bluuebunny/crossref_metadata_2025 huggingface dataset:
Seguridad remanente a flexión en forjados con corrosión en las viguetas
Authors: Gil E. , Vercher J. , Mas A. , Fenollosa E.
Published: April 2015

A nivel nacional han aparecido un gran número de forjados de viguetas prefabricadas con graves problemas de corrosión, potenciada en muchas ocasiones por el empleo del cemento aluminoso. El propósito de este trabajo es evaluar la seguridad residual de los mecanismos de flexión en los casos más habituales de forjados dañados, para decidir la magnitud de la intervención necesaria. Los forjados dañados se han evaluado formando parte de un edificio completo, ya que las condiciones de contorno son fundamentales para la obtención del comportamiento real, teniendo en cuenta las distintas fases del proceso constructivo y de deterioro en el tiempo. En bastantes ocasiones en la inspección no se observa una fisuración importante en los elementos constructivos, como solados o tabiquería, y hemos comprobado que existe una seguridad residual suficiente para acometer las obras de rehabilitación sin necesidad de adoptar medidas excepcionales.
Is the Complement Activation Product C3a a Proinflammatory Molecule? Re-evaluating the Evidence and the Myth
Authors: Coulthard Liam G. , Woodruff Trent M.
Published: April 2015

The complement activation product C3a is often described as a proinflammatory mediator, alongside its downstream cousin, C5a. However, emerging studies show that C3a has several anti-inflammatory facets in vivo. For example, in the acute inflammatory response, C3a acts in direct opposition to C5a, through preventing the accumulation of neutrophils in inflamed tissues by independently regulating their mobilization. This acute, protective, and opposing activity of C3a to C5a is also illustrated in models of septicemia. In this article, we reinvestigate the discovery and original classification of C3a as a proinflammatory mediator and highlight the emerging studies demonstrating anti-inflammatory effects for C3a in the immune response. It is our hope that this review illuminates these apparently contradictory roles for C3a and challenges the general dogma surrounding C3a, which, historically, has ubiquitously been described as a proinflammatory mediator. In light of this, we urge investigators to use “inflammatory modulator” as the descriptor for C3a.
Endothelial Actin-Binding Proteins and Actin Dynamics in Leukocyte Transendothelial Migration
Authors: Schnoor Michael
Published: April 2015

The endothelium is the first barrier that leukocytes have to overcome during recruitment to sites of inflamed tissues. The leukocyte extravasation cascade is a complex multistep process that requires the activation of various adhesion molecules and signaling pathways, as well as actin remodeling, in both leukocytes and endothelial cells. Endothelial adhesion molecules, such as E-selectin or ICAM-1, are connected to the actin cytoskeleton via actin-binding proteins (ABPs). Although the contribution of receptor–ligand interactions to leukocyte extravasation has been studied extensively, the contribution of endothelial ABPs to the regulation of leukocyte adhesion and transendothelial migration remains poorly understood. This review focuses on recently published evidence that endothelial ABPs, such as cortactin, myosin, or α-actinin, regulate leukocyte extravasation by controlling actin dynamics, biomechanical properties of endothelia, and signaling pathways, such as GTPase activation, during inflammation. Thus, ABPs may serve as targets for novel treatment strategies for disorders characterized by excessive leukocyte recruitment.
Sport-Specific Training Targeting the Proximal Segments and Throwing Velocity in Collegiate Throwing Athletes
Authors: Palmer Thomas , Uhl Timothy L. , Howell Dana , Hewett Timothy E. , Viele Kert , Mattacola Carl G.
Published: April 2015

Context

The ability to generate, absorb, and transmit forces through the proximal segments of the pelvis, spine, and trunk has been proposed to influence sport performance, yet traditional training techniques targeting the proximal segments have had limited success improving sport-specific performance.

Objective

To investigate the effects of a traditional endurance-training program and a sport-specific power-training program targeting the muscles that support the proximal segments and throwing velocity.

Design

Randomized controlled clinical trial.

Setting

University research laboratory and gymnasium.

Patients or Other Participants

A total of 46 (age = 20 ± 1.3 years, height = 175.7 ± 8.7 cm) healthy National Collegiate Athletic Association Division III female softball (n = 17) and male baseball (n = 29) players.

Intervention(s)

Blocked stratification for sex and position was used to randomly assign participants to 1 of 2 training groups for 7 weeks: a traditional endurance-training group (ET group; n = 21) or a power-stability–training group (PS group; n = 25).

Mean Outcome Measure(s)

The change score in peak throwing velocity (km/h) normalized for body weight (BW; kilograms) and change score in tests that challenge the muscles of the proximal segments normalized for BW (kilograms). We used 2-tailed independent-samples t tests to compare differences between the change scores.

Results

The peak throwing velocity (ET group = 0.01 ± 0.1 km/h/kg of BW, PS group = 0.08 ± 0.03 km/h/kg of BW; P < .001) and muscle power outputs for the chop (ET group = 0.22 ± 0.91 W/kg of BW, PS group = 1.3 ± 0.91 W/kg of BW; P < .001) and lift (ET group = 0.59 ± 0.67 W/kg of BW, PS group = 1.4 ± 0.87 W/kg of BW; P < .001) tests were higher at postintervention in the PT than in the ET group.

Conclusions

An improvement in throwing velocity occurred simultaneously with measures of muscular endurance and power after a sport-specific training regimen targeting the proximal segments.
Neural Excitability Alterations After Anterior Cruciate Ligament Reconstruction
Authors: Pietrosimone Brian G. , Lepley Adam S. , Ericksen Hayley M. , Clements Amy , Sohn David H. , Gribble Phillip A.
Published: April 2015

Context

Neuromuscular dysfunction is common after anterior cruciate ligament reconstruction (ACL-R). However, little is known about quadriceps spinal-reflex and descending corticomotor excitability after ACL-R. Understanding the effects of ACL-R on spinal-reflex and corticomotor excitability will help elucidate the origins of neuromuscular dysfunction.

Objective

To determine whether spinal-reflex excitability and corticomotor excitability differed between the injured and uninjured limbs of patients with unilateral ACL-R and between these limbs and the matched limbs of healthy participants.

Design

Case-control study.

Setting

Laboratory.

Patients or Other Participants

A total of 28 patients with unilateral ACL-R (9 men, 19 women; age = 21.28 ± 3.79 years, height = 170.95 ± 10.04 cm, mass = 73.18 ± 18.02 kg, time after surgery = 48.10 ± 36.17 months) and 29 participants serving as healthy controls (9 men, 20 women; age = 21.55 ± 2.70 years, height = 170.59 ± 8.93 cm, mass = 71.89 ± 12.70 kg) volunteered.

Main Outcome Measure(s)

Active motor thresholds (AMTs) were collected from the vastus medialis (VM) using transcranial magnetic stimulation. We evaluated VM spinal reflexes using the Hoffmann reflex normalized to maximal muscle responses (H : M ratio). Voluntary quadriceps activation was measured with the superimposed-burst technique and calculated using the central activation ratio (CAR). We also evaluated whether ACL-R patients with high or low voluntary activation had different outcomes.

Results

The AMT was higher in the injured than in the uninjured limb in the ACL-R group (t27 = 3.32, P = .003) and in the matched limb of the control group (t55 = 2.05, P = .04). The H : M ratio was bilaterally higher in the ACL-R than the control group (F1,55 = 5.17, P = .03). The quadriceps CAR was bilaterally lower in the ACL-R compared with the control group (F1,55 = 10.5, P = .002). The ACL-R group with low voluntary activation (CAR < 0.95) had higher AMT than the control group (P = .02), whereas the ACL-R group with high voluntary activation (CAR ≥ 0.95) demonstrated higher H : M ratios than the control group (P = .05).

Conclusions

The higher VM AMT in the injured limbs of ACL-R patients suggested that corticomotor deficits were present after surgery. Higher bilateral H : M ratios in ACL-R patients may be a strategy to reflexively increase excitability to maintain voluntary activation.
A Refined Prediction Model for Core and Lower Extremity Sprains and Strains Among Collegiate Football Players
Authors: Wilkerson Gary B. , Colston Marisa A.
Published: April 2015

Context

Researchers have identified high exposure to game conditions, low back dysfunction, and poor endurance of the core musculature as strong predictors for the occurrence of sprains and strains among collegiate football players.

Objective

To refine a previously developed injury-prediction model through analysis of 3 consecutive seasons of data.

Design

Cohort study.

Setting

National Collegiate Athletic Association Division I Football Championship Subdivision football program.

Patients or Other Participants

For 3 consecutive years, all 152 team members (age = 19.7 ± 1.5 years, height = 1.84 ± 0.08 m, mass = 101.08 ± 19.28 kg) presented for a mandatory physical examination on the day before initiation of preseason practice sessions.

Main Outcome Measure(s)

Associations between preseason measurements and the subsequent occurrence of a core or lower extremity sprain or strain were established for 256 player-seasons of data. We used receiver operating characteristic analysis to identify optimal cut points for dichotomous categorizations of cases as high risk or low risk. Both logistic regression and Cox regression analyses were used to identify a multivariable injury-prediction model with optimal discriminatory power.

Results

Exceptionally good discrimination between injured and uninjured cases was found for a 3-factor prediction model that included equal to or greater than 1 game as a starter, Oswestry Disability Index score equal to or greater than 4, and poor wall-sit–hold performance. The existence of at least 2 of the 3 risk factors demonstrated 56% sensitivity, 80% specificity, an odds ratio of 5.28 (90% confidence interval = 3.31, 8.44), and a hazard ratio of 2.97 (90% confidence interval = 2.14, 4.12).

Conclusions

High exposure to game conditions was the dominant injury risk factor for collegiate football players, but a surprisingly mild degree of low back dysfunction and poor core-muscle endurance appeared to be important modifiable risk factors that should be identified and addressed before participation.
Fully endoscopic supraorbital keyhole approach to the anterior cranial base: A cadaveric study
Authors: Akçakaya Mehmet Osman , Aras Yavuz , İzgi Nail , Gayretli Özcan , Sabancı Pulat Akın , Aydoseli Aydın , Gürses İlke Ali , Sencer Altay , Öztürk Adnan , Hepgül Kemal
Published: April 2015

Introduction: The supraorbital keyhole approach for anterior cranial base lesions has been increasingly used in clinical practice. Anatomical studies focusing on the endoscopic anatomy via this approach are few, although the microscopic anatomy has been well studied. The aim of this study is to describe the anatomical features and surgical exposure provided by the endoscopic supraorbital keyhole approach using quantitative measurements. Materials and Methods: Nine formalin-fixed human cadavers from the inventory of the Anatomy department were used. A total of 18 supraorbital keyhole cranitomies were conducted. The distances between the target anatomical structures and the dura mater at the craniotomy site, and the distances between deep anatomical structures were measured with purpose-designed hooks. Results: The distance between the dura mater and optic canal was measured as 69.5 ± 6.7 mm (62-83 mm); optic chiasm as 76.2 ± 5.4 mm (67-86 mm); anterior communicating artery as 82.6 ± 6.1 mm (71-93 mm); internal carotid artery (ICA) bifurcation as 74.7 ± 6.0 mm (66-84 mm) and the basilar tip as 94.9 ± 7.0 mm (87-111 mm). The mean diameter of the optic canal was 7.4 ± 1.3 mm (6-11 mm), whereas the mean diameter of diaphragma sellae was measured as 8.4 ± 1.1 mm (7-10 mm). Conclusions: The results of this study showed that the anterior anda medial aspects of the anterior cranial fossa can be visualized properly. Dissection of the ipsilateral arteries of Circle of Willis can be performed easily using an endoscopic supraorbital keyhole approach.
Dural metastasis masquerading as an en plaque meningioma
Authors: Kapoor Ankur , Savardekar Amey , Chaterjee Debajyaoti , Salunke Pravin , Vasishta Rakesh K , Bhattacharya Anish
Published: April 2015

Metastatic adenocarcinoma mimicking meningioma is rare; and any metastatic lesion masquerading as an en plaque meningioma is extremely rare. We report the case of a 50-year-old female, who presented with headache and left hemiparesis for 1 month and on imaging showed a dural-based enhancing mass along the right hemisphere. The patient was operated with a working diagnosis of en plaque meningioma. Histopathology revealed metastatic adenocarcinoma. This report highlights an unusual radiological presentation of a metastatic lesion as dural based en plaque variety. Metastasis should be borne in mind for any en plaque lesion with rapid clinical progression.
Segmental neuromyotonia
Authors: Panwar Ajay , Junewar Vivek , Sahu Ritesh , Shukla Rakesh
Published: April 2015

Unilateral focal neuromyotonia has been rarely reported in fingers or extraocular muscles. We report a case of segmental neuromyotonia in a 20-year-old boy who presented to us with intermittent tightness in right upper limb. Electromyography revealed myokymic and neuromyotonic discharges in proximal as well as distal muscles of the right upper limb. Patient’s symptoms responded well to phenytoin therapy. Such an atypical involvement of two contiguous areas of a single limb in neuromyotonia has not been reported previously. Awareness of such an atypical presentation of the disease can be important in timely diagnosis and treatment of a patient.
Successful Prednisolone Therapy in Elderly Patients with Severe Forms of Henoch–Schönlein Purpura Nephritis
Authors: Kato-Okada Saiko , Suzuki Hiromichi , Inoue Tsutomu , Kikuta Tomohiro , Okada Hirokazu
Published: April 2015

Introduction

Recently, Henoch–Schönlein purpura (HSP) has been observed in elderly people, although it was believed to be uncommon in these subjects. The increased risks of developing end-stage renal disease (ESRD) in adults in comparison with children were highlighted by different studies; however, limited data are available on the treatment of HSP nephritis in adults.

Methods

Between 2002 and 2008, five elderly Japanese patients (>65 years old) (mean age, 68 years, ranging from 65 to 72) with severe forms of HSP nephritis were entered into a prospective study to evaluate prednisolone therapy on the outcome of nephropathy in terms of clinical symptoms and histopathological changes. The patients were considered at risk of developing chronic renal failure when they presented with a nephrotic syndrome and crescentic glomeruli.

Results

At the last follow-up, 4–10 years after initiation of the therapy, four patients had clinically recovered and one died of lung cancer. No patients developed ESRD. The clinical outcome seemed to be correlated with glomerular activity (massive proteinuria and crescent formation). In spite of a relatively large dose of prednisolone, a few adverse effects, such as insomnia and skin lesions, were observed.

Discussion

Our preliminary small study suggests that renal outcome as well as survival of elderly patients with severe forms of HSP might be altered by aggressive prednisolone therapy.
Knowledge, Attitude and Behavior of Women toward Abnormal Menstrual Bleeding and Its Impact on Quality of Life
Authors: Kaur Harpreet , Sharma Sushmita , Goraya SPS
Published: April 2015

Abnormal menstrual bleeding (AMB) is a common gynecological complaint. It may have serious repercussions on women's quality of life. Most of the studies on abnormal menstrual bleeding focus on the quantity of blood loss with little emphasis on the effect, it has on the quality of women's life. Recent research in the area of abnormal menstrual bleeding has recognized the importance of the ‘patient experience’ as an outcome that should be measured. So, it is very important to know about women's perception about the problem so that the healthcare professional can provide them appropriate care. The present study was undertaken to assess effect of AMB on various aspects of women's life and to assess their knowledge toward causes and management of AMB and its health impacts. Though majority of women know about abnormal bleeding as something serious, but still they lack in depth understanding of its consequences and various treatment modalities available.

Significance for public research

The article gives us valuable inputs regarding patient's viewpoint about abnormal uterine bleeding. Knowing the patients perceptions, their attitude toward abnormal menstrual bleeding and various social factors affecting it may be very helpful for the health professionals and researchers in knowing the impact of abnormal bleeding on quality of life and hence selecting the treatment strategies that will improve patient's satisfaction.

How to cite this article

Kaur H, Sharma S, Goraya SPS. Knowledge, Attitude and Behavior of Women toward Abnormal Menstrual Bleeding and Its Impact on Quality of Life. J South Asian Feder Obst Gynae 2015;7(1):5-9.
A Comparative Study to Evaluate the Efficacy and Safety of Single Dose Intravenous Iron Carboxymaltose vs Multidose Iron Sucrose in Postpartum Cases of Severe Iron Deficiency Anemia
Authors: Garg Ruchika , Rajvanshi Renu
Published: April 2015

Objective

To evaluate the efficacy and safety of single dose intravenous iron carboxymaltose vs multidose iron sucrose in postpartum cases of severe iron deficiency anemia.

Materials and methods

One hundred cases with iron deficiency anemia in postpartum patient were selected from postpartum wards and assigned in two groups of 50 each. In group A, iron carboxymaltose injection administered by intravenous infusion upto a maximum single dose of 20 ml of iron carboxymaltose injection (1000 mg of iron). In group B Iron sucrose was given as 200 mg elemental iron (2 ampules of 5 ml) in 100 ml of 0.9% normal saline infusion over 15 minute alternate days up to 5 days. All the patients were monitored for rise in hemoglobin level at 2, 4, 8 and 12 weeks of iron therapy, adverse effect and rise in hematological parameter at 4 weeks.

Results

In group A, mean Hb level rise is 3.95 g/dl and in group B, it is 3.32 g/dl at 4 weeks of initial therapy. In group A, 100% cases achieved target Hb at 12 weeks after therapy while in group B 98% cases achieved target Hb at 12 weeks after therapy. In group A, 12% cases have grade 1 adverse reaction while in group B, 20% cases have adverse reaction.

Conclusion

Administration of intravenous iron has a good clinical result, with minimum adverse reactions. Thus, we can conclude that intravenous iron carboxymaltose therapy is safe, convenient, more effective and faster acting than intravenous iron sucrose for treatment of severe iron deficiency anemia in postpartum patient.

How to cite this article

Garg R, Singh S, Singh S, Rajvanshi R. A Comparative Study to Evaluate the Efficacy and Safety of Single Dose Intravenous Iron Carboxymaltose vs Multidose Iron Sucrose in Postpartum Cases of Severe Iron Deficiency Anemia. J South Asian Feder Obst Gynae 2015;7(1):18-21.
Cabergoline for Ovarian Hyperstimulation: A Review of Clinical Evidence
Authors: Garg Ruchika , Jain Meenal
Published: April 2015

How to cite this article

Garg R, Singh S, Jain M. Cabergoline for Ovarian Hyperstimulation: A Review of Clinical Evidence. J South Asian Feder Obst Gynae 2015;7(1):30-32.
A Rare Case of Acute Axonal Motor Neuropathy in a Puerperal Woman
Authors: Sundari N , Swarup Asha , Nayak Ashwini , Girish Jyothi
Published: April 2015

We report the case of a puerperal woman who presented to us with sepsis, multiorgan dysfunction and motor weakness of both lower limbs. On detailed evaluation, patient was found to have axonal neuropathy establishing the diagnosis of critical illness polyneuropathy (CIP). A high index of suspicion is required to arrive at the diagnosis as this condition is not only associated with high mortality and morbidity rates but also can affect the quality of life of the individual in the long-term. This case has been reported to highlight the importance of recognition of this common, but rarely diagnosed condition as it can help us to portend the prognosis.

How to cite this article

Nayak A, Sundari N, Swarup A, Girish J. A Rare Case of Acute Axonal Motor Neuropathy in a Puerperal Woman. J South Asian Feder Obst Gynae 2015; 7(1):48-49.
Análise de vulnerabilidades computacionais em repositórios digitais
Authors: Belarmino Valdete Fernandes , Araújo Wagner Junqueira
Published: April 2015

Objetivo. Apresenta os resultados de pesquisa que teve como objetivo analisar as vulnerabilidades computacionais dos diretórios digitais das universidades públicas. Destaca a relevância da informação na sociedade contemporânea como um recurso de valor inestimável, enfatizando a informação científica como elemento essencial para constituir o progresso científico. Caracteriza o surgimento dos Repositórios Digitais e ressalta sua utilização em meio acadêmico para preservar, divulgar, disseminar e incentivar a produção científica. Descreve os principais softwares para a construção de repositórios digitais. Método. A pesquisa identificou e analisou as vulnerabilidades que estão expostos os repositórios digitais institucionais em das universidades em âmbito federal, por meio da execução de Testes de Penetração, especificando os níveis de riscos e os tipos de vulnerabilidades. Resultados. De uma amostra de 30 repositórios, foi possível analisar 20, sendo identificados que: 5% dos repositórios possuem vulnerabilidades críticas, 85% altas, 25% médias e 100% baixas. Conclusões. Evidencia a necessidade da adoção de medidas para estes ambientes que promovam a segurança dos ativos informacionais, visando minimizar a incidência de ataques externos e/ou internos aos sistemas das instituições.
A revista Perspectivas em Gestão & Conhecimento (PG&C): Criação, gestão editorial e espectro de temas publicados
Authors: Costa Luciana Ferreira da , Duarte Emeide Nóbrega , Gomes Jorge de Oliveira , Silva Alan Curcino Pedreira da
Published: April 2015

Objetivo. Apresenta o espectro de temas publicados na revista Perspectivas em Gestão & Conhecimento (PG&C) identificados por meio da frequência de ocorrência das palavras-chave dos artigos. Método. Utiliza análise categorial temática. Assim, foram determinadas como categorias de trabalho os itens de caracterização da revista quanto aos seus dados gerais, processo de gestão editorial e os principais assuntos dos artigos publicados extraídos das palavras-chave, numa abordagem qualitativa-narrativa com aporte de dados quantitativos. Resultados. Evidencia os assuntos com maior índice de freqüência: Gestão do conhecimento, Gestão da informação, Ciência da Informação, Aprendizagem, Sistemas de informação e Tecnologias de informação. Este resultado expressa a tendência dos estudos convergentes entre a Administração e a Ciência da Informação. Conclusões. Conclui que o periódico PG&C já se firmou como veículo de referência nacional para diversas áreas que tratam da Gestão e do Conhecimento como objeto inter-relacional de estudo, não deixando de reconhecer aí a visibilidade e interesse internacional.
Description at the Edge? I-It / I-Thou Relations and Action in Prisons Research
Authors: Liebling Alison
Published: April 2015

I argue in this article that, far from being ‘policy advisors’, our main moral purpose in research is ‘getting the description right’. Doing this takes time, effort and energy. Good description constitutes what Ferrell and Hamm (1998) called ‘edgework’. It requires courage and skill, and an I-Thou orientation toward our participants. The paradox, as Paul Rock (2014) suggests, is that whilst ‘policy change’ should not be the primary aim of criminological research, research done well can make poor policy choices, or ‘facile gestures’, less defensible, and can have impact on the world of practice in indirect as well as direct ways.
Reform and Research: Re-connecting Prison and Society in the 21st Century
Authors: Smith Peter Scharff
Published: April 2015

IIn this contribution I briefly outline some of the historical and current trends in prison research and question how a prison researcher can work towards influencing policy and practice. I discuss the current role of ‘what works’ research and the way it is sometimes utilized in a time of penal populism and rising prison populations. I argue in favour of a broader approach which recognizes the wider societal effects of imprisonment and I provide a concrete example of how one can attempt to plan research and project work in order to facilitate progression from research and knowledge production to action and implementation. Finally I discuss some of the scientific and ethical implications which can arise when working with reform and implementation projects.
Assessing the Prison Experience for Australian First Peoples: A Prospective Research Approach
Authors: Rynne John , Cassematis Peter
Published: April 2015

Australian First Peoples hyperincarceration is concomitant with the trauma of historical and contemporary colonisation in perpetuating social dysfunction. Ongoing colonisation has been sustained by research that does not respect First Peoples epistemology, axiology, and ontology. Given this, the impact of prison quality and the potential association with First Peoples imprisonment and recidivism has been inadequately researched. Therefore there is a need to examine prison quality as experienced by Australian First Peoples. The purpose of this paper is to conceptualise a decolonising prison quality research method that is respectful of and culturally sensitive to Australian First Peoples. The proposed method interfaces First Peoples yarning with Appreciative Inquiry. Underpinning the proposed method is that all researchers, First Peoples or non-Indigenous, are attuned to cultural awareness and sensitive to the engagement process. When yarning is interfaced with Appreciative Inquiry and the latter is modified in consultation with First Peoples input, the proposed research method empowers research participants, potentially contributing to de-colonisation.
Researching Human Rights in Prisons
Authors: Naylor Bronwyn
Published: April 2015

This paper examines two issues: the author’s recent research on the capacity of prisons to incorporate human rights considerations into their routine management; and the methods employed in this research in prisons in two Australian jurisdictions. The first element examines the impact of formal human rights instruments on prison management and on the lived experiences of prisoners, and the potential for the practical application of human rights obligations in this environment. The second gives closer analysis to the specific use of qualitative methodologies in carrying out this research, and the potential implications of methodology for subsequent acceptance of research findings by governments.
Murray Lee and Alyce McGovern(2014) Policing and Media: Public Relations, Simulations and Communications. Abingdon, Oxon; New York: Routledge.
Authors: McCulloch Jude
Published: April 2015

Not applicable
Malignant (Diffuse) Mesothelioma in Patients With Hematologic Malignancies: A Clinicopathologic Study of 45 Cases
Authors: Li Xin , Brownlee Noel A. , Sporn Thomas A. , Mahar Annabelle , Roggli Victor L.
Published: April 2015

Context

Ionizing radiation has a role in the development of malignant mesothelioma, in several epidemiologic studies, including patients with hematologic malignancies.

Objective

To study the clinicopathologic characteristics of patients with malignant mesothelioma and hematologic malignancies with and without a history of radiotherapy.

Design

From a database of approximately 3600 patients with malignant mesothelioma, we identified 45 patients (1%) who also had hematologic malignancies. We examined clinicopathologic features and noted whether the patient had received radiotherapy for malignancy, comparing those with and those without such exposure.

Results

Among the 45 cases, 18 (40%) had Hodgkin lymphoma, 15 (33%) had non-Hodgkin lymphoma, 10 (4%) had chronic lymphocytic leukemia, and 2 (22%) had chronic myelogenous leukemia; 20 patients (44%) had a history of radiotherapy, and 23 (51%) did not. Most patients with Hodgkin lymphoma (16 of 18; 90.0%) received radiation, whereas none of the patients with leukemia (0 of 12) and only 20% (3 of 15) of the patients with non-Hodgkin lymphoma did so. Patients without radiation were older than patients who received radiotherapy (median, 73 versus 54 years, respectively; P < .001), had a shorter interval from diagnosis of hematologic malignancy to that of mesothelioma (median, 2 versus 24 years, respectively; P < .001), and had a shorter survival period (median, 6.0 versus 14.0 months, respectively; P = .02). Epithelial mesotheliomas were proportionately more common in patients with a history of radiotherapy.

Conclusions

Patients with mesothelioma and hematologic malignancies with a history of radiation tended to be younger, had a longer interval from diagnosis of hematologic malignancy to that of mesothelioma, had a longer survival period, and were more likely to have the epithelial variant compared with patients without radiotherapy.
RESPOSTAS FISIOLÓGICAS DE PLÂNTULAS DE Erythrina verna SOB TRATAMENTOS PRÉ-GERMINATIVOS DE SEMENTES E PROFUNDIDADE DE SEMEADURA
Authors: Pêgo Rogério Gomes , Grossi José Antonio Saraiva , Queiroz Isabel Dayane de Sousa , Vasconcellos Henrique Castro
Published: April 2015

http://dx.doi.org/10.5902/1980509817463Este trabalho objetivou determinar o melhor tratamento pré-germinativo de sementes e a profundidade de semeadura mais adequada para a produção de mudas de Erythrina verna. Para isso, os seguintes tratamentos pré-germinativos foram estudados: testemunha (sementes intactas), escarificação mecânica na região oposta ao hilo com auxílio de lixa no 80, escarificação mecânica na região da rafe com auxílio de lixa no 80, embebição em água por 24 horas. Em um segundo experimento, as sementes foram semeadas nas profundidades de 1, 2, 3, 4, 5 e 6 cm. Após 15 dias avaliou-se a porcentagem de emergência, índice de velocidade de emergência, comprimento da parte aérea e comprimento da raiz das plântulas, massa seca de parte aérea e massa seca de raiz das plântulas. As sementes de Erythrina verna apresentam dormência tegumentar que pode ser superada pela escarificação mecânica na região oposta ao hilo. As plântulas apresentam a melhor qualidade fisiológica quando as sementes são semeadas à profundidade de 1 a 3 cm, onde a maior porcentagem de emergência, índice de velocidade de emergência, comprimento da parte aérea e da raiz e massa seca da parte aérea são obtidos.
UTILIZAÇÃO DE RESÍDUOS DE COCO (Cocos nucifera) CARBONIZADO PARA A PRODUÇÃO DE BRIQUETES
Authors: Pimenta Alexandre Santos , Santos Rosimeire Cavalcante dos , Carneiro Angélica Cássia de Oliveira , Castro Renato Vinicius Oliveira
Published: April 2015

http://dx.doi.org/10.5902/1980509817471O presente trabalho teve como objetivo produzir briquetes com finos de carvão de resíduos de coco e avaliar a qualidade dos briquetes. Cascas de coco foram coletadas no APL de coco em Touros - RN. Após secagem ao ar livre por dois meses, as cascas foram carbonizadas em forno de alvenaria tipo “rabo quente JG” e trituradas em moinho de martelo. O pó resultante foi peneirado, utilizando-se a fração inferior a 40 mesh para produção de briquetes em um delineamento inteiramente casualizado envolvendo 12 tratamentos (divididos em três grupos) e três repetições. Como aglutinantes, foram empregados amido de milho e argila. Os tratamentos foram divididos em três grupos, correspondendo cada grupo a uma proporção de argila, respectivamente 12, 15 e 18%, em relação ao peso seco total do briquete. Em cada grupo, as proporções de amido foram de 6, 8, 10 e 12%. O pó de carvão foi misturado com a argila finamente triturada e a seguir foi adicionado o amido pré-gelatinizado em água a 80°C. A massa para cada tratamento foi misturada até completa homogeneização, separando-se quantidades de 17 gramas de massa por repetição. Os briquetes foram produzidos em briquetadeira de laboratório, com pressão de 1.500 psi e tempo de prensagem de quatro minutos. Foram avaliadas as seguintes propriedades dos briquetes: densidade aparente, poder calorífico, composição química imediata (umidade, teores de carbono fixo, matérias voláteis e cinzas) e resistência à compressão. Os melhores tratamentos para fins comerciais foram os 12/12 e 12/15.
INFLUÊNCIA DE DIFERENTES COMBINAÇÕES DE LÂMINAS DE Eucalyptus saligna E Pinus taeda EM PAINÉIS LVL
Authors: Müller Marcos Theodoro , Haselein Clovis Roberto , Melo Rafael Rodolfo de , Stangerlin Diego Martins
Published: April 2015

http://dx.doi.org/10.5902/1980509817473Investigou-se a influência do posicionamento de lâminas de madeira de Eucalyptus saligna e Pinus taeda nas camadas de painéis Laminated Veneer Lumber (LVL). As composições foram manufaturadas em seis diferentes combinações de cinco lâminas de 3,2 mm de espessura, coladas com adesivo fenol-formaldeído, resultando em tratamentos compostos de madeira de uma mesma espécie e outros com mistura de madeira das duas espécies. A avaliação dos arranjos propostos foi realizada mediante a caracterização de propriedades físicas (teor de umidade e massa específica) e mecânicas (módulo de elasticidade – MOE e módulo de ruptura – MOR), estas verificadas em ensaios de flexão estática flatwise e edgewise. Os resultados obtidos indicaram que, na maior parte das vezes, as diferentes posições das lâminas de maior massa específica (nas camadas externas, intermediárias e de miolo) influenciaram as propriedades mecânicas dos painéis. A influência constatada mostrou-se variada para MOE e MOR, em especial quando comparados valores para os ensaios flatwise e edgewise. Em determinadas posições, nas camadas das composições LVL, a presença de lâminas de eucalipto resultou em aumentos de rigidez e resistência. Contudo, os tratamentos constituídos por lâminas intercaladas de eucalipto e pinus mostraram interessantes performances para uso estrutural, tanto em flatwise quanto em edgewise, por apresentarem valores de MOE e de MOR que permitem distingui-los como de 1ª classe, segundo o documento técnico norte-americano APA/EWS PRL–501 (2001).
RESISTÊNCIA BIOLÓGICA DA MADEIRA TRATADA DE Eucalyptus grandis E Eucalyptus cloeziana A FUNGOS APODRECEDORES EM ENSAIOS DE LABORATÓRIO
Authors: Vivian Magnos Alan , Santini Elio José , Modes Karina Soares , Garlet Alencar , Morais Weslley Wilker Corrêa
Published: April 2015

http://dx.doi.org/10.5902/1980509817475A presente pesquisa teve por objetivo avaliar a resistência biológica da madeira tratada de Eucalyptus grandis e Eucalyptus cloeziana sob a ação de organismos biodeterioradores em ensaios de laboratório. Para tanto, foram utilizadas árvores de Eucalyptus grandis e Eucalyptus cloeziana, ambas com 16 anos de idade, as quais foram desdobradas em tábuas e submetidas ao tratamento preservativo em autoclave com arseniato de cobre cromatado (CCA). Em seguida, confeccionaram-se os corpos de prova para condução do ensaio de apodrecimento acelerado com os fungos Trametes versicolor e Gloeophyllum trabeum, seguindo as recomendações da norma ASTM. A partir dos resultados obtidos, observou-se para o fungo Trametes versicolor que o tratamento preservativo foi eficiente na redução da degradação biológica da madeira das duas espécies, com redução da perda de massa em 35,17 e 82,31% para a madeira de Eucalyptus grandis e Eucalyptus cloeziana, respectivamente, já para o fungo Gloeophyllum trabeum, a perda de massa foi reduzida em 6,79 e 96,65%, em comparação à testemunha. Com base nas condições de realização do presente estudo observou-se que o tratamento preservativo com CCA é eficiente no aumento da resistência biológica da madeira a ação dos fungos apodrecedores Trametes versicolor e Gloeophyllum trabeum.
RIQUEZA, DIVERSIDADE E COMPOSIÇÃO FLORÍSTICA EM ÁREAS DE CERRADO EM REGENERAÇÃO E PRESERVADO NA ESTAÇÃO ECOLÓGICA DE ITIRAPINA - SP
Authors: Paula Alessandro de , Martins Fernanda Quintas , Batalha Marco Antônio Portugal Luttembarck , Rodrigues Rodrigo , Manhães Marco Antônio
Published: April 2015

http://dx.doi.org/10.5902/1980509817481A capacidade das espécies do cerrado de se regenerar a partir da rebrota de estruturas subterrâneas depende tanto das propriedades físicas e químicas do solo quanto do tempo decorrido após o desmatamento. Na Estação Ecológica de Itirapina, realizam-se levantamentos florísticos e fitossociológicos dos componentes herbáceo-subarbustivo e arbustivo-arbóreo da vegetação de cerrado em uma área em regeneração, após dois anos da remoção de um talhão de Pinus elliotti, e em uma área preservada. Em cada uma das duas áreas, foram lançadas, ao longo de uma transecção, 20 parcelas de 5 x 5 m, distribuídas sistematicamente a cada 20 m. Nessas parcelas foi amostrado o componente arbustivo-arbóreo (todos os indivíduos lenhosos com diâmetro do caule no nível do solo igual ou maior a 3 cm). Em cada uma das parcelas foi delimitada uma subparcela de 0,5 x 0,5 m, em que foi amostrado o componente herbáceo-subarbustivo (todos os indivíduos lenhosos com diâmetro do caule no nível do solo menor do que 3 cm e todos os não lenhosos). O menor índice de diversidade encontrado foi para o componente herbáceo-subarbustivo da área em regeneração (1,29 nats.indivíduo-1), enquanto que o maior foi para o componente herbáceo-subarbustivo da área de cerrado preservado (2,75 nats.indivíduo-1). Entre as áreas em regeneração e preservada, os índices de similaridade de Sørensen, tanto para o componente herbáceo-subarbustivo (0,23) quanto para o componente arbustivo-arbóreo (0,31), mostraram uma baixa semelhança florística entre as áreas. Além disso, a densidade e a riqueza para ambos os componentes foram significativamente maiores para o cerrado preservado. Os resultados encontrados mostraram que os dois anos decorridos desde o corte raso de Pinus elliotti não foram suficientes para que a vegetação natural se restabelecesse no talhão.
Development and Initial Validation of a Program Director's Evaluation Form for Third-Year Residents
Authors: Artino Anthony R. , Dong Ting , Cruess David F. , Gilliland William R. , Durning Steven J.
Published: April 2015

Background: Using a previously developed postgraduate year (PGY)-1 program director's evaluation survey, we developed a parallel form to assess more senior residents (PGY-3). The PGY-3 survey, which aligns with the core competencies established by the Accreditation Council for Graduate Medical Education, also includes items that reflect our institution's military-unique context. Purpose: To collect feasibility, reliability, and validity evidence for the new PGY-3 evaluation. Methods: We collected PGY-3 data from program directors who oversee the education of military residents. The current study's cohort consisted of Uniformed Services University of the Health Sciences students graduating in 2008, 2009, and 2010. We performed exploratory factor analysis (EFA) to examine the internal structure of the survey and subjected each of the factors identified in the EFA to an internal consistency reliability analysis. We then performed correlation analysis to examine the relationships between PGY-3 ratings and several outcomes: PGY-1 ratings, cumulative medical school grade point average (GPA), and performance on U.S. Medical Licensing Examinations (USMLE) Step 1, Step 2 Clinical Knowledge, and Step 3. Results: Of the 510 surveys we distributed, 388 (76%) were returned. Results from the EFA suggested four factors: “Medical Expertise,” “Professionalism,” “Military-unique Practice,” and “Systems-based Practice.” Scores on these four factors showed good internal consistency reliability, as measured by Cronbach's α (α ranged from 0.92 to 0.98). Further, as expected, “Medical Expertise” and “Professionalism” had small to moderate correlations with cumulative medical school GPA and performance on the USMLE Step examinations. Conclusions: The new program director's evaluation survey instrument developed in this study appears to be feasible, and the scores that emerged have reasonable evidence of reliability and validity in a sample of third-year residents.
America's Medical School: 5,000 Graduates Since the “First Class”
Authors: Artino Anthony R. , Gilliland William R. , Cruess David F. , Durning Steven J.
Published: April 2015

In 1980, the Uniformed Services University of the Health Sciences (USU) graduated its first class of medical students. As a national university intended to produce “career-committed” military officers and future leaders of the Military Health System, USU functions as the service academy for military medicine and public health. More than 40 years after the school's charter and 5,000 graduates since the first class, we describe the original purpose of USU and provide an update on its achievements. In particular, we address the question of the “staying power” of the University's alumni—the degree to which graduation from the nation's military medical school is associated with long years of devoted service to military medicine. At a time when the MHS is confronting the challenge of extended deployments, rising health care costs, and a growing array of threats to our nation's health, we suggest that America needs USU now more than ever.
Longitudinal Effects of Medical Students' Communication Skills on Future Performance
Authors: Dong Ting , LaRochelle Jeffrey S. , Durning Steven J. , Saguil Aaron , Swygert Kimberly , Artino Anthony R.
Published: April 2015

Background: The Essential Elements of Communication (EEC) were developed from the Kalamazoo consensus statement on physician–patient communication. The Uniformed Services University of the Health Sciences (USU) has adopted a longitudinal curriculum to use the EEC both as a learning tool during standardized patient encounters and as an evaluation tool culminating with the end of preclerkship objective-structured clinical examinations (OSCE). Medical educators have recently emphasized the importance of teaching communication skills, as evidenced by the United States Medical Licensing Examination testing both the integrated clinical encounter (ICE) and communication and interpersonal skills (CIS) within the Step 2 Clinical Skills exam (CS). Purpose: To determine the associations between students' EEC OSCE performance at the end of the preclerkship period with later communication skills assessment and evaluation outcomes in the context of a longitudinal curriculum spanning both undergraduate medical education and graduate medical education. Methods: Retrospective data from preclerkship (overall OSCE scores and EEC OSCE scores) and clerkship outcomes (internal medicine [IM] clinical points and average clerkship National Board of Medical Examiners [NBME] scores) were collected from 167 USU medical students from the class of 2011 and compared to individual scores on the CIS and ICE components of Step 2 CS, as well as to the communication skills component of the program directors' evaluation of trainees during their postgraduate year 1 (PGY-1) residency. In addition to bivariate Pearson correlation analysis, we conducted multiple linear regression analysis to examine the predictive power of the EEC score beyond the IM clerkship clinical points and the average NBME Subject Exams score on the outcome measures. Results: The EEC score was a significant predictor of the CIS score and the PGY-1 communication skills score. Beyond the average NBME Subject Exams score and the IM clerkship clinical points, the EEC score explained an additional 13% of the variance in the Step 2 CIS score and an additional 6% of the variance in the PGY-1 communication skills score. In addition, the EEC score was more closely associated with the CIS score than the ICE score. Conclusion: The use of a standardized approach with a communication tool like the EEC can help explain future performance in communication skills independent of other education outcomes. In the context of a longitudinal curriculum, this information may better inform medical educators on learners' communication capabilities and more accurately direct future remediation efforts.
Using Concept Maps in a Modified Team-Based Learning Exercise
Authors: Knollmann-Ritschel Barbara E.C. , Durning Steven J.
Published: April 2015

Medical school education has traditionally been driven by single discipline teaching and assessment. Newer medical school curricula often implement an organ-based approach that fosters integration of basic science and clinical disciplines. Concept maps are widely used in education. Through diagrammatic depiction of a variety of concepts and their specific connections with other ideas, concept maps provide a unique perspective into learning and performance that can complement other assessment methods commonly used in medical schools. In this innovation, we describe using concepts maps as a vehicle for a modified a classic Team-Based Learning (TBL) exercise. Modifications to traditional TBL in our innovation included replacing an individual assessment using multiple-choice questions with concept maps as well as combining the group assessment and application exercise whereby teams created concept maps. These modifications were made to further assess understanding of content across the Fundamentals module (the introductory module of the preclerkship curriculum). While preliminary, student performance and feedback from faculty and students support the use of concept maps in TBL. Our findings suggest concept maps can provide a unique means of determining assessment of learning and generating feedback to students. Concept maps can also demonstrate knowledge acquisition, organization of prior and new knowledge, and synthesis of that knowledge across disciplines in a unique way providing an additional means of assessment in addition to traditional multiple-choice questions.
Relationship of Neuroimaging to Typical Sleep Times During a Clinical Reasoning Task: A Pilot Study
Authors: Durning Steven J. , Kelly William , Costanzo Michelle E. , Artino Anthony R. , Vleuten Cees van der , Beckman Thomas J. , Roy Michael J. , Holmboe Eric S. , Wittich Christopher M. , Schuwirth Lambert
Published: April 2015

Background: Sleep deprivation and fatigue have been associated with medical errors, clinical performance decrements, and reduced quality of life for both practicing physicians and medical students. Greater understanding of the impact of sleep quantity on clinical reasoning could improve patient care. The purpose of our pilot study was to examine relationships between clinical reasoning (assessed by functional magnetic resonance imaging) and sleep time (measured in different ways by actigraphy) while answering multiple-choice questions (MCQs) from licensing agencies. Methods: Residents and faculty were administered a clinical reasoning exercise (MCQs from licensing bodies) during functional magnetic resonance imaging. Usual sleep patterns were sampled with actigraphy. Covariate analysis was used to examine the relationship between sleep duration (mean sleep, minimum sleep, maximum sleep) and brain activity during clinical reasoning (solving MCQs from licensing bodies). Results: The mean sleep time over the duration of monitoring for the group was 7.19 hours (SD 0.66) with a range of 6.1 to 8.1 hours (internal medicine faculty 7.1 hours, SD 0.41; internal medicine residents 7.27 hours, SD 0.92). There was a negative relationship between activation in the prefrontal cortex and minimum sleep time while reflecting on MCQs. Conclusion: Our findings provide evidence that the quantity of sleep can modulate brain activity while completing a clinically meaningful task that should be confirmed in larger studies. Our findings suggest that the construct of sleepiness may be more complex than appreciated by many and that the most important of these sleep measures in terms of outcomes remains to be determined.