bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence of Osteoporosis-Related Complications Following Posterior Lumbar Fusion
Authors: Bjerke Benjamin T. , Zarrabian Mohammad , Aleem Ilyas S. , Fogelson Jeremy L. , Currier Bradford L. , Freedman Brett A. , Bydon Mohamad , Nassr Ahmad
Published: December 2017

Study Design:

Retrospective review.

Objectives:

This study investigates the prevalence of adverse postsurgical events, or osteoporosis-related complications (ORCs), following spinal fusion.

Methods:

Patients undergoing primary posterior thoracolumbar or lumbar fusion by 1 of 2 surgeons practicing at a single institution were analyzed from 2007 to 2014. ORCs were defined in one of the following categories: revision surgery, compression fracture, proximal junctional kyphosis, pseudarthrosis, or failure of instrumentation. Patients with a bone mineral density of the hips and/or spine performed within 1 year of the index procedure were included. Patients were stratified into normal bone density, osteopenia, and osteoporosis using WHO guidelines. Patients were excluded if they were younger than 18 years at the time of surgery, with infection, malignancy, skeletal dysplasia, neuromuscular disorders, concomitant or staged anterior-posterior procedure, or fusion performed because of trauma.

Results:

Out of 140 patients included, the prevalence of normal bone density was 31.4% (44/140), osteopenia 58.6% (82/140), and osteoporosis 10.0% (14/140). There were no differences between groups for gender, age, body mass index, and interbody device rate. The overall prevalence of ORCs was 32.1% (45/140). By group, there was a prevalence of 22.7% (10/44), 32.9% (27/82), and 50.0% (7/14) for normal bone density, osteopenia, and osteoporosis, respectively. These differences were significantly higher for both the osteopenia and osteoporosis groups.

Conclusions:

Patients with T scores below −1.0 undergoing posterior lumbar fusion have an increased prevalence of ORCs. Consideration of bone density plays a crucial role in patient selection, medical management, and counseling patient expectations.
Use of Tachycardia in Patients With Submassive Pulmonary Emboli to Risk Stratify for Early Initiation of Thrombolytic Therapy: A Case Series Comparing Early Versus Late Thrombolytic Initiation
Authors: Cheta Jordana , Long Ashleigh , Marik Paul
Published: December 2017

Pulmonary embolism (PE) represents a prevalent cause of morbidity and mortality in the United States, with approximately 600 000 cases diagnosed annually. The mortality rate for untreated PE is as high as 30%. Right ventricular (RV) dysfunction is a sign of possible adverse outcomes with right-sided heart failure being the usual cause of death from PE. There is a spectrum of clinical presentations associated with PE diagnoses, from incidental and asymptomatic to rapid hemodynamic collapse. Despite successes in identifying patients with “high-risk” PEs for aggressive thrombolytic interventions and “low-risk” PEs for outpatient anticoagulation, a significant lack of consensus exists regarding intervention modalities for PEs identified as “intermediate risk” or “submassive,” defined as normotensive (systolic blood pressure ≥90 mm Hg) with acute RV dysfunction and myocardial injury. In this case series, we review the management and outcomes of 2 patients with submassive PEs and sustained tachycardia in the setting of normal blood pressures, and we address the need to recognize tachycardia as an ominous RV compensatory sign, indicative of impending hemodynamic collapse, that should lead to aggressive therapy with vascular intervention.
Cancer nanomedicine: a review of recent success in drug delivery
Authors: Tran Stephanie , DeGiovanni Peter‐Joseph , Piel Brandon , Rai Prakash
Published: December 2017

Cancer continues to be one of the most difficult global healthcare problems. Although there is a large library of drugs that can be used in cancer treatment, the problem is selectively killing all the cancer cells while reducing collateral toxicity to healthy cells. There are several biological barriers to effective drug delivery in cancer such as renal, hepatic, or immune clearance. Nanoparticles loaded with drugs can be designed to overcome these biological barriers to improve efficacy while reducing morbidity. Nanomedicine has ushered in a new era for drug delivery by improving the therapeutic indices of the active pharmaceutical ingredients engineered within nanoparticles. First generation nanomedicines have received widespread clinical approval over the past two decades, from Doxil® (liposomal doxorubicin) in 1995 to Onivyde® (liposomal irinotecan) in 2015. This review highlights the biological barriers to effective drug delivery in cancer, emphasizing the need for nanoparticles for improving therapeutic outcomes. A summary of different nanoparticles used for drug delivery applications in cancer are presented. The review summarizes recent successes in cancer nanomedicine in the clinic. The clinical trials of Onivyde leading to its approval in 2015 by the Food and Drug Adminstration are highlighted as a case study in the recent clinical success of nanomedicine against cancer. Next generation nanomedicines need to be better targeted to specifically destroy cancerous tissue, but face several obstacles in their clinical development, including identification of appropriate biomarkers to target, scale‐up of synthesis, and reproducible characterization. These hurdles need to be overcome through multidisciplinary collaborations across academia, pharmaceutical industry, and regulatory agencies in order to achieve the goal of eradicating cancer. This review discusses the current use of clinically approved nanomedicines, the investigation of nanomedicines in clinical trials, and the challenges that may hinder development of the nanomedicines for cancer treatment.
Health Technology Assessment capacity development in low- and middle-income countries: Experiences from the international units of HITAP and NICE
Authors: Tantivess Sripen , Chalkidou Kalipso , Tritasavit Nattha , Teerawattananon Yot
Published: December 2017

Health Technology Assessment (HTA) is policy research that aims to inform priority setting and resource allocation. HTA is increasingly recognized as a useful policy tool in low- and middle-income countries (LMICs), where there is a substantial need for evidence to guide Universal Health Coverage policies, such as benefit coverage, quality improvement interventions and quality standards, all of which aim at improving the efficiency and equity of the healthcare system.

The Health Intervention and Technology Assessment Program (HITAP), Thailand, and the National Institute for Health and Care Excellence (NICE), UK, are national HTA organizations providing technical support to governments in LMICs to build up their priority setting capacity. This paper draws lessons from their capacity building programs in India, Colombia, Myanmar, the Philippines, and Vietnam. Such experiences suggest that it is not only technical capacity, for example analytical techniques for conducting economic evaluation, but also management, coordination and communication capacity that support the generation and use of HTA evidence in the respective settings. The learned lessons may help guide the development of HTA capacity in other LMICs.
Analysis of Quality of Financial Results: Problems and Decisions
Authors: Вахорина Марина , Vakhorina Marina
Published: December 2017

The problems connected with carrying out the analysis of financial results as subject of the economic analysis are considered. Within the research the main objectives and the directions of the analysis of financial results are proved. Special attention is paid problems of assessment of quality of profit, directed to her increase.
The Urgency of the Ideas of Russian Space Scientists on the Spiritual and Moral Development of the Individual in Modern Pedagogy and Education
Authors: Иванова Ирина , Ivanova Irina
Published: December 2017

The article is based on the theoretical analysis of the works of Russian space scientists, in which the ideas of spiritual and moral development and personal development are expressed in the context of space education. These ideas are especially relevant in the light of modernization of modern education, one of the leading directions of which is to create conditions for positive socialization, spiritual and moral formation and the formation of value-semantic orientations of the younger generation.
The Idea of "Life in the World" in the Space of Education
Authors: Волкова Светлана , Volkova Svetlana
Published: December 2017

The article is devoted to the comprehension of the philosophical and methodological foundations of the theory and practice of education. The focus is on the phenomenology of the "vital world" (E. Husserl) and "being-in-the-world" (M. Heidegger). Implantation of these phenomenological ideas into the fabric of educational discourseserves the purpose of revealing the possibilities of phenomenology in the study of the educational space. The subject of the study is the everyday educational reality, as well as those meanings and meanings that have a reality in the mind of the teacher and student. Particular attention is paid to the description of multiple ways of understanding the space in which teachers and students are immersed. The method of hermeneutic phenomenology used by the author makes it possible to demonstrate the heuristic and fruitfulness of addressing the idea of a "vital world" in the analysis of educational reality.In conclusion, the author comes to the conclusion that for the specificity of human being lies in his "life world" (or in "being-in-the-world"), then the teacher and student can be screened from each other by their own space-time, and itself "Resettlement" of pedagogical relationships is discrete. In this regard, pedagogical interaction will become a meeting of the student and the teacher only when it finds support in the value-semantic structures that make up the life world of the students, their being-in-the-world.
About the Program Vocational-Personal Self-Development Teacher Montessri
Authors: Сафаралиева О. , Safaralieva O.
Published: December 2017

Humanization of the modern national education inevitably entailed changes to the requirements for the individual nature of the competence of professionals working with the child. From the teacher it is required to create a very special environment, in collaboration with the child. It increases the relevance of the professional transformation of the modern teacher and changes in their professional training. Practice shows that many established professionals pedagogical ideas of Montessori discovers the true foundations of the humanistic paradigm of education. Training of Specialists in Montessori system allows them not only to obtain new skills, but also the personality and self-modifying self-development. The course of professional and personal self-development Montessori teacher turns from simple to complex, from cognition to interpersonal and internal communication. In this sequence, each stage of the program appears as an element of the whole process of personal development.
Differentiated Approach As One of the Ways to Optimize the Process of Training Foreign Languages at Non-Linguistic University
Authors: Колмакова Ольга , Kolmakova Ol'ga , Лазицкая Е. , Lazickaya E.
Published: December 2017

The article is devoted to the problem of the formation and development of a communicative competence in a non-linguistic university. The authors define “internal” differentiation as the most effective way to solve the problem presented in the article. The levels of students’ training, as well as communicative tasks for each level are considered. Particular attention is paid to practical implementation of the differentiated approach, namely, the types of different levelstechniques are proposed for the formation and development of a communicative competence. The results of the educational process with the use of “internal” differentiation are analyzed and visualized. Its effectiveness is proved.
The Art of the Renaissance Era As an Interlink of the World Culture
Authors: Ульянова Наталия , Ulyanova Nataliya
Published: December 2017

The article is devoted to the analysis of the features of Italian artistic culture, the Renaissance period, on the example of the work of the outstanding artist Michelangelo Buonarroti. Particular attention is paid to the significance and influence of the Italian culture of the Renaissance period on the world artistic culture. An analysis is made of the patterns of the further development of cultural relations based on the principles of the aesthetics of humanism.
Moodle in the System of Education and Self-Education of the Educator
Authors: Казанцева Елена , Kazanceva Elena
Published: December 2017

At the present time in connection with the establishment of a national system of teacher growth becomes a key point of improvement of qualification of workers of education. Refresher training is available in various forms, one of which is remote form. This is quite convenient if you'll be on the Moodle platform. The passage of remote training courses of this kind is important in the framework of education and self-education of the teacher, since it contributes to increase ICT competence.
The Essence of Risk and Its Types
Authors: Губанов Н. , Gubanov N. , Губанов Н. , Gubanov N.
Published: December 2017

The essence of the risk is given, which refers to the actions or inactions of a person or a social group in conditions of uncertainty and awareness of a possible danger, as well as the knowledge that success will lead to the intended benefit, and failure to the alleged damage. The following types of risk are identified and described: justified and unjustified (adventurism), active and passive, selfless and self-serving, big and small, real and imaginary, autorisk and heterorisk. The concept of "risk threshold" is defined, which means the limit of the alleged danger, after which there is a rejection of risky actions. The correlation of the concepts "risk", "danger", "reliability" is revealed. The inevitability and progressiveness of risk in the development of new facilities and new activities is shown.
Documentation of spinal red flags during physiotherapy assessment
Authors: Cooney Fran , Graham Claire , Jeffrey Sarah , Hellawell Michael
Published: December 2017

This project was designed as a retrospective service evaluation using audit to assess the identification and documentation of red flags in initial assessment of patients with low back pain. Firstly, the documentation of 11 predetermined red flags was assessed. Secondly, the documentation of relevant additional information was assessed and finally, compliance with local policy to highlight positive red flag findings in the designated area on the paper work was examined. The documentation for the majority of red flags was high, however, clear gaps were identified. Additionally, there was no evidence of further clinical consideration of positive red flags during the diagnostic process. Possible factors influencing red flag documentation are discussed and suggestions are provided to improve recording and response to clinical indicators of malignancy.
A center manifold application: existence of periodic travelling waves for the 2D abcd-Boussinesq system
Authors: Quintero Jose R. , Montes Alex M.
Published: December 2017

In this paper we study the existence of periodic travelling waves for
the 2D abcd Boussinesq type system related with the three-dimensional
water-wave dynamics in the weakly nonlinear long-wave regime. Small
solutions that are periodic in the direction of translation form an infinite-dimensional
family, by characterizing them using a center manifold reduction
of infinite dimension and codimension due to the fact that at
the linear level we are dealing with an ill-posed mixed-type initial-value
problem. As happens for the Benney-Luke model and the KP II model
for wave speed large enough and large surface tension, we show that
a unique global solution exists for arbitrary small initial data for the
two-component bottom velocity, specified along a single line in the direction
of translation (or orthogonal to it). As a consequence of this
fact, we show that the spatial evolution of bottom velocity is governed
by a dispersive, nonlocal, nonlinear wave equation.
CNN architecture for robotic arm control in a 3D virtual environment by means of by means of EMG signals
Authors: Velandia Natalie Segura , Moreno Robinson Jimenez , Hernandez Ruben Dario
Published: December 2017

This paper presents the development of a 3D virtual environment to validate the
effectiveness of a Convolutional Neural Network (CNN) in a virtual application,
controlling the movements of a manipulator or robotic arm through commands
recognized by the network. The architecture of the CNN network was designed to
recognize five (5) gestures by means of electromyography signals (EMGs) captured
by surface electrodes located on the forearm and processed by the Wavelet Packet
Transform (WPT). In addition to this, the environment consists of a manipulator of
3 degrees of freedom with a final effector type clamp and three objects to move
from one place to another. Finally, the network reaches a degree of accuracy of
97.17% and the tests that were performed reached an average accuracy of 98.95%.
Low cost regulation and load control system for low power wind turbine
Authors: Ochoa Yonatan , Rodriguez Jhon , Martinez Fredy
Published: December 2017

Context: Electric power generation systems designed as a point
solution to supply needs away from the power grid typically make use
of the energy resources available in the area. These systems are custom
designed to supply a specific need, and with high efficiency criteria
in mind. A fundamental element in these systems are the batteries
charge and control circuits. Method: The regulation system was designed
for the wind turbine prototype of the Francisco Jos de Caldas
District University, campus of the Technological Faculty, and considering
its use in low-income housing. The module has three intermediate
stages of regulation: rectification and conditioning, DC/DC regulation
and battery charging, and voltage inversion. Results: We achieved a
prototype of high efficiency, low cost and high performance in laboratory
tests. Conclusions: The load control and regulation system is
a low-cost, high-performance alternative to solve problems of supplying
electric power in non-interconnected areas of the Colombian power grid.
A Liderança dos Diretores no Contexto Educativo Português: a Ética e a Moral, Quais as Competências e Tendências?
Authors: Neves Lurdes , Coimbra Joaquim Luís
Published: December 2017

A escola, como unidade básica e espaço de realização de objetivos e metas do sistema educativo, encontra-se em constante remodelação, tornando-se num grande desafio para os diretores, por exigir deles novas competências, conhecimentos, capacidades e atitudes, que convergem na necessidade de desenvolvimento de competências para a tomada de decisões participativas e justas. Assim, este estudo teve como objetivo conhecer quais as perceções e práticas de liderança exercidas por 30 diretores de Agrupamentos de Escolas. Para alcançar este objetivo, recorreu-se a um estudo misto, tendo sido realizada uma entrevista semiestruturada aos Diretores e aplicadas três escalas de liderança (ética, moral e transformacional). Foi possível constatar perceções de liderança que variam entre o transacional e transformacional e que algumas capacidades do líder são preditoras do tipo de liderança exercida.
Comparação da atenção em jogadores de futebol e em não atletas
Authors: Barbosa Cláudia , Montiel José Maria , Machado Afonso Antônio , Bartholomeu Daniel
Published: December 2017

Os aspetos atencionais e motores demonstram grande relevância em atividades desportivas. Este estudo teve como objetivo comparar a atenção de atletas e não atletas, e verificar os efeitos da idade nestas diferenças. Participaram 554 indivíduos do sexo masculino na faixa etária entre os 10 e os 17 anos. Os instrumentos utilizados foram o Teste de Atenção por Cancelamento e a avaliação da habilidade motora específica para o futebol. Os resultados indicaram que um bom desempenho do atleta e um bom desempenho desportivo estão relacionados com um elevado nível de atenção ao jogo e de habilidade motora. Ainda pode sublinhar-se que bons desempenhos em testes de atenção por cancelamento tendem a estar relacionados com melhores desempenhos em avaliações da habilidade motora.
LOS CÉSPEDES ESPONTÁNEOS DEL PARQUE J.F. VILLARINO (ZAVALLA–SANTA FE) Y SU BANCO DE SEMILLAS
Authors: Boccanelli Silvia Irene , Alzugaray Claudia , Franceschi Eduardo Andrés
Published: December 2017

El objetivo de este trabajo fue caracterizar las comunidades herbáceas espontáneas que constituyen los céspedes del parque J.F. Villarino (Provincia de Santa Fe, Argentina) y evaluar la vegetación emergente y el banco de semillas del suelo. Se utilizaron parcelas de inventario de 16 m 2 . Los datos fueron analizados con métodos multivariados. En la vegetación se observaron tres grupos: Grupos 1, 2 y 3 dominados por Cynodon dactylon, Paspalum notatum y Digitaria sanguinalis, respectivamente. En el banco de semillas se reconocieron dos grupos, que se diferenciaron por la importancia relativa de alguna de sus especies. El 62 % de las especies del banco presentó una distribución agregada (Índice de Morisita). La similitud entre la vegetación y el banco fue de 55,7% (Índice de Sörensen). El 47 % de las especies que en la vegetación se destacaron por su constancia y/o abundancia, también se encontraron en el banco, aunque pocas alcanzaron una densidad alta. En ambas situaciones predominaron las especies nativas (80,3 % en céspedes y 61,9 % en el banco del suelo) y perennes (73,8 % y 58,5 % respectivamente). Los resultados señalan la importancia de preservar los céspedes espontáneos, dado que contienen y actúan como refugio de especies nativas del pastizal pampeano extinto en la región.
LAS LOMBRICES DE TIERRA (ANNELIDA: CRASSICLITELLATA: OLIGOCHAETA) DEL PARQUE NACIONAL IGUAZÚ (MISIONES, ARGENTINA)
Authors: Teisaire Ernestina Susana , Picón María Cristina , García Moreno Ana
Published: December 2017

Las lombrices de tierra son cruciales para el funcionamiento del suelo como una importante parte de la macrofauna de ese ecosistema. En las áreas naturales es sabido que las especies exóticas o invasoras pueden desplazar las nativas y también producir su extinción. Estas consecuencias se explican por los cambios sufridos en las condiciones del ambiente, que posibilitan la inserción de las especies exóticas y amenazan la supervivencia de las nativas. La causa más común de alteraciones de ambientes naturales son las actividades realizadas por el hombre y que al mismo tiempo en forma accidental pueden introducir especies provenientes de otras regiones. La gran actividad turística desarrollada en parte del Parque Nacional Iguazú ofrece una excelente oportunidad para estudiar el impacto de esta actividad en la composición de la fauna de lombrices de tierra. En estos sitios se realizaron colectas en forma manual en lugares elegidos por su cercanía con senderos o instalaciones para visitantes. Los animales recolectados fueron identificados y depositados en la Colección Helmintológica de Oligochaeta de la Fundación Miguel Lillo, San Miguel de Tucumán. Se encontró un total de nueve especies de lombrices, cuatro nativas, como Glossoscolex bergi, Opisthodrilus borelli borellii, Pontoscolex corethrurus y Eukerria garmani argentinae y cinco exóticas: Nematogenia lacuum, Dichogaster bolaui, Dichogaster saliens, Amynthas gracilis y Methaphire californica. La prevalencia de especies exóticas en los sitios de muestreo es indicativa del grado de alteración que han sufrido estosambientes y de la invasión de especies introducidas por el hombre.
COMENTARIOS BIBLIOGRÁFICOS: LA PUGNA ANTÁRTICA. EL CONFLICTO POR EL SEXTO CONTINENTE 1939–1959
Authors: López Hugo L.
Published: December 2017

La pugna antártica. El conflicto por el sexto continente 1939–1959Autor: Fontana, P.Editorial: Guazuvira Ediciones.Año: 2014.Cantidad de páginas: 323.
SEMBLANZAS Demetrio Boltovskoy.
Authors: López Hugo L.
Published: December 2017

SEMBLANZAS Demetrio Boltovskoy.
A study on cancer pain and sleep parameters of cancer patıents: Hydromorphone Hydrochloride
Authors: Baltaoğlu Alp Hayriye
Published: December 2017

The ratio of painless sleep was 80% in our study.26 (52%) of the patients showed no side effects, while 10 (20%) had nausea and 6 (12%) had constipation. 8 (16%) of the patients were found to have other side effects. The frequency of those side effects was nausea, constipation, dizziness, vomiting, respiratory failure and diarrhea respectively.[table 4]Hydromorphone hydrochloride helped to eliminate sleep disorder, shortness of breath and snoring and relatively improved amount of sleep and adequacy of sleep. It was found that 90% of our patients were able to fall asleep in 1-5 minutes; however 82% did not have enough amount of sleep. 78% of patients had no feeling of dizziness during the day; 82% did not have shortness of breath; 80% reported that they slept without pain, while 41% reported that they did not sleep at all.
Wspieranie empowermentu w sytuacji zinstytucjonalizowanego nauczania języków obcych: możliwości, wyzwania i ograniczenia
Authors: Blachowska-Szmigiel Marzena
Published: December 2017

The aim of this article is to present opportunities, challenges and constraints related to the support of a student’s empowerment in the context of institutionalized foreign language teaching. In the first part of the article, we describe empowerment as the approach, the process and the action that support the growth of power in individuals, communities and organizations. In the following part we present teaching and learning of foreign languages as a process supporting student’s empowerment. In the last part, we point to a foreign language teacher as a source of opportunities, challenges and constraints related to the support of a student’s empowerment.
Uczeń ze specjalnymi potrzebami edukacyjnymi na lekcji języka obcego w szkole podstawowej – rola nauczyciela i środowiska szkolnego w realizacji koncepcji inkluzji
Authors: Janicka Monika
Published: December 2017

The article presents the tenets of the inclusion concept and the ways as well as the problems concerned with its implementation. Special attention has been given to primary school-students with special educational needs in the language classroom. In the article results of a research project are presented. The project had two aims. The first was to elicit the level of implementation of the inclusion concept at Polish primary schools using the example of teaching foreign languages. The other aim was to sensitise the students of applied linguistics – future language teachers – to the challenges concerned with teaching languages to children with special educational needs.
Rola kontekstu społecznego oraz czynników indywidualnych w rozwijaniu kompetencji różnojęzycznej polskich gimnazjalistów
Authors: Kucharczyk Radosław
Published: December 2017

The aim of this article is to reflect on the role of social context and individual factors that influence the development of multilingual competence. The first part of the article deals with the analysis of the definition of the multi-lingual competence and its role in language teaching. The next part is the presentation of the relation between the social and educational context, taking into consideration students’ individual features and multilingual competence. The last part of the article consists of the analysis of the results of the research study conducted among Polish Junior High School students. The aim of the study was to establish the impact of different factors influencing learning French as the second language.
Różnice indywidualne w uczeniu się języków obcych w wiejskiej szkole gimnazjalnej
Authors: Ellis Melanie
Published: December 2017

School achievement in foreign languages is often reported in mean scores, or on normalized scales, where schools are compared with each other and against a national average. This has led to the common belief that rural lower secondary schools in Poland are ‘worse’ than schools in larger centres of population. This paper sets out to demonstrate that such a view is erroneous as it fails to take into consideration the context, either at the level of the school as a whole, or at the level of individual learners. Based on data obtained from the first two years of a large scale longitudinal research project, “Teaching and Learning Foreign languages” (BUNJO 2012, 2013), this case study describes the context of one lower secondary school in a village in the east of Poland and profiles four teenage learners (aged 13-14) who attend this school and their achievement in English over the period of one year.
Risk factors for positive resection margins of breast cancer tumorectomy specimen following breast-conserving surgery
Authors: Heiss Niko , Rousson Valentin , Ifticene-Treboux Assia , Lehr Hans-Anton , Delaloye Jean-François
Published: December 2017

Background

The aim of the study was to identify risk factors for positive surgical margins in breast-conserving surgery for breast cancer and to evaluate the influence of surgical experience in obtaining complete resection.

Methods

All lumpectomies for invasive breast carcinoma and ductal carcinoma in situ (DCIS) between April 2008 and March 2010 were selected from the database of a single institution. Re-excision rates for positive margins as well as patient and histopathologic tumor characteristics were analyzed. Surgical experience was staged by pairs made of Resident plus Specialist or Consultant. Two periods were defined. During period A, the majority of operations were performed by Residents under supervision of Specialist or Consultant. During period B, only palpable tumors were operated by Residents.

Results

The global re-excision rate was 27% (50 of 183 patients). The presence of DCIS increased the risk for positive margins: 60% (nine of 15 patients) in the case of sole DCIS compared to 26% (41 of 160 patients) for invasive cancer (p = 0.005) and 35% (42 of 120 patients) in the case of peritumoral DCIS compared to 11% (seven of 62 patients) in the case of sole invasive cancer (p = 0.001). Re-excision rate decreased from 36% (23 of 64 patients) during period A to 23% (27 of 119 patients) during period B (p = 0.055). There was no significant difference between the surgical pairs.

Conclusion

In our study, DCIS was the only risk factor for positive surgical margins. Breast-conserving surgery for non-palpable tumors should be performed by Specialists, however, palpable tumors can be safely operated by Residents under supervision.
Valuing Historical Claims of Loss of Use of Land with Sparse Data
Authors: Lazar Fred , Prisman Eliezer Z
Published: December 2017

There have been numerous historical claims by First Nations across Canada for damages resulting from the taking of land and the resulting loss of use of such land. Many of these cases have come before the courts. Generally in such cases, there is agreement that either the Federal Government and/or a provincial government has not fulfilled its fiduciary duty. Hence, the disputes before the courts usually pertain to valuing the losses of the First Nation(s) who is (are) the Plaintiff(s) in these cases. Since the original taking of the lands occurred many decades in the past, the court is challenged with difficult valuation issues, which are complicated by a lack of historical data and transaction records. Hence, even if the parties agree on the methodology for valuing the losses and on an annual lease rate, they still need to determine the annual price of the land. A common practice for generating a price trajectory for the land is to use a very small sample of land prices, and interpolate between these prices to estimate the intervening land prices. This practice does not generate the expected trajectory given the known observations. It implicitly assumes a deterministic price process with an annual fixed appreciation of the asset throughout the period. These assumptions are inconsistent both with realistic price movements and the literature modeling asset price processes. Consequently this practice can, and mostly does, generate a very significant bias in the value of the loss. This paper suggests a loss of use valuation method that is based on a land price process consistent with the literature modeling asset price processes.
Percepción del aprendizaje basado en problemas y el desarrollo de capacidades en estudiantes de una Facultad de Estomatología
Authors: Lamas Lara Víctor Fernando , Gómez Meza Dora Noelia
Published: December 2017

Objetivo: Determinar la relación existente entre la percepción de estudiantes sobre el uso del aprendizaje basado en problemas y el desarrollo de capacidades en la Facultad de Estomatología de la Universidad Inca Garcilaso de la Vega (UIGV). Materiales y método: Estudio descriptivo, transversal y correlacional. La población fueron estudiantes del quinto ciclo la Facultad de Estomatología de la UIGV del 2015-I, de Prótesis Parcial Removible que cumplieron con los criterios de inclusión (matriculados en la asignatura de Prótesis Parcial Removible del año 2015-I, accesibilidad, disponibilidad horaria y aceptar participar en el trabajo). Se trabajó con 49 alumnos. El instrumento utilizado: Un cuestionario de evaluación. El tenor de las preguntas indaga sobre la percepción que desarrollan los estudiantes sobre la estrategia de aprendizaje basada en problemas y el desarrollo de capacidades que considera haber desarrollado. Resultados: No se encontró correlación entre la dimensión condiciones sobre el uso del modelo didáctico de aprendizaje basado en problemas con el desarrollo de capacidades conceptuales, procedimentales y actitudinales por medio de la prueba de correlación de Spearman. La dimensión instrumentalidad y el desarrollo de capacidades conceptuales, procedimentales y actitudinales por medio de la prueba de Spearman tuvieron correlación directa moderada en todas ellas (p<0,001) con valores del índice rho de Spearman de 0,524, 0,481 y 0,503 respectivamente. Conclusiones: La percepción de los estudiantes sobre la estrategia de aprendizaje basado en problemas se correlaciona positivamente con el desarrollo de capacidades.
Estudio in vitro de la relación entre el foramen apical y ápice anatómico
Authors: Olivera-Rojas Piero , Lugo-Huertas Wendy , Pumahualcca-García Graciela , Lara-Verástegui Rosa , Quispe-Romero Pamela , Castro Rodríguez Yuri
Published: December 2017

Objetivo: Evaluar la relación entre la posición del foramen apical y el ápice anatómico en piezas dentarias uniradiculares. Materiales y método: Estudio in vitro que incluyó 71 piezas dentarias (incisivos, caninos y premolares) uniradiculares. Se evaluó la posición del foramen apical (vestibular, palatino/lingual, mesial y distal) así como la distancia desde el foramen apical hasta el vértice del ápice anatómico a través de un Vernier electrónico. Resultados: Treinta y dos piezas dentarias (45,1%) coincidieron la ubicación entre el foramen apical y ápice anatómico; el 56,4% de forámenes apicales se encontró a nivel vestibular y palatino/lingual. De las piezas dentarias donde se encontró la coincidencia, la mayor cantidad fue encontrada a nivel de los incisivos centrales superiores (31,3%). La distancia entre la ubicación del foramen apical y el ápice anatómico fue de 0,36±0,41 mm. Conclusiones: El foramen apical se ubicó en mayor frecuencia a nivel vestibular y palatino/lingual. La coincidencia entre la posición del foramen apical y el vértice del ápice anatómico se encontró presente en un 45% de casos. La distancia promedio entre ambas estructuras anatómicas fue de 0,36 ± 0,41 mm; siendo esta distancia mayor a nivel de premolares superiores.
Síndrome de Goldenhar y microsomía hemifacial. Revisión de la literatura
Authors: Cazenave Lissette , Leiva Noemi , Morovic Carmen Gloria
Published: December 2017

La microsomía hemifacial corresponde a la segunda malformación congénita en prevalencia, luego de la fisura labiopalatina, y se describe como una alteración congénita del primer y el segundo arcos branquiales. El síndrome de Goldenhar tiene características típicas de la microsomía hemifacial, con la adición de dermoides epibulbares y anomalías vertebrales. Ambas patologías presentan características de expresión variable y por tanto los tratamientos son acordes a su individualidad. En esta revisión de tema se analizan su etiología, clasificaciones, características y tratamiento.
Percepción de la desviación de la línea media de la sonrisa por individuos no relacionados a la odontología y por especialistas en ortodoncia
Authors: Cabello-Pérez Sandra Victoria , Soldevilla-Galarza Luciano Carlos , Paredes-Sampén Ney Alberto
Published: December 2017

Objetivo: Comparar la percepción de la desviación de la línea media de la sonrisa por individuos no relacionados a la odontología y ortodoncistas. Materiales y método: Estudio descriptivo y transversal; en el que participaron 102 personas, 60 no relacionados a la odontología y 42 ortodoncistas, quienes calificaron la estética de la sonrisa en fotografías según la posición de la línea media, usando una escala visual análoga de 0-100 mm; para ello se modificó la fotografía de sonrisa de un paciente varón, de 17 años, en oclusión óptima, simétrico, con posición de línea media de la sonrisa centrada, creándole desviaciones a la derecha e izquierda, usando el programa Adobe Photoshop CS6. Resultados: Para ambos grupos de evaluadores, la percepción de las desviaciones de la línea media de la sonrisa de 1, 2, 3 y 4 mm hacia la derecha y de 1 mm hacia la izquierda fueron estadísticamente significativos (p<0,05) y los resultados de las desviaciones hacia la izquierda de 2, 3 y 4 mm y posición centrada no fueron estadísticamente significativos (p>0,05). Se encontraron diferencias en las percepciones según el lado para el cual se encuentran éstas desviaciones. Conclusiones: Los ortodoncistas fueron más críticos al mostrar la percepción de la desviación de la línea media de la sonrisa en comparación con los individuos no relacionados a la odontología, lo que se evidencia en la menor tolerancia al percibir la estética de las desviaciones mayores de línea media de sonrisa.
La evidencia científica como motor de los procedimientos en Odontología
Authors: Castillo Cevallos Jorge Luis
Published: December 2017

Hace unos cuatro años la revista de la Asociación Americana de Ortodoncistas publicó un editorial, escrito por una de las figuras más importantes de la Ortodoncia contemporánea: el Dr Vincent Kokich. El título del editorial era “¿Tiene usted una práctica clínica basada en evidencia?”. Dentro del artículo se podía leer una frase muy importante: “Una practica clínica basada en evidencia significa integrar la experiencia clínica individual con la mejor investigación clínica disponible”
Síndrome de dolor miofascial. Revisión de la literatura a propósito de un caso clínico
Authors: Landa Román Cristóbal , Gómez Pamatz Francisco Javier
Published: December 2017

En el presente artículo se resume una evaluación literaria de los últimos 17 años en relación al síndrome de dolor miofascial en el cual se recopila la información más relevante para su diagnóstico, además se presenta un caso clínico en el cual se pudo determinar la etiología psicológica que comenzó el trastorno patológico. Se presenta el caso de un paciente con disminución en la apertura bucal, mialgia y puntos gatillo en los músculos masetero y temporal. Se diagnosticó síndrome de dolor miofascial posterior a realizar pruebas musculares, exámenes radiográficos y de laboratorio con la finalidad excluir etiologías sistémicas. El tratamiento indicado consistió en la aplicación de una férula oclusal, fisioterapia, relajantes musculares, corticoesteroides, antiinflamatorios y la interconsulta con un psicólogo. En la primera consulta se midió una apertura bucal de 1,2 cm, en la segunda cita 1,6 cm, en la última consulta se registró una apertura máxima de 4,8 cm después del tratamiento farmacológico, en conjunto con el profesional en psicología. Se concluye que los problemas psicológicos tienen una gran repercusión en el sistema gnatológico y que resulta de gran apoyo la interconsulta psicológica.
Prenatal Paternal Selective Serotonin Reuptake Inhibitors Use and Risk of ADHD in Offspring
Authors: Yang Fen , Liang Hong , Chen Jianping , Miao Maohua , Yuan Wei , Nørgaard Mette , Li Jiong
Published: December 2017

OBJECTIVES:

It has been shown that maternal prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) may be a risk factor for attention-deficit/hyperactivity disorder (ADHD) in offspring. Our goal was to examine whether paternal SSRI use before conception increases the risk of ADHD in offspring.

METHODS:

On the basis of Danish national registers, we conducted a cohort study of 781 470 singletons born between 1996 and 2008 with follow-up throughout 2013. The children whose fathers used SSRIs during the last 3 months before conception were identified as the exposed. Cox regression was used to estimate the hazard ratio (HR) of ADHD.

RESULTS:

A total of 7216 children (0.92%) were born to fathers who had used SSRIs during the last 3 months before conception. There were 12 520 children diagnosed with ADHD. Compared with unexposed children, the exposed had a 26% increased risk of ADHD (HR = 1.26, 95% confidence interval [CI]: 1.06–1.51) after adjusting for potential confounders. When extending the exposure window to 1 year before conception, paternal use of SSRIs only during the period of 12 to 3 months before conception was associated with the HR of 1.35 (95% CI: 1.10–1.66), whereas paternal use of SSRIs only during the last 3 months before conception was associated with a similarly increased risk of ADHD (adjusted HR = 1.31, 95% CI: 0.95–1.82).

CONCLUSIONS:

The mildly increased risk of ADHD in offspring associated with paternal SSRI use before conception could probably be due to the underlying indications related to SSRI use.
Las competencias digitales del docente y su desarrollo en un curso de cálculo diferencial e integral
Authors: Figueroa-Flores Nuria , Espinoza-Guzmán Julia
Published: December 2017

Propósito: ante el reto que significa la nivelación de los jóvenes en contenidos de matemática universitaria, el docente tiene que asumir su nuevo rol como orientador, guía y creador de nuevos espacios para el aprendizaje, por lo cual debe buscar potenciar sus propios atributos. Temas: como parte de la asignatura Cálculo diferencial e integral en modalidad bimodal, se analiza el impacto de la dimensión emocional en la actitud de los jóvenes, y su permanencia en el curso, con el pro­pósito de lograr la aprobación y sobre todo el aprendizaje de la base del análisis matemático. Desarrollo: para cumplir este cometido, en el Instituto Tecnológico de Costa Rica el uso de las tecnologías de in­formación y comunicación (TIC) en el proceso de enseñanza-aprendi­zaje se ve fortalecido por su plataforma TEC Digital, que es el Learning Management System (LMS) de la Universidad. Conclusiones: no obs­tante, se sabe que para lograr los mejores resultados de aprendizaje en los estudiantes no basta con disponer de la herramienta tecnológica, por lo que es necesario que el docente visualice la oportunidad para desarrollar las diferentes competencias digitales que exige la educa­ción superior del siglo XXI.
Evaluación del aprendizaje de las competencias de los estudiantes
Authors: Acosta-Gil Ednna Lucena , Montero-Ojeda Rosalba
Published: December 2017

Propósito: en la Tecnológica FITEC se asume la evaluación como un proceso que permite comprender y valorar la manera en que se alcan­zan y cumplen las finalidades educativas propuestas por la Institución, lo que se expresa particularmente en la formación de los estudiantes. Descripción: proceso, dado que no es una acción, que se desarrolla de manera puntual y en un momento determinado, sino que la evaluación recae e influye en la organización y planeación de la acción educativa y pedagógica. Punto de vista: por ello, se entiende como un componen­te esencial para valorar la calidad educativa, brindando información sobre el cumplimiento de los resultados institucionales, como parte del cumplimiento de compromisos adquiridos con la sociedad. Con­clusiones: la evaluación se constituye en una herramienta que permi­te comprender los procesos pedagógicos curriculares y didácticos; al brindar información oportuna y relevante, facilita establecer el sentido, la secuencia, la dimensión y el alcance de los propósitos de formación; precisa la definición de la naturaleza de las enseñanzas y las metodologías para desarrollarlas, siendo responsabilidad de la evaluación esta­blecer los criterios que dan cuenta del alcance del aprendizaje esperado por los estudiantes.
ʻWhere danger is, there rescue growsʼ: Technology, Time, and Dromology in Tom McCarthy’s C
Authors: Wrethed Joakim Hans
Published: December 2017

On one level, Tom McCarthy’s C comes out as a postmodern intertextual patchwork that borrows the form of the Bildungsroman. Accordingly, the protagonist Serge travels from birth to death in a forthrightly chronological narrative, but that journey is accompanied by the fact that the text’s modernist historical context is partly embedded in a posthuman and postmodern ontology. Technologically speaking, this version of modernity displays itself as technē, both in terms of artistic creation and as technology innovation (the radio transmitter, the car, the aeroplane, the cinema). Moreover, the novel equates technology with dromology (from Gr. dromos: race course) dealing with increasing speed as economic and political advantage, but it also reveals its human downside in terms of disaster (war, car crash, aeroplane crash). Through the protagonist, C forwards technology as death drive and the human as always already being ahuman (technē as primordial attribute of bios). In terms of time, the narrative seemingly incarnates the occidental obsession with teleology and eschatology. This article goes through these dimensions, but in addition it contends that there is another level at work in the narrative. Considered as artistically rendered philosophical cognition, the novel puts forth the Stoic apathea (equanimity), Husserlian flux, and anachronistic temporality as giving way to a peculiar kind of faith. This is closely tied to the artistic creativity of technē, including the activity of writing, which rescues a form of transcendence from conventional postmodern elimination. Dominant discourses of technology and time—apocalyptic and utopian—are challenged in this reading.
“Enymärä”
Authors: Háhn Judit
Published: December 2017

It has been a long tradition in Finland to use locally published textbooks in primary foreign language education. The books have been designed for linguistically homogenous groups of students, which explains why Finnish, as the learners’ L1, is the instructive metalanguage chosen for the EFL activity books. However, the growing number of immigrant children in the Finnish educational system raises the question to what extent these activity books can serve the needs of linguistically more diverse groups of learners. The connection between the two languages is so strong that Finnish seems to serve as a precondition for the acquisition of English. The high proportion of tasks requiring fluency in Finnish and the exclusive use of the language in the instructions might position Finnish as a gatekeeper language and thus hinder the acquisition of English in the case of non-Finnish students. The background trigger for the research was the case of an immigrant child, who had problems solving the English workbook exercises due to his weak Finnish skills. The paper investigates the role of Finnish in six EFL activity books that are used in Finnish comprehensive education to see to what extent it is present in the books, what functions it takes and what difficulties the lack of fluency might cause in task comprehension and solution. The analysis will be supplemented by interviews made with teachers of English and a textbook author to explore their views and experience regarding the use of the majority language in the activity books.