bluuebunny/crossref_metadata_2025 huggingface dataset:
A checklist of the termites of Kruger National Park, South Africa
Authors: Lind Brianna M. , Davies Andrew B.
Published: April 2019

The protection of biodiversity is critical to ecosystem function and is a primary management goal for conservation areas globally. Maintaining a current inventory of known diversity is a central component of achieving this goal and serves as an essential starting point for future research endeavours. Since the first published survey of termites in South Africa’s Kruger National Park (KNP) over 55 years ago, our understanding of termite diversity has expanded sufficiently to merit an update and formal checklist. Here we revise the inventory of termite diversity in KNP and summarise the taxonomic and functional diversity of termites in the park. A thorough review of recent termite research in KNP added 6 new genera and 13 species to what was found in Coaton’s original survey, with one genus, Anenteotermes, recorded for the first time in southern Africa. Based on the updated species checklist, the majority of genera in the park belong to Feeding Group II (39%) and the Termitidae family (75%).Conservation implications: In savannas, termites play crucial roles in nutrient cycling, water redistribution and plant dynamics. Systematically cataloguing termite diversity and assemblage composition in the park provides an essential baseline for scientific research, aids biodiversity conservation efforts and encourages scientists and managers to consider termites in ecosystem functioning and management. Having more detailed descriptions of genera, species and feeding groups allows for more tangible, ecologically relevant attributions of termite influence, facilitates enhanced inquiry and allows for more realistic quantification of termite roles in key ecosystem processes.
Network meta-analysis: application and practice using R software
Authors: Shim Sung Ryul , Kim Seong-Jang , Lee Jonghoo , Rücker Gerta
Published: April 2019

The objective of this study is to describe the general approaches to network meta-analysis that are available for quantitative data synthesis using R software. We conducted a network meta-analysis using two approaches: Bayesian and frequentist methods. The corresponding R packages were “gemtc” for the Bayesian approach and “netmeta” for the frequentist approach. In estimating a network meta-analysis model using a Bayesian framework, the “rjags” package is a common tool. “rjags” implements Markov chain Monte Carlo simulation with a graphical output. The estimated overall effect sizes, test for heterogeneity, moderator effects, and publication bias were reported using R software. The authors focus on two flexible models, Bayesian and frequentist, to determine overall effect sizes in network meta-analysis. This study focused on the practical methods of network meta-analysis rather than theoretical concepts, making the material easy to understand for Korean researchers who did not major in statistics. The authors hope that this study will help many Korean researchers to perform network meta-analyses and conduct related research more easily with R software.
El dibujo y la arquitectura en la obra de Lyonel Feininger: del prismatismo cubista a la abstracción espiritual
Authors: Linares García Fernando
Published: April 2019

Este artículo rinde homenaje a la figura del pintor y profesor germano-estadounidense Lyonel Feininger, uno de los principales maestros de la Bauhaus, a los 100 años de su primera exposición individual en Berlín, en 1917. Feininger fue un artista independiente y muy versátil, gran cultivador del dibujo como principio y fin de su obra, sobre todo del apunte in situ; dominador de multitud de técnicas gráficas y pictóricas: cómic, caricatura, grabado, carboncillo, acuarela, óleo, maquetas, etc. Bebió de las fuentes de numerosas vanguardias, desde el expresionismo hasta la abstracción, pasando por el cubismo y el orfismo, y culminando en su particular “prismatismo”, pero sin llegar a vincularse del todo con ningún movimiento en concreto. Destacó en el trascurso de su vida por una evolución plástica y una búsqueda espiritual muy personal de las que este escrito da cuenta.
conversando con...RCR arquitectes. Parte II: Ad Naturam. De la construcción del paisaje y de la ciudad
Authors: Merino Gómez Elena , Moral Andrés Fernando , Delgado Jiménez Alexandra
Published: April 2019

RCR arquitectes no repiten caminos recorridos por otros anteriormente. Su anclaje en un contexto, casi rural, al tiempo que su paradójica expansión internacional muestran claramente por qué estamos ante uno de los equipos de arquitectos más singulares de nuestra contemporaneidad. Conversar con ellos es sencillo, sin ambages, son capaces de trasladarte a paisajes sugerentes gracias a sus palabras y a la vigorosidad que transmiten sus afirmaciones. RCR, de forma serena, nos presentan un mundo donde solo se puede entrar después de comprender el concepto de “creatividad compartida” pero sobre todo después de volver a entender que la arquitectura debe emocionar. Una obra que, como ellos señalan, avanza a partir de la experiencia de su quehacer diario. Este grupo de arquitectos, compañeros de escuela, inicia su recorrido en los años finales de la década de los ochenta del siglo pasado. Volvieron a su ciudad de origen, Olot, para desde ella poder involucrarse en un mundo global: Pritzker Architecture Prize, 2017.Médaille d’Or de l’Académie d’Architecture Française 2015. Chevalier de l’Ordre des Arts et des Lettres de la République Française 2008-14.International Fellows by the Royal Institute of British Architects (RIBA) 2012. Honorary Fellows by the American Institute of Architecture (AIA) 2010. Premi Nacional de Cultura en Arquitectura de la Generalitat de Catalunya 2005. Esta secuencia de reconocimientos no les ha apartado de su paisaje nativo, desde 1989 son arquitectos consultores del Parque Natural de la zona volcánica de La Garrotxa. Esta dualidad de cercanía y de expansión marca indeleblemente su forma de pensar y de hacer. Ese paisaje que les acoge, que estudian y entienden de forma profunda, les lleva a extrapolar esa sistemática a otros lares sin perder rigor ni sensibilidad. Dentro de este marco el dibujo se convierte en un instrumento clave para poder transmitir sus ideas profundas y libres de cualquier atadura física que las condicione. Su técnica, de raíces orientales, posibilita una transmisión de conocimiento sintético que impregna todas las decisiones posteriores desarrolladas por la oficina. Su obra sobre papel es el máximo ejemplo de esa singularidad que durante treinta años llevan construyendo.
Coherencia plástica: pintura y arquitectura de Joaquín Vaquero Palacios
Authors: Moreno Moreno María Pura
Published: April 2019

Este artículo pretende demostrar la coherencia plástica entre la obra construida por Joaquín Vaquero Palacios y una subjetiva visión pictórica desarrollada influyendo y en sinergia con su arquitectura a través de diferentes contextos. La pintura constituyó una actividad fundamental en su vida, y su objetivo confesado de integrar las distintas disciplinas artísticas ha sido ampliamente difundido gracias al análisis de sus proyectos construidos complementados con sus esculturas y sus murales pictóricos. Una vez reconocido ese esfuerzo, la metodología de esta investigación se alejará de dicho enfoque para tratar de establecer comparaciones, por etapas coetáneas, entre su pintura y su arquitectura. El propósito es descubrir cómo aspectos genéricos de sus cuadros y murales –corporeidad, espacialidad y monumentalidad; o más concretos como color, forma y equilibrio– se convirtieron en valores metapictóricos que traspasaron lo bidimensional, reflejándose tanto en lo espacial como en lo constructivo.
Direito internacional de águas e soberania: velhas e novas antinomias
Authors: Rodrigues de Quadros Jefferson , Cavalcanti e Silva Filho Erivaldo
Published: April 2019

As antinomias existentes entre o direito e a soberania não constituem discussões novas: remontam à própria formação do Estado. O direito internacional moderno, pautado por forte carga humanitária, reconhece a existência de bens jurídicos supranacionais, os quais não respeitam fronteiras, como o direito à água. O direito humano e universal ao acesso à água, instrumentalizado pelos fundamentos principiológicos do direito internacional de águas, como também pelos objetivos do desenvolvimento sustentável propostos pela ONU, por meio das premissas da Agenda 2030, enquanto plataformas jurídicas internacionais, resultaram por produzir proposições capazes de provocar uma novel discussão acerca das relações entre os Estados com as águas transfronteiriças. Os cursos de águas em bacias hidrográficas transfronteiriças desconhecem as fronteiras dos Estados, razão pela qual demandam a construção de modelos gestão que, não raras vezes, encontram-se inviabilizados na seara da efetividade, especialmente, em decorrência da complexidade de normas e procedimentos burocráticos estabelecidos pelos Estados que compartilham as suas bacias hidrográficas, o que, inexoravelmente, justifica a revisitação sobre o sentido de soberania no contexto contemporâneo. Assim, o objetivo deste artigo consiste em provocar uma reflexão sobre as antinomias existentes entre o direito internacional de águas e a soberania dos Estados, enquanto fatores de tensão comprometedores à governança hídrica e consequente gestão nas bacias hidrográficas transfronteiriças. A metodologia de pesquisa empregada foi a bibliográfica e documental, de natureza qualitativa, sendo utilizada a doutrina e a legislação especializada sobre soberania e direito internacional de águas.
Chamber-based insights into the factors controlling IEPOX SOA yield, composition, and volatility
Authors: D'Ambro Emma L. , Schobesberger Siegfried , Gaston Cassandra J. , Lopez-Hilfiker Felipe D. , Lee Ben H. , Liu Jiumeng , Zelenyuk Alla , Bell David , Cappa Christopher D. , Helgestad Taylor , Li Ziyue , Guenther Alex , Wang Jian , Wise Matthew , Caylor Ryan , Surratt Jason D. , Riedel Theran , Hyttinen Noora , Salo Vili-Taneli , Hasan Galib , Kurtén Theo , Shilling John E. , Thornton Joel A.
Published: April 2019

Abstract. We present measurements utilizing the Filter Inlet for Gases and Aerosols (FIGAERO) applied to chamber measurements of isoprene-derived epoxydiol (IEPOX) reactive uptake to aqueous acidic particles and associated SOA formation. Similar to recent field observations with the same instrument, we detect two molecular components desorbing from the IEPOX SOA in high abundance: C5H12O4 and C5H10O3. The thermal desorption signal of the former, presumably 2-methyltetrols, exhibits two distinct maxima, suggesting it arises from at least two different SOA components with significantly different effective volatilities. Isothermal evaporation experiments illustrate that the most abundant component giving rise to C5H12O4 is semi-volatile, undergoing nearly complete evaporation within 1 hour, while the second, less volatile, component remains unperturbed and even increases in abundance. We thus confirm, using controlled laboratory studies, recent analyses of ambient SOA measurements showing that IEPOX SOA is of very low volatility and commonly measured IEPOX SOA tracers, such as 2-methyltetrols and C5-alkene triols, result predominantly from artifacts of measurement techniques associated with thermal decomposition and/or hydrolysis. We further show that IEPOX SOA volatility continues to evolve via acidity enhanced accretion chemistry on the timescale of hours, potentially involving both 2-methyltetrols and organosulfates.
Sampling bias adjustment for sparsely sampled satellite measurements applied to ACE-FTS carbonyl sulfide observations
Authors: Kloss Corinna , von Hobe Marc , Höpfner Michael , Walker Kaley A. , Riese Martin , Ungermann Jörn , Hassler Birgit , Kremser Stefanie , Bodeker Greg E.
Published: April 2019

Abstract. When computing climatological averages of atmospheric trace-gas mixing ratios
obtained from satellite-based measurements, sampling biases arise if data
coverage is not uniform in space and time. Homogeneous spatiotemporal
coverage is essentially impossible to achieve. Solar occultation
measurements, by virtue of satellite orbit and the requirement of direct
observation of the sun through the atmosphere, result in particularly sparse
spatial coverage. In this proof-of-concept study, a method is presented to
adjust for such sampling biases when calculating climatological means. The
method is demonstrated using carbonyl sulfide (OCS) measurements at 16 km
altitude from the ACE-FTS (Atmospheric Chemistry Experiment Fourier Transform
Spectrometer). At this altitude, OCS mixing ratios show a steep gradient
between the poles and Equator. ACE-FTS measurements, which are provided as
vertically resolved profiles, and integrated stratospheric OCS columns are
used in this study. The bias adjustment procedure requires no additional
information other than the satellite data product itself. In particular, the
method does not rely on atmospheric models with potentially unreliable
transport or chemistry parameterizations, and the results can be used
uncompromised to test and validate such models. It is expected to be
generally applicable when constructing climatologies of long-lived tracers
from sparsely and heterogeneously sampled satellite measurements. In the
first step of the adjustment procedure, a regression model is used to fit a
2-D surface to all available ACE-FTS OCS measurements as a function of
day-of-year and latitude. The regression model fit is used to calculate an
adjustment factor that is then used to adjust each measurement individually.
The mean of the adjusted measurement points of a chosen latitude range and
season is then used as the bias-free climatological value. When applying the
adjustment factor to seasonal averages in 30∘ zones, the maximum
spatiotemporal sampling bias adjustment was 11 % for OCS mixing ratios at
16 km and 5 % for the stratospheric OCS column. The adjustments were
validated against the much denser and more homogeneous OCS data product from
the limb-sounding MIPAS (Michelson Interferometer for Passive Atmospheric
Sounding) instrument, and both the direction and magnitude of the adjustments were in agreement with the adjustment of
the ACE-FTS data.
Using the ECMWF OpenIFS model and state-of-the-art training techniques in meteorological education
Authors: Szépszó Gabriella , Sinclair Victoria , Carver Glenn
Published: April 2019

Abstract. The OpenIFS programme of the European Centre for Medium-Range
Weather Forecasts (ECMWF) maintains a version of the ECMWF forecast model
(IFS; Integrated Forecasting System) for use in education and research at
universities, national meteorological services and other institutes. The
OpenIFS model can be run on high-performance computing systems, desktop or
laptop computers to produce weather forecasts in a similar way to the
operational forecasts at ECMWF. Application of OpenIFS as a training tool is
wide ranging. At several universities, masters students are taught modelling
aspects via sensitivity studies, such as numerical stability, impact of
spatial resolution and physical parameterisation settings on the forecast
quality. The OpenIFS single column model is used to study a subset of
physical processes in the atmosphere. Participants of the OpenIFS user
workshops are trained through selected weather events on interpretation of
different forecasts, for example ensemble forecasts, probabilistic
information, seasonal forecasts. The OpenIFS user meetings and training
events demonstrate advanced and easy-to-use graphical tools and training
technologies. Metview is developed to analyse, visualise and evaluate the
forecast outputs. OpenIFS and Metview “virtual machines” relieve the
tutors from the difficulties often found in installing this software on the
local computing environment. They provide data, applications and documents
in a package tested in-house and deployed easily to another site. A further
step on virtualisation is utilising cloud servers, ensuring the
computational resources demanded by model runs are available in the cloud
space. This paper shows the education activity in the OpenIFS programme with
some examples.
Fine-scale vertical structure of sound scattering layers over an east border upwelling system and its relationship to pelagic habitat characteristics
Authors: Diogoul Ndague , Brehmer Patrice , Perrot Yannick , Tiedemann Maik , Thiam Abou , El Ayoubi Salaheddine , Mouget Anne , Migayrou Chloé , Sadio Oumar , Sarré Abdoulaye
Published: April 2019

Abstract. Sound scattering layers SSLs distribution and their relationship to pelagic habitat characteristics is a first step to understand their role in ecosystem dynamics and their interactions with other pelagic components such as small pelagic fish. In this study two areas of the Senegalese shelf have been characterized during upwelling season corresponding to a cold inshore area and a deeper and warmer stratified offshore area that was sharply separated by a strong thermal boundary. Marine pelagic organisms usually aggregates and occurs as SSLs on echosounder. Mean SSL thickness and SSL vertical depth increase with continental shelf depth; thickest and deepest SSLs were observed in the offshore part of the continental shelf. SSLs preferendum was reported for stratified water conditions rather than fresh upwelled water. The SSLs spatiotemporal variability was mostly explained by bottom depth which influence depth, thickness, and biomass of the SSLs. Diel period and water physico-chemical characteristics had also an effect on SSL depth and SSL thickness but not on SSL biomass. Despite chlorophyll-a has statistically no effect on SSLs structure, we report that the chlorophyll-a peak was always located above or in the middle of the SSLs, often matching with the peak of SSLs biomass. Such observations indicate trophic relationships, highlighting SSLs being mainly composed of phytoplanktivorous organisms. Acoustic mapping technique of mixed layer depth is not always efficient in east border upwelling system. Lastly, over the Senegalese continental shelf the level of dissolved oxygen was not found limitative (no hypoxia) for SSLs marine pelagic organisms during upwelling event.
Orthotanasia and dignified death in cancer patients: The perception of health professionals
Authors: Rimet Alves de Almeida Hélen , Freitas de Melo Cynthia
Published: April 2019

Objective: to analyze the perception about dignified death and orthothanasia in the view of health professionals who provide curative and palliative care in oncology. Method: this is a research with exploratory, qualitative approach. Saturation criteria included the participation of eight health professionals from the Cancer Institute of Ceará, Brazil: a physician, a nurse, a social worker and a psychologist of the palliative care team, and an oncologist, a nurse, a social worker and a psychologist of the curative care team. Three instruments were used: semi-structured interview; Free Word Association Test (WAT) with “cancer” and “orthothanasia” as inductive stimulus; and a Photo Projection Test (PPT) using five images. A textual analysis was carried out using the Iramuteq software to analyze the interviews. For the analysis of the WAT, the frequencies of the words of each stimulus were counted; then they were submitted to the word reduction technique and understood through simple frequency analysis. For the analysis of the PPT, the frequencies were counted, followed by analysis of meanings. Results: cancer is perceived by professionals as synonymous with death, pain and suffering, and orthothanasia as a practice of care and affection. The importance of the transition from curative care to exclusive palliative care is evident when there is no prognosis of cure, so as to offer quality of death and pain relief. This process can be facilitated by the acceptance of death and participation on the part of the family. The family must also receive care. Conclusion: health professionals recognize the importance and challenges of orthothanasia.
Validación de la Escala de Ansiedad Preoperatoria y de Información Ámsterdam (APAIS) en mujeres latinoamericanas con cáncer de mama: Estudio México - Costa Rica
Authors: Méndez-Meneses Karla Janeth , Rebolledo García María Luisa , Díaz Chacón Stephanie , Rodríguez Vázquez Luis Alberto , Acosta Maldonado Brenda Lizeth , Mantilla-Maya Blanca , González-Rodríguez Eva , Aguilar Ponce José Luis , Galindo Vázquez Oscar , Rivera-Fong Liliana
Published: April 2019

El tratamiento más frecuente contra el cáncer es la cirugía; sin embargo es un procedimiento invasivo que se ha asociado con la presencia de sintomatología psicológica hasta en el 76% de los pacientes. El estudio de la ansiedad ante la cirugía requiere de herramientas específicas adaptadas a las peculiaridades del constructo; entre ellas se encuentra la Escala de Ansiedad Preoperatoria y de Información Ámsterdam (APAIS) que ha sido validada en pacientes sometidos a diversas cirugías en múltiples países; mostrando consistentemente propiedades psicométricas adecuadas. Objetivo: Obtener la confiabilidad y validez de la APAIS en población oncológica para población latinoamericana. Método: Estudio transversal, no experimental, de análisis psicométrico que incluyó una muestra no probabilística de 117 mujeres con edades entre 25 y 75 años, todas diagnosticadas con cáncer de mama y programadas para cirugía en un hospital público de México (57 mujeres) o Costa Rica (63 mujeres). Resultados: Los seis reactivos de la Escala APAIS mostraron adecuada distribución de las contestaciones de las participantes entre las opciones de respuestas, tener capacidad de discriminación entre grupos extremos y contribuyeron a la consistencia interna del instrumento. El análisis factorial de máxima verosimilitud con rotación varimax mostró una estructura que explicó el 58,58% de la varianza con dos factores, la cual fue confirmada por análisis factorial confirmatorio; la escala total mostró una consistencia interna de α=0,816. Dicha escala mostró adecuada sensibilidad y especificidad con un punto de corte de 14 puntos. Conclusiones: La escala APAIS muestra propiedades psicométricas adecuadas para considerarla válida y confiable para evaluar ansiedad prequirúrgica en mujeres con cáncer de mama.
Correction: Quantifier spreading: Children misled by ostensive cues
Authors: Kiss Katalin É. , Mády Katalin , Zétényi Tamás
Published: April 2019

This article details a correction to the article É. Kiss, Katalin & Tamás Zétényi. 2017. Quantifier spreading: children misled by ostensive cues. Glossa: A Journal of General Linguistics 2(1). 38. DOI: https://doi.org/10.5334/gjgl.147
n. 10 - O PRINCÍPIO DE AUTONOMIA DOS INSTITUTOS FEDERAIS E SUA POLÍTICA EDUCACIONAL EM OPOSIÇÃO À REFORMA DO ENSINO MÉDIO
Authors: Heeren Marcelo Velloso , Da Silva Marta Leandro
Published: April 2019

O objetivo da presente pesquisa foi analisar a lei 13.415/17, que regulamenta a reforma do ensino médio, caracterizando os aspectos conflitantes em relação ao princípio de autonomia e da produção dos atos normativos específicos dos Institutos Federais (IFs). A pesquisa segue abordagem de pesquisa qualitativa em educação com destaque para a pesquisa/ e análise documental. Os Institutos federais possuem uma autonomia relativa condizente à sua natureza jurídica de “Autarquia Federal”. Essa condição legal determina que as ações políticas, pedagógicas, didáticas e estruturais dos IFs devem ser guiadas para a obtenção dos objetivos e finalidades para a qual a instituição foi criada. A lei 11.892/08 que instituiu a criação da Rede Federal de Educação defini suas finalidades e apresenta o Ensino Profissional Técnico de Nível Médio (EPTNM) na modalidade integrada como prioridade de oferta dos IFs. A resolução CEB/CNE n° 6/12 indica a formação integral do estudante como finalidade do EPTNM, objetivo contrário à formação fragmentada indicada pela reforma. Ainda é relevante ressaltar que as modificações no texto da LDB não fazem referência à EPTNM, fato este que também convalida a manutenção do modelo de ensino médio adotado pelos IFs. Existem indicações jurídico-normativas que possibilitam aos IFs a manutenção da sua política curricular, convalidando assim, o relativo grau de autonomia e as prerrogativas dos IFs diante da sua atuação política-pedagógica necessária para a consolidação das suas finalidades institucionais.
Durability of Smoking Cessation for Elective Lower Extremity Orthopaedic Surgery
Authors: Smith Danica H. , McTague Michael F. , Weaver Michael J. , Smith Jeremy T.
Published: April 2019

Introduction:

Smoking tobacco is a risk factor for impaired wound healing, infection, delayed fracture healing, and prolonged hospital stay. Smoking cessation before surgery has shown a 40% relative risk reduction in total perioperative complications. The primary purpose of this study was to evaluate the effectiveness of preoperative smoking cessation on long-term smoking habits in patients undergoing elective lower extremity orthopaedic surgery. The secondary outcome is patient-reported effectiveness of the smoking cessation method.

Methods:

A retrospective cohort study was performed by identifying all patients who were smokers that were required to quit and subsequently had a normal nicotine/cotinine serum test before lower extremity orthopaedic surgery. Attempts were made to contact all patients and administer a survey inquiring about their demographics, medical history, smoking history, smoking cessation process, and the current smoking status.

Results:

Of 36 eligible patients, 23 completed the survey. Eleven patients identified as current nonsmokers (48%) at the time of survey follow-up (mean follow-up was 55 months with a range of 12 to 88 months). Of these 11, 82% said they were very likely to continue to refrain from smoking. Twelve patients identified as current smokers at the time of survey, and more than half of them stopped smoking for at least three months perioperatively. The most effective smoking cessation techniques reported were “cold turkey,” “nonnicotine medication,” and “transdermal nicotine patches.”

Discussion:

Elective surgery offers a unique opportunity for smoking cessation. Of 23 patients required to quit smoking before surgery, 48% maintained smoking cessation for at least one year postoperatively. Of the 12 patients who relapsed, 55% stated that they did not resume smoking until at least 3 months postoperatively, suggesting that this particular period may be an important time for intensified smoking cessation counseling.

Level of Evidence:

Therapeutic level III
The Dynamic Relationship Between Stock and Real Estate Prices in Kuwait
Authors: Abul Sadeq J.
Published: April 2019

This paper examines empirically the dynamic relationship existing between the stock and real estate markets in the State of Kuwait for the period from January 2007 to December 2017. The main features of the real estate market in Kuwait are reviewed, and two indices are constructed to measure the activity of the residential real estate (land and houses) and multi-apartment buildings in the Kuwaiti real-estate market. The empirical analysis employs the main proper tests, such as the Johansen (1998) cointegration test and Vector Error Correction Model (VECM). These two tests confirm the long- and short-term association between Kuwaiti stock prices and multi-apartment building prices only, while no evidence of such a relationship is found for the residential real estate (land and houses) prices. This paper extends the literature available on the emerging stock markets, as the Kuwaiti Stock Market is one of the oldest stock markets in the member countries of the Gulf Cooperation Council (GCC). In addition, the results obtained in this paper have useful implications for academics and policy-makers in Kuwait.
Atenção integral à saúde da população LGBT: Experiência de educação em saúde com agentes comunitários na atenção básica
Authors: Albuquerque Mário Roberto Tavares Cardoso de , Botelho Nara Macedo , Rodrigues Cybelle Cristina Pereira
Published: April 2019

Objetivo: Relatar uma experiência de educação em saúde com agentes comunitários de saúde acerca da saúde da população LGBT na atenção básica. Métodos: Foi realizada uma ação de educação continuada por meio do estudo de casos escolhidos pelos agentes de saúde dentro de suas microáreas de atuação seguida de discussão em grupo e reflexão sobre as práticas vigentes. Resultados: Foram discutidos três casos apresentados pelos agentes de saúde que abordavam as temáticas de: (1) a escola e o preconceito; (2) a importância do apoio familiar e social; e (3) o papel da estratégia saúde da família e da educação em saúde. Percebeu-se que o tema permanece excluído das grandes discussões, sobretudo nas escolas médicas e na atenção básica, que é o primeiro contato do usuário com o Sistema Único de Saúde. Dessa forma, estratégias que objetivem discutir as peculiaridades da prevenção, promoção e assistência à saúde desses grupos devem ser estimuladas e reproduzidas tendo em vista uma melhor qualidade do atendimento a fim de captar esses pacientes em um ambiente favorável a práticas integrativas com respeito à diversidade sexual. Conclusão: Conclui-se que a atividade educacional realizada foi de extrema importância para desmistificar mitos e preconceitos envolvendo a saúde LGBT no cenário da atenção básica. Observou-se que após a atividade educacional os ACS se mostraram mais confiantes e sensibilizados sobre as temáticas abordadas e mudaram concepções no sentido de respeitar as decisões dos pacientes e realizar abordagem adequada para o acolhimento a esses usuários.
Entamoeba histolytica como causa de diarreia crônica
Authors: Castro Andreia Alves de , Bacalhau Filipe , Silva Francisco Ferreira e , Avillez Catarina , Batalheiro João
Published: April 2019

A diarreia crônica, caracterizada pela presença de mais de três dejeções de consistência pastosa durante pelo menos quatro semanas, é frequentemente encontrada na prática clínica. Na diarreia crônica, a probabilidade de uma etiologia infecciosa é baixa, sendo as causas funcionais, inflamatórias, osmóticas ou secretórias mais comuns. A amebíase intestinal é uma causa de diarreia crônica, causada pelo protozoário Entamoeba histolytica, sendo comum e prevalente em países em desenvolvimento. Pode ter várias formas de apresentação, sendo na maioria dos casos assintomática. Apresenta-se o caso clínico de um paciente de 27 anos, sexo masculino, raça caucasiana, homem que pratica sexo com homens (HSH), com diarreia crônica com início há cerca de seis anos. O exame objetivo não revelava alterações. Realizou exame parasitológico de fezes, com isolamento de quistos de Entamoeba histolytica. Foi medicado com metronidazol e paromomicina com resolução clínica do quadro. É importante para o Médico de Família equacionar esta etiologia na investigação de pacientes com diarreia, para um correto e atempado diagnóstico e tratamento, de modo a evitar exames desnecessários, possíveis complicações, a transmissãodo agente e um grave problema de saúde pública.
Autoimmune Lymphoproliferative Syndrome: An Overview
Authors: Matson Daniel R. , Yang David T.
Published: April 2019

Autoimmune lymphoproliferative syndrome (ALPS) is an inherited nonmalignant lymphoproliferative disorder characterized by heterozygous mutations within the first apoptosis signal receptor (FAS) signaling pathway. Defects in FAS-mediated apoptosis cause an expansion and accumulation of autoreactive CD4− and CD8− (double-negative) T cells, leading to cytopenias, splenomegaly, lymphadenopathy, autoimmune disorders, and a greatly increased lifetime risk of lymphoma. The differential diagnosis of ALPS includes infection, other inherited immunodeficiency disorders, primary and secondary autoimmune syndromes, and lymphoma. The most consistent pathologic feature is a florid paracortical expansion of double-negative T cells in lymph nodes. A presumptive clinical diagnosis can be made from symptoms and a constellation of laboratory test results. However, a definitive diagnosis requires ancillary testing and enables disease subclassification. Recognition of ALPS is critical, as treatment with immunosuppressive therapies can effectively reduce or ameliorate symptoms for most patients.
Delta-like Protein 3 Prevalence in Small Cell Lung Cancer and DLL3 (SP347) Assay Characteristics
Authors: Huang Richard S. P. , Holmes Burton F. , Powell Courtney , Marati Raji V. , Tyree Dusty , Admire Brittany , Streator Ashley , Newell Amy E. Hanlon , Perez Javier , Dalvi Deepa , ElGabry Ehab A.
Published: April 2019

Context.—

Delta-like protein 3 (DLL3) is a protein that is implicated in the Notch pathway.

Objective.—

To present data on DLL3 prevalence in small cell lung cancer and staining characteristics of the VENTANA DLL3 (SP347) Assay. In addition, the assay's immunoreactivity with other neoplastic and nonneoplastic tissues is outlined.

Design.—

Individual formalin-fixed, paraffin-embedded specimens of small cell lung cancer and tissue microarrays comprising neoplastic and nonneoplastic tissues were procured. Sections were cut and stained with DLL3 (SP347) assay. The slides were examined to determine prevalence, staining characteristics, and immunoreactivity.

Results.—

Cytoplasmic and/or membranous staining was observed in 1040 of 1362 specimens of small cell lung cancer (76.4%). Homogenous and/or heterogeneous and partial and/or circumferential granular staining with varied intensities was noted. Immunoreactivity was also observed in other neoplastic and nonneoplastic tissues.

Conclusions.—

Our study findings provided the profile of DLL3 staining characteristics that can be used for determining the level of DLL3 expression in small cell lung cancer.
Competencia matemática de los estudiantes andaluces: un análisis multinivel de la encuesta PISA 2015
Authors: Ramos Rodriguez Francisco Javier , Lara Porras Ana María , Molina Muñoz David
Published: April 2019

El objetivo de este trabajo es identificar los factores más importantes que afectan al rendimiento en matemáticas de los estudiantes de Andalucía. Para ello, se han tomado como base los datos del estudio PISA 2015.Para alcanzar este objetivo hemos seleccionado predictores relacionados con el alumno (género, condición de inmigrante, condición de alumno repetidor y nivel cultural y socio-económico familiar) y con la escuela (tipo de centro –público o privado–, localización –entorno rural o urbano– e índices de responsabilidad del centro en la gestión de los recursos o en el currículum y la evaluación) y hemos elaborado un modelo de regresión de dos niveles.Los resultados del análisis indican que la mayor parte de las variables con una influencia significativa en el rendimiento en matemáticas del alumnado son características de los propios alumnos tales como, la condición de inmigrante, la condición de alumno repetidor y el género femenino (en sentido negativo) y el nivel sociocultural y económico (en sentido positivo). Y en el ámbito escolar, las variables que presentan una mayor influencia son el índice de responsabilidad del centro en el currículum y la evaluación y la titularidad pública del colegio (ambas en sentido positivo).
La culpa la tiene Hipatia
Authors: Jiménez Ayala Elena Soledad
Published: April 2019

Vivimos en una sociedad donde las ciencias están en todo lo que nos rodea, particularmente las Matemáticas. Sin embargo, cuando entramos en las aulas nos encontramos ante situaciones que nos pueden resultar un tanto comprometidas o incluso, muy complicadas de resolver. El “para qué debo estudiar ecuaciones si no las voy a usar nunca” es una barrera a veces muy difícil de superar. Esto, como profesores, nos plantea el siguiente reto: inculcar el gusto por las ciencias, y en este caso, por las Matemáticas. Ello debe hacerse desde edades muy tempranas, y en particular, que las descubran por si mismos suele ser la mejor estrategia. Así pues, a lo largo de este trabajo se verán métodos que nos han resultado útiles para alcanzar nuestro objetivo. A través de películas como Hipatia de Alejandría o Dentro del Laberinto, se presentarán conceptos como: el cono de Apolonio, cónicas o grafos.Estos trabajos han sido realizados tanto por alumnos de secundaria, en este caso de 2º y de 4º de la ESO, como por profesores de secundaria de diferentes materias, ya que, por experiencia, sabemos que lo interdisciplinar funciona mejor. Como resultado obtuvimos un aumento en las solicitudes de alumnos en las ramas de ciencias y una visión de las Matemáticas más amplia por parte del profesorado involucrado.
Números enteros, relojes y criptografía
Authors: Felipe María José , Monserrat Francisco , Ortiz Sotomayor Víctor Manuel
Published: April 2019

Los rápidos avances científico-tecnológicos determinan un constante y raudo cambio tanto en la vida cotidiana como en la percepción del mundo que nos rodea, lo cual implica una necesidad de adaptación del conocimiento a dicho acelerado progreso. Sin embargo, los contenidos curriculares que se impartenen las asignaturas de matemáticas a lo largo de la Educación Secundaria (tanto en la ESO como en Bachillerato) adolecen, a nuestro entender, de un evidente estancamiento y no evolucionan de forma acorde a dicho progreso. Cuando a un alumno de Educación Secundaria se le menciona la palabra "matemática", en su mente aparecen, fundamentalmente, conceptos tales como ecuaciones, límites,derivadas, integrales, etc., todos ellos relacionados con la "matemática del continuo". Sin embargo, existen muchos aspectos de la "matemática no continua" que, bien por su belleza o por su utilidad, podrían tener un hueco más predominante en el currículum: teoría de números, combinatoria o teoríade grafos, por citar algunos ejemplos, que permiten acercar al estudiante de forma elemental al mundo de la informática y programación a través de aplicaciones computacionales sencillas aprovechando la variada disponibilidad de softwares de acceso libre en la web.
Thorax masculinization in a transsexual patient: Inferior pedicle mastectomy without an inverted T scar
Authors: Cely Adriana Marcela Gonzalez , Triana Carlos Enrique , Triana Lina Maria
Published: April 2019

Transsexual individuals with gender dysphoria or gender identity disorder are rare, with a prevalence reported to range from 0.002% to 0.014%. Studies have shown that mastectomy yields significant improvements in body image and self-esteem in female-to-male transsexual patients. In patients with grade III breast ptosis, mastectomy with a nipple-areolar complex (NAC) graft is the most commonly used technique, although it has several disadvantages. In the case described herein, a bilateral mastectomy preserving the NAC in an inferior pedicle was performed. Additionally, a thin superior thoracic dermal-fat flap was preserved and eventually sutured at the previous inframammary fold, preventing an inverted T scar. This case shows the advantage of this technique for preserving the blood supply and innervation of the NAC, with a low hypopigmentation risk. Furthermore, in this technique, the patch effect does not impair the results of the NAC graft, and there is no need to use an inverted T scar that may result in thoracic feminization.
Italian Version of the Risk Assessment and Prediction Tool: Properties and Usefulness of a Decision-Making Tool for Subjects’ Discharge after Total Hip and Knee Arthroplasty
Authors: Monticone Marco , Frigau Luca , Sconza Cristiano , Foti Calogero , Mola Francesco , Respizzi Stefano
Published: April 2019

Background: Growing attention is being given to standardized outcome measures to improve interventions for total hip arthroplasty (THA) and total knee arthroplasty (TKA). We culturally adapt and validate the Italian version of the Risk Assessment and Prediction Tool (RAPT-I) to allow its predictive use after THA and TKA.
Methods: The RAPT-I was adapted by forward–backward translation, a final review by an expert committee and a test of the pre-final version to establish its correspondence with the original version. The psychometric testing included test–retest reliability (intraclass correlation coefficient, ICC). The RAPT score was used to predict the subjects’ destination (<6: rehabilitation unit; 6–9: additional intervention before discharging home; or >9: discharge directly at home) by comparing the actual discharge destination with the predicted destination. The predictive effects of RAPT items on the discharge destination were further described by a logistic regression model (repeated leave-one-out bootstrap procedure).
Results: The questionnaire was administered to 78 subjects with THA and 70 subjects with TKA and proven to be acceptable. The questionnaire showed excellent test–retest reliability (ICC = 0.839; with 95% confidence interval (CI) of 0.725–0.934 for THA; ICC = 0.973, with 95% CI of 0.930–0.997 for TKA). The RAPT-I overall predictive validity was 87.2%, and the discharge destination was directly related to living condition (odds ratio (OR) = 2.530), mobility (OR = 2.626) and age (OR = 1.332) and inversely related to gait aids (OR = 0.623) and gender (OR = 0.474).
Conclusions: The RAPT-I was successfully adapted into Italian and proven to exhibit satisfactory properties, including predictive validity in determining discharge destination.
Language Teaching Methods to Students with Special Needs
Authors: Orazakynkyzy Farida , Sakipzhamal Uzakpayeva , Vinara Nurlanova , Marina Savankova , Klara Kabylgazina
Published: April 2019

The idea of this research paper arose out of an awareness that students with language learning disabilities are completely ignored in the educational system and there are no special programs that cater to these students. They are placed in normal schools that are not prepared to deal with their unique difficulties. This paper, therefore, is an attempt to provide teachers with multiple-strategies models for teaching English language skills to these students at the intermediate level and beyond. More specifically, this research will help pre-and in-service teachers to:

Identify effective strategies for learning and using language skills,
Use multiple-strategies models for teaching language skills,
Strategies for language learning and language use into regular language activities, and finally,
Both the processes and products of language learning of students with learning disabilities.

Thus, the target audience of this research includes pre-and in-service regular teachers, special education teachers, school psychologists, counsellors, and administrators.
Predictors of Locoregional Recurrence After Failure to Achieve Pathologic Complete Response to Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer
Authors: Gabani Prashant , Merfeld Emily , Srivastava Amar J. , Weiner Ashley A. , Ochoa Laura L. , Mullen Dan , Thomas Maria A. , Margenthaler Julie A. , Cyr Amy E. , Peterson Lindsay L. , Naughton Michael J. , Ma Cynthia , Zoberi Imran
Published: April 2019

Background:This study evaluated factors predictive of locoregional recurrence (LRR) in women with triple-negative breast cancer (TNBC) treated with neoadjuvant chemotherapy who do not experience pathologic complete response (pCR).Methods:This is a single-institution retrospective review of women with TNBC treated with neoadjuvant chemotherapy, surgery, and radiation therapy in 2000 through 2013. LRR was estimated between patients with and without pCR using the Kaplan-Meier method. Patient-, tumor-, and treatment-specific factors in patients without pCR were analyzed using the Cox proportional hazards method to evaluate factors predictive of LRR. Log-rank statistics were then used to compare LRR among these risk factors.Results:A total of 153 patients with a median follow-up of 48.6 months were included. The 4-year overall survival and LRR were 70% and 15%, respectively, and the 4-year LRR in patients with pCR was 0% versus 22.0% in those without (P<.001). In patients without pCR, lymphovascular space invasion (LVSI; hazard ratio, 3.92; 95% CI, 1.64–9.38;P=.002) and extranodal extension (ENE; hazard ratio, 3.32; 95% CI, 1.35–8.15;P=.009) were significant predictors of LRR in multivariable analysis. In these patients, the 4-year LRR with LVSI was 39.8% versus 15.0% without (P<.001). Similarly, the 4-year LRR was 48.1% with ENE versus 16.1% without (P=.002). In patients without pCR, the presence of both LVSI and ENE were associated with an even further increased risk of LRR compared with patients with either LVSI or ENE alone and those with neither LVSI nor ENE in the residual tumor (P<.001).Conclusions:In patients without pCR, the presence of LVSI and ENE increases the risk of LRR in TNBC. The risk of LRR is compounded when both LVSI and ENE are present in the same patient. Future clinical trials are warranted to lower the risk of LRR in these high-risk patients.
Advance Care Planning Improves Psychological Symptoms But Not Quality of Life and Preferred End-of-Life Care of Patients With Cancer
Authors: Tang Siew Tzuh , Chen Jen-Shi , Wen Fur-Hsing , Chou Wen-Chi , Chang John Wen-Cheng , Hsieh Chia-Hsun , Chen Chen Hsiu
Published: April 2019

Background: This study was conducted to examine whether a longitudinal advance care planning (ACP) intervention facilitates concordance between the preferred and received life-sustaining treatments (LSTs) of terminally ill patients with cancer and improves quality of life (QoL), anxiety symptoms, and depressive symptoms during the dying process. Patients and Methods: Of 795 terminally ill patients with cancer from a medical center in Taiwan, 460 were recruited and randomly assigned 1:1 to the experimental and control arms. The experimental arm received an interactive ACP intervention tailored to participants’ readiness to engage in this process. The control arm received symptom management education. Group allocation was concealed, data collectors were blinded, and treatment fidelity was monitored. Outcome measures included 6 preferred and received LSTs, QoL, anxiety symptoms, and depressive symptoms. Intervention effectiveness was evaluated by intention-to-treat analysis. Results: Participants providing data had died through December 2017. The 2 study arms did not differ significantly in concordance between the 6 preferred and received LSTs examined (odds ratios, 0.966 [95% CI, 0.653–1.428] and 1.107 [95% CI, 0.690–1.775]). Participants who received the ACP intervention had significantly fewer anxiety symptoms (β, −0.583; 95% CI, −0.977 to −0.189; P= .004) and depressive symptoms (β, −0.533; 95% CI, −1.036 to −0.030; P= .038) compared with those in the control arm, but QoL did not differ. Conclusions: Our ACP intervention facilitated participants’ psychological adjustment to the end-of-life (EoL) care decision-making process, but neither improved QoL nor facilitated EoL care honoring their wishes. The inability of our intervention to improve concordance may have been due to the family power to override patients’ wishes in deeply Confucian doctrine–influenced societies such as Taiwan. Nevertheless, our findings reassure healthcare professionals that such an ACP intervention does not harm but improves the psychological well-being of terminally ill patients with cancer, thereby encouraging physicians to discuss EoL care preferences with patients and involve family caregivers in EoL care decision-making to eventually lead to patient value–concordant EoL cancer care.