bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Cement on the Engineering Properties of Pavement Materials
Authors: Sounthararajah Arooran , Nguyen Nhu , Bui Ha Hong , Jitsangiam Peerapong , Leung Gordon L.M. , Kodikara Jayantha
Published: August 2016

It is well known that cement stabilization of granular materials is a cost-effective and environmentally friendly technique for the highway construction. However, the testing and design methods for these stabilized materials have not been sufficiently advanced scientifically, which hinders their full potential application. The proper characterization of the stabilized pavement materials is vital for the successful pavement design and construction. This paper presents the results from an experimental study on the effect of cement stabilization on pavement materials in terms of engineering properties essential for use in mechanistic design of road pavements. The test results from this study revealed that the index and shrinkage properties of the pavement materials are significantly influenced by cement content, and the tensile and compressive resistances of a cement stabilized pavement base layer increase significantly with the increasing cement content and increasing curing period. Based on the test results, it is concluded that the flexural modulus/UCS and the flexural strength/UCS ratios of the cement stabilized pavement materials depend on the material, age of curing, initial stage of the compacted material and laboratory testing practices.
Influence of Portland Cement Brands and Aggregates Sizes on the Compressive Strength of Normal Concrete
Authors: Ede Anthony N. , Bamigboye Gideon , Olofinnade Oluwarotimi Michael , Shittu Kuburat K.
Published: August 2016

A good number of building failures have occurred in Nigeria which resulted in the loss of lives and a lot of these failures are attributed to the poor concrete practices used for the execution of these constructions. These have shown that the concrete technology adopted in Nigeria has some issues and requires urgent attention for development and improvement. This study explored methods of improving concrete practices so as to obtain better qualities structures. The research replicated some of the common concrete practices adopted by the construction industry in Nigeria to obtain the compressive strength of normal concrete. Two types of Portland cement brand, Type A and Type and three aggregate sizes (12.5mm, 19mm and 30mm) together with a mixed-size aggregate were utilized for the research. The concrete produced were tested for compressive strength and compared with test results from sites in Lagos Nigeria. The results showed how cement brands and aggregate sizes influence the compressive strength of normal concrete. The results also proved that the common poor quality concrete verified in Nigeria are not properly prepared.
Involvement of NK Cells and NKp30 Pathway in Antisynthetase Syndrome
Authors: Hervier Baptiste , Perez Mikaël , Allenbach Yves , Devilliers Hervé , Cohen Fleur , Uzunhan Yurdagül , Ouakrim Hanane , Dorgham Karim , Méritet Jean-François , Longchampt Elisabeth , Stenzel Werner , Cremer Isabelle , Benveniste Olivier , Vieillard Vincent
Published: August 2016

Antisynthetase syndrome (aSS) is characterized by the association of interstitial lung disease and myositis with anti–tRNA synthetase autoantibodies. Immune mechanisms leading to aSS could be initiated in the lungs, but the role of NK cells has not yet been studied. Both extensive NK cell phenotype and functions were compared between 33 patients and 26 controls. Direct and redirected polyfunctionality assays (degranulation and intracellular production of TNF-α and IFN-γ) were performed spontaneously or after IL-12 plus IL-18 stimulation in the presence of K562 or P815 target cells, respectively. NK cells from inactive patients showed normal phenotype, whereas active aSS revealed a differentiated NK cell profile, as indicated by increased CD57 and Ig-like transcript 2 and an inability to produce IFN-γ (p = 0.002) compared with controls. Importantly, active aSS was more specifically associated with a significant NKp30 decrease (p = 0.009), although levels of mRNA and intracellular protein were similar in aSS and healthy controls. This NKp30 decrease was strongly correlated with reduced NK cell polyfunctionality in both direct and redirected killing assays with anti-NKp30 Abs (p = 0.009 and p = 0.03, respectively), confirming its important impact in aSS. Histological studies revealed massive infiltrations of NK cells inside the lungs of aSS patients (148 versus 11/mm2). Taken together, these data suggest that NK cells and NKp30 could play a role in aSS pathogenesis.
Cocaine Use and Splenic Rupture: A Rare Yet Serious Association
Authors: Karthik Nishrutha , Gnanapandithan Karthik
Published: August 2016

Cocaine abuse is frequent in patients visiting the emergency department. The knowledge of the cardiovascular complications of cocaine is excellent among physicians. However the awareness regarding its abdominal complications, the most important of which include gastroduodenal perforation, bowel ischemia and splenic rupture is less adequate. We report a 58-year-old with cocaine use who presents with upper abdominal pain and a rapidly worsening clinical status. He was found to have atraumatic splenic rupture causing a hemoperitoneum that was managed by intervention radiology guided splenic artery embolization. Splenic hemorrhage and rupture need timely recognition, as they are difficult to diagnose clinically and can be potentially fatal. In the encounter of patients with cocaine use who present with chest or upper abdominal pain, clinicians should consider imaging to look for splenic rupture as it is often masked or overlooked due to the complicated clinical picture.
Medication Error When Switching from Warfarin to Rivaroxaban Leading to Spontaneous Large Ecchymosis of the Abdominal and Chest Wall
Authors: Egger Flavio , Targa Federica , Unterholzner Ivan , Grant Russell P. , Herrmann Markus , Wiedermann Christian J.
Published: August 2016

Non-vitamin K oral anticoagulant (NOAC) therapy may be inappropriate if prescription was incorrect, the patient’s physiological parameters change, or interacting concomitant medications are erroneously added. The aim of this report was to illustrate inappropriate NOAC prescription in a 78-year-old woman with non-valvular atrial fibrillation and borderline renal dysfunction who was switched from warfarin to rivaroxaban and subsequently developed bruising with hemorrhagic shock and acute on chronic renal failure. Administration of 4-factor prothrombin complex concentrate effectively reversed coagulopathy and stopped bleeding. Retrospective determination of circulating plasma levels of rivaroxaban and warfarin confirmed that excessive anticoagulation was likely due to warfarin that the patient probably continued to take although rivaroxaban was initiated. Pharmacodynamic interaction between rivaroxaban and warfarin may not only be additive but synergistic. In patients at high risk of complications, judicious prescribing and dosing of NOACs, and regular monitoring of concomitant medications and renal function are highly recommended.
The impact of saffron (Crocus sativus) supplementation on visual function in patients with dry age-related macular degeneration
Authors: Riazi Abbas , Panahi Yunes , Alishiri Ali Agha , Hosseini Mohammad Ahmad , Karimi Zarchi Ali Akbar , Sahebkar Amirhossein
Published: August 2016

The aim was to evaluate the impact of saffron supplementation on visual function in patients with dry age-related macular degeneration (ARMD). Fifty-four participants, 23 male and 31 female, with dry ARMD were assigned to one of the following two groups. The treatment group (n=29) consumed 50 mg saffron daily during a 3- month period, while 25 subjects served as the control group. Visual acuity, contrast sensitivity, and retinal thickness were measured at the beginning and at the end of the study. Quality of life was evaluated using the Melbourne Low Vision Index (MLVI) before and after treatment. Significant increases in visual acuity and contrast sensitivity were found in the saffron group but not in the control group. Changes in macular thickness were not statistically different between the two groups. Short-term consumption of saffron may slow down the progression of disease and improve visual function, especially contrast sensitivity, in patients with dry ARMD.
Fishermen and Little Fish: Migration and Hospitality in Maxine Beneba Clarke’s ‘The Stilt Fishermen of Kathaluwa’
Authors: Edwards Natalie , Hogarth Christopher
Published: August 2016

In this article, we argue that Maxine Beneba Clarke’s tale ‘The Stilt Fishermen of Kathaluwa,’ in Foreign Soil (2014), is a provocative representation of migration in contemporary Australia. At a time in which the world is facing its largest migration since the Second World War and in which Australian border policy is making headlines around the world, Clarke’s tale is a powerful intervention in discourses of contemporary Australian identity and nationhood. We demonstrate that the tale is a subtle manipulation of what McCullough terms the ‘refugee narrative structure’ since it carefully undercuts the myth of a nation as a coherent narrative across time and space. By juxtaposing the tales of an illegal migrant and a volunteer case worker, and by setting the tale largely in a functioning detention centre, Clarke gives voice to the voiceless and draws parallels between individuals on different sides of the insider/outsider binary. The encounter that finally takes place between them implicates the reader very directly in discourses of contemporary migration and border policy.
Design It Yourself Surabaya: Reflective Notes on Designing a Festival
Authors: Azali Kathleen , Budiman Andriew
Published: August 2016

As a relatively new, imported word, the term desain (design) in Indonesian is still mostly understood within its relations to three common academic fields—graphic, interior, and product design—and thus tends to be viewed as belonging to the ‘merely’ visual. While local cultural events and festivals have proliferated in Indonesia, the scope for a conference or a festival that explicitly address design therefore tends to be rather limited. This is not to say that design exhibitions and festivals do not exist. In fact, they have flourished in the country, particularly among university students, reflecting the growth of university design programs and schools to meet contemporary demand. Yet visual-based, market-led development has not been accompanied by institutional development in research and outreach (in the form of dialogues or critical publications), particularly ones that connect that development across different fields. Attaching the word desain to an event in Indonesia invariably means it is associated with either design student exhibitions, or an industrial expo showcasing printers or interior furnitures. This curated piece emerges as our reflection on designing—cobbling up, and calibrating—a design conference-festival from Surabaya, East Java, Indonesia in light of the national context in which desain is received and made meaningful.
Designing for Irrelevance
Authors: Scott-Kemmis Will Owen
Published: August 2016

My job title is ‘designer’ but I’m reluctant to describe myself as a designer for a number of reasons: first, because the practice has a lot to answer for; and second, because I don’t do a whole lot of design. I help groups of people to collaborate and converse their way through problems towards solutions—activating a latent capability for design in people as they think and work differently, together. The sense of agency that accompanies this is intoxicating. This work can produce strategies, systems, and services, as well as spaces, objects, and graphics. The awareness that design can shape both our (intangible) experiences and our (tangible) environments—and that, as a mode of thinking, it can be accessible, inclusive, and participatory—shifts it from a practice to a stance. In this sense, is design a choice that we make to perceive and move through the world in a contextual and intentional way? What does this mean for the practice of design?I respod to these question by reflecting on my experience of participating in the Indonesia Australia Design Futures project.
Collective Improvisation
Authors: Cooper Clare M.
Published: August 2016

Collective improvisation as a creative practice is intensely social, trusting, unpopular, anti-hierarchical and, for these reasons, political. Cooper describes the risks and rich rewards of improvising with fellow artists and identifies the parallels between improvising ensembles of musicians in Australia with the collectively painted protest banners of the Taring Padi Collective in Indonesia after a brief visit to Jogjakarta.
Batik of Batang - A Design Story
Authors: Dunn Jessica Lea
Published: August 2016

During my time living in Central Java, Indonesia, I stayed in the family home of one of my Indonesian friends on multiple occasions. In my friend’s village, located in the district of Batang, along the north coast of Java, west of Semarang city, almost every woman has the ability to produce exquisitely detailed hand-drawn batik fabric. A walk up a lane or a peep into a neighbour’s house will often reveal a solo entrepreneur contributing their wares to a dynamic cottage industry. However, the lifestyle is hard and the reward almost not enough to justify the patience and hours required to produce fine batik cloth.
Making Black Bloody Rosella Jam
Authors: Farhana Ili
Published: August 2016

The rosella (or roselle) plant originated in West Africa, but has been cultivated throughout Africa, Asia and Australia. Not only can rosella be used to make teas and jams, but every part of the plant is edible; the young leaves can be eaten raw and make great salads. Rosella is a type of hibiscus, and it has a beautiful pink flower. Although the whole plant is edible, it is the calyx (the bright red fruit) that is used to make syrups, teas or jams. If you eat it fresh, straight off the stalk, it has a sour taste. Inside the calyx is a round seed pod. If it is left to mature, it will turn brown. When dry it provides the mature seeds for the next planting. At Kebun Setaman Pejeng, our small-scale community arm and learning centre at Bamjar Panglan, Pejeng, on the island of Bali, we harvest rosella to make jam.
Constraining sector-specific CO2 and CH4 emissions in the United
States
Authors: Miller Scot M. , Michalak Anna M.
Published: August 2016

Abstract. This review paper explores recent efforts to estimate state- and national-scale carbon dioxide (CO2) and methane (CH4) emissions from individual anthropogenic source sectors in the United States. Nearly all state and national climate change regulations in the US target specific source sectors, and detailed monitoring of individual sectors presents a greater challenge than monitoring total emissions. We particularly focus on opportunities to synthesize disparate types of information on emissions, including emissions inventory data and atmospheric greenhouse gas data. We find that inventory estimates of sector-specific CO2 emissions are sufficiently accurate for policy evaluation at national scale but that uncertainties increase at state and local levels. CH4 emissions inventories are highly uncertain for all source sectors at all spatial scales, in part because of the complex, spatially-variable relationships between economic activity and CH4 emissions. In contrast to inventory estimates, top-down estimates use measurements of atmospheric concentrations to infer emissions at the surface; these efforts have had little success identifying CO2 emissions from anthropogenic sources but have successfully identified sector-specific CH4 emissions in several opportunistic cases. We also describe a number of forward-looking opportunities that would aid efforts to estimate sector-specific emissions: fully combine existing top-down datasets, expand intensive aircraft measurement campaigns and measurements of secondary tracers, and improve the economic and demographic data (e.g., activity data) that drive emissions inventories. These steps would better synthesize inventory and top-down data to support sector-specific emissions reduction policies.
Reconstructing geographical boundary conditions for palaeoclimate modelling during the Cenozoic
Authors: Baatsen Michiel , van Hinsbergen Douwe J. J. , von der Heydt Anna S. , Dijkstra Henk A. , Sluijs Appy , Abels Hemmo A. , Bijl Peter K.
Published: August 2016

Abstract. Studies on the palaeoclimate and palaeoceanography using numerical model simulations may be considerably dependent on the implemented geographical reconstruction. Because building the palaeogeographic datasets for these models is often a time-consuming and elaborate exercise, palaeoclimate models frequently use reconstructions in which the latest state-of-the-art plate tectonic reconstructions, palaeotopography and -bathymetry, or vegetation have not yet been incorporated. In this paper, we therefore provide a new method to efficiently generate a global geographical reconstruction for the middle-late Eocene. The generalised procedure is also reusable to create reconstructions for other time slices within the Cenozoic, suitable for palaeoclimate modelling. We use a plate-tectonic model to make global masks containing the distribution of land, continental shelves, shallow basins and deep ocean. The use of depth-age relationships for oceanic crust together with adjusted present-day topography gives a first estimate of the global geography at a chosen time frame. This estimate subsequently needs manual editing of areas where existing geological data indicate that the altimetry has changed significantly over time. Certain generic changes (e.g. lowering mountain ranges) can be made relatively easily by defining a set of masks while other features may require a more specific treatment. Since the discussion regarding many of these regions is still ongoing, it is crucial to make it easy for changes to be incorporated without having to redo the entire procedure. In this manner, a complete reconstruction can be made that suffices as a boundary condition for numerical models with a limited effort. This facilitates the interaction between experts in geology and palaeoclimate modelling, keeping reconstructions up to date and improving the consistency between different studies. Moreover, it facilitates model inter-comparison studies and sensitivity tests regarding certain geographical features as newly generated boundary conditions can more easily be incorporated in different model simulations. The workflow is presented covering a middle-late Eocene reconstruction (38 Ma), using a MatLab script and a complete set of source files that are provided in the supplementary material.
Integrating peatlands into the coupled Canadian Land Surface Scheme
(CLASS) v3.6 and the Canadian Terrestrial Ecosystem Model (CTEM) v2.0
Authors: Wu Yuanqiao , Verseghy Diana L. , Melton Joe R.
Published: August 2016

Abstract. Peatlands, which contain large carbon stocks that must be accounted for in the global carbon budget, are poorly represented in many earth system models. We integrated peatlands into the coupled Canadian Land Surface Scheme (CLASS) and the Canadian Terrestrial Ecosystem Model (CTEM), which together simulate the fluxes of water, energy, and CO2 at the land surface–atmosphere boundary in the family of Canadian Earth system models (CanESMs). New components and algorithms were added to represent the unique features of peatlands, such as their characteristic ground floor vegetation (mosses), the slow decomposition of carbon in the water-logged soils and the interaction between the water, energy, and carbon cycles. This paper presents the modifications introduced into the CLASS–CTEM modelling framework together with site-level evaluations of the model performance for simulated water, energy and carbon fluxes at eight different peatland sites. The simulated daily gross primary production (GPP) and ecosystem respiration are well correlated with observations, with values of the Pearson correlation coefficient higher than 0.8 and 0.75 respectively. The simulated mean annual net ecosystem production at the eight test sites is 87 g C m−2 yr−1, which is 22 g C m−2 yr−1 higher than the observed annual mean. The general peatland model compares well with other site-level and regional-level models for peatlands, and is able to represent bogs and fens under a range of climatic and geographical conditions.
Applying the Theory of Planned Behavior to Correct Posture in Operating Room Staffs
Authors: Fakhri Ahmad , Mohammadi Zeidi Isa , Morshedi Hadi
Published: August 2016

OBJECTIVE: Ergonomic risk factors such as prolonged and awkward postures increase the risk of work related musculoskeletal disorders (WRMSDs) in operating room staffs. Understanding the factors influencing the prevalence of the WRMSDs is an essential step in any targeted health promotion interventions. This research aimed to determine the factors associated with correct posture maintenance based on the theory of planned behavior (TPB) among the operating room staffs from educational hospital affiliated to Qazvin university medical sciences, in 2013.

METHODS: A total of 130 subjects with mean ages of 31.2±6.38 years participated in this study. Demographic data and TPB constructs were assessed using reliable and valid scales. Path analysis, based on TPB components, was applied to determine specific factors that most contribute to and predict actual behavior toward correct posture maintenance.

RESULTS: Psychometric properties of the model were consistent with the recommendations and results showed that variables were fit to the data. 58% of the variance in behavioral intention (BI) was described by the TPB constructs (P<0.05). Also, attitude (AT), subjective norms (SN), perceived behavioral control (PBC) and BI explained 39% of the variance in maintenance of a correct posture (P<0.05). Consistent with predictions from the TPB, AT (βi=0.44, P<0.05) were the major predictors of BI. In addition, PBC (βi=0.52, P<0.05) and BI (βi=0.41, P<0.05) were the important factors that influence the maintenance of a correct posture in the operating room staffs.

CONCLUSION: As a conclusion, TPB is a useful model to determine and to predict maintenance of a correct posture in the operating room staffs.
Occupational Exposure to Positive Blood and Body Fluids among Health Care Workers in a Chinese University Hospital: A Three Years Retrospective Study
Authors: Tao Xiubin , Peng Hui , Qian Lihua , Li Yan , Wu Qun , Ruan Jingjing , Cai Dongzhen
Published: August 2016

Health care workers (HCWs) are exposed to blood and body fluids (BBF) due to occupational accidents. However, few studies have investigated the prevalence of occupational exposure in Chinese HCWs thus far. There is a clearly a critical need to characterize its epidemiology more fully in China so that effective prevention programs can be implemented. We conducted a retrospective study at a university hospital in China, giving an epidemiological analysis on these exposed HCWs whose pathogens of BBF from patients were positive [human immunodeficiency virus (HIV) / hepatitis B (HBV) / hepatitis C (HCV)]. From July 1st 2011 to June 30th 2014, a total of 155 occupational exposures to positive BBF were reported, with an incidence of 16.64 (/1000 person-years). Percutaneous injuries were the most common type of exposure episodes (89.03%). The most common type of exposed blood-borne pathogens was HBV (83.87%), and the majority of the respondents were nursing students, with an incidence of 34.22 (/1000 person-years). More effective preventive strategies on HCWs’ BBF occupational exposure should be implemented in China, especially for nursing students.
ATUAÇÃO DO PODER JUDICIÁRIO NAS INTERNAÇÕES COMPULSÓRIAS DEDEPENDENTES QUÍMICOS
Authors: Dos Reis Wanderlei José
Published: August 2016

Os efeitos mentais causados pela dependência química são devastadores, podendo colocar o toxicômano em situação de risco para si e para terceiros devido ao alto grau de dependência, e, diante disto, o Estado pode, por meio do Poder Judiciário, lançar mão de medida que, apesar de extrema, tem por fim preservar a saúde do usuário, bem como sua vida e dignidade humana e, por consequência, a paz social, qual seja, a internação compulsória prevista na Lei n.º 10.216/01.
O TEXTO SÓ GANHA VIDA NA SUA NORMA: por um resgate hermenêutico da compreensão ou porque não há como dar respostas antes das perguntas!
Authors: Tovar Leonardo Zehuri , Moreira Nelson Camatta
Published: August 2016

O objetivo do artigo é apresentar as principais bases da hermenêutica filosófica e ao fim, através de exemplo, mostrar sua relevância para a interpretação jurídica. 
Husserl's Missing Multistability
Authors: Rosenberger Robert ,   Philosophy Documentation Center
Published: August 2016

The notion of “multistability” is a central fixture of the postphenomenological framework of thought, one of the central ideas that enables this perspective to avoid both shallow determinism and instrumentalism. While this notion has been put to use in numerous case studies and theoretical treatments, here I argue that the work of following out the philosophical implications of technological multistability has only just begun. Don Ihde’s new book, Husserl’s Missing Technologies, provides a helpful jumping off point as he provides a leading-edge formulation of this idea. I continue with an attempt to sketch out the vast philosophical ground opened up by this concept, and review the contemporary work by postphenomenologists that is just starting to explore this new terrain.
La littérature latino-canadienne en traduction : zones de contact, zones de tension
Authors: Turcotte Julie
Published: August 2016

Cet article adopte une approche postcoloniale pour examiner dans un premier temps le rôle et la place de la traduction dans la production et la diffusion d’une littérature en espagnol au Québec et au Canada, et la façon dont cette littérature bouscule certains présupposés des théories traditionnelles de la traduction. Dans un deuxième temps, l’insertion problématique des oeuvres latino-québécoises dans le corpus littéraire du Québec est examinée sous l’angle des défis que posent ces oeuvres en traduction pour la définition des frontières de la littérature québécoise contemporaine.
Multilinguïsation des systèmes traitant des sous-langages
Authors: Hajlaoui Najeh
Published: August 2016

Dans le cadre de nos travaux sur la multilinguïsation ou « portage linguistique » des services de gestion de contenu traitant des énoncés spontanés en langue naturelle, nous avons dégagé trois méthodes de portage possibles d’une langue L1 vers une nouvelle langue L2, et les avons appliquées sur des cas de systèmes de e-commerce. Le portage par traduction statistique, une de ces trois méthodes, a donné de très bonnes performances, et ce, avec un corpus d’apprentissage très petit (moins de 10 000 mots). Cela prouve que, dans le cas de sous-langages très petits, la traduction statistique peut être de qualité suffisante en partant de corpus 100 à 500 fois moins grands que pour de la langue générale.
Seroprevalencia del virus linfotrópico humano de tipos I y II en donantes del Banco de Sangre de la Fundación Valle del Lili, Cali, Colombia, 2008-2014
Authors: Macía Carmenza , Vargas Sandra , Mora Ana María , Sarmiento Ashly Melissa , Pacheco Robinson , Rosso Fernando
Published: August 2016

Introducción. El virus linfotrópico humano (HTLV) de tipos I y II es un retrovirus prevalente en la Costa Pacífica colombiana que puede transmitirse por transfusiones de sangre. En el 2014 se reglamentó la tamización para bancos de sangre con el fin de reducir la transmisión por medio de la donación. La información sobre la seroprevalencia del virus en el suroccidente colombiano es limitada.
Objetivo. Determinar la seroprevalencia, el comportamiento a lo largo del tiempo de los resultados reactivos antes y después de la introducción del inmunoensayo Western blot y la concomitancia del HTLV con otros marcadores de infección en donantes de un banco de sangre de Cali, Colombia.
Materiales y métodos. Se hizo un estudio trasversal de 77.117 donantes del Banco de Sangre de la Fundación Valle del Lili mediante el análisis de los registros de donantes con prueba reactiva para anticuerpos IgG anti HTLV I-II entre enero de 2008 y diciembre de 2014.
Resultados. La seroprevalencia acumulada fue de 0,24 %. Los resultados reactivos fueron más frecuentes en mujeres (61 %) y la mediana de edad fue de 37 años. La seroprevalencia en los años previos a la introducción del Western blot fue de 0,13, 0,19, 0,31 y 0,32 % (2008-2012), y posteriormente fue de 0,18, 0,08 y 0,07 % (2012-2014). La reacción positiva concomitante con otros marcadores de infección fue de 11 %: sífilis (57 %), HIV (19 %), hepatitis B (14 %) y hepatitis C (9 %). La mayor
seroprevalencia (0,38 %) se registró en el 2012.
Conclusión. Se encontró una alta prevalencia de pruebas reactivas para el HTLV I-II en comparación con otros estudios. Los resultados de este estudio son un punto de partida para el desarrollo de estudios poblacionales.
Priorización de enfermedades virales zoonóticas en la interfaz de cerdos silvestres, cerdos domésticos y seres humanos
Authors: Benavides-Arias Diana , Soler-Tovar Diego
Published: August 2016

Introducción. Para entender la ecología de las enfermedades es necesario comprender los agentes patógenos en la interfaz de vida silvestre y ganado. Los cerdos silvestres (Sus scrofa) constituyen un problema sanitario cuando se trata de prevenir y controlar las enfermedades zoonóticas, pues en ocasiones sus poblaciones son portadores de agentes infecciosos transmisibles a los cerdos domésticos y a otras especies animales, incluidos los seres humanos.
Objetivo. Priorizar las enfermedades zoonóticas en la interfaz de cerdos silvestres, animales domésticos y seres humanos.
Materiales y métodos. Se utilizó el método de priorización semicuantitativa basado en 27 criterios sustentados en publicaciones recientes, los cuales se clasificaron en las siguientes cinco categorías con base en la etiología viral: epidemiología (ocho), prevención y control (tres), economía y comercio (cuatro), salud pública (nueve) y sociedad (tres). A cada criterio se le adjudicó un coeficiente entre 0 y 7 de acuerdo con su impacto medido con base en la información científica (suma total de 189). La información sobre los criterios para las nueve enfermedades virales analizadas se recolectó mediante la revisión de 81 fuentes publicadas entre 1977 y 2015.
Resultados. Las tres enfermedades con mayor puntaje y potencial zoonótico fueron la influenza porcina (133), la hepatitis E (123) y la infección por hantavirus (103), y la mayor puntuación se observó en los criterios de epidemiología y salud pública.
Conclusión. Los métodos semicuantitativos de priorización son una fuente de información para la toma de decisiones, pero su utilización es poco frecuente en los países en desarrollo por la falta de datos de vigilancia en salud pública. El control de las enfermedades que afectan tanto a los seres humanos como a los animales silvestres, requiere el desarrollo de estrategias que reduzcan la transmisión de patógenos de estos a los animales domésticos y a los seres humanos.
Prevalencia y curso clínico de la infección por dengue en adultos mayores con cuadro febril agudo en un hospital de alta complejidad en Cali, Colombia
Authors: Rosso Fernando , Vanegas Sara , Rodríguez Sarita , Pacheco Robinson
Published: August 2016

Introducción. Hay pocas series de casos publicadas sobre la prevalencia y el curso clínico del dengue en adultos mayores con síndrome febril, habitantes en zonas endémicas para la infección. Se cree que tales casos presentan una baja prevalencia pero revisten mayor gravedad, y más complicaciones y mortalidad.
Objetivos. Describir la prevalencia y el curso clínico del dengue en adultos mayores atendidos por síndrome febril agudo en un hospital de alta complejidad de una zona endémica de la enfermedad.
Materiales y métodos. Se hizo un estudio observacional descriptivo en una cohorte de pacientes adultos mayores con diagnóstico serológico confirmado de dengue entre el 2011 y el 2014.
Resultados. Se evaluaron las historias clínicas de 235 pacientes adultos mayores con cuadro febril agudo y se confirmó la infección en solo 43 (18,3 %) de ellos. La mediana de edad de los pacientes con diagnóstico confirmado fue de 71 años y 48,7 % correspondía a mujeres; 89 % de los pacientes presentaba al menos otra enfermedad concomitante; 51,4 % fue positivo para Ag NS1, 27 % para IgM y 54,1 % para IgG, en tanto que 64,8 % correspondió a infecciones secundarias. Los casos clasificados como dengue fueron 13 (35 %), como dengue con signos de alarma, 16 (43 %), y como dengue grave, 8 (22 %). Se hospitalizó a 56,7 % de los pacientes, de los cuales 21,6 % fue internado en la unidad de cuidados intensivos. No hubo casos fatales.
Conclusión. La infección por dengue fue frecuente en adultos mayores como causa de síndrome febril agudo. Una importante proporción requirió hospitalización y presentó complicaciones, sin embargo, el manejo adecuado evitó los casos fatales.
Detección de Aedes albopictus (Skuse) (Diptera: Culicidae) en el municipio de Istmina, Chocó, Colombia
Authors: Carvajal José Joaquín , Honorio Nildimar Alves , Díaz Silvia Patricia , Ruiz Edinso Rafael , Asprilla Jimmy , Ardila Susanne , Parra Gabriel Jaime
Published: August 2016

Introducción. Aedes albopictus se encuentra ampliamente distribuido en el mundo. Su introducción en las Américas ocurrió en 1985 y es considerado vector potencial de los virus dengue y uno de los principales vectores del virus chikungunya. En Colombia, su primer reporte fue en Leticia (Amazonas) en 1998, seguido de Buenaventura (Valle del Cauca) en 2001, Barrancabermeja (Santander) en 2010 y Medellín (Antioquia) en 2011. Esta especie actualmente se ha reportado en 10 departamentos del país.

Objetivo. Notificar el hallazgo de Ae. albopictus en el municipio de Istmina, Chocó, Colombia y su importancia en salud pública.

Materiales y métodos. En enero de 2015 se realizó la inspección de formas inmaduras de Aedes en criaderos de los barrios de San Agustín, Santa Genoveva y Subestación del municipio de Istmina, Chocó, Colombia. Las formas inmaduras recolectadas en el municipio de Istmina fueron identificadas en la Unidad de Entomología del Laboratorio de Salud Pública Departamental de Chocó, y confirmadas en el Laboratorio de Entomología, Red Nacional de Laboratorios del Instituto Nacional de Salud en Bogotá.

Resultados. En enero de 2015, se encontraron doce larvas de Ae. albopictus en criaderos ubicados en los barrios Subestación y San Agustín en el municipio de Istmina, Chocó.

Conclusión. La detección de Ae. albopictus en el municipio de Istmina, Chocó, refuerza la importancia del fortalecimiento de estrategias de vigilancia entomológica contínua a nivel municipal y departamental en el país y especialmente en el municipio de Istmina y municipios aledaños.
Primer reporte de la mutación F1534C, asociada con resistencia cruzada a DDT y piretroides, en Aedes aegypti de Colombia
Authors: Atencia María Claudia , Pérez María de Jesús , Jaramillo María Cristina , Caldera Sandy Milena , Cochero Suljey , Bejarano Eduar Elías
Published: August 2016

Introducción. La principal estrategia para el control de Aedes aegypti, vector de los virus dengue, chikungunya y Zika, se basa en la utilización de insecticidas con el fin de disminuir las poblaciones del vector. Sin embargo, su uso ha conllevado a que el insecto desarrolle resistencia a estos químicos.

Objetivo. Determinar la presencia de la mutación F1534C, asociada con resistencia cruzada a DDT y piretroides, en mosquitos de la especie Ae. aegypti de la ciudad de Sincelejo, Colombia.

Materiales y métodos. El estudio se desarrolló con nueve ejemplares de Ae. aegypti que mostraron resistencia a lambdacialotrina en bioensayos desarrollados por la Secretaría de Salud de Sucre. Se realizó una PCR semi-anidada, según la la metodología descrita por Harris y colaboradores (2010), con el fin de amplificar el exón 31 del gen para del canal de sodio dependiente de voltaje de Ae. aegypti. Los productos de PCR se secuenciaron, editaron y analizaron con el programa MEGA 5.

Resultados. En todos los mosquitos evaluados se detectó la presencia del alelo silvestre y mutante del exón 31. En la secuencia nucleotídica del alelo mutante, se observó una sustitución de timina por guanina, que produce el cambio del codón UUC por UGC y conlleva al reemplazo del aminoácido fenilalanina por cisteína en el residuo 1534 de la proteína.

Conclusión. Los nueve mosquitos analizados presentaron un genotipo heterocigoto para la mutación F1534C, cuyo efecto fenotípico es la resistencia al derribo (kdr) por los insecticidas DDT y piretroides.
Inmunoterapia con alérgenos: mecanismos de acción, impacto terapéutico y socioeconómico. Consenso de la Asociación Colombiana de Alergias Asma e Inmunología
Authors: Sánchez Jorge , Cardona Ricardo , Caraballo Luis , Serrano Carlos , Ramírez Ruth , Diez Susana , García Elizabeth , Segura Ana María , Cepeda Alfonso , Minotas María
Published: August 2016

Las alergias comprenden un conjunto de enfermedades altamente prevalentes. Cuando los procesos alérgicos no son controlados pueden poner en peligro la vida y tienen un alto costo para la salud del paciente y además un impacto económico y social importante. El objetivo de esta revisión es presentar un consenso práctico de la evidencia científica sobre el empleo de la inmunoterapia en las enfermedades alérgicas, a través de una revisión colaborativa por varios institutos y universidades de Colombia a solicitud de la Asociación Colombiana de Alergia Asma e Inmunología. Este artículo incluye aspectos prácticos desde el punto de vista de médicos generales, alergólogos, inmunólogos, internistas y pediatras con experiencia en el campo de las alergias.

Basado en la evidencia científica actual tanto nacional como internacional, en este artículo se describe de forma detallada en qué consiste la inmunoterapia, sus indicaciones, contraindicaciones y sus beneficios tanto a nivel sanitario como socioeconómico. Los autores basados en la evidencia obtenida, concluimos que la inmunoterapia es un tratamiento clínicamente efectivo, seguro y que puede reducir de forma sustancial el costo del tratamiento global de los pacientes alérgicos.
Transcriptional activation of muscle atrophy promotes cardiac muscle remodeling during mammalian hibernation
Authors: Zhang Yichi , Aguilar Oscar A. , Storey Kenneth B.
Published: August 2016

Background.Mammalian hibernation in thirteen-lined ground squirrels (Ictidomys tridecemlineatus) is characterized by dramatic changes on a physiological and molecular level. During hibernation, mammalian hearts show a propensity to hypertrophy due to the need for increasing contractility to pump colder and more viscous blood. While cardiac hypertrophy is quite often a process characterized by decompensation, the ground squirrel studied is an excellent model of cardiac plasticity and cardioprotection under conditions of hypothermia and ischemia. The forkhead box O (Foxo) family of proteins and myogenin (MyoG) are transcription factors that control protein degradation and muscle atrophy by regulating the expression of the E3 ubiquitin ligases, MAFbx and MuRF1. These ligases are part of the ubiquitin proteasome system by transferring ubiquitin to proteins and targeting these proteins for degradation. Regulation of Foxo1 and 3a occurs through phosphorylation at different residues. The threonine-24 (Thr-24) and serine-319 (Ser-319) residues on Foxo1, and the Thr-32 residue on Foxo3a are phosphorylated by Akt, leading to cytoplasmic localization of Foxo. We propose that the described mechanism contributes to the changes taking place in cardiac muscle throughout hibernation.

Methods.Total and phosphorylated protein levels of Foxo1 and Foxo3a, as well as total protein levels of MyoG, MAFbx, and MuRF1, were studied using immunoblotting.

Results.Immunoblotting results demonstrated upregulations in Foxo1 and Foxo3a total protein levels (1.3- and 4.5-fold increases relative to euthermic control, for Foxo1 and 3a respectively) during late torpor, and protein levels remained elevated throughout the rest of torpor and at interbout arousal. We also observed decreases in inactive, phosphorylated Foxo1 and 3a proteins during throughout torpor, where levels of p-Foxo1 Ser319and Thr24, as well as p-Foxo3a Thr32decreased by at least 45% throughout torpor. MyoG was upregulated only during late torpor by 2.4-fold. Protein levels of MAFbx and MuRF1 increased in late torpor as well as during early arousal by as much as 2.8-fold, and MAFbx levels remained elevated during interbout arousal, whereas MuRF1 levels returned to control levels.

Discussion.The present results indicate that upregulation and activation of Foxo1 and 3a, in addition to the increase in MyoG levels at late torpor, may be upregulating the expression of MAFbx and MuRF1. These findings suggest that there is activation of the ubiquitin proteasome system (UPS) as ground squirrels arouse from torpor. Therefore, the signalling pathway involving MyoG, and the E3 ligases MAFbx and MuRF1, plays a significant role in cardiac muscle remodelling during hibernation. These findings provide insights into the regulation of protein degradation and turnover in the cardiac muscle of a hibernator model.
The modified Thomas test is not a valid measure of hip extension unless pelvic tilt is controlled
Authors: Vigotsky Andrew D. , Lehman Gregory J. , Beardsley Chris , Contreras Bret , Chung Bryan , Feser Erin H.
Published: August 2016

The modified Thomas test was developed to assess the presence of hip flexion contracture and to measure hip extensibility. Despite its widespread use, to the authors’ knowledge, its criterion reference validity has not yet been investigated. The purpose of this study was to assess the criterion reference validity of the modified Thomas test for measuring peak hip extension angle and hip extension deficits, as defined by the hip not being able to extend to 0º, or neutral. Twenty-nine healthy college students (age = 22.00 ± 3.80 years; height = 1.71 ± 0.09 m; body mass = 70.00 ± 15.60 kg) were recruited for this study. Bland–Altman plots revealed poor validity for the modified Thomas test’s ability to measure hip extension, which could not be explained by differences in hip flexion ability alone. The modified Thomas test displayed a sensitivity of 31.82% (95% CI [13.86–54.87]) and a specificity of 57.14% (95% CI [18.41–90.10]) for testing hip extension deficits. It appears, however, that by controlling pelvic tilt, much of this variance can be accounted for (r= 0.98). When pelvic tilt is not controlled, the modified Thomas test displays poor criterion reference validity and, as per previous studies, poor reliability. However, when pelvic tilt is controlled, the modified Thomas test appears to be a valid test for evaluating peak hip extension angle.
Delivering a medical school elective with massive open online course (MOOC) technology
Authors: Robinson Robert
Published: August 2016

Introduction:The educational technology of massive open online courses (MOOCs) has been successfully applied in a wide variety of disciplines and are an intense focus of educational research at this time. Educators are now looking to MOOC technology as a means to improve professional medical education, but very little is known about how medical MOOCs compare with traditional content delivery.

Methods:A retrospective analysis of the course evaluations for the Medicine as a Business elective by fourth-year medical students at Southern Illinois University School of Medicine (SIU-SOM) for the 2012–2015 academic years was conducted. This course was delivered by small group flipped classroom discussions for 2012–2014 and delivered via MOOC technology in 2015. Learner ratings were compared between the two course delivery methods using routinely collected course evaluations.

Results:Course enrollment has ranged from 6–19 students per year in the 2012–2015 academic years. Student evaluations of the course are favorable in the areas of effective teaching, accurate course objectives, meeting personal learning objectives, recommending the course to other students, and overall when rated on a 5-point Likert scale. The majority of all student ratings (76–95%) of this elective course are for the highest possible choice (Strongly agree or Excellent) for any criteria, regardless if the course was delivered via a traditional or MOOC format. Statistical analysis of these ratings suggests that the Effective Teacher and Overall Evaluations did not statistically differ between the two delivery formats.

Discussion:Student ratings of this elective course were highly similar when delivered in a flipped classroom format or by using MOOC technology. The primary advantage of this new course format is flexibility of time and place for learners, allowing them to complete the course objectives when convenient for them. The course evaluations suggest this is a change that is acceptable to the target audience.

Conclusions:This study suggests that learner evaluations of a fourth-year medical school elective course do not significantly differ when delivered by flipped classroom group discussions or via MOOC technology in a very small single center observational study. Further investigation is required to determine if this delivery method is an acceptable and effective means of teaching in the medical school environment.
Ion Larmor radius effects near a reconnection X line at the magnetopause: THEMIS observations and simulation comparison
Authors: Phan T. D. , Shay M. A. , Haggerty C. C. , Gosling J. T. , Eastwood J. P. , Fujimoto M. , Malakit K. , Mozer F. S. , Cassak P. A. , Oieroset M. , Angelopoulos V.
Published: August 2016

We report a Time History of Events and Macroscale Interactions during Substorms (THEMIS‐D) spacecraft crossing of a magnetopause reconnection exhaust ~9 ion skin depths (di) downstream of an X line. The crossing was characterized by ion jetting at speeds substantially below the predicted reconnection outflow speed. In the magnetospheric inflow region THEMIS detected (a) penetration of magnetosheath ions and the resulting flows perpendicular to the reconnection plane, (b) ion outflow extending into the magnetosphere, and (c) enhanced electron parallel temperature. Comparison with a simulation suggests that these signatures are associated with the gyration of magnetosheath ions onto magnetospheric field lines due to the shift of the flow stagnation point toward the low‐density magnetosphere. Our observations indicate that these effects, ~2–3 di in width, extend at least 9 di downstream of the X line. The detection of these signatures could indicate large‐scale proximity of the X line but do not imply that the spacecraft was upstream of the electron diffusion region.