bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence, Trends, and Survival of Children With Embryonal Tumors
Authors: Tulla M. , Berthold F. , Graf N. , Rutkowski S. , von Schweinitz D. , Spix C. , Kaatsch P.
Published: August 2015

BACKGROUND:

Central nervous system (CNS) and non-CNS embryonal tumors occur principally in children and are rarely seen in adults. The incidence rates for rare entities such as atypical teratoid/rhabdoid tumors (AT/RT) or primitive neuroectodermal tumors in the CNS are rarely published. Incidence rates for certain subgroups, such as hepatoblastomas, have been increasing in some countries.

METHODS:

Data of 8337 embryonal tumors, registered in children (0–14 years) between 1991 and 2012 (for AT/RT 2000–2012) in the population-based German Childhood Cancer Registry with complete national coverage were analyzed for incidence rates, time trends, and survival.

RESULTS:

For most entities, the incidence rates were the highest for children <1 year. An important exception was medulloblastomas, which occurred mainly in 1- to 9-year-olds. Neuroblastomas and ganglioneuroblastomas as well as Wilms tumors (nephroblastomas) had the highest age standardized incidence rates (13.7 and 9.4 per million, respectively). A statistically significant increasing trend for hepatoblastomas (annual average percent change 4.6%) was detected. The survival probabilities varied between the diagnostic groups: primitive neuroectodermal tumors and AT/RT had the lowest and retinoblastomas the highest. The survival was dependent on the age at diagnosis, the most extreme examples being neuroblastomas, for which the survival probability declined steeply for children ≥1 year and medulloblastomas, for which the highest survival was seen for 10- to 14-year-olds.

CONCLUSIONS:

This study presents a comprehensive overview of pediatric embryonal tumors from a well-established, complete nationwide cancer registry. Significant increasing trend for hepatoblastomas was detected for the first time in Europe.
Metronidazole Toxicity in Cockayne Syndrome: A Case Series
Authors: Wilson Brian T. , Strong Andrew , O’Kelly Sean , Munkley Jennifer , Stark Zornitza
Published: August 2015

Cockayne syndrome (CS) is a rare genetic disorder characterized by small stature, intellectual disability, and accelerated pathologic aging. Through the Cockayne Syndrome Natural History Study, we have identified 8 cases of acute hepatic failure after metronidazole administration (8% of our cohort), 3 of which were fatal. The interval between initial administration and death was 6 to 11 days. Two of these patients also experienced acute neurologic deficit. Both hepatotoxicity and acute neurologic deficit have been reported previously as extremely rare adverse events after metronidazole administration. However, we have not identified any patients with CS who have received metronidazole without serious adverse effects. We recommend that a diagnosis of CS be considered an absolute contraindication to the use of metronidazole.
Concurrent Respiratory Viruses and Kawasaki Disease
Authors: Turnier Jessica L. , Anderson Marsha S. , Heizer Heather R. , Jone Pei-Ni , Glodé Mary P. , Dominguez Samuel R.
Published: August 2015

BACKGROUND:

The diagnosis of Kawasaki disease (KD) remains challenging without a definitive diagnostic test and currently is guided by using clinical patient characteristics and supported by laboratory data. The role of respiratory viruses in the pathogenesis of KD is not fully understood.

METHODS:

Charts of patients with KD admitted to Children’s Hospital Colorado from January 2009 to May 2013 were retrospectively reviewed. Patients with KD who had a nasopharyngeal wash submitted for multiplex polymerase chain reaction (PCR) viral testing were included. Clinical characteristics, laboratory data, and outcomes of patients with and without positive respiratory viral PCR results were compared.

RESULTS:

Of 222 patients with KD admitted to the hospital, 192 (86%) had a respiratory viral PCR test performed on or shortly after admission. Ninety-three (41.9%) of the 192 patients with KD had a positive respiratory viral PCR, and the majority were positive for rhinovirus/enterovirus. No statistically significant differences were found in the clinical characteristics and laboratory values between the groups with and without positive respiratory viral PCR findings. Both groups had the same frequency of upper respiratory and gastrointestinal symptoms and had the same incidence of admission to the PICU, intravenous immunoglobulin–resistant disease, and coronary artery lesions.

CONCLUSIONS:

No differences in clinical presentations or outcomes in children with KD stratified according to positive or negative respiratory viral PCR testing were observed. A positive respiratory viral PCR or presence of respiratory symptoms at the time of presentation should not be used to exclude a diagnosis of KD.
Outcome of Patients Initiating Chronic Peritoneal Dialysis During the First Year of Life
Authors: Carey William A. , Martz Karen L. , Warady Bradley A.
Published: August 2015

BACKGROUND AND OBJECTIVE:

Among children with end-stage renal disease (ESRD), those who initiated chronic dialysis during the first year of life historically were less likely to survive or receive a kidney transplant compared with those who initiated dialysis later in childhood. We hypothesized that recently treated infants have experienced improved outcomes.

METHODS:

We queried the North American Pediatric Renal Trials and Collaborative Studies database, obtaining information on 628 children who initiated maintenance peritoneal dialysis for treatment of ESRD at <1 year of age. We further subcategorized these children by age (neonates, ≤31 days and infants, 32–365 days) and date of dialysis initiation (past, 1992–1999, and recent, 2000–2012).

RESULTS:

Survival while on dialysis and overall survival were significantly better among neonates and infants in the recent cohort. Overall survival at 3 years after dialysis initiation was 78.6% and 84.6% among the recently treated neonates and infants, respectively. Neonates and infants in the recent cohort also were more likely to terminate dialysis for transplantation, and graft survival was improved among recently transplanted infants (3-year graft survival 92.1%).

CONCLUSIONS:

Among children who initiate chronic peritoneal dialysis for treatment of ESRD in the first year of life, survival has improved in recent years. Graft survival also has improved for the subset of these patients who received a kidney transplant.
A rebeldia dos Bragança no Rio da Prata: redes comerciais e laços parentais portugueses na Buenos Aires seiscentista
Authors: Ceballos Rodrigo
Published: August 2015

Este artigo contém breve apresentação seguida de transcrição de trecho de processo judicial, presente no Arquivo Geral das Índias (Sevilha), em defesa dos lusitanos expulsos da cidade de Buenos Aires em 1643. No ano de 1641, logo após a Restauração portuguesa, marinheiros lusitanos fugiram para o Rio de Janeiro, levantando na região austral suspeitas de traição de moradores do Rio da Prata ao monarca espanhol.
Festa popular e identidade nacional nos dois lados do Atlântico durante o século XX
Authors: Melo Daniel
Published: August 2015

Neste texto reflecte-se sobre as relações entre festa popular e identidade nacional no Brasil e em Portugal durante o século XX, partindo da análise comparativa de duas manifestações culturais centrais nos dois países: o desfile das escolas de samba do Rio de Janeiro e as marchas populares de Lisboa. O exercício, sustentado num conjunto relevante de estudos sobre cada um dos casos, justificou-se pela riqueza de similitudes no processo histórico, no conteúdo, na estrutura e na organização destes desfiles populares urbanos. Nele se realçou ainda a importância dos períodos ditatoriais para a construção e centralidade dessas festas urbanas.
Construct Validity of the Attitude Diagnostic Inventory
Authors: Bitinas Bronislovas , Jegelevičienė Violeta
Published: August 2015

The article reflects a part of the research, which aims at designing an inventory intended for the evaluation of the attitude towards learning by the students of Lithuanian comprehensive school. Since the experience of preparing this kind of diagnostic tools in Lithuania is minimal, “SMALSI” (School motivation and learning strategies inventory; compiled by K. C. Stroud, C. R. Reynolds, 2006), an inventory designed in the USA, has been referred to. The quality of the tool has been tested under the condition of the USA; however, the application of the diagnostic tool for the social and education reality of Lithuania invokes both a scientific and a practical problem as the students’ answers directly depend on their understanding of the question. Therefore, the adaptation of culture-dependent means falls under certain requirements, analogical to the requirements raised for the original diagnostic tool.

The inventory has been modified with reference to the results of the analysis of content validity. It consisted of 48 statements classified into three scales. It was filed in by 648 students of 8–10th classes of nine schools. The data required for the description of construct validity were analyzed using computer software: alpha factor analysis for the verification of the hypothesis of contents mono-dimensionality; method of correlation pleiads for a detailed insight into the internal structure of each scale; relations of estimates, which students attributed to the statements, with the charts presenting the scale; weighted coefficients, which were intended for the quantitative assessment of the resolution of the initial estimates of the statements; scale reliability coefficients obtained by the method of half-splitting the mass of initial estimates; indices of statement popularity, which defied the differences in the frequency of approving and disapproving statements.

The research resulted in the empirical verification of the scales intended for the measurement of students’ attitude towards learning: low academic motivation, learned helplessness and concentration / attention difficulties, which, depending on the application needs (education, management, research, etc.) can be transformed as quantitative or ordinal measurement scales while interpreting the data of each individual scale or general estimates of the attitude towards learning.
Modelagem matemática para seleção de conjuntos mecanizados agrícolas pelo menor custo operacional
Authors: Baio Fábio H. R. , Rodrigues Andrew D. , Santos Gilson S. dos , Silva Simone P. da
Published: August 2015

A seleção de uma máquina agrícola pode tornar-se uma tarefa árdua, pois há diversas variáveis que devem ser consideradas. A escolha do equipamento mais adequado para uma propriedade agrícola é uma das etapas mais importantes do processo produtivo. O objetivo deste trabalho foi desenvolver um modelo de computador por programação linear em plataforma web para seleção automatizada de conjuntos mecanizados agrícolas, baseados no menor custo operacional. O programa, desenvolvido em linguagem ASP.NET, pode ser acessado gratuitamente pela Internet (http://www.maquinas.ufms.br). O usuário pode selecionar um conjunto mecanizado agrícola dentro de uma vasta lista de opções que contém suas especificações técnicas ou deixar que o programa lhe retorne automaticamente a melhor opção, pelo menor custo operacional. O programa desenvolvido proporciona ao usuário uma seleção racional via Internet de conjuntos mecanizados, permitindo o estudo econômico do uso das máquinas e implementos, sem a necessidade da instalação de programas dedicados no computador, que dificultariam a manutenção do banco de dados.
Fibrogenesis in Primary Myelofibrosis: Diagnostic, Clinical, and Therapeutic Implications
Authors: Nazha Aziz , Khoury Joseph D. , Rampal Raajit K. , Daver Naval
Published: August 2015

Primary myelofibrosis is a stem cell-derived clonal malignancy characterized by unchecked proliferation of myeloid cells, resulting in bone marrow fibrosis, osteosclerosis, and pathologic angiogenesis. Bone marrow fibrosis (BMF) plays a central role in the pathophysiology of the disease. This review describes current issues regarding BMF in primary myelofibrosis, including the pathophysiology and impact of abnormal deposition of excess collagen and reticulin fibers in bone marrow spaces, the modified Bauermeister and the European Consensus grading systems of BMF, and the prognostic impact of BMF on the overall outcome of patients with primary myelofibrosis. The impact of novel therapeutic strategies, including JAK-STAT inhibitors and allogeneic stem cell transplant, on BMF is discussed.

Implications for Practice:

Bone marrow fibrosis (BMF) plays an important role in the pathophysiology and the clinical outcomes of patients with primary myelofibrosis. The severity of BMF correlates with the clinical manifestations of the disease and impacts the survival in patients with myelofibrosis. Treatment with ruxolitinib has been shown to reverse BMF and to continue that trend with ongoing treatment. Further studies to fully understand the mechanisms of fibrosis, to further explore the ability of currently available agents (e.g., JAK-STAT inhibitors) to stabilize and/or reverse fibrosis, and to develop additional fibrosis-targeted therapies are warranted.
Modeling power fitness girls grades 6—7
Authors: Іващенко О. В. , Цеслицка Мирослава , Худолій О. М. , Єрмаков С. С.
Published: August 2015

Purpose — to determine the model of strength abilities in girls grades 6—7.Material and methods. To achieve the objectives adopted the following methods: analysis of scientific literature, educational testing and treatment methods of mathematical statistics research results. In the study involved girls 6 and 7 classes 21 and 26 people respectively.Research results. Analysis shows that the most statistically significant differences in the test results of girls 6 and 7 classes observed in tests 2 «long jump from their seats, see ‘and 5’ Squat, times» (p <0,001; p <0,01 respectively). The level of motor readiness girls 6—7 grade determines the development of speed-strength abilities.Conclusions. Structural canonical discriminant function coefficients suggest that more attention is paid to speed-strength training, the more likely improve motor fitness girls 6—7 class. The canonical discriminant function can be used for estimation and forecasting the development of motor abilities in girls grades 6—7.
Риторика и повседневность информального образования анархистов
Authors: Litvina Daria , Omelchenko Elena
Published: August 2015

Литвина Дарья Александровна — стажер-исследователь Центра молодежных исследований НИУ ВШЭ — Санкт-Петербург, второе место на Конкурсе аналитических работ. Эл. адрес: litvina.darya@mail.ru Омельченко Елена Леонидовна — доктор социологических наук, профессор факультета социологии, директор Центра молодежных исследований НИУ ВШЭ — Санкт-Петербург, второе место на Конкурсе аналитических работ. Эл. адрес: eomelchenko@hse.spb.ru Выявлено, что, несмотря на резкую критику формальной образовательной системы, ценность образования в представлении анархистов остается высокой, поэтому информальные образовательные каналы как свободные источники информации пользуются у них наибольшим доверием. Социальным пространством информального образования является коммуникация — трансляция ключевых ценностей анархистских сообществ посредством повседневного общения индивидов, демонстрация своей групповой и солидарной принадлежности через отнесение к значимым текстам, именам и событиям. Информальная система образования в субкультурной среде формируется по тому же принципу, что и формальная: знания отбираются, легитимируются, рационализируются и воспроизводятся в соответствии с идеологическими принципами. В отличие от формального образования, в информальной образовательной структуре идеология имеет характер открытости. Тематические области информального образования анархистов вписаны в контекст их активистских и политических проектов, связаны с их повседневностью и мировоззрением. Результатом включенности индивидов в информальные образовательные практики, базирующиеся на альтернативных интерпретациях существующего экономического, государственного и социального устройства, становятся изменение их представлений о мире и реорганизация жизненных стратегий и повседневных практик.В ходе проведенного анализа показано, как информальные системы знаний могут замещать формальные и производить новые формы социальности, изменяя не только риторику, но и стиль жизни, виды активности и потребительские практики индивидов.
Учреждения дополнительного образования детей (данные статистики и Мониторинга экономики образования)
Authors: Kupriyanov Boris , Kosaretsky Sergey , Mertsalova Tatyana , Semenova Tatiana
Published: August 2015

Материал подготовлен по данным Центра социально-экономического развития школы НИУ ВШЭ Куприянов Борис Викторович — ведущий научный сотрудник Центра социально-экономического развития школы (ЦСЭРШ) НИУ ВШЭ. Эл. адрес: boriskuprianoff2012@yandex.ru Косарецкий Сергей Геннадьевич — директор ЦСЭРШ НИУ ВШЭ. Эл. адрес: skosaretski@hse.ru Мерцалова Татьяна Анатольевна — ведущий научный сотрудник ЦСЭРШ НИУ ВШЭ. Эл. адрес: tmertsalova@hse.ru Семенова Татьяна Вадимовна — стажер-исследователь ЦСЭРШ НИУ ВШЭ. Эл. адрес: tsemenova@hse.ru  Представлены результаты опроса руководителей учреждений дополнительного образования детей (УДОД).При анализе доступности услуг дополнительного образования для различных категорий детей рассмотрены возрастной состав обучающихся и динамика его изменений; определена структура контингента учащихся по территории проживания, источнику финансирования обучения; выявлен охват программами дополнительного образования детей с разным образовательным потенциалом и разным социальным статусом их семей.Исследованы направленность реализуемых в УДОД программ, их продолжительность, наличие трудностей при комплектовании контингента и уровень кадровой обеспеченности.При анализе состава педагогических работников в УДОД рассмотрены возрастная структура, уровень профессионального образования, продолжительность стажа и уровень заработной платы преподавателей.Проанализированы структура доходов и расходов учреждений дополнительного образования детей, существующая и прогнозируемая динамика объемов бюджетного и внебюджетного финансирования.Рассмотрены методы управления УДОД. Представлены оценка руководителями устойчивости финансового положения, конкурентоспособности учреждения дополнительного образования детей, их отношение к обсуждаемым в правительстве и экспертном сообществе мерам по модернизации системы дополнительного образования детей.Полученные данные позволят выстроить полную картину функционирования УДОД в условиях социальных изменений и модернизации сферы образования, охарактеризовать актуальное состояние системы и тенденции развития учреждений дополнительного образования и сформировать эмпирическую основу для выстраивания образовательной политики на федеральном, региональном и муниципальном уровнях.
Студенческий отсев в российских вузах: к постановке проблемы
Authors: Gruzdev Ivan , Gorbunova Elena , Froumin Isak
Published: August 2015

Груздев Иван Андреевич —магистр социологии, аналитик Центра внутреннего мониторинга НИУ ВШЭ. Эл. адрес: van@gorod.org.ruГорбунова Елена Васильевна — магистр социологии, аналитик Центра внутреннего мониторинга НИУ ВШЭ. Эл. адрес: evgorbunova@hse.ru Фрумин Исак Давидович — доктор педагогических наук, профессор, научный руководитель Института образования НИУ ВШЭ. Эл. адрес: ifroumin@hse.ruВ связи с демографическими изменениями в обществе, приводящими к сокращению в общей численности населения доли людей студенческого возраста, а также институциональными изменениями в образовательной системе (реформой финансирования вузов) проблема отчисления студентов ставится как одно из приоритетных направлений исследования высшего образования. Феномен студенческого отсева в российских университетах рассматривается на основе анализа данных анкетирования и интервьюирования отчисленных из вуза студентов. Установлено, что отечественная система высшего образования характеризуется особым типом студенческого отсева, который представляет собой принудительный по отношению к студентам процесс, субъектом которого является университет, в частности преподаватели. Отчисление студентов в российских вузах качественно отлично от явления, описываемого в зарубежной литературе термином dropout и представляющего собой добровольное выбытие студента из вуза. Dropout является следствием недостаточной интеграции студента в университетскую жизнь и может быть предотвращен реализацией социализирующих и адаптационных программ. Специфика студенческого отсева в России требует особых принципов регулирования уровня отчислений. Выявлено, что при принудительном отсеве отчисленным студентам присуще стремление вернуться к обучению (только 4% респондентов не планируют получать высшее образование), что свидетельствует о необходимости совершенствования критериев, использующихся для оценки студентов, и разработки институциональных форм дисциплинирования учащихся, не предполагающих их отчисление. Исследование механизмов и причин отсева имеет практическое значение для повышения эффективности образовательной политики университетов.
Mexico's Rural Poor and Targeted Educational and Health Programs
Authors: Wilson Tamar Diana
Published: August 2015

A paradigm shift from the articulation of modes of production approach to the livelihoods diversification approach, occurring in the early 1990s, coincided and was symbiotic with neoliberal and capitalist interventions among the peasant poor, whether they continue to live in rural regions of origin or have migrated to urban centers. Although partially successful in relieving the dire situation of some of the poor, programs such as Progresa/Oportunidades and Seguro Popular (Popular Health Insurance) in Mexico have many flaws, including in the first case, increasing burdens on mothers and, in the second case, underfunding and exclusionary factors. Endorsed by international financial institutions such as the World Bank, the Inter-American Development Bank, and the International Monetary Fund, they target individual behavior in the interests of poverty reduction. They also rest on a debatable hope that by skilling and insuring improved health among the dispossessed, a more adequate labor force will be available for the promised, yet unrealized, expansion of the formal economy.
Social Capital and the Vulnerability of Aboriginal Food Systems in Canada
Authors: Natcher David C.
Published: August 2015

This research examined the traditional food system of the Little Red River Cree Nation (LRRCN) of Alberta, Canada. By quantifying the annual wild food harvest and tracing the social networks in which wild foods are shared, the social capital of First Nation members has been made visible, as has the inclusivity and exclusivity of the social networks that support their local food system. Results indicate that the LRRCN wild food system is characterized by a high degree of centrality where thirteen households (<3 percent) are responsible for procuring and distributing nearly half of the LRRCN's total wild food harvest (135,525\293,498 lbs.). Under these conditions, the removal of any one of these thirteen households may have a significant impact on the harvest and flow of resources, thereby threatening the viability of the entire LRRCN food system and contributing to the vulnerability of food insecure households.
Hydropower, Encroachment and the Re-patterning of Hydrosocial Territory: The Case of Hidrosogamoso in Colombia
Authors: Duarte-Abadía Bibiana , Boelens Rutgerd , Roa-Avendaño Tatiana
Published: August 2015

Mega-hydraulic projects tend to produce severe social and environmental impacts, with burdens and benefits unevenly distributed among different social groups, regions, and scales. This triggers socioenvironmental conflicts, since “territory” has incommensurable functions and values for the diverse parties. This article examines the dominant human-nature interactions that underlie recent hydropower developments and the reconfiguration of the hydrosocial network in Colombia's Sogamoso basin. We use the Echelon of Rights Analysis (ERA) to examine conflicts over hydrosocial patterning, involving struggles over resources, norms, authority, and discourses. The Sogamoso mega-project highlights how modernist policies discursively frame clean energy, sustainable development, and public utility, while breaking up existing socioecological relationships and aligning water users, rights, and uses in new hydro-political network hierarchies. In Sogamoso, hydropower development discourse ends up declaring local subsistence activities illegal while denying existing rights frameworks. Therefore, crucial questions about water rights, legitimacy, and justice remain unasked and unanswered within political arenas.
A Riqueza Simbólica produzida pelo Movimento Roqueiro dos anos 80 * The Symbolic Wealth produced by the Rock Movement in the 80’s
Authors: PRADO GUSTAVO DOS SANTOS
Published: August 2015

 

A música, enquanto fonte de pesquisa, proveniente da vulcanização dos postulados teórico-metodológicos da História Cultural, coloca no cenário acadêmico, uma série de possibilidades, desafios e riscos, provenientes de seu caráter amplamente subjetivo. Notadamente, tal fonte necessita de um diálogo interdisciplinar, para prover um processo de historicidade profícuo. Visando contribuir nesse debate, o artigo em questão, utiliza-se da semiótica como mecanismo de tal interlocução, na tentativa de discutir os símbolos criados pelo movimento roqueiro dos anos 80, levando em consideração a letra e o conjunto melódico. Espera-se, que a proposta provoque inquietações, resoluções e irresoluções, fulcrais para o desenvolvimento científico.

Palavras-chave: Música – Símbolo – Rock.

 

Abstract: Music, as a source of research, originating from the vulcanization of theoretical and methodological postulates of Cultural History, places in the academic setting, a series of possibilities, challenges and risks, originating from its largely subjective character. In particular, such a source requires an interdisciplinary dialogue to provide a fruitful process of historicity. Aiming to contribute to this debate, the article in question makes use of semiotics as a mechanism for such a dialogue in an attempt to discuss the symbols created by the Rock movement in the eighties, taking into account the lyrics and melody. It is expected that the proposal causes concerns, resolutions and irresolutions, fundamental to the   scientific development.

Keywords: Music – Symbol – Rock.

 
Linfadenitis por vacuna de bacilo Calmette-Guérin
Authors: Reyes-Cadena Armando
Published: August 2015

La linfadenitis por vacunación con bacilo de Calmette-Guérin (BCG) es la complicación más frecuente de esta vacuna. Se define como el crecimiento de los ganglios linfáticos regionales ipsilaterales posteriores a la vacunación, su incidencia se estima en < 0.4/1 000 vacunados menores de 1 año y en 0.03/1 000 vacunados de entre 1 y 20 años de edad.1 Se recomienda que este término se utilice cuando el crecimiento ganglionar se palpe con facilidad, el paciente se mantenga afebril y en buen estado general. Se manifiesta con mucha frecuencia entre las 2 semanas y los 6 meses después de la aplicación de la vacuna y la gran mayoría ocurre en un lapso de 24 meses.2,3
La importancia de la vacunación y el tratamiento con inmunoglobulina para pacientes con inmunodeficiencias primarias
Authors: Reda Shereen M , Cant Andrew J
Published: August 2015

Las inmunodeficiencias primarias son un grupo heterogéneo de enfermedades genéticas raras
que afectan el desarrollo o el funcionamiento de la inmunidad innata o la adaptativa. La mayoría de los pacientes que las padecen tienen mayor susceptibilidad a infecciones tanto comunes como raras, a veces con desenlace fatal. Por lo tanto es esencial ofrecer tratamiento rápido y eficaz para prevenir infecciones, proporcionando programas de vacunación adecuados
y administrando regularmente el tratamiento con inmunoglobulina G (IgG) de reemplazo, en
los trastornos con defecto en la producción o funcionamiento de los anticuerpos. En algunas
condiciones también está indicada la quimioprofilaxis con antibióticos y antifúngicos.

 
Consideración del problema de maltrato infantil en los planes de estudio de medicina y de especialidades médicas en México
Authors: Pérez-Rendón José Gabriel , Flores-Pérez Lizbeth , García-Piña Corina , Loredo-Abdalá Arturo , Trejo-Hernández Jorge , Casimiro-Victoria Arminda
Published: August 2015

Introducción: en México se estima que uno de cada diez niños sufre alguna forma de maltrato, pero solamente uno de cada 100 es detectado y atendido. Una posible razón es que el personal de salud no está adecuadamente entrenado o sensibilizado para detectar y referir estos casos, lo cual produce subregistro.

Objetivo: conocer si el tópico de maltrato infantil está incluido en los planes de estudio de licenciatura de la carrera de médico cirujano y en los programas de residencias incluidas en el Programa Único de Especialidades Médicas de la Facultad de Medicina de la Universidad Nacional Autónoma de México. 

Materiales y métodos: se buscó información acerca de la inclusión del tópico del maltrato infantil en los programas académicos de los planes de estudio de la carrera de médico cirujano en las escuelas y facultades de medicina certificadas durante 2008, así como de las 78 especialidades médicas incluidas en el Programa Único de Especialidades Médicas avalado por la Facultad de Medicina de la UNAM.

Resultados: A) Licenciatura: de 76 escuelas y facultades de medicina certificadas por la Asociación Mexicana de Facultades y Escuelas de Medicina, A.C., en 2008, se obtuvo la versión completa del plan de estudios de 20 (28.5%). En seis programas se documentaron contenidos sobre maltrato infantil (30.0% con respecto al número de programas recabados). En todos ellos, las asignaturas fueron obligatorias, de tipo presencial y ubicadas en el cuarto (n = 3) y quinto años de la carrera (n = 3). En todos los casos el maltrato infantil se ubicó en el área de pediatría y en un caso se incluyó también en las unidades didácticas de
psiquiatría y medicina legal. B) Posgrado: de 78 especialidades del Programa Único de Especialidades Médicas hubo contenidos sobre maltrato infantil en siete (8.97%, cuatro especialidades y tres subespecialidades); en dos de ellas el tópico aparece en el segundo año, en cuatro se ubica en el primero. En un programa no se especificó el nivel en que se debe cursar. El estudio de los contenidos fue obligatorio y presencial dentro del componente denominado “seminario de atención médica”.

Conclusiones: de acuerdo con la información obtenida, el tópico de maltrato infantil parece ser poco considerado en los planes de estudio de medicina. Por la magnitud del fenómeno, y la oportunidad que tiene el médico de atender este tipo de casos, es necesario incluirlo en todos los programas de formación médica. 
Síndrome del niño sacudido: cuadro clínico y evolución de 17 casos en el Instituto Nacional de Pediatría
Authors: Loredo-Abdalá Arturo , Casas-Muñoz Abigail , Trejo-Hernández Jorge , Melquiades-Parra Isabel , Martín-Martín Verónica
Published: August 2015

Introducción: el síndrome del niño sacudido es una modalidad grave del maltrato infantil: afecta al cerebro, la retina y a veces algunos huesos. Su frecuencia y características no se han precisado en México.

Objetivo: describir y determinar los posibles factores desencadenantes, los cuidadores, el cuadro clínico y la evolución de pacientes afectados por el síndrome del niño sacudido.

Materiales y métodos: estudio de serie de casos mediante el análisis de 17 expedientes de pacientes diagnosticados con síndrome del niño sacudido, en el Instituto Nacional de Pediatría, entre 2002 y 2010. 

 

Resultados: doce pacientes (70%) eran del sexo masculino; la edad promedio fue de 5.7 meses (límites de 2 a 14 meses). Los antecedentes en el niño que probablemente pudieron desencadenar el sacudimiento fueron: en 11 casos la irritabilidad (71%), en 8 (47%) el llanto inconsolable y en 6 la presencia de una enfermedad aguda (35%). En los padres se identificó como posible desencadenante impulsividad en cinco casos (29%), estrés en cinco (29%) y enojo en tres (18%). Los cuidadores habituales del menor fueron la madre en 11 casos (65%), los tíos en cinco (29%), ambos padres en cuatro (24%) y los abuelos en tres (18%); el padre presenció el inicio de los síntomas de gravedad en 6 casos (35%), los tíos en cuatro (24%), la madre en tres (18%) y ambos padres en dos (12%). El cuadro clínico se caracterizó por crisis convulsivas en 13 pacientes (76%), irritabilidad en siete (41%), dificultad respiratoria en siete casos (41%), cianosis en seis (35%) y rechazo al alimento en cinco (29%). En el hospital se corroboraron: crisis convulsivas en 14 casos (82%), alteraciones en el estado de conciencia en once (65%), necesidad de apoyo ventilatorio en siete (41%) e irritabilidad en tres (18%). La exploración de fondo de ojo reveló: hemorragia retiniana unio bilateral en 15 pacientes (88%), hemorragia vítrea en nueve (53%) y desprendimiento de retina bilateral en tres (18%). La tomografía axial
computada de cráneo mostró edema cerebral en diez casos (59%), hemorragia subaracnoidea en nueve (53%), hematoma subdural en cinco (29%) y fractura de cráneo en cinco (29%), alteraciones con las que se estableció el diagnóstico de síndrome del niño sacudido (71%) y síndrome de niño sacudido y azotado (35%). Fallecieron seis niños (35%). Todos los sobrevivientes (11 pacientes) tuvieron secuelas: daño visual (59%), daño motor (53%), crisis convulsivas (50%), problemas del lenguaje (41%) y problemas en la audición (18%).

Conclusión: el síndrome del niño sacudido es una forma de abuso físico que debe ser motivo de sospecha en un niño menor de un año que súbitamente presenta crisis convulsivas, dificultad cardiorrespiratoria o llega muerto al hospital.

 
Peso y talla en niños con retinoblastoma
Authors: Ridaura-Sanz Cecilia , Murata Chiharu , Ysusi-Mendoza Fátima , Leal-Leal Carlos
Published: August 2015

Introducción: la talla baja se ha descrito como característica clínica de niños con retinoblastoma. Esta particularidad puede estar relacionada directamente con la enfermedad de base o con factores externos. 

Objetivo: el propósito de esta investigación fue conocer la frecuencia de talla y peso bajos en niños mexicanos con retinoblastoma y correlacionar los valores antropométricos con variables de la enfermedad y ambientales.

Materiales y métodos: se analizaron expedientes clínicos de 346 pacientes con retinoblastoma. Se obtuvieron los datos de peso y talla referidos al ingreso; antes del tratamiento. Se comparó el valor de Z con las referencias de la distribución normal de la población mexicana. La asociación de las medidas antropométricas con las variables clínicas, sociales y genéticas se estableció con la prueba de c2.

Resultados: la talla y el peso promedio de los niños con retinoblastoma fueron significativamente más bajos que los de la población general (p < 0.001 y p = 0.013, respectivamente). La talla y peso bajos fueron más frecuentes en niños con enfermedad avanzada, provenientes de medio rural y de bajo nivel socioeconómico.

Conclusiones: los déficits en peso y talla en niños con retinoblastoma se deben a factores relacionados con enfermedad avanzada al momento del diagnóstico, lo cual a su vez es consecuencia de la situación de marginación de la población rural mexicana. Dado que la mayoría de las variables sociales y ambientales están muy relacionadas y que no podemos descartar posibles factores genéticos, las conclusiones de este estudio deben verificarse analizando las medidas de los padres y hermanos y establecer grupos comparativos para controlar las variables confusas.

 
Manejo paliativo de manifestaciones estomatológicas en un paciente pediátrico con leucemia en etapa terminal. Reporte de caso clínico
Authors: Rivera-Flores Lorena Guadalupe , De la Teja-Ángeles Eduardo , Durán-Gutiérrez Luis Américo
Published: August 2015

Los cuidados paliativos en México son programas de asistencia que surgen a partir de la atención de los pacientes con cáncer en la fase terminal de su enfermedad; evitan el sufrimiento del enfermo, aceptan los límites entre el tratamiento curativo y el paliativo, controlan el dolor y atienden los aspectos psicosociales y espirituales. El estomatólogo pediatra debe estar capacitado para poder ofrecer atención de su especialidad como parte del equipo multidisciplinario de cuidados paliativos y eliminar cualquier factor que pueda desencadenar dolor, infección o hemorragia, así como otros síntomas bucales habituales en estos pacientes. Se informa el caso de un paciente pediátrico con leucemia aguda linfoblástica en fase terminal y la intervención de cada uno de los servicios tratantes, incluyendo estomatología, para otorgar
al paciente confort y bienestar en los últimos días de vida.

 
Ecuaciones de predicción del gasto de energía en reposo en escolares de la Ciudad de México
Authors: Becerril-Sánchez Marlu Estephanie , Flores-Reyes Margarita , Ramos-Ibáñez Norma , Ortiz-Hernández Luis
Published: August 2015

Introducción: existen diferentes ecuaciones de predicción para estimar el gasto de energía en reposo en niños; sin embargo, no hay consenso de cuál es la más adecuada para usarse en población pediátrica mexicana.

Objetivo: conocer la concordancia del gasto de energía en reposo medido por calorimetría indirecta con el estimado con diferentes ecuaciones de predicción en un grupo de escolares de la Ciudad de México.

Material y método: se realizó un estudio transversal en escolares de 6 a 12 años de edad (n = 63). El gasto de energía en reposo fue medido mediante calorimetría indirecta, se usó como referencia para conocer la exactitud de las ecuaciones de predicción de Schofield, de FAO/OMS, de Tverskaya y de Harris-Benedict. Para conocer la concordancia entre las ecuaciones y el gasto de energía en reposo se estimaron coeficientes de correlación intraclase (r).

Resultados: en esta población las cuatro ecuaciones sobrestimaron el gasto de energía en reposo; en promedio, las diferencias fueron de 12.1 a 97.5 kcal/día. Las ecuaciones que tuvieron la mayor concordancia con el gasto de energía en reposo medido fueron las de Schofield y las de FAO/OMS (r = 0.74), mientras que las de Tverskaya y de Harris-Benedict tuvieron la menor (r = 0.64). La concordancia fue menor en los niños más pequeños, especialmente con las ecuaciones de Harris-Benedict (r = 0.33) y Tverskaya (r = 0.47).

Conclusiones: aunque se requiere más investigación sobre la conveniencia de usar ecuaciones de predicción del gasto de energía en reposo en población pediátrica de México, nuestros resultados muestran que las ecuaciones de FAO/OMS o las de Schofield son las más adecuadas.

 
Evidence and population consequences of shared larval dispersal histories in a marine fish
Authors: Shima Jeffrey S. , Swearer Stephen E.
Published: August 2015

Larval dispersal is disproportionately important for marine population ecolgy and evolution, yet our inability to track individuals severely constrains our understanding of this key process. We analyze otoliths of a small reef fish, the common triplefin (Forsterygion lapillum), to reconstruct individual dispersal histories and address the following questions: (1) How many discrete sets of dispersal histories (dispersal cohorts) contribute to replenishment of focal populations; (2) When do dispersal cohorts converge (a metric of shared dispersal histories among cohorts); and (3) Do these patterns predict spatiotemporal variation in larval supply? We used light traps to quantify larval supply, and otolith microstructure and microchemistry (using laser ablation inductively coupled plasma mass spectrometry; LA‐ICP‐MS) to reconstruct daily environmental histories of individuals in their 30‐d lead‐up to settlement. Our results indicate that a variable number of dispersal cohorts replenish focal populations (range of 2–8, mean of 4.3, standard deviation of 2.8). Convergence times varied (from 0 to >30 d prior to settlement), and larval supply was negatively correlated with cohort evenness but not with the number of cohorts, or when they converged, indicating disproportionately large contributions from some cohorts (i.e., sweepstakes events). Collectively, our results suggest that larval reef fishes may variably disperse in shoals, to drive local replenishment and connectivity within a metapopulation.
Origin of Overpressure in a Field in the Southwestern Malay Basin
Authors: Satti Iftikhar Ahmed , Ghosh Deva , Yusoff Wan Ismail , Hoesni M. Jamaal
Published: August 2015

This study demonstrates the use of wireline logs for the overpressure-mechanisms analysis in a field in the southwestern Malay basin. The development of overpressure means that the fluid movement in the pores is retarded, both vertically and laterally. In many Tertiary basins, overpressure is mainly generated by compaction disequilibrium caused by a high deposition rate and low permeability in shales. In the Malay basin, temperature and high-heat flow also play an important role in generating overpressure at a shallow depth, because the geothermal gradient is very high (40–60°C/km). Pore-pressure profiles and crossplots of sonic velocity/vertical effective stress and of velocity/density are used to derive the overpressure-generating mechanisms. The results obtained from the crossplots of 10 wells reveal that in the study area, overpressure is generated by both primary (compaction-disequilibrium) and secondary (fluid-expansion) mechanisms. The overpressure-magnitude analysis suggests that the overpressure generated by the secondary mechanism is very high compared with the primary mechanism. In all the wells, the Eaton (1972) method with an exponent of 3 gives good prediction when overpressure is the result of the compaction-disequilibrium mechanism, but it underpredicted the high pore pressure where the fluid-expansion mechanism is also present. However, by use of a higher Eaton exponent of 5 for the fluid-expansion mechanism, the overpressures are predicted quite well. The Bowers (1995) method, by use of the unloading parameter (U) of 6, is also used for pressure prediction and it gives a reasonably good prediction in the high-overpressure zone of all the wells.
Hydrochar production by hydrothermal carbonization of faecal sludge
Authors: Fakkaew K. , Koottatep T. , Pussayanavin T. , Polprasert C.
Published: August 2015

Faecal sludge (FS) management is a serious problem in developing countries which has caused environmental pollution and health risks. Hydrothermal carbonization (HTC) is an alternative technology that can be used to treat FS and convert it into a valuable solid product called hydrochar. This study evaluated the technical feasibility of hydrochar production from FS, determined the reaction kinetics of HTC of FS, and developed an empirical model which could estimate energy content of the produced hydrochar using the relevant parameters such as temperature (T), reaction time (t), moisture content (M), and volatile solid concentration (VS) in FS. The experiments were conducted with a 1-L high pressure reactor operated at the following conditions; T of 180–250 °C, t of 0.5–10.0 h, M of 70–95%wt, and VS of 40–340 g/L, which could produce at the energy content and hydrochar yield of 17–20 MJ/kg and 65%–80%, respectively. From these experimental data, an empirical model for determining energy content of the produced hydrochar was developed and validated satisfactorily with the literature data. Feasibility of applying the HTC process for FS treatment was discussed.
Availability and satisfactoriness of latrines and hand washing stations in health facilities, and role in health seeking behavior of women: evidence from rural Pune district, India
Authors: Steinmann Peter , Bratschi Martin W. , Lele Pallavi , Chavan Uddhavi , Sundaram Neisha , Weiss Mitchell G. , Juvekar Sanjay , Hirve Siddhivinayak
Published: August 2015

Water, sanitation and hygiene (WASH) installations are indispensable in health care facilities. Their quality might also influence the decision whether to visit a health facility. We investigated the WASH infrastructure in small health facilities in rural Pune, India, and surveyed expectations and satisfactoriness among women. The availability and quality of WASH installations was assessed in 12 facilities using a checklist. Dedicated questions in a household survey provided the community perspective, complemented by qualitative methods. A few public facilities had no latrine or hand washing station. On the contrary, all private facilities offered such installations. The bed/outpatient-to-installation ratio was also lower in private compared to public facilities. While most latrines were functional and well maintained, they often lacked garbage bins. Soap was often missing from hand washing stations. Dedicated latrines for women were rare. Women were generally satisfied with the WASH installations in the local health facility, but considered private facilities as better. WASH installations in health facilities are generally acceptable in private facilities while improvements are needed in some government facilities. Women expect WASH installations in health facilities, and view their quality in a broader framework of ‘cleanliness,’ which they consider when choosing facilities.
Effect of hydraulic loading on the performance of unplanted drying beds treating low-concentrated faecal sludge
Authors: Sonko El hadji Mamadou , Diop Cheikh , Mbéguéré Mbaye , Seck Alsane , Guèye Amadou , Koné Doulaye
Published: August 2015

To optimize faecal sludge (FS) treatment plants in operation in Dakar (Senegal), this study was conducted to test the effectiveness of the solid/liquid separation on unplanted drying beds under different loading rates and two operation strategies (one or two feedings per campaign). Clogging, purification performances, dryness and hygienic quality were monitored. Results have shown that the load fractionation has reduced the clogging. Only removals of total solids (TS) and slightly those of total Kjeldahl nitrogen and chemical oxygen demand are influenced by the loading rate and the feeding mode. The reduction of faecal coliforms (FC) and helminth eggs (HE) in leachates is, respectively, 1 log unit and 100%. Two to nine days were sufficient to obtain a dryness higher than 80% TS with nominal loads of 13.7–122 kg/m2*year. Concentrations of the dried sludge in FC and HE were, respectively, about 7.104 FCU/100 g and 46 eggs/g with a reduction of 3 log unit after 15 days of drying and 32% in the sludge stored during 30 days. Unplanted beds are not effective for the treatment of low concentrated FS. The use of other technologies such as planted drying beds could be advisable in these types of sludge.
Modelling biological oxygen demand in wastewater of Arak City, Iran
Authors: Sakizadeh Mohamad , Shayegan Eshagh , Lar Mojtaba Sheykh
Published: August 2015

Due to the fact that the laboratory analysis of biological oxygen demand (BOD) is time-consuming and uncertain because of some interferences during analysis, automatic estimation of BOD by modeling methods would be of great importance to researchers. The main aim of this study was to compare the performance of three models for the prediction of BOD in the wastewater of Arak City, Iran. The methods were artificial neural network (ANN with early stopping and ANN with Bayesian regularization), an Ensemble of ANN (EANN), and partial least squares regression. The models trained and were validated on a data set containing 18 parameters sampled periodically from the wastewater of Arak City. The performance of these models was assessed by mean squared error (MSE) and R2 of the test data set besides correlation coefficient of observed and predicted values of BOD for each model. Concerning the Bayesian regularization algorithm, the perfect fitting of the model to both training and test data with correlation coefficients of 0.999 and 0.945 confirmed that this method outperformed the results of other models. Moreover, the results of sensitivity analysis indicated that chemical oxygen demand (COD), next to sulfate and fecal coliforms are the most important parameters in the prediction of BOD by ANN modeling.