bluuebunny/crossref_metadata_2025 huggingface dataset:
Queueing Models of Case Managers
Authors: Campello Fernanda , Ingolfsson Armann , Shumsky Robert A.
Published: March 2016

Many service systems use case managers, servers who are assigned multiple customers and have frequent, repeated interactions with each customer until the customer’s service is completed. Examples may be found in healthcare (emergency department physicians), contact centers (agents handling multiple online chats simultaneously) and social welfare agencies (social workers with multiple clients). We propose a stochastic model of a baseline case-manager system, formulate models that provide performance bounds and stability conditions for the baseline system, and develop two approximations, one of which is based on a two-time-scale approach. Numerical experiments and analysis of the approximations show that increasing case throughput by increasing the probability of case completion can lead to much greater waiting-time reductions than increasing service speed. Many systems place an upper limit on the number of customers simultaneously handled by each case manager. We examine the impact of these caseload limits on waiting time and describe effective, heuristic methods for setting these limits.

This paper was accepted by Yossi Aviv, operations management.
Target Firm-Specific Information and Acquisition Efficiency
Authors: Martin Xiumin , Shalev Ron
Published: March 2016

This study investigates whether firm-specific information about targets improves acquisition efficiency. We define acquisition efficiency as the total surplus generated by an acquisition and measure it as the difference in the value of the merged firm and the sum of the two firms operating separately. We find a positive association between target firm-specific information and acquisition efficiency that is driven mainly by diversifying acquisitions. Additional evidence suggests that both the likelihood of the withdrawal of an announced acquisition and the likelihood of a future divestiture of a target decrease with target firm-specific information. Taken together, our findings suggest that the availability of this information improves merger and acquisitions efficiency.

This paper was accepted by Mary Barth, accounting.
Rate-Based Daily Arrival Process Models with Application to Call Centers
Authors: Oreshkin Boris N. , Réegnard Nazim , L’Ecuyer Pierre
Published: March 2016

We propose, develop, and compare new stochastic models for the daily arrival rate in a call center. Following standard practice, the day is divided into time periods of equal length (e.g., 15 or 30 minutes), the arrival rate is assumed random but constant in time in each period, and the arrivals are from a Poisson process, conditional on the rate. The random rate for each period is taken as a deterministic base rate (or expected rate) multiplied by a random busyness factor having mean 1. Models in which the busyness factors are independent across periods, or in which a common busyness factor applies to all periods, have been studied previously. But they are not sufficiently realistic. We examine alternative models for which the busyness factors have some form of dependence across periods. Maximum likelihood parameter estimation for these models is not easy, mainly because the arrival rates themselves are never observed. We develop specialized techniques to perform this estimation. We compare the goodness-of-fit of these models on arrival data from three call centers, both in-sample and out-of-sample. Our models can represent arrivals in many other types of systems as well. Estimating a model for the vector of counts (the number of arrivals in each period) is generally easier than for the vector of rates, because the counts can be observed, but a model for the rates is often more convenient and natural, e.g., for simulation. We examine and provide insight on the relationship between these two types of modeling. In particular, we give explicit formulas for the relationship between the correlation between rates and that between counts in two given periods, and for the variance and dispersion index in a given period. These formulas imply that for a given correlation between the rates, the correlation between the counts is much smaller in low traffic than in high traffic.
Minor burn management: an Australian regional perspective
Authors: Madsen W. , Flanders M. , Reid-Searl K. , Jones J. , Jirojwong S.
Published: March 2016

Minor burns are commonly treated in hospital emergency departments. This study aimed to identify the nursing management of minor burns in hospitals in the Queensland region of Australia.

A total of 200 questionnaires were distributed to hospitals with emergency departments in this region. The semi-structured questionnaire enquired about the respondents' initial and ongoing management of minor burns. Fifty completed questionnaires were returned, a response rate of 25%. Most respondents (80%) were registered nurses and the rest enrolled nurses.

The respondents' practice was compared with that recommended in the literature. Their practice reflected the variations found in the literature, suggesting that some may not be as effective or efficient as others. The authors conclude that further research is required on the efficacy of products used in minor burn management.
Enhancing Effective Chemistry Learning Through Hypermedia Instructional Mode of Delivery
Authors: Oluwafemi Mutahir
Published: March 2016

This study provides a framework for the production of Hypermedia Instructional package. It also assessed the effectiveness of hypermedia instructional mode of delivery on students’ performance in Chemistry. This is with a view of improving the learning of Chemistry which may eventually help to improve students’ performance. The developmental study employed a pre-test, post-test control group design. The research sample consisted of 60 private secondary school students in Osun State with an enrolment of 30 students from each of the two schools selected. The students were thereafter assigned to experimental and control groups. The stimulus material used for the experimental group was the Hypermedia Instructional Package, while the Control group received instruction with similar content through the conventional method. The test instrument used was Hypermedia Learning Achievement Test (HLAT). Content and face validity of the instrument used was carried out by experts in the area of tests and measurement. The Cronbach’s alpha reliability coefficient for the HLAT gave a value of 0.72. Data collected were analyzed using descriptive and inferential statistics. Results obtained showed that students exposed to the Hypermedia Instructional Package (HIP) performed significantly better than those exposed to the conventional teaching method (t = 5.458, df = 58, p < 0.05). Results also revealed a significant difference in the retention ability of students in Chemistry between those exposed to the package and those that were not (t= 6.842, df=58, p<0.05). The study concluded that the use of HIP was an intervention which improved students’ performance retention and attitude towards Chemistry.
Cyclic Refinements of the Different Versions of Operator Jensen's Inequality
Authors: Horvath Laszlo , Khan Khuram , Pecaric Josip
Published: March 2016

Refinements of the operator Jensen's inequality for convex and operator convex functions are given by using cyclic refinements of the discrete Jensen's inequality. Similar refinements are fairly rare in the literature. Some applications of the results to norm inequalities, the Holder McCarthy inequality and generalized weighted power means for operators are presented.
Shade tree species diversity and coffee productivity in Sumberjaya, West Lampung, Indonesia
Authors: EVIZAL RUSDI , SUGIATNO SUGIATNO , PRASMAWATI FEMBRIARTI ERRY , NURMAYASARI INDAH
Published: March 2016

Evizal R, Sugiatno, Prasmatiwi FE, Nurmayasari I. 2016. Shade tree species diversity and coffee productivity in Sumberjaya,Â West Lampung, Indonesia. Biodiversitas 17: 234-240. Shade tree is an important variable that determines the productivity andÂ sustainability of coffee plantation. In West Lampung, Indonesia coffee is grown on private land and on state land of Community ForestÂ Program (CFP) using various types of shade trees. The research explored the diversity of shade trees and its influence on theÂ productivity of coffee farms. The study area was one purposively sampled coffee farmer group in Sumberjaya District, West Lampung.Â We purposively chose one coffee farmer group. The group membersâ€™ farms located in private land and in CFP land were sampledÂ randomly, each consisted of 18 farms. From each farm, we observed a plot of 50 m x 50 mand interviewed the farmer who managed theÂ farm. Data collected were on the species and the number of trees, farm age, coffee tree densities, and productivity of coffee in the last 3Â years. Data analyses of important value, tree species diversity, correlation, and regression were performed. Shade trees found in coffeeÂ farms of Sumberjaya were 36 species, 10 species (28%) of them were legume trees. Technical shade trees that have high importance value were Gliricidia sepium and Erythrina subumbrans. Multi Purpose Trees Species (MPTS) widely planted were Durio zibethinusÂ and Parkia speciosa. The wood trees with a high importance value in the CFP coffee farms were Shorea javanica and MicheliaÂ champaca while in private coffee farms were Maesopsis eminii and Litsea sp. Based on Shannonâ€™s index (Hâ€™) and Simpsonâ€™s dominanceÂ index (Î»), a high diversity of shade tree species was found in CFP coffee farms at age â‰¥20 years. Shade trees with high dominance indexÂ had a positive effect on productivity of coffee and the percentage of MPTS had a negative effect. Whereas, the types of land tenure (private or CFP)Â and the abundance of shade trees did not affect the productivity of coffee.
Challenges for Worldwide Harmonization of Newborn Screening Programs
Authors: Martínez-Morillo Eduardo , Prieto García Belén , Álvarez Menéndez Francisco V
Published: March 2016

BACKGROUND

Inherited metabolic disorders (IMDs) are caused by a defect in a metabolic pathway, leading to malfunctioning metabolism and/or the accumulation of toxic intermediate metabolites. To date, hundreds of IMDs have been identified. Many of these diseases are potentially fatal conditions that are not apparent at birth. Newborn screening (NBS) programs involve the clinical and laboratory examination of neonates who exhibit no health problems, with the aim of discovering those infants who are, in fact, suffering from a treatable condition.

CONTENT

In recent years, the introduction of tandem mass spectrometry has allowed the expansion of screening programs. However, this expansion has brought a high degree of heterogeneity in the IMDs tested among different NBS programs. An attempt to harmonize the metabolic conditions recommended to be screened has been carried out. Two uniform screening panels have been proposed in the US and European Union, by knowledgeable organizations. Here, we review current evidence-based processes to assess and expand NBS programs. We also discuss the IMDs that have recently been introduced in some screening programs, such as severe combined immunodeficiencies, lysosomal storage disorders, and adrenoleukodystrophy.

NBS programs have been an established public health function for more than 50 years to efficiently and cost-effectively identify neonates with severe conditions. However, NBS is not yet optimal. This review is intended to elucidate the current degree of harmonization of NBS programs worldwide as well as to describe the major controversial points and discuss the multiple challenges that must be confronted in expanded NBS strategies.
Early-Phase Studies of Biomarkers: What Target Sensitivity and Specificity Values Might Confer Clinical Utility?
Authors: Pepe Margaret S , Janes Holly , Li Christopher I , Bossuyt Patrick M , Feng Ziding , Hilden Jørgen
Published: March 2016

BACKGROUND

Many cancer biomarker research studies seek to develop markers that can accurately detect or predict future onset of disease. To design and evaluate these studies, one must specify the levels of accuracy sought. However, justified target levels are rarely available.

METHODS

We describe a way to calculate target levels of sensitivity and specificity for a biomarker intended to be applied in a defined clinical context. The calculation requires knowledge of the prevalence or incidence of cases in the clinical population and the ratio of benefit associated with the clinical consequences of a positive biomarker test in cases (true positive) to cost associated with a positive biomarker test in controls (false positive). Guidance is offered on soliciting the cost/benefit ratio. The calculations are based on the longstanding decision theory concept of providing a net benefit on average in the population, and they rely on some assumptions about uniformity of costs and benefits to those tested.

RESULTS

Calculations are illustrated with 3 applications: predicting colon cancer recurrence in stage 1 patients; predicting interval breast cancer (between mammography screenings); and screening for ovarian cancer.

CONCLUSIONS

It is feasible to specify target levels of biomarker performance that enable evaluation of the potential clinical impact of biomarkers in early-phase studies. Nevertheless, biomarkers meeting the criteria should still be tested rigorously in studies that measure the actual impact on patient outcomes of using the biomarker to make clinical decisions.
Biological Variation: The Effect of Different Distributions on Estimated Within-Person Variation and Reference Change Values
Authors: Røraas Thomas , Støve Bård , Petersen Per Hyltoft , Sandberg Sverre
Published: March 2016

BACKGROUND

Good estimates of within-person biological variation, CVI, are essential for diagnosing and monitoring patients and for setting analytical performance specifications. The aim of the present study was to use computer simulations to evaluate the impact of various measurement distributions on different methods for estimating CVI and reference change value (RCV).

METHOD

Data were simulated on the basis of 3 models for distributions of the within-person effect. We evaluated 3 different methods for estimating CVI: standard ANOVA, ln-ANOVA, and CV-ANOVA, and 3 different methods for calculating RCV: classic, ln-RCV, and a nonparametric method. We estimated CVI and RCV with the different methods and compared the results with the true values.

RESULTS

The performance of the methods varied, depending on both the size of the CVI and the type of distributions. The CV-ANOVA model performed well for the estimation of CVI with all simulated data. The ln-RCV method performed best if data were ln-normal distributed or CVI was less than approximately 12%. The nonparametric RCV method performed well for all simulated data but was less precise.

CONCLUSIONS

The CV-ANOVA model is recommended for both calculation of CVI and the step-by-step approach of checking for outliers and homogeneity in replicates and samples. The standard method for calculation of RCV should not be used when using CVs.
A study of prey-predator model with harvesting on susceptible prey and predator
Authors: Verma Dinesh , Badshah V.H. , Jain Suman , Kadam Nayna
Published: March 2016

In this paper, we study the prey predator model with susceptible prey and predator. Stability of the system is discussed in the present model. We analyzed the model in terms of catch rate coefficient.
PENGALAMAN WISATAWAN DALAM LINGKUNGAN BINAAN: STRATEGI DISAIN LINGKUNGAN FISIK DAN INTEGRASINYA
Authors: Muazir Syaiful
Published: March 2016

Recent day, tourism has become one of the important (experience) industries, which has ability to promoted financial sector growth, steering physical development, and self-promotion event. In sum, tourism has many perspective fields of studies, and some of them are city-regional studies, built environment and architecture. The aim of this paper is to provide a perspective on the“design structure” and also the integration in multi-disciplinary level in a perspective of physical environmental design (built environment). The construction of ideas was done through deepening and searching of related literatures and then complemented by practices side reviewed. In the realm of physical environmental design, theoretically, there are some multi-disciplinary considerations; emotional-personal to the adaptation of physical design process. And, some of the approaches may be formed by “frame” of: architectural design, zoning and division, routes and circulation, natural condition, as well as technology utilization.
On invariance of plurigenera for foliations on surfaces
Authors: Cascini Paolo , Floris Enrica
Published: March 2016

We show that if

(

X
t

,

ℱ
t

)

t
∈
Δ

{(X_{t},\mathcal{F}_{t})_{t\in\Delta}}

is a family of foliations with reduced singularities on a smooth family of surfaces, then invariance of plurigenera

h
0

⁢

(

X
t

,

m
⁢

K

ℱ
t

)

{h^{0}(X_{t},mK_{\mathcal{F}_{t}})}

holds for sufficiently large m.
On the other hand, we provide examples on which the result fails, for small values of m.
On convergence rates for asymptotic discrepancy principle
Authors: Bakushinsky Anatoly , Smirnova Alexandra
Published: March 2016

A series of recent numerical experiments for parameter estimation inverse problems in epidemiology [7, 6] have indicated that applicability of the discrepancy principle (DP) does not depend on the structure of a particular regularizing operator. This observation confirmed the original theoretical analysis by Bakushinsky [1, 2] on the construction of fairly general stabilizing algorithms in Banach and Hilbert spaces. In [7, 6], a unified approach to the implementation of the DP for linear ill-posed problems, the Abstract Discrepancy Principle, has been proposed and justified. The current paper investigates the convergence rates of the ADP. Special cases of sectorial and self-adjoint operators are studied.
Inverse spectral problems of transmission eigenvalue problem for anisotropic
media with spherical symmetry assumptions
Authors: Xu Xiao-Chuan , Yang Chuan-Fu , Buterin Sergey A.
Published: March 2016

We investigate the inverse spectral problem of the interior transmission eigenvalue problem for an anisotropic
medium supported in

D
:=

{
x
:

r
=

|
x
|

≤
1

}

${D:=\{{\rm x}:r=|{\rm x}|\leq 1\}}$

:

{

α
⁢
Δ
⁢
u

+

k
2

⁢
n
⁢
u

=
0

,

Δ
⁢
v

+

k
2

⁢
v

=
0

,

x
∈
D

,

$\left\{\begin{aligned} \displaystyle\alpha\Delta u+k^{2}nu&\displaystyle=0,\\
\displaystyle\Delta v+{k^{2}}v&\displaystyle=0,\quad\mathrm{x}\in D,\end{%
aligned}\right.$

with the boundary conditions

u
=
v

${u=v}$

,

α
⁢
ν

⋅

∇
⁡
u

=

ν
⋅

∇
⁡
v

${\alpha\nu\cdot\nabla u=\nu\cdot\nabla v}$

for

x
∈

∂
⁡
D

${{\rm x}\in\partial D}$

, where α and n are physical parameters. In the spherical symmetry case, we consider the case

α
≠
1

${\alpha\neq 1}$

, whereas most previous
work deals with

α
=
1

${\alpha=1}$

only. In this paper we prove that all transmission eigenvalues (including multiplicity) uniquely determine n and α under the condition

a
:=

∫
0
1

n
⁢

(
r
)

/
α

⁢

𝑑
r

≤
1

${a:=\int_{0}^{1}{\sqrt{n(r)/\alpha}\,dr}\leq 1}$

, and provide construction algorithms. In particular, when

a
=
1

${a=1}$

one needs an additional condition for unique recovery and reconstruction.
Laos in 2015
Authors: Ku Samuel C. Y.
Published: March 2016

Laos’ economy declined slightly in 2015, but its political and economic integration with neighboring countries gradually deepened. While China continued to be a key actor in Vientiane’s foreign relations, Laos’ ties with neighboring Vietnam, Thailand, Cambodia, and even Japan and South Korea also strengthened in 2015.
Cambodia in 2015
Authors: O’Neill Daniel C.
Published: March 2016

The political compromise and cooperation established in 2014 between Prime Minister Hun Sen’s long-ruling Cambodian People’s Party and opposition leader Sam Rainsy’s Cambodian National Rescue Party (CNRP) continued into 2015, highlighted by electoral reforms in March. However, by mid-year, CNRP criticism of Hun Sen led to a crackdown and the self-imposed exile of Rainsy and other high-ranking members of the opposition.
North Korea in 2015
Authors: Hayes Peter , Cavazos Roger
Published: March 2016

North Korea upgraded its nuclear and military power and grew its economy slightly, thereby realizing Kim Jong Un’s byungjin line. It also attempted to open new external fronts and to coerce the South to cooperate on its terms, but failed. Instead, it retreated into a repaired relationship with China.
Acute exercise restores insulin clearance in diet-induced obese mice
Authors: Kurauti Mirian A , Costa-Júnior José M , Ferreira Sandra M , dos Santos Gustavo J , Protzek André O P , Nardelli Tarlliza R , de Rezende Luiz F , Boschero Antonio C
Published: March 2016

The aim of this study was to investigate the insulin clearance in diet-induced obese (DIO) mice submitted to acute endurance exercise (3h of treadmill exercise at 60–70% VO2max). Glucose-stimulated insulin secretion in isolated islets; ipGTT; ipITT; ipPTT; in vivo insulin clearance; protein expression in liver, skeletal muscle, and adipose tissue (insulin degrading enzyme (IDE), insulin receptor subunitβ(IRβ), phospho-Akt (p-Akt) and phospho-AMPK (p-AMPK)), and the activity of IDE in the liver and skeletal muscle were accessed. In DIO mice, acute exercise reduced fasting glycemia and insulinemia, improved glucose and insulin tolerance, reduced hepatic glucose production, and increased p-Akt protein levels in liver and skeletal muscle and p-AMPK protein levels in skeletal muscle. In addition, insulin secretion was reduced, whereas insulin clearance and the expression of IDE and IRβ were increased in liver and skeletal muscle. Finally, IDE activity was increased only in skeletal muscle. In conclusion, we propose that the increased insulin clearance and IDE expression and activity, primarily, in skeletal muscle, constitute an additional mechanism, whereby physical exercise reduces insulinemia in DIO mice.
Identification of altered microRNAs and mRNAs in the cumulus cells of PCOS patients: miRNA-509-3p promotes oestradiol secretion by targeting MAP3K8
Authors: Huang Xin , Liu Chang , Hao Cuifang , Tang Qianqing , Liu Riming , Lin Shaoxia , Zhang Luping , Yan Wei
Published: March 2016

Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder in women and is characterised by polycystic ovaries, hyperandrogenism and chronic anovulation. Although the clinical and biochemical signs of PCOS are typically heterogeneous, abnormal folliculogenesis is considered a common characteristic of PCOS. Our aim is to identify the altered miRNA and mRNA expression profiles in the cumulus cells of PCOS patients to investigate their molecular function in the aetiology and pathophysiology of PCOS. In this study, the miRNA expression profiles of the cumulus cell samples isolated from five PCOS and five control patients were determined by an miRNA microarray. At the same time, the altered mRNA profiles of the same cumulus cell samples were also identified by a cDNA microarray. From the microarray data, 17 miRNAs and 1263 mRNAs showed significantly different expression in the PCOS cumulus cells. The differentially expressed miRNA-509-3p and its potential target gene (MAP3K8) were identified from the miRNA and mRNA microarrays respectively. The expression of miRNA-509-3p was up-regulated and MAP3K8 was down-regulated in the PCOS cumulus cells. The direct interaction between miRNA-509-3p and MAP3K8 was confirmed by a luciferase activity assay in KGN cells. In addition, miRNA-509-3p mimics or inhibitor transfection tests in KGN cells further confirmed that miRNA-509-3p improved oestradiol (E2) secretion by inhibiting the expression of MAP3K8. These results help to characterise the pathogenesis of anovulation in PCOS, especially the regulation of E2 production.
Safety of an Oral Fixed Combination of Netupitant and Palonosetron (NEPA): Pooled Data From the Phase II/III Clinical Program
Authors: Aapro Matti , Hesketh Paul J. , Jordan Karin , Gralla Richard J. , Rossi Giorgia , Rizzi Giada , Palmas Marco
Published: March 2016

Background.

Standard prophylaxis for chemotherapy-induced nausea and vomiting (CINV) with highly emetogenic and anthracycline-cyclophosphamide-based chemotherapy includes a 5-hydroxytryptamine-3 receptor antagonist, a neurokinin-1 receptor antagonist (NK1RA), and corticosteroid therapy. NEPA is a fixed combination of netupitant and palonosetron. The primary objective of this analysis was to document the safety profile, including cardiac safety, of NEPA + dexamethasone in comparison with current therapies across all phase II/III trials.

Materials and Methods.

This pooled analysis was based on data from 3,280 patients in 4 randomized, double-blind clinical trials. Patients were categorized into 1 of 3 pooled groups on the basis of actual treatment received: NEPA + dexamethasone, palonosetron + dexamethasone, and aprepitant + ondansetron/palonosetron + dexamethasone. Safety was assessed by number and frequency of adverse events (AEs) and changes from baseline electrocardiogram measures.

Results.

Most patients were female and younger than 65 years of age. Demographic characteristics varied among studies and pooled groups. Frequencies of treatment-emergent AEs (TEAEs) and treatment-related AEs (TRAEs) were similar across groups. TEAEs were mostly mild and consistent with expected chemotherapy and disease-related AEs (hematologic events, hair loss, general weakness). TRAEs in ≥2% of patients were headache and constipation. Frequencies of cardiac TEAEs were similar across groups, with QT prolongation (1.6%), tachycardia (1.1%), and dyspnea (0.9%) the most common. Serious cardiac TEAEs were rare.

Conclusion.

NEPA was well-tolerated, with an AE profile as expected for the regimen. Sample size, demographic characteristics, study design, chemotherapy, and antiemetic regimen differences across the four studies may have contributed to differences in frequencies of neutropenia and alopecia. Adding an NK1RA to a CINV prophylaxis regimen can improve outcomes without additional toxicity.
Forty-Year Trends in Cholangiocarcinoma Incidence in the U.S.: Intrahepatic Disease on the Rise
Authors: Saha Supriya K. , Zhu Andrew X. , Fuchs Charles S. , Brooks Gabriel A.
Published: March 2016

Background.

Challenges in the diagnosis and classification of cholangiocarcinoma have made it difficult to quantify the true incidence of this highly aggressive malignancy.

Methods.

We analyzed the Surveillance, Epidemiology, and End Results data to assess long-term trends in the age-standardized incidence of intrahepatic and extrahepatic cholangiocarcinoma between 1973 and 2012, correcting for systematic coding errors. Because intrahepatic cholangiocarcinoma (ICC) may frequently be misdiagnosed as cancer of unknown primary (CUP), we also analyzed trends in the incidence of CUP.

Results.

Between 1973 and 2012, the reported U.S. incidence of ICC increased from 0.44 to 1.18 cases per 100,000, representing an annual percentage change (APC) of 2.30%; this trend has accelerated during the past decade to an APC of 4.36%. The incidence of extrahepatic cholangiocarcinoma increased modestly from 0.95 to 1.02 per 100,000 during the 40-year period (APC, 0.14%). The incidence of CUP with histologic features potentially consistent with cholangiocarcinoma decreased by 51% between 1973 and 2012 (APC, −1.87%), whereas the incidence of CUP with squamous or nonepithelial histologic features increased modestly (APC, 0.42%).

Conclusion.

The recognized incidence of ICC in the U.S. continues to rise, whereas the incidence of ECC is stable. The incidence of CUP has fallen dramatically during the same time period.
Mitochondrial Pathology and Glycolytic Shift during Proximal Tubule Atrophy after Ischemic AKI
Authors: Lan Rongpei , Geng Hui , Singha Prajjal K. , Saikumar Pothana , Bottinger Erwin P. , Weinberg Joel M. , Venkatachalam Manjeri A.
Published: March 2016

During recovery by regeneration after AKI, proximal tubule cells can fail to redifferentiate, undergo premature growth arrest, and become atrophic. The atrophic tubules display pathologically persistent signaling increases that trigger production of profibrotic peptides, proliferation of interstitial fibroblasts, and fibrosis. We studied proximal tubules after ischemia-reperfusion injury (IRI) to characterize possible mitochondrial pathologies and alterations of critical enzymes that govern energy metabolism. In rat kidneys, tubules undergoing atrophy late after IRI but not normally recovering tubules showed greatly reduced mitochondrial number, with rounded profiles, and large autophagolysosomes. Studies after IRI of kidneys in mice, done in parallel, showed large scale loss of the oxidant–sensitive mitochondrial protein Mpv17L. Renal expression of hypoxia markers also increased after IRI. During early and late reperfusion after IRI, kidneys exhibited increased lactate and pyruvate content and hexokinase activity, which are indicators of glycolysis. Furthermore, normally regenerating tubules as well as tubules undergoing atrophy exhibited increased glycolytic enzyme expression and inhibitory phosphorylation of pyruvate dehydrogenase. TGF-β antagonism prevented these effects. Our data show that the metabolic switch occurred early during regeneration after injury and was reversed during normal tubule recovery but persisted and became progressively more severe in tubule cells that failed to redifferentiate. In conclusion, irreversibility of the metabolic switch, taking place in the context of hypoxia, high TGF-β signaling and depletion of mitochondria characterizes the development of atrophy in proximal tubule cells and may contribute to the renal pathology after AKI.
EFEITOS DA ELETROLIPOLISE NA ADIPOSIDADE ABDOMINAL: REVISÃO
Authors: Valentim da Silva Rodrigo Marcel , Basilio Franciane Batista , Nóbrega Mariana Gurgel , Beserra de Medeiros Clarissa Raquel
Published: March 2016

Introdução: O excesso de gordura abdominal tem afetado uma grande parcela da população que se preocupa com a aparência. A adiposidade localizada é o acúmulo do excesso de gordura em regiões especificas do corpo humano. A eletrolipólise é uma técnica de microcorrente específica de baixa freqüência destinada ao tratamento das adiposidades e acúmulo de ácidos graxos localizados. Objetivo: Observar os efeitos da eletrolipolise na adiposidade abdominal. Método: Trata-se de uma revisão sistemática, a qual foi constituída por estudos experimentais de 2002 até o ano de 2012 publicados nas bases de dados indexadas Bireme, Lilacs e Scielo. Resultados: Observou-se que a maioria dos estudos verificou redução da adiposidade localizada, utilizando a eletrolipólise. Conclusão: Pode-se concluir que existe uma escassez na literatura referente ao uso da eletrolipólise sobre adiposidade abdominal, sendo necessário novos estudos relativos ao tema.
APLICAÇÃO DO KINESIO TAPING® ASSOCIADO À CINESIOTERAPIA NA CORREÇÃO DA MARCHA PÓS ACIDENTE VASCULAR ENCEFÁLICO
Authors: Pereira Junior Altair Argentino , Butzke Jaqueline , Persuhn Jéssica Janaína
Published: March 2016

Introdução: O Acidente Vascular Encefálico (AVE) representa a sexta causa mais importante de enfermidades em todo o mundo e nos Estados Unidos é a terceira causa de morte mais comum. Uma das sequelas mais comuns nos hemiparetico é o déficit da marcha, que é caracterizada por alterações na fase de balanço e apoio. Objetivo: verificar a influência da aplicação do Método Kinesio Taping® associado à Cinesioterapia nas alterações da marcha do paciente pós AVE. Estudo do Caso: Estudo realizado na forma de relato de caso, experimental, quantitativo, qualitativo, realizado na Clínica de Fisioterapia Benedito, na cidade de Benedito Novo, paciente do sexo feminino, 32 anos de idade, com diagnóstico de AVE do tipo Isquêmico, há 5 anos, apresenta hemiparesia em lado direito. Resultados e Discussão: Houve uma diminuição da espasticidade do membro afetado, um aumento da amplitude de movimento global, colaborando assim para uma melhor execução e velocidade da marcha e do equilíbrio nas atividades de vida diária. Conclusão: Considerando as evidências encontradas neste estudo, o mesmo pode ser considerado relevante na prática, onde acredita-se que o método Kinesio Taping® associado à cinesioterapia pode reduzir a alteração na marcha do paciente com AVE.
Efeito do telemonitoramento no pós-operatório de idosos facectomizados: ensaio clínico randomizado
Authors: Delphino Tallita Mello , Santana Rosimere Ferreira
Published: March 2016

Problema: a cirurgia de facectomia tem sido cada vez mais frequente e, com isso, há necessidade de estratégias que auxiliem a recuperação cirúrgica e o seguimento pós-operatório. Objetivos: testar o efeito da intervenção acompanhamento por telefone comparado ao tratamento convencional em pacientes idosos em pós-operatório de facectomia; analisar a incidência do diagnóstico de enfermagem em recuperação cirúrgica retardada ao longo de quatro semanas no grupo acompanhado por telefone e no grupo controle. Método: ensaio clínico randomizado cego que está sendo realizado em um hospital universitário no município de Niterói/RJ. A amostra, obtida por cálculo amostral pela analise estatística de Pocock (1983), será de 48 sujeitos divididos em igual número entre grupos de experimento e controle, de forma randomizada.
Trajetória de vida dos pescadores vítimas de lesão medular por mergulho: experiências, representações sociais e estresse
Authors: Cavalcante Eliane Santos , Miranda Francisco Arnoldo Nunes de
Published: March 2016

Objetivo: analisar as representações sociais, níveis de estresse e experiências dos pescadores vítimas de lesão medular por acidente de mergulho. Método: estudo exploratório-descritivo com dados quantitativos, qualitativos e representacionais. Desenvolvido em colônias de pescadores de nove praias do litoral Norte/RN, com 44 pescadores, entre outubro de 2013 a agosto de 2014. Utilizou-se entrevista semiestruturada, questões fechadas e semiabertas, dados analisados por meio de estatística descritiva e analítica do software ALCESTE à luz da análise da Teoria das Representações Sociais e análise de conteúdo. Resultados: Os participantes eram do sexo masculino, média de idades de 49,6 anos, ensino fundamental (68,2%), casados (77,3%) e com sequela de paraplegia (50%). Os dados qualitativos originaram sete categorias. Conclusão: as representações sociais sobre a Lesão Medular se encontram em momento de transição entre o antes e depois com atividade da pesca impedida, enfrentamento da situação com potenciais remanescentes e acometimento de estresse.
Mensuração de área de úlceras venosas por meio de dois softwares: reprodutibilidade de testes
Authors: Eberhardt Thaís Dresch , Lima Suzinara Beatriz Soares de , Dias Lopes Luis Felipe , De Avila Soares Rhea Silvia , Kessler Marciane
Published: March 2016

Objetivo: comparar a mensuração de área de úlceras venosas por meio dos softwares AutoCAD® e Image Tool. Método: pesquisa de avaliação de reprodutibilidade de testes, com abordagem quantitativa. Na amostra (por julgamento), serão incluídos todos os pacientes portadores de úlceras venosas atendidos no período de coleta de dados (março a julho de 2015); excluem-se os pacientes com idade inferior a 18 anos, capacidade cognitiva diminuída ou comunicação verbal prejudicada sem acompanhante e portadores de úlcera que se estenda por mais de uma face do membro inferior. A coleta de dados será realizada por meio de fotografia e formulário. Resultados esperados: este estudo pretende propor, em conjunto com o Grupo de Estudos de Lesões de Pele do hospital, a implantação e implementação de método de avaliação e mensuração de feridas. Implicações para a saúde: aprofundar e divulgar a temática, para que os profissionais passem a utilizar métodos objetivos na mensuração.
Atenção à saúde de crianças e adolescentes vivendo com HIV: estudo descritivo
Authors: Kinalski Daniela dal forno , De Paula Cristiane Cardoso
Published: March 2016

Objetivo: discutir a constituição da rede de atenção à saúde das crianças e adolescentes vivendo com HIV. Método: Abordagem qualitativa do tipo descritiva exploratória. A população do estudo será composta pelos profissionais de saúde dos serviços de Atenção Primária à Saúde e do serviço especializado para HIV. Critérios de inclusão: ser profissional que atue em um dos cenários do estudo; de exclusão: não pertencer ao quadro efetivo do município. Será realizada a técnica de grupo focal com até 15 participantes com representação de categoria profissional e serviço. Será desenvolvida Análise de Conteúdo Temática. Resultados esperados: Contribuir com a qualidade da atenção à saúde desta população a partir da discussão das ações desenvolvidas em cada serviço. O fluxo de atendimento, construído junto aos profissionais, auxiliará no acesso de primeiro contato na APS, na transferência dos usuários entre os serviços e, consequentemente, na longitudinalidade e integralidade da atenção.
Prática pedagógica na disciplina Educação Física do Instituto Federal Fluminense: estudo descritivo
Authors: Boynard Carlos Augusto Sanguedo , Daher Donizete Vago
Published: March 2016

RESUMOObjetivos: descrever o conhecimento dos docentes sobre o Projeto Pedagógico do Curso e a matriz curricular; caracterizar como se efetiva a prática pedagógica dos professores da disciplina Educação Física no Instituto Federal Fluminense-IFF campus Campos Centro e analisar as limitações e potencialidades vivenciadas pelos professores no processo ensino-aprendizagem da Educação Física. Método: Abordagem qualitativa do tipo descritiva, a ser realizada de janeiro a julho de 2015. Os participantes serão todos os 13 professores ativos e atuantes há pelo menos 10 anos e que desenvolvam atividades regulares da disciplina Educação Física. Será utilizado para a realização desta pesquisa um questionário em forma de entrevista semiestruturada, com 07 questões abertas subdivididas em 24 itens relacionados a prática pedagógica dos professores. Serão analisadas as “falas” dos mesmos com respostas convergentes e divergentes, sendo criadas categorias com base nas afinidades das respostas.
Vulnerabilidade física, social e programática de idosos: estudo descritivo
Authors: Barbosa Keylla Talitha Fernandes , Melo Fernandes Maria das Graças
Published: March 2016

Objetivo: identificar vulnerabilidades física, social e programática entre os idosos atendidos na Estratégia Saúde da Família (ESF) do município de João Pessoa/PB. Método: inquérito domiciliar com delineamento descritivo, de corte transversal, realizado com 368 idosos no período de fevereiro a abril de 2014. Resultado: constatou-se que a maioria dos indivíduos era fisicamente vulnerável, apresentando autoavaliação da saúde ruim e dificuldades na mobilidade e na realização das atividades da vida diária. Houve predominância de idosos que residiam em áreas de baixa vulnerabilidade social e utilizavam com maior frequência os serviços prestados pelo Sistema Único de Saúde. Conclusão: embora pouco estudado na gerontologia, o conceito da vulnerabilidade enfatiza a importância da ampliação do cuidado integral e contextualizado na saúde do idoso por meio de reconhecimento de aspectos individuais e coletivos que influenciam na sua qualidade de vida.
A criança vivenciando a revelação de ter HIV/aids: estudo descritivo-exploratório
Authors: Freitas Hilda Maria Barbosa , Rubeiro Circéa Amalia
Published: March 2016

Objetivo: Compreender o significado de vivenciar o processo de revelação do diagnóstico de HIV/aids na infância. Método: Utilizou-se como referencial metodológico a Teoria Fundamentada nos Dados (TFD) e como referencial teórico o Interacionismo Simbólico, nos meses de junho a dezembro de 2012. Os sujeitos foram treze crianças e/ou adolescentes que foram informados sobre o diagnóstico de HIV/aids na infância. Resultados: Evidenciaram a percepção da criança sobre a condição de portadora de uma doença crônica, descobrindo sozinha ou por alguma complicação de saúde. Conclusão: A revelação do HIV/aids é um processo singular, dinâmico e interativo, que não tem um momento certo, por mais que as crianças demonstrem que esta interação deva acontecer na infância e/ou no momento das suas dúvidas e questionamentos.
Transplantes de córneas, perfil clínico e epidemiológico: estudo descritivo e analítico
Authors: Cruz Giovanna Karinny Pereira , Carvalho Diana Paula de Souza Rego Pinto , Azevedo Isabelle Campos de , Vitor Allyne Fortes , Santos Viviane Euzébia Pereira , Ferreira Júnior Marcos Antonio
Published: March 2016

Objetivo: Determinar a distribuição e caracterização clínica e epidemiológica dos pacientes em fila de espera para transplantes de córnea e transplantados com tecido corneano, segundo o tempo, o lugar e as características dos indivíduos. Método: Estudo epidemiológico de abordagem quantitativa, de corte transversal que incluirá todos os pacientes em fila de espera e os transplantados com tecido corneano em um serviço de referência no período de 2010 a 2014. Questão norteadora: Como ocorre a distribuição e caracterização clínica e epidemiológica dos transplantes de córnea realizados em um serviço de referência e dos pacientes em fila de espera, de acordo com o tempo, o lugar e as características dos indivíduos no estado do Rio Grande do Norte? Os dados foram coletados em sua totalidade e geraram dois bancos que se encontram compilados e serão submetidos à análise estatística mediante medidas de associação (qui-quadrado) e diferença significativa (Teste t de Student e ANOVA).
Banho-efetividade em infartados: ensaio clínico sobre consumo de oxigênio e contractilidade miocárdica
Authors: Reis Fernanda Faria , Santos Silva Monyque Evelyn , Silva Barros Lucelia dos Santos , Dos Santos Karine Carrilho , Marins dos Santos Silvia Regina , Valério de Lima Dalmo Machado
Published: March 2016

Problema: A adoção de estratégias poupadoras de oxigênio às fibras cardíacas, no período de instabilidade, é sine qua non para a preservação do miocárdio, a minimização de complicações e o desconforto torácico. Objetivo: Comparar as repercussões hemodinâmicas e de consumo miocárdico de oxigênio durante o banho no leito, sem manipulação da temperatura da água e posicionamento, em pacientes internados com Infarto agudo do miocárdio e não- infartados. Método: Ensaio clínico controlado randomizado. Seleção de pacientes com e sem IAM. Washout: 24h entre banhos. Variáveis dependentes: frequência cardíaca, pressão arterial sistólica e diastólica, débito cardíaco, índice cardíaco, índice de trabalho de ventrículo esquerdo, índice de conteúdo de fluxo torácico, índice de distribuição de oxigênio, índice de trabalho sistólico esquerdo, período de pré-ejeção do ventrículo esquerdo, resistência vascular sistêmica, volume sistólico, duplo produto e consumo de oxigênio miocárdico.
Sistematização da assistência de enfermagem no serviço materno infantil: uma pesquisa-ação
Authors: Esteves Ana Paula Vieira dos Santos , Almeida Viviane Saraiva de , Vigo Priscilla dos Santos , Querido Danielle Lemos , Amim Júnior Joffre , Bornia Rita Bernardete Ribeiro Guérios
Published: March 2016

Objetivo:Implementar a sistematização da assistência de enfermagem (SAE) na Maternidade Escola da Universidade Federal do Rio de Janeiro. Método: pesquisa-ação. A teoria escolhida foi das Necessidades Humanas Básicas de Wanda Horta. A CIPE® foi selecionada como sistema de classificação único para terminologia de diagnósticos, resultados esperados e intervenções de enfermagem. A coleta de dados será realizada de acordo com a implantação da SAE em cada setor da instituição, constituída das etapas: pesquisa documental, realizada a partir da busca de documentos produzidos pela equipe de enfermagem e diagnósticos de enfermagem da clientela; pesquisa de campo através da observação sistemática participante do processo de trabalho da equipe; seminários. Para análise dos dados obtidos com o levantamento dos problemas de enfermagem, os termos extraídos do prontuário serão analisados e classificados segundo o modelo de diagnósticos de enfermagem da CIPE® 2.0
Avaliação do sono de enfermeiros nos diferentes turnos hospitalares: estudo descritivo
Authors: Silva Kézia Katiane Medeiros da , De Martino Milva Maria Figueiredo
Published: March 2016

Objetivo: Avaliar o padrão de sono, a qualidade do sono, latência do sono e hábitos de cochilar em enfermeiros nos diferentes turnos hospitalares. Método: Delineamento do tipo transversal e descritivo, com uma abordagem quantitativa. O estudo será desenvolvido no Hospital Universitário Onofre Lopes. Será aplicada uma ficha de identificação para o reconhecimento sociodemografico, juntamente com os questionários: Índice de qualidade de sono de Pittsburgh que ira avaliar o padrão de sono e o Diário de sono que avaliará o ciclo vigília-sono. Resultados esperados: Identificar a qualidade do sono dos enfermeiros nos turno diurno e noturno. O estudo será positivo para a enfermagem, a fim de evitar ou diminuir os efeitos do trabalho em turnos a partir do conhecimento prévio dos enfermeiros com relação a sua qualidade do sono.
Vivência do adolescente e adulto jovem no pós-parto da companheira: um estudo exploratório-descritivo
Authors: Araújo Mércio Gabriel , Carvalho Jovanka Bittencourt Leite
Published: March 2016

Objetivos: compreender a vivência do adolescente e adulto jovem sobre o pós-parto da companheira na estratégia saúde da família; identificar o significado do pós-parto para o homem adolescente e adulto jovem; descrever o papel do homem adolescente e adulto jovem no pós-parto; analisar as ações desenvolvidas pelo homem adolescente e adulto jovem no contexto familiar durante o pós-parto. Método: estudo exploratório e descritivo com abordagem qualitativa desenvolvido nas unidades de saúde da família do município do estado do Rio Grande do Norte. Serão entrevistados homens adolescentes e adultos jovens que estejam com sua companheira no pós-parto mediato. A técnica de coleta de dados será entrevista semiestruturada. As informações coletadas serão apreciadas pela Teoria Fundamentada nos Dados e interpretada a partir do interacionismo simbólico. Resultados esperados: A partir da análise da vivência do adolescente e adulto jovem pretende-se delinear ações de enfermagem que poderão ser desenvolvidas a esse grupo na fase puerperal. Também, fomentar discussões para fortalecimento da participação masculina e aprimoramento da assistência de enfermagem nas ações da atenção à saúde da família.
Um Diagnóstico da Distribuição Espacial da Atenção Primária à Saúde no Sudeste Brasileiro
Authors: Braga Gustavo Bastos , Marques Marco Aurélio Ferreira , Braga Beatriz Bastos
Published: March 2016

O Estado como provedor do bem público busca disseminar a saúde entre seus habitantes, sendo que uma das principais formas de realizar isso é por meio da Atenção Primária à Saúde. Esse contexto contribuiu para o escopo deste artigo, cujo objetivo é verificar a distribuição espacial da Atenção Primária à Saúde, no âmbito do sudeste brasileiro. Com uma abordagem teórica, discorreu-se sobre a equidade na gestão da saúde pública e os modelos da administração pública e a relação com a equidade. Para o cumprimento de tal objetivo, utilizou-se uma abordagem quantitativa, por estatística espacial utilizando o I de Moran e o Local Indicators of Spatial Association, e, em complemento, estatística não-paramétrica. Os resultados apontaram para uma inequidade e uma inigualada distribuição da Atenção Primária à Saúde na região. Além de apontar o que oferece indícios de inequidade nos recursos, evidenciando assim que são importantes intervenções e ações proativas na gestão da atenção primária à saúde. 