bluuebunny/crossref_metadata_2025 huggingface dataset:
Chaotic Mixing Analyses by Distribution Matrices
Authors: Anderson Patrick D. , Meijer Han E. H.
Published: May 2019

Distributive fluid mixing in laminar flows is studied using the concept of concentration distribution mapping matrices, which is based on the original ideas of Spencer & Wiley [1], describing the evolution of the composition of two fluids of identical viscosity with no interfacial tension. The flow domain is divided into cells, and large-scale variations in composition are tracked by following the cell-average concentrations of one fluid using the mapping method of Kruijt et al. [2]. An overview of recent results is presented here where prototype two- and three-dimensional time-periodic mixing flows are considered. Efficiency of different mixing protocols are compared and for a particular example the (possible) influence of fluid rheology on mixing is studied. Moreover, an extension of the current method including the microstructure of the mixture is illustrated. Although here the method is illustrated making use of these simple flows, more practical, industrial mixers like twin screw extruders can be studied using the same approach.
Calibration of a Commercial Kneader for Rheological Applications
Authors: Kealy Tim , Tiu Carlos
Published: May 2019

In the case of some highly viscous fluids, or thick pastes (such as those exhibiting high yield stress and/or high plastic viscosity), neither rotational nor tube type viscometers are suitable for rheological characterisation. Due to their capacity for generating and maintaining high torque or high rates of rotation, kneaders and mixers can often engender shear rates in excess of those of conventional rotational viscometers. Often these devices are instrumented, to measure and record the rate of rotation of the mixing blades and the related torque on the shaft turning the blades. The major problem facing users of these mixers lies in data interpretation, specifically in relating rate of rotation and torque data to shear rate and shear stress respectively. If it were possible to obtain such relationships, useful rheological data could be generated with instrumented mixers.
Blood Electrical Impedance Closely Matches Whole Blood Viscosity as Parameter of Hemorheology and Inflammation
Authors: Pop G.A.M. , Hop W.J. , Moraru L. , van der Jagt M. , Quak J. , Dekkers D. , Chang Z. , Gijsen F.J. , Duncker D.J. , Slager C.J.
Published: May 2019

Red blood cell aggregation (RBCa) is a sensitive inflammation marker. RBCa determination from erythrocyte sedimentation rate, ESR, is used since long, but is unspecific unless corrected for hematocrit, Ht. Whole blood viscosity measurement at low shear rate is also sensitive to RBCa but is cumbersome to apply. To investigate whether electrical blood impedance, being sensitive to spatial red cell distribution, can be a good alternative to determine RBCa in low shear conditions. Blood was collected from 7 healthy volunteers. From each 16 different samples were prepared with 4 different Ht’s and with 4 different fibrinogen concentrations. Viscosity was measured at low shear rate (4.04 s-1) with a rotational viscometer at 37˚C. Electrical blood impedance was measured during similar shear conditions and temperature in a specially designed cuvette. ESR was determined according to Westergren. A logarithmic increase of viscosity as well as of capacitance, Cm, is seen when fibrinogen rises and an exponential increase when Ht rises. However, ESR shows a logarithmic decrease with increasing Ht and an exponential increase when fibrinogen rises. The viscosity could be accurately described using an exponential model. Under similar low shear conditions and temperature in-vitro, either whole blood viscosity or electrical blood capacitance reflect red blood cell aggregation due to fibrinogen and Ht variation in a similar way.
Characterization of the Linear Viscoelastic Region in Suspensions of Zirconium Oxide: Cohesive Energy Obtained From the Critical Parameters
Authors: Megías-Alguacil David
Published: May 2019

The linear viscoelastic regions (L.V.R.) of suspensions of zirconium oxide particles were determined and characterized through the so-called "critical parameters". These are the values of shear-stress and strain at the crossover between the linear and the non-linear viscoelastic responses. From these magnitudes, the cohesive energy between the particles is calculated as a function of volume fraction of solids and at different electrolyte concentrations. The oscillatory measurements were carried out using a constant-stress rheometer at a fixed frequency of 1 Hz and increasing shear-stress. The suspensions cover a volume fraction range between 3% - 25% with electrolyte (sodium chloride) concentrations of 10-1 M, 10−2 M, 10−3 M and 10−5 M. Two different kinds of ZrO2 particles were used: commercially obtained -with no defined geometry- and spheres synthesized by us following the method described by Aiken, Hsu and Matijevic [1].
Discrete Relaxation Spectrum and K-BKZ Constitutive Equation for PVC, NBR and Their Blends
Authors: Sodeifian Gholamhossein , Haghtalab Ali
Published: May 2019

Frequency sweep experiments were performed on poly(vinyl chloride) (PVC) and acrylonitrile butadiene rubber (NBR) as well as their miscible blends PVC/NBR (70/30), PVC/NBR (50/50), and PVC/NBR (30/70) in oscillatory shear. The samples were prepared by mechanical blending at 160˚C. In order to investigate the validity of time temperature superposition (TTS) principle the loss angle δ versus the logarithm of the absolute value of the complex modulus, G*, were plotted. It was shown that the TTS principle is not valid for the above-mentioned polymer materials and therefore they are not thermorheologically simple. Master curves of PVC, NBR, and PVC/NBR (50/50) blend were therefore obtained approximately. Using a nonlinear regression method, discrete relaxation spectra were determined for PVC, NBR, and PVC/NBR (50/50). To study non-linear viscoelasticity behavior, the experiments of steady shear, start up steady shear, and step strain were carried out. The damping function was determined by the step strain experiments. Using K-BKZ constitutive equation, the shear viscosity and the shear stress growth function were calculated from the discrete relaxation spectra and the damping function and then compared to experimental data. The K-BKZ constitutive equation provides very good prediction over the entire range of experimental results.
Rheological Testing of Xerographic Liquid Inks: A Need for Printing Technology
Authors: Valverde J.M. , Pérez A.T. , Castellanos A. , Viturro R.E.
Published: May 2019

Rheological properties of xerographic liquid inks of different concentrations of solid particles have been tested. Generally we have found that viscosity decreases with increasing shear rate, i.e. the system is pseudoplastic as corresponds to the break down of aggregated particles by the applied shear. The viscosity of inks may vary in orders of magnitude depending on solids concentration, reaching up values of ~ 108 Pas for solids concentration of 40 wt%. The existence of a yield critical stress has been discussed and we estimate that it increases exponentially with solids concentration. We have looked for possible differences in the rheological behavior of ink samples obtained either diluting more concentrated inks or drying less concentrated ones. Concentration and dilution of xerographic inks do not change their rheological properties meaning that the microscopic structure of the concentrated dispersion is broken (when diluting) and recovered (when drying) reversibly. On the other hand processed ink (previously subjected to high mechanical and electrostatic stresses) behaves differently than non-processed ink. The properties of processed inks are not totally recovered when diluting, manifesting itself in a higher effective apparent viscosity. This result should be of main concern to liquid ink based printing technologies, for which elimination of waste by recycling processed ink is a major goal.
A Quick Guide to Better Viscosity Measurements of Highly Viscous Fluids
Authors: Schweizer Thomas
Published: May 2019

The performance of tests with elastic liquids at high shear rates is cumbersome due to viscous dissipation heating, high normal forces, and - above all - edge fracture. This paper shows how such measurements can be improved and simplified over the conventional cone-plate technique by using a partitioned plate. For a polystyrene melt with zero shear viscosity 44.5 kPas at 190˚C, steady state viscosities can be obtained up to 100 s−1. For samples with twice the diameter of the sensing area of the tool, the strain beyond which disturbances can be noticed is about 2 - 3 times higher than for conventional cone-plate. As a consequence of the design, precise viscosity measurements can be made without knowing the exact radius of the sample and without well centring it. This geometry is ideal for quick and dirty loading. Drawbacks are that the tool requires regular cleaning of the ring gap, that it can only be fitted to rheometers with a non-displacing force measuring cell (force rebalance transducer), and that it is not suited to measure low viscous systems such as polymer solutions.
Present status of prophylactic thyroidectomy in pediatric multiple endocrine neoplasia 2: a nationwide survey in Japan 1997–2017
Authors: Matsushita Rie , Nagasaki Keisuke , Ayabe Tadayuki , Miyoshi Yoko , Kinjo Saori , Haruna Hidenori , Ihara Kenji , Hasegawa Tomonobu , Ida Shinobu , Ozono Keiichi , Minamitani Kanshi
Published: May 2019

Background

In Japan, prophylactic thyroidectomy involves out-of-pocket expense. The American Thyroid Association (ATA) recommends prophylactic thyroidectomy for medullary thyroid carcinoma (MTC) during early childhood in patients with multiple endocrine neoplasia type 2 (MEN2). The ATA reports a high frequency of postoperative complications in childhood, which also influenced the delay of prophylactic thyroidectomy in Japan.

Methods

This retrospective study of multiple medical centers in Japan included individuals aged <20 years diagnosed with germline RET mutations between 1997 and 2017. The onset and onset possibility were defined based on confirmed lesions or calcitonin levels. The definition of risk and prophylactic thyroidectomy were based on the ATA 2015 revised guideline.

Results

Twenty-one patients with MEN2 were enrolled (highest risk, n = 5; high risk, n = 5; and moderate risk, n = 11). The cumulative incidence of the onset/onset possibility reached 50% at 5 and 8 years and 100% at 9 years and 17 years in high- and moderate-risk patients, respectively. Of 7 patients with MEN2A, 71% underwent prophylactic thyroidectomy. Only one 5-year-old patient (C634Y) had increased serum calcitonin level after prophylactic thyroidectomy in the MEN2A group. The only permanent complication, which did not occur in patients who underwent total thyroidectomy alone, was hypoparathyroidism (33% of patients). This permanent complication occurred with clinically developed MTC. No permanent postoperative complications occurred in patients aged 5–6 years.

Conclusions

Prophylactic thyroidectomy reduces recurrence and postoperative complications in pediatric patients with MEN2. Early thyroidectomy based on only calcitonin level could possibly reduce thyroidectomy delay.
Competitive balance with unbalanced schedules
Authors: Lee Young Hoon , Kim Yongdai , Kim Sara
Published: May 2019

Many empirical studies on competitive balance (CB) use the ratio of the actual standard deviation to the idealized standard deviation of win percentages (RSD). This paper suggests that empirical studies that use RSD to compare CB among different leagues are invalid, but that RSD may be used for time-series analysis on CB in a league if there are no changes in season length. When schedules are unbalanced and/or include interleague games, the final winning percentage is a biased estimator of the true win probability. This paper takes a mathematical statistical approach to derive an unbiased estimator of within-season CB that can be applied to not only balanced but also unbalanced schedules. Simulations and empirical applications are also presented, which confirm that the debiasing strategy to obtain the unbiased estimator of within-season CB is still effective for unbalanced schedules.
The “Fiat 500L” commercial: A journey into Italian style
Authors: Paris Orlando
Published: May 2019

This essay will analyze a single script, the television commercial that advertises the Fiat 500L in the United States, released in 2013. This commercial has stimulated wide debate both in Italy and the United States. It was generally well received by the press, even if it did attract some criticism on the part of those who simply read it as the latest version of a series of stereotypes of Italian mores. Without neglecting the functional dynamic of advertising (narratological structure and underlying rhetorical devices), this analysis will focus in particular on the decisive role played by Italianness and the Italian language.
“May I tell you something?”: When questions do not anticipate responses
Authors: Alvanoudi Angeliki
Published: May 2019

This conversation analytic paper reports on the interactional functions of the Greek subjunctive polar interrogative clausena (su) po (káti)?‘may I tell you something?’ in informal Greek conversation (Corpus of Spoken Greek). It is shown that the clause is a practice for securing a multi-unit turn and prefacing big packages in interaction, such as arguments and tellings. It is argued that the interrogative clause is used as a discourse marker when it occupies the initial slot of an extended turn. By employing an interactional approach to grammar, this study brings sequential context, social action and practice into the analysis of the clausena (su) po (káti)?, and sheds light on the vehicular structure of social action and the emergence of linguistic devices that project multi-unit turns.
The "Double-edged Sword" of Institutional Power: COSATU, Neo-liberalisation and the Right to Strike
Authors: Runciman Carin
Published: June 2019

On 1 January 2019 amendments to the Labour Relations Act came into force that significantly altered and curtailed the right to protected strike action in South Africa. Internationally, the right to strike has been eroded in recent years with many countries adopting legal provisions that violate the International Labour Organization’s principles. Comparatively, the rights of South African workers to go on protected strikes remain better than many other places in the world, a reflection of the militant history of the South African labour movement. But the erosion of these rights, with the active support of the Congress of South African Trade Unions, should be a cause for concern for activists and labour scholars in South Africa and beyond. This article develops the Power Resources Approach to consider how union institutional power has entrenched neo-liberalism in South Africa. Grounding the analysis of institutional power within the analytical framework of corporatism allows this article to develop an analysis of institutional power that is attentive to class forces. This provides an avenue for understanding the “double-edged sword” of institutional power in the South African context in order to comprehend when and under what circumstances trade unions advance and defend the interests of the working class and when they defend those of capital.

 KEY WORDS: labour; neo-liberalism; institutional power; corporatism; South Africa
Male catheter insertion simulation using a low-fidelity 3D-printed model in undergraduate medical learners
Authors: Gillis Charlie , Harvey David , Bishop Nicole , Walsh Greg , Dubrowski Adam
Published: May 2019

Urinary catheter insertion is one of the most widely performed procedures in a clinical setting. Inexperienced cath- eterizations constitute a high percentage of urethral trauma in hospital settings, with as high as 75% of comorbidities related to inaccurate insertion. Simulation training can help learners feel more confident, shorten the learning curve, and provide a safe learning environment for novices to make, and learn from, mistakes. Three dimensional (3D)- printed simulation models are as effective as commercially available models for novice learners, and have the benefits of being inexpensive, anatomically correct, portable and can be easily modified and rapidly produced as needed. A 3D-printed male urinary catheter insertion simulation model, designed by MUNMed 3D, was offered to Memorial University medical students as part of pre-clerkship procedural training. Fourteen students were provided with a checklist for the procedure and the 3D-printed urinary catheter insertion simulator, and following the simulation, were asked to complete a 5-point Likert survey on their experience.The average self-reported skill before using the model was 1.29 (out of 5), which increased to 3.21 (out of 5). All 14 respondents selected either “agree” or “strongly agree” for the following four survey items: the simulation was an accurate anatomical representation, they would prefer learning on this simulation model before performing this procedure, they would recommend the model to other learners, and they found this model beneficial overall. Simulation training with a 3D-printed urinary catheter insertion simulator allows trainees the opportunity to become confident and familiarize themselves with the procedure before performing it on a real patient.
First-positive surveillance screening in an asymptomatic SDHA germline mutation carrier
Authors: White Gemma , Tufton Nicola , Akker Scott A
Published: May 2019

At least 40% of phaeochromocytomas and paraganglioma’s (PPGLs) are associated with an underlying genetic mutation. The understanding of the genetic landscape of these tumours has rapidly evolved, with 18 associated genes now identified. Among these, mutations in the subunits of succinate dehydrogenase complex (SDH) are the most common, causing around half of familial PPGL cases. Occurrence of PPGLs in carriers of SDHB, SDHC and SDHD subunit mutations has been long reported, but it is only recently that variants in the SDHA subunit have been linked to PPGL formation. Previously documented cases have, to our knowledge, only been found in isolated cases where pathogenic SDHA variants were identified retrospectively. We report the case of an asymptomatic suspected carotid body tumour found during surveillance screening in a 72-year-old female who is a known carrier of a germline SDHA pathogenic variant. To our knowledge, this is the first screen that detected PPGL found in a previously identified SDHA pathogenic variant carrier, during surveillance imaging. This finding supports the use of cascade genetic testing and surveillance screening in all carriers of a pathogenic SDHA variant.

Learning points:

SDH mutations are important causes of PPGL disease.

SDHA is much rarer compared to SDHB and SDHD mutations.

Pathogenicity and penetrance are yet to be fully determined in cases of SDHA-related PPGL.

Surveillance screening should be used for SDHA PPGL cases to identify recurrence, metastasis or metachronous disease.

Surveillance screening for SDH-related disease should be performed in identified carriers of a pathogenic SDHA variant.
Development of a Multidisciplinary Pediatric Airway Program: An Institutional Experience
Authors: Dalesio Nicholas M. , Diaz-Rodriguez Natalia , Koka Rahul , Kudchadkar Sapna , Jones Sara I. , Mark Lynette J. , Cover Renee , Pandian Vinciya , Tunkel David , Brown Robert
Published: May 2019

Rapid response teams have become necessary components of patient care within the hospital community, including for airway management. Pediatric patients with an increased risk of having a difficult airway emergency can often be predicted on the basis of clinical scenarios and medical history. This predictability has led to the creation of airway consultation services designed to develop airway management plans for patients experiencing respiratory distress and who are at risk for having a difficult airway requiring advanced airway management. In addition, evolving technology has facilitated airway management outside of the operating suite. Training and continuing education on the use of these tools for airway management is imperative for clinicians responding to airway emergencies. We describe the comprehensive multidisciplinary, multicomponent Pediatric Difficult Airway Program we created that addresses each component identified above: the Pediatric Difficult Airway Response Team (PDART), the Pediatric Difficult Airway Consult Service, and the pediatric educational airway program. Approximately 41% of our PDART emergency calls occurred in the evening hours, requiring a specialized team ready to respond throughout the day and night. A multitude of devices were used during the calls, obviating the need for formal education and hands-on experience with these devices. Lastly, we observed that the majority of PDART calls occurred in patients who either were previously designated as having a difficult airway and/or had anatomic variations that suggest challenges during airway management. By instituting the Pediatric Difficult Airway Consult Service, we have decreased emergent Difficult Airway Response Team calls with the ultimate goal of first-attempt intubation success.
Parental Refusal of Standard-of-Care Prophylactic Newborn Practices: In One Center’s Experience, Many Refuse One but Few Refuse All
Authors: Danziger Phoebe , Skoczylas Maria , Laventhal Naomi
Published: May 2019

OBJECTIVES:

Several interventions to reduce neonatal morbidity and mortality are universally recommended: intramuscular (IM) vitamin K (VK), erythromycin ophthalmic prophylaxis, and hepatitis B vaccine for newborns, and maternal pertussis vaccine. Despite robust efficacy and safety evidence, parental refusal of these practices is increasing. We sought to define the current declination rate and characterize the association between declination of 1 intervention and declination of the others.

METHODS:

A retrospective cohort study was performed of all inborn singletons admitted to the well newborn nursery over a 12-month period (November 15, 2015 through November 15, 2016) at a large quaternary center.

RESULTS:

In total, 3758 infants met inclusion criteria. 25% (n = 921) did not receive at least 1 of the 4 interventions. 13.6% (n = 511) did not receive the hepatitis B vaccine, 2.3% (n = 85) did not receive IM VK, 5.9% (n = 223) did not receive erythromycin, and 7.2% (n = 271) of mothers did not receive the prenatal tetanus, diphtheria, pertussis vaccine. Odds of refusal of IM VK were 6.2 times greater for infants delivered by a certified nurse midwife versus physician (95% confidence interval 3.3–11.6). Pattern of declination was variable; of 921 mother-infant dyads who did not receive at least 1 intervention, only 2 dyads received none of the interventions.

CONCLUSIONS:

Our study is one of the first in which patterns of refusal of standard-of-care perinatal practices are characterized. Alarmingly, one-fourth of our cohort did not receive at least 1 core infant health intervention. Our finding of only modest overlap in declination of each intervention carries implications for the development of targeted interventions.
Hematopoietic Stem Cell Transplantation: A Neonatal Perspective
Authors: Hall Erin , Shenoy Shalini
Published: May 2019

Allogeneic hematopoietic stem cell transplantation (HSCT) is indicated in various nonmalignant disorders that arise from genetic, hematopoietic, and immune system defects. Many of the disorders described here have life-threatening consequences in the absence of HSCT, a curative intervention. However, timing and approach to HSCT vary by disorder and optimum results are achieved by performing transplantation before irreversible disease-related morbidity or infectious complications. This article details the principles of HSCT in the very young, lists indications, and explores the factors that contribute to successful outcomes based on transplantation and disease-related nuances. It provides an overview into the HSCT realm from a neonatologist's perspective, describes the current status of transplantation for relevant disorders of infancy, and provides a glimpse into future efforts at improving on current success.
Investigating the Relationship between Volitional Strategies and Academic Achievement in a Flipped Learning Environment/Istraživanje odnosa voljnih strategija i akademskog postignuća u 'obrnutoj učionici'
Authors: Birgili Bengi , Seggie Nevra , Kızıltepe Zeynep
Published: June 2019

AbstractThis study was conducted to determine whether there is a relationship between academic volitional strategies and academic achievement in a flipped learning environment. Academic achievement entails an environment where students exert self-discipline on classroom tasks. By using volitional strategies, learners can enhance engagement on academic tasks and complete assignments more efficiently. Undergraduate students enrolled in a teacher education programme at a higher education institution in Turkey participated in the research. Academic Volitional Strategies Inventory (AVSI), with α = .87 internal consistency, was applied to a group of students. The obtained data were explored through Pearson correlation. The results showed a statistically significant positive relationship between AVSI scores and academic achievements (r =.39, p=<.05). Hence, volitional skills and academic achievements act in concert in a teacher education programme.Key words: correlational study; flipped learning; higher education; self-regulated learning; teacher education.---SažetakOva studija provedena je kako bi se utvrdilo postojanje veze između akademskih voljnih strategija i akademskog postignuća u 'obrnutoj učionici'. Akademsko postignuće podrazumijeva okolinu u kojoj studenti pokazuju samodisciplinu na nastavnim zadatcima. Studenti mogu povećati angažman tijekom akademskih zadataka koristeći se voljnim strategijama te ih učinkovitije izvršiti. Sudionici istraživanja bili su dodiplomski studenti upisani u program obrazovanja budućih učitelja na instituciji visokog obrazovanja u Turskoj. Na toj skupini studenata primijenjen je Upitnik akademskih voljnih strategija (AVSI) unutarnje konzistentnosti α = ,8. Dobiveni podatci istraženi su Pearsonovom korelacijom. Rezultati pokazuju statistički pozitivan odnos između AVSI rezultata i akademskih postignuća (r =,39, p=<,05). Stoga voljne vještine i akademska postignuća djeluju zajedno u programu obrazovanja učitelja.Ključne riječi: korelacijska studija; obrnuto učenje; visoko obrazovanje; obrazovanje učitelja; samoregulirano učenje
The Underpinning of Technical Training of Talented male Football athletes From 11 To 12 Years Old After A Training Year
Authors: Dr. Pham Thi Le Hang*,Dr. Nguyen Thi Gam
Published: May 2019

The aim of this was to underpin technical training in football players 11-12 years old.For improving technical skills in football players, sixty three talented male Vietnamfootball players 11-12 years old have participated in this quasi-experimental study.After modifying the complex of technical tests by our research group, the technicaltraining was underpinned due to their mistakes in technical skills. The quality andquantity of techniques were improved after designed technical training in this age.
An Old Uigur Version of the Kasibhāradvāja sutta Extended by a Poem
Authors: Zhang Tieshan , Zieme Peter
Published: May 2019

In this paper, we introduce some new fragments preserved at the Dunhuang Academy. These are five detached pieces of a Chinese scroll of the Prajñāpāramitāsūtra (Da banruo boluomiduo jing 大般若波羅蜜多經). The first text on the verso side is a conversation between a brahman and the Buddha. It is similar to the Kasibhāradvāja sutta which is a talk between a brahman working as a ploughman and the Buddha who comes to him to beg for food. One gets the impression that the Old Uigur text is essentially based on the Pāli text. After a long gap, the second text presents quatrains following the metrical structure of Buddhist verses, as they were widespread among the Old Uigurs. We edit the texts with transliteration and transcription, as well as offer an English translation accompanied by comments.
Impact of 21-Gene Breast Cancer Assay on Treatment Decision for Patients with T1–T3, N0–N1, Estrogen Receptor-Positive/Human Epidermal Growth Receptor 2-Negative Breast Cancer: Final Results of the Prospective Multicenter ROXANE Study
Authors: Dieci Maria Vittoria , Guarneri Valentina , Zustovich Fable , Mion Marta , Morandi Paolo , Bria Emilio , Merlini Laura , Bullian Pierluigi , Oliani Cristina , Gori Stefania , Giarratano Tommaso , Orvieto Enrico , Griguolo Gaia , Michieletto Silvia , Saibene Tania , Del Bianco Paola , De Salvo Gian Luca , Conte PierFranco ,   on behalf of the Veneto Oncology Network
Published: May 2019

Background

The ROXANE Italian prospective study evaluated the impact of the 21-gene Recurrence Score (RS) results on adjuvant treatment decision for patients with early breast cancer.

Materials and Methods

Nine centers participated. Physicians used the RS test whenever unsure about adjuvant treatment recommendation for patients with estrogen receptor-positive/human epidermal growth receptor 2-negative, T1–T3, N0–N1 early breast cancer. Pre-RS and post-RS treatment recommendations were collected.

Results

A total of 251 patients were included. N0 patients (61%) showed higher grade (p < .001) and higher Ki67 (p = .001) and were more frequently progesterone receptor negative (p = .012) as compared with N1 patients. RS results were as follows: <11, n = 63 (25.1%); 11–25, n = 143 (57%); and ≥26, n = 45 (17.9%). Higher RS was found in N0 vs. N1 patients (p = .001) and in cases of G3 (p < .001) and higher Ki67 (p < .001). The rate of change in treatment decision was 30% (n = 75), mostly from chemotherapy (CT) plus hormone therapy (CT + HT) to hormone therapy (HT; 76%, n = 57/75). The proportion of patients recommended to CT + HT was significantly reduced from pre-RS to post-RS (52% to 36%, p < .0001). CT use reduction was more evident for N1 patients (55% to 27%) than for N0 patients (50% to 42%) and was observed only in cases of RS ≤17.

Conclusion

Physicians predominantly used the 21-gene assay in N0 patients with a more aggressive biology or in N1 patients showing more indolent biology. In this selected patient population, the use of RS testing led to a 30% rate of change in treatment decision. In the N1 patient subgroup, the use of RS testing contributed to reduce CT use by more than half.

Implications for Practice

This study shows that, even in a context in which physicians recommend a high proportion of patients to endocrine treatment alone before knowing the results of the Recurrence Score (RS) assay, the use of the RS test, whenever uncertainty regarding adjuvant treatment recommendation is present, significantly contributes in further reducing the use of chemotherapy, especially for N1 patients.
Safety and Success of Repeat Lung Needle Biopsies in Patients with Epidermal Growth Factor Receptor-Mutant Lung Cancer
Authors: Fintelmann Florian J. , Troschel Fabian M. , Kuklinski Martin W. , McDermott Shaunagh , Petranovic Milena , Digumarthy Subba R. , Sharma Amita , Troschel Amelie S. , Price Melissa C. , Hariri Lida P. , Gilman Matthew D. , Shepard Joanne O. , Sequist Lecia V. , Piotrowska Zofia
Published: May 2019

Background

Postprogression repeat biopsies are critical in caring for patients with lung cancer with epidermal growth factor receptor (EGFR) mutations. However, hesitation about invasive procedures persists. We assessed safety and tissue adequacy for molecular profiling among repeat postprogression percutaneous transthoracic needle aspirations and biopsies (rebiopsies).

Materials and Methods

All lung biopsies performed at our hospital from 2009 to 2017 were reviewed. Complications were classified by Society of Interventional Radiology criteria. Complication rates between rebiopsies in EGFR-mutants and all other lung biopsies (controls) were compared using Fisher's exact test. Success of molecular profiling was recorded.

Results

During the study period, nine thoracic radiologists performed 107 rebiopsies in 75 EGFR-mutant patients and 2,635 lung biopsies in 2,347 patients for other indications. All biopsies were performed with computed tomography guidance, coaxial technique, and rapid on-site pathologic evaluation (ROSE). The default procedure was to take 22-gauge fine-needle aspirates (FNA) followed by 20-gauge tissue cores. Minor complications occurred in 9 (8.4%) rebiopsies and 503 (19.1%; p = .004) controls, including pneumothoraces not requiring chest tube placement (4 [3.7%] vs. 426 [16.2%] in rebiopsies and controls, respectively; p < .001). The only major complication was pneumothorax requiring chest tube placement, occurring in zero rebiopsies and 38 (1.4%; p = .4) controls. Molecular profiling was requested in 96 (90%) rebiopsies and successful in 92/96 (96%).

Conclusion

At our center, repeat lung biopsies for postprogression molecular profiling of EGFR-mutant lung cancers result in fewer complications than typical lung biopsies. Coaxial technique, FNA, ROSE, and multiple 20-gauge tissue cores result in excellent specimen adequacy.

Implications for Practice

Repeat percutaneous transthoracic needle aspirations and biopsies for postprogression molecular profiling of epidermal growth factor receptor (EGFR)-mutant lung cancer are safe in everday clinical practice. Coaxial technique, fine-needle aspirates, rapid on-site pathologic evaluation, and multiple 20-gauge tissue cores result in excellent specimen adequacy. Although liquid biopsies are increasingly used, their sensitivity for analysis of resistant EGFR-mutant lung cancers remains limited. Tissue biopsies remain important in this context, especially because osimertinib is now in the frontline setting and T790M is no longer the major finding of interest on molecular profiling.
Navigating Challenging Conversations About Nonmedical Opioid Use in the Context of Oncology
Authors: Sager Zachary , Childers Julie
Published: May 2019

Opioids are commonly used in the context of oncology to treat cancer-related pain. In the context of increased awareness of nonmedical use of opioids, including misuse and opioid use disorder among individuals with cancer, oncologists may find themselves having difficult conversations with patients regarding the use of opioids. We offer a review of pertinent literature and a conversation framework for providers to use, as well as key communication strategies for clinicians. Building on the therapeutic alliance between provider and patient, emphasizing the importance of nonabandonment, and using a benefit-to-harm framework, we hope clinicians find they are more able to navigate these challenging but important conversations with patients.

Implications for Practice

Providers may find it difficult and uncomfortable to discuss nonmedical use of opioids with patients. To the authors’ knowledge, no previous articles discuss ways to communicate about nonmedical use of opioids in the oncology setting. This work borrows from other specialties and offers a communication framework and key communication strategies to help clinications communicate more effectively with patients who may have an opioid use disorder or may be using their prescribed opioids for reasons other than their pain.
As Emergências Ambientais no Paraná e as Intersecções com o Sistema Estadual de Proteção e Defesa Civil
Authors: Pinheiro Eduardo Gomes , Ferentz Larissa Maria da Silva , Fonseca Murilo Noli da
Published: May 2019

As emergências ambientais costumam afetar diretamente regiões urbanizadas ou o seu entorno, configurando-se como desastres urbanos. Desastres são provenientes de eventos extremos, sejam de origem natural ou de origem tecnológica, os quais resultam em diversos impactos negativos para as cidades. Estes fatores são consequência da falta de preparação de seus gestores e comunidades para o enfrentamento destas situações, além de uma cadeia de falhas desde o planejamento, legislação e fiscalizações ineficientes. Dessa forma, faz-se necessária a análise da organização estrutural dos órgãos públicos para atuar de forma a mitigar esses eventos ou seus efeitos. Nessa linha, encontra-se não um órgão apenas, mas um sistema chamado Proteção e Defesa Civil. O Estado do Paraná, possuidor de um histórico relevante em termos de emergências ambientais, encontra, na sua defesa civil, um núcleo agregador de instituições para tratar o tema. Este artigo se dedica a analisar essa estrutura, suas potencialidades e apresenta alternativas para o aprimoramento voltado à efetividade dos recursos existentes e disponíveis.
Dimensões sociais da resiliência a desastres
Authors: Marchezini Victor , Forini Henrique Almeida
Published: May 2019

Os estudos sociais sobre os desastres ainda são um tema de pouca pesquisa científica no Brasil, em particular àqueles que se referem aos processos de reconstrução e recuperação frente a desastres. Recentemente, esse debate tem sido impulsionado pelas ciências naturais e engenharias, que compreendem o desastre como um evento/acontecimento, ao qual cabe responder com estrategias de resiliência, isto é, de responder, fazer frente ao evento adverso. Surgido no campo das ciências biológicas e engenharias, o termo resiliência tem sido aplicado às sociedades humanas. Entretanto, a participação das ciências sociais nesse ainda é incipiente. O objetivo deste artigo é discutir o conceito de resiliência a desastres, sob a perspectiva da Sociologia dos Desastres. Essa reflexão é feita à luz da revisão bibliográfica, da pesquisa documental e da pesquisa de campo, de base qualitativa, realizada nos desastres em Ilhota/SC (2008) e São Luiz do Paraitinga/SP (2010). A partir desses elementos de pesquisa de campo, apresentam-se alguns caminhos metodológicos e teóricos para a compreensão do conceito de resiliência no âmbito da Sociologia dos Desastres. Por fim, recomendam-se alguns futuros percursos de pesquisa no tema.
El delito como castigo: las cárceles colombianas
Authors: Moreno Torres Aurora Inés
Published: June 2019

El objetivo de este estudio es analizar hasta qué punto la cárcel se convierte en un lugar de nuevos aprendizajes delincuenciales, donde la lucha por la supervivencia es un desafío diario y la falta de dinero deja al reo en estado de vulnerabilidad frente a los grupos u organizaciones delictivas que operan dentro del penal. La resocialización a través de una ocupación, el aprendizaje de un oficio y el estudio profesional son modalidades que deben existir en toda cárcel para evitar la reincidencia, para que el castigo resulte una oportunidad para aprender un nuevo oficio y para persuadir contra el delito. Contrario a esto, existe un alto índice de reincidencia y hacinamiento, que impide que el delincuente se aparte del delito. En este artículo se hace un análisis dentro de dos cárceles en Colombia.

 

Abstract

This article aims to analyze the extent to which the prison becomes a place of new delinquent learning, where the struggle for survival is a daily challenge and the lack of money leaves the prisoner in a vulnerable state in front of groups or criminal organizations who operate inside the prison. The re-socialization through an occupation, learning a trade and professional study are modalities that must exist in every prison to avoid recidivism, for the punishment to become an opportunity to learn a new trade and to persuade against crime. On the contrary, there is a high rate of recidivism and overcrowding, which prevents the offender from separating from the crime. This article presents an analysis inside two prisons in Colombia.
Crimen y castigo. Una reflexión desde América Latina
Authors: Coimbra Luiz Octavio , Briones Álvaro
Published: June 2019

Este artículo presenta el debate entre dos visiones relativas a la forma de enfrentar el fenómeno criminal. De una parte, aquella que establece que existe en los seres humanos la capacidad de decidir de forma racional su comportamiento y elegir libremente frente a los valores contrastados del delito y su castigo. De otra, la que plantea que el fenómeno delictivo puede tener raíces en situaciones sociales y económicas frente a las cuales es posible actuar corrigiendo anomalías sociales y previniendo el delito antes de que este se cometa. Para la primera de estas visiones, la sanción penal, la cárcel, representa exclusivamente el castigo; para la segunda, es el camino de la rehabilitación y la reinserción social. El artículo muestra que, entre estas dos alternativas, en la mayoría de los países latinoamericanos se ha optado durante las últimas décadas por la primera. En consecuencia, han adoptado políticas públicas de “mano dura”, que enfatizan el castigo por sobre la prevención y la rehabilitación. El artículo busca demostrar que ese camino no ha dado resultados, en relación con el objetivo de disuadir de la conducta delictual. En consecuencia, esa política debe ser modificada.

Abstract

This article presents the debate between two visions regarding ways to confront the criminality. On the one hand, the vision that human beings rationally decide their behavior and choose their options freely when facing the contrasted values ??of crime and punishment. On the other hand, the idea that criminality may have roots in social and economic situations in which it is possible to act by correcting social anomalies and preventing crime. For the first of these visions, the penal sanction, the prison, represents exclusively the punishment; for the second, it is the path of rehabilitation and social reintegration. The article shows that, between these two alternatives, most Latin American countries have opted for the first during the last decades. Consequently, they have adopted “iron-fist” public policies, which emphasize the punishment instead of prevention and rehabilitation. The article seeks to demonstrate that this path has not yielded results in relation to the objective of dissuading delinquent behavior. Consequently, that policy must be modified.
Vecinos en alerta: un rol difícil de institucionalizar. Estudio en la Ciudad de Buenos Aires
Authors: Dikenstein Violeta
Published: June 2019

En este artículo nos proponemos analizar la actividad de un conjunto de actores, residentes de un barrio del sur de la ciudad de Buenos Aires, que hacen de la inseguridad su ámbito de intervención, de ejercicio y de “trabajo”, a quienes denominamos –provisoriamente– vecinos en alerta. Desde una perspectiva cualitativa basada en la realización de entrevistas en profundidad con los actores implicados en el proceso estudiado y observación participante en los múltiples escenarios por donde circulan, reconstruimos los perfiles de los vecinos en alerta, el repertorio de actividades que llevan adelante, las relaciones que establecen entre sí y con otros actores, los lazos de coordinación y conflicto que entablan en este transcurso, así como las situaciones de interacción en las que este rol entra en juego. Hallamos que hay un repertorio compartido de actividades que desempeñan estos actores, variado dentro de ciertos límites. También, que el rol de vecino en alerta está sujeto a una constante negociación y redefinición, en las instancias de encuentro con diversas autoridades institucionales encargadas de la seguridad.

Abstract

In this article we propose to analyze the activity of a group of people, residents of a neighborhood in the south of the city of Buenos Aires, who make insecurity their area of intervention, exercise and "work", whom we call alert neighbors. From a qualitative perspective based on in-depth interviews with those involved in the process studied, and participatory observation in the scenarios where they circulate, we describe the profiles of the alert neighbors, the repertoire of activities that they carry out, the relationships they establish among themselves and with other actors, the bonds of coordination and conflict that they establish in this course, as well as the situations of interaction in which this role comes into play. We find that there is a shared repertoire of activities performed by these actors, varied within certain limits. Also, that the role of alert neighbor is subject to constant negotiation and redefinition, in the instances of meeting with various institutional authorities in charge of security.
Contribution analysis of electrical energy management in the industrial and commercial sector: a challenge to the Tanzania utility industry
Authors: Mohamed A.K. , Kahn M.T.E.
Published: June 2019

The investigation of electrical energy management (EEM) in the industrial and commercial sector determines how energy management affects elec-tricity consumption and what makes its potential for being used to reduce peak demand of utility indus-tries. The aim of this paper is to analyze the contri-bution of electrical energy management in the industrial and commercial sector and highlight its challenges to the Tanzanian utility industry. Energy efficiency technology analyzed in this paper includes energy efficiency lighting and power factor improvement. The analysis found that, if EEM is properly implemented, a significant amount of energy could be saved and could be converted to monetary benefits which might facilitate the devel-opment of other activities. The utility industry can benefit from saving considerable amounts of energy as well as the reduction of peak demand which can minimize the race of stumbling on new energy sources and construction of new power plants. The saved energy can be distributed to other consumers so as to improve accessibility or reliability of the electrical system and consequently minimize the impact of environmental pollution.
A Kinetic Photometric Method For Benzalkonium Chloride Determination In Eye Drops
Authors: Blazheyevskіy Mykola , Koval’ska Olena
Published: June 2019

A novel sensitive kinetic photometric method for the Benzalkonium Chloride (BAC) determination has been developed. The method is based on the ability to inhibit the reaction of Acetylcholine hydrolysis by cholinesterase. The reaction rate is evaluated by the non-hydrolysed Acetylcholine residue, which is determined by the amount of Peracetic acid, produced during the interaction with the excess of H 2 O 2 . Indicator reaction is an interaction of p-phenetidine with Peracetic acid that leads to the formation of 4,4'-azoxyphenetole with λ max = 358 nm (lg ε = 4.2). The conditions affecting the reaction (reagents concentration, pH, order of addition of reagents, stability in time) have been optimized. The linear dependence has been obeyed in the range of (1.4-8.4)·10 -6 mol L -1 of BAC with correlation coefficient of 0.999. The assay LOQ (20 % of the inhibition degree) has been 1.9·10 -6 mol L -1 . The proposed method has been successfully applied to the analysis of the eye drops and has shown an accuracy and reliability of the results obtained.
Criminal responsibility of minors under the criminal code of the Russian Federation and the criminal code of the Azerbaijan republic: comparative characteristics
Authors: Imanly M. N.
Published: May 2019

The specifics of criminal responsibility and punishment of minors in both the Criminal Code of the Russian Federation and the Criminal Code of the Azerbaijan Republic are regulated separately. At the same time, there are both coincident and different prescriptions in these codes. The paper identifies the advantages and disadvantages of the relevant criminal law provisions in the legislation of the Russian Federation and the Azerbaijan Republic. In the course of analyzing the criminal codes, the author shows which standards of the Criminal Code of the Russian Federation may be useful to the Criminal Code of the Azerbaijan Republic and vice versa. Some provisions on the criminal responsibility of minors are proposed to be removed from the criminal legislation of both countries, while others are to be introduced into it.