bluuebunny/crossref_metadata_2025 huggingface dataset:
 A relação da mulher e a terra na revista Agriculturas: uma análise de conteúdo
 The relationship between women and the earth in the journal Agriculturas: a content analysis

Authors: Faggion Alencar Maria De Cleofas , Santiago de Abreu Lucimar
Published: May 2016

Este trabalho é resultado de uma parceria entre a biblioteca e o setor de PD&I da Embrapa Meio Ambiente onde, através da aplicação do método de análise de conteúdo em artigos publicados pela Revista Agriculturas, buscou-se entender qual é o lugar e importância das mulheres, a percepção ou visão dos autores sobre a contribuição das mulheres e as principais atividades que elas desenvolvem. A grande parte dos artigos mostra que as mulheres atuam diretamente em atividades produtivas e em particular em atividades especificas, na unidade de produção e no artesanato, além de outras funções igualmente importantes. Elas têm tido sensibilidade para trabalhar respeitando os princípios da Agroecologia, cujas práticas se expressam nas atividades desenvolvidas na unidade de produção. Nos artigos da Revista Agriculturas, as mulheres desempenham o papel de "guardiãs das sementes”, de sua cultura e muitas vezes estão no centro das decisões sobre o que plantar, como plantar e onde vender a produção. Assim, o trabalho em conjunto com a Biblioteca possibilitou o desenvolvimento desta pesquisa destacando a aplicação do método de análise de conteúdo nos artigos da revista Agriculturas para identificar a relação da mulher e a terra.AbstractThis paper is the result of a partnership between the library and the RD&I sector of Embrapa Meio Ambiente through the content analysis method of articles of the journal Agriculturas. The search comprised to understand the role and importance of women, in the view of authors, and the main activities that they develop. The majority of articles show that women act in the productive unity with specific activities, and also, with handcraft, besides other functions equally noteworthy. They have sensibility to work respecting the agroecology principles where the practices are expressed on the developed activities in the production unity. On the articles of the journal Agriculturas, the women perform the role of “seed custodians”, also, the keeper of local culture and many times they are on the center of the decisions about what to plant, how to plant and where to sell the production. Therefore, working in conjunction with the Library has allowed the development of this research, highlighting the method of content analysis to identify articles about the role of women in the field.
Protective role of aqueous extract of Phyllanthus amarus on oxidative stress in pancreas of streptozotocin induced diabetic male Wistar rats
Authors: Bongu Sasi Bhusana Rao , Sagree Saisree , Gudapareddy Vijayabharathi , Putakala Malliah , Nukala Sreenivasulu , Gujjala Sudhakara , Bellamkonda Ramesh , Desireddy Saralakumari
Published: May 2016

Diabetes mellitus has been associated with oxidative stress. The present study was performed to investigate the pancreas protective activities of Phyllanthus amarus aqueous extract (PAAEt) in streptozotocin (STZ) induced diabetic rats. Oral administration of PAAEt (200mg/kg bw) to diabetic rats for 60 days significantly (p<0.05) decreased antioxidant enzymes such as glutathione peroxidase, glutathione-s-transferase, glutathione reductase, superoxide dismutase, catalase and depletion of reduced glutathione in panceas which illustrates that increased lipid peroxidation (107 %) was restored to control levels. Co-treatment with PAAEt revealed the therapeutic efficacy against oxidative stress in pancreatic tissue. Hence extract of this plant could be used as an adjuvant therapy for the prevention and/or management of diabetes.
Synovial Chondromatosis
Authors: Neumann Julie A. , Garrigues Grant E. , Brigman Brian E. , Eward William C.
Published: May 2016

➢ Synovial chondromatosis is a rare, benign condition of unknown etiology in which the synovium undergoes metaplasia leading to cartilaginous nodules that ultimately break free, mineralize, and even ossify.

➢ The most commonly involved joint is the knee.

➢ Patients may be asymptomatic or may present with pain, swelling, and limited range of motion.

➢ Plain radiographs can be diagnostic and mineralized nodules are pathognomonic.

➢ Recommended treatment involves arthroscopic or open removal of loose bodies with or without a synovectomy to prevent further articular and periarticular destruction and to relieve symptoms.
Nível de Evidenciação Contábil de Organizações do Terceiro Setor
Authors: Zittei Marcus Vinicius Moreira , Politelo Leandro , Scarpin Jorge Eduardo
Published: May 2016

Esta pesquisa objetiva identificar o nível de evidenciação contábil das entidades do terceiro setor participantes do projeto de Desenvolvimento de Princípios de Transparência e Prestação de Contas em Organizações da Sociedade Civil – BID. A população da pesquisa é composta por 76 entidades e a amostra compreendeu 15 entidades que divulgaram sua prestação de contas em seus sítios. Para coleta dos dados foi elaborado um check list composto por 63 itens, destes, 53 baseados no Pronunciamento Técnico CPC 26 e 10 itens baseados na norma NBC T 10.19. Os resultados da pesquisa mostram que as entidades enfatizam a evidenciação das informações qualitativas, e apresentam informações quantitativas de maneira sintética em sua maioria. Conclui-se que o nível médio de evidenciação das entidades participantes do projeto foi de 27%, percebendo assim necessidade de estudos para apresentar as reais necessidades de evidenciação e fomentar normas específicas para o setor.
Indicadores Hospitalares - Receita Hospitalar
Authors: UFMG AHMG -
Published: May 2016

COMPOSIÇÃO DA RECEITA POR FONTE PAGADORA 2006COMPOSIÇÃO DA RECEITA POR FONTE PAGADORA 2007COMPOSIÇÃO DA RECEITA POR FONTE PAGADORA 2008COMPOSIÇÃO DA RECEITA HOSPITALAR FILANTRÓPICO-PRIVADO 2006/2008COMPOSIÇÃO DE RECEITA POR ATENDIMENTOS PRESTADOS 2006COMPOSIÇÃO DE RECEITA POR ATENDIMENTOS PRESTADOS 2007COMPOSIÇÃO DE RECEITA POR ATENDIMENTOS PRESTADOS 2008COMPOSIÇÃO DOS GASTOS HOSPITALARES 2006COMPOSIÇÃO DOS GASTOS HOSPITALARES 2007COMPOSIÇÃO DOS GASTOS HOSPITALARES 2008GASTO POR LEITO-DIARECEITA POR INTERNAÇÃOGASTOS POR PACIENTE-DIAINVESTIMENTOS 2007
Experiência de sucesso na implantação de leitos de unidade de terapia intensiva adulta no Norte de Minas Gerais
Authors: Dutra Elisabete Costa Reis , Lima Helidéia De Oliveira , Diniz Jacqueline Salles , Oliveira Osvaldo Kurshus de , Gonçalves Renata Melgaço , Orsini Telma Braga
Published: May 2016

Este artigo objetiva relatar experiência exitosa na implementação da Rede de Urgência e Emergência (UeE) com foco nos leitos de Unidade de Terapia Intensiva (UTI), na Macrorregião Norte, do Estado de Minas Gerais, no período de 2002 a 2010, nos hospitais públicos previamente selecionados, pertencentes as microrregiões pólos de Brasília de Minas, Janaúba, Pirapora, e Taiobeiras . O planejamento do trabalho desenvolvido nesse relato, na escolha dessas micros teve como indicadores de saúde escolhidos pela Coordenadoria de UTI da Secretaria de Estado de Minas Gerais (SES/MG): Índice de Desenvolvimento Humano (IDH), Disability Adjusted Life Years (DALY) ou Anos de Vida Perdidos Ajustados por Incapacidade (AVPI), Deficiência dos Hospitais, Localização Geográfica, Renda Per Capta, Tripla Carga de Doenças, Alto Índice de Mortalidade, e outros. Tendo como resultados a ampliação do parque de leitos de UTI no total de 40 leitos nesses municípios, onde foram criadas câmaras técnicas de trauma, cardiologia e AVC, diminuição da mortalidade, e núcleos de educação permanente implantados.
PAPÉIS GERENCIAIS DOS DIRETORES DOS HOSPITAIS PÚBLICOS DE BELO HORIZONTE
Authors: Da Silva Wânia Candida , Cunha Nina Rosa Da Silveira , Capanema Flávio Diniz , Lima Afonso Augusto Teixeira de Freitas de Carvalho
Published: May 2016

O mapeamento dos papéis gerenciais que os gestores dos hospitais desempenham é uma forma de identificar o que esses profissionais consideram como essencial para o desenvolvimento das atribuições do cargo. O objetivo geral do trabalho foi identificar os papéis gerenciais esperados dos gestores dos hospitais públicos de Belo Horizonte. A amostra foi composta por 13 diretores de hospitais. Foi utilizada a técnica de análise de conteúdo das entrevistas e os papéis gerenciais foram analisados como base o Modelo de Quinn. Os resultados indicam que o papel político e o papel diretor foram os mais resaltados pelos entrevistados. O conhecimento da administração pública e a capacidade de articulação política constituem o papel político e devem estar presente na figura do diretor hospitalar. O destaque do papel diretor reflete a adoção do modelo de gestão pautado na busca pela eficiência a partir da definição de metas e objetivos. A principal contribuição deste trabalho foi o diagnóstico de que o modelo de Quinn mostra-se incompleto diante da realidade dos hospitais públicos de Minas Gerais, desta forma o papel político representa a adequação do modelo de à realidade estudada.
SISTEMA DE GESTÃO HOSPITALAR UM ESTUDO DESCRITIVO DA SATISFAÇÃO DOS USUÁRIOS
Authors: Dantas Sheila De Lima Cunha , Pereira Fernando Antonio de Melo
Published: May 2016

Esta pesquisa tem como objetivo medir o nível de satisfação dos usuários quanto ao sistema de gestão hospitalar utilizado em um hospital de Natal/RN. Para tanto foi realizada uma pesquisa quantitativa, pelo método survey, realizada a partir da adaptação dos modelos de Ely (2010) e Wu e Wang (2007). Através da Análise Fatorial Exploratória (AFE) foi possível avaliar as variáveis medidas no instrumento de pesquisa, e através da Análise de Regressão chegou-se a um modelo final contendo três dimensões como fatores influenciadores da satisfação dos usuários com o sistema na organização objeto do estudo, são elas: confiança, tempo de resposta e envolvimento, sendo esta a principal colaboração desta pesquisa. A análise das evidências empíricas revelou que os usuários de forma geral encontram-se satisfeitos com o sistema e também foi possível apontar um conjunto de reflexões que podem contribuir para o aperfeiçoamento no uso do sistema hospitalar pesquisado, bem como para enriquecimento no meio acadêmico sobre o tema.
AVALIAÇÃO DOS REGISTROS DO NÚMERO DE CONSULTAS DE PRÉ-NATAL NO CARTÃO DA GESTANTE, SANITAS E SISPRENATAL
Authors: GONÇALVES LAÍSS ALMEIDA , COSTA LUDMILA CABRAL , FERREIRA VINÍCIUS LANNA , ABREU MERY SILVA
Published: May 2016

Os diferentes Sistemas de Informações em Saúde devem fornecer informações confiáveis, pois subsidiam a organização de estratégias e políticas na área da saúde. Visando identificar a compatibilidade de dados nos indicadores de saúde relacionados à assistência ao pré-natal, decidimos avaliar os registros referentes ao número de consultas no cartão da gestante, SANITAS e no SISPRENATAL. A amostra foi composta por mulheres do município de Ipatinga que concluíram o pré-natal no período de 2011/12, que possuíam o cartão da gestante, registros no SANITAS e no SISPRENATAL. Os dados foram coletados por meio de relatórios dos sistemas e acesso direto ao cartão da gestante, coletados em unidades básicas de saúde previamente sorteadas. Sendo exportados para o epiinfo 3.5.3 e para o SPSS 15.0 para análise. Nesta pesquisa houve correlação significativa e mais elevada entre os registros contidos no cartão e no SANITAS. Não se pode observar correlação significativa entre os registros do cartão versus SISPRENATAL ou SANITAS versus SISPRENATAL, demonstrando baixa compatibilidade de dados entre eles. Palavras chaves: Pré-natal. Sistemas de informação. Compatibilidade de dados.
A garantia de acesso à saúde e as regras de repartição da competência entre os gestores
Authors: Dresch Renato Luis
Published: May 2016

A saúde é um direito humano fundamental reconhecido na Constituição da República Federativa do Brasil. Trata-se de um direito de todos e dever do Estado, cumprindo à União, aos Estados, o Distrito Federal e aos Municípios organizar o sistema público de saúde, de modo que sejam instituídas as políticas públicas que assegurem o acesso universal e igualitário com atendimento integral. A garantia constitucional de pleno acesso à saúde ainda está longe de ser concretizada. Isso se reflete no exponencial crescimento da chamada judicialização da saúde, consistente no ajuizamento de ações judiciais para que o Poder Judiciário assegure o acesso aos serviços de saúde negados administrativamente. A complexidade da normatização e da regulação, a falta de informações claras e a deficiência na gestão, tem dificultado a compreensão do Sistema Único de Saúde (SUS) pelos órgãos jurídicos, sobretudo pelos membros do Poder Judiciário, que os tem levado a cometer alguns equívocos, deferindo o acesso a serviços de saúde sem evidência científica comprovada, além de ordenar providências em descompasso com a regulação das políticas públicas instituídas, tumultuando ainda mais a gestão da saúde e causando um impacto deslocativo no orçamento. O art. 23, II da Constituição Federal que instituiu a competência comum da União, dos Estados, do Distrito Federal e dos Municípios para cuidar da saúde, tem levado os julgadores a desconsiderar as normas jurídicas legais e infra legais de repartição da competência e distribuição de atribuições entre os gestores, impondo indistintamente aos três entes federados a responsabilidade por qualquer ação e serviço de saúde. É necessário discutir os limites da universalidade de acesso e a integralidade do atendimento assim como a validade das normas de repartição de competência e a distribuição de atribuições entre os gestores.
LOGÍSTICA DE MEDICAMENTOS E MATERIAIS EM UM HOSPITAL PÚBLICO DO DISTRITO FEDERAL
Authors: Raimundo Eliane Amâncio , Dias Cleidson Nogueira , Guerra Mariana
Published: May 2016

Os hospitais são estruturas organizacionais complexas, dado a natureza dos serviços prestados. Esta pesquisa buscou analisar a percepção dos servidores sobre a logística de medicamentos e materiais de um hospital público do Distrito Federal. Para tanto, realizou-se um estudo de caso no Hospital Regional de Ceilândia, com coleta de dados por meio de documentos da organização e entrevistas semiestruturadas.
The use of integrated supply chain management model for promoting competitiveness in the fast moving consumer goods (FMCG) manufacturing industry in Nigeria
Authors: Oyebanjo Ogunlela Gabriel , Mpele Lekhanya Lawrence
Published: May 2016

The importance of integrated supply chain management cannot be overemphasized in any business due to the emergence of inter and intra firm trade, literature has confirmed that the success of any business in all parts of the world depends on the effectiveness of their supply chain management. The focus of this paper is to present an exploratory study on the use of integrated supply chain management model for promoting competitiveness in the fast moving consumer goods (FMCG) manufacturing industry in Nigeria and explore critical factors affecting implementation and use. Primary data are collected from 80 selected respondents in FMCG manufacturing industry based in Lagos Nigeria. Quantitative method of data collection is used. SPSS 22.0 is used to analyze data. Findings of the research indicate the significance of .000* with .879* Cronbach’s Alpha reliability. It also reveales that most of the tested variables are very significant. The study will benefit FMCG manufacturing industry in Nigeria and affiliated stakeholders as well as international communities by providing them with recent model. The findings are limited by the study’s exploratory, quantitative nature and small sample, therefore, generalization of the results should be done with care and further research, with a large sample encouraged
The use of budgets by small and medium enterprises in Cape Metropolis, South Africa
Authors: Chidinma Maduekwe Caroline , Kamala Peter
Published: May 2016

Failure to budget has been identified as one of the main causes of failure of Small and Medium Enterprises (SMEs). This study seeks to determine the extent to which SMEs in the Cape Metropolis use budgets. Specifically, the study aims to determine the types of budgets used, methods of budgeting employed, purpose for which budgets are used, perceived effectiveness of budgets used and factors that may inhibit SMEs from using budgets. Data were collected using a questionnaire and analyzed using both descriptive and inferential statistics. The findings of this study revealed that most of the SMEs sampled used budgets. The three most frequently used budgets were sales budgets, purchases budgets and cash budgets, while the most frequently used budgeting method was fixed budgeting. The findings also revealed that budgets were mostly used for monitoring, measuring business performance, future planning and control purposes. The findings further revealed that budgets were perceived to be effective but the lack of top management support and qualified personnel were the main factors that inhibit SMEs from using budgets. This study not only fills the gap in the literature on the use of budgets, but also provides invaluable insights on their use by SMEs. These insights could inform future endeavours of the Government when developing interventions meant to avert the high failure rates of these entities. The findings may also assist SMEs to gauge and review their own use of budgets with a view to optimising the benefits derived from these tools, as well as to overcome the factors that could inhibit them from using the budgets in the first place
Model- vs. data-based approaches applied to fault diagnosis in potable water supply networks
Authors: Cugueró-Escofet M. À. , Quevedo J. , Alippi C. , Roveri M. , Puig V. , García D. , Trovò F.
Published: May 2016

The problem of fault diagnosis in potable water supply networks is addressed in this paper. Two different fault diagnosis approaches are proposed to deal with this problem. The first one is based on a model-based approach exploiting a priori information regarding physical/temporal relations existing among the measured variables in the monitored system, providing fault detection and isolation capabilities by means of the residuals generated using these measured variables and their estimations. This a priori information is provided by the topology and the physical relations between the elements constituting the system. Alternatively, the second approach relies on a data-driven solution meant to exploit the spatial and temporal relationships present in the acquired data streams in order to detect and isolate faults. Relationships between data streams are modelled using sequences of linear dynamic time-invariant models, whose estimated coefficients are used to feed a hidden Markov model. Afterwards, a cognitive method based on a functional graph representation of the system isolates the fault when existing. Finally, a performance comparison between these two approaches is carried out using the Barcelona water supply network, showing successful and complementary results which suggest the integrated usage in order to improve the results achieved by each one separately.
Assessment of the quality, effectiveness, and acceptability of ceramic water filters in Tanzania
Authors: Lemons Ansley , Branz Ariel , Kimirei Mesiaki , Hawkins Tracy , Lantagne Daniele
Published: May 2016

Globally, approximately two billion people drink contaminated water. Use of household water treatment (HWT) methods, such as locally manufactured ceramic filters, reduces the diarrheal disease burden associated with unclean water. We evaluated the quality, effectiveness, and acceptability of ceramic filters in two communities in Arusha, Tanzania, by conducting: 1) baseline household surveys with 50 families; 2) filter flow rate testing; 3) filter distribution with training sessions; 4) follow-up surveys at 2, 4, and 6 weeks after distribution; and 5) project end focus group discussions. We tested Escherichia coli (E. coli) and turbidity at baseline and the first two follow-ups. We found: 1) filter quality was low, as only 46% of filters met recommended flow rate guidelines and 18% of filters broke during the 6-week study; 2) filter effectiveness was moderate, with 8% and 35% of filters effectively reducing E. coli to <1 CFU/100 mL and <10 CFU/100 mL, respectively, at follow-ups; and, 3) filter acceptability was high, with 94% overall satisfaction and 96–100% reported use in the previous day. These results highlight the importance of mixed methods research as HWT product quality, effectiveness, and acceptability all impact product efficacy, and the need for quality assurance/quality control and certification schemes for locally manufactured HWT products.
Effects of different culture media on biodegradation of triclosan by Rhodotorula mucilaginosa and Penicillium sp.
Authors: Ertit Taştan Burcu , Özdemir Caner , Tekinay Turgay
Published: May 2016

Triclosan is an antimicrobial agent and a persistent pollutant. The biodegradation of triclosan is dependent on many variables including the biodegradation organism and the environmental conditions. Here, we evaluated the triclosan degradation potential of two fungi strains, Rhodotorula mucilaginosa and Penicillium sp., and the rate of its turnover to 2,4-dichlorophenol (2,4-DCP). Both of these strains showed less susceptibility to triclosan when grown in minimal salt medium. In order to further evaluate the effects of environmental conditions on triclosan degradation, three different culture conditions including original thermal power plant wastewater, T6 nutrimedia and ammonium mineral salts medium were used. The maximum triclosan degradation yield was 48% for R. mucilaginosa and 82% for Penicillium sp. at 2.7 mg/L triclosan concentration. Biodegradation experiments revealed that Penicillium sp. was more tolerant to triclosan. Scanning electron microscopy micrographs also showed the morphological changes of fungus when cells were treated with triclosan. Overall, these fungi strains could be used as effective microorganisms in active uptake (degradation) and passive uptake (sorption) of triclosan and their efficiency can be increased by optimizing the culture conditions.
Brazilian economic performance since the emergence of the great recession: The effects of income distribution on consumption
Authors: Arestis Philip , Troncoso-Baltar Carolina , Magalhães-Prates Daniela
Published: May 2016

After a long period of unstable and low economic activity, Brazil achieved a
relatively high economic growth with low inflation from 2004 to 2008, when
the world scenario was favourable for the Brazilian trade balance. An incomes
policy, focused on real increases in the minimum wage along with a credit
boom, led to a decade of high consumption growth rates. High levels of
consumption and exports, in turn, induced investment and stimulated
manufacturing production, despite the real appreciation of the national
currency. However, the Great Recession that emerged after the global
financial crisis of 2007/2008 brought challenges to the Brazilian economic
performance, with unpleasant consequences for the country?s GDP growth.
Consumption, investment and exports have decelerated, despite anti-cyclical
macroeconomic policies. In this setting, manufacturing production stagnated
and GDP growth slowed down substantially, while imports continued rising
considerably. The aim of this paper is to provide an explanation to the
slowdown of Brazilian growth rates after the Great Recession. The main
hypothesis is that consumption was the main source of effective demand in the
country since 2003. However, Brazil has not yet been able to sustain
manufacturing and economic growth without a more active government policy to
stimulate productive investment.
Redistribution and transmission mechanisms of income inequality - panel analysis of the affluent OECD countries
Authors: Josifidis Kosta , Dragutinovic-Mitrovic Radmila , Supic Novica , Glavaski Olgica
Published: May 2016

The aim of this paper is to point out the limitations of conventional
approaches, articulated via political processes, in reducing income
inequality. Using the panel data methods, on the sample of 21 affluent OECD
countries in the period from 1980 to 2011, it is observed that the increase
in labour productivity as well as preferences of voters to parties that
advocate greater redistribution, contrary to common perception, not
necessarily lead to reduction in income inequality. Increasing dominance of
big capital in the field of technological progress changes the conventions
about contribution of workers to labour productivity. The result is a
weakening of workers? bargaining power in relation to employers as well as
increase in gap between labour productivity growth and real wage growth,
which both lead to increase in income inequality. In comparison with the
other political parties, it seems that the right-wing parties are more
efficient in using voters? support to implement their concept of the welfare
state, which contributes to maintaining the high market-generated income
inequality. Such situation could be explained that de jure power of the
government depends on election results, whereas de facto power depends on the
support of so-called globally-oriented super elites.
Evaluation of the Glutamine 27 Glutamic Acid Polymorphism in the Adrenoceptor β2 Surface Gene on Obesity and Metabolic Phenotypes in Taiwan
Authors: Hsiao Tun-Jen , Lin Eugene
Published: May 2016

Background

The single-nucleotide polymorphism (SNP), rs1042714 or glutamine 27 glutamic acid (Gln27Glu), in the adrenoceptor β2 surface ( ADRB2) gene has previously been examined for association with obesity with inconclusive results. The objective of this study was to determine whether the ADRB2 rs1042714 SNP could influence obesity and obesity-related metabolic traits in a Taiwanese population.

Methods

The ADRB2 rs1042714 SNP and obesity-related metabolic traits including blood pressure, total cholesterol, triglyceride, fasting glucose, waist circumference, and body mass index (BMI) were examined in 967 individuals with general health examinations.

Results

Our data revealed that the ADRB2 rs1042714 SNP exhibited a significant association with obesity among the subjects ( P = 0.021). Furthermore, the carriers of the GG genotype had a significantly higher BMI than those with the CC genotype (26.0 ± 5.6 vs 24.3 ± 3.8 kg/m2; P = 0.009) and those with the CG genotype (26.0 ± 5.6 vs 23.6 ± 3.3 kg/m2; P = 0.001). We also found a nominal association with systolic blood pressure ( P = 0.058) and triglyceride ( P = 0.055) levels in the ADRB2 rs1042714 SNP.

Conclusions

Our study indicates that the ADRB2 rs1042714 SNP may contribute to the risk of obesity and predict obesity-related metabolic traits such as BMI, triglyceride, and systolic blood pressure in Taiwanese subjects.
Thr130Ile Polymorphism of HNF4A Gene is Associated with Gestational Diabetes Mellitus in Mexican Population
Authors: Monroy Virginia Sánchez , Díaz César Antonio González , Trenado Lucila Maritza Lozano , Peralta José Manuel Campos , Soto Salvador Martín Polo
Published: May 2016

Hepatocyte nuclear factor 4α ( HNF4A) is a transcription factor that regulates the expression of genes in the liver, pancreas, kidney, intestine, and other tissues. Previous studies in the Mexican population have shown a high frequency of the Thr130Ile polymorphism and have suggested its important role in the pathogenesis of early-onset type 2 diabetes. The aim of the present study was to determine whether this variant also contributes to gestational diabetes mellitus (GDM) in a Mexican population. We studied 213 unrelated postpartum women and their neonates, who were divided into 2 groups: control and GDM. The control group was formed by 108 healthy postpartum women and their neonates, and the GDM group was formed by 105 postpartum women diagnosed with GDM and their neonates. All subjects were genotyped for the Thr130Ile polymorphism in HNF4A by Taqman allelic discrimination assays and sequencing. Our results showed a higher frequency of the minor allele of the Thr130Ile polymorphism in the GDM group compared with the control group ( P = 0.0452; odds ratio, 2.59; 95% confidence interval, 1.02–6.59). With respect to offspring, the frequency of the polymorphism was higher in the offspring of the GDM group than in the offspring of the control group; however, no significant differences between the groups were observed ( P = 0.2551; odds ratio, 1.90; 95% confidence interval, 0.99–3.64). The findings suggest that the Thr130Ile polymorphism is associated with GDM in the studied Mexican population.
Neutrophil CD64 as a Diagnostic Marker of Sepsis in Neonates
Authors: Elawady Sanaa , Botros Shahira K. , Sorour Ashraf E. , Ghany Eman Abdel , Elbatran Gamal , Ali Raghdaa
Published: May 2016

Background

Sepsis in neonates hospitalized in the neonatal intensive care unit is a global problem and is a significant contributor to morbidity and mortality. Neutrophil surface CD64, the high-affinity Fc receptor, is quantitatively up-regulated during infection and sepsis.

Objective

Our goal in this prospective study was to measure the neutrophil CD64 in blood as an adjunct to our previously validated hematologic scoring system for detecting neonatal sepsis.

Methods

A prospective study enrolled newborns with documented sepsis (n = 25), clinical sepsis (n = 25), and control newborns (n = 25). C-reactive protein, neutrophil CD64, complete blood counts, and blood cultures were taken. Neutrophil CD64 was analyzed by flow cytometry.

Results

CD64 was significantly elevated in the groups with documented and clinical sepsis ( P < 0.001). CD64 had a sensitivity of 96%, a specificity of 100%, a positive predictive value of 96.2%, and a negative predictive value of 100% with a cutoff value of 45.8% and 46.0% in the confirmed and the clinical sepsis groups, respectively.

Conclusions

CD64 expression on neutrophils increases significantly in neonates with sepsis and can be considered a useful diagnostic marker for early diagnosis of neonatal infection as a single determination compared with other inflammatory markers.
Improvement of Sample Size Calculations for Binary Diagnostic Test Assessment
Authors: Bailly Sébastien , Dupont Cyrielle , Iwaz Jean , Bossard Nadine , Rabilloud Muriel
Published: May 2016

Objective

This study aimed to formulate a new R function to improve sample size calculation for more accurate estimations of sensitivity (Se) and specificity (Sp).

Methods

The developed function is based on the binDesign function of the binGroup R package. This allowed the use of an “exact” method based on the binomial distribution. In addition, the function takes into account a joint testing of Se and Sp and a nonmonotonous behavior of the power function.

Results

Four tables were generated to display the number of cases (or controls) in joint or separate assessments for an expected combination of Se (or Sp) and a determined difference between the expected Se (or Sp) and the minimum acceptable Se (or Sp). Using the formula for a joint testing of Se and Sp, it resulted in a higher increase of the sample sizes than simply allowing for the sawtooth shape of the power curve.

Conclusion

Whenever equal Se and Sp values are important, a joint testing should be favored and used for sample size determination.
The Measurement of 3-Epimer 25-Hydroxyvitamin D by Mass Spectrometry in Clinical Specimens Detects Inconsequential Levels in Adult Subjects
Authors: Goldman Mildred M. , Viec Khanh V. , Caulfield Michael P. , Reitz Richard E. , McPhaul Michael J. , Clarke Nigel J.
Published: May 2016

Background

Vitamin D is derived from dietary sources or from the action of ultraviolet light on 7-dehydrocholesterol and undergoes a number of enzymatic modifications that lead to the synthesis of active vitamin D metabolites or metabolites with reduced biological activity. Among these, epimerization at the 3-hydroxyl group leads to the synthesis of 3-epimer 25-hydroxyvitamin D (3EVD). Described first in biological system experiments using in vitro incubation of vitamin D in cell culture, this molecule has been reported as having distinct activities when compared with 25-hydroxy vitamin D (25OHVD). Measurements of vitamin D have been conducted using a variety of methodologies and have led to conflicting assessments of the quantities of 3EVD3 that are measured.

Method

The present article describes the development and use of a simple liquid chromatography–tandem mass spectrometry method validated by the Clinical Laboratory Improvement Amendments to quantitate 3EVD3 in 3528 subjects, including 309 children (162 are <2 years) and 232 pregnant women.

Results

Our findings demonstrate that, although 3EVD3 constitutes a significant proportion of measureable 25OHVD3 in subjects younger than 1 year, 3EVD3 levels are negligible in most subjects older than 1 year.

Conclusions

It is important to choose the correct 25OHVD assay dependent on the age of the patient. Patients younger than 1 year should be run on a liquid chromatography–tandem mass spectrometry assay proven to not have potential contributions from any 3EVD present in the sample.
Use of Informatics and Information Technologies in the Clinical Research Enterprise within US Academic Medical Centers
Authors: DiLaura Robert , Turisco Fran , McGrew Cherri , Reel Stephanie , Glaser John , Crowley William F.
Published: May 2016

Background

Data on the state of information systems infrastructures used in the clinical research enterprise of academic medical centers are limited and mostly anecdotal. What has been published is slowly beginning to make important distinctions, such as clinical trials as a specialized form of clinical research and between “Informatics” in an academic setting from health care information technology. However, this field continues to undergo fundamental changes, accelerated by the National Institutes of Health's creation of Clinical and Translational Science Awards to build a new “home” for biomedical research.

Methods

We surveyed all Clinical Research Forum member institutions regarding their enterprise infrastructure and use of information systems in support of clinical research. The questions in this on-line study expanded on one first done in 2005. Of the 52 sites invited, 19 (37%) responded. We analyzed the responses and also made matched comparisons for those organizations that participated in both surveys.

Results

Although there continues to be conceptual agreement on information system elements for the clinical research enterprise, no single institution achieved the ideal, a similar result to the 2005 survey. Indeed, little progress was made over the past 2 years at most locations other than in information technology planning, strategy, and governance.

Conclusions

There is increased recognition of the importance of information systems infrastructure and expertise for biomedical research, but the needs are accelerating much faster than institutions can build or pay for. A much greater realization of and innovative solution for this growing chasm is urgently required.
Detection of α1 Integrin in Urine of Patients with Immunoglobulin a Nephropathy
Authors: Bank Jonathan , Ben-David Aharon , Doolman Ram , Sela Ben-Ami , Bank Ilan
Published: May 2016

Background

The α1β1 integrin is a cell surface membrane heterodimer composed of noncovalently linked α1 and β1 polypeptides that is up-regulated on activated and proliferating mesangial cells.

Methods

A double-sandwich enzyme-linked immunosorbent assay that detects α1 integrin in a specific and dose-dependent manner at concentrations greater than 150 ng/mL was used to evaluate whether intact α1 polypeptides are secreted in the urine samples of 29 patients with various kidney diseases and in those of 5 healthy individuals.

Results

α1 Integrin was detected in 8 of the 29 patients including 3 of 3 patients with biopsy-proven immunoglobulin A nephropathy and 3 of 3 clinically suspected but non-biopsy-proven immunoglobulin A nephropathy with evidence of active nephritis. No α1 integrins were found in samples of 5 healthy controls.

Conclusions

α1 Integrin polypeptides can be detected in human urine, particularly in immunoglobulin A nephropathy. Further extensive studies are required to clarify the significance of secretion of α1 integrins in urine of patients with kidney disease.
Ethnic Difference in Sex Gap in High-Density Lipoprotein Cholesterol between Asian Indians and Whites
Authors: Chandalia Manisha , Mohan Viswanathan , Adams-Huet Beverley , Deepa Raj , Abate Nicola
Published: May 2016

Objective

To study whether low plasma high-density lipoprotein cholesterol (HDL-C) reported in Asian Indians is common in both men and women when compared with whites and whether it is related to increased body mass index (BMI) and plasma triglyceride concentration.

Design

We evaluated the lipid profile and prevalence of low HDL-C (<40 mg/dL in men and <50 mg/dL in women) in the following cohorts of normoglycemic 1404 men and 1817 women: Asian Indians living in rural India; urban Chennai, India; and Dallas, TX; and whites living in Dallas, TX.

Results

After adjustment for age, BMI, and smoking, HDL-C was not significantly different in Asian Indian men compared with whites. However, Asian Indian women had lower HDL-C compared with white women, and rural Asian Indian women had the lowest HDL-C even in the absence of high triglycerides. Lean Asian Indian women with BMI of less than 23 kg/m2 had higher frequency of low HDL-C compared with lean white women with BMI of less than 25 kg/m2 (72%, 56%, 48%, and 25% in rural, urban, and Dallas Asian Indian and white women, respectively) and lean men (52%, 42%, 28%, and 35% in rural, urban, and Dallas Asian Indian and white men, respectively). Sex differences in HDL-C was estimated as 6.6 ± 0.5 mg/dL for Asian Indians and 15.3 ± 1.1 mg/dL for whites ( P < 0.0001 for sex difference in the 2 ethnic groups).

Conclusions

Increased prevalence of low HDL-C independently of obesity or hypertriglyceridemia is observed in women but not in men of Asian Indian origin. The sex gap in HDL-C is significantly smaller in Asian Indians compared with whites independent of geographical location.
Genetic Factors Impacting Therapy in Acute Lung Injury/Acute Respiratory Distress Syndrome
Authors: Maloney James Peter
Published: May 2016

Acute lung injury (ALI) and its most severe form the acute respiratory distress syndrome occur in patients who have a predisposing severe inflammatory insult to the lung. Most often ALI is due to sepsis from bacterial infection, but ALI can occur with any infection and with noninfectious insults such as severe trauma, acute pancreatitis, aspiration, and near-drowning. After any of these insults, the interindividual risk of progression to ALI and the risk of death remain difficult to predict. Our inability to predict an individual's susceptibility to acute lung injury has long suggested that genetic factors influence ALI risk. There is substantial evidence for heritable predispositions to severe infections and an emerging body of literature implicating genetic factors in ALI pathogenesis. A paradigm is emerging that the genetic risk for ALI can be best understood in terms of factors that control 3 overlapping stages of ALI pathogenesis: risk for the acquisition of a predisposing condition (such as a severe pneumonia), risk for progression to lung injury during systemic inflammatory states (such as severe sepsis), and risk for failure of endogenous mechanisms to resolve the lung injury. The evidence supporting this paradigm is herein reviewed, along with potential treatment strategies that could be directed by knowledge of specific genetic factors in an individual patient.
Patient Experiences with MedlinePlus.gov
Authors: Smalligan Roger D. , Campbell Emily O. , Ismail Hassan M.
Published: May 2016

Background

In 2004, the American College of Physicians joined with the National Library of Medicine in an effort to help patients find reliable health information free of commercial bias at the Web site MedlinePlus.gov. The aim of this study was to evaluate the usefulness of the MedlinePlus.gov site as perceived by patients who were referred to the site by their internist.

Materials and Methods

A 27-item questionnaire developed by the American College of Physicians Foundation was distributed between January and May 2005 to a convenience sample of 893 adult patient volunteers attending 34 internal medicine practices across the United States.

Results

The questionnaire revealed that although most patients (55%) routinely look up medical information, only 43% had used MedlinePlus.gov. Of those who had used the site, 95% were satisfied with the information they found there, and 94% said the information they found at MedlinePlus.gov would help them make better health decisions.

Discussion

Patients who used the MedlinePlus.gov site at the recommendation of their physician found it easy to use, informative, and felt it would help them make better health decisions. Directing patients to this high quality, noncommercial, educational resource online may be an important adjunct to patient education efforts by physicians.
Effect of a Single Intravenous Immunoglobulin Infusion on Neutrophil Gelatinase-Associated Lipocalin Levels in Proteinuric Patients with Normal Renal Function
Authors: Bolignano Davide , Coppolino Giuseppe , Aloisi Carmela , Romeo Adolfo , Nicocia Giacomo , Buemi Michele
Published: May 2016

The aim of the present study was to evaluate levels of neutrophil gelatinase-associated lipocalin (NGAL), a stress protein increased after renal and systemic stimuli, in a cohort of 15 patients with severe proteinuria secondary to idiopathic membranous nephropathy and conserved renal function. Neutrophil gelatinase-associated lipocalin levels and the fractional excretion of this protein were higher in patients than in healthy controls. Furthermore, a close correlation was found between serum NGAL and urinary (uNGAL) ( r = 0.81; P < 0.01) and between uNGAL and daily proteinuria ( r = 0.44; P < 0.03). One hour after infusion of a single high-dose bolus of intravenous immunoglobulin (0.4 g/kg), a new and promising therapy for several kidney diseases, a marked reduction was found in NGAL levels (serum NGAL 194.1 ± 121 vs 370.1 ± 180.5 ng/mL, P < 0.05; urinary NGAL 153.3 ± 108.6 vs 502.2 ± 293.4 ng/mL, P < 0.03); this was maintained 24 hours after the treatment. The findings made suggest that the NGAL balance is altered in patients with severe proteinuria who have not yet developed overt chronic renal failure, thus confirming the potential use of this protein as an early biomarker of kidney damage preceding the increase in serum creatinine levels. Furthermore, also extra-renal cells (neutrophils, endothelium) may hyper-release NGAL, expressing systemic stress related to severe proteinuria. This would explain the impressive decrease occurring in NGAL values after intravenous immunoglobulin infusion, thus providing further evidence of the antiinflammatory properties of this particular therapeutic approach and indicating the possible value of NGAL measurement in monitoring the efficacy of treatment of renal diseases.
Cardiac Natriuretic Peptides Gene Expression and Secretion in Inflammation
Authors: Vesely David L. , de Bold Adolfo J.
Published: May 2016

The genetic expression and secretion of the cardiac polypeptide hormones atrial natriuretic factor (ANF or ANP) and brain natriuretic peptide (BNP) have been studied mainly in the context of cardiac diseases associated with neuroendocrine and hemodynamic changes arising from cardiac dysfunction such as in chronic congestive heart failure. In this type of pathology, both ANF and BNP plasma levels change in an approximate coordinated fashion so that the use of these hormones as biomarkers of cardiac disease is, in principle, indistinctive. However, we reported that during an acute cardiac allograft rejection episode, BNP plasma levels can significantly increase in the absence of a similar increase in ANF plasma levels. We tested the hypothesis that these changes were related to cytokines and found that some pro-inflammatory cytokines, including TNFα and IL-1β, selectively promote BNP synthesis and secretion in cultures of neonatal rat ventricular cardiocytes. This effect was found related to increased BNP promoter activity and sensitive to p38 mitogen-activated protein kinase inhibition.

In order to determine in vivo if the selective up-regulation of BNP would be observed in inflammatory processes other than acute cardiac allograft rejection, we carried out investigation using the experimental autoimmune myocarditis rat model, which histologically resembles human giant cell myocarditis. It was found that this model is also accompanied by a specific increase in BNP-circulating levels although the cytokines involved seem to differ from those characterized earlier through in vitro studies.

Recent studies in humans have found that in sepsis, plasma BNP levels increase in the absence of hemodynamic changes.

In conclusion, BNP appears to be regulated uniquely in the setting of an inflammatory process. This sets it apart from ANF in terms of potential roles in the pathogenesis of disease and in its use as a biomarker of cardiac disease.
Natriuretic Peptides in Chronic Kidney Disease and during Renal Replacement Therapy An Update
Authors: Khalifeh Neda , Haider Dominik , Hörl Walter H.
Published: May 2016

Natriuretic peptides play a major role in sodium and body volume homeostasis in patients with adequate kidney function. Circulating B-type natriuretic peptide (BNP) and its amino-terminal fragment NT-proBNP provide important information on cardiac dysfunction, hypervolemia, and risk for hospitalization or death even in patients with severe impairment of kidney function. NT-proBNP acts also as significant independent predictor of progression of chronic kidney disease (CKD). Differences in elimination and degradation as well as molecular weight and half-life between BNP and NT-proBNP are responsible for different plasma levels, different membrane-dependent removal during hemodialysis, and different diagnostic and prognostic power to predict morbidity and mortality in patients at different stages of CKD and in those on hemodialysis or peritoneal dialysis. Serial estimations of natriuretic peptides will help in the identification of potential complications in CKD patients with or without renal replacement therapies and probably improve outcome of these patients.
Impaired Hepatic Ketogenesis in Moderately Obese Men with Hypertriglyceridemia
Authors: Vega Gloria Lena , Dunn Fredrick L. , Grundy Scott M.
Published: May 2016

Background

Several studies suggest that increased nonesterified fatty acid flux and increased de novo lipogenesis may contribute to hypertriglyceridemia, but few studies have examined fatty acid oxidation as a factor.

Rationale

Endogenous hypertriglyceridemia (increased very low density lipoprotein triglyceride) could result from ( a) re-esterification of excess nonesterified fatty acids entering the liver, ( b) activation of hepatic lipogenesis, and/or ( c) defective oxidation of hepatic fatty acids leading to greater triglyceride synthesis. Therefore, this study used plasma levels of 3-hydroxybutyrate as a marker for fatty acid oxidation. The study was carried out in hypertriglyceridemic and normotriglyceridemic subjects under 3 conditions: ( a) in the fasting state, ( b) after a fatty meal that should enhance fatty acid oxidation, and (c) after an oxandrolone challenge, which we recently showed increases fatty acid oxidation.

Results

In the fasting state, 3-hydroxybutyrate concentrations in hypertriglyceridemic patients were only 53% of levels in normotriglyceridemic subjects. After a fatty meal, moderate increases in 3-hydroxybutyrate were observed, but values for patients with hypertriglceridemia remained 62% of the levels in the normotriglyceridemic group. A similar pattern of response was observed with oxandrolone challenge. There were no significant changes in fasting or postprandial levels of nonesterfified fatty acids, glycerol, or triglycerides before and during the oxandrolone challenge.

Conclusion

Patients with endogenous hypertriglyceridemia seem to have a defect in fatty acid oxidation as indicated by reduced levels of 3-hydroxybutyrate. This defect was observed during fasting, postprandially, and during oxandrolone challenge. We propose that this defect contributes to the development of hypertriglyceridemia.