertainties
Authors: Fang Jiunn-Shiou , Tsai Jason Sheng-Hong , Yan Jun-Juh , Guo Shu-Mei
Published: December 2020

A robust adaptive tracker is newly proposed for a class of nonlinear systems with input nonlinearities and uncertainties. Because the upper bounds of input nonlinearities and uncertainties are difficult to be acquired, the adaptive control integrated with sliding mode control (SMC) and radial basis function neural network (RBFNN) are utilized to cope with these undesired problems and effectively complete the robust tracker design. The main contributions are concluded as follows: (1) new sufficient conditions are obtained such that the proposed adaptive control laws can avoid overestimation; (2) A smooth [Formula: see text] function is introduced to eliminate the undesired chattering phenomenon in the traditional SMC systems; (3) A robust tracker is proposed such that the controlled system outputs can robustly track the pre-specified trajectories directly, even when subjected to unknown input nonlinearities and uncertainties. Finally, the numerical simulation results are illustrated to verify the proposed approach.
Long-Term Follow-Up After Fat Graft Myringoplasty: Do Size and Location Matter?
Authors: Diaz Alfonso Rodriguez , Reina Carlos O’Connor , Plaza Guillermo , Posadas Elena Rodriguez , Arevalo Francisco Valdeon , Iriarte Maria Teresa Garcia
Published: December 2020

Objective:

To assess clinical and functional outcomes of a fat graft myringoplasty under local in an office setting.

Study Design:

Prospective case series.

Setting:

Tertiary care facility.

Patients:

Patients with a tympanic membrane (TM) perforation presenting between December 2005 and June 2019. Inclusion criteria included perforation size >25% of the surface of the pars tensa of the TM, entire perforation margins visualized through a transcanal view, and lack of spontaneous closure at the 6-month follow-up. The exclusion criteria were the presence of cholesteatoma, wet appearance of the mucosa in the tympanic cavity, ear discharge in the 3 months before surgery, or signs of ossicular inconsistency.

Intervention:

In-office fat graft myringoplasty technique under local anesthesia.

Main outcome Measures:

Complete perforation closure rate and audiometric outcomes.

Results:

A total of 121 patients underwent the procedure, of whom 21 had bilateral sequential procedures (total 142 ears). Average age was 51.1 ± 18.4 years (range, 3-78 years). The size of perforation was <25% of TM in 39 (27.5%) ears, 25% to 50% of TM in 49 (34.55%) ears, 50% to 75% of TM in 34 (23.91%) ears, and 75% to 100% of TM in 20 (14.10%) ears. Complete perforation closure was evident in 130 (91.55%) of the 142 ears. Preoperative mean air conduction threshold was 59.3 dB (17-95 dB) and significantly improved into 35.6 dB (10-85 dB; P < .0004) after surgery. Preoperative air–bone gap was 30.2 dB (5-70 dB) and also significantly improved into 10.2 dB (5-65 dB; P < .0001) after surgery.

Conclusion:

In office fat graft myringoplasty, in adult and pediatric patients with variable perforation sizes, is a well-tolerated procedure with very satisfactory clinical results.
Use of GlideScope in Patients Undergoing NIM Thyroidectomy
Authors: Casano Kelsey , Cannon C Ron , Didlake Ralph , Replogle William R. , Cannon Robert
Published: December 2020

Objectives:

Thyroidectomy and parathyroidectomy using the nerve integrity monitor (NIM) require proper placement of the endotracheal tube with electrodes aligned correctly within the larynx. The purpose of this study is to determine the percentage of patients who require positional adjustments of the endotracheal tube prior to beginning surgery and to understand the value of using the GlideScope to assure proper NIM tube placement within the larynx.

Methods:

This prospective study examines operative data from 297 patients who underwent NIM thyroidectomy and parathyroidectomy. After routine orotracheal intubation by an anesthesiologist and positioning of the patient for surgery, a GlideScope was used to check the position of the tube in 2 planes: depth of tube placement and rotation of the tube within the larynx assuring proper placement of the electromyogram electrodes within the glottis.

Results:

Tube adjustment was required for 66.5% of patients. In 48.1% of cases, tube retraction or advancement to a proper depth was needed. Tube rotation was required for 30.1% of patients, and 11.8% of patients required both adjustment of tube depth and tube rotation to properly align electrodes.

Conclusions:

After the anesthesiologist places the NIM endotracheal tube, and the patient is positioned for surgery, additional tube adjustment is often needed prior to the start of surgery. The GlideScope is readily available in the operating suite, its use adds little time to the procedure, and assures proper NIM tube placement. The use of the GlideScope is recommended.
Professional Training Needs for Using Augmentative and Alternative Communication in Inclusive Classrooms: Voices From Saudi Arabia
Authors: Aldabas Rashed
Published: December 2020

Research reveals that augmentative and alternative communication (AAC) can improve the communication competency of students who have complex communication needs. However, special educators often lack the competencies to effectively implement AAC strategies in the classroom. The present study aimed to explore the special educators’ level of need for professional training in AAC. Furthermore, it explored whether certain educator, student, and classroom characteristics were associated with the level of professional need for AAC training. In this descriptive study, 869 special educators in Saudi Arabia responded to a survey. The findings show that there is a high level of need for a wide variety of training areas in AAC. The findings indicate that participants differed significantly in their levels of need for professional AAC training depending on the participants’ previous training and experience, as well as the category of students taught, level of education, and grade level. Implications for how AAC training programs can be customized to effectively meet the diverse needs of educators and their students are discussed.
The Research Protocol of SENIOR Project—Psychiatric Services and Support System for Serious Mental Illness in Old Age, Kerala, India
Authors: Thavody Jayakrishnan , Shibu Kumar TM  , Sujina CM  , Tharayil Harish M , Chandran Priya , George Biju , Neethu Mohan VM  , Prabakaran Anusha
Published: December 2020

Background:

India has the second-largest population of elderly in the world. Serious mental illness (SMI) is a subset of the mental disorders that result in significant functional impairment and is usually long term. Persons with SMI face several challenges in their old age that are different from the issues faced by younger people with SMI. Understanding the problems faced by elderly individuals suffering from SMI is fundamental for planning programs to address them. The SENIOR (Support Systems Evaluation of Neuropsychiatric Illness in Old age) project is a study aimed at evaluating the problems faced in obtaining mental health care by elderly persons having SMI in the Kerala state of India.

Aim:

To describe the scientific methodology of the SENIOR project.

Methods:

This study employs mixed-methods cross-sectional design among a minimum sample of 768 SMI patients identified through cluster sampling from three districts, and Focus Group Discussion among mental health program officials.

Discussion:

This paper presents a methodological model to assist researchers in future field epidemiological studies on mental illness. Assessing service needs and barriers to access for the most vulnerable among the mentally ill will help the policymakers make evidence-based decisions to improve their quality of life.
Inferior vena cava filters utilization in patients with venous thromboembolism: Analysis of a database of a tertiary hospital
Authors: Arslanbekov Magomed M , Efremova Oksana I , Lebedev Igor S , Kirienko Aleksandr I , Zolotukhin Igor A
Published: December 2020

Purpose

The aim of the study was to assess the inferior vena cava filter (IVCF) utilization in patients with venous thromboembolism (VTE) in tertiary care.

Methods

We performed a retrospective analysis of database of a tertiary hospital in 2016–2017. All the records of patients admitted for VTE or diagnosed with VTE being hospitalized for other reasons were extracted. The data collected were number of patients, who received IVCF, indications to filter insertion, PE and death rate after procedure, frequency of IVCF occlusion.

Results

2399 patients with VTE were admitted to hospital. 442 (18,4%) of them received IVCF (239 in 2016 and 203 in 2017). Retrievable models were used in most cases (98,8%). In 119 (5,0%) patients cava filters were used due to contraindications for anticoagulation, while in 184 (7,7%) patients’ anticoagulation was not effective and thrombosis progression was registered. 101 (4,2%) patients received IVCF due to high PE risk (length of floating thrombus ≥7 cm, in proximal location), high pulmonary hypertension was indication to IVCF insertion in 38 (1,6%) patients with deep vein thrombosis (DVT) in combination with pulmonary embolism (PE). Overall mortality rate after IVCF insertion was 5 (0,2%). No fatal PE was registered. IVCF occlusion during hospitalization occurred in 116 (4,8%) cases. Only 29 (1,2%) of patients were admitted back for IVCF removal.

Conclusions

Every one in five patients with proximal DVT and/or PE receives IVCF in a routine practice in tertiary hospital. The most common indications for IVCF implantation were inability for anticoagulation or anticoagulation failure. Removal rate of retrievable cava filters is low.