bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical analysis of 48 cases of malignant superior vena cava syndrome
Authors: Sun Manzhen , Chen Xiaoli , Li Hongfei , Zhang Xudong , Wang Xiaofei , Zheng Ruipan , Li Guowen , Wang Lin , Li Dianyuan
Published: June 2021

Background

The aim of our study was to observe and compare the curative effect of radiotherapy, chemotherapy, and combined radiotherapy and chemotherapy, as well as comprehensive treatment on superior vena cava syndrome (SVCS) caused by malignant etiology.

Methods

A total of 48 patients with malignant SVCS admitted to our hospital from 2015 to 2020 were selected in this study. According to the different treatment methods, they were divided into radiotherapy group (group 1, 10 cases), chemotherapy group (group 2, 8 cases), combined radiotherapy and chemotherapy group (group 3, 22 cases), and comprehensive treatment group (group 4, 8 cases).

Results

There were no significant differences in efficacy and side effects among the four groups (all P > 0.05). Group 4 (median survival time of 36 months) could provide longer survival time than groups 1, 2, and 3 (median survival time of 10 months, 13.5 months, and 12 months, respectively).

Conclusions

For patients with severe symptoms or good prognosis, comprehensive treatment could be selected to improve the quality of life and prolong the survival period; for patients with mild symptoms, radiotherapy, chemotherapy, or combined radiotherapy and chemotherapy could also reduce the symptoms of SVCS and treat tumor lesions.
Treatment of posterolateral tibial plateau fractures with a rotational support plate and special pressurizer: technical note and retrospective case series
Authors: Chen Yu-Feng , Ren Dong , Geng Lin-Dan , Yao Shuang-Quan , Song Zhao-Hui , Guang Liang , Wang Tian-Ci , Wang Peng-Cheng
Published: June 2021

Background

In tibial plateau fractures, the posterolateral segment of the tibia plateau is frequently affected and challenging to treat. Although there are many surgical approaches and fixation methods for the treatment of these fractures, all of these methods have limitations. We designed a new rotational support plate (RSP) and a special pressurizer that can fix the fracture directly via the anterolateral approach. This method is advantageous because it leads to little trauma, involves a simple operation, and has a reliable fixation effect. This study details the technique of treating these fractures with the RSP and special pressurizer and provides the outcomes.

Methods

From May 2016 to January 2019, the data of 12 patients with posterolateral tibial plateau fractures treated with the RSP and special pressurizer in our hospital were retrospectively analyzed. Postoperative rehabilitation was advised, knee X-rays were taken at follow-ups, and fracture healing, complications, and knee range of motion were assessed. The Hospital for Special Surgery (HSS) knee score and Knee Injury and Osteoarthritis Outcome Score (KOOS) were used to evaluate knee function at the last follow-up.

Results

The average follow-up time of all patients was 16.5 months (range, 12–25 months). The average bony union time was 3.2 months (range, 3–4.5 months). At the last follow-up, the average knee range of motion was 138° (range, 107–145°). The average HSS score was 91 (range, 64–98). The average KOOS Symptoms score was 90 (range, 75–96). The average KOOS Pain score was 91 (range, 72–97). The average KOOS ADL score was 91 (range, 74–97). The average KOOS sport/recreation score was 83 (range, 70–90). The average KOOS QOL score was 88 (range, 69–93). Skin necrosis, incision infections, and fixation failure did not occur during the follow-up period.

Conclusions

With our newly designed RSP and special pressurizer, posterolateral tibial plateau fractures can be easily and effectively reduced and fixed through the anterolateral approach, which serves as a novel treatment for posterolateral tibial plateau fractures.
Prevalence and risk factors of preoperative deep venous thrombosis in closed patella fracture: a prospective cohort study
Authors: Tan Zhanchao , Hu Hongzhi , Wang Zhongzheng , Wang Yuchuan , Zhang Yingze
Published: June 2021

Background

The preoperative prevalence of deep venous thromboembolism (DVT) of patella fracture is not well established. The study aimed to investigate the preoperative prevalence, the associated risk factors, and the locations of deep venous thrombosis (DVT) in patients with closed patella fracture.

Methods

Patients who sustained closed patella fracture between January 1, 2016, and April 1, 2019, were included. Blood analyses and ultrasonography of bilateral lower extremities were routinely performed. Data of demographics, comorbidities, mechanism of injury, fracture type, total hospital stay, time from injury to DVT, and laboratory indexes were prospectively collected and compared between groups with and with non-DVT. Multivariate logistic regression analyses were performed to determine the independent risk factors of DVT.

Results

Among the study cohort of 790 patients, 35 cases occurred in preoperative DVTs, indicating a prevalence of 4.4%, with 3.2% distal and 1.2% proximal DVT. Age ≥ 65 years old (OR, 3.0, 95% CI, 1.1–8.1), D-dimer > 0.5 mg/L (OR, 2.3, 95% CI, 1.1–4.8), and albumin < 35 g/L (OR, 2.5, 95% CI, 1.2–5.3) were identified to be risk factors of DVT in closed patella fracture. Among the DVTs, 30 cases (85.7%) occurred in the injured extremity, 3 cases (8.6%) in bilateral extremities, and 2 cases (5.7%) solely in the uninjured extremity.

Conclusion

The prevalence of preoperative DVT in closed patella fracture was 4.4%, with 3.2% for distal and 1.2% for proximal DVT. We recommend individualized risk stratification and early anticoagulation for patients with risk factors (age ≥ 65 years, D-dimer > 0.5 mg/L and albumin < 35g/L).
Molecular docking, chemo-informatic properties, alpha-amylase, and lipase inhibition studies of benzodioxol derivatives
Authors: Hawash Mohammed , Jaradat Nidal , Shekfeh Suhaib , Abualhasan Murad , Eid Ahmad M. , Issa Linda
Published: June 2021

Currently, available therapies for diabetes could not achieve normal sugar values in a high percentage of treated patients. In this research project, a series of 17 benzodioxole derivatives were evaluated as antidiabetic agents; that belong to three different groups were evaluated against lipase and alpha-amylase (α-amylase) enzymes. The results showed that 14 compounds have potent inhibitory activities against α-amylase with IC50 values below 10 µg/ml. Among these compounds, 4f was the most potent compound with an IC50 value of 1.11 µg/ml compared to the anti-glycemic agent acarbose (IC50 6.47 µg/ml). On the contrary, these compounds showed weak or negligible activities against lipase enzyme. However, compound 6a showed the best inhibitory anti-lipase activity with IC50 44.1 µg/ml. Moreover, all the synthesized compounds were undergone Molinspiration calculation, and the result showed that all compounds obeyed Lipinski’s rule of five. Molecular docking studies were performed to illustrate the binding interactions between the benzodioxole derivatives and α-amylase enzyme pocket. Related to the obtained results it was clear that the carboxylic acid, benzodioxole ring, halogen or methoxy substituted aryl are important for the anti-amylase activities. The potent inhibitory results of some of the synthesized compounds suggest that these molecules should go further in vivo evaluation. It also suggests the benzodioxole derivatives as lead compounds for developing new drug candidates.
Surfing the clinical trials of mesenchymal stem cell therapy in ischemic cardiomyopathy
Authors: Razeghian-Jahromi Iman , Matta Anthony G. , Canitrot Ronan , Zibaeenezhad Mohammad Javad , Razmkhah Mahboobeh , Safari Anahid , Nader Vanessa , Roncalli Jerome
Published: June 2021

While existing remedies failed to fully address the consequences of heart failure, stem cell therapy has been introduced as a promising approach. The present review is a comprehensive appraisal of the impacts of using mesenchymal stem cells (MSCs) in clinical trials mainly conducted on ischemic cardiomyopathy. The benefits of MSC therapy for dysfunctional myocardium are likely attributed to numerous secreted paracrine factors and immunomodulatory effects. The positive outcomes associated with MSC therapy are scar size reduction, reverse remodeling, and angiogenesis. Also, a decreasing in the level of chronic inflammatory markers of heart failure progression like TNF-α is observed. The intense inflammatory reaction in the injured myocardial micro-environment predicts a poor response of scar tissue to MSC therapy. Subsequently, the interval delay between myocardial injury and MSC therapy is not yet determined. The optimal requested dose of cells ranges between 100 to 150 million cells. Allogenic MSCs have different advantages compared to autogenic cells and intra-myocardial injection is the preferred delivery route. The safety and efficacy of MSCs-based therapy have been confirmed in numerous studies, however several undefined parameters like route of administration, optimal timing, source of stem cells, and necessary dose are limiting the routine use of MSCs therapeutic approach in clinical practice. Lastly, pre-conditioning of MSCs and using of exosomes mediated MSCs or genetically modified MSCs may improve the overall therapeutic effect. Future prospective studies establishing a constant procedure for MSCs transplantation are required in order to apply MSC therapy in our daily clinical practice and subsequently improving the overall prognosis of ischemic heart failure patients.
Habitat environmental factors influence intestinal microbial diversity of the short-faced moles (Scaptochirus moschata)
Authors: Chen Lei , Xu Di , Zhu Jing , Wang Shen , Liu Mi , Sun Mengyao , Wang Geyang , Song Lingyu , Liu Xiaoyu , Xie Tianyu
Published: June 2021

The short-faced moles (Scaptochirus moschata) are unique Chinese mammal that live in burrows for life. They have complex ecological adaptation mechanisms to adapt to perennial underground life. Intestinal microbes play an important role in the ecological adaptation of wild animals. The gut microbiota diversity and its function in short-faced moles’ ecological adaptation is a scientific issue worth exploring. In this study, the Illumina HiSeq sequencing platform was used to sequence the V3-V4 hypervariable regions of the 16S rRNA genes of 22 short-faced moles’ intestinal samples to study the composition and functional structure of their intestinal microbiota. The results showed that in the short-faced moles’ intestine, there are four main phyla, Firmicutes, Proteobacteria, Actinobacteria and Bacteroidete. At the family level, Peptostreptococcaceae and Enterobacteriaceae have the highest abundance. At the genus level, Romboutsia is the genus with the highest microbial abundance. According to the KEGG database, the main functions of short-faced mole gut microbes are metabolism, genetic information processing, environmental information processing, and cellular processes. The function of short-faced mole intestinal microbiota is suitable for its long-term burrowing life. No gender difference is found in the composition and function of the short-faced mole intestinal microbiota. There are significant differences in the composition and functional structure of the short-faced mole gut microbiota between samples collected from different habitats. We conferred that this is related to the different environment factors in which they live, especially to the edaphic factors.
The potential of pharmacological activities of the multi-compound treatment for GERD: literature review and a network pharmacology-based analysis
Authors: Park Junghyun , Jang Dongyeop , Phung Hung Manh , Choi Tae Joon , Kim Chang-Eop , Lee Sanghyun , Kang Ki Sung , Choi Seo-Hyung
Published: June 2021

The prevalence of gastroesophageal reflux disease (GERD) is rapidly increasing due to the adoption of a Westernized lifestyle; at the same time, safe and efficient treatment is required due to the side effects and refractoriness of proton pump inhibitors (PPIs). The frequently used multi-compound treatment for GERD in the current traditional Korean medicine (TKM) clinical field comprisesCrassostrea gigasThunberg shell (CGTS), Bambusae Caulis in Taeniam (BCT), Ponciri Fructus Immaturus (PFI),Scutellaria baicalensisGeorgi (SBG), medicated leaven (ML) and Glycyrrhizae Radix et Rhizoma (GRR). The current review was based on “Kun-Shin-Choa-Sa” theory and network analysis was conducted to explore the potential pharmacological activities, including efficacy and mechanisms of action of multi-compound treatment against GERD. Hypergeometric test results showed that the targets of multi-compound treatment are significantly associated with GERD gene sets, consistent with the literature review findings. In particular, the enrichment analysis indicated that the SBG targets are related to the IL-17 signaling pathway, bile secretion, small-cell lung cancer, and non-small cell lung cancer, corroborating the literature review, particularly concerning anti-inflammatory effect. In the literature review, CGTS and BCT, classified as “Kun,” play a role in anti-acid, anti-inflammatory, and anti-oxidative effects. The complementary “Shin” herbs, PFI and SBG, showed functions related to improving the prolonged gastric emptying rate, peristalsis, and a gastric cytoprotective effect. With the role of “Choa,” ML was suggested to inhibitH. pylorigrowth and diminish gastric acid secretion, consistent with the gastric acid secretion pathway in the enrichment analysis. However, the enrichment analysis did not show any significantly related pathways for CGTS and PFI, which may reflect the lack of information in the KEGG database in terms of the link between GERD, its mechanisms, and the abundance of minerals in CGTS. Despite the pharmacological potential of multi-compound treatment, this study should be corroborated by well-designed future experimental studies.
Deep learning for semi-automated unidirectional measurement of lung tumor size in CT
Authors: Woo MinJae , Devane A. Michael , Lowe Steven C. , Lowther Ervin L , Gimbel Ronald W.
Published: June 2021

Background

Performing Response Evaluation Criteria in Solid Tumor (RECISTS) measurement is a non-trivial task requiring much expertise and time. A deep learning-based algorithm has the potential to assist with rapid and consistent lesion measurement.

Purpose

The aim of this study is to develop and evaluate deep learning (DL) algorithm for semi-automated unidirectional CT measurement of lung lesions.

Methods

This retrospective study included 1617 lung CT images from 8 publicly open datasets. A convolutional neural network was trained using 1373 training and validation images annotated by two radiologists. Performance of the DL algorithm was evaluated 244 test images annotated by one radiologist. DL algorithm’s measurement consistency with human radiologist was evaluated using Intraclass Correlation Coefficient (ICC) and Bland-Altman plotting. Bonferroni’s method was used to analyze difference in their diagnostic behavior, attributed by tumor characteristics. Statistical significance was set atp < 0.05.

Results

The DL algorithm yielded ICC score of 0.959 with human radiologist. Bland-Altman plotting suggested 240 (98.4 %) measurements realized within the upper and lower limits of agreement (LOA). Some measurements outside the LOA revealed difference in clinical reasoning between DL algorithm and human radiologist. Overall, the algorithm marginally overestimated the size of lesion by 2.97 % compared to human radiologists. Further investigation indicated tumor characteristics may be associated with the DL algorithm’s diagnostic behavior of over or underestimating the lesion size compared to human radiologist.

Conclusions

The DL algorithm for unidirectional measurement of lung tumor size demonstrated excellent agreement with human radiologist.
General anesthesia with remimazolam in a patient with mitochondrial encephalomyopathy: a case report
Authors: Suzuki Yuji , Doi Matsuyuki , Nakajima Yoshiki
Published: June 2021

Background

Systemic anesthetic management of patients with mitochondrial disease requires careful preoperative preparation to administer adequate anesthesia and address potential disease-related complications. The appropriate general anesthetic agents to use in these patients remain controversial.

Case presentation

A 54-year-old woman (height, 145 cm; weight, 43 kg) diagnosed with mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes underwent elective cochlear implantation. Infusions of intravenous remimazolam and remifentanil guided by patient state index monitoring were used for anesthesia induction and maintenance. Neither lactic acidosis nor prolonged muscle relaxation occurred in the perioperative period. At the end of surgery, flumazenil was administered to antagonize sedation, which rapidly resulted in consciousness.

Conclusions

Remimazolam administration and reversal with flumazenil were successfully used for general anesthesia in a patient with mitochondrial disease.
Social inequality and the risk of living in a nursing home: implications for the COVID-19 pandemic
Authors: Bernardi Fabrizio , Cozzani Marco , Zanasi Francesca
Published: June 2021

Across EU countries, all available evidence suggests that the number of deaths linked to COVID-19 among those living in nursing homes has been extremely high. However, it is largely unknown to what extent income and education affect the probability of being a nursing home resident. If the probability of residing in a nursing home is stratified by socio-economic status, under the current COVID-19 pandemic socio-economic inequality in the probability of living in a nursing home could contribute to enlarge socio-economic inequalities in the risk of mortality with COVID-19. In this article, we investigate whether there are income and educational differences in the likelihood of being a resident in a nursing home across 12 European countries. We use SHARE data (waves 5–7) and compute logistic regression models for rare events. We find that low-educated individuals and those having household income below the national median are more likely to live in a nursing home. This general pattern holds across all the European countries considered. However, there is considerable uncertainty in our estimates due to a small sample size, and firm conclusions on how the effect of socio-economic characteristics varies across countries cannot be drawn. Still, there is some indication that educational and income differences are the largest in the Scandinavian countries (Denmark and Sweden) and the Netherlands, while the smallest ones are found in Italy, with the remaining countries laying in between.
Cannabidiol use and effectiveness: real-world evidence from a Canadian medical cannabis clinic
Authors: Rapin Lucile , Gamaoun Rihab , El Hage Cynthia , Arboleda Maria Fernanda , Prosk Erin
Published: June 2021

Background

Cannabidiol (CBD) is a primary component in the cannabis plant; however, in recent years, interest in CBD treatments has outpaced scientific research and regulatory advancement resulting in a confusing landscape of misinformation and unsubstantiated health claims. Within the limited results from randomized controlled trials, and lack of trust in product quality and known clinical guidelines and dosages, real-world evidence (RWE) from countries with robust regulatory frameworks may fill a critical need for patients and healthcare professionals. Despite growing evidence and interest, no real-world data (RWD) studies have yet investigated patients’ reports of CBD impact on symptom control in the common expression of pain, anxiety, depression, and poor wellbeing. The objective of this study is to assess the impact of CBD-rich treatment on symptom burden, as measured with a specific symptom assessment scale (ESAS-r).

Methods

This retrospective observational study examined pain, anxiety, depression symptoms, and wellbeing in 279 participants over 18 years old, prescribed with CBD-rich treatment at a network of clinics dedicated to medical cannabis in Quebec, Canada. Data were collected at baseline, 3 (FUP1), and 6 (FUP2) month after treatment initiation. Groups were formed based on symptom severity (mild vs moderate/severe) and based on changes to treatment plan at FUP1 (CBD vs THC:CBD). Two-way mixed ANOVAs were used to assess ESAS-r scores differences between groups and between visits.

Results

All average ESAS-r scores decreased between baseline and FUP1 (all ps < 0.003). The addition of delta-9-tetrahydrocannabinol (THC) during the first follow-up had no effect on symptom changes. Patients with moderate/severe symptoms experienced important improvement at FUP1 (all ps < 0.001), whereas scores on pain, anxiety, and wellbeing of those with mild symptoms actually increased. Differences in ESAS-r scores between FUP1 and FUP2 were not statistically different.

Conclusion

This retrospective observational study suggests CBD-rich treatment has a beneficial impact on pain, anxiety, and depression symptoms as well as overall wellbeing only for patients with moderate to severe symptoms; however, no observed effect on mild symptoms. The results of this study contribute to address the myths and misinformation about CBD treatment and demand further investigation.
Involuntary isolation: interpreting mental health legislation during the COVID-19 pandemic
Authors: Sediqzadah Saadia , Ghebrehariat Lwam , Weersink Kristen T. , Fisman David N. , Naidoo Kendra A.
Published: June 2021

The coronavirus disease 2019 (COVID-19) pandemic poses new and unprecedented challenges to the interpretation of mental health law. The authors present pragmatic and ethical considerations in the psychiatric safety assessment at the intersection of COVID-19 and severe mental illness.
The Use of Morning Urinary Gonadotropins and Sex Hormones in the Management of Early Puberty in Chinese Girls
Authors: Zhan Shumin , Huang Ke , Wu Wei , Zhang Danni , Liu Ana , Dorazio Robert M , Shi Jianrong , Ullah Rahim , Zhang Li , Wang Jinling , Dong Guanping , Ni Yan , Fu Junfen
Published: June 2021

Context

Although gonadotropin-releasing hormone stimulation test (GnRHST) is the gold standard in diagnosing central precocious puberty (CPP), it is invasive, expensive, and time-consuming, requiring multiple blood samples to measure gonadotropin levels.

Objective

We evaluated whether urinary hormones could be potential biomarkers for prepuberty or postpuberty, aiming to simplify the current diagnosis and prognosis procedure.

Methods

We performed a cross-sectional study of a total of 355 girls with CPP in National Clinical Research Center for Child Health in China, including 258 girls with positive and 97 girls with negative results from GnRHST. Twenty patients received GnRH analogue (GnRHa) treatment and completed a 6-month follow up. We measured luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, prolactin, progesterone, testosterone, and human chorionic gonadotropin in the first morning voided urine samples.

Results

Their urinary LH levels and the ratios of LH to FSH increased significantly with the advancement in Tanner stages. uLH levels were positively associated with basal and peak LH levels in the serum after GnRH stimulation. A cutoff value of 1.74 IU/L for uLH reached a sensitivity of 69.4% and a specificity of 75.3% in predicting a positive GnRHST result. For the combined threshold (uLH ≥ 1.74 + uLH-to-uFSH ratio > 0.4), the specificity reached 86.6%. After 3 months of GnRHa therapy, the uLH and uFSH levels decreased accordingly.

Conclusion

uLH could be a reliable biomarker for initial CPP diagnosis and screening; uLH could also be an effective marker for evaluating the efficacy of clinical treatment.
Carcinoma ex pleomorphic adenoma of major salivary glands: CT and MR imaging findings
Authors: Wang Can , Yu Qiang , Li Siyi , Sun Jingjing , Zhu Ling , Wang Pingzhong
Published: June 2021

Objectives:

To describe the CT and MR imaging characteristics of primary carcinoma ex pleomorphic adenoma (Ca-ex-PA) in major salivary glands and present more information for recognizing this malignancy.

Methods:

212 patients with primary Ca-ex-PA in major salivary glands (169 in the parotid gland, 36 in the submandibular gland, 7 in the sublingual gland) underwent CT and MR imaging (plain and contrast-enhanced scans) prior to surgical management and histopathological examination. The CT and MR imaging findings of this condition were retrospectively reviewed and correlated with their pathological types: non-invasive carcinoma (Type I, 37 cases), minimally invasive carcinoma (Type II, 18 cases), and widely invasive carcinoma (TypeIII, 157 cases). The binary logistic regression analysis was used to analyze the independent influencing factors of morphology and boundary for differentiating between Type I/II and Type III of Ca-ex-PA, and the sensitivity, specificity and positive predictive value were calculated. Differences in apparent diffusion coefficient (ADC) values between Type I/II and Type III of Ca-ex-PA were calculated by independent sample t-tests.

Results:

On CT and MR imaging, there were 190/212 cases (89.6%) identified as lobular, 203/212 cases (95.8%) with enhancement, and 173/212 cases (81.6%) with inhomogeneous after contrast administration.Calcification within the mass was shown in 76 of 192 cases (39.6%) on plain CT examination. Of 55 neoplasms with Type I and II, 38 (69.1%) were presented as round or oval and 42 (76.4%) as well-defined margins. Of 157 neoplasms with Type III, 103 (65.6%) were presented as irregular form and 110 (70.1%) as uneven margins or with partial uneven margins.The sensitivity, specificity and positive predictive value for distinguishing Type I/II and Type III tumors according to the morphology and boundary were 78.34%, 63.64% and 86.01%, respectively. The mean ADC value of Ca-ex-PA (22 cases) in major salivary glands was about 0.93 × 10−3 mm2 s−1, and there was no significant difference in mean ADC value between Type I/II and Type III of this neoplasm. Cervical lymph node metastasis and distance metastasis were found in 67 patients (31.6%, Type III) and 32 patients (15.1%, Type I in 1; Type II in 1; and Type III in 30), respectively.

Conclusions:

Most Ca-ex-PA is characterized by an irregular, lobular, and inhomogeneous enhanced neoplasm with uneven margin or partial uneven margin on CT and MR imaging, which is frequently corresponding with Type III. And a round or oval mass with well-defined margin usually correlates with Type I and II. Morphology and boundary are important basis for distinguishing Type I/II and Type III tumors. Calcification within the neoplasm shown on CT may be regarded as a specific sign for indicating this malignancy. Low ADC value is an important manifestation of this neoplasm.Ca-ex-PA with Type III is more likely to have cervical lymph node metastasis and distant metastasis.
Conselhos de políticas públicas e intersetorialidade: o caso Brasil Carinhoso
Authors: Cruz Maria do Carmo Meirelles Toledo , Merchan Catherine Rojas , Farah Marta Ferreira Santos
Published: June 2021

Neste artigo, aborda-se o potencial dos conselhos nacionais de políticas públicas de contribuírem para a incorporação de uma perspectiva multidimensional na promoção do desenvolvimento infantil. Para investigar essa possibilidade, uma pesquisa foi conduzida para verificar se o programa intersetorial para a primeira infância Brasil Carinhoso foi debatido nos conselhos nacionais aos quais está relacionado (saúde, educação, assistência social e política para mulheres) e, em caso positivo, como essa discussão ocorreu. Na análise dos marcos legais e das atas de reuniões de 2012 a 2015, poucas evidências foram encontradas de discussões relacionadas ao programa nas reuniões dos conselhos. Concluiu-se que as deliberações não obedeceram a uma lógica intersetorial e que as ações de cada conselho ficaram restritas aos seus próprios setores de intervenção.
Reforma administrativa no Brasil: passado, presente e perspectivas para o futuro frente à PEC 32/2020
Authors: Secchi Leonardo , Farranha Ana Claudia , Rodrigues Karina Furtado , Bergue Sandro Trescastro , Medeiros-Costa Caio César
Published: June 2021

O objetivo deste artigo é analisar quantitativamente e qualitativamente a PEC 32/2020, apontando aspectos críticos de formulação e decisão. Primeiro, parte-se de uma revisão da literatura em reformas da administração pública e do resgate histórico de reformas na Administração Pública federal brasileira. Segundo analisa-se a PEC 32/2020 em duas etapas: na primeira é realizada uma análise sistemática de conteúdo a partir da contagem de palavras e codificação destas de acordo com categorias de políticas de gestão pública e desenho de organizações programáticas. Na segunda parte, aprofunda-se na análise qualitativa sobre as propostas de alteração de princípios constitucionais da Administração Pública e da gestão de pessoas (concurso, estabilidade, cargos em comissão e desempenho). Conclui-se que, por dedicar mais da metade (53%) do conteúdo total da PEC 32/2020, e 74% do seu conteúdo efetivo (dispositivos substantivos) para a regulamentação da relação de trabalho com o servidor público, a etiqueta que melhor representaria o seu conteúdo seria reforma do funcionalismo público, ao invés de Reforma Administrativa. Com relação aos novos princípios constitucionais, verifica-se redundância entre eles, especialmente ligados ao direito fundamental à boa governança. Por fim, reitera-se a atualidade e pertinência da discussão de modelos de concurso, estabilidade do servidor, cargos em comissão e desempenho funcional, desde que sintonizadas com um entendimento ético e constitucional do servidor e do serviço público como um patrimônio da sociedade, incorporado ao ordenamento jurídico e respondendo continuamente às necessidades de bem estar da população.
Flexibilidade e fragilidade nas contratações temporárias do setor público
Authors: De Oliveira Parisio Isabela , Ari Sundfeld Carlos
Published: June 2021

Um levantamento jurisprudencial exploratório das decisões do Tribunal de Justiça de São Paulo (TJ-SP) entre julho de 2019 e julho de 2020 revela as principais controvérsias jurídicas atuais sobre as contratações temporárias de agentes públicos estaduais e municipais (Constituição Federal, art. 37, IX). O documento mostra a tensão gerada pela diferença de direitos entre os servidores estatutários e celetistas e os agentes temporários e sugere que a redução da fragilidade destes deve ser objetivo da reforma administrativa. Mostra também que, embora seja sensível à necessidade de existirem espaços de flexibilidade na gestão dos recursos humanos públicos, o Judiciário, atento ao regime constitucional, empenha-se em proteger o espaço dos cargos efetivos, que exigem concurso público, contra a expansão descontrolada das contratações temporárias.
Controle Judicial da Reforma Administrativa
Authors: Meneses Clara
Published: June 2021

O artigo aborda o papel do Poder Judiciário no contexto da reforma administrativa e de políticas fiscais tomadas em tempos de crise. Busca-se testar a aplicabilidade da Teoria do Equilíbrio Pontuado e contribuir para a compreensão da judicialização da política pública durante a crise das dívidas soberanas, especificamente as medidas administrativas de corte remuneratório aos trabalhadores do setor público. A metodologia adotada foi pesquisa qualitativa, bibliográfica e documental, através de um estudo do caso que visa compreender a atuação do Tribunal Constitucional português de 2010 a 2014, no controle de constitucionalidade dessas políticas. Tais medidas foram tomadas durante o acordo de resgate financeiro, Programa de Assistência Económica e Financeira - PAEF que emprestou €78 mil milhões de euros, com a Comissão Europeia, o Banco Central Europeu e o Fundo Monetário Internacional. A jurisprudência de crise foi desenvolvida em graus de permissibilidade com o legislador e culmina com a pontuação e mudança da política inicialmente estabelecida. No seu conteúdo, os julgamentos adotaram a técnica da ponderação de princípios, cuja inerente subjetividade deixa espaço para uma mudança de política. Conclui-se que a Teoria do Equilíbrio Pontuado demonstra poder explicativo para a compreensão da participação do Judiciário na política pública, e sua aplicação deve ser testada por pesquisas futuras, considerando outros momentos de ruptura.
Impactos da reforma administrativa sobre as formas de contratação e a estabilidade no setor público
Authors: Bettega Braunert Mariana , Da Silva Bernardo Kelen Aparecida , Da Cruz Bridi Maria Aparecida
Published: June 2021

O artigo tem como objetivo analisar os impactos da reforma administrativa consubstanciada na Proposta de Emenda Constitucional PEC - nº 32, de 2020, sobre a estabilidade dos trabalhadores do setor público, tendo em vista a amplificação das possíveis formas de contratação prevista pela reforma. Do ponto de vista metodológico, nossa análise é baseada em dados do Atlas do Estado Brasileiro, produzido pelo Instituto de Pesquisa Econômica Aplicada (IPEA), em pesquisa empírica qualitativa realizada com docentes do ensino público superior e em revisão da bibliografia pertinente ao tema. Apontamos para um processo de flexibilização das formas de contratação no setor público brasileiro, caracterizado pelo aumento das contratações de trabalhadores com vínculos instáveis e precários, notadamente os temporários e terceirizados. Esse processo de precarização das relações de trabalho, também identificado no setor privado, está relacionado a importantes transformações políticas e econômicas que ocorreram no Brasil a partir da década de 1990, afetando o papel do Estado e, consequentemente, também os servidores públicos. Concluímos que a reforma administrativa apresentada tende a intensificar o processo de flexibilização e precarização das relações de trabalho no setor público já em curso, pondo em risco não apenas a estabilidade dos servidores, mas o próprio Estado democrático e republicano de direito, que deve ser pautado pela isonomia, igualdade e pelo respeito à coisa pública.
Burocracia e desempenho da administração pública
Authors: Gomide Alexandre , Da Silva Lins Rafael , Amorim Machado Raphael
Published: June 2021

O trabalho tem como objetivo contribuir com a discussão sobre o Estado do século XXI ao apontar para características críticas da burocracia pública que merecem mais pesquisas empíricas para o fornecimento de evidências, visando a embasar propostas de reforma administrativas em países em desenvolvimento. Nesse sentido, a partir da análise multivariada de bases de dados disponíveis, o artigo verifica se as características institucionais da burocracia brasileira questionadas pela PEC 32/2020 – o recrutamento por concurso, a profissionalização dos cargos de alta gestão, a existência de um regime especial de trabalho para os servidores e a adoção de salários atrativos– - estão associadas a indicadores internacionais de desempenho da administração pública. Os achados corroboram os argumentos teóricos de que, além dos salários atrativos e do recrutamento por meio de concurso, a existência de regime especial de trabalho com estabilidade funcional para os servidores civis apresenta relações significativas com a diminuição da corrupção e melhoria da governança pública nos países em desenvolvimento.  Isso porque os riscos de práticas de patronagem nesses países são maiores quando comparados a países desenvolvidos com burocracias bem estabelecidas.
As reformas da administração pública em Portugal
Authors: Bilhim João
Published: June 2021

O objetivo deste trabalho é discutir as reformas implementadas em Portugal nos últimos 20 anos e apreciar o seu impacto nos cidadãos, pois frequentemente essas reformas são apresentadas como referências, mas raramente é evidenciado o seu fraco impacto na população. Do ponto de vista metodológico, seguiu-se uma abordagem qualitativa: foi feito o levantamento da documentação relevante – relatórios técnicos e textos jurídicos – e nela tiveram origem as questões que foram discutidas com 30 informadores qualificados escolhidos em bola de neve, amostra indicativa. Neste trabalho sustenta-se que as reformas efetuadas em Portugal durante os últimos 20  anos foram de caráter reativo, assimétrico e fragmentário,   provocadas pela necessidade de equilibrar as finanças públicas e por mimetismo e necessidade de legitimação face à pressão externa.
Empreendedores escondem suas ideias?
Authors: Bussmann Luis
Published: June 2021

Estudo com Startups do setor financeiro mostra que essas empresas são bem mais abertas do que muitos esperariam.
Home office e o modelo híbrido de trabalho
Authors: Costa Sergio Amad
Published: June 2021

A  experiência do home office deve ser vista com cautela pelas empresas que aderiram à prática recentemente. Quando tudo isso passar, será o momento de avaliar se o modelo híbrido de trabalho funciona bem ou não para a realidade em que cada organização está inserida.
O novo normal e as mudanças comportamentais do consumidor
Authors: De Oliveira Tânia Veludo
Published: June 2021

As pessoas foram levadas a ressignificar os símbolos de consumo e de socialização: o uso de álcool em gel e de máscaras, por exemplo, traduziu-se em respeito pelo outro.
futuro chegou
Authors: Wilner Adriana , Lilian dos Santos Aline
Published: June 2021

Como a pandemia confirmou o que a netshow.me acredita há quase 10 anos: a predominância das plataformas de eventos e conteúdos digitais.
Negócios digitais: como crescer?
Authors: Angotti Guissoni Leandro
Published: June 2021

Investir no core business, lançar serviços adicionais e entrar em novos mercados são três caminhos que, se bem combinados, trazem ganhos de escala e monetização.
potencial da loja dentro da loja
Authors: Ulisses de Moraes Leandro , Rosenthal Benjamin
Published: June 2021

O sistema shop-in-shop desponta como uma alternativa de menor custo para fortalecer marcas, expor melhor produtos e expandir clientes e vendas.
Todos pela inovação
Authors: Teixeira Alvares Antonio Carlos
Published: June 2021

Sistemas horizontais como o da Brasilata e da Tube mostram o potencial de inovar com a colaboração do corpo inteiro de funcionários.
sereia de duas cabeças
Authors: Sandroni Paulo
Published: June 2021

Iniciar 2021 com recorde de desempregados e uma segunda onda da epidemia vai impor algum tipo de auxílio emergencial, ou as consequências serão das mais sombrias do ponto de vista da estabilidade social.
Onde tem fumaça, tem fogo... cruzado
Authors: Gama Marina , Lana Jeferson
Published: June 2021

De 2013 a 2017, houve um aumento de 29% no número de doações das empresas listadas na bolsa brasileira para organizações não-governamentais – o que está associado à melhora no valor de mercado das companhias.
Faça a coisa certa
Authors: Wilner Adriana , Dos Santos Aline Lilian
Published: June 2021

Caroline Cintra e Marta Saft, da Thoughtworks, mostram como um time diverso pode criar valor para a empresa e seus clientes e contribuir para o desenvolvimento social.
Fazendo justiça na pandemia
Authors: Jordão da Motta Armiliato de Carvalho Luciana
Published: June 2021

Por trás dos dados de aumento da produtividade de decisões judiciais pela virtualização dos serviços, despontam as desigualdades de acesso entre os usuários.
Desafios da administração pública brasileira
Authors: Peci Alketa , Carvalho Teixeira Marco Antonio
Published: June 2021

A crise da covid-19 evidenciou o papel central da gestão e burocracia profissional do estado, que precisa resgatar mecanismos de autonomia decisória, fortalecer-se em um ambiente de cooperação e coordenação federativa e passar por uma reforma que elimine distorções e favoreça sua legitimidade e poder de ação.
Making sense of it all: Ethical reflections on the conditions surrounding the first genome-edited babies
Authors: Chen Qi , Ma Yonghui , Labude Markus , Schaefer G Owen , Xafis Vicki , Mills Peter
Published: June 2021

In November 2018 the birth of the first genome-edited human beings was announced by Chinese scientist, He Jiankui. The ensuing ethical controversy, institutional investigations and legal proceedings led to the revision of standards, rules and procedures at many levels. Arguably, however, these developments have not fundamentally changed the conditions or the culture that nourished He Jiankui’s vaulting ambition in the first place and enabled it to find expression. In this paper we explore the clinical, regulatory and societal circumstances of the ‘gene-edited baby’ case, the political, cultural and economic conditions that created a radical and dangerous climate for biotechnology innovation, and the responsibilities of the international research community, many of whose members were apprised of Dr He’s intentions. The aim is not to heap anathemas on the heads of implicated individuals but to draw attention to the need for different communities (researchers, authorities and domestic publics) to play a part actively in the governance of biomedical innovation and for research to be bridled by human values.
Pharmacokinetics and pharmacodynamics of azithromycin in severe malaria bacterial co-infection in African children (TABS-PKPD): a protocol for a Phase II randomised controlled trial
Authors: Olupot-Olupot Peter , Okiror William , Mnjalla Hellen , Muhindo Rita , Uyoga Sophie , Mpoya Ayub , Williams Thomas N , terHeine Rob , Burger David M , Urban Britta , Connon Roisin , George Elizabeth C , Gibb Diana M , Walker A Sarah , Maitland Kathryn
Published: June 2021

Background: African children with severe malaria are susceptible to Gram-negative bacterial co-infection, largely non-typhoidal Salmonellae, leading to a substantially higher rates of in-hospital and post-discharge mortality than those without bacteraemia. Current evidence for treating co-infection is lacking, and there is no consensus on the dosage or length of treatment required. We therefore aimed to establish the appropriate dose of oral dispersible azithromycin as an antimicrobial treatment for children with severe malaria and to investigate whether antibiotics can be targeted to those at greatest risk of bacterial co-infection using clinical criteria alone or in combination with rapid diagnostic biomarker tests.

Methods: A Phase I/II open-label trial comparing three doses of azithromycin: 10, 15 and 20 mg/kg spanning the lowest to highest mg/kg doses previously demonstrated to be equally effective as parenteral treatment for other salmonellae infection. Children with the highest risk of bacterial infection will receive five days of azithromycin and followed for 90 days. We will generate relevant pharmacokinetic data by sparse sampling during dosing intervals. We will use population pharmacokinetic modelling to determine the optimal azithromycin dose in severe malaria and investigate azithromycin exposure to change in C-reactive protein, a putative marker of sepsis at 72 hours, and microbiological cure (seven-day), alone and as a composite with seven-day survival. We will also evaluate whether a combination of clinical, point-of-care diagnostic tests, and/or biomarkers can accurately identify the sub-group of severe malaria with culture-proven bacteraemia by comparison with a control cohort of children hospitalized with severe malaria at low risk of bacterial co-infection.

Discussion: We plan to study azithromycin because of its favourable microbiological spectrum, its inherent antimalarial and immunomodulatory properties and dosing and safety profile. This study will generate new data to inform the design and sample size for definitive Phase III trial evaluation.

Registration: ISRCTN49726849 (27th October 2017).
Methodology Assessment of Working Environment Factors on Health Status of Workers of Radiation Hazardous Productions
Authors: Bobrov Alexandr , Kuznetsova L. , Sedin V. , Tukov A. , Shcheblanov V. , Proskuryakova N , Afonin S. , Smirnov Yu.
Published: June 2021

Purpose: Development of methodology and criteria for establishing causal relationships between the health status of workers in radiation-hazardous industries with factors of the working environment.

Results: A methodology and criteria have been developed for assessing the cause-and-effect relationships of the health of workers in radiation-hazardous industries with the factors of the working environment. The assessment is carried out in three stages. At the 1st stage, according to the data of periodic medical examinations and psychophysiological examinations, the level of the employee’s health loss is assessed, at the 2nd stage (using the risk matrix) – the level of occupational risk. At the 3rd stage, according to the relative risk of a specific disease (or its etiological share) and the level of occupational risk, a decision is made on the causation of the disease by unfavorable factors of the working environment.
Bioelectric Activity of the Brain in the Operational Personnel of the Russian Nuclear Power Plant with a Low Level of Psychophysiological Adaptation
Authors: Torubarov F. , Zvereva Z , Luk'yanova S.
Published: June 2021

Purpose: The aim is to study the bioelectric activity of the brain in the operational workers of the Novovoronezh and Beloyarsk nuclear power plants with a low level of psychophysiological adaptation.

Material and methods: An EEG study of 101 operational employees of the NPP was conducted, visual and spectral analyses were used. EEG indicators of individuals with a low level of psychophysiological adaptation and low functional activity of structural and functional formations of the central nervous system were compared with those of individuals with a high level of adaptation, high functional activity of structural and functional formations of the central nervous system.

Results: Visual analysis of individuals with a low level of psychophysiological adaptation revealed abnormal EEG indicators, indicating functional disorders of the central nervous system. The greatest violations were revealed in the structural and functional formation responsible for the central regulation of the cardiovascular system. A comparative assessment of the spectral power of the EEG at different levels of psychophysiological adaptation revealed a state of tension (tense adaptation) observed in individuals with both low and high levels of adaptation. The similarity between the structural and functional formation "central regulation of the cardiovascular system" with low functional activity and a low level of psychophysiological adaptation in terms of the number of abnormal EEG indicators can be considered as evidence of its greatest contribution to the formation of a low level of adaptation.The evaluation of interhemispheric interactions in structural and functional formations at their low and high activity, as well as at low and high levels of adaptation, suggested that the formation of a high level of psychophysiological adaptation as an integral characteristic of the main role played by the formation of the "Cortex" and "central regulation of the cardiovascular system".

In the formation of a low level of psychophysiological adaptation as an integral characteristic, the main role is played by the formations "cortex" and "cortical-subcortical interaction".

Conclusion: A violation of the bioelectric activity of the brain may be one of the pathogenetic mechanisms of reduced adaptation. The presence of statistically significant differences in EEG indicators in individuals with low and high levels of adaptation, revealed by visual and spectral analysis, allows us to consider these indicators as informative not only in terms of identifying deviations in the diagnosis of functional disorders, but also in assessing the effectiveness of rehabilitation and health measures.