bluuebunny/crossref_metadata_2025 huggingface dataset:
Withdrawing or withholding life-sustaining treatment
Authors: Griffith Richard
Published: July 2015

The previous article in this column considered a patient's right to demand or refuse treatment for their heart condition. This article considers the cardiac team's rights and responsibilities when considering withdrawing or withholding life-sustaining treatment. It focuses on the UK Supreme Court judgment in Aintree University Hospitals Foundation Trust v. James [2013] and considers the impact of the ruling on a cardiac nurse's practice.
Disparities in Interpretation of Primary Testicular Germ Cell Tumor Pathology
Authors: Sharma Pranav , Dhillon Jasreman , Agarwal Gautum , Zargar-Shoshtari Kamran , Sexton Wade J.
Published: July 2015

Objectives:

Accurate pathologic interpretation of testicular germ cell tumors (GCTs) can be problematic due to low incidence and variation in histologic patterns. By analyzing changes in the diagnosis of testicular specimens after secondary review, we hoped to determine how these can affect prognosis and treatment.

Methods:

From 1999 to 2013, a total of 235 patients underwent radical orchiectomy at a referring facility and had pathology specimens reanalyzed by our center’s pathologists with expertise in genitourinary malignancies. We identified discrepancies in pathologic reporting.

Results:

Fifty (21.3%) patients had variations in interpretation of their orchiectomy specimens. A clinically significant alteration was identified in 16 (6.8%) patients, most commonly due to recognition (or misrecognition) of lymphovascular invasion (LVI) associated with nonseminomatous germ cell tumors (NSGCTs). Changes in LVI status resulted in upstaging or downstaging from clinical stage 1A to stage 1B or vice versa in six patients with NSGCTs, with a subsequent change in therapeutic strategy. In addition, one patient with stage 1 pure seminoma had been misclassified with nonseminoma.

Conclusions:

Inaccurate interpretation of orchiectomy specimens is not uncommon and may lead to incorrect tumor staging, imprecise assignment of progression risk, and inappropriate management recommendations. Secondary opinions of primary GCT orchiectomy specimens potentially facilitate appropriate counseling and therapeutic strategies.
Extramedullary Manifestations of Myeloid Neoplasms
Authors: Wilson Carla S. , Medeiros L. Jeffrey
Published: July 2015

Objectives:

This session of the 2013 Society of Hematopathology/European Association for Haematopathology workshop focused on extramedullary manifestations of myeloid neoplasms.

Methods:

We divided the submitted cases into four subgroups: (1) isolated myeloid sarcoma (MS); (2) MS with concurrent acute myeloid leukemia (AML), with a focus on karyotypic and molecular findings; (3) extramedullary relapse of AML, including relapse in the posttransplant setting; and (4) blast phase/transformation of a myeloproliferative neoplasm or chronic myelomonocytic leukemia.

Results:

Establishing a diagnosis of isolated MS requires a high index of suspicion and use of immunophenotypic methods. Recurrent cytogenetic abnormalities or gene mutations that occur in MS mirror those known to occur in AML.

Conclusions:

In the era of targeted therapy and sophisticated risk stratification, every attempt must be made to perform a complete workup on MS cases (or concurrent AML) since the diagnosis of MS, in itself, is no longer adequate for patient management. Cases of blastic plasmacytoid dendritic cell neoplasm were also included and discussed in this session.
Primary Marginal Zone Lymphoma of the Subcutis Associated With Panniculitis and Fat Necrosis
Authors: Chui M. Herman , Kukreti Vishal , Wei Cuihong , Delabie Jan
Published: July 2015

Objectives:

Lymphocytic infiltrates in the subcutaneous adipose tissue, often accompanied by fat necrosis, are typically seen in benign panniculitis. Diagnostic considerations include subcutaneous panniculitis-like T-cell lymphoma and cutaneous γδ T-cell lymphoma, whereas a primary subcutaneous B-cell lymphoma in this setting has not been previously described.

Methods:

We report the case of a 72-year-old woman with multiple deep cutaneous nodules on the trunk and upper extremities.

Results:

During 3 years of clinical follow-up, new skin nodules developed, while existing lesions remained stable or regressed. No other organ involvement was detected. Sequential biopsy specimens of the subcutaneous lesions revealed patchy, predominantly septal, lymphocytic infiltrates associated with extensive hyaline fat necrosis. The histologic and immunophenotypic features were consistent with marginal zone lymphoma. Genotyping revealed an identical monoclonal immunoglobulin gene rearrangement across all biopsy specimens.

Conclusions:

This case represents, to our knowledge, the first reported case of primary subcutaneous B-cell lymphoma closely associated with panniculitis.
Correlation of High Body Mass Index With More Advanced Localized Prostate Cancer at Radical Prostatectomy Is Not Reflected in PSA Level and PSA Density but Is Seen in PSA Mass
Authors: Kryvenko Oleksandr N. , Epstein Jonathan I. , Meier Frederick A. , Gupta Nilesh S. , Menon Mani , Diaz Mireya
Published: July 2015

Objectives:

Prostate cancer screening algorithms and preoperative nomograms do not include patients’ body mass index (BMI). We evaluated outcomes at radical prostatectomy (RP) adjusted to BMI.

Methods:

Serum prostate-specific antigen (PSA) levels, PSA mass, PSA density (PSAD), and RP findings were analyzed with respect to BMI in 4,926 men who underwent RP between 2005 and 2014.

Results:

In total, 1,001 (20.3%) men were normal weight, 2,547 (51.7%) were overweight, and 1,378 (28%) were obese. Median PSA levels (ng/mL) were normal weight, 5.0; overweight, 5.1; and obese, 5.2 (P = .094). Median PSA mass increased with increasing BMI: 15.9 vs 17.4 vs 19.4 μg (P < .001). Median PSAD was not significantly different: 0.11 vs 0.11 vs 0.11 ng/mL/g (P = .084). Median prostate weight increased with increasing BMI: 44 vs 45 vs 49 g (P < .001). Median prostatectomy tumor volume increased with increasing BMI: 3.9 vs 4.7 vs 5.9 cm3 (P < .001). Overweight and obese patients had a higher Gleason score and more locally advanced cancer (P < .001). Frequency of positive surgical margins increased with higher BMIs (P < .001). Frequency of lymph node metastasis did not differ significantly (P = .088).

Conclusions:

While BMI correlates with tumor volume, Gleason score, and extent of disease at RP, there is no routinely measured clinical parameter reflecting this. Only PSA mass highlights this correlation. Thus, BMI and potentially PSA mass should be taken into account in predictive algorithms pertaining to prostate cancer and its surgical treatment.
B-Lymphoblastic Leukemia in Patients With Chronic Lymphocytic Leukemia
Authors: Chakhachiro Zaher , Yin C. Cameron , Abruzzo Lynne V. , Aladily Tariq N. , Barron Lynn L. , Banks Haley E. , Thomas Deborah A. , Keating Michael , Medeiros L. Jeffrey , Huh Yang O.
Published: July 2015

Objectives:

B-lymphoblastic leukemia (B-LBL) arising in patients with chronic lymphocytic leukemia (CLL) is exceedingly rare and poorly characterized.

Methods:

We describe four patients with CLL and concurrent or subsequent B-LBL diagnosed by morphologic, immunophenotypic, cytogenetic, and molecular analysis and reviewed the literature.

Results:

In three patients, B-LBL followed CLL by 5 to 15 years, and in one patient, B-LBL was diagnosed simultaneously with CLL. In all cases, the CLL had a typical immunophenotype, and the B-LBL blasts showed an immature B-cell immunophenotype with expression of CD10, CD19, and TdT and absence of surface immunoglobulin. In two patients, B-LBL blasts harbored t(9;22)(q34;q11.2)/BCR-ABL1. We sequenced the IGHV genes in both CLL and B-LBL in two patients and showed that IGHV usage differed.

Conclusions:

Our data suggest that at least some cases of B-LBL arising in patients with CLL are independent, secondary neoplasms rather than a manifestation of histologic transformation.
Status and Benefits of Renewable Energy Technologies in the Rural Areas of Ethiopia: A Case Study on Improved Cooking Stoves and Biogas Technologies
Authors: Addis Alemayehu Yitayal
Published: July 2015

The majority of Ethiopia’s people (85%) reside in rural areas, deriving their livelihood from agriculture. Ethiopia’s energy system is characterized mainly by biomass fuel supply, with households being the greatest energy consumers. The household sector takes up nearly 94 % of the total energy supplies. Access to energy resources and technologies in rural Ethiopia is highly constrained which makes the energy supply and consumption pattern of the country to show many elements of un-sustainability. The concern on cooking practices, household economics, health, forest and agricultural resource management, and global greenhouse gas emissions has emerged as a transformative opportunity to improve individual lives, livelihoods, and the global environment. More decentralized renewable energy projects could play an important role in mitigating traditional biomass fuel use. Improved cooking stove (ICS) dissemination projects have been launched involving the private sector in the production and commercialization of the stoves. In doing so, about 3.7 million ICSs have been disseminated in the country so far which benefited stove users, producers and the total environment as about 30 million hectare of forest per year can be conserved. Conversion of animal waste to biogas energy to replace traditional fuel and use of the slurry as a fertilizer is the other current focus of the government of Ethiopia and installed more than 860 biogas digesters. The benefits obtained from these technologies are considerable and promising. However, the programs are not that much benefited the rural households where it had been intended to address. So, due attention should be given for those of the rural households in order to address the fuel wood crisis, environmental degradation and their health condition.
Loyalty Programs in Emerging and Developed Markets: The Impact of Cultural Values on Loyalty Program Choice
Authors: Thompson Frauke Mattison , Chmura Thorsten
Published: July 2015

Loyalty programs increase customers’ repeat purchase behavior and reward their continued patronage by enhancing the firm's value proposition. Yet little is known about how cultural values affect loyalty program choice as firms expand abroad. This understanding is important because multinational corporations must decide whether to standardize or adapt their loyalty programs when internationalizing. The authors develop and test theory proposing that cultural values influence loyalty program choice. The results indicate that cultural differences matter. Consumers from countries high in power-distance values and low in individualism values prefer loyalty programs that offer related rewards, whereas consumers from countries low in masculinity values and low in uncertainty avoidance values prefer unrelated rewards. The analysis also indicates that consumers from countries high in masculinity values and high in uncertainty avoidance values shun loyalty programs altogether and prefer immediate promotional offers. This finding suggests that loyalty programs do not work equally well in all countries and that multinational corporations may need to adapt reward programs as they internationalize to ensure that their loyalty-building efforts are successful.
Advertising Effectiveness: The Moderating Effect of Firm Strategy
Authors: McAlister Leigh , Srinivasan Raji , Jindal Niket , Cannella Albert A.
Published: July 2015

Advertising's influence on firm sales and firm value has drawn early attention from economists and accountants and more recent attention from marketers. Most studies that have investigated a link between advertising and sales have found such a link. However, studies that have investigated a link between advertising and firm value have only sometimes found that link. Meta-analysis has failed to determine moderators that govern the link between advertising and firm value. In this article, the authors hypothesize that advertising influences firm value for a differentiator because advertising can elaborate the firm's point of difference into brand equity, thereby building firm value. Advertising cannot build brand equity for a cost leader because such a firm has no point of difference on which to build. Identifying differentiators and cost leaders on the basis of firms’ reactions to a change in accounting regulations, the authors confirm hypotheses: advertising is related to sales for all firms, but it is more strongly related to firm value for differentiators than for cost leaders. Beyond explaining differences in advertising effectiveness, this study's indicator of differentiation versus cost leadership should enhance future analyses of marketing's effect on firm-level outcomes using archival financial data.
Investigating how Word-of-Mouth Conversations about Brands Influence Purchase and Retransmission Intentions
Authors: Baker Andrew M. , Donthu Naveen , Kumar V.
Published: July 2015

This study investigates how the valence, channel, and social tie strength of a word-of-mouth (WOM) conversation about a brand relate to the purchase intentions and WOM retransmission intentions of WOM recipients. The analysis uses a nationally representative sample of 186,775 individual conversations about 804 different brands. The authors find insights linking WOM valence, WOM channel, and social tie strength that could not be revealed if the WOM conversations were analyzed in an aggregated form. The findings contribute to research that investigates differences between offline WOM and online WOM. The authors find that the relationship of WOM valence with purchase intentions is exacerbated when the conversation occurs offline, whereas offline conversations tend to be more strongly associated with WOM retransmission intentions regardless of the conversation's valence. The results also provide insights into how interpersonal characteristics influence WOM outcomes. Specifically, the authors find that the strength of the social tie relationship tends to influence a WOM receiver's intentions to purchase a brand; however, social tie strength has a much weaker association with a consumer's WOM retransmission intentions.
Willful Understanding: Avicenna’s Philosophy of Action and Theory of the Will
Authors: Ruffus Anthony , McGinnis Jon
Published: July 2015

In this study, we look at two interpretive puzzles associated with the thought of Avicenna that are still of intrinsic philosophical interest today. The first concerns to what extent, if at all, Avicenna’s deity can be said to act freely. The second concerns to what extent, if at all, humans within Avicenna’s philosophical system can be said to act freely. It is our contention that only through a careful analysis of Avicenna’s theory of action can one begin to assess his position concerning the status of the will and so provide a satisfactory response to these two interpretative issues. We hope to show that Avicenna can account for divine freedom and that, at least in the case of prophets and sages, humans too are capable of free action.
The Cyclical Behaviour of Bank Capital Buffers: An Empirical Evidence for MENA Banking Systems
Authors: Saadaoui Zied
Published: July 2015

Bank exposure to systemic shocks induced the Basel Committee on Banking Supervision to introduce a countercyclical capital buffers’ requirement in its new regulatory framework (Basel III). But is this macro-prudential tool useful for Middle East and North African countries (MENA) countries’ banking systems? Should it be implemented in a homogenous way for all banks in these countries? Trying to give plausible answers to these questions weakly debated in the literature for the case of MENA banking systems, this study uses an enough representative sample of commercial banks based in 15 MENA countries. Estimating a partial adjustment framework using system generalized method of moments (GMM) with Windmeijer’s correction, we show that large banks and banks with high market power are more inclined to behave in a countercyclical way than small banks and banks with low market power. These results are robust to several sensitivity checks. Accordingly, we think that the implementation of countercyclical capital buffers in the MENA region should take into consideration bank-specific characteristics like size and market power.
Feeding stimulants for larvae ofGraphium sarpedon nipponum(Lepidoptera: Papilionidae) fromCinnamomum camphora
Authors: Zhang Yong , Zhan Zhi-Hui , Tebayashi Shin-ichi , Kim Chul-Sa , Li Jing
Published: July 2015

The feeding response of larvae of the swallowtail butterfly,Graphium sarpedon nipponum(Lepidoptera: Papilionidae), is elicited by a methanolic extract from camphor tree (Cinnamomum camphora) leaves.Based on bioassay-guided fractionation, three compounds, isolated from the methanolic extract of fresh leaves of the camphor tree, were revealed to be involved in a multi-component system of feeding stimulants. Structures of these feeding stimulants were identified as sucrose, 5-O-caffeoylquinic acid and quercetin 3-O-β-glucopyranoside by NMR and LC-MS.
Antecedentes de Relaciones Públicas en los manuales de publicidad. Algunos precedentes de actividad en España desde mediados del siglo XIX
Authors: Reina Estévez Jesús , González España Mª Inmaculada
Published: July 2015

El presente estudio localiza antecedentes de relaciones públicas en los manuales de publicidad que han estudiado la situación española. A través de la revisión bibliográfica exhaustiva de las obras, se ha perseguido el objetivo de encontrar actividades precedentes de la actividad de las relaciones públicas, anteriores al comienzo oficial de la disciplina en nuestro país en la década de los 60, que fueron llevadas a cabo principalmente a mediados y finales del siglo XIX y principios del XX. La labor de rastreo conlleva el reclamar la autoría sobre algunos antecedentes de comunicación de naturaleza ambigua, que tradicionalmente se han desarrollado en el terreno de la publicidad, la propaganda y el periodismo, y reubicarlos en el ámbito de las relaciones públicas.
El showrooming, nuevo hábito de compra. Un estudio exploratorio sobre jóvenes universitarios
Authors: Tapia Frade Alejandro , Torinos Fernández María Cristina
Published: July 2015

Internet ha sido el precursor de cambios en los proceso de compra. El que trata este artículo, el showrooming, trata de visitar la tienda física para ver, tocar y probar el producto, y realizar la compra en un retailer online con precios más competitivos, bien en casa o in-store.Así, este artículo muestra los resultados de un estudio exploratorio realizado sobre una muestra de 100 estudiantes universitarios acerca de este fenómeno. Dicho estudio muestra que la compra por internet es para ellos un acto cotidiano, más frecuente y de menor valor unitario en el caso de las mujeres. De igual modo, el showrooming es una práctica conocida fundamentalmente a través de redes sociales y blogs, realizada por aproximadamente la mitad de las mujeres, que visitan esencialmente showrooms de ropa y complementos, y en menor medida tecnología.Del mismo modo, se observó un freno importante entre los no practicantes, que afirman preferir en todo caso una experiencia de compra física, y no muestran interés por este modo de compra.
Actitudes y valoración en el uso de una red social para el aprendizaje del francés lengua extranjera
Authors: Álvarez Álvarez Alfredo
Published: July 2015

En este artículo se presentan los resultados más relevantes de un estudio realizado en torno a la valoración que un grupo de estudiantes del Grado de Estudios Ingleses de la Universidad de Alcalá realizaron, en la materia Francés III, del 3er curso, impartida mediante el uso de una red social. Entre otros objetivos, se pretendía valorar la percepción de los alumnos con relación a las posibilidades de uso que ofrece un entorno virtual como la red para el aprendizaje de una lengua extranjera. Para llevar a cabo la investigación, se consideró conveniente adoptar un enfoque metodológico de carácter cuantitativo, estableciendo dos líneas de trabajo diferenciadas. De un lado, se propuso una encuesta de carácter mixto, distribuida en cuatro bloques y, de otro, se planteó el curso desde la propuesta de una serie de tareas que, por su carácter de progresividad, permitieran, además de una evaluación individualizada, una valoración de carácter cuantitativo que pudiera aportar elementos de contraste con la encuesta realizada.A grandes rasgos, los resultados confirman los datos obtenidos por otras investigaciones similares realizadas en otros contextos educativos, en lo que se refiere al aprendizaje de una lengua extranjera.Desde esta perspectiva y, partiendo del estudio realizado, cabe señalar que se abren nuevas vías de investigación, en particular en lo que se refiere a la evaluación del proceso de aprendizaje del Francés Lengua Extranjera en un contexto TIC.
Inhibitory Plasticity Permits the Recruitment of CA2 Pyramidal Neurons by CA3
Authors: Nasrallah Kaoutsar , Piskorowski Rebecca A. , Chevaleyre Vivien
Published: July 2015

Area CA2 is emerging as an important region for hippocampal memory formation. However, how CA2 pyramidal neurons (PNs) are engaged by intrahippocampal inputs remains unclear. Excitatory transmission between CA3 and CA2 is strongly inhibited and is not plastic. We show in mice that different patterns of activity can in fact increase the excitatory drive between CA3 and CA2. We provide evidence that this effect is mediated by a long-term depression at inhibitory synapses (iLTD), as it is evoked by the same protocols and shares the same pharmacology. In addition, we show that the net excitatory drive of distal inputs is also increased after iLTD induction. The disinhibitory increase in excitatory drive is sufficient to allow CA3 inputs to evoke action potential firing in CA2 PNs. Thus, these data reveal that the output of CA2 PNs can be gated by the unique activity-dependent plasticity of inhibitory neurons in area CA2.
Molecular dynamics simulations of the two-way shape-memory effect in NiTi nanowires
Authors: Srinivasan Prashanth , Nicola Lucia , Thijsse Barend , Simone Angelo
Published: July 2015

Shape memory alloys (SMAs) exist in different phases depending on temperature and stress level. Experimental evidence shows that SMAs oscillate between two shapes during thermal cycling. This phenomenon, known as two-way shape-memory effect, occurs due to a transformation between the austenitic phase and the martensitic phase. The two-way shape-memory behavior is studied here by molecular dynamics simulations in NiTi nanowires of different diameter to understand the effect of loading on the size-dependent behavior. Thermal cycling is performed while holding the system at zero stress and at a fixed compressive stress. At zero stress, the martensite structure formed on cooling depends on the wire diameter. However, when cooling is performed at a sufficiently large constant compressive stress, the formation of a single martensitic variant is observed for all diameters.
Prevalência da dor lombar no Brasil: uma revisão sistemática
Authors: Nascimento Paulo Roberto Carvalho do , Costa Leonardo Oliveira Pena
Published: July 2015

O artigo descreve a qualidade metodológica dos estudos publicados sobre prevalência de dor lombar realizados no Brasil. Dezoito estudos foram considerados elegíveis após pesquisas nas seguintes bases de dados: LILACS, PubMed, Embase, CINAHL, SPORTDiscus e SciELO. Alto risco de viés foi encontrado nos critérios de validade externa relacionados com a amostragem, e viés de não-resposta. Considerando os critérios de validade interna, a principal fonte de viés estava relacionada com a falta de uma definição de caso aceitável, bem como a utilização de instrumentos que não apresentavam construto de confiabilidade e a validade provados. Nenhum estudo representativo com valores de prevalência da dor lombar no Brasil foi encontrado. Os trabalhos publicados incluídos nesta revisão apresentaram um alto risco de viés que afetam os dados de prevalência. Futuros estudos com desenho metodológico adequado são necessários, a fim de apresentar o real impacto da dor lombar no Brasil e permitir comparações.
Análise dos determinantes que influenciam o tempo para o início do tratamento de mulheres com câncer de mama no Brasil
Authors: Medeiros Giselle Coutinho , Bergmann Anke , Aguiar Suzana Sales de , Thuler Luiz Claudio Santos
Published: July 2015

Este estudo teve como objetivo analisar o intervalo de tempo entre o diagnóstico e o início do tratamento do câncer de mama em mulheres e seus determinantes. Foi realizado um estudo de coorte retrospectiva com 137.593 mulheres diagnosticadas em 239 unidades hospitalares do Brasil entre 2000 a 2011. Em 63,1% dos casos, o intervalo entre o diagnóstico e o tratamento foi de até 60 dias. No país, as mulheres mais suscetíveis ao atraso foram não brancas (OR = 1,18; IC95%: 1,13-1,23), sem companheiro (OR = 1,05; IC95%: 1,01-1,09), com menos de oito anos de estudo (OR = 1,13; IC95%: 1,08-1,18), com doença em estadiamento inicial (OR = 1,27; IC95%: 1,22-1,32), tratadas de 2006 a 2011 (OR = 1,54; IC95%: 1,47-1,60) e provenientes do sistema público de saúde (OR = 1,19; IC95%: 1,13-1,25). Na análise estratificada foi observada a variabilidade dos fatores entre as regiões do Brasil. A identificação de fatores associados à demora no início do tratamento poderá possibilitar a elaboração de propostas de intervenções destinadas a grupos populacionais específicos.
Family structure and use of prenatal care
Authors: Alves Elisabete , Silva Susana , Martins Simone , Barros Henrique
Published: July 2015

This cross-sectional study intended to assess the use of prenatal care according to the family structure in a population with free universal access to prenatal care. In 2005-2006, the Portuguese birth cohort was assembled by the recruitment of puerperae at public maternity wards in Porto, Portugal. In the current analysis, 7,211 were included. Data on socio-demographic characteristics, obstetric history, and prenatal care were self-reported. Single mothers were considered as those whose household composition did not include a partner at delivery. Approximately 6% of the puerperae were single mothers. These women were more likely to have an unplanned pregnancy (OR = 6.30; 95%CI: 4.94-8.04), an inadequate prenatal care (OR = 2.30; 95%CI: 1.32-4.02), and to miss the ultrasound and the intake of folic acid supplements during the first trimester of pregnancy (OR = 1.71; 95%CI: 1.30-2.27; and OR = 1.67; 95%CI: 1.32-2.13, respectively). The adequacy and use of prenatal care was less frequent in single mothers. Educational interventions should reinforce the use and early initiation of prenatal care.
“Não” para jovens bombados, “sim” para velhos empinados: o discurso sobre anabolizantes e saúde em artigos da área biomédica
Authors: Moraes Danielle Ribeiro de , Castiel Luis David , Ribeiro Ana Paula Pereira da Gama Alves
Published: July 2015

Abordamos o discurso médico sobre o uso dos esteroides anabolizantes androgênicos (EAA), drogas sintéticas cujo abuso vem sendo caracterizado como problema de saúde pública, sendo operado na contraposição entre usos “médicos” e “não-médicos”. Com base em abordagem qualitativa, realizamos análise de enunciações presentes em 76 artigos da área biomédica entre 2002 e 2012. Nesse discurso, permanece o banimento, entre jovens, de usos de EAA não regulados pela medicina, ao passo em que as fronteiras do emprego clinicamente qualificado parecem se expandir para pessoas idosas, mesmo frente a contradições que tensionam o argumento de prevenção dos riscos à saúde. Percebem-se marcações biopolíticas moralizantes, seja via distinções de gênero, seja sob o signo da criminalização do uso de drogas.
Fatores associados à não adesão aos antirretrovirais em adultos com AIDS nos seis primeiros meses da terapia em Salvador, Bahia, Brasil
Authors: Silva José Adriano Góes , Dourado Inês , Brito Ana Maria de , Silva Carlos Alberto Lima da
Published: July 2015

O controle da replicação viral é essencial na terapia antirretroviral altamente potente (TARV) e a adesão ao tratamento é o fundamento para esse controle. Fatores individuais e externos influenciam a adesão aos antirretrovirais (ARV). Estudo transversal para investigar fatores associados à não adesão à TARV, em indivíduos com AIDS em Salvador, Bahia, Brasil, com idade ≥ 13 anos e primeira prescrição em 2009. Dados coletados em prontuários e registros da farmácia. Dos 216 pacientes, 65,3% eram homens; idade média 37,8 ± 9,5 anos, solteiros 67,9%; heterossexuais 64%; > 8 anos de estudo 65,3%, etilistas 61,5% e não relatou tabagismo 75,1% ou uso de drogas 93,7%. Iniciaram a TARV com TCD4+ < 350 células/mm3 94%, 61,8% sintomáticos e 68,4% apresentaram reação adversa ao medicamento. Prevalência de não adesão 25%. Variáveis associadas: maior tempo entre o diagnóstico de infecção pelo HIV e a AIDS (aOR = 3,9), reação adversa ao medicamento (aOR = 2,4), idade menor que 34 anos (aOR = 2,2), menos que 8 anos de estudo (aOR = 2,2) e uso de drogas (aOR = 2,6). A alta taxa de não adesão é um problema importante nos seis primeiros meses da TARV.
Energy expenditure and cardiovascular response to traumatic lower limb amputees’ gait
Authors: Garcia Marília Mendes do Nascimento , Lima Jorge Roberto Perrout de , Costa Junior José Dilermando , Freire Humberto Almeida Ottoni de Luna , Mazilão Jaqueline de Paula , Vicente Eduardo José Danza
Published: July 2015

Introduction Amputations cause functional, musculoskeletal and cardiovascular alterations and, the more proximal the amputation, the larger the alterations. Objectives To observe the effect of using lower limb prosthetics and that of gait speed on heart rate (HR), blood pressure (BP), oxygen consumption (VO2) and energy cost (EC) during gait in traumatic lower limbs amputees. Materials and methods The sample was composed of 30 men with unilateral amputations, 10 transfemoral and 10 transtibial, compared to 10 people with no amputations. All of them selected a pleasant walking speed (PWS) on the treadmill, and two other speeds were calculated, 20% above and 20% below the original one. The subjects walked for 10 minutes at each of the speeds and, in the last three minutes, the VO2, HR, and BP were assessed. In order to compare variables between groups the variance was performed (ANOVA) followed by the Post Hoc Sheffé test (p < 0.05). Results The amputees selected lower values of PWS and had higher HR, BP, and EC, VO2 during gait when compared to normal individuals. The transfemoral amputees had higher VO2 and EC compared to the transtibial ones. By analyzing the speed effect, it was observed that, although the VO2 did not increase with the increased speed, there was increased cardiovascular response and reduced EC. Conclusions Traumatic lower limb amputees have higher energy expenditure and cardiovascular responses during gait and, at higher speeds, they become more economical, reducing the EC.
Hippotherapy and respiratory muscle strength in children and adolescents with Down syndrome
Authors: Costa Valéria Sovat de Freitas , Silva Hudday Mendes da , Alves Elioenai Dornelles , Coquerel Patrick Ramon Stafin , Silva André Ribeiro da , Barros Jônatas de França
Published: July 2015

Introduction Individuals with Down syndrome may have decreased respiratory muscle strength due to hypotonia, a common characteristic in this population. Objective To analyze the effects of a hippotherapy program on respiratory muscle strength in individuals with Down syndrome. Materials and methods The study included 41 subjects, 20 of which were in the hippotherapy practicing group (PG) and 21 of which were in the non-practicing group (NPG). Study subjects were of both sexes, aged 7-13 years, and all diagnosed with Down syndrome. A manovacuometer was used to measure respiratory muscle strength, following the protocol proposed by Black and Hyatt (23). Statistical analysis was performed by means of descriptive distribution. After verifying normality and homoscedasticity of the variables, the Mann-Whitney test was used to determine differences between the means of the two groups (PG and NPG), and the Spearman’s rank correlation coefficient test was used to view possible relationships with age and time practicing hippotherapy. Significance was set at p < 0.05. Results and discussion Individuals who practiced hippotherapy showed improvements in both inspiratory and expiratory respiratory muscle strength, although no significant difference was demonstrated. Conclusion This study demonstrates that hippotherapy benefits respiratory muscle strength in individuals with Down syndrome, and that the youngest subjects had the best results.
Adverse Effects on PMMA Caused by Mechanical and Combined Methods of Denture Cleansing
Authors: Sorgini Danilo Balero , Silva-Lovato Cláudia Helena da , Muglia Valdir Antônio , Souza Raphael Freitas de , Arruda Carolina Noronha Ferraz de , Paranhos Helena de Freitas Oliveira
Published: July 2015

This study evaluated the abrasiveness of mechanical and combined methods of denture hygiene, by the analysis of mass loss and surface roughness. Acrylic resin specimens (Plexiglass) were brushed by a tooth brushing machine (Mavtec) with a soft brush (Tek) and water (control) or four dentifrices (Sorriso, Colgate, Polident and Corega) (Experimental groups) for 50 min, representing one year of brushing (mechanical method). After brushing, the specimens were immersed in 0.5% sodium hypochlorite simulating a daily cleaning of 20 min for one year (combined method). Distilled water (23 ºC) was employed as control. The mass loss (g) was analyzed by an analytical balance and the surface roughness (μm) by a rugosimeter. Data were subjected to ANOVA and Bonferroni test (α=0.05). Polident dentifrice showed lowest values of mass loss for both methods (mechanical: -0.0072±0.0017, combined:-0.011±0.002) and the combined method resulted in greater mass loss than the mechanical, except for Corega. For the surface roughness, after the mechanical method, the lowest values were registered for water (-0.007±0.016) and Polident (0.402±0.378); for the combined method, water (-0.063±0.013) showed the lowest values; there was no statistically significant difference between methods. It was concluded that Polident was the less abrasive dentifrice and the association between chemical and mechanical methods increased the mass loss but did not change the surface roughness of specimens.
Three-dimensional Digital Evaluation of Dental Arches in Infants with Cleft Lip and/or Palate
Authors: Fernandes Viviane Mendes , Jorge Paula Karine , Carrara Cleide Felício Carvalho , Gomide Márcia Ribeiro , Machado Maria Aparecida Andrade Moreira , Oliveira Thais Marchini
Published: July 2015

The aim of this study was to measure and compare the dimensions of the dental arches on three-dimensional digital study models in children with and without cleft lip and palate before the primary surgery. The sample consisted of 223 digital models of children aged 3-9 months, divided into 5 groups: without craniofacial deformities, unilateral and bilateral incomplete cleft lip and alveolus, unilateral and bilateral complete cleft lip and alveolus, unilateral cleft lip and palate, and bilateral cleft lip and palate. Dental casts of the maxillary dental arches of the children were used. The dental casts underwent a process of scanning through 3D scanner and the measurements used for the correlation among groups were made on the scanned images. Statistical analysis was performed by t test and ANOVA followed by Tukey test. The results showed that the intercanine distance and anterior cleft width was wider in children with unilateral cleft lip and palate. The intertuberosity distances and posterior cleft width was wider in children with bilateral cleft lip and palate among the groups. Children with cleft lip and palate before the primary surgery had wider maxillary arch dimensions than the children without cleft lip and palate.
New Methodology to Evaluate Bond Strength of Root-End Filling Materials
Authors: Marques Jorge Henrique Stefaneli , Silva-Sousa Yara Teresinha Corrêa , Rached-Júnior Fuad Jacob Abi , Mazzi-Chaves Jardel Francisco , Miranda Carlos Eduardo Saraiva , Silva Silvio Rocha Correa da , Steier Liviu , Sousa-Neto Manoel Damião
Published: July 2015

This study evaluated the bond strength of root-end filling materials to root-end cavities using a new methodology. Twenty maxillary central incisors were subjected to biomechanical preparation (#80 hand file) and sectioned transversally 2 mm short of the apex and 4 mm coronally to this point. The root cylinders were embedded in acrylic resin and positioned at 45° to the horizontal plane for preparation of root-end cavities with a diamond ultrasonic retrotip. Two groups (n=10) were formed according to the root-end filling material: MTA and Super EBA. A gutta-percha cone (#80) was tug-backed at the limit between the canal and the root-end cavity. The cavity was filled and the gutta-percha cone was removed after complete setting of the sealer. The specimens were placed in an Instron machine with the root-end filling turned downwards. The push-out shaft was inserted in the space previously occupied by the gutta-percha cone and run at a crosshead speed of 1.0 mm/min for pushing out the root-end filling material. Data were analyzed by ANOVA (α=5%). Super EBA (6.03±1.31) presented higher bond strength (MPa) than MTA (1.81±0.45) (p>0.05). There was a predominance of cohesive failures for Super EBA and mixed for MTA. The protocol of specimen preparation is effective and introduces a specific methodology for assessing bond strength of root-end filling materials to dentin. Among the materials, Super EBA presented the highest bond strength.
Small mammals (Chiroptera, Didelphimorphia, and Rodentia) from Jaíba, middle Rio São Francisco, northern Minas Gerais State, Brazil
Authors: Nogueira Marcelo Rodrigues , Pol André , Pessôa Leila Maria , Oliveira João Alves de , Peracchi Adriano Lúcio
Published: July 2015

We report the results of small mammals inventories conducted in the region of Jaíba, northern Minas Gerais state, southeastern Brazil, from 1990 to 1995. This region is located in the southern limit of the Caatinga biome, and harbors a unique set of natural ecosystems and extensive agricultural areas. With a total effort of 2964 trap-nights and 44 net sessions, we captured 893 small mammals from 46 species, including four marsupials, 13 rodents, and 29 bats. We report on species that are endemic to the Caatinga (Wiedomys pyrrhorhinos and Xeronycteris vieirai), and species that are new to the mammal fauna of the state of Minas Gerais (Tonatia saurophila, X. vieirai, and Myotis lavali). We also provide the first valid voucher-supported record of Micronycteris sanborni from southeastern Brazil, and extend the known range of X. vieirai 800 km southward. All bats highlighted here as endemic or representing new records were associated to limestone outcrops, suggesting that preservation of this kind of habitat may be particularly relevant to the conservation of these mammals.
As Comunidades Terapêuticas religiosas na recuperação de dependentes de drogas: o caso de Manguinhos, RJ, Brasil
Authors: Ribeiro Fernanda Mendes Lages , Minayo Maria Cecília de Souza
Published: July 2015

Este artigo analisa o papel de Comunidades Terapêuticas (CT) religiosas na recuperação e reabilitação de usuários de drogas, tomando como caso o complexo de favelas de Manguinhos, Rio de Janeiro, Brasil. Trata-se de estudo com abordagem qualitativa, por meio de entrevistas, observação participante e materiais institucionais. Para compreensão e interpretação do material, foi utilizada a análise de enunciação. Há ampla presença de instituições religiosas que têm a CT como proposta de cuidado à dependência de drogas. As principais formas de recuperação e de reabilitação são a evangelização e a conversão religiosa. As CT confessionais concebem um modelo de tratamento centrado na oração e na abstinência, modelo este em desacordo com as políticas públicas de saúde mental. No entanto, os equipamentos públicos não têm conseguido dar respostas eficazes à demanda. A controvérsia gerada nesse particular encerra este artigo.
Análise quantitativa da ecogenicidade testicular pela técnica do histograma de ovinos da baixada ocidental maranhense
Authors: Silva Elzivânia G. , Gonçalves Mysa T.C. , Pinto Sâmara C.C. , Soares Diego M. , Oliveira Rudson A. , Alves Flávio R. , Araújo Adriana V.C. , Guerra Porfírio C.
Published: July 2015

A ultrassonografia é um método de diagnóstico por imagem que permite a avaliação de diferentes órgãos e estruturas corpóreas de maneira não invasiva. No entanto, a avaliação subjetiva das imagens caracteriza um dos grandes entraves na utilização desta técnica de diagnóstico, havendo necessidade de mecanismos que minimizem a subjetividade do exame e a divergência na interpretação dos achados ultrassonográficos. Desta forma este trabalho objetivou caracterizar a ecogenicidade do parênquima e mediastino testicular de ovinos utilizando a técnica do histograma escala-cinza. Foram utilizados 30 animais divididos em três grupos de acordo com a faixa etária (FE): de três a seis meses (FE1), sete a 12 meses (FE2), 13 a 18 meses (FE3) e realizadas varreduras testiculares nos planos frontal, sagital e transversal, elaborando ao final um histograma a partir das imagens ultrassonográficas. Observou-se que tanto a ecogenicidade do parênquima quanto a do mediastino testicular aumentaram gradativamente com a progressão das idades dos animais, com média e desvio-padrão de 95,00±19,05 e 94,35±18,82 para a ecogenicidade do parênquima do antímero direito e esquerdo, respectivamente, e 127,95±12,97 para o mediastino direito e 126,59±11,78 para o esquerdo. A técnica do histograma escala-cinza demonstrou ser um método eficiente na determinação da ecogenicidade testicular, possibilitando o estabelecimento de padrões de normalidade que venham a auxiliar pesquisas futuras no monitoramento do desenvolvimento testicular bem como na detecção de patologias. Para a regimes exclusivos de criação extensiva, como na baixada maranhense, representa ferramenta valiosa para sua utilização em projetos sociais do Estado que atendem a agricultura familiar.
Micropropagação de alcachofra a partir de plântulas germinadas in vitro
Authors: Didoné Silvana F , Grando Magali F , Calvete Eunice O , Costa Angélica R , Suzin Marilei , Augustin Lizete
Published: July 2015

A alcachofra é uma hortaliça consumida tanto in natura quanto industrializada. Seu alto valor nutricional e medicinal desperta interesse pelo seu cultivo no Brasil. A micropropagação é uma técnica que permite a produção de populações homogêneas e a rápida multiplicação de progênies selecionadas. Este trabalho objetivou estabelecer um protocolo de micropropagação para progênies de alcachofra, utilizando explantes obtidos de plântulas germinadas in vitro. Nós cotiledonares de três progênies (P1, P2 e P3) foram avaliados quanto à taxa de multiplicação, altura e número de folhas, ao longo de quatro subcultivos sucessivos, em dois meios de cultura (M1 e M2). Na fase de enraizamento in vitro foram avaliados o enraizamento de mudas (%), o comprimento da maior raiz (cm) e o volume de raiz (cm3). E, na fase de aclimatização foi avaliada a taxa de sobrevivência das brotações com e sem raízes, aos 30 dias do transplante, em três diferentes substratos. O meio de cultura M1 (1,0 mg/L de BAP e 0,1 mg/L de ANA) promoveu maior desenvolvimento de brotos axilares e taxa média de multiplicação 5,1 para as progênies P1 e P2. A progênie P1 apresentou maior frequência de enraizamento in vitro das brotações (51,9%) em comparação com a progênie P2 (14,9%). Os substratos S1 (Mecplant Horta 2(r): 100%) e S2 (Mecplant Horta 2(r): 50% e casca de arroz carbonizada: 50%) foram os mais adequados para a aclimatização das mudas micropropagadas das progênies P1 e P2, respectivamente, sendo alcançada a frequência de sobrevivência de 75%. Foi possível estabelecer o processo de micropropagação de duas progênies de alcachofra, selecionadas para o consumo in natura, utilizando como fonte de explante nó cotiledonar obtido a partir de plântulas germinadas in vitro.
Appraising knowledge management perceptions among construction practitioners
Authors: Zuofa Tarila , Ochieng Edward , Burns Alan
Published: July 2015

Contemporary studies have identified knowledge and its management as strategic resources within organisations. Lessons learned from the construction industry have also proved that effective generation, reusing and sharing of knowledge can enhance the outcomes of construction projects by reducing the associated costs, time of completion and improving the overall competitiveness within organisations. However, the fragmented project-based and task-oriented nature of most construction activities has often made knowledge management (KM) implementation unfeasible within the construction industry. One major challenge to KM implementation in construction organisations is the lack of systematic procedures that support the development and application of KM. Utilising semi-structured interviews, this paper examines the perceptions of KM among practitioners within the Nigerian construction industry. The key findings indicate that, even though practitioners in the Nigerian construction industry may be aware of KM and its benefits, in practice its systematic application still remains largely uncommon. The paper also highlights the need for shifts in organisational culture as a means of facilitating a more KM-conscious construction industry in Nigeria.
The Cyclicality of Sales, Regular and Effective Prices: Comment
Authors: Gagnon Etienne , López-Salido J. David , Sockin Jason A.
Published: July 2015

Coibion, Gorodnichenko, and Hong (2015) argue that the CPI underestimates the deceleration in consumer prices during economic downturns because the index fails to account for the reallocation of consumer spending from high- to low-price stores. We show that these authors' Measures of inflation with and without store switching suffer from several methodological deficiencies, including an excessive truncation of price adjustments and the lack of a treatment for missing observations. When we address these deficiencies, the authors' key regression results no longer suggest that greater store switching during downturns is a statistically or economically significant phenomenon.
Liderazgo educativo en México
Authors: Parés Isabel
Published: July 2015

El liderazgo educativo en México es una tema que estuvo olvidado, en cuanto a su estructura formal y desarrollo profesional, por muchas décadas y que finalmente, empieza a cobrar relevancia dentro del contexto de la última Reforma Educativa promulgada en febrero 2013 y que poco a poco, se ha ido implementando, bajo un clima contradictorio entre quienes la apoyan y algunos opositores que han presionado con acciones sociales pacíficas y no pacíficas, para que el gobierno suavice y/o erradique algunas de las medidas de la Reforma Educativa. En concreto, la función directiva vista desde la perspectiva de la Secretaría de Educación Pública, está vinculada al concepto de Gestión Escolar, pues es visto como un supervisor y administrador “moderno” de la educación. Sin embargo, México se encuentra en un proceso de profesionalización de la función directiva, con la finalidad de que directivos y supervisores escolares, sean agentes del cambio y la mejora de la calidad educativa del país.
Pedagogía y liderazgo pedagógico
Authors: Ureta Xavier
Published: July 2015

La búsqueda de respuestas a su profesión como pedagogo, le llevó a estudiarlas a partir de la interpretación y comprensión de su propia historia de vida profesional, siguiendo el camino que, en este sentido, nos abre la metodología fenomenológica hermenéutica. En la primera parte se exponen los fundamentos metodológicos. En la segunda, el autor explica una etapa de su vida, que marcó su futuro profesional como pedagogo y sus etapas de liderazgo pedagógico. Al final nos abre la puesta para proyectarnos nosotros mismos a través de la interpretación y comprensión de los ámbitos de trabajo pedagógico que su experiencia le ha sugerido.