bluuebunny/crossref_metadata_2025 huggingface dataset:
THE USE OF HYBRID VEHICLES AS A PROPOSAL FOR REDUCING CO2 EMISSIONS AND ITS CONTRIBUTION TO REDUCING GREENHOUSE GAS EMISSIONS
Authors: De Carvalho C. A. R. , Lamas W. Q.
Published: October 2018

The problems related to energy consumption and pollutant emissions for thetransport sector represent a major global concern regarding climate changes caused by greenhouse gases, directly related to the increased level of gas emissions from fossil fuels , the main one being carbon dioxide. One way tominimize this problem is through the introduction of new technologies. Hybrid cars are one of the new technology options that has the main advantage of reducing fuel consumption and therefore reducing the amount of CO2 in the atmosphere. This paper gives an introduction to hybrid vehicles, with the aim of presenting their main advantages and evaluate their impact on emissions of CO2 in the Brazilian fleet, compared to conventional vehicles.
ERROR ANALYSIS IN THE NUMERICAL SOLUTION OF 3D CONVECTION-DIFFUSION EQUATION BY FINITE DIFFERENCE METHODS
Authors: Romão E. C. , Campos-Silva J. B. , De Moura L. F. M.
Published: October 2018

In this work an error analysis for numerical solution of 3D convectiondiffusionequation by finite difference methods has been done. The backward, the forward and the central difference schemes are applied for three applications: a case with diffusion dominant corresponding to high diffusion coefficients and two cases with convection dominant or with low diffusion coefficients. In the second application the convective coefficients are function only of the diffusion coefficient that in dimensionless form is named Reynolds numbers. In the third application the convective coefficients are function of both the Reynolds number and of the space. The three applications have analytical solutions to facilitate numerical comparisons of the solutions.
NUMERICAL SIMULATION OF AIR – WATER FLOWS IN AN EVAPORATIVE CONDENSER
Authors: Acunha Jr I. C. , Schneider P. S.
Published: October 2018

Evaporative condensers present a hard problem for numerical modeling because of the complex phenomena of heat and mass transfer outside of the bundle tubes in turbulent flows. The goal of this work is to study the air and water behavior inside an evaporative condenser operating with ammonia as the refrigerant fluid. A commercial CFD software package (FLUENT) is employed to predict the two-phase flow of air and water droplets in this equipment. The air flow is modeled as a continuous phase using the Eulerian approach while the droplets water flow is modeled as a disperse phase with Lagrangian approach. The coupling between pressure and velocity fields is performed by the SIMPLE algorithm. The pressure, velocity and temperature fields are used to perform qualitative analyses to identify functional aspects of the condenser, while the temperature and the relative humidity evolution contributed to verify the agreement between the results obtained with the numerical model and those presented by equipment manufacturer.
GFEM AND LSFEM IN THE SOLUTION OF THE TRANSIENT BIDIMENSIONAL CONVECTION-DIFFUSION EQUATION
Authors: Romão E. C. , Aparecido J. B. , Campos-Silva J. B. , De Moura L. F. M.
Published: October 2018

Convection dominated flows result in a hyperbolic system of equations which leads to ill-conditioned matrices and oscillatory approximations when using the classical Galerkin Finite Element Method (GFEM). In this paper, the Least Square Finite Method (LSFEM) is introduced in the study of transient bidimensional convection-diffusion problems. The differentiated equation of second order which describes the convective-diffusive phenomenon is transformed into an equivalent system of partial differentiated equations of first order which is discretized by the formulation of the LSFEM resulting in a defined algebraic, symmetrical and positive system. The performance of the method is verified by the solution of a test- problem.
A COMPARISON BETWEEN RANDOM AND DETERMINISTIC DYNAMICS OF RIVER DRAINAGE BASINS FORMATION
Authors: Marin C. A. , Errera M. R.
Published: October 2018

This work contributes to the discussion on how and why tree networks in drainage basin arises in nature. A fully deterministic erosion model recently developed was used to explain the spontaneous origin of river networks, which until then was assumed to be due to the optimal reduction of the flow resistance in a area to point flow. A random evolution model was devised in order to investigate the contribution of two separate features: the relative area size of the network and the structure (configuration) of the network. Two random models were applied, namely, restricted random choosing selection and fully random. Results showed that indeed the mere presence of low flow resistance portions of the basin does improve global performance and that randomness does not create networks. Further gain in performance is given by the network formation by erosion or by optimization. This suggest that local factors also are important to the explanation of the very existence of natural networks.
DEVELOPMENT OF A CORRELATION FOR EVALUATING THE CIGARETTE FIRMNESS FOR PRODUCTION QUALITY CONTROL
Authors: Nogueira F. G. , Orlando A. F.
Published: October 2018

Cigarette quality can be monitored in the market by evaluating its degree of rigidity, which is defined as the ratio of the final cigarette diameter, following a compression test, to its initial diameter, and is usually called cigarette firmness. Aiming the comparison between several products, the measured firmness is corrected to a previously specified reference moisture value by means of an exponential model, as validated and accepted by cigarette manufacturers. Following already qualified procedures, the firmness of eleven cigarette brands were measured in this work as a function of upright deformation, as produced by applying a standard load, mean circumference and specified tobacco moisture. The method of minimum squares was used for generating several correlations, together with the uncertainty evaluation, in order to achieve the one that could result in the lowest uncertainties, not estimated yet. The conclusion is that the tobacco characteristics are the largest contribution to the uncertainty of firmness measurement, resulting in a poor repeatability. On the basis of these results, it is suggested that a product acceptance criteria in the production line be established on the basis of the measurement uncertainties, using for reference the firmness value ranges usually accepted and tested by the market.
PREDICTING THE IMPACT OF A FCC TURBO EXPANDER ON PETROLEUM REFINERIES
Authors: Fermoselli N. E. G.
Published: October 2018

Implementing a turbo expander connected to a fluid catalytic cracking (FCC) unit in order to produce power from flue gas has already become a common practice in oil refineries worldwide. Despite of recovering energy which used to be wasted in an orifice chamber, the implementation of expander and its skids still requires high investment, which often begins with a third-stage cyclones installation to enhance flue gas cleanness. Moreover, machine and also pipes need to be made with special materials in order to resist high temperatures and erosion. Hence, there are some items to be checked before start up a turbo expander to ensure the return on investment will reach expectations, keeping in mind that its ability to extract energy from flue gas changes widely depending on FCC operational conditions. Then, the aim of this paper is to provide the analysis of one stage turbo expander which is fed with flue gas from partial combustion FCC unit and installed with isolation valves, highlighting some points which deserve special attention before start up this type of machine. It brings together some approaches to provide valuable information about a turbo expander, particularly when it is not running yet, including the results to a hypothetical case and the sequence of calculus that can be done without using any special software applied for: • To estimate real energy generation through the turbo expander as a function of FCC feed; • To check the leaks effect; • To predict the impact of turbo expander on carbon monoxide boiler, due to a fall in temperature of the expanded flue gas; • To calculate the appropriate amount of extra supplementary gas required to be burned in the flue gas boiler in order to keep the production of steam stable; • To analyze the moisture of the flue gas so that it may predicts condensation when hot gas comes into contact with the cold duct, after opening isolation valves; • And finally, how turbo expanders fit in cleaning development mechanism to get certified carbon credits.
STUDY OF THERMAL DECOMPOSITION AND IGNITION TEMPERATURE OF BAGASSE, COAL AND THEIR BLENDS
Authors: Mortari D. A. , Avila I. , Dos Santos A. M. , Crnkovic P. M.
Published: October 2018

In Brazil, due to its availability, sugar cane bagasse has a high potential for power generation. The knowledge of ignition behavior, as well as the knowledge of the chemical kinetics, in of fuels combustion process is important features in boilers projects and in the stability of the combustion process control. The aim of this study is to investigate the thermal behavior of sugar cane bagasse, coal and their blends. The methodology proposed by Tognotti et al. (1985) was applied to determine the ignition temperature for all samples. Ignition temperatures were 256oC for neat bagasse and 427oC for neat coal, and 275oC for both blends (50-50% and 25-75%). The Model-Free Kinetics was applied to determine the apparent activation energy (Eα) of the thermal decomposition of sugar cane bagasse. For the two major events of mass loss of bagasse which correspond to the thermal decomposition of organic matter (mainly hemicellulose, cellulose and lignin), average values of Eα were obtained for both combustion and pyrolysis processes. In synthetic air atmosphere, the Eα were 170.8±26.3 kJ⋅mol-1 and 277.8±58.6 kJ⋅mol-1, while in nitrogen atmosphere, the Eα were 185.0 ± 11.4 kJ⋅mol-1 and 82.1±44.4 kJ⋅mol-1. The results obtained can be explained by synergistic effects when both bagasse and coal were blended, changing the fuel reactivity.
LIME AND GYPSUM APPLICATIONS ON SOIL CHEMICAL ATTRIBUTES AND INITIAL GROWTH OF EUCALYPTUS
Authors: Gabriel Camila Adaime , Cassol Paulo Cezar , Simonete Marcia Aparecida , Moro Letícia , Pfleger Priscylla , Mumbach Gilmar Luiz
Published: October 2018

Eucalyptus crops in Southern Brazil are generally conducted in acidic soils, thus their yield can be increased by lime and gypsum applications. The objective of this study was to evaluate the effect of lime and gypsum applications on soil chemical attributes and initial growth of Eucalyptus benthamii and Eucalyptus dunnii in a Humic Cambisol (Inceptisol). The experiment was conducted in a greenhouse, with seedlings of both species of eucalyptus grown in soil treated with different rates of lime (0, 3, 6, and 12 Mg ha-1), and gypsum (0, 6, 3, 12.6, and 25.2 Mg ha-1). At 90 days after application of the treatments, the soil chemical attributes and growth components of eucalyptus seedlings. The lime increased the production shoot dry weight, however, the response to gypsum was negative. The lime increased the soil pH, exchangeable calcium (Ca), base saturation (V %), and slightly the soil electrical conductivity, decreased the soil aluminium saturation (m %), and promoted little reduction in the exchangeable potassium (K) and magnesium (Mg) contents. The gypsum didn't alter the soil pH, but decreased the m%, increased soil phosphorus (P) contents, and expressively increased the electrical conductivity, which may have had a negative effect on the eucalyptus growth. In conclusion, the addition of limestone decreases the soil acidity and benefits the growth of eucalyptus seedlings. However, the addition of gypsum has no expressive effects upon those variables, but it can decrease the growth of seedlings when the rates are excessive.
POLYPHENOLS IN YERBA MATE SEEDS: POTENTIAL INHIBITORS OF GERMINATION
Authors: Mireski Maria Cecília , Helm Cristiane Vieira , Wendling Ivar , Negra Elisa Serra , Dos Santos Álvaro Figueredo , Nogueira Antonio Carlos
Published: October 2018

Due to its economic, social, and ecological potentials, yerba mate can be a source of employment and income in the southern region of Brazil. The objectives of the present study was to (1) quantify the total polyphenols in fresh yerba mate seeds (FS), seeds dehydrated for 70 d (SD), and seeds stratified in sand for 180 d (SS); (2) evaluate the potential germination and growth inhibitory effects of water, ethanol + water (1:1), and ethanol (99%) extracts of yerba seeds (FS, SD, and SS) using lettuce seedlings; and (3) verify the presence of polyphenols in fresh seeds of yerba mate through histochemical methods. In the bioassay, extracts of yerba mate seeds were used in the germination of lettuce seeds. For the histochemical analysis, sections of yerba mate seeds were stained with specific dyes. The results revealed that yerba mate fresh seeds contain higher concentration of phenolic compounds, which decreased in dehydrated seeds, and almost no phenolic compound was observed in stratified seeds. The bioassay results showed that the polyphenols present in the extracts of yerba mate seeds resulted in phytotoxic effect on the roots of lettuce seedlings. The histochemical observations revealed the presence of “lignified rough barrier” and phenolic compounds between the endocarp and endosperm of the yerba mate seeds
USE OF MINI POLYTUNNELS FOR THE MAINTENANCE OF A CLONE GARDEN OF ACACIA MEARNSII DE WILDEMAN IN DIFFERENT SEASONS OF THE YEAR
Authors: Flôres Junior Paulo César , Engel Mara Luana , Ikeda Angela Cristina , Alcantara Giovana Bomfim , Higa Antonio Rioyei
Published: October 2018

The aim of this study was to verify the influence of mini polytunnels on the quality of shoots produced in a black wattle clone garden. The treatments used were: T1 – clone garden with mini polytunnels inside the greenhouse; T2 – clone garden with no mini polytunnels inside the greenhouse; T3 – clone garden with mini polytunnels outside the greenhouse; and T4 – clone garden with no mini polytunnels outside thegreenhouse. These four treatments formed a 4 x 3 factorial along with three seasons of the year: winter/2015, summer/2015-2016, and autumn/2016. A randomized block design was used with six blocks and ten cuttings per plot. Survival rate, number of shoots per cutting, and mean shoot length were evaluated. Shoots were collected from the cuttings and a rooting experiment with the same design was installed. Rooting rate, rate of shoots with calluses, number of roots per shoot, and mean shoot length per cutting were evaluated. There was interaction between the environment in the clone garden and the season of the year. In the winter, the treatment with mini polytunnels outside the greenhouse (T3) showed the best results, mainly in what concerns to the rooting of shoots. Shoots survived in the four clone garden environments, and the lowest survival rates were observed in the autumn/2016 season. The best responses were observed in the summer season.
Challenges of Medical Care Delivery in Professional Sports: Lessons From Professional Baseball
Authors: Duralde Xavier , Jones Troy , Griffith Timothy
Published: October 2018

Team medical management for professional sports teams is a demanding and high-risk activity. Every different sport has unique features and the stresses athletes place on themselves, be it from collisions or repetitive stress, result in specific challenges for the medical team and team organization in general. Injuries in professional sports are costly both to the player and organization. The challenges of managing a professional baseball team exemplify these concerns and correlate well with other professional sports. Multiple strategies exist for improvement of medical care in baseball based on observed deficiencies in player evaluation, injury prevention, and injury treatment, which will require prospective evaluation to determine their success. These include draft strategies, individualized motion and strength analyses, customized in-season and off-season training programs for individuals, and standardized treatment protocols for injuries all based on best practices. Best practices are currently poorly defined in all of these areas.
THE SPEECH RATE OF PEOPLE AT AN ADVANCED OLD AGE
Authors: Michalik Mirosław , Kaczorowska-Bray Katarzyna , Milewski Stanisław , Solak Anna
Published: October 2018

The aim of the article was to evaluate the rate of speech of people at an advanced old age and without any demential illnesses when compared to the control group of 9-years-old children without any developmental disorders. Because of the fact that the control group consisted of children, we have also made references to the notion of elderspeak – a phenomenon similar to the baby-talk – but related to the way younger people talk to senior citizens.

We tested the rate of speech in 32 subjects: the experimental group comprising 16 healthy people of an advanced old age without any neurodevelopmental illnesses (the average age: 83.1) and the control group, which included 16 children without any developmental disorders (the average age: 9.0) in order to achieve a correlation in terms of the male/female ratio for the comparative analysis. The analysed parameters included: the speaking rate, the articulation rate, the numer of pauses, and the ratio of pauses within the speech samples.

The estimative quantitative analysis showed insignificant differences in the parameters that influence the rate of speech in both groups. The statistical analysis also showed that there were no significant differences in the main research parameters – the speaking rate, the articulation rate, the number of pauses, and the ratio of pauses.

The research hypotheses regarding the differences in the speech rate of those at an advanced old age and of the children at the age of 9 were negated by the results of the ana lyses. It has been proven that the rate of speech of the elderly who age physiologically does not differ from the rate of speech production by the children.
HYPERBARIC THERAPY INFLUENCE ON PSYCHOMOTOR ABILITIES EFFECTIVENESS DEVELOPMENT – TWO CASES STUDY
Authors: Gotner Kacper , Gotner Robert , Pedrycz-Wieczorska Agnieszka , Wilczyńska Dominika , Jastrzębowska Grażyna , Dornowski Marcin
Published: October 2018

Background: Hyperbaric therapy is a relatively new non-invasive therapeutic method. It involves inhaling the patient with pure oxygen using a pressure of 2 to 3 absolute atmospheres (ATA). The main purpose of this therapy is to improve the healing mechanisms and repairing processes in the case of various types of wounds and diseases. While in medicine this method is quite popular, in sport it is rarely used today and if so than mainly for the purposes of faster return to full fitness of athletes after injuries or after heavy, intense training conditions.
Case study: Two subjects took part in the experiment. Training sessions were performed based on the selected original set of exercises within 29 days. Experiment participant was under conditions of increased pressure (2.5 ATA), during the session he breathed 100% oxygen, provided by the individual respiratory system. The measurement of muscle strength level of selected muscle groups, in selected motor tasks was estimated in (maximum weight – which is the maximum external resistance defeated in one repetition). It was found that there were increases in the level of muscle strength in selected muscles groups in first participant as a result of the applied set of exercises (motor tasks) and the effect of the hyperbaric sessions.
Conclusions: The results of the study show that there was a visible/significant influence of the hyperbaric session on increasing the muscle function based on strength training example. This method in combination with adequate strength training sessions could be used in many areas connected with psychomotor development of human abilities.
Selected clinical syndromes of genetic variability in pain sensation
Authors: Świtała Wojciech , Juszczyszyn Beata , Jurga Szymon , Pilchowska-Ujma Emilia
Published: October 2018

Pain sensation is variable both in animals and humans. Factors that influence the threshold and intensity of pain include race, ethnic origin, sex, material standard of living, stress exposure, environmental conditions and genetic factors. Methods used to identify potential gene variants responsible for the development of pain syndromes include identification of mutation or single nucleotide polymorphism (SNP), analysis of genetic variability in twins, and recently, genome wide association study (GWAS). Pain sensation disorders are the result of a single mutation, as in Biemond syndrome (congenital analgesia), erythromelalgia and paroxysmal extreme pain disorder, or polygenic mutations, as in fibromyalgia and migraine. Sensation of pain starts when the stimulus acts through chemical mediators to activate nerve endings. The signal is then transduced through neurons and spinal pathways to the brain. This process involves synaptic neurotransmitters, membrane receptors, neuromodulators and cell structures that ultimately affect the intensity of pain. The objective of this paper is to present selected clinical syndromes of genetically determined pain sensation disorders and the use of genetic diagnostics in explaining their cause.
Succinate Dehydrogenase–Deficient Renal Cell Carcinoma: A Short Review
Authors: Wang Gang , Rao Priya
Published: October 2018

Succinate dehydrogenase (SDH) is a mitochondrial enzyme complex composed of 4 protein subunits (SDHA, SDHB, SDHC, and SDHD). Germ line mutations of the genes encoding these SDH subunits result in hereditary syndromes harboring pheochromocytomas/paragangliomas, gastrointestinal stromal tumors, renal cell carcinomas, and pituitary adenomas. SDH-deficient renal cell carcinomas are rare, with a mean age of 38 to 40 years. Histologically, these tumors show a characteristic appearance that includes a solid, nested, or tubular architecture with variable cysts. Cells are typically cuboidal, have indistinct cell borders and eosinophilic cytoplasm, and show flocculent intracytoplasmic inclusions. Loss of immunohistochemical staining for SDHB is the hallmark of these tumors. Although most SDH-deficient renal cell carcinomas are clinically indolent, some tumors may behave aggressively, particularly those with a high nuclear grade, tumor necrosis, or sarcomatoid differentiation. Accurate classification of these tumors is important for clinical follow-up, screening, and genetic evaluation of the patients and other family members for this hereditary tumor syndrome.
Dedifferentiated Liposarcoma With Myofibroblastic Differentiation
Authors: Wang Grace Y. , Lucas David R.
Published: October 2018

Context.—

Liposarcoma is divided into myxoid, pleomorphic, well-differentiated, and dedifferentiated subtypes. Dedifferentiated liposarcoma displays the greatest histomorphologic diversity, including a subset with myofibroblastic differentiation that shares similarities with a spectrum of reactive, benign, and malignant soft tissue lesions. Misdiagnosis may lead to deleterious consequences, as dedifferentiated liposarcoma differs significantly in its prognosis and treatment from its mimics.

Objective.—

To review the clinicopathologic, immunohistochemical, and molecular features of the myofibroblastic variant of dedifferentiated liposarcoma as well as the key distinguishing features from its mimics.

Data Sources.—

Review of pertinent literature on major features and current understanding of dedifferentiated liposarcoma with myofibroblastic differentiation.

Conclusions.—

The myofibroblastic variant of dedifferentiated liposarcoma is an uncommon and underrecognized sarcoma with several important differential diagnoses, and likely represents the major subset of aggressive retroperitoneal tumors that may have been misdiagnosed as desmoid-type fibromatosis, inflammatory myofibroblastic tumor, or another type of sarcoma in the past.
Les obstacles sur la voie du sacerdoce chez les Inuits du Canada. Manernaluk, Sikkuaq et les Oblats
Authors: Laugrand Frédéric Benjamin
Published: October 2018

Au Canada, les Oblats de Marie-Immaculée ont participé intensivement à l’évangélisation des populations autochtones. Historiens et anthropologues ont analysé cette histoire complexe et mis l’accent sur les stratégies de ces missionnaires pour la plupart issus de France, de Belgique et d’autres pays européens. Ils ont cependant laissé de côté l’étude des vocations féminines et masculines autochtones. Cet article examine deux trajectoires masculines, celle d’Anthony Manernaluk et celle de Nick Sikkuaq, tout deux frères de sang et frères coadjuteurs. L’auteur montre que le célibat comme les exigences sociales des Oblats étaient difficilement acceptables et des obstacles pour le sacerdoce, les Inuits demeurant attachés à d’autres sociabilités.
Portrait de Brice Pauset en maître du temps jadis
Authors: Feneyrou Laurent
Published: October 2018

Compositeur français né en 1965, connaisseur et interprète des répertoires baroques
et classiques, mais empruntant aussi à la métrique antique et à la combinatoire médiévale,
Brice Pauset édifie une oeuvre où l’usage d’instruments anciens, principalement le clavecin,
porte l’influence de la musique française des xviie et xviiie siècles. Cet
article entend nouer l’usage par Brice Pauset de ces instruments, leur facture et les
tempéraments qui leur sont prescrits, ainsi que les techniques vocales anciennes, aux formes
musicales dans lesquelles ils se déploient, notamment le choral, sur les traces de Bach, et
le canon prolationnel, sur celles de Pierre de la Rue. L’article met ainsi en évidence un
principe commun à plusieurs oeuvres de Brice Pauset, celui d’une accumulation de trois
temporalités distinctes, et une exigence de rhétorique, sous le signe d’un procès
dialectique de l’Histoire.
The Legacy of the “Cyprus Codex” (MS. Torino J.II.9): Creating New Technologies and Compositions through a Collaborative Process
Authors: Sammoutis Evis , Sheppard Skaerved Peter , Hsu Timothy
Published: October 2018

MS. J.II.9 (also known as the “Cyprus Codex”) is an anonymous Codex composed in the court of Nicosia in the first part of the 15th century during Cyprus’s Frankish period and the Lusignan Dynasty. It is the only known Codex of Western music in the region and one of the few exclusively French codices known from that time. Its style lies in the threshold between Ars Nova and Ars Subtilior with unique features. Composer Evis Sammoutis, violinist Peter Sheppard Skaerved and Music technology professor Timothy Hsu have built a collaboration inspired by the legacy of MS. J.II.9. This resulted in the creation of new bows and techniques of performing the violin and the creation of new compositions based both on the material from MS. J.II.9 and technological advancements.
L’importance des ressources dans la construction identitaire du manager
Authors: Gagne Jean-François
Published: October 2018

La recherche sur la construction identitaire du manager a mis l’accent sur les constructions narratives offertes par le discours organisationnel, qui vont lui permettre de retrouver de l’autonomie et une capacité d’adaptation. Mais ces constructions identitaires restent fragiles et instables, soulignant l’importance de schémas disponibles pour les managers dans leur interaction avec l’environnement. Cette recherche explore en quoi les ressources, définies au sens d’actifs renouvelables qui aident l’individu dans son interaction avec le monde et regroupées autour de trois formes principales - ressources personnelles, ressources d’emploi et ressources relationnelles - sont contributives de la construction identitaire du manager.
La médiation par les artefacts visuels : une source spécifique dans la génération des connaissances nouvelles en situation ?
Authors: Chouki Mourad , Persson Sybille
Published: October 2018

Cet article contribue à la gestion des connaissances en examinant le processus de génération des savoirs à partir de la question de l’intercompréhension entre les acteurs. Le cadre théorique mobilise l’approche des knowledge boundaries dans une perspective pragmatique. A partir d’une observation in situ de six mois, il devient possible de souligner les difficultés d’intercompréhension entre un designer et un architecte. Le rôle des artefacts visuels apparaît alors clairement dans la médiation mise en oeuvre par les acteurs eux-mêmes, à la fois contraints et portés par la situation.
Le management relationnel d’une association de l’économie sociale et solidaire1
Authors: Phanuel Dominique
Published: October 2018

Les tenants de la « -Relational View- invitent à une lecture partenariale des parties prenantes de l’organisation. Cet article mobilise trois perspectives complémentaires des parties prenantes. L’approche normative exige la reconnaissance des parties prenantes, l’approche descriptive s’appuie sur leur connaissance et l’approche instrumentale ou stratégique fait référence au management du portefeuille relationnel. Comment identifier le portefeuille de parties prenantes de l’organisation ? Quelles stratégies relationnelles formuler et mettre en oeuvre ? Nous répondrons à ces questions à l’appui d’une étude de cas issue de l’économie sociale et solidaire : l’association « A.I.D.E.R ».
La collecte de fonds dans les établissements de santé : facteurs clefs d’efficacité
Authors: Busson-Villa Florence , Gallopel-Morvan Karine , Le Gall-Ely Marine
Published: October 2018

La collecte de fonds (ou fundraising) de la part des établissements de santé est une pratique très ancienne. Mais, en France, peu ont déployé une démarche professionnelle. A l’inverse, le fundraising est pratiqué dans un grand nombre de structures de santé aux Etats-Unis, au Québec. Par ailleurs, les travaux des chercheurs sur le sujet restent peu nombreux. L’objectif de cet article est donc exploratoire. Il vise à mettre en lumière les leviers, spécificités et caractéristiques du fundraising des établissements de santé en nous basant sur cette littérature parcellaire et des entretiens exploratoires menés auprès de 18 hôpitaux français et québécois.
Factitious disorders and the 'professional patient'
Authors: Lande Col. Raymond G.
Published: October 2018

Factitious disorders are fabricated illnesses. Conceptually, these disorders lie in the gray zone between malingering and real diseases. Clinical awareness will prevent unnecessary diagnostic and therapeutic interventions. The author profiles those patients and symptoms that accompany factitious disorders as well as factitious disorders by proxy. In the case of the latter, child abuse may be uncovered as well. Although rare, factitious disorders will be present in a busy primary care practice. Clinical detection based on patient profiles can aide discovery. Early recognition and management may prevent a chronic and debilitating course from culminating into one in which the person becomes a "professional patient."
Inferior glenohumeral dislocation (luxatio erecta humeri)
Authors: Padgham Michael , Walker James S.
Published: October 2018

A 67-year-old woman was seen in the emergency department because of severe pain and inability to move her left shoulder after falling on an abducted left arm. The fall was the result of a near-syncopal episode. On examination, the left arm was hyperabducted and elevated approximately 80 degrees from the horizontal plane. Furthermore, the patient was unable to move her left arm. Radiographs of the shoulder revealed an inferior dislocation of the glenohumeral joint. Closed reduction in the emergency department was successful. This rare but classic case of inferior glenohumeral dislocation (Iuxatio erecta humeri) serves to emphasize that a heightened awareness for this injury is necessary if it is to be recognized and treated appropriately. It is important to obtain orthopedic consultation or follow-up (or both) for this injury, because of the high incidence of accompanying tears of the rotator cuff. Neurovascular compromise is also commonly associated with this dislocation. The neurologic injuries are more common than the vascular injuries but tend to resolve after reduction.
The motherhood meanings for adolescents assisted by the family health strategy / O significado da maternidade para adolescentes atendidas na Estratégia de Saúde da Família
Authors: Torres Jaqueline D'Paula Ribeiro Vieira , Torres Silvério de Almeida Souza , Vieira Gedeon D'Paula Ribeiro , Barbosa Géssica Pereira , Souza Meriele Santos , Teles Mariza Alves Barbosa
Published: October 2018

Objetivo: Conhecer os significados da maternidade para as adolescentes atendidas pela Estratégia de Saúde da Família, no município de Montes Claros-MG/Brasil. Métodos: Trata-se de um estudo descritivo com abordagem qualitativa, cujos sujeitos foram 11 adolescentes mães cadastradas na ESF Santa Rafaela.  Resultados: Dentre os motivos que levaram a adolescente à gravidez, destacaram-se o desejo de ser mãe e a não utilização de métodos contraceptivos. Em relação às mudanças ocorridas após o nascimento do filho, as adolescentes revelaram a adoção de novas responsabilidades e o abandono de atividades relacionadas ao lazer, amizades, estudo e trabalho. Quanto aos projetos futuros, as adolescentes mães demonstram preocupações em prover uma boa qualidade de vida aos filhos. Conclusão: Contribui para o incremento da qualidade da assistência à saúde dos adolescentes, na elaboração de programas de intervenção e com outros estudos relacionados à maternidade na adolescência.
The consensual universe of family caregivers and their standing in the care services: a social representation study / O universo consensual do cuidador-familiar e sua ancoragem dentro do cuidado: um estudo de representações sociais
Authors: Da Silva Silvio Éder Dias , Da costa Joel Lobato , Araújo Jeferson Santos , Moura Adriana Alaíde Alves , Da Cunha Natacha Mariana Farias , Dos Santos Arielle Lima
Published: October 2018

A figura da morte é caracterizada como um estágio final fisiológico, ou seja, um processo tecnicamente ordenado e natural da natureza, dessa uma forma geral, é a única certeza que possuímos na vida, o estudo possui como objetivo de analisar as representações de familiares de pacientes em cuidados paliativos. O artigo trata-se de uma pesquisa abordagem qualitativa de cunho descritivo, a qual visou conhecer as representações de familiares de pacientes em cuidados paliativos, aonde essa pesquisa baseou-se na Teoria das Representações Sociais criada por Serge Moscovici. A morte pode ser vista como um mistério incompreensível, como um absurdo inaceitável ou pode ser tratada como um tabu ou uma representação social de um universo próprio e pessoal. Aprofundando o resultado, registramos que apesar deste paciente não possuir, mas possibilidade de cura mediante as terapêuticas convencionais, ele necessita de cuidados especiais ou cuidados paliativos.
Nurses’ perception towards the teaching-learning process of Nursing management / Percepção de enfermeiras quanto ao ensino e aprendizagem da gestão em Enfermagem
Authors: Da Silva Alexsandra Martins , Celich Kátia Lilian Sedrez , Da Silva Tatiana Gaffuri , De Souza Silvia Silva , Bittencourt Julia Valéria Vargas , Godinho Bertoncello Kátia Cilene
Published: October 2018

Objetivo: Desvelar a percepção de enfermeiras quanto ao ensino e aprendizagem do componente curricular de Gestão e Gerenciamento em Saúde e Enfermagem e os subsídios para a atuação profissional. Método: Estudo com abordagem qualitativa, norteada pelo Itinerário de Pesquisa de Paulo Freire. Resultados: Realizado com três egressas do curso de enfermagem da Universidade Federal da Fronteira Sul que trabalham no município de Chapecó, SC. O Círculo de Cultura, nos quais percorreram-se as etapas do Itinerário de pesquisa, resultou três quadros: Importância da transversalidade da gestão no curso de enfermagem; Diálogo entre academia e o serviço; Auto percepção do preparo para o desempenho profissional. Considerações finais: As enfermeiras desvelaram que o ensino da gestão, durante a graduação apresenta fragilidades para o desenvolvimento da prática profissional e sugerem que o tema seja transversal durante o processo de formação.
The viewpoint of hospitalized children with regards to oncological treatment / Percepção de crianças hospitalizadas acerca do tratamento oncológico
Authors: Emidio Suellen Cristina Dias
Published: October 2018

Objetivo: compreender a percepção de crianças, na faixa etária de seis a doze anos, acerca do tratamento em uma unidade oncológica pediátrica de Petrolina/Pernambuco. Método: pesquisa descritiva, com abordagem qualitativa, realizada em um hospital público, localizado no interior do estado de Pernambuco. Participaram cinco (05) crianças, na faixa etária de seis a doze anos, por meio da entrevista semiestruturada. A análise ocorreu tendo como referência a análise temática de conteúdo proposta por Bardin. Resultados: emergiram categorias que revelam a necessidade do processo terapêutico, as alterações da autoimagem e os procedimentos invasivos como importantes fontes de sofrimento para a criança e o familiar acompanhante; os aspectos negativos e positivos da experiência hospitalar; e os motivos pelos quais as crianças aderiam à terapêutica e enfrentavam a doença. Conclusão: estratégias devem ser priorizadas no sentido de estabelecer comunicação com a criança e a família, incluindo aspectos como o protocolo terapêutico, a rotina da unidade, os procedimentos invasivos, as modificações estéticas, dentre outros; organizar a unidade, considerando a rotina da criança e do familiar acompanhante; e os incentivar para a superação de dificuldades e para a adesão ao tratamento.
The health of elderly people bearing Alzheimer’s disease: an integrative review / Saúde do idoso com doença de Alzheimer: revisão integrativa
Authors: Ventura Hemmily Nóbrega , Tavares da Fonseca Leila de Cássia , Borges Bruno César Fernandes , Nóbrega Jéssica Yasmine Lacerda , Ventura Herbert Nóbrega , Nóbrega Maria Leosimar Leite
Published: October 2018

Objetivo: Verificar o conhecimento produzido pelos pesquisadores a respeito da saúde do idoso com Doença de Alzheimer (DA). Métodos: Revisão integrativa da literatura com levantamento bibliográfico realizado na Biblioteca Virtual em Saúde (BVS), MEDLINE e nos bancos de dados do Portal de Periódicos Capes.  Resultados: Observou-se a incipiência de artigos científicos publicados sobre a Doença de Alzheimer com enfoque na saúde da pessoa idosa. Conclusão: Verificou-se a necessidade de pesquisas para investigar a saúde do idoso em face à doença de Alzheimer que possibilitem aporte teórico na elaboração de políticas públicas de saúde mais abrangentes para os cuidados aos idosos. Descritores: Envelhecimento, Doença de Alzheimer, Autonomia pessoal, Saúde do idoso.
Serum vitamin D level not correlated with hepatitis B virus replication in patients with chronic hepatitis B virus infection
Authors: Yang Chun‐Chun , Tseng Tai‐Chung , Chen Jiann‐Hwa , Li Chung‐Hsien , Wang Pin‐Chao , Lin Hans Hsienhong , Wang Chia‐Chi
Published: October 2018

Backgrounds

Vitamin D is an important immune modulator in chronic liver diseases. The study aims to investigate the relationship between vitamin D and hepatitis B virus replication.

Methods

This was a prospective study. Hepatitis B virus (HBV) carriers were enrolled from May to Oct 2014 in Taipei Tzu Chi Hospital. All have positive hepatitis B surface antigen (HBsAg) for more than 6 months. Serum alanine aminotransferase (ALT), quantitative HBsAg (qHBsAg), HBV DNA and 25(OH)D3 were measured in each participant.

Results

204 patients (male 103; mean age 47.86 ± 10.22 years) with chronic HBV infection (94.12% HBeAg‐negative) were enrolled. Of them, 13 (6.4%) had severe deficiency (25(OH)D3 < 10 ng/mL), 176 (86.3%) insufficiency (25(OH)D3 ≥ 10 and < 30 ng/mL) and 15 (7.4%) adequate (25(OH)D3 ≧ 30 ng/mL) vitamin D levels. In the regard of age and sex, there was no difference in vitamin D levels. Using linear regression analysis, there was no correlation between serum vitamin D and HBV DNA/qHBsAg levels. While serum vitamin D levels were categorized by quartiles, there was no association between vitamin D levels and HBV DNA/qHBsAg levels using univariate and multivariate analyses.

Conclusions

In this study, 92.6% of patients with chronic HBV infection have inadequate vitamin D levels. Serum vitamin D levels do not correlate with the markers of HBV replication including serum HBV DNA and qHBsAg levels.

Copyright © 2017, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.
Acute phlegmonous gastritis
Authors: Chen Chi‐Hung , Shin Jeng‐Shiann , Huang Jen‐Chieh
Published: October 2018

Acute phlegmonous gastritis is an uncommon and often life‐threatening disease characterized by suppurative bacterial infection of the stomach. Here we report a case of acute plegmonous gastritis in a 51‐year‐old male patient with underlying alcoholic cirrhosis. When admitted to the emergency department, he initially presented with upper abdominal pain, and fever for three days. The patient's vital signs were unstable, including blood pressure 90/55 mmHg, heart rate 110 beats per minute, respiratory rate 25 breaths per minute, and body temperature 38°C. Emergent imaging results suggested acute phlegmonous gastritis. The patient was admitted to the intensive care unit for immediate treatment with intravenous antibiotics, and results of endoscopic tissue culture and blood culture on day four identified the underlying pathogen as Klebsiella pneumonia. In this case report, we share the patient's clinical course, ultrasonography and computed tomography images, and endoscopic findings, accompanied by brief literature review.

Copyright © 2017, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.
Type 1 (IgG4‐related) autoimmune pancreatitis: Experiences in a medical center in southern Taiwan within the past 10 years
Authors: Chen Yen‐Chun , Chan Hoi‐Hung , Lai Kwok‐Hung , Tsai Tzung‐Jiun , Hsu Ping‐I
Published: October 2018

Backgrounds

Autoimmune pancreatitis (AIP) is a relatively rare disease and has similar presentations to pancreatic cancer. There are limited reports about this disease in Taiwan.

Methods

We retrospectively reviewed 14 cases of type 1 AIP from March 2007 to March 2016 in Kaohsiung Veterans General Hospital. The diagnosis was made according to the international consensus diagnostic criteria (ICDC) for AIP.

Results

There were 12 male and two female patients diagnosed with type 1 AIP, with a mean age of 63.6 (33 – 88) years. The rates of DM and HTN were 28.5% and 35.7%, respectively. The clinical presentations were mainly weight loss, epigastric pain, and obstructive jaundice. Most patients didn't have the habits of cigarette smoking or drinking alcohol. Minority of these patients had leukocytosis but the majority of them had anemia. All patients had a normal range of platelet count. Most patients had elevation of alanine transaminase, alkaline phosphatase or lipase. Serum immunoglobulin G (IgG) or IgG4 tests were done in most cases, and high‐up levels were seen in most of them. Six of them had an upraised CA 19‐9. All patients had a normal range of coagulation profiles (prothrombin time and activated partial thromboplastin time). Diffuse or focal swellings of the pancreas were observed from CT or MRI among different patients. Six of them had pathology evidence. Three of them received Whipple's operation. Seven of them underwent ERCP. Four of them received PTCD. Two of them received PTGBD. Corticosteroids were prescribed to all patients after the diagnosis of AIP except of that one lost to follow‐up. There were eight patients taking steroid only and five taking steroid in combination with another immunomodulator.

Conclusions

Type 1 AIP has several common features with pancreatic cancer so accurate diagnosis is important to avoid unnecessary operation. The diagnosis involves clinician's alertness and several diagnostic modalities, including serology, radiology and pathology. Though steroid is effective for type 1 AIP, the relapse rate is high. longterm follow‐up is required. Several clinical features in this study are different from those in other reports and further study is still required for investigation.

Copyright © 2017, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.
Metachronous duodenal neuroendocrine neoplasms after endoscopic mucosal resection
Authors: Wang Hsin‐Ming , Liang Chih‐Ming , Wu Cheng‐Kun , Chiu Yi‐Chun , Chou Yeh‐Pin , Wu Keng‐Liang , Huang Chao‐Cheng , Chuah Seng‐Kee , Tai Wei‐Chen , Lu Lung‐Sheng
Published: October 2018

Duodenal neuroendocrine tumors (D‐NETs) may or may not be associated with a functional clinical syndrome. The term D‐NETs includes all duodenal tumors with neuroendocrine features as determined by histological/ immunohistochemical methods including positivity for neuroendocrine cytosolic markers (neuron‐specific enolase, or secretory vesicle proteins (chromogranin A (CgA), synaptophysin)). More than 90% of all D‐NETs arise in the first and second part of the duodenum. Approximately 20% of D‐NETs occurs in the periampullary region. Most D‐NETs are asymptomatic and incidentally detected during upper gastrointestinal (GI) endoscopy examinations for symptoms unrelated to the carcinoid tumor. D‐NETs account for 2% ‐ 5% of GI neuroendocrine tumors, and usually present as solitary small lesions confined to the duodenal submucosa. Endoscopic treatment is generally recommended for D‐NETs less than 10 mm as it is associated with a low frequency of lymph node invasion and distant metastases. However, the report of metachronous or synchronous concurrence of D‐NETs is scarce. Herein, we present a case of metachronous duodenal neuroendocrine tumor status successfully treated by hybrid endoscopic submucosal dissection.

Copyright © 2017, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.
Recurrent bleeding of colonic diverticular hemorrhage after endoscopic treatment: Clinical experience of an endoscopic center
Authors: Huang Chun‐Lin , Wu Chi‐Huan , Chen Tsung‐Hsing , Lin Wei‐Pin , Sung Chang‐Mu , Kuo Chia‐Jung , Chen Chun‐Wei , Lin Wei‐Ran , Ho Yu‐Pin , Lin Chun‐Jung , Hsu Chen‐Ming , Su Ming‐Yao , Chiu Cheng‐Tang
Published: October 2018

Aims

Diverticular bleeding is one of the most common etiologies of lower GI bleeding. Endoscopy is a useful tool in both diagnosis and therapeutic management. The endoscopic hemostatic methods included epinephrine injection, thermal coagulation, clipping or combination of them. The aim of this study was to evaluate the outcome of different type of hemostasis.

Patients and methods

We reviewed the medical record of all patients who underwent endoscopic therapy for diverticular bleeding from December 2000 to December 2011. We measured hemoglobulin before procedure, early rebleeding (< 30 days), late rebleeding (> 30 days), blood transfusion requirement, hospital stay and complication.

Results

In our hospital, acute lower GI bleeding leads to almost 600 patients in the past 10 years. We identified 21 patients who underwent endoscopic hemostatic treatment for the diverticular hemorrhage. Patients with epinephrine injection alone had one of thirteen with early rebleeding (< 30 days) and one of thirteen with late rebleeding (> 30 days). Patients with combination therapy (epinephrine injection combined with coagulation or clipping) had one of eight with early bleeding and two of eight patients had late bleeding. There was no significant difference between these two groups on early rebleeding and late rebleeding.

Conclusions

In our series, epinephrine injection alone for diverticular hemorrhage seems to be non‐inferior to the combination therapy for providing good initial hemostasis and preventing recurrent bleeding.

Copyright © 2017, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.