bluuebunny/crossref_metadata_2025 huggingface dataset:
The association of opium dependence and postoperative complications following coronary artery bypass graft surgery: A propensity-matched study
Authors: Sadeghian, MD Saeed , Karimi, MD Abbasali , Dowlatshahi, MD Samaneh , Hossein Ahmadi, MD Seyed , Davoodi, MD Saeed , Marzban, MD Mehrab , Movahedi, MD Namvar , Abbasi, MD Kyomars , Tazik, MD Mokhtar , Sheikh Fathollahi, PhD Mahmood
Published: February 2018

Objective: Opium is an overwhelming public health problem in some countries. Different studies have suggested this drug as a risk factor for cardiovascular disease. Although the effect of opium on immune system, lung disease, nephropathy, stroke, and cardiac arrhythmia has been found in different studies, its effect on postoperation complications is not clear yet. The authors conducted this study to assess the effect of opium on post operation in hospital complications among patients who underwent coronary artery bypass graft.Design: The authors retrospectively analyzed the data in this study.Setting: This study has been done at Tehran Heart Center.Patients: A total of 4,398 patients who had undergone isolated CABG were studied.Main outcome measure: Patients who fulfilled the DSM-IV-TR criteria for opium dependence (by smoking) were enrolled as Opium Dependent Patients. Also outcome variables were: Perioperative MI, septicemia, UTI, TIA, continuous coma, prolonged ventilation, pulmonary embolism, renal failure, acute limb ischemia, heart block, AF, mortality.Results: The prevalence of opium dependence was 15.6 percent among patients. The authors used a propensity matched model to analyze the relationship between opium and post operation complications. The authors adjusted opium and non-opium dependent patients in all of the baseline preoperative risk factors, so all of the matched patients were same and there was no bias in assessment.Conclusion: Opium dependent patients had significantly longer resource utilization. However, no significant relationship was found between opium dependence and other cardiac and non cardiac in hospital complications.
Intranasal abuse of prescription hydrocodone/acetaminophen results in oronasal fistula: A case report
Authors: Sloan, MD Paul A. , Klimkina, MD Oksana
Published: February 2018

Opioids are becoming more common in the treatment of chronic nonmalignant pain. With increased availability of opioids for chronic pain we may expect an increased misuse of these as analgesics as well. The authors describe the case report of a young woman with chronic back pain and intranasal abuse of prescribed hydrocodone/acetaminophen who was diagnosed after presenting for hypernasal speech and foreign body in the nose. This case report highlights the need for vigilance on the part of the physician for any aberrant drug-related behaviors. Any unusual symptoms or signs such as hypernasal speech, chronic nasal infection, or unexplained foreign body sensation in the nose should be thoroughly investigated.
Determination of medication cutoff values in a pain patient population
Authors: Pesce, PhD, DABCC Amadeo , West, PhD Cameron , West, MS Robert , Crews, PhD Bridgit , Mikel, PhD Charles , Rosenthal, DO, FAPA Murray , Almazon, MT(ASCP) Perla , Latyshev, MS Sergey
Published: February 2018

Background: Clinical laboratories are required to establish reference intervals for all the analytes tested, and these are provided along with the test results. In contrast, laboratories testing for pain medications use cutoffs established by the manufacturers of immunoassay reagents. These cutoffs may be inappropriate for monitoring patients being treated for chronic pain with opioid therapy because the cutoffs are set too high.Purpose of the study: To use quantitative urine drug excretion data determined by liquid chromatography-tandem mass spectrometry analysis to calculate cutoffs needed to best determine patient compliance with prescribed medications.Methods: Two methods of calculation were used to estimate cutoffs. First, all positive results for each drug or drug metabolite were ranked from highest to lowest. The lowest value was one-half of the lower limit of quantitation. A nonparametric 2.5 percent estimator was used to establish each cutoff. Second, positive results were normalized using creatinine values, resulting in the excretion being expressed as nanograms of excreted drug per gram of creatinine. A nonparametric 2.5 percent estimator was used to establish the cutoff.Results: Cutoffs established using these calculations included at least 97.5 percent of the data for the drugs: 7-aminoclonazepam, α-hydroxalprazolam, buprenorphine, carisoprodol, hydrocodone, hydromorphone, meperidine, meprobamate, methadone, morphine, oxycodone, oxymorphone, propoxyphene, and tramadol gave cutoffs near the lower limit of quantitation. One exception was with the drug codeine, where the lower limit could not be identified.Conclusions: These cutoffs were significantly lower than those suggested by many immunoassay manufacturers and better identify patient compliance in a representative population of pain patients. The limitation of the study is that only values one-half of our lowest calibrator were used. By using population values, laboratories can establish appropriate cutoffs for best monitoring pain patient medication compliance.
Opioid-dependent error processing
Authors: Fellows-Smith, MBBS, MMedSc, MRCPsych, FRANZCP, FAchAM James
Published: February 2018

Objective: To evaluate error processing in contrasting opioid treatment samples by finding the relative risk of fatal dosing errors leading to opioid overdose in a controlled cohort of detoxified patients with opioid dependence.Methods: Data linkage was performed between the Western Australian deaths register and recorded admissions to the Perth Naltrexone Clinic and community-based methadone program. Death register and corresponding data of coronial findings for all the patients who were treated with rapid opioid detoxification under sedation and oral naltrexone were compared with corresponding data for all the patients who were prescribed methadone over a 2-year period.Results: Data for naltrexone-treated patients (n = 1,097) and community-based methadone-treated patients (n = 2,520) showed mortality rates to be 2.6 percent per year for naltrexone treatment when compared with 0.7 percent for methadone treatment (p < 0.001). This was due to 4.3 times the relative risk of death from opioid toxicity for naltrexone-treated patients (p < 0.001).Conclusions: Naltrexone increases vulnerability to overdose as enhanced opioid effects following neuroanatomical blockade can reverse behavioral tolerance and lead to greater fatal dosing errors on reinstatement of opioid dependence.
Assessment, stratification, and monitoring of the risk for prescription opioid misuse and abuse in the primary care setting
Authors: Brown, MD James , Setnik, PhD Beatrice , Lee, MD, PhD Keung , Wase, MD Linda , Roland, PharmD Carl L. , Cleveland, MS Jody M. , Siegel, MD Sherry , Katz, MD, MS Nathaniel
Published: February 2018

Objectives: To evaluate potential for and incidence of aberrant drug-related behaviors among patients with chronic, moderate-to-severe pain in a primary care setting and to determine investigator compliance with universal precautions (UP) approach to pain management.Design: Open label, multicenter.Setting: Primary care centers (N = 281) across the United States.Patients: Opioid naïve and opioid experienced with chronic, moderate-to-severe pain (N = 1,487).Interventions: Morphine sulfate extended-release capsules for ≤4 months. Tools comprising UP approach were treatment agreement, card for obtaining/tracking prescriptions, Screener and Opioid Assessment for Patients with Pain®-Revised questionnaire, pill counts, pain-patient follow-up tool, investigator assessment/plan, and urine drug screens (UDSs).Outcome measures: Proportion of patients at low, moderate, and high risk of opioid misuse/abuse based on prespecified criteria and investigator judgment, proportion of patients with aberrant drug-related behaviors, and proportion of investigators compliant with UP approach.Results: Patients were primarily white (87 percent), women (57 percent); mean age, 53 years (range, 21-92 years). At baseline, 47 percent were considered low risk for opioid misuse/abuse, 52 percent moderate, and 1 percent high. UDSs were positive for illicit/nonprescribed drugs in a proportion of patients throughout the study. Overall, 64 percent of investigators were compliant with major components of UP approach in ≥75 percent of their patients. However, there was a tendency for investigators to assign risk levels for opioid misuse/abuse as lower than protocol specified.Conclusions: Most patients in these primary care study centers were categorized as at least moderate risk for opioid misuse/abuse at baseline. Most primary care investigators complied with the UP approach to pain management and risk assessment. The completion of the brief training and clinical use of the tools during the study led to retained behavior change, but there was a tendency for investigators to assign lower risk levels than those that were protocol-specified, suggesting a need for better understanding of factors influencing investigator decisions.
The prevalence and economic impact of prescription opioid-related side effects among patients with chronic noncancer pain
Authors: Ivanova, MA Jasmina I. , Birnbaum, PhD Howard G. , Yushkina, BA Yana , Sorg, MPH Rachael A. , Reed, MD John , Merchant, MBA, PhD Sanjay
Published: February 2018

Objectives: To estimate the prevalence of opioid-related side effects among patients with chronic noncancer pain (CNCP) who initiated opioids and compare healthcare costs of patients with and without side effects using patient survey, medical charts, and claims data.Patients, participants: Patients initiating opioids, who were aged ≥18 years, had ≥1 pain diagnosis, and did not have cancer, were identified through claims data and medical records from a Central Massachusetts medical group practice and mailed surveys between October 2010 and July 2012.Main outcomes measures: Prevalence of opioid-related side effects was estimated from patient surveys, charts, and claims data within 90 days after opioid initiation (study period). Study period healthcare costs were compared between patients with and without side effects (self-reported problematic side effects or side effects recorded in medical charts or claims).Results: Among patients with CNCP who initiated opioids and completed the survey (N = 167), the average age was 53 years, and 62.9 percent were women. Based on the survey, charts, and claims, 91.6 percent, 15.0 percent, and 19.2 percent of patients, respectively, had ≥1 opioid-related side effect. Overall, 59.3 percent of patients reported having ≥1 problematic side effect or side effect recorded in charts or claims. In the analysis that controlled for baseline characteristics and resource use, patients with versus without side effects had higher mean study period healthcare costs ($3,347 vs $2,521, p = 0.049).Conclusions: Prevalence of opioid-related side effects among patients with CNCP who initiated opioids was substantially higher based on patient survey than from charts or claims. Opioid-related side effects were associated with significantly higher healthcare costs.
Review of perioperative pain management of opioid-dependent patients
Authors: Vadivelu, MD Nalini , Mitra, MD, MAMS Sukanya , Kai, BA Alice M. , Kodumudi, MS Gopal , Gritsenko, MD Karina
Published: February 2018

Opioid dependence can occur due to prescription opioid use, recreational opioid use, or as a result of opioid use for the treatment of drug addiction. Pain control in these patients is truly a challenge. It is important to understand the patient's condition such as the phenomenon of drug dependence, drug addiction, and pseudo-addiction to provide effective analgesia. This may be accomplished using appropriate multimodal therapies and by treatment of coexisting diseases such as anxiety. The goal is to provide effective analgesia, prevent cognitive and emotional problems, and produce a positive postoperative rehabilitation process. Multimodal options include pharmacological and nonpharmacological approaches, psychological support, and interventional pain procedures, all focused toward providing optimal pain control while preventing undertreatment, withdrawal symptoms, and other complications.
Transient low testosterone levels after oral hydrocodone may contribute to misdiagnosis of hypogonadism
Authors: Daniell, MD Harry W.
Published: February 2018

Context: Multiple morning testosterone levels are needed to establish the presence of male hypogonadism and to justify its replacement therapy. Any influence on these levels by short-term opioid ingestion has not, however, been reported.Case Description: Serial testosterone levels are reported at 2-hour intervals once weekly for 22 weeks in a man after his ingestion of 0, 5, or 10 mg of hydrocodone.Conclusions: Five milligrams of hydrocodone did not significantly alter postingestion testosterone levels, but 10 mg ingestion lowered them at 2, 4, and 6 hours postingestion.
Assessment of acute pain in trauma—A retrospective prehospital evaluation
Authors: Hebsgaard, MD Stine , Mannering, MD Anne , Zwisler, MD, PhD Stine T.
Published: February 2018

Objective: To elucidate pain treatment with analgesics in a prehospital trauma population.Design: Retrospective database study.Setting: Prehospital data from the anesthesiologist-manned Mobile Emergency Care Unit (MECU) in Odense, Denmark, were extracted and subjected to analysis.Patients: During the period of January 1, 2013 to December 31, 2014, patients with the diagnoses “unspecified multiple injuries,” “examination and observation following traffic accident,” “examination and observation following other accident,” and “commotio cerebri” were included in the analysis.Main Outcome Measures: Evaluation of the application of the pain scale Numeric Rating Scale (NRS). Furthermore, the authors performed a characterization of the patients with mild pain and severe pain according to specific parameters such as pharmacological interventions, opioid consumption, intubation, and others.Results: Nine hundred eighty-five cases were analyzed. NRS was documented only in one case. In all, 787 patients experienced no pain or mild pain (no pain, n = 242; mild pain, n = 545) and 168 patients severe pain or worse (severe pain, n = 155; intolerable pain, n = 13). In the severe pain group, 138 were treated with opioid analgesics or S-ketamine, while no pharmacological intervention was documented in 30 cases. Eight of the 138 cases with severe pain needed endotracheal intubation, whereas nine cases in the patients with mild or no pain needed endotracheal intubation; odds ratio (OR) 4.3 (p = 0.003).Conclusions: Effect was only documented in one patient after administering opioids in a patient with trauma population, where approximately 17 percent of patients experienced severe pain. Severe pain was correlated to male gender, respiratory intervention, opioid administration, and the diagnosis unspecified multiple injuries.
The ideal opioid: Is oliceridine the answer?
Authors: Nair, MD Abhijit S.
Published: February 2018

There is no ideal opioid available in present clinical practice. Characteristics of an ideal opioid should be rapid onset of action, short acting, minimal respiratory depression, least peripheral side effects like constipation, urinary retention and devoid of dependence or tolerance with chronic use.
Educational intervention for physicians to address the risk of opioid abuse
Authors: Pasquale, PhD Margaret K. , Sheer, BA Richard L. , Mardekian, PhD Jack , Masters, MS, MPH Elizabeth T. , Patel, PharmD, PhD Nick C. , Hurwitch, PharmD, BCPS Amy R. , Weber, PharmD, MS, BCPS, CGP, BCACP Jennifer J. , Jorga, MD Anamaria , Roland, PharmD, MS Carl L.
Published: February 2018

Objective: To evaluate the impact of a pilot intervention for physicians to support their treatment of patients at risk for opioid abuse.Setting, design and patients, participants: Patients at risk for opioid abuse enrolled in Medicare plans were identified from July 1, 2012 to April 30, 2014 (N = 2,391), based on a published predictive model, and linked to 4,353 opioid-prescribing physicians. Patient-physician clusters were randomly assigned to one of four interventions using factorial design.Interventions: Physicians received one of the following: Arm 1, patient information; Arm 2, links to educational materials for diagnosis and management of pain; Arm 3, both patient information and links to educational materials; or Arm 4, no communication.Main outcome measures: Difference-in-difference analyses compared opioid and pain prescriptions, chronic high-dose opioid use, uncoordinated opioid use, and opioid-related emergency department (ED) visits. Logistic regression compared diagnosis of opioid abuse between cases and controls postindex.Results: Mailings had no significant impact on numbers of opioid or pain medications filled, chronic high-dose opioid use, uncoordinated opioid use, ED visits, or rate of diagnosed opioid abuse. Relative to Arm 4, odds ratios (95% CI) for diagnosed opioid abuse were Arm 1, 0.95(0.63-1.42); Arm 2, 0.83(0.55-1.27); Arm 3, 0.72(0.46-1.13). While 84.7 percent had ≥ 1 psychiatric diagnoses during preindex (p = 0.89 between arms), only 9.5 percent had ≥ 1 visit with mental health specialists (p = 0.53 between arms).Conclusions: Although this intervention did not affect pain-related outcomes, future interventions involving care coordination across primary care and mental health may impact opioid abuse and improve quality of life of patients with pain.
Reality and responsibility revisited: Stakeholder accountability in the effort to develop safer opioids
Authors: Passik, PhD Steven D. , Heit, MD Howard A. , DeGeorge, PharmD Michael
Published: February 2018

This supplement is dedicated to an exploration of the science, potential utility, and the current state of abuse-deterrent formulations (ADF) of opioid analgesics. There are many stakeholders in the search for safer pain treatments in general, and safer opioid therapy in particular. Healthcare providers, patients, third-party payors, law enforcement and government regulators, the pharmaceutical industry, and the media all have a stake in seeing pain treated and addiction and overdose avoided. As it applies to ADFs, obviously not everyone has a stake in seeing that ADFs succeed commercially; but all stakeholders certainly have a responsibility to see that any potential advance, including ADFs, in protecting the public health is fairly and thoroughly evaluated. Particularly at a time of crisis. In this article, we revisit the framework used by Passik, Heit, and Kirsh (2006) to evaluate stakeholders’ responsibilities with regard to both the opioid abuse and chronic pain epidemics. After evaluating the present status of aspirations delineated over a decade ago, we discuss the updated roles and responsibilities of each stakeholder, with emphasis on the role of ADFs as this technology was unavailable when the original manuscript was written.
Abuse-deterrent features of an extended-release morphine drug product developed using a novel injection-molding technology for oral drug delivery
Authors: Skak, MS Nikolaj , Elhauge, MSc Torben , Dayno, MD Jeffrey M. , Lindhardt, MSc, PhD, DBE Karsten
Published: February 2018

Objective: A novel technology platform (Guardian™ Technology, Egalet Corporation, Wayne, PA) was used to manufacture morphine abuse-deterrent (AD), extended-release (ER), injection-molded tablets (morphine-ADER-IMT; ARYMO® ER [morphine sulfate] ER tablets; Egalet Corporation), a recently approved morphine product with AD labeling. The aim of this article is to highlight how the features of Guardian™ Technology are linked to the ER profile and AD characteristics of morphine-ADER-IMT.Results: The ER profile of morphine-ADER-IMT is attributed to the precise release of morphine from the polymer matrix. The approved dosage strengths of morphine-ADER-IMT are bioequivalent to corresponding dosage strengths of morphine ER (MS Contin®; Purdue Pharma LP, Stamford, CT). Morphine-ADER-IMT was very resistant to physical manipulations intended to reduce particle size, with <10 percent of particles being reduced to <500 μm, regarded by the US Food and Drug Administration as a relevant cutoff for potential insufflation in their generic solid oral AD opioid guidance. Furthermore, morphine was not readily extracted from the polymer matrix of morphine-ADER-IMT in small- or large-volume solvent extraction studies that evaluated the potential for intravenous and oral abuse.Conclusions: The ER profile and AD characteristics of morphine-ADER-IMT are a result of Guardian™ Technology. The combination of the polyethylene oxide matrix and the use of injection molding differentiate morphine-ADER-IMT from other approved AD opioids that deter abuse using physical and chemical barriers. The high degree of flexibility of the Guardian™ Technology enables the development of products that can be tailored to almost any desired release profile; as such, it is a technology platform that may be useful for the development of a wide range of pharmaceutical products.
Application of hot-melt extrusion technology in immediate-release abuse-deterrent formulations
Authors: Wening, PhD Klaus , Schwier, PhD Sebastian , Stahlberg, MD Hans-J. , Galia, PhD Eric
Published: February 2018

Objective: Hot-melt extrusion (HME) technology has been used for manufacturing extended-release abuse-deterrent formulations (ADFs) of opioid-type analgesics with improved tamper-resistant properties. Our objective was to describe application of this technology to immediate-release (IR) ADFs.Design: For development of a sample IR ADF (hydrocodone 10 mg/acetaminophen 325 mg) based on HME, feasibility studies were performed using different excipients. The formulation selected for further development was evaluated via in vitro test battery. Moreover, in vivo performance of IR ADF technologies was investigated in an open-label, randomized, cross-over, phase 1, relative oral bioavailability study with another opioid (model compound).Setting: Single-center bioavailability trial.Participants: Twenty-four healthy white male subjects.Interventions: ADF IR formulation of an opioid and marketed IR formulation.Main Outcome Measure(s): For feasibility and in vitro studies, dissolution profiles, syringeability, particle size distribution after physical manipulation, and extractability were evaluated. For the phase 1 study, pharmacokinetic parameters were evaluated and compared for ADF IR and a marketed IR formulation.Results: After manipulation, the majority of particles from the ADF IR formulation were >500 μm and, thus, not considered suitable for intranasal abuse, while the majority of particles for the reference marketed IR formulation were <500 μm. The ADF IR formulation was resistant to syringing and preparation for potential intravenous injection. In healthy subjects, pharmacokinetics of an ADF and marketed IR formulation of an opioid were nearly identical.Conclusions: Application of HME to IR formulations led to development of products with improved mechanical resistance to manipulation for intranasal or intravenous preparation, but similar bioavailability.
Sequências volumétricas por ressonância magnética em tumores da cabeça
Authors: Santos Ronaldo Luiz do , Munhoz Bergman Nelson Sanchez , Goto Rafael Eidi , Melo Homero José de Farias e , Nobeschi Leandro
Published: February 2018

A aplicação das sequências de volumétricas por Ressonância Magnética – VIBE (Volume Interpolated Breath Hold Examination) são utilizadas para verificação do estadiamento de tumores da cabeça, e demonstram ser o melhor método nesses casos devido ao menor tempo de aquisição. Este artigo visa elucidar a aplicação e a relevância das sequências de volumétricas por meio de uma revisão da literatura, analisando a aquisição por meio do método VIBE, apurando as vantagens com relação ao T1 volumétrico e as demais sequências, T2, Fast Spin Eco e Spin Eco, pós-contraste com relação ao tempo. O exame VIBE equivale a um mecanismo relativamente novo de sequência RM gradiente-eco, sendo capaz de encurtar tempos de aquisição. Para esta hipótese, demonstra-se ser de grande valia em imaginologia do cérebro, como um substituto para imagens pesadas em T1 spin-eco pós-contraste convencional na avaliação dos tumores da cabeça.
Funcionalidade em pessoas idosas atendidas no centro de atendimento comunitário do UniCEUB (CAC-UniCEUB)
Authors: Silva Jaquelyne Bernard da , Benito Linconl Agudo Oliveira
Published: February 2018

Trata-se de um estudo de coorte, transversal, analítico e quantitativo, que utilizou o Índex de Katz, proposto por Sidney Katz em 1998. Num universo de 49 idosos avaliados, o perfil dos atores sociais participantes deste estudo se constituiu de 53,05% (n=26) pessoas do sexo feminino, 97,95% (n=48) brasileiros, 87,75% (n=43) negam tabagismo, 81,65% (n=40) negam etilismo, 42,85% (n=21) possuir ensino fundamental, 49% (n=24) realizam exercícios físicos, 55,10% (n=27) possuem sono normal, 69,40% (n=34) possuem entre 2 e 4 filhos, 14,30% (n=07) moram respectivamente junto as cidades satélites do Gama (RA-II) e São Sebastião (RA-XIV), 24,50% (n=12) possuem renda de 02 a 04 salários, 28,55% (n=14) realizam caminhada, 51% (n=25) eram da região nordeste. Foi verificado que 95,90% (n=47) adquiriram 06 enquanto pontuação e 4,10% (n=02) adquiriram 05, se caracterizando respectivamente enquanto idosos independentes por conseguirem realizar as atividades de banhar-se, vestir-se, ir ao banheiro, transferência, continência e alimentação.
Da membrana ao núcleo: mecanismos moleculares de armazenamento da memória
Authors: Nunes Benilson Souza , Queiroz Paulo Roberto
Published: February 2018

Os estudos relacionados ao armazenamento de memória têm apresentado notáveis avanços em sua abordagem molecular. Enzimas como a proteína cinase A (PKA) e a proteína cinase C (PKC), bem como fatores de transcrição como a CREB-1 e a CREB-2, participam da plasticidade neuronal de consolidação da memória. O objetivo do trabalho, portanto, foi apresentar, de maneira sistemática, a cadeia de eventos moleculares e celulares que acompanham o armazenamento da memória implícita em suas diferentes durações. A bibliografia deste trabalho descreve alguns estudos relacionados à transdução de sinal em circuitos neuronais simples. As pesquisas se pautam em duas modalidades de armazenamento convencionadas: facilitação de curta duração (STF) e facilitação de longa duração (LTF), cada uma apresentando seus mecanismos particulares. A facilitação de duração média (ITF) também é mencionada. Os avanços da biologia molecular prometem fornecer perspectivas cada vez mais íntimas dos mecanismos que governam as funções mentais, em especial da memória.
Conhecimento de estudantes universitários sobre a cirurgia bariátrica (CB)
Authors: Lopes Fernanda Souza , Benito Linconl Agudo Oliveira
Published: February 2018

Trata-se de um estudo transversal, descritivo e de abordagem quantitativa que analisou o conhecimento de estudantes de uma instituição de ensino superior (IES) com sede em Brasília (D.F.) sobre a CB. Foram entrevistados quatrocentos (400) estudantes, sendo que 48% (n=192) cursavam “enfermagem”, 24% (n=96) cursavam “nutrição”, 15,50% (n=62) cursavam “medicina”, 8,25% (n=33) cursavam “biomedicina” e 4,25% (n=17) cursavam “biologia”. O perfil dos atores sociais participantes do presente estudo se constituiu de 78,75% (n=315) pessoas do sexo feminino, 87,75% (n=351) solteiras, 70,75% (n=283) não desenvolvem atividade remunerada, 93,25% (n=373) negam enfermidade(s), 94,50% (n=378) negam tabagismo, 78% (n=312) negam consumo medicamentoso, 93% (n=372) negam etilismo, 99,25% (n=397) negam hipertensão arterial (HA), 100% (n=400) negam diabetes mellitus (DM), 81,50% (n=326) negam sobrepeso e 95% (n=380) negam obesidade. Foi identificado ainda reduzido conhecimento dentre os entrevistados, apenas na categoria analítica relacionada a necessidade de suplementação alimentar utilizando polivitamínicos após a realização da CB.
Microfoundations of the Arab Uprisings
Authors: Volpi Frédéric , Jasper James , Chalcraft John , Pearlman Wendy , Schwedler Jillian , Kurzman Charles , Khosrokhavar Farhad , Chazli Youssef
Published: February 2018

This book brings together a roster of prominent contributors to present a strategic interactionist perspective on the study of contentious politics in the Middle East in response to the Arab uprisings. The common thread among the contributions is an interest in the micro-level interactions between various strategic players, including not only the mobilisation of protestors during the uprisings but also the responses of regimes. The book also examines short to medium-term adaptations of the regimes and the collective action of opponents in the post-uprisings period, as well as the subsequent trajectories of the protesters themselves in the face of new forms of authoritarianism or democratisation.
Relating large-scale subsidence to convection development in Arctic mixed-phase marine stratocumulus
Authors: Young Gillian , Connolly Paul J. , Dearden Christopher , Choularton Thomas W.
Published: February 2018

Abstract. Large-scale subsidence, associated with high-pressure systems, is often imposed in large-eddy simulation (LES) models to maintain the height of boundary layer (BL) clouds. Previous studies have considered the influence of subsidence on warm liquid clouds in subtropical regions; however, the relationship between subsidence and mixed-phase cloud microphysics has not specifically been studied. For the first time, we investigate how widespread subsidence associated with synoptic-scale meteorological features can affect the microphysics of Arctic mixed-phase marine stratocumulus (Sc) clouds. Modelled with LES, four idealised scenarios – a stable Sc, varied droplet (Ndrop) or ice (Nice) number concentrations, and a warming surface (representing motion southwards) – were subjected to different levels of subsidence to investigate the cloud microphysical response. We find strong sensitivities to large-scale subsidence, indicating that high-pressure systems in the ocean-exposed Arctic regions have the potential to generate turbulence and changes in cloud microphysics in any resident BL mixed-phase clouds.Increased cloud convection is modelled with increased subsidence, driven by longwave radiative cooling at cloud top and rain evaporative cooling and latent heating from snow growth below cloud. Subsidence strengthens the BL temperature inversion, thus reducing entrainment and allowing the liquid- and ice-water paths (LWPs, IWPs) to increase. Through increased cloud-top radiative cooling and subsequent convective overturning, precipitation production is enhanced: rain particle number concentrations (Nrain), in-cloud rain mass production rates, and below-cloud evaporation rates increase with increased subsidence.Ice number concentrations (Nice) play an important role, as greater concentrations suppress the liquid phase; therefore, Nice acts to mediate the strength of turbulent overturning promoted by increased subsidence. With a warming surface, a lack of – or low – subsidence allows for rapid BL turbulent kinetic energy (TKE) coupling, leading to a heterogeneous cloud layer, cloud-top ascent, and cumuli formation below the Sc cloud. In these scenarios, higher levels of subsidence act to stabilise the Sc layer, where the combination of these two forcings counteract one another to produce a stable, yet dynamic, cloud layer.
An empirical model of nitric oxide in the upper mesosphere and lower thermosphere based on 12 years of Odin-SMR measurements
Authors: Kiviranta Joonas , Pérot Kristell , Eriksson Patrick , Murtagh Donal
Published: February 2018

Abstract. Nitric Oxide (NO) is produced by solar photolysis and auroral activity in the upper mesosphere and lower thermosphere region and can, via transport processes, eventually impact the ozone layer in the stratosphere. This work uses measurements of NO taken between 2004 and 2016 by the Odin Sub Millimetre Radiometer (SMR) to build an empirical model which links the prevailing solar and auroral conditions with the measured number density of NO. The measurement data are averaged daily and sorted into altitude and magnetic latitude bins. For each bin, a multivariate linear fit with five inputs, the planetary K-index, solar declination, and the F10.7cm flux, and two newly devised indices which take the planetary K-index and the solar declination as inputs in order to take NO created on previous days into account, constitutes the link between environmental conditions and measured NO. This results in a new empirical model, SANOMA, which only requires the three indices to estimate NO between 85 km–115 km and 80° S–80° N in magnetic latitude. Furthermore, this work compares the NO calculated with SANOMA and an older model, NOEM, with measurements of the original SMR-dataset, as well as measurements from four other instruments: ACE, MIPAS, SCIAMACHY, and SOFIE. The results suggest that SANOMA can capture roughly 31–70 % of the variance of the measured datasets near the magnetic poles, and between 16–73 % near the magnetic equator. The corresponding values for NOEM are 12–38 % and 7–40 %, indicating that SANOMA captures more of the variance of the measured datasets than NOEM. The simulated NO for these regions was on average 20 % larger for SANOMA, and 78 % larger for NOEM, than the measured NO. Two main reasons for SANOMA outperforming NOEM are identified. Firstly, the input data (Odin SMR NO) for SANOMA spans over 12 years, while the input data for NOEM from the Student Nitric Oxide Experiment (SNOE) only covers 1998–2000. Additionally, some of the improvement can be accredited to the introduction of the two new indices, since they include information of auroral activity on prior days which can significantly enhance the number density of NO in the MLT during winter in the absence of sunlight. As a next step, SANOMA could be used as input in chemical models, as apriori information for the retrieval of NO from measurements, or as a tool to compare Odin SMR NO with other instruments. SANOMA and accompanying scripts are available on http://odin.rss.chalmers.se.
Microphysical Characteristics of Frozen Droplet Aggregates
from Deep Convective Clouds
Authors: Um Junshik , McFarquhar Greg M. , Stith Jeffrey L. , Jung Chang Hoon , Lee Seoung Soo , Lee Ji Yi , Shin Younghwan , Lee Yun Gon
Published: February 2018

Abstract. During the 2012 Deep Convective Clouds and Chemistry (DC3) experiment the National Science Foundation/National Center for Atmospheric Research Gulfstream-V (G-V) aircraft sampled the upper anvils of two storms that developed in eastern Colorado on 6 June 2012. A cloud particle imager (CPI) mounted on the G-V aircraft recorded images of ice crystals at altitudes of 12.0–12.4 km and T = −61– −55 °C. A total of 22,393 CPI crystal images were analyzed, all with maximum dimension Dmax
Dissolved Pb and Pb isotopes in the North Atlantic from the GEOVIDE transect (GEOTRACES GA-01) and their decadal evolution
Authors: Zurbrick Cheryl M. , Boyle Edward A. , Kayser Rick , Reuer Matthew K. , Wu Jingfeng , Planquette Hélène , Shelley Rachel , Boutorh Julia , Cheize Marie , Contreira Leonardo , Menzel Barraqueta Jan-Lukas , Sarthou Géraldine
Published: February 2018

Abstract. During the 2014 GEOVIDE transect, seawater samples were collected for dissolved Pb and Pb isotope analysis. These samples provide a high resolution snapshot of the source regions for the present Pb distribution in the North Atlantic Ocean. Some of these stations were previously occupied for Pb from as early as 1981, and we compare the 2014 data with these older data some of which are reported here for the first time. Lead concentrations were highest in subsurface Mediterranean Water (MW) near the coast of Portugal, which agrees well with other recent observations by the U.S. GEOTRACES program (Noble et al., 2015). The recently formed Labrador Sea Water (LSW) between Greenland and Nova Scotia is much lower in Pb concentration than the older LSW found in the Western European Basin due to decreases in Pb emissions into the atmosphere during the past 20 years. Comparison of North Atlantic data from 1989–2014 shows decreasing Pb concentrations consistent with decreased anthropogenic inputs, active scavenging, and advection/convection. The nearly-homogenous isotopic composition of northern North Atlantic seawater implies that the relative proportions of U.S. and European Pb sources to the ocean have been relatively uniform during the past two decades. Using our measurements in conjunction with emissions inventories, we support the findings of previous atmospheric analyses that up to 50 % of the Pb deposited to the ocean in 2014 was natural, although it remains unclear if that natural dust is from the mid- or high-latitudes.
The World Optical Depth Research and Calibration Center (WORCC) quality assurance and quality control of GAW-PFR AOD measurements
Authors: Kazadzis Stelios , Kouremeti Natalia , Nyeki Stephan , Gröbner Julian , Wehrli Christoph
Published: February 2018

Abstract. The World Optical Depth Research Calibration Center (WORCC) is a section within the World Radiation Center at Physikalisches-Meteorologisches Observatorium (PMOD/WRC), Davos, Switzerland, established after the recommendations of the World Meteorological Organization for calibration of aerosol optical depth (AOD)-related Sun photometers. WORCC is mandated to develop new methods for instrument calibration, to initiate homogenization activities among different AOD networks and to run a network (GAW-PFR) of Sun photometers. In this work we describe the calibration hierarchy and methods used under WORCC and the basic procedures, tests and processing techniques in order to ensure the quality assurance and quality control of the AOD-retrieved data.
Thetis coastal ocean model: discontinuous Galerkin discretization for the three-dimensional hydrostatic equations
Authors: Kärnä Tuomas , Kramer Stephan C. , Mitchell Lawrence , Ham David A. , Piggott Matthew D. , Baptista António M.
Published: February 2018

Abstract. Unstructured grid ocean models are advantageous for simulating the coastal ocean and river-estuary-plume systems. However, unstructured grid models tend to be diffusive and/or computationally expensive which limits their applicability to real life problems. In this paper, we describe a novel discontinuous Galerkin (DG) finite element discretization for the hydrostatic equations. The formulation is fully conservative and second-order accurate in space and time. Monotonicity of the advection scheme is ensured by using a strong stability preserving time integration method and slope limiters. Compared to previous DG models advantages include a more accurate mode splitting method, revised viscosity formulation, and new second-order time integration scheme. We demonstrate that the model is capable of simulating baroclinic flows in the eddying regime with a suite of test cases. Numerical dissipation is well-controlled, being comparable or lower than in existing state-of-the-art structured grid models.
Novel thermocouples for automotive applications
Authors: Gierth Paul , Rebenklau Lars , Augsburg Klaus , Bachmann Eric , Niedermeyer Lars
Published: February 2018

Abstract. Measurement of temperatures in engine and exhaust systems in automotive
applications is necessary for thermal protection of the parts and optimizing
of the combustion process. State-of-the-art temperature sensors are very
limited in their response characteristic and installation space requirement.
Miniaturized sensor concepts with a customizable geometry are needed. The
basic idea of this novel sensor concept is to use thick-film technology on
component surfaces. Different standardized and especially nonstandard
material combinations of thermocouples have been produced for the validation
of this technology concept. Application-oriented measurements took place in
the exhaust system of a test vehicle and were compared to standard laboratory
conditions.
Assessment of the physicochemical and bacteriological qualities of Nono - a fermented cow milk
Authors: Okiki Pius Abimbola , Adeniji Comfort Adetutu , Oyetunji Oluwadunsin Adedeji , Yusuf Omosolape Aminat , Peters Omolara
Published: February 2018

Nono is a spontaneously fermented yoghurt-like milk product consumed is a staple food commodity in parts of the Sub-Saharan West Africa. Nono is usually consumed along with 'Fura' as 'Fura da Nono' in Nigeria. Studies on physicochemical and bacteriological qualities were carried out on samples of Nono obtained from 5 different sources in Ado-Ekiti, Nigeria. The Nono samples were found to be nutritious, containing moderate levels of ash, crude fat, crude protein and carbohydrate. The pH of the Nono samples was relatively low (4.04 ±0.04), while the density and specific density were close to that of distilled water at room temperature. Total aerobic plate count of Nono samples was 1.8 ±0.02 × 106 CFU.mL-1. A total of 15 bacteria species namely Eubacterium nodatum, Bacillus subtilis, Chromobacterium violaceum, Propionibacterium acnes, Amycolatopsis benzotilytica, Tropheryma whipplei, Moraxella catarrhalis, Campylobacter gracilis, Neisseria sicca, Vibrio natiensis, Photobacterium damselae, Corynebacterium kutsceri, Corynebacterium xerosis, Lactobacillus fermentum and Lactobacillus casei were isolated from the Nono samples. The gram-positive bacterial isolates were resistant to all antibiotics tested with the exception of Erythromycin where 40% susceptibility was obtained, while the gram-negative bacteria showed high resistance to the tested antibiotics, but with 80% susceptibility to Ofloxacin. The nono samples were observed to exhibit antibacterial activity against cultures of Salmonella typhimurium ATCC 14028, Escherichia coli ATCC 29929 and Staphylococcus aureus ATCC 29293. Most of the bacteria isolated were of less public health importance, but the high prevalence of multi-drug resistance is of great concern.
English Teachers Assess Instructional Methods Supporting Knowledge Processes
Authors: Zendle Andreas
Published: February 2018

Answers to the questions of which instructional methods are suitable for school, which instructional methods should be applied in teaching individual subjects and how instructional methods support the act of learning represent challenges to general education and education in individual subjects. This article focuses on the empirical examination of instructional methods supporting knowledge processes in the act of learning. A survey was conducted in which English teachers evaluated 20 instructional methods in regard to the following knowledge processes: build, process, apply, transfer, assess and integrate. The results of the study demonstrate that certain instructional methods are especially predestined for the English classroom: project work, jigsaw, problem-based learning, learning tasks, learning stations, presentation, learning by teaching, discovery learning, and role-play.
Reciprocal expressions and the Maximal Typicality Hypothesis
Authors: Poortman Eva B. , Struiksma Marijn E. , Kerem Nir , Friedmann Naama , Winter Yoad
Published: February 2018

In two experiments, we study the effects of verb concepts on the interpretation of reciprocal expressions in Dutch and Hebrew. One experiment studies Hebrew to test a previous account, the Strongest Meaning Hypothesis, which suggests that listeners resolve ambiguity in reciprocal sentences using the logically strongest meaning that is consistent with the context. The results challenge this proposal, as participants often adopt a weaker meaning than what the Strongest Meaning Hypothesis expects. We propose that these results reflect the sensitivity of reciprocal quantifiers to verb concepts, which is modelled by a new principle, the Maximal Typicality Hypothesis (MTH). For any given reciprocal sentence, the MTH specifies a core situation: the maximal situation that is also maximally typical for the verb concept. The MTH predicts reciprocal sentences to be maximally acceptable in the core situation and, under certain conditions, in situations that contain it, but substantially less acceptable in other situations. To test this prediction, we conducted a two-part experiment among Dutch speakers: (a) a membership test that ranks typicality preferences with different verbs; (b) a truth-value judgement test with reciprocal sentences containing these verbs. The results show that the typical number of patients per agent varies between verbs, with a significant effect of these preferences on reciprocal quantification: the stronger the verb concept’s bias is for one-patient situations, the weaker is the interpretation of reciprocal sentences containing it. These results support the MTH as a basis for a general theory of reciprocal quantification.
The cost of raising quantifiers
Authors: Wurmbrand Susanne
Published: February 2018

The main proposal of this paper is that quantifier raising (QR) is not subject to QR-specific locality or domain restrictions but that differences observed between overt and covert movement are the result of an increased processing burden associated with multiple steps of covert movement and the lack of a cue for the parser to initiate a search for a covert dependency. One of the main observations is that QR from different types of clausal complements is gradient and speakers’ acceptance of non-local inverse scope tracks syntactic complexity defined over clausal domains. The account develops a preliminary algorithm for calculating processing costs based on the complexity of the structure, which in turn is reflected in the number of steps QR has to undergo in a cyclic movement approach to inverse scope.
Monseñor Romero ha vencido al poder
Authors: González Luis Armando
Published: February 2018

No abstract available.Realidad: Revista de Ciencias Sociales y Humanidades No. 103, 2005: 11-17
Sobre la filosofía de la religión en América Latina
Authors: Solari Enzo
Published: February 2018

No abstract available.Realidad: Revista de Ciencias Sociales y Humanidades No. 103, 2005: 127-169
Pedro Geoffroy Rivas, la mágica raíz olvidada
Authors: Rivas Jaime
Published: February 2018

No abstract available.Realidad: Revista de Ciencias Sociales y Humanidades No. 103, 2005: 187-192
"Crisis energética": la energía nuclear, ¿una alternativa complementaria?
Authors: Editor El
Published: February 2018

No abstract available.Realidad: Revista de Ciencias Sociales y Humanidades No. 104, 2005: 195-206
El año histórico de 1968. Diez acontecimientos que cambiaron el mundo
Authors: Ribera Ricardo
Published: February 2018

The author reviews the main facts of that year: from the death of Che Guevara, the student revolt known as "the French May" and the Chinese cultural revolution; the offensive of Tet in Vietnam and the protests against the war in the Asian country; the students massacre in Tlatelolco square in Mexico, the teacher's strike in El Salvador and the Episcopal Conference in Medellín, Colombia; the beginning of computer nets -an antecedent to Internet- and the conquest of the moon in the context of the spacial race. These were key events to understand the present and the future. A synthesis year in the century, a reflex of 20th century, 1968 is a very suggestive year.Realidad: Revista de Ciencias Sociales y Humanidades No. 104, 2005: 241-268
Perfil de los comunicadores sociales desde la perspectiva de la comunicación humanizadora
Authors: Ayala Ramírez Carlos
Published: February 2018

The media have an important role in the contemporary societies. Some use to say that today's society is a mediatic society, but usually it is forgotten that this society needs humanizing values. In this esssay, the author pleads for a humanized profile for joumalists, as a response to the ruling marketing conceptions.Realidad: Revista de Ciencias Sociales y Humanidades No. 105, 2005: 505-522
Una deuda saldada con la literatura salvadoreña: la poesía completa de Roque Dalton
Authors: Alvarenga Luis
Published: February 2018

No abstract availableRealidad: Revista de Ciencias Sociales y Humanidades No. 105, 2005: 523-524
Las bibliotecas y la tolerancia
Authors: Miller Katherine
Published: February 2018

No abstract availableRealidad: Revista de Ciencias Sociales y Humanidades No. 105, 2005: 525-529