bluuebunny/crossref_metadata_2025 huggingface dataset:
Morphea in children: a retrospective study of its clinical characteristics and extracutaneous manifestations
Authors: Rodríguez Salgado Pamela , Hernández Zepeda Carolina , Saez de Ocariz Marimar , Yamazaki Nakashimada Marco Antonio , García Romero María Teresa
Published: March 2019

BACKGROUND: Morphea is an inflammatory disease with diffuse thickening and hardening of the skin. It is common in children and it has been reported that as many as 40% have extracutaneous articular and neurological manifestations, vascular and ocular disorders, and gastrointestinal or respiratory symptoms.RATIONALE: There are no studies of associated extracutaneous manifestations in Mexican children with morphea.OBJECTIVE: Describe clinical characteristics, frequency of extracutaneous manifestations, and treatment of pediatric patients with morphea who received care at the Instituto Nacional de Pediatría.MATERIAL AND METHODS: A retrospective study of patients with morphea, 1 to 18 years of age, who received care between January 1, 2000, and December 31, 2015.RESULTS: Thirty-two patients with morphea were included, half (n = 16) with the linear subtype, followed by plaque-type morphea in 7 (22%). Extracutaneous manifestations were reported in 23 (72%) patients; the most common were: musculoskeletal in 23 (72%), neurological in 9 (28%), and ophthalmological in 3 (9%). Twenty-three patients (72%) required systemic treatment. Nineteen patients (60%) required orthopedic and surgical treatment for complications. The clinical evolution was toward remission in 72% of the patients (n = 23).CONCLUSIONS: In this series of 32 cases of children with morphea, 72% had extracutaneous manifestations, principally musculoskeletal and neurological. It is important to conduct targeted questioning, and if necessary perform paraclinical studies, to identify extracutaneous manifestations which may be associated with morphea, especially when it is linear or extensive.
Tratamiento individualizado de la deshidratación hipernatrémica en el recién nacido
Authors: López Candiani Carlos
Published: March 2019

La hipernatremia (sodio sérico 145 mEq/L) es un desequilibrio que, cuando es grave (160 mEq/L), puede causar alteraciones vasculares y neurológicas agudas, dejar secuelas graves o causar la muerte en recién nacidos.1-4 Se han descrito: trombosis del seno sagital superior,5-6 aórtica 7-8 mesentérica, renal, iliaca, femoral, poplítea7 y arteria retinal;9 hemorragia parenquimatosa,10 gangrena distal,7,11-12 enterocolitis necrosante,13 hipertensión arterial pulmonar e insuficiencia cardiaca derecha.14 La patogénesis de las lesiones cerebrales se describió hace más de medio siglo,15 muchas secundarias a una corrección inadecuada. Oddie16 informa una incidencia de 7 x cada 100,000 nacidos vivos. Se trata, en sí, de un trastorno de la concentración relativa de sodio en el espacio extracelular, y no necesariamente de la cantidad de sodio corporal total que puede estar elevada o ser normal; puede asociarse con volumen de agua corporal normal, alto o bajo.
Guia interativo de boas práticas em Engenharia de Software
Authors: De Almeida Jonathas Arestides , Rangel Helder Jerônimo Leite , Costa Matheus Augusto Coutinho , De Lira Filho Maurício Barbosa , De Medeiros Francisco Petrônio Alencar , Lira Heremita Brasileiro
Published: March 2019

Analyzing the diversity of best practices in Software Engineering present in industry, the Software Engineering Research Group of the Federal Institute of Paraíba realized the need to organize them together in a web repository so that the access, identification and proper application in various software project scenarios is easier. The objective of work is to present the first functional version of this web environment, in order to enable the best practices in Software Engineering as researched by the group. This project has been developed using agile methodologies and is the result of a trio of complementary and collaborative projects from the research group: Repository of Practices in Management of Software Project, Repository of Practices in the Software Development Process, together with the project Reconfigurable Best Practices Environment in Software Engineering.
Interaction of phenothiazines, stilbenes and flavonoids with multidrug resistance-associated transporters, P-glycoprotein and MRP1.
Authors: Wesołowska Olga
Published: March 2019

Multidrug resistance (MDR) of cancer cells poses a serious obstacle to successful chemotherapy. The overexpression of multispecific ATP-binding cassette transporters appears to be the main mechanism of MDR. A search for MDR-reversing agents able to sensitize resistant cells to chemotherapy is ongoing in the hope of their possible clinical use. Studies of MDR modulators, although they have not produced clinically beneficial effects yet, may greatly enrich our knowledge about MDR transporters, their specificity and mechanism of action, especially substrate and/or inhibitor recognition. In the present review, interactions of three groups of modulators: phenothiazines, flavonoids and stilbenes with both P-glycoprotein and MRP1 are discussed. Each group of compounds is likely to interact with the MDR transporters by a different mechanism. Phenothiazines probably interact with drug binding sites, but they also could indirectly affect the transporter's activity by perturbing lipid bilayers. Flavonoids mainly interact with ABC proteins within their nucleotide-binding domains, though the more hydrophobic flavonoids may bind to regions within transmembrane domains. The possible mechanism of MDR reversal by stilbenes may result from their direct interaction with the transporter (possibly within substrate recognition sites) but some indirect effects such as stilbene-induced changes in gene expression pattern and in apoptotic pathways should also be considered. Literature data as well as some of our recent results are discussed. Special emphasis is put on cases when the interactions of a given compound with both P-glycoprotein and MRP1 have been studied simultaneously.
Hyperhomocysteinemia among Omani autistic children: a case-control study.
Authors: Ali Amanat , Waly Mostafa I , Al-Farsi Yahya M , Essa Musthafa M , Al-Sharbati Marwan M , Deth Richard C
Published: March 2019

High serum homocysteine (Hcy) level is regarded as an indicator for impairment of folate-dependent methionine cycle and is associated with oxidative stress. In a case control study, we evaluated eighty 3-5 years old Omani children (40 diagnosed with Autism Spectrum Disorder and 40 their age and gender matched controls) for their fasting serum homocysteine levels as a biomarker of Autism Spectrum Disorder (ASD). Serum folate and vitamin B(12) status were also evaluated. The serum homocysteine was measured using an enzyme immunoassay (EIA) technique whereas folate and vitamin B(12) were measured using an automated random access immune-assay system. The results indicated that mean serum Hcy levels were significantly (P < 0.05) higher in autistic children (20.1 ± 3.3 µmol/L) as compared to controls (9.64 ± 2.1 µmol/L). Significantly (P < 0.05) lower serum folate (1.8 ± 0.4 µg/L) and vitamin B(12) (191.1 ± 0.9 pg/mL) levels were observed in autistic children as compared to controls (6.1 ± 0.6 µg/L and 288.9 ± 1.3 pg/mL, respectively). The levels of homocysteine in autistic children were also much higher as compared to normal reference values (5-15 µmol/L). The results suggest that high fasting serum homocysteine and low folate and vitamin B(12) levels could be used as clinical biomarkers for an early diagnosis and management of ASD.
Mentha longifolia in vitro cultures as safe source of flavouring ingredients.
Authors: Bertoli Alessandra , Leonardi Michele , Krzyzanowska Justine , Oleszek Wieslaw , Pistelli Luisa
Published: March 2019

In vitro plantlets and callus of M. longifolia were established and their volatile constituents characterized by GC-MS analysis of their headspaces (HSs) and essential oils (EOs). Significant quali-quantitative differences were found in the aromatic fingerprints in comparison with the M. longifolia parent plants. In fact, limonene and carvone were the main constituents in the EOs of the mother plants, while the aroma of the in vitro plant material were especially enriched in oxygenated terpenes. In particular, huge amounts of piperitenone and piperitenone oxide (75 %) were found for in vitro plantlets, while trans-carvone oxide (19 %) and trans-piperitone epoxide (9 %) were found in callus EO. However, the established in vitro plant material showed lack of pulegone and menthofurane, thus preserving an important feature observed in the volatile fingerprint of the parent plants. In fact, because of their well-known toxicity significant amounts of pulegone and menthofurane may compromise the safety using of mint essential oil. Therefore the in vitro M. longifolia plantlets and callus may be regarded as a potential source of a safe flavouring agent.
Differences in glutathione S-transferase pi expression in transgenic mice with symptoms of neurodegeneration.
Authors: Kaźmierczak Beata , Kuźma-Kozakiewicz Magdalena , Usarek Ewa , Barańczyk-Kuźma Anna
Published: March 2019

Glutathione S-transferase pi (GST pi) is an enzyme involved in cell protection against toxic electrophiles and products of oxidative stress. GST pi expression was studied in transgenic mice hybrids (B6-C3H) with symptoms of neurodegeneration harboring SOD1G93A (SOD1/+), Dync1h1 (Cra1/+) and double (Cra1/SOD1) mutations, at presymptomatic and symptomatic stages (age 70, 140, 365 days) using RT-PCR and Western blotting. The main changes in GST pi expression were observed in mice with the SODG93A mutation. In SOD1/+ and Cra1/SOD1 transgenics, with the exception of cerebellum, the changes in GST pi-mRNA accompanied those in GST pi protein. In brain cortex of both groups the expression was unchanged at the presymptomatic (age 70 days) but was lower at the symptomatic stage (age 140 days) and at both stages in hippocampus and spinal cord of SOD1/+ but not of Cra1/SOD1 mice compared to age-matched wild-type controls. In cerebellum of the presymptomatic and the symptomatic SOD1/+ mice and presymptomatic Cra1/SOD1 mice, the GST pi-mRNA was drastically elevated but the protein level remained unchanged. In Cra1/+ transgenics there were no changes in GST pi expression in any CNS region both on the mRNA and on the protein level. It can be concluded that the SOD1G93A but not the Dync1h1 mutation significantly decreases detoxification efficiency of GST pi in CNS, however the Dync1h1 mutation reduces the effects caused by the SOD1G93A mutation. Despite similarities in neurological symptoms, the differences in GST pi expression between SOD1/+ and Cra1/+ transgenics indicate a distinct pathogenic entity of these two conditions.
Growth factor/growth factor receptor loops in autocrine growth regulation of human prostate cancer DU145 cells.
Authors: Ligęza Janusz , Ligęza Joanna , Klein Andrzej
Published: March 2019

Autocrine growth factors produced by epithelial cells mediate the development and proliferation of neoplastic human prostate tissue. Various approaches have been used to down-regulate neoplastic growth of prostate cancer using natural flavonoids, soluble receptors, pseudo-ligands, monoclonal antibodies and tyrosine kinase inhibitors (tyrphostins). Selected growth factor/growth factor receptor loops (mainly TGFα/EGFR and IGFs/IGFIR) have been proposed as regulators of prostate cancer cell growth. We have previously determined that blockade of IGFIR or VEGF2R signaling pathways by tyrphostin AG1024 and SU1498 inhibits autocrine growth and viability of DU145 cells in vitro. Recently, we compared the activity of AG1024 and SU1498 with the inhibiting effect of tyrphostin A23 (a selective inhibitor of EGFR). The results described in this paper confirm that DU145 cells do not produce IGFI or EGF. In contrast, DU145 cells produce a great amount of VEGF, much more than TGFα (about 60-fold), and VEGF may be the real autocrine growth factor of the investigated cells. The results indicate that the growth of DU145 may be regulated by at least three autocrine loops: TGFα/EGFR, IGFII/IGFIR and VEGF/VEGFR2. Neither AG1024 nor SU1498 affected the production of TGFα substantially, which excludes the possibility that IGFRs or VEGFR2 inhibitors arrest the growth of these cells by inhibition of synthesis and/or secretion of TGFα. The obtained data indicate that all tree investigated tyrphostins (AG1024, SU1498 and A23) inhibit signal transmission by Akt (PKB), ERK(1/2), Src and STAT in a similar manner. A comparison of the effects of the investigated tyrphostins indicates that TGFα, IGFII and VEGF stimulate cell growth by affecting the same signaling pathway. The hypothesis was confirmed by the effect of the investigated tyrphostins on activation of EGFR. All these inhibitors decreased phosphorylation of EGFR to the same extent, and after the same time of incubation with cell culture. These results strongly suggest that stimulation of EGFR kinase is the main step in the initiation of mitogen signaling in DU145 cells, regardless of the type of ligand (TGFα, IGFs or VEGF) and their specific receptors.
Twin pregnancy in the unicornuate uterus and non-communicating rudimentary horn: A case report
Authors: Hafizi Leili , Ghomian Nayereh
Published: March 2019

Background: A unicornuate uterus is present in 0.1% of the general population. This müllerian anomaly carries significant obstetrical risk including abortion, preterm delivery, and rudimentary horn ruptures.
Case: The patient is a 24-yr-old primigravida with 12-wk gestational age and a twin pregnancy in the unicornuate uterus and non-communicating rudimentary horn. One fetus in the unicornuate uterus and other in the rudimentary horn that was ruptured. In urgent laparotomy rudimentary horn and fallopian tube excised. Pregnancy in the unicornuate uterus was continued and at 38-wk gestational age, cesarean section due to premature rupture of the membrane was performed and then normal fetus was delivered.
Conclusion: Twin pregnancy in a unicornuate uterus and rudimentary horn is a rare condition that carries a considerable risk to the mother. There is a need for increased awareness of this rare condition to prevent maternal morbidity and mortality.
Key words: Twin pregnancy, Uterus, Mullerian ducts.
Evaluation of orally disintegrating tablets (ODTs) containing microspheres with losartan potassium
Authors: Sarecka-Hujar Beata , Łyczak Karol , Balwierz Radosław , Jankowski Andrzej
Published: March 2019

Wprowadzenie

Układy wielokompartmentowe, w których dawka substancji leczniczej jest rozdzielona między nośniki (liposomy, mikrosfery, mikrokapsułki, nanokapsułki), otwierają nowe możliwości w uzyskaniu przedłużonego lub kontrolowanego uwalniania substancji leczniczej. Mikrosfery to monolityczne, porowate lub gładkie cząstki sferyczne
o wielkości 1–500 µm, w których substancja lecznicza jest zawieszona, inkorporowana, rzadziej emulgowana w matrycy polimerowej. Celem pracy było sporządzenie mikrosfer zawierających losartan potasu i Eudragit L 100-55 jako matrycę polimerową, a następnie tabletek rozpadających się w jamie ustnej (orally disintegrating tablets – ODTs) z otrzymanymi mikrosferami.

Metody

Mikrosfery o stosunku lek : polimer 1 : 1 i 1 : 2 otrzymano metodą suszenia rozpyłowego w następujących warunkach: temperatura na wlocie 150°C, wydajność aspiratora 80% oraz wydajność pompy 10%. Morfologia i wielkość mikrosfer oceniana była mikroskopowo. Tabletki zawierające mikrosfery z losartanem wykonano metodą tabletkowania bezpośredniego. Otrzymane ODTs oceniano zgodnie z wymogami Farmakopei Polskiej X (FPX) dla tej postaci leku. Analizę statystyczną przeprowadzono za pomocą programu Statistica 10.1.

Wyniki

Otrzymane ODTs spełniały normy wyglądu, wielkości i jednolitości masy. Czas rozpadu ODTs nie przekraczał wymaganych 3 min. W przypadku analizy uwalniania losartanu dla mikrosfer o stosunku lek : polimer 1 : 1 w 0,1 M roztworu kwasu solnego (HCl) maksymalna ilość substancji czynnej (21%) uwolniła się w 60 minucie. Po 120 min proces kontynuowano w sztucznym soku jelitowym (pH = 6,8), w którym losartan uwolnił się całkowicie w czasie 270 min. W przypadku mikrosfer 1 : 2 w 0,1 M HCl maksymalna ilość losartanu (36%) uwolniła się w 90 minucie, a dalsze uwalnianie w sztucznym soku jelitowym wykazało uwolnienie 99,43% substancji czynnej w czasie 300 min.

Wnioski

Modelowe mikrosfery z losartanem potasu mogą być wykorzystane jako pośrednia postać leku do stworzenia ODTs.
Análisis de la satisfacción de pacientes del servicio de urgencias en un hospital público de Jalisco
Authors: Vizcaíno Antonio De-Jesus , Vizcaíno-Marín Vanessa Del-Pilar , Fregoso-Jasso Gabriel Salvador
Published: March 2019

Objetivo: Determinar a través del desempeño del personal de salud, el nivel de satisfacción en pacientes que acudieron al servicio de urgencias de un hospital público del estado de Jalisco.
Material y métodos: Se realizó un estudio cuantitativo de tipo descriptivo, transversal y correlacional en un solo momento, con base al modelo SERVice PERFormance; aplicación de encuestas en un hospital de Zapopan, Jalisco a una muestra aleatoria de 96 pacientes abarcando las urgencias atendidas en el turno matutino, vespertino y nocturno durante una semana en abril 2017, utilizando un cuestionario con escala Likert para obtener la satisfacción del servicio desde las dimensiones tangibilidad, empatía, seguridad, confiabilidad y capacidad de respuesta.
Resultados: Los hallazgos indican que las pacientes del sexo femenino percibieron mejor trato y orientación del servicio por parte del personal médico y de enfermería, a diferencia del sexo masculino; los pacientes atendidos en el turno vespertino obtuvieron mayor percepción de la rapidez con la que fueron atendidos; la facilidad en los trámites de ingreso al área de urgencias fue totalmente satisfactoria en el turno matutino y la mayoría de los pacientes concuerdan en que los trámites de egreso son fáciles independientemente del turno de atención.
Conclusiones: La percepción de los pacientes respecto a la calidad del servicio depende del desempeño que otorgue todo el personal de salud de la institución, por lo que los resultados posibilitan la toma de decisiones para que los directivos garanticen calidad en la atención en todo momento.
Automated Scheduling of Household Appliances Using Predictive Mixed Integer Programming
Authors: Nagpal Himanshu , Staino Andrea , Basu Biswajit
Published: March 2019

In this work, an algorithm for the scheduling of household appliances to reduce the energy cost and the peak-power consumption is proposed. The system architecture of a home energy management system (HEMS) is presented to operate the appliances. The dynamics of thermal and non-thermal appliances is represented into state-space model to formulate the scheduling task into a mixed-integer-linear-programming (MILP) optimization problem. Model predictive control (MPC) strategy is used to operate the appliances in real-time. The HEMS schedules the appliances in a dynamic manner without any a priori knowledge of the load-consumption pattern. At the same time, HEMS responds to the real-time electricity market and the external environmental conditions (solar radiation, ambient temperature etc). Simulation results exhibit the benefits of proposed HEMS by showing the reduction of up to 47% in electricity cost and up to 48% in peak power consumption.
Pattern Recognition with Convolutional Neural Networks: Humpback Whale Tails
Authors: de Mingo López Luis Fernando , Morales Lucas Clemencio , Gómez Blas Nuria , Ivanova Krassimira
Published: March 2019

This paper presents a study and implementation of a convolutional neural network to identify and recognize humpback whale specimens from the unique patterns of their tails. Starting from a dataset composed of images of whale tails, all the phases of the process of creation and training of a neural network are detailed – from the analysis and pre-processing of images to the elaboration of predictions, using TensorFlow and Keras frameworks. Other possible alternatives are also explained when it comes to tackling this problem and the complications that have arisen during the process of developing this paper.
Vive la Difference! Effects of Natural and Conventional Wines on the Blood Alcohol Concentrations: A Randomized, Triple-Blind Controlled Study
Authors: Ferrero Federico Francesco , Fadda Maurizio , De Carli Luca , Barbetta Marco , Sethi Rajandrea , Pezzana Andrea
Published: March 2019

Background When equalized for alcohol content by volume, however, not all alcoholic beverages have the same effect on blood alcohol concentration (BAC) or neurotoxicity. The aim of this study was to investigate differences between metabolism of a natural wine and of a conventional wine. Methods Fifty-five healthy male volunteers were randomly administered the equivalent of 2 units of alcohol (24 g of ethanol) of a natural or of a conventional wine, and one week later received the same dose of the other wine. At each of the two sessions, a breathalyzer was used to estimate BAC levels before the intake of the wine and then every twenty-minute for 2 hours. The entire study was conducted in triple-blind conditions. Results The blood alcohol curves after consumption of the two different wines diverged significantly at the twenty-minute mark (T20) and then again at their peak values. In both cases, the BAC induced by the natural wine was lower than the one corresponding to the conventional wine (T20 0.44 vs. 0.49 [p<0.012], peak 0.56 vs. 0.60 [p<0.032]). Conclusions The results of the study suggest that natural and conventional wines have a different effect on BAC. The alcohol in the natural wine seems to be absorbed more slowly. Different techniques applied in the production chain likely lead to the development of different amino acids and different types and amounts of antioxidants in the two wines. These compounds, in turn, may affect the kinetics of alcohol absorption and metabolism. The presence or absence of residues of pesticides and other agrochemicals, differences in sugar and fiber content, and the use of either indigenous or selected yeasts, are additional factors that may contribute to the differences observed. If this hypothesis is confirmed, it could have important public health and policy implications.
Agricultural Subsidies, Production Certification and Green Pesticide Use Rate: Evidence from Experiments
Authors: Lin Nan , Zhang Yang , Hu Xin , Liu Lijuan , Wu Chengliang
Published: March 2019

This paper studies the impact of agricultural subsidies and product certification on the use rate of green pesticides based on experimental economics. We found that agricultural subsidies effectively increased the utilization rate of green pesticides. If the agricultural subsidies raised from 20% to 100%, the green pesticides’ using rate increased by 438.51%. We also found that product certification increased the utilization rate of green pesticides by 376.16%%.The increase of agricultural subsidies is more effective than the product certification. Under a higher proportion of agricultural subsidies, farmers’ behavior will maintain “status bias”. Therefore, there are three suggestions proposed. Firstly, because of high price of green pesticides and lower production, the subsidies for agricultural materials should raise greatly to effectively improve the utilization rate of green pesticides. It is recommended that green pesticide provided free of charge in some wealthy areas. Secondly, both subsidies and product certification can improve the use rate of green pesticides. However, since the effect of agricultural subsidies is better than product certification, and farmers may have status bias. Therefore, it is recommended to give priority to the substantial increase on the proportion of agricultural subsidies, and then to product certification.
Resident Surgical Skills Web-Based Evaluation
Authors: Van Heest Ann E. , Agel Julie , Ames S. Elizabeth , Asghar Ferhan A. , Harrast John J. , Marsh J. Lawrence , Patt Joshua C. , Sterling Robert S. , Peabody Terrance D.
Published: March 2019

Background:

Evaluation of surgical skill competency is necessary as graduate medical education moves toward a competency-based curriculum. This study by the American Board of Orthopaedic Surgery (ABOS) and the Council of Orthopaedic Residency Directors (CORD) compares 2 web-based evaluation tools that assess the level of autonomy that is demonstrated by residents during surgical procedures in the operating room as measured by faculty.

Methods:

Two hundred and ninety-four residents from 16 orthopaedic surgery residency programs were evaluated by 370 faculty using 2 web-based evaluation tools in a crossover design in which residents requested faculty review of their surgical skills before starting a case. One thousand, one hundred and fifty Ottawa Surgical Competency Operating Room Evaluation (O-Score) assessments, which included a 9-question evaluation of 8 steps of the surgical procedure, were compared with 1,186 P-score evaluations, which included a single-question summative evaluation. Twenty-five different surgical procedures were evaluated.

Results:

There were no significant differences in rates of resident requests or faculty completion of the 2 scores. The most common surgical procedures that were assessed were total knee arthroplasty (n = 254, 11%), carpal tunnel release (n = 191, 8%), open reduction and internal fixation (ORIF) of stable hip fractures (n = 170, 7%), ORIF of simple ankle fractures (n = 169, 7%), and total hip arthroplasty (n = 166, 7%). Both instruments disclosed significant differences in competency among entry, intermediate, and advanced-level residents. The findings support the construct validity of the evaluation method. The survey results indicated that >70% of the faculty were confident that use of either the P-score or the O-score allowed them to distinguish a resident who can perform the surgery independently from one who needs additional training.

Conclusions:

This research has led to the modification of the O-score and the P-score into a combined OP-score instrument. The ABOS envisions that the OP-score instrument can be used with an expanded number of surgical procedures as a required element of residency training in the near future.

Clinical Relevance:

This study allows the profession of orthopaedic surgery education to take a leadership role in the measurement of competence for surgical skills for orthopaedic surgeons in residency training, an important clinically relevant topic to the practice of orthopaedic surgery.
Prediction of Complications, Readmission, and Revision Surgery Based on Duration of Preoperative Opioid Use
Authors: Jain Nikhil , Brock John L. , Malik Azeem Tariq , Phillips Frank M. , Khan Safdar N.
Published: March 2019

Background:

Preoperative opioid use results in adverse outcomes and higher costs after elective surgery. However, duration thresholds for higher risk are not entirely known. Therefore, the purpose of our study was to determine the number and duration of preoperative opioid prescriptions in order to estimate the risk of postoperative adverse events after major joint replacement and lumbar fusion.

Methods:

National insurance claims data (2007 to September 30, 2015) were used to identify primary total knee arthroplasties (TKAs), total hip arthroplasties (THAs), and 1 or 2-level posterior lumbar fusions (PLFs) performed for degenerative disease. The effect of preoperative opioid burden (naive, ≤3 months, >3 to 6 months, >6 months but stopped 3 months before surgery, and >6 months of continuous use) on the risks of various adverse outcomes was studied using Cox proportional hazards analysis with adjustment for demographic and clinical covariates.

Results:

A total of 58,082 patients stratified into 3 cohorts of 32,667 with TKA, 14,734 with THA, and 10,681 with 1 or 2-level PLF were included for this analysis. A duration of preoperative opioids of >3 months was associated with a higher risk of 90-day emergency department (ED) visits for all causes and readmission after TKA. Preoperative opioid prescription for >6 months was associated with a higher risk of all-cause and pain-related ED visits, wound dehiscence/infection, and hospital readmission within 90 days as well as revision surgery within 1 year after TKA, THA, and PLF. Stopping the opioid prescription 3 months preoperatively for chronic users resulted in a significant reduction in the risk of adverse outcomes, with the greatest impact seen after THA and PLF.

Conclusions:

Patients with a preoperative opioid prescription for up to 3 months before a major arthroplasty or a 1 or 2-level lumbar fusion had a similar risk of adverse outcomes as opioid-naive patients. While >6 months of opioid use was associated with a higher risk of adverse outcomes, a 3-month prescription-free period before the surgery appeared to mitigate this risk for chronic users.

Level of Evidence:

Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Efficient variational simulation of non-trivial quantum states
Authors: Ho Wen Wei , Hsieh Timothy H.
Published: March 2019

We provide an efficient and general route for preparing non-trivial
quantum states that are not adiabatically connected to unentangled
product states. Our approach is a hybrid quantum-classical variational
protocol that incorporates a feedback loop between a quantum simulator
and a classical computer, and is experimentally realizable on near-term
quantum devices of synthetic quantum systems. We find explicit protocols
which prepare with perfect fidelities (i) the
Greenberger-Horne-Zeilinger (GHZ) state, (ii) a quantum critical state,
and (iii) a topologically ordered state, with
\bm{L}𝐋
variational parameters and physical runtimes
\bm{T}𝐓
that scale linearly with the system size \bm{L}𝐋.
We furthermore conjecture and support numerically that our protocol can
prepare, with perfect fidelity and similar operational costs, the ground
state of every point in the one dimensional transverse field Ising model
phase diagram. Besides being practically useful, our results also
illustrate the utility of such variational Ansätze as good descriptions
of non-trivial states of matter.
Occurrence and characteristics of perfluoroalkyl substances (PFASs) in electroplating industrial wastewater
Authors: Jiawei Tang , Yizhen Zhang , Jiajun Sun , Xuelu Shi , Chao Sun , Chunhui Zhang
Published: March 2019

The potential negative effects of perfluoroalkyl substances (PFASs) discharged into aquatic environments are drawing increasing attention. However, little research has been undertaken on PFASs in wastewater from electroplating industrial parks. In this study, the concentration profiles and geographical distribution of 11 PFASs were analyzed in water samples collected from different production workshops and an artificial landscaped lake. The total concentrations of PFASs (Σ11PFASs) at various points in the production drainage system range from 229.5 to 5410.6 ng/L, and are mainly contributed by nickel plating, pickling, and the cyanide bright silver plating procedure, which correspond to cyanide-containing and acid-alkali wastewater conditioning tanks. Wastewater treatment by oxidation and precipitation removed 52.6% and 20% of PFASs, respectively. Σ11PFASs in effluents is about 538 ng/L, which consists of perfluorooctanoic acid (PFOA, 430.5 ng/L), followed by perfluorooctane sulfonate (PFOS, 35.27 ng/L), perfluorohexane sulfonate (PFHxS, 28.05 ng/L), and perfluorohexanoic acid (PFHxA, 18.3 ng/L). Principal component analysis suggests that the Σ11PFASs in electroplating wastewater is very high and short-chain (C4–C8) PFASs have high detection and contribution rates. As a result, much attention should be paid to the increase in short-chain substitution effects and pollution around the factory area.
Processos de gestão em microempresas rurais: estudo multicasos
Authors: Scalon Liamara , Maia Fabrício Simplício , Maia Tatiane Silva Tavares
Published: March 2019

O presente estudo tem por objetivo analisar e discutir as características dos processos de gestão das equipes de direção de microempresas rurais em uma cidade de pequeno porte na região oeste catarinense. Para tanto, utilizou-se como base o modelo teórico proposto por Filion (1999b), o qual focaliza o processo gerencial dos empreendedores. O método de pesquisa adotado foi o estudo multicasos, de cunho qualitativo-descritivo. Os casos foram construídos por meio de entrevistas semiestruturadas com oito equipes de direção das empresas rurais pesquisadas. Os resultados desse estudo indicaram que, com base no modelo de Filion (1999b), as oito equipes de direção investigadas possuem características empreendedoras. Demonstrando que os agricultores familiares possuem condições de serem empreendedores no seu setor. Conclui-se, portanto, que uma gestão eficiente de suas propriedades possibilita que os microempresários rurais se tornem competitivos e sustentáveis nesse segmento tão importante a economia.
Hyponatremia in Heart Failure: Pathogenesis and Management
Authors: Rodriguez Mario , Hernandez Marcelo , Cheungpasitporn Wisit , Kashani Kianoush B. , Riaz Iqra , Rangaswami Janani , Herzog Eyal , Guglin Maya , Krittanawong Chayakrit
Published: March 2019

Hyponatremia is a very common electrolyte abnormality, associated with poor short- and
long-term outcomes in patients with heart failure (HF). Two opposite processes can result in hyponatremia
in this setting: Volume overload with dilutional hypervolemic hyponatremia from congestion,
and hypovolemic hyponatremia from excessive use of natriuretics. These two conditions require
different therapeutic approaches. While sodium in the form of normal saline can be lifesaving
in the second case, the same treatment would exacerbate hyponatremia in the first case. Hypervolemic
hyponatremia in HF patients is multifactorial and occurs mainly due to the persistent release
of arginine vasopressin (AVP) in the setting of ineffective renal perfusion secondary to low
cardiac output. Fluid restriction and loop diuretics remain mainstay treatments for hypervolemic/
dilutional hyponatremia in patients with HF. In recent years, a few strategies, such as AVP
antagonists (Tolvaptan, Conivaptan, and Lixivaptan), and hypertonic saline in addition to loop diuretics,
have been proposed as potentially promising treatment options for this condition. This review
aimed to summarize the current literature on pathogenesis and management of hyponatremia
in patients with HF.
Association of CYP2D6*10 (c. 100 C>T) Genotype with Z-END Concentration in Patients with Breast Cancer Receiving Tamoxifen Therapy in Indonesian Population
Authors: Yenny  , Panigoro Sonar S. , Purwanto Denni J. , Hidayat Adi , Louisa Melva , Andalusia Rizka , Setiabudy Rianto
Published: March 2019

Background:

Tamoxifen (TAM) is a frequently used hormonal prodrug for patients with
breast cancer that needs to be activated by cytochrome P450 2D6 (CYP2D6) into Zusammen-endoxifen
(Z-END).

Objective:

The purpose of the study was to determine the association between CYP2D6*10
(c.100C>T) genotype and attainment of the plasma steady-state Z-END minimal threshold concentration
(MTC) in Indonesian women with breast cancer.

Methods:

A cross-sectional study was performed in 125 ambulatory patients with breast cancer
consuming TAM at 20 mg/day for at least 4 months. The frequency distribution of CYP2D6*10
(c.100C>T) genotypes (C/C: wild type; C/T: heterozygous mutant; T/T: homozygous mutant) was
detected using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP),
the results of which were subsequently confirmed by sequencing. The genotypes were categorized
into plasma Z- END concentrations of <5.9 ng/mL and ≥5.9 ng/mL, which were measured using
ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS).

Results:

Percentages of C/C, CT, and T/T genotypes were 22.4%, 29.6%, and 48.8%, respectively.
Median (25-75%) Z-END concentrations in C/C, C/T, and T/T genotypes were 9.58 (0.7-6.0), 9.86
(0.7-26.6), and 3.76 (0.9-26.6) ng/mL, respectively. Statistical analysis showed a significant difference
in median Z-END concentration between patients with T/T genotype and those with C/C or C/T
genotypes (p<0.001). There was a significant association between CYP2D6*10 (c.100C>T) genotypes
and attainment of plasma steady-state Z-END MTC (p<0.001).

Conclusion:

There was a significant association between CYP2D6*10 (c.100C>T) and attainment of
plasma steady-state Z-END MTC in Indonesian breast cancer patients receiving TAM at a dose of 20
mg/day.
The Design of an Integrated Crude Oil Distillation Column with Submerged Combustion Technology
Authors: Mamudu Angela O. , Okonkwo Ebenezer , Okocha Stephen I. , Okoro Emeka E. , Elehinafe Francis , Igwilo Kevin
Published: March 2019

Objective:

Generally, Petroleum refineries are put in place to convert or refine unprocessed crude oil into more useful products using both physical separation and chemical conversion processes. Albeit, different refining unit are subsets of the physical separation category. The atmospheric and vacuum distillation unit seems to be more prominent. Conventionally, the crude atmospheric residue cannot be further heated in an atmospheric condition due to: coke formation, pipes plugging, thermal cracking and straining of the furnace. A vacuum distillation column is therefore required.

Methods:

This study, therefore, focuses on the limitations, “over straining of the furnace to provide the necessary heat” and “non-reliance on the additional re-boiler since it only acts as a heat exchanger”. An integrated distillation column with a capacity of 10,000 barrel per day was therefore designed for the concurrent production of all distillate cuts.

Results:

This was achieved through the introduction of a submerged combustion zone at the stripping section of the column where Naphtha was utilized as the source of fuel. Verification of this approach was also conducted using Autodesk invention software and a finite element analysis tool to evaluate both thermal and computational fluid analysis impact. Overall, all derived distilled products met the American Society for Testing and Material Standard Table 6.
Psychopharmacological Options in the Multidisciplinary and Multidimensional Treatment of Eating Disorders
Authors: Milano Walter , Capasso Anna
Published: March 2019

Eating Disorders (ED) are a syndrome characterized by persistent alteration of eating behavior and the conditions that cause insufficient ingestion and/or adsorption of foods. There are three different ED diseases: Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorders (BED). ED are complex conditions that arise from a combination of long-standing behavioral, emotional, psychological, interpersonal, and social factors. A common trait to all EDs is the incongruous diet, often based on arbitrary parameters, disconnected from physiological needs, with a strong alteration of the sensations of hunger and satiety, to which variations in weight, body composition, health status and quality of life of patients occur. Although EDs are relatively frequent psychiatric disorders in the general population, especially in adolescent and juvenile age groups, evidence based on the scientific evidence of the efficacy of the pharmacological treatment of EDAs remains modest. The currently available international guidelines related to the pharmacological treatment of EDs are currently few and not always adequately informative, as they are affected by the lack of studies on the subject. As a further consequence of this it is not surprising that, with the sole exception of fluoxetine for the treatment of Bulimia Nervosa (BN) symptoms, no psychopharmaceutical has been authorized by national and international regulators for the treatment of ED.

This narrative review focuses on the advantages and limitations of drugs used in the treatment of ED.
La familia Sarcoscyphaceae (Pezizales, Ascomycota) en México
Authors: Ortega-López Ismael , Valenzuela Ricardo , Gay-González Alfonso Daniel , Lara-Chávez Ma. Blanca Nieves , López-Villegas Edgar Oliver , Raymundo Tania
Published: March 2019

Antecedentes y Objetivos: La Familia Sarcoscyphaceae es la quinta más numerosa del orden Pezizales con 102 especies; se caracteriza por presentar apotecios de colores rojos a anaranjados brillantes, debido a la presencia de pigmentos carotenoides y ascas suboperculadas con esporas lisas u ornamentadas, principalmente con estrías longitudinales vistas al microscopio óptico. El objetivo del presente estudio es realizar una revisión taxonómica de la familia Sarcoscyphaceae en México, basada en caracteres morfológicos macro y microscópicos y observación de las esporas al MEB para separar las especies.Métodos: Los especímenes estudiados fueron recolectados entre 2013 y 2018; además, se revisaron los que están depositados en la colección de hongos del herbario ENCB. Los ejemplares fueron estudiados, descritos y determinados de acuerdo a las técnicas tradicionales en micología. Por otro lado, se analizó el habito de crecimiento y tipo de vegetación donde se desarrollan las especies, de acuerdo al habitat donde crecen las aquí descritas.Resultados clave: Se determinaron 18 especies de Sarcoscyphaceae en México, de las cuales Geodina guanacastensis, Nanoscypha pulchra, Phillipsia olivacea y Sarcoscypha austriaca se citan por primera vez para el país. De acuerdo al habitat, las especies de esta familia se asociaron principalmente a los bosques tropicales caducifolios y perennifolios, mientras que el hábito lignícola de 16 especies fue el dominante.Conclusiones: La familia Sarcoscyphaceae se encuentra bien representada en México, siendo una de las mejores estudiadas del Orden Pezizales en el Phylum Ascomycota. La familia presenta una distribución destacadamente tropical con más de 60% de las especies localizadas en bosques tropicales caducifolios y perennifolios. Las especies de zonas templadas presentan distribución restringida y una mayor especificidad por el hospedero, en la mayoría de los casos, coníferas.
Cultural Adaptation of Digital Knowledge Translation Tools for Acute Otitis Media in Low- to Middle-Income Countries: Mixed Methods Usability Study (Preprint)
Authors: Meherali Salima , Hartling Lisa , Scott Shannon D
Published: March 2019

BACKGROUND

Acute otitis media (AOM) is the most common pediatric bacterial ear infection. AOM presents challenges to parents who lack accurate information. Digital knowledge translation tools offer a promising approach to communicating complex health information. We developed AOM knowledge translation tools for Canadian parents and augmented them for Pakistani parent end users.

OBJECTIVE

This pilot study aimed to (1) develop AOM knowledge translation tools for Canadian parents, (2) adapt the knowledge translation tools across cultural contexts, and (3) evaluate the usability of the adapted knowledge translation tools.

METHODS

Parents’ perceptions of the translated knowledge translation tools’ usability were explored using a mixed-methods design. We recruited parent participants from a hospital in Pakistan to complete usability surveys (n=47) and focus group interviews (n=21). Descriptive statistics and content analysis were used to analyze data.

RESULTS

Usability results showed the usefulness and effectiveness of both adapted knowledge translation tools. Parents reported preferring a digital media narrative format in their own language. Findings revealed that culturally adapted knowledge translation tools are effective in transferring health information to parents.

CONCLUSIONS

Digital knowledge translation tools offer a promising approach to improving health literacy and communicating complex health information to parents of children with AOM. Culturally adapting the tools generated important knowledge that will contribute to knowledge translation advancements. Evaluation of the tool effectiveness is a critical next step to exploring the impact of knowledge translation tools on child health outcomes.
Tecnologia educacional digital na educação básica: estética do empoderamento nas narrativas discentes
Authors: Senra Michel Wanderson , May Berkenbrock Rosito Margaréte
Published: March 2019

RESUMO O presente artigo tem como linha condutora a estética como gosto e desgosto, no desenvolvimento da autonomia e emancipação dos sujeitos. Este processo é analisado nas narrativas dos discentes do nono ano do Ensino Fundamental a respeito do empoderamento na utilização da Tecnologia Digital, ao perceber as sensações de gosto e desgosto pelo enfoque hermenêutico. Abordamos os conceitos de autonomia em Freire (2011), Educação Estética por Schiller (2002), indústria cultural em Adorno (2002) e Tecnologia Digital na educação com Papert (2008). Assim, analisamos se a relação com a tecnologia ocorre como mero consumo ou na possibilidade do sujeito ser construtor e produtor de conhecimento, compreendendo o trabalho de mediador do docente.   Palavras-chave: Educação Estética; Tecnologia Digital; empoderamento. ABSTRACT The following paper has as a guiding line the like and dislike aesthetic, in the development of the autonomy and emancipation of the subjects. This process is analyzed in the narratives of Elementary School ninth grade students regarding the empowerment in using Digital Technology, when they like or dislike the hermeneutical approach. The authors approach the concepts of autonomy in Freire (2011), Aesthetic Education by Schiller (2002), cultural industry in Adorno (2002) and Digital Technology in education according to Papert (2008). Thus, there was an analysis whether the relation with technology occurs as mere consumption or there is the possibility of the subject to construct and produce knowledge, including the role of teacher mediator.   Keywords: Aesthetic Education; Digital Technology; empowerment.     RESUMEN El presente artículo tiene como línea conductora la estética como gusto y disgusto, en el desarrollo de la autonomía y emancipación de los sujetos. Este proceso es analizado en las narrativas de los discentes del noveno año de la Enseñanza Fundamental acerca del empoderamiento en la utilización de la Tecnología Digital, al percibir las sensaciones de gusto y disgusto por el enfoque hermenéutico. (2002), Educación Estética por Schiller (2002), industria cultural en Adorno (2002) y Tecnología Digital en la educación con Papert (2008). Así, analizamos si la relación con la tecnología ocurre como mero consumo o en la posibilidad del sujeto ser constructor y productor de conocimiento, comprendiendo el trabajo de mediador del docente. Palabras clave: Educación Estética; Tecnología Digital; empoderamiento.     DOI: http://dx.doi.org/10.22169/revint.v13i30.1453