bluuebunny/crossref_metadata_2025 huggingface dataset:
Incretin levels in patients with hypothyroidism and the evaluation of incretin levels alterations with treatment
Authors: Alemdar Serkan , Yilmaz Nusret , Ozdem Sebahat , Sari Ramazan
Published: December 2019

Background

Incretin hormones may influence the effects of thyroid hormones on insulin secretion, insulin resistance, and glucose metabolism. Thyroid hormones regulate insulin secretion, and the risk of diabetes was found to be associated with thyroid hormones.

Objectives

To determine whether incretin hormones influence the effects of thyroid hormones on insulin resistance and glucose metabolism.

Methods

A total of 26 patients were included in 2 groups consisting of 13 patients with hypothyroidism and 13 healthy controls. Levels of glucose, insulin, glucagon-like peptide 1 (GLP-1), and gastric inhibitory polypeptide (GIP) levels were measured in 0, 30, 60, 90, and 120th min during the oral glucose tolerance test in the control group and before and after thyroxine treatment in the hypothyroid group.

Results

In the hypothyroid group, waist circumference decreased after the euthyroid state was achieved (P = 0.026). No statistically significant differences were detected in the GLP-1 and GIP levels at baseline and 30, 60, 90, and 120 min between the hypothyroidism and control groups or after ensuring the euthyroid state in patients with hypothyroidism. Peak GLP-1 levels were observed at 30 min in the control group, whereas peak GLP-1 and GIP levels were detected at 90 min in the hypothyroidism group. After achieving the euthyroid state, peak GLP-1 and GIP levels were detected at 30 min as well.

Conclusion

In patients with hypothyroidism, the incretin hormones, especially the peak response of the incretin system, are significantly affected. Significant changes were observed in the incretin system by correcting hypothyroidism.
Pathways to parental anxiety: effect of coping strategies for disruptive behaviors in children with attention deficit-hyperactivity disorder
Authors: Buathong Napakkawat , Pityaratstian Nuttorn , Unahalekhaka Apittha
Published: December 2019

Background

Disruptive behaviors are commonly found in children with attention deficit-hyperactivity disorder (ADHD) and affect the mental health of parents. However, a study of the direct and indirect effects between disruptive behaviors in children with ADHD and parental anxiety and coping strategies is apparently lacking.

Objective

To examine the direct and indirect relationship between disruptive behaviors in children with ADHD and parental anxiety and coping strategies as a mediator.

Method

A cross-sectional study was conducted at King Chulalongkorn Memorial Hospital, Thailand between March 2015 and January 2016. Participants comprised 200 parents whose children were diagnosed with ADHD by physicians. Participants completed questionnaires regarding sociodemographic characteristics including The Thai Hospital Anxiety and Depression Scale, The Swanson, Nolan and Pelham (SNAP-IV): parent form (Thai version), and The Coping Scale Questionnaire (Thai version).

Results

The direct path between disruptive behaviors and anxiety was significant (b = 0.21, P = 0.002). Moreover, a significant indirect path was found between disruptive behaviors and coping behavior with escape–avoidance (β = 0.20, P = 0.005), and an indirect path was found between escape–avoidance and anxiety (b = 0.31, P <0.001).

Conclusions

Health care professionals should evaluate the use of coping strategies by parents of children with ADHD and encourage the parents to use a positive strategy for coping with the disruptive behaviors of their children.
Epidemiological study of congenital and hereditary anomalies in Sialkot District of Pakistan revealed a high incidence of limb and neurological disorders
Authors: Bhatti Nadeem Ahmad , Mumtaz Sara , Malik Sajid
Published: December 2019

Background

Pakistan faces high incidence of congenital anomalies (CA) and hereditary anomalies due to various factors, including a high rate of consanguinity, early marriages, and predominance of extended families. There is a paucity of epidemiological studies that could provide a baseline for management strategies for these anomalies.

Objectives

We aimed to elucidate the pattern, as well as the clinical and genetic aspects, of CA prevalence among the general population in Sialkot District of Pakistan.

Methods

In a cross-sectional sampling design, subjects and families with a certain type of CA were recruited from hospitals and medical centers in Sialkot District. Subjects were also selected from various towns and remote villages by visiting public places. Phenotypic and descriptive data were obtained, pedigrees were constructed, and parental and demographic attributes were recorded.

Results

A total of 241 independent subjects and/or families with CA were recruited. The malformations were classified into five major and 56 minor categories. Limb defects had the highest representation (n = 113; proportion = 0.469; 95% confidence interval (CI) = 0.406–0.532), followed by neurological anomalies (n = 76; proportion = 0.315; 95% CI = 0.257–0.374). Among the limb defects, polydactyly and talipes were most prevalent while, among neurological disorders, intellectual disability and cerebral palsy were more frequent. In this cohort, sporadic occurrence was customary compared to the familial presentation (n = 144 vs 97). Analyses of various attributes, such as gender differences, parental consanguinity, and paternal ages, as well as pedigree analyses, revealed marked heterogeneity among the major and minor categories of CA.

Conclusion

The pattern of anomalies witnessed in this cohort and a high occurrence of sporadic cases point to a substantial role of nongenetic etiological factors, which could be minimized by strengthening the health-care system.
Renal tubular epithelial cells add value in the diagnosis of upper urinary tract pathology
Authors: Oyaert Matthijs , Speeckaert Marijn , Boelens Jerina , Delanghe Joris R.
Published: December 2019

Background

Diagnosis of upper urinary tract infections (UTI) is challenging. We evaluated the analytical and diagnostic performance characteristics of renal tubular epithelial cells (RTECs) and transitional epithelial cells (TECs) on the Sysmex UF-5000 urine sediment analyzer.

Methods

Urinary samples from 506 patients presenting with symptoms of a UTI were collected. Only samples for which a urinary culture was available were included. Analytical (imprecision, accuracy, stability and correlation with manual microscopy) and diagnostic performance (sensitivity and specificity) were evaluated.

Results

The Sysmex UF-5000 demonstrated a good analytical performance. Depending on the storage time, storage conditions (2–8 °C or 20–25 °C) and urinary pH, RTECs and TECs were stable in urine for at least 4 h. Using Passing-Bablok and Bland-Altman analysis, an acceptable agreement was observed between the manual and automated methods. Compared to TECs, RTECs demonstrated an acceptable diagnostic performance for the diagnosis of upper UTI.

Conclusions

While TECs do not seem to serve as a helpful marker, increased urinary levels of RTECs add value in the diagnosis of upper UTI and may be helpful in the discrimination between upper and lower UTIs.
Principles of True Industrial Policy
Authors: Cherif Reda , Hasanov Fuad
Published: December 2019

Industrial policy is tainted with bad reputation among policymakers and academics and is often viewed as the road to perdition for developing economies. Yet the success of the Asian Miracles with industrial policy stands as an uncomfortable story that many ignore or claim it cannot be replicated. We argue that one can learn from these miracles and we suggest that three key principles were behind their success: (i) the support of domestic producers in sophisticated industries, beyond the initial comparative advantage; (ii) export orientation; and (iii) the pursuit of fierce competition with strict accountability.
Ancestral Reconstruction and Investigations of Genomic Recombination on some Pentapetalae Chloroplasts
Authors: Guyeux Christophe , Salomon Michel , Al-Nuaimi Bashar , AlKindy Bassam , Couchot Jean-François
Published: December 2019

In this article, we propose a semi-automated method to rebuild genome ancestors of chloroplasts by taking into account gene duplication. Two methods have been used in order to achieve this work: a naked eye investigation using homemade scripts, whose results are considered as a basis of knowledge, and a dynamic programming based approach similar to Needleman-Wunsch. The latter fundamentally uses the Gestalt pattern matching method of sequence matcher to evaluate the occurrences probability of each gene in the last common ancestor of two given genomes. The two approaches have been applied on chloroplastic genomes from Apiales, Asterales, and Fabids orders, the latter belonging to Pentapetalae group. We found that Apiales species do not undergo indels, while they occur in the Asterales and Fabids orders. A series of experiments was then carried out to extensively verify our findings by comparing the obtained ancestral reconstruction results with the latest released approach called MLGO (Maximum Likelihood for Gene-Order analysis).
Topological insulator overlayer to enhance the sensitivity and detection limit of surface plasmon resonance sensor
Authors: Zhu Jiaqi , Ke Yuxuan , Dai Jianfeng , You Qi , Wu Leiming , Li Jianqing , Guo Jun , Xiang Yuanjiang , Dai Xiaoyu
Published: December 2019

Surface plasmon resonance (SPR) sensors have been applied in a wide range of applications for real-time and label-free detection. In this article, by covering the topological insulators nanosheets on the surface of the noble metal (Au), the sensitivity of the SPR sensor is greatly enhanced because of the strong interaction of light with Au–bismuth selenide (Bi2Se3) heterostructure. It is shown that the sensitivity of proposed SPR sensors depends on the concentration of Bi2Se3 solution or the thickness of the coated Bi2Se3 film. The optimised sensitivity (2929.1 nm/RIU) and figure of merit (33.45 RIU−1) have been obtained after three times drop-casting, and the enhancement sensitivity of proposed sensors is up to 51.97% compared to the traditional Au–SPR sensors. Meanwhile, the reflection spectrum is simulated by using the method of effective refractive index, and the reason for the increase of sensitivity is analysed theoretically. For researching the application of modified SPR sensor, heavy metal detection is employed to detect in the last part. Our proposed SPR sensors have potential applications in heavy metal detections and biosensing.
Dependence Modelling in Insurance via Copulas with Skewed Generalised Hyperbolic Marginals
Authors: Alexeev Vitali , Ignatieva Katja , Liyanage Thusitha
Published: December 2019

This paper investigates dependence among insurance claims arising from different lines of business (LoBs). Using bivariate and multivariate portfolios of losses from different LoBs, we analyse the ability of various copulas in conjunction with skewed generalised hyperbolic (GH) marginals to capture the dependence structure between individual insurance risks forming an aggregate risk of the loss portfolio. The general form skewed GH distribution is shown to provide the best fit to univariate loss data. When modelling dependency between LoBs using one-parameter and mixture copula models, we favour models that are capable of generating upper tail dependence, that is, when several LoBs have a strong tendency to exhibit extreme losses simultaneously. We compare the selected models in their ability to quantify risks of multivariate portfolios. By performing an extensive investigation of the in- and out-of-sample Value-at-Risk (VaR) forecasts by analysing VaR exceptions (i.e. observations of realised portfolio value that are greater than the estimated VaR), we demonstrate that the selected models allow to reliably quantify portfolio risk. Our results provide valuable insights with regards to the nature of dependence and fulfils one of the primary objectives of the general insurance providers aiming at assessing total risk of an aggregate portfolio of losses when LoBs are correlated.
Mechanical Interlock Made by Electromagnetic Crimping for Axial Load Resistance Using Aluminum Tube and Steel Rod
Authors: Areda Getu Tilahun , Kore Sachin D.
Published: December 2019

Joining an aluminum tube with a steel rod using thermal-based welding processes like arc welding is challenging because of oxide formation, which requires a higher melting temperature than the parent metal. In this article, the electromagnetic crimping process is used to join the aluminum tube and a steel profiled rod mechanically. The circumferential double grooves, which have a rectangular shape, were machined on the steel rod with different geometrical parameters. Discharge energy of 4.7 kJ and a groove edge angle of 0.5 mm were kept constant. Therefore, the primary goal of this study is to investigate the effect of geometrical parameters on joint strength using a double rectangular groove. The result of the pullout test revealed that the joint strength of most crimped samples was found in the range of the strength of the aluminum tube. Based on the results obtained, a design guideline that describes the effects of the width-to-depth ratio on joint strength is proposed. Further, the effect of groove depth on the percentage of gap filling, wrinkling, and tube thickness reduction was studied in detail. Moreover, microhardness at the joint interface was also investigated.
Factores determinantes da disposición a pagar por recursos naturais. O caso da lagoa e o areal de Valdoviño
Authors: Massa Teba Félix
Published: December 2019

O método de valoración continxente (MVC) baséase na construción de mercados hipotéticos a través dunha enquisa, onde normalmente se lles pregunta aos entrevistados pola súa disposición a pagar (DAP) por un determinado ben que carece de mercado e, polo tanto, de prezo. O obxectivo principal deste traballo é identificar as variables explicativas que condicionan a DAP dos visitantes por gozar dun dos principais elementos do patrimonio natural de Galicia: o conxunto formado pola lagoa e o areal de Valdoviño. A información obtida pode ser de grande utilidade na análise custo-beneficio como fundamento das decisións políticas que afectan á xestión deste recurso natural.
De Novo Assembly of a High-Quality Reference Genome for the Horned Lark (Eremophila alpestris)
Authors: Mason Nicholas A , Pulgarin Paulo , Cadena Carlos Daniel , Lovette Irby J
Published: December 2019

The Horned Lark (Eremophila alpestris) is a small songbird that exhibits remarkable geographic variation in appearance and habitat across an expansive distribution. While E. alpestris has been the focus of many ecological and evolutionary studies, we still lack a highly contiguous genome assembly for the Horned Lark and related taxa (Alaudidae). Here, we present CLO_EAlp_1.0, a highly contiguous assembly for E. alpestris generated from a blood sample of a wild, male bird captured in the Altiplano Cundiboyacense of Colombia. By combining short-insert and mate-pair libraries with the ALLPATHS-LG genome assembly pipeline, we generated a 1.04 Gb assembly comprised of 2713 scaffolds, with a largest scaffold size of 31.81 Mb, a scaffold N50 of 9.42 Mb, and a scaffold L50 of 30. These scaffolds were assembled from 23685 contigs, with a largest contig size of 1.69 Mb, a contig N50 of 193.81 kb, and a contig L50 of 1429. Our assembly pipeline also produced a single mitochondrial DNA contig of 14.00 kb. After polishing the genome, we identified 94.5% of single-copy gene orthologs from an Aves data set and 97.7% of single-copy gene orthologs from a vertebrata data set, which further demonstrates the high quality of our assembly. We anticipate that this genomic resource will be useful to the broader ornithological community and those interested in studying the evolutionary history and ecological interactions of larks, which comprise a widespread, yet understudied lineage of songbirds.
Missing Data - Better "Not to Have Them", but What If You Do? (Part 1)
Authors: Temme Dirk , Jensen Sarah
Published: December 2019

Missing values are ubiquitous in empirical marketing research. If missing data are not dealt with properly, this can lead to a loss of statistical power and distorted parameter estimates. While traditional approaches for handling missing data (e.g., listwise deletion) are still widely used, researchers can nowadays choose among various advanced techniques such as multiple imputation analysis or full-information maximum likelihood estimation. Due to the available software, using these modern missing data methods does not pose a major obstacle. Still, their application requires a sound understanding of the prerequisites and limitations of these methods as well as a deeper understanding of the processes that have led to missing values in an empirical study. This article is Part 1 and first introduces Rubin’s classical definition of missing data mechanisms and an alternative, variable-based taxonomy, which provides a graphical representation. Secondly, a selection of visualization tools available in different R packages for the description and exploration of missing data structures is presented.
Latent Class Conjoint Choice Models: A Guide for Model Selection, Estimation, Validation, and Interpretation of Results
Authors: Paetz Friederike , Hein Maren , Kurz Peter , Steiner Winfried
Published: December 2019

The consideration of preference heterogeneity in consumer choice behavior has become state of the art. In addition, the identification of consumer segments remains essential for marketing managers. For disaggregate consumer choice data representing the basis of segmentation, the latent class multinomial logit (MNL) model is currently the most popular approach for estimating segment-specific preferences. After addressing the theoretical background of the latent class MNL model, we use an empirical choice-based conjoint data set to illustrate model estimation and validation, as well as how the estimation results should be interpreted. A particular focus lies on the model selection process, i.e. the determination of an appropriate number of segments. We further work out interpretation pitfalls when the existing preference heterogeneity of consumers is ignored. This will ultimately provide a guide for applying the latent class MNL model regarding model selection, estimation, validation, and interpretation of results both from a statistical and managerial perspective.
Glycemia monitoring
Authors: Basov Igor , Švitra Donatas
Published: December 2019

Here a system of two non-linear difference-differential equations, which is mathematical model of self-regulation of the sugar level in blood, is investigated. The analysis carried out by qualitative and numerical methods allows us to conclude that the mathematical model explains the functioning of the physiological system "insulin-blood sugar" in both normal and pathological cases, i.e. diabetes mellitus and hyperinsulinism.
On Waring's problem for a prime modulus
Authors: Dubickas A.
Published: December 2019

We obtain a lower bound for the minimum over positive integers such that the sum of certain powers of some integers is divisible by a prime number, but none of these integers is divisible by this prime number.
Firing Pattern Formation by Transient Calcium Current in Model Motoneuron
Authors: Svirskienė N. , Svirskis G.
Published: December 2019

Firing properties of neurons are important in signal detection and generation in nervous system. Spinal cord motoneurons have membrane properties adapted to muscle properties. In this work we explored the relation between the first interspike interval and the amplitude of injected current. It was shown that increased sensitivity of firing frequency to the injected current at higher firing frequencies is due to the transient calcium current. Particularly, the specific density of N-type channels and the speed of their deactivation define the steepness and onset of the second range in frequency versus current relation.
Population model based on cells with internal dynamics
Authors: Tamošiūnaitė Minija , Vaišnys J. Rimas
Published: December 2019

A model of a population is constructed by bringing together individual model organisms (cells) which have explicit internal dynamics. An attempt is made to preserve analyzability of the relatively complex model by describing the nonlinear dynamics of each cell by a set of piece-wise linear equations. In the simplest case of three linear pieces, a population with inherent oscillations in the number of cells as a function of time is obtained. A proposal is made to approximate realistic internal dynamics of selected biological features by introducing the appropriate number of linear patches, and to simulate realistic populations in this way. Another extension of the model, the description of interactions between cells through released metabolites, is used to represent the situation of a chemostat.
Improving Culture Teaching in the English Major at Universidad Nacional: Perceptions and practices
Authors: Espinoza Murillo Ligia , Rodríguez Chaves José David
Published: December 2019

The present study aims at exploring the bond between culture and language learning, in the curriculum of the English major (Bachillerato en Inglés, in Spanish) at Universidad Nacional (UNA). Specifically, the major under study is affiliated to Escuela de Literatura y Ciencias del Lenguaje and implemented at Sede Interuniversitaria de Alajuela, Costa Rica. The researchers seek to diagnose current needs in this major by examining perceptions and practices in culture teaching in the classroom of English as a foreign language (EFL). Although culture is part of the curriculum of the English major, perceptions and practices toward the integration of the cultural component in this study plan have been first addressed in this research. Through a quantitative approach, this study determines several cultural teaching practices developed in EFL courses along four academic levels in the English major. Participants comprised 74 students and five faculty members. Learners’ understanding and perceptions toward culture learning were analyzed through a survey. Likewise, a questionnaire for professors was administered to identify teaching approaches to culture. Findings revealed that cultural aspects are addressed in most of the courses in the major; however, the practices implemented for approaching such aspects must be authentic and reflective for the broadening of cultural understanding per se and in turn the enhancement of cross-cultural communication.
R2D2: An effective model to incorporate ICTs in the EFL classroom?
Authors: Olivares Garita Cinthya , Brenes Sánchez Verónica , Valverde Marín Evelyn
Published: December 2019

Information and Communication Technologies (ICT) in English language teaching have become effective tools to boost meaningful learning. In an EFL environment, the need to apply a model to incorporate web tools and free apps in the classroom takes prominence for teachers at the university level. The present study is an attempt at determining the effectiveness of the implementation of the Read-Reflect-Display and Do (R2D2) model by Bonk and Zhang (2006) through the design and application of a booklet of activities used by a group of 14 students of the Associate’s program in English and 17 students of the Bachelor’s degree in English Teaching at Universidad Nacional, Brunca Branch. Due to its nature, this research encompasses a case study with a descriptive scope. The design and implementation will be analyzed through an empirical predictive and retrospective evaluation considering the administration of a teacher and a student questionnaire and a focus group. The instruments were administered to 31 students and 7 teachers. The results of the analysis led to conclude that the model implemented in a booklet of activities can be effective to integrate ICTs and innovate in both the techniques used to incorporate technology and the pedagogical materials EFL teachers bring to the classroom only if teachers open up to new ideas and keep abreast of the constant technological changes that education and society demand.
PRINCIPAL AGENT DALAM INDUSTRI PERIKANAN TANGKAP; KONTRAK YANG MENGUATKAN ATAU MELEMAHKAN? (STUDI KASUS PERIKANAN TANGKAP DI PESISIR MALANG SELATAN)
Authors: Kornitasari Yenny , Manzilati Asfi , Efani Anthon
Published: December 2019

Penelitian ini bertujuan untuk mengidentifikasi secara detail bagaimana hubungan kerja/ industrial (principal-agent) dalam menjaga keberlanjutan suatu usaha di sektor perikanan. Penelitian ini menggunakan pendekatan kualitatif untuk melihat realitas yang tidak hanya dilihat sebagai sebuah hasil, tetapi juga proses yang berlangsung. Proses observasi dan intreprestasi menggunakan metode blumer. Hasil penelitian menunjukan bahwa sumber modal sebagai pembiayaan dalam operasional sektor perikanan di pesisir Malang Selatan secara umum berasal dari tiga sumber yaitu bank, aset pribadi dan pengambek. Modal yang berasal dari bank hanya bisa diakses oleh nasabah yang memiliki agunan seperti sertifikat rumah/tanah dan kendaraan bermotor.  Pedagang kecil yang tidak memiliki asset untuk dijadikan agunan lebih memilih permodalan yang berasal dari koperasi, bank thitil dan pengambek. Sumber pemodalan yang berasal dari bank, koperasi maupun bank thitil sudah jelas kontrak yang terbangun. Yang unik pada kasus ini adalah sistem permodalan yang dilakukan antara nelayan dengan pengambek. Dalam hal ini, kontrak yang terbentuk antara principal dan agent disini seperti menguntungkan kedua belah pihak, akan tetapi dalam kenyataannya nelayan tidak punya kekuatan dan pilihan lain dalam mengembangkan usaha karena terikat dengan kontrak pemodalan dan juga utang yang tidak boleh dilunasi.Title: principal – agent; kontrak bisnis; masyarakat pesisir The study aims to identify in detail how work / industrial relationship (principal-agent) in maintaining the sustainability of fisheries business. This study used a qualitative approach to perceive reality as a result as well as an ongoing process. The Blumer method was used for the observation and interpretation of the data. As financial support of fisheries sector in the coast of South Malang, capital generally comes from three sources: banks, personal assets and scavengers. Bank capital can only be accessed by customers having collateral asset such as house, land, or vehicles certificates. While cooperative, thitil bank and pengambek were the capital sources for the small traders who do not have collateral assets. It is clear that there is a contract system for acquiring bank and cooperative capital. The unique case appears from capital system between fishers and “pengambek”. The system seemed to have a mutual advantageous for both party, however, fishers have less power and choice to get alternative source of capital in developing their business due to the restriction of their contract and they are not allowed to settle their debt.
ANTUNES, RICARDO. O privilégio da servidão o novo proletariado de serviços na era digital. 1. Ed. São Paulo: Boitempo,2018.
Authors: Boschini Fernanda Ferreira
Published: December 2019

Ricardo Antunes, sociólogo e estudioso das relações entre capital e trabalho na perspectiva marxista, traz em seu novo livro, lançado em 2018 O privilégio da servidão: o novo proletariado de serviços na era digital, uma leitura impactante, clara e objetiva, ainda que estes adjetivos não signifiquem que seja uma leitura fácil. Composto por quatro partes, o autor compõe um panorama global de formação da nova classe trabalhadora da era digital, denominada por ele como o proletariado de serviços.
On Redrawing the Force-Content Distinction
Authors: Martin Christian Georg
Published: December 2019

Frege distinguished the thought qua logical content from the assertoric force attached to it when judged to be true. The gist of this distinction is captured by the so-called Frege-Geach point. Recently, several authors have drawn inspiration from Wittgenstein to reject this point and the distinction it is based on. This article proceeds from the observation that Wittgenstein himself did not reject the force-content distinction but urged us to reformulate it in a non-dualistic way. While drawing on Wittgensteinian lessons about thought and its expression, the overall purpose of this paper is systematic, not exegetic: it seeks to contribute to the contemporary debate aboute force and content by arguing that this distinction should be redrawn in such a way as to exhibit force as internal to thought, namely, as that which provides for the unity of thought. To this end, it is investigated what it is for a thought to occur as a forceless part of a propositionally complex assertion (e. g. for p to occur as a part of the assertion that not p).
Understanding Wittgenstein, Understanding Modernism, ed. Anat Matar
Authors: Hertzberg Lars
Published: December 2019

Review  of  Anat Matar, ed., Understanding Wittgenstein, Understanding Modernism. New York et al: Bloomsbury, 2017, ISBN: HB: 978-1-5013-0243-5, xv+270 pp.
Use of the LI-RADS classification in patients with cirrhosis due to infection with hepatitis B, C, or D, or infected with hepatitis B and D
Authors: Pereira Rita de Cassia Ribeiro , Heming Carolina Augusta Modena , Tejo Thiago Ramos , Oliveira Thais Cristina Lima de , Silva Rita do Socorro Uchoa da , Parente Daniella Braz
Published: December 2019

Abstract Objective: To evaluate liver lesions, in accordance with the LI-RADS classification, using contrast-enhanced multiphase dynamic computed tomography in patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, as well as to determine the level of agreement between radiologists. Materials and Methods: We evaluated 38 patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, all of whom underwent contrast-enhanced multiphase dynamic computed tomography. For each examination, two radiologists selected up to three hepatic lesions, categorizing them in accordance with the LI-RADS classification and evaluating signs of chronic liver disease and portal hypertension. To determine the level of agreement between radiologists, we calculated the kappa statistic (κ) . Results: Radiologist 1 and radiologist 2 selected 56 and 48 liver lesions, respectively. According to radiologist 1 and radiologist 2, respectively, 27 (71%) and 23 (61%) of the 38 patients had at least one liver lesion; 13 (34%) and 12 (32%) had a LI-RADS 5 lesion (κ = 0.821); 19 (50%) and 16 (42%) had a hypervascular lesion (κ = 0.668); and 30 (79%) and 24 (63%) had splenomegaly (κ = 0.503). Both radiologists identified chronic liver disease in 31 (82%) of the patients (κ = 1.00). Conclusion: Lesions categorized as LI-RADS 5 were detected in approximately 32% of the patients, with almost perfect agreement between the radiologists. The level of agreement was substantial or moderate for the other LI-RADS categories.
IS-LM: uma história?
Authors: ANDRADE ALEXANDRE AUGUSTO SEIJAS DE , MAGALHÃES MATHEUS ALBERGARIA DE
Published: December 2019

RESUMO Para alguns economistas, o modelo IS-LM já passou, correspondendo a uma fase remota da história do pensamento econômico. Neste artigo, tentamos demonstrar que isso não é necessariamente verdade. Ao mesmo tempo, aproveitamos a longevidade do modelo para fornecer uma breve descrição de alguns eventos em Macroeconomia. Além disso, chamamos a atenção para as crescentes diferenças entre macroeconomia “acadêmica” e “prática”, fato que pode indicar a existência de problemas relativos ao ensino e às aplicações no campo. Apesar de todas as falhas do modelo, acreditamos que ele ainda não entrou no salão de ícones históricos da Economia e ainda pode ser útil, pelo menos no sentido de treinar novas gerações de alunos com conceitos macroeconômicos básicos.
Influência das características hospitalares na realização de cesárea eletiva na Região Sudeste do Brasil
Authors: Zaiden Laura , Nakamura-Pereira Marcos , Gomes Maria Auxiliadora Mendes , Esteves-Pereira Ana Paula , Leal Maria do Carmo
Published: December 2019

Resumo: Este artigo tem como objetivo avaliar a influência das características hospitalares sobre a chance de realização de cesariana eletiva na Região Sudeste do Brasil. Foram utilizados dados da pesquisa Nascer no Brasil, realizada entre fevereiro de 2011 e outubro de 2012. A presente análise inclui a amostra da Região Sudeste, compreendendo 10.155 mulheres. O grupo de mulheres submetidas à cesariana eletiva foi comparado ao de mulheres que entraram em trabalho de parto ou foram submetidas à indução do parto, independentemente se fizeram cesariana intraparto ou parto vaginal. Com exceção da idade gestacional, todas as características obstétricas analisadas mostraram-se associadas à cesariana eletiva. Nesse grupo, 60,5% não possuíam cesariana prévia à gestação atual e 64,7% eram de baixo risco. Dentre os partos com financiamento público, observou-se maior chance de cesárea eletiva nas mulheres que foram atendidas nos hospitais com < 1.500 (OR = 2,11; IC95%: 1,37-3,26) e entre 1.500-2.999 partos/ano (OR = 1,45; IC95%: 1,04-2,02) e nos hospitais mistos (OR = 1,81; IC95%: 1,37-2,39). Nos hospitais mistos, a magnitude da associação é maior quando localizados em não capitais com volume > 3.000 partos/ano (OR = 3,45; IC95%: 1,68-7,08) e atinge seu maior valor nos hospitais localizados em não capitais com volume < 3.000 partos/ano (OR = 4,08; IC95%: 2,61-6,37). Em contrapartida, não observou-se associação entre cesariana eletiva e os hospitais públicos localizados em não capitais do Sudeste. As prevalências de cesariana eletiva nos hospitais públicos da Região Sudeste são altas quando comparadas a outros países, e sofrem importante influência das características hospitalares.
Fatores associados à qualidade de registros de acidentes de trabalho no Sistema de Informações sobre Mortalidade no Brasil
Authors: Galdino Adriana , Santana Vilma Sousa , Ferrite Silvia
Published: December 2019

Resumo: Este estudo teve como objetivo identificar fatores associados à qualidade do registro de acidentes de trabalho fatais no Sistema de Informações sobre Mortalidade (SIM), ocorridos com pessoas de 18 a 65 anos, entre 1998 e 2013, no Brasil. A qualidade do registro da possível relação causal de acidentes com o trabalho , campo existente em declarações de óbitos, exclusivo para acidentes dentre as causas externas, foi analisada com duas variáveis: (1) registro “ignorado” (R-IGN, sim/não); (2) registros ausentes ou inconsistentes (R-AUS, sim/não). Foram encontrados 665.531 óbitos dentre os quais 67,7% dos registros de  eram de má qualidade. Fatores associados a registro “ignorado” foram: sexo masculino; cor da pele branca; escolaridade menor que a superior; não operários ou não agricultores; atestante Instituto Médico Legal (IML); regiões Sudeste e Nordeste; e óbito em hospital. Registros ausentes ou inconsistentes se associaram: à idade acima de 34 anos; à cor da pele não branca; a sem escolaridade; a todas as regiões, exceto à Sudeste; a óbito em hospital ou no domicílio; a boletim de ocorrência como fonte; e a atestante IML. Esses fatores, independentemente associados à má qualidade de preenchimento do campo , compreendiam dimensões individuais, da fonte de emissão, do local do óbito e geográficas. Isso revela a necessidade de melhoria da qualidade de declarações de óbito em hospitais, IML e boletins de ocorrência, treinando e supervisionando equipes em todo o Brasil.
Conselho de saúde e efetividade participativa: estudo sobre avaliação de desempenho
Authors: Rocha Maricélia Braga , Moreira Diane Costa , Bispo Júnior José Patrício
Published: December 2019

Resumo: O artigo tem por objetivo apresentar e analisar os resultados de um modelo de avaliação de desempenho de conselhos de saúde. O referencial teórico metodológico está fundamentado no método spidergram, adaptado à realidade dos conselhos de saúde. A matriz avaliativa considerou cinco dimensões de maior influência sobre a participação: autonomia, organização, representatividade, envolvimento comunitário e influência política. Com base na avaliação dos indicadores, foi estimado o valor de desempenho de cada dimensão e localizado no gráfico de cinco eixos. A aplicação da matriz foi realizada no Conselho de Saúde de Vitória da Conquista, Bahia, Brasil. Utilizou-se análise de documentos, observação das reuniões e entrevistas com 18 conselheiros como técnicas de coleta de dados. Os resultados demonstram nível avançado de autonomia do conselho com condições estruturais adequadas, porém, com limitações na independência financeira. A dimensão organização atingiu nível máximo de desempenho com a realização regular de reuniões, disponibilidade de informações para os conselheiros e funcionamento das comissões temáticas. A representatividade foi a dimensão de pior desempenho, demostrado pela frágil relação dos representantes com as entidades. A dimensão envolvimento comunitário apresentou nível avançado, com elevada participação de conselheiros e não conselheiros às reuniões e perfil de atuação propositivo. A dimensão influência política obteve nível intermediário. Constatou-se elevada influência dos representantes sociais no processo deliberativo e diminuta capacidade de acompanhamento das políticas. A matriz utilizada mostrou-se adequada e viável para a avaliação de desempenho dos conselhos de saúde.
BARIATRIC SURGERY IMPACT ON GASTROESOPHAGEAL REFLUX AND DENTAL WEAR: A SYSTEMATIC REVIEW
Authors: CASTILHO Ana Virgínia Santana Sampaio , FORATORI-JUNIOR Gerson Aparecido , SALES-PERES Silvia Helena de Carvalho
Published: December 2019

ABSTRACT Introduction: Several oral problems may be perceived in individuals who were submitted to bariatric surgery, due to metabolic and behavioral changes relative to diet and oral hygiene. Tooth wear appears to suffer impact after bariatric surgery, because there may be an increase in gastroesophageal reflux. Objective: To systematically review the literature regarding the impact of bariatric surgery on gastroesophageal reflux and tooth wear. Method: The following databases were accessed by two independent, calibrated examiners: PubMed, Medline, Lilacs, Scielo and Cochrane using the following descriptors: “bariatric surgery” AND “dental erosion” OR “bariatric surgery” AND “dental erosion” AND “gastroesophageal reflux disease”. After excluding duplicate studies, 12 studies were initially evaluated by the title and abstract. The excluded studies were those without relevance to the present research, literature review studies and case reports. Thus, four articles were included in this study. All the articles evaluated indicated high association between gastroesophageal reflux and tooth wear in patients submitted to bariatric surgery. Association of these outcomes was more evident six months after the surgical procedure. Conclusion: Patients submitted to bariatric surgery showed higher prevalence of gastroesophageal reflux and tooth wear.
RISK FACTORS FOR SEVERE POSTOPERATIVE COMPLICATIONS AFTER GASTRECTOMY FOR GASTRIC AND ESOPHAGOGASTRIC JUNCTION CANCERS
Authors: NORERO Enrique , QUEZADA Jose Luis , CERDA Jaime , CERONI Marco , MARTINEZ Cristian , MEJÍA Ricardo , MUÑOZ Rodrigo , ARAOS Fernando , GONZÁLEZ Paulina , DÍAZ Alfonso
Published: December 2019

ABSTRACT Background: Gastrectomy is the main treatment for gastric and Siewert type II-III esophagogastric junction (EGJ) cancer. This surgery is associated with significant morbidity. Total morbidity rates vary across different studies and few have evaluated postoperative morbidity according to complication severity. Aim: To identify the predictors of severe postoperative morbidity. Methods: This was a retrospective cohort study from a prospective database. We included patients treated with gastrectomy for gastric or EGJ cancers between January 2012 and December 2016 at a single center. Severe morbidity was defined as Clavien-Dindo score ≥3. A multivariate analysis was performed to identify predictors of severe morbidity. Results: Two hundred and eighty-nine gastrectomies were performed (67% males, median age: 65 years). Tumor location was EGJ in 14%, upper third of the stomach in 30%, middle third in 26%, and lower third in 28%. In 196 (67%), a total gastrectomy was performed with a D2 lymph node dissection in 85%. Two hundred and eleven patients (79%) underwent an open gastrectomy. T status was T1 in 23% and T3/T4 in 68%. Postoperative mortality was 2.4% and morbidity rate was 41%. Severe morbidity was 11% and was mainly represented by esophagojejunostomy leak (2.4%), duodenal stump leak (2.1%), and respiratory complications (2%). On multivariate analysis, EGJ location and T3/T4 tumors were associated with a higher rate of severe postoperative morbidity. Conclusion: Severe postoperative morbidity after gastrectomy was 11%. Esophagogastric junction tumor location and T3/T4 status are risk factors for severe postoperative morbidity.
Multiple resistance to glyphosate and imazethapyr in Bidens subalternans
Authors: Mendes Rafael Romero , Adegas Fernando Storniolo , Takano Hudson Kagueyama , Silva Vanessa Francieli Vital , Machado Fellipe Goulart , Oliveira Junior Rubem Silvério de
Published: December 2019

ABSTRACT Glyphosate has been widely used to control greater beggarticks populations that are resistant to acetolactate synthase (ALS) inhibitors in South America. However, herbicide control failures has been observed over the last three growing seasons in grain production areas of Paraguay. In this research, we report the first case of multiple resistance to glyphosate (EPSPs) and imazethapyr (ALS) in greater beggarticks (Bidens subalternans) population from Paraguay. This conclusion was supported by dose-response experiments conducted in two consecutive years (2018 and 2019) with a putative resistant (R) and a susceptible (S) population. Alternative herbicides were also tested for post-emergence control of R population. For glyphosate, the resistant factor (RF) values were 8.8- (2018) and 15.7-fold (2019). For imazethapyr, the RF values were 59- and 58-fold, in 2018 and 2019, respectively. Treatments with 2,4-D, dicamba, 2,4-D + glyphosate, dicamba + glyphosate, lactofen, fomesafen, ammonium-glufosinate, atrazine, and bentazon provided more than 80% control of the R population. This is the first case of multiple resistance to glyphosate and imazethapyr in greater beggarticks (Bidens subalternans) in the world. The mechanisms underlying resistance in this biotype should be evaluated in future research.
Morphology of yellow passion fruit seedlings submitted to triazole induced growth inhibition
Authors: Teixeira Ednilson Carvalho , Matsumoto Sylvana Naomi , Silva Delmira da Costa , Pereira Luanna Fernandes , Viana Anselmo Eloy Silveira , Arantes Alessandro de Magalhães
Published: December 2019

ABSTRACT Inhibiting seedling vegetative growth may be a strategy for improving modulation against biotic and abiotic stresses after transplanting. The objective of this study was to evaluate morphological responses of yellow passion fruit (Passiflora edulis) seedlings to growth inhibition resulted from the application of an inhibitor of gibberellin biosynthesis. The experiment was carried out in a greenhouse using seedlings grown in 290 cm3 polyethylene tubes. At 40 days after emergence, trays containing the seedlings were immersed in solutions at concentrations of 0, 40, 80, 120 and 160 mg (Paclobutrazol) PBZ L-1 up to substrate saturation. These five treatments were laid out in a randomized block design with four replicates. At 15, 30 and 45 days after PBZ application (DAA), basal stem diameter was measured; at 45 DAA, stem diameter, individual leaf area, specific leaf area, root diameter and root volume were measured, lignin content and the anatomy of leaves, stems, and roots were analyzed. Triazole-induced anatomical alterations in stems, leaves and roots cause morphological traits and intensify the specific reagent staining of phenolic compounds and lignin in yellow passion fruit (Passiflora edulis) seedlings.
Fatores associados ao uso de serviços odontológicos públicos por adultos no estado de São Paulo, Brasil, 2016
Authors: Fonseca Suelen Garcia Oliveira da , Fonseca Emílio Prado da , Meneghim Marcelo de Castro
Published: December 2019

Resumo O objetivo deste artigo é analisar os fatores associados ao uso dos serviços odontológicos públicos por adultos. Estudo transversal com amostra representativa de adultos de 35 a 44 anos, com dados do Levantamento Epidemiológico das Condições de Saúde Bucal da População do Estado de São Paulo (SBSP-2015). Utilizou-se análise de regressão logística multivariada, baseada em modelo proposto por Andersen para predizer o acesso aos serviços odontológicos públicos. Visitaram o serviço privado 3.421 (59,9%) adultos e 2.288 (40,1%), o público. Os serviços odontológicos públicos foram mais acessados por mulheres (41,8%) e menos escolarizados (50,2%). Indivíduos não brancos (OR = 1,32; IC95%:1,16; 1,50), menor renda familiar (OR = 2,37; IC95%:2,11; 2,65), histórico de dor de dente (OR = 1,60; IC95%:1,39; 1,83) e necessidade de tratamento endodôntico (OR = 1,44; IC95%:1,12; 1,85) foram associados ao uso dos serviços odontológicos públicos. Fatores contextuais, individuais e necessidade de tratamento foram associados à utilização dos serviços odontológicos públicos por adultos residentes no estado de São Paulo, em 2015.
Consórcios públicos de saúde: uma revisão da literatura
Authors: Flexa Raquel Gonçalves Coimbra , Barbastefano Rafael Garcia
Published: December 2019

Resumo A regionalização é uma estratégia de hierarquização dos serviços de saúde que orienta a descentralização das ações e serviços. Existem, entretanto, desafios para efetivar a regionalização, tais como as dificuldades para integrar e coordenar as ações e serviços, em diferentes espaços geográficos, com distintas gestões para atender as necessidades de saúde na escala, qualidade e custos adequados. Nesse contexto, surgem os consórcios públicos enquanto solução organizacional para suprir as necessidades de coordenação e integração entre os entes federativos. Os benefícios dos consórcios são o ganho de escala na prestação de serviços, a racionalidade de processos e de despesas, a realização de projetos conjuntos que seriam inviáveis de forma isolada. O objeto deste artigo é realizar uma investigação sobre como os consórcios intermunicipais de saúde conseguem obter melhor desempenho no que tange aos processos de aquisição e contratação de serviços de forma cooperativa, através de uma revisão bibliográfica narrativa. Os resultados da revisão foram divididos em 3 blocos: i) definições e conceitos dos consórcios públicos, ii) definições e conceitos sobre consórcios intermunicipais de saúde (CIS), iii) estudos de caso de CIS no Brasil.
Mercado de trabalho e processos regulatórios – a Enfermagem no Brasil
Authors: Machado Maria Helena , Koster Isabella , Aguiar Filho Wilson , Wermelinger Mônica Carvalho de Mesquita Werner , Freire Neyson Pinheiro , Pereira Everson Justino
Published: December 2019

Resumo O presente artigo faz uma análise do mercado de trabalho dos profissionais da Enfermagem, a partir dos dados obtidos através da Pesquisa Perfil da Enfermagem no Brasil (Cofen - Fiocruz), evidenciando que uma parcela significativa desses trabalhadores, a maioria auxiliares e técnicos de enfermagem, vivem em condições precárias de sobrevivência, com precarização, multiempregos e a insegurança no ambiente de trabalho cada vez mais frequentes, o que os impede de exercerem com dignidade suas atividades laborais. Analisa também o processo de regulação da Enfermagem, tendo como referencial a sociologia das profissões, a partir da criação do Sistema Conselho Federal/Conselhos Regionais de Enfermagem, na década de 1970, quando a categoria passa a ter autonomia da autorregulação, sendo que na atualidade, a profissão demonstra possuir um marco legal robusto e altamente regulador, considerando o quantitativo de resoluções emitidas pelo Cofen, que impactam sobre o exercício profissional. O artigo aponta como sendo essencial que o Estado desenvolva e aprimore as políticas de gestão do trabalho e de regulação, de modo a contribuir para a superação dos problemas enfrentados pela Enfermagem.