bluuebunny/crossref_metadata_2025 huggingface dataset:
The Study of PM10 Concentration and Trace Metal Content in Different Areas of Karachi, Pakistan
Authors: Hashmi Durdana Rais , Shareef Akhtar , Khan Farooq Ahmed
Published: June 2021

Atmospheric particulate matter may exert serious health hazards because of its chemicalcharacteristics. Aim of this study was to determine the concentrations of particulate matter (PM) with anaerodynamic diameter <10 mm (PM10), and air transmitted particulate trace metals in different areas ofKarachis ambient air, for the period of 01 year viz. June 2011 to June 2012. Furthermore, the present workcompares the levels of particulate matter and trace metals with the proposed limiting values from the U.S.Environmental Protection Agency (65 mg/m3 for PM10). The sampling for PM10 was performed by usinga high volume air sampler. The PM10 levels were determined by gravimetry and the metals by graphitefurnace. Arithmetic means of 361.0 mg/m3 was determined for PM10 in commercial areas, 275.0 mg/m3 inresidential areas, 438.0 mg/m3 in industrial areas and 68.9 mg/m3 in background areas of Karachi. Tracemetal content in PM10, such as lead (Pb) and cadmium (Cd) were also analysed separately during the sameperiod using atomic absorption spectrometry. The average concentration of Pb were found in commercialzone 1.36 mg/m3, in residential zone 1.0 mg/m3, in industrial zone 1.46 mg/m3 and in urban backgroundzone 0.6 mg/m3, whereas; Cd concentration in commercial zone 0.10 µg/m3, in residential zone 0.02 µg/m3,in industrial zone 0.25 µg/m3 and in urban background zone 0.01 µg/m3, respectively.
Quantification of Pesticide Residues in Drinking Water in Different Areas of District Charsadda, Pakistan
Authors: Qureshi Muhammad Nasimullah , Rahman Inayat-Ur-Rahman
Published: June 2021

Pesticides residues were determined quantitatively in drinking water samples collected fromdistrict Charsadda of the province Khyber Pakhtunkhwa, Pakistan employing GC-MS technique. Thesurvey was conducted soon after the flood in 2010. Aldicarb (0.003 mg/L) was found only in C7, whileresidues of acetachlor (0.001 mg/L) was found in C8. Among the pesticides quantified Chlorpyrifosdelivered highest amount of residues in C8, C9, C10, C11 and C12. Residues of o, p'-DDT were foundhigher in C1 to C6 than the permitted value (0.002 mg/L), while higher concentration of Pyridaben thanthe allowed value (0.0001 mg/L) was resulted in C1, C5, C6 and C14. Residues of Carbofuran, Atrazine,a-Endosulfan and Dieldrin, b-Endosulfan, Difenoconazole-1 and Difenoconazole-2 were not detectedin any of the collected water samples. Concentrations of rest of the pesticides residues detected in watersamples were within the permissible limits. The study revealed that water samples collected from districtCharsadda are highly contaminated with pesticides, which is a health risk factor for the inhabitant ofthis areas.
Biosorption of Chromium (VI) and Calculations of Langmuirs and Freundlichs Isotherms
Authors: Butt Muhammad Tahir , Amjad Zara , Khan Rauf Ahmad
Published: June 2021

In the present study yeast biomass has been successfully used as biosorbent for removal of Crfrom aqueous solution. Yeasts of Saccharomyces cerevisiae are effective biosorbents for heavy metal ionsand it can be bought in large quantity at low cost. S. cerevisiae can remove toxic metals from aqueoussolutions to various levels. This low-cost biosorbent will make the process cost-effective and competitiveparticularly for environmental applications in detoxifying effluents. Langmuirs and Freundlichs isothermswere also plotted to observe the maximum biosorption of heavy metal chromium (VI).
Efficiency for Sorption Behaviour of Polymeric Resins of (2-hydroxybenzaldehyde) with Aliphatic and Aromatic Diamines Towards Different Metal Ions
Authors: Shah Ambreen , Shah Asif Ali , Shah Sobia Shafaq Ambreen.shah@usindh.edu.pk
Published: June 2021

Aliphatic and aromatic polymeric resins of (2-hydroxybenzaldehyde) with 1,2-propylenediamineand 1,4-phenylenediamine were synthesised and characterised employing elemental and thermal analysis,FT-IR and UV-visible spectroscopy. The metal uptake behaviour of synthesised polymers (PMBHBPn,PMBHBPh) towards different metal ions were investigated and optimised by variety of conditions. Thesorption data of these metal ions were followed Langmuir, Freundlich, and Dubinin-Radushkevich(D-R) isotherms. The Freundlich parameters were computed at 1/n = 0.26 ± 0.02, 0.309 ± 0.02, 0.35 ±0.05, 0.368 ± 0.04 and 0.23 ± 0.01, A = 3.9 ± 0.03, 4.31 ± 0.02, 4.683 ± 0.01, 5.43 ± 0.03, and 2.81 ± 0.05mmol/g for Cu(II), Co(II), Ni(II), Fe(III) and Cd(II) ions, respectively. The variation of sorptionwith temperature gives thermodynamic quantity (DH) in the range of (AH = 36.33 - 52.14 KJ/mol) for(PMBHBPn) and (39.21-56.29 KJ/mol) for (PMBHBPh). The sorption procedure could preconcentratemetal ions, and it can be determined by atomic absorption spectrophotometer.
Predictive factors of stone-free status in renal stone treatment with flexible ureterorenoscopy
Authors:   Division of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand, Pattarawongpaiboon Suppasek , Usawachintachit Manint ,   Division of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
Published: June 2021

Objective: Flexible ureterorenoscopy (fURS) is one of the standard treatments for renal calculi up to 20 mm. This study aims to identify factors associated with stone-free status. Materials and Methods: We included patients undergoing fURS for treatment of small to medium-size renal stone (no single stone larger than 20 mm) from April 2017 to September 2019 at King Chulalongkorn Memorial Hospital. All patients had a preoperative CT scan and postoperative imaging for comparison. We collected patient characteristics (sex, age, previous ipsilateral urinary tract surgery, preoperative ureteral stent placement), stone factors (total stone burden, stone number, stone density) and renal factors (anatomical abnormalities, stone location in a lower pole, number of caliceal involvement) and correlated the data against postoperative stone-free status (defined as residual fragment ≤ 2 mm). Results: The overall stone-free rate was 53.3%. From the univariate analysis, previous surgery, total stone burden, stone number, stone location in the lower pole, and the number of caliceal involvement were associated with stone-free status. However, only the total stone burden remained statistically significant in the multivariate analysis (p-value < 0.05). The stone-free rates were 75.9%, 57.1%, and 11.1% in the total stone burden ≤ 10 mm, 11-20 mm, > 20 mm, respectively. Conclusion: Following treatment of renal stones ≤ 20 mm with fURS, the stone-free rate was 53.3% and was significantly associated with the preoperative total stone burden.
Urine neutrophil gelatinase-associated lipocalin (NGAL) measurement is not predictive for ureteral patency in pediatric patients following pyeloplasty: a pilot study
Authors:   Division of Urology, Department of Surgery, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, The Thai Red Cross Society, Bangkok, Thailand, Lumyai Varathon , Srisawat Nattachai ,   Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, The Thai Red Cross Society, Bangkok, Thailand, Ngamwuttiwong Promwong ,   Division of Urology, Department of Surgery, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, The Thai Red Cross Society, Bangkok, Thailand, Bunyaratavej Chanatee ,   Division of Urology, Department of Surgery, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, The Thai Red Cross Society, Bangkok, Thailand, Usawachintachit Manint ,   Division of Urology, Department of Surgery, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, The Thai Red Cross Society, Bangkok, Thailand
Published: June 2021

Objective: To evaluate the benefit of urine neutrophil gelatinase-associated lipocalin (NGAL) measurement to predict the ureteral patency in pediatric patients undergoing pyeloplasty. Materials and Methods: Ureteropelvic junction obstruction patients who underwent unilateral dismembered pyeloplasty had urine NGAL measurements taken intraoperatively during pyeloplasty and postoperatively at six months following surgery. All patients were evaluated preoperatively and postoperatively with renal scans. Pairwise comparisons and correlation analyses were performed to determine the dynamics and benefits of urine NGAL measurement. Results: Thirteen patients were included in this pilot study with a mean age of 3.2 years at surgery. Mean intraoperative bladder urine level was 4.43 ng/mL, and median intraoperative renal pelvic urine NGAL level was 3.70 ng/mL. There was no significant difference between these two levels (p-value = 0.76). Six months after pyeloplasty, 9/13 patients demonstrated significant reduction in the bladder urine NGAL level (at least 50% reduction), and 5/13 patients showed ureteral patency based on postoperative renal scan (more than 5% improvement in differential renal function or the conversion of diuretic half time. However, the finding of significant reduction of urine NGAL level did not correlate with ureteral patency (r = -0.50, p-value = 0.08). Conclusion: Although bladder urine NGAL level reduces in most pediatric patients following pyeloplasty, this decline is not reflective of the finding of ureteral patency from renal scanning. The benefits of urine NGAL measurement in this context remain unclear and require further large-scale investigation.
Burkholderia pseudomallei infection in the genitourinary tract: a case report
Authors:   Division of Urology, Department of Surgery, Buri Ram Hospital, Buri Ram, Thailand, Prohsoontorn Ornnicha , Pimratana Chaowat ,   Division of Urology, Department of Surgery, Buri Ram Hospital, Buri Ram, Thailand
Published: June 2021

Melioidosis, caused by the gram-negative bacillus Burkholderia pseudomallei, is an infectious disease which is endemic in areas like Southeast Asia and Northern Australia. Urogenital involvement is less common in Thailand. This is a case study of a 60-year-old Thai male who had no underlying diseases and developed a renal abscess from melioidosis. He presented with a high grade fever for about 2 weeks. Physical examination disclosed costovertebral angle tenderness but otherwise was unremarkable. Laboratory and imaging investigations revealed leukocytosis in the complete blood count. White blood cells and red blood cells were detected in urinalysis. There was no growth in either the hemoculture or urine culture but melioidosis antibody level was positive (1:5, 120). Computerized tomography of the whole abdomen showed multiple areas of hypodensity lesions at mid and lower pole extended to the right perirenal space indicating likely renal abscesses. The final diagnosis was melioidosis with renal abscesses.
ANALYSIS OF INTEGRATED BUS TERMINAL SERVICES IN PULO GEBANG IN INCREASING CUSTOMER SATISFACTION
Authors: Setyawati Aswanti , Nur Huda Muhammad , Suripno Suripno , Tannady Hendy
Published: June 2021

This study aims to analyze the service level of the Pulo Gebang Integrated bus terminal in increasing customer satisfaction. Based on the analysis and discussion, the results of the gap analysis between customer perceptions and expectations of 22 service attributes are all negative (-) with a range of -0.15 to -1 , 49. This indicates that the quality of service is still far from customer expectations, the attributes of interest after analyzing with the Importance Performance Analysis, the priority for improvement is obtained as well as in an effort to improve the quality of customer service at the Pulo Gebang Integrated bus terminal, after analyzing the approach with the Quality Function Deployment method, seven order of priority improvement.
Desafios para a regularização do uso de águas da União para a prática da maricultura em Santa Catarina
Authors: Tortato Novaes André Luís , De Novaes Vianna Luiz Fernando
Published: June 2021

Resumo – Santa Catarina foi o primeiro estado da federação a regularizar áreas aquícolas marinhas para o cultivo de moluscos bivalves. Seiscentas e dezenove áreas foram cedidas no estado pelo governo federal. Apesar dessa conquista, há desafios relacionados à ocupação do mar por projetos de aquicultura que ainda precisam ser superados visando ao desenvolvimento sustentável do setor. Estes desafios são: atender a demanda ainda existente por áreas aquícolas no estado; resolver conflitos de uso da zona costeira; realizar ajustes de posicionamento de áreas aquícolas e promover a ocupação das áreas aquícolas respeitando os limites geográficos estipulados nas cessões de uso. O objetivo do presente documento é abordar esses desafios e apontar soluções visando sobrepujá-los.
Comportamento de híbridos de couve-flor em plantio direto sob manejo fitossanitário convencional e alternativo no cultivo de inverno/primavera em Santa Catarina
Authors: Vieira Neto João , Menezes Júnior Francisco Olmar Gervine de , Gonçalves Paulo Antônio de Souza
Published: June 2021

O objetivo do estudo foi avaliar o desempenho de híbridos de couve-flor em sistema de manejo fitossanitário convencional e alternativo. Dois experimentos foram realizados na Inserir local em agosto de 2018 e 2019. Em cada manejo foi adotado delineamento de blocos ao acaso com quatro repetições, tendo como parcelas vinte plantas de cada cultivar, parcela útil constituída por seis plantas centrais. Os híbridos de couve-flor Alpina, Verona e Júlia são os mais indicados para a semeadura em cultivos de inverno/primavera, na região do Alto Vale do Itajaí, SC. O controle de pragas e doenças é possível com produtos fitossanitários de menor toxicidade.
Subsídios para o manejo de percevejos na fase inicial da cultura do milho
Authors: Lopes de Toledo Taiane , Cazarotto Madalóz José Carlos , Prado Ribeiro Leandro
Published: June 2021

No sul do Brasil, os percevejos barriga-verde (Dichelops furcatus e Dichelops melacanthus) têm se constituído em pragas-chave do milho, causando expressiva redução na produtividade pelo ataque na fase inicial da cultura. Assim, neste informativo são apresentados aspectos aplicados relacionados a dinâmica de percevejos nos sistemas de produção milho-soja, características bioecológicas e comportamentais e as principais estratégias de monitoramento e manejo recomendadas para as condições de cultivo desse cereal no sul do Brasil.
Produtividade de frutos e nutrição mineral de pepineiro para conserva submetido a soluções nutritivas em semi-hidroponia
Authors: Vieira Neto João , Morales Rafael Gustavo Ferreira , Mora Cristiano
Published: June 2021

O presente trabalho foi realizado com objetivo de avaliar o efeito de soluções nutritivas sobre a produtividade e qualidade de frutos de pepineiro para conserva, sob ambiente protegido. Dois experimentos foram conduzidos na Inserir local após avaliação, nos anos de 2019 e 2020, com o híbrido Kybria F1. O delineamento experimental foi o de blocos casualizados com seis repetições, sendo os tratamentos: 80, 90, 100, 110 e 120% das quantidades de fertilizantes recomendadas por Andriolo & Peil. Houve efeito significativo das diferentes concentrações de soluções nutritivas avaliadas sobre a produtividade do pepineiro. Os tratamentos que proporcionaram maior desempenho produtivo foram T2 (90% da solução padrão) e T3 (solução padrão 100%). Os frutos apresentaram boa qualidade para todas as concentrações de soluções avaliadas.
Measuring and Analyzing the Common and Idiosyncratic Cycles: An Application for Turkish Manufacturing Industry
Authors: Siklar Emel , Siklar Ilyas
Published: June 2021

This study uses the Butterworth filter to decompose cyclical signals at low and high frequencies in the production data of the manufacturing industry and its sub-sectors. At low frequencies, the production trend exhibits considerable differences among industrial activities while most of the sub-sectors are more sensitive to common cycle than their own dynamics at high frequencies. Moreover, it is predicted that changes in the manufacture of basic metals sub-sector production can be used as a leading indicator for the expansion and contraction periods of the common cycle estimated for the manufacturing industry.
The Impact of China-Africa Trade on Industries in Africa: A Case Study of FOCAC and BRI
Authors: Mbona Reginald Masimba
Published: June 2021

Over the last two decades, the trade between Africa and China has grown significantly but there is still a debate on how local industries in Africa are being affected. Two key foreign policies, FOCAC and BRI, by China are the foundations on which the trade is done with its African partners. This study aims to assess which industries in Africa are being affected by these Chinese-led foreign trade policies and the significance of that impact. Using panel data, the study examines the effect of the FOCAC era and the FOCAC+BRI era on the energy, agriculture, mining, manufacturing, and technology industries for six partners. The results from the analysis showed that imports positively affect the agriculture and the energy sectors while the manufacturing industry is negatively affected by imported goods. On the other hand, exports have shown a positive impact on the mining sector. However, the agriculture industry is still struggling to have positive gains from exports. The findings of this study are important as the continent works towards "One Africa" which seeks to promote sustainable development of the continent. Also, the study focuses on specific industries that are significant to the economic growth of these countries as shown by their positive relationship with the GDP of these nations.
Successful intravenous lipid emulsion therapy: Olanzapine intoxication
Authors:   Haseki Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey, Yeniocak Selman , Kalkan Asim ,   Okmeydani Training and Research Hospital, Department of Emergency Medicine, İstanbul, Turkey, Metin Dondu Dilek ,   Haseki Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey, Demirel Ahmet ,   Okmeydani Training and Research Hospital, Department of Emergency Medicine, İstanbul, Turkey, Sut Rumeysa ,   Haseki Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey, Akkoc Ibrahim ,   Haseki Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey
Published: June 2021

Olanzapine is an antipsychotic drug used in psychiatric diseases. At high doses it exhibits cardiovascular and neurological sideeffects in particular. Lipid emulsion therapy for the removal of medication from plasma in high-dose lipophilic drug use has recently become very widespread. In the light of current literature, this report discusses the successful treatment of a patient within 4 hrs of olanzapine overdose as an attempted suicide, who presented with agitation and clouded consciousness
Examining trainee awareness of dermatoses and dermatological assessments during acute admissions (A quality improvement project)
Authors:   Norfolk and Norwich University Hospital, Colney Lane, Patel Priya , King Natalie ,   East Surrey Hospital, Canada Avenue, Redhill
Published: June 2021

Studies demonstrate 67% of elderly patients can have dermatoses, which could result in functional and psychological consequences. Elderly presentations are further complicated by comorbidities and polypharmacy. This combined with limited dermatology training at undergraduate and postgraduate levels creates diagnostic challenges. This project investigated dermatology assessments by trainees using the Trust’s acute medical admissions proforma. 100 proforma were reviewed for skin assessments alongside nursing skin care bundles. Subsequently, a skin survey was conducted amongst trainees evaluating knowledge and confidence when diagnosing and managing common dermatoses. Successively, a dermatology teaching series was delivered. Post-intervention the above were reassessed, demonstrating improvements in most areas. The dermatology teaching series will continue alongside a Trust hospital guideline to sustain improvements in dermatological care on admission.
An unusual case of dysphagia
Authors:   Acute and General Internal Medicine, Queen Elizabeth University Hospital, Glasgow, Williamson Adam , Kelly Christopher ,   Forth Valley Royal Hospital, Larbert, Scotland
Published: June 2021

A 51-year-old lady, with a background of an arachnoid cyst and ventriculo-peritoneal shunt in situ, presented to the Acute Medical Unit with a 2-day history of neck pain. She awoke from sleep with the pain and it persisted since. She had not been involved in any trauma, had no previous history of neck or back pain and her pain was not controlled with simple analgesia. She also complained of new odynophagia and high dysphagia, particularly to solid foods. There was no history of upper respiratory tract infection.
The Problems with Risk Prediction during an Emergency Medical Admission Using Laboratory Data – Evidence from Potassium
Authors:   St James’s Hospital, Dublin 8, Ireland., Conway Richard , Byrne Declan ,   St James’s Hospital, Dublin 8, Ireland., Cournane Seán ,   St. Vincent’s University Hospital, Dublin 4., O’Riordan Deirdre ,   St James’s Hospital, Dublin 8, Ireland., Silke Bernard ,   St James’s Hospital, Dublin 8, Ireland.
Published: June 2021

Background: The prediction of clinical outcomes using biochemical markers is an important tool. Methods: We calculated a risk score for all emergency admissions 2002-2017. We related potassium and mortality in a multivariable fractional polynomial model. We investigated the potassium distribution and relationship of potassium to mortality over time. Results: There were 106,586 admissions in 54,928 patients. Mortality was higher for those with an admission potassium above the median – 6.1% vs 4.6% (p<0.001), OR 1.07 (95%CI: 1.06, 1.09). There was a progressive increase in mortality from the lowest – 8.9% (95%CI: 8.3%, 9.4%) to highest potassium decile – 14.2% (95%CI: 13.5%, 14.8%). The frequency of admission hypokalaemia and the mortality at any given potassium decreased over time. Conclusion: Admission potassium predicts mortality.
Socio-Economic Status and MultiOriginal morbidity – Fact or Fiction?
Authors: Byrne Declan , Cournane Seán ,   Medical Physics and Bioengineering Department, St. Vincent’s University Hospital, Dublin 4, Conway Richard ,   MED Directorate, St James’s Hospital, Dublin 8, Ireland, O’Riordan Deirdre ,   MED Directorate, St James’s Hospital, Dublin 8, Ireland, Silke Bernard ,   MED Directorate, St James’s Hospital, Dublin 8, Ireland
Published: June 2021

Background: Areas of low socio-economic status (SES) have a disproportionate number of emergency medical admissions; we quantitate the profile of multi-morbidity related to SES. Methods: We developed a logistic multiple variable regression model, based on over 15 years of hospital data, to examine the effect of socio-demography on hospital outcomes. Results: Admissions from low SES cohort were a decade younger, and had a shorter hospital stay, and lower 30-day episode mortality outcome. The number of morbidities was equivalent between groups, but the more disadvantaged were more likely to have a respiratory diagnosis or diabetes. Conclusion: Low SES emergency admissions present > 10 yr. earlier than the high SES population; their equivalent multimorbidity, despite a lower age, could reflect accelerated disease progression.
Struggling with the last breath: breathlessness at the end of life on the AMU
Authors:   Basildon & Thurrock University Hospital, Lander M , Martin Jonathan ,   Department of Palliative Medicine, Central and North West London NHS Foundation Trust, National Hospital for Neurology & Neurosurgery, University College London Hospitals
Published: June 2021

Breathlessness is one of the most common symptoms experienced at the end of life, affecting all areas of a patient’s life. It is frightening and leads to high rates of emergency hospital attendances. Often, there is no easily reversible cause and patients are admitted to the acute medical unit (AMU) in order to manage their symptoms with little overall benefit – frustrating patients and clinicians alike. This review reminds the generalist of the significance of breathlessness as a symptom. It highlights the management strategies available to effect improvement and gives practical tips on how this can be achieved within the busy and time-pressured environment of the AMU.
Fever increases heart rate and respiratory rate; a prospective observational study of acutely admitted medical patients
Authors:   Rigshospitalet Glostrup, Valdemar Hansens Vej 1-23, DK-2600 Glostrup, Denmark, Jensen Maria Maj , Kellett John G ,   Finsensgade 35, 6700 Esbjerg, Denmark., Hallas Peter ,   Rigshospitalet Glostrup, Valdemar Hansens Vej 1-23, DK-2600 Glostrup, Denmark, Brabrand Mikkel ,   Department of Emergency Medicine Odense University Hospital
Published: June 2021

Background: The relationship between increase in body temperature, heart rate, and respiratory rate has only been studied in young, healthy subjects. Aim: To show the changes in heart and respiratory rate associated with fever in acutely admitted medical patients. Design: A prospective observational cohort study Methods: Vital parameters from 4,493 patients were retrospectively extracted. Linear and multiple variable regression analysis was used to calculate the change in heart and temperature rate for every degree rise in temperature (i.e. ΔHR/°C and ΔRR/°C) in the entire study group and in those with low (<36.1°C), normal (36.1-38°C) and high (>38°C) body temperatures. Results: The ΔHR/°C and ΔRR/°C was 7.2±0.4 beats per minute (bpm) and 1.4 ±0.1 (1.2 to 1.62) breaths per minute (bpm). Adjusting for age, oxygen saturation and mean blood pressure, the results were 6.4±0.4 (5.7 to 7.1) bpm and 1.2±0.1 (1.0 to 1.4) bpm. In low, normal and high body temperature the ΔHR/°C were 2.7±1.9, 6.9±1.9 and 7.4±0.9 bpm, respectively; for ΔRR/°C the values were -0.5±0.5, 1.5±0.5 and 2.3±0.3 bpm, respectively. Conclusions: We only found a modest association between fever and changes in heart rate and respiratory rate.
Life threatening pembrolizumabinduced myositis in a patient treated for advanced adenocarcinoma of the lung
Authors:   Department of Oncology, North Middlesex University Hospital, London, Robinson Stephen D , Lai Carmen ,   Department of Oncology, North Middlesex University Hospital, London, Hotton Gary ,   Department of Neurology, North Middlesex University Hospital, London, Anand Girija ,   Department of Oncology, North Middlesex University Hospital, London
Published: June 2021

The advent of immunotherapy in oncology has led to the emergence of a new spectrum of adverse effects. A number of these have the potential to contribute to life-threatening outcomes; and therefore require prompt identification and aggressive treatment to optimise management. In this report, we describe a case of pembrolizumab-induced CTCAE (common toxicity criteria for adverse events) grade 4 myositis in a non-small cell lung cancer patient.
An unusual suspect for heart failure
Authors:   Department of Cardiology, The Alfred Hospital, Australia, Tan Christianne , C Patel Hitesh ,   Department of Cardiology, The Alfred Hospital, Australia, Mariani Justin ,   Department of Cardiology, The Alfred Hospital, Australia
Published: June 2021

Constrictive pericarditis though an uncommon diagnosis is a potentially reversible form of heart failure (with surgical pericardiectomy) and hence is imperative to diagnose. Diagnosis is dependent on a high index of clinical suspicion and further testing with appropriate cardiac investigations including cardiac imaging with invasive cardiac catheterisation as the gold standard.
Letter to the editor: Acute Medicine Journal
Authors:   Acute and General Medicine, West of Scotland Deanery, Williamson Adam
Published: June 2021

Editor- I note with interest that the Joint Royal College of Physicians Training Board curriculum for Acute Internal Medicine (AIM) has been reviewed and circulated for comment and consideration of implementation in August 2022. The proposed curriculum hopes to produce doctors with generic professional and specialty specific capabilities needed to manage patients presenting with a wide range of medical symptoms and conditions. It aims to produce a workforce that reflects the current trends of increasing patient attendances to bothprimary care and emergency departments- one that has a high level of diagnostic reasoning, the ability to manage uncertainty, deal with comorbidities and recognise when specialty input is require in a variety of settings, including ambulatory and critical care. The new curriculum moves away from each trainee being required to develop a specialist skill, such as medical education, echocardiography or endoscopy throughout their training1, to trainees acquiring competencies in a specialist theme for their final 24 to 30 months of their training programme after they have completed their Point of Care Ultrasound certification. The current curriculum allows trainees to have regular dedicated time to develop interests inside or outside acute medicine to supplement their professional experience and training. This often allows trainees time away from the ‘front door’, can be welcomed break from high intensity acute care and uniquely offers trainee physicians flexibility in their training programmes and curriculum requirements. This sets acute medicine training apart from other physician training programmes and can attract trainees to apply to the specialty. It also addresses Shape of Training recommendations, which suggest more flexibility and choice in career structure for postgraduate doctors.2 Point of Care Ultrasound will undoubtedly be a welcome addition to the curriculum and will benefit patients, trainees and front door services up and down the country.3 However, concerns regarding supervision and maintenance of competency exist.4 More importantly, time spent gaining competency in this before pursuing an interest in an additional area or procedure will offer trainees less time to attain accreditation in some of the existing specialist skills currently available. With ongoing concerns regarding recruitment and retention in Acute Internal Medicine5 we should be careful that we do not lose a unique selling point that acute internal medicine training offers.
Point-of-care lung ultrasound in the assessment of suspected COVID-19: a retrospective service evaluation with a severity score
Authors:   Sandwell and West Birmingham NHS Trust, Department of Acute Medicine, Birmingham, United Kingdom, Knight Thomas , Edwards Lloyd ,   Sandwell and West Birmingham NHS Trust, Department of Acute Medicine, Birmingham, United Kingdom, Rajasekaran Arvind ,   Sandwell and West Birmingham NHS Trust, Department of Acute Medicine, Birmingham, United Kingdom, Clare Sarbjit ,   Sandwell and West Birmingham NHS Trust, Department of Acute Medicine, Birmingham, United Kingdom, Lasserson Daniel ,   Sandwell and West Birmingham NHS Trust, Department of Acute Medicine, Birmingham, United Kingdom
Published: June 2021

Introduction: Point-of-care lung ultrasound (POCUS) has been advocated as a tool to assess the severity of COVID19 and thereby aid risk stratification. Methods: We conducted a retrospective service evaluation between the 3rd March and the 5th May 2020 to describe and characterise the use of POCUS within an acute care pathway designed specifically for the assessment of suspected or confirmed COVID-19. A novel POCUS severity scale was formulated by assessing pleural and interstitial abnormalities within six anatomical zones (three for each lung). An aggregated score was calculated for each patient and evaluated as a marker of disease severity using standard metrics of discriminatory performance. Results: POCUS was performed in the assessment of 100 patients presenting with suspected COVID-19. POCUS was consistent with COVID-19 infection in 92% (n = 92) of the patients assessed. Severity, as assessed by POCUS, showed good discriminatory performance to predict all-cause inpatient mortality, death or critical care admission, and escalated oxygen requirements (AUC .80, .80, 82). The risk of all-cause mortality in patients with scores in lowest quartile was 2.5% (95%CI 0.12- 12.95) compared with 42.9% (95CI 15.8 – 75.0%) in the highest quartile. POCUS assessed severity correlated with length of stay and duration of supplemental oxygen therapy. Conclusion: A simple aggregated score formed by the summating the degree of pleural and interstitial change within six anatomical lung zones showed good discriminatory performance in predicting a range of adverse outcomes in patients with suspected COVID-19.
Evaluating quality in acute care using patient reported outcome measures: a scoping review
Authors:   Máxima MC, Veldhoven/Eindhoven, the Netherlands, EM Mols Elsemieke , GAM van der Velde Marleen ,   Máxima MC, Veldhoven/Eindhoven, the Netherlands, WB Nanayakkara Prabath ,   Amsterdam University Medical Centre, VU University, The Netherlands, R Haak Harm ,   Máxima MC, Veldhoven/Eindhoven, the Netherlands, NT Kremers Marjolein ,   Máxima MC, Veldhoven/Eindhoven, the Netherlands
Published: June 2021

The aim of this scoping review is to identify patient reported outcome measures (PROMs) in acute care settings, assess their psychometric properties and provide recommendations for their use in daily practice. We performed a search in the PubMed database to identify publications concerning PROMs in an acute care setting. The COSMIN checklist was used to assess the psychometric properties of the reported PROMs. We found 1407 publications and included 14 articles, describing 15 measures. Most publications provided limited information on psychometric properties. Three generic PROMs were deemed of adequate quality for use in acute care. We recommend future development and evaluation of PROMs focussing on acute care to further evaluate and improve the quality of acute care.
Heart failure from thyrotoxicosis due to Graves’ disease
Authors:   Northumbria Healthcare NHS Foundation Trust, North Shields, UK, Aujayeb Avinash , Dundas James ,   Northumbria Healthcare NHS Foundation Trust
Published: June 2021

A 30-year-old female patient with a past medical history of pernicious anaemia presented with pleuritic chest pain, palpitations, fatigue, coryzal symptoms and a high temperature. She was hypoxic and tachycardic and was extensively investigated as well as aggressively treated. A type 1 ‘gut feeling’ assessment by the admitting medical registrar made the diagnosis possible as thyroid function tests were grossly deranged and pointed to Graves’ disease causing heart failure, complicated by pneumonia. The patient was discharged on carbimazole, antibiotics and beta blockers. Due to a resultant thrombocytopaenia, she has now been swapped onto propylthiouracil and is under active follow up.
Idiopathic systemic capillary leak syndrome (Clarkson’s disease) presenting with recurrent hypovolemic shock
Authors:   Northumbria Healthcare NHS Trust, Davies Kristen , Thomas Kirsty ,   Northumbria Healthcare NHS Trust, Barton Lorna ,   Northumbria Healthcare NHS Trust, Williams Chris ,   Northumbria Healthcare NHS Trust, Aujayeb Avinash ,   Northumbria Healthcare NHS Foundation Trust, North Shields, UK, Premchand Nikhil ,   Northumbria Healthcare NHS Trust
Published: June 2021

A 49-year old male with a past medical history of myocardial infarction and compartment syndromes requiring fasciotomies presented on five occasions with hypovolemic shock. We describe his admissions and presumptive diagnoses which required large volumes of intravenous fluids, admission to intensive care for vasopressors and renal replacement therapy. The presentations were always precipitated by a prodrome of fatigue and pre-syncopal episodes. On his last admission, a diagnosis of Idiopathic systemic capillary leak syndrome (ISCLS), also known as Clarkson’s Disease, was reached. He is currently receiving high dose intravenous immunoglobulins on a monthly basis.
COSMOVISÃO CRISTÃ E ECOLOGIA: UM DIÁLOGO NECESSÁRIO PARA A COMPREENSÃO DA CRISE AMBIENTAL
Authors: Santos Joel Silva dos
Published: June 2021

A crise ambiental ultrapassa os limites da ciência ecológica, pois ela pode ser entendida como uma crise de civilização com aspectos políticos, sociais e econômicos. A sua compreensão requer um olhar contextualizado, holístico e integral sobre a sociedade humana e a Criação. Dessa forma, uma visão distorcida e dualista do entendimento da estrutura criacional e de sua extensão pode comprometer a visão interdisciplinar e profunda (aspectos éticos e morais) dos problemas ambientais que afetam a sociedade pós-moderna. Sendo assim, é diante deste contexto que este artigo se insere, tendo como objetivo principal, verificar a contribuição de uma cosmovisão bíblica reformada e da ciência ecológica profunda na compreensão dos problemas ambientais e na promoção da sustentabilidade ambiental. Para a realização da pesquisa, inicialmente foi feito um levantamento bibliográfico a respeito da temática em questão: ecologia e cosmovisão cristã. Posteriormente, foram desvelados alguns pressupostos do humanismo confessional que possibilitaram a revolução técno-científica e o surgimento de uma ciência experimental e cartesiana. Em seguida, foram verificadas as categorias teológicas: Criação, Queda e Redenção, basilares no pensamento cristão reformado neocalvinista e os pressupostos da Ecologia Profunda para se chegar a uma compreensão integral e holística da crise ambiental e de seus desdobramentos na sociedade pós-moderna. A pesquisa revela que uma visão distorcida\dualista do pensamento cristão ao longo da Idade Média fundamentada em Platão e Aristóteles comprometeu o envolvimento dos cristãos pela causa ambiental e o seu real entendimento. A ciência moderna experimental com seus pressupostos racionais e desenvolvimentista contribui diretamente para degradação ambiental e a separação (dicotomia) homem e natureza.  O resgaste de uma cosmovisão bíblica reformada, com base na escola de pensamento neocalvinista e o surgimento da ecologia profunda, contribuem para o debate ecológico contextualizado e holístico, além do engajamento da comunidade cristã e sociedade em geral no enfrentamento da crise ambiental e promoção da sustentabilidade ambiental. O diálogo salutar entre fé (teologia pública) e ciência (ecologia profunda) estabelece bases espistemológicas para a busca de uma sociedade economicamente viável, socialmente justa e ecologicamente sustentável.
OS BATISTAS E O CRESCIMENTO EVANGÉLICO
Authors: Pereira Adair Nelo , Sá Maria do Socorro Freire de
Published: June 2021

O presente artigo traz um estudo sobre o crescimento evangélico mostrado nos últimos Censos do IBGE, com destaque para os evangélicos de missão, tentando explicar por que dos protestantes históricos de missão só os batistas crescem. Se fará uma comparação entre os números das pessoas que se declararam batistas com os membros das demais igrejas de missão, principalmente a presbiteriana, metodista e congregacional. Será descrita a história, princípios e como se deu a relação das igrejas evangélicas de missão, entre si e com os católicos. E quais aspectos diferenciam os batistas das demais igrejas, e o quanto isso influenciou e influencia no seu crescimento numérico.
TENDE BOM ÂNIMO: ANSIEDADE, DEPRESSÃO E TEOLOGIA PRÁTICA CRISTÃ
Authors: Falcão Sérgio Da Cunha
Published: June 2021

Saúde e religião têm sido estudadas principalmente por psicólogos, médicos e enfermeiros, sendo pouco frequentes pesquisas feitas por teólogos e cientistas da religião. O presente artigo tem como objetivo refletir acerca da relação entre ansiedade, depressão e teologia prática cristã. Foi realizada revisão das evidências da literatura no banco de dados PubMed. A prevalência da ansiedade foi de 3,6% no mundo e 9,3% no Brasil; país mais ansioso do mundo. A depressão acomete 4,4% da população mundial e 5,8% dos brasileiros. Ao mesmo tempo, 90% da população mundial está envolvida em alguma forma de prática religiosa ou espiritual, e existem consistentes evidências que os indivíduos que têm mais religiosidade têm menos depressão, ansiedade, tentativas de suicídio e uso/abuso de drogas, e experimentam melhor qualidade de vida, remissão mais rápida dos sintomas depressivos e melhores resultados psiquiátricos. No entanto, apesar de menos prevalente, o uso negativo da religião ou da espiritualidade no lidar com os problemas da vida (coping religioso/espiritual negativo) tem sido causa de adoecimento mental e foi encontrado em algumas pesquisas. Essas relações positivas e negativas precisam ser compreendidas por líderes e conselheiros cristãos, por professores, psiquiatras, psicólogos, teólogos e cientistas da religião.
REFLEXOS DO CONSUMISMO NO CUSTEIO DO REINO DE DEUS: UMA DISCUSSÃO SOB A ÓTICA DA COSMOVISÃO CRISTÃ
Authors: Leitão Rachel Ferreira Moreira
Published: June 2021

Este artigo tem como objetivo analisar a influência do consumismo, enquanto narrativa pós-moderna, no modo de vida do cristão na atualidade e os reflexos desta influência no cumprimento do chamado missional da Igreja e no custeio da implantação do Reino de Deus. Neste contexto, objetiva-se analisar as raízes históricas do distanciamento do cristão do plano financeiro divino, bem como problematizar a visão dualista de mundo, advinda da modernidade, em contraponto a cosmovisão cristã integradora e todo abrangente, aplicadas ao aspecto financeiro do cristão pós-moderno. Serão analisados alguns princípios extraídos da narrativa bíblica, bem como a experiência da igreja primitiva e dos reformadores na Suíça, com o intuito de discernir a cosmovisão cristã na vida financeira.
PAZ UMA VISÃO CRISTÃ NÃO-REDUCIONISTA DA POLÍTICA
Authors: PAZ ANDERSON BARBOSA
Published: June 2021

O presente trabalho discute como uma visão cristã não-reducionista da política pode legitimar a pluralidade social e as liberdades individuais. A partir de uma leitura crítica das ideologias modernas, identificadas como um tipo de idolatria, busca-se perceber como a visão reformacional, notadamente, em Abraham Kuyper (1837-1920) e Herman Dooyeweerd (1894-1977), pode contribuir no debate político contemporâneo na legitimação dos limites das diferentes esferas sociais e na preservação das liberdades individuais. Por meio de pesquisa e discussão eminentemente bibliográfica, afirma-se que a absolutização, feita pelas diferentes ideologias modernas, de um aspecto da realidade como proposta de redenção dos problemas sociais causa a desarmonia da estrutura de uma sociedade plural. A visão cristã, que parte de uma perspectiva heterorreferente, pode propor uma perspectiva política não-reducionista que legitime e ajuste as diversas esferas sociais em uma simbiose de associação pública que garanta a vida política. Assim, uma visão cristã não-reducionista da política entende que as liberdades individuais são fundamentadas na soberania de Deus que determina os limites de atuação das esferas sociais, evitando que decisões políticas retirem direitos implícitos dados por Deus e ameacem a harmonia da estrutura social.
A A RELEVÂNCIA DA PRÁTICA DA MISSIO DEI NO CONTEXTO ACADÊMICO
Authors: BARRETO MOTTA VERA LÚCIA , MOTTA FÁBIO BARRETO
Published: June 2021

Este artigo é uma perspectiva de como docentes e discentes cristãos podem praticar a Missio Dei em instituições de ensino superior, onde a fé é relegada a segundo plano, face a natureza secular do ambiente acadêmico. Tendo como base uma pesquisa bibliográfica com renomados autores cristãos, na visão da Missio Dei e da Missão Integral, onde o próprio Deus Criador enviou o seu Filho com o propósito salvífico e redentor da humanidade, e os cristãos devem continuar essa missão. A nova moralidade do “politicamente correto” tem influenciado a juventude no mundo inteiro e no Brasil, com ideologias contrárias a Palavra de Deus, o que tem limitado e intimidado o viver cristão na academia. Foi feita uma breve retrospectiva histórica da atuação do cristianismo na educação, e apresentado um modelo de integração da fé com o aprendizado nas universidades públicas norte-americanas (ALVIM, 2014) e como esse modelo pode ser adaptado no Brasil em qualquer instituição de ensino superior, onde os cristãos docentes e discentes através de pesquisas e outras atividades acadêmicas, poderão atuar, com liberdade de pensamento, sobre temas de fé, de acordo com as normas praticadas na academia, cuja autonomia delegada por seus pares, garante essa oportunidade.
A ESCOLA DE ANTIOQUIA
Authors: Fernandes Aragão Junior Ricardo José
Published: June 2021

As múltiplas interpretações dadas às escrituras é algo evidente na história desde a sua formação. A Hermenêutica do texto se bem compreendida e realizada com as ferramentas corretas de interpretação, sempre foram de grande relevância para a saúde da igreja. Vários teólogos têm discorrido ao longo dos anos qual a melhor maneira de se interpretar as escrituras. A resposta pode estar numa regra hermenêutica de que a bíblia interpreta a própria bíblia e o Espírito Santo é o agente que conduz a essa verdade. Pudemos observar na Escola de Antioquia, bem como, em um dos seus líderes João Crisóstomo esses princípios. O objetivo deste trabalho foi fazer uma reflexão sobre o estilo de interpretação da Escola de Antioquia, a luz de um dos seus mais importantes líderes, João Crisóstomo, com base em seus escritos.  Para tanto, utilizou-se o método de pesquisa bibliográfica e descritiva. Chegou-se à conclusão de que os escritos de João Crisóstomo em sua maioria são de grande relevância para a história da interpretação bíblica, pois mostram como essa escola interpretava os textos sagrados, objetivando extrair a verdade simples e literal, porém revolucionária do mesmo.
Direitos Humanos e cristianismo
Authors: Farias Alana Carla Lucena
Published: June 2021

O ser humano foi criado à imagem e semelhança de Deus para viver no shalom do Éden, logo, não consegue se conformar com o sofrimento e opressão que há neste mundo. Essa inconformidade ocasionou, ao longo do tempo, a criação de várias leis e institutos com o intuito de tutelar e restaurar a dignidade do indivíduo. Ocorre que, por terem sido criações de seres caídos, as duas declarações dos direitos humanos não estabelecem Deus como o soberano, pregando a soberania popular. Apesar disso, não se pode negar a inspiração divina nelas, apresentando marcas da ética cristã em seus textos. Tendo em vista a importância da discussão e das divergentes linhas de pensamento existentes ao relacionar os direitos humanos com o cristianismo, o presente trabalho tem o objetivo de expor os diversos posicionamentos e desenvolver uma análise equilibrada e bíblica com relação a essa problemática. Cristo foi um grande defensor da dignidade humana e nos instruiu a agir pautados na misericórdia, assim, não deixando de lado a soberania de Deus e a centralidade das escrituras, podemos analisar criticamente os ideais existentes. Foi utilizada a pesquisa bibliográfica e descritiva a fim de coletar materiais relevantes para o desenvolvimento do tema.
Métodos quantitativos aplicados à religião e seus fenômenos
Authors: Souza Josemar Jeremias Bandeira
Published: June 2021

O propósito desse artigo é mostrar que os métodos quantitativos são apropriados para a investigação das religiões e dos fenômenos a elas associados. Respondemos a três grandes objeções ao uso de métodos quantitativos no campo dos estudos da religião: 1) que a religião é complexa demais para ser classificada e medida; 2) que os métodos quantitativos são simplificadores e empiristas demais para serem usados ​​dentro de uma estrutura epistemológica não-positivista; e, 3) que a religiosidade é muito dependente do contexto e sensível ao erro de medição para ser quantificada de forma confiável. O método utilizado foi o da pesquisa bibliográfica, trazendo além da argumentação lógica o amparo comparativo com ciências essencialmente subjetivas, similares à teologia e ciências da religião, tais como psicologia e sociologia. As conclusões apontam para a ideia de que os métodos quantitativos são apropriados para os estudos da religião e dos seus fenômenos assim como apresenta recomendações para os iniciantes nesse tipo de investigação.