bluuebunny/crossref_metadata_2025 huggingface dataset:
Lytic Bacteriophages and Phage Cocktails Seem to be a Future Alternative Against Multi-Drug Resistant Bacterial Infections
Authors: Pallavali Roja Rani , Degati Vijaya Lakshmi , Durbaka Vijaya Raghava Prasad
Published: June 2019

Lytic bacteriophages have the efficacy to act and eradicate pathogenic bacteria as an attractive tool in the near future. Bacteriophages specifically kill multidrug-resistant bacteria even which have the capacity to form biofilms. The present review mainly focused on the efficacy of bacteriophages and cocktails as therapeutic agents against predominate MDR-bacteria and their biofilms which are isolated from septic wound infections. The body of evidence includes data from studies investigating bacteriophages from sewage samples as novel antibacterial and antibiofilm agents against pathogenic bacteria. The goal of this review is to present an overview on predominant bacteria from septic wound infection, the biofilm-forming capacity of bacteria, lytic effect of bacteriophages and phage cocktails with an emphasis on the application of bacteriophages against septic wound causing bacteria.
On the Cosmological Origin of the Rest Mass of Elementary Particles: The Ideas of Maximons and Minimons Revisited
Authors: T.E Girish , V Vipindas , C Radhakrishnan Nair
Published: June 2019

It is suggested that physical properties of common elementary particles can be associated with microscopic Primordial Black Holes (PBH) which is inferred to have formed between 10−24 to 10−20 seconds from Big bang in the early universe. This is also found to be related to the phenomenon of Hawking radiation from these PBH. We have revisited the properties of minimons and maximons introduced by Markov [1] in this context. Planck particles which is inferred to form near Planck time (3.857 ×10−43 seconds) are identiﬁed as maximons with a mass √πmp where mp is the Planck mass. The minimons are associated with a PBH with Hawking temperature identical with the cosmic microwave background temperature of the universe. The mass of the minimons are found to be comparable to that of the lightest neutrinos (0.0185 eV). They also possess highest Compton wavelength (10−4 m) known for an elementary particle.
Teto constitucional de remuneração dos agentes públicos: uma crônica de mutações e emendas constitucionais
Authors: Modesto Paulo
Published: June 2019

1. Improbidade da expressão teto de remuneração. 2. Fixação de limites máximos de remuneração na redação original da CF/88. 3. Sistema de estabelecimento de limites máximos de retribuição previstos pela EC 19/98. 4. Parcelas excluídas dos limites máximos no novo regime constitucional. 5. Previsão de limites inferiores ao teto constitucional nacional (subteto). 6. Diferenças e semelhanças entre o novo sistema e o previsto originalmente pela Constituição de 1988. 7. A posição do Supremo Tribunal Federal sobre a eficácia das novas disposições constitucionais sobre o teto de retribuição. 9. Impasse na definição do teto constitucional. 9. Impropriedade da fixação de tetos constitucionais estaduais. 10. Alteração do novo teto constitucional.
O regíme jurídico das licitações no Brasil e no Mercosul
Authors: Pereira Cesar A. Guimarães
Published: June 2019

1. Introdução. 2. O regime constitucional das licitações no Brasil. 3. O regime legal das licitações no Brasil. 4. O tratamento de licitantes estrangeiros no Brasil. 5. O Estado atual do tema no âmbito do mercosul. 6. Conclusão.
Um novo Estado? privatização do Estado versus publicização do setor privado
Authors: Filho Valmir Pontes
Published: June 2019

O autor busca discutir um chamado "Novo Estado", em um contexto de privatização do Estado que teve inicio durante a década de 1990.
Um caso paradigmático de violação ao direito
Authors: Mello Celso Antônio Bandeira de
Published: June 2019

O estudo se propõe a analisar o caso relativo ao processo de alienação das ações que a União Federal detinha na TELEBRAS, o qual foi efetuado com diversos vícios jurídicos.
O princípio da isonomia nas licitações públicas
Authors: Niebuhr Joel De Menezes
Published: June 2019

1. Introdução. 2. Conceito de princípios. 3. Conceito e natureza jurídica da licitação. 4. O princípio da isonomia. 5. O princípio da isonomia na licitação pública. 6. O princípio da isonomia e a lei das licitações públicas. 7. Das modalidades de licitação. 8. Das fases do procedimento licitatório. 9. Conclusão. 10. Referências bibliográficas.
Parecer
Authors: Filho Valmir Pontes
Published: June 2019

O parecer tem por objetivo responder a seguinte consulta: "Considerando o art. 30, II, § 1º, I e II, da Lei 8.666/93 e o Edital de Concorrência 005/99, originário da Secretaria..., pode a Administração exigir em concorrência de obra e serviço de engenharia a capacidade técnico-operacional? Sendo possível tal exigência, além do interesse público, qual outra limitação existiria para os parâmetros de aferição dessa capacidade? A exigência do subitem 02, "d", item 03.02 do Edital acima indicado caracteriza ilegalidade?"
La discrecionalidad administrativa y su control judicial
Authors: Viale Claudio Martín
Published: June 2019

O presente artigo tem como objeto analisar o tema do controlejudicial da discricionariedade administrativa. Para tanto, serão examinadosos temas da divisão entre direito público e direito privado, da distinção entreatividade vinculada e atividade discricionária e do desvio de poder.
A necessidade de defesa técnica no processo administrativo disciplinar e a inconstitucionalidade da Súmula Vinculante nº 5 do STF
Authors: Bacellar Filho Romeu Felipe , Hachem Daniel Wunder
Published: June 2019

O objetivo do presente artigo é examinar a necessidade de defesatécnica no processo administrativo disciplinar e a inconstitucionalidade daSúmula Vinculante nº 5 do STF, a partir da análise dos argumentos utilizadospela Corte Suprema para justificar a sua edição.
El lenguaje entre tiempo y norma
Authors: Magliacane Alessia
Published: June 2019

Partiendo desde el filósofo del derecho Otto Pfersmann, y progresandohasta de la filosofía del lenguaje de Wittgenstein a través de Peircey Deleuze, Apel, Habermas y Dussel, la autora propone una interpretaciónde la norma jurídica como una concentración de signos en el espacio y en eltiempo que ofrecese a el intérprete como un discurso de emancipación socialy cultural. La constitución emerge peus como un proyecto de transformacióncolectiva de los intérpretes, que, solo después una transición (revolucionariao democrática), se encuentran como actores del derecho.
Sociedades em conta de participação e as licitações envolvendo concessões de transporte coletivo – Riscos e possibilidades
Authors: Sabino Carlos Henrique de Mattos
Published: June 2019

O artigo versa sobre os riscos e as possibilidades da atuação desociedades em conta de participação em contratos administrativos envolvendoconcessões de transporte coletivo. Analisa-se, também, os benefícios trazidosà população e a Administração Pública, bem como as melhores formasde incrementar os serviços prestados à população a partir da utilização deinvestimentos oriundos de sociedades em conta de participação firmadasentre concessionários de serviços públicos e terceiros investidores.
O controle de constitucionalidade pelo Estado-Administração
Authors: Freitas Juarez
Published: June 2019

A Administração Pública tem o dever prioritário de proteger os direitos constitucionais. Tal dever supõe ampliação do autocontrole, respeito às decisões judiciais consolidadas e favorece a afirmação do princípio da deferência. A tarefa de evitar a ação ou omissão inconstitucional é de todos os agentes de Estado e, de acordo com as suas atribuições, representa aspecto crítico do novo Direito Administrativo. Por outras palavras, a constitucionalidade — além da conformidade com as regras legais — precisa ser assegurada e garantida pelo Estado inteiro, incluída a Administração Pública.
A constitucionalização do direito administrativo e as políticas públicas
Authors: Ferrari Regina Maria Macedo Nery
Published: June 2019

O objetivo do presente estudo consiste em analisar o processo de constitucionalização do direito administrativo brasileiro, sob o enfoque de temas como a incidência dos princípios constitucionais sobre a Administração Pública, a supremacia do interesse público, os direitos fundamentais e as políticas públicas.
Fiscalização abstrata de constitucionalidade e medida cautelar
Authors: Nobre Júnior Edilson Pereira
Published: June 2019

A expansão da jurisdição constitucional tornou necessária a instituiçãode mecanismos de urgência destinados a evitar que a pronta execuçãoda lei ou ato normativo inconstitucional venha a resultar na formação deirreversível realidade, razão pela qual os sistemas jurídicos vêm se preocupando com a disciplina de providências cautelares mesmo no âmbito da fiscalização abstrata.
Amministrazione pubblica e analisi economica del diritto: istruzioni per l’uso dall’Italia
Authors: Carducci Michele , Macrì Michele
Published: June 2019

Il principale obiettivo dell’articolo è quello di considerare ilpunto di vista realistico dell’approccio italiano all’analisi economia deldiritto nel campo del diritto amministrativo. Tale approccio è sviluppato conparticolare enfasi sulle sue finalità di efficienza, che non negato il ruolo dellaCostituzione, ma sottolineano l’influenza delle continue e ripetute riformeamministrative nella effettiva prassi economica del pubblico potere.
Controle jurisdicional de políticas públicas
Authors: Aragão Alexandre Santos de
Published: June 2019

O artigo trata do tema do controle de políticas públicas pelo PoderJudiciário, com enfoque na problemática dos direitos sociais, apresentandoalguns obstáculos para esse controle. Versa também sobre o controle judicialda discricionariedade administrativa.
Considerações críticas sobre as licitações e contratos administrativos
Authors: Bacellar Filho Romeu Felipe
Published: June 2019

O autor tece comentários sobre os contratos administrativos, em geral, e sobre a Lei de Licitações, em específico, comentando sobre possíveis modificações de tal diploma que venham a aprimorá-lo.
Descentralização administrativa - sua evolução face às reformas à Constituição de 1988
Authors: Aragão Alexandre Santos de
Published: June 2019

O artigo investiga o atual estágio da organização administrativa brasileira, principalmente no tocante à descentralização administrativa e sua evolução face à Constituição de 1988.
Voto aberto e processo legislativo
Authors: Filho Ubirajara Custódio
Published: June 2019

Consultam-nos os ilustres Vereadores de Curitiba Jorge Samek e Ney Leprevost a respeito da constitucionalidade das Proposições nº 01.00001.2001 e nº 11.00001.2001, ambas datadas de 18 de abril p.p. e que buscam introduzir a regra do voto aberto no processo legislativo da Câmara Municipal local. A Proposição nº 01.00001.2001 altera a redação dos arts. 35 e 47, § 1º, da Lei Orgânica do Município de Curitiba, enquanto a Proposição nº 11.00001.2001 altera a redação do art. 13, § 5º, revoga o inciso IV do § 2º do art. 132 e altera a redação do § 6º, todos do Regimento Interno da Câmara Municipal de Curitiba, objeto da Reso lução nº 04, de 28 de junho de 1990.A resposta à consulta envolve o exame preliminar de alguns dispositivosda Consti tuição Federal de 1988 (CF/88), atinentes aos seus princípios fundamentais e à posição do Município na Federação, após o que se passará em revista específica das proposições legislativas em tela.
A lei de responsabilidadade fiscal como instrumento limitador da discricionariedade na execução orçamentária
Authors: Bruno Reinaldo Moreira
Published: June 2019

1 Cenário da execução orçamentária nos Municípios brasileiros - 2 Instrumento limitador da discricionariedade na execução orçamentária e dasações administrativas - 3 Principais limitações na execução orçamentária dosMunicípios - 3.1 Instituição de todos os tributos de competência Municipal - 3.2 Uso indiscriminado da renúncia fiscal - 3.3 Despesas vinculadas às leisorçamentárias - 3.4 Despesas com pessoal - 3.5 Aporte financeiro a entidadesda administração indireta - 3.6 Nível de endividamento - 3.7 Operações decrédito - 3.8 Preservação do patrimônio público - 3.9 Final de mandato - Bibliografia
A dimensão do amicus curiae no processo constitucional brasileiro: requisitos, poderes processuais e aplicabilidade no âmbito estadual
Authors: Binenbojm Gustavo
Published: June 2019

1 O amicus curiae e a sua configuração no direito brasileiro - 2 A possibilidade da intervenção do amicus curiae nas Representações por Inconstitucionalidade estaduais - 3 Requisitos para a participação do amicus curiae: relevância da matéria e representatividade dos postulantes - 4 Momento processual oportuno para a intervenção - 5 Poderes processuais reconhecidos ao interveniente admitido como amicus curiae no controle abstrato: manifestações escrita e oral e legitimidade recursal - 6 Síntese conclusiva
Fenômeno convencional, sistema brasileiro de recepção de tratados internacionais e a necessidade hodierna de integração econômica
Authors: Reck Melina Breckenfeld
Published: June 2019

Introdução - I Intensificação do fenômeno convencional: estreita relação entre tratado internacional e organizações internacionais - II Celebração e recepção no direito interno dos tratados internacionais e responsabilização internacional - III As clássicas concepções: monismo e dualismo - IV A recepção e a hierarquia dos tratados internacionais no Direito brasileiro - V Fragilidade da regra brasileira de recepção de tratados internacionais e integração econômica - Conclusão - Bibliografia
Participação administrativa
Authors: Oliveira Gustavo Henrique Justino de
Published: June 2019

1 Introdução - 2 Cidadania e participação - 3 Democracia representativa e democracia participativa - 4 Participação administrativa - 4.1 Conceituação - 4.2 A problemática da participação administrativa - 4.3 Participação administrativa e participação procedimental - 4.3.1 Momentos e efeitos da participação procedimental - 4.4 Legitimidade pelo procedimento e legitimidade pela participação - 4.5 Participação, descentralização e negociação - 4.6 A participação gerencial - 5 Considerações finais - Bibliografia
Prescrição do processo disciplinar começa a fluir da data do fato investigado: crítica aberta ao §1º, do artigo 142, da Lei nº 8.112/90
Authors: Mattos Mauro Roberto Gomes de
Published: June 2019

I Introdução - II O fator tempo nas relações jurídicas públicas - III Do prazo inicial da prescrição disciplinar, crítica ao §1º, do artigo 142, da Lei nº 8.112/90 - IV O §1º, do artigo 142, da Lei nº 8.112/90, interpretado em sua  literalidade, fere o art. 5º, LXXVIII, da CF (inserido pela EC nº 45/2004) - V Do início do prazo (dies a quo) no processo disciplinar comparado - VI Supremo Tribunal Federal – STF não permite a interpretação da prescriçãoindefinidamente - VII Conclusão
O controle judicial nas omissões no planejamento financeiro
Authors: Broliani Jozélia Nogueira
Published: June 2019

1 Cinco anos da Lei de Responsabilidade Fiscal - 1.1 Estado burocrático x Estado gerencial - 1.2 Planejamento visando resultados – metas e controle - 1.3 Transparência - 2 Controle externo e controle judicial dos atos discricionários - 2.1 Limites do controle judicial do ato discricionário – atos comissivos e omissivos - 2.2 O Poder Judiciário suprindo omissões no planejamento e determinando ações, despesas, obras - 2.3 A responsabilidade do Estado por atos comissivos e omissivos no planejamento- 2.4 Responsabilidade por dano decorrente do planejamento
Considerações sobre a ação direta interventiva e a proteção dos direitos fundamentais
Authors: Krol Heloísa Da Silva
Published: June 2019

Neste artigo busca-se tratar de alguns pontos relacionados à ação direta interventiva, porém dentro do contexto de proteção dos direitos fundamentais. Desta forma, não serão abordadas especificamente questõesreferentes ao processo de intervenção, suas hipóteses e pressupostos.
LRF, despesa de pessoal e período pré-eleitoral: um roteiro prático de providências
Authors: Valle Vanice Lírio do
Published: June 2019

Dissecando a conduta vedada: a expedição de ato, e seu inegáveltraço voluntarístico, e a demonstração de sua inocorrência - 2 Avaliando umaconduta possível: ação voluntária isoladamente determinante de aumentode despesa, mas contenível no limite consistente no total de gastos da datade referência - 3 Breves recomendações com vistas à suavização do períodosuspeito
O custo dos direitos prestacionais
Authors: Honório Cláudia
Published: June 2019

Introdução - 1 Os direitos prestacionais - 2 A reserva do possível - 3Frente à escassez, uma solução - 4 O papel do judiciário - 5 A ponderação deinteresses - 6 Instrumental novo - Conclusão - Referências
A Emenda Constitucional nº 45 e a desconstrução do Direito Internacional: apontamentos críticos
Authors: Santos Sandro Schmitz dos
Published: June 2019

1 O contexto em que surge a emenda - 2 Os tratados de direitos humanos - 3 A previsão expressa ao Tribunal Penal Internacional - 4 A modificação de competências internacionais dos Tribunais Superiores - 5 A federalização dos crimes de Direitos Humanos - 6 A arbitragem - 7 Oportunidades perdidas - Conclusão - Referências
Reflexões a propósito do regime disciplinar do servidor público
Authors: Bacellar Filho Romeu Felipe
Published: June 2019

O artigo busca analisar questões relacionadas ao processo administrativo e ao regime disciplinar do servidor público, sobretudo em face das mudanças ocorridas no Direito Administrativo brasileiro após a promulgação da Constituição Federal de 1988.
A pesagem dos veículos ônibus do transporte coletivo rodoviário interestadual de passageiros nas estradas federais
Authors: Maluf Sérgio Roberto
Published: June 2019

O presente artigo aborda a questão da pesagem dos veículos ônibus do transporte coletivo rodoviário interestadual e de passageiros nas estradas federais. Inicialmente trata-se do Estado de Direito, o qual detém poderes e limitações decorrentes da lei. Em seguida, analisam-se alguns aspectos sobre as rodovias federais e a estrutura legal aplicável. Trata-se da normatividade do trânsito, especialmente questões sobre capacidade e licença dos veículos sujeitos à pesagem. No que se refere aos veículos ônibus, vários dispositivos do Código de Trânsito Brasileiro são analisados. Demonstram-se alguns óbices no tocante à pesagem do veículo ônibus, e do seu uso derivado para encomendas ou cargas. Trata-se das infrações e notificações previstas no Código de Trânsito Brasileiro. Sustenta-se que a lotação de um veículo de transporte de passageiros deve ser aferida em número de pessoas. Por fim, elencam-se alguns pontos que cabe aos proprietários de veículos requerer, quando operam transporte coletivo rodoviário.
A competência legislativa municipal para a inovação da linha substitutiva em caso de impedimento ou vacância do Prefeito - Entre autonomia política e democracia popular
Authors: Gabardo Emerson , Salgado Eneida Desiree
Published: June 2019

Trata da questão da autonomia do Município na federação brasileira. Inicia com uma perspectiva histórico-evolutiva. Descreve as características da sistemática constitucional de autonomia, indicando os dispositivos normativos concernentes à matéria. Analisa a questão da competência municipal para a sua auto-organização e, particularmente, para o estabelecimento do regime substitutivo dos chefes do Poder Executivo. Aponta para a existência de limites expressos e imanentes para o exercício desta função político-organizacional, tais como o princípio da simetria, o princípio democrático e o da soberania popular. Promove uma refutação à comum proposta legislativa de alocar o Procurador-Geral do Município na linha de substituição e sucessão do Prefeito. Finaliza com uma crítica à condescendência jurisprudencial na matéria, que aceita amplamente a total discricionariedade do legislador municipal.
Prorrogação do prazo de vigência de contrato de concessão de serviço público
Authors: Alencar Dilermando Gomes de
Published: June 2019

EMENTA: Cláusula de prorrogação. Artigo 19 da Lei nº 9.074/95. Subsunção da hipótese fática ao permissivo legal. Constitucionalidade questionada pela doutrina. Descabimento de tal análise na via angusta deste Parecer. Garantia da qualidade de atendimento aos usuários a custos adequados. Demonstração pela área técnica de tais elementos. Saldo a depreciar. Quando o saldo a depreciar é de monta razoável, a  recomposição  do  equilíbrio-financeiro mostra-se  viável  com  a prorrogação do prazo de vigência da concessão. Impor aos usuários (aumento das  tarifas)  ou  ao Estado  o  ônus de  adimplir  referido montante devido ao  titular da Concessão  revela-se desarrazoado. Possibilidade de encaminhamento ao Ministério de Minas e Energia, vez que o Processo encontra-se regularmente instruído.
La responsabilidad estatal ante la huida del Derecho administrativo
Authors: Delpiazzo Carlos E.
Published: June 2019

Esse artigo trata da responsabilidade estatal diante da fuga do direito administrativo. Inicialmente analisa-se a questo da responsabilidade como princpio geral de direito. Em seguida delimitada a extenso da responsabilidade estatal. Abordam-se as caractersticas do fenmeno da fuga do direito administrativo, bem como as privatizaes e terceirizaes que envolvem os setores pblicos e privados. Pautam-se alguns aspectos a respeito da responsabilidade e das concesses administrativas. O princpio da responsabilidade relacionado com o princpio da legalidade. Trata-se da extenso do direito administrativo, e da fuga do direito administrativo diante das terceirizaes. Aborda-se a tcnica do desmascaramento que a jurisprudncia tem aplicado a fim de diminuir a diferena entre a verdade material e a verdade formal. Por fim, conclui-se que independentemente do objetivo perseguido pela Administrao, tem que ser respeitada a dignidade da pessoa humana.
O direito fundamental à presunção de inocência no processo administrativo disciplinar
Authors: Bacellar Filho Romeu Felipe
Published: June 2019

O objetivo do presente trabalho consiste em realizar uma reflexão aprofundada sobre o conteúdo jurídico e a aplicabilidade do direito fundamental à presunção de inocência no processo administrativo disciplinar.
A volta do regime jurídico único – Algumas discussões inadiáveis sobre a função pública brasileira
Authors: Pinto e Netto Luísa Cristina
Published: June 2019

O artigo versa a definição da natureza do regime jurídico da função pública brasileira. Analisa-se criticamente o modelo estatutário, majoritariamente defendido, e propõe-se a contratualização da função pública com a conjugação de disciplina legal heterônoma e disciplina autônoma, possibilitando-se o exercício dos direitos coletivos da função pública, porconsiderar-se o modelo contratual mais adequado ao Estado de Direito Democrático e Social.
Bilateral Isolated Fractures of the Sustentaculum Tali
Authors: Radley Joseph M. , Nicolaou Daemeon A.
Published: June 2019

Case:

This article presents a case of bilateral isolated fractures of the sustentaculum tali. Subtle radiographic findings of sustentaculum fractures on routine foot and ankle series are often difficult to detect, which can result in a delayed diagnosis. Early diagnosis and timely operative management allowed for a good short-term outcome.

Conclusions:

We emphasize the importance of a thorough physical examination in all high-energy trauma patients and an awareness of less common injury patterns that are subtle on radiographs and may require further workup. When clinical suspicion exists, we recommend the use of computed tomography scans for evaluation.
The Effect of Workers’ Compensation Status on the Patient Experience
Authors: Compton Jocelyn , Glass Natalie , Fowler Timothy
Published: June 2019

Background:

Rating the patient experience is an increasingly important component of value-based health care. Generation of lower ratings on validated functional assessments by patients with Workers’ Compensation is well known; however, the relationship between Workers’ Compensation status and patient satisfaction is poorly described in orthopaedic patient populations.

Methods:

All orthopaedic outpatient patient satisfaction surveys (Press Ganey) generated over an 18-month period at a U.S. academic tertiary care center were included in this study. Data with regard to the primary payer, demographic characteristics, orthopaedic subspecialty, and planned surgical interventions with the provider for whom the survey was completed were analyzed in conjunction with patient satisfaction data.

Results:

During the study period, 3,720 consecutive patient satisfaction surveys were generated, and 244 surveys were generated by 215 patients with Workers’ Compensation. Satisfied patients with Workers’ Compensation were more likely to be male (p = 0.0007), to have higher mental health self-assessments (p = 0.004), and to be scheduled for surgical intervention (p = 0.03). Scheduling a surgical procedure was independently associated with improved patient satisfaction, whereas Workers’ Compensation status was independently associated with dissatisfaction when adjusting for sex, language, race, and marital status. Across all patient satisfaction domains, patients with Workers’ Compensation gave significantly lower scores (p < 0.05) compared with all other patients. Patients with Workers’ Compensation were more likely to rate their overall health as lower compared with other patients (p < 0.0001). Patients with Workers’ Compensation were more likely to give lower ratings to providers on a 1-to-10 scale (p < 0.0001) and were less likely to recommend the practice to others (p < 0.0001).

Conclusions:

Workers’ Compensation status is a non-modifiable independent predictor of dissatisfaction with health care compared with other primary payer groups. Further research is warranted to understand the factors influencing patient satisfaction ratings.
New Innovations in Targeted Muscle Reinnervation
Authors: Oh Christine , Carlsen Brian T.
Published: June 2019

» Targeted muscle reinnervation allows for the creation of additional electromyographic signals for a myoelectrically controlled prosthesis in patients who have undergone an upper-extremity amputation.

» Targeted muscle reinnervation shows promise in addressing neuroma pain in both the upper and lower extremities.

» Areas of further research include targeted sensory reinnervation as well as use in pediatric patients.

» Osseointegration remains a challenge in need of further research given the high risk of infection.
Epigenetics in non-small cell lung carcinomas
Authors: Peralta-Arrieta Irlanda , Armas-López Leonel , Zúñiga Joaquín , Ávila-Moreno Federico
Published: June 2019

Objective. To perform a systematic review of the main epi­genetic aberrations involved in non-small cell lung carcinomas’ (NSCLC) diagnosis, progression, and therapeutics. Materials and methods. We performed a systematic review of the scientific literature on lung cancer epigenetics, focusing on NSCLC. Results. Several advances in the molecular study of classical epigenetic mechanisms and massive studies of lung cancer epigenome have contributed relevant new evidence revealing that various molecular complexes are functionally influencing genetic-epigenetic and transcriptional mechanisms that promote lung tumorigenesis (initiation, promotion, and progression), and are also involved in NSCLC therapy-resistance mechanisms. Conclusion. Several epigenetic complexes and mechanisms must be analyzed and considered for the design of new and efficient therapies, which could be fundamental to develop an integrated knowledge to achieve a comprehensive lung cancer personalized medicine.
Tobacco control in Mexico: A decade of progress and challenges
Authors: Reynales-Shigematsu Luz Myriam , Wipfli Heather , Samet Jonathan , Regalado-Pineda Justino , Hernández-Ávila Mauricio
Published: June 2019

Mexico was the first country in the Americas to sign and ratify the World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC) in 2004. More than a decade later, it is appropriate to evaluate legislative and regulatory progress and the associated challenges; and also, to propose a roadmap to prioritize the problems to be addressed to achieve long-term sustainable solutions. Mexico has made substantial progress in tobacco control. However, regulations have been only weakly enforced. The tobacco industry continues to interfere with full implementation of the WHO-FCTC. As a result, tobacco consumption remains stable at about 17.6%, with a trend upwards among vulne­rable groups: adolescents, women and low-income groups. The growing popularity of new tobacco products (electronic cigarettes or e-cigs) among young Mexicans is an increasing challenge. Our review reveals the need to implement all provisions of the WHO-FCTC in its full extent, and that laws and regulations will not be effective in decreasing the tobacco epidemic unless they are strictly enforced.
HMGR overexpression and interference affects the expression of steroidogenic genes and cholesterol content in bovine intramuscular adipocytes
Authors: Liu Xiaomu , You Wei , Zhang Xianglun , Jin Qing , Tan Xiuwen , Wei Chen , Zhao Hongbo , Zhang Chen , Liu Yifan , Wan Fachun , liu guifen
Published: June 2019

Background:Previously, we found that mevalonic acid stimulates HMGR expression in bovine intramuscular adipocytes, and influences adipocyte differentiation. However, it remains unclear whether there is any direct link between HMGR, steroidogenic genes, and cholesterol content. RNA-Seq was conducted to determine the differences between the gene expression profiles of bovine adipocytes containing different HMGR expression constructs.
Results:In total, 10 234 differentially expressed genes (DEGs) were found. Of these, 35 and 6 DEGs between the control and the overexpression groups were functionally related to lipid and energy metabolisms, respectively. Additionally, 43 and 8 DEGs between the control and the HMGR inhibition groups were related to lipid and energy metabolism. Additionally, several DEGs related to lipid and energy metabolism were identified between the HMGR overexpression group and the HMGR interference group. Several DEGs correlated positively or negatively with overexpression or inhibition of HMGR. We also found that, following activation or inhibition of the HMGR gene, AMPK and SIRT1 had opposite expression patterns in bovine intramuscular adipocytes. Interestingly, the HMGR gene was downregulated when HMGR was overexpressed, and upregulated when HMGR was inhibited.
Conclusion:Our findings establish a theoretical understanding of signaling pathways involved in cholesterol synthesis by elucidating the relationships between key genes.
How do Lebanese Patients Perceive the Ideal Doctor Based on the CanMEDS Competency Framework?
Authors: Aoun Mabel , Sleilaty Ghassan , Jaoude Simon Abou , Chelala Dania , Moussa Ronald
Published: June 2019

Background

During their training, Lebanese medical students develop a high medical expertise but are less acquiring other competencies such as communication, collaboration, erudition, professionalism, leadership and health promotion. There is also insufficient data about patients’ preference for these skills. This study describes the different weights patients attribute to these physician’s competencies.

Methods

This is a cross-sectional study based on a questionnaire distributed to 133 Lebanese patients. It included 15 questions assessing how patients prioritize the physician’s competencies, with open-ended questions asking them to define “the good doctor”. Krippendorff’s alpha coefficient was used to analyze the reliability of the competencies’ classification.

Results

125 patients completed the questionnaire in this cross-sectional study. Their mean age was 48 ± 16.76 years. When classifying competencies, 73.6% opted for medical expertise as first choice and 48% put communication as second. Based on the Krippendorff’s coefficient, we identified a moderate agreement for the seven choices (alpha=0.44). In open-ended questions, patients defined the good doctor in 325 answers: 64.3% mentioned medical expertise, 34.1% high ethics and 26.2% communication.

Conclusions

This patient-centered study concurs well with the worldwide practice that puts medical expertise at the center of medical education. However Lebanese patients don’t perceive equally other competencies and favor professionalism and communication that should be integrated in priority in students’ curricula.
Impact of bronchiectasis on long-term survival in patients with acute exacerbation of chronic obstructive pulmonary disease
Authors: Zhang Ying , Zhang Shu , Gao Yan-Li , Wang Zhen , Bu Xiao-Ning , Huang Ke-Wu , Shi Huan-Zhong , Lin Ying-Xiang
Published: June 2019

Background

Only few studies have reported the association between bronchiectasis and mortality in patients with Chronic Obstructive Pulmonary Disease (COPD) and the results were controversial. This study aimed at assessing the prognostic influence of bronchiectasis on COPD patients and comparing differences of prognostic influence of different types of bronchiectasis on COPD patients.

Patients and methods

This study enrolled patients hospitalized for COPD exacerbation between 2013 and 2014. Bronchiectasis was identified on high-resolution computed tomography (HRCT) within 2 years prior to this hospitalization due to COPD exacerbation and Smith score was used to determine the extent of bronchiectasis. Clinical data were obtained from electronic inpatient medical record. The survival data were obtained through telephone follow-up or electronic medical record. Cox regression analysis was used to assess the prognostic influence of bronchiectasis on COPD patients.

Results

748 COPD patients were included in this study. 318 patients were identified to have bronchiectasis. During a median follow-up time of 46 months, 624 COPD patients completed follow-up. There were 210 deaths, 112 of whom were comorbid bronchiectasis patients. Comorbid bronchiectasis patients revealed higher mortality than without bronchiectasis patients in 3 years and the whole follow-up, other than in hospital, 1 year and 2 years. The presence of bronchiectasis and its severity were independently associated with increased mortality of COPD patients. The presence of cystic/varicose bronchiectasis revealed higher mortality than cylindrical bronchiectasis and was independently associated with increased mortality of comorbid bronchiectasis patients.

Conclusions

The presence of bronchiectasis and its severity were independently associated with increased risk of all-cause mortality and mainly affected the long-term mortality of COPD patients. The presence of cystic/varicose bronchiectasis predicted higher death risk of COPD patients.
Algorithm for asthma diagnosis and management at Chitungwiza Central Hospital, Zimbabwe.
Authors: Ndarukwa Pisirai , Chimbari Moses John , Sibanda Elopy N
Published: June 2019

Asthma is a chronic inflammatory and a heterogeneous condition of respiratory system whose pathogenesis is linked with variable structural changes. The clinical manifestation of asthma includes attacks of breathlessness, cough, chest tightness and wheezing. Provision of basic equipment and test for asthma diagnosis and access to essential medicines by asthmatic patients reduces morbidity and mortality rates. Significant progress has been made in the diagnosis and management of asthma in other countries but not in the health care delivery system in Zimbabwe. Therefore, the aim of this study was to develop algorithm for asthma diagnosis and management for Zimbabwe.
A two stage Delphi model was used to collect data to develop an algorithm of asthma diagnosis and management. A baseline interview with 44 doctors was done to understand their experiences and knowledge regarding asthma diagnosis and management. We collected data using KoBo Collect Toolbox installed on Android mobile phone and transferred the data to an Excel 2016 spreadsheet for cleaning. The data was qualitatively analysed and themes were constructed. These themes were further explored in stage two at an algorithm development workshop which was led by 4 medical expert panellists in order to develop consensus on the information to be included in the algorithms for asthma diagnosis and management. A total of 15 doctors and 30 nurses participated at the workshop.

Doctors who attended the workshop described the challenges in asthma diagnosis and management that they experienced. These challenges were attributed to lack of basic equipment such as spirometers and Peak Expiratory Flow Meters and tests which included IgE tests, Skin Allergen Tests and RAST. Asthma diagnosis clinical history and management was based on the doctors’ knowledge. The doctors indicated the need for refresher courses to update their knowledge on asthma diagnosis and enhance their diagnostic skills. A draft algorithm framework for asthma diagnosis was developed at the workshop and later refined by the core-research team.

We established the need for doctors to receive constant refresher courses on asthma diagnosis for upskilling. We recommend adoption by the Zimbabwe’s Ministry of Health and Child Care of the asthma diagnostic algorithm we developed.
18FDG PET/CT-derived parameters successfully predict clinical stage and prognosis of esophageal cancer.
Authors: Mantziari Styliani , Pomoni Anastasia , Prior John , Winiker Michael , Allemann Pierre , Demartines Nicolas , Schäfer Markus
Published: June 2019

Background

Although 18FDG PET/CT is validated in baseline workup of esophageal cancer to detect distant metastases, it remains underused in assessing local staging and biology of the primary tumor. This study aimed to evaluate the association between 18FDG PET/CT-derived parameters of esophageal cancer, and its clinico-pathological features and prognosis.

Methods

All patients with esophageal adenocarcinoma or squamous cell cancer of operated between 2005-2014 were analyzed. Linear regression was used to identify clinico-pathologic features of esophageal cancer associated with the tumor’s maximal Standardized Uptake Value (SUVmax), Total Lesion Glycolysis (TLG) and Metabolic Tumor Volume (MTV). ROC curve analysis was performed to precise the optimal cutoff of each variable associated with a locally advanced (cT3/4) status, long-term survival and recurrence. Kaplan Meier curves and Cox regression were used for survival analyses.

Results

High baseline SUVmax was associated with cT3/4 status and middle-third tumor location, TLG with a cT3/4 and cN+ status, whereas MTV only with active smoking. A cT3/4 status was significantly predicted by a SUVmax >8.25g/mL (p<0.001), TLG>41.7 (p<0.001) and MTV>10.70 cm3 (p<0.01) whereas a SUVmax > 12.7 g/mL was associated with an early tumor recurrence and a poor disease-free survival (median 13 versus 56 months, p=0.030), particularly in squamous cell cancer.

Conclusions

Baseline 18FDG PET/CT has a high predictive value of preoperative cT stage, as its parameters SUVmax, TLG and MTV can predict a locally advanced tumor with high accuracy. A SUVmax > 12.7 g/mL may herald early tumor recurrence and poor disease-free survival.
The prevalence and risk factors of Early Childhood Caries among 3-year-old children in Wenzhou
Authors: Mei Liqin , Wei Zhiyuan , Li Qiao , Wang Xiping
Published: June 2019

Background

This study aimed to investigate the prevalence and risk factors of Early Childhood Caries (ECC) among 3-year-old children in Wenzhou China.

Methods

Kindergarten children aged 3 were recruited using a stratified cluster sampling method. Dental examinations were conducted by one trained dentist, and oral health-related data were collected. Examinations were surface-specific for dental caries, following World Health Organization (WHO) criteria. Bivariate tests and logistic regression models were used to assess the association between ECC and different risk factors.

Results

A total of 693 children were recruited for the study, and 445 completed the dental examination. Among the 445 children, the prevalence of ECC was 59.8%. The mean decayed, missing, and filled primary teeth (dmft) was 2.9, and of the total dmft, only 6.3% were filled. The mean decayed, missing, and filled primary surface (dmfs) was 4.9. Logistic regression analyses identified age and parents’ oral health knowledge level were associated with the experience of ECC (P<0.05).

Conclusions

A higher prevalence of ECC was observed and most of the carious teeth were untreated. The experience of ECC was related to age and parents’ oral health knowledge level.
THEORETICAL AND EXPERIMENTAL INVESTIGATION OF THE EFFICIENCY OF THE USE OF HEAT-ACCUMULATING MATERIAL FOR HEAT SUPPLY SYSTEMS
Authors: Klymchuk Oleksandr , Denysova Alla , Shramenko Aleksandr , Borysenko Krystyna , Ivanova Lidiia
Published: June 2019

As a result of research, the conditions for the effective use of the volume of heat accumulator based on solid materials were determined. In the course of research, various schemes of the device of tubular heating elements for charging the channel elements of the heat accumulator were considered. Fire clay was used as a heat-accumulating material, capable of operating in a wide temperature range (up to 600 °С). Mathematical modeling of temperature change in the process of discharge over the cross section of the heat-accumulating unit has been carried out. Mathematical modeling was carried out using an application package that allows to obtain the temperature distribution over the cross section of the heat accumulator at key points of its work. The obtained simulation results were tested on an experimental setup consisting of four heat-accumulating units during the charging process and during the discharge of the heat accumulator. According to the research results, the most effective layout of the heating elements was determined, which allows to make the most of the volume of the heat-accumulating material. The dependencies to determine the exponent and the averaging coefficient of the heat flux are also found, which allow a more rational use of the volume of the accumulating nozzle.

The research results can be used to reconstruct decentralized heat supply systems for both residential buildings and public buildings. This will significantly align the schedule of electricity consumption during the day and reduce the consumption of hydrocarbon fuels.
METHOD OF STIMULATION OF PHARMACY WORKERS INVOLVED IN THE GOVERNMENT PROGRAM “AVAILABLE MEDICINES”
Authors: Moroz Svitlana , Nemchenko Alla , Podgaina Maryna , Vynnyk Olena , Zoidze Diana
Published: June 2019

The aim is to study the current state of the organization of work in pharmacies under the government program “Available medicines” and to create proposals for the improvement of material incentives to increase the motivation of workers of such pharmacies.

Materials and methods. The research used the general methods of scientific knowledge: analysis and synthesis, analogy and comparison; method of questioning to determine the actual state and opinions of specialists on the organization of work in the conditions of pharmacy participation in the program "Available medicines".

Results and discussion. In the course of the study, the problem of lack of incentives and motivation for the work of pharmacy workers under the Government program "Available medicines" has been highlighted. According to the results of the survey of specialists of three different forms of pharmacy’ ownership, participating in the program of reimbursement of the cost of drugs, it was found that the volume and intensity of work of workers has significantly increased, and wages have remained at the same level. The number of operations performed by employees in such pharmacies has considerably increased, which is related to the registration and maintenance of recipes under the program "Available medicines". The questionnaire survey has showed that the best option for optimizing the organization of remuneration in the prevailing conditions would be to pay extra for work (overpays). It was found that the number of recipes taken by one pharmacist per day varies considerably in different pharmacies, and there are also differences in the duration of the work of pharmacies under the reimbursement program during the month. To increase the motivation of pharmacists to work in the prevailing conditions, the method of calculating the additional payment for work in the conditions of the program "Available medicines" for each chemist's worker is offered individually in accordance with the post based on a formula that takes into account the intensity of labor using the intensity coefficient and the percentage of the additional payment.

Conclusions. The conducted researches have shown that the increased intensity of labor, which takes place in pharmacies working under the program "Available medicines", is the basis for the calculation of additional payments. The application of the system of material stimulation of the work of pharmacists based on the proposed methodology will allow compensating additional labor of specialists, taking into account the intensity of their work.
SELECTION OF A FILLER FOR TABLETS MANUFACTURED WITH DIRECT COMPRESSION METHOD CONTAINING DRY GINGER EXTRACT
Authors: Ruban Оlena , Alkhalaf Malek , Gerbina Nataliia
Published: June 2019

The preliminary studies of physico-chemical and pharmaco-technological properties of the dry extract of ginger have determined the need for introduction of different groups of excipients for developing a solid dosage form for the treatment of type II diabetes mellitus.

Aim. To choose the rational filler in the composition of tablets with ginger obtained by direct compression.

Materials and methods. The study object was the dry extract of ginger (DEG) (producer “Megaprom”, Dnepr,Ukraine) and modern excipients for the production of tablets by direct compression: GalenIQ 721 (BENEO-Palatinit Gmb), Flowlac 100 (Meggle Co.), Tablettose 80 (Meggle Co.), Farmaxx (Merck), Microcelac 100 (Meggle Co.), Vivapur 112 and 102 (JRS Pharm), Prosolv HD 90, Prosolv SMCC 50 (JRS Pharm) manufactured in Germany. Pharmaco-technological and physico-chemical properties of the samples were studied according to conventional methods of the State Pharmacopoeia of Ukraine.

Results and discussion. According to the results of the crystallographic analysis, the ability to the moisture absorption, resistance to crushing, disintegration time, fluidity indicators, angle of repose and bulk volume the effect of modern excipients on physicochemical and pharmaco-technological properties of the dry extract of ginger has been studied.

Conclusions. According to the results of microscopic analysis, it has been found, that the rational fillers are GalenIQ 721, Prosolv HD 90, Prosolv SMCC 50, Vivapur 102 and Vivapur 112, as they provide a uniform system and the necessary resistance to destruction. The study of the kinetics of the moisture absorption has shown that addition of the fillers significantly reduces the increase in moisture compared to the dry extract. The mixture with GalenIQ 721 has the lowest parameters of moisture absorption at a relative air humidity of 45 %, 75 % and 100 %. In accordance with the results of the pharmaco-technological studies, it has been found that addition of GalenIQ 721 leads to improved flowability, disintegration, settling qualities; it indicates the feasibility of its inclusion into the composition of the solid dosage form.