bluuebunny/crossref_metadata_2025 huggingface dataset:
Preditores individuais e contextuais da intenção empreendedora entre universitários: revisão de literatura
Authors: Ferreira Aleciane da Silva Moreira , Loiola Elisabeth , Gondim Sônia Maria Guedes
Published: July 2017

Resumo Esta revisão de literatura teve por objetivo identificar em estudos empíricos os principais preditores individuais e contextuais da intenção empreendedora (IE) entre estudantes universitários. Utilizou-se a teoria do comportamento planejado, levando em conta pesquisas sobre a disposição atitudinal do estudante para desenvolver o próprio negócio. A busca foi realizada mediante as palavras-chave “intenção empreendedora” e “entrepreneurial intention” nos principais periódicos internacionais e nacionais das áreas de empreendedorismo, psicologia, organizações e administração e também na base de dados Scientific Electronic Library Online (SciELO). A revisão abrangeu o período de 2004 a 2015. Foram analisados 60 artigos. Constatou-se ter havido um crescimento de 41% dos estudos sobre IE entre 2004 e 2015, em diversos países e continentes, o que revela o aumento do interesse no tema. Os principais preditores individuais são: traços pessoais, motivações de realização pessoal, atitude positiva, autoeficácia, percepção de controle, lócus de controle interno, percepção de barreiras e criatividade. Os preditores contextuais são as famílias e a rede de amigos, as quais operam como modelos a ser seguidos e como suporte no desenvolvimento do negócio. Sobre a educação empreendedora (EE), os resultados são inconclusivos, especialmente levando-se em conta o contexto. Finaliza-se com algumas limitações do estudo e pontos a ser incluídos na construção de uma agenda de pesquisa.
Desenhando a resistência: estética e contra-hegemonia no movimento agroecológico no Brasil
Authors: Naves Flávia , Reis Yuna
Published: July 2017

Resumo No presente artigo teórico-empírico, busca-se contribuir para os Estudos Organizacionais trazendo para o debate os movimentos sociais, em especial o movimento agroecológico, que tem se constituído como meio de resistência à hegemonia do agronegócio no Brasil. O estudo estabelece também uma “ponte” teórico-empírica não convencional, neste campo disciplinar, entre estudos em estética e abordagem neogramsciana de discurso em Laclau e Mouffe. Desse modo, à luz dos conceitos de estética e da análise neogramsciana de discurso em hegemonia e antagonismo, investigou-se de que forma as expressões estéticas influenciam a construção da contra-hegemonia no movimento agroecológico brasileiro. A pesquisa adota uma metodologia com enfoque qualitativo na análise de desenhos produzidos por agricultores e agricultoras no III Encontro Nacional de Agroecologia (III ENA), denominados de Painéis de Facilitação Gráfica. Ao final, é possível observar que a estética dos painéis do III ENA permitiu aos agricultores e agricultoras a (re)construção de suas visões de mundo, a divulgação de suas inquietações, realidades e alternativas agrícolas locais, e, principalmente, a orientação de práticas, propostas e legitimação do movimento, que passaram a ser centrais aos valores contra-hegemônicos e na construção de um inimigo comum. A complexidade expressa nas relações construídas nos painéis também ressaltou que a estética pode trazer uma perspectiva efetiva, acessível e sensível na construção das visões de mundo de grupos subalternos. Dessa forma, o movimento agroecológico brasileiro, construído também na perspectiva estética, revela-se como importante ator na resistência à hegemonia do agronegócio e ao modelo capitalista.
É melhor prevenir do que remediar: a doença imaginária no jornalismo
Authors: Gomes Denise Cristina Ayres
Published: July 2017

Utilizamos as teorias do imaginário para compreender como o jornalismo tende a redefinir o estatuto do que é ser ou sentir-se doente a partir da disseminação da cultura do risco. O dispositivo jornalístico promove a doença em potencial ou imaginária e intervém no cotidiano, constituindo-se uma “tecnologia do imaginário”. Sofremos por antecipação, receosos do futuro que pode ser portador de alguma patologia. Devemos nos prevenir, seja por meio do regramento de nossos hábitos ou por meio da descoberta de tendências genéticas que nos predisponham a desenvolver doenças. Prolongar a existência e viver com qualidade tornaram-se quase um dever moral. O corpus é composto por oito matérias da Folha de S. Paulo. O jornalismo emprega recursos considerados racionais, mas mobiliza os leitores pela emoção, produzindo um imaginário que tende a se disseminar na sociedade.
Quality of life based on level of physical activity among elderly residents of urban and rural areas
Authors: Ribeiro Cezar Grontowski , Ferretti Fátima , Sá Clodoaldo Antônio de
Published: July 2017

Abstract Objective: To analyze quality of life (QOL) according to level of physical activity among elderly persons living in rural (RA) and urban (UA) areas. Method: A descriptive cross-sectional study, analyzing 358 elderly residents of RA and 139 of UA, in the municipal region of Palmas, Paraná, Brazil was performed. Quality of life, level of physical activity and economic condition were evaluated. For the analysis of the continuous variables, the student’s t-test or the Mann-Whitney test were used, based on the normality or otherwise of the data. Pearson's chi-squared or Fischer’s exact test were used to analyze the categorical variables. Results: The general perception of QOL reported in RA was better than in UA (p<0.05). The analysis of the level of physical activity according to place of residence showed that the elderly are more physically active in RA (p<0.05), whereas insufficiently active or sedentary subjects prevail in UA. The variables age and gender were not associated with QOL (p>0.05), irrespective of place of residence, and active elderly persons had better QOL scores than insufficiently active or sedentary individuals, again irrespective of place of residence (p<0.05). Conclusion: The present study provides evidence that QOL is positively influenced by both maintaining satisfactory levels of physical activity and by residing in RA. It is important to establish public policies aimed at ensuring a more active and independent old age, thus generating greater health and quality of life.
Clinical and epidemiological characterization of patients receiving home care in the city of Maceió, in the state of Alagoas, Brazil
Authors: Carnaúba Carla Montenegro Dâmaso , Silva Thaysa Dayse Alves e , Viana Juliana Felizardo , Alves Júlia Badra Nogueira , Andrade Natália Lima , Trindade Filho Euclides Maurício
Published: July 2017

Abstract Objective: To clinically and epidemiologically characterize patients receiving home care in the city of Maceio, in the state of Alagoas, Brazil. Methods: An observational, cross-sectional study with a sample of 859 patients was carried out, based on data obtained from the medical records of institutions that provide a home care service. A total of 445 patients were from a public service and 414 were from a private service. Descriptive analysis was used for the demographic, clinical and functional variables. Results: Most patients were elderly, female, bedridden, fed orally and had neurological disorders, with stroke the most common diagnosis. Regarding patient evolution, 16.8% of individuals were discharged from home care, 45% of patients died and 24% were hospitalized during the period of home care. A total of 9% of patients had a tracheostomy, 84.7% breathed room air, 9.3% used oxygen, 4% used noninvasive mechanical ventilation, 1.9% used invasive mechanical ventilation, and 24.9% of patients had pressure ulcers. All patients received medical visits, with 693 receiving nursing care, 767 undergoing physiotherapy, 233 receiving speech therapy sessions, 665 patients accompanied by a nutritionist, 64 undergoing occupational therapy sessions and 98 receiving counseling. Conclusion: It was noted that some results differed from literature and between the public and private service. This divergence could be related to the specific epidemiology of each region and the type of insurance paying for care (Unified Health Service or Private).
Subjective and psychological well-being among elderly participants of a University of the Third Age
Authors: Cachioni Meire , Delfino Lais Lopes , Yassuda Mônica Sanches , Batistoni Samila Sathler Tavares , Melo Ruth Caldeira de , Domingues Marisa Accioly Rodrigues da Costa
Published: July 2017

Abstract Objective: The present study aimed to analyze the distribution of measures of subjective and psychological well-being according to demographic criteria and length of participation in the program. Method: A cross sectional study using the following instruments was carried out: a sociodemographic questionnaire (age, gender, education, length of participation in University of the Third Age (U3A) and similar programs located in the city of São Paulo, Brazil; an Overall Life Satisfaction Scale; a Life Satisfaction Scale that contemplated four domains: health, physical capacity, mental capacity and social involvement; a Positive/Negative Affect Scale; and a Personal Development Scale. The data were analyzed by the chi-squared test (for comparison of categorical variables), the Mann-Whitney and the Kruskal-Wallis U tests (for comparison of continuous variables). Results: Age and gender were the main factors that were significantly associated with overall life satisfaction, life satisfaction in specific domains, and morale. Higher education was associated with psychological adjustment. Conclusion: Participating in a U3A contributes to high levels of subjective and psychological well-being. Elderly individuals of more advanced ages and men had higher rates of satisfaction with life and positive feelings. The elderly can assess their development trajectory, their commitment to society and consider their efforts in pursuing an ideal of personal excellence.
Improving sweet pepper yield and quality by means of fertigation management
Authors: Oliveira Francisco A , Duarte Sergio N , Medeiros José F , Lima Carlos JGS , Oliveira Mychelle KT , Silva Ricardo CP
Published: July 2017

ABSTRACT Fertigation can be managed using fixed fertilizer doses or by assessing the ionic concentration of soil solution throughout the growing period. This work studied how different fertigation management systems affected sweet pepper yield and quality. The experiment was carried out in greenhouse, in pots. Fertigation was managed according to the crop uptake rate (M1) or by monitoring either the electrical conductivity (M2) or the N and K concentration (M3) in the soil solution. Fertigation management was combined with six N and K doses (0, 50, 100, 150, 200 and 300% of the recommended dose for sweet pepper in the region), in complete blocks at random, with four replications, and treatments in 3x6 factorial. Dry matter accumulation, yield and fruit grading were evaluated. Fertigation managed by means of monitoring the soil solution improved the vegetative growth in up to 25% and increased yield in up to 20% when compared to management according to the uptake rate. Highest fruit yields in M1, M2 and M3 were achieved with N and K levels corresponding to 127.6% (1.33 kg/plant), 222.5% (1.60 kg/plant) and 215% (1.48 kg/plant), respectively. N and K can be supplied successfully to sweet peppers using electrical conductivity or concentration of ions in the soil solution to manage fertigation. These management systems resulted in high quality fruits and up to 47% increase in N and K use efficiency. N and K concentration equivalent to 200% of the recommended for growing sweet pepper in hydroponics should be taken as reference.
Yield of determinate tomato cultivars grown in a closed hydroponic system as affected by plant spacing
Authors: Maboko Martin M , Plooy Christian P Du , Chiloane Silence
Published: July 2017

ABSTRACT In South Africa there are no established spacing recommendations for determinate tomato cultivar production under closed hydroponic systems. This study was conducted to determine yield and quality of hydroponically grown determinate tomato cultivars at different plant densities. Four determinate tomato cultivars (Dynimo, Mariana, Mion and Sama) were subjected to four plant densities (10, 16, 20 and 25 plants/m2) during the spring/summer and summer/fall seasons. Experimental layout was a randomized complete block design in a factorial scheme of four plant spacing x four cultivars with three replicates. There were no significant differences in marketable yield between the cultivars tested during the spring/summer and summer/fall seasons. Cultivar Mion showed higher incidence of blossom end rot, while Mariana showed the highest fruit rot during the spring/summer season as compared to the other cultivars. During the spring/summer season, marketable yield increased with increased plant density with the highest yield obtained at 25 plants/m2 followed by 20 plants/m2. During the summer/fall season, plant density did not show a significant effect on total and marketable yield although a tendency for declined yield with increased density was observed. Number of fruit per plant as well as fruit size decreased with increased plant density during both seasons which did not have an effect on overall yield per plot area. Increasing the plant density to 25 plants/m2 can improve marketable yield of determinate tomato cultivars during spring/summer season while using a plant density of 10 plants/m2 will be more cost effective during the summer/fall season. This information will enable farmers to optimise yield and quality of determinate tomato cultivars under closed hydroponic systems.
Effect of essential oils from Mangifera indica L. cultivars on the antifungal susceptibility of Candida spp. strains isolated from dogs
Authors: FONTENELLE Raquel Oliveira dos Santos , SOBRINHO Antonio Carlos Nogueira , SOARES Bruna Vieira , AGUIAR Francisca Lidiane Linhares de , BRITO Erika Helena Sales de , CAVALCANTE Carolina Sidrim de Paula , ROCHA Marcos Fábio Gadelha , MORAIS Selene Maia de
Published: July 2017

SUMMARY This work reports the chemical study, and anti-Candida spp. activity of leaf essential oil from Mangifera indica cultivars. The essential oils were obtained by hydro-distillation and analyzed by gas chromatography/mass spectroscopy. The anti-Candida spp. activity was evaluated against strains isolated from dogs by the agar-well diffusion method and the minimum inhibitory concentration (MIC) by the broth microdilution method. Tommy Atkins cultivar presented β–selinene (29.49%), caryophyllene oxide (12.40%) and humulene II epoxide (8.66%) as main constituents, while the main constituents of Rosa, Moscatel and Jasmim varieties were caryophyllene oxide (23.62, 48.42 and 30.77%, respectively) and humulene epoxide II (11.56, 23.45, and16.27%, respectively). The means of inhibition zones were 11 ± 0.71, 13.5 ± 3.54, 10.5 ± 0.71 and 13.5 ± 0.71mm to Tommy Atkins, Rosa, Moscatel and Jasmim varieties, respectively. For Tommy Atkins, the MIC ranged from 0.62 to 1.25 mg/mL; for Rosa, ranged from 0.31 to 1.25 mg/mL; for Jasmim ranged from 0.31 to 0.62 mg/mL; while for the Moscatel variety the MIC value was 1.25 mg/mL for all Candida strains. Essential oils of four M. indica cultivars were active in vitro against Candida spp., demonstrating good antifungal activity and can be a useful source of antifungal compounds for veterinary medicine.
Effective tobacco control measures: agreement among medical students
Authors: Martins Stella Regina , Paceli Renato Batista , Bussacos Marco Antônio , Fernandes Frederico Leon Arrabal , Prado Gustavo Faibischew , Lombardi Elisa Maria Siqueira , Terra-Filho Mário , Santos Ubiratan Paula
Published: July 2017

ABSTRACT Objective: To determine the level of agreement with effective tobacco control measures recommended by the World Health Organization and to assess the attitudes toward, knowledge of, and beliefs regarding smoking among third-year medical students at University of São Paulo School of Medicine, located in the city of São Paulo, Brazil. Methods: Between 2008 and 2012, all third-year medical students were invited to complete a self-administered questionnaire based on the Global Health Professionals Student Survey and its additional modules. Results: The study sample comprised 556 students. The level of agreement with the World Health Organization recommendations was high, except for the components “received smoking cessation training” and “raising taxes is effective to reduce the prevalence of smoking”. Most of the students reported that they agree with banning tobacco product sales to minors (95%), believe that physicians are role models to their patients (84%), and believe that they should advise their patients to quit cigarette smoking (96%) and using other tobacco products (94%). Regarding smoking cessation methods, most of the students were found to know more about nicotine replacement therapy than about non-nicotine therapies (93% vs. 53%). Only 37% of the respondents were aware of the importance of educational antismoking materials, and only 31% reported that they believe in the effectiveness of encouraging their patients, during medical visits. In our sample, the prevalence of current cigarette smoking was 5.23%; however, 43.82% of the respondents reported having experimented with water-pipe tobacco smoking. Conclusions: Our results revealed the need to emphasize to third-year medical students the importance of raising the prices of and taxes on tobacco products. We also need to make students aware of the dangers of experimenting with tobacco products other than cigarettes, particularly water-pipe tobacco smoking.
Frequency of indeterminate results from an interferon-gamma release assay among HIV-infected individuals
Authors: Oliveira Sandra Maria do Valle Leone de , Trajman Anete , Paniago Anamaria Mello Miranda , Motta-Castro Ana Rita Coimbra , Ruffino-Netto Antonio , Maciel Ethel Leonor Noia , Croda Julio , Bonecini-Almeida Maria da Gloria
Published: July 2017

ABSTRACT Objective: To evaluate the frequency of and factors associated with indeterminate interferon-gamma release assay (IGRA) results in people living with HIV/AIDS (PLWHA). Methods: We tested 81 PLWHA in the central-west region of Brazil, using the tuberculin skin test and an IGRA. Information on sociodemographic and clinical variables was gathered through the use of questionnaires and from medical records. The association of those variables with indeterminate results was analyzed by calculating the adjusted ORs in a multivariate logistic regression model. Concordance was evaluated by determining the kappa statistic. Results: Among the 81 patients evaluated, the tuberculin skin test results were positive in 18 (22.2%) of the patients, and the IGRA results were positive in 10 (12.3%), with a kappa of 0.62. The IGRA results were indeterminate in 22 (27.1%) of the patients (95% CI: 17.8-38.1%). The odds of obtaining indeterminate results were significantly higher in smokers (adjusted OR = 6.0; 95% CI: 1.4-26.7) and in samples stored for less than 35 days (adjusted OR = 14.0; 95% CI: 3.1-64.2). Patients with advanced immunosuppression (CD4+ T-cell count < 200 cells/mm3) were at a higher risk for indeterminate results (OR adjusted for smoking and inadequate duration of sample storage = 4.7; 95% CI: 0.91-24.0), although the difference was not significant. Conclusions: The high prevalence of indeterminate results can be a major limitation for the routine use of IGRAs in PLWHA. The need to repeat the test increases its costs and should be taken into account in cost-effectiveness studies. The processing of samples can significantly alter the results.
A numerical study of capacity and stiffness of circular skirted foundations in clay subjected to combined static and cyclic general loading
Authors: Skau K. S. , Chen Y. , Jostad H. P.
Published: July 2017

Skirted foundations have been widely applied as offshore foundations for several decades. In design, the use of failure envelopes is convenient for assessing stability under combined loading. A large number of studies on failure envelopes exist in the literature based on experiments and numerical analyses. Most of these studies focus on ultimate capacity and static loading. This paper presents a numerical study focusing on cyclic degradation and failure envelopes for skirted foundations subjected to combined cyclic and static loading. It was found that the shapes of the failure envelopes are little affected by degradation expressed by the number of equivalent cycles. In addition to failure envelopes, contours of displacements were computed in the three-dimensional load space (vertical, horizontal and moment load) for a more complete description of the response. As an example, the well-defined cyclic contour diagrams of Drammen clay were utilised to demonstrate how foundation response diagrams can be established. The database is accompanied by a simplified procedure to account for cyclic degradation through equivalent number of cycles, different normalised load–displacement response and variation in foundation geometry. The framework of procedures can be used to estimate foundation stiffness and capacity and the results can serve as a basis for the development of foundation macro-element models.
Eurocode 7-based design of SCL tunnels by means of numerical analyses
Authors: Schweiger H. F. , Paternesi A. , Tschuchnigg F.
Published: July 2017

Although the design of tunnels is not explicitly covered in Eurocode 7 (EC7), a tendency in practice towards EC7-compatible design can be observed, at least for shallow tunnels in soil. However, there is no experience available to indicate which of the design approaches defined in the current version of EC7 is the most suitable for the analysis of shallow tunnels, in particular when it comes to numerical models. This paper presents the results of numerical calculations assessing ultimate limit state conditions of a shallow tunnel constructed using a sprayed concrete lining in overconsolidated soil, comparing different design approaches. It is shown that all the design approaches defined in EC7 can be easily accommodated when the shotcrete lining is modelled as linear elastic. When a non-linear material model for the shotcrete lining is employed the situation is less clear; a so-called implicit design, taking into account partial factors for the time-dependent shotcrete strength, is discussed.
Hypercortisolism and pregnancy
Authors: Repina Margarita A.
Published: July 2017

In this study we retrospectively analyzed data from 221 autopsy protocols of maternal mortality 1996-2015 years. Pathology of adrenal cortex detected in 11 dead. Microadenoma with or without adenomatous hyperplasia of adrenal cortex detected in 8 dead, simple hyperplasia detected in 3 dead. In one case detected bilateral diffuse nodular hyperplasia adrenal cortex in combination with focal adenomatous hyperplasia basophil adenocytes pituitary. In this article presented the background pathology analysis, course and outcomes of the last pregnancy. The conclusion was that the microadenomas of adrenal cortex rarely remain asymptomatic incidentalomas, but more often occur the subclinical or clinical hypercortisolism. The pregnancy on their background carries a high risk of developing of serious complications.
Endocarditis of an ASD Occluder Mimicking Adult-onset Still Disease in a Grown-up with Congenital Heart Disease
Authors: Sinning Christoph , Schrage Benedikt , Müller Götz C , Zengin Elvin
Published: July 2017

The case describes the endocarditis of an ASD occluder in a grown-up with congenital heart disease. The patient was at first treated as Adult-onset Still disease because of an infection with unkown focus. Due to the immunosuppressive therapy the infection was at first not related to the endocarditis. After treatment symptoms and signs of Adult-onset Still disease completely vanished.
A novel computed tomography method to detect normal from abnormal psoas muscle: a pilot feasibility study
Authors: Patel Jayshil J , Baruah Dhiraj , Shahir Kaushik
Published: July 2017

Background

Sarcopenia is a syndrome characterized by progressive loss of skeletal muscle which can be detected by computed tomography (CT) by estimating total psoas muscle cross‐sectional area (CSA). Relying on total psoas CSA alone takes into account abnormal muscle and intramuscular fat, both of which may be increased in sarcopenic obesity. We developed a novel CT‐method to identify the proportion of normal to abnormal psoas muscle at the third lumbar (L3) level. The primary objective of our pilot study was to measure inter‐observer agreement between measuring total psoas CSA and proportion of normal and abnormal psoas muscle using a novel CT‐method. We hypothesized total psoas CSA and proportion of normal and abnormal psoas muscle would be reliably quantifiable.

Methods

CT abdomen images were obtained for 20 adults. Two radiologists independently identified and traced the L3 psoas muscle circumference to estimate CSA. Hounsfield units were applied to the tracing to identify proportion of normal muscle, abnormal muscle, and fat. Inter‐observer agreement was assessed using Pearson's correlation coefficient.

Results

Of the 20 patients, 13 were male and six were obese. Mean age was 66 years. Correlation coefficient was excellent for total psoas CSA (r=0.93, p‐value<0.00001) and proportion of normal psoas muscle (r=0.94, p‐value<0.0001). Correlation was excellent between BMI and abnormal muscle (r=0.67, p‐value=0.001). Correlation was poor between total psoas CSA and body mass index (BMI) (r=0.369, p‐value=0.108) and negative between proportion of normal muscle and BMI (r= ‐0.50, p‐value=0.025).

Conclusions

Our study findings demonstrate that total psoas CSA and proportion of normal and abnormal psoas can be reliably quantified. Our CT‐method may be superior to total psoas CSA in identifying sarcopenic obesity, the results of which can be used to explore clinical outcomes.
Correlation of prolonged fasting and gall bladder sludge formation after emergency G. I. surgery
Authors: Singh Shailendra Pal , Singh Pradeep Kumar , Singh Praveen , Verma Shashank , Tiwari Krishna Kumar
Published: July 2017

Background: After emergency laparotomy due to some intestinal pathology patient are kept fasting to rest the bowel so that repaired pathology could get the proper time for healing. And during this period body’s nutritional requirement are replenished either by total parenteral nutrition or other intravenous fluids containing glucose and electrolytes. The major complication of TPN is liver disease that most commonly include steatosis, cholestasis, Cholelithiasis. Development of cholestasis, biliary sludge, and gall stone are due to loss of enteric stimulation and not directly linked to TPN. The effect of fasting on the composition of hepatic and gall bladder bile in humans has already been studied and this shows gall bladder bile is significantly supersaturated after fasting and can lead to sludge formation.Methods: A prospective study was conducted in department of general surgery, a rural tertiary care centre in north india (UPUMS, Saifai, Etawah, Uttar Pradesh, India) between January 2016 to May 2017. Study included all the patients in emergency who were planned for emergency laparotomy based on inclusion and exclusion criteria.Results: Of the 116 patients 83 (71.5%) were male patients and 33 (28.4%) were female patients, aged between (23 - 64 years). Total no. of sludge positive patients after 7 days was 39 (33.6%). Sludge positive female patients were 17 in 33 (51.1%) and sludge positive male patients were 22 out of 83 male patients (26.5%). Out of 53 patients of duodenal and gastric surgery 28 patients (52.8%) developed sludge formation. Out of other 63 surgeries only 10 (15.8%) patients developed sludge. Out of 39 sludge positive patients 28 (71.7%) were alone from group of duodenal and gastric surgery.Conclusions: our study supports that the prolonged restriction of oral food intake in patient operated on the gastrointestinal tract that results in decreased contractility due to absence of food stimulated gall bladder contraction, may be an important cause to sludge development in our group of patients.
Clinico sonological and laboratory co-relation with histopathology of acute appendicitis to develop new diagnostic scoring system (Yash scoring system)
Authors: Lamture Yashwant R. , Ramteke Harshal , Shinde R. K. , Shahapurkar Vinay V. , Gajbhiye Varsha P.
Published: July 2017

Background: Of the many scoring systems currently available, the modified Alvarado scoring system (MASS) is the most widely employed, because of its ability to reduce negative appendectomy rate (NAR). Unfortunately, this system is more accurate in western population. In spite of the advances in the diagnostic and imaging techniques NAR have not decreased much. This clearly indicates the need of development of new diagnostic scoring system so we have developed new diagnostic scoring system (Yash Score). The objective of this study was to develop and study diagnostic accuracy of new diagnostic scoring system (Yash scoring system) for acute appendicitis.Methods: A prospective comparison YSS and MASS was done on 418 patients. Depending on clinical judgement appendicectomy was done. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for YSS and MASS were calculated using SPSS 17.0 statistical software for statistical analysis and compared using Chi-square test.Results: The sensitivity and specificity of YSS was found to be 99.48 per cent and 92.86 percent respectively. The sensitivity and specify of MASS was 52.05 per cent and 100 per cent respectively. The positive predictive value and negative predictive value of YSS was 99.48 per cent and 92.86 per cent respectively. Negative and positive predictive values of MASS were 13.02% and 100% respectively.Conclusions: Comparison in between YSS and MASS in the present study shows significant statistical difference.
Clinicopathological profile, diagnosis and treatment of skin cancers at a tertiary care center: a retrospective study
Authors: Jina Abhishek , Singh Vineet , Saini Sunil , Chotan Neena , Rajan Manu
Published: July 2017

Background: Majority of skin cancers are basal cell carcinoma, Squamous cell carcinoma and Malignant melanoma which account for more than 95% of total skin malignancies. There is an increase in incidence in India over some 10 years of period. This study was done for analysing clinicopathological profile of skin malignancies and association of human papilloma virus (HPV) in skin malignancies in Himalayan Institute of Medical Sciences (HIMS, Uttarakhand, India.Methods: It was a retrospective study done on 101 patients having malignant skin lesions attending the Department of Surgery at HIMS from October 2005 to October 2008 and given their consent.Results: Out of 101 patients, 68 had squamous cell carcinoma, 21 had basal cell carcinoma and 10 had malignant melanoma, prevalence is high in men of lower socioeconomic status (M:F) 1.9:1. The mean age was 54.50 years. Most of the patients were laborers, farmers and factory workers. Ulcers and ulceroproliferative growth were common mode of presentation. Most commonly associated risk factor was exposure to sunlight, the commonest location of skin cancer was face and scalp. Wide local excision was the commonest done procedure with closure of primary defect by SSG, fasciocutaneous or cutaneous flaps. No HPV association was seen.Conclusions: Skin cancers are quite common and their incidence has increased in last few decades, in this study we found that skin cancer were more common in males of lower socioeconomic status, probable cause was increased sun exposure and chemical exposure, in respect to females. Cancer could manifest in many forms but ulcers quite common, Squamous cell carcinoma outnumbered basal cell carcinoma, Wide local excision with skin grafts was main stay of treatment.
Influence of prosthetic joint line position on outcome after total knee replacement
Authors: Choudhary Preetesh , Bahre Skand
Published: July 2017

Background: The current study had been designed so as to assess whether joint line elevation and change in patellar tendon length influences knee flexion after primary cruciate retaining TKR.

Methods: This prospective study involved patients with advanced degenerative joint disease involving one or both knees who presented to the outpatient department of a tertiary care hospital. Exclusion criteria were any prior knee surgery. Surgery was performed under tourniquet with standard medial para-patellar arthrotomy to expose all our knees. In the study radiological assessment was done by true lateral X-ray view of knee in 30 degree of flexion. We choose Caton-Deschamps indices (CI) for diagnosis of post TKR patella infera and joint line elevation. CI<0.6 was defined as patella infera (normal range of CI 0.60-1.45). After all data collection comparison was done between joint line elevation versus without joint line elevation patients (with/without patellar tendon shortening) range of movement.

Results: Total of 100 patients (72 females and 28 males) with 176 knees (bilateral=76, unilateral=24) who fulfilled the above said criteria involved in study. The mean age of the patients at the time of surgery was 64.4 years with range of 54 years to 80 years. The average follow up of 24 months, with minimum follow up of 18 months. Average range of motion (ROM) in NO Joint line elevation/patella tendon shortening patient measured 107.2°, and joint line elevation with patellar tendon shortening (prior patella infera) and joint line elevation without patella tendon shortening(prior patella infera) patient average ROM was measured 86.7 and 87.8 degree respectively.
Conclusions: In our study patellar tendon shortening and joint line elevation reduces ROM knee. Mechanical factors also explain the association between joint line elevation and patellar tendon length with range of motion. Reduction in length of extensor apparatus reduces the range of flexion.
Fatores limitantes à criação de galinhas caipiras nos estabelecimentos agrícolas familiares da micro-região de Marabá
Authors: Machado Rosinaldo Da Costa
Published: July 2017

Fatores limitantes à criação de galinhas caipiras nos estabelecimentos agrícolas familiares da micro-região de Marabá
Introdução
Authors: Astier M , García-Barrios L , González-Esquivel C , Larrondo-Posadas L , López-Ridaura S , Masera O , Galván-Miyoshi Y
Published: July 2017

Leia a introdução.
Surgical treatment in hypertension associated with adrenal diseases
Authors: Maystrenko N. A. , Romashchenko P. N. , Dovganyuk V. S. , Lysanyuk M. V. , Yanbukhtina V. R. , Blyumina S. A.
Published: July 2017

Despite the recent advancesin diagnosis and surgical treatment of hormonally active adrenal tumors (GAAT), the awareness of medical practitioners about the disease remains insufficient. The results of examination and treatment of 758 GAAT patients prove that long existing symptomatic (secondary) arterial hypertension (SHTN) is malignant characterized by the development of vascular complications involving cardiac and/or cerebral arteries, and drug-resistance and requires pre-surgery correction of metabolic and endocrine disorders. In GAAT, adrenalectomy is the main method of SHTN treatment. The reasons for maintaining or recurrence of arterial hypertension (HTN) after surgery in 35,7% of patients are not associated with surgery itself, but are due to the long duration of high blood pressure due to a 5,37 ± 3,30 years before the manifestation of the tumor in adult patients (older 44,75 ± 3,89 s), and co-existent endocrine, metabolic and cardiovascular disorders. The predominance of the pressor hormones over depressor ones leads to the cardiovascular remodeling, causes the development of left ventricular diastolic dysfunction due to impaired relaxation and the increased role of atrial systole in its filling. If these factors are identified, the selection and follow-up of the patients after surgery, and the choice of antihypertensive therapy are required. Early diagnosis of GAAT, adequate preoperative drug therapy, and implementation of timely surgical treatment contribute to the elimination of adrenal-related SHTN, provide good treatment results and better quality of life in GAAT patients.
Prehypertension and cardiometabolic risk factors (data of the ESSE-RF study)
Authors: Erina A. M. , Rotar O. P. , Orlov A. V. , Solntsev V. N. , Shalnova S. A. , Deev A. D. , Baranova E. I. , Konradi A. O. , Chazova I. E. , Boytsov S. A. , Shlyakhto E. V.
Published: July 2017

Theobjectiveof our work was to assess the prevalence of prehypertension (PHT) and the relationship with cardiovascular risk factors in the population sample of the inhabitants of the Russian Federation.Design and methods.The ESSE-RF study was carried out in 12 regions of the Russian Federation (Volgograd, Vologda, Voronezh, Vladivostok, Ivanovo, Kemerovo, Krasnoyarsk, Orenburg, Tomsk, Tyumen, St Petersburg, and North Ossetia (Alania)) with different climatic, geographic, economic and demographic characteristics. A stratified random sample was formed in each region. In total, 20652 inhabitants of the Russian Federation aged 25–65 years were examined. All participants signed informed consent and completed approved questionnaires regarding behavioral risk factors, socioeconomic status and concomitant diseases/therapy. Anthropometry, fasting blood sampling, measurement of blood pressure (BP) were performed. BP was measured by the OMRON device (Japan) twice on the right arm in the sitting position with calculation of the mean BP. The optimal blood pressure corresponds to the BP level < 120/80 mm Hg. The normal BP is 120–129/80–84 mm Hg. High normal BP is 130–139/85–89 mm Hg. PHT is diagnosed in case of BP 120–139/80–89 mm Hg. Hypertension is diagnosed case of BP ≥ 140/90 mm Hg or antihypertensive therapy. PHT includes groups of normal and high normal blood pressure. The statistical analysis was carried out using SPSS Statistics 20.Results.Data of 20607 participants were analyzed, among them 7806 men (37,9  %) and 12801 women (62,1  %). The optimal BP was registered in 3848 (23,4  %), normal BP in 3551 (20,1  %), high normal BP in 2861 (14,9  %), PHT — in 6412 (35,0  %), hypertension — in 10347 (41,6  %). The prevalence is standardized according to the age structure of the World Health Organization (2000). Among men, compared with women, PHT was significantly more frequent (41,2  % and 30,1  %, respectively). The probability of PHT, adjusted for sex, age and obesity is associated with hypercholesterolemia > 4,9 mmol / l (OR 1,27 [1,15, 1,39]), increased HDL > 3,0 mmol / l (1,25 [1,14, 1,37]), triglycerides > 1,7 mmol / l (OR 1,39 [1,23, 1,58]), hyperglycemia ≥ 5,6 mmol / l (OR 1,46 [1,28, 1,67], p < 0,05). The presence of higher education reduced the likelihood of PHT, behavioral risk factors were not significant predictors.Conclusions.The results demonstrate the high prevalence of PHT and the association of metabolic abnormalities with the transformation of optimal blood pressure in PHT, which emphasizes the importance of timely diagnosis of PHT and correction of cardiometabolic risk factors in the Russian population.
Health Risk Assessment of VOCs from Surgical Smoke
Authors: She Shaohua , Lu Gang , Yang Wah , Hong Mianwei , Zhu Lingfei
Published: July 2017

Surgical smoke is produced by energy-based surgical instruments. The airborne volatile organic compounds (VOCs) from surgical smoke may have potential health risk. This study aimed to evaluate the evidence for the harmful effects on the operating theater staff. An internationally recognized evaluation model of health risk assessment (HRA) was adapted to preliminarily assess the health risks caused by VOCs in surgical smoke. Results of HRA indicated that non-carcinogenic risk indexes of VOCs did not exceed one, indicating that these pollutants didn't cause significant non-carcinogenic harm to the health of the operating theater staff. But the cancer risk indexes exposed to formaldehyde and benzene all exceed 10-5, which was higher than the suggested value of USEPA (10-6) and might cause potential harm to the health of the operating theater staff. Long-term exposure of such surgical smoke will be harmful to the health of the operating theater staff and have a great risk of cancer.
Multipurpose Low Cost Table Machine
Authors: Shirbhate Sanjay
Published: July 2017

The concept of this paper is to develop idea of multipurpose machine as by conducting various operation on same machine, using single operating system. Here, in this machine there is a electric motor which is connected to the pulleys driven by belt (more than one pulley for various speed). The pulley is connected with the shaft which rotate in circular motion and to this shaft circular tools are connected as per required operation as circular saw cuts wooden pieces, pipe cutter will cuts iron rod or iron hollow pipe, grinding circular wheel grinds the job, polishing wheel polishes the job etc. more types of tools and the operation can be done on the same machine. The idea of this machine is to motivate small scale house hold units for ex. Furniture making, office table, Chair, show case for wedding ceremony etc. with low cost machines with multipurpose operation done on same machine.
Community Wastewater Treatment with Attached Growth Assisted Constructed Wetland Reactor
Authors: Ingole Nitin , Gulhane Mangesh
Published: July 2017

Constructed wetlands are systems of artificial wastewater treatment which consists of shallow ponds or channels that have been planted with aquatic plants. The treatment is based on the natural, biological, physical and chemical treatment of wastewater. The technique is reported to be cost effective as compared to other methods. The constructed wetlands have impermeable clay or synthetic coatings and artificial structures for controlling the direction of flow, liquid retention time and the water level. However, there are certain limitations of constructed wetland system, which need improvement for its wide adoptability. As such the effort was made to assist the constructed wetland system with attached growth system with the aim to design an economical and user friendly waste water treatment option for the small community. The laboratory scale model was fabricated using GI sheet of thickness 0.5 mm. The overall capacity of the model was 275 L. The laboratory scale reactor model consisted of four compartments out of which first three compartments were based on attached growth system and the fourth compartment acted as constructed wetland reactor. All the three compartments were packed with different types of artificial, semi-artificial and natural media. The fourth compartment consisted of media packed from bottom as aerocon stone layers 03 in numbers followed by snail shell, followed by a soil layer of 80 mm thick which holds the plants in rows. The reactor was operated as continuous flow reactor with varying detention time and change of different type of media packed in the reactor. The performance of Customized Constructed Wetland reactor was observed under various operating conditions for removal of BOD, COD and TS parameters. The paper presents the details regarding the development of the reactor model, operation of the reactor model and results obtained during the course of study. The paper also cover the discussion regarding the improved performance of reactor noted during the study and adoptability of the developed reactor model for community waste treatment.
Burnout in Orthopaedic Surgeons: A Challenge for Leaders, Learners, and Colleagues
Authors: Ames S. Elizabeth , Cowan James B. , Kenter Keith , Emery Sanford , Halsey David
Published: July 2017

Burnout, depression, suicidal ideation, and dissatisfaction with work-life balance have been reported in all medical specialties and at all stages of medical education and practice experience. Burnout consists of progressive emotional, attitudinal, and physical exhaustion. Physicians with burnout may treat patients as objects and feel emotionally depleted. Burnout is characterized by a loss of enthusiasm for work (emotional exhaustion), feelings of cynicism (depersonalization), and a low sense of personal accomplishment. The most complete study of emotional burnout among different medical specialties demonstrated that orthopaedic surgery is one of the specialties with the highest burnout rate. Qualitative descriptive studies are available. There was a 45.8% burnout rate among physicians in the U.S. in 2012, and a 2014 update suggested even higher rates. Burnout has a correlation with medical education. Burnout rates are similar to those in the general population when medical students enter school, and increase steadily through medical education prior to residency. Burnout rates in residents are high, reported to be between 41% and 74% across multiple specialties. This impacts our young physician workforce in orthopaedics. The purpose of this review is to provide the available information that characterizes burnout and addresses the issues inherent to preventing burnout, and to build awareness in orthopaedic surgeons. Wellness “goes beyond merely the absence of distress and includes being challenged, thriving, and achieving success in various aspects of personal and professional life.” The challenge for the orthopaedic community is to develop interventions and strategies that are personalized to the individuals in this specialty.
Arterial Topographic Anatomy Near the Femoral Head-Neck Perforation with Surgical Relevance
Authors: Rego Paulo , Mascarenhas Vasco , Collado Diego , Coelho Ana , Barbosa Luis , Ganz Reinhold
Published: July 2017

Background:

Knowledge of the vascular supply of the femoral head is crucial for hip-preserving surgical procedures. The critical area for reshaping cam deformity is at the retinacular vessel penetration, an area with ill-defined topographic anatomy. We performed a cadaver study of the extension of the lateral retinaculum near the head-neck junction, distribution of the arterial vascular foramina, and initial intracapital course of these vessels.

Methods:

In 16 fresh proximal parts of the femur without head-neck deformities, the deep branch of the medial femoral circumflex artery was injected with gadolinium for magnetic resonance imaging (MRI) sequences to identify arterial structures.

Results:

We found a mean number of 4.5 arterial foramina, showing a predominance from 10 to 12 o’clock. The retinaculum extended 20 mm from 1 to 10 o’clock. The surface distance from the cartilage border to the vascular foramina under the synovial fold was 6.5 mm, and the depth from the same cartilage border to the initial intraosseous vessel pathways was 5.3 mm.

Conclusions:

The data add further precision to the arterial topography at the retinacular foramina, an area that is crucial for the perfusion of the femoral head. It may overlap with the area of anterolateral cam deformity and plays a role in choosing the cuts for subcapital and intracapital osteotomies.

Clinical Relevance:

The information is taken from normal hips and may not be directly applicable to the deformed hip. Nevertheless, it is a prerequisite for a surgeon to understand the normal anatomy and use those boundaries to prevent mistakes during intra-articular joint-preserving hip surgical procedures.