bluuebunny/crossref_metadata_2025 huggingface dataset:
Safe and Efficient Practice of Bronchoscopic Sampling from Mechanically Ventilated Patients: A Structured Evaluation of the Ambu Bronchosampler-Ascope 4 Integrated System
Authors: Singh Suveer , Shah Pallav L.
Published: January 2021

Background: Bronchoscopic sampling of bronchoalveolar fluid (BAL) should be safe and effective. Current sampling practice risks loss of sample to the attached negative flow, aerosolisation, or spillage, due to repeated circuit breaks, when replacing sample containers. Such concerns were highlighted during the recent coronavirus pandemic. Objectives: Evaluation of an alternative integrated sampling solution, with the Ambu Bronchosampler with aScope 4, by an experienced bronchoscopist in ICU. Methods: An observational study of 20 sequential bronchoscopic diagnostic sampling procedures was performed on mechanically ventilated patients with suspected ventilator-associated pneumonia. Mixed methods assessment was done. The predefined outcome measures were (1) ease of set up, (2) ease of specimen collection, (3) ease of protecting specimen from loss or spillage, and (4) overall workflow. The duration of the procedure and the % volume of sample retrieved were recorded. Results: The mean (±standard deviation [SD]) time for collecting 1 sample was 2.5 ± 0.8 min. The mean (±SD) specimen yield for instilled miniBAL was 54.2 ± 17.9%. Compared with standard sampling, the set-up was much easier in 18 (90%), or easier in 2 (10%) of procedures, reducing the connection steps. It was much more intuitive to use in 14 (70%), more intuitive in 4 (20%), and no more intuitive to use in 2 (10%). The overall set-up and workflow was much easier in 69% of the 13 intraprocedural connections and easier or as easy in the remaining 31% procedures. All procedures where pre connection was established were much easier (7, 100%). The Ambu Bronchosampler remained upright in all procedures with no loss or spillage of sample. Obtaining a sample was much easier in 60%, easier in 10%, no different in 20%, and worse in 10%. The ability to protect a sample from start to finish compared to standard procedures was much easier in 80%, easier in 15%, and no different in 5% of procedures. Overall workflow was much easier in 14 (70%), easier in 4 (20%), and no different in 2 (10%) of procedures. Conclusions: The Ambu Bronchosampler unit was a reliable, effective, and possibly safer technique for diagnostic sampling in ICU. It may improve safety standards during the coronavirus pandemic. A randomized control trial against the standard sampling technique is warranted.
Ler os manuscritos de Lima Barreto
Authors: Kurz Giovani T.
Published: January 2021

Apenas nos últimos anos a crítica genética passou a ser um instrumento para a leitura da ficção de Lima Barreto — e, ainda assim, de maneira muito incipiente. Desde seus contemporâneos, a recepção de sua literatura sempre caminhou por uma trilha muito particular, retomando referenciais biográficos do escritor como chaves de leitura do seu trabalho ficcional — sendo seu primeiro biógrafo, Francisco de Assis Barbosa, expoente dos estudos que partem desse viés. Mais recentemente, o caminho inverso também vem sendo empreendido: a busca, em sua ficção, de elementos que possam preencher “lacunas” biográficas — a antropóloga Lilia M. Schwarcz, por sua vez, encabeça esse movimento. A retomada dos manuscritos de Lima Barreto aparece, nesse sentido, como melhor meio de se enfatizar seu trabalho com o texto. Em 1976, Osman Lins já havia dedicado um estudo a destrinchar a construção literária de Lima, marginalizando tais projeções biográficas. A crítica genética surge como herdeira dessa trilha de leitura e se encarrega de produzir novas possibilidades de se ler Lima Barreto. A partir de Clara dos Anjos, este artigo sintetiza as leituras passadas e dá contornos a novas possibilidades de recepção da literatura do escritor carioca, enfatizando seu processo de (re)escritura.
Reflexões sobre os estudos do processo de criação em diálogo com a história da Crítica Genética
Authors: Salles Cecilia Almeida
Published: January 2021

O artigo apresenta algumas reflexões sobre a metodologia dos estudos de processos de criação, em diálogo com alguns marcos da história da crítica genética e de sua expansão, a crítica de processo. A discussão será feita a partir do filme O mistério de Picasso de H. Clouzot (1956), do livro The genesis of a painting: Picasso’s Guernica de R. Arnheim (1962) e algumas cartas de V. Flusser (1974) ao artista plástico brasileiro Antônio Henrique Amaral. Serão apresentadas algumas das recorrências desse debate como a constatação do potencial dos documentos ou sobras (Arnheim) dos processos, a delimitação dos objetivos das pesquisas às singularidades dos artistas estudados e os embates com a metodologia do acompanhamento dos processos. Essas conclusões parciais serão levadas para a continuidade das reflexões teórico-críticas aqui propostas, no âmbito da expansão dos estudos sobre processo de criação.
Homenagem a Bernard Brun
Authors: Willemart Philippe , E Silva Carla Cavalcanti
Published: January 2021

Homenagem a Bernard Brun (Item/Cnrs)
Do rascunho à edição: análise preliminar das versões de “The Sicilian Tale: King Robert of Sicily” por D. Pedro II
Authors: Mafra Adriano
Published: January 2021

Neste trabalho, apresento uma análise genética preliminar de três conjuntos de documentos autógrafos de uma tradução do monarca D. Pedro II do poema intitulado The Sicilian Tale: King Robert of Sicily, de autoria do poeta estadunidense Henry Wadsworth Longfellow. As três versões do imperador encontram-se em uma fase pré-editorial, ou seja, foram passadas a limpo. Um desses trabalhos, porém, difere dos outros manuscritos e do texto publicado em 1889, o que nos faz refletir sobre as campanhas de escritura do monarca e sobre a escolha do texto a ser editado. Além disso, objetiva-se, a partir dessas traduções, discutir acerca do panorama histórico-cultural pertinente à interação entre o último imperador do Brasil e os intelectuais e literatos norte-americanos com quem se relacionou e que traduziu, em especial, Longfellow.
Livro-objeto-brinquedo (2020), de Mara Perpétua
Authors: Alves Lindomberto Ferreira
Published: January 2021

Fac-simile comentado dos registros da série Livro-brinquedo-objeto (2020), da artista Mara Perpétua.
Crítica Genética, psicanálise e neurociência
Authors: Willemart Philippe Marie
Published: January 2021

O artigo trata de abrir o campo da crítica literária a outros pesquisadores pouco visitados em geral e articular as descobertas relativas ao cérebro às pesquisas sobre os processos de criação e a rasura.
Filologia, Edição Digital e Estudos do Processo Criativo
Authors: Rocha Juliana Pereira , Lose Alícia Duhá , Barreiros Patrício Nunes
Published: January 2021

A escrita de trovas e poemas em trovas está presente nos mais variados documentos do acervo do escritor Eulálio de Miranda Motta (1907-1988) e, de acordo com as datações registradas, infere-se que, durante todos os anos em que o escritor se dedicou à literatura, ele produziu trovas. Rocha (2018) identificou 253 trovas no acervo datadas entre as décadas de 1926 e 1988. Das 253 trovas, 110 foram editadas, com base nos estudos da Crítica Textual e da Crítica Genética. Entretanto, os poemas em trovas ainda não foram editados, por se tratarem de textos com significativas singularidades no processo de criação, com tesselas que a edição impressa não daria conta de explorar em sua pluralidade, movimentos de inserção, remoção e reaproveitamento dos versos. O presente artigo pretende discutir sobre a Edição digital e as possibilidades de acesso ao texto em processo, tendo como pano de fundo as mudanças no paradigma dos estudos filológicos, com base nos estudos da “Nova Filologia”. Como referências teóricas e metodológicas utiliza-se alguns dos estudos já realizados acerca do escritor Eulálio Motta: Barreiros (2015, 2012, 2009); Barreiros (2017, 2012); Rocha (2018); no âmbito da Filologia e Humanidades Digitais: Barreiros (2018, 2015, 2013); Lose (2018, 2012, 2010); Paixão de Souza (2013); Hay (2007); Sacramento (2017); Borges (2012); Warem (2003), entre outros.
No rastro da ausência
Authors: Spineli Patricia Kiss
Published: January 2021

O presente artigo tem como objetivo estudar e pensar aquilo que está ausente nos documentos de processo de criação na fotografia, mais especificamente discutir um modo de conduzir o estudo do processo quando há lacunas de fotogramas nas sequências fotográficas. Para isso, apresenta a metodologia utilizada para lidar com essa falta específica no material analógico de Otto Stupakoff expandindo a discussão para a pesquisa em fotografia digital. Ao se tratar da imagem digital, o trabalho explora modos de identificar as ausências através do mapeamento dos arquivos e também discute possibilidades de lidar com tais eclipses no digital.
Processo criativo, direção de arte e cinema português
Authors: Cucinotta Caterina , Souza Nivea Faria de
Published: January 2021

Através desta entrevista inédita de 2018, conseguimos individuar alguns dos pontos relevantes das problemáticas e do percurso histórico da direção de arte no cinema português contemporâneo. Passando por um início repentino nos anos oitenta, assistimos a um percurso criativo peculiar, longe de ser um comum modelo de gênese artística. O processo criativo toca outros ofícios do cinema, com os quais trabalha em estrito contato para uma construção visual da obra cinematográfica. A entrevista mostra questões pertinentes à própria terminologia da função, que revela posição e valorização diante a toda a equipa. Apresenta-se um processo criativo como “ginástica” entre a técnica e a criação, em uma constante de equilíbrio para não obstaculizar a materialização das ideias em imagens. Isabel Branco apresenta um percurso entre a pesquisa teórica e de imagens, que encontra a sua natural evolução no desenho. A artista mistura os figurinos e as cenografias e afirma desenhar “situações”. Isto faz do seu testemunho uma prova incontestável da sua validade artística e de colaboradora indispensável para a construção da gênese do filme como obra de arte coletiva.
Como nasce um museu: Lygia Fagundes Telles e os bastidores do desconhecido Museu da Literatura Brasileira
Authors: Almeida Elizama
Published: January 2021

O artigo é parte de uma intensa pesquisa na coleção Museu da Literatura Brasileira, idealizado pela escritora Lygia Fagundes Telles na década de 1970, que reuniu número apreciável de documentos literários de diversos autores, mas que não chegou a se concretizar como instituição resultando em uma massa de manuscritos, fotografias e cartas inéditos sob a guarda do Instituto de Estudos Brasileiros (IEB) nos últimos 40 anos. Neste artigo, mapeio a construção deste desconhecido Museu a partir do desejo da comunidade dos autores envolvidos. O material reunido por Lygia pode ser lido em duas categorias: a categoria do documento e a categoria do movimento, que se referem, respectivamente, aos itens doados para compor o fundo e aos itens que dão notícias da força do coletivo nos bastidores de sua criação. Por último, proponho um contato do “Museu da Lygia” com o Arquivo-Museu de Literatura Brasileira, na Fundação Casa de Rui Barbosa, seu irmão quase gêmeo, criado por Plínio Doyle no mesmo período, para pontuar aproximações e diferenças entre esses dois espaços a partir de uma carta inédita.
Construir o contemporâneo: Bauchau revendo Antígona, de Sófocles
Authors: Willemart Philippe Marie
Published: January 2021

Comparando Antígona, o segundo livro de Bauchau sobre o ciclo de Tebas e a tragédia do mesmo nome de Sófocles, pergunto em que medida a personagem Antígona se aproxima das teorias queer, freudiana e da astrofísica. Distinta de Sófocles, a Antígona de Bauchau se desdobra não só em outra mulher, Io, que anuncia o futuro da mulher, livre e portadora de esperanças, mas andrógena, ela, como Freud, define a psique humana como dupla contrária à divisão tradicional em gêneros da sociedade e confirma o poema de Mario de Andrade: sou trezentos.
Materia e (des)tempos: as formas do contemporâneo na obra de Darío Canton
Authors: Di Milta Luciana
Published: January 2021

Desde la publicación de su primer libro, La saga del peronismo (1964), el poeta argentino Darío Canton (9 de julio, Buenos Aires, 1928) recorrió los márgenes del campo intelectual argentino de las décadas del 60 y 70, sin dejar por ello de ser un poeta contemporáneo, en el sentido en que Giorgio Agamben piensa la temporalidad de las producciones artísticas. Rara avis y solitario, Canton modula el tono de su poética a lo largo de sucesivas publicaciones. Tanto el poema “Corrupción de la naranja”, leído y recuperado por los poetas objetivistas del noventa, como La mesa. Tratado poeti-lógico (1972) se resisten a encajar en las categorías de las poéticas sesentistas y setentistas; por el contrario, estos poemas presentan más puntos de contacto con la poética de Francis Ponge (aunque ninguno de los dos llegó a leer al otro) que con las de los “contemporáneos cronológicos” o “compañeros de generación” de Canton. La materialidad de la escritura y del archivo, que el mismo autor pone a disposición de los lectores a través de la serie autobiográfica De la misma llama (2000-2017), funciona como dispositivo clave para pensar la temporalidad compleja que atraviesa su obra.
Entre reescritura e expansão do texto: da gênese à criação pós-editorial de Proust e os signos, de Gilles Deleuze
Authors: Antunes Thiago Leão
Published: January 2021

O presente artigo tem como objetivo apresentar aspectos do processo de reescrita editorial e possíveis abordagens de tais elementos na obra Proust e os signos, de Gilles Deleuze. Esse livro será reeditado em três momentos distintos (1964, 1970, 1976) sobre os quais também foram publicados, respectivamente, três artigos preliminares (1963, 1970, 1973), dando a ver rastros de uma criação da qual não restaram documentos preparatórios, mas que se desenvolve, para além das versões mencionadas, em escritos que os antecedem – como é caso de “Dizeres e perfis”, textos publicado em 1946 na revista Poésie. Dessa forma, busca-se explorar tais documentos através de duas perspectiva. A primeira uma abordagem centrada nas condições de enunciabilidade e das práticas de escrita, combinada à construção de um avant-texte através de publicações na qual Deleuze começa a desenvolver com sua leitura uma reflexão sobre o romance de Marcel Proust, Em busca do tempo perdido, que já anuncia brevemente elementos que serão retomados parcialmente no ensaio de 1964. Enquanto a segunda abordagem, mais detida aos movimentos escriturais que emergem da comparação entre as diferentes versões de Proust e os signos por meio do software de comparação de versões do Institut des Textes et Manuscrits, Machine pour l’étude diachronique et interprétative du travail de l’écrivain (MEDITE). Dessa forma, elaborando hipóteses a respeito das mudanças encontradas, buscou-se examinar a produtividade do programa de processamento e comparação de texto como ferramenta no estudo das fases pós-editorais de criação, adotando como ponto de partida o artigo preliminar “L’unité de A la recherche du temps perdu” de 1963 e a primeira edição, Marcel Proust et les signes, de 1964.
A ontologia do negativo: na língua, verdadeiramente, só existem diferenças?
Authors: Lucas Fábio Roberto , Maniglier Patrice
Published: January 2021

Nenhuma tese contribuiu mais para o eco filosófico das linguísticas estruturais do que a célebre frase de Saussure: “Na língua, só existem diferenças, sem termo positivo”. É também uma das mais criticadas: o caráter diferencial do signo não decorre, simplesmente, de a linguagem ser um meio limitado que deve comunicar mensagens em número ilimitado? (cf. Jakobson, Martinet, depois V. Descombes ou Th. Pavel)? Mostra-se aqui que essa evasão da questão ontológica tem, contudo, um custo teórico: ela obriga a aderir a uma concepção funcionalista da linguagem e a uma semântica referencialista. Ademais, contrariamente à interpretação habitual, apenas o significante e o significado separadamente são diferenciais; o signo em totalidade, esse, é positivo. Por meio de uma releitura de Bergson e Hegel, mostra-se que a noção de diferença qualitativa pura é filosoficamente insustentável, e procura-se reconstituir a teoria do valor por meio da distinção entre diferença e oposição. Obtém-se daí uma concepção diferente da ideia segundo a qual o que caracteriza a espécie humana é sua capacidade simbólica.
O processo é a obra: alguns apontamentos sobre a série “Sobras” de Geraldo de Barros
Authors: Paula Maíra Vieira de
Published: January 2021

Nos dois últimos anos de sua vida, Geraldo de Barros dedicou-se à elaboração da série “Sobras”, que restou inacabada devido à morte do artista em 1998. Em função dessa produção ter sido interrompida em pleno desenvolvimento, não é possível precisar os rumos que Barros lhe daria. Apesar de tal limitação, este artigo buscou identificar os procedimentos criativos acionados pelo artista, com o objetivo de compreender quais foram os princípios poéticos que o guiaram durante a realização da série. Este estudo foi empreendido por meio do exame dos artefatos que a compõem e dos materiais que restaram de sua produção. A investigação norteou-se pelas diretrizes teóricas e metodológicas da crítica de processos de criação, formuladas pela estudiosa Cecília Almeida Salles. Como resultado, propõe-se que a série “Sobras” seja compreendida a partir de uma perspectiva na qual os limites entre processo e obra não sejam tão delimitados. Tal proposta não advém dos limites que a condição inacabada do trabalho impôs à análise, mas da constatação de que Geraldo de Barros percebia as obras da série não como etapas finais, mas como artefatos transitórios e dinâmicos.
Entre riscos e rabiscos: questões de crítica genética na teatralização de A Pedra do Reino por Antunes Filho
Authors: Andrade Lucimara de
Published: January 2021

Este trabalho tem como proposta a investigação do processo de teatralização dos romances: Romance d’A Pedra do Reino e o príncipe do sangue do vai-e-volta e História d’O Rei Degolado nas Caatingas do Sertão: ao Sol da Onça Caetana, do escritor Ariano Suassuna, pelo encenador Antunes Filho. Esse artigo aborda questões teóricas suscitadas a partir da análise de uma parte do vasto material genético do processo de adaptação de A Pedra do Reino cedido por Antunes Filho.
A espiral poética e o tempo da criação em Rubiane Maia: notas em processo
Authors: Alves Lindomberto Ferreira
Published: January 2021

O artigo aborda o tempo da criação no âmbito dos processos criativos da artista multimídia Rubiane Maia. Parte-se da hipótese de que embora os deslocamentos e os desdobramentos atrelados à construção poética desta artista possam ser examinados segundo uma estrutura cronológica e linear, enquanto forma essa organização no espaço e no tempo não dá conta de expressar a complexidade e os dinamismos que agenciam o seu tempo da criação, confinando seus processos criativos a um tempo linear, distanciado e apartado do tempo à luz da multiplicidade. Assim, tendo como aporte teórico as noções de tempo como multiplicidade pura, de Michel Serres (1982), e de espiral do tempo, de Bruno Latour (1994) – bem como as considerações da própria artista sobre o tempo da criação que percorre seus processos artísticos entre os anos de 2006 e 2016 – situamos aqui, em perspectiva, a noção de espiral poética. Figura conceitual que, segundo nossas análises ao redor dos fluxos temporais dos primeiros dez anos de carreira de Rubiane, aproximaria-nos da temporalidade subjacente aos seus processos criativos, uma temporalidade em espiral – leitura que não só aguça nossa percepção à amplitude e à densidade das tramas poéticas que tecem o tempo da criação desta artista, como, também, insinua a singularidade dos modos com os quais ela agencia a tríade arte-vida-obra no turbilhão do fluxo temporal que agencia seus processos de criação.
Passado a limpo
Authors: Amaral Cleber Araújo
Published: January 2021

Notícias de crítica genética.
Aneurysm Wall Enhancement in Unruptured Intracranial Aneurysms: A Histopathological Evaluation
Authors: Zhong Weiying , Su Wenjing , Li Tao , Tan Xianjun , Chen Chao , Wang Qian , Wang Donghai , Su Wandong , Wang Yunyan
Published: January 2021

Background

Unruptured intracerebral aneurysm wall enhancement (AWE) on vessel wall magnetic resonance imaging scans may be a promising predictor for rupture‐prone intracerebral aneurysms. However, the pathophysiology of AWE remains unclear. To this end, the association between AWE and histopathological changes was assessed in this study.

Methods and Results

A total of 35 patients with 41 unruptured intracerebral aneurysms who underwent surgical clipping were prospectively enrolled. A total of 27 aneurysms were available for histological evaluation. The macroscopic and microscopic features of unruptured intracerebral aneurysms with and without enhancement were assessed. The microscopic features studied included inflammatory cell invasion and vasa vasorum, which were assessed using immunohistochemical staining with CD68, CD3, CD20, and myeloperoxidase for the former and CD34 for the latter. A total of 21 (51.2%) aneurysms showed AWE (partial AWE, n=7; circumferential AWE, n=14). Atherosclerotic and translucent aneurysms were identified in 17 and 14 aneurysms, respectively. Aneurysm size, irregularity, and atherosclerotic and translucent aneurysms were associated with AWE on univariate analysis (
P
<0.05). Multivariate logistic regression analysis showed that atherosclerosis was the only factor significantly and independently associated with AWE (
P
=0.027). Histological assessment revealed that inflammatory cell infiltration, intraluminal thrombus, and vasa vasorum were significantly associated with AWE (
P
<0.05).

Conclusions

Though AWE on vessel wall magnetic resonance imaging scans may be associated with the presence of atherosclerotic lesions in unruptured intracerebral aneurysms, inflammatory cell infiltration within atherosclerosis, intraluminal thrombus, and vasa vasorum may be the main pathological features associated with AWE. However, the underlying pathological mechanism for AWE still needs to be further studied.
Application of the sigma metrics to evaluate the analytical performance of cystatin C and design a quality control strategy
Authors: Liu Qian , Zhu Wenjun , Bian Guangrong , Liang Wei , Zhao Changxin , Yang Fumeng
Published: January 2021

Background

Sigma metrics are commonly used to evaluate laboratory management. In this study, we aimed to evaluate the analytical performance of cystatin C using sigma metrics and to develop an individualized quality control scheme for cystatin C concentrations.

Methods

Bias was calculated based on the samples used for the external quality assessment. The coefficient of variation was calculated using six months of internal quality control measurements at two levels, and desirable specification derived from biological variation was used as the quality goal. The sigma value for cystatin C was calculated using the above data. The internal quality control scheme and improvement measures were formulated according to the Westgard sigma standards for batch size and quality goal index.

Results

The sigma values for cystatin C, for quality control levels 1 and 2, were 3.04 and 4.95, respectively. The 13s/22s/R4s/41s/6x multirules ( n = 6, R = 1), with a batch size of 45 patient samples, were selected as the internal quality control schemes for cystatin C. With different concentrations of cystatin C, the power function graph showed a probability for error detection of 94% and 100% and a probability for false rejection of 4% and 2%, respectively. According to the quality goal index of cystatin C, its precision needs to be improved.

Conclusions

With a ‘desirable’ biological variation of 6.50%, the Westgard rule 13s/22s/R4s/41s/6x ( n = 6, R = 1, batch size of 45) with high efficacy for determining the detection error is recommended for individualized quality control schemes of cystatin C.
Porphyria cutanea tarda precipitated by ovarian stimulation during oocyte retrieval in a genetically susceptible female
Authors: Rasheed Erum , Savage Sarah , Walsh Elena , Brazil Nadia , Ralph Nicola , Gorman Peter O’ , Crowley Vivion
Published: January 2021

We report a case of 33-year-old female with underlying genetic susceptibility for familial porphyria cutanea tarda due to novel UROD variant (c.636 + 2 dupT) unmasked by transient exposure to supraphysiological oestrogen concentrations following a single cycle of successful controlled ovarian stimulation for oocyte retrieval. Use of oral oestrogen in the form of oral contraceptive pills and hormone replacement therapy has been well known to trigger active porphyria cutanea tarda phenotype in susceptible women. However, to date, the emergence of clinically overt porphyria cutanea tarda has not been reported in association with fertility treatment in the literature before.
Microscopic subinguinal varicocelectomy for testicular pain: a retrospective study on outcomes and predictors of pain relief
Authors: Al-Gadheeb Abdullah , El-Tholoth Hossam S. , Albalawi Abdulaziz , Althobity Abdulmajeed , AlNumi Mussa , Alafraa Tala , Jad Amr
Published: January 2021

Background

Approximately 2–10% of patients with varicocele complain of pain. Varicocelectomy for testicular pain is a surgical choice when conservative therapy fails to relieve the pain. Different variables have been reported as prognostic factors for pain relief following varicocele ligation. Moreover, the success rate of varicocelectomy for testicular pain has varied among studies. This retrospective study aimed to investigate the predictors and success rate of microscopic subinguinal varicocelectomy performed for the treatment of painful varicocele.

Results

Among the 132 patients, 83.3% reported pain relief. A significant association was identified between varicocelectomy for unilateral testicular pain and pain resolution (P < 0.0001); no other factors were predictors of pain relief.

Conclusions

Microscopic subinguinal varicocelectomy for testicular pain is an effective surgical alternative. Varicocelectomy for unilateral testicular pain may predict postoperative pain relief in appropriately selected patients.
Recurrence of a neuroendocrine tumor of adrenal origin: a case report with more than a decade follow-up
Authors: Rahmani Fatemeh , Tohidi Maryam , Dehghani Maryam , Broumand Behrooz , Hadaegh Farzad
Published: January 2021

Background

Neuroendocrine tumor (NET) with adrenocorticotropic hormone (ACTH) secretion are very rare. To our knowledge, no follow-up study is published for ACTH-secreting NET, regardless of the primary site, to show second occurrence of tumor after a long follow-up, following resection of primary tumor.

Case presentation

Here, we describe a 49-year-old-man with cushingoid feature, drowsiness and quadriparesis came to emergency department at December 2005. Laboratory tests revealed hyperglycemia, metabolic alkalosis, severe hypokalemia, and chemical evidence of an ACTH-dependent hypercortisolism as morning serum cortisol of 57 μg /dL without suppression after 8 mg dexamethasone suppression test, serum ACTH level of 256 pg/mL, and urine free cortisol of > 1000 μg /24 h. Imaging showed only bilateral adrenal hyperplasia, without evidence of pituitary adenoma or ectopic ACTH producing tumors. Importantly, other diagnostic tests for differentiating Cushing disease (CD) from ectopic ACTH producing tumor, such as inferior petrosal sinus sampling (IPSS), corticotropin releasing hormone (CRH) stimulation test, octreotide scan or fluorodeoxyglucose (FDG)-positron emission tomography (PET) scan were not available in our country at that time. Therefore, bilateral adrenalectomy was performed that led to clinical and biochemical remission of hypercortisolism and decreased ACTH level to < 50 pg/mL, findings suggestive of a primary focus of NET in adrenal glands. After 11 years uncomplicated follow up, the ACTH level elevated up to 341 pg/mL and re-evaluation showed a 2 cm nodule in the middle lobe of the right lung. Surgical excision of the pulmonary nodule yielded a carcinoid tumor with positive immunostaining for ACTH; leading to decrease in serum ACTH level to 98 pg/mL. Subsequently after 7 months, serum ACHT levels rose again. More investigation showed multiple lung nodules with metastatic bone lesions accompanied by high serum chromogranin level (2062 ng/mL), and the patient managed as a metastatic NET, with bisphosphonate and somatostatin receptor analogues.

Conclusion

This case of surgically-treated NET showing a secondary focus of carcinoid tumor after one decade of disease-free follow-up emphasizes on the importance of long-term follow-up of ACTH-secreting adrenal NET.
An evaluation survey of traditional Chinese medicine learning among international students majoring in conventional medicine: a study from a university in China
Authors: Qu Fan , Zhang Qing , Dai Minchen , He Yijing , Wu Jiaqi , Zhang Xian , Zhu Yuhang , Gu Ying’er , Wang Fangfang , Xu Xiangrong
Published: January 2021

Background

Traditional Chinese medicine (TCM) has gained increasing acceptance and popularity by the global community. The current study aimed to investigate self-reported evaluations of learning TCM and opinions about TCM courses among undergraduate international students majoring in conventional medicine at a university in China.

Methods

A cross-sectional survey was conducted at the Zhejiang University School of Medicine. A self-reported questionnaire was administered to international undergraduates who were enrolled in the TCM course during the 2018 and 2019 academic years (n = 157). The course employed a student-centered, multiform learning model. Demographic data and self-reported evaluations of TCM learning background and TCM learning course were obtained to conduct the analysis.

Results

A total of 133 students responded to the questionnaire. Among the respondents, 21.0% had some TCM-related knowledge, and 51.1% were interested in learning TCM before the course. Ninety-six students (85.7%) were from Asia. Students from Thailand showed significantly more interest in learning TCM than did students from other Asian countries (p = 0.025). After the course, 77.2% of students agreed that the course had brought about many benefits, 86.4% were satisfied with the course content, and 77.3% were satisfied with the teaching method. Students expressed their willingness to further learn acupuncture and to obtain more skilled practice through more visualized learning methods.

Conclusions

The majority of the international students we surveyed agreed that the TCM course improved their interest in and understanding of TCM. It is thus suggested that TCM education should be directed toward students’ learning barriers and needs.
The application of a new laminitis scoring method to model the rate and pattern of improvement from equine endocrinopathic laminitis in a clinical setting
Authors: Meier A. , McGree J. , Klee R. , Preuß J. , Reiche D. , de Laat M. , Sillence M.
Published: January 2021

Background

Endocrinopathic, or hyperinsulinaemia-associated laminitis (HAL) is a common and debilitating equine foot disease, and although no pharmacological treatments are registered, several are under development. To evaluate the effect of such treatments, an accurate and consistent method is needed to track the clinical signs of laminitis over time, and the natural history of the disease, in terms of a ‘normal’ pattern of improvement, needs to be understood. This study examined the improvement pattern in clinical cases of naturally-occurring HAL subjected to a range of best-practice interventions, using two different scoring methods. Eighty horses and ponies with suspected HAL were enrolled in a study conducted at 16 veterinary practices across Germany. The severity of laminitis was assessed by independent veterinarians using both the traditional Obel method and a modified Obel method developed by Meier and colleagues. Assessments were made on the day of diagnosis (d 0), then on days 4, 9, 14, 25 and 42 during the intervention period. Pain medications were withheld for 24 h prior to clinical examination in all cases.

Results

Time to marked improvement from laminitis varied between individuals, but was difficult to monitor accurately using the Obel method, with the median grade being 2/4 on days 0 and 4, then 0/4 from d 9 onwards. More subtle changes could be identified using the Meier method, however, and the median scores were seen to follow the form of an exponential decay model in most horses, improving from 8/12 on d 0, to 0/12 on d 25. Within this composite scoring method, considerable variation was observed in the rate of improvement of individual clinical signs, with the average time taken for each sign to reach a median score of 0 ranging from 4 days (foot lift and weight shifting) to 25 days (gait when turned in a circle) across all 80 horses.

Conclusions

The Meier method provides a reliable and consistent method for monitoring the clinical status of horses with HAL, and despite the variability, the pattern of improvement described here should provide a useful benchmark against which individual cases and new treatments can be assessed.
Factors affecting the urinary aldosterone-to-creatinine ratio in healthy dogs and dogs with naturally occurring myxomatous mitral valve disease
Authors: Galizzi Alberto , Bagardi Mara , Stranieri Angelica , Zanaboni Anna Maria , Malchiodi Dario , Borromeo Vitaliano , Brambilla Paola Giuseppina , Locatelli Chiara
Published: January 2021

Background

Chronic renin-angiotensin-aldosterone system (RAAS) activation in course of heart diseases contributes to cardiac remodeling and heart failure. Myxomatous mitral valve disease (MMVD) is characterized by different stages of severity and trend of RAAS activity during the course of the disease is still uncertain. The urinary aldosterone-to-creatinine ratio (UAldo:C) has been proven to reflect RAAS activation in dogs and might be a useful marker in monitoring therapy and disease progression, but data about this parameter need to be expanded. The objective of this study was to evaluate the UAldo:C in healthy dogs and dogs with naturally occurring MMVD, and to investigate the relationships between this parameter and clinical, echocardiographic and laboratory variables.

Results

The study population consisted of 149 dogs: 49 healthy and 100 MMVD dogs (45 stage B1, 13 stage B2 and 42 stage C). Urinary aldosterone-to-creatinine ratio was not significantly different among healthy and MMVD dogs of any stages. Breed, sex and age showed a significant impact on UAldo:C. In particular, Chihuahua and Cavalier King Charles spaniel showed significantly higher UAldo:C than other breeds, as well as intact females than other genders. In stage C dogs, UAldo:C appeared to be increased by spironolactone and was positively associated with furosemide dose (P = 0.024). Aldosterone breakthrough (ABT) appeared to occur in 36% (8/22) of stage C dogs not receiving spironolactone. A significant positive association between UAldo:C and left atrium-to-aortic root ratio (LA/Ao) was found.

Conclusions

Individual factors such as breed, sex and age appeared to influence UAldo:C, and therapy seemed to add further variability. In the light of these results, comparing the UAldo:C of a single patient with a population-based reference value might lead to wrong interpretations and an individual monitoring should be considered. The prevalence of ABT in the present study (36%) was in line with those previously reported. However, due to the high individual variability of UAldo:C found in the study, even this result should be re-evaluated in the setting of an individual longitudinal approach. The positive association between UAldo:C and LA/Ao supports the mutual relationship between RAAS and cardiac remodeling.
A refined method to monitor arousal from hibernation in the European hamster
Authors: Markussen Fredrik A. F. , Melum Vebjørn J. , Bothorel Béatrice , Hazlerigg David G. , Simonneaux Valérie , Wood Shona H.
Published: January 2021

Background

Hibernation is a physiological and behavioural adaptation that permits survival during periods of reduced food availability and extreme environmental temperatures. This is achieved through cycles of metabolic depression and reduced body temperature (torpor) and rewarming (arousal). Rewarming from torpor is achieved through the activation of brown adipose tissue (BAT) associated with a rapid increase in ventilation frequency. Here, we studied the rate of rewarming in the European hamster (Cricetus cricetus) by measuring both BAT temperature, core body temperature and ventilation frequency.

Results

Temperature was monitored in parallel in the BAT (IPTT tags) and peritoneal cavity (iButtons) during hibernation torpor-arousal cycling. We found that increases in brown fat temperature preceded core body temperature rises by approximately 48 min, with a maximum re-warming rate of 20.9℃*h-1. Re-warming was accompanied by a significant increase in ventilation frequency. The rate of rewarming was slowed by the presence of a spontaneous thoracic mass in one of our animals. Core body temperature re-warming was reduced by 6.2℃*h-1and BAT rewarming by 12℃*h-1. Ventilation frequency was increased by 77% during re-warming in the affected animal compared to a healthy animal. Inspection of the position and size of the mass indicated it was obstructing the lungs and heart.

Conclusions

We have used a minimally invasive method to monitor BAT temperature during arousal from hibernation illustrating BAT re-warming significantly precedes core body temperature re-warming, informing future study design on arousal from hibernation. We also showed compromised re-warming from hibernation in an animal with a mass obstructing the lungs and heart, likely leading to inefficient ventilation and circulation.
Determinants of uptake of malaria preventive interventions among pregnant women in eastern Uganda
Authors: Wafula Solomon Tsebeni , Mendoza Hilbert , Nalugya Aisha , Musoke David , Waiswa Peter
Published: January 2021

Background

Consistent use of insecticide-treated nets (ITNs) and intermittent preventive treatment in pregnancy (IPTp) have been recommended as cost-effective interventions for malaria prevention during pregnancy in endemic areas. However, the coverage and utilization of these interventions during pregnancy in sub-Saharan Africa is still suboptimal. This study aimed to determine the uptake of IPTp and ITNs and associated factors among women during their recent pregnancy in Eastern Uganda.

Methods

This was a cross-sectional study conducted among 2062 women who had delivered within the last 12 months prior to the start of the study in three districts of Eastern Uganda. The primary outcomes were consistent ITN use and optimal uptake (at least 3 doses) of IPTp. A modified Poisson regression was used to examine the association between consistent ITN use and the uptake of optimal doses of IPTp with independent variables. Data were analysed using Stata 14 software.

Results

The level of uptake of IPTp3 (at least three doses) was 14.7%, while IPTp2 (at least two doses) was 60.0%. The majority (86.4%) of mothers reported regularly sleeping under mosquito nets for the full duration of pregnancy. Uptake of IPTp3 was associated with engaging in farming (adjusted PR = 1.71, 95% CI [1.28–2.28]) or business (adjusted PR = 1.60, 95% CI [1.05–2.44]), and attending at least 4 antenatal care (ANC) visits (adjusted PR = 1.72, 95% CI [1.34–2.22]). On the other hand, consistent ITN use was associated with belonging to the fourth wealth quintile (adjusted PR = 1.08, 95% CI [1.02–1.14]) or fifth wealth quintile (adjusted PR = 1.08, 95% CI [1.02–1.15]), and attending at least 4 ANC visits (adjusted PR = 1.07, 95% CI [1.03–1.11]).

Conclusion

Uptake of IPTp3 and consistent ITN use during pregnancy were lower and higher than the current Ugandan national targets, respectively. Study findings highlight the need for more efforts to enhance utilization of ANC services, which is likely to increase the uptake of these two key malaria preventive measures during pregnancy.
Drug Abstinence Self-Efficacy Scale (DASES): psychometric properties of the Farsi version
Authors: Khazaee-Pool Maryam , Naghibi Seyed Abolhassan , Pashaei Tahereh , Chaleshgar-Kordasiabi Mosharafeh , Daneshnia Mahbobeh , Ponnet Koen
Published: January 2021

Background

Research has demonstrated that therapeutic interventions based on the self-efficacy theory produce positive outcomes for people who exhibit addictive behaviors, such as alcohol and drug use. Several questionnaires based on self-efficacy theory have been developed to evaluate the extent to which intervention programs can modify behavior. The present study describes the psychometric properties of the Farsi version of the Drug Abstinence Self-Efficacy Scale (DASES).

Design and methods

The forward–backward approach was employed to translate the DASES from English into Farsi. A cross-sectional study was conducted, and the psychometric properties of the Farsi version of the DASES were measured. Using a cluster sampling method, 400 male people who use drugs aged 20 years or older were selected from 10 addiction treatment clinics in Mazandaran, Iran. The internal consistency and test–retest methods were used to measure the reliability of the DASES. Face and content validity were measured, and the construct validity of the DASES was assessed through both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The data were analyzed using SPSS and AMOS.

Results

The results of the EFA indicated a four-factor solution for the DASES that accounted for 64.72% of the observed variance. The results obtained from the CFA demonstrated that the data fitted the model: the relative chi square (× 2/df) equaled 1.99 (p < 0.001), and the root mean square error of approximation equaled 0.071 (90% CI = 0.059–0.082). All the comparative indices of the model were equal to or greater than 0.90 (0.91, 0.93, 0.94, 0.93, and 0.90, respectively). The Cronbach’s alpha ranged from 0.90 to 0.93, proving a satisfactory reliability. Additionally, the intraclass correlation coefficient ranged from 0.75 to 0.98, which is an acceptable result.

Conclusions

This study’s results show that the Iranian version of the DASES has good psychometric properties and is appropriate for assessing substance use behaviors among Iranian addicted persons.
Using trend arrows in continuous glucose monitoring systems for insulin adjustment in clinical practice: Brazilian Diabetes Society Position Statement
Authors: Rodacki M. , Calliari L. E. , Ramalho A. C. , Vianna A. G. D. , Franco D. R. , Melo K. F. S. , Araujo L. R. , Krakauer M. , Scharf M. , Minicucci W. , Ziegler R. , Gabbay M.
Published: January 2021

This manuscript reports the Brazilian Diabetes Society Position Statement for insulin adjustments based on trend arrows observed in continuous glucose monitoring systems. The Brazilian Diabetes Society supports the utilization of trend arrows for insulin dose adjustments in patients with diabetes on basal-bolus insulin therapy, both with multiple daily insulin doses or insulin pumps without closed-loop features. For those on insulin pumps with predictive low-glucose suspend feature, we suggest that only upward trend arrows should be used for adjustments. In this paper, tables for insulin adjustment based on sensitivity factors are provided and strategies to optimize the use of trend arrows in clinical practice are discussed.
The use of non-prescribed antibiotics; prevalence estimates in low-and-middle-income countries. A systematic review and meta-analysis
Authors: Torres Neusa F. , Chibi Buyisile , Kuupiel Desmond , Solomon Vernon P. , Mashamba-Thompson Tivani P. , Middleton Lyn E.
Published: January 2021

Background

The global increase in the utilization of non - prescribed antibiotics (NPA), is concerning, with high persistence within the low and middle-income countries (LMICs). With a negative impact on the health of individuals and communities the use of NPA paves the way to the  propagation of superbugs that potentially predisposes to changes in bacterial resistance patterns, antibiotic resistance (AR) and antimicrobial resistance (AMR). This study aimed at estimating through a systematic review and meta-analysis, the prevalence of NPA utilisation and describe its primary sources in LMICs.

Methods

The study is a systematic review and meta-analysis which study protocol was registered in PROSPERO (CRD42017072954). The review used The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines.  The studies searched in databases were deemed eligible if reported evidence of practices of self-medication with antibiotics (SMA) and the prevalence of NPA utilisation within adult participants from LMICs, published between 2007 to 2017. The pooled analyses were carried out using Meta XL statistical software. The pooled prevalence was calculated with a 95% confidence interval (CI). The risk of bias of the included studies was assessed using the Quality in Prognosis Studies (QUIPS) tool.

Results

The review included a total of 11 cross-sectional studies, involving 5080 participants and conducted in LMICs from Asia (India, Laos, Nepal, Pakistan, Sri Lanka and Yemen), Latin America (Guatemala), Africa (Nigeria). All studies reported existing  practices of SMA, with reported prevalence ranging from 50% to 93,8%. The pooled prevalence of SMA was 78% (95% CI: 65–89%). The main sources of NPA were; pharmacies, family and friends, old prescriptions, home cabinet and leftover antibiotics.

Conclusion

This study revealed a high prevalence of utilisation of NPA in the studied LMICs, these were found to be twice as high in women than men and those participants aged between 18 and 40 years old. The review suggests f considering broader qualitative and comprehensive contextuallized research to better understand the nuances of NPA use. These would be benefitial to uncover uncover gray areas, inform decisions, support the (re) design and implementation of multifaceted interventions towards antibiotic stewardship and conservancy in LMICs.
Prevalence and associated factor of Campylobacter species among less than 5-year-old children in Ethiopia: a systematic review and meta-analysis
Authors: Diriba Kuma , Awulachew Ephrem , Anja Asrat
Published: January 2021

Background

Despite the significant reductions in under-five mortality, campylobacteriosis has emerged as one of the most common causative agents of bacterial foodborne gastroenteritis in humans. We performed this systematic review and meta-analysis to estimate the pooled prevalence of Campylobacter species and associated risk factors among children less than 5 years of age in Ethiopia.

Methods

A systematic search was conducted on PubMed, Web of Science, EMBASE, Google Scholar and the Cochrane Library. All identified observational studies reporting the prevalence and determinants of diarrhea among children under 5 years of age in Ethiopia were included. Two authors independently extracted data and analyzed them using STATA Version 13 statistical software. A random-effects model was computed to estimate the pooled prevalence and the associations between determinant factors and campylobacteriosis.

Results

Out of 166 papers reviewed, 8 studies fulfilled the inclusion criteria and were included in the meta-analysis. The pooled prevalence of Campylobacter species among children under 5 years of age in Ethiopia was 10% (95% CI: 7, 13). Contact with domestic animals (OR: 3.2, 95% CI: 2.0, 5.1), illiterate mothers (OR: 2.1, 95% CI: 1.1, 3.8), consumption of animal products (OR: 1.7, 95% CI: 0.7, 4.5), and status of mothers’ personal hygiene (OR: 1.1, 95% CI: 0.7, 1.8) were significantly associated with the prevalence of Campylobacter species.

Conclusion

In our study, Campylobacter species among children under 5 years of age in Ethiopia were significantly high. Contact with domestic animals, illiterate mothers and consumption of animal products were significantly associated with prevalence of Campylobacter species