bluuebunny/crossref_metadata_2025 huggingface dataset:
Constructal design aplicado à cavidades convectivas inseridas em um sólido cilíndrico
Authors: Estrada Emanuel Da Silva Diaz , Gonzales Gill Velleda , Dos Santos Elizaldo Domingues , Isoldi Liércio André , Rocha Luiz Alberto Oliveira
Published: September 2015

Este trabalho aplica Constructal design no estudo numérico da geometria de cavidades em contato com um fluido com coeficiente de transferência de calor constante que são inseridas em um sólido cilíndrico. Tem-se por objetivo minimizar a temperatura máxima entre o sólido e o ambiente através da variação da geometria da cavidade. A geração interna de calor é distribuída uniformemente no sólido que tem condições adiabáticas nas superfícies externas. O volume total e o volume das cavidades são fixos. As cavidades são retangulares, com razões variáveis. A geometria otimizada e desempenho são apresentados como funções da razão entre o volume das cavidades e o volume total, o número de cavidades e o parâmetro adimensional que representa a transferência de calor por convecção, λ. Os resultados principais mostram que para um número fixo de cavidades, fc e o parâmetro adimensional λ, existe um número ideal de cavidades que minimiza a temperatura máxima e este número ideal de cavidades aumenta, em geral, a medida que fc e λ aumentam.
Extração de conhecimento a partir de bancos de dados oceanográficos mistos
Authors: Barbat Mauro Medeiros , Coleto Juliano Lauser , Goulart Mauricio Gayer , Teixeira Eduardo Porto , Dos Santos Karina Machado , Borges Eduardo Nunes
Published: September 2015

Em estudos oceanográficos é comum o uso de diferentes bases de dados visando correlacionar estruturas comuns que evidenciem ou comprovem determinado aspecto. Tal como dados oceanográficos e meteorológicos provenientes de satélites, boias, entre outros, disponibilizados publicamente por órgãos internacionais de pesquisa. O intuito deste trabalho foi desenvolver um processo de extração de conhecimento de forma a correlacionar dados de sensoriamento remoto como temperatura do oceano e níveis de clorofila-a, com dados pontuais de captura provenientes de empresas de pesca. Desta forma, a abundância do recurso vivo Bonito-Listrado (Katsuwonus Pelamis) foi correlacionada com parâmetros ambientais provenientes de sensores satelitais.
Modelando um sistema Tutor Multiagentes para auxiliar na aprendizagem da Matemática
Authors: Helms Fernanda Krumreich , Loreto Aline Brum , Adamatti Diana Francisca , Buss Cristiane Leitzke , Ferreira André Andrejew
Published: September 2015

O presente trabalho tem como objetivo propor uma modelagem de agentes pedagógicos para desenvolver um sistema tutor baseado em multiagentes a fim de auxiliar na aprendizagem da Matemática no ensino médio. Mais especificamente, modela-se um tutor para auxiliar o aluno na resolução de exercícios para aprendizagem do conteúdo de equações algébricas. Com o desenvolvimento do sistema tutor multiagentes espera-se incentivar o estudo de Matemática, de forma lúdica, com auxílio de uma ferramenta computacional e reforçar os conteúdos da Matemática do Ensino Médio.
Supply Chain Control: A Theory of Vertical Integration
Authors: Ursino Giovanni
Published: September 2015

Improving a company’s bargaining position is often cited as a chief motivation to vertically integrate with suppliers. This paper expands on that view in building a new theory of vertical integration. In my model firms integrate to gain bargaining power against other suppliers in the production process. The cost of integration is a loss of flexibility in choosing the most suitable suppliers for a particular final product. I show that the firms who make the most specific investments in the production process have the greatest incentive to integrate. The theory provides novel insights into the understanding of numerous stylized facts such as the effect of financial development on the vertical structure of firms, the observed pattern from FDI to outsourcing in international trade, and the effect of technological obsolescence on organizations.
Pharmacokinetics of a novel dosing regimen of oral melatonin in critically ill patients
Authors: Bellapart Judith , Roberts Jason Alexander , Appadurai Vinesh , Wallis Steven C. , Nuñez-Nuñez Maria , Boots Robert James
Published: September 2015

Loss of circadian rhythms and reduced concentrations of endogenous melatonin are common in critically ill patients. After exogenous administration, supra-physiological concentrations in serum are only ephemeral, which may explain the absence of significant therapeutic effect on sleep. The aim of this study is to describe the pharmacokinetics of enteral melatonin in critically ill patients administered in a novel regimen aiming to simulate endogenous release.

Thirteen patients in the recovery phase of critical illness were randomised to receive enteral melatonin or placebo. In the melatonin group, a total of 6 mg was administered as solution through their feeding tube, commencing with a 3 mg loading dose at 9 pm and six subsequent 0.5 mg doses hourly. The placebo was administered using a similar regimen. Serial blood samples were taken and measured using a validated chromatographic method. The concentration-time data for serum melatonin concentrations were described using non-linear mixed-effects modelling.

The observed concentrations in the melatonin patients were significantly higher than that observed in the placebo patients. The concentrations in the patients administered melatonin were also higher than endogenous melatonin concentrations previously reported in non-critically ill patients. The patients administered melatonin had a mean clearance, volume of distribution and absorption rate constant of melatonin was 55.2 L/h, 767 L and 0.76 h

Exogenous administration of melatonin with a loading dose of 3 mg followed by an hourly dose of 0.5 mg demonstrates good oral bioavailability and results in supra-physiological and sustained concentrations of serum melatonin during 12 h overnight.
Grain boundary anodic phases affecting environmental damage
Authors: Vasudevan A.K. , Sadananda K.
Published: September 2015

Stress corrosion characterization is analyzed in two alloys, 5083 and binary AL-3Li, both having anodic grain boundary precipitates. The 5083 commercial alloy forms AL3Mg2 (β phase), whereas the AL-3Li alloys have ALLi (δ phase). These are intermetallic phases that form on the grain boundaries and grow in size and area fraction with heat treatment time. When exposed to the NaCl solution, they anodically dissolve and form grain boundary cracks under an applied stress. A brief electrochemical description of these phases reacting with NaCl solution is described. The crack initiation occurs when the appropriate local environmental conditions at the crack tip and stress state is established. Overall, crack initiation mechanism seems to be a combination of mostly anodic dissolution coupled with hydrogen-assisted cracking.
Environmentally assisted cracking and hydrogen diffusion in traditional and high-strength pipeline steels
Authors: Cabrini Marina , Lorenzi Sergio , Pellegrini Simone , Pastore Tommaso
Published: September 2015

This article deals with the risk of environmentally assisted cracking of steel structures that are kept under cathodic protection (CP). The experimental results collected on both hydrogen diffusion and hydrogen embrittlement (HE) of high-strength low-alloy (HSLA) steels under CP are discussed. Hydrogen diffusion was evaluated by permeation experiments and a scanning photoelectrochemical current technique, as a function of microstructure orientation, on both loaded and unloaded specimens. HE tests were carried out under constant load, slow strain rate (SSR tests), and slow bending conditions. Tests were also carried out on several grades of HSLA steel having different microstructures. The results confirm that HE in artificial seawater under CP can occur in steel with tensile yield strength in the range of 400–660 MPa only in the presence of high cathodic polarization and continuous plastically straining conditions. HE susceptibility increased with increasing applied cathodic polarization and with decreasing strain rate. HE susceptibility of the rolled steels at relatively high strain rate (10-4to 10-5s-1) increased with the hydrogen diffusion coefficient. Similar results were observed in terms of the HE contribution to corrosion fatigue crack growth rate. High-temperature-tempered martensitic steels showed a lower HE susceptibility.
Are pregnant women safer in motor vehicle accidents?
Authors: Miller Netanella , Biron-Shental Tal , Peleg Kobi , Fishman Ami , Olsha Oded , Givon Adi , Kessel Boris
Published: September 2015

: Motor vehicle accidents (MVAs) are a major incidental cause of pregnancy-associated maternal deaths in the US. The goal of this research was to evaluate the incidence, risks, and fetal and maternal outcomes of pregnant women involved in MVAs. In addition, we examined the relationship between the injury severity score (ISS) and car seat location in pregnant and non-pregnant women.

: This involved a retrospective cohort study of female patients who were involved in MVAs and hospitalized between the years 2006 and 2013. Data were collected from the Israeli National Trauma Registry. Severity and outcomes of pregnant and non-pregnant women with blunt trauma were compared.

: In this study, 3794 pregnant and 3441 non-pregnant patients aged 18–40 years were analyzed. The majority of pregnant patients were drivers (n=2515, 67%) as opposed to passengers (n=1279, 33%). Pregnant patients had lower ISS than non-pregnant patients (P<0.001). Out of these pregnant patients, 38 (1%) had adverse maternal-fetal pregnancy outcomes, including (1) placental abruption 0.1% and (2) miscarriage (0.2%). One pregnant patient died (0.03%) compared with 32 (0.93%) of the non-pregnant patients (P<0.0001). A significant negative correlation between gestational age and spontaneous abortion was found (P<0.009).

The severity of injury and the mortality rate of pregnant patients involved in MVAs are significantly lower compared with non-pregnant patients. Pregnant drivers had a significantly lower severity of trauma compared with pregnant passengers.
Is there any relationship between serum sirtuin-1 level and neutrophil-lymphocyte ratio in hyperemesis gravidarum?
Authors: Caglayan Emel Kiyak , Engin-Ustun Yaprak , Gocmen Ayşe Yesim , Sarı Nagihan , Seckin Levent , Kara Mustafa , Polat Muhammed Fevzi
Published: September 2015

The aim of this study was to evaluate the relationship between serum sirtuin-1 (SIRT1) level and neutrophil-lymphocyte ratio (NLR) with hyperemesis gravidarum (HG).

Overall, 90 patients who presented with pregnancy between August 2013 and November 2014 were included in the study. The patients were divided into two groups: patients with HG (n=45) and patients without HG (control group [C]; n=45). The patients with comorbid conditions other than pregnancy (disease or medication) were excluded. In all patients, demographic data including age, body mass index (BMI), gestational week, and smoking status were recorded. Blood samples were drawn for complete blood count and measurements of blood lipid, liver enzymes, serum SIRT1, and insulin levels. NLR was calculated from CBC.

No significant differences were detected in age, BMI, or GA between groups (P>0.05). Serum SIRT1 and NLR were found to be significantly higher in patients with HG compared with those in the control group (P=0.001 and 0.006, respectively).

In HG, both SIRT1 level and NLR increased. In HG, this occurred as a response to metabolic alterations and potential inflammation.
Factors associated with choice of delivery with or without epidural analgesia among laboring women: a cross-sectional survey at a tertiary care hospital of a developing country
Authors: Ismail Samina , Abbasi Shemila , Khan Sobia , Monem Abdul , Afshan Gauhar
Published: September 2015

Aims:

The aim of this study was to evaluate the factors responsible for epidural analgesia (EA) refusal among parturient patients.

Methods:

In this prospective cross-sectional study of six months, we included all consenting postpartum patients having a non-operative delivery in the obstetric unit of our hospital. Data were collected on a predesigned questionnaire and included information such as parity, education, reasons for delivering with or without EA, source of information and patient satisfaction. Knowledge regarding EA was assessed from patients delivering without EA.

Results:

From 933 patients enrolled, 730 (78.2%) delivered without EA, and 203 (21.7%) with EA. Only 11 (1.5%) patients refused EA for the reason of having natural birth process. Otherwise common reasons were misconceptions (65.9%) and lack of awareness about EA (20.5%); 70.5% had no knowledge of common side effects of EA. Among patients delivering with EA, 92.6% were offered EA by health care providers and had obstetricians and anesthesiologists as their sources of information.

Conclusions:

Patients in developing countries are laboring without EA, even in centers where there is a provision for it. The main reasons for not availing themselves of EA are lack of awareness and knowledge and misconceptions, rather than the desire to have un-medicated natural birth.
Kennen Sie Ihr Labor? Ein Weg zur Selbstbewertung in medizinischen Laboratorien nach dem EFQM-Modell
Authors: Petersmann Astrid , Baum Hannsjörg , Bietenbeck Andreas , Braun Siegmund L. , Fabricius Hans-Åke , Freytag Claudia Christine , Gottschall Katharina , Hansen Carmen , Hiefinger-Schindlbeck Renate , Hubmann Michael , Kerkin Sandra , Lamp Sophia , Masch Helga , Montanus Georg , Nordmann Stephan , Otte Klaus-Martin , Patscheke Heinrich , Peetz Dirk , Pick Karl-Heinz , Rünz Thilo , Schäfer-Lüdtke Helga , Schüller Mario , Schwenz Britt , Sommerhoff Benedikt , Sonntag Oswald , Stein Wolfgang , Streichert Thomas , Vogt Wolfgang , Wiegel Bernhard , Winter Theresa , Zabel Lutz , Nauck Matthias
Published: September 2015

INQUAM e.V. fördert den Excellencegedanken und unterstützt medizinische Laboratorien auf dem Weg zur ersten Stufe des European Foundation for Quality Management (EFQM)-Excellence Modells „Committed to Excellence“ mit der angepassten Selbstbewertungsmatrix für medizinische Laboratorien.
Reliability and accuracy in the space Lp
(T) for the calculation of integrals depending on a parameter by the Monte Carlo method
Authors: Kozachenko Yuriy V. , Mlavets Yuriy Y.
Published: September 2015

This paper is devoted to the estimation of the accuracy and reliability (in Lp
(T) metrics) for the calculation of improper integrals depending on a parameter t using the Monte Carlo method. For this estimates we use the theory of 𝐅ψ(Ω) spaces.
Multiscale modeling of plasticity in a copper single crystal deformed at high strain rates
Authors: Chandra Sagar , Samal M. K. , Chavan V. M. , Patel R. J.
Published: September 2015

A hierarchical multiscale modeling approach is presented to predict the mechanical response of dynamically deformed (1100 s−1−4500 s−1) copper single crystal in two different crystallographic orientations.Anattempt has been made to bridge the gap between nano-, micro- and meso- scales. In view of this, Molecular Dynamics (MD) simulations at nanoscale are performed to quantify the drag coefficient for dislocations which has been exploited in Dislocation Dynamics (DD) regime at the microscale. Discrete dislocation dynamics simulations are then performed to calculate the hardening parameters required by the physics based Crystal Plasticity (CP) model at the mesoscale. The crystal plasticity model employed is based on thermally activated theory for plastic flow. Crystal plasticity simulations are performed to quantify the mechanical response of the copper single crystal in terms of stressstrain curves and shape changes under dynamic loading. The deformation response obtained from CP simulations is in good agreement with the experimental data.
Preparation of alginate membrane for tissue engineering
Authors: Gong Ying , Han Guang Ting , Zhang Yuan Ming , Zhang Jin Feng , Jiang Wei , Tao Xiao Wei , Gao Sheng Chuan
Published: September 2015

Sodium alginate was provided with good processibility according to physical and chemical characterization of itself. Alginate scaffold has been used for preparation of soft or hard tissue engineering, but the structure of the scaffold needs to be improved for better performance for skin tissue engineering. In this study, highly porous alginate membrane was formed with ionic crosslinking. High molecular weight (Mw=3.0×105) alginate showed the best film-forming property. Therefore, the appropriate molecular weight should be selected for improving its performance. With freeze-drying technology and pre-freezing at -10°C, we have built the honeycomb materials (porosity=92.06%). Changing the pre-freezing temperature can regulate pore structure to some extent. With the increased dosage of sodium alginate, the porosity and the pore size of the materials were reduced, whereas tensile strength and elongation at break increased. Water absorption performance of the materials was good. The above studies lay a foundation for construction of skin tissue engineering scaffold.
Qualitätsaspekte von Gesundheits-Apps: Wie lässt sich Qualität erkennen?
Authors: Scherenberg Viviane
Published: September 2015

Die Anzahl an Gesundheits-Apps steigt stetig. Wissenschaftliche Langzeitstudien, welche Anforderungen Gesundheits-Apps erfüllten sollten, um einen wirkungsvollen Public Health-Beitrag zu leisten, fehlen. Zwar existieren qualitätsbezogene Transparenzkriterien, indes sollte der tatsächliche Einfluss auf das Gesundheitsverhalten und den Gesundheitsstatus insbesondere auf gesundheitlich vulnerable Bevölkerungsgruppen auch hier stärker in Gestalt eines (Qualitäts-)Wettbewerbs in den Vordergrund rücken.
Herausforderungen digitaler Prävention
Authors: Hintz Elisabeth , Blättner Beate
Published: September 2015

Sollen Jugendliche in der Prävention erreicht werden, gewinnt das Social Web als Setting an Bedeutung. Allerdings reicht es nicht, präventive Botschaften in digitalen Medien zu posten oder Online-Angebote zur Verfügung zu stellen. Die Intervention muss den Regeln sozialer Netzwerke folgen. Botschaften, die nicht gelikt, geteilt oder kommentiert werden, werden im Netz nicht sichtbar. Botschaften, die den Kommunikationsregeln entsprechen, stehen in Konkurrenz zu den Inhalten der Nutzerinnen und Nutzer.
MeineReha®– Gesamtsystem für die telemedizinisch assistierte Rehabilition und Prävention
Authors: John Michael , Klose Stefan , Kock Gerhard , Bernert Sebastian
Published: September 2015

In dem Projekt MyRehab entwickelte das Fraunhofer-Institut für offene Kommunikationssysteme (FOKUS) eine telemedizinisch assistierte Trainings- und Therapieumgebung für die Lebensbereiche übergreifende Rehabilitation und Prävention, die aus einer häuslichen, einer klinischen und einer mobilen Komponente besteht. Die Trainings- und Therapieumgebung soll den Menschen wieder an Bewegung heranführen und Patienten bei der korrekten Ausführung von Therapieübungen nach einem stationären Aufenthalt in der Klinik assistieren. Nach der dreijährigen Entwicklungsphase wurden die entwickelten Module für den Patienten von der Charité in einer 6-monatigen Studie auf ihre Akzeptanz und Usability im Reha-Zentrum Lübben evaluiert.
Arztbewertungsportale: Was können sie leisten?
Authors: Schwarz Sabine , Schaefer Corinna
Published: September 2015

Auf Arztbewertungsportalen können Patienten ihre Ärzte anonym bewerten. Die Beurteilungen können von anderen interessierten Personen eingesehen werden und sollen sie bei der Suche nach einem „guten“ Arzt unterstützen. Da die Webseiten einige Schwachstellen aufweisen, ist umstritten, ob sie bei der Arztwahl hilfreich sind. Damit das gelingt, sollten sich seriöse Anbieter an Standards halten und darlegen, was die Portale tatsächlich leisten können: Sie können z.B. Patientenzufriedenheit und -erfahrungen abbilden, zur Beurteilung der fachlichen Kompetenz und der Qualität einer medizinischen Behandlung scheinen sie derzeit jedoch nicht geeignet.
Comments on Patricia Blanchette's Book: Frege's Conception of Logic
Authors: Cook Roy T
Published: September 2015

All contributions included in the present issue were originally presented at an ‘Author Meets Critics’ session organised by Richard Zach at the Pacific Meeting of the American Philosophical Association in San Diego in the Spring of 2014.
Harnessing Genetic Variation in Leaf Angle to Increase Productivity of Sorghum bicolor
Authors: Truong Sandra K , McCormick Ryan F , Rooney William L , Mullet John E
Published: September 2015

The efficiency with which a plant intercepts solar radiation is determined primarily by its architecture. Understanding the genetic regulation of plant architecture and how changes in architecture affect performance can be used to improve plant productivity. Leaf inclination angle, the angle at which a leaf emerges with respect to the stem, is a feature of plant architecture that influences how a plant canopy intercepts solar radiation. Here we identify extensive genetic variation for leaf inclination angle in the crop plant Sorghum bicolor, a C4 grass species used for the production of grain, forage, and bioenergy. Multiple genetic loci that regulate leaf inclination angle were identified in recombinant inbred line populations of grain and bioenergy sorghum. Alleles of sorghum dwarf-3, a gene encoding a P-glycoprotein involved in polar auxin transport, are shown to change leaf inclination angle by up to 34° (0.59 rad). The impact of heritable variation in leaf inclination angle on light interception in sorghum canopies was assessed using functional-structural plant models and field experiments. Smaller leaf inclination angles caused solar radiation to penetrate deeper into the canopy, and the resulting redistribution of light is predicted to increase the biomass yield potential of bioenergy sorghum by at least 3%. These results show that sorghum leaf angle is a heritable trait regulated by multiple loci and that genetic variation in leaf angle can be used to modify plant architecture to improve sorghum crop performance.
Comparison of Pediatric Early Warning Score to Physician Opinion for Deteriorating Patients
Authors: Fenix JB , Gillespie Catherine W. , Levin Amanda , Dean Nathan
Published: September 2015

BACKGROUND:

This study compares a Pediatric Early Warning Score (PEWS) to physician opinion in identifying patients at risk for deterioration.

METHODS:

Maximum PEWS recorded during each admission was retrospectively ascertained from electronic medical record data. Physician opinion regarding risk of subsequent deterioration was determined by assignment to an institutional “senior sign-out” (SSO) list that highlights patients whom senior pediatric residents have identified as at risk. Deterioration events were defined as intubation, initiation of high flow nasal cannula, inotropes, noninvasive mechanical ventilation, or aggressive fluid resuscitation within 12 hours of transfer to the PICU. We assessed the relationships of sociodemographic variables, PEWS, and SSO assignment with subsequent deterioration events using multivariate regression analysis to control for a number of covariates.

RESULTS:

There were 97 patients with nonelective transfers to the PICU who were eligible for placement on the SSO lists before transfer, 51 of whom experienced qualifying deterioration events. Maximum recorded PEWS was significantly higher for patients with a subsequent deterioration event during the first 12 hours after transfer, compared with those who were transferred but did not experience a deterioration event in the first 12 hours (mean [SD]: 3.9 [2.0] vs 2.9 [2.0]; P = .01). This association persisted even after multivariate adjustment. SSO assignment was only marginally associated with risk of deterioration among this patient population, with or without adjustment for covariates.

CONCLUSIONS:

The PEWS was significantly associated with ICU deterioration, whereas physician opinion was not. Used alone or in conjunction with physician assessment, PEWS is a valuable tool for identifying patients vulnerable to acute deterioration.
Current State of Institutional Privileging Profiles for Pediatric Procedural Sedation Providers
Authors: Kamat Pradip P. , Hollman Gregory A. , Simon Harold K. , Fortenberry James D. , McCracken Courteny E. , Stockwell Jana A.
Published: September 2015

BACKGROUND AND OBJECTIVE:

Providers from a variety of training backgrounds and specialties provide procedural sedation at institutions in the United States. We sought to better understand the privileging patterns and practices for sedation providers.

METHODS:

Surveys were sent to 56 program directors belonging to the Society for Pediatric Sedation using Research Electronic Data Capture to 56 pediatric sedation programs. The survey was designed to gather information regarding characteristics of their sedation service and the privileging of their sedation providers.

RESULTS:

The overall response rate was 41 (73%) of 56. Most programs surveyed (81%) said their physicians provided sedation as a part of their primary subspecialty job description, and 17% had physicians whose sole practice was pediatric sedation and no longer practiced in their primary subspecialty. Fifty-one percent of surveyed sedation programs were within freestanding children’s hospitals and 61% receive oversight by the anesthesiology department at their institution. Eighty-one percent of the sedation programs require physicians to undergo special credentialing to provide sedation. Of these, 79% grant privileging through their primary specialty, whereas 39% require separate credentialing through sedation as a stand-alone section. For initial credentialing, requirements included completion of a pediatric sedation orientation and training packet (51% of programs), sedation training during fellowship (59%), and documentation of a specific number of pediatric procedural sedation cases (49%).

CONCLUSIONS:

In this survey of pediatric sedation programs belonging to the Society for Pediatric Sedation, the process for privileging providers in procedural sedation varies significantly from institution to institution. An opportunity exists to propose privileging standards for providers of pediatric procedural sedation.
Advancing Neurologic Care in the Intensive Care Nursery
Authors: Glass Hannah C.
Published: September 2015

Up to 25% of neonates at tertiary care nurseries are diagnosed as having neurologic conditions, including encephalopathy and hypoxic-ischemic encephalopathy [HIE], as well as seizures, stroke, and intracranial hemorrhage. These children are at high risk for lifelong disabilities, including cerebral palsy, epilepsy, and cognitive and behavioral disabilities. Establishing a neurointensive care nursery involves a culture change toward brain-focused care, with all bedside clinicians (including physicians, nurses, respiratory technologists, and trainees) maintaining constant awareness of the potential neurologic complications of critical illnesses, as well as the effect of management on the developing or injured brain. Team-based, brain-focused care to monitor, diagnose, and treat neurologic conditions of the developing brain has the potential to improve outcomes in neonates with brain injuries and congenital conditions of the developing nervous system.
Alcohol and Marijuana Use and Treatment Nonadherence Among Medically Vulnerable Youth
Authors: Weitzman Elissa R. , Ziemnik Rosemary E. , Huang Quian , Levy Sharon
Published: September 2015

BACKGROUND AND OBJECTIVE:

Adolescents face peak risks for onset and intensification of alcohol and marijuana use. However, we know little about these behaviors and their associations with knowledge or treatment adherence among chronically ill youth, a medically vulnerable group.

METHODS:

Cross-sectional assessment of consented youth ages 9 to 18 years receiving care for asthma/cystic fibrosis, type 1 diabetes, arthritis, or inflammatory bowel disease (IBD) by using a self-administered online tool. Prevalence and correlates of risk behaviors and associations with knowledge and treatment adherence were estimated using descriptive statistics and logistic regression, controlling for demographics, mental health, and the multiclinic sampling frame.

RESULTS:

Of 403 consented youth (75.8% response), 51.6% were girls, 75.1% were white, and average age was 15.6 years. Of high school youth, 36.5% and 12.7% reported past-year alcohol use and binge drinking, respectively; 20% reported past-year marijuana use. Among high school youth, 53.1% and 37.2% answered correctly that alcohol can interfere with their medications and laboratory tests; youth answering incorrectly were 8.53 and 4.46 times more likely to drink and binge drink, respectively (P values < .001). Thirty-two percent and 8.3% of high school youth reported regularly forgetting or skipping their medications in the past 30 days; compared with past-year nondrinking youth, drinkers were 1.79 and 1.61 times as likely to report regularly missing or skipping medications (P values < .05).

CONCLUSIONS:

Alcohol and marijuana use are common among youth with chronic medical conditions. Alcohol use is associated with treatment nonadherence. Education and preventive interventions are warranted to ameliorate risk.
Developmental Trajectories of Subjective Social Status
Authors: Goodman Elizabeth , Maxwell Sarah , Malspeis Susan , Adler Nancy
Published: September 2015

BACKGROUND AND OBJECTIVE:

Subjective social status (SSS), a person’s sense of their (or for youth, their family’s) position in the socioeconomic hierarchy, is strongly related to health in adults but not health in adolescence. Understanding this developmental discrepancy requires first understanding the developmental trajectory of SSS. The objective of this study was to identify the number and shape of SSS trajectories as adolescents transition to adulthood and explore if trajectory membership affects health.

METHODS:

Using data from 7436 assessments from the Princeton School District Study, a decade-long cohort study of non-Hispanic black and white youth, latent class growth models with 3 to 7 SSS trajectories were developed. Model fit, trajectory structure, and shape were used to guide optimal model selection. Using this optimal model, the associations of trajectory membership with BMI and depressive symptoms in young adulthood were explored.

RESULTS:

The 5-class model was optimal. In this model, trajectories were persistent high (7.8%), mid–high (32.2%), middle (43.4%), low–lower (7.4%), and high–low (9.1%). Non-Hispanic black race/ethnicity, lower household income, and low parent education were associated with membership in this high–low trajectory. High–low trajectory membership was associated with higher BMI and depressive symptoms in non-Hispanic white subjects but was not associated with depressive symptoms. It was associated with lower BMI only after adjustment for BMI in adolescence in non-Hispanic black subjects.

CONCLUSIONS:

SSS is relatively stable in adolescence and the transition to adulthood, and it generally reflects objective markers of social advantage. However, socially disadvantaged youth with high SSS in early adolescence may be at increased health risk.
Skin-to-Skin Care for Term and Preterm Infants in the Neonatal ICU
Authors: Baley Jill ,   COMMITTEE ON FETUS AND NEWBORN, Watterberg Kristi , Cummings James , Eichenwald Eric , Poindexter Brenda , Stewart Dan L. , Aucott Susan W. , Puopolo Karen M. , Goldsmith Jay P.
Published: September 2015

“Kangaroo mother care” was first described as an alternative method of caring for low birth weight infants in resource-limited countries, where neonatal mortality and infection rates are high because of overcrowded nurseries, inadequate staffing, and lack of equipment. Intermittent skin-to-skin care (SSC), a modified version of kangaroo mother care, is now being offered in resource-rich countries to infants needing neonatal intensive care, including those who require ventilator support or are extremely premature. SSC significantly improves milk production by the mother and is associated with a longer duration of breastfeeding. Increased parent satisfaction, better sleep organization, a longer duration of quiet sleep, and decreased pain perception during procedures have also been reported in association with SSC. Despite apparent physiologic stability during SSC, it is prudent that infants in the NICU have continuous cardiovascular monitoring and that care be taken to verify correct head positioning for airway patency as well as the stability of the endotracheal tube, arterial and venous access devices, and other life support equipment.
Antenatal Counseling Regarding Resuscitation and Intensive Care Before 25 Weeks of Gestation
Authors: Cummings James ,   COMMITTEE ON FETUS AND NEWBORN, Watterberg Kristi , Eichenwald Eric , Poindexter Brenda , Stewart Dan L. , Aucott Susan W. , Puopolo Karen M. , Goldsmith Jay P.
Published: September 2015

This Clinical Report was reaffirmed November 2021.

The anticipated birth of an extremely low gestational age (<25 weeks) infant presents many difficult questions, and variations in practice continue to exist. Decisions regarding care of periviable infants should ideally be well informed, ethically sound, consistent within medical teams, and consonant with the parents’ wishes. Each health care institution should consider having policies and procedures for antenatal counseling in these situations. Family counseling may be aided by the use of visual materials, which should take into consideration the intellectual, cultural, and other characteristics of the family members. Although general recommendations can guide practice, each situation is unique; thus, decision-making should be individualized. In most cases, the approach should be shared decision-making with the family, guided by considering both the likelihood of death or morbidity and the parents’ desires for their unborn child. If a decision is made not to resuscitate, providing comfort care, encouraging family bonding, and palliative care support are appropriate.
Is There a Paradox of Liberation and Religion? Muslim Environmentalists, Activism, and Religious Practice
Authors: Hancock Rosemary
Published: September 2015

Social movement theorists have often posited that religion and political activism are inherently opposed—that religion cannot liberate people from situations of social or political discontent in the same manner as activism. Through a study of Muslim environmental activists in the United Kingdom and United States of America, this article directly challenges this belief—not only by charting the theoretical problems of this belief within the social movement theory corpus, but also by demonstrating that Muslim environmentalists in the US and UK are both religious and politically active simultaneously. Environmental activism is drawn into Islamic practice in such a way that activism becomes religious practice in the lives of these Muslim activists.
Caso atípico de leucoplasia bucal
Authors: Ribeiro Fabiana Gama , Martins Gabriela Botelho , Oliveira Marcio Campos , Cerqueira Arlei
Published: September 2015

As leucoplasias são as lesões cancerizáveis encontradas com maior freqüência na cavidade bucal. Ela é caracterizada pela OMS como “uma placa ou mancha branca que não pode ser caracterizada clinicamente ou patologicamente como qualquer outra doença”. Sua etiologia ainda é controversa, mas existe uma estreita ligação com traumatismos crônicos,em especial o uso prolongado do tabaco. A localização mais comumente relatada é o vermelhão do lábio, seguida pela mucosa jugal e gengiva. O objetivo deste trabalho é apresentar e discutir um caso atípico de leucoplasia em paciente encaminhada para o Centro de Referência de Lesões Bucais (CRLB) da Universidade Estadual de Feira de Santana (UEFS). O caso descrito chama a atenção pela localização incomum e por ter sido confundida com estomatite nicotínica.
LEVANTAMENTO EPIDEMIOLÓGICO DOS DIAGNÓSTICOS HISTOPATOLÓGICOS DE UM CENTRO DE REFERÊNCIA EM PATOLOGIA BUCOMAXILOFACIAL EM UM PERÍODO DE 10 ANOS
Authors: Dias Neto Bernadete , Medrado Alena P. , Reis Silvia Regina A.
Published: September 2015

O levantamento epidemiológico da casuística das patologias que acometem o complexo bucomaxilofacial é de fundamental importância para a clínica odontológica. Todavia, poucos estudos relacionados a este tema têm sido publicados na literatura, a despeito de sua relevância para a viabilização de programas de saúde. Neste contexto, o objetivo deste trabalho foi avaliar a frequência e os principais tipos de patologias que são comumente biopsiados e enviados ao Serviço de Patologia Bucomaxilofacial do Curso de Odontologia da Escola Bahiana de Medicina e Saúde Pública. Através da realização de um estudo retrospectivo abrangendo os dados coletados durante os anos de 2001 a 2010, foram avaliadas 1095 fichas de biópsias. Considerando o diagnóstico histopatológico de cada caso, avaliou-se a freqüência das lesões patológicas, a distribuição geral das amostras quanto ao sexo e idade, a localização das lesões, e o diagnóstico clínico e histopatológico. As patologias mais freqüentes foram a hiperplasia fibroepitelial (16,62%);  inflamação crônica inespecífica (6,30%) e cisto radicular/residual (4,87%). A importância de se buscar o correto diagnóstico da patologia apresentada pelo paciente é tão importante quanto a escolha dos métodos e técnicas a serem utilizadas no seu tratamento, ou controle. É evidente que quanto melhor e mais preciso for o diagnóstico, mais eficiente será o tratamento desenvolvido.
DURABILIDADE DA UNIÃO À CERÂMICA DE ZIRCÔNIA TETRAGONAL POLICRISTALINA CONTENDO ÍTRIO (Y-TZP)
Authors: Carvalho Juliana Souza , Giannini Marcelo , Cavalcanti Andrea Nóbrega
Published: September 2015

Objetivo: Este estudo avaliou in vitro a durabilidade da união do cimento resinoso à cerâmica Y-TZP, verificando o efeito de diferentes tratamentos de superfície e da aplicação prévia do sistema adesivo na peça. Metodologia: Quarenta placas de cerâmica foram distribuídas em quatro grupos experimentais (n=10) de acordo com a combinação entre tratamento de superfície (abrasão a ar ou irradiação com laser de Er:YAG) e aplicação de dois diferentes tipos de sistema adesivo (Scotchbond Multi Purpose - catalisador e Single Bond 2) sobre a peça previamente à inserção do cimento resinoso. Após o tratamento da cerâmica, cilindros de cimento resinoso foram construídos, utilizando matrizes com 0,8x1mm (diâmetro x altura). Em cada grupo experimental, 5 corpos-de-prova foram submetidos ao ensaio de microcisalhamento após 24h, e outros 5 corpos-de-prova foram testados após 6 meses em armazenamento em água. Resultados: Independentemente do adesivo e do tempo, as maiores médias foram obtidas nos grupos submetidos à abrasão a ar. Não foram detectadas diferenças significativas entre os sistemas adesivos e nem entre os tempos. Conclusão: Pode-se concluir que a abrasão a ar e o uso do agente adesivo quimicamente ativado sobre a peça podem melhorar a união à zircônia.
REPERCUSSÃO DE DOENÇAS SISTÊMICAS NO REPARO TECIDUAL
Authors: Fonseca Mariana Achy de , Almeida Renata Reis de , Reis Silvia Regina De Almeida , Medrado Alena Ribeiro Alves Peixoto de
Published: September 2015

Vários são os estímulos, endógenos e exógenos, que podem causar uma lesão tecidual. Neste trabalho são relatadas algumas patologias, a exemplo dos distúrbios circulatórios, desnutrição e doenças associadas ao déficit de cicatrização que podem modular as diferentes fases do reparo tecidual. É de grande relevância o conhecimento das complicações causadas por estas entidades clínicas para o cirurgião-dentista, haja vista que este lida diretamente como o processo de cicatrização através de procedimentos comuns em sua prática clinica.
FATORES QUE INFLUENCIAM NO SUCESSO DA TÉCNICA DO RETALHO POSICIONADO CORONALMENTE
Authors: Ferreira Patricia Santos , Barbosa Renata De Araújo , Ribeiro Erica Del Peloso , Bittencourt Sandro
Published: September 2015

A recessão gengival é definida como a localização da margem tecidual apical à junção cemento-esmalte e pode ser causada pelo biofilme bacteriano, fator etiológico primário da inflamação periodontal, assim como pelo trauma de escovação. O tratamento da recessão gengival é normalmente um recontorno da arquitetura gengival, com ou sem associação de técnicas, para alcançar o recobrimento da superfície radicular exposta e aumentar a quantidade de tecido queratinizado. Estes procedimentos visam a uma melhoria estética e tratamento da hipersensibilidade dentinária, assim como a redução do risco de cárie. O retalho posicionado coronalmente é uma técnica muito utilizada para realização de recobrimento radicular. Na literatura, têm sido relatados diversos fatores que podem interferir no sucesso dessa técnica, dentre os quais estão os relacionados ao tecido periodontal, à técnica cirúrgica e aos hábitos dos pacientes. O objetivo desse artigo foi reunir os fatores que poderiam influenciar no resultado final da técnica de retalho posicionado coronalmente, mediante uma revisão de literatura.
SOLUÇÕES ESTÉTICAS PARA PRÓTESES PARCIAIS REMOVÍVEIS RETIDAS POR GRAMPOS METÁLICOS
Authors: Andrade Meyer Guilherme , Oliveira Júnior Francisco , Valadares Oliveira Luciana , Peixoto de Souza Bruno , Vilasboas Rodrigues Felipe , Castor Xisto Lima Emilena Maria
Published: September 2015

A construção de uma Prótese Parcial Removível (PPR) tem por finalidade a reposição das unidades dentárias perdidas, incorporando-as ao sistema estomatognático, sem ferir o equilíbrio biomecânico, além do grande desafio, na atualidade, de aliar a função à estética. A dificuldade em se conseguir harmonia estética pela presença dos grampos em metal nas superfícies vestibulares de dentes anteriores justifica estudos que visam solucionar esse problema das PPRs, e ainda, o fato de se tratar de procedimento mais simples e menos oneroso para o paciente frente a outras opções de tratamento. Logo, o presente estudo apresentou soluções estéticas para PPR, propondo a comparação de grampos metálicos convencionais na face vestibular com grampos retentores na palatina, através de três casos clínicos de pacientes que apresentavam ausência parcial de unidades dentárias anteriores. Foram confeccionadas duas peças protéticas para cada paciente: 1) enfatizando apenas os princípios biomecânicos e 2) considerando princípios biomecânicos e estéticos. Observou-se que os grampos MDL modificado e Quereilhac são alternativas viáveis para atender às condições em PPRs de indivíduos desdentados anteriores, cujos arcos são Classe III e IV de Kennedy. Desta forma, foi possível constatar que houve melhora estética do sorriso em indivíduos parcialmente desdentados na região anterior, por meio da não visualização de estrutura metálica na face vestibular dos dentes pilares.
ANOMALIAS DENTÁRIAS NAS FISSURAS LABIAIS E/OU PALATINAS NÃO-SINDRÔMICAS: REVISÃO DA LITERATURA
Authors: Oliveira Sá Jamile De , Cintra Maranhão Samário , Leite Canguçú Daiane , Souza Lima Coutinho Thaynara De , Peixoto Medrado Alena , Almeida Reis Sílvia Regina de
Published: September 2015

Fissuras do lábio e/ou palato não sindrômicas (FL/PNS) representam as anomalias congênitas mais comuns da face. Entre as particularidades odontológicas mais frequentes nestes indivíduos, encontram-se as alterações dentárias, localizadas nas regiões das fissuras e também fora delas. O objetivo deste trabalho é revisar a literatura sobre as anomalias dentárias associadas às FL/PNS. Efetuou-se uma busca de artigos em bases de dados computadorizadas, como Medline, Lilacs e PubMed. Segundo a análise crítica dos estudos pesquisados, observou-se que as anomalias dentárias foram mais comuns na dentição permanente. A maior prevalência foi de agenesia e dentes supranumerários. O incisivo lateral superior foi o elemento mais acometido pela agenesia, dentes supranumerários e microdontia. Os dentes mais próximos da fenda são os mais susceptíveis às malformações, entretanto a presença de anomalias dentárias fora da região fissurada aponta para eventos genéticos em comum envolvidos nesses processos.
REANATOMIZAÇÃO DENTAL COM RESINA COMPOSTA: RELATO DE CASO
Authors: Rodriguez Stephanie Dias Rivera , Argolo Saryta , Cavalcanti Andrea Nóbrega
Published: September 2015

Objetivo: apresentar um caso clínico em que optou-se, como plano de tratamento, pelo clareamento dental seguido da confecção de semi-faceta em resina composta dos caninos superiores a fim de devolver a anatomia dental. Descrição do caso: Paciente do sexo masculino, com histórico de bruxismo infantil, onde foram perdidas as características anatômicas dos caninos superiores, mostrava-se insatisfeito com a aparência estética do seu sorriso. A resolução estética deste caso baseou-se no emprego do clareamento dental e da técnica direta, com a utilização de resina composta, para a obtenção de um sorriso harmônico, observando-se o protocolo correto baseado nas últimas evidências apresentadas na literatura, sendo que o resultado atendeu as expectativas estéticas do paciente. Conclusão: As restaurações diretas em resina composta são excelentes para a reanatomização de dentes anteriores, reabilitando e reproduzindo a forma, tamanho e cor dos dentes. Dente canino; Estética dentária; Materiais dentários.
MANUTENÇÃO DE VIA AÉREA SUPERIOR APÓS REDUÇÃO FECHADA DE FRATURA NASAL: RELATO DE CASO
Authors: Dantas Renata Moura Xavier , De Paula Daniel Miranda , Malaquias Pietry Dy Tarso Inã Alves , Macedo Thiago Felippe Oliveira de , Carneiro Júnior Bráulio
Published: September 2015

Objetivo: apresentar um caso clínico de redução fechada de fratura nasal com modificação da técnica de tamponamento nasal anterior e consequente manutenção das vias aéreas superiores no pós-operatório imediato. Descrição do caso: paciente vítima de acidente desportivo (capoeira) com histórico de trauma em terço médio de face e epistaxe no momento do trauma. Ao exame físico facial, observou- se edema em região nasal, edema e equimose periorbitária bilateral, hemorragia subconjuntival em olho direito, látero desvio de dorso nasal para o lado esquerdo, crepitação nasal e obstrução principalmente em narina direita e demais contornos ósseos da face preservados. Ao exame de imagem (tomografia computadorizada), foram evidenciados sinais sugestivos de fratura dos ossos próprios do nariz. A redução da fratura deu-se de forma fechada sob anestesia local. Após a redução, optou-se pelo uso intra-nasal de uma sonda Nelaton, visando a manutenção das vias aéreas superiores, seguido do tamponamento nasal anterior com gaze vaselinada. O paciente foi acompanhado com um mês, e seis meses de pós-operatório. Conclusão: a redução de fraturas dos ossos nasais com manutenção das vias aéreas, de forma fechada sob anestesia local, é uma técnica que pode ser realizada com boa margem de segurança, proporcionando ao paciente um maior conforto no período pós-operatório.
IMPACTO DO PROGRAMA DE EDUCAÇÃO TUTORIAL (PET/MEC) SOBRE A SAÚDE BUCAL EM MUNICÍPIOS DO ESTADO DA BAHIA
Authors: Fonseca Elisabeth Martinez , Araújo Thamiles Pinheiro , Santos Marina Cartibani , Nobre Camila Neves , Sampaio Monah , Medrado Alena Peixoto
Published: September 2015

O presente artigo descreve uma atividade de ensino e extensão desenvolvida por bolsistas integrantes do Programa de Educação Tutorial do curso de odontologia da Escola Bahiana de Medicina e Saúde Pública intitulada “PET sobre os trilhos”. Objetiva relatar duas experiências bem sucedidas no âmbito da promoção de saúde bucal em cidades do interior do estado da Bahia. Foram realizadas atividades lúdico-educativas em comunidades dos municípios de São Domingos e Ribeira do Pombal, a exemplo de escovação bucal supervisionada, palestras educativas, jogos e brincadeiras de caráter educativo e distribuição de escovas e cremes dentais. Houve plena participação de bolsistas do grupo PET, com supervisão da tutora. Temáticas relacionadas à promoção de saúde bucal e sistêmica foram abordadas com indivíduos de diferentes faixas etárias. Desta maneira, a relevância deste projeto é atribuída aos impactos sociais no desenvolvimento de conhecimentos e atitudes sobre a adequada manutenção da saúde bucal por parte das comunidades envolvidas, bem como a compreensão acerca das causas e consequências de uma má higiene oral.