bluuebunny/crossref_metadata_2025 huggingface dataset:
Frequency of Impaired Spinal Mobility in Patients with Chronic Back Pain Compared to Patients with Early Axial Spondyloarthritis
Authors: Fongen Camilla , Dagfinrud Hanne , Berg Inger Jorid , Ramiro Sofia , van Gaalen Floris , Landewé Robert , Ramonda Roberta , van der Heijde Désirée , Fagerli Karen Minde
Published: July 2018

Objective.

To examine the frequency of impaired spinal mobility in patients with chronic back pain of short duration and to compare it with the frequency of impaired spinal mobility in patients with axial spondyloarthritis (axSpA), possible SpA, and no SpA.

Methods.

The SpondyloArthritis Caught Early (SPACE) cohort includes patients with chronic back pain (≥ 3 mos, ≤ 2 yrs, onset < 45 yrs). Spinal mobility was assessed with lateral spinal flexion, chest expansion, cervical rotation, occiput-to-wall distance, and lumbar flexion. Hip mobility was assessed with intermalleolar distance. Mobility measures were defined as impaired if below the 5th percentile reference curve from general population, adjusted for age and height when appropriate. Proportions of patients categorized with impaired mobility were examined with chi square.

Results.

In total, 393 patients with chronic back pain were included: 142 axSpA, 140 possible SpA, and 111 no SpA. Impairment in ≥ 1 mobility measure was present in 66% of all patients. The most frequently impaired mobility measure was lateral spinal flexion (40%), followed by chest expansion (22%), cervical rotation (18%), intermalleolar distance (17%), lumbar flexion (15%), and occiput-to-wall distance (11%). No statistically significant differences in proportion of patients with impaired spinal mobility were found between patients with axSpA and the other subgroups in any of the tests.

Conclusion.

Two out of 3 patients with chronic back pain of short duration had impaired spinal mobility compared to the general population. Impaired spinal mobility occurs as often in patients with early axSpA as in other forms of chronic back pain.
Reproducibility and Utility of the 6-minute Walk Test in Systemic Sclerosis
Authors: Pugnet Grégory , Marjanovic Zora , Deligny Christophe , Boussardon Karine , Benzidia Ilham , Puyade Mathieu , Lansiaux Pauline , Vandecasteele Els , Smith Vanessa , Farge Dominique
Published: July 2018

Objective.

To assess the reproducibility and the utility of the 6-minute walk test (6MWT) in systemic sclerosis (SSc).

Methods.

All patients with SSc who underwent at least two 6MWT within a minimum 3-month interval plus simultaneous routine clinical, biological, and functional evaluations were consecutively enrolled in this observational study over 6 years. Following American Thoracic Society guidelines, each 6MWT was repeated twice to assess the 6-minute walk distance (6MWD) reproducibility, with the highest value being reported for subsequent analysis.

Results.

Among 56 (38 female) included patients aged 46 ± SD 12.7 years, with 17 ± 10 modified Rodnan skin score (mRSS) and 1 ± 0.8 Scleroderma Health Assessment Questionnaire (SHAQ) at first referral, 277 6MWT evaluations (5 ± 3.9 6MWT per patient) were performed over 23 ± 22.5 months followup. Meanwhile, 8 deaths (87.5% SSc-related) occurred. The mean 6MWD absolute value was 457 ± 117 m with a 4 ± 2.2 mean Borg dyspnea score. The 6MWD intraclass correlation coefficient was 0.996 (95% CI 0.995–0.999, p < 0.0001). In multivariate linear regression analysis, these factors were independently associated with a lower 6MWD: sex (R2 = 0.47, p < 0.0001), mRSS (R2 = 0.47, p = 0.008), tendon friction rub (R2 = 0.47, p = 0.003), SHAQ (R2 = 0.47, p = 0.02), muscle disability score (R2 = 0.47, p = 0.03), DLCO% (R2 = 0.47, p = 0.0008), and left ventricular ejection fraction (R2 = 0.47, p = 0.006). The 6MWD at first referral was an independent predictor for the overall mortality (HR 0.99, 95% CI 0.988–0.999) and the SSc-related mortality (HR 0.99, 95% CI 0.988–0.999).

Conclusion.

We show strong reproducibility for the 6MWD and confirm the 6MWT utility to assess the overall prognosis of patients with SSc.
Do Poor Prognostic Factors in Rheumatoid Arthritis Affect Treatment Choices and Outcomes? Analysis of a US Rheumatoid Arthritis Registry
Authors: Alemao Evo , Litman Heather J. , Connolly Sean E. , Kelly Sheila , Hua Winnie , Rosenblatt Lisa , Rebello Sabrina , Kremer Joel M. , Harrold Leslie R.
Published: July 2018

Objective.

To characterize patients with rheumatoid arthritis (RA) by number of poor prognostic factors (PPF: functional limitation, extraarticular disease, seropositivity, erosions) and evaluate treatment acceleration, clinical outcomes, and work status over 12 months by number of PPF.

Methods.

Using the Corrona RA registry (January 2005–December 2015), biologic-naive patients with diagnosed RA having 12-month (± 3 mos) followup were identified and categorized by PPF (0–1, 2, ≥ 3). Changes in medication, Clinical Disease Activity Index (CDAI), and work status (baseline–12 mos) were evaluated using linear and logistic regression models.

Results.

There were 3458 patients who met the selection criteria: 1489 (43.1%), 1214 (35.1%), and 755 (21.8%) had 0–1, 2, or ≥ 3 PPF, respectively. At baseline, patients with ≥ 3 PPF were older, and had longer RA duration and higher CDAI versus those with 0–1 PPF. In 0–1, 2, and ≥ 3 PPF groups, respectively, 20.9%, 23.2%, and 26.5% of patients received ≥ 1 biologic (p = 0.011). Biologic/targeted synthetic disease-modifying antirheumatic drug (tsDMARD) use was similar in patients with/without PPF (p = 0.57). After adjusting for baseline CDAI, mean (standard error) change in CDAI was −4.95 (0.24), −4.53 (0.27), and −2.52 (0.34) for 0–1, 2, and ≥ 3 PPF groups, respectively. More patients were working at baseline but not at 12-month followup in 2 (13.9%) and ≥ 3 (12.5%) versus 0–1 (7.3%) PPF group.

Conclusion.

Despite high disease activity and worse clinical outcomes, number of PPF did not significantly predict biologic/tsDMARD use. This may warrant reconsideration of the importance of PPF in treat-to-target approaches.
Influence of Axial Involvement on Clinical Characteristics of Psoriatic Arthritis: Analysis from the Corrona Psoriatic Arthritis/Spondyloarthritis Registry
Authors: Mease Philip J. , Palmer Jacqueline B. , Liu Mei , Kavanaugh Arthur , Pandurengan Renganayaki , Ritchlin Christopher T. , Karki Chitra , Greenberg Jeffrey D.
Published: July 2018

Objective.

We analyzed the characteristics of patients with psoriatic arthritis (PsA) with and without axial involvement in the US-based Corrona Psoriatic Arthritis/Spondyloarthritis Registry.

Methods.

All patients were included who had PsA and data on axial involvement, defined as physician-reported presence of spinal involvement at enrollment, and/or radiograph or magnetic resonance imaging showing sacroiliitis. Demographics, clinical measures, patient-reported outcomes, and treatment characteristics were assessed at enrollment.

Results.

Of 1530 patients with PsA, 192 (12.5%) had axial involvement and 1338 (87.5%) did not. Subgroups were similar in sex, race, body mass index, disease duration, presence of dactylitis, and prevalence of most comorbidities. However, patients with axial involvement were younger and more likely to have enthesitis, a history of depression, and more frequently used biologics at enrollment. They were also more likely to have moderate/severe psoriasis (body surface area ≥ 3%, 42.5% vs 31.5%) and significantly worse disease as measured by a lower prevalence of minimal disease activity (30.1% vs 46.2%) and higher nail psoriasis scores [visual analog scale (VAS) 11.4 vs 6.5], enthesitis counts (5.1 vs 3.4), Bath Ankylosing Spondylitis Disease Activity Index (4.7 vs 3.5) scores, Bath Ankylosing Spondylitis Functional Index (3.8 vs 2.5) scores, C-reactive protein levels (4.1 vs 2.4 mg/l), and scores for physical function (Health Assessment Questionnaire, 0.9 vs 0.6), pain (VAS, 47.7 vs 36.2), and fatigue (VAS, 50.2 vs 38.6).

Conclusion.

Presence of axial involvement was associated with a higher likelihood of moderate/severe psoriasis, with higher disease activity and greater effect on quality of life. These findings highlight the importance of monitoring patients with PsA for signs of axial symptoms or spinal involvement.
Sarcoidosis in Patients with Antisynthetase Syndrome: Presentation and Outcome
Authors: Couture Priscille , Brillet Pierre-Yves , Varin Stéphane , Le Goff Benoît , Meyer Alain , Sibilia Jean , Jouneau Stéphane , Valeyre Dominique , Hervier Baptiste , Uzunhan Yurdagül
Published: July 2018

Objective.

To investigate the uncommon co-occurrence of antisynthetase syndrome (AS) and sarcoidosis.

Methods.

From 2000 to 2015, patients with sarcoidosis were extracted from a retrospective multicentric cohort of 352 patients with AS.

Results.

Ten patients (2.8%; 6 men, 8 whites, 5 smokers, median age 50 yrs) had both AS and sarcoidosis. Most of the time, sarcoidosis and AS occurred simultaneously (n = 7). Antibody testing revealed anti-Jo1 (n = 5), anti-PL12 (n = 4), or anti-PL7 (n = 1). Finally, no patient had a worsening of muscular condition, 5 patients presented respiratory deterioration, 3 remained stable, and 2 showed improvement.

Conclusion.

Sarcoidosis may be underdiagnosed in patients with AS.
Maternal and Fetal Outcomes in a Cohort of Patients Exposed to Tumor Necrosis Factor Inhibitors throughout Pregnancy
Authors: Genest Geneviève , Spitzer Karen A. , Laskin Carl A.
Published: July 2018

Objective.

Tumor necrosis factor inhibitors (TNFi) are increasingly used in pregnancy but are frequently withheld in the second or third trimesters. We evaluated the maternal and fetal outcomes of women who continued their TNFi throughout pregnancy compared to women who interrupted TNFi during pregnancy.

Methods.

We retrospectively analyzed the outcomes of women seen in clinic with rheumatoid arthritis (RA), psoriatic arthritis, juvenile idiopathic arthritis (JIA), or ankylosing spondylitis, who were exposed to TNFi during pregnancy. We separated pregnancies into 2 groups based on the level of TNFi exposure and compared outcomes.

Results.

In Group 1 (TNFi exposure in first trimester only), 11 women had 14 pregnancies and 12 live births. There were 2 first-trimester losses (2/14, 14%), one in the setting of active RA. Five pregnancies (5/14, 35.7%) were complicated by a disease flare. Eight patients (8/12, 66%) flared postpartum. In Group 2 (TNFi exposure throughout pregnancy), 29 women had 32 pregnancies and 34 live births. Three (3/28, 10.7%) adverse pregnancy outcomes were reported in 2 patients. One patient had a twin pregnancy and delivered at 33 weeks after developing preterm premature rupture of membranes at 32 weeks in the setting of a JIA flare. Her second pregnancy was complicated by active JIA before and throughout gestation, and hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome at 39 weeks. Another patient with comorbid antiphospholipid syndrome underwent a cesarean birth at 36 weeks for suspicion of HELLP syndrome. Six (6/32, 18.7%) postpartum flares occurred.

Conclusion.

Women who discontinued their TNFi during pregnancy had a higher risk of peri- or postpartum flare compared to those who continued their TNFi throughout pregnancy.
Increased Rates of Both Knee and Hip Arthroplasties in Older Patients with Ankylosing Spondylitis
Authors: Ward Michael M.
Published: July 2018

Objective.

To determine the risks of primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) in older patients with ankylosing spondylitis (AS).

Methods.

We used administrative data from 1999 to 2013 on US Medicare beneficiaries to identify patients (< 75 yrs old) with AS and a comparison group without AS. Rates of primary THA and primary TKA were computed for each group, and standardized for age, sex, and race. We also examined risks of primary TKA among patients with AS by their THA status.

Results.

We analyzed 52,568 patients with AS and 4,617,179 patients without AS. Between 1999 and 2013, the standardized incidence of primary THA in patients with AS doubled from 4.5 per 1000 patient-years (PY) to 9.6 per 1000 PY. Rates of primary TKA were higher in patients with AS than controls in all years. In 2013, the standardized incidence of primary TKA in AS was 12.3 per 1000 PY versus 5.7 per 1000 PY in the comparison group (RR 2.14, 95% CI 1.93–2.38). Rates of primary TKA were twice as high among patients with AS and THA than among those without THA (20.4 vs 10.2 per 1000 PY).

Conclusion.

Rates of THA in older patients with AS doubled over recent years, outpacing the increase in the general population. Rates of TKA were also substantially higher in older patients with AS. The increased risk of TKA in AS may be a consequence of damage from knee inflammation, or alterations in lower extremity biomechanics due to hip arthritis.
Hospitalization Increases the Risk of Acute Arthritic Flares in Gout: A Population-based Study over 2 Decades
Authors: Zleik Nour , Elfishawi Mohanad M. , Kvrgic Zoran , Michet Clement J. , Crowson Cynthia S. , Matteson Eric L. , Bongartz Tim
Published: July 2018

Objective.

To assess in-hospital gout flares in patients with gout.

Methods.

Hospitalizations were evaluated for gout flares in a cohort of Olmsted County, Minnesota, residents with incident gout in 1989–1992 or 2009–2010.

Results.

There were 429 patients followed up to 5 years. Of these, 169 patients experienced 454 hospitalizations. Hospitalization rates increased without reaching statistical significance from 1989–1992 to 2009–2010 [rate ratio (RR) 1.19, 95% CI 0.98–1.45]. The gout flare rate increased significantly during hospitalization (RR 10.2, 95% CI 6.8–14.5). In-hospital gout flare increased the average hospital stay by 1.8 days (p < 0.001).

Conclusion.

Hospitalization increased the risk of gout flares 10-fold. In-hospital gout flares were associated with longer hospitalization.
Influence of Disease Manifestations on Health-related Quality of Life in Early Psoriatic Arthritis
Authors: Wervers Kim , Luime Jolanda J. , Tchetverikov Ilja , Gerards Andreas H. , Kok Marc R. , Appels Cathelijne W.Y. , van der Graaff Wiebo L. , van Groenendael Johannes H.L.M. , Korswagen Lindy-Anne , Veris-van Dieren Josien J. , Hazes Johanna M.W. , Vis Marijn
Published: July 2018

Objective.

Psoriatic arthritis (PsA) is a multifaceted disease. Affecting joints, skin, entheses, and dactylitis, its effect on health-related quality of life (HRQOL) could be substantial. We aim to assess HRQOL in patients newly diagnosed with PsA and analyze its associations with disease manifestations.

Methods.

Data collected at time of diagnosis from patients with PsA included in the Dutch south-west Early Psoriatic Arthritis cohort (DEPAR) study were used. HRQOL was assessed using 8 domains of the Medical Outcomes Study Short Form-36 (SF-36) questionnaire. Patients were classified based on primary manifestation in arthritis subtypes (i.e., mono-, oligo-, or polyarthritis) and other subtypes (i.e., enthesitis, dactylitis, and axial disease). In all patients, presence of arthritis, enthesitis, dactylitis, psoriasis, and chronic inflammatory back pain was determined. Multivariable linear regression was used to determine associations of PsA manifestations with HRQOL.

Results.

Of 405 patients, primary manifestation was peripheral arthritis in 320 (78 monoarthritis, 151 oligoarthritis, and 91 polyarthritis), enthesitis in 37, axial disease in 9, and dactylitis in 39. Mean scores of SF-36 domains were lower than the Dutch reference population and similar across arthritis subtypes. A higher number of enthesitis locations and tender joints, and presence of chronic back pain, were independently associated with worse SF-36 scores. Psoriasis and dactylitis were not associated with worse scores.

Conclusion.

HRQOL was diminished in PsA at time of diagnosis compared to the Dutch reference population, and tender joints, enthesitis at clinical examination, and back pain as indicators of pain affected HRQOL.
Assessing Vasculitis in Giant Cell Arteritis by Ultrasound: Results of OMERACT Patient-based Reliability Exercises
Authors: Schäfer Valentin S. , Chrysidis Stavros , Dejaco Christian , Duftner Christina , Iagnocco Annamaria , Bruyn George A. , Carrara Greta , D’Agostino Maria Antonietta , De Miguel Eugenio , Diamantopoulos Andreas P. , Fredberg Ulrich , Hartung Wolfgang , Hocevar Alojzija , Juche Aaron , Kermani Tanaz A. , Koster Matthew J. , Lorenzen Tove , Macchioni Pierluigi , Milchert Marcin , Døhn Uffe Møller , Mukhtyar Chetan , Ponte Cristina , Ramiro Sofia , Scirè Carlo A. , Terslev Lene , Warrington Kenneth J. , Dasgupta Bhaskar , Schmidt Wolfgang A.
Published: July 2018

Objective.

To test the reliability of Outcome Measures in Rheumatology Clinical Trials (OMERACT) consensus-based ultrasound definitions for normal and vasculitic temporal and axillary arteries in patients with giant cell arteritis (GCA) and in controls.

Methods.

A preliminary 1-day meeting and a full 3-day meeting fulfilling OMERACT Ultrasound Group guidelines were held. Temporal and axillary arteries were examined at 2 timepoints by 12 sonographers on 4 patients with GCA and 2 controls. The aim was to test inter- and intrareader reliability for normal findings, halo sign, and compression sign. In both meetings, patients had established GCA. Pathology was more recent in the full meeting, which was preceded by 6 h of training. Scanning time was 15–20 min instead of 10–13 min.

Results.

In the preliminary exercise, interreader reliabilities were fair to moderate for the overall diagnosis of GCA (Light κ 0.29–0.51), and poor to fair for identifying vasculitis in the respective anatomical segments (Light κ 0.02–0.46). Intrareader reliabilities were moderate (Cohen κ 0.32–0.64). In the main exercise, interreader reliability was good to excellent (Light κ 0.76–0.86) for the overall diagnosis of GCA, and moderate to good (Light κ 0.46–0.71) for identifying vasculitis in the respective anatomical segments. Intrareader reliability was excellent for diagnosis of GCA (Cohen κ 0.91) and good (Cohen κ 0.71–0.80) for the anatomical segments.

Conclusion.

OMERACT-derived definitions of halo and compression signs of temporal and axillary arteries are reliable in recent-onset GCA if experienced sonographers (> 300 examinations) have 15–20 min for a standardized examination with prior training and apply > 15 MHz probes.
JRCR - updated prescreening process for submissions
Authors: Talanow Roland
Published: July 2018

This article describes updates on the prescreening process for manuscripts submitted on or after July 1, 2018 to the interactive Journal of Radiology Case Reports.
Relationships Among Palliative Care, Ethical Climate, Empowerment, and Moral Distress in Intensive Care Unit Nurses
Authors: Altaker Krista Wolcott , Howie-Esquivel Jill , Cataldo Janine K.
Published: July 2018

Background

Intensive care unit nurses experience moral distress when they feel unable to deliver ethically appropriate care to patients. Moral distress is associated with nurse burnout and patient care avoidance.

Objectives

To evaluate relationships among moral distress, empowerment, ethical climate, and access to palliative care in the intensive care unit.

Methods

Intensive care unit nurses in a national database were recruited to complete an online survey based on the Moral Distress Scale–Revised, Psychological Empowerment Index, Hospital Ethical Climate Survey, and a palliative care delivery questionnaire. Descriptive, correlational, and regression analyses were performed.

Results

Of 288 initiated surveys, 238 were completed. Participants were nationally representative of nurses by age, years of experience, and geographical region. Most were white and female and had a bachelor’s degree. The mean moral distress score was moderately high, and correlations were found with empowerment (r = −0.145; P = .02) and ethical climate scores (r = −0.354; P < .001). Relationships between moral distress and empowerment scores and between moral distress and ethical climate scores were not affected by access to palliative care. Nurses reporting palliative care access had higher moral distress scores than those without such access. Education, ethnicity, unit size, access to full palliative care team, and ethical climate explained variance in moral distress scores.

Conclusions

Poor ethical climate, unintegrated palliative care teams, and nurse empowerment are associated with increased moral distress. The findings highlight the need to promote palliative care education and palliative care teams that are well integrated into intensive care units.
Family Members’ Experiences With Bereavement in the Intensive Care Unit
Authors: Jones Casey , Puntillo Kathleen , Donesky Doranne , McAdam Jennifer L.
Published: July 2018

Background

Losing a loved one in the intensive care unit can be challenging for families. Providing bereavement support may assist in the grieving process.

Objective

To describe family members’ experiences with bereavement after the death of a loved one in the intensive care unit.

Methods

This secondary analysis used an exploratory, descriptive design to study family members’ experiences with bereavement. Family members of patients from 2 intensive care units in a tertiary medical center in the western United States participated. Audiotaped telephone interviews using a semistructured questionnaire were conducted. A qualitative, descriptive technique was used for data analysis. Two independent raters coded transcripts of audiotaped interviews with family members about their bereavement experiences.

Results

Seventeen family members participated in the study. Most participants were female (n = 12; 71%) and spouses of deceased patients (n = 14; 82%), and their mean (SD) age was 62.4 (10.0) years. Three themes emerged: (1) bereavement was an individual experience; (2) situations occurring during the intensive care unit encounter remained significant for family members beyond a year after the death; and (3) social, cultural, spiritual, and religious events after the death hold importance for families of patients in the intensive care unit.

Conclusions

Bereavement is a challenging experience for families of deceased intensive care unit patients. The themes identified in this study add insight into the experiences of these family members. The results of this study may guide future interventions to help support bereaved families of intensive care unit patients.
Ensuring Breathing Comfort at the End of Life: The Integral Role of the Critical Care Nurse
Authors: Campbell Margaret L.
Published: July 2018

This article describes the author’s program of clinical research focused on assessment and treatment of respiratory distress among critically ill patients at the end of life. Dyspnea is a subjective experience of breathing discomfort that occurs in the presence of cardiopulmonary and neuromuscular diseases. Dyspnea is one of the most common and most distressing symptoms experienced by critically ill patients. Many critically ill patients, particularly those not expected to survive, become cognitively impaired or unconscious and lose the ability to report symptoms, although dyspnea can be known only from a patient’s report. When self-reporting ability is lost, the critical care nurse must rely on signs indicative of a patient’s respiratory distress. The critically ill patient unable to self-report is vulnerable to under-recognition of symptom distress and subsequent over-treatment or undertreatment. When the patient is dying, there is only 1 chance to optimize the assessment and treatment of symptoms.
Educational Intervention to Improve Delirium Recognition by Nurses
Authors: Blevins Cheri S. , DeGennaro Regina
Published: July 2018

Background

Delirium poses increased morbidity and mortality risks for hospitalized patients. Underrecognition by health care providers contributes to poor outcomes for patients. Little has been published about methods used to teach health care providers how to screen for delirium using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).

Objective

To evaluate the effectiveness of a multimodal educational intervention for nurses in the medical intensive care unit to improve their knowledge and skills regarding delirium and delirium recognition.

Methods

An educational intervention was done in the medical intensive care unit of an academic medical center. Effectiveness was evaluated via a quasi-experimental design and using preintervention and postintervention assessments. Procedural correctness of performing the CAM-ICU delirium screening also was measured.

Results

Nurses participated in 1 small-group session (n = 34). Fifteen sessions were conducted from June to September 2016, and assessments were completed before and after the intervention. The sample consisted of predominantly nurses with a bachelor’s degree (56%) who had 1 to 5 years’ experience (59%). Mean scores overall and on the knowledge subscale differed significantly (P < .001) from before to after the intervention. No correlation was found between demographic groups and score differences. Seventy-nine percent of participants used the tool correctly after the intervention.

Conclusions

The educational intervention provided for these nurses further validated published reports of the benefits of an educational program about delirium. The content of the educational intervention should be targeted for the setting, the risk factors for the patient population in question, and the specific delirium screening tool used.
Patientsâ€™ self-evaluation of symptoms, signs and compliance to therapy for heart failure surveillance: A pilot study on identification of worsening heart failure
Authors: Palmieri Vittorio , Palermo Antonio
Published: July 2018

In patients with chronic heart failure (HF), it is unclear whether self-evaluation of HF-related symptoms and signs may contribute to the surveillance of clinical stability over time or the early identification of worsening HF. Â Â Therefore, HF-related symptoms and signs, and compliance to therapy were investigated by a self-administrated questionnaire in patients hospitalized due to worsening HF (cases) as well in those with stable HF (controls).Â  The temporal interval of interest for the questionnaire focused on 2 to 7 days before the hospitalization of the control visit. Â A method called â€œclassicâ€ extrapolated a surveillance score by 4 questions revealing HF-related symptoms or signs (higher score indicative of more symptoms or sings reported).Â  Alternatively, 3 additional questions enriched the â€œclassicâ€ questionnaire, including one on whether the health status was perceived as stable, improved or worsening.Â  The score from â€œperceived health statusâ€Â  inquiry was used as â€œconditional factorâ€ to computed the surveillance score as: conditional factor + [conditional factor X (the sum of the points yielded by the responses to each question on symptoms, sings and compliance to therapy)]. Â Among 51 patients hospitalized due to worsening HF and 104 with chronic HF (retrospective study), the area under the curve (receiver operating characteristic) discriminating worsening HF was 0.90 by the classic, and 0.96 by the conditional method (both p<0.001), yielding error rates of 2 in 10 by the classic and 1 in 10 by the conditional method.Â  In a pilot longitudinal study in 37 ambulatory HF patients from a different population source, predicting worsening HF by alternative questionnaires within 12 weeks from the visit yielded consistent results.Â  In conclusion, patientsâ€™ self-monitoring symptoms, signs and compliance by a standardized questionnaire and a conditional method for generating relative a score, may be a promising method for HF stability surveillance.
Real-World Effectiveness of Intravenous Stroke Thrombolysis is more than the Expectation of Practicing Neurologists
Authors: Ghafoor Fazal , Khan Firosh , Shehna Abdulkhader
Published: July 2018

Background: The objective of the study was to compare the actual results of intravenous thrombolytic therapy (IVTT) in acute ischemic stroke with results anticipated by neurologists in practice. Methods: Neurologists practicing in Thrissur metropolitan region, covering a population of 1.8 million, were telephonically surveyed about the number of yearly IVTT and their expert opinion/comment about effects of thrombolysis. This was compared with the results of IVTT from a single institution in the same region from 2012 to 2016. Results: Eight neurologists in the region give approximately 140–150 IVTT per year. Nearly 20%–40% (median 32%) patients have good outcome, 5%– 10% (median 9%) have intracerebral hematoma (ICH), and 25%–35% (median 30%) have death/bad outcome. Two neurologists from a tertiary care hospital in the region treated 122 cases of ischemic strokes with IVTT from 2012 to 2016. Age ranged from 8 to 88 years and 88 were males. Average delay in reaching hospital was 138.1 min and the door-to-needle time was 56.3 min. There were 26 cases of posterior-circulation strokes and 14 cases of cardioembolic strokes. At presentation, average National Institute of Health Stroke Scale (NIHSS) was 14.7; Modified Rankin Scale (mRS) 0.4; and CT Alberta Stroke Program Early Computerized Tomography Scores was 9.5. Good and sustained benefit (GSB) (>4 reduction in NIHSS at 24 h and 7 days) was there in 49% and no improvement (NI)/worsening in 36%. mRS 0–2 at discharge/30 days was documented in 57.3%. Symptomatic ICH was 10% (12/122) and mortality rate was 11.5% (14/122). GSB in posterior circulation strokes was 69.2% and NI/worsening in only 7.7%. mRS was 0–2 in 77% of posterior circulation strokes. Conclusion: Contrary to the popular belief of the practicing neurologists, IVTT has a high percentage of good outcome with a reasonable bleeding risk and low rates of absolute futility.
-Rota–Baxter Operators, Infinitesimal Hom-bialgebras and the Associative (Bi)Hom-Yang–Baxter Equation
Authors: Liu Ling , Makhlouf Abdenacer , Menini Claudia , Panaite Florin
Published: July 2018

We introduce the concept of a
$\{\unicode[STIX]{x1D70E},\unicode[STIX]{x1D70F}\}$
-Rota–Baxter operator, as a twisted version of a Rota–Baxter operator of weight zero. We show how to obtain a certain
$\{\unicode[STIX]{x1D70E},\unicode[STIX]{x1D70F}\}$
-Rota–Baxter operator from a solution of the associative (Bi)Hom-Yang–Baxter equation, and, in a compatible way, a Hom-pre-Lie algebra from an infinitesimal Hom-bialgebra.
ENERGIA SOLAR – SISTEMA TRANSIENTE DE ENERGIA SOLAR: ESTUDO DA UTILIZAÇÃO DE ENERGIA SOLAR PARA O ABASTECIMENTO DO PLANO PILOTO
Authors: Magalhães Campos da Cunha Fernanda , Pereira De Macedo Renata , Cornils Monteiro Araújo Eugênia
Published: July 2018

A energia solar vem se mostrando como uma alternativa a utilização de energias produzidas através de combustíveis fósseis; dentre os fatores que conduzem a isso está a redução de impactos ambientais na sua geração. O Distrito Federal integra uma localização geográfica propícia para a produção de energia fotovoltaica por ser uma região de grandes altitudes e por não possuir longos períodos chuvosos; a Asa Norte foi escolhida por ser a região em que o Centro Universitário de Brasília está localizado. O objetivo dessa pesquisa foi compreender a eficiência da geração de energia fotovoltaica, assim como investigar a viabilidade do aproveitamento desta energia na região escolhida, na intenção de que uma unidade consumidora de eletricidade virtual possa ser sua unidade geradora. Foi selecionada virtualmente uma amostra de edifícios na Asa Norte; e suas dimensões, coordenadas geográficas e situação de disponibilidade para aproveitamento solar foram checadas. A atividade em campo foi realizada para confirmar os dados obtidos no software de simulação do Centro de Referência para Energia Solar e Eólica Sérgio Brito e as dimensões adquiridas através do Google Earth, e identificar também possíveis obstruções ou problemas relacionados à implantação de painéis fotovoltaicos na cobertura do edifício escolhido. Foram medidas, calculadas e analisadas taxas de incidência solar, assim como irradiação e as angulações de zênite e azimute, de modo a verificar a eficiência de produção energética com placas em posição e tamanhos padrões. Determinou-se que a produção de energia para o edifício estudado na Asa Norte seria de um valor compreendido entre 3.197 e 5.754 quilowatts-hora por ano, distribuídos em doze painéis, no edifício em questão. Também foram analisados virtualmente outros três prédios aleatórios na Asa Norte, onde foi observado que, em geral, possuem espaço disponível em suas coberturas e com baixos índices de obstrução dos raios solares, concluindo assim haver uma captação similar ao edifício estudado inicialmente. Em resumo, foi concluído que a Asa Norte possui áreas que podem ser adequadas para instalação de painéis fotovoltaicos, dados os resultados estudados neste trabalho, ficando sugerida assim a viabilidade de implantação desse sistema para redução dos custos e redução dos impactos ambientais.
ESTUDO DA EFICIÊNCIA DA FAIXA EXCLUSIVA DE ÔNIBUS DA VIA W3 UTILIZANDO SOFTWARE DE MICROSSIMULAÇÃO DE TRÁFEGO
Authors: Freire de Carvalho Luiza , Soares Velloso Mônica , Bonelli Henrique de Faria Rômulo
Published: July 2018

A implantação de corredores exclusivos e faixas exclusivas de ônibus são consideradas importantes estratégias para fomentar a política de prioridade de transporte público nas cidades. No Distrito Federal, desde 2012, alguns corredores e faixas exclusivas de ônibus têm sido implementadas em várias de suas Regiões Administrativas. No entanto, tal ação foi parte de uma política de governo que não contou com nenhum estudo pré ou pós implantação. Nesse sentido, o presente trabalho pretendeu avaliar o desempenho da faixa exclusiva de ônibus da via W3 Sul, importante via arterial da cidade, como estudo de caso. Para tanto, foi escolhida uma interseção típica da via, que se repete ao longo de sua extensão, para ser alvo de uma microssimulação de tráfego. Foram então realizadas pesquisas tais como, contagem volumétrica e classificatória de veículos - com identificação de horários de pico, pesquisas sobe-desce nas linhas ônibus que trafegam na faixa exclusiva, identificação e locação das paradas de ônibus, levantamento dos tempos semafóricos dos cruzamentos, cálculo da velocidade média de deslocamento dos ônibus e índice de carregamento. A partir das pesquisas realizadas, que deram sustentação para conhecimento do diagnóstico da situação atual, ou seja, a operação da via com tráfego segregado entre veículos particulares e transporte público, foram selecionados alguns dos dados levantados com o objetivo de calibrar a interseção escolhida utilizando como ferramenta o software Syncro. A partir dessa calibração, foi possível simular o cenário antigo da via, ou seja, a operação em trânsito misto. O estudo considerou que a implantação da faixa exclusiva permitiu uma operação com fluxo mais estável ao longo do dia se comparada com o cenário anterior de fluxo misto, no entanto, observou-se que na hora pico o fluxo de ônibus opera com graves retenções nas regiões de parada de ônibus. Concluiu-se, portanto, que alterações na geometria dos pontos de parada de ônibus se fazem necessárias para que se alcance uma melhora nas condições de operação da via.
LEVANTAMENTO DO PERFIL DOS USUÁRIOS DAS CICLOVIAS DE TRÊS REGIÕES ADMINISTRATIVAS DO DISTITO FEDERAL
Authors: Carolina Viegas de Araujo Maria , Soares Velloso Mônica
Published: July 2018

A bicicleta desempenha um importante papel na mobilidade sustentável de uma cidade. Sua utilização em larga escala contribui de forma inconteste para a redução da emissão de poluentes na atmosfera, assim como mitiga problemas de poluição acústica. Do ponto de vista social, o uso cotidiano da bicicleta oferece diversos benefícios a seus usuários, como maior flexibilidade na escolha do deslocamento, melhoria da qualidade de vida, além de permitir a aproximação de diferente classes sociais, gêneros e idades. No quesito economia, existe um real possibilidade dos usuários reduzirem seus custos pessoais, tais como combustível, manutenção, estacionamento, entre outros. Brasília é uma cidade que conta com diversos fatores que favorecem a prática do ciclismo, tais como relevo pouco acidentado, período de chuvas bem marcado e uma extensa malha cicloviária, contando com uma infraestrutura superior a 400 quilômetros distribuídos por todo o seu território. No entanto, apesar de todas as facilidades, os ciclistas da região enfrentam alguns fatores limitantes no que concerne à infraestrutura: a falta de continuidade do traçado e problemas de sinalização vertical e horizontal são alguns desses problemas. Além disso, a crônica deficiência de calçadas por toda a cidade induz pedestres a utilizarem as ciclovias no seu deslocamento, causando sérios conflitos com os ciclistas. O presente estudo teve como objetivo levantar o perfil dos usuários das ciclovias de diferentes Regiões Administrativas de Brasília, classificadas em três classes de renda distintas (alta, média e baixa), verificando se o perfil econômico dos ciclistas influenciava o uso e a percepção da infraestrutura cicloviária. Verificou-se, também, que fatores influenciavam a escolha da bicicleta como meio de transporte na cidade, além de terem sido realizadas contagens de pedestres e ciclistas nas ciclovias e fora delas
A CONSTRUÇÃO DA PROTEÇÃO DE DADOS DE TESTE NO BRASIL: UMA ANÁLISE A PARTIR DO LEGISLATIVO
Authors: Jordane Lucena Costa Hugo , Edelvacy Pinto Marinho Maria
Published: July 2018

Esta pesquisa teve seu norte como fruto de discussão do grupo de pesquisa Propriedade Intelectual e Desenvolvimento promovido pelo Programa de Mestrado e Doutorado do Centro Universitário de Brasília, orquestrado pela Professora Doutora MARIA EDELVACY PINTO MARINHO, também orientadora deste projeto.De início, traçou-se o caminho para compreender melhor a dogmática através da análise de conteúdo e da análise do discurso para, ao final, compreender e interpretar as diversas discussões sobre o tema nos anais do Congresso Nacional.Adotou-se o método dedutivo tendo como técnica de pesquisa o método de estudo de caso. Utilizou-se como fonte a análise legal e documental discurso legislativo.Na primeira fase da pesquisa, o estudo foi concentrado no desenvolvimento metodológico e o aprendizado dos conceitos e ferramentas relevantes para o tema, quais sejam, dados de teste, processo legislativo, análise do conteúdo. Além dessas informações, nesse período, realizou-se a coleta dos dados necessários no Congresso Nacional para proceder a análise de conteúdo das discussões realizadas de modo que o objetivo desta pesquisa levasse em conta o histórico das discussões.Com o referencial conceitual e metodológico identificado, passou-se para a segunda etapa: compreender o processo legislativo nas Casas do Congresso Nacional. Trata-se de um recurso importante na pesquisa, uma vez que o projetodeve ser, categoricamente, na técnica legislativa respeitando a Lei Complementar 95 de 26 de fevereiro de 1998.Foram examinados os instrumentos legais, quais sejam, o Laudo Arbitral nº VII do MERCOSUL, Medida Provisória nº 69/2002, Projeto de Lei de Conversão 22/2002 e, Lei 10.603/2002.
A CRIMINALIDADE JUVENIL E A RELAÇÃO ENTRE RISCO E CULTURA
Authors: Vieira de Sousa Gustavo , Pedro Garcia Bortolini João , De La Vega Miranda Alessandra
Published: July 2018

Importante assunto hodiernamente, a interação entre os jovens e o universo das subculturas criminais chama a atenção e atrai o foco de debates. Buscou-se, neste trabalho, uma maior compreensão entre as relações dos jovens em conflito com a lei, que se encontram dentro do aparato estatal de ressocialização, e a subcultura na qual estão inseridos, bem como os reflexos eventualmente causados no próprio jovem e no coletivo, no contexto do Distrito Federal. O principal objetivo desta pesquisa foi compreender como os fatores de risco se relacionam com as diferentes subculturas das quais os jovens fazem parte. Para isso utilizou-se, principalmente, do aporte etnográfico. O método etnográfico possibilitou aos pesquisadores, através da inserção no campo, compreender melhor a confluência entre a sua observação e a visão do nativo. Diversas vezes, foram norteados pelos aspectos simbólicos que trazem uma explicação das relações dos jovens e dos fatores que se desenvolvem em uma subcultura. Como resultado, observou-se que há uma estrita conexão entre as subculturas das quais os jovens fazem parte e os fatores de risco que compõem uma dimensão simbólica, que acabam por influenciar a criminalidade juvenil. Deve-se levar em consideração que os fatores de risco aqui tratados não são vistos como sendo determinantes para a criminalidade juvenil em si, mas um tanto quanto influentes. A partir do momento em que esses fatores de risco são somados à determinadas subculturas, há uma possibilidade de que este jovem entre em conflito com a lei. Portanto, há a necessidade de compreender o liame da relação entre fatores de risco e subculturas, no contexto do Distrito Federal, e se as características subculturais contribuem para determinados comportamentos delitivos, que vão de encontro à norma legal. Abre-se, pois, um campo de novas indagações sobre como lidar com tais fatores e com determinadas subculturas, buscando-se assim medidas eficazes de pacificação e de redução da criminalidade juvenil
A LUTA PELA TERRA E PELO RECONHECIMENTO SOCIAL: OS KALUNGA NO CURSO DE LICENCIATURA EM EDUCAÇÃO DO CAMPO DA UNIVERSIDADE DE BRASÍLIA E A IMPLEMENTAÇÃO DA LEI 10.639/2003
Authors: Alves Da Silva Filho José , Alves Ferreira Tiago , Santos Bulhões de Jesus Leandro
Published: July 2018

A trajetória das lutas das populações negras rurais em nosso país é marcada por invisibilidades, silenciamentos e acúmulos de desigualdades. Nos últimos anos, entretanto, a geração de políticas públicas direcionadas para estes coletivos trouxe à tona a problemática das identidades quilombolas em meio aos movimentos social do campo. Os cursos de Licenciatura em Educação do Campo (Ledoc), implantados recentemente em várias universidades do Brasil, configuram-se enquanto demanda destes movimentos que há tempos exigiam do Estado brasileiro uma educação diferenciada, calcada em valores, saberes, temporalidades, subjetividades e projetos de sociedade que os dispositivos educacionais nacionais vigentes não contemplavam. Se os quilombolas integram a categoria de povos do campo isso significa dizer que, de uma maneira interseccional, enfrentam também o racismo e o epistemicídio. Nesta pesquisa, interessou-nos saber se o curso Ledoc, oferecido pela Universidade de Brasília e constituído expressivamente por alunos/as quilombolas kalunga, tem abordado questões que consideramos cruciais para o processo de formação de um/a futuro/a educador/a do quilombola que provavelmente voltará para sua comunidade, a saber: implementação da Lei 10.639/03; racismo e educação; identidades quilombolas; memória; reconhecimento e justiça cognitiva; formação continuada, entre outros. Analisamos documentos oficiais que norteiam o Curso, como o Projeto Político Pedagógico; as Diretrizes Curriculares Nacionais para a Educação Escolar Quilombola; a Lei 10.639/03; as ementas de todas as disciplinas ofertadas nos últimos trimestres acadêmicos, assim como aplicamos questionários com questões objetivas e subjetivas para cerca de cinquenta educandos/as. Há, decerto, muitos caminhos a serem percorridos, contudo, o curso Ledoc/UnB parece estar cumprindo de modo expressivo o seu papel enquanto lugar específico de problematização dos entrecruzamentos de teorias, abordagens e temas que dizem respeito às questões quilombolas, em especial aos kalunga
EFEITO DO TIPO DE PERGUNTA: ABERTA OU FECHADA SOBRE A CORRESPONDÊNCIA VERBAL EM SITUAÇÃO LÚDICA
Authors: De Matos Demoly Patricia , Augusto de Medeiros Carlos
Published: July 2018

O presente estudo foi realizado com seis participantes com idades entre 20 e 30 anos e teve como objetivo avaliar a influência de perguntas abertas e fechadas sobre a Correspondência Verbal em um jogo de cartas. O experimento envolveu seis partidas disputadas em duplas em duas condições experimentais: três participantes que jogaram primeiro partidas com perguntas abertas (PA) e depois partidas com perguntas fechadas (PF), e outros três participantes que jogaram primeiro partidas com perguntas fechadas (PF) e depois partidas com perguntas abertas (PA). O jogo foi realizado em três dias, sendo que, a cada dia, cada dupla de participante jogava duas partidas por dia, com 20 rodadas cada partida. Cada rodada tinha uma carta trunfo, que venceria de todas as outras cartas do baralho. Durante o jogo, os participantes deveriam relatar o valor de suas cartas, e o que relatasse o menor valor, deveria responder a uma pergunta feita pela pesquisadora. Um exemplo de pergunta em partidas PF seria “Você tem a carta trunfo macaco vermelho?”, e em partidas PA seria “Qual a cor e o animal de sua carta?”. Houve uma probabilidade de checagem de 0,17, isto é, quando o dado caía em seis, os participantes mostravam suas cartas. Para relatos distorcidos havia uma punição de compra de cartas. A probabilidade de checagem foi controlada experimentalmente por um programa de dado no computador. Foi possível observar que a mudança na topografia da pergunta influenciou a correspondência verbal do relato dos participantes. A maioria dos participantes distorceu mais, com relação à carta trunfo, em partidas PF do que em partidas PA, o que corroborou com a hipótese inicial do estudo de que perguntas abertas tendem a evocar maior correspondência verbal de relatos