bluuebunny/crossref_metadata_2025 huggingface dataset:
New model of care for patients with central nervous system cancers.
Authors: Pentsova Elena , Nevel Kathryn Sara , Konig Franchesca , Sibilla Maryann , Skakodub Anna , Manne Malbora , Errante Mimma , Gordilo Milagros , Rawlins-Peters Gayle , Jean-Charles Dominique , Zankowsky Anastasia , Gilman Jody , Kelly Brian , Zavolas Stephanie , Goldman Hannah , Syrkin Grigory , Diamond Eli L. , DeAngelis Lisa Marie , Ruppert Lisa Marie , Carver Alan
Published: November 2019

87

Background: Patients (pts) with primary or metastatic central nervous system (CNS) cancers often have multiple physical, psychosocial, and spiritual needs. Likewise, neurological impairments can transform pts’ relationship dynamics with caregivers. These issues, along with prognosis and end of care planning, are difficult to address within a single outpatient oncology clinic. Methods: The Neurological Multidisciplinary Care Clinic (MdCC) at Memorial Sloan Kettering Cancer Center was a pilot study from 8/2017 to 6/2019 to foster a new model of care for complex pts with CNS cancers to identify and address their needs. Twice a month between 8/2017- 6/2019, a team comprised of a neurologist, nurse, physiatrist (RM), physical therapist, social worker (SW), case manager (CM), dietitian (RD), and chaplain (C) saw patients with neurological deficits and KPS ≤80. Within a 3 hour-visit, providers rotated in to see patients and their caregivers. Since 11/2017 participants completed validated surveys on unmet needs, financial strain, and home equipment prior to their visit, and satisfaction surveys afterward. Descriptive statistics were used to analyze results. Results: Eighty-two pts with advanced cancer were seen: 40 were female, median age 59. Of these 82 pts, 66 had primary CNS cancers, predominantly high-grade glioma/glioblastoma (79%). Over 60% had never seen a CM, RM, RD or C prior to MdCC. Seventy-eight pts (95%) received symptom management recommendations. Prognosis/coping with cancer was discussed with 75 pts (91%) which increased signed health care proxy forms by 16% and DNR orders by 6% at time or within a month post-MdCC. New/updated physical therapy was ordered for 50 pts (61%), orthotics for 10 (12%), and new equipment for 14 (17%). Forty-nine pts completed a satisfaction survey: of these, 96% were highly satisfied, and would recommend MdCC to others. Conclusions: Pts’/caregivers’ unmet needs were effectively identified and addressed within a single MdCC visit. The presence of several providers through MdCC allows for the assessment of pts’/caregivers’ needs and coping skills in real time. The MdCC also facilitates discussing pts’ goals of care, assessing their support system, and implementing a safe patient-centered plan of care.
Patient-reported symptom profiles: A tool to direct palliative care referral.
Authors: Kaufmann Tara L. , Hsu Jesse Y. , Getz Kelly D. , Kamal Arif , DeMichele Angela
Published: November 2019

93

Background: Both routine PRO monitoring and specialty palliative care are associated with a survival benefit in advanced cancer patients, yet the integration of these efforts has not been described. As PRO collection becomes standard of care, there is a need to understand how PROs may be leveraged to identify patients who could benefit from palliative care referral. Methods: We applied latent profile analysis (LPA) to PROs from a national palliative care registry collected from 2008 – 2017 on 745 solid tumor patients at the time of initial outpatient palliative care visit. LPA is an established method to identify unobserved groups from variables of interest. We used patients’ responses to 11 questions across 4 palliative care domains (9 ESAS items and 2 items for social and existential distress) to generate “PRO profiles” and examined their clinical and demographic correlates using multinomial logistic regression. Results: Four PRO profiles were identified using 9 ESAS items (Table). Young age, metastatic disease, and tumor type (including breast, GYN, GI) differed across PRO profiles compared to lung. Patients with PPS < 70% were 4.5 times more likely to be in the High vs. Low symptom profile compared to those with PPS > 70%. Subgroup analyses showed correlation of social and existential distress PROs with Mood and High profiles. Conclusions: Cancer patients referred to outpatient palliative care can be differentiated into clinically meaningful PRO profiles using brief, routinely collected data in the real-world setting. PRO profiles provide richer data on patient needs compared to prognosis estimates or cancer stage, and synthesize big data for use in clinical practice and epidemiologic research. PRO profiles should include comprehensive palliative domains and be tested as screening thresholds for palliative care referral. [Table: see text]
Living with multiple myeloma: A life disrupted.
Authors: LeBlanc Matthew Roger , LeBlanc Thomas William , Bryant Ashley Leak , Pollack Kathryn Ilonka , Bailey Chip , Smith Sophia Kustas
Published: November 2019

95

Background: Multiple myeloma (MM) an incurable cancer of the plasma cells is the second most common hematologic malignancy. Over 30,000 new diagnoses and over 12,000 deaths are attributed to MM annually in the United States. Dramatic improvements in survival over the past fifteen years have been fueled by the rapid introduction of new therapies and resulting changes in treatment patterns. Extended survival coupled with complex and ongoing treatment contributes to significant disruptions to daily living. Therefore, the purpose of this study was to explore the many ways that a MM diagnosis disrupts and interferes with a person’s life in the current treatment era. Methods: A cross sectional qualitative descriptive study was conducted to explore the impacts of MM diagnosis and treatment on patients’ lives in the era of novel MM treatment. Semi-structured one-hour interviews were conducted at the Duke Cancer Center with MM patients and MM clinicians to explore MM’s impact on patients’ lives. Results: Fifteen MM patients and ten MM clinicians were interviewed between September 2017 and September 2018. Themes arose around ways that a MM diagnosis and treatment had far reaching and serious impacts on patients’ lives. Four major themes emerged: ‘Impacts on Social Life and Hobbies’, Maintaining Employment’, ‘Financial Pressure’, and ‘Relationship Stress'. Conclusions: The care of MM patients has made great strides as new and more effective treatments have extended survival for many patients. Health care at its best endeavors to reduce suffering as well as extend life. This study highlights the far-reaching impacts MM has on all aspects of patients’ lives. Understanding how a myeloma diagnosis and its treatment may interfere in patients’ lives could inform the development of interventions that target management strategies to limit these negative impacts.
The development and implementation of a gynecologic cancer survivorship tool.
Authors: Carter Jeanne , Abu-Rustum Nadeem , Saban Sally , Chen Ling Y. , Vickers Andrew , Billanti Gabriela , Connors Nicole A , Broach Vance , Brown Carol L. , Chi Dennis , Gardner Ginger J. , Goldfrank Deborah J. , Jewell Elizabeth Lin , Leitao Mario M. , Long-Roche Kara C. , Mueller Jennifer Jean , Sonoda Yukio , Zivanovic Oliver
Published: November 2019

98

Background: To assess the implementation and use of an electronic survivorship tool to enhance patient/clinician communication and intervention of survivorship concerns in women treated for gynecologic cancer. Methods: The clinical survivorship tool was developed using evidence-based data, multidisciplinary expert input, and patient feedback. The tool is composed of 17 questions encompassing 6 main categories: gynecologic health (abnormal bleeding/pain), lymphedema, vaginal/vulvar dryness, sexual health concerns, menopause (hot flushes, sleep difficulties), and bowel/urinary issues. The electronic tool was piloted and incorporated into clinic for endometrial and cervical cancer patients. Patients were introduced to the tool at their first postop visit and emailed an introduction form before their 3-month follow-up visit. The form could be completed at home or at the time of scheduled visit. Results: From 6/1/18 to 6/1/19, 1269 patients were eligible to complete at least one survivorship tool survey. Compliance rates increased over the year and reached 67% (1,015/1,525 assigned surveys completed) with the addition of clinic coordinator, staff and nurse training; the initiation of daily emails screening for survey respondents; clinic coordinator feedback and modification of screening emails; and the addition of nurses to daily screening emails. Of those who completed surveys between 01/1/19 and 06/1/19, the most common survivorship concerns noted were bowel (48%, n=484) and urinary function (35%,n=352) issues, menopausal symptoms such as trouble sleeping (33%, n=333) and hot flashes (25%, n=249), lower extremity symptoms (heaviness 17%, n=175; swelling 17%, n=171; numbness 17%, n=171), and vaginal dryness (26%, n=263), with actionable items of education and referrals, as needed. Conclusions: This survivorship tool enhanced the ability of healthcare providers to identify, monitor, and address survivorship concerns over the continuum of care. Patients and healthcare providers found this tool to be clinically feasible with potential to promote communication and education to enhance clinical care. Our multidisciplinary approach and training were key to implementation success.
Elevated HbA1c Is Associated with Altered Cortical and Trabecular Microarchitecture in Girls with Type 1 Diabetes
Authors: Mitchell Deborah M , Caksa Signe , Joseph Taïsha , Bouxsein Mary L , Misra Madhusmita
Published: November 2019

Context

Skeletal fragility is a significant complication of type 1 diabetes (T1D), with an increased risk of fracture observed starting in childhood. Altered bone accrual and microarchitectural development during the critical peripubertal years may contribute to this fragility.

Objective

To evaluate differences in skeletal microarchitecture between girls with T1D and controls and to assess factors associated with these differences.

Design

Cross-sectional comparison.

Participants

Girls ages 10–16 years, 62 with T1D and 61 controls.

Results

Areal bone mineral density (BMD) measured by dual-energy x-ray absorptiometry did not differ between girls with and without T1D. At the distal tibia, trabecular BMD was 7.3 ± 2.9% lower in T1D (P = 0.013), with fewer plate-like and axially-aligned trabeculae. Cortical porosity was 21.5 ± 10.5% higher, while the estimated failure load was 4.7 ± 2.2% lower in T1D (P = 0.043 and P = 0.037, respectively). At the distal radius, BMD and microarchitecture showed similar differences between the groups but did not reach statistical significance. After stratifying by HbA1c, only those girls with T1D and HbA1c > 8.5% differed significantly from controls. P1NP, a marker of bone formation, was lower in T1D while CTX and TRAcP5b, markers of bone resorption and osteoclast number, respectively, did not differ. The insulin-like growth factor 1 (IGF-1) Z-score was lower in T1D, and after adjustment for the IGF-1 Z-score, associations between T1D status and trabecular microarchitecture were largely attenuated.

Conclusions

Skeletal microarchitecture is altered in T1D early in the course of disease and among those with higher average glycemia. Suppressed bone formation and lower circulating IGF-1 likely contribute to this phenotype.
Establishing neuronal diversity in the spinal cord: a time and a place
Authors: Sagner Andreas , Briscoe James
Published: November 2019

The vertebrate spinal cord comprises multiple functionally distinct neuronal cell types arranged in characteristic positions. During development, these different types of neurons differentiate from transcriptionally distinct neural progenitors that are arrayed in discrete domains along the dorsal-ventral and anterior-posterior axes of the embryonic spinal cord. This organization arises in response to morphogen gradients acting upstream of a gene regulatory network, the architecture of which determines the spatial and temporal pattern of gene expression. In recent years, substantial progress has been made in deciphering the regulatory network that underlies the specification of distinct progenitor and neuronal cell identities. In this Review, we outline how distinct neuronal cell identities are established in response to spatial and temporal patterning systems, and outline novel experimental approaches to study the emergence and function of neuronal diversity in the spinal cord.
Temporary caging results in reduced levels of circulating melatonin in migratory robins
Authors: Lupi Sara , Canoine Virginie , Pedrini Paolo , Fusani Leonida
Published: November 2019

The hormone melatonin, a main component of the avian circadian system, plays an important role in the physiological transitions that accompany the activation of the migratory phenotype in passerine birds. Most small passerines migrate at night when circulating concentrations of melatonin are elevated. Previous work measured nocturnal melatonin levels of migratory birds only in captive animals, because free-living individuals are usually caught at day time. In this study, we compared nocturnal melatonin levels of European robins (Erithacus rubecula) caught during the day and held in cages overnight with those of birds that were caught at night and sampled immediately. We found that circulating melatonin at night was lower in birds held in cages compared to birds that were actively migrating. This result suggests that temporary caging affects the melatonin system and that in nature melatonin levels could be generally higher than those previously described by studies on captive birds.
Virtual arthroplasty follow-up: five-year data from a district general hospital
Authors: Fisher R , Hamilton V , Reader S , Khatun F , Porteous M
Published: November 2019

Introduction

Follow-up after hip and knee arthroplasty is advocated to identify asymptomatic loosening and improve patient satisfaction. There are, however, financial and time implications associated with regular clinic appointments. Assessment through virtual means has been suggested as an alternative.

Materials and methods

At the West Suffolk Hospital, following arthroplasty surgery of the lower limb, patients are followed-up via a questionnaire at one and five years postoperatively, then subsequently at five-yearly intervals. Patients are recalled based on the outcome of these assessments. Using a locally compiled data base we identified all patients reviewed between 2011 and 2015 using this virtual assessment process and examined their outcomes.

Results

During the five years of follow-up, 5,380 patients were eligible for assessment. Compliance varied from 77% follow up for hips and 83% for knees. Ten patients were recalled following total hip replacement, eight for x-ray changes and one for a poor satisfaction score. Five went on to undergo revision surgery. Some 56 recalls to clinic following knee arthroplasty were seen; 42 due to a poor Oxford Knee Score, 6 with associated x-ray abnormalities and 6 isolated abnormal x-rays. Five subsequently underwent revision surgery; 30 (54%) were discharged after initial review and 18 (32%) were referred to different subspecialties. As a result of the virtual review process, 4,219 clinic appointments were avoided, with no documented admissions as a result of a missed complication from virtual review.

Discussion

A virtual arthroplasty clinic significantly reduces the number of patients attending regular follow-up clinics, without compromising safe practice.
Bio-inertia resonates life into evolution
Authors: Lai Yi Yu
Published: November 2019

Life is an environmental signal compromised Le Châteliers system. The potential for it to issue Le Châteliers effect to discernable signals is defined as bio-inertia. To track the origin of such system recovering capability, we composite brachistochrone curves with experiments to prove that a path which can be projecting into three-dimensional simple harmonic motion with internal commutation is an efficient sustaining signal accumulating and transferring system. It is defined as a bio quantum path which composes of the fundamental physical splicing structures of bio-systems. Experiments calibrate gravitational loss as empirical bio-inertia. Surface tension inversion is therefore evidently to be the fundamental gravitational binding and polarization manner in bio-systems. CSF, as the highest gravitational binding system of vertebrates, has also been originated back to the inversion of an earlier phospholipid bilayer based on the ancient somatic physical training. By adapting Chus constant into Planck's law and the born of the Schrödinger Cats babies, the fragile Copenhagen superposition becomes converging superposition that can be modulated by a music frequency notation in enough binding Le Châteliers system. Inside surface tension regions, quantum mechanics recovers its gravitational quiddity by redefining Schrödinger wave function, and binding Einsteins gravitational waves that regenerate bio-functions get an equivalent definition. Wave-particle duality is reinterpreted, and the Principle of Least Action is generalized as the relay or harmonic inversion of the multi-surface tension transferring in bio-systems. From the binding and inversions of gravity on bio quantum paths, life is physically abiogenesis from a whirlpool by surface tension inversions. NKT cell clinical trial based on new definition confirms that ancient spinal training systems are still unsurpassable for precluding of spinal cancerous recurrent factors before modern biotechnologies can establish spinal CSF surface tension interference method in someday.
Educação Popular em Saúde e Estratégia de Saúde da Família: Potencialidades do Cuidado / Popular Health Education and Family Health Strategy: Potentialities of the Care
Authors: Holanda Carlos Welmer Bezerra , Santos Agostinho Porfirio dos , Gomes Genielly Albuquerque , Santos Rosely Leyliane dos
Published: November 2019

Este artigo tem como objetivo realizar reflexão teórica acerca da educação popular em saúde como potencializadora do cuidado na Estratégia de Saúde da Família. Trata-se de um artigo de reflexão. Os resultados evidenciaram que os profissionais atuantes na Estratégia de Saúde da Família valorizam o cuidado do indivíduo e sua comunidade. Nesse aspecto, devem atuar no processo de transformação do meio e que pode gerar novas concepções acerca da dinâmica da saúde. Tal fator, torna essencial para a assistência qualificada, efetiva e humanizada. A Educação Popular em Saúde é uma estratégia que favorece a participação popular e portanto, é importante que seja reconhecida na dinâmica de trabalho dessas equipes de saúde. A reflexão aqui trabalhada permite apontar a educação popular em saúde como proposta metodológica de trabalho para esse modelo de atenção à saúde que pode contribuir para a superação do modelo fragmentado da saúde.
Perfil Sociodemográfico e Epidemiológico de Novos Casos de Hanseníase no Município de Almenara - MG / Sociodemographic and Epidemiological Profile of new Leprosy Cases in Almenara – MG
Authors: Araújo Bruna Gil Lacerda , Brito Daniela Pereira Costa , Coelho Viviane Amaral Toledo , Nascimento Ednardo De Souza , Pereira Monica Cecília Santana , Lacerda Luiza Gobira , Souza Carla Giselly De
Published: November 2019

Conhecida como lepra antigamente, a Hanseníase atualmente apresenta-se como um sério problema de saúde pública no Brasil. Sendo assim, esta pesquisa teve como objetivo caracterizar a descrição do perfil sociodemográfico e epidemiológico dos novos casos de Hanseníase no município de Almenara - MG, considerando-se dados da notificação oficial fornecidos pelo setor de vigilância epidemiológica do município. Trata-se de um estudo teórico embasado em pesquisas bibliográficas já publicadas e analisadas entre os anos de 2002 á 2017 e, concomitantemente com um estudo prático realizado a partir de dados obtidos da cidade de Almenara - MG durante o período de 2014 á 2018. Causada pela bactéria Mycobacterium Leprae, a Hanseníase manifesta-se em através de lesões cutâneas e nos nervos periféricos, e se não diagnosticada e tratada a tempo a doença pode desenvolver deformidades e gerar em meios sociais, preconceitos e estigmas sobre o indivíduo enfermo. Com o estudo prático pode-se constatar que a classificação operacional multibacilar foi a mais prevalente, apresentando uma maior predominância de casos em pessoas do sexo masculino e com baixa escolaridade. Foram evidenciados também novos casos em pessoas de idades variantes de 0-15 anos, que é o fator mais preocupante para os Órgãos Públicos.
Docentes Universitários: Expectativas acerca da Aposentadoria / Teachers College: Expectations about Retirement
Authors: Moraes Jesana Sá damasceno , Oliveira Francisca Bezerra de , Cezário Paula Frassinetti Oliveira , Batista Juliana Pereira , Pinheiro Lívia Viviane Lins Pereira
Published: November 2019

Objetivou-se conhecer as expectativas de docentes universitários em transição à aposentadoria acerca deste processo. Estudo descritivo com abordagem qualitativa, realizado com vinte docentes universitários. Para coleta de dados foi utilizado um roteiro de entrevista semiestrurado. Os dados foram processados e analisados através da análise de conteúdo. Diante de todas as constatações advindas desta pesquisa, é possível afirmar que o modo como cada docente enxerga a aposentadoria está intrinsecamente conexo ao modo como vive a sua própria vida, no que tange aos seus princípios e valores e as suas prioridades, tanto no aspecto profissional como no pessoal.
Implante Dentário Imediato com Inserção de Enxerto Conjuntivo e Carga Imediata: Relato de Caso / Immediate Implant Placement with Connective Tissue Grafting and Immediate Load: Case Report
Authors: Souza Luane Dos Santos , Viana Ana Luiza Cajazeira Fernandes , Coelho Yasmin Correia , Dias Glauber Vasconcelos Silva , Ferraz Marcílio Alves , Ladeia Fernando De Góes
Published: November 2019

Os implantes dentários correspondem a terapia que visa substituir, não apenas estética como funcionalmente, um elemento dentário que, por diversos motivos, pode ter sido perdido. Essa técnica tem sofrido diversas alterações no decorrer dos anos, destacando-se para o implante imediato, que corresponde à técnica na qual é realizada o procedimento de exodontia e, em seguida, a instalação de implantes, assim como outras terapias coadjunvante, como enxertos ósseos e de tecido conjuntivo. Assim, o objetivo deste estudo é relatar o caso clínico de uma paciente que sofreu trauma dentário em região ântero-superior, e reabilitação com implante dentário imediato associado a enxertos de tecidos ósseo e conjuntivo e prótese com carga imediata. Como resultado obteve-se devolução a estética e funcionalidade da paciente sejam reestabelecidas de forma satisfatória. Evidenciando a efetividade dos implantes dentários, quando bem indicados.
Fatores contribuintes para o Estresse em Discentes de Odontologia de uma Faculdade no Sudoeste Baiano / Contributing Factors to Stress in Dentistry Students at a College in Southwest Bahia
Authors: Cezimbra Luciana Araújo , Souza Fabiana Monteiro Braga , Trindade Victória Luzia Lopes
Published: November 2019

O estresse é compreendido como um estado de percepção de estímulos que desencadeia inquietação emocional que compromete a hemostasia e leva o organismo a disparar um processo de adaptação com alterações psicológicas e fisiológicas. Objetivo: O objetivo desse estudo foi avaliar a condição de estresse em discentes do curso de Odontologia em uma instituição de ensino superior do sudoeste baiano. Metodologia: Trata-se de um estudo analítico e quantitativo que foi utilizado o instrumento de questionário, com uma amostra de 117 estudantes do I, II, IX e X semestres, regularmente matriculados no curso de Odontologia de uma Instituição de Ensino Superior do Sudoeste Baiano. Resultados: Os resultados foram avaliados através da análise de dados, sendo categorizados em: características sociodemográficas dos participantes, condições de estudo e permanência no curso de Odontologia, prevalência de sinais físicos e emocionais. Dentre elas, destaca-se o nível de estresse no primeiro semestre (21,03 ± 4,62), no segundo (22,85 ± 5,14), no nono (23,28 ± 3,60) e o décimo semestre (24,92 ± 3,79). Conclusão: Em suma, os fatores estressores vivenciados por esses discentes podem interferir de forma direta na vivência acadêmica, bem como na qualidade do cuidado e segurança do paciente.
A importância do diagnóstico conclusivo na erupção fisiológica em dentes impactados por supranumerário: Caso Clínico / The importance of concclusion diagnosis in physiological eruption in theeth impacted by supernumerary: Case Report
Authors: Nascimento Ravena Madalena , Silva Fernanda Oliveira , Pinchemel Edite Novais Borges , Carvalho Milena Tavares de
Published: November 2019

Objetivo: Descrever um caso clínico de paciente pediátrico que obteve um diagnóstico tardio de um elemento supranumerário que impactava a erupção do dente permanente correspondente. Descrição do caso: Paciente de 8 anos de idade, gênero masculino, melanoderma, compareceu à clínica odontológica com queixa principal da ausência de um incisivo central superior. Em avalição clínica e radiográfica anterior, os pais foram orientados a aguardar um ano pela erupção do incisivo, pois tudo estava dentro da normalidade. Transcorridos 12 meses, como não houve a erupção, os pais procuraram outro profissional, que solicitou radiografia panorâmica confirmando o supranumerário e o dente incluso e impactado (estágio 09 de Nolla). Foram realizadas tomadas radiográficas periapicais pela técnica de Clarck, para localização exata do supranumerário, facilitando o acesso cirúrgico. Realizado o procedimento cirúrgico imediato, houve posterior acompanhamento clínico e radiográfico da erupção. O prognóstico para a erupção do dente impactado sem o tracionamento ortodôntico é duvidoso devido ao fechamento do ápice radicular. Conclusão: O diagnóstico correto, com a execução de um planejamento terapêutico adequado a cada caso, viabiliza a intervenção em tempo hábil para evitar complicações na erupção dentária.
Knowledge and Practice for Bio-Medical Waste Management among Healthcare Personnel at Kabgayi District Hospital, Rwanda
Authors: Rutayisire Erigene , Nsabimana Jean Aime , Habtu Michael
Published: November 2019

Background
Globally, about 10 to 25% of the volume of bio-medical waste from hospitals and healthcare institutions presents a serious health risks to patients, healthcare personnel, and anybody who comes in contact with it. The waste management practices in Rwanda healthcare facilities are poor and need improvement.

Objectives
To assess the knowledge and practices regarding bio-medical waste management among healthcare personnel at Kabgayi district hospital in Southern Province of Rwanda.

Materials and Methods
A cross-sectional study design was conducted. A total of 200 healthcare personnel were selected randomly out of 400 target population including doctors, nurses, social workers, and cleaners. Structured questionnaire was used to collect data. Descriptive analysis using frequency and proportions were used. Chi-Square test was used to determine the association between the variables and level of significance was set at p ≤ 0.05.

Results
The study found that about half (49.0%) of healthcare personnel had good knowledge about waste management. We found that the majority of healthcare personel 133(66.5%) had poor practices towards bio-medical waste management. The factors associated with good practice were better knowledge on bio-medical waste management (p=0.013) and older age group (p=0.001).

Conclusion/Recommendations
The level of in both knowledge and practice towards bio-medical waste management among healthcare personnel was low. Continuing education and training programmes and short courses on bio-medical waste management should be carried out to improve the knowledge and practices towards bio-medical waste management among healthcare personnel.
ANÁLISE EXPLORATÓRIA DOS DADOS CLIMÁTICOS E SUA INFLUÊNCIA NO Aedes aegypti, NO MUNICÍPIO DE CHAPECÓ/SC: RESULTADOS PARCIAIS
Authors: Matiola Cleusa , Ribeiro Eduardo Augusto Werneck
Published: November 2019

A dengue é uma doença viral que vem colocando em risco parte da população do mundo. O vírus é transmitido pelo Aedes aegypti, também transmissor do zika vírus e da febre chikungunya. O número de A. aegypti é significativo em Santa Catarina ao longo dos anos. As variações climáticas contribuem para o aumento do vetor, porém as condições socioeconômicas da população e a ação antrópica também influenciam. O objetivo deste estudo é uma análise exploratória das variáveis climáticas e possíveis correlações com o aumento de número de mosquitos em Chapecó/SC. Para isto,  foi realizado modelagem estatística do número de A. aegypti, disponibilizados pela Diretoria de Vigilância Epidemiológica de Santa Catarina (DIVE), com distribuição da precipitação, médias de temperatura mínimas e máximas com recorte diário, entre 2010 e 2017, fornecidos por Modern Era Retrospective-Analysis For Research and Applications (MERRA2) da NASA. A pesquisa se mostrou promissora, os dados de MERRA2, trazem uma escala temporal que possibilitaram o estudo do clima com a proliferação do mosquito, tendo em vista que nem toda cidade conta com estação meteorológica. Este trabalho apresenta resultados parciais da pesquisa ainda em desenvolvimento, no programa de mestrado profissional Clima e Ambiente do Instituto Federal de Santa Catarina (IFSC).
Analysing the chemistry in beauty blogs for curriculum innovation
Authors: Belova Nadja , Velikina Irina
Published: November 2019

Cosmetics play an important role in our everyday lives. However, the variety of different products and brands appears confusing to consumers. Products vary from basic, indispensable, everyday items such as soaps, shower gels and shampoos, to decorative cosmetics and high-end skin creams with specific, “innovative” ingredients for every skin type imaginable. In recent years, beauty blogs have become a popular platform to seek information on cosmetic products. Such blogs often contain chemistry-based content, which is only rarely written or at least double-checked by someone with a scientific background. Often such blogs reach a readership of several million users per month. But which role do chemical aspects play in beauty blog texts? This paper describes a qualitative content analysis of 60 recent posts from six popular English-language beauty blogs. The texts were coded according to categories such as the number of chemistry-related terms, supporting information for such terms, positive and negative claims regarding chemical aspects, references to studies etc. Based on the distribution of the categories, three main types of blogs could be distinguished: The “scientific type”, the “semi-scientific type” and “the non-scientific type”. By color-coding the different categories, a difference between these types can be easily depicted. The paper will discuss first findings and ideas on how to make use of corresponding analyses of beauty blogs for the teaching of chemistry.
Mathematical Study of a Class of Epidemiological Models with Multiple Infectious Stages
Authors: Bowong S. , Temgoua A. , Malong Y. , Mbang J.
Published: November 2019

This paper deals with the mathematical analysis of a general class of epidemiological models with multiple infectious stages for the transmission dynamics of a communicable disease. We provide a theoretical study of the model. We derive the basic reproduction number

R

0

$\mathcal R_0$

that determines the extinction and the persistence of the infection. We show that the disease-free equilibrium is globally asymptotically stable whenever

R

0

≤
1

$\mathcal R_0 \leq 1$

, while when

R

0

>
1

$\mathcal R_0 \gt 1$

, the disease-free equilibrium is unstable and there exists a unique endemic equilibrium point which is globally asymptotically stable. A case study for tuberculosis (TB) is considered to numerically support the analytical results.
Microtubule and Actin Differentially Regulate Synaptic Vesicle Cycling to Maintain High-Frequency Neurotransmission
Authors: Piriya Ananda Babu Lashmi , Wang Han-Ying , Eguchi Kohgaku , Guillaud Laurent , Takahashi Tomoyuki
Published: November 2019

Cytoskeletal filaments such as microtubules (MTs) and filamentous actin (F-actin) dynamically support cell structure and functions. In central presynaptic terminals, F-actin is expressed along the release edge and reportedly plays diverse functional roles, but whether axonal MTs extend deep into terminals and play any physiological role remains controversial. At the calyx of Held in rats of either sex, confocal and high-resolution microscopy revealed that MTs enter deep into presynaptic terminal swellings and partially colocalize with a subset of synaptic vesicles (SVs). Electrophysiological analysis demonstrated that depolymerization of MTs specifically prolonged the slow-recovery time component of EPSCs from short-term depression induced by a train of high-frequency stimulation, whereas depolymerization of F-actin specifically prolonged the fast-recovery component. In simultaneous presynaptic and postsynaptic action potential recordings, depolymerization of MTs or F-actin significantly impaired the fidelity of high-frequency neurotransmission. We conclude that MTs and F-actin differentially contribute to slow and fast SV replenishment, thereby maintaining high-frequency neurotransmission.

SIGNIFICANCE STATEMENTThe presence and functional role of MTs in the presynaptic terminal are controversial. Here, we demonstrate that MTs are present near SVs in calyceal presynaptic terminals and that MT depolymerization specifically prolongs the slow-recovery component of EPSCs from short-term depression. In contrast, F-actin depolymerization specifically prolongs fast-recovery component. Depolymerization of MT or F-actin has no direct effect on SV exocytosis/endocytosis or basal transmission, but significantly impairs the fidelity of high-frequency transmission, suggesting that presynaptic cytoskeletal filaments play essential roles in SV replenishment for the maintenance of high-frequency neurotransmission.
Sacred Sounds: The Cult of Pan and the Nymphs in the Vari Cave
Authors: Laferrière Carolyn M.
Published: November 2019

Religious ritual in ancient Greece regularly incorporated music, so much so that certain instruments or vocal genres frequently became associated with the religious veneration of specific gods. The Attic cult of Pan and the Nymphs should also be included among this group: though little is often known about the specific ritual practices, the literary and visual evidence associated with the cults make repeated reference to music performed on the panpipes—and to auditory and sensory stimuli more generally—as a prominent feature of the worship of these gods. I consider the Vari Cave, sacred to Pan and the Nymphs, together with the surviving marble votive reliefs from that space, to explore the sounds and sensations associated with the veneration of the rural gods. I argue that the sensory experience offered by the cave and the images within it would have enhanced the worshiper's experience of the ritual and the gods for whom they were performed. In this way, visual and auditory perceptions blurred together to create a powerful experience of the divine.
Adrenocortical carcinoma and pulmonary embolism from tumoral extension
Authors: Shekhar Skand , Gubbi Sriram , Papadakis Georgios Z , Nilubol Naris , Hannah-Shmouni Fady
Published: November 2019

Adrenococortical carcinoma (ACC) is a rare cancer, occurring at the rate of one case in two million person years. Cushing syndrome or a mixed picture of excess androgen and glucocorticoid production are the most common presentations of ACC. Other uncommon presentations include abdominal pain and adrenal incidentalomas. In the present report, a 71-year-old male presented with abdominal pain and was eventually diagnosed with ACC. He was found to have pulmonary thromboembolism following an investigation for hypoxemia, with the tumor thrombus extending upto the right atrium. This interesting case represents the unique presentation of a rare tumor, which if detected late or left untreated is associated with poor outcomes, highlighting the need for a low index of suspicion for ACC when similar presentations are encountered in clinical practice.

Learning points:

ACC is a rare but aggressive tumor.

ACC commonly presents with rapid onset of hypercortisolism, combined hyperandrogenism and hypercortisolism, or uncommonly with compressive symptoms.

Clinicians should have a low index of suspicion for ACC in patients presenting with rapid onset of symptoms related to hypercortisolism and/or hyperandrogenism.

Venous thromboembolism and extension of the tumor thrombus to the right side of the heart is a very rare but serious complication of ACC that clinicans should be wary of.

The increased risk of venous thromboembolism in ACC could be explained by direct tumor invasion, tumor thrombi or hypercoagulability secondary to hypercortisolism.

Early diagnosis and prompt treatment can improve the long-term survival of patients with ACC.
Educación y competitividad: una aplicación del enfoque de Michael Porter en El Salvador. Periodo 2014-2018
Authors: Sibrián Sánchez Kevin Alexis , Escobar Bonilla Valeria Cristina
Published: November 2019

El Salvador presenta la necesidad de garantizar un sistema educativo de calidad y de carácter universal, reconociendo el derecho a la educación que tiene cada individuo. Sin embargo, esto no es así, ya que se han presentado dificultades para formar el recurso humano con niveles de educación superior y capacitación continua. Esto se refleja en el bajo nivel de escolaridad promedio y la poca o nula capacidad para responder a las innovaciones tecnológicas.De acuerdo con Michael Porter, la formación del recurso humano requiere fortalecer la educación, hasta el punto de generar innovación en la economía, mejorando la productividad y competitividad en el ámbito global. Es así como, desde la óptica de Porter, la baja productividad y competitividad en El Salvador encuentra una de sus causas en la escasa formación del recurso humano, que implica que la mano de obra sea no especializada o semiespecializada. Parte del bajo nivel de competitividad reside precisamente en la poca atención al factor educativo. Esto se refleja en el reducido porcentaje de gasto público que se destina a educación, que pasó del 3.9 % del PIB al 3.8 % entre 2014 y 2017, según datos del Ministerio de Educación (Mined) y del Banco Central de Reserva (BCR) (Mined, 2018, p. 148).
On a mathematical model of dissociative adsorption and associative desorption
Authors: Ambrazevičius Algirdas , Eismontaitė Alicija
Published: November 2019

A mathematical model of dissociative adsorption and associative desorption for diatomic molecules is considered. The model is described by a system of parabolic and ordinary differential equations. The existence and uniqueness theorem of the classical solution is proved.
Classification of the real remotely sensed image covered with clouds
Authors: Stabingienė Lijana
Published: November 2019

In this paper supervised classification method is proposed. It is based on Bayes discriminant functions (BDF) and it deals with the problem of optimal classification for images, which are corrupted by natural phenomenon such as cloud, smoke or fog. Solving such a problem is very important when we have remotely sensed information, which very often is corrupted by clouds. For example, the remotely sensed images from the territory of Lithuania are very often corrupted by clouds. The idea of classification, using BDF with incorporated spatial dependency between the observation to be classified and the training sample is presented in earlier works of the author. The novelty of this paper is the method how to use these methods for the real situation, i.e. for the remotely sensed image which is naturally covered by clouds. Visual and numerical results are presented in this paper, which show the advantage of this method against BDF ignoring spatial dependency between training sample and observation to be classified and against the method using grey level cooccurrence matrices.
On the exact polynomial time algorithm for a special class of bimatrix game
Authors: Mockus Jonas , Sabaliauskas Martynas
Published: November 2019

The Strategy Elimination (SE) algorithm was proposed in [2] and implemented by a sequence of Linear Programming (LP) problems. In this paper an efficient explicit solution is developed and the convergence to the Nash Equilibrium is proven.Keywords: game theory, polynomial algorithm, Nash equilibrium.
THE INFLUENCE OF THE EUROPEAN UNION MULTILINGUALISM POLICY ON THE TRAINING OF FOREIGN LANGUAGE TEACHERS IN ROMANIAN UNIVERSITIES
Authors: Koroliova Larisa
Published: November 2019

The article highlited the European policy of multilingualism and multiculturalism of language education in European countries. Besides the article also deals with directions of joint activities of countries of the European Area in the organization of training foreign language teachers, the formation of uniform professional qualification standards for determining the professional definition of foreign language teachers, strategies and practical steps for the implementation of projects in the field of training foreign language teachers funded by the European Union and participation of European countries, in paticular Romania, in these projects. The European Union constantly emphasizes the fact that every citizen should be able to speak in his native language plus two other European languages, stresses the need to promote of linguistic diversity and the motivation of European citizens to learn less widely used languages and improve the quality of teaching foreign languages in educational establishments at different levels and focus its efforts to realize these ideas through the implementation of projects and programs that it has funded. The author focuses on the fact that Romania like all European countries is actively involved in the numerous projects and programs offered by the European Union as one of the priority areas of the Romanian Government is the quality of education at all levels and brings it in conformity with European standards. At the end of the article, the author concludes that the multilingual policy of the European Union has a certain influence on the training of foreign language teachers at the Romania Universities. The author also sums up that due to the participation in various educational projects and programs financed by the European Union among higher education institutions aimed at the development of multilingualism and multiculturalism of language education, the professional level of foreign languages teachers in Romania is increasing.
IMAGERY CREATED AND REFLECTED IN MULTILINGUAL POETIC TRANSLATIONS
Authors: Yashkina Victoria
Published: November 2019

Successful poetic text translation, as well as its entire possibility, has been of current relevance since the appearance of translations as they are, but have not received final solving. Linguists are proving failures of full conceptual, semantic and language preservation of the original in its translation. Both professionals and amateurs never stop arguing on the dilemma of equivalence versus adequacy. Translators offer numerous variants of one and the same poetic masterpiece with the aim of achieving maximum original beauty and sense. As a result, it becomes obvious, that the more different language translation samples appear, the better the original message of a poem is restored.   In given article we concentrated our attention on multilingual  translations of the original poems poems, specifically comparing grammar, lexical, phonetic and strophe-building translation variants and discussing discrepancies between the original and its Romanic and Slavic translations. The main aim lies in an attempt to prove that multilingual translation practice serves as a source for translation variants to add to each other or open different aspects of the original, and, possibly, to achieve perfect revealing of a poetic masterpiece. It has been proved by the research, that noncoincidence of certain translation equivalents accompanied by full correspondence of others, results in definite semantic loss. This fact underlines urgency of multilingual translations as means of achieving as full poetic texts comprehension as it is possible in other languages.
KEPEMIMPINAN OTENTIK DALAM ORGANISASI
Authors: Winbaktianur Winbaktianur , Sutono Sutono
Published: November 2019

The purpose of this study is to explain the concept of authentic leadership. Authentic leadership includes something that has growing rapidly in the last two decades, and it is interesting to discuss. Authentic leadership as a pattern of leader behavior that utilizes and enhances positive psychological capacity and a positive ethical climate, to foster greater self-awareness, internalized moral perspective, balanced information processing, and relational transparency from leaders who work with followers, encourage positive self-development. In its implementation authentic leadership is a leader who is able to be honest with himself and followers. Authentic leaders must be aware of themselves and be able to foster self-awareness of their employees to work optimally in the organization.
PENGARUH MEMBACA AL-QUR’AN TERHADAP PENINGKATAN ADVERSITY QUOTIENT PADA SISWI ASRAMA SITI KHADIJAH
Authors: Murisal Murisal , Arianti Dian
Published: November 2019

Al-Qur'an which was revealed to change the thoughts, attitudes and human behavior and pointed at them. So that humans can avoid the downturn in the face of life problems. Each individual has a different response to the problem it faces. Some choose to avoid problems and some struggle to resolve the issue. This is seen from the toughness or the individual's Adveristy Quotient. Adversity Quotient is one form of intelligence that underlies one's success in facing a challenge in the event of difficulty or failure. In this case reading the Qur'an that is reflected to the teenager to get motivation and understanding of his views on the problems they face. As well as through reading the Qur'an will contribute to the improvement of adolescent Adversity Quotient.The research method used is pure experimental method, with pretest-posttest control group design design with 38 subjects. Subjects were selected based on randomization measured using Adveristy Quotient scale, divided into two groups: the experimental group and the control group, each group was 19 people. The experimental group was given the treatment of reading al-Qur'an, while the control group did not. Based on the pretest results, the experimental group and the control group showed moderate category Adversity Quotient. In the posttest results, the experimental group experienced improvement after treatment. While the untreated control group did not increase, even the decrease of Adversity QuotientThe result of the research proves that the giving of treatment in reading al-Qur'an has an effect on the increase of Adversity Quotient to the students of hostel Siti Khadijah MAN Koto Baru Solok. Adversity Quotient scale proves that the implementation of reading al-Qur'an takes place smoothly for the participants.