bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of dexmedetomidine for prevention of withdrawal syndrome in the pediatric intensive care unit: protocol for an adaptive, multicenter, randomized, double-blind, placebo-controlled, non-profit clinical trial
Authors: Mondardini Maria Cristina , Sperotto Francesca , Daverio Marco , Caramelli Fabio , Gregori Dario , Caligiuri Maria Francesca , Vitale Francesca , Cecini Maria Teresa , Piastra Marco , Mancino Aldo , Pettenazzo Andrea , Conti Giorgio , Amigoni Angela
Published: December 2019

Background

Prolonged treatment with analgesic and sedative drugs in the pediatric intensive care unit (PICU) may lead to undesirable effects such as dependence and tolerance. Moreover, during analgosedation weaning, patients may develop clinical signs of withdrawal, known as withdrawal syndrome (WS). Some studies indicate that dexmedetomidine, a selective α2-adrenoceptor agonist, may be useful to prevent WS, but no clear evidence supports these data. The aims of the present study are to evaluate the efficacy of dexmedetomidine in reducing the occurrence of WS during analgosedation weaning, and to clearly assess its safety.

Methods

We will perform an adaptive, multicenter, randomized, double-blind, placebo-controlled trial. Patients aged < 18 years receiving continuous intravenous analgosedation treatment for at least 5 days and presenting with clinical conditions that allow analgosedation weaning will be randomly assigned to treatment A (dexmedetomidine) or treatment B (placebo). The treatment will be started 24 h before the analgosedation weaning at 0.4 μg/kg/h, increased by 0.2 μg/kg/h per hour up to 0.8 μg/kg/h (neonate: 0.2 μg/kg/h, increased by 0.1 μg/kg/h per hour up to 0.4 μg/kg/h) and continued throughout the whole weaning time. The primary endpoint is the efficacy of the treatment, defined by the reduction in the WS rate among patients treated with dexmedetomidine compared with patients treated with placebo. Safety will be assessed by collecting any potentially related adverse event. The sample size assuring a power of 90% is 77 patients for each group (total N = 154 patients). The study was approved by the Ethics Committee of the University-Hospital S.Orsola-Malpighi of Bologna on 22 March 2017.

Discussion

The present trial will allow us to clearly assess the efficacy of dexmedetomidine in reducing the occurrence of WS during weaning from analgosedation drugs. In addition, the study will provide a unique insight into the safety profile of dexmedetomidine.

Trial registration

ClinicalTrials.gov, NCT03645603. Registered on 24 August 2018.

EudraCT, 2015–002114-80. Retrospectively registered on 2 January 2019.
Management of adult-onset Still’s disease with interleukin-1 inhibitors: evidence- and consensus-based statements by a panel of Italian experts
Authors:   AOSD Consensus Group, Colafrancesco Serena , Manara Maria , Bortoluzzi Alessandra , Serban Teodora , Bianchi Gerolamo , Cantarini Luca , Ciccia Francesco , Dagna Lorenzo , Govoni Marcello , Montecucco Carlomaurizio , Priori Roberta , Ravelli Angelo , Sfriso Paolo , Sinigaglia Luigi
Published: December 2019

Background

Adult-onset Still’s disease (AOSD) is a rare inflammatory condition characterized by fever, rash, and arthritis. Because of its rarity, clinical trials are inherently small and often uncontrolled. Our objective was to develop recommendations for the use of interleukin (IL)-1 inhibitors in the management of patients with AOSD, based on the best evidence and expert opinion.

Methods

A panel of 10 experts (9 rheumatologists and 1 pediatrician) was established. The first step was dedicated to a comprehensive literature review and development of statements. Two separate literature searches were performed on the MEDLINE (Pubmed), EMBASE, and BIOSIS databases through April 2018 to identify (1) differences and similarities between AOSD and pediatric Still’s disease (systemic juvenile idiopathic arthritis [SJIA]) and (2) the efficacy and safety of IL-1 inhibitors in AOSD treatment. In the second step, the statements were submitted in a Delphi process to a panel of 67 rheumatologists. Consensus threshold was set at 66%: positive, > 66% of voters selected scores 3 to 5; negative, > 66% of voters selected scores 1 or 2. In the third step, the voting results were analyzed, and the statements were finalized.

Results

Eleven statements were developed. Forty-six of 67 rheumatologists (72%) participated in the Delphi process. A positive consensus was reached after the first round of voting and was full (> 95%) on the majority of statements. A large consensus was achieved in considering AOSD and SJIA as the same disease. The use of anti-IL-1 therapies in refractory patients was considered quite safe and effective both as the first and as a subsequent line of biologic treatment, especially in systemic patients. Because of the lack of head-to-head comparisons, a different profile of efficacy among IL-1 inhibitors could not be established. There was a large consensus that failure of the first IL-1 inhibitor does not preclude response to another one. The lack of studies comparing early versus late treatment did not allow to draw conclusions; however, data from SJIA suggest a better response in early treatment.

Conclusions

The Delphi method was used to develop recommendations that we hope will help clinicians in the management of patients with AOSD refractory to conventional therapies.
The comparative efficacy and risk of harms of the intravenous and subcutaneous formulations of trastuzumab in patients with HER2-positive breast cancer: a rapid review
Authors: Van den Nest Miriam , Glechner Anna , Gold Maria , Gartlehner Gerald
Published: December 2019

Background

Trastuzumab is a monoclonal antibody for patients with HER2 (human epidermal growth factor receptor 2)-positive breast cancer, which is added to regular treatment and reduces mortality. Originally, trastuzumab had to be administered intravenously (IV) over 30 min every 3 weeks for 1 year. Since 2012, a formulation for the subcutaneous (SC) administration of trastuzumab has been available, which has not yet been approved in the USA. Advocates claim that the SC formulation saves time and money, despite higher costs. The purpose of this study is to review existing literature concerning the comparative efficacy and risk of harms of trastuzumab IV and SC concerning patient-relevant health outcomes.

Methods

We conducted searches in the Cochrane Library and MEDLINE for articles published through May 2018 in English or German. In addition, we searchedClinicalTrials.govto identify unpublished studies. We dually reviewed the abstracts and full-text articles based on a priori defined inclusion criteria, rated the risk of bias of included studies, and assessed the strength of the evidence for each outcome of interest. Because data was insufficient for quantitative synthesis, we summarized results narratively.

Results

We identified three RCTs (randomized controlled trials) meeting our eligibility criteria, which included data on 1003 patients. We found moderate evidence for similar event rates (20.05% vs. 18%, HR (hazard ratio) 0.88, CI 95% = 0.62–1.27), and mortality rates (10% vs. 8%, HR 0.76, CI 95% = 0.44–1.32) after 1.7 years for patients receiving trastuzumab IV and for patients receiving SC. Results remained similar after 3.3 years, though evidence lacked strength due to a high dropout rate. All trials reported more adverse events among the SC group than in the IV group. Evidence for these findings was of moderate strength. Nevertheless, more than 85% of the patients preferred trastuzumab SC over IV. Results concerning serious adverse events appeared to be heterogeneous.

Conclusion

Results of studies indicate similar efficacy between the two routes of administration. The higher rates of adverse events for SC administration were mainly attributable to injection site–related events. The clinical decision of whether to administer trastuzumab SC or IV requires the consideration of several factors and should be determined individually.
Uniqueness of meromorphic functions with their reduced linear c-shift operators sharing two or more values or sets
Authors: Banerjee Abhijit , Bhattacharyya Saikat
Published: December 2019

In the paper, we introduce a new notion of reduced linear c-shift operator $L _{c}^{r}\,f$Lcrf, and with the aid of this new operator, we study the uniqueness of meromorphic functions $f(z)$f(z) and $L_{c}^{r}\,f$Lcrf sharing two or more values in the extended complex plane. The results obtained in the paper significantly improve a number of existing results. Further, using the notion of weighted sharing of sets, we deal the same problem. We exhibit a handful number of examples to justify certain statements relevant to the content of the paper. We are also able to determine the form of the function that coincides with its reduced linear c-shift operator. At the end of the paper, we pose an open question for future research.
Gendered dynamics of transnational social protection
Authors: Bilecen Başak , Barglowski Karolina , Faist Thomas , Kofman Eleonore
Published: December 2019

Social protection refers to resources and strategies to deal with social risks, such as poverty or obligations and needs of care, which might impede the realization of life chances and well-being. Previous research has shown that migrants are particularly affected by challenges when accessing or providing social protection, because of unfamiliar welfare regulations in the immigration country and their family and friends being located in various locations, calling for an investigation of gendered dynamics in transnational spaces. Inthis special issuewe aim to advance these vital debates by elucidating the social consequences of the articulation and organization of formal and informal social protection across borders for different actors involved through a joint investigation of gender and transnationality as key dimensions of social inequality. More specifically, the papers collected inthis special issueare devoted to investigating the link of formal and informal dimensions of transnational social protection and showing its impact on unequal life chances of mobile people in Europe. This introduction frames the articles collected inthis special issuefrom an inequality perspective, thereby pointing to the ways in which gender and transnationality interact with other dimensions of inequality in the field of social protection, which currently constitutes one of the most vital issues in the field of migration scholarship.
Disease surveillance using online news: an extended study of dengue fever in India
Authors: Zhang Yiding , Ibaraki Motomu , Schwartz Franklin W.
Published: December 2019

Background

The study demonstrates the potential in using newspaper information as a proxy for monitoring dengue fever outbreaks in India. Online newspapers are being considered as sources of information on disease surveillance, early outbreak detection, and epidemiology research. Our objective is to understand the complex dengue epidemiology and discover inter-relationships between dengue fever and local social-environmental factors by mining information from local Indian news articles.

Results

We search and extract articles from the newspaper database, LexisNexis. News articles related to dengue fever in India are analyzed together with local environmental, climate, and population data in both temporally and spatially to study disease epidemiology. We also examine the influence of newsworthiness for constructing a disease surveillance system. In terms of temporal aspects, dengue outbreaks follow consistent patterns every year. However, for many areas, this application is frustrated by the relatively small numbers of news articles.

Conclusions

The study has advanced capabilities in producing approaches that provide for richer interpretations of textual information provided in newspaper articles. Such approaches appear particularly well suited for developing countries with relatively poor medical infrastructures and records.
Excited delirium syndrome from psychostimulant abuse can mimic a violent scene of death
Authors: Jothee Shatishraj , Shafie Mohamed Swarhib , Nor Faridah Mohd
Published: December 2019

Background

Previous reported cases on excited delirium syndrome studied on the common clinical manifestations of the syndrome. The usual forensics implication for the syndrome is that death commonly is associated with restraint procedures by law enforcement agencies; however, not many cases reported highlights the difficulties in attributing a violent scene of death to the syndrome.

Case presentation

We present a case of a partially naked body found in an apartment unit under suspicious circumstances with multiple injuries. The scene of death was violent, and the body was found with blood wiped all over the floor and walls. Investigators believed a violent crime had occurred, and a suspect was reprimanded. However, upon autopsy, it was found that all injuries were superficially inflicted and were unlikely to have been part of an act of commission or caused his death. Internal examination found no remarkable pathology. Toxicology revealed a presence of psychostimulants, that is, methamphetamine, MDMA, and ethyl alcohol. Reconstruction of events by the witness, who was initially suspected of the ‘murder’, revealed that the injuries and his death could likely be explained by an episode of excited delirium.

Conclusion

The case highlights the challenges faced when attributing excited delirium syndrome as a cause of death. The syndrome can present with injuries from aggressive or bizarre behaviour, coupled with the destruction of property, which may confuse investigators on the possible manner of death.
Role of multidetector CT virtual cystoscopy compared to conventional cystoscopy in the diagnosis of urinary bladder neoplasms
Authors: Niazi Gamal , Hetta Waleed M.
Published: December 2019

Background

The study was done to assess the utility of multidetector CT virtual cystoscopy versus conventional cystoscopy in the diagnosis of urinary bladder tumors. Thirty patients were included, 23 patients with recently diagnosed bladder masses, 7 patients with history of previously resected bladder masses. Conventional cystoscopy was done to all patients with biopsy of suspicious lesions. CT examinations were performed with a 16 and a 320-MDCT scanners. Multiplanar reconstructed (MPR) images were obtained. Also virtual cystoscopic images were obtained with the volume rendering technique and the same software used for MPR images.

Results

CTVC detected 9 out of 10 polypoid masses detected by conventional cystoscopy (90% sensitivity), 23 out of 23 sessile masses (100% sensitivity), 4 out of 4 areas of wall thickening (100% sensitivity), and 0 out of 1 case mucosal color change (0% sensitivity).

Conclusion

CTVC is a minimally invasive technique that can be of value for primary diagnosis, surveillance and screening of urinary bladder neoplasms.
Developing of the smart quadcopter with improved flight dynamics and stability
Authors: Malik Waqas , Hussain Sakhawat
Published: December 2019

The cause of the rapid growth and enhancement in the dynamics of unmanned aerial vehicles (UAVs) is due to its vast utilization in every-day application. The major advantage of UAVs is no risk of human life with secure and suitable surveillance. The UAV facilitates in live video streaming and wide aerial coverage for monitoring. In this project, a type of UAV named quadcopter has been developed. The work mainly consists of design of the quadcopter frame, interfacing of the brushless DC motors and bluetooth module with the microcontroller, and adjustment of the roll, pitch, and yaw for keeping the smooth flight dynamics by flight controller board containing MEMS sensors, i.e., gyroscope, accelerometer, magnetometer, and pressure sensors. The repeated simulation and testing has been carried out in MATLAB for the mathematical modeling of the dynamics of the system, i.e., Euler method for solving differential equation for finding system states, computation of the rotation matrix R and functions to convert from an angular velocity vector w to the derivatives of roll, pitch, and yaw. The improvement in the parameters of the flight dynamics and removing the errors to gain stability in the frame are the main core issues which have been achieved by the several iterations. A closed-loop control system, i.e., PID controller, has been simulated and carefully designed for stabilizing the actual angle from the sensors and desired angle from the pilot. The reduced error rate of 0.05 degrees after every 10 s was achieved.
Outcome in Children With Standard-Risk B-Cell Acute Lymphoblastic Leukemia: Results of Children’s Oncology Group Trial AALL0331
Authors: Maloney Kelly W. , Devidas Meenakshi , Wang Cindy , Mattano Leonard A. , Friedmann Alison M. , Buckley Patrick , Borowitz Michael J. , Carroll Andrew J. , Gastier-Foster Julie M. , Heerema Nyla A. , Kadan-Lottick Nina , Loh Mignon L. , Matloub Yousif H. , Marshall David T. , Stork Linda C. , Raetz Elizabeth A. , Wood Brent , Hunger Stephen P. , Carroll William L. , Winick Naomi J.
Published: December 2019

PURPOSE

Children’s Oncology Group (COG) AALL0331 tested whether intensified postinduction therapy that improves survival in children with high-risk B-cell acute lymphoblastic leukemia (ALL) would also improve outcomes for those with standard-risk (SR) ALL.

PATIENTS AND METHODS

AALL0331 enrolled 5,377 patients between 2005 and 2010. All patients received a 3-drug induction with dexamethasone, vincristine, and pegaspargase (PEG) and were then classified as SR low, SR average, or SR high. Patients with SR-average disease were randomly assigned to receive either standard 4-week consolidation (SC) or 8-week intensified augmented Berlin-Frankfurt-Münster (BFM) consolidation (IC). Those with SR-high disease were nonrandomly assigned to the full COG-augmented BFM regimen, including 2 interim maintenance and delayed intensification phases.

RESULTS

The 6-year event-free survival (EFS) rate for all patients enrolled in AALL0331 was 88.96% ± 0.46%, and overall survival (OS) was 95.54% ± 0.31%. For patients with SR-average disease, the 6-year continuous complete remission (CCR) and OS rates for SC versus IC were 87.8% ± 1.3% versus 89.1% ± 1.2% ( P = .52) and 95.8% ± 0.8% versus 95.2% ± 0.8% ( P = 1.0), respectively. Those with SR-average disease with end-induction minimal residual disease (MRD) of 0.01% to < 0.1% had an inferior outcome compared with those with lower MRD and no improvement with IC (6-year CCR: SC, 77.5% ± 4.8%; IC, 77.1% ± 4.8%; P = .71). At 6 years, the CCR and OS rates among 635 nonrandomly treated patients with SR-high disease were 85.55% ± 1.49% and 92.97% ± 1.08%, respectively.

CONCLUSION

The 6-year OS rate for > 5,000 children with SR ALL enrolled in AALL0331 exceeded 95%. The addition of IC to treatment for patients with SR-average disease did not improve CCR or OS, even in patients with higher MRD, in whom it might have been predicted to provide more value. The EFS and OS rates are excellent for this group of patients with SR ALL, with particularly good outcomes for those with SR-high disease.
Low High-Density Lipoprotein Cholesterol to Monitor Long-Term Average Increased Triglycerides
Authors: Langsted Anne , Jensen Anne Marie Reimer , Varbo Anette , Nordestgaard Børge G
Published: December 2019

Context

Increased triglyceride-rich remnants represent a causal risk factor for ischemic cardiovascular disease.

Objective

We tested the hypothesis that low high-density lipoprotein (HDL) cholesterol can be used to monitor long-term high triglycerides/remnant cholesterol, just as high hemoglobin A1c (HbA1c) can be used to monitor long-term high glucose levels.

Design, Setting, Participants, and Interventions

We studied cross-sectionally 108 731 individuals, dynamically 1313 individuals with lipid measurement at 10 repeated visits, short-term 305 individuals during a fat load, and long-term 10 479 individuals with 2 lipid measurements 10 years apart.

Main Outcome Measures

Levels of HDL cholesterol and triglycerides.

Results

Cross-sectionally, HDL cholesterol was inversely associated with triglycerides (R2 = 0.26) and remnant cholesterol (R2 = 0.26). Dynamically, major changes in triglyceride levels from measurement to measurement were mimicked by corresponding modest changes in HDL cholesterol. In the short-term after a fat load, median triglycerides increased 96% while HDL cholesterol decreased only 1%. Long-term, in individuals with measurements 10 years apart, those who initially had the highest triglycerides and corresponding lowest HDL cholesterol, still had highest triglycerides and lowest HDL cholesterol 10 years later. Prospectively, individuals with increased triglycerides/remnant cholesterol had increased risk of myocardial infarction; however, when the HDL cholesterol monitoring was removed, increased triglycerides/remnant cholesterol were largely no longer associated with increased risk of myocardial infarction.

Conclusions

Low HDL cholesterol is a stable marker of average high triglycerides/remnant cholesterol. This suggests that low HDL cholesterol can be used to monitor long-term average high triglycerides and remnant cholesterol, analogous to high HbA1c as a long-term monitor of average high glucose levels.
Thyroid Therapy or Dysfunction in Athletes: Is it Time to Revisit the Clinical Practice Guidelines?
Authors: Austin Krista G. , Petak Steven
Published: December 2019

Recent media have highlighted the controversy surrounding treatment of elite athletes for hypothyroidism. The World Anti-Doping Agency denied a request by the United States Anti-Doping Agency to ban the use of thyroid medication. At present, there is no scientific evidence that thyroid medication has the potential to enhance performance. Clinical practice guidelines are not definitive in regard to what classifies a patient as having hypothyroidism. Thyroid-stimulating hormone and free T4 are recommended to screen for thyroid disease; however, the thyrotropin-releasing hormone stimulation test is still advocated by some for detecting the earliest stages of hypothyroidism. Hypothyroidism has been demonstrated to reduce cardiopulmonary function and result in musculoskeletal symptoms, such as fatigue and muscle stiffness. Symptoms of hypothyroidism, including depression, fatigue, and impaired sleep, are similar to those reported in overtraining. These patients may have hypothalamic-pituitary dysfunction that may complicate interpretation of basal thyroid-stimulating hormone and free T4. To date, no association has been identified between training state and hypothyroidism. Research to more clearly define hypothyroidism using provocative testing, evaluate the potential for thyroid medication to enhance performance, and examine whether training may induce hypothyroidism in athletes is desirable.
Comparing the Aerobic Fitness of Professional Male Soccer Players and Soccer Referees
Authors: Santos-Silva Paulo R. , D’Andrea Greve Júlia M. , Pedrinelli André , Almeida Adriano M. , Osorio Bruna B. , Ferreira Marcelo , Ferreira Celso
Published: December 2019

We looked to compare the aerobic performance between professional soccer referees and players. Fifty male soccer referees and 61 male soccer players were tested on a treadmill. The referees and players possessed 15 ± 7 years and 7 ± 3 years of experience in soccer, respectively. Significant differences were observed between the referees and players with regards to: age (34.8 ± 4.6 years vs 20.8 ± 2.7 years; P < 0.001, maximum oxygen uptake (54.7 ± 5.4 mL·kg−1·min−1 vs 58.8 ± 4.4 mL·kg−1·min−1; P < 0.001), and maximal heart rate in peak exercise (184 ± 11 bpm vs 192 ± 9 bpm, P < 0.001). Less significant differences also were observed and included; running speed at the maximum oxygen uptake (16.6 ± 1 km·h−1 vs 16.4 ± 1.1 km·h−1), running speed at the ventilatory threshold (213.5 ± 1.1 km·h−1 vs 13.2 ± 0.9 km·h−1), and percentage of maximal oxygen uptake at the ventilatory threshold (285.1% ± 3.2% vs 84.1% ± 6.2%). The effect size of most comparative variables between the two groups was small (<0.6). Older elite-level soccer referees are able to reach and maintain aerobic physical fitness levels similar to professional soccer players. Aerobic physical fitness may be a measurable factor for maintaining elite-level soccer licensure rather than age alone.
The Use of Regional Museums Materials in the Process of Patriotic Education of Primary Schoolchildren
Authors: Ivashchenko Elena , Balyasnikova T.
Published: December 2019

The article discusses the opportunities that expositions of regional museums provide for the education of younger schoolchildren in the spirit of respect and love for their homeland. The successful experience of cooperation of primary school teachers with the museums of Borisovka, Belgorod Region, is presented. On the example of conducting extra-curricular activities at the integrated regional training course “My land is my native Belgorod region”, the effectiveness of such pedagogical work is substantiated, which allows to familiarize children with the socio-historical and cultural heritage of their small homeland, educate them as patriotic citizens of Russia.
Integrated Mathematics and Computer Science Lessons in Primary School
Authors: Bizyaeva Natal'ya , Konstantinova N.
Published: December 2019

The article substantiates the need for a scientific and practical orientation in organizing modern education, which meets the challenges of the time and the requirements for ensuring the competitiveness of our country, outlined in the “Forecast of the Scientific and Technological Development of the Russian Federation for the Period until 2030”. The possibilities of binary lessons in elementary school, integrating the content of instruction in mathematics and computer science, are revealed. Examples of educational tasks that are aimed at developing the skills of primary schoolchildren to put into practice the acquired theoretical knowledge are given.
Modeling Dependent Outages of Electric Power Plants
Authors: Malladi Vishwakant , Mendoza-Arriaga Rafael , Tompaidis Stathis
Published: December 2019

In the article “Modeling Dependent Outages of Electric Power Plants,” Malladi, Mendoza-Arriaga, and Tompaidis study simultaneous outages of many electric power plants, a problem that can have severe economic consequences. Using real data, they separate power plants into possibly overlapping groups. Each group is affected by a single cause—input fuel, geographic proximity, or location relative to the transmission network, for example. Using the mathematical technique of time subordination, the authors build dependence in outages among power plants in each group. With outage data from NERC, they determine these groups for Texas and the western United States and calculate the impact on system reliability and on the addition of new generation assets. Looking ahead, the methodology in the article can help account for dependence in generation from renewable sources as their share of generation capacity increases. The article will be of interest to owners of generating assets, regulators, and energy and reliability researchers.
“A guerra ia nos seguindo como a nossa própria sombra”: Brecht no exílio dinamarquês
Authors: Andrade Débora El Jaick
Published: December 2019

O artigo versa sobre o período de 1933-1939 quando o poeta, dramaturgo e crítico teatral Bertolt Brecht exilou-se na Dinarmaca, a partir da ascensão do Partido Nacional Socialista ao poder na Alemanha (1933). Aborda o exílio como um tema historiográfico e sociológico e como fenômeno histórico no século XX. Caracteriza o período da República de Weimar como favorável às vanguardas artísticas, ao pensamento liberal, quando Brecht estabeleceu os princípios do seu teatro épico. Todo o intenso desenvolvimento teatral foi interrompido pela política de “alinhamento” que determinou a emigração dos maiores nomes da intelectualidade alemã. No exílio desde 1933, Brecht caracterizou a condição do exilado político e realizou a crítica ao nazifascismo através da poesia e da dramaturgia, em cartas, poemas, diários de trabalho. Através da abordagem da história intelectual é possível depreender a evolução de seu pensamento, assim como relações de amizade e solidariedade entre emigrados que consistiam em uma forma fundamental de sobrevivência, no sentido de atenuar o isolamento e permitir a continuidade dos trabalhos literários. Para Brecht, uma tarefa fundamental era mobilizar os emigrados, romper o conformismo, aproveitar-se de sua projeção literária para combater o regime nazista de fora do país.
Resistência política, redes intelectuais e atividades editoriais no exílio durante a ditadura militar chilena
Authors: Coelho Neto Raphael
Published: December 2019

Intelectuais e políticos, a maioria deles ligados a partidos de esquerda no Chile, após o golpe de 1973, tiveram de sair do país rumo a destinos diversos. Desde o exílio, estabeleceram formas de sociabilidade e solidariedade que possibilitaram a formação de redes intelectuais e políticas de oposição à ditadura militar. Neste artigo, traçamos como objetivo central apontar e refletir sobre algumas atividades editoriais do exílio chileno, iniciativas que contemplaram a fundação de editoras e a publicação de importantes revistas e livros em países como Estados Unidos, Canadá, México, França, Itália e Espanha. Não tivemos a pretensão de elencar e analisar todo o universo editorial proporcionado pelos intelectuais exilados, mas, sim, apontar para algumas experiências que certamente evidenciaram práticas marcantes do exílio chileno, indicando possibilidades de atuação conjunta de modo a resistir à ditadura de Augusto Pinochet.
Intelectuales y democracia Notas a propósito de los encuentros de Maryland
Authors: Garategaray Martina
Published: December 2019

Entre 1984 e 1994, cinco reuniões de intelectuais latino-americanos convocadas por Saúl Sosnowski foram realizadas na Universidade de Maryland para discutir "Cultura e redemocratização no cone sul". Embora em cada reunião tenham sido discutidas questões específicas que formaram a cultura política da Argentina, Uruguai, Brasil, Chile e Paraguai, respectivamente, acreditamos que é possível conectar essas reuniões pela recorrência de tópicos ou tópicos, e também porque esses temas foram erigidos sobre uma linguagem política comum. Nesse sentido, este trabalho procura explorar essas reuniões como entradas para o debate político-intelectual do "retorno à democracia" e às coordenadas comuns que delimitaram as possibilidades e limitações das democracias nascentes.
O racismo na atualidade e o conhecimento como estratégia para seu o enfrentamento
Authors: Raimundo Valdenice José , Jesus Dilma Franclin de
Published: December 2019

Entrevista com Silvio Almeida.
... para depois dividir: notas sobre Reforma Previdenciária e assimetrias raciais no Brasil
Authors: Paixão Marcelo , Theodoro Mario
Published: December 2019

O artigo analisa o perfil cor ou raça do público contribuinte e beneficiário da previdência social no Brasil e os efeitos da reforma previdenciária sobre as desigualdades raciais. A previdência social contribui para a melhoria da qualidade de vida da população preta e parda, especialmente através das políticas de transferência de renda para os mais pobres, do estabelecimento do piso dos proventos em um Salário Mínimo e através do regime especial de previdência para o trabalhador rural. Por outro lado, o acesso à previdência social é marcado pelas assimetrias de cor ou raça provenientes da segregação e discriminação no mercado de trabalho, pelo diferente formato da pirâmide etária de brancos e negros e tempo de sobrevida. O artigo conclui que a reforma da previdência não somente não contribui para a superação das atuais desvantagens de cor ou raça, como ainda apresenta um potencial de aprofundá-las ainda mais. Palavras-Chave: previdência social; reforma da previdência; desigualdades; cor; raça.
Política de igualdade racial na realidade cearense
Authors: Madeira Maria Zelma de Araújo
Published: December 2019

Este artigo tem o propósito de refletir acerca das especificidades que assumem o racismo e as desigualdades raciais na cena contemporânea, bem como as estratégias adotadas para enfrentá-los no âmbito das políticas públicas, tendo como fio condutor o registro significativo das principais ações desenvolvidas pela Coordenadoria Especial de Políticas Públicas para Promoção da Igualdade Racial do estado do Ceará (Ceppir), no período de 2015 a 2018. Por fim, serão elucidadas as especificidades e o movimento empreendido para a constituição de uma política pública de caráter transversal na realidade cearense. Palavras-Chave: racismo; desigualdades raciais; política de promoção da igualdade racial.
A lei de cotas por um fio: o retrocesso social atual
Authors: Pinheiro Carina Lilian Fernandes , Soares Maria De Lourdes
Published: December 2019

A conjuntura política atual exige que estejamos preparados para enfrentar uma realidade marcada por incertezas em relação aos direitos sociais. Eleito um governo de extrema direita e neoliberal, que preza pela economia acima de tudo, políticas sociais como a das cotas estão sendo atacadas. Já existe, inclusive, o projeto de lei federal nº 1.531/2019, que pretende acabar com as cotas raciais. Diante disso, é preciso refletir sobre a conjuntura atual na busca por caminhos alinhados à luta e à resistência. Por isso, neste artigo, objetivamos fazer uma reflexão sobre as perspectivas para as políticas sociais no Brasil nessa conjuntura política de desmonte e desregulação, analisando particularmente as notícias e reportagens veiculadas recentemente sobre os riscos de extinção da política de cotas. Vislumbramos que o Brasil de fato atravessa um momento de desfoque e regressão das políticas sociais e que a política de cotas é somente uma das que estão ameaçadas. Palavras-Chave: conjuntura; cotas; perspectivas; políticas sociais; extinção.
Multidisciplinary team management of patients with urological cancer
Authors: Molokwu CN , Naqvi T , Tyson D
Published: December 2019

Several specialist teams are involved in the management of patients with urological cancer. These specialists have been brought together as a multidisciplinary team to discuss, plan and deliver care to patients in an effective, patient-centred approach. This article discusses the benefits of this approach and ways in which multidisciplinary team working can be optimized.
Neurogenic heterotopic ossification: a pictorial review
Authors: McCormack Richard , McGlone Brian
Published: December 2019

Neurogenic heterotopic ossification is a condition whereby bone forms in an extra-skeletal site. It may occur in the context of major neurological insult involving the brain or spinal cord. It causes pain and restricts movement, most commonly at the hip joints. Although neurogenic heterotopic ossification is associated with significant morbidity, the diagnosis is not always considered when referring for imaging in susceptible individuals. This article highlights its key features to promote better awareness and recognition, by reviewing clinical findings and imaging of patients across various modalities including plain radiographs, ultrasound and computed tomography. The management of neurogenic heterotopic ossification is limited by late identification and consequently clinicians should always be aware of this potentially significant diagnosis. Recognition in the acute hospital setting before transfer to rehabilitation services may prevent further clinical sequelae including urinary tract infection and pressure ulcers.
Genetics of breast cancer: management strategies and risk-reducing surgery
Authors: Balasubramanian Rajesh , Rolph Rachel , Morgan Catrin , Hamed Hisham
Published: December 2019

The last two decades have witnessed major advances in genetic sequencing which have led to more accurate identification of women at risk of developing breast cancer and calculating the associated cancer risk. This review discusses the current genetic mutations conferring risk of developing breast cancer and the management pathway for these women with identifiable mutations as well as those with a strong family history for breast cancer.

Management of these individuals is complex and should involve a multidisciplinary team with interest and expertise in breast cancer genetics. There are several treatment options ranging from surveillance to risk-reducing surgery. Risk reduction surgery has been popularised by celebrities who are carriers of breast cancer genes, and raised public awareness of breast cancer genetics and associated risk.
Safe and effective prescribing for symptom management in palliative care
Authors: Harris Dylan
Published: December 2019

Palliative and end of life care forms an important part of the role of any doctor in training, and an awareness of a structured approach to managing common symptoms and end of life care is essential. Common symptoms include pain, nausea and vomiting, constipation, and breathlessness. Anticipatory prescribing of the 4 A's (analgesic, anti-emetic, anxiolytic, and anti-secretory) is a proactive approach to ensure medication is available, if required, for common symptoms in the last hours to days of life, such as pain, upper airway secretions, anxiety, and agitation. Prescribing or medication errors in relation to symptom control in palliative care can relate to individual errors, poor communication, poor care coordination, equipment and care planning. There are some important key points relating to prescribing to consider, for example, using recognized conversions when changing between opioids and from the oral to syringe drivers route; that diamorphine and morphine are not equipotent; prescribing liquid opioids in milligrams not millilitres where there are multiple concentrations available; making the indication for steroids clear when used, as they are multiple possible indications (and also their intended duration, to avoid unintended longer term sequelae of steroid use); and avoiding the use of oxygen for symptomatic relief of breathlessness in the absence of hypoxia.
How is Students’ Motivation Enhanced in English Classrooms in Unstable Socio-political Contexts?
Authors: Nra Hkawn San , Vibulphol Jutarat
Published: December 2019

In a situation where life is insecure and the future seems to hang by a thread, motivating students to learn a second language that has no immediate need in their daily lives could be challenging. This article explores the motivation to learn English as a second language of students and the use of motivational strategies of English teachers in one state of Myanmar, which has undergone civil wars for more than seventy years. Sequential explanatory mixed-method research was employed to investigate this complex phenomenon. Questionnaires, classroom observations, and semi-structured interviews were used to collect the data. A pleasantly surprised finding showed that the students could still remain a certain level of motivation to learn English amidst great hardship and fear in everyday life. As for the teachers’ motivational strategies, most that were observed and reported did not tend to support students’ autonomy. The findings lend support to previous studies on the effects of unstable sociopolitical situations on students and teachers and highlight the needs for effective teacher trainings for pre-service and in-service teachers in such areas.
Electrophysiological Outcome Measures in Spinal Cord Injury Clinical Trials: A Systematic Review
Authors: Korupolu Radha , Stampas Argyrios , Singh Mani , Zhou Ping , Francisco Gerard
Published: December 2019

Background: Electrophysiological measures are being increasingly utilized due to their ability to provide objective measurements with minimal bias and to detect subtle changes with quantitative data on neural function. Heterogeneous reporting of trial outcomes limits effective interstudy comparison and optimization of treatment. Objective: The objective of this systematic review is to describe the reporting of electrophysiological outcome measures in spinal cord injury (SCI) clinical trials in order to inform a subsequent consensus study. Methods: A systematic search of PubMed and EMBASE databases was conducted according to PRISMA guidelines. Adult human SCI clinical trials published in English between January 1, 2008 and September 15, 2018 with at least one electrophysiological outcome measure were eligible. Findings were reviewed by all authors to create a synthesis narrative describing each outcome measure. Results: Sixty-four SCI clinical trials were included in this review. Identified electrophysiological outcomes included electromyography activity (44%), motor evoked potentials (33%), somatosensory evoked potentials (33%), H-reflex (20%), reflex electromyography activity (11%), nerve conduction studies (9%), silent period (3%), contact heat evoked potentials (2%), and sympathetic skin response (2%). Heterogeneity was present in regard to both methods of measurement and reporting of electrophysiological outcome measures. Conclusion: This review demonstrates need for the development of a standardized reporting set for electrophysiological outcome measures. Limitations of this review include exclusion of non-English publications, studies more than 10 years old, and an inability to assess methodological quality of primary studies due to a lack of guidelines on reporting of systematic reviews of outcome measures.
Time and Waiting: The Fulcrum of Palestinian Identity
Authors: Singh Ashutosh
Published: December 2019

The theoretical concepts of time and waiting have evolved mostly around the units of clocks and calendars. The Palestinians have been forced to let waiting be part of their national and cultural life. The forced displacement has scattered many Palestinians in exile around the globe. These Palestinians in diasporas have been waiting to return home one day and this perpetual state of waiting is one of the greatest tragedies of our time. The Palestinians' experience of time and waiting are quite different from most parts of the world. The linearity of time seems to break its rhythm when it enters Palestinian lives. The temporality appears to have multiple dimensions when it comes to Palestine. There are times when the clock is not the reference point of Palestinians' time, and hours and minutes can no longer gauge their waiting. They have given a new meaning to time, waiting and exile through not only the physical existence of their being, but also through their literature and art. Although we live in a culture that denigrates waiting, we have a whole Palestine hanging on for what can put an end to its wait. The concept of time, waiting and exile suddenly jumps out of the theoretical notions and embodies itself in Palestine. Palestinians' literature, movies and other art forms have encompassed these ideas to strengthen their collective memory and identity. The life of a dispossessed Palestinian has many internal contradictions that are at times not obvious but beyond the contradiction typically experienced by individuals in life. The Palestinian struggle for land is also a struggle against the established unitary idea of time and waiting of colonizers. This article will try to delve into such meanings of time and waiting for Palestinians in their cultural lives and their everyday existence.
Color temperature tunable white light based on monolithic color-tunable light emitting diodes
Authors: El-Ghoroury Hussein S. , Nakajima Yoshitake , Yeh Milton , Liang Evan , Chuang Chih-Li , Chen J. C.
Published: December 2019

A color-temperature tunable white light-emitting diode (LED) based on a newly developed monolithic color-tunable LED structure was demonstrated. The color-tunable LED structure consists of three different sets of quantum wells separated by intermediate carrier blocking layers that can independently emit visible lights from 460 to 650 nm under different injection currents. To generate white light, the color-tunable LED is operated under pulsed conditions with each pulse consisting of multiple steps of different current amplitudes and widths emitting different colors. The combined spectrum of different colors is aimed to mimic that of the blackbody radiation light source. The pulse rate is designed to be higher than the human eye response rate, so the human eye will not discern the emission of successive colors but a singular emission of white light. Results of a two-step pulse design show this method is able to generate white light from 2700 K – 6500 K. Moreover, their color coordinates fall within the 4-step MacAdam ellipses about the Planckian locus while achieving the Color Rendering Index (CRI) in the 80-90 range. Finally, simulations show improvement of CRI into the 90-100 range is possible with further optimization to the color-tunable LED spectral emission and use of three-step pulses.
Experiments all the way in programmatic design research
Authors: Bang Anne Louise , Eriksen Mette Agger
Published: December 2019

Experiments take various forms, have various purposes, and generate various knowledge; depending on how, when and why they are integrated in a design research study with a programmatic approach. This is what we will argue for throughout this article using examples and experiences from
our now finalized Ph.D. studies. Reviewing the prevailing literature on research through design the overall argument is that design experiments play a core role both in conducting the research, in theory construction and in knowledge generation across the different design domains and methodological
directions. However, we did not identify sources that explicitly discuss and operationalize roles and characteristics of design experiments in different stages of programmatic design research. The aim of this article is therefore to outline a (tentative) systematic account of roles and characteristics
of design experiments. Building upon Schön’s definition of experiments in practice we propose adding to the prevailing understanding of experiments in research through design understanding and operationalizing design experiments (1) as initiators or drivers framing a research programme,
(2) as ways to reflect on and mature the research programme serving as vehicles for theory construction and knowledge generation and finally (3) as a ‘designerly’ approach to the written knowledge dissemination and clarification of research contributions.
Creating algorithmic audio-visual narratives through the use of augmented reality prints
Authors: Laskari Iro
Published: December 2019

This article investigates the hypothesis of creating non-linear audio-visual narratives, through an unanticipated use of traditional print-based games, enriched with videos, via augmented reality (AR) possibilities. A ludic system has been created and presented. Based on a traditional card game, a non-linear cinematic narrative occurs. We attempt to examine the following questions: in which way can we bring together different forms of visual communication, such as graphic design and video? Can the above forms create a complex narrative whole and what kind of rules will be needed for this? How can we enrich traditional forms of gaming with the potentials of AR? Gaming itself demands a set of rules. Can these rules play the role of algorithms in the combined universe that we have designed and created? In which way can the designer on the one hand and the user on the other influence the overall output of the system? What will the user experience be like? The printed card system chosen for this is Tarot and more precisely the Great Arcana, which makes use of the 22 fundamental Tarot figures.
Energyscapes: Interconnecting body, clinic, qi and dao
Authors: Lewis-King Michelle
Published: December 2019

Drawing upon my expertise as an artist and clinical acupuncturist with training in biomedicine, my artistic research adapts Chinese medicine practice into a strategic tool to investigate new synergies between art, medicine, technology, East, West, modernity and pre-modernity. In my performances, I use Chinese pulse diagnosis and acupuncture point location as transdisciplinary artistic technologies (qi / 器) that are capable of measuring and responding to quantum entanglements between individuals and their social, natural and cosmic milieus – or what can be referred to as dao (道). This is achieved by combining the principles of CM with digital (audio software and physical computing) and 'moist' media (the body).