bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional Hypogonadotropic Hypogonadism in Men: Underlying Neuroendocrine Mechanisms and Natural History
Authors: Dwyer Andrew A , Chavan Niraj R , Lewkowitz-Shpuntoff Hilana , Plummer Lacey , Hayes Frances J , Seminara Stephanie B , Crowley William F , Pitteloud Nelly , Balasubramanian Ravikumar
Published: March 2019

Context

After completion of puberty a subset of men experience functional hypogonadotropic hypogonadism (FHH) secondary to excessive exercise or weight loss. This phenomenon is akin to hypothalamic amenorrhea (HA) in women, yet little is known about FHH in men.

Objective

To investigate the neuroendocrine mechanisms, genetics, and natural history underlying FHH.

Design

Retrospective study in an academic medical center.

Participants

Healthy postpubertal men presenting with symptoms of hypogonadism in the setting of excessive exercise (>10 hours/week) or weight loss (>10% of body weight). Healthy age-matched men served as controls.

Interventions

Clinical assessment, biochemical and neuroendocrine profiling, body composition, semen analysis, and genetic evaluation of genes known to cause isolated GnRH deficiency.

Main Outcome Measures

Reproductive hormone levels, endogenous GnRH-induced LH pulse patterns, and rare genetic variants.

Results

Ten men with FHH were compared with 18 age-matched controls. Patients had significantly lower body mass index, testosterone, LH, and mean LH pulse amplitudes yet normal LH pulse frequency, serum FSH, and sperm counts. Some patients exhibited nocturnal, sleep-entrained LH pulses characteristic of early puberty, and one FHH subject showed a completely apulsatile LH secretion. After decreased exercise and weight gain, five men with men had normalized serum testosterone levels, and symptoms resolved. Rare missense variants in NSMF (n = 1) and CHD7 (n = 1) were identified in two men with FHH.

Conclusions

FHH is a rare, reversible form of male GnRH deficiency. LH pulse patterns in male FHH are similar to those observed in women with HA. This study expands the spectrum of GnRH deficiency disorders in men.
Alteration of 28S rRNA 2′-O-methylation by etoposide correlates with decreased SMN phosphorylation and reduced Drosha levels
Authors: Burke Marilyn F. , McLaurin Douglas M. , Logan Madelyn K. , Hebert Michael D.
Published: March 2019

The most numerous types of modifications in human rRNA are pseudouridylation and 2′-O ribose methylation. These modifications are performed by small nucleolar ribonucleoproteins (snoRNPs) which contain a guide RNA (snoRNA) that base pairs at specific sites within the rRNA to direct the modification. rRNA modifications can vary, generating ribosome heterogeneity. One possible method that can be used to regulate rRNA modifications is by controlling snoRNP activity. RNA fragments derived from some small Cajal body-specific RNAs (scaRNA 2, 9 and 17) may influence snoRNP activity. Most scaRNAs accumulate in the Cajal body, a subnuclear domain, where they participate in the biogenesis of small nuclear RNPs. But scaRNA 2, 9 and 17 generate nucleolus-enriched fragments of unclear function, and we hypothesize that these fragments form regulatory RNPs that impact snoRNP activity and modulate rRNA modifications. Our previous work has shown that SMN, Drosha and various stresses, including etoposide treatment, may alter regulatory RNP formation. Here we demonstrate that etoposide treatment decreases the phosphorylation of SMN, reduces Drosha levels and increases the 2′-O-methylation of two sites within 28S rRNA. These findings further support a role for SMN and Drosha in regulating rRNA modification, possibly by affecting snoRNP or regulatory RNP activity.
Neuroimaging reward, craving, learning, and cognitive control in substance use disorders: review and implications for treatment
Authors: Tanabe Jody , Regner Michael , Sakai Joseph , Martinez Diana , Gowin Joshua
Published: March 2019

Substance use disorder is a leading causes of preventable disease and mortality. Drugs of abuse cause molecular and cellular changes in specific brain regions and these neuroplastic changes are thought to play a role in the transition to uncontrolled drug use. Neuroimaging has identified neural substrates associated with problematic substance use and may offer clues to reduce its burden on the patient and society. Here, we provide a narrative review of neuroimaging studies that have examined the structures and circuits associated with reward, cues and craving, learning, and cognitive control in substance use disorders. Most studies use advanced MRI or positron emission tomography (PET). Many studies have focused on the dopamine neurons of the ventral tegmental area, and the regions where these neurons terminate, such as the striatum and prefrontal cortex. Decreases in dopamine receptors and transmission have been found in chronic users of drugs, alcohol, and nicotine. Recent studies also show evidence of differences in structure and function in substance users relative to controls in brain regions involved in salience evaluation, such as the insula and anterior cingulate cortex. Balancing between reward-related bottom-up and cognitive-control-related top-down processes is discussed in the context of neuromodulation as a potential treatment. Finally, some of the challenges for understanding substance use disorder using neuroimaging methods are discussed.
Repúdio aos “súditos do eixo”: legalização dos campos de concentração na Era Vargas
Authors: Covolan Fernanda Cristina , Almeida Melissa Pinheiro
Published: March 2019

Esta pesquisa dedicou-se ao estudo dos campos de concentração brasileiros na Era Vargas e do sistema legal que o amparou, para compreender de que maneira tais institutos se organizaram e encontraram legitimação no país. Inicialmente, buscou-se compreender o contexto histórico e os primeiros campos brasileiros, organizados para conter a migração em uma época de seca, para serem incrementados a partir da mudança de postura do governo Vargas diante dos imigrantes, que deveriam, então, ser nacionalizados. Na sequência, viu-se que o confi namento de italianos, alemães e japoneses, ou seus descendentes, nos campos de concentração, atendia não apenas às pretensões varguistas para o Estado nacional, mas também agradava aos parceiros internacionais na guerra, em especial os Estados Unidos. Por fim, esta pesquisa demonstrou como a ditadura iniciada em 1937 com o Estado Novo, em especial com a Constituição outorgada de 1937, deu subsídios jurídicos para a centralização de poder nas mãos do presidente, que governaria por meio de decretos até sua deposição. Uma vez que o país entrou em guerra ao lado dos Aliados, ocorreu a decretação do estado de guerra que derrubou direitos constitucionais antes garantidos aos estrangeiros e permitiu que estes fossem perseguidos e internados em campos de concentração.
Responsabilização na Lei Anticorrupção: natureza e amplitude subjetiva
Authors: Silva Cristiana Maria Fortini Pinto e , Dadalto Lucas Dutra
Published: March 2019

O presente artigo busca abordar a questão da responsabilização na Lei nº 12.846/2013, também chamada de Lei Anticorrupção, a partir da defi nição de sua natureza jurídica e da delimitação de sua amplitude subjetiva. Antes disso, far-se-á rápida digressão para explanar o tema da Corrupção a partir de suas raízes históricas, demonstrando sua presença, desde os primórdios da colonização brasileira até os dias atuais. Destaca-se, assim, o liame temporal que acabou por desembocar na edição da Lei Anticorrupção como uma forma de completar o sistema legal pátrio de defesa da moralidade. No núcleo do artigo, questiona-se se a amplitude da referida lei também abarcaria a responsabilização das pessoas físicas responsáveis pelos atos lesivos defi nidos neste diploma ou se esta lei se restringiria apenas à responsabilização das pessoas jurídicas. Procura-se delimitar de forma mais objetiva os sujeitos ativos e passivos abarcados pela Lei Anticorrupção e como as sanções previstas se amoldam às especificidades de cada caso. Tudo isso visa a favorecer sua aplicação racional, sempre em homenagem ao princípio da segurança jurídica.
Typology, technical efficiency and scale economy of dibiteries in Dakar, Senegal
Authors: Orou Seko Malik , Ossebi Walter , Traoré Gnamien Sylvain , Ndour Andrée Prisca Ndjoug , Saric Jasmina , Fokou Gilbert , Dao Daouda , Bonfoh Bassirou
Published: March 2019

Background: In recent years, a profound transformation has been observed in the eating habits of the populations of African cities, induced by accelerated socioeconomic and demographic growth. In Senegal, these changes have manifested in the proliferation of collective informal catering enterprises, such as the ‘dibiteries’, where the roasted meat of sheep is prepared and sold. The rise of the average household income has contributed substantially to increasing levels of meat consumption, leading to the expansion of the dibiteries. The purpose of the current work was to evaluate the managerial performance of these establishments in Dakar, Senegal.

Methods: To achieve this, a cross-sectional study was conducted among 163 dibiteries using a questionnaire. Efficiency scores were determined via the data envelopment analysis method. The pure technical scores thereby obtained were subsequently used as dependent variables in a Tobit model to identify the socioeconomic determinants of dibiterie efficiency.

Results: The resulting average score of the dibiteries suggests that the majority are operating inefficiently (79.6%). Moreover, it was demonstrated that this inefficiency seems to be related to scale rather than technical issues. However, few of the dibiteries assessed (20.4%) were nevertheless in a situation of constant scale economy. Among the socioeconomic variables tested, experience, leadership (family or individual-run), the ownership status of the restaurant building (own or lease) and the type of workforce (family, recruited, mixed or without) had a significant impact on the efficiency of the establishments.

Conclusions: The scale economy and waste reduction in food production can result in economic gains that can in turn be used in the safety of finished products. Indeed, by following best practices, dibiteries can make gains which could be used to invest in good hygiene practices on handwashing, cleaning and disinfecting grilling tools, optimizing work space and training staff.
EpiLog: A software for the logical modelling of epithelial dynamics
Authors: Varela Pedro L. , Ramos Camila V. , Monteiro Pedro T. , Chaouiya Claudine
Published: March 2019

Cellular responses are governed by regulatory networks subject to external signals from surrounding cells and to other micro-environmental cues. The logical (Boolean or multi-valued)  framework proved well suited to study such processes at the cellular level, by specifying qualitative models of involved signalling pathways and gene regulatory networks. 

Here, we describe and illustrate the main features of EpiLog, a computational tool that implements an extension of the logical framework to the tissue level. EpiLog defines a collection of hexagonal cells over a 2D grid, which embodies a mono-layer epithelium. Basically, it defines a cellular automaton in which cell behaviours are driven by associated logical models subject to external signals. 

EpiLog is freely available on the web at http://epilog-tool.org. It is implemented in Java (version ≥1.7 required) and the source code is provided at https://github.com/epilog-tool/epilog under a GNU General Public License v3.0.
The nocebo effect as a source of bias in the assessment of treatment effects
Authors: Wartolowska Karolina
Published: March 2019

The term nocebo effect refers to the harmful outcomes that result from people’s negative beliefs, anticipations, or experiences related to the treatment rather than the pharmacological properties of the treatment. These outcomes may include a worsening of symptoms, a lack of expected improvement, or adverse events, and they may occur after the active treatment and the placebo that is supposed to imitate it.  The nocebo effect is always unwanted and may distort estimates of treatment effectiveness and safety; moreover, it may cause discontinuation of therapy or withdrawal from a trial.

The nocebo effect may be unintentionally evoked by the explanations given by healthcare professionals during a clinical consultation or consent procedures, or by information from other patients, the media, or the Internet. Moreover, it may be a consequence of previous bad experiences with the treatment, through learning and conditioning, and the conditioning may happen without patients’ conscious awareness. In trial settings, a study design, for example lack of blinding, may introduce bias from the nocebo effect.

Unlike the placebo effect, which is usually taken into consideration while interpreting treatment outcomes and controlled for in clinical trials, the nocebo effect is under-recognised by clinical researchers and clinicians. This is worrying, because the nocebo phenomenon is common and may have potentially negative consequences for the results of clinical treatment and trials. It is therefore important that doctors and medical researchers consider any potential nocebo effect while assessing the treatment effect and try to minimise it through careful choice and phrasing of treatment-related information given to patients.
Causes of death among homeless people: a population-based cross-sectional study of linked hospitalisation and mortality data in England.
Authors: Aldridge Robert W , Menezes Dee , Lewer Dan , Cornes Michelle , Evans Hannah , Blackburn Ruth M , Byng Richard , Clark Michael , Denaxas Spiros , Fuller James , Hewett Nigel , Kilmister Alan , Luchenski Serena , Manthorpe Jill , McKee Martin , Neale Joanne , Story Alistair , Tinelli Michela , Whiteford Martin , Wurie Fatima , Hayward Andrew
Published: March 2019

Background: Homelessness has increased by 165% since 2010 in England, with evidence from many settings that those affected experience high levels of mortality. In this paper we examine the contribution of different causes of death to overall mortality in homeless people recently admitted to hospitals in England with specialist integrated homeless health and care (SIHHC) schemes. 

Methods: We undertook an analysis of linked hospital admission records and mortality data for people attending any one of 17 SIHHC schemes between 1st November 2013 and 30th November 2016. Our primary outcome was death, which we analysed in subgroups of 10th version international classification of disease (ICD-10) specific deaths; and deaths from amenable causes. We compared our results to a sample of people living in areas of high social deprivation (IMD5 group).

Results: We collected data on 3,882 individual homeless hospital admissions that were linked to 600 deaths. The median age of death was 51.6 years (interquartile range 42.7-60.2) for SIHHC and 71.5 for the IMD5 (60.67-79.0).  The top three underlying causes of death by ICD-10 chapter in the SIHHC group were external causes of death (21.7%; 130/600), cancer (19.0%; 114/600) and digestive disease (19.0%; 114/600).  The percentage of deaths due to an amenable cause after age and sex weighting was 30.2% in the homeless SIHHC group (181/600) compared to 23.0% in the IMD5 group (578/2,512).

Conclusion: Nearly one in three homeless deaths were due to causes amenable to timely and effective health care. The high burden of amenable deaths highlights the extreme health harms of homelessness and the need for greater emphasis on prevention of homelessness and early healthcare interventions.
Social play in senior dogs: ‘not just a young dog's game’
Authors: Tomlinson Catherine
Published: March 2019

Play, whether it be social or with toys on their own, is purposeful and benefits the animal. There is a disproportionate amount of studies on play in younger dogs compared to senior dogs. It is unclear why research on play behaviour in senior dogs is limited and why play behaviour apparently declines with age. Further studies are certainly warranted, since play could offer many benefits for senior dogs and improve their quality of life. This article offers hypotheses into the apparent decline in play with ageing. In addition, the article proposes that continuation of play throughout the life stages and into senior years could be beneficial for the dog in multiple ways.
Feline myasthenia gravis: a review
Authors: Mignan Thomas , Lowrie Mark
Published: March 2019

Myasthenia gravis is an immune mediated disorder of neuromuscular transmission. Both an acquired and a congenital form have been reported in cats. Generalised weakness is considered a hallmark of myasthenia gravis, but in cats, due to their sedentary nature, this may not be as evident as in dogs. Feline acquired myasthenia gravis is associated with a significant incidence of cranial mediastinal masses, and a lower percentage of associated megaoesophagus than myasthenia gravis in dogs. The diagnosis of acquired myasthenia gravis remains challenging for the clinician, and there are currently no evidence-based treatment protocols. Reports describing outcomes in acquired feline myasthenia gravis are conflicting, with survival rates ranging from 42–85%. Data concerning the rate of spontaneous remission in feline acquired myasthenia gravis is limited, however the reported incidence appears low (9.2%). Recently, a mutation affecting the COLQ gene has been identified in the Sphynx and Devon Rex breeds, demonstrating a genetic basis to feline congenital myasthenia gravis.
Equine periodontal disease
Authors: Lilly Gemma
Published: March 2019

Gemma Lilly BAEDT, The Donkey Sanctuary, discusses a painful, self-perpetuating disease
Internal parasites and drug resistance in horses
Authors: Watson Rebecca
Published: March 2019

Rebecca Watson Msc RVN gives an insight as to exactly what damage worms are doing to our horses and why preserving the efficacy of the anthelmintic drugs we have is so important
Equine distal interphalangeal joint lameness
Authors: Parker Russell A
Published: March 2019

Russell A Parker BVSc MSc DECVS MRCVS, Liphook Equine Hospital, discusses the options for managing and treating this common, but diagnostically challenging cause of lameness
Stop bullies in their tracks
Authors: Abbiss Adele
Published: March 2019

There are important ways in which schools, teachers, and technology companies can work collaboratively to protect children from bullying in all its guises – and it is never too early to start.
Big ideas for mini dens
Authors: Roberts Ann R
Published: March 2019

If you have limited space, mini den building is a great alternative to the larger variety, giving children the opportunity to experiment with building materials and scale, and create imaginative scenarios.
Let me explain
Authors: Tassoni Penny , Tassoni Anne-Marie
Published: March 2019

What type of expressive language should you expect three-to five-year-olds to be able to use when re-telling a story or event? Anne-Marie Tassoni and Penny Tassoni advise
Going to the supermarket
Authors: Rawstrone Annette
Published: March 2019

From planning the outing to turning it into an educational and fun experience while you're there, Annette Rawstrone gives some tips on grocery shopping with children
Is the laparoscopic approach a safe choice for the management of acute appendicitis in pregnant women? A meta-analysis of observational studies
Authors: Frountzas M , Nikolaou C , Stergios K , Kontzoglou K , Toutouzas K , Pergialiotis V
Published: March 2019

Introduction

Acute appendicitis is a common and serious situation during pregnancy, because of the increased risk of fetal loss and perforation in the third trimester, as well as a diagnostic difficulty. During recent years laparoscopic approach has been introduced to clinical practice with encouraging results. The purpose of this meta-analysis is to compare the surgical and obstetrical outcomes between laparoscopic and open appendectomy during pregnancy.

Materials and methods

MEDLINE, SCOPUS, Clinicaltrials.gov, CENTRAL and Google Scholar were searched for studies reporting on postoperative outcomes between laparoscopic and open appendectomy during pregnancy. The random effects model (DerSimonian–Laird) was used to calculate pooled effect estimates when high heterogeneity was encountered, otherwise the fixed-effects (Mantel–Haenszel) model was implemented.

Results

Twenty-one studies that enrolled 6276 pregnant women are included in the present meta-analysis. Of these women, 1963 underwent laparoscopic appendectomy and 4313 underwent an open appendectomy. Women who underwent laparoscopic appendectomy demonstrated an increase in fetal loss risk, while neonates of women that underwent open appendectomy presented decreased Apgar score at five minutes after birth. All the rest outcomes were similar between the two groups. The time that each study took place seemed to affect the comparison of birth weight and postoperative hospital stay between the two groups.

Conclusion

Laparoscopic appendectomy seems to be a relatively safe therapeutic option in pregnancy when it is indicated. Thus, it should be implemented in clinical practice, always considering the experience of the surgeon in such procedures. Nevertheless, the need of new studies to enhance this statement remains crucial.
Necrotising fasciitis in the North East of Scotland: a 10-year retrospective review
Authors: Neilly DW , Smith M , Woo A , Bateman V , Stevenson I
Published: March 2019

Introduction

Necrotising fasciitis is a life-threatening rapidly progressing bacterial infection of the skin requiring prompt diagnosis and treatment. Optimum care warrants a combination of surgical debridement, antibiotics and intensive care support. All cases of necrotising fasciitis in 10 years in the North East of Scotland were reviewed to investigate and improve patient care.

Methods

Cases between August 2006 and February 2016 were reviewed using case notes and electronic hospital records. Data including mode of admission, clinical observations, investigations, operative interventions, microbiological and clinical outcomes was collected and reviewed. Analysis required multidisciplinary input including microbiology, infectious disease, trauma and orthopaedics, plastic surgery and intensive care teams.

Results

A total of 36 cases were identified. The mean laboratory risk indicator for necrotising fasciitis (LRINEC) score was 7 and 86% of patients fulfilled the criteria for necrotising fasciitis. Patients were commonly haemodynamically stable upon admission but deteriorated rapidly; 36% of patients had a temperature of over 37.5 degrees C on initial observations; 29/36 patients were discharged, 6 patients died acutely (acute mortality rate of 17%); 18/31 of cases were polymicrobial with Streptococcus pyogenes, the common organism. Six amputations or disarticulations were performed from a total of 82 operations in this group, with radical debridement the usual primary operation. The mean time to theatre was 3.54 hours. Highly elevated admission respiratory rate (50 breaths/minute) was associated with increased mortality.

Conclusions

Necrotising fasciitis presents subtly and carries significant morbidity and mortality. A high index of suspicion allows early diagnosis and intervention. We believe that a pan-specialty approach is the cornerstone for good outcomes.
Systematic review and meta-analysis on outcomes of salvage therapy in patients with tumour recurrence during ‘watch and wait’ in rectal cancer
Authors: On J , Shim J , Aly EH
Published: March 2019

Introduction

The ‘watch and wait’ approach has recently emerged as an alternative approach for managing patients with complete clinical response in rectal cancer. However, less is understood whether the intervention is associated with a favourable outcome among patients who require salvage therapy following local recurrence.

Materials and methods

A comprehensive systematic search was performed using EMBASE, PubMed, MEDLINE, Journals@Ovid as well as hand searches; published between 2004 and 2018, to identify studies where outcomes of patients undergoing watch and wait were compared with conventional surgery. Study quality was assessed using the Newcastle–Ottawa assessment scale. The main outcome was relative risks for overall and disease specific mortality in salvage therapy.

Results

Nine eligible studies were included in the meta-analysis. Of 248 patients who followed the watch and wait strategy, 10.5% had salvage therapy for recurrent disease. No statistical heterogeneity was found in the results. The relative risk of overall mortality in the salvage therapy group was 2.42 (95% confidence interval 0.96–6.13) compared with the group who had conventional surgery, but this was not statistically significant (P > 0.05). The relative risk of disease specific mortality in salvage therapy was 2.63 (95% confidence interval 0.81–8.53).

Conclusion

Our findings demonstrated that there was no significant difference in overall and disease specific mortality in patients who had salvage treatment following recurrence of disease in the watch and wait group compared with the standard treatment group. However, future research into the oncological safety of salvage treatment is needed.
Management of pancreaticoduodenal artery aneurysm associated with coeliac artery stenosis
Authors: Kamarajah SK , Kharkhanis S , Duddy M , Isaac J , Sutcliffe RP , Mehrzad H , Dasari BVM
Published: March 2019

Pancreaticoduodenal and gastroduodenal artery aneurysms are rare but require early radiological or surgical intervention due to a high risk (61%) of rupture. A 71-year-old woman presented with an incidental 30-mm aneurysm arising from the inferior pancreaticoduodenal artery associated with coeliac axis stenosis. She underwent embolisation of the pancreaticoduodenal aneurysm, but the coeliac axis stenosis was not amenable to radiological intervention. She remained well at six months of follow-up and a repeat computed tomography angiogram six months later reported stable appearances. The management of pancreaticoduodenal aneurysms is discussed.
Malakoplakia of the parotid gland: a case report and review of localised malakoplakia of the head and neck
Authors: Samian C , Ghaffar S , Nandapalan V , Santosh S
Published: March 2019

Introduction

Malakoplakia is a rare chronic inflammatory disorder, predominantly affecting the urinary tract. In the head and neck region, it is very rare and may confuse the clinicians during investigations, as features may mimic malignancy.

Materials and methods

We report a case of malakoplakia involving the parotid gland and review of the reported cases of malakoplakia in head and neck region.

Results

Histologically, this is the first classic case report of malakoplakia involving the parotid gland in the world literature. A total of 49 cases have been reported in the head and neck region; 38.7% of these are cutaneous. In soft tissue, the tongue is the most common site. Salivary gland involvement is very rare. Previously, submandibular salivary gland involvement has been reported.

Conclusion

A possibility of malakoplakia should be considered as a differential diagnosis in patients with enlarged head and neck masses. Histology is essential to diagnose this benign inflammatory disorder and to differentiate from a malignant process.
The role of cross-sectional imaging in suspected nasopharyngeal carcinoma
Authors: Shayah A , Wickstone L , Kershaw E , Agada F
Published: March 2019

Introduction

Nasopharyngeal carcinoma is a rare neoplasm in the UK. The current gold standard for detection is endoscopic examination under anaesthesia of the nasopharynx with biopsy. Many clinicians are now advocating cross-sectional imaging as the primary investigation. The objective of this study is to evaluate the role of cross-sectional imaging in detecting nasopharyngeal carcinoma and ultimately to avoid unnecessary biopsy.

Material and methods

This is a retrospective uncontrolled case series review of patients who were investigated for suspected nasopharyngeal carcinoma between 2009 and 2017 at York Teaching Hospital NHS Foundation Trust. At present, any suspected nasopharyngeal carcinoma requires biopsy. Search terms used were ‘endoscopic biopsy of nasopharynx’, ‘endoscopic examination + biopsy nasopharynx’. The main outcome measures are reported histological and radiological features of malignancy. Only patients who had imaging prior to the biopsy were included.

Results

A total of 144 patients had endoscopic examination under anaesthesia of the nasopharynx with biopsy. Approximately one-third of these patients had cross-sectional imaging before the biopsy. The study revealed that magnetic resonance imaging had 100% sensitivity and 84% specificity; however, the endoscopic examination under anaesthesia and biopsy had only 88% sensitivity. This is due to a negative histological finding despite radiological characteristics of nasopharyngeal carcinoma in some patients. However, the specificity was 100%.

Conclusion

The study supports magnetic resonance imaging as the primary investigation in patients with suspected nasopharyngeal carcinoma followed by endoscopic examination under anaesthesia and biopsy in cases with suspicious findings on imaging only.
The effect of time to surgery on outcomes and complication rates following total hip arthroplasty for fractured neck of femur
Authors: Craik J , Geleit R , Hiddema J , Bray E , Hampton R , Railton G , Ward D , Windley J
Published: March 2019

Introduction

Total hip arthroplasty is recommended for elderly patients with fractured neck of femur who are independently mobile, have few co-morbidities and are not cognitively impaired. Providing a daily total hip arthroplasty service is challenging for some units in the UK and considering that these patients may be physiologically distinct from the average hip fracture patient, loss of the best practice tariff as a result of surgical delay may be unjustified. The aim of this study was to determine whether time to surgical intervention for patients eligible for total hip arthroplasty had a negative impact on patient complications, length of stay and functional outcomes.

Methods

All patients undergoing total hip arthroplasty for fractured neck of femur at our institution over a ten-year period were identified. Complications and functional outcomes were compared between patients receiving total hip arthroplasty before and after 36 hours.

Results

Of 112 consecutive patients undergoing total hip arthroplasty, 70 responded to a questionnaire or telephone consultation. Four patients were excluded owing to delayed presentation, the presence of advanced rheumatoid arthritis or a pathological fracture. Two-thirds (64%) of the remaining 66 patients underwent surgery within 36 hours of presentation. There were no significant differences between the groups of patients receiving surgery before or after 36 hours with regard to postoperative length of stay, complications, Oxford hip scores or visual analogue scale scores for state of health.

Conclusions

Delaying surgery for patients eligible for total hip arthroplasty as per the National Institute for Health and Care Excellence guidelines is justified and should not incur loss of the best practice tariff.
A novel technique to remove a broken tibiotalocalcaneal intramedullary nail using Moreland hip revision instrumentation
Authors: Papachristos IV , Dalal RB
Published: March 2019

Hindfoot intramedullary devices are increasingly used in tibiotalocalcaneal arthrodesis after failed total ankle arthroplasty or as a salvage procedure after complex trauma. Nail breakage is a well-described complication and numerous techniques for removal of broken parts can be found in the literature, especially for femoral and tibial nails. There is a relative paucity regarding techniques solving the challenge of removing a broken hindfoot intramedullary nail. We describe a novel technique using a curved thin hook from the Moreland hip revision set to remove the distal part of a broken tibiotalocalcaneal intramedullary nail.
Az egyházi iskolák szerepe a zenei nevelésben
Authors: Váradi Judit , Dragony Gábor
Published: March 2019

Empirikus kutatásunk napjaink zeneoktatásának gyakorlati kérdéseivel foglalkozik. Vizsgáljuk az egyházi iskolák szerepét a zenei művészeti nevelésben összehasonlítva a nem felekezeti iskolák ének-zene oktatásával. Megállapítottuk, hogy az egyházi és állami iskolákban is érvényesül az élményszerű zenei művészeti gyakorlati oktatás. Az egyházi iskolák jobban ellátottak hangszerekkel, az ének-zene tanárok tudnak hangszeren játszani és a tanulók jelentősen többet énekelnek kánonban. Az egyházi iskolai tanulók több mint 90 százaléka már volt élőzenei hangversenyen, ebben az iskolának, az énekkarnak és a szülőknek is jelentős szerepük van. Az állami iskolák tanulói kevesebbszer, jellemzően iskolai szervezéssel látogatják a hangversenyeket. Megállapíthatjuk, hogy egyházi iskolák nagyobb hangsúlyt fektetnek a zenei művészeti nevelésre kurrikuláris és extrakurrikuláris színtéren is. Az ének-zene órák gyakorlati oktatását jelentősen kellene erősíteni, a koncertpedagógia élménypedagógiai vonatkozásban nem tölti be maradéktalanul szerepét.
Biosafety measures in dental practice: Literature Review
Authors: Barbieri Ana Amélia , Feitosa Fernanda , Ramos Carolina Judica , Teixeira Symone Cristina
Published: March 2019

Objective: There is a great concern with biosafety nowadays, given the knowledge of diseases and potential complications in health practice. In this context, this review aims to provide information capable of improving good health practices and consequent minimization of operational risks in dental practice. Material and Methods: A review of biosafety literature was carried out covering the last seven years considering the health descriptors: "odontologia" and "biossegurança" / "Contenção de Riscos Biológicos" in the following Databases: Biblioteca Virtual em Saúde - BVS (Virtual Health Library); Bibliografia Brasileira de Odontologia - BBO (- Brazilian Bibliography of Dentistry ) and Literatura Latino-Americana e do Caribe em Ciências da Saúde – LILACS (Latin American and Caribbean Literature in Health Sciences); and with the descriptors "dentistry" and "biosecurity" / "Containment of Biohazards" in the Databases: Scientific Electronic Library Online (SciELO), National Library of Medicine (MEDLINE), US National Library of Medicine National Institutes of Health Search (PubMed) and SCOPUS. Results: There were found 33 articles that met the criteria established for this research. Conclusion: From the literature, it is concluded that the evaluation of procedures, knowledge and constant study, the improvement of procedures and joint action of all staff is of fundamental importance so that health improvement can go beyond health care and the resolution of a specific problem.KeywordsDentistry; Containment of biohazards; Biosafety.
Effect of Polyethylene Terephthalate Tongue Scraper on Oral Levels of Volatile Sulfur Compounds: a randomized clinical trial
Authors: Leal Mônica Barbosa , Góes Joelmir da Silva , Dellovo Andrea Gomes , Sao Mateus Carla Rocha , Macedo Guilherme de Oliveira
Published: March 2019

Objective: To evaluate the effect of Polyethylene Terephthalate (PET) tongue scraper on the volatile sulfur compound (VSC) levels. Material and Methods: A randomized, controlled, parallel design was used in this study. Out of the 48 volunteers from Dentistry Department of the Federal University of Sergipe, 40 subjects who met the inclusion criteria were randomly divided into 4 groups (n=10): G1 (control), rinsing of distilled water solution (WS); G2, WS and tongue coating removal (TCR) with toothbrush; G3, WS and TCR with a commercial tongue scraper; and G4, WS and TCR with PET tongue scraper. PET bottles were cut with a rectangular shape (1.0 cm wide x 20 cm long) to obtain PET tongue scraper. The VSC measurements were performed before (T0) and immediately after (T1) each therapy by portable sulfide monitor. Data (ppb) were submitted to Wilcoxon test (?=0.05). The differences between T0 and T1 were calculated and percentage values were assigned. Data (percentage) were submitted to ANOVA and Tukey test (?=0.05). Results: All 40 selected subjects completed the study. All groups reduced significantly the VSC levels after therapy (P<0.01). ANOVA indicated a significant difference among groups (P<0.001). The Tukey test showed that G1 (reduction of 21%) was similar to G2 (31%); G2 was similar to G3 (42%) and different from G4 (52%); G3 and G4 were similar. Conclusion: PET tongue scraper was similar to commercial tongue scraper and provided higher reductions of VSC levels than the toothbrush. KeywordsHalitosis; Polyethylene terephthalates; Sulfur compounds; Tongue.
The impact of at home and in-office bleaching agents on the color stability of bulk-fill composite resins
Authors: Araújo Rodrigo Máximo , Lemes Elisangela Costa , Pachito Rubens Ferri , Feitosa Fernanda Alves
Published: March 2019

Objective: This study compared different composites for color stability after exposure to at home and in-office bleaching gels. Material and Methods: Composite resin specimens (6mm diameterx2mm thickness) were manufactured according to the following groups (n=20): RC- Conventional; BF-Bulk Fill; RF-Flow; BFF-Bulk-Fill Flow. The surfaces were stained with coffee solution for 36hrs. A spectrophotometer was used to record the initial color (L*a*b*). Half of the specimens from each group underwent bleaching with 35% hydrogen peroxide (in-office) in three 45-minute applications. New color measurements were performed after 7, 14 and 21 days. The other half of the specimens underwent bleaching with 22% carbamide peroxide (at home) in 14 1-hour applications. Further color measurements were performed after 7 and 14 hours. For comparison between the color coordinates in different periods, ANOVA for repeated measures was applied (?=5%). The color variation (?E) was calculated for each group. Results: For in-office bleaching, there were no significant differences between the periods b* coordinate of the RF group, and for L* and b* coordinates of the BFF group. For at home bleaching the groups BF and BFF showed no differences for the L* coordinate. For the other coordinates, there was difference between the initial periods and after 14 days. The ?E variation presented higher values for the at home bleaching groups. For both whiteners the bulk-fill resins presented the greatest color variations. Conclusions: Bulk Fill resins do not guarantee greater color stability than the other composite resins tested, including conventional flow resin. The conventional composite resin showed the lower ?E.
Biaxial flexural strength of different types of monolithic zirconia
Authors: Nossair Shereen Ahmed , Salah Tarek , Ebeid Kamal Khaled
Published: March 2019

Objective: This study was designed to evaluate the biaxial flexural strength (BFS) of different types of unshaded and shaded monolithic zirconia. Material and Methods: 120 monolithic zirconia ceramic discs were fabricated. They were divided into twelve groups (n=10), Group 1; Bruxzir unshaded, Group 2; Bruxzir shaded A2, Group 3; Bruxzir anterior white, Group 4; Bruxzir anterior shade A2, Group 5; Prettau unshaded, Group 6; Prettau shaded with A2 coloring liquid, Group 7; Prettau anterior white, Group 8; Prettau anterior shaded with A2 coloring liquid, Group 9; Katana HT white, Group 10; Katana HT shade A2, Group 11; Katana ST white, Group 12; Katana ST shade A2. All discs were milled using a dental milling machine, and had final dimensions after sintering of 15 mm diameter and 1 mm thickness. BFS was tested using piston on three ball technique. Results:  One-way ANOVA revealed significant differences among the 12 groups. Tukey post-hoc tests revealed no significant differences between the groups 3, 4, ,7 ,8 11, and 12. However, they all had BFS values that are significantly lower than all other groups. Group 2 showed statistically significant higher BFS values when compared to group 3,4, 7, 8, 11, and 12 while it showed statistically significant lower values when compared to groups 1, 5, 6, 9, and 10. Conclusion: Increase in the yttria content in zirconia led to a decrease in its BFS. Shading of zirconia did not have a significant effect on the final strength of zirconia. KeywordsDental ceramics; Dental esthetics; Flexural strength; Shaded zirconia.
Hayden White nas páginas de History and Theory. Dois momentos: 1980 e 1998
Authors: Avelar Alexandre De Sá
Published: March 2019

Ao longo das últimas cinco décadas, o nome de Hayden White sempre esteve associado a importantes debates e disputas historiográficas. A inegável relevância e extensão do seu legado suscitou reações ambíguas, controvérsias variadas e deu origem a uma vasta produção bibliográfica conduzida por seus comentadores e analistas. O objetivo deste artigo é analisar dois momentos (1980 e 1998) da recepção do livro Metahistory (1973), obra magna de Hayden White, nas páginas da prestigiosa History and Theory. Esta revista, referência incontornável para o campo da teoria e filosofia da história, teve papel decisivo na estruturação de um conjunto de reflexões e análises sobre a relevância dos pressupostos teóricos contidos no livro seminal de White.

palavras-chave: Hayde White; Metahistory; History and Theory.
Itinerários da conquista: a história trágico-marítima de Portugal (séculos XVI-XVIII)
Authors: Felipe Cleber Vinicius Do Amaral
Published: March 2019

FELIPE, Cleber Vinicius do Amaral. Heroísmo na singradura dos mares: histórias de naufrágios e epopeias nas conquistas ultramarinas portuguesas. São Paulo: Paco (no prelo).
Uma modernidade encharcada de misticismo
Authors: Machado Ricardo
Published: March 2019

FLORES, Maria Bernardete Ramos. Xul Solar e Ismael Nery entre outros místicos modernos: sobre o revival espiritual. Campinas: Mercado de Letras, 2017, 288 p.
O autoconceito na população com Dificuldade Intelectual e Desenvolvimental (DID) em Portugal: Revisão sistemática
Authors: Fonseca Inês , Almeida Bruno , Roldão Sara , Jesus Rita , Lopes Joana , Santos Sofia
Published: March 2019

A mudança de paradigma da pessoa com Dificuldade Intelectual e Desenvolvimental (DID) como agente ativo e autodeterminado vem evidenciar a forma como o próprio se vê, ou seja, o seu autoconceito, sendo este um tema que a nível nacional ainda carece de mais investigação. Esta revisão sistemática objetiva identificar e caracterizar os aspetos que influenciam o autoconceito destes indivíduos. A pesquisa foi realizada em várias bases de dados e revistas eletrónicas. Os estudos foram considerados elegíveis se relatassem aspetos ligados ao autoconceito e à DID, apresentassem parte empírica, incluíssem amostras nacionais e se tivessem acesso livre. Posteriormente, os estudos foram submetidos a vários processos de seleção, até ao processo de avaliação metodológica. Foram considerados oito estudos, onde dois analisaram a influência da atividade física, e os restantes outras variáveis (e.g., desinstitucionalização) no autoconceito da pessoa com DID. Os oito estudos compreenderam 1 a 50 participantes (N=179), entre os 8 e os 65 anos com DID ligeira a moderada. Seis dos estudos foram classificados como “fortes” e os restantes como “moderados”. Existem vários aspetos que influenciam positivamente o autoconceito nesta população, destacando-se uma boa rede de suporte social e a educação parental. Quanto à autoestima, salienta-se a prática da atividade física e a desinstitucionalização. A aposta na investigação na área desde a validação de instrumentos específicos para a avaliação do autoconceito deste subgrupo populacional e da análise das suas propriedades psicométricas, passando pela identificação dos fatores preditores do autoconceito neste subgrupo, na relevância da monitorização dos processos de desinstitucionalização e identificação das estratégias e implementação de programas centrados na pessoa para uma maior participação, para a mudança de atitudes, são algumas das recomendações para a prática.
Reshaping engineering learning to promote innovative entrepreneurial behavior
Authors: Caten Carla Schwengber ten , Silva Diego Souza , Aguiar Rafael Barbosa , Silva Filho Luiz Carlos Pinto , Huerta Josep Miquel Piqué
Published: March 2019

Goal: To foster innovative and creative thinking in the curricula of Engineering schools, as well as other technology-based courses, contributing to the innovation ecosystems’ growth and sustainability.

Design/Methodology/Approach: The research was structured as an exploratory research and was conducted by means of a focus group comprised of representatives from Porto Alegre (RS) working directly with higher education and/or playing key roles within the city’s innovation ecosystem. The group’s discussion was analyzed along with current literature on the topic.

Results: The paper provides insightful perceptions of the obstacles faced by faculty members when attempting to develop innovative methodologies within classes so that potential partnerships are fostered by agents of the innovation ecosystem in order to better prepare professionals that will later be inserted in this new innovative scenario.

Limitations of the investigation: The present study is structured as an exploratory research based on a focus group discussion and analysis. Thus, as any qualitative approach, it might lack generalizability, once its purpose is to investigate a specific phenomenon and promote further investigation on the issue. However, all discussion from the focus group was analyzed and supported by extant literature on the topic, in order to mitigate such limitation and strengthen the research relevance.

Practical implications: The analysis and discussion obtained from both the focus group and literature are imperative on the need of critical changes on universities’ organizational culture to support entrepreneurial activities, as well as fostering partnerships with key agents within innovation ecosystems to better prepare professionals to the new market setting.

Originality/value: Although some studies investigate the relationship involving universities and Science and Technology Parks, few studies explore how engineering schools’ curricula can benefit from such alliances. Additionally, the present study lists a few hurdles faced by professors during the development of active-based practices, as well as alternative possibilities to overcome resistance in traditional courses.
When does it end? Monte Carlo Simulation Applied to Risk Management in Defense Logistics’ Procurement Processes
Authors: Laudares Abel De Castro , Ricco Maria Filomena Fontes , Silveira dos Santos Rodrigo Antônio
Published: March 2019

Goal: The main objective of this research was to evaluate the application of the Monte Carlo simulation, in comparison with other estimation methodology, in order to verify if it would be possible to apply this tool to improve the risk perception of deadlines during a procurement process for logistical support of defense projects.

Methodology: By means of collected data from 2015 to 2017, a comparison was conducted among deadlines of real procurement processes versus simulated processes with the use of the Monte Carlo simulation.

Results: The performance analysis of the Monte Carlo simulation suggests that it could be possible to apply it to the first phase of risk management in order to improve the risk perception of deadlines during a procurement process for logistical support of defense projects.

Limitations of the investigation: The main limitation of the research relates to the database analyzed, which involved three different modalities of Bidding Processes.

Practical implications: The data from this research reveals that the Monte Carlo simulation can be used as an effective tool for advising the decision maker and, mainly, the managers of internal control about aspects of corporate risk management in public organizations.

Originality/Value: This research presents an original contribution to corporate governance related to risk management, which is not commonly seen in the Brazilian public sector.