bluuebunny/crossref_metadata_2025 huggingface dataset:
De Nottingham à Calais, le genre de la dentelle mécanique à l’épreuve des migrations (1810-1860)
Authors: Bensimon Fabrice
Published: December 2021

Jusqu’au XIX e  siècle, la dentelle à la main est, en Europe, un secteur exclusivement féminin. Dans la dentelle mécanique, développée dans la région de Nottingham à partir de 1809, seuls des hommes opèrent avec les « Leavers », des machines sophistiquées bientôt couplées à des métiers Jacquard, dont la production ruine progressivement la dentelle à la main. Autour d’eux, souvent dans un cadre familial, femmes et enfants s’activent à la préparation des fils et des bobines, à la broderie, aux retouches, au blanchissage et aux teintures, à toutes les activités périphériques, souvent accomplies dans des conditions difficiles. Ces tâches, parfois très qualifiées, sont considérées comme annexes et sont moins payées. Après 1815, des dentelliers émigrent et développent une industrie dans le Calaisis. La ségrégation sexuée qui prévaut outre-Manche se reproduit-elle en France ? Comment les dentelliers migrants négocient-ils les différences et les similitudes législatives et coutumières entre les deux pays ? Ce sont les questions qui sont ici posées.
Tisseurs et tisseuses en soie au travail dans les ateliers de la Fabrique de Lyon au milieu du XIX e siècle
Authors: Martini Manuela , Vernus Pierre
Published: December 2021

Cette étude propose d’observer d’un point de vue genré l’un des univers ouvriers les plus emblématiques du XIX e  siècle : la Fabrique lyonnaise des tissus en soie. L’organisation de l’industrie de la soie à Lyon permet d’étudier, d’une part, la division genrée du travail dans une multitude de métiers très spécialisés et, d’autre part, les hommes et les femmes au travail dans le même espace et effectuant des tâches semblables. Cette mixité professionnelle, peu fréquente dans bien des espaces de travail au milieu du XIX e  siècle, est au cœur de ce travail. L’article dessine, tout d’abord, les contours de cet univers mixte dans un moment charnière de la transformation de la Fabrique lyonnaise, et de son expansion vers les pentes et le plateau de la Croix-Rousse. Il aborde ensuite une question peu étudiée dans la vaste historiographie qui s’est intéressée aux « canuts » : la diversité et l’hétérogénéité du groupe des chefs d’atelier. Pour cerner quelques traits marquants de cette diversité, il s’approche enfin de l’atelier familial en prenant le mariage comme moment fondateur de l’atelier et de resserrement des liens professionnels indispensables pour son fonctionnement.
La bureaucratie internationale et le système des Nations unies : Introduction
Authors: Thorvaldsdottir Svanhildur , Patz Ronny , Eckhard Steffen
Published: December 2021

Construite sur le système administratif de la Société des Nations, l’Organisation des Nations unies (ONU) est devenue, depuis la Seconde Guerre mondiale, un système important, complexe et à plusieurs niveaux, composé de plusieurs dizaines de bureaucraties internationales. En dehors d’une brève période dans les années 1980, et malgré la multiplication des études sur les administrations publiques internationales au cours des deux dernières décennies, il y a eu peu de publications dans la Revue internationale des sciences administratives (RISA) sur l’évolution du système des Nations unies et de ses nombreuses administrations publiques. Le numéro spécial intitulé « La bureaucratie internationale et le système des Nations unies » vise à encourager un regain d’intérêt de la part des chercheurs pour ce niveau mondial d’administration publique. Dans la présente introduction, nous expliquons en quoi l’étude des bureaucraties de l’ONU est importante du point de vue de l’administration publique, nous faisons le point sur la littérature pertinente et examinons la manière dont les sept articles contribuent à des avancées substantielles et méthodologiques clés dans l’étude des administrations du système de l’ONU.
Le recrutement du personnel et la représentation géographique dans les organisations internationales
Authors: Eckhard Steffen , Steinebach Yves
Published: December 2021

Qu’est-ce qui explique la représentation géographique dans le personnel professionnel des organisations intergouvernementales (OI) ? Nous abordons cette question d’un point de vue organisationnel en considérant les processus de recrutement des OI. Dans le système des Nations unies (ONU), les processus de recrutement sont conçus pour garantir le mérite bureaucratique, l’expérience et la formation étant les critères de mérite pertinents. Nous développons et testons une théorie de l’offre, en postulant que les différences dans l’offre de candidats qualifiés et très expérimentés dans les pays peuvent expliquer la représentation géographique. En nous appuyant sur les données relatives au personnel de 34 OI et sur les données relatives à l’offre de 174 États membres, et en tenant compte de l’endogénéité et des autres explications, nous n’avons observé aucune relation de ce type pour la formation. Cependant, les pays qui disposent d’un grand nombre de candidats ayant une expérience professionnelle et régionale pertinente présentent des valeurs significativement plus élevées en termes de représentation. Ces résultats offrent une explication complémentaire sur les raisons pour lesquelles certains pays sont plus fortement représentés dans le personnel professionnel international que d’autres. Ils révèlent également la nature du mérite bureaucratique au sein de l’ONU, qui semble privilégier les connaissances locales et l’expérience professionnelle par rapport à l’éducation formelle (occidentale). Remarques à l’intention des praticiens Comment expliquer la représentation des États membres dans les organes du personnel des organisations du système des Nations unies ? Les travaux antérieurs ont montré que la puissance des États membres est un bon indicateur. Mais qu’en est-il du mérite bureaucratique ? L’article montre que les schémas de représentation peuvent également être expliqués en mesurant l’offre des États en termes de candidats possédant une expérience professionnelle et régionale pertinente. L’offre de candidats instruits ne joue aucun rôle significatif. Le mérite bureaucratique au sein de l’ONU semble mettre l’accent sur les connaissances locales et l’expérience professionnelle plutôt que sur l’éducation formelle (occidentale).
Partenariats public-privé : l’imputabilité procédurale plutôt que celle axée sur les résultats
Authors: Parrado Salvador , Reynaers Anne-Marie
Published: December 2021

L’article examine dans quelle mesure les fonctionnaires néerlandais et espagnols font des compromis entre l’imputabilité des processus et des résultats lors de la conception, de la gestion et de l’adaptation des contrats pour les partenariats public-privé. Nous nous attendons à ce que les traditions administratives distinctes des deux pays (respectivement légaliste et axée sur la gestion) aient une influence. En analysant les contrats, les documents stratégiques et les entretiens menés avec 89 membres de projets néerlandais et espagnols, l’article montre que les administrateurs néerlandais se concentrent sur l’imputabilité des résultats, conformément aux principes de la gouvernance relationnelle, tandis que les responsables espagnols optent pour l’imputabilité des processus, conformément au cadre de gouvernance contractuel pour les services non cliniques, et pour l’imputabilité axée sur les résultats pour les services cliniques dans les hôpitaux. Remarques à l’intention des praticiens L’imputabilité procédurale et l’imputabilité par les résultats ne sont pas nécessairement des substituts. Les pays très légalistes peuvent mettre l’accent sur l’imputabilité des processus, mais l’imputabilité par les résultats est nécessaire pour exploiter le potentiel de l’opérateur du secteur privé qui fournit des services publics. Les contrats à long terme exigent que le maître d’ouvrage fixe d’abord les résultats à atteindre, puis élabore les mécanismes d’imputabilité les plus appropriés. L’imputabilité par les résultats exige des compétences que l’on ne trouve pas facilement dans le secteur public des pays légalistes, ce qui est essentiel pour rendre compte correctement du contrat.
Banques Alimentaires : une aide alimentaire structurée autour d’un écosystème circulaire solidaire
Authors: Mauvilain Barbara , Evain Suzanne
Published: December 2021

Depuis sa création en 1984, le réseau des Banques Alimentaires s’est développé, structuré, professionnalisé et constamment adapté. En 2020, les Banques Alimentaires ont accompagné plus de 2 millions de bénéficiaires. Ce travail est accompli au quotidien par les 79 Banques Alimentaires et leurs 31 antennes. Il s’appuie sur les quelque 7 000 bénévoles et plus de 500 salariés qui assurent un maillage au plus près des territoires en France métropolitaine, aux Antilles et à la Réunion. Les Banques Alimentaires distribuent leurs produits à plus de 6 000 associations et ccas partenaires. Depuis mars 2020, la crise sanitaire et sociale a remis en avant l’importance de l’aide alimentaire. Elle a marqué la grande capacité d’adaptation et d’innovation de ce réseau, amplifiant souvent des transformations déjà engagées : distribution directe, achats de produits alimentaires locaux diversifiés et de qualité, distribution de produits d’hygiène, prévention santé, dispositifs pour les étudiants, etc. Ancrées sur un modèle non lucratif qui s’inscrit dans l’économie sociale et solidaire, les Banques Alimentaires ont pour projet d’inscrire leur action dans les grands défis auxquels notre société est confrontée : la lutte contre le gaspillage, le lien entre nutrition et santé, le changement climatique, la construction de systèmes alimentaires locaux, la réduction des inégalités sociales.
L’aide alimentaire : entre bénévolat et injonctions managériales
Authors: Gelot Didier , Ward John
Published: December 2021

À partir de plusieurs entretiens réalisés auprès de bénéficiaires et de responsables locaux et départementaux de deux grandes structures de l’aide alimentaire, cet article (qui ne prétend ni à l’exhaustivité ni à la représentativité) cherche à décrire le sens que donnent ces personnes à leur engagement, et les tensions qu’elles rencontrent à un moment où la pression sociale se fait de plus en plus vive. Il pointe comment la parole des bénéficiaires reste peu audible, voire peu valorisée par les personnes en situation de grande précarité elles-mêmes.
Investigation into the Hub-and-Spoke model using brand and frequent-flyer program
Authors: Boroh Johannes
Published: December 2021

Purpose: This paper seeks to understand if customer acceptance on flying through a hub has changed today, compared to the findings from past research conducted many years ago. The study involves investigations of Singapore Airlines, a successful FSC in terms of its ability to generate sustainable profits for many consecutive years as reflected in its annual financial reports. The carrier also has a strong corporate brand, a world-class airport hub as well as a frequent flyer program, which makes it attractive to explore. Design/methodology/approach: The survey method is utilized in order to seek the answers to the three questions developed in the literature review. Descriptive statistics are employed to analyze 723 datasets using SPSS v20. Findings: Although the paper shows that some findings resonated past arguments, some others have changed. Brand has no longer become a significant factor for passengers when deciding to travel with a full-service carrier (FSC) via its hub, and an FFP that is likely to hold less compelling attractiveness with passengers with regard to purchasing consideration.Research limitations/implications: The research involved only passengers traveling two routes in Southeast Asia, therefore the generalization of the findings must be carried out with caution. Future studies to extend this research to different geographical markets are necessary to investigate if similar behaviours are also observed, as described in this study.Originality/value: This paper offers insights into in the hub-and-spoke airline business model discipline. The author suggests that the role of strong brands and frequent flyer program to attract passengers travelling via a hub have diminished. Nowadays, even FSC passengers are more concern with airfare.
Health Literacy and Access to Care in Cancer Screening Among Korean Americans
Authors: Lee Moonju , Lee Mikyoung A. , Ahn Hyochol , Ko Jisook , Yon Esther , Lee Jeeyoung , Kim Miyong , Braden Carrie Jo
Published: December 2021

Background:

Health literacy and access to care are critical facilitators for preventive health behaviors. After the passage of the Affordable Care Act in March 2010, little has been studied about how improved health insurance coverage has impacted the use of preventive health services among Korean Americans.

Objective:

The study assessed the impact of access to care, use of services, and health literacy on cancer screening among Korean Americans.

Methods:

A descriptive cross-sectional study of 377 Korean Americans age 18 years and older was conducted with a survey and convenient sampling in Texas.

Key Results:

Although 79% of the sample had health insurance, 32% had never visited a health care provider, and 14% were delayed in care in the past 12 months. Only 11.6% were confident to complete medical forms, and 69.5% had limited levels of confidence. Cancer screening compliance rates were: mammography (50.4% at age 40–54 years; 46.6% at age 55 years and older), a Pap smear (29.4% at age 21–29 years; 78.4% at age 30–65 years; 72.2% at age 66 years and older), and colorectal cancer screening at age 45 years and older (stool tests 15.1%; sigmoidoscopy 27%; colonoscopy 51.3%). Multiple logistic regression analyses revealed that household income, gender, health insurance, and health literacy were significantly associated with self-reported cancer screening.

Conclusions:

Korean Americans who participated in this study are characterized by marginalized health literacy, underused health care services, and significantly lower cancer screening compliance than the goals of Healthy People 2020. The following interventions are suggested to improve health literacy and health insurance literacy on cancer screening: culturally sensitive and linguistically appropriate education for the guidelines concordant with cancer screening, effective communication skills with health care providers, support for navigating the health care system, and development of internet- or social media-based health education programs to meet the preferred communication methods of this population.

[
HLRP: Health Literacy Research and Practice
. 2021;5(4):e310–e318.

]

Plain Language Summary:

Despite having improved health insurance coverage, Korean Americans of this study have marginalized health literacy, limited health insurance literacy, low cancer screening compliance, and underused health care services. The results of this study suggest several strategies to improve health literacy and health insurance literacy for Korean Americans, which may also apply to other groups with similar barriers.
Certain inequalities in frame of the left-sided fractional integral operators having exponential kernels
Authors: Yu Shuhong ,   Three Gorges Mathematical Research Center, China Three Gorges University, Yichang 443002, China, Du Tingsong ,   Department of Mathematics, College of Science, China Three Gorges University, Yichang 443002, China
Published: December 2021

By virtue of the left-sided fractional integral operators having exponential kernels, proposed by Ahmad et al. in [J. Comput. Appl. Math. 353:120-129, 2019], we create the left-sided fractional Hermite–Hadamard type inequalities for convex mappings. Moreover, to study certain fractional trapezoid and midpoint type inequalities via the differentiable convex mappings, two fractional integral identities are proven. Also, we show the important connections of the derived outcomes with those classical integrals clearly. Finally, we provide three numerical examples to verify the correctness of the presented inequalities that occur with the variation of the parameter $ \mu $.
Factors associated with social support for family members who care for stroke survivors
Authors: Kavga Anna ,   Department of Nursing, University of West Attica, Athens, Greece, Kalemikerakis Ioannis , Konstantinidis Theocharis , Tsatsou Ioanna , Galanis Petros , Karathanasi Eugenia , Govina Ourania ,   Department of Nursing, Hellenic Mediterranean University, Heraklion, Crete, Greece,   Oncology-Hematology Department, Hellenic Airforce General Hospital, Athens, Greece,   Department of Nursing, National and Kapodistrian University, Athens, Greece,   Department of Nursing, Dafni, Attica Psychiatric Hospital, Athens, Greece
Published: December 2021

Introduction

Vascular strokes are a primary cause of long-term disability for adults, with many social consequences for the patient, the family and healthcare systems worldwide.

Aim

To investigate the relation between patients' and caregivers' characteristics, as well as burden and depression, and the social support received by carers for stroke victims in Greece.

Method

Patients and caregivers were recruited from community settings in the Attica region of Greece, using purposive sampling. They completed a set of questionnaires during face-to-face interviews. Correlational and multiple regression analyses were performed to identify factors associated with caregivers' perceptions of social support.

Results

In total, 109 dyads of patients and their respective caregivers were recruited. The patients' mean age was 69.3 years, while caregivers' mean age was 58.0 years; 51.4% of patients were males, whereas 67.9% of the caregivers were females. The majority of both patients and caregivers were married, with an annual family income less than €10,000. The level of perceived social support was significantly associated with patients' or caregivers' annual family income, caregivers' working status and the daily caring hours (p < 0.01). Greater perceived support was significantly associated with a lower care burden BCOS (r = 0.29, p < 0.01) and female gender (p = 0.023), but not with the patient's functional level nor with depression (p > 0.05).
Americanizar las intendencias de Gálvez: la propuesta de Francisco Machado Fiesco
Authors: Dubet Anne
Published: December 2021

Deseo contribuir al estudio de la génesis y significado del proyecto de intendencias americanas. Analizo la propuesta del contador general de Indias, Francisco Machado Fiesco, colaborador del ministro y miembro de la junta encargada desde 1778 de reformular las ordenanzas redactadas por Gálvez en 1774. Machado deseaba amoldar el proyecto a una tradición americana heredera, como creía, de las instituciones aragonesas. Argumento la hipótesis de que pesó en este sentido en la junta, obligándonos a matizar la idea de que las intendencias fueron una pura importación en América del modelo peninsular
«Pardas y morenas», libres y libertas. Propietarias y emprendedoras a finales del siglo XVIII en Trinidad, Cuba
Authors: Chaviano Lizbeth Jhoanna
Published: December 2021

A pesar del papel subalterno al que ha sido relegada la mujer en la sociedad patriarcal, las mujeres libres de color y libertas tuvieron una destacada participación en la economía local de Trinidad del último cuarto de siglo XVIII. Las fuentes notariales demuestran su capacidad para la administración y gestión de los bienes propios y de terceros, así como para compartir actividades y espacios con los hombres tanto en el mercado de viviendas como en el de mano de obra, o incluso en la marinería.
La expansión de la frontera colonizadora en Guarayos, 1950-1970. El acceso a la tierra, base económica del poder local carai en las poblaciones guarayas
Authors: García Jordán Pilar
Published: December 2021

Bajo la administración de la Intendencia Delegacional de Guarayos (Bolivia) surgió en la región un embrionario grupo dirigente blanco-mestizo, los carai, conformado por empleados públicos y colonos llegados a partir de 1938. El acceso a las tierras fiscales permitió a los carai consolidar su poder económico en el ámbito local guarayo, en particular tras la aprobación de la reforma agraria por el gobierno del Movimiento Nacionalista Revolucionario. El objetivo de este artículo es analizar los principales aspectos que presentó el acceso a la tierra desde la década de 1950 hasta 1970.
Allegretto Allegretti: un diplomático de Ragusa al servicio de los Habsburgo
Authors: Conde-Pazos Miguel
Published: December 2021

Originario de la república de Ragusa, Allegretto Allegretti fue uno de los principales agentes con los que la Casa de Austria contó a mediados del siglo XVII. Este eclesiástico realizó numerosas misiones para las dos ramas de la dinastía —en Varsovia, Constantinopla y Moscú, entre otros lugares—, distinguiéndose por sus dotes idiomáticas. En Viena formó parte del entorno de la embajada española, sirviendo a la emperatriz María Ana, así como a los sucesivos embajadores entre las décadas de 1630 y 1650. Este artículo reconstruye una parte de su vida, centrándonos en sus servicios a la rama hispana de la dinastía y su carrera cortesana. Una biografía que refleja las grandes trasformaciones que se produjeron durante aquellas décadas en la Europa central y suroriental, sobre todo en sus relaciones con Madrid. Pero también, una vida que plasma los cambios en los equilibrios dentro de la propia Casa de Austria, en los que la Monarquía Hispana perdió una parte importante de su influencia en la corte de Viena.
Deep Learning in Retinal Image Segmentation and Feature Extraction: A Review
Authors: Hoque Mohammed Enamul , Kipli Kuryati
Published: December 2021

Image recognition and understanding is considered as a remarkable subfield of Artificial Intelligence (AI). In practice, retinal image data have high dimensionality leading to enormous size data. As the morphological retinal image datasets can be analyzed in an expansive and non-invasive way, AI more precisely Deep Learning (DL) methods are facilitating in developing intelligent retinal image analysis tools. The most recently developed DL technique, Convolutional Neural Network (CNN) showed remarkable efficiency in identifying, localizing, and quantifying the complex and hierarchical image features that are responsible for severe cardiovascular diseases. Different deep layered CNN architectures such as LeeNet, AlexNet, and ResNet have been developed exploiting CNN morphology. This wide variety of CNN structures can iteratively learn complex data structures of different datasets through supervised or unsupervised learning and perform exquisite analysis for feature recognition independently to diagnose threatening cardiovascular diseases. In modern ophthalmic practice, DL based automated methods are being used in retinopathy screening, grading, identifying, and quantifying the pathological features to employ further therapeutic approaches and offering a wide potentiality to get rid of ophthalmic system complexity. In this review, the recent advances of DL technologies in retinal image segmentation and feature extraction are extensively discussed. To accomplish this study the pertinent materials were extracted from different publicly available databases and online sources deploying the relevant keywords that includes retinal imaging, artificial intelligence, deep learning and retinal database. For the associated publications the reference lists of selected articles were further investigated.
Classification of Sleep Apnea using Multi Scale Entropy on Electrocardiogram Signal
Authors: Rizal Achmad , Iman Usman Rizki , Fauzi Hilman
Published: December 2021

One of sleep-disordered breathing (SDB) form is sleep apnea, commonly known as snoring during sleep, based on various complex mechanisms and predisposing factors. Sleep apnea is also related to various medical problems. It impacts morbidity and mortality so that it becomes a burden on public health services. Its detection needs to be done correctly through electrocardiogram signals to detect sleep apnea more quickly and precisely. This study was conducted to detect sleep apnea based on electrocardiogram signals using multi-scale entropy analysis. Multi-scale entropy (MSE) is used in a finite length of time series for measuring the complexity of the signal. MSE can be applied to both physical and physiological data sets and. In this paper we used MSE to detect Sleep Apnea on electrocardiogram (ECG) signals. MSE was applied two classes of ECG data, normal ECG signals, and apnea ECG signals. In this paper, classification and verification were carried out using the Support Vector Machine (SVM) and N-fold cross-validation (N-fold CV). From the experimental results, the highest accuracy was 85.6% using 5-fold CV and MSE scale of 10. The result shows that the system model that can detect sleep using the multi-scale entropy method
How AI Can Aid Bioethics
Authors: Sinnott-Armstrong Walter , Skorburg Joshua (Gus) August
Published: December 2021

This paper explores some ways in which artificial intelligence (AI) could be used to improve human moral judgments in bioethics by avoiding some of the most common sources of error in moral judgment, including ignorance, confusion, and bias. It surveys three existing proposals for building human morality into AI: Top-down, bottom-up, and hybrid approaches. Then it proposes a multi-step, hybrid method, using the example of kidney allocations for transplants as a test case. The paper concludes with brief remarks about how to handle several complications, respond to some objections, and extend this novel method to other important moral issues in bioethics and beyond.
Estar em Grupo: psicoeducação para experienciar sensações corporais e emoções
Authors: Esteves Brito Eduardo José , Tinoco Ponciano Edna Lúcia
Published: December 2021

A psicoeducação em grupo pode ser vinculada à promoção da saúde. A experiência de estar em grupo gera fatores terapêuticos e tem efeitos sobre a autorregulação. As referências teórico-técnicas utilizadas são a Focalização e a Experiência Somática® (SE), que têm características psicoeducativas facilitadoras do processo autorregulatório, ao criar um contexto de segurança. O objetivo é apresentar e discutir uma pesquisa que analisou a aplicação de uma proposta interventiva com foco nas sensações corporais e nas emoções. A pesquisa, transversal e de caráter exploratório, com ênfase nas narrativas dos participantes, enfatiza a construção da experiência na relação. A intervenção investigada, dividida em cinco etapas, iniciada pelo corpo e com a posterior elaboração de significados sentidos, teve como instrumento de coleta de dados as atividades desenvolvidas em grupo, que foram gravadas e transcritas. Participaram 25 estudantes universitários. Foram analisadas as falas sobre a experiência de estar em grupo, nas categorias experiências positivas, negativas e mistas, autorreferência, novas perspectivas e fatores terapêuticos, que implementam a autorregulação em um contexto de regulação comunal. Concluímos destacando os fatores terapêuticos no processo de estar em um grupo, no qual a insegurança e o estranhamento iniciais são substituídos pela segurança, desencadeando mudanças experienciais.
Caminhos pelos quais o Terapeuta Comportamental Aprende com seus Clientes
Authors: Rodrigues da Cunha Olívia , Vandenberghe Luc
Published: December 2021

A literatura profissional admite que terapeutas adquirem competências clínicas essenciais através da atuação. Porém os caminhos pelos quais essa aprendizagem se dá foram pouco explorados. Este é o objetivo deste estudo. Entrevistamos 14 terapeutas comportamentais e cognitivo-comportamentais sobre suas experiências de aprendizagem com seus clientes. A análise dos dados foi pautada nos preceitos da Grounded Theory Analysis. Os resultados sugerem que terapeutas consideram sua atuação como uma oportunidade de aprender e que clientes direcionam seu desenvolvimento profissional. A aprendizagem com o cliente é bilateral, gradual e cumulativa. Envolve interações com o modelo teórico, com os desafios encontrados no caso, os paralelos com a vida do terapeuta, os seus estudos contínuos e com o que ocorre na supervisão. Concluímos que aprender com o cliente não ocorre por uma assimilação passiva de conhecimentos. Contribuições do terapeuta como sua adesão teórica, suas dificuldades com o caso e a similaridade que enxerga entre ele e o cliente influenciam na aprendizagem. Seu envolvimento em estudos e supervisões influencia como o terapeuta processa o que aprende do cliente. Tudo isso mostra o terapeuta como um participante ativo que traz suas características individuais e empenho para o processo de aprendizagem.
Management of long-standing edentulous space with dental implants
Authors: Naidu Ashwini , Naidu Monish Shashikumar
Published: December 2021

Long-standing edentulous cases due to missing permanent mandibular first molars commonly result in mesial tipping and migration of second molars in the edentulous space. In order to place an optimum-sized dental implant and crown for replacement of the missing tooth space regaining by uprighting and distalization of the second molar is essential. Various orthodontic techniques using fully bonded fixed appliances and segmental orthodontics with coil springs, loops, and miniscrew orthodontic implants have been used for space regaining. Obtaining three-dimensional control during tooth movement in segmental orthodontics is challenging as all the forces are applied to the teeth buccally. This case report shows a method to regain space using a long head miniscrew orthodontic implant placed at the retromolar pad area with three-dimensional control during second molar uprighting and distalization followed by restoration with a dental implant.
Use of Thrombolytic Agents for ST-Elevation Myocardial Infarction Care in India
Authors: Chopra Arun , Patted Suresh V , Parikh Mukesh , Agarwal Rajeev , Jaishankar K , Modi Nitin
Published: December 2021

In India, ST-elevation myocardial infarction (STEMI) is the predominant form of acute coronary syndrome. It is estimated to affect approximately 30 million people in India. The mainstay treatment approach for STEMI management is primary percutaneous coronary intervention (PCI) within 90 min after the first medical contact. However, due to existent clinical and practical barriers in performing timely PCI, optimal treatment is not offered on a timely basis. The challenges or barriers to timely PCI can be overcome by a pharmaco-invasive approach, in which thrombolysis is performed as soon as the patient is diagnosed with STEMI and transferred for PCI. Pharmaco-invasive approach is effective in shortening time to reperfusion therapy by allowing prompt initiation of thrombolysis followed by PCI as soon as possible. An experts' panel discussion was conducted involving 47 cardiologists all over India to review evidence-based concept of pharmaco-invasive treatment approach and to gain their expert opinion on emergency management of STEMI patients in the Indian setting. The experts highlighted that thrombolysis is the most implemented reperfusion strategy in India, especially when primary PCI is not available for STEMI patients. According to them, pharmaco-invasive approach would be appropriate to gain time to treatment in the event of expected treatment delays. Among thrombolytic agents, the experts recommended using third-generation thrombolytic agents because of their faster patency, more effectiveness, and ease of administration. They also emphasized on various clinical factors and practical considerations to be assessed before employing thrombolytic agents. In their opinion, bolus thrombolytic agents such as tenecteplase and reteplase offer effective, safer, easier, and faster administration for varied clinical profiles in all practical ways.
Cleansing the Augean Stables - Time to Reclassify Coronary Artery Disease
Authors: Thomas George
Published: December 2021

Although there have been spectacular developments in the diagnosis and treatment of coronary artery disease (CAD), the diagnostic terminology has not evolved accordingly. The present diagnostic terms are symptom, complication, and electrocardiogram based instead of the causative pathology. In the present era of excellent therapies, angina and infarction need not occur. When our efforts are directed at preventing these ill effects of CAD, the present diagnostic terms seem anachronistic. This article presents a simple, logical, and practical approach to CAD terminology.
Midgut volvulus with giant jejunal diverticulum in an elderly patient
Authors: Jasim Hasanain Abdulameer
Published: December 2021

Midgut volvulus is a rare cause of acute intestinal obstruction in elderly patients. It can be classified into primary (without obvious cause) or secondary (secondary to other abnormality). Jejunal diverticula are an uncommon type of diverticulum of the small bowel. However, associated with a high rate of complications such as diverticulitis, perforation, or rarely volvulus. In this case report, we present a female elderly patient with a proximal small bowel volvulus around the axis of superior mesenteric vessels with the giant jejunal diverticulum at the tip of the volvulus.
Effects of Omega-3 and Vitamin C on Methotrexate-Induced Liver Injury
Authors: Mohammed Dohah Saad , Al-Gareeb Ali Ismail A.
Published: December 2021

Context:

Methotrexate (MTX)-induced liver injury is a serious side effect characterized by the increased level of hepatic biomarkers and resulted in acute liver failure. Omega 3 and Vitamin C act as antioxidant that participate in the fighting of free radicals generation during the inflammatory process.

Aims:

To evaluate the effect of omega 3 and Vitamin C on hepatotoxicity induced by MTX.

Settings and Design:

42 (Swiss albino mice) used and divided into six groups (7 mice each): First: Maintained with normal saline, second: Received a single dose injection of MTX (20 mg/kg, intraperitoneally), third: Pretreated with omega 3 100 mg/kg, fourth: Pretreated with omega 3 200 mg/kg, fifth: Pretreated with Vitamin C 100 mg/kg, sixth: Pretreated with Vitamin C 200 mg/kg, then these group injected with MTX on day 10.

Subjects and Methods:

MTX as 50 mg injection. Omega 3 as capsule 1000 mg. Vitamin C as powder 1000 mg. Assessment of liver enzymes (alanine aminotransferase [ALT], aspartate aminotransferase [AST], and alkaline phosphatase [ALP]) made using automated computering device (Flexor–EL80) provider by Vitalab (South Africa). Assessment of oxidative stress markers (malondialdehyde [MDA], superoxide dismutase [SOD], reduced glutathione [GSH]) and lactate dehydrogenase (LDH) made by using competitive ELISA kits using (ELISA microplate Humareader).

Results:

This study showed a significant increase in the liver enzymes (ALT, AST, ALP, and LDH) as well oxidative stress markers (MDA, SOD, and GSH) with severe changes in the histopathological findings (severe inflammatory cell necrosis) among group injected with MTX as compared with control group and illustrated improvement in serum level of ALT, ALP, LDH, MDA, SOD and reduced GSH; besides improved histopathological findings (mild and moderate changes) for a group of mice pretreated with omega 3 and Vitamin C.

Conclusions:

This study concluded that pretreatment with omega 3 (which was strong antioxidant supplement) and Vitamin C (which was dose-dependent manner with beneficial antioxidant action) exert more hepatoprotective effect against oxidative tissue damage induced by MTX.
Microbiological profile of aerobic and anaerobic bacteria and its clinical significance in antibiotic sensitivity of odontogenic space infection
Authors: Umeshappa Hemavathi , Shetty Akshay , Kavatagi Kiran , Vivek G. K. , Vaibhav N. , Mohammed Imran
Published: December 2021

Introduction:

Odontogenic infections are mixed aerobic-anaerobic microbial flora. Infections caused by anaerobic bacteria are serious and life-threatening. The microbial specificity in odontogenic infections is technique sensitive depending on the sampling and culturing of specimens.

Materials and Methods:

A prospective study was carried out on 100 consecutive cases of odontogenic infections treated at our institute over a period of 5 years by surgical intervention and intravenous antibiotics. This study evaluates the pathogenic potential and virulence factors of aerobes and anaerobes as well as its synergistic interrelations with other infectious flora, by culturing of specimens and testing antibiotic sensitivity in standard microbiological methodology in correlation with patient demographic factors.

Results:

Of the 100 patients of odontogenic space infection, males were more affected, between third and fourth decades. Caries is the most common etiology with involvement of mandibular molars. Submandibular and buccal space is commonly involved. The most common microorganisms isolated being Staphylococcus aureus and Streptococcus viridans are facultative anaerobes which belong to aerobes and Peptostreptococcus predominated among obligate anaerobes. The empirical antibiotic regimen followed is amoxicillin plus clavulanic acid with Metronidazole, followed by surgical treatment. Clindamycin was preferred as the second line of choice in patients resistance to penicillin drugs with comparable efficacy in it.

Conclusion:

Our study expanded the knowledge base of the microbial flora associated with odontogenic infections, with special reference to anaerobes. Successful management of odontogenic space infection lies in decompression, removal of etiological factors, and also in selecting appropriate antimicrobial therapy depending on microbial flora isolated, for recovery of patients and preventing complications associated with fascial space infection.
Neonatal vascular malformation of parietal bone
Authors: Sahoo N. K. , Bhat Sudarshan , Kumar Sanjay
Published: December 2021

Vascular malformations (VaMs) are congenital lesions and are present at birth. They grow commensurately with age. These lesions often affect the soft tissues with intraosseous involvement of the scalp being rare. Here, we discuss a case of intraosseous VaM in a 2-month-old infant which was involving the parietal bone.
Evaluation of surface changes of stainless steel miniplates and screws following retrieval from maxillofacial trauma and orthognathic surgery patients
Authors: Devendrappa Mouneshkumar Chapi , Kulkarni Madhura Dattatraya , Haidry Nazia , Kulkarni Pranay , Verma Flora , Pawar Dhanashree Anand
Published: December 2021

Background:

Metal implants have the potential to degrade body fluids. Corrosive degradation has been demonstrated in laboratory tests, both under simulated clinical conditions and by electrochemical methods, as well as in studies of retrieved metal implants. The clinical importance of degradation of metal implants is evidenced by particulate corrosion and wear products in tissue surrounding the implant, which may ultimately lead to bone loss.

Materials and Methods:

The present study is to evaluate the surface changes such as corrosion, surface roughness, and microfractures and for the tensile strength of 18 stainless steel miniplates and 18 stainless steel screws which were used as rigid internal fixation in the management of maxillofacial fractures and orthognathic surgeries.

Results:

In this study, surface roughness and microfractures were found in all the miniplates and screws that is 100%. Corrosion degradation was found in 12 of 18 plates that is 66.66%.

Conclusion:

Our results through scanning electron microscopy and stereo electron microscopy showed surface roughness, microfractures, and corrosion. However, tensile strength was not affected when the plates were in situ. Through our study, we recommend their retrieval after the purposes of rigid fixation have been fulfilled.
Novel technique for esthetic root coverage with titanium prepared platelet-rich fibrin
Authors: Sachdeva Shivani V. , Saluja Harish , Mani Amit
Published: December 2021

Leukocyte- and platelet-rich fibrin (L-PRF) can be defined as an autologous leukocyte and platelet-rich biomaterial. Unlike other platelet-rich products, this technique does not require an anticoagulant or bovine thrombin. However, it is simply centrifuged blood without any additives, which makes it possible to avoid all of the legal restrictions related to the reimplantation of blood-derived products. L-PRF is composed of a fibrin matrix polymerized in a tetramolecular structure and is involved in the joining of platelets, leukocytes, cytokines, and circulating stem cells. The use of silica- coated test tubes is arising a lot of queries about the safety of L-PRF prepared within these test tubes. So, to avoid the use of silicacoated test tubes, titanium prepared PRF has come in practice now, as titanium is biocompatible metal and has property of histoconduction. The present case report is about successful esthetic root coverage around mandibular anterior teeth with clinical attachment loss of 4–5 mm at baseline. The patient had reduced sensitivity, CAL was 1 mm, and attached gingiva covered denuded root surface after 15 days and after 3-month recall appointment.
Diversifying the rehabilitation of calvarial defects
Authors: Gupta Abhishek Kumar , Kumari Mamta , Gupta Rekha , Gill Shubhra
Published: December 2021

Cranial vault defects are either congenital or acquired in origin. Cranioplasty is most commonly done in patients after trauma, decompressive craniectomies, tumor resections, infections or because of congenital malformations. The purpose of a Cranioplast is to protect the underlying brain tissues, reduce pain, and to improve the calvarial contour, symmetry, and esthetics. Rehabilitation of these defects possesses a challenge to the surgical team and prosthodontist. With advancement in three-dimensional (3D) engineering technology, the use of rapid prototyping technology (RPT) can be used in the fabrication of 3D skull eliminating conventional impression for recording defect region. Custom-made cranial prosthesis now can be fabricated using the conventional method of wax-up and lost-wax method. Case 1 had a history of road traffic accident followed by decompressive craniectomy, which led to frontoparietotemporal defect of the right side. The 3D model was fabricated using RPT technology. The wax pattern fabricated on 3D prototyped skull was contoured using digital photographic superimposition method. Case 2 had a history of trauma on the head causing intracerebral hemorrhage followed by decompressive craniectomy which led to frontoparietotemporal defect of the right side. The 3D model was fabricated using RPT. The wax pattern fabricated on 3D prototyped skull was contoured using the compass method. The use of these methods with the added advantage of RPT resulted in prosthesis with good esthetics and better fit. The contour of the prosthesis was replicated in the same manner as compared to the contralateral side. These techniques are easy to use and are less time consuming and had few chances of errors.
Closure of oroantral fistula
Authors: Shukla Bharat , Singh Gaurav , Mishra Madan , Das Gourab , Singh Abhishek
Published: December 2021

Background:

The oro antral fistula (OAF) is an unnatural epithelialized communication between oral cavity and maxillary sinus. It may heal spontaneously but a larger fistula requires surgical intervention. OAF causes excruciating pain, escape of fluids from nose, escape of air from mouth into nose, epistaxis, change in voice due to resonance, purulent discharge in case of chronic OAF, post nasal discharge, popping out of antral polyp into oral cavity and sinusitis. Closure of OAF is strenuous, technique sensitive and challenging.

Aims and Objectives:

To compare and evaluate the efficacy of buccal fat pad and buccal advancement pad for closure of oroantral fistula.

Materials and Methods:

Twenty patients of age ranging from 24–64 years with complaint of OAF were included in this prospective, comparative analytic study. In group I, OAF was treated with a buccal advancement flap and in group II, BFP was sutured over the defect. All patients were called for follow up on 1st, 7th, 14th and 21st day post operatively. Pain, mouth opening, edema, infection and wound dehiscence were evaluated on each visit.

Result:

The mean age of selected patients in both the treatment groups was comparable. The mean age of patients in group I was 45.00 ± 13.33 years whereas in group II the mean age was 44.00 ± 13.13 years. Pain, edema was less in Group I. Mouth opening was less in group II. We did not encountered infection and wound dehiscence in any case.

Conclusion:

Various techniques can be utilized for the closure; regardless of the technique used, success of the surgical procedure depends on effective removal of fistulous tract and complete extermination of any sinus pathology and/or infection. The major factors determining the type of surgery for closure of OAF are dimension and location of the defect. The other decisive factors could be the adequacy and health of adjoining tissue. We observed buccal fat pad to be better option for closure of OAF, despite of its more morbidity; as all the complications were of some time period and when evaluated for long term.
Comparative evaluation of crestal bone levels following placement of implant in delayed implant bed
Authors: Rana Chhavi , Nagpal Abhishek , Bhatia Vishwas , Kalra Jasneet Singh
Published: December 2021

Background:

Restoring lost dentition using dental implant is one of the most promising treatment modality, for both complete and partially dentulous situation. In order to have more predictable outcome, the quest for coming up with a surgical protocol has been never ending. Keeping the same in mind the present study was conducted to place implant in delayed implants beds, i.e., 14 days after the osteotomy site was prepared.

Materials and Methods:

For the purpose of the study, ten implants measuring 4.2 mm × 10 mm were placed in ten healthy individuals with missing mandibular first molars in site prepared 14 days before actual placement of implants, i.e., delayed implant beds.

Results:

The study revealed that, on evaluation of the bone levels at the time of placement of prosthetic loading revealed, a bone gain was maximum after 3 months of prosthetic loading.

Conclusion:

A significant bone gain with a mean of 0.8 mm makes this technique of placing implants in delayed implant beds a more predictable technique than conventional protocol.