bluuebunny/crossref_metadata_2025 huggingface dataset:
Repetitive transcranial magnetic stimulation in combination with neuromuscular electrical stimulation for treatment of post-stroke dysphagia
Authors: Zhang Chengliang , Zheng Xiuqin , Lu Rulan , Yun Wenwei , Yun Huifang , Zhou Xianju
Published: October 2018

Objective

This study was performed to determine whether repetitive transcranial magnetic stimulation (rTMS) combined with neuromuscular electrical stimulation (NMES) effectively ameliorates dysphagia and how rTMS protocols (bilateral vs. unilateral) combined with NMES can be optimized.

Methods

Sixty-four patients were randomly divided into four groups using a random distribution table: the sham rTMS plus NMES (Sham-rTMS/NMES), ipsilesional 10-Hz rTMS plus NMES (Ipsi-rTMS/NMES), contralesional 1-Hz rTMS plus NMES (Contra-rTMS/NMES), and bilateral rTMS plus NMES (Bi-rTMS/NMES) groups. Cortical excitability as measured by the amplitude of the motor evoked potential at the mylohyoid muscle cortical representative area, swallowing function as measured by the Standardized Swallowing Assessment, and the degree of dysphagia were evaluated at baseline, after the stimulation course, and at the 1-month follow-up.

Results

Bi-rTMS/NMES produced higher cortical excitability and better swallowing function recovery. Compared with NMES alone, unilateral rTMS plus NMES had additional effects on cortical excitability and rehabilitation of dysphagia, but there were no differences between the Contra-rTMS/NMES and Ipsi-rTMS/NMES groups. No adverse events occurred.

Conclusion

The combination of rTMS with NMES was superior to NMES alone in improving the recovery of post-stroke dysphagia, and the combination of bilateral rTMS with NMES was more effective than unilateral rTMS combined with NMES.
Engaging With the Community to Promote Physical Activity in Urban Neighborhoods
Authors: Deatrick Janet A. , Klusaritz Heather , Atkins Rahshida , Bolick Ansley , Bowman Cory , Lado Juan , Schroeder Krista , Lipman Terri H.
Published: October 2018

Purpose:

To describe perceptions of physical activity, opinions, on intergenerational approaches to physical activity and a vision for increasing physical activity in an underresourced urban community.

Approach:

Focus groups embedded in a large Community-Based Participatory Research Project.

Setting:

West and Southwest Philadelphia.

Participants:

15 parents, 16 youth, and 14 athletic coaches; youth were 13 to 18 years old and attended West Philadelphia schools; parents’ children attended West Philadelphia schools; and coaches worked in West Philadelphia schools.

Methods:

Six focus groups (2 youth, 2 parent, and 2 coach) were conducted guided by the Socio-Ecological Model; transcriptions were analyzed using a rigorous process of directed content analysis.

Results:

Factors on all levels of the Socio-Ecological Model influence the perception of and engagement in physical activity for youth and their families. Future strategies to increase engagement in physical activity need to be collaborative and multifaceted.

Conclusion:

When physical activity is reframed as a broad goal that is normative and gender-neutral, a potential exists to engage youth and their families over their lifetimes; with attention to cross-sector collaboration and resource sharing, engaging and sustainable intergenerational physical activity interventions can be developed to promote health in underresourced urban communities.
Fluid Intelligence Predicts Change in Depressive Symptoms in Later Life: The Lothian Birth Cohort 1936
Authors: Aichele Stephen , Ghisletta Paolo , Corley Janie , Pattie Alison , Taylor Adele M. , Starr John M. , Deary Ian J.
Published: October 2018

We examined reciprocal, time-ordered associations between age-related changes in fluid intelligence and depressive symptoms. Participants were 1,091 community-dwelling older adults from the Lothian Birth Cohort 1936 study who were assessed repeatedly at 3-year intervals between the ages of 70 and 79 years. On average, fluid intelligence and depressive symptoms worsened with age. There was also a dynamic-coupling effect, in which low fluid intelligence at a given age predicted increasing depressive symptoms across the following 3-year interval, whereas the converse did not hold. Model comparisons showed that this coupling parameter significantly improved overall fit and had a correspondingly moderately strong effect size, accounting on average for an accumulated 0.9 standard-deviation increase in depressive symptoms, following lower cognitive performance, across the observed age range. Adjustment for sociodemographic and health-related covariates did not significantly attenuate this association. This implies that monitoring for cognitive decrements in later life may expedite interventions to reduce related increases in depression risk.
Disproved or vindicated? Stein Rokkan’s ‘impossibility theorem’ on welfare democracy and European integration
Authors: Ferrera Maurizio
Published: October 2018

In the mid-1970s, the great Norwegian scholar Stein Rokkan argued that the consolidation of the national welfare state was going to set definite limits to European integration. While the impetuous strengthening of the latter – from Maastricht to Lisbon – has largely disproved Rokkan’s factual expectations, developments during the last decade seem to have vindicated the theoretical insights which underpinned his original argument. If appropriately re-elaborated, such insights can help us to identify the conditions under which the economic and social dimension of the European Union might be reconciled in the future.
Work must pay: Does it? Precarious employment and employment motivation for low-income households
Authors: Trlifajová Lucie , Hurrle Jakob
Published: October 2018

One of the core dilemmas of current welfare politics is the question of how to ensure social protection while providing incentives to seek employment at the same time. A way to address this dilemma is to base policies and policy models on the principle notion that ‘work must pay’; in other words, income from employment should be higher than the social support of the unemployed. However, how accurately do these approaches and models represent the reality of benefit recipients, particularly in the context of increased employment precariousness? In this article, we use the cases of two disadvantaged regions in Czech Republic in order to contrast the presumptions of ‘making work pay’ policies with the everyday experience of welfare recipients. As we show, their situations are strongly shaped by current changes in the labour market, particularly the precarious character of accessible employment and high levels of indebtedness. The modelling of financial employment incentives and the public policies based on these calculations often do not correspond with the reality of welfare recipients that are often cycling in and out of precarious forms of employment. However, the authors’ main claim is that the very idea of the ‘work must pay’ approach focuses on the wrong question. A truly functioning financial incentive would need to focus not solely on the difference in income between those who work and those who do not work, but rather should analyse what type of arrangements allow working households to rise permanently above the poverty line.
Capturing the impact of adolescent inpatient admissions: The Social Connectedness Scale
Authors: Phillips Katy , Lawler Whatson Bridie , Wells Emma , Milson Gordon , Hartley Samantha
Published: October 2018

Background:

Outcome measurement is central to health service provision. In child and adolescent mental health services (CAMHS), there are established tools used to assess symptoms and track progress. However, there is a relative dearth of assessments of subjective well-being or recovery. Social connectedness is a concept linked with well-being and risk in young people. We sought to evaluate the utility and acceptability of a measure of social connectedness in inpatient CAMHS.

Method:

As part of routine clinical practice, we asked 92 young people (mean age 16 years old) on two inpatient CAMHS wards to complete the Social Connectedness Scale, alongside other assessments, and also comment on its acceptability. We repeated the measure on discharge from the unit.

Results:

The findings showed that the measure was internally consistent (α = .910) and sensitive to change in this population. Scores also correlated with another self-report measure focusing on well-being and mental distress, but not with clinician-rated measures. Ratings of relevance and ease of understanding were reasonable and young people value social connection.

Conclusion:

The Social Connectedness Scale might offer an appropriate method of exploring this element of young peoples’ experience and progress, as part of inpatient mental health admissions.
Third culture kids’ sense of international mindedness: Case studies of students in two International Baccalaureate schools
Authors: Poonoosamy Mico
Published: October 2018

This paper uses part of the data from a larger qualitative inquiry in two International Baccalaureate schools, one in Australia and one in an Indian Ocean Island Nation (a pseudonym), to identify the factors and forces that contribute to the sense of self and understanding of and engagement with the notion of international mindedness in two ‘third culture kids’. Socio-cultural theory is used as a conceptual framework to explore cross-cultural differences and similarities between the students and the schooling contexts. Analysing the students’ perspectives about their understandings of international mindedness through grounded theory methods, the paper also develops hypotheses on the notions of being, belonging and becoming.
Current frontline approaches in the management of hepatocellular carcinoma: the evolving role of immunotherapy
Authors: Brar Gagandeep , Greten Tim F. , Brown Zachary J.
Published: October 2018

Hepatocellular carcinoma (HCC) is a major cause of cancer-associated mortality worldwide and is expected to rise. Patients with early-stage disease may have a good prognosis with a 5-year survival rate of greater than 70%. However, the majority of patients are diagnosed with late-stage disease with a dismal overall survival rate of less than 16%. Therefore, there is a great need for advances in the treatment of advanced HCC, which for approximately the past decade, has been sorafenib. Immunotherapy is an evolving cancer treatment and has shown promise in treating patients with advanced HCC. In this review, we discuss the current standard of care for advanced HCC and then discuss the evolving role of immunotherapies.
Appropriate secondary prevention and clinical outcomes after acute myocardial infarction according to atherothrombotic risk stratification: The FAST-MI 2010 registry
Authors: Tea Victoria , Bonaca Marc , Chamandi Chekrallah , Iliou Marie-Christine , Lhermusier Thibaut , Aissaoui Nadia , Cayla Guillaume , Angoulvant Denis , Ferrières Jean , Schiele François , Simon Tabassome , Danchin Nicolas , Puymirat Etienne ,   for the FAST-MI investigators
Published: October 2018

Background

Full secondary prevention medication regimen is often under-prescribed after acute myocardial infarction.

Design

The purpose of this study was to analyse the relationship between prescription of appropriate secondary prevention treatment at discharge and long-term clinical outcomes according to risk level defined by the Thrombolysis In Myocardial Infarction (TIMI) Risk Score for Secondary Prevention (TRS-2P) after acute myocardial infarction.

Methods

We used data from the 2010 French Registry of Acute ST-Elevation or non-ST-elevation Myocardial Infarction (FAST-MI) registry, including 4169 consecutive acute myocardial infarction patients admitted to cardiac intensive care units in France. Level of risk was stratified in three groups using the TRS-2P score: group 1 (low-risk; TRS-2P=0/1); group 2 (intermediate-risk; TRS-2P=2); and group 3 (high-risk; TRS-2P≥3). Appropriate secondary prevention treatment was defined according to the latest guidelines (dual antiplatelet therapy and moderate/high dose statins for all; new-P2Y12 inhibitors, angiotensin-converting-enzyme inhibitor/angiotensin-receptor-blockers and beta-blockers as indicated).

Results

Prevalence of groups 1, 2 and 3 was 46%, 25% and 29% respectively. Appropriate secondary prevention treatment at discharge was used in 39.5%, 37% and 28% of each group, respectively. After multivariate adjustment, evidence-based treatments at discharge were associated with lower rates of major adverse cardiovascular events (death, re-myocardial infarction or stroke) at five years especially in high-risk patients: hazard ratio = 0.82 (95% confidence interval: 0.59–1.12, p = 0.21) in group 1, 0.74 (0.54–1.01; p = 0.06) in group 2, and 0.64 (0.52–0.79, p < 0.001) in group 3.

Conclusions

Use of appropriate secondary prevention treatment at discharge was inversely correlated with patient risk. The increased hazard related to lack of prescription of recommended medications was much larger in high-risk patients. Specific efforts should be directed at better prescription of recommended treatment, particularly in high-risk patients.
Taurine attenuates acrylamide-induced axonal and myelinated damage through the Akt/GSK3β-dependent pathway
Authors: Sun Guohua , Qu Shuxian , Wang Siyi , Shao Ying , Sun Jingsong
Published: October 2018

Acrylamide (ACR), formed during the Maillard reaction induced by high temperature in food processing, is one of the main causes of neurodegenerative diseases. Taurine, a free intracellular β-amino acid, is characterized by many functions, including antioxidation, anti-inflammatory, and neuroprotective properties. This promotes its application in the treatment of neurodegenerative diseases. In this study, the neuroprotective effects of taurine against ACR-induced neurotoxicity and the potential underlying mechanisms were explored. Rats were intoxicated with ACR and injected with taurine in different groups for totally 2 weeks between January and July 2017. Electron microscopic analysis was used to observe the changes in tissues of the rats. Meanwhile, the levels of proteins including p-Akt, p-GSK3β, SIM312, and MBP were detected by Western blot. Furthermore, the GSK3β phosphorylation in taurine-treated dorsal root ganglion (DRG) with ACR was examined in the presence of the Akt inhibitor, MK-2206. The analysis of behavioral performances and electron micrographs indicated that taurine treatment significantly attenuated the toxic manifestations induced by ACR and stimulated the growth of axons and the medullary sheath, which was associated with the activation of the Akt/GSK3β signaling pathway. Mechanistically, it was found that taurine activated GSK3β, leading to significant recovery of the damage in ACR-induced sciatic nerves. Furthermore, MK-2206, an inhibitor of Akt, was applied in DRG cells, suggesting that taurine-induced GSK3β phosphorylation was Akt dependent. Our findings demonstrated that taurine attenuated ACR-induced neuropathy in vivo, in an Akt/GSK3β-dependent manner. This confirmed the treatment with taurine to be a novel strategy against ACR-induced neurotoxicity.
Dual cholinergic signals regulate daily migration of hematopoietic stem cells and leukocytes
Authors: García-García Andrés , Korn Claudia , García-Fernández María , Domingues Olivia , Villadiego Javier , Martín-Pérez Daniel , Isern Joan , Bejarano-García José A. , Zimmer Jacques , Pérez-Simón José A. , Toledo-Aral Juan J. , Michel Tatiana , Airaksinen Matti S. , Méndez-Ferrer Simón
Published: October 2018

Hematopoietic stem and progenitor cells (HSPCs) and leukocytes circulate between the bone marrow (BM) and peripheral blood following circadian oscillations. Autonomic sympathetic noradrenergic signals have been shown to regulate HSPC and leukocyte trafficking, but the role of the cholinergic branch has remained unexplored. We have investigated the role of the cholinergic nervous system in the regulation of day/night traffic of HSPCs and leukocytes in mice. We show here that the autonomic cholinergic nervous system (including parasympathetic and sympathetic) dually regulates daily migration of HSPCs and leukocytes. At night, central parasympathetic cholinergic signals dampen sympathetic noradrenergic tone and decrease BM egress of HSPCs and leukocytes. However, during the daytime, derepressed sympathetic noradrenergic activity causes predominant BM egress of HSPCs and leukocytes via β3–adrenergic receptor. This egress is locally supported by light-triggered sympathetic cholinergic activity, which inhibits BM vascular cell adhesion and homing. In summary, central (parasympathetic) and local (sympathetic) cholinergic signals regulate day/night oscillations of circulating HSPCs and leukocytes. This study shows how both branches of the autonomic nervous system cooperate to orchestrate daily traffic of HSPCs and leukocytes.
Short-course regimens of rifapentine plus isoniazid to treat latent tuberculosis infection in older Chinese patients: a randomised controlled study
Authors: Gao Lei , Zhang Haoran , Xin Henan , Liu Jianmin , Pan Shouguo , Li Xiangwei , Guan Ling , Shen Fei , Liu Zisen , Wang Dakuan , Guan Xueling , Yan Jiaoxia , Li Hengjing , Feng Boxuan , Cao Xuefang , Chen Yu , Cui Wei , Zhang Zongde , Ma Yu , Chen Xiaoyou , Zhou Xinhua , Jin Qi
Published: October 2018

Latent tuberculosis infection (LTBI) management is now a critical component of the World Health Organization's End TB Strategy.

In this randomised controlled trial (Chinese Clinical Trial Registryidentifier ChiCTR-IOR-15007202), two short-course regimens with rifapentine plus isoniazid (a 3-month once-weekly regimen and a 2-month twice-weekly regimen) were initially designed to be evaluated for rural residents aged 50–69 years with LTBI in China.

Due to the increasingly rapid growth and unexpected high frequency of adverse effects, the treatments were terminated early (after 8 weeks for the once-weekly regimen and after 6 weeks for the twice-weekly regimen). In the modified intention-to-treat analysis on the completed doses, the cumulative rate of active disease during 2 years of follow-up was 1.21% (14 out of 1155) in the untreated controls, 0.78% (10 out of 1284) in the group that received the 8-week once-weekly regimen and 0.46% (six out of 1299) in the group that received the 6-week twice-weekly regimen. The risk of active disease was decreased, with an adjusted hazard ratio of 0.63 (95% CI 0.27–1.43) and 0.41 (95% CI 0.15–1.09) for the treatments, respectively. No significant difference was found in the occurrence of hepatotoxicity (1.02% (13 out of 1279)versus1.17% (15 out of 1279); p=0.704).

The short regimens tested must be used with caution among the elderly because of the high rates of adverse effects. Further work is necessary to test the ultrashort regimens in younger people with LTBI.
Distraction-Free Induction Zone: A Quality Improvement Initiative at a Large Academic Children’s Hospital to Improve the Quality and Safety of Anesthetic Care for Our Patients
Authors: Crockett Christy J. , Donahue Brian S. , Vandivier Deana C.
Published: October 2018

BACKGROUND:

Noise in the operating room may cause distractions during critical periods and impair reliable communication between staff. Even momentary inefficiency while administering anesthesia can lead to errors and serious consequences for the patient. Distractions to an anesthesia provider during critical periods such as induction and emergence are a patient safety issue. Because of concerns regarding unacceptable noise levels and distractions during induction of general anesthesia, our institution developed a quality improvement initiative, the “Distraction-Free Induction Zone.” The specific aim of this project was to decrease the percentage of cases with a distraction, described as music, unnecessary conversations, or loud noises, occurring during induction of general anesthesia in pediatric otolaryngology operating rooms from 61% to 15%.

METHODS:

To complete this quality improvement initiative, a multidisciplinary team used improvement science methods, including The Model for Improvement with interventions tested via Plan-Do-Study-Act cycles. We used tools such as the Key Driver Diagram, Pareto Charts, Process Flow Chart, and Plan-Do-Study-Act worksheets. Data were manually collected and entered weekly in an Excel spreadsheet. Statistical process control methods, including a run chart and a P-control chart, were used for data analysis. Our measure was a composite measure in which observation of 1 of the 3 distractions during induction of general anesthesia categorized the case as a case with a distraction.

RESULTS:

We tested and implemented several interventions via Plan-Do-Study-Act cycles in which 3 main interventions collectively were associated with an observed decrease in distractions during induction of general anesthesia. These included educating the perioperative staff present in the operating room to help them understand that distractions to anesthesia providers represent a patient safety issue, the operating room circulating nurse taking responsibility to pause any music on arrival to the operating room, and the anesthesiologist reminding the staff in the operating room of induction time and/or asking for quiet during induction if a distraction occurs. The percentage of cases with a distraction during induction of general anesthesia in our pediatric otolaryngology operating rooms decreased from 61% to 15% by April 15, 2017 and to 10% by June 5, 2017.

CONCLUSIONS:

Using improvement science methods, we observed a decrease in distractions during induction of general anesthesia, improved a process, and encouraged change in culture at a large academic children’s hospital to enhance the quality and safety of the anesthetic care we provide our patients.
Political Kludges
Authors: Kawai Keiichi , Lang Ruitian , Li Hongyi
Published: October 2018

This paper explores the origins of policy complexity. It studies a model where policy is difficult to undo because policy elements are entangled with each other. Policy complexity may accumulate as successive policymakers layer new rules upon existing policy. Complexity emerges and persists in balanced democratic polities, when policymakers are ideologically extreme, and when legislative frictions impede policymaking. Complexity begets complexity: simple policies remain simple, whereas complex policies grow more complex. Patience is not always a virtue: farsighted policymakers may engage in obstructionism, deliberately introducing complex policies to hinder future opponents. (JEL C73, D72, D73, D78)
Dual coding potential of a 2′,5′-branched ribonucleotide in DNA
Authors: Döring Jessica , Hurek Thomas
Published: October 2018

Branchpoints in RNA templates are highly mutagenic, but it is not known yet whether this also applies to branchpoints in DNA templates. Here, we report how nucleic acid polymerases replicate a 2′,5′-branched DNA (bDNA) molecule. We constructed long-chained bDNA templates containing a branch guanosine and T7 promoters at both arms by splinted ligation. Quantitative real-time PCR analysis was used to investigate whether a branchpoint blocks DNA synthesis from the two arms in the same manner. We find that the blocking effect of a branchpoint is arm-specific. DNA synthesis from the 2′-arm is more than 20,000-fold decreased, whereas from the 3′-arm only 15-fold. Our sequence analysis of full-length nucleic acid generated by Taq DNA polymerase, Moloney murine leukemia virus reverse transcriptase, and T7 RNA polymerase from the 2′-arm of bDNA shows that the branched guanine has a dual coding potential and can base-pair with cytosine and guanine. We find that branchpoint templating is influenced by the type of the surrounding nucleic acid and is probably modulated by polymerase and RNase H active sites. We show that the branchpoint bypass by the polymerases from the 3′-arm of bDNA is predominantly error-free, indicating that bDNA is not as highly mutagenic as 2′,5′-branched RNA.
New records of lichens and allied fungi from Lapponia petsamoënsis, Murmansk Region, Russia
Authors: Urbanavichus Gennadii , Urbanavichene Irina
Published: October 2018

Fourteen species of lichens, four lichenicolous and two non-lichenized calicioid fungi are reported for the first time from the biogeographic province Lapponia petsamoënsis (NW Murmansk Region, Russia); of these, Buellia pulverea, Endococcus brachysporus and Micarea coppinsii are reported for the first time for Russia, Rosellinula haplospora is new to European Russia, and Aspicilia mashiginensis, Chaenothecopsis rubescens, C. vainioana, Lecidea sudetica, Micarea micrococca, Porpidia pachythallina, Protoparmelia atriseda and Psorotichia schaereri are new to the Murmansk Region. Brief notes, mainly on habitats and distribution, are provided for all species listed.
New and noteworthy records of lichens and allied fungi from Sakhalin Island, Russian Far East, II
Authors: Ezhkin Alexander K. , Schumm Felix
Published: October 2018

Eopyrenula intermedia is a new finding for Eurasia. Fauriea orientochinensis and Hafellia subnexa are reported for the first time for Russia, from Sakhalin Island. A further seventeen species are noteworthy for Sakhalin Island, including two species new to the Russian Far East and five species new to the southern part of the region.
Konevets Island (Leningrad Region, Russia) – a historical refuge of lichen diversity in Lake Ladoga
Authors: Himelbrant Dmitry E. , Stepanchikova Irina S. , Kuznetsova Ekaterina S. , Motiejūnaitė Jurga , Konoreva Ludmila A.
Published: October 2018

We present an updated checklist for Konevets Island (Leningrad Region, Russia). The revealed lichen biota comprises 435 species, including 378 lichens, 46 lichenicolous fungi and 11 non-lichenized saprobic fungi, of which 31 species (27 lichens and 4 lichenicolous fungi) are known only from collections made by Veli Räsänen (1917, 1938). Acremonium hypholomatis is reported for the first time for Russia; Caloplaca soralifera, Trapelia corticola, and Muellerella lichenicola for Northwestern European Russia; and Bacidia vermifera, Lecanora mughicola, Micarea contexta, Pyrenochaeta xanthoriae, Rhizocarpon disporum, Stigmidium squamariae and Xylographa difformis for Leningrad Region. From lichenological point of view, the most valuable habitats of Konevets Island are old-growth spruce forests. The studied lichen biota is rich and diverse and exceptionally well-preserved in comparison to the mainland part of Karelian Isthmus. It definitely deserves protection.
Revised Red Data List of Estonian bryophytes
Authors: Ingerpuu Nele , Vellak Kai , Ehrlich Loore
Published: October 2018

All Estonian bryophyte species (597) that had written records up to 2018 were evaluated against IUCN criteria. More than half of the species belong to the least concern category, but almost one fourth (158) is evaluated as threatened, and one tenth (65) as near threatened. Eleven species are data deficient and 15 species are considered to be regionally extinct from Estonia. To achieve adequate assessment results for a small country, some criteria were adjusted. Changes compared to the previous red list and threats to the species are discussed. 

This version replaces the version of the same paper from 2018-08-14.
New records of lichens and allied fungi from the Leningrad Region, Russia. IX
Authors: Stepanchikova Irina S. , Himelbrant Dmitry E. , Motiejūnaitė Jurga , Ahti Teuvo , Suija Ave , Kuznetsova Ekaterina S. , Dyomina Aleksandra V.
Published: October 2018

Eight species of lichens and seven lichenicolous fungi are reported for the first time for St. Petersburg, the whole Leningrad Region or its western or eastern parts. The lichen Xylographa septentrionalis is reported for the first time for Russia, Europe and Asia, the lichenicolous fungus Skyttea gregaria is new for Russia, the lichen Xylographa pallens, lichenicolous fungi Didymellopsis collematum and Intralichen lichenicola are new for the North-Western European Russia. The most interesting records are briefly discussed.
Gestión Integral de Riesgos y Antisoborno: Un enfoque operacional desde la perspectiva iso 31000 e iso 37001
Authors: Lizarzaburu Bolaños Edmundo R , Barriga Gabriela , Noriega Eduardo
Published: October 2018

El presente artículo busca explicar de qué manera las empresas pueden aplicar la gestión de riesgos desde un enfoque operacional y los lineamientos necesarios para llevar a cabo una eficiente gestión de los mismos (Bromiley et al., 2015). En primer lugar, se analiza el riesgo en las operaciones y se explican los tipos de pérdidas y los factores que las puede originar; además, se detallan herramientas de medición como la severidad. Luego, se revisa la teoría de los estándares de gestión relacionados a los riesgos, tales como el iso 37001, iso 31000 y COSO, en sus últimas versiones. El documento de investigación propone una aplicación en el área de riesgos, mediante una propuesta de esquema general de riesgos y una estructura de gestión de riesgos para las organizaciones. Finalmente, se desarrollan nuevos aspectos a considerar como el caso del riesgo cibernético.
Medición del clima organizacional con un enfoque de género en la Escuela Politécnica Nacional
Authors: Espinoza-Santeli Genoveva , Jiménez Angélica
Published: October 2018

La investigación mide el clima organizacional percibido por los docentes de la EPN y determina si existen diferencias cuando se desagregan los resultados por género. La metodología es de naturaleza cuantitativa con una muestra de 61 docentes; la herramienta se construyó considerando dos factores: las dimensiones que son evaluadas con mayor frecuencia por  instrumentos psicométricos validados de medición del clima organizacional y los parámetros que determinan discriminación laboral por género establecidos en el Modelo de Equidad de Género. Algunos resultados son: proporcionalmente existe una baja participación de mujeres que desempeñan labores de docencia y un menor porcentaje de contratos con nombramiento; existen diferencias marcadas en cuanto a sueldos y acceso a posiciones de poder; ninguna mujer gana más que la media de hombres y no hay mujeres en puestos directivos, en general, las mujeres consideran que el clima laboral no es adecuado en ninguna de las dimensiones consideradas -toma de decisiones, claridad organizacional, liderazgo y motivación-. En conclusión, la percepción del clima laboral difiere cuando se analizan los resultados desagregados por sexo, las mujeres perciben un clima organizacional inadecuado en tres de las dimensiones analizadas; además, se evidencia la existencia del techo de cristal en esta institución.
GOBIERNO CORPORATIVO DEL CONCEPTO A LA EVOLUCION ORGANIZACIONAL EN BANCOLOMBIA.
Authors: Murillo Vargas Guillermo , González-Campo Carlos Hernán , Garcia Solarte Monica
Published: October 2018

En los últimos 25 años el sector financiero, y en especial, el subsector bancario, ha presentado grandes cambios organizacionales en parte por cambios sectoriales internacionales, y por otra parte, por cambios institucionales inducidos por el Estado Colombiano. El Gobierno Corporativo y su proceso de implantación en los bancos del País, ha generado grandes efectos sobre la gestión en el sector. La presente investigación es realizada en Bancolombia, la principal organización del sector, con relación a productos, clientes y trabajadores, donde el Gobierno Corporativo y los mecanismos de definición de las relaciones entre los propietarios de la empresa y los trabajadores del mas alto nivel. Este articulo realiza una estructuración del concepto de Gobierno Corporativo y se presentaran los principales hallazgos del proceso de cambio en Bancolombia.
Orthodontic/restorative interface part 2
Authors: Hosni Sara , Darcey James , Malik Ovais H
Published: October 2018

Establishing optimal aesthetics, function and periodontal health in patients with missing teeth is a complex and challenging process, which demands the interaction of several dental specialties for effective multidisciplinary management. The most frequent scenario encountered within the orthodontic-restorative interface is missing teeth; this article focuses on the management of missing teeth, discussing diagnosis, the treatment planning process, treatment outcome and retention. This is demonstrated throughout a series of clinical cases treated within a multidisciplinary team.

CPD/Clinical Relevance: The management of patients with missing teeth is often challenging; with a variety of orthodontic and restorative treatment options for the general practitioner.
The aesthetic prosthodontic management of periodontally involved teeth
Authors: Laverty Dominic P , Green David , Van Rensburg JJ Jansen
Published: October 2018

There are a number of aesthetic issues that may occur as a result of periodontal disease and/or its management and it is a common motivation for patients to seek treatment, particularly when it affects the anterior teeth due to their prominence within the dentition. Clinicians and patients are becoming increasingly aware of the importance of the periodontal/muco-gingival tissues to provide an aesthetic smile and, as a result, this has led to the development of both surgical and prosthodontic techniques to improve or maintain the dental aesthetics. The aim of this article is to provide an overview of the prosthodontic solutions available to improve the aesthetics of retained periodontally involved teeth.

CPD/Clinical Relevance: To present an overview of the prosthodontic solutions available to improve the aesthetics of retained periodontally involved teeth.
Evaluating an educational programme for dignity care intervention with community nurses in Ireland
Authors: Connolly Michael , Charnley Karen , Collins Rita , Barry Catriona , McIlfatrick Sonja , Larkin Philip , Brenner Maria , Johnston Bridget
Published: October 2018

Background:

A key aspect to the provision of palliative care is maintaining the dignity of the individual being cared for. Nurses working in the community setting need knowledge and skills to meet the needs of individuals who need palliative care and their families. Dignity Care Intervention Ireland is a community-based pilot project designed to implement a dignity care intervention for individuals with a life-limiting condition living in their own home. As part of the overall intervention, an education programme was developed for nurses working in the community.

Method:

Completion of a locally-designed questionnaire pre- and post-education.

Results:

Nurses working in the community setting welcomed and highly valued the Dignity Care Intervention Ireland education programme. There was an overall improvement in the understanding of palliative care for both groups and improved understanding of the principles of palliative care, with self-evaluated competence to apply these principles in daily clinical practice.

Conclusion:

The importance of education about palliative care to support the delivery of dignity-preserving care cannot be underestimated. Ensuring nurses have the requisite knowledge will enhance future practice development and subsequently improve care for patients with life-limiting conditions and their families.
The 2D lingual appliance – a useful adjunctive treatment
Authors: Hodge Trevor , Baumgaertel Sebastian
Published: October 2018

The 2D lingual appliance is a popular choice for achieving cost-effective and timely results in carefully selected cases and with the minimum aesthetic impact. This article will describe how to use the appliance and highlight particular areas where introducing it into your clinical practice may be particularly beneficial.

CPD/Clinical Relevance: 2D lingual orthodontics is a popular treatment modality and, whilst it is important to recognize the appliance limitations, there are situations where it is an ideal addition to your armamentarium for meeting the expectations of some patients. Awareness of this appliance system should lead to benefits for patients once successfully integrated into clinical practice.
Early treatment of severe class II division 1 malocclusions
Authors: Witwit Shayma , Spary David John
Published: October 2018

The early orthodontic management of a severe Class II division 1 malocclusion and its advantages are discussed. Two cases are described, both of which were successfully treated on a non-extraction basis, with a phase of functional appliance therapy followed by fixed appliances.

CPD/Clinical Relevance: The article outlines how, with careful case selection and early treatment, severe overjets can be successfully treated with orthodontics alone.
A modified intrusion approach for a periodontally compromised adult patient
Authors: Kumar Santosh , Tummuru Yehoshuva Reddy , Lodha Surendra , Sawhney Chand
Published: October 2018

Loss of periodontal attachment in adults usually manifests as pathological migration, traumatic deep bite and irregular dental spacing, which lead to compromised aesthetics and function.

This article describes the interdisciplinary management of an adult patient presenting with severe periodontitis accompanied by marginal bone loss and pathological migration of the upper right anterior teeth. The combination of a modified intrusion procedure of the upper anterior teeth and periodontal therapy led to significant improvement in function and aesthetics.

CPD/Clinical Relevance: The modified intrusion technique described in the present case can be a useful alternative to improve the periodontal condition as well as the aesthetics in periodontally compromised adult patients.
The economic and cultural values of stingless bees (Hymenoptera: Meliponini) among ethnic groups of tropical America
Authors: Quezada-Euán José Javier G , Nates-Parra Guiomar , Maués Marcia M. , Roubik David W , Imperatriz-Fonseca Vera Lucia
Published: October 2018

Stingless honey bees— commonly known as stingless bees— have long provided food and materials to the inhabitants of tropical America. We conducted a literature search to codify available information, including non-peer reviewed ‘grey literature’, on the purported value of stingless bees to indigenous people. Among >400 species of Neotropical stingless bees several are widely used in beekeeping. Varied cultural and economic values are associated with their use, and in some cases husbandry, as a consequence of ongoing contact between people and these social insects. Adapting new species to husbandry is being attempted in many countries. The bees remain culturally important, and beliefs associated with them are significant for different groups, beyond utilization as commodities. We find values in food, craft, religion and medicine, with cultural values ranging from utilitarian to mythological.Values transmitted across generations allow cohesion and communal identity of native organisms associated with any indigenous society. Such cultural values seem in danger of extinction, primarily due to external factors. We provide examples of successful regional strategies in averting cultural and economic loss in natural human heritage, in this case bees that provide honey and other benefits. Preserving stingless bees and the cultural heritage around them provides a good example on how the sustainable use of native species can help in the development of indigenous communities. Bees are important agents for conservation of the environment.
Seasonal Variation in Bee-Plant Interactions in an Inselberg in the Atlantic Forest in Southeastern Brazil
Authors: Marques Marcelita França , Deprá Mariana Scaramussa , Gaglianone Maria Cristina
Published: October 2018

Studies on bee-plant interactions are relevant to the understanding of temporal patterns in neotropical communities. In isolated habitats such as inselbergs little is yet known about the temporal dynamics in the availability of fl oral resources and interacting bee. In the present study, the objective is to verify the eff ect of seasonality on the bee-plant interaction in an Atlantic Forest inselberg in southeastern Brazil. The bees were sampled monthly in the dry (April/2008-September/2008) and wet seasons (October/2008-March/2009) using an entomological net. A total of 322 bees of 33 species were captured on fl owers of 34 species of plants during the year. Bees richness was similar between seasons (22 species in the wet season and 21 in the dry season), but abundance was higher in the wet season (60% of individuals) and higher diversity occurred in the dry season. Augochloropsis sp1 were the most abundant species and visited the largest number of plant species at each season. In the interaction network, plants with the highest degree were distinct between the seasons. The number of possible interactions was higher in the dry season compared to the wet season and connectance was similar; nestedness however varied between the seasons. The composition of plant and bees species was distinct between the seasons, as well as the interactions between them, mainly due to the alteration in the composition of the plant species and the change in the choice of the bees for the floral resources between the seasons.
Leucine-aminopeptidase A (LAP-A) Encoding Gene in Apoidea: from Genomic Identification to Functional Insights Based on Gene Expression
Authors: Bataglia Luana , Godoy Isabel Cristina , Del Lama Marco Antonio , Nunes Francis Morais Franco
Published: October 2018

Aminopeptidases are enzymes that cleave the N-terminal region of proteins and show structural conservation in prokaryotes and eukaryotes. We aimed to identify leucine-aminopeptidase A (LAP-A) orthologs in the genome of bee species with diff erent levels of social organization, and to explore the putative roles of this enzyme based on gene expression data. We identified a single gene for LAP-A on chromosome 15 of Apis mellifera L. and predicted orthologs in genomes of 11 bee species. We found evidence of LAP-A expression in more than 50 bee species. In honeybee and other bees, LAP-A transcripts were expressed in diverse tissues, including: brains, fat bodies, ovaries, testicles, integuments, and glands, on diff erent developmental stages that spanned from embryogenesis to adult life. Our fi ndings on the transcriptional activity of LAP-A are consistent with previously published data on enzymatic activity of LAP-A in bees throughout the development in different tissues and in both sexes. The presence of LAP-A gene in the Apoidea genomes and its ubiquitous expression support housekeeping roles of this enzyme and broad-spectrum functions in bees, independente of their life styles.
Molecular Testing for Detection of Groups A, C, and G β-Hemolytic Streptococci in Pharyngeal Samples from Children
Authors: Van Tam T , Mestas Javier , Dien Bard Jennifer
Published: October 2018

Background

Group A Streptococcus (GAS) and large colony-forming group C (GCS) and G (GGS) β-hemolytic streptococci are important causes of acute pharyngitis in children and adults. Rapid and accurate diagnosis of streptococcal pharyngitis can improve patient care and potentially reduce transmission. In this study, we evaluated the performance of the Lyra Direct Strep (LDS) assay for detection of GAS and GCS/GGS compared with traditional culture methods.

Methods

Pharyngeal samples obtained from 278 children presenting to the emergency department with initial negative GAS rapid antigen detection test (RADT) were used. All samples were cultured as part of routine care and tested in batches using the LDS assay.

Results

Of 278 pharyngeal samples with negative GAS RADT, 37 (13.3%) and 63 (22.7%) patients were positive for GAS by culture and LDS assay, respectively. Four (1.4%) patients were positive for GCS or GGS by culture or LDS assay. The LDS assay demonstrated sensitivity and specificity of 97.6% and 89.0%, respectively, compared with culture as the gold standard. Repeat culture and an alternate PCR showed that 85.7% (24 of 28) of discrepant samples agreed with findings of the LDS assay. Since implementation, the LDS assay shows a positivity rate of 21.0% (281 of 1340) compared with 11.7% (246 of 2110) by culture in the previous year.

Conclusions

We successfully implemented the LDS assay at our institution and have observed a significant increase in the positivity rate of GAS compared with culture. The LDS assay alone allowed for the elimination of β-streptococci screening by culture at our institution.
Elimination of 72-Hour Quantitative Fecal Fat Testing by Restriction, Laboratory Consultation, and Evaluation of Specimen Weight and Fat Globules
Authors: Korostensky Michael , Martin Steven R , Swain Mark , Raman Maitreyi , Naugler Christopher T , Sadrzadeh S M Hossein , de Koning Lawrence
Published: October 2018

Background

The 72-h quantitative fecal fat test has been mostly obsolete for many years. Our objective was to reduce and eliminate the use of this test, while providing suitable alternatives.

Methods

We assessed (2010–2016) utilization of the fecal fat test in Calgary, Central Alberta, and Southern Alberta, Canada. Alternatives were identified through literature review and consultation with gastroenterologist stakeholders. Logistic regression and ROC curves were used to characterize discrimination power of 72-h specimen weight on abnormal fat excretion. This was also examined in 91 subspecimens that were additionally tested for the presence of fat globules.

Results

As 69% of fecal fat tests (total, 106/year) were on adults (age ≥ 18), stakeholders agreed that adult specimens should not be tested until ordering physicians consulted with a clinical biochemist. This change reduced fecal fat testing by 81% to 20/year in 2015. The 72-h specimen weight was a significant predictor of abnormal fat excretion [P < 0.001; area under curve (AUC) = 0.75–0.79, n = 115–417] in historic fecal fat data. A similar result was observed among subspecimens (AUC = 0.70), which improved when additionally considering the presence of fat globules (AUC = 0.74). Stakeholders consented to replacing fecal fat with a comparison of specimen weight to cutpoints with 80% specificity for abnormal fat excretion, and the test for fat globules.

Conclusion

Through stakeholder engagement, we implemented changes that eliminated 72-h quantitative fecal fat testing in a large geographic region in Alberta, Canada. Future fecal fat orders would be reflexed to an assessment of 72-h specimen weight and a qualitative test for fat globules in stool.
Creation of a Professional Development Program for Women in a Major US Medical School Pathology Department
Authors: Gronowski Ann M , Burnham Carey-Ann D
Published: October 2018

Background

Improving promotion and retention of women in pathology at major medical schools is important, especially in schools and departments that are below Association of American Medical College averages for these metrics. Our objective was to create a professional development program for women within the Department of Pathology at Washington University School of Medicine and to assess its perceived value.

Methods

A forum for women faculty, residents, and fellows was created and has been in place for 5 years. The forum meets once per month; the content includes various topics, articles, books, and invited speakers and covers a broad range of professional development subjects. The success of the forum was assessed by surveying attendees. A survey was created with Surveymonkey.com and sent to 65 women who had been invited to the forum over the 5-year period.

Results

Responses were received from 26/65 (40%) women surveyed. Junior faculty constituted 42% of attendees, with fellows, residents, midcareer faculty, and senior faculty attending in the descending order of frequency. All responders found the forum valuable. The most valuable content can be broken into 2 major themes: (a) issues facing women in medicine (such as unconscious bias) and (b) tools for improving professional development (such as negotiation skills for women).

Conclusions

Survey responses and comments indicate that this forum is perceived as extremely valuable. This format and content could easily be replicated in any academic department. Knowledge of what topics women found the most valuable can help direct the content and enhance successful outcomes of this type of professional development program.