bluuebunny/crossref_metadata_2025 huggingface dataset:
Combate às más condutas
Authors: Tonelli Maria José , Wilner Adriana
Published: September 2019

Os custos da corrupção para o mundo superam 3,6 trilhões de dólares por ano, perto de 5% do produto interno bruto (PIB) global, segundo a Organização das Nações Unidas (ONU), a qual destaca que essas perdas em fraudes, subornos, evasão fiscal e lavagem de dinheiro estão entre os principais  bstáculos para o cumprimento dos Objetivos do Desenvolvimento Sustentável (ODS).A corrupção desvia recursos fundamentais para o desenvolvimento das nações e afeta a competitividade dos países. Traz prejuízos às finanças, à reputação e à cultura das organizações, o que em última instância ameaça sua sobrevivência. Uma economia alicerçada por esquemas de desvios ilegais de  ecursos não se sustenta.
O que é liberalismo, afinal?
Authors: Godoi Alexandra Strommer
Published: September 2019

A palavra voltou com força ao debate econômico no brasil. Para fugir dos chavões e memes de rede social, recuperamos um pouco do significado do termo ao longo da história do pensamento econômico.
Desafios de usar dados para novos fins
Authors: Luvizan Simone S.
Published: September 2019

Para explorar o potencial pleno do big data, precisamos compreender a complexidade de questões operacionais, tecnológicas, legais, econômicas e sociais que surgem quando informações são reutilizadas.
Collateralized Assets Prices and Monetary Policy
Authors: Arango Mauricio
Published: September 2019

Un sistema financiero bien informado y cauteloso puede mejorar el bienestar de una economía al canalizar los excedentes de los ahorradores a los prestatarios. Sin embargo, en una situación de crisis, el menor precio de bienes hipotecables limita la capacidad de crédito de la economía, generando la posibilidad de una reducción en el crédito inclusive en un escenario de bajas tasas de interés. Este documento ilustra el punto anteriormente mencionado através de un modelo de equilibrio general en el que el uso de activos como colateral determina que tan riesgoso es el comportamiento del sistema financiero. Esta y varias otras condiciones amplifican la magnitud de un choque de productividad negativo
Liquidez de los mercados accionarios latinoamericanos y su impacto en el crecimiento económico per-cápita
Authors: Naula Sigua Freddy Benjamin , Campoverde Campoverde Jorge Arturo , Mora Pacheco Pedro Fabian , Loyola Ochoa Diego Mauricio
Published: September 2019

El presente artículo aporta evidencia empírica respecto a la influencia que tiene la liquidez del mercado accionario en el crecimiento económico, para una muestra de 11 países latinoamericanos. Con ésta finalidad, se utilizaron datos de panel, estimados por el método de Momentos Generalizados (GMM por sus siglas en inglés), además de variantes de dicho modelo. A pesar de que uno de los indicadores de liquidez, específicamente el Turnover, presenta un signo negativo, lo cual es contrario a lo típicamente esperado, a nivel general es posible concluir que la liquidez sí influye en el crecimiento económico. Además, existen países que pueden ser considerados atípicos; por eso se realizó el análisis con y sin ellos, obteniendo en ambos casos que se mantenía el mismo resultado. El estudio se corresponde de forma parcial con la literatura existente.
A LIÇÃO DE ANTONIO CANDIDO E NOTAS SOBRE UM PERCURSO NO ENSINO DE LITERATURA / Antonio Candido's lesson and notes on a path in literature teaching
Authors: Gomes da Silva Mônica
Published: September 2019

Este relato de experiência apresenta algumas notas reflexivas sobre as ações de fomento à leitura literária realizadas pelo Grupo de Pesquisa e Extensão LEIA. A lição de Antonio Candido (1989) sobre a importância da literatura e da fruição estética no processo de formação e humanização do indivíduo é a base tanto para o exame de uma abordagem mais ampla para o ensino de literatura, quanto das ações empreendidas pelo GPE LEIA e descritas no relato. Além do ensaio do Professor, a abordagem teórica recorre aos estudos de Tzvetan Todorov (2009), Vincent Jouve (2010) e Leyla Perrone-Moisés (2016) para o estabelecimento do atual panorama do ensino de literatura, a questão do baixo índice de leitura literária e as possíveis estratégias para reverter o afastamento em relação à literatura no âmbito das instituições de Ensino Superior. Assim como o ensaio de Antonio Candido, essas obras apontam para o potencial de humanização, isto é, a capacidade da literatura em atender a necessidades subjetivas profundas, como uma das chaves para o seu ensino. Atesta-se, por conseguinte, a validade e a vigência da lição de Antonio Candido. Na sequência, o relato contextualiza o âmbito de atuação do grupo, destacando a importância em promover um acesso qualificado à literatura numa instituição de formação de professores. Por fim, descreve-se uma parte do percurso através dos ciclos destinados ao estímulo e o interesse pela leitura literária dentro dos marcos conceituais abordados.
ENSINO DE LITERATURAS EM PRÉ-VESTIBULARES SOCIAIS: IDENTIDADES EM TRÂNSITO / Teaching literatures in social pre-college preparatory courses: identities in transit
Authors: Pereira Maria Betânia Almeida
Published: September 2019

O artigo discorre acerca das ações desenvolvidas no projeto de iniciação à docência, “O ensino do texto literário e suas inter-relações com outras linguagens”, iniciado em 2016 na Faculdade de Formação de Professores, da Universidade do Estado do Rio de Janeiro (FFP-UERJ). Tendo em vista o recorte do corpus para análise, nos detivemos em uma das experiências cujo enfoque volta-se ao ensino do texto literário em pré-vestibulares sociais. Desta forma, a pesquisa objetiva: contextualizar o projeto e seus desdobramentos; refletir sobre o ensino de literatura em pré-vestibulares sociais, considerando algumas abordagens teórico-metodológicas; trazer à baila depoimentos de professores voluntários -  licenciandos em Letras da FFP-UERJ -  de forma a repensar o ethos de professor e sua construção identitária nesse processo de ensino-aprendizagem. A fundamentação teórica apoiou-se em: Antonio Candido (2004), quando defende a literatura enquanto direito de todos; Todorov (2009) ao pontuar uma visão reducionista no ensino de literatura e ao analisar a formação universitária; Brian Street (2014), ao considerar as práticas sociais de leitura e de escrita, pondo em relevância o método etnográfico; Stuart Hall (2014) em sua conceituação das identidades enquanto representações sociais; Paulo Freire (1996) ao situar o processo de ensino-aprendizagem como via de mão dupla em que professores e alunos se constroem e se reconstroem; dentre outros. Esperamos que o trabalho possa motivar debates em torno do ensino de literatura, em diversificados espaços de aprendizagens.
CONVERSAS ENTRE A UNIVERSIDADE E A ESCOLA PÚBLICA: ENCONTRO COM EGRESSOS, MESTRANDOS E PROFESSORES DO PROFLETRAS FFP/UERJ / Talks between the University and the public school: meeting with PROFLETRAS FFP/UERJ’s graduates, master’s students and teachers
Authors: Rodrigues Andréa , Oliveira Marcia Lisbôa Costa de
Published: September 2019

Resenha sobre o II Encontro de Egressos do PROFLETRAS FFP/UERJ e o I Simpósio do PROFLETRAS FFP/UERJ, que aconteceram paralelamente em 25 de junho de 2019 na Faculdade de Formação de Professores da Universidade do Estado do Rio de Janeiro.
A DIVISÃO NO ESPORTE DEVE SER SEPARADA POR SEXO OU GÊNERO
Authors: Da Silva Maria Eduarda Aguiar
Published: September 2019

Artigo científico que tem objetivo analisar se a separação nos esportes deve ser por sexo biológico ou gênero, fruto de pesquisa iniciada em março de 2018 após a polêmica com a jogadora transexual de volei Tyfanni Abreu. O trabalho enfoca a temática da divisão sexual nos esportes e se a separação deve ser por sexo biológico ou gênero auto identificado, enfrentando questões polêmicas que envolvem a idéia de vantagem ou desvantagem pretérita, uma vez que padrões biológicos e médicos, com viés patologizantes ainda são utilizados nos discursos de muitos envolvidos de modo direto nessa ação. Neste trabalho são apresentados argumentos favoráveis e contrários a inclusão de atletas transexuais nos esportes. Um olhar trans emerge a partir dessa narrativa, evidenciando o protagonismo necessário.
O CORPO TRANSGÊNERO E O DIREITO BRASILEIRO - UMA BREVE ANÁLISE DO SISTEMA JURÍDICO BRASILEIRO A RESPEITO DO NÃO BINÁRIO
Authors: Marques de Souza Aedan Dougan
Published: September 2019

O presente trabalho tendo como base bibliografias que versam sobre os corpos transexuais pretende evidenciar a construção social do sexo e do gênero, tal qual apresenta o papel do direito como instituição que mantem o controle dos corpos, mostrando que tal posição leva à marginalização e contribui para a estigmatização dos corpos transexuais. Afim de ponderar a situação do sistema jurídico brasileiro atual, que apresenta uma pequena caminhada ao reconhecimento ao direito à identidade de gênero, com a proposta de Lei João W. Nery, e principalmente com a decisão do STF de 2018, que reconheceu o direito de mudança de prenome sem a necessidade de cirurgia ou tratamento hormonal. Mas que, porém, essa caminhada ainda é lenta e por isso contribui com a violência transfóbica.
DENSIDADES, DEVENIRES Y NOMADISMOS PARA RESTAURAR UNA VIEJA E IMPERMANENTE PEDAGOGÍA: UNA CONVERSACIÓN CON MARÍA MARTA YEDAIDE
Authors: Ramallo Francisco
Published: September 2019

En esta conversación la pedagogía es presentada de una manera nómade y expandida, más que una disciplina su densidad deviene en narrativa. Desde la investigación educativa como una vocación política que desata y amarra pasados y presentes, esta entrevista biográfica reafirma una intención de indisciplinarla. El texto restaura condiciones que afectan y enredan nuestra condición humana, a la vez que convoca a autorizar otras narrativas para la educación más amables con nosotros mismos. De este modo el programa histórico de desafectación que promueve y sella la continuidad de nuestras instituciones sociales, es interrumpido parcialmente por la voz de esta pedagoga, en la que se reconocen prácticas de una pedagogía descolonial que trata de no moverse lejos de la vida y aspira a resistirse a la pulsión por los absolutos.
MEMÓRIAS DE FORMAÇÃO
Authors: Martins Shenia Mineiro
Published: September 2019

A primeira vez que entrei em um museu ainda estava no sexto ano. Era o Museu Imperial de Petrópolis, o mais próximo à  minha cidade - Nova Friburgo. Nas férias que passávamos meu irmão e eu no Rio de Janeiro, frequentávamos o Palácio do Catete. Sua gruta foi palco de inúmeras brincadeiras nossas. Comecei a descobrir os espaços culturais do Rio somente quando comecei minha primeira graduação. O Parque das ruínas foi o primeiro. O Museu do Índio e o Villa Lobos descobri por acaso por acas. A Casa Rui Barbosa, no mesmo bairro, foi palco de longas conversas sobre Eisenstein. O Real Gabinete e seu acervo mexe com meu imaginário tanto quanto os astros que observo no Planetário de Nova Friburgo, paixão que herdei de meu irmão. Há diversos espaços que não estão presentes por falta de permissão para fotografá-los. Ainda que seja um equipamento portátil o que tenho levado ele ainda causa estranheza e fui impedida de fotografar principalmente os interiores. No final da exposição há um link no qual é possível visitar os locais de onde tirei as fotos em 360 graus. Experimente fazê-lo em um óculos de realidade virtual se você tiver a oportunidade. https://photos.app.goo.gl/tCbfa1ttJmhYErr96
POLÍTICA NACIONAL DE EDUCAÇÃO MUSEAL – PNEM: MUSEUS, EDUCAÇÃO E REDES
Authors: Teixeira de Vargas Márcia Isabel , Becker Andréia Von Hausen Bederode
Published: September 2019

ResumoEste artigo apresenta uma análise do cenário emergido com a efetivação da Política de Educação Museal (PNEM), temática principal, e a participação das Redes de Educadores em Museus, vivenciadas pelos sujeitos da dinâmica educacional em instituições culturais desde a sua concepção. Relata a participação da Rede de Educadores em Museus do Rio Grande do Sul (REM-RS), na elaboração compartilhada do Programa de Educação Museal, no período de 2012 a 2017. Tem o objetivo de evidenciar tensões experimentadas pelo museu, a escola e por seus agentes nas atividades do setor educacional museológico. Sugere que as ações empreendidas para fomentar a incorporação da PNEM às instituições museológicas sejam efetivadas de forma articulada e com indispensável reconfiguração de acordo com os princípios e diretrizes da política pública voltada aos museus brasileiros, enquanto referencial para o setor. Destaca a Carta de Petrópolis, a Carta de Belém e a Carta de Porto Alegre documentos que demonstram a participação e as discussões, presenciais e em rede, geradas pelos profissionais efetivamente envolvidos nos processos de construção que resultaram na referida política.  Conclui com relatos de experiências e atividades na formação docente no espaço museológico como forma de adequar o trabalho educacional em museus ao PNEM.Palavras-chave: Educação Museal. Redes. Rede de Educadores em Museus. Formação docente. NATIONAL POLICY OF MUSEAL EDUCATION - PNEM:Museums, Education and Networks  Abstract               This article presents an analysis of the emerged scenario with the implementation of the Museum Education Policy (PNEM), the main theme, and the participation of the Educator Networks in Museums, experienced by the subjects of the educational dynamics in cultural institutions from their conception. It reports on the participation of the Network of Educators in Museums of Rio Grande do Sul (REM-RS), in the shared elaboration of the Museum Education Program, from 2012 to 2017. Its objective is to tensions experienced by the museum, the school and its agents in the activities of the museum educational sector. It suggests that the actions undertaken to promote the incorporation of PNEM to museological institutions should be carried out in an articulated manner and with an indispensable reconfiguration in accordance with the principles and guidelines of the public policy focused on Brazilian museums, as a reference for the sector. The Petrópolis Charter, the Belém Charter and the Porto Alegre Charter emphasize the documents that demonstrate the participation and the discussions, both in person and in a network, generated by the professionals effectively involved in the construction processes that resulted in this policy. Concludes with reports of experiences and activities in teacher training in the museum space as a way to adapt the educational work in museums to the PNEM. Key words: Museum Education. Networks. Educators Network in Museums. Teacher training.
INTERLOCUÇÕES INICIAS - DESCORTINANDO NOVOS CENÁRIOS
Authors: Carvalho Felipe Da Silva Ponte de , Santos Edmea
Published: September 2019

INTERLOCUÇÕES INICIAS - DESCORTINANDO NOVOS CENÁRIOS
Heat Transfer During Cooling of Bulk Distillers Dried Grains with Solubles (DDGS)
Authors: Siliveru Kaliramesh , Casada Mark   E. , Ambrose R. P. Kingsly
Published: September 2019

Abstract. DDGS is often transported in railcars and trucks from the ethanol plants to the feed mills and animal farms. During unloading, flowability of DDGS is often reduced due to caking of DDGS bulk. Based on published research, the environmental relative humidity, DDGS glass transition temperature, syrup content, and duration of cooling of DDGS piles influence the caking behavior of DDGS. The objective of this study was to develop and validate a heat transfer model for predicting the cooling pattern of DDGS piles. A finite volume method approach was used to develop the heat transfer model. Ergun’s equation was used to implement airflow resistance in the porous media of the DDGS bulk. The heat transfer inside the pile was simulated for winter (6°C) and summer (24°C) ambient conditions. The model agreed well with the experimental temperature measurements from the three sets of experiments with two sizes of experimental piles. The overall predicted temperatures were 2.7°C and 0.7°C higher than the observed temperatures for small- and medium-size experimental piles, respectively. This heat transfer model could be used to predict the temperature variations in DDGS bulk during storage and as a measure to predict the caking behavior. Keywords: Caking, DDGS, Finite volume method, Heat transfer.
Enhancing Groundwater Recharge with Sand Ditches
Authors: Abu-Zreig Majed M , Fujimaki Haruyuki , Abdel Baset Mohamed
Published: September 2019

Abstract.

Localized and artificial groundwater recharge is an important water management strategy in arid regions. However, artificial recharge is limited by the hydraulic characteristics of surface soil which control downward water percolation to the aquifers. In heavy soils with low infiltration and hydraulic conductivity rate, water percolation can be enhanced by constructing deep ditches filled with highly permeable materials, such as sand. Laboratory experiments were conducted to examine the effect of constructing a deep sand ditch across the slope of a soil box (50 × 20 × 25 cm3) on runoff and deep percolation to the drainage outlet of the soil box. A sandy loam soil packed in two bulk densities (1200 and 1500 kg/m3) was used for the experiments. The experiments were carried out using simulated steady runoff of about 300 mL/min for a duration of 60 min. Experimental results showed that sand ditches greatly enhanced water deep percolation in soils but their relative effect was more profound in compacted high-density soil compared to soil having low-density. The drainage water collected from compacted soil boxes in the presence of sand ditches increased by 10 times compared to control soil without sand ditches. In the case of low-density soil, the presence of sand ditches eliminated the runoff but the increase in drainage water was about 18% compared to control. The experimental results clearly revealed that creating high infiltration zones within the soil matrix, such as sand ditches, significantly increased water deep percolation and herewith groundwater recharge in drylands, especially in heavy soils. Keywords: Arid regions, Groundwater recharge, Percolation, Rapid infiltration.
Comparative Analysis of Sorption Isotherms for Wood Pellets and Solid Wood
Authors: Lee Jun Sian , Sokhansanj Shahab , Lim C. Jim , Lau Anthony , Bi Tony
Published: September 2019

Abstract.

The published data on equilibrium moisture content vs. equilibrium relative humidity (EMC-ERH) for wood pellet do not cover the range of temperature and relative humidity to which a pellet is exposed to during its storage and handling. A few published EMC-ERH relations covering a wider range of temperatures and relative humidity are available for solid wood (lumber) and wood chips. The question is whether the data for solid wood is applicable to wood pellets. For this research, we examined the sorption isotherms of wood pellets and solid wood. The analysis shows that EMC for solid wood is higher than the EMC for wood pellet for a relative humidity larger than 30%. The slope of EMC-ERH isotherm for solid wood in the range of 30%-70% is slightly steeper than the slope of isotherm for wood pellet, indicating the pellet’s EMC is less sensitive to ERH when compared to EMC-ERH for solid wood. Keywords: EMC, ERH, Densified biomass, Equilibrium moisture content, Equilibrium relative humidity, Solid wood, Wood pellets.
Research of the Influence of Road Excitation on Human Body Comfort under the Harvester Working Condition
Authors: Jiang Wei , Zhou Jie , Xu Hongmei , Liu Shuang , Wang Chenglong , Dong Jiajun
Published: September 2019

Abstract. When the harvester travels in the field, road excitation will cause low-frequency vibration within 3 Hz, which is the most sensitive frequency range of human body. In order to evaluate the influence of road excitation on the comfort feelings of the harvester driver, vibration acceleration data were collected when the combine harvester was travelling at high and low speeds on flat-soft road, flat-solid road, and rough-solid road. The vibration comfort of the harvester was evaluated by root mean square (RMS) of weighted acceleration. The results showed that the speed of harvester, road surface roughness and hardness have great effects on harvester vibration comfort. Soft road has an obvious absorption effect on the vibration at 70 Hz. The increase in the speed of harvester and road surface hardness and roughness elevates the subjective discomfort of the driver. Keywords: Combine harvester, Comfort research, Road excitation, Root mean square of weighted acceleration, Vibration test.
“I’m finally allowed to be me”: parent-child estrangement and psychological wellbeing
Authors: Linden Audrey Helen , Sillence Elizabeth
Published: September 2019

Estrangement from a family member is characterised by lack of trust and emotional intimacy, and often includes ceased communication and contact. Existing estrangement research suggests adult children report three main reasons for estrangement from a parent: abuse, poor parenting and betrayal. However, research into estrangement and experiences of psychological wellbeing is sparse. This study used semi-structured interviews to explore this with 7 female participants with experiences of parental maltreatment, aged 24–37. Interpretative Phenomenological Analysis resulted in 4 main themes: experiences of contact; gaining agency; navigating relationships; and navigating estrangement. Results suggest estrangement can be experienced both positively and negatively in terms of psychological wellbeing. Positive experiences provide insight into maintenance of estrangement, and suggest processes of benefit-finding following stressful life events can be applicable to estrangement. Practice implications for those working with adult children include considering reasons for estrangement, and facilitating sense-making to assist with coming to terms with estrangement.
Women's Expectation of Receiving Reproductive Health Care at Catholic and Non‐Catholic Hospitals
Authors: Stulberg Debra B. , Guiahi Maryam , Hebert Luciana E. , Freedman Lori R.
Published: September 2019

CONTEXT

Catholic hospitals operate under directives that prohibit the provision of contraceptives, sterilization and abortion. Little research has examined women's awareness of these institutions’ policies, which affects their ability to make informed decisions about where to seek care.

METHODS

In 2016, some 1,430 women aged 18–45 were recruited from a U.S. probability‐based research panel for a survey about hospital care. Respondents were randomized to a hypothetical Catholic or nonreligious hospital group and asked about their expectations for receiving nine specific reproductive services. Multivariable logistic regression analyses were used to evaluate associations between participants’ characteristics and their correctly identifying a hospital as Catholic, as well as between characteristics and expecting that birth control pills, tubal ligation or abortion for serious fetal indications would be provided there.

RESULTS

Women randomized to the Catholic hospital group were less likely than those randomized to the nonreligious group to expect provision of birth control pills (77% vs. 86%), tubal ligation (70% vs. 78%) or abortion for serious fetal indications (42% vs. 54%). Income level was associated with correctly identifying the Catholic hospital: Compared with individuals with the lowest income, those in three of the four other income groups were more likely to identify the hospital as Catholic (odds ratios, 1.9–2.2). In comparison with women who misidentified the Catholic hospital, those who identified it as Catholic had lower expectations that the hospital would provide birth control pills (0.3), tubal ligation (0.5) or abortion (0.2).

CONCLUSIONS

Many women do not realize the breadth of restrictions on reproductive health care at Catholic hospitals. Without institutional transparency, patient autonomy and health outcomes may be compromised.
P: 9 Pharmacotherapies that Specifically Target Ammonia for the Prevention and Treatment of Hepatic Encephalopathy in Adults With Crrhosis
Authors: Zacharias Harry D. , Zacharias Antony P. , Gluud Lise Lotte , Morgan Marsha Y.
Published: September 2019

BACKGROUND:

Ammonia plays a key role in the genesis of hepatic encephalopathy (HE). Recent interest has focused on drugs which specifically target ammonia, e.g. sodium benzoate (SB), glycerol phenylbutyrate (GPB), ornithine phenylacetate (OP), AST-120, and polyethylene glycol (PEG). This study aims to evaluate the utility of these pharmacotherapies vs. placebo or non-absorbable disaccharides (NAD), for the management of HE in people with cirrhosis. L-ornithine L-aspartate is not included.

METHODS:

Electronic/manual searches of the literature were undertaken for relevant RCTs. The results of the meta-analyses are presented as risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CIs). Bias control was assessed using the CHBG domains and the certainty of the evidence using GRADE.

RESULTS:

Eleven RCTs were identified involving SB (n = 1), GPB (n = 1), OA (n = 2), AST-120 (n = 2) and PEG (n = 3). Treatment periods ranged from five days to 16 weeks. All but one trial was at “high risk of bias”; the certainty of the evidence was very low for all outcomes. Nine trials, with 733 participants, reported blood ammonia concentrations. Significant reductions were observed in placebo-controlled trials evaluating SB (MD −32.00, 95% CI −46.85 to −17.15); GPB (MD −12.00, 95% CI −23.37 to −0.63); OP (MD −27.10, 95% CI −48.55 to −5.65) and AST-120 (MD −22.00, 95% CI −26.75 to −17.25). No significant differences in blood ammonia concentrations were observed when compared to NADs. Eleven trials, with 943 participants, reported mortality data, although there were no events in five trials. No beneficial or harmful effects were found in any of the trials. Seven trials, with 521 participants reported data on HE. Beneficial effects were identified for GPB vs. placebo (RR 0.57, 95% CI 0.36 to 0.90; 178 participants; 1 trial; NNTB = 6) and for PEG vs. lactulose (RR 0.19, 95% CI 0.08 to 0.44; 190 participants; 3 trials; NNTB = 4); no beneficial effects were observed in the remaining three trials with extractable data (Figure 1). Ten trials, with 790 participants, reported a total of 130 serious adverse events. There was no evidence of beneficial or harmful effects of the five agents when compared to placebo or NADs.

CONCLUSIONS:

These agents generally reduce blood ammonia concentrations, when compared to placebo, but not when compared to NADs. Their overall effects on clinical outcomes of interest and the potential harms associated with their use remain uncertain. Further evidence is needed to fully evaluate their utility in this clinical setting.
P: 16 Traditional Prognostic Tools are Superior to Cognitive Testing and Stool Frequency as Predictors of Poor Outcomes in Cirrhotic Patients Admitted with Hepatic Encephalopathy
Authors: Pringle Bloom Patricia
Published: September 2019

BACKGROUND:

Model for end-stage liver disease-sodium (MELD-Na) score and extrahepatic organ failures (EHOFs) predict poor outcomes in cirrhotic patients, including those with hepatic encephalopathy (HE); however, there is a need for the development of additional and specific predictors for outcomes in HE. We aimed to determine if cognitive testing, total daily lactulose dose (TDLD), and stool frequency at hospital discharge predicts readmission and other poor outcomes in patients admitted with overt HE.

METHODS:

We performed a prospective study of patients admitted to a single transplant center with overt HE. When the primary team anticipated discharge within 48 hours, consented subjects underwent Psychometric HE Score (PHES), Montreal Cognitive Assessment (MOCA), liver frailty index (LFI), and stool frequency assessment. MELD-Na, EHOFs, and other clinical variables were assessed via chart review. At 30 days post-discharge, subjects were called to evaluate for a composite primary outcome of HE readmission, transition to hospice, liver transplantation, or death. T-test or chi-square test compared predictors between those who did and did not meet the primary endpoint.

RESULTS:

Of 175 potential candidates, 52 patients provided informed consent and enrolled, with the majority (82) of patients excluded for discharge, death, transplant, or transfer to hospice before enrollment could be performed. Within 30 days, 7 patients had a readmission for HE, and 11 died, were transplanted or transferred to hospice. Seventeen patients met the primary composite endpoint. MELD-Na (28.1 ± 8.0 vs. 22.0 ± 6.0, P = .01) and the number of EHOFs (1.3 ± 1.3 vs. 0.5 ± 0.8, P = 0.03) were higher in patients who met the primary composite outcome. Most predictors did not vary between those who met and did not meet the primary endpoint, including MOCA score (P = 0.73), PHES (P = 0.97), stool frequency (P = 0.34), total daily lactulose dose (P = 0.80), LFI (P = 0.57), admission ammonia (P = 0.58), or being discharged on rifaximin (P = 0.70). Stool frequency at discharge did not correlate with PHES (P = 0.71) or MOCA score (P = 0.51).

CONCLUSIONS:

Traditional prognostic tools in cirrhosis, including MELD-Na and EHOF, were superior to cognitive assessments, total daily lactulose dose, and stool frequency in predicting 30-day outcomes for those admitted with overt HE. Future studies should evaluate MELD-Na and the presence of EHOFs as determinants of discharge readiness or discharge destination in patients admitted with cirrhosis and HE.
P: 24 Comparative Morphological Analysis of Astroglia Reactivity in the Hippocampus of Rats With Acute and Chronic Hepatic Encephalopathy
Authors: Omar El Hiba , Abdelaati El Khiat , Mohamed Aitihya , Halima Gamrani
Published: September 2019

BACKGROUND:

Hepatic encephalopathy (HE) is a serious complication of advanced liver failure which represents the whole neuropsychiatric abnormalities resulting from liver disease ranging from abnormal behavior to coma. Impairment of cognitive function is well described in HE patients, while mechanisms of memory impairment in HE patients is still not fully understood, however, it may involve a possible gliopathy as well as neuropathy in various brain areas, including the hippocampus known as the main brain structure associated to the memorization process. The aim of the present investigation is to assess astroglia reaction of the hippocampus, in a comparative approach between acute and chronic HE in rat.

METHODS:

Sprague-Dawley rats were divided into 3 groups: controls; rats were treated with saline solution (NaCl 0.9 % i.p) during 3 days, chronic HE group: rats were subjected to Bile Duct Ligation and acute HE group; rats were subjected to 3 i.p injections of thioacetamide (TAA) 300 mg/kg BW. Astroglia was assessed through an immunohistochemical analysis using anti-GFAP antibody on frontal sections of the hippocampus following.

RESULTS:

Our data showed in the TAA rats (3 days following 3 TAA injections) compared to controls, a significant increase of GFAP immunoreactivity within the whole hippocampal areas, while astrocytic processes length and ramification were reduced, the GFAP-immunoreactive area was increased. In contrast to BDL rats, at the cirrhotic stage (4 weeks after surgery), showing the opposite tendency with a drop of the astrocytic GFAP-immunoreactive area as well as the astrocytic length and ramification levels.

CONCLUSIONS:

The present finding sustains a differential astroglial reactivity within the hippocampus of acute and chronic HE rats. Astrocytic morphology changes depends to the severity of liver failure and seems to HE type-dependent, while those astroglial changes lead to a severe gliopathy which may be behind the disturbed cognitive function, especially memory seen in patients with chronic as well as acute HE.
P: 28 Decreased Mean Kurtosis in the Putamen Is a Diagnostic Feature of Minimal Hepatic Encephalopathy in Patients With Cirrhosis
Authors: Sato Takuro
Published: September 2019

BACKGROUND:

To prevent development of overt hepatic encephalopathy, early intervention for minimal hepatic encephalopathy (MHE) based on accurate diagnosis is essential. This study evaluated to investigate whether magnetic resonance diffusion kurtosis imaging (DKI) and diffusion tensor imaging (DTI) could detect brain microstructure abnormalities in MHE. The aim was to confirm whether brain microstructure abnormalities detected by magnetic resonance imaging were used as diagnosis of MHE.

METHODS:

Thirty-two subjects were prospectively examined with a 3-T MR scanner. Tract-based spatial statistics and region of interest analyses of diffusion imaging were performed to compare mean kurtosis (MK), fractional anisotropy (FA), and mean diffusivity (MD) values between patients with/without minimal hepatic encephalopathy. Diagnostic performance for detection of MHE was assessed with the receiver operating characteristic analysis.

RESULTS:

Ten subjects were diagnosed as MHE by neuropsychological testing. After exclusion of unsuitable subjects, we analyzed 9 subjects with MHE and 14 subjects without MHE. There were no significant differences in the sex, age, and etiology of liver cirrhosis (alcohol/HCV/NAFLD; 4/3/2 vs 7/3/4, P = 0.87) in the MHE group and non-MHE group. In TBSS, compared with FA and MD, MK detected the broadest area with significant changes in the white matter of patients with MHE (MK, 54.8%; FA, 34.3%; MD, 4.0%, respectively). Regarding ROI analysis in the basal ganglia, FA values of the caudate nucleus (CN), putamen (Put), and globus pallidus (GP) were significantly lower in the MHE group (0.15, 0.19, and 0.29, respectively) when compared with the non-MHE group (0.16, 0.21, and 0.32, respectively) (P = 0.012, 0.002, and 0.0001, respectively). In contrast, MD values in the basal ganglia showed no apparent differences between the groups. Subsequently, we performed ROC analysis on the sites where significant differences were found in the ROI analysis. Among the metrics, MK values of the Put achieved AUROC of 0.90, and sensitivity, specificity, positive predictive value, and negative predictive value of more than 80% (0.89, 0.86, 0.80, and 0.92, respectively) between the MHE and non-MHE groups. In conclusion, mean kurtosis on the putamen was a useful finding to distinguish patients with MHE among subjects with liver cirrhosis.

CONCLUSIONS:

DKI detects changes in the cerebral white matter and basal ganglia regions of the patients with MHE more sensitively than DTI. MK values in the putamen can be a useful marker for diagnosing MHE from cirrhotic patients without MHE.
P: 36 Antibiotic Rifaximin for Treatment of Chronic Liver Disease-Induced HE: A Longitudinal In Vivo 1H-MRS Study of Brain Metabolism on BDL Rats
Authors: Flatt Emmanuelle , Braissant Olivier , Mitrea Stefanita , Sessa Dario , Gruetter Rolf , McLin Valérie A. , Cudalbu Cristina
Published: September 2019

BACKGROUND:

Rifaximin is a commonly-used antibiotic to treat hepatic encephalopathy (HE), a complex neuropsychiatric syndrome caused by hepatic dysfunction. Rifaximin aims at reducing the production of gut ammonia, an important toxin in HE pathogenesis. In a previous study using bile duct ligated (BDL) rats, we showed that rifaximin at the recommended human dose may help reduce brain Gln levels in early stages of HE.1 These findings raised the question of the efficacy of the dose used at later stages. Therefore we hypothesized that the effect of rifaximin on neurometabolic profile may be dose-related. In this study, the effects of a dose 6.2x that recommended in humans 2 were assessed in vivo and longitudinally in BDL rats. They were compared with non-treated rats (n = 17) and human-dose treated rats (15.7 mg/kg/day, n = 12).1

METHODS:

Plasma measurements of NH4+, bilirubin and 1H-MRS scans were performed on adult Wistar rats (n = 8) before BDL ('week 0') and at weeks 2, 4, 6, 8 post-BDL. Rifaximin was administered twice daily (6x-human-dose = 97.3 mg/kg/day) starting two weeks after BDL-surgery ('week 2'). In vivo 1H-MRS was performed on a 9.4 Tesla MRI system. Changes in metabolites were studied in the hippocampus (2 × 2.8 × 2 mm3) using SPECIAL3 sequence (TE = 2.8 ms). Metabolite concentrations were estimated by LCModel using water as internal reference. Open field test was performed at week 4, 6 and 8 to evaluate motor activity.4

RESULTS:

Plasma measurements of bilirubin confirmed the presence of CLD in all groups of rats. They displayed similar ammonium concentration across groups (Figure 1a). 1H-MRS revealed some significant differences between the 'high-dose rifaximin' rats and non-treated rats: glutamine increase was lower in the 'high-dose rifaximin' group at week 6 and at week 8, both in absolute value and relative to week 2 (+42% vs +118% at week 8, Figure 1b). Moreover, a decrease of glutamine was observed between week 4 and week 6 in the 'high-dose rifaximin' group (−10%), contrary to the non-treated group (Figure 1b). Also, in the 'high-dose rifaximin' group, decreases in the following metabolites were less pronounced during the time course of the study: myo-inositol, taurine, glutamate, ascorbate, creatine, total creatine (Figure 1c).

CONCLUSIONS:

While rifaximin at human dose appeared to have an effect only at the early stages of the disease, a higher dose gave stronger positive effects on the neurometabolic profile. Importantly, no differences between the groups were observed in behavioural tests, but the 'high-dose rifaximin' rats had the tendency to move less. It is therefore possible that such a high dose of antibiotics also leads to some undesirable side-effects such as electrolyte abnormalities or inherent drug toxicity.5,6
P: 42 To Assess Frequency of Hepatic Encephalopathy in Spontaneous Bacterial Peritonitis Patients
Authors: Hassan Adil , Ali Mashooque , Bughio Ubedullah , Bhatti Rehmatullah , Ali Mohsin , Iqbal Javed , Hafeez Abdul
Published: September 2019

BACKGROUND:

Hepatic encephalopathy (HE) is a commonly encountered complication in cirrhotics. The incidence of HE ranges from 2% to 20% per year in patients with liver cirrhosis. HE is associated with increased morbidity and mortality as well as significant utilization of health care resources. Most cases of significant HE are precipitated by gastrointestinal bleeding, infection, constipation, electrolyte imbalance and medications. Spontaneous bacterial peritonitis (SBP) is an independent predictor of HE. We evaluated frequency of HE in SBP patients.

METHODS:

This cross-sectional study was conducted at the Gastro-hepatology section of Asian Institute of Medical Sciences in Hyderabad, Pakistan from April 2017 to March 2019. 120 Patients with paracentesis-proven SBP [Absolute Neutrophils counts (ANC) >250/mm3], aged from 18 to 80 years were included. Frequency of HE evaluated.

RESULTS:

A total of 120 patients of SBP with mean age 47.80 years, with 88 (73.3%) males and 32 (26.7%) females were examined. Most common serology was HCV (61.7%). 21 were CTP B (17.5%) and 99 were Child C (82.5%). HE was present in 75 (62.5%) with most common grades were II (29.33%) and III (29.33%) and IV (21.33%). Mean ANC 5086, 96 (80%) were PPI users and 64.58% have HE.

CONCLUSIONS:

Hepatic encephalopathy has strong association with SBP and PPI use. Screening for asymptomatic SBP in all patients with HE should be considered and over-the-counter PPI use should be restrained.
P: 65 Drug-induced Hyperammonaemia: Data From VigiBase, the WHO Database
Authors: Weiss Nicolas , Salem Joe-Elie , LeBrun-Vignes Benedicte , Bihan Kevin , Rudler Marika , Bouzbib Charlotte , Sultanik Philippe , Thabut Dominique
Published: September 2019

BACKGROUND:

Altered consciousness secondary to metabolic encephalopathies represents a major cause of ICU admission with favorable outcome when diagnosed and treated rapidly. Ammonia dosage is thus recommended in most textbooks in the absence of any diagnosis after etiological work-up encompassing biological sampling, cerebral imaging and EEG. Despite hyperammonaemia is most commonly secondary to liver diseases, portosystemic shunts, inborn errors of metabolism, mostly urea cycle defects, microbial pullulation or drug-induced hyperammonaemia (DIH) are other possible causes. DIH is poorly described but is mainly recognized as the consequence of valproic acid. Some antineoplastic agents, fluorouracile or asparaginase, have been implicated but this class is evolving rapidly. To describe the drugs associated with DIH.

METHODS:

We used VigiBase, the WHO global Individual Case Safety Report (ICSR) database, which contains reports of suspected adverse drug reactions (ADRs) collected by national drug authorities in over 130 countries between 1967 and 8 May 2019. This observational retrospective study included all ADRs reported as "hyperammonaemia" according to the Medical Dictionary for Drug Regulatory Activities (MedDRAv21.1) term (Prefered term [PT] level). The drugs considered in the analysis were those notified as suspected treatments. Drugs used to treat hyperammonaemia or hepatic encephalopathy were excluded as were drugs reported less than 3 times. Drugs with a positive lower end of the 95% credibility interval for the information component (IC025) ≥0, an indicator value for disproportionate Bayesian reporting, was considered as causative of hyperammonaemia.

RESULTS:

Among 19 438 165 ICSRs, 576 drugs were identified for the term "hyperammonaemia [PT]". Six were excluded because they were used to treat hyperammonaemia or hepatic encephalopathy. Thus, 73 drugs had a an IC025 ≥0 and represented 2759 cases (0.014%). Twelve drugs were reported more than thirty times (Table 1).

CONCLUSION:

Besides commonly involved drugs, some other commonly used drugs seem associated in DIH. These data could help in the etiological work-up of hyperammonemia.
P: 81 Previously Identified Candidate Gene Associations in Hepatic Encephalopathy Do Not Replicate in the STOPAH Cohort
Authors: Atkinson Stephen R. , Forrest Ewan , Goh Ee Teng , Thursz Mark R. , McQuillin Andrew , Morgan Marsha Y.
Published: September 2019

BACKGROUND:

Hepatic encephalopathy (HE) is a common complication of cirrhosis and negatively affects quality of life and prognosis. However, the development of HE is not inevitable, even in patients severe hepatic decompensation. Recently, there has been interesting the possibility that the susceptibility to develop HE is, at least in part, genetically determined. In 2017, Gil-Gómez et al (J Hepatol 2017;66(Suppl 1):S144) reported significant associations between variants in nine candidate genes and the presence of overt HE in 400 patients included in the CLIF consortium cross-sectional study. In this study overt HE was diagnosed using the West Haven criteria, while acute on chronic liver failure (ACLF) was diagnosed using the CLIF-OF score. The aim of the present study was to replicate these findings in participants in the STOPAH alcoholic hepatitis treatment trial.

METHODS:

Genomic DNA was available in 731 participants in the STOPAH trial. Overt HE was diagnosed using the West Haven criteria; ACLF was diagnosed using the CLIF-OF score. Data on six of the nine SNP associated with overt HE and/or ACLF in the Spanish study were identified in the STOPAH GWAS database. Genotypic association analyses were undertaken for each of the genetic variants in the entire population and in subgroups defined by the presence of overt HE and/or ACLF.

RESULTS:

A total of 199 (27.2%) of the 731 STOPAH participants had overt HE on admission, while 193 (26.4%) had ACLF; patients were classified as follows: HE and ACLF (n = 61), HE but no ACLF (138); ACLF but no HE (n = 132); no ACLF and no HE (n = 400). Only one significant association was identified viz. rs752949 in SLC1A2 in participants with overt HE but without ACLF (Table 1); however, the significance of this association was lost when the data were corrected for multiple testing.

CONCLUSIONS:

The previously reported genetic associations with overt HE were not replicated in the present study. The number of participants was almost double that in the Spanish study but the proportions of patients with HE and ACLF were similar. Not all of the reported SNPs were available but at least two SNPs were tested for association in each patient subgroup. Further large case-control studies and meta-analyses of existing data are needed.
Queering the Panthers: Rhetorical Adjacency and Black/Queer Liberation Politics
Authors: Corrigan Lisa M.
Published: September 2019

Using Stonewall as an anchor point, this article charts the coterminous relationship between the black liberation movement and the gay liberation movement with special emphasis on the relationship between the Black Panther Party and the Gay Liberation Front. It begins with an assessment of the political and social context of 1969 to discuss the importance of rhetorical adjacency in the collaboration between the movements. Rhetorical adjacency describes how movements borrow and share political frameworks, movement goals, terminology, and spatial sensibility as they navigate points of ideological contention, especially around identity issues. The rhetorical adjacency of these two movements is complicated by the early critiques of the gender politics of the Panthers, which the first section takes up at length. Then, the article turns to critiques of policing, imprisonment, capitalism, and colonialism absorbed and redeployed by the gay liberation movement from the black liberation movement to understand how activists during and after Stonewall conceptualized police power, resistance, and movement strategy. The article concludes with a discussion of the Black Panther Party Chairman Huey Newton’s rhetorical defense of gay liberation as a revolutionary perspective in the wake of Stonewall to understand how and why the Panthers saw promise in intentional adjacency with gay liberation activists as well as to demonstrate why gay liberation activists praised Newton and collaborated with the Panthers. The rhetorical adjacency between the organizations amplified radical black and gay movement politics, circulating rhetorical tropes that continued to mobilize activism.
Las marcas de los sujetos en el Estado. Los trabajadores de la economía popular y las políticas públicas en la Argentina reciente
Authors: Muñoz Maria Antonia
Published: September 2019

El presente artículo analiza la evolución de las políticas públicas orientadas a resolver los problemas que se generaron en el mercado laboral (desocupación, informalidad y pobreza) durante las últimas décadas en Argentina. Se problematizan las interacciones entre actores claves (gobiernos y organizaciones) en la formación de las mismas, prestándose especial atención a dos programas; el Programa de Ingreso Social con Trabajo (2009) y el de Transición al Salario Social Complementario (2016). Entre las fuentes primarias se analizan datos estadísticos de carácter nacional (provenientes de diferentes fuentes oficiales y privadas), entrevistas en profundidad a referentes de las organizaciones y análisis de discurso de las políticas. Se muestra como estas complejas interacciones colaboraron con la ampliación, consolidación y transformación de un nuevo sujeto/objeto de aquellas políticas: «los trabajadores de la economía popular». Se concluye con la necesidad de ver las potencias transformadoras a la vez que los límites que las políticas conllevan.