bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of depressive symptoms among elderly in the city of Tremembé, Brazil: Preliminary findings of an epidemiological study
Authors: César Karolina G. , Takada Leonel T. , Brucki Sonia M.D. , Nitrini Ricardo , Nascimento Luiz Fernando C. , Oliveira Maira O. , Gomes Camila M.S. , Almeida Milena C.S. , Porto Fábio H. , Senaha Mirna L.H. , Bahia Valéria S. , Yassuda Mônica S. , Silva Thaís B.L. , Ianof Jéssica N. , Spíndola Lívia , Schmidt Magali T. , Jorge Mário S. , Vale Patrícia H.F. , Cecchini Mário A. , Cassimiro Luciana , Soares Roger T. , Gonçalves Márcia Rúbia , Martins Ana Caroline S. , Rocha Elisângela , Daré Patrícia
Published: May 2016

ABSTRACT Depression is a heterogeneous mental disease classified as a set of disorders, which manifest with a certain duration, frequency and intensity. The prevalence of depression in the elderly ranges from 0.5 to 16%. Objective To establish, in an epidemiological study, the prevalence of significant depressive symptoms in the population aged 60 years or older. Methods: Results of a cross-sectional epidemiological study, involving home visits, being carried out in the city of Tremembé, Brazil, were reported. The sample was randomly selected by drawing 20% of the population over 60 years from each of the city's census sectors. In this single-phase study, the assessment included clinical history, physical and neurological examination, cognitive evaluation, the Cornell scale and the Patient Health Questionnaire for psychiatric symptoms. Scores greater than or equal to 8 on the Cornell scale were taken to indicate the presence of depressive symptoms. Results: A total of 455 elders were assessed, and of these 169 (37.1%) had clinically significant depressive symptoms (CSDS). Depression prevalence was higher among women (p<0.001) and individuals with lower education (p=0.033). The Chi-square test for trends showed a significant relationship where lower socioeconomic status was associated with greater likelihood of depressive symptoms (p=0.005). Conclusion: The prevalence of depressive symptoms was high in this sample of the population-based study and was associated with female gender, low educational level and socioeconomic status. The assessment of the entire population sample must be completed.
Neuropsychiatric symptoms (NPS) in patients with pure vascular dementia (VaD) and mixed dementia (MD) from a memory outpatient clinic in Southeast Brazil
Authors: Siqueira-Neto José Ibiapina , Pontes-Neto Octávio Marques , Vale Francisco de Assis Carvalho do , Santos Júnia Vieira dos , Sales Paulo Marcelo Gondim , Santos Júnia Vieira dos , Santos Antônio Carlos
Published: May 2016

ABSTRACT Vascular Dementia (VaD) and Vascular Cognitive Impairment (VCI) are increasingly common worldwide. Nevertheless, the clinical-neuropsychiatric profile of these patients at presentation is still poorly characterized in developing countries. Objective: We aimed to characterize the prevalence of neuropsychiatric symptoms, as well as the clinical and cognitive profile of patients with VaD and VCI in our tertiary University outpatient cognitive clinic. Methods: We reviewed data on 253 patients diagnosed with VaD or VCI at our center between January 1996 and December 2005, located in an industrial region of the state of Sao Paulo, southeast Brazil. We excluded 19 patients who did not complete the medical investigation or who did not meet the clinical or neuroimaging criteria for vascular dementia. We collected socio-demographic data, educational level, vascular risk factors, behavioral and neuropsychological symptoms and cognitive complaints at presentation. Results: Two hundred and thirty-four cases were included in this analysis. The mean age was 67.77±10.35 years; 72% were males and 82% had less than four years of education (average 2.84±2.96 years). The initial Clinical Dementia Rating score was 2 & 3 in 68%. A total of 185 patients had neuropsychiatric symptoms distributed in main categories as follows: psychosis (52.6%), hallucinations (23.5%), psychomotor agitation (22.5%), depression (17.5%) and apathy (17.5%). Hypertension and previous stroke were the most prevalent risk factors. Conclusion: We found a high prevalence of neuropsychiatric symptoms. The clinical-neuropsychiatric profile of patients presenting to cognitive clinics in developing countries may differ greatly to that of more developed nations. These characteristics may have implications for public health strategies.
Serum levels of soluble TNF-α receptors but not BDNF are associated with apathy symptoms in mild Alzheimer's disease and amnestic mild cognitive impairment
Authors: Guimarães Henrique Cerqueira , Caramelli Paulo , Fialho Patricia Paes Araujo , França Elisa de Paula , Afonso Marcelo Pelizzaro Dias , Teixeira Antonio Lucio
Published: May 2016

ABSTRACT Apathy is intimately associated with dementia. Unfortunately, its pathophysiology remains poorly understood. The motivational impairment that characterizes this disorder might share the same inflammatory mechanisms, as suggested by the sickness behavior theory. Objective: The primary aim of this study was to investigate the association between apathy symptoms and serum levels of tumor necrosis factor alpha (TNF-α) and its soluble receptors. Brain-derived neurotrophic factor (BDNF) levels were also analyzed since these have been associated with depression, a condition which shares abulic features with apathy. Methods: The sample consisted of 27 subjects with mild Alzheimer's disease or amnestic mild cognitive impairment, who were submitted to specific apathy evaluation using the Apathy Scale (AS) and provided blood samples for biomarker analysis. Participants were categorized into two groups according to median AS scores (17 points). Results: Subjects with higher apathy symptoms (n=13) displayed higher levels of TNF-α soluble receptors (type 1: p=0.03; type 2: p=0.04). No other difference was found between groups. Conclusion: These findings point to the involvement of inflammatory mediators in the genesis of apathy symptoms, as suggested by the sickness behavior theory.
Depressive symptoms and cognitive deficits in a cancer patient submitted to chemotherapy with 5-Fluoracil: A case report
Authors: Bottino Sara Mota Borges , Garcia Célia Petrossi Gallo , Viana Bernardo de Mattos , Bottino Cássio Machado de Campos
Published: May 2016

ABSTRACT Cognitive deficits in cancer patients can be related to depression, anxiety, and the side effects of treatments such as fatigue. In this case report, we described an elderly patient with rectal adenocarcinoma, which presented depressive symptoms and memory complaints after treatment with 5-Fluoracil and Leucovorin. Depressive symptoms improved after two months but cognitive and functional impairment worsened suggesting the diagnosis of mild dementia. Structural and functional brain changes were seen on neuroimaging exams. Rivastigmine was introduced up to 12 mg/day, and after a one-year follow up the patient remained stable. Cognitive deficits can be a consequence of cancer therapies and a protocol to investigate deficits cognitive could be useful to the diferential diagnosis and management of elderly cancer patients submitted to chemotherapy.
Immunopathogenesis of West Nile Virus infection
Authors: Diosa-Toro Mayra , Hernández-López Juan Carlos
Published: May 2016

The reappearance of West Nile virus (WNV) infection in last years has highlighted that arthropod-borne diseases are not circumscribed to tropical regions of the world. WNV is maintained in enzootic cycles involving, Culex spp. mosquitoes and avian hosts, with epizootic spread to mammals, including humans. Human infection results in mild symptomatic illness in 25% of cases or neurological disease in less than 1% of infected persons. Additional understandings on how WNV interacts with its hosts is recently growing; the virus exploits immune system, both at the peripheral tissues and the central nervous system, which could explain the differences in virulence, progression and severity of WNV infection. The continuing spread of WNV, combined with the lack of specific therapeutics or vaccines to combat or prevent infection, imparts a pressing need to identify the viral and host processes that control the outcome and immunity to WNV infection. Here, we provide an overview of a subset of information regarding the immune-pathological response generated during WNV infection.
The Role of Teacher Behavior, Motivation and Emotion in Predicting Academic Social Participation in Class
Authors: Sánchez-Rosas Javier , Takaya Paula Belén , Molinari Alicia Verónica
Published: May 2016

Introduction: Academic social participation addresses student engagement behaviors that involve social interactions with peers and teachers. Objective: Perceived teacher behavior, task value, academic self-efficacy, class enjoyment and shame’s role in predicting academic social participation was analyzed. Method: Psychology students from a large national university completed self-report questionnaires assessing the model variables. A proposed model was evaluated by path analysis. Results: Model showed good fit to thedata, explaining 31% of variance. Positive influences were detected of perceived teacher behavior on task value (β = 0.42), academic self-efficacy (β = 0.19), and class enjoyment (β = 0.24); of task value on class enjoyment (β = 0.52); and of class enjoyment on academic social participation (β = 0.44). Academic self-efficacy negatively affected class shame (β = -0.38), while class shame (β = -0.44) and task value (β = -0.24) showed a negative influence on academic social participation. Conclusion: Utility of modifying teacher behavior and motivation as a means to affect emotion was demonstrated. Class enjoyment and shame were the stronger predictors of academic social participation. Individual variables’ importance in moderating contextual influence on engagement was suggested.
Significados de convivencia: una comprensión desde la dinámica cotidiana que los promueve
Authors: Sánchez Villafañe Ana Lucía , Quiceno Pérez Jhon Jairo
Published: May 2016

Introducción: la convivencia se constituye en un factor primordial en el establecimiento de relaciones sociales. Infortunadamente, en Colombia se ha visto fracturada por altos índices de violencia que han exigido el desarrollo de políticas públicas, muchas de ellas impuestasy alejadas de las necesidades de las comunidades. Objetivo: por tal motivo, se hace indispensable que sean las comunidades quienes definan y signifiquen la convivencia, a fin de generar propuestas más cercanas a la realidad. En este sentido, se pretende identificar los significados que en relación con las prácticas de convivencia comunitaria construye un grupo de líderes. Metodología: se realizó un estudio cualitativo-descriptivo con diseño etnográfico, en un grupo de cinco (5) líderes. Resultados: la convivencia fue definida como aquellos procesos que hacen posible la construcción y el establecimiento de acuerdos que garantizan la consolidación de buenas relaciones en la comunidad y evitar los conflictos. Esta concepción solo puede operar en la medida en que la solidaridad sea el valor que guíe y oriente las relaciones, y que la participación comunitaria sea efectiva. Sin embargo, la conducta de solidaridad termina en el acto mismo de ayuda, y no se extiende a otras experiencias comunitarias que promuevan la cohesión social. Conclusiones: se evidenció una visión idealizada de convivencia en torno a una anhelada solidaridad. En la cotidianidad priman dinámicas focalizadas en el individualismo y la apatía, debido a la desconfianza mutua, a la politización de las relaciones y a una visión asistencialista que impide la transformación desde un proyecto colectivo.
Relación entre tipos de colegio y niveles de ansiedad en una muestra de escolares bogotanos
Authors: González Salazar Erika , Timón Guzmán Karla , Riveros Munévar Fernando
Published: May 2016

Introducción: la ansiedad es una respuesta humana normal, pero se convierte en patológica cuando persiste y se mantiene en el tiempo. Según estudios nacionales y mundiales, este es uno de los trastornos que ha aumentado, al aparecer cada vez con mayor frecuencia en la población joven. Objetivos: determinar la relación entre tipos de colegio y niveles de ansiedad, así como hallar diferencias o similitudes en cuanto al sexo y grado escolar, según tipo de colegio en una muestra de escolares colombianos. Metodología: investigación de tipo cuantitativa, de corte transversal y de alcance descriptivo por comparación de grupos. La muestra estuvo conformada por 658 escolares de colegios públicos y privados entre los cursos de tercero de primaria a séptimo de bachillerato; se utilizó el inventario de ansiedad estado-rasgo en niños (STAIC) utilizando la versión validada para Colombia. Resultados: se hallaron diferencias estadísticamente significativas en las calificaciones del componente de preocupación, siendo más altas las puntuaciones en la muestra de estudiantes de colegios privados, puntuaciones en tranquilidad mayores para el sexo masculino y las de preocupación para el sexo femenino. Por otra parte, no existen diferencias en los niveles y tipos de ansiedad según el grado académico cursado. Conclusiones: existen mayores niveles de ansiedad en niños escolarizados en colegios privados y mayores niveles de preocupación en escolarizados del sexo femenino.
PROJETOS/PROGRAMAS DE REDUÇÃO DE DANOS NO BRASIL: UMA REVISÃO DE LITERATURA
Authors: Santos Valcleiton Bispo , Miranda Marlene
Published: May 2016

A Redução de Danos (RD), enquanto estratégia de saúde pública, se refere à políticas, programas e práticas que visam primeiramente minimizar riscos e danos de natureza biológica, psicossocial e econômica, provocados ou secundários ao uso/abuso de drogas lícitas e ilícitas, sem necessariamente requerer do usuário uma redução ou abstinência. No Brasil, a RD foi adotada como estratégia de saúde pública pela primeira vez em Santos-SP no ano de 1989, contudo é só no ano de 1995 no PRD CETAD na cidade de Salvador/BA que a RD tem suas ações financiadas por organizações internacionais para o combate ao HIV/AIDS. No ano de 2003 o governo federal reconhece a RD enquanto estratégica no cuidado aos usuários de álcool e outras drogas e a insere no Programa Nacional de Atenção Integrada aos Usuários de Álcool e outras Drogas passando assim a financiar as ações. Diante da história da RD no Brasil, este artigo tem como objetivo, realizar uma revisão bibliográfica, a fim de identificar, a partir dos artigos publicados, os projetos/programas de RD, o público alvo atendido, o local e o período de atuação. Para tal análise, foram selecionados 10 artigos que utilizaram o banco de dados dos projetos/programas de RD no período entre 1995-2014. A Metodologia utilizada foi a revisão sistemática realizada no banco de dados da Biblioteca Virtual de Saúde (BVS). Nos Resultados e Discussão, os artigos foram organizados a fim de responder aos objetivos específicos. Na conclusão foram levantadas questões sobre a RD no Brasil e no Mundo.
Huaiqihuang may protect from proteinuria by resisting MPC5 podocyte damage via targeting p-ERK/CHOP pathway
Authors: Li Tingxia , Mao Jianhua , Huang Lei , Fu Haidong , Chen Shuohui , Liu Aimin , Liang Yuqin
Published: May 2016

The purpose of this study was to investigate the potential effects of Huaiqihuang (HQH) granule, a Chinese herbal medicine, in treating proteinuria and to reveal its possible mechanism. MPC5 podocytes were cultured in vitro at 37°C and induced with tunicamycin (TM). The TM-induced cells were treated with HQH at different concentrations. The cell proliferation was detected using the MTT assay. The optimal effective dose of HQH for MPC5 cells was determined by the MTT assay and LDH assay respectively. The influences of HQH on the proteinuria-related protein expression and the signaling pathway associated protein expression were also detected using quantitative reverse transcription PCR and Western blotting analysis. The results showed that the MPC5 cell model was successfully constructed in vitro. The HQH application could improve the harmful effects induced by TM on the MPC5 cells, including promoted cell proliferation and suppressed cell apoptosis. Furthermore, the protein expression, including podocin, nephrin, and synaptopodin was down-regulated by the TM treatment in the MPC5 cells. On contrary, the expression of these proteins was up-regulated after the HQH application. Also, the effect of TM on integrin α3 and integrin β1 expressions was also reversed by the HQH treatment. Moreover, the HQH application decreased the expression of p-ERK and DNA-damage-inducible transcript 3 (DDIT3 or CHOP) in the MPC5 cells, which was opposite to the effect observed in the cells treated with TM. Taken together, our study suggest that HQH application may protect podocytes from TM damage by suppressing the p-ERK/CHOP signaling pathway.
Контроль и надзор как функции управления в экологии
Authors: Яковенко Д.А.
Published: May 2016

В учебном пособии автором рассматриваются вопросы осуществления контроля, надзора и аудита в экологии как элементы функции управления. Экологическая безопасность Российской Федерации является составной частью ее национальной безопасности в целом, ориентирована на реализацию осуществляемых в Российской Федерации экологических преобразований. Реализация функции обеспечения безопасности, защиты жизни и здоровья людей, охраны здоровья граждан и окружающей среды, природных ресурсов, возложена на государство в соответствии с Конституцией. В настоящее время в сфере экологии в России имеется достаточно разветвленная система контроля и надзора как со стороны органов государственной власти и местного самоуправления, так и негосударственная, в том числе общественная. Наличие развитой и разветвленной системы контроля и надзора, однако, не дает гарантию ее эффективности. Среди имеющихся проблем, автор отмечает, что предусмотренная законодательством обязательная государственная экспертиза начинаемой вновь деятельности далеко не всегда реализуется на практике, отсутствует устанавливаемый регламентами порядок межведомственного взаимодействия по закреплению обязательности проведения государственной экологической экспертизы. Несмотря на то, что экологический аудит как институт существует в России более 25 лет, до сих пор отсутствует Федеральный закон, регулирующий данные правоотношения, нет стандартов аудиторской деятельности в сфере экологии, отсутствует даже кодекс профессиональной этики экологического аудитора, не узаконены случаи обязательного проведения экологического аудита. Монография может быть использована в качестве учебного пособия при обучении студентов по программам подготовки магистров по специальностям Государственное и муниципальное управление, Менеджмент, Государственный аудит.
The plane grating monochromator beamline U49-2 PGM-1 at BESSY II
Authors: Kachel Torsten
Published: May 2016

U49/2 PGM1 is one of HZB open-port VUV beamlines. Therefore and due to the fact that it delivers highest flux with very acceptable energy resolution it is the most heavily booked BESSY II beamline. Earlier work has largely focused on surface science and catalysis. After shut down of the former U41 PGM an increasing number of experiments on liquids and solutions are carried out.
Comparative study of the clinical parameters of pregnancy and childbirth in teenagers and women of the optimal reproductive age
Authors: Laryusheva Татьяна М , Istomina Natal’ya G , Baranov Aleksey N
Published: May 2016

Objective. Pregnancy in teenagers is still frequent, while notions about the level of it’s safety and risk of specific obstetrical complications is controversial. Materials and methods. On the basis of interview and medical charts analysis in 500 minors (13 to 18 years) and 1500 women of the optimal reproductive age (20 to 25 years) for the years 2011-2014, social status, main clinical parameters of pregnancy and labor were examined. Results. The average age of young pregnant women was 17,2 ± 0,89 years. Among pregnant teens the students of schools and specialized secondary schools (57.8 %) were dominated, while majority of 20-25-year-olds (66.9 %) were employed. In adolescents, sexual debut was on average two years earlier than in the control group of women. Primigravida were 94.4 % of adolescents and 74.4 % of women aged 20-25. Among most common complications of pregnancy were anemia, threatened abortion, fetal hypoxia, gestational hypertension and preeclampsia. The risk of complications was slightly greater in young women. In 92.2 % of adolescents and 94.4 % of controls, pregnancy was finished with term delivery. The average duration of labor was similar in both groups. The rate of caesarean section was 13 % in minors and 17.6 % in 20-25 years-old women. Conclusions. Pregnancy in adolescents is usually unplanned and occurs in early onset of sexual relations, “socio-adjective position” and low professional status. Among minors precipitate delivery and preterm birth were more common as well as greater percentage of low birth weight newborns in comparison with 20-25 year old women.
Vaginal flora in bacterial vaginosis - the criteria Amsel
Authors: Nazarova Veronika V , Shalepo Kira V , Menukhova Yulia N , Savicheva Alevtina M
Published: May 2016

The article presents the results of a survey of 84 women diagnosed with bacterial vaginosis on the basis of criteria of Amsel. The frequency of detection of various microorganisms/groups of microorganisms present in the vaginal microbiocenosis when different diagnostic criteria for bacterial vaginosis Amsel. Structure and diversity vaginal microbiocenosis assessed using molecular PCR in real time. Bacterial vaginosis is polyetiology syndrome. However, the search for individual bacteria and their combinations in bacterial vaginosis is an actual problem of modern researchers.
Methodological approaches to the definition of ovarian aromatase in polycystic ovary syndrome
Authors: Timofeeva Ekaterina M , Misharina Elena V , Nikolaenkov Igor P , Samoylovich Yanina A , Tkachenko Natalya N
Published: May 2016

In order to study ovarian flavor ase activity in polycystic ovary syndrome (PCOS) examined 49 patients with PCOS and 33 healthy women of reproductive age. Aromatase activity determined using estradiol/number of antral follicles in both ovaries ratio (Е2/n). Values ovarian aromatase positively correlated (p < 0.05) with the results of its determination by a test with the aromatase inhibitor letrozole in PCOS. Reduced aromatase activity of antral follicles was present in 59 % of patients with PCOS. These data indicate that Е2/n ratio allows to evaluate ovarian aromatase and that an absolute or relative deficiency of ovarian aromatase underlies the pathogenesis of PCOS.
The Damages from Unwanted Birth in the Italian Legal System: Between Law and Social Consciousness
Authors: Genovese Umberto , Lombardo Cristina , Akulin Igor M , Chesnokova Еkaterina А
Published: May 2016

In Europe, the modern legal systems, as a rule, provide for the right of citizens to a free and informed choice in matter of family planning and procreation, and therefore the right of women to resort to abortion in case of medical and social indications, or even in case of the mother’s request to terminate an unwanted pregnancy. However, being abortion not only a legal issue, but also a social and moral one, different legal systems adopt a wide range of normative models, which take into account, among other things, the existing cultural traditions and the influence of Church on society. Many states recognize the mother and other relatives’ right to compensation arising from the birth of an unwanted child. Much more controversial is the recognition of the rights of a child with a congenital pathology to indemnity from unwanted birth as a result of medical error. In the present article it is examined the experience of Italy, a country where family traditionally represents a considerable cultural and symbolic value. The paper reviews the main normative acts governing the performance of abortion. The research investigates the issues concerning the legal regulation of the compensation for damages arising in connection with the birth of an unwanted child. The present study examines the trend, emerging in the judicial practice, towards the recognition of the physically challenged child’s rights to compensation for the damage deriving from the birth as a result of medical errors.
Improving Patient Outcomes in Preventing Atrial Fibrillation-related Stroke with Non-Vitamin K Antagonist Oral Anticoagulants
Authors: Kelly Peter , Molina Carlos , Ruff Christian T. , Veltkamp Roland ,   Professor, Stroke Service and NeuroVascular Unit for Translational and Therapeutics Research, University College Dublin, Ireland,   Professor, Vall d’Hebron University Hospital, Barcelona, Spain,   Physician, Brigham and Women’s Hospital, Boston, USA,   Professor, Imperial College, London, UK
Published: May 2016

The rising incidence of atrial fibrillation (AF) is increasingly resulting in a substantial worldwide increase in AF-related stroke, particularly in elderly patients and this is creating an increasingly serious healthcare burden. Guidelines recommend the use of AF-related stroke prophylaxis but adherence to these remains poor. Studies conducted in the 1990s showed that warfarin reduced the risk of AF-related stroke by an overall 64% compared with placebo. Subsequently, prophylactic treatment was further improved with the development of non-vitamin K antagonist oral anticoagulants (NOACs). More recently, a meta-analysis of four large clinical trials on NOACs (dabigatran, rivaroxaban, apixaban, and edoxaban) showed there was a relative risk reduction of 0.81 (p<0.0001) favouring NOAC treatment over warfarin for stroke or systemic embolic events in patients with AF. The largest trial of NOACs in AF-related stroke, to date, was the ENGAGE AF-TIMI 48 study (n=21,105) which showed that edoxaban was non-inferior to warfarin for ischaemic stroke reduction but significantly reduced bleeding and cardiovascular mortality. A recent subgroup analysis of this study showed that with edoxaban the incidences of intracranial haemorrhage (ICH) subtypes (all ICH, fatal ICH, fatal, subdural and epidural bleed) were significantly lower with 60 mg of edoxaban (p=0.013–<0.001). Edoxaban was also shown to be an effective option in patients with prior stroke. In addition, edoxaban was shown to reduce deaths due to fatal bleeds compared with warfarin. The results of current studies, especially the ENGAGE AF-TIMI 48 subgroup analysis therefore, show that the benefits of anticoagulation therapy in patients with AF substantially outweigh the risks.
Multi-stakeholder Colloquium – Opportunities and Challenges in Multiple Sclerosis Management
Authors: Vermersch Patrick , Gold Ralf , Holloway Chris , Rovira Alex , Giovannoni Gavin , Toumi Mondher ,   Professor of Neurology, University of Lille, France,   Professor of Neurology, St. Josef-Hospital, Ruhr University, Bochum, Germany,   Group Director of Regultory Affairs & Chief Scientific Officer, ERA Consulting Group, Walsrode, Germany,   Department of Radiology, Hospital Universitari Vall d’Hebron, Barcelona, Spain,   Queen Mary University, London, Blizard Institute, Barts and the London School of Medicine and Dentistry, London, UK,   Professor of Public Health, Aix-Marseille University, Marseille, France
Published: May 2016

In Europe, despite recent therapeutic advances, there are many deficiencies in the management of multiple sclerosis (MS). Diagnostic and monitoring measures, guidelines, development of new treatments and best practice care are often suboptimal. These shortcomings were discussed at two MS multi-stakeholder colloquia that were convened in Brussels, Belgium in May 2014 and May 2015, and gathered experts from a range of different specialities to identify the key issues and propose means of tackling them. After considering all the testimony and discussion, the organising committee drew up a list of 10 calls to action, which included: increase awareness and understanding in the EU about the burden of MS; obtain better insights into the direct and indirect cost burden of MS; (re)define treatment goals and clinical study endpoints; develop new tools to better capture the total clinical burden of MS; develop a protocol to standardise magnetic resonance imaging (MRI); develop biomarkers of treatment response prediction and disability progression; integrate drug licensing and cost-effectiveness decision-making processes; develop separate European Medicines Agency guidelines for evaluating follow-on products of non-biological complex drugs and biologicals; implement a set of evidence-based standards of care and incentives to support people with MS to remain physically and mentally active. Addressing these ambitious calls to action requires cooperation from various health bodies and governments and some will require additional funding, but they are achievable and worthwhile. They would help minimise disease impact and would reduce disease progression and the consequent burden on people with MS, their caregivers, and on health budgets. These calls to action set out a strategy for future MS management and should be acted upon with urgency.
Elevated Coagulation Factor IX and Risk of Thrombosis Development
Authors: AlDallal Salma ,   Hematology Laboratory Specialist, Amiri Hospital, Kuwait
Published: May 2016

Coagulation involves the regulated sequence of proteolytic activation of a series of zymogens to achieve an appropriate and timely hemostasis in an injured vessel in an environment that favors an anticoagulant state. Alteration of hemostatic balance between the prothrombotic and antithrombotic factors can result in insufficient inhibition of coagulation ‘thrombosis’ or bleeding due to excessive antithrombotic treatment. Fibrin is the key component of thrombi and anticoagulant drugs that reduce thrombin formation are effective in both prevention and treatment of thrombosis. Therefore, an increased circulating level of coagulation factor is a must for treatment mechanisms of both venous and arterial thrombosis. The existing anticoagulants may have only limited effects due to their modest therapeutic benefits, increased bleeding risks, narrow clinical applications, and drug-induced thrombophilia. However, some new oral anticoagulants, when administered optimally, are associated with significant anti-ischemic benefits and lower bleeding risk when compared with heparin and vitamin K antagonists. Since factor IX (FIX) plays a key role in tissue factor-mediated thrombin production, it may represent a promising target for drug development. This review aims to summarize the current data for FIX and its role in the development of thrombosis (although thrombosis is a platelet-centric process and FIX may not have any direct and specific effect on platelets).
The Future of Melanoma Immunotherapy
Authors: Khushalani Nikhil I , Sondak Vernon K ,   Associate Member, Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida, US; Associate Professor, Department of Oncologic Sciences, University of South Florida Morsani College of Medicine, Tampa, Florida, US,   Chair, Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida, US; Professor, Departments of Oncologic Sciences and Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, US
Published: May 2016

The resurgence of immunotherapy in melanoma has led to impressive gains in therapeutic outcome. Yet we remain limited in our ability to predict response, toxicity, and prognosis. In this brief review, we outline pressing questions for clinical investigation using the backbone of checkpoint inhibition in melanoma. Future trials must also evaluate strategies to improve the economics of melanoma therapy.
Estudo comparativo de sistemas metroviários para aumento da eficiência energética das subestações de tração
Authors: Pereira Sergio Luiz , Sousa Carlos Alberto de
Published: May 2016

Reaproveitar a energia da frenagem regenerativa produzida pelos trens de um sistema metroviários é essencial para o aumento da eficiência energética do sistema, mas de difícil aplicação no metrô de São Paulo devido ao pequeno intervalo entre composições e as partidas e frenagens frequentes. Este artigo fornece uma avaliação abrangente e comparação das soluções atualmente disponíveis para a recuperação e gestão adequada da energia da frenagem regenerativa no transporte metroviário. Neste artigo são comparadas as diferentes estratégias existentes atualmente para aumentar o aproveitamento da energia regenerada da frenagem dos trens, como o armazenamento de energia em baterias estacionária ou em supercapacitores, a utilização de subestações inversoras recuperadoras de energia como forma de devolver o excedente de energia regenerada para a rede de distribuição e implementação de algoritmo genético.
Um Algoritmo Robusto e Rápido para Detecção de Afundamento de Tensão
Authors: Dantas Joacillo L. , Lima Francisco Kleber de A. , Guerrero Josep M. , Vasquez Juan C. , Branco Carlos Gustavo C.
Published: May 2016

Afundamento de tensão é um problema recorrente em sistemas elétrico, sendo o mesmo considerado um dos mais relevantes fatores que contribuem para deterioração da qualidade de energia elétrica. Neste artigo, um novo e abrangente algoritmo de detecção de afundamentos de tensão, batizado de ADAMF, é apresentado. O algoritmo pode, rapidamente,detectar afundamentos de tensões simétricos e assimétricos devido a sua habilidade de monitorar, independentemente, a componente fundamental de tensão em cada fase. O valor agregado das tensões, no referencial αβ, é comparado com 0,9 com o intuito de detectar ocorrência deste tipo de contingência. Simulações e resultados experimentais são apresentados para validação do algoritmo proposto.
Controlador Multimalhas para Inversor Monofásico e Controle de Chave Estática de Transferência Aplicados em Fontes Ininterruptas de Energia
Authors: Rodrigues Marcus Vinícius Maia , Silva Newton da
Published: May 2016

Este trabalho apresenta o projeto de um controlador multimalhas para utilização em um inversor monofásico e também o controle do acionamento de uma chave estática de transferência (STS, Static Transfer Switch), ambos aplicáveis em UPS (Uninterruptible Power Supplies). Duas malhas de realimentação são utilizadas no controle do inversor, uma malha interna de corrente e outra externa de tensão. Controladores do tipo proporcional- ressonante atuam como compensadores em ambas as malhas. O atraso da resposta dinâmica do modulador PWM (Pulse Width Modulation) digital é considerado no projeto dos controladores, uma vez que é um fator que limita os ganhos dos compensadores. Uma topologia da STS, composta de IGBTs (Insulated Gate Bipolar Transistor) e diodos em substituição a convencional, de tiristores, obtendo-se uma redução significativa no tempo de transferência da alimentação de uma carga crítica da rede elétrica para uma fonte auxiliar (inversor monofásico). A estratégia de controle para o acionamento da STS é baseada no método de detecção do valor de pico do sinal de tensão utilizando um algoritmo de PLL (Phased Locked Loop). Resultados experimentais comprovam o bom desempenho do controlador multimalhas e também do rápido tempo de transferência da chave estática.
Relevance Of Cultural Intelligence And Communication Effectiveness For Global Leadership Preparedness: Study Of Indian Managers
Authors: Mukherji Shoma , Jain Neera , Sharma Radha
Published: May 2016

Business environment world over has undergone major transformation in the last fifty years. Global organisations, where operations are not restricted to home or host country, need business leaders with a global mindset and multicultural effectiveness. This paper examines and confirms the relevance on leadership preparedness of global managers of two important constructs – cultural intelligence and communication effectiveness in the context of anxiety and uncertainty management. Adding to extant literature, the study empirically confirms the suitability of three assessment instruments. It establishes the importance of cultural adaptability and AUM theory for assessing leadership potential of managers working in multicultural environments with culturally diverse teams. The objective of this study is to understand the relevance of cultural intelligence and communication effectiveness for leadership preparedness in a multicultural environment. The present century is seeing accelerated transformation of businesses into truly global entities. As organizations operate in a boundary-less world, multicultural teams are the order of the day. Business leaders, who are able to understand, accept, and effectively respond to cultural differences are therefore in great demand.
Event Marketing and Attitude Changes
Authors: Nufer Gerd
Published: May 2016

The most important objective of event marketing is to improve the image of a brand or a company. The paper presents an image transfer model for event marketing. Based on current research, an image transfer model for event marketing is developed and the conditions required for an image transfer to take place from an event to a brand or a company are explained. Depending on which conditions are met, there are different consequences with regard to the image transfer from the event to the brand or company that are structured and characterized in detail. The image transfer model is developed against the backdrop of selected event types often used in actual practice. The focus of its application lies mainly in brand-oriented leisure and infotainment events directed towards external target groups. The model provides a discussion and analysis of the impact category of the image transfer in event marketing. The paper explains that the possibility of an attitude change is given within the context of event marketing. The presented model serves to structure the image transfer in event marketing. It is intended to illustrate the steps that are involved in the emergence of an image transfer as well as the resulting alternative consequences.
Aplikasi Pembelajaran Berbasis Mobile Untuk Tuna Aksara
Authors: Padli Nasution Muhammad Irwan , Andriana Septiana Dewi
Published: May 2016

Abstract - Learning is a process of transformation that is initially not knowing to knowing. Has developed a lot of learning strategies from simple to more complex models even complicated and required a lot of tools in its application. Literacy is a basic of knowledge for humans.  They can read by improving their quality, which leads to the high intellect of a person. Especially at this time humanity has entered the information age. The phenomenon of globalization is happening now accelerating so quickly, as the impact of  application of Hi-tech society (high-tech society), which causes humans followed on interaction patterns very quickly. Using Information and Communication Technology (ICT) could be developed multimedia teaching materials with the concept of learning by playing fun and implemented on a mobile based learning applications. The use of mobile devices that is easy and flexibility is very useful to support the learning process for the illiterate.
PEMODELAN BAWAH PERMUKAAN METODE PRE-STACK TIME MIGRATION (PSTM) ISOTROPY DAN METODE PSTM ANISOTROPY HIGH ORDER MOVEOUT (HOM)
Authors: Luthfin Ahmad , Susilo Adi , Suroso Teguh
Published: May 2016

Struktur bawah permukaan memiliki perlapisan yang sangat komplek, sehingga memungkinkan penjalaran gelombang seismik memiliki kecepatan yang berbeda tergantung arah rambatnya. Hal inilah yang mendasari perlunya proses pengolahan data dengan melibatkan parameter anisotropi (η). Umumnya data seismik memiliki nilai anisotropi dengan presentase tertentu, sehingga tidak semua data harus diproses dengan proses anisotropi. Ketepatan metode migrasi yang digunakan dapat menghasilkan gambar penampang struktur bawah permukaan dengan resolusi yang tinggi. Penelitian ini bertujuan untuk memodelkan struktur bawah permukaan dengan menggunakan metode PSTM isotopi (lapisan isotropi) sedangkan untuk lapisan anisotropi dimodelkan dengan metode PSTM anisotropi HOM. Hasil dari metode PSTM isotropi berupa citra, dimana lapisan pertama pada CMP 2073-CMP 2413 hasilnya jelek (beresolusi rendah), tetapi untuk lapisan kedua dan ketiga tampak bagus (beresolusi tinggi). Pada saat diproses dengan PSTM anisotropi, peneliti menggunakan nilai (η) sekitar 0,25 pada lapisan pertama. Berdasarkan hasil PSTM anisotropi pada CMP 2073-CMP 2413 model lapisan pertama menghasilkan citra beresolusi lebih tinggi (lebih bagus), sedangkan model lapisan kedua dan ketiga tidak mengalami kenaikan resolusi yang signifikan. Hal ini karena rasio far offset dan kedalaman lapisan pertama besar menyebabkan lapisan pertama mengalami efek anisotropi, sedangkan lapisan kedua dan ketiga tidak mengalami efek anisotropi
Polydactyly: A Review
Authors: Farrugia Marie Claire , Calleja-Agius Jean
Published: May 2016

ABSTRACT

Polydactyly, also known ashyperdactyly, is a common congenital limb defect, which can present with various morphologic phenotypes. Apart from cosmetic and functional impairments, it can be the first indication of an underlying syndrome in the newborn. Usually, it follows an autosomal dominant pattern of inheritance with defects occurring in the anteroposterior patterning of limb development. Although many mutations have been discovered, teratogens have also been implicated in leading to this anomaly, thus making it of multifactorial origin. There are three polydactyly subtypes (radial, ulnar, and central), and treatment options depend on the underlying feature.
Predicting Occurrence of Spine Surgery Complications Using “Big Data” Modeling of an Administrative Claims Database
Authors: Ratliff John K. , Balise Ray , Veeravagu Anand , Cole Tyler S. , Cheng Ivan , Olshen Richard A. , Tian Lu
Published: May 2016

Background:

Postoperative metrics are increasingly important in determining standards of quality for physicians and hospitals. Although complications following spinal surgery have been described, procedural and patient variables have yet to be incorporated into a predictive model of adverse-event occurrence. We sought to develop a predictive model of complication occurrence after spine surgery.

Methods:

We used longitudinal prospective data from a national claims database and developed a predictive model incorporating complication type and frequency of occurrence following spine surgery procedures. We structured our model to assess the impact of features such as preoperative diagnosis, patient comorbidities, location in the spine, anterior versus posterior approach, whether fusion had been performed, whether instrumentation had been used, number of levels, and use of bone morphogenetic protein (BMP). We assessed a variety of adverse events. Prediction models were built using logistic regression with additive main effects and logistic regression with main effects as well as all 2 and 3-factor interactions. Least absolute shrinkage and selection operator (LASSO) regularization was used to select features. Competing approaches included boosted additive trees and the classification and regression trees (CART) algorithm. The final prediction performance was evaluated by estimating the area under a receiver operating characteristic curve (AUC) as predictions were applied to independent validation data and compared with the Charlson comorbidity score.

Results:

The model was developed from 279,135 records of patients with a minimum duration of follow-up of 30 days. Preliminary assessment showed an adverse-event rate of 13.95%, well within norms reported in the literature. We used the first 80% of the records for training (to predict adverse events) and the remaining 20% of the records for validation. There was remarkable similarity among methods, with an AUC of 0.70 for predicting the occurrence of adverse events. The AUC using the Charlson comorbidity score was 0.61. The described model was more accurate than Charlson scoring (p < 0.01).

Conclusions:

We present a modeling effort based on administrative claims data that predicts the occurrence of complications after spine surgery.

Clinical Relevance:

We believe that the development of a predictive modeling tool illustrating the risk of complication occurrence after spine surgery will aid in patient counseling and improve the accuracy of risk modeling strategies.
Publication Productivity and Experience: Factors Associated with Academic Rank Among Orthopaedic Surgery Faculty in the United States
Authors: Ence Andrew K. , Cope Seth R. , Holliday Emma B. , Somerson Jeremy S.
Published: May 2016

Background:

Many factors play a role in academic promotion among orthopaedic surgeons. This study specifically examined the importance of publication productivity metrics, career duration, and sex on academic rank in orthopaedic surgery programs in the United States.

Methods:

Faculty at 142 civilian academic orthopaedic surgery departments in 2014 were identified. Geographic region, department size, and 3 specific faculty characteristics (sex, career duration, and academic position) were recorded. The Hirsch index (h-index), defined as the number (h) of an investigator’s publications that have been cited at least h times, was recorded for each surgeon. The m-index was also calculated by dividing the h-index by career duration in years. Thresholds for the h-index and the m-index were identified between junior and senior academic ranks. Multivariate analysis was used to determine whether the 3 physician factors correlated independently with academic rank.

Results:

The analysis included 4,663 orthopaedic surgeons at 142 academic institutions (24.7% clinical faculty and 75.3% academic faculty). Among academic faculty, the median h-index was 5, the median career duration was 15 years, and the median m-index was 0.37. Thresholds between junior and senior faculty status were 12 for the h-index and 0.51 for the m-index. Female academic faculty had a lower median h-index (3 compared with 5; p < 0.001) and career duration (10 years compared with 16 years; p < 0.001) than male academic faculty, but had a similar median m-index (0.33 compared with 0.38; p = 0.103). A higher h-index and longer career duration correlated independently with an increased probability of senior academic rank (p < 0.001), but sex did not (p = 0.217).

Conclusions:

This analysis demonstrates that a higher h-index and m-index correlate with a higher academic orthopaedic faculty rank. Although female surgeons had a lower median h-index and a shorter median career duration than male surgeons, their m-index was not significantly different, and thus sex was not an independent predictor for senior academic rank. The identified thresholds (h-index of 12 and m-index of 0.51) between junior and senior academic ranks may be considered as factors in promotion considerations.