bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving the safety of patient transfer from AMU using a written checklist
Authors:   Heart of England NHS Foundation Trust Bordesley Green Birmingham, B9 5SS, Hindmarsh David , Leese Liz ,   Heart of England NHS Foundation Trust
Published: June 2021

Unsafe patient transfers are one of the top reasons for incident reporting in hospitals. Criteria guiding safe transfer have been issued by the NHS Litigation Authority. To meet this standard, a “transfer check list” was redesigned for all patients leaving the Acute Medical Unit (AMU) in the Heartlands Hospital. Following the introduction of the checklist two full audit cycles were conducted. The first cycle highlighted an extremely poor uptake of the checklist. After interventions to educate nursing staff and raise awareness of the issues at the regular staff meetings, re-audit demonstrated significant improvement in completion rate. Subsequent monitoring indicates continued improvement, with compliance up to 95% for completion of the transfer checklist on AMU. Incident reporting relating to transfer has also decreased significantly.
Endogenous endophthalmitis and liver abscesses
Authors:   Royal Free Hospital, London, Koay S , Jain S ,   Royal Free Hospital, London, Cropley I ,   Royal Free Hospital, London, Petrushkin H ,   Royal Free Hospital, London, Beynon H ,   Royal Free Hospital, London
Published: June 2021

Abstract We present a case of endogenous endophthalmitis secondary to liver abscesses, in a patient with no previous medical comorbidities or risk factors for immunosuppression. The patient presented with acute painless loss of vision and feeling generally unwell. Investigations revealed Streptococcus anginosus-constellatus bacteraemia, and evidence of diverticular disease that likely predisposed to the liver abscesses. Due to prompt diagnosis and administration of antibiotics, the patient had a good visual outcome. This case highlights the importance of being aware of endogenous endophthalmitis, as early diagnosis and prompt administration of antibiotics will optimise visual outcomes.
Haemoptysis: Diagnosis and Treatment
Authors:   Royal Brompton Hospital and Imperial College, London, Hurt Katharine , Bilton Diana ,   Royal Brompton Hospital and Imperial College, London
Published: June 2021

Haemoptysis is a common symptom in clinical practice, which requires further investigation. Fortunately, massive haemoptysis only accounts for a small proportion of these episodes. It is a medical emergency that carries a high mortality rate. There are no agreed management guidelines. This review discusses proposed methods of resuscitation as well as outlining a diagnostic algorithm and discusses treatments including bronchial artery embolization, endobronchial therapy, surgery and medical therapies.
A young patient with heart failure – Picture Quiz Answer
Authors:   Eastbourne District General Hospital Eastbourne BN22 2UD, Patel H , Dhillon G ,   Eastbourne District General Hospital Eastbourne BN22 2UD, Bandali A ,   Eastbourne District General Hospital Eastbourne BN22 2UD, Patel Neil ,   Eastbourne District General Hospital Eastbourne BN22 2UD
Published: June 2021

There is no ‘gold standard’ non-invasive test to diagnose myocarditis. It is a clinico-histopathological diagnosis.1 Clinical manifestations include: heart failure, chest pain (from either pericarditis or angina from coronary artery spasm/inf lammation), sudden cardiac death and arrhythmias (sinus tachycardia, ectopics, ventricular tachycardia, heart blocks). Examination may reveal raised JVP, pulmonary crackles, a gallop rhythm or a pericardial rub.
Predicting outcomes in emergency medical admissions – role of laboratory data and co-morbidity
Authors:   Division of Internal Medicine, Royal Colleges of Physicians, O’Sullivan Esther , Callely Elizabeth ,   Division of Internal Medicine, Royal Colleges of Physicians, Bennett Kathleen ,   Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, O’Riordan Deirdre ,   MED Directorate, St James’s Hospital, Dublin, Ireland, Silke Bernard ,   MED Directorate, St James’s Hospital, Dublin, Ireland
Published: June 2021

Background: The utility of risk stratification following an emergency medical admission has been debated. We have examined the predictability of outcomes, from a database of all emergency admissions to St James’ Hospital, Dublin, over a six year period (2005-2010). Methods: Analysis was performed using the hospital in-patient enquiry system, linked to the patient administration system and laboratory data. The utility of a fractional polynomial laboratory only model to predict 30-day in-hospital mortality was determined. Results: The AUROC for the laboratory parameters to predict a 30 day death was 0.90 (95% CI 0.89, 0.90) in the 2002 – 2010 derivation dataset and was 0.88 (95% CI 0.86, 0.90) in the 2011 validation set. The addition of co-morbidity measures did not improve the model prediction (0.89 : 95% CI 0.88 – 0.89). Conclusion: A fractional polynomial laboratory only model can reliably predict 30-day hospital mortality following an emergency medical admission, potentially allowing resources to be risk focused and patients to be prioritised.
An unusual cause of a recurrent painful rash
Authors:   Acute Medicine, John Radcliffe Hospital, Headley Way, Headington, Oxford, Min Fung Timothy Hoi , Wong Cristopher ,   Acute Medicine, John Radcliffe Hospital, Headley Way, Headington, Oxford, Ahmed Urooj ,   Acute Medicine, John Radcliffe Hospital, Headley Way, Headington, Oxford, Meo Samina ,   Acute Medicine, John Radcliffe Hospital, Headley Way, Headington, Oxford, Dwight Jeremey ,   Cardiology, John Radcliffe Hospital, Headley Way, Headington, Oxford
Published: June 2021

Churg-Strauss syndrome is an uncommon multisystem disease involving small and medium-sized arteries, capillaries, veins, and venules. It is characterised by the presence of asthma, hypereosinophilia, and evidence of vasculitis affecting a number of organs. It is important for acute physicians to recognise this condition as delayed diagnosis results in a higher morbidity and mortality. Here we describe a case of Churg-Strauss syndrome in a 41 year old woman presenting with a recurrent painful rash. The clinical manifestations and management of this condition are discussed.
Cardiac Tamponade: atypical presentations after cardiac surgery Ravikirti & R Karadi
Authors:   Dewsbury and District Hospital, Halifax Road, Dewsbury, Karadi Rangaprasad ,   Calderdale Royal Hospital, Halifax
Published: June 2021

We present two cases of cardiac tamponade presenting in the aftermath of cardiac surgery. We have briefly discussed the aetiology, presentation, diagnosis and management of the condition with emphasis on its atypical presentation in postoperative patients. A high index of suspicion and early access to echocardiography is necessary for prompt recognition and treatment of this life threatening emergency.
Problem based review: The patient presenting with an acutely swollen arm
Authors:   Kings Mill Hospital Sutton in Ashfield Notts, Dwivedi R , Ham-Ying L ,   Kings Mill Hospital Sutton in Ashfield Notts, Snape J ,   Kings Mill Hospital Sutton in Ashfield Notts
Published: June 2021

A 69 year old female presented to the Emergency Department with swelling of her right arm and elbow, one week following a fall which resulted in a fracture of the middle third of her right clavicle (Figure 1). The forearm was hot and tender and the arm and hand function were somewhat impaired by swelling, but sensation was intact. Initial bloods were unremarkable, apart from a mild neutrophilia.
Presentations to An Acute Medical Unit Due to Headache: A Review of 306 Consecutive Cases
Authors:   Hull York Medical School, Knox James , Chuni Chandini ,   Hull York Medical School, Naqvi Zehra ,   Hull York Medical School, Crawford Pam ,   York Teaching Hospital NHS Foundation Trust, Waring W Stephen ,   York Teaching Hospital NHS Foundation Trust
Published: June 2021

The United Kingdom National Health Service has recently prioritised the need for ambulatory care pathways for acute headache. The present study sought to better characterise patients referred to an Acute Medical Unit so as to inform pathway development. In 2011, York Hospital received 306 referrals due to acute headache, representing 3% of acute medical admissions. Investigations included CT scan (38%), lumbar puncture (38%), and MRI (18%); there were no specialised investigations in 26%, and 18% of patients were discharged on the day of presentation. Subarachnoid haemorrhage occurred in only 4 patients (1%), meningitis in 10 (3%), and intracranial tumour in 5 (2%). The findings indicate that a significant proportion of patients with acute headache could be managed by ambulatory care.
Out with the old, in with the new? Case reports of the clinical features and acute management of two novel designer drugs
Authors:   Norfolk and Norwich University Hospital NHSFT, Hamilton E J , Misselbrook Gary Peter ,   Norfolk and Norwich University Hospital NHS Foundation Trust
Published: June 2021

Methoxydine (4-MeO-PCP) and Methoxetamine (3-MeO-2-Oxo-PCE) are both commercially produced designer drugs with structural and biochemical similarities to phencyclidine (PCP). Although phencyclidine toxicity is well documented, its recreational use in present times is rare. With the advent of new designer drugs being available widely through internet sites, Acute Physicians should be aware of the clinical features and management of these potential toxins. We present a case of methoxydine ingestion (which to our knowledge has not been previously documented in any medical journals) and a case of methoxetamine ingestion, and discuss their history, contrasting clinical features and acute management.
An Unusual Cause of Abdominal Pain and Anaemia
Authors:   NHS Fife Victoria Hospital, Hayfield Road, Kirkcaldy, Scotland, KY2 5AH, Yang Lee Matthew Meng , David McKenna Christopher ,   NHS Fife Victoria Hospital, Hayfield Road, Kirkcaldy, Scotland, KY2 5AH, Hart Alistair James ,   Victoria Infirmary, Glasgow, Scott David ,   NHS Fife, Rahilly Maeve Anne ,   NHS Fife
Published: June 2021

A 52-year old gentleman was referred to acute medicine by an out-of-hours general practitioner, with an unexplained ‘collapse’. The patient stated to have just ‘tripped and fallen’ with no new preceding symptoms immediately beforehand. Closer questioning revealed that he also been suffering from general malaise, shortness of breath, and five days of right upper quadrant pain and abdominal swelling. In the last six months he had lost thirtyeight kilograms in weight. He was diagnosed with a deep vein thrombosis in 1999 for which he had been treated with Warfarin. Both his parents had deep vein thromboses in their late 60s. He was a non-smoker, drank minimal alcohol and worked as a janitor. He was no longer anti-coagulated.
Problem based review: Pleuritic Chest Pain
Authors:   Darent Valley Hospital, Lee Richard William , Hodgson Luke Eliot ,   Brighton & Sussex University Hospitals NHS Trust., Jackson Mark Basil ,   Brighton and Sussex Medical School University of Brighton, Adams Nick ,   Western Sussex Hospitals NHS Trust
Published: June 2021

Pleuritic pain, a sharp discomfort near the chest wall exacerbated by inspiration is associated with a number of pathologies. Pulmonary embolus and infection are two common causes but diagnosis can often be challenging, both for experienced physicians and trainees. The underlying anatomy and pathophysiology of such pain and the most common aetiologies are presented. Clinical symptoms and signs that may arise alongside pleuritic pain are then discussed, followed by an introduction to the diagnostic tools such as the Wells’ score and current guidelines that can help to select the most appropriate investigation(s). Management of pulmonary embolism and other common causes of pleuritic pain are also discussed and highlighted by a clinical vignette.
Journal Watch: May-July 2012
Authors:   Department of Medicine & Elderly Care Royal Hampshire County Hospital, Bhullar J , Devlin Joanna ,   North Hampshire Hospitals Trust Winchester, Couzens Christopher J ,   Medicine North Hampshire Hospitals Trust Winchester
Published: June 2021

The treatment of infective endocarditis remains controversial with differing advice regarding timing of surgery in current guidelines. DH Kang, YJ Kim, SH Kim et al. N Engl J Med 2012; 366: 2455-2473. The treatment of infective endocarditis remains controversial with differing advice regarding timing of surgery in current guidelines.
Profiling the medical admissions of the homeless
Authors:   Internal Medicine, St James’s Hospital, Dublin, Ireland, Romero-Ortuno Roman , O’Riordan Deirdre ,   St James’s Hospital, Dublin, Ireland, Silke Bernard ,   St James’s Hospital, Dublin, Ireland
Published: June 2021

Aim: to describe the characteristics and outcomes of homeless people admitted to our Internal Medicine service in St. James’s Hospital, Dublin (Ireland), between 2002 and 2011. Methods: we interrogated an anonymized in-patient database. Results: there were 1,460 homeless admissions (623 unique patients; 39% admitted more than once). Most patients were young, male, and had low comorbidity levels. Thirty-seven percent of the admissions were alcohol-related and 27% substance abuse-related. Thirteen percent had an active psychiatric illness. Their in-patient mortality rate was 5%. Seventy two percent were discharged without the residential arrangement being explicitly documented, 15% self-discharged or absconded, and 8% were discharged to a residential facility. Conclusion: results are novel in our context and will be relevant for local policy and practice.
Non-Convulsive Status Epilepticus as a cause for prolonged delirium: an under-diagnosed phenomenon?
Authors:   Acute Medicine, University College London Hospitals, London, Lovell Ben , Lander M ,   Basildon & Thurrock University Hospital, Negus Rupert ,   Acute Medical Service, The Royal Free Hospital, The Royal Free London NHS Foundation Trust, Pond Street, Hampstead, London
Published: June 2021

Delirium is a common cause for acute hospital admissions. There are many potential causes for this presentation, including infection, polypharmacy and metabolic disorders. We present the case of a patient with hyponatraemia and prolonged delirium, in whom the diagnosis of non-convulsive status epilepticus (NCSE) was made following electroencephalography (EEG).
Problem-Based Review: A patient with metabolic acidosis
Authors:   Queen Elizabeth University Hospital, Glasgow, Allan Russell , Foster Cristopher ,   Acute Medicine, Royal Alexandra Hospital, Paisley
Published: June 2021

Metabolic acidosis is a common metabolic derangement present in the acute medical patient. A thorough and structured investigative approach is required as there are many causes and management is reliant on identifying these. In particular calculation of the anion gap with correction for albumin level and use of the delta ratio can be helpful in complex cases especially in patients where a combination of metabolic derangements may be present.
Picture Quiz: An Acute, Blue, Swollen, Painful Leg (Answer)
Authors:   Department of Medicine & Elderly Care, Royal Hampshire County Hospital, Honney R , Bhullar J ,   Department of Medicine & Elderly Care, Royal Hampshire County Hospital, Swales P ,   Department of Medicine & Elderly Care, Royal Hampshire County Hospital
Published: June 2021

Urgent Duplex ultrasound demonstrated ilio-femoral deep vein thrombosis (DVT) with involvement of the long saphenous and short saphenous superficial veins. Arterial Doppler waveforms were normal distally with no evidence of stenosis. The diagnosis was therefore Phlegmasia cerulea dolens (PCD), resulting from an extensive, proximal DVT with total or near total venous outflow occlusion.
Green synthesis of metal nanoparticles using plant phytochemicals and their potential applications
Authors: Dash Shib Shankar
Published: June 2021

Various plant extract rich in phytochemicals have been utilized for the one step synthesis of metal nanoparticles at room temperature. The phytochemicals especially polyphenolic compounds are highly efficient to reduce metal ions and also stabilize them in nanometric dimension. Interestingly, no other stabilizing agent is necessary for such synthesis. The metal nanoparticles especially gold and silver using plants (plant tissue, plant extracts and living plant) has gained much interest in recent years because of their applications in pharmaceuticals, optoelectronic devices, drug delivery into cell and catalysis etc. In this review, I have addressed the one step facile synthesis of metal nanoparticles using different plant extracts, various methods of characterization and applications of metal nanoparticles.
Ficus carica Linn (Dumur) Fruit Extract Mediated Green Synthesis of Gold Nanoparticles and its Application in Catalytic Reduction
Authors: Dash Shib Shankar , Bag Braja Gopal , Midya Abhisek
Published: June 2021

The fruit extract of Ficus carica Linn (Dumur) is rich in different types of plant secondary metabolites such as terpenoids, polyphenols including flavanoids, etc. We have
demonstrated the use of the fruit extract for the synthesis of gold nanoparticles in water at room temperature under very mild conditions. There was no need of additional stabilizing or capping agents and the synthesis of the gold nanoparticles was complete in several minutes. The gold nanoparticles were characterized by HRTEM, EDX, SAED, Surface
Plasmon Resonance Spectroscopy and X-Ray diffraction studies. The freshly prepared gold nanoparticles have been used as an efficient catalyst for the sodium borohydride
reduction of 4-nitrophenol to 4-aminophenol in water at room temperature and the kinetics of the reduction reaction have been studied spectrophotometrically.
Philosophy of Military Leadership from The Perspective of Mustafa Kemal Atatürk
Authors: ŞENGÖZ Murat
Published: June 2021

The success of an army depends on the presence of advanced weapons and means of warfare, an effective command chain, a functional institutional structure, an established management climate, and a well-trained sense of obedience to meet the demands of the modern age as a whole. No matter how advanced the warfare, weapons, tools and equipment are, there will be no success without the devoted, well-trained, stout-hearted soldiers who will use those systems.Just like a football club that lacks the team spirit of the world's best stars on the field, the best coaches and professionals such as technical boards, material suppliers or the club doctor sitting on the bench, the most enthusiastic fans in the stands cannot provide a masterstroke. Even an army consisting of the most well-trained soldiers with the latest technology in warfare, weapons and vehicles cannot be successful if the spirit of companionship is not established, hearts are not united for a common ideal. The concept of the friendship of arms is a reflection of the spiritual atmosphere of an army, a harmonic instrument that makes an army real and gives it the strength it needs. The friendship of arms is a shared set of ideals, the law of brotherhood, the honor of men and of a nation that is matured, cooked and shaped in the flesh and bones in the hearts of its soldiers. Officers are the sworn guards of the honor and good name of the armies and nations they belong to. They are the veins and the backbone of their armies, which feed the brains and the hearts of the people. This study considers the principles regarding the administration and management of the Armed Forces, the management climate, the necessary qualifications of officers, the concepts of commander and leadership and the issues that need to be emphasized in the training of officers, the army and the notion of leadership through an axiological paradigm and normative criteria.
Inductive general grammar
Authors: Abney Steven
Published: June 2021

General-linguistic datasets that have become available in recent years promise to enable new progress toward a theory of general grammar. A barrier to success is the incompatibility between the inductive, externalist approach that is natural for exploiting the datasets and the deductive, mentalist philosophy that is currently dominant within linguistics. I argue that the externalist philosophy is viable and that there are reasons to consider it preferable. I argue that the mainstream approach is in some cases unnecessarily concerned with psychological reality, and in other cases too quick to reject required subtheories on the grounds that they belong to “language processing” rather than linguistics, with the result that current grammars give systematically inaccurate answers to questions of the linguistic status of sentences. I suggest that the inductive development of general grammar is already being carried out (though not in those terms) in the field of natural language processing, and that linguistic participation in the effort would be of benefit to both fields.
Divórcio, fim ou recomeço? Avaliações e percepções frente às Oficinas de Parentalidade
Authors: Silva Liniker douglas Lopes da , Silva Luciana Maria da
Published: June 2021

No decorrer dos processos de divórcio/dissolução conjugal, os genitores podem apresentar dificuldades em dissociar parentalidade de conjugalidade, envolvendo os filhos em seus embates, o que pode ser prejudicial ao desenvolvimento das crianças e adolescentes. Pensando nisso, em 8 de maio de 2014 o Conselho Nacional de Justiça (CNJ), por meio da Recomendação 050/14, orientou aos tribunais do País a adotarem as Oficinas de Parentalidade como política pública de resolução e prevenção de conflitos familiares. Nesse sentido, o presente trabalho objetiva verificar as avaliações e percepções imediatas dos genitores que participaram das Oficinas de Parentalidade em um município do Triângulo Mineiro (Minas Gerais, Brasil). Trata-se de um estudo de corte transversal amparado na abordagem mista de pesquisa que contou com a participação de 78 genitores. Dados quantitativos foram descritos em porcentagens e qualitativos foram analisados via técnica de análise de conteúdo. Os resultados evidenciaram que, na opinião dos genitores, as Oficinas de Parentalidade constituíram-se como um importante espaço de reflexão, auxiliando-os a melhorar suas relações familiares, ainda que o conflito conjugal e a culpabilização do ex-parceiro continue preponderando para alguns participantes. Enquanto uma política pública as Oficinas de Parentalidade demostram que o divórcio não significa o fim das relações familiares, mas sim um recomeç
Perception of Racial and Intersectional Discrimination in the Workplace Is High Among Black Orthopaedic Surgeons: Results of a Survey of 274 Black Orthopaedic Surgeons in Practice
Authors: Ode Gabriella E. , Brooks Jaysson T. , Middleton Kellie K. , Carson Eric W. , Porter Scott E.
Published: June 2021

Introduction:

There are approximately 573 practicing Black orthopaedic surgeons in the United States, which represents 1.9% overall. The purpose of this study was to describe this underrepresented cohort within the field of orthopaedic surgery and to report their perception of occupational opportunity and workplace discrimination.

Methods:

An anonymous survey was administered to 455 practicing orthopaedic surgeons who self-identify as Black. The 38-question electronic survey requested demographic and practice information and solicited perspectives on race and racial discrimination in current orthopaedic practices and general views regarding occupational opportunity and discrimination.

Results:

The survey was completed by 274 Black orthopaedic surgeons (60%). Over 97% of respondents believe that Black orthopaedic surgeons in the United States face workplace discrimination. Most Black orthopaedic surgeons (94%) agreed that racial discrimination in the workplace is a problem but less than 20% agreed that the leaders of national orthopaedic organizations are trying sincerely to end it. Black female orthopaedic surgeons reported lower occupational opportunity and higher discrimination than Black male orthopaedic surgeons across all survey items.

Discussion:

This study is the first to report on the workplace environment and the extent of discrimination experienced by Black surgeons, specifically Black orthopaedic surgeons in the United States. Most respondents, particularly female respondents, agreed that racial discrimination and diminished occupational opportunity are pervasive in the workplace and reported experiencing various racial microaggressions in practice.
Microcatheter Stabilization Technique Using Partially Inflated Balloon for Coil Embolization of Paraclinoid Aneurysms
Authors: Song Yunsun , Kwon Boseong , Al-abdulwahhab Abdulrahman Hamad , Kurniawan Ricky Gusanto , Suh Dae Chul
Published: June 2021

Purpose: Coil embolization of paraclinoid aneurysms should be simple, safe, and effective considering the benign nature of the aneurysm. Here, we present a microcatheter stabilization technique using a partially inflated balloon for the treatment of paraclinoid aneurysms.Materials and Methods: This retrospective study included 58 patients who underwent balloon-assisted coiling (BAC) for unruptured paraclinoid aneurysms at a tertiary neuro-intervention center between January 2019 and March 2020. We applied a technique to stabilize the microcatheter’s position using the modified BAC technique in paraclinoid aneurysms showing various projections around the ophthalmic curve of the internal carotid artery. The basic concept of the technique is to place a partially inflated balloon just distal to the aneurysm neck and support the distal curve of the microcatheter using the proximal bottom of the balloon. Immediate radiological outcomes were analyzed, and clinical outcomes were evaluated with modified Rankin Scale (mRS) scores.Results: The BAC was successfully performed in 51 of 58 patients (88%). We treated the remaining seven patients by switching to stent-assisted coiling. We obtained a 37% mean packing density resulting in favorable occlusion in all 58 aneurysms (complete occlusion in 35 and residual neck in 23). There were no intraprocedural thromboembolic or hemorrhagic events except one that revealed an asymptomatic infarction after the procedure (1.7%). Magnetic resonance angiography follow-up was performed in 37 patients at an average of 11.8 months, in which 11 minor recurrences (29.7%) were found. There was no major recurrence nor retreatment. The mRS score was 0 in all patients during a mean follow-up of 17.7 months (range, 12–25 months).Conclusion: The modified balloon-assisted coiling technique using a partially inflated balloon was safe and effective and could serve as an option for treating paraclinoid aneurysms.
Pharmacotherapy of Systemic Vasculitis Combined with Cryoglobulinemic Syndrome Using Pharmacoeconomic Approaches
Authors: Hayduchok Ihor
Published: June 2021

BACKGROUND: It was substantiated the relevance and necessity of the chosen research topic as a result of a review of the scientific literature on the epidemiology and pharmacotherapy of patients with systemic vasculitis associated with cryoglobulinemic syndrome.

OBJECTIVE: In this study were selected drugs that have the diagnostic ATC-code J05 Antiviral agents for systemic use; J05A Antivirals of direct action; J05AB01 antiviral agents for systemic use according to INN Aciclovir.

METHODS: This study is based on pharmacoeconomic, organizational and legal, forensic and pharmaceutical approaches to pharmacotherapy with using literature review. Experimental data were processed on the basis of the Department of Internal Medicine of the Lviv Medical Institute and the Department of Medical and Pharmaceutical Law, General and Clinical Pharmacy of the Kharkiv Medical Academy of Postgraduate Education.

RESULTS: Clinical and pharmacological analysis of basic therapy of systemic vasculitis was performed. Pharmacoeconomic studies have been conducted. According to the results of ABC analysis, drugs according to INN Aciclovir ATC-code J05AB01 for pharmacotherapy of patients with systemic vasculitis combined with cryoglobulinemic syndrome were distributed in descending order of value. According to the results of VEN-analysis, it is estimated that category V drugs accounted for the largest number of prescriptions and the cost of therapy (100%).

CONCLUSION: This study provide an opportunity to make administrative and managerial decisions in determining the pharmacotherapy of patients with systemic vasculitis combined with cryoglobulinemic syndrome to improve the use of drugs in hospitals.
Thermo-flow Analysis of Cylinder with Crossed Splitter Plates with a Characteristics-based Scheme
Authors: RAZAVİ Seyed Esmail , ADİBİ Tohid , HASSANPOUR Hussein
Published: June 2021

In the present work, the laminar flow through a circular cylinder with two crossed splitter plates is analyzed. The characteristic-based method has been used along with the unstructured grid. The current research has been done to detect the proper conditions according to the geometrical parameters in which the optimal heat transfer is taking place. Geometric control parameters are the angle of splitter plates (\theta) and the ratio of length of the splitter plate to cylinder radius (n=L/D). It was found that the use of a two-branched splitter plate is not wise in Reynolds number less than 100 due to its insignificant effect in flow properties. In angle 30° between two plates, the least drag force is witnessed with respect to other angles. Application of double branched splitter with angles more than 60° is not recommended, which will increase the total drag significantly. Since the splitter plate increases, the overall heat transfer from the cylinder and splitter set is enhanced. Minimum drag over the cylinder, and maximum convection drop from it is taken place when the dimension length is 0.75. Between dimensionless lengths 1.25 and 1.5, the Nusselt number oscillates with least amplitude and such behavior is also observed when two splitters are 60°apart.
Vidas que se cruzam na pedagogia do insulto: uma análise das vivências escolares de pessoas LGBTQIA
Authors: Oliveira Júnior Isaias Batista de , Ferreira Diego Raone
Published: June 2021

A pedagogia do insulto atinge inúmeros estudantes LGBTQIA – Lésbicas, Gays, Bissexuais, Travestis, Transexuais, Transgêneros, Queer, Questionadores, Intersexos, Indecisos, Assexuados e Aliados, e representa estratégias que (re)produzem preconceitos, discriminações, violências e retirada de direitos elementares. Nesse sentido, questionamo-nos: de que maneira ela se manifesta nas vivências escolares, em desatendimento ao que a sociedade convencionou como norma? A fim de responder ao problema proposto, temos como objetivo analisar os relatos das vivências escolares de 118 participantes que se reconhecem como pessoas LGBTQIA. Para tanto, recorremos à análise de conteúdo sob o viés das seguintes categorias: interditos da diversidade sexual; des/contextualizando a LGBTQIAfobia;  re/des/construindo estereótipos de gênero, as quais discutimos com base nos Estudos Culturais, nos estudos de gênero e na ordem do discurso.  Concluímos que os padrões normalizadores adotados pela escola excluem aqueles considerados diferentes, impactando diretamente na esfera dos sentimentos, da dignidade e do desempenho escolar.
Conflito no ambiente escolar e o cuidado de si em Michel Foucault
Authors: Mendonça Samuel , Leandro Kelly Cristina
Published: June 2021

O conceito de cuidado de si de Michel Foucault, extraído do livro A Hermenêutica do Sujeito, caracteriza-se como caminho necessário para a construção da existência humana, ao demonstrar a necessidade de voltar-se a si mesmo. Desse modo, a realidade de conflitos existente na escola expressa-se como potência para a transformação das pessoas. Em vista disso, o presente artigo tem como pergunta: o conceito de cuidado de si de Michel Foucault pode auxiliar na resolução de conflitos em sala de aula? A metodologia utilizada reside em pesquisa bibliográfica, que se configurou em revisão de literatura e exame minucioso do livro do pensador francês. De forma sistemática, obteve-se como resultados: (i) a possibilidade de auxílio do conceito de cuidado de si como busca de retorno a si; (ii) o uso do cuidado de si como elemento de transformação da subjetividade na conquista individual; e (iii) a construção de abertura de postura para que se possa lidar com conflitos.
Pesquisa-formação: diários reflexivos sobre os cuidados com professoras da educação infantil
Authors: Sousa Clara Maria Miranda de , Ribeiro Marcelo Silva de Souza
Published: June 2021

O artigo analisa diários reflexivos de professoras da Educação Infantil, compreendendo as formas de vivenciar o cuidado em suas práticas pedagógicas a partir do processo formativo vivenciado. Baseia-se na compreensão de cuidado fundamentada em Heidegger (2005) e Boff (1999), além de articular diálogos sobre formação, saberes docentes e reflexão, conduzidos por Gadamer (2002), Josso (2007) e Freire (2015). A abordagem metodológica foi a pesquisa-formação de cunho fenomenológico hermenêutico “heideggeriano”. Esta foi realizada em escola da rede pública municipal de Juazeiro - BA, envolvendo treze profissionais. Como dispositivos de colheita de informações foram utilizados: diário de observação, diários reflexivos escritos pelos participantes, roteiros dos encontros formativos e os processos avaliativos. Para este artigo, debruçamo-nos na análise dos diários reflexivos de dois encontros (quarto e quinto encontro) do total de cinco realizados. As análises dos diários foram guiadas pela Analítica do Sentido de Critelli (1996), baseada na perspectiva hermenêutica de Heidegger. As unidades de sentido foram descritas como: a identidade docente e o cuidar, a reflexão da prática docente que contribui para melhor cuidar e formação no sentido de cuidar das professoras da Educação Infantil (EI). A vivência da pesquisa-formação em cuidado, com essas educadoras, mostrou-se um lugar de convivência harmoniosa, de interação, de reflexão da prática, de abertura a si e ao outro, de maneira a favorecer ainda mais a qualidade nas ações educativas, levando a beneficiar toda comunidade escolar.
Teachers’ Perceptions of Teacher–Child Relationships, Student Behavior, and Classroom Management
Authors: Chen Szu-Yu , Lindo Natalya A , Blalock Sarah , Yousef Dina , Smith LaToya , Hurt-Avila Kara
Published: June 2021

Children’s relationships with their teachers are a potential resource for enhancing developmental and academic outcomes. The effects of positive or negative teacher–child relationships can be either beneficial or detrimental to students’ academic progress, behaviors, and emotions. In the current study, we utilized a qualitative research design to examine 18 pre-kindergarten to fourth-grade teachers’ perceptions of teacher–child relationships, student behavior, and classroom management. Analysis of in-depth interviews yielded five major themes: (a) beliefs in children, (b) teaching strategies, (c) acknowledging individual differences, (d) challenges, and (e) relationships. Findings of this study have the potential to inform in-service training regarding relationship-building skills and attending to children’s social-emotional development. We discuss the limitations of the study, implications for professional school counselors, and recommendations for future research.
Physical Transport Processes that Affect the Distribution of Oil in the Gulf of Mexico: Observations and Modeling
Authors:   New Jersey Institute of Technology, Boufadel Michel , Bracco Annalisa , Chassignet Eric , Chen Shuyi , D’Asaro Eric , Dewar William , Garcia-Pineda Oscar , Justić Dubravko , Katz Joseph , Kourafalou Vassiliki , MacDonald Ian , Özgökmen Tamay , Paris-Limouzy Claire , Socolofsky Scott , Halpern David , Shepherd John
Published: June 2021

Physical transport processes such as the circulation and mixing of waters largely determine the spatial distribution of materials in the ocean. They also establish the physical environment within which biogeochemical and other processes transform materials, including naturally occurring nutrients and human-made contaminants that may sustain or harm the region’s living resources. Thus, understanding and modeling the transport and distribution of materials provides a crucial substrate for determining the effects of biological, geological, and chemical processes. The wide range of scales in which these physical processes operate includes microscale droplets and bubbles; small-scale turbulence in buoyant plumes and the near-surface “mixed” layer; submesoscale fronts, convergent and divergent flows, and small eddies; larger mesoscale quasi-geostrophic eddies; and the overall large-scale circulation of the Gulf of Mexico and its interaction with the Atlantic Ocean and the Caribbean Sea; along with air-sea interaction on longer timescales. The circulation and mixing processes that operate near the Gulf of Mexico coasts, where most human activities occur, are strongly affected by wind- and river-induced currents and are further modified by the area’s complex topography. Gulf of Mexico physical processes are also characterized by strong linkages between coastal/shelf and deeper offshore waters that determine connectivity to the basin’s interior. This physical connectivity influences the transport of materials among different coastal areas within the Gulf of Mexico and can extend to adjacent basins. Major advances enabled by the Gulf of Mexico Research Initiative in the observation, understanding, and modeling of all of these aspects of the Gulf’s physical environment are summarized in this article, and key priorities for future work are also identified.
Innovative approaches to teaching vascular access to nursing students in the COVID-19 era
Authors: Marchionni Caroline , Connolly Madolyn , Gauthier Mélanie , Lavoie-Tremblay Mélanie
Published: June 2021

Purpose: For the student nurse, peripheral venous cannulation is one of the most stressful skills to be learned. Although some healthcare employers/establishments offer courses on vascular access and infusion nursing as part of their onboarding programs, ultimately educational institutions should share the responsibility to ensure that graduating nurses can provide safe infusion therapies. Methods: An innovative vascular access and infusion nursing (VAIN) curriculum was created and mapped onto the entry-to-practice undergraduate nursing program at McGill University in Montréal, Québec, Canada. This presented an opportunity to implement new teaching approaches. Results: Students experienced multiple new teaching approaches including multimedia and experiential learning and live simulation to ensure acquisition of knowledge and psychomotor skills. The teaching approaches had to be rapidly modified with the advent of the COVID-19 pandemic. Conclusions: The VAIN curriculum emphasizes simulation and directed practice, seeking to increase competence, confidence, and knowledge. The pandemic underscored the need for flexibility and creativity in content delivery.
Towards the Reform of the System of Epistemological Goals and Values
Authors: Porus Vladimir N. ,   Institute of Philosophy, Russian Academy of Sciences
Published: June 2021

Cultural and historical epistemology is not only a special branch of philosophical researches of science, but also the base of reform of a system of the epistemological categories expressing the purposes and values of scientific knowledge. Its need follows from the nature of development of modern science. Preservation of the traditional epistemological categories applied to the analysis of this development results in rough relativism. This danger can be eliminated, having developed the holistic system of epistemological values proceeding from the principle of historicism and “collective” understanding of the subject of scientific knowledge. Both of these bases allow to disclose historical and cultural conditionality of processes of scientific research and broadcast of their results. Such purposes and values of science as the truth and the objectivity of knowledge have historical measurement: they exist only in the course of continuous emergence and destruction, being affected by cultural factors. The collectivity of the subject of scientific knowledge is defined together with concepts of a “transcendental” and “individual and empirical” subject according to the principle of complementarity (N. Bohr) finding an epistemological transcription. The possibilities of political subjectivity of science in connection with the epistemological investigations from participation of scientific communities in political structures and movements are considered.
Rhetoric of Science
Authors: Griftsova Irina N. , Kozlova Natalia Yu. ,   Institute of Philosophy, Russian Academy of Sciences
Published: June 2021

This contribution examines the status of the rhetoric of science in two contexts. The first one is the effect that the changing interpretation of logic (the changing 'image of logic') has had on the status of the rhetoric of science. The second is the role that imagery has in scientific discourse. It is argued that the very possibility of a rhetorical interpretation of science depends on how the logic of science is understood. Informal logic, which acts here as a variant of argumentation theory or a logic of argumentation, is proposed as such a logic. This leads to a revision of the nature of justification in science in general, the substitution of apodictic logic for a logic of argumentation as a principal tool, and the consideration of strict formal ways of material implication-based justification as mere individual cases of a logic of argumentation. The role of imagery in scientific discourse is analysed. It is demonstrated that the situation of rhetoric and perception of imagery is paradoxical: although using rhetorical mechanisms in scientific communication is unavoidable, rhetoric has been criticised for many centuries. It is shown that the negative attitude to using rhetorical elements in scientific texts has long historical roots going back to ancient philosophical thought, namely, Socrates's criticism of eloquence and sophistic rhetoric. Analysis of the functions of imagery in scientific discourse suggests that imagery is an inalienable mechanism of both professional communication and the creation of theoretical models of knowledge.
From “Nomos” to “Physis” and Back
Authors: Dmitriev Igor S. ,   Institute of Philosophy, Russian Academy of Sciences
Published: June 2021

The article focuses on the following three issues: the characteristic features of understanding and using the term “law of nature” before F. Bacon, the novelty of F. Bacon’s approach to the interpretation of this concept, theological and legal origins of the concept. It is shown that in works related to the Middle Ages the term “law of nature” had either a purely descriptive (descriptive-stating) or mixed prescriptive-descriptive character. It is shown that in the works of medieval authors the term “law of nature” had either a purely descriptive or mixed prescriptive-descriptive character. The novelty of the approach to understanding the law of nature in the works of F. Bacon lies primarily in the fact that in his interpretation the contours of the understanding of the “law of nature” as an expression of the causal relationship between facts and phenomena are clearly visible. Moreover, Bacon points to the “Latentis Processus et Latentis Schematismi” of bodies as the deepest causes of natural phenomena, that is, he refers to the micro-level of organization of matter. The article also examines the theological (in the context of the notion “God acts in the world only through secondary causes” and the Protestant doctrine of “cessation of miracles”) and legal (in the context of norms and practices of “common law”) sources of the Baconian understanding of the concept of “law of nature”.
A Minimal Sense of Here-ness
Authors: de Vignemont Frédérique ,   Journal of Philosophy Inc.
Published: June 2021

In this paper, I give an account of a hitherto neglected kind of ‘here’, which does not work as an intentional indexical. Instead, it automatically refers to the immediate perceptual environment of the subject’s body, which is known as peripersonal space. In between the self and the external world, there is something like a buffer zone, a place in which objects and events have a unique immediate significance for the subject because they may soon be in contact with her. I argue that seeing objects as being here in a minimal sense means seeing them in the place in which the perceptual system expects the world and the body to collide. I further argue that this minimal notion of here-content gives rise to a tactile sense of presence. It provides a unique experiential access to the reality of the seen object by making us aware of its ability to have an effect on us.
Perfect Happiness
Authors: Rönnedal Daniel ,   Romanian Academy - Iasi Branch
Published: June 2021

In this paper, I will develop a new theory of the nature of happiness, or “perfect happiness.” I will examine what perfect happiness is and what it is not and I will try to answer some fundamental questions about this property. According to the theory, which I shall call “the fulfillment theory,” perfect happiness is perfect fulfillment. The analysis of happiness in this paper is a development of the old idea that happiness is getting what you want and can be classified as a kind of desire-satisfaction theory. According to the fulfillment theory of happiness, it is necessarily the case that an individual x is perfectly happy if and only if all x’s wants are fulfilled. The interpretation of this basic definition is important, since the consequences of the particular version defended in this essay are radically different from the consequences of many other popular theories of happiness. The fulfillment theory is also quite different from most other desire-satisfaction theories of happiness. We will see that it has many interesting consequences and that it can be defended against some potentially serious counterarguments. The upshot is that the analysis of (perfect) happiness developed in the present paper is quite attractive.
The Learning Curve for Peroral Endoscopic Myotomy in Latin America: A Slide to the Right?
Authors: Kahaleh Michel , Tyberg Amy , Suresh Supriya , Lambroza Arnon , Casas Fernando Rodriguez , Rey Mario , Nieto Jose , Martínez Guadalupe Ma , Zamarripa Felipe , Arantes Vitor , Porfilio Maria G , Gaidhane Monica , Familiari Pietro , Carames Juan Carlos , Vargas-Rubio Romulo , Canadas Raul , Hani Albis , Munoz Guillermo , Castillo Bismarck , Moura Eduardo T , Galileu Farias F , Lukashok Hannah P , Robles-Medranda Carlos , Moura Eduardo G de
Published: June 2021

Background/Aims: Peroral endoscopic myotomy (POEM) has been increasingly used for achalasia in Latin America, where Chagas disease is prevalent, and this makes POEM more challenging. The aim of this study was to determine the learning curve for POEM in Latin America.Methods: Patients undergoing POEM in Latin America with a single operator were included from a prospective registry over 4 years. Non-linear regression and cumulative sum control chart (CUSUM) analyses were conducted for the learning curve.Results: A total of 125 patients were included (52% male; mean age, 59 years), of which 80 had type II achalasia (64%), and 38 had Chagas disease (30%). The average pre-procedure and post-procedure Eckardt scores were 6.79 and 1.87, respectively. Technical success was achieved in 93.5% of patients, and clinical success was achieved in 88.8%. Adverse events occurred in 27 patients (22%) and included bleeding (4 patients), pneumothorax (4 patients), mucosal perforation (13 patients), mediastinitis (2 patients), and leakage (4 patients). The CUSUM chart showed a median procedure time of 97 min (range, 45-196 min), which was achieved at the 61st procedure. Procedure duration progressively decreased, with the last 10 procedures under 50 min approaching a plateau (p-value <0.01).Conclusions: Mastering POEM in Latin America requires approximately 61 procedures for both POEM efficiency and to accomplish the procedure within 97 minutes.