bluuebunny/crossref_metadata_2025 huggingface dataset:
O EMPODERAMENTO DOS PACIENTES E A DELIBERAÇÃO MÉDICA
Authors: Saliba Moreira Pinto Samuel
Published: September 2020

O presente artigo visa analisar, nas relações médicas, como seria possível garantir o empoderamento dos pacientes, ou seja, o seu protagonismo nos tratamentos, como condição de possibilidade para a justificação de uma deliberação médica bioéticamente limitada, atinente ao emprego de novas tecnologias. Dada a grande incerteza que paira sobre algumas das novas tecnologias, especialmente àquelas aplicadas no âmbito das ciências da saúde, imperiosa é a discussão jurídica acerca de limites para a deliberação técnica-médica, sem ignorar-se o desenvolvimento científico e a inovação, precisando o homem-cientista aceitar que deverá ter a dignidade humana como moldura intransponível para sua ação/inação, sob pena de a humanidade ver-se diante de danos eventualmente irreversíveis.
A PROTEÇÃO AO MEIO AMBIENTE E A VEDAÇÃO À CRUELDADE CONTRA OS ANIMAIS: ANÁLISE JURÍDICA DO CONSUMO DE QUELÔNIOS POR COMUNIDADES LOCAIS NA AMAZÔNIA.
Authors: Braga Brasil Victória , Macedo Rosa e Silva Túlio
Published: September 2020

Trata-se como prática comum o consumo de quelônios na Região Amazônica, sendo a prática difundida através das comunidades locais, que enxergam na Tartaruga da Amazônia e “tracajás” verdadeiras iguarias, de alto valor e prestígio culinário. Há, ainda, o hábito de se extrair os ovos, seja, a prole dos quelônios, a fim de que esses também sejam consumidos ou sirvam de base para cosméticos. Trata-se de pressão que leva à diminuição da população das espécies envolvidas na Região, com grande chance de extinção. Da mesma maneira como o ordenamento jurídico pátrio se propôs a proteger aspectos culturais, também o fez em relação ao Meio Ambiente, com o dever e direito de preservação desse para as presentes e futuras gerações, o que inclui a fauna e a flora. Há, ainda, extraído da própria Constituição da República Federativa do Brasil de 1988, a vedação à crueldade contra animais, prática que se encontra na forma como se mata a tartaruga. Diante da preocupação com a extinção da espécie e a crueldade envolvida no processo, o presente trabalho se propõe a estudar quais direitos devem prevalecer em tais circunstâncias.
O PACOTE ANTICRIME NO TOCANTE ÀS FACÇÕES CRIMINOSAS, À LUZ DA TEORIA DO DIREITO PENAL DO INIMIGO, PONDERADA COM O GARANTISMO PENAL
Authors: Alves de Oliveira Marcus Viniícius , Dos Santos Pedro Sérgio
Published: September 2020

Inegável o avanço da atuação das facções criminosas no Brasil, o que gera hoje o maior fenômeno/problema a ser enfrentado pelas políticas públicas de segurança pública, diante da estruturação organizada que dissemina o tráfico de drogas e crimes correlatos por todos os rincões do país. Essa criminalidade extrema leva a pensar que estaríamos diante do inimigo conceituado pela Teoria do Direito Penal do Inimigo, idealizado por Günther Jakobs, como sendo o sujeito ao qual não devem ser conferidos direitos fundamentais, por demonstrar o faccionado que está avesso à ressocialização, que seria um dos objetivos da pena, já que estaria somente voltado em incrementar cada vez mais a atuação criminosa organizada. Porém, em um estado democrático de direito, tal restrição de direitos seria inconcebível, conforme preleciona Ferrajoli (2014), mesmo em relação a um desviante extremo, sendo necessária a ponderação de conflitos diante do caso concreto, de modo a não afastar tais direitos. Como política pública de tentativa de controle das ditas organizações criminosas instaladas em presídios e que controlam o crime externamente, parte do pacote anticrime foi direcionada a elas, contendo dispositivos de maior coercibilidade frente a seu avanço. Nesse passo discute-se cada alteração para se verificar ofensa a direitos fundamentais ou se representariam medidas necessárias para garantia da ordem pública, sem afrontar a dignidade do ser humano, principalmente.
A EPILEPSIA COMO DOENÇA INCAPACITANTE E OS CRITÉRIOS QUE IMPEDEM O ACESSO DOS EPILÉPTICOS AO AUXÍLIO-DOENÇA E À APOSENTADORIA POR INVALIDEZ NO BRASIL.
Authors: Aires Araújo Lucas , De Andrade Barbosa Igor
Published: September 2020

A fim de investigar os critérios que impedem o pleno acesso ao auxílio-doença e à aposentadoria por invalidez pelos epilépticos, em um primeiro momento, este artigo visa à apresentação dos direitos fundamentais contidos na Constituição Federal de 1988, com seus fundamentos e princípios. Com isso, posteriormente, passa-se ao estudo dos critérios para concessão dos benefícios previdenciários do tipo auxílio-doença e aposentadoria por invalidez e mais o benefício de prestação continuada (BPC), da Assistência Social. Ao final, são apontadas lacunas no ordenamento jurídico brasileiro no que diz respeito ao pleno acesso do epiléptico - pessoa com distúrbio neurológico crônico, incapaz de prover o próprio sustento - à Previdência Social e à Assistência Social, pois, por razão da ausência de dispensação de tratamento especial a estes deficientes, a rigidez dos critérios legais termina negando acesso a esses benefícios àqueles indivíduos que não se encaixam em todos os requisitos exigidos pela legislação. Ademais, ressalta-se que a conclusão deste trabalho é fruto de uma investigação científica baseada primordialmente em revisão da literatura específica e em consulta às leis brasileiras e às jurisprudências, com uma abordagem qualitativa.
ANÁLISE DA EFICIÊNCIA DOS MÉTODOS AUTOCOMPOSITIVOS DE CONCILIAÇÃO NA 1ª INSTÂNCIA DA JUSTIÇA DO TRABALHO DO BRASIL ENTRE OS ANOS DE 2015 A 2017
Authors: Gazoli Rodrigues Rogerio , Schelive Correia Italo
Published: September 2020

Diante da crise atual do Poder Judiciário buscou-se analisar no presente artigo os instrumentos processuais de composição da lide, judicial ou extrajudicial, particularmente nos casos cuja questão principal admite a aplicabilidade de conciliação ou mediação. O estudo teve por base averiguar se na técnica de métodos consensual e autocompositivo houve a capacidade do resgate do diálogo, assim como se elas podem ser utilizadas como instrumento de efetividade do direito ao acesso a justiça na Justiça do Trabalho, com base nos dados do Conselho Nacional de Justiça (CNJ), além de examinar semelhanças, diferenças e aspectos conceituais. A metodologia adotada foi o método dedutivo, embasado no estudo teórico em livros jurídicos, legislação, jurisprudências, estatutos e materiais de apoio dos sistemas de aprendizagem, tendo como recursos o bibliográfico, documental e técnicas de pesquisa em conformidade com a metodologia adotada capaz de auxiliar a pesquisa. O método de pesquisa utilizado foi o hermenêutico, com a coleta de dados através de pesquisa bibliográfica e dados fornecidos através do CNJ. Os resultados alcançados verificaram que através da conciliação e a mediação, há colaboração com o desafogamento e consequente celeridade na justiça do trabalho. No entanto, aponta-se a necessidade de uma análise mais profunda sobre o assunto e os resultados alcançados, particularmente envolvendo as etapas e instâncias processuais.

PALAVRAS-CHAVE: Acesso à justiça; Meios alternativos na resolução de conflitos; Justiça Trabalhista Nacional; Conselho Nacional de Justiça.
ANÁLISE DA RELAÇÃO ENTRE O DIREITO AO MEIO AMBIENTE ECOLOGICAMENTE EQUILIBRADO E O DIREITO À MANIFESTAÇÃO CULTURAL NA VAQUEJADA APÓS A EMENDA CONSTITUCIONAL 96/17
Authors: Rocha Renata Rodrigues de Castro , Alves Bittencourt Felipe
Published: September 2020

O presente artigo tem como objetivo analisar o direito da pessoa humana ao meio ambiente ecologicamente equilibrado, bem como a proteção jurídica aos animais inseridos na prática da Vaquejada em face ao direito à manifestação cultural após a implementação da emenda constitucional 96 de 2017. Esta emenda acrescentou o § 7º ao artigo 225 da Constituição Federal que passou a vigorar reconhecendo como não cruéis práticas desportivas que utilizem animais desde que sejam manifestações culturais. Ressalta-se que em 2016 o Supremo Tribunal Federal declarou inconstitucional a Lei cearense 15.299/13 que regulamentava a Vaquejada por considerá-la cruel. Portanto desponta um conflito aparente entre regramentos constitucionais. A pesquisa foi desenvolvida por meio do método dialético que busca através de argumentos fundamentados estabelecer o entendimento mais adequado às divergências jurídicas encontradas em relação à regulamentação da Vaquejada.
A APLICAÇÃO DO HOMESCHOOLING NO BRASIL: UMA ANÁLISE INTERPRETATIVA À LUZ DE TRATADOS DE DIREITOS HUMANOS
Authors: Alencar Bolwerk Aloísio , Dos Santos Carneiro Ivone
Published: September 2020

O escopo deste trabalho está objetivado em abordar a viabilidade jurídica do homeschooling no Brasil, mediante a ótica de tratados de direitos humanos ratificados pelo ordenamento jurídico pátrio, como a Convenção sobre os Direitos da Criança, a DUDH (Declaração Universal dos Direitos Humanos), e a Convenção Americana sobre Direitos Humanos (Pacto São José da Costa Rica). A pesquisa possui alicerce na metodologia indutiva, utilizando como subsídios a análise da estrutura didática e metodológica, dos impactos positivos e negativos da educação domiciliar, bem como da forma que o ordenamento jurídico brasileiro acompanha o aumento do número de adeptos à prática do ensino desescolarizado no país.
Factors Influencing Genomic Prediction Accuracies of Tropical Maize Resistance to Fall Armyworm and Weevils
Authors: Badji Arfang , Machida Lewis , Kwemoi Daniel Bomet , Kumi Frank , Okii Dennis , Mwila Natasha , Agbahoungba Symphorien , Ibanda Angele , Bararyenya Astere , Nghituwamhata Selma Ndapewa , Odong Thomas , Wasswa Peter , Ochwo-Ssemakula Mildred , Talwana Herbert , Asea Godfrey , Otim Michael , Kyamanywa Samuel , Rubaihayo Patrick
Published: September 2020

Genomic selection (GS) can accelerate variety improvement when training set (TS) size, and its relationship with the breeding set (BS) are optimized for prediction accuracies (PA) of genomic prediction (GP) models. Sixteen GP algorithms were run on phenotypic best linear unbiased predictors (BLUPs) and estimators (BLUEs) of resistance to both fall armyworm (FAW) and maize weevil (MW) in a tropical maize panel. For MW resistance, 37% of the panel was the TS, and BS was the remainder whilst for FAW, random-based training sets (RBTS) and pedigree-based training sets (PBTS) were designed. PAs achieved with BLUPs varied from 0.66 to 0.82 for MW resistance traits, and, for FAW resistance, 0.694 to 0.714 for RBTS of 37%, and 0.843 to 0.844 for RBTS of 85%, and, these were at least two-fold those from BLUEs. For PBTS, FAW resistance PAs were generally higher than those for RBTS, except for one dataset. GP models generally showed similar PAs across individual traits whilst the TS designation was determinant since a positive correlation (R=0.92***) between TS size and PAs was observed for RBTS and, for the PBTS, it was negative (R=0.44**). This study pioneers the use of GS for maize resistance to insect pests in sub-Saharan Africa.
The Undervalued Avenue to Reinstate Tumor Suppressor Functionality of the p53 Protein Family for Improved Cancer Therapy - Drug Repurposing
Authors: Zawacka-Pankau Joanna E
Published: September 2020

p53 and p73 are critical tumor suppressors often inactivated in human cancers through various mechanisms. Owing to high structural homology, the proteins have many common functions and recognize the same set of genes involved in apoptosis and cell cycle regulation. p53 is known as the ‘guardian of the genome’ and together with p73 form a barrier against cancer development and progression. The TP53 is mutated in more than 50% of all human cancers and the germline mutations in TP53 predispose to the early onset of multiple tumors in Li-Fraumeni Syndrome (LFS), the inherited cancer predisposition. In cancers where TP53 gene is intact, p53 is degraded. Despite the ongoing efforts, the treatment of cancers remains challenging. This is due to late diagnoses, the toxicity of current standard of care and marginal benefit of newly approved therapies. Presently, the endeavours focus on reactivating p53 exclusively, neglecting the potential of the restoration of p73 protein for cancer eradication. Taken that several small molecules reactivating p53 failed in clinical trials, there is a need to develop new treatments targeting p53 proteins in cancer. This review outlines the most advanced strategies to reactivate p53 and p73 and describes drug repurposing approaches for the efficient reinstatement of the p53 proteins for cancer therapy.
Radiation Protection Legislation and Sustainable Development of a Rural Green-Tuff Village of Ischia Island
Authors: La Verde Giuseppe , D'Avino Vittoria , Sabbarese Carlo , Ambrosino Fabrizio , Roca Vincenzo , Raulo Adelaide , Pugliese Mariagabriella
Published: September 2020

Radiological risk affect the quality of the environment in buildings since population and workers can be potentially exposed to high level of dose. Radon gas emanated from both subsoil and building materials represents the most important source of radiation exposure for people. This study investigates the sustainability concept of a small rural village of Ischia Island, named Ciglio, in relation to the radiological risk. Radon activity concentration was measured in typical green tuff dwellings and in water samples collected from a local spring using E-Perm devices. Moreover, for green-tuff as building material, the radon emanation coefficient was calculated by gamma spectroscopy. The results highlight the importance to perform environmental radon monitoring and to investigate the radon content of building materials, especially in geographical areas characterized by traditional use of typical stones for constructions. In conclusion, the sustainability development of rural buildings is possible if the radiological risk for inhabitants and workers was assessed.
GRK5 is an Essential Co-repressor for Cardiac Mineralocorticoid Receptor Antagonism induced by Finerenone but not Eplerenone
Authors: Desimine Victoria L. , Ghandour Jennifer , Cora Natalie , Pollard Celina M. , Valiente Rachel , Ferraino Krysten E. , Pereyra Janelle , Pi Noa Daniela , Duarte Yanelys , Martinez Yaimiry , Maning Jennifer , Parker Barbara M. , Brill Ava R. , Guidi Valentina , Aukszi Beatrix , Lymperopoulos Anastasios
Published: September 2020

Background: In the heart, aldosterone (Aldo) binds the mineralocorticoid receptor (MR) to exert damaging, adverse remodeling-promoting effects. We recently showed that G protein-coupled receptor (GPCR)-kinase (GRK)-5 blocks the cardiac MR by directly phosphorylating it, thereby repressing its transcriptional activity. MR antagonist (MRA) drugs block the cardiac MR reducing morbidity and mortality of advanced human heart failure. Non-steroidal MRAs, such as finerenone, may provide better cardio-protection against Aldo than classic, steroidal MRAs, like spironolactone and eplerenone. Herein, we sought to investigate potential differences between finerenone and eplerenone at engaging GRK5-dependent cardiac MR phosphorylation and subsequent blockade. Methods: We used the cardiomyocyte cell line H9c2 and neonatal rat ventricular myocytes (NRVMs). Results: GRK5 phosphorylates the MR in H9c2 cardiomyocytes in response to finerenone but not to eplerenone. Unlike eplerenone, finerenone alone potently and efficiently suppresses cardiac MR transcriptional activity, thus displaying inverse agonism. GRK5 is necessary for finerenone`s inverse agonism, since GRK5 genetic deletion renders finerenone incapable of blocking cardiac MR transcriptional activity. Eplerenone alone does not fully suppress cardiac MR basal activity regardless of GRK5 expression levels. Finally in NRVMs, GRK5 is necessary for the anti-apoptotic and anti-fibrotic effects of both finerenone and eplerenone against Aldo, as well as for the higher efficacy and potency of finerenone at blocking Aldo-induced apoptosis and fibrosis. Conclusions: Finerenone, but not eplerenone, induces GRK5-dependent cardiac MR inhibition, which underlies, at least in part, its higher potency and efficacy, compared to eplerenone, as an MRA in the heart. GRK5 acts as a co-repressor of the cardiac MR and is essential for efficient MR antagonism in the myocardium.
The Relationship Between Category Richness and Morphological Diversity in Jewel Beetles
Authors: Tong Yijie , Yang Haidong , Yang Xingke , Bai Ming
Published: September 2020

Correlation between the category richness (CR) and morphological diversity (MD) of some communities at a local scale was found pendent, however, examination of a whole category using a large dataset are lacking. In this study, 1119 jewel species from around the world representing all existing subfamilies and 33.78% of Buprestidae genera were selected as a test group. A geometric morphometric analysis on the contour of homologous traits: pronotum and elytra was conducted to quantify morphological diversity. Correlations between MD and CR among subfamilies were found to be consistently positive with the exceptions of a pronotum genus-level test on the subfamily category. The correlation was also found to be higher at the genus-level than it on the species-level, in both pronotum and elytron measurements. Based on our analyses the hypothesis of positive correlations was expected in the genus-level test of jewel beetles but rejected in species-level test. The inconsistent correlation between morphological diversity and species richness revealed convergent morphological variation of pronotum under the similar functional diversity in Buprestidae. In addition, our test revealed variable correlation between MD and CR based on different groups and characters, which might be caused by morphological changes under coevolution with different ecological factors.
Protection of Polyphenols Against Glyco-Oxidative Stress: Involvement of Glyoxalase Pathway
Authors: Cianfruglia Laura , Morresi Camilla , Bacchetti Tiziana , Armeni Tatiana , Ferretti Gianna
Published: September 2020

Chronic high glucose (HG) exposure increases methylglyoxal (MG)-derived AGEs and is involved in the onset of pathological conditions, such as diabetes, atherosclerosis and chronic‐degenerative diseases. Under physiologic condition the harmful effects of MG are contrasted by glyoxalase system that is involved in the detoxification of Reactive Carbonyl Species (RCS) and maintain the homeostasis of the redox environment of the cell. Polyphenols are the most abundant antioxidants in the diet and present various health benefits. The study aimed at investigating the role of polyphenols extracted from an apple high in polyphenols (Calville White Winter), on glyco-oxidative stress induced by chronic HG-exposure. Intestinal Caco-2 cells were treated in physiological glucose condition (25mM) as a control and in HG condition (50mM) with or without apple extract for one week. Our data demonstrated that HG-treatment triggers glyco-oxidation stress with a significantly increase in ROS, lipid peroxidation, AGEs and Glyoxalase I (GlxI) activity with a significant decrease in total antioxidant intracellular defense. Treatment with polyphenols under HG condition restores to the control levels GlxI activity, decreases Glyoxalase II (GlxII) in relation to the control and induces a drop of glyco-oxidative damage. This paper seeks to highlight the roles of polyphenols in glyco-oxidative stress.
Alpha-glucosidase and Alpha-amylase Inhibitory Activities, Molecular Docking and Antioxidant Capacities of Salvia Aurita Constituents
Authors: Etsassala Ninon G.E.R , Badmus Jelili A. , Marnewick Jeanine L. , Nchu Felix , Hussein Ahmed A.
Published: September 2020

Diabetes mellitus (DM) is one of the most dangerous metabolic diseases with high rate of mortality worldwide. It is well known that insulin resistance and deficiency in insulin production from pancreatic β-cells are the main characteristic of DM. Due to the detrimental side effects of the current treatment, there is a considerable need to develop new effective antidiabetic drugs, especially alpha-glucosidase and alpha-amylase inhibitors with lesser adverse effects. These inhibitors are known to be directly involved in the delay of carbohydrate digestion, resulting in a reduction of glucose absorption rate and consequently reduce the post-prandial raise of plasma glucose, which can reduce the risk of long-term diabetes complications. Hence, natural products are well-known sources for the discovery of new scaffold for drugs discovery, including new antidiabetic drugs. The phytochemical investigation of Salvia aurita collected from Hogobach pass, Eastern Cape, South Africa (SA), yielded four known abietane diterpenes namely carnosol (1), rosmanol (2), 7-methoxyrosmanol (3), 12-methoxycarnosic acid (4) and one flavonoid named 4,7-dimethylapigenin (5). Structural characterization of these isolated compounds was conducted using 1 and 2D NMR, in comparison with reported spectroscopic data. These compounds are reported for the first time from S. aurita. The biological evaluation of the isolated compound against alpha-glucosidase exhibited strong inhibitory activities for 3 and 2 with IC50 values of 4.2 ± 0.7 and 16.4 ± 1.1 µg/mL respectively, while 4 and 1 demonstrated strong alpha-amylase inhibitory activity amongst the isolated compounds with IC50 of 16.2 ± 0.3 and 19.8 ± 1.4 µg/mL. Molecular docking analysis confirms strong inhibitory activity of 3 against alpha-glucosidase. Additionally, excellent antioxidant capacities were displayed by 2, 1 and 3 respectively as ORAC (25789.9 ± 10.5; 23961.8 ± 14.1; 23939.3 ± 2.4) µM TE/g; 1 and 2 as FRAP (3917.8 ± 2.1; 1522.3 ± 0.9) µM AAE/g; 5 and 2 as TEAC (3190.4 ± 2.8; 2055.0 ± 2.6) µM TE/g. The methanolic extract of S. aurita is a rich source of abietane diterpenes with excellent antioxidant and anti-diabetic activities that can be useful to modulate oxidative stress, and might possibly be excellent candidates for the management of diabetes. This is the first scientific report on the phytochemical isolation and biological evaluation of alpha-glucosidase and alpha-amylase inhibitory activities of Salvia aurita.
Seeking Gender Difference in Code-Switching by Investigating Mandarin-English Child Bilingual in Singapore
Authors: Huang Weihang , Lyu Danqian , Lin Jingping
Published: September 2020

As a behavior of bilingual individuals and an indispensable part of bilingual speech, code-switching has been investigated by many researchers. However, there are many variables influencing code-switching, and each variable has the potential to be a confounding variable. Among these variables is the gender; however, whether there are significant gender differences and what are the gender differences in code-switching remains unknown for Mandarin Mandarin-English child bilinguals, as previous literature diverse on the existence of gender differences. Therefore, this paper seeks potential code-switching and distribution of code-switching by quantitative analysis of speech data in Singapore Bilingual Corpus. The results indicate that gender differences are significant in the amount of intra code-switching. However, neither considerable gender difference is observed in the amount of inter nor the code-switching related environment.
DeepSOCIAL: Social Distancing Monitoring and Infection Risk Assessment in COVID-19 Pandemic
Authors: Rezaei Mahdi , Azarmi Mohsen
Published: September 2020

Social distancing is a recommended solution by the World Health Organisation (WHO) to minimise the spread of COVID-19 in public places. The majority of governments and national health authorities have set the 2-meter physical distancing as a mandatory safety measure in shopping centres, schools and other covered areas. In this research, we develop a Deep Neural Network-based Model for automated people detection, tracking, and inter-people distances estimation in the crowd, using common CCTV security cameras. The proposed DNN model along with an inverse perspective mapping technique leads to a very accurate people detection and social distancing monitoring in challenging conditions, including people occlusion, partial visibility, and lighting variations. We also provide an online infection risk assessment scheme by statistical analysis of the Spatio-temporal data from the moving trajectories and the rate of social distancing violations. We identify high-risk zones with the highest possibility of virus spread and infection. This may help authorities to redesign the layout of a public place or to take precaution actions to mitigate high-risk zones. The efficiency of the proposed methodology is evaluated on the Oxford Town Centre dataset, with superior performance in terms of accuracy and speed compared to three state-of-the-art methods.
Potential Impact of COVID-19–Related Racial Discrimination on the Health of Asian Americans
Authors: Chen Justin A. , Zhang Emily , Liu Cindy H.
Published: September 2020

Anti-Asian discrimination and assaults have increased significantly during the Coronavirus disease 2019 (COVID-19) pandemic, contributing to a “secondary contagion” of racism. The United States has a long and well-documented history of both interpersonal and structural anti-Asian discrimination, and the current pandemic reinforces longstanding negative stereotypes of this rapidly growing minority group as the “Yellow Peril.”

We provide a general overview of the history of anti-Asian discrimination in the United States, review theoretical and empirical associations between discrimination and health, and describe the associated public health implications of the COVID-19 pandemic, citing relevant evidence from previous disasters in US history that became racialized.

Although the literature suggests that COVID-19 will likely have significant negative effects on the health of Asian Americans and other vulnerable groups, there are reasons for optimism as well. These include the emergence of mechanisms for reporting and tracking incidents of racial bias, increased awareness of racism’s insidious harms and subsequent civic and political engagement by the Asian American community, and further research into resilience-promoting factors that can reduce the negative health effects of racism.
Minimally Invasive Plate Osteosynthesis for Tibial Shaft Fracture A Case Report of an Adolescent Male with Open Growth Plates
Authors: Riehl John T. , Munro Mark W.
Published: September 2020

Case: An adolescent male patient with a highly comminuted fracture of the distal third of the tibia underwent minimally invasive plate osteosynthesis (MIPO) 1 day post‐injury. Postoperatively, tibial radiographs showed callus at 6 weeks and healed fracture at 10 weeks. Seventeen months after fracture, the hardware was removed because of prominence. The patient remained active at a high level as of the last follow‐up (3.5 years after injury).

Conclusion: Percutaneous plating offers a number of advantages in the treatment of distal tibial fractures in adolescents. In the case presented, we were able to control alignment and rotation while providing stability to the distal aspect of the tibia.
Clopidogrel Use Should Not Routinely Delay Surgical Hip Fracture Repair
Authors: Hull Jonathan
Published: September 2020

The prevalence of hip fractures continues to rise as the population ages. Delay in fixation greatly increases postoperative complications and mortality. The purpose of this review was to determine if surgical hip fracture repair should be delayed for patients taking clopidogrel. Delayed surgical fixation of hip fractures increases patient 1‐year mortality. Some institutions wait 5 days to perform operative hip repair in patients taking clopidogrel, in keeping with the drug manufacturer guidelines. The current literature was searched for evidence suggesting increased perioperative risks in this population. Five studies addressing this topic were selected for review.

The prevalence of hip fractures is growing exponentially. This is increasing the burden on health care. Many health‐care systems not only are experiencing budget cuts but also must find a way to continue to treat the increasing number of patients. “Length of stay” (LOS) has become a phrase well known in today's medical model. LOS directly impacts insurance reimbursements and will become more important with bundled payments. Every facet of the health‐care industry is trying desperately to reduce LOS in facilities. This trend, in the setting of hip fracture, will actually improve patient outcomes. It is extremely important to repair hip fractures as soon as possible. If surgical repair of a hip fracture is delayed, then the risk of patient mortality increases.

Many patients who present with a hip fracture are also taking the drug clopidogrel. In the past, the use of clopidogrel has delayed hip fracture repair by as much as 5 days. No current Level‐I evidence in support of this practice of delaying repair exists, to my knowledge. Evidence does suggest that there is no need to wait 5 days to repair hip fractures in the clopidogrel population. Many surgical disciplines, including vascular, are performing procedures within 48 hours after discontinuing clopidogrel.
Perioperative Pain Management in the Chronic Opioid User
Authors: Sasek Cody
Published: September 2020

Perioperative pain management for patients who chronically consume opioids must be managed carefully to provide optimal pain control while avoiding negative outcomes. This review examines current pain management options in the perioperative period, including patient education and treatment planning; pharmacologic management with opioid pain medications; management with non‐opioids, including acetaminophen, nonsteroidal antiinflammatory drugs, N‐methyl‐D‐aspartate (NMDA) receptor antagonists, alpha‐adrenergic agonists, anxiolytics, and psychiatric medications; and use of local and regional anesthesia techniques.
Pengaruh Corporate Social Responsibility terhadap loyalitas pelanggan
Authors: Nisa Sorayya Khairun , Singgih Mohamad Nur
Published: September 2020

Penelitian bertujuan menganalisis pengaruh corporate social responsibilty (CSR) terhadap loyalitas merek, dan menganalisis kesadaran merek, brand attitude dan kepuasan pelanggan sebagai mediasi CSR terhadap loyalitas merek. Menggunakan pendekatan penelitian kuantitatif, eksplanatory research. Variabel penelitian terdiri dari CSR, kesadaran merek, brand attitude, kepuasan pelanggan, dan loyalitas merek.  Teknik pengumpulan data menggunakan survei online terhadap 115 konsumen pakaian yang dilakukan secara random. Hasil penelitian menunjukkan CSR memiliki pengaruh positif terhadap loyalitas merek, selanjutnya kesadaran merek dan kepuasan konsumen menjadi mediasi pengaruh CSR terhadap loyalitas merek, sedangkan brand attitude tidak memediasi pengaruh CSR terhadap loyalitas merek.
Pengaruh Corporate Social Responsibility dan brand image terhadap nilai perusahaan dimoderasi kinerja keuangan
Authors: Suidah Yuniep Mujati , Purbowati Rachyu
Published: September 2020

Penelitian bertujuan untuk mengetahui pengaruh Corporate Social Responsibility (CSR) dan brand image terhadap nilai perusahaan dimoderasi kinerja keuangan, metode yang digunakan  dalam penelitian ini adalah kuantitatif. Sampel menggunakan purposive sampling, yaitu 10 perusahaan perusahaan manufaktur sektor makanan dan minuman yang terdaftar di BEI tahun 2014-2018. Teknik analisis data menggunakan Structural Equation Modelling-Partial Least Square(SEM-PLS). Hasil penelitian CSR dan brand image tidak berpengaruh yang signifikan terhadap nilai perusahaan (NP), namun variabel CSR berpengaruh positif terhadap nilai perusahaan dan variabel brand image tidak berpengaruh positif terhadap nilai perusahaan. Variabel kinerja keuangan dapat memperkuat pengaruh CSR terhadap nilai perusahaan dan pengaruh brand image terhadap nilai perusahaan.  Jika terjadi peningkatan kinerja keuangan, maka pengaruh CSR terhadap nilai perusahaan tinggi, begitu juga sebaliknya jika nilai kinerja keuangan turun, maka pengaruh CSR terhadap nilai perusahaan semakin rendah. Namun, jika terjadi peningkatan pada kinerja keuangan maka pengaruh brand image terhadap nilai perusahaan semakin rendah.
Secreted protein, acidic and rich in cysteine is crucial for the vascular endothelial growth factor-stimulated fibrotic process in human Tenon’s fibroblasts
Authors: Xiang XiaoQiong , Luo LiYing , Chen YuHong , Ye FuXiang , Fu Yang , Tang Min
Published: September 2020

Background

Aberrant post-surgical scarring is responsible for failure of glaucoma filtration surgery (GFS) and is attributed to strong fibrotic process of human Tenon’s fibroblasts (HTFs). Vascular endothelial growth factor (VEGF) and secreted protein, acidic and rich in cysteine (SPARC) contribute to angiogenesis and fibrosis. However, whether SPARC can regulate the VEGF-mediated fibrotic process in HTFs has not been clarified. This study aimed to examine how SPARC and VEGF crosstalk to regulate the expression of Collagen-I and matrix metalloproteinase 9 (MMP9) as well as the ERK signalling in HTFs.

Methods

Human Tenon's capsule tissues were cultured for preparation of HTFs, which were characterized by immunofluorescence. The effects of VEGF treatment on SPARC, Collagen-I and MMP9 expression and ERK phosphorylation were determined by Western blot, quantitative RT-PCR and immunofluorescence. The proliferation and wound healing induced by VEGF were examined in HTFs and SPARC-silenced HTFs.

Results

Following successful passages, immunofluorescent assays indicated that HTFs at passages 3-9 displayed unique characters of fibroblasts with Vimentin, but not keratin, expression. Treatment with VEGF significantly up-regulated SPARC, Collagen-I and MMP9 expression and ERK phosphorylation, and promoted the proliferation and wound healing of HTFs. The stimulatory effects of VEGF were significantly mitigated by SPARC silencing in HTFs.

Conclusions

Our data provided novel evidence that SPARC was crucial for the VEGF-stimulated fibrotic process in HTFs and may be a novel target for anti-fibrotic therapies post GFS.
Barriers and opportunities for cleanliness of shared sanitation facilities in low-income settlements in Kenya
Authors: Simiyu Sheillah , Kweyu Raphael M. , Antwi-Agyei Prince , Adjei Kwaku A.
Published: September 2020

Background: Sharing of sanitation is commonly being practiced in low income areas in Sub Saharan Africa. However, shared sanitation is categorized as a limited sanitation service, and they may therefore not count towards achieving the global goals. These shared facilities are often the only option available for most residents in low income settlements, and improving their cleanliness and overall management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved cleanliness of shared sanitation in low income settlements of Kisumu in Kenya. Methods: Thirty-nine In-depth interviews and 11 focus group discussions were held with residents, who were mainly tenants and landlords. Analysis followed a thematic approach to define the problem, specify the target behaviour and define what needs to change. Results: Sanitation facilities were mainly pit latrines commonly shared among landlords and tenants. Participants singled out behavioural (poor use of the shared toilets) and social (lack of cooperation in cleaning) challenges that led to unclean shared toilets. Available opportunities for improvement included instituting clear cleaning plans, improving communication among users, and enhanced problem solving mechanisms between landlords and tenants. These approaches could form the basis for designing intervention strategies for improving the cleanliness of shared sanitation. Conclusion: The results highlight the need to focus on social aspects for improvement of shared sanitation cleanliness in low income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to afford the millions of low income residents an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the JMP’s recommendation for high quality shared facilities.
Identifying Community Physical Activity and Health Resources for Treatment of Back Pain by Utilizing Members of a Physical Activity Network
Authors: Sedney Cara L. , Haggerty Treah , Zizzi Sam , Dekeseredy Patricia
Published: September 2020

Background: Back pain is one of the leading causes of health care expenditure in the US and is linked to an increased body mass index. Many evidence-based modalities for the prevention and treatment of back pain closely mirror recommendations for weight loss and include physical activity and health maintenance activities (PAHM). The primary aim of this study was to ascertain community assets, and perceptions of the use of PAHM in the treatment of back pain by West Virginia Physical Activity Network (WVPAN) members. Methods: Participants for the study were recruited from the West Virginia Physical Activity Network. This grassroots organization is filled with volunteers from various sectors who were recruited from various workshops, conferences, or coalition meetings over a period of several years. This network was purposely selected as the study population because of the statewide reach and their familiarity with resources in their local communities. A brief survey instrument was designed to gather their scaled perceptions about various treatment modalities related to back pain, and to gather their local knowledge related to specific providers in their communities. In addition, participants were given a free text box to list any local assets or resources for the nine treatments listed, and county of residence, and the nature of their connection to the physical activity network. Descriptive analyses were used to describe overall patterns of survey data. The qualitative data were compiled manually by the research team to show themes of specific treatments mentioned across different parts of the state. Results: Participants overwhelmingly supported physical therapy, flexibility training, yoga, and core strengthening as treatments for back pain. The majority of respondents were “undecided” about other treatments such as cognitive behavioral therapies and acupuncture. Conclusions: The implementation of PAHM interventions in communities could help treat patients with back pain, and may reduce reliance on the pharmacological treatment for back pain. The current study’s data support the potential of such approaches in many West Virginia counties. Also, local resources, and context can be gleaned from community leader surveys utilizing previously developed infrastructure for PAHM promotion.
Statistical field theory of the transmission of nerve impulses
Authors: Balzo Gianluigi Zangari del
Published: September 2020

Background: Stochastic processes leading voltage-gated ion channel dynamics on the nerve cell membrane are a sufficient condition to describe membrane conductance through statistical mechanics of disordered and complex systems. Results: Voltage-gated ion channels in the nerve cell membrane are described by the Ising model. Stochastic circuital elements called ”Ising machines” are introduced. Action potentials are described as quasi-particles of a statistical field theory for the Ising system. Conclusions: The particle description of action potentials is a powerful new tool for describing the generation and propagation of nerve impulses. We thus have the opportunity to exploit another useful point of view to describe the generation and propagation of nerve impulses, especially when classical electrophysiological models break down. Moreover, the corpuscular description allows us to develop new hardware and software devices based on particle physics to study neurodegenerative and demyelinating diseases (Multiple Sclerosis), even integrated by connectomes. It is also suitable for the study of complex networks, cryptography, machine learning, quantum computing and many other applications of medical, physical and engineering interest.
Inequality in health service utilization among migrant and local children: a cross-sectional survey of children aged 0–14 years in Shenzhen, China
Authors: Ke Xiatong , Zhang Liang , Tang Wenxi , Li Zhong
Published: September 2020

Background: Shenzhen is characterized with the largest scale of migrant children among all the cities in China. Unequal access to health services among migrant and local children greatly affects health equity and has a profound impact on the quality of human capital. This study aimed to investigate differences in using community-based healthcare between local and migrant children and to identify the influencing factors in Futian District of Shenzhen.Methods: Households in 12 communities in Futian District of Shenzhen were randomly sampled. Children aged 0-14 years were investigated using self-administered questionnaire - the 2018 Survey of Health Service Needs of Chinese Residents. Differences in healthcare including physical examination, feeding guidance, development guidance, disease prevention guidance, injury prevention guidance, oral health guidance, and mental health guidance, were tested between local and migrant children. Binary logistic regressions were used in identifying potential influencing factors which affected the use in the above healthcare items.Results: A total of 936 participants from1512 families were sampled and 508 of them were included. Compared with local children, migrant children had less use of development guidance (OR=0.417, 95% CI: 0.279-0.624) and oral health care guidance (OR=0.557, 95% CI: 0.381-0.813). Children whose father received higher education level enjoyed a better use of disease prevention guidance as compared to whose father stopped at junior high school education or below (senior high vs junior high and below, OR=1.286, 95% CI: 0.791-2.090; bachelor and above vs junior high and below, OR=2.257, 95% CI: 1.417-3.595). Children whose fathers were blue-collar workers had less use of injury prevention guidance (OR=0.750, 95% CI: 0.334-1.684) and mental health guidance (OR=0.784, 95% CI: 0.295-2.080) as compared to whose father were white collar workers. Conclusions: Except feeding guidance, healthcare utilization were lower among migrant children than among local children. Generally, fathers have a stronger influence on children’s use of community-based healthcare than mothers do. The potential influence of fathers in promoting children’s healthcare use behaviors should be carefully considered, and fathers’ attention to children’s health should be increased.
Differential susceptibility of Onchocerca volvulus microfilaria to ivermectin in two areas of contrasting history of mass drug administration in Cameroon: Relevance of microscopy and molecular techniques for the monitoring of skin microfilarial repopulation within six months of direct observed treatment
Authors: Abong Raphael Awah , Amambo Glory N. , Ndongmo Patrick W. Chounna , Njouendou Abdel Jelil , Manuel Ritter , Beng Amuam Andrew , Esum Mathias Eyong , Deribe Kebede , Cho Jerome Fru , Fombad Fanny Fri , Nji Theobald Mue , Enyong Peter Ivo , Poole Catherine B. , Pfarr Kenneth , Hoerauf Achim , Carlow Clotilde K.S. , Wanji Samuel
Published: September 2020

Background. Ivermectin is an excellent microfilaricide against Onchocerca volvulus. However, in some regions, long term use of ivermectin has resulted in sub-optimal responses to the treatment. More data to properly document the phenomenon in various contexts of ivermectin mass drug administration (IVM-MDA) is needed. Also, there is a need to accurately monitor a possible repopulation of skin by microfilariae following treatment. Skin snip microscopy is known to have a low sensitivity in individuals with light infections, which can be the case following treatment. This study was designed with two complementary objectives: (i) to assess the susceptibility of O. volvulus microfilariae to ivermectin in two areas undergoing IVM-MDA for different lengths of time, and (ii) to document the repopulation of skin by the O. volvulus microfilariae following treatment, using 3 independent diagnostic techniques. Method. Identified microfilaridermic individuals were treated with ivermectin and re-examined after 1, 3, and 6 months using microscopy, actin real-time PCR (actinqPCR) and O-150 LAMP assays. Susceptibility to ivermectin and trends in detecting reappearance of skin microfilariae were determined using three techniques. Microscopy was used as an imperfect gold standard to determine the performance of actin-qPCR and LAMP. Results. In Bafia with over 20 years of IVM-MDA, 11/51 (21.6%) direct observe treated microfilaridemic participants were still positive for skin microfilariae after 1 month. In Melong, with 10 years of IVM-MDA, 2/29 (6.9%) treated participants were still positive. The microfilarial density reduction per skin biopsy within one month following treatment was significantly lower in participants from Bafia. In both study sites, the molecular techniques detected higher proportions of infected individuals than microscopy at all monitoring time points. LAMP demonstrated the highest levels of sensitivity and real-time PCR was found to have the highest specificity. Conclusion. Patterns in skin mirofilariae clearance and repopulation were established. O. volvulus worms from Bafia with higher number of annual MDA displayed a lower clearance and higher repopulation rate after treatment with ivermectin. Molecular assays displayed higher sensitivity in monitoring O. volvulus microfilaridemia within six months following treatment.
Determinants of health-related quality of life decline in interstitial lung disease
Authors: Maqhuzu Phillen Nozibuyiso , Szentes Boglárka Lilla , Kreuter Michael , Bahmer Thomas , Kahn Nicolas , Claussen Martin , Holle Rolf , Schwarzkopf Larissa
Published: September 2020

Background: Health-related quality of life (HRQL) in interstitial lung disease (ILD) patients is impaired. We aimed to identify baseline predictors for HRQL decline within a 12-month observation period.Methods: We analyzed 194 ILD patients from two German ILD-centers in the observational HILDA study. We employed the disease-specific King’s Brief Interstitial Lung Disease questionnaire (K-BILD) with the subdomains ‘psychological impact’, ‘chest symptoms’ and ‘breathlessness and activities’, and the generic EQ-5D Visual Analog Scale (VAS). We evaluated how many patients experienced a clinically meaningful decline in HRQL. Subsequently, we investigated medical and sociodemographic factors as potential predictors of HRQL deterioration.Results: Within the study population (34.0% male, Ø age 61.7) mean HRQL scores hardly changed between baseline and follow up (K-BILD: 52.8 vs. 52.5 | VAS: 60.0 vs. 57.3). On the intra-individual level, 30.4% (n = 59) experienced a clinically relevant deterioration in K-BILD total score and 35.4% (n = 68) in VAS. Lower baseline forced vital capacity (FVC) % predicted determined HRQL decline in K-BILD total score (ß–coefficient: -0.02, p = 0.007), VAS (ß–coefficient: -0.03, p < 0.0001), and in the subdomain ‘psychological impact’ (ß–coefficient: -0.02, p = 0.014). Lower baseline diffusing capacity of carbon monoxide (DLCO) % predicted determined deterioration in ‘breathlessness and activities’ (ß– coefficient: -0.04, p = 0.003) and ‘chest symptoms’ (ß– coefficient: -0.04, p = 0.002). Additionally, increasing age predicted decline in ‘psychological impact’ (ß–coefficient: 0.06, p < 0.007).Conclusion: Around a third of ILD patients experienced a clinically relevant HRQL deterioration in a 12-month period, which was associated with baseline lung function values in all K-BILD domains. As lung function values are time-dependent variables with possible improvements, in contrast to age and ILD subtype, it, thus, seems important to improve lung function and prevent its decline in order to maintain HRQL on the possibly highest level.