bluuebunny/crossref_metadata_2025 huggingface dataset:
THE PRELIMINARY DESIGN AND TECHNICAL-ECONOMIC EFFICIENCY OF THE TWO-LEVEL BRANCHED CABLE-STAYED BRIDGE
Authors: Stragys Modestas
Published: March 2019

An innovative steel cable-stayed pedestrian bridge structure and the preliminary design methodology are provided in this article. The advantages and disadvantages of the bridge design are presented. The comparative analysis of the innovative steel cable-stayed pedestrian bridge structure and a similar structure of a single pylon fan cable-stayed bridge with an 80 m span is provided, the main criteria are reviewed and conclusions are formulated. The main features of the innovative branched cable-stayed bridge behaviour are reviewed. An overview of technical-economic efficiency and conclusions are presented.
Adoptive T-cell Therapy with CD45RA-depleted Donor in the Treatment of Cytomegalovirus Disease in Immunocompromised Non-transplant Patients
Authors: Yuste Jose R , de Cerio Ascensión López-Díaz , Rifón Jose , Moreno Cristina , Panizo María , Inogés Susana
Published: March 2019

Cytomegalovirus (CMV) infections can induce severe complications in immunosuppressed patients. Currently, ganciclovir represents the preferred treatment option; however, in patients with resistance or toxicity related to ganciclovir, the therapeutic options are limited.

Cellular immunity plays an important role in the control of viral infections. Adoptive T-cell therapy can contribute to recovering immunological function in immunosuppressed patients. Selective T-cell depletion targeting CD45RA enhances early T-cell recovery and can represent a salvage therapy. In this study, an immunocompromised non-transplanted patient with CMV disease and toxicity to conventional therapy was successfully treated by adoptive transfer of CD45RA-depleted T-cells.
Sorbus lushanensis, a new species of Rosaceae from China
Authors: Qiu Jing , Zhao Yang , Qi Qi , Chen Xin
Published: March 2019

Sorbuslushanensis Xin Chen & Jing Qiu, sp. n. (Rosaceae), a new simple-leaved species belonging to Sorbussubg.Ariasect.Alnifoliae, is described from Anhui and Jiangxi provinces in China. Illustrations, photographs of wild plants and a distribution map are presented. The new species is morphologically similar to S.folgneri, but can be distinguished easily by its abaxially greenish-grey tomentose leaves, scale-like stipules and glabrous styles.
The shadow of the future and the shadow of the past: Studying the impact of climate change on human behaviour
Authors: Vollan Björn
Published: March 2019

There is consent among researchers that climate change results in increasing number of extreme weather events, migration and even the need to resettle entire populations. Understanding the behaviour of climate refugees and people exposed to extreme events are key in order to avoid emergency mass movements or even conflict over natural and social resources. I propose a research project with two related parts that identify the human reaction to the impacts of climate change by combining a comparative research design and the use of economic experiments, survey methods and modelling techniques. The first part of the project builds upon a unique sample of experimentally measured risk and solidarity preferences of 800 Filipinos taken in 2012 in. In order to assess the impact of the damages induced by typhoon 'Haiyan' and the following recovery aid we will carry out two follow-up studies with the same people in order to obtain panel data on solidarity and risk preferences for robust statistical inference.The second part of the project will focus on the effects of anticipated forced and permanent relocation. The major innovation offered by the proposed set-up is a sample of inhabitants from atoll and island communities where the communities only differ in the timing of the expected relocation due to sea level rise with additional use of priming techniques. The set-up allows studying how preferences and behavior of people change with the prospect of being severely affected by climate change and whether and how these affect short and medium-term adaptation strategies such as an increased extraction of natural resources and migration.
Preoperative Patient Functional Status Is an Independent Predictor of Outcomes After Primary Total Hip Arthroplasty
Authors: Raad Micheal , Amin Raj M. , El Abiad Jad M. , Puvanesarajah Varun , Best Matthew J. , Oni Julius K.
Published: March 2019

This study was designed to determine whether preoperative functional status of patients with osteoarthritis predicts outcomes after primary total hip arthroplasty. The American College of Surgeons National Surgical Quality Improvement Program database was queried for records of patients who underwent primary total hip arthroplasty for a principal diagnosis of osteoarthritis from 2009 to 2013 (N=43,179). Patients were categorized as dependent or independent according to their preoperative functional status. The groups were compared regarding several potential confounders using Student's
t
and chi-square tests. Logistic and Poisson regression models (inclusion threshold of
P
<.1) were used to assess the associations of functional status with outcomes. The alpha level was set at 0.05. Compared with independent patients, dependent patients were likely to be older (mean, 70 vs 66 years,
P
<.01) and to have more preoperative comorbidities. After controlling for potential confounders, preoperative dependent functional status was predictive of major complications (odds ratio, 2.34; 95% confidence interval, 1.67–3.28), nonroutine discharge (odds ratio, 2.80; 95% confidence interval, 2.35–3.34), and longer hospital stay (incidence risk ratio, 1.19; 95% confidence interval, 1.12–1.27). Rates of unplanned reoperation were similar between groups on multivariate analysis. Compared with preoperative independent functional status, preoperative dependent functional status was independently associated with worse outcomes after primary total hip arthroplasty for osteoarthritis. [
Orthopedics.
2019; 42(3):e326–e330.]
Evolución de las revistas de arquitectura y construcción en España
Authors: Monjo Carrió J.
Published: March 2019

Con motivo del 70 aniversario de Informes de la Construcción, se realiza un breve recorrido por las revistas de construcción aparecidas desde mediados del siglo XIX, en que empezaron este tipo de publicaciones, hasta la segunda mitad del siglo XX. Se agrupan en tres grandes periodos: segunda mitad del XIX; de 1901 a 1936; de 1940 a 1950. Se mencionan sus nombres, sus responsables, sus objetivos principales y sus años de edición, destacando dos como más permanentes; la Revista de Obras Públicas y Arquitectura, cubriendo los dos grandes campos de actividad en el sector. Se menciona la aparición de Informes de la Construcción en 1948, como publicación que logra conjugar el diseño arquitectónico con sus soluciones constructivas (arte formal y arte técnico), inspiración clara de la mente de Eduardo Torroja. Finalmente, se alcanzan la conclusión de que “Informes” es la consecuencia lógica de la evolución de las revistas de Arquitectura y Construcción hasta ese momento.
Occurrence and traceability of Salmonella spp. in five Sardinian fermented sausage facilities
Authors: Piras Francesca , Spanu Carlo , Mocci Anna Maria , Demontis Mariella , De Santis Enrico Petro Luigi , Scarano Christian
Published: March 2019

The aims of the present study were to evaluate the presence of Salmonella in five fermented sausage processing plants and their products during the production process, and to trace the possible sources of contamination. A total of 270 samples were collected: mixture of ground pork meat and fat, products at the end of acidification, sausages at the end of ripening and, during production stages, surfaces in contact with meat and surfaces not in contact with meat. For samples of ground meat, product at the end of acidification and sausages at the end of ripening, the pH and water activity (aw), were determined. All the samples were tested for the presence of Salmonella. Thirtytwo Salmonella isolates were obtained, subjected to serotyping and PFGE. The sausages at the end of ripening pH and aw mean values were 5.39±0.24 and 0.91±0.03, respectively. Salmonella was detected in three processing plants with an overall prevalence of 16.7% in food samples and 5.8% in environmental samples. Salmonella prevalence was 24% in ground meat and products at the end of acidification and was also detected in a sample of sausage at the end of ripening (2%). In environmental samples, Salmonella was detected in 6.6% of surfaces in contact with meat and 5% of surfaces not in contact with meat. Five serotypes were identified among 32 isolates: S. Derby (37.5%), S. Typhimurium and S. Rissen (both 25%), S. Give and monophasic S. Typhimurium (both 6.25%). Six different pulsotypes were obtained with PFGE. The serotypes and the PFGE pattern of the strains were specific for each facility with no overlapping between different processing plants. The same observation can be pointed out considering different sampling days for the same processing plants, thus presumably indicating the raw material (ground pork meat and fat) as the source of contamination. The detection of Salmonella in a sample of sausage at the end of ripening highlights the ability of the pathogen to survive during manufacturing process.
Formations of finite groups with the M. Hall property
Authors: Auinger Karl , Bors Alexander
Published: March 2019

The first examples of formations which are arboreous (and therefore Hall) but not freely indexed (and therefore not locally extensible) are found. Likewise, the first examples of solvable formations which are freely indexed and arboreous (and therefore Hall) but not locally extensible are constructed. Some open questions are also mentioned.
Case Report: Scrub Typhus and Q Fever Coinfection
Authors: Jeong Hang Jin , Choi Sangho , Lee Jeongmin , Gill Byoungchul , Lee Kang Mo , Lee Yeong Seon , Kim Choon-Mee , Yun Na-Ra , Kim Dong-Min
Published: March 2019

A 56-year-old female goat herder had scrub typhus that persisted after receiving doxycycline for 5 days. Her symptoms continued, prompting us to perform further examinations that revealed coinfection of Q fever and scrub typhus via molecular and serological testing. We also isolated Orientia tsutsugamushi using BALB/c mice and L929 cells.
A Comparison of Pretravel Health Care, Travel-Related Exposures, and Illnesses among Pediatric and Adult U.S. Military Beneficiaries
Authors: Ashley David P. , Fraser Jamie , Yun Heather , Kunz Anjali , Fairchok Mary , Tribble David , Mitra Indrani , Johnson Mark D. , Hickey Patrick W. , Ganesan Anuradha , Deiss Robert G. , Lalani Tahaniyat , _ _
Published: March 2019

We evaluated differences in pretravel care, exposures, and illnesses among pediatric and adult travelers, using a prospective, observational cohort. Eighty-one pediatric travelers were matched 1:1 with adult military dependents by travel region, destination’s malaria risk, and travel duration. Pediatric travelers were more likely to have coverage for hepatitis A and B (90% versus 67% of adults; 85% versus 44%), visit friends and relatives (36% versus 16%), report mosquito bites (69% versus 44%), and have close contact with wild or domesticated animals (40% versus 20%) than adults (P < 0.05). Subjects < 10 years of age were less likely to be prescribed antibiotics (28% versus 95%; RR = 0.63; 95% CI: 0.46–0.85) and antidiarrheals (9% versus 100%; RR = 0.10; 95% CI: 0.03–0.29) for travelers’ diarrhea (TD) self-treatment than adults. Travel medicine providers should emphasize strategies for vector avoidance, prevention of animal bites and scratches, and TD self-treatment in pediatric pretravel consultations.
High Prevalence of Leptospira spp. in Rodents in an Urban Setting in Madagascar
Authors: Rahelinirina Soanandrasana , Bourhy Pascale , Andriamiaramanana Fehivola , Garin Benoit , Rajerison Minoarisoa
Published: March 2019

Leptospirosis is a neglected zoonotic bacterial disease caused by pathogenic Leptospira spp. Only limited studies have been conducted on the presence of Leptospira spp. in rats in Antananarivo, the capital city of Madagascar. We assessed Leptospira prevalence in small mammals in urban areas of Antananarivo where sanitation is inadequate and there is risk of flooding during the rainy season. We captured rodents and shrews at two sites and examined kidney samples from 114 animals using culture and a real-time polymerase chain reaction (PCR) assay specific to pathogenic Leptospira spp. We identified 23 positive samples containing Leptospira interrogans and Leptospira borgpetersenii, with a high prevalence in Rattus norvegicus (44.9%). Our results indicate that small mammals, in particular R. norvegicus, present a major public health risk for acquiring leptospirosis in Antananarivo.
Desvelando el tiempo. Martín Vitaliti y la soledad secuencial
Authors: Tarancón Royo Héctor
Published: March 2019

Desde su nacimiento, la cultura de masas tuvo una gran aceptación entre el público, pero fue ignorada por los estudios académicos.  Vista como algo superficial y alienante para el individuo, movimientos artísticos como el pop o fenómenos culturales como el cómic o las series televisivas, no han sido analizados como elementos formales hasta estas últimas décadas.  Disciplinas recientes como los estudios visuales, los estudios culturales, de género, o lingüísticos, al ampliar su objeto de estudio han observado el potencial crítico e ideológico de estas nuevas formas de expresión.  De esta manera, desde una aproximación interdisciplinar el presente artículo aborda la obra del artista argentino Martín Vitaliti en relación al superhéroe y su temporalidad épica, el choque entre sus sentimientos y su compromiso y su secuencialidad formal dentro del cómic. Planteado como una historia fragmentada que entrelaza sus estrategias apropiacioncitas de omisión, repetición y distinción, las imágenes quedan abiertas a distintas perspectivas y referencias que la obra de Vitaliti expone y por un momento ayuda a resolver.
Correlato de la figura del observador. Estatuto del mundo en sus fundamentos imaginarios
Authors: De la Villa Liso Lourdes
Published: March 2019

Este trabajo es un estudio sobre la memoria como dominio específico que surge de un problema perceptivo concreto: el tener acceso al mundo por el canal sensorial de la vista. Le preceden dos estadios de investigación. En este tercer estadio se aborda lo “real” como resultado o solución al problema.  La metodología se ha construido a partir de la interpretación del proyecto de fenomenología antropológica de A. Schnell, que propone una definición del hombre como “Homo imaginans”. Se realiza una operación de reflexión con respecto a los resultados que habíamos obtenido hasta ahora. Se formula la vía hacia lo “real” como aquella que resolvería el aparato psíquico movilizado durante el “hacer imágenes”. Se analizan las características y temporalidades de la memoria en su relación con la función visual y la consciencia.
Ocean acidification and high irradiance stimulate growth of the
Antarctic cryptophyte Geminigera cryophila
Authors: Trimborn Scarlett , Thoms Silke , Karitter Pascal , Bischof Kai
Published: March 2019

Abstract. Ecophysiological studies on Antarctic cryptophytes to assess whether climatic changes such as ocean acidification and enhanced stratification affect their growth in Antarctic coastal waters in the future are lacking so far. This is the first study that investigated the combined effects of increasing availability of pCO2 (400 and 1000 µatm) and irradiance (20, 200 and 500 μmol photons m−2 s−1) on growth, elemental composition and photophysiology of the Antarctic cryptophyte Geminigera cryophila. Under ambient pCO2, this species was characterized by a pronounced sensitivity to increasing irradiance with complete growth inhibition at the highest light intensity. Interestingly, when grown under high pCO2 this negative light effect vanished and it reached highest rates of growth and particulate organic carbon production at the highest irradiance compared to the other tested experimental conditions. Our results for G. cryophila reveal beneficial effects of ocean acidification in conjunction with enhanced irradiance on growth and photosynthesis. Hence, cryptophytes such as G. cryophila may be potential winners of climate change, potentially thriving better in more stratified and acidic coastal waters and contributing in higher abundance to future phytoplankton assemblages of coastal Antarctic waters.
The Effect of Re-engineering of Administrative Processes in Achieving the Competitive Advantage of Sustainable in Five-Star Hotels in Jordan - Field Study
Authors: EL-Dalahmeh Suleiman Mustafa
Published: March 2019

The main aim of the research was to identify the effect of Re-engineering of Administration Processes in Achieving the competitive Advantage of Sustainable in Five Star Hotels in Jordan. To achieve the objective of this study, a questionnaire distributed on 120 persons in Five Star Hotels in Jordan. 90 returned with a rate of 75%. The results of the study showed that there is a significant statistical effect at the level of significance of α ≤ 0.05 for the re - engineering of administrative processes in achieving sustainable competitive advantage in five - star hotels in Jordan in the following dimensions:* - Leadership * - Ability to analyze * - Advanced design * - Organizational communication * - Continuous improvementStrategic Planning. The total score of the mean of the study instrument was 4.43 and with a standard deviation of 0.35 and 88.6% at a very high degree.The results of the statistical analysis revealed the realization of the sample of the study in the investigated hotels, the extent of the effect of re-engineering the administrative processes in all its dimensions in achieving the competitive advantage.Based on the results of hypotheses tested, the six null hypotheses of the study were rejected. In the light of the findings, the researcher recommended that:1- The need to convince the management of hotels and hotel staff the importance of the application of re-engineering of administrative processes to achieve competitive advantage sustainable2- Utilizing the potential of graduates of new universities from the faculties of economics, administrative sciences and information technology.
Age-Telling in Intergenerational First-encounter Talks between College Students and Older Adults in Taiwan: A Gerontological Sociolinguistic Study
Authors: Chen Chin-Hui , Hong Yu-Ting , Chen Yen-Ju
Published: March 2019

This study extends gerontological sociolinguistics by investigating how older Taiwanese adults disclosed their age and the relevant conversational sequences around their age-telling behaviours in first-encounter talks with college students. The 13-pair young-old conversational data were coded using Coupland, Coupland, Giles and Henwood’s (1991) six age-telling strategies, and 70 age-telling utterances were identified. Frequency analysis of the age-telling utterances indicated that the older participants mostly constructed their older-age identities by referring to age-related roles and to historical changes they had witnessed. Conversation analysis suggested that both of these age-telling strategies could endow older people with greater power by casting them in roles such as information-givers or proud grandparents, and ascribe positive qualities to their age group. However, the data raised concerns that age-telling conversations could also sometimes be disenfranchising and the younger interlocutors’ minimal responses to such talks were common. Wider implications of the findings for intergenerational communication are discussed in the conclusion.
From Traditional Regional Analysis to Dynamics of Local Development: Foundations and Theoretical Reorientations
Authors: Vlados Charis , Deniozos Nikolaos , Chatzinikolaou Dimos , Digkas Agis
Published: March 2019

The conventional and traditional regional analysis seems to gradually changing focus, content and hermeneutic optic. The regional analysis of past seems increasingly saturated, being incapable to interpret and propose policy solutions that originate primarily from the potential of local development, innovation and entrepreneurship. To this end, new, multidisciplinary approaches of local development seem to prevail progressively, leading the study of development to the analysis of dynamically evolving localities.
Editorial No. 28
Authors: Castillo Herrera Beverly
Published: March 2019

Revista Científica de FAREM-Estelí. No. 28.
Proceso Administrativo enfocado en la producción para la comercialización de los puros en el mercado extranjero de la empresa Perdomo Cigars S.A Sede Estelí, Nicaragua. 2016-2017
Authors: Juárez Rodríguez Ana Junieth , Pineda Sánchez Perla Massiel , Bermúdez Jennifer Auxiliadora , Castillo Herrera Beverly
Published: March 2019

Este artículo científico presenta los resultados del Proceso Administrativo enfocado en la Producción para la Comercialización de los puros en el mercado extranjero de la Empresa Perdomo Cigars S.A, Sede Estelí en el periodo 2016-2017. Esta investigación es de tipo cualitativo porque aborda a profundidad la problemática del proceso administrativo en la elaboración de los puros para su comercialización. Las técnicas de recolección de datos fueron: la entrevista a cuatro personas involucradas en el proceso productivo y la comercialización de los productos terminados. Se aplicó la guía de observación en ambos procesos y la revisión documental para sustentar la investigación. Como resultado de esta investigación se obtuvo que el recurso más influyente para poder producir y comercializar los puros hacia el mercado extranjero además de la materia prima, la mano de obra es indispensable para garantizar la calidad del producto terminado. Como estrategias se proponen la contratación de mano de obra para cumplir con las ordenes de los clientes y el plan de producción, así como también el mejoramiento de la organización del trabajo para la disminución de los desperdicios de la materia prima, de igual modo la creación de políticas de motivación para el personal que permita elevar el desempeño y el rendimiento de los mismos.
Influencia de la imagen corporal en la práctica excesiva de ejercicios físicos en adolescentes de Estelí, Nicaragua
Authors: Aráuz Castillo Gissell Beatriz , Dávila Montiel Karina , Acuña Flores Yaritza Daniela , Solís Zúniga Franklin
Published: March 2019

La influencia que tiene la imagen corporal en la población de adolescentes, es una temática poco indagada, a pesar de ser esta relevante ante la sociedad, abarca distintas áreas de conocimiento especialmente desde la psicología. El presente escrito, se enmarca en una investigación realizada con 32 adolescentes entre las edades de 14 y 17 años, siendo escogidos 8 adolescentes por cada 4 gimnasios con mayor afluencia en Estelí período 2017. El propósito fue analizar cómo influye la percepción de la imagen corporal en la práctica de ejercicios físicos excesivos, en adolescentes. El enfoque metodológico fue mixto con prevalencia cualitativa. Las técnicas utilizadas para la recolección de la información fueron: Entrevista, técnica de listado libre, test de autoestima y escala de Likert. Los principales hallazgos muestran que los adolescentes se ven influidos por la percepción de su propia imagen corporal, realizando excesivamente ejercicios físicos, siendo afectados por factores como: la sociedad, autoestima, estereotipos de género que se difunden erróneamente, dedicando más de 2 horas a la práctica de ejercicios donde descuidan otras actividades que solían hacer. A partir de los resultados de esta investigación se realizó como sugerencia un plan de intervención psicológica que pueda ser utilizado por siguientes investigadores para trabajar con entrenadores y adolescentes practicantes del ejercicio físico excesivo para prevenir el trastorno dismórfico corporal o también conocido popularmente como vigorexia.
FATORES DE PERTURBAÇÃO IDENTIFICADOS EM ÁREA DE PROTEÇÃO AMBIENTAL CORUMBATAÍ-BOTUCATU-TEJUPÁ, PERÍMETRO BOTUCATU, ESTADO DE SÃO PAULO
Authors: Pollo Ronaldo Alberto , Silva César De Oliveira Ferreira , Cardoso Lincoln Gehring , Lessa Luís Gustavo Frediani
Published: March 2019

As imagens de satélite de alta resolução espacial se tornaram muito importantes na análise, interpretação e quantificação das transformações ambientais ocorridas ao longo do tempo, permitindo o monitoramento da dinâmica do uso e ocupação do solo, e o monitoramento de áreas protegidas por lei, promovendo instrumentos para um desenvolvimento sustentável, que concilia a produção agrícola e a proteção dos recursos naturais. O presente trabalho é uma análise espacial dos fatores de perturbação e seus potenciais impactos ambientais nos recursos hídricos identificados na Área de Proteção Ambiental (APA) Corumbataí-Botucatu-Tejupá – Perímetro Botucatu-SP em sua porção localizada dentro do município de São Manuel, Estado de São Paulo, por meio de imagens digitais do Google Earth Pro dos anos de 2010 e 2016. Identificou-se  oito áreas com fatores de perturbação (A, B, C, D, E, F, G, H) onde foram detectados focos de desmatamento e avanço de pastagem e monoculturas sobre áreas de preservação ambiental, tais como nascentes e locais de potencial recarga de aquífero. Essas ocupações irregulares geram impactos na produção de água, tais como impermeabilização do solo, escoamento superficial e erosão com transporte de sedimentos. Esse procedimento é aplicável à municípios de pequeno e médio porte para detecção e monitoramento de inconformidades ambientais.
Romanos e Não-Romanos: o nascimento da Christianitas
Authors: Covalchuk Gabriel Irinei
Published: March 2019

No presente artigo, buscamos mostrar a relação entre romanos e não romanos e como elas se travaram até o nascimento da Christianitas. Partimos de uma discussão de Momigliano (1991), sobre a recusa de certas práticas que eram consideradas profanas pelos judeus e como esse mesmo método foi adotado pelos cristãos nascentes do primeiro século. Analisaremos as leis de como comportar-se em território não Cristão pregado por Bardaisan e uma moral pregada por Tertuliano, abordando o desenvolvimento da prática cristã e sua legitimação. Encaminhando para o fim dessa primeira ‘etapa’, com o nascimento da Cristandade, e como ela foi desenvolvendo-se durante o governo de Constantino no século IV, concluindo assim, com a demonstração de seu papel ativo e participante na política do Império Romano, mudando um conceito chave, ou seja, antes da ascensão cristã, ser romano era não ser cristão, com a Christianitas legitimada, ser romano é ser um genuíno cristão.
As habilidades militares de Ricardo I no Itinerarium Peregrinorum et Gesta Regis Ricardi (1217-1222)
Authors: Rodrigues Gabriel Toneli
Published: March 2019

O presente artigo tem como objetivo expor as habilidades militares ideais na crônica Itinerarium Peregrinorum et Gesta Regis Ricardi, que se dedica a narrar a participação de Ricardo I na Terceira Cruzada do Oriente. Considerado o primeiro rei-cavaleiro, abordaremos brevemente o estado da cavalaria medieval durante o período deste rei inglês, sua ética e seu processo histórico que levaria no aumento do grau de formalização, se instituindo em uma ordem distinta de combatentes. Faremos também uma pequena exposição da visão historiográfica moderna sobre a cruzada, mais precisamente da atuação de Ricardo I. Escrito entre 1217 e 1222, procuramos salientar o aspecto de crítica a João I da crônica e também seu caráter de promoção de uma figura régia vista como ideal destinada a Henrique III. Procuramos desta forma demonstrar como é feita a caracterização de um rei ideal, em especial no tocante à guerra, indicando quais as virtudes militares celebradas pelo autor.
Health literacy and use of healthcare services among community-dwelling older adults living with chronic conditions
Authors: Dufour Isabelle , Lacasse Anaϊs , Chouinard Maud-Christine , Chiu Yohann , Lafontaine Sarah
Published: March 2019

Objective: Only 12% of the Canadian older adults have adequate health literacy (HL) to understand and handle health information sufficiently. A descriptive correlation study was conducted to describe HL and to examine its relationship with healthcare services use among community-dwelling older adults living with chronic conditions in a distant region of Quebec, Canada.Methods: Data was collected through self-report instruments including the Health Literacy Questionnaire (HLQ), which assesses HL on nine dimensions.Results: Based on health characteristics of the nine HLQ dimensions, the results showed significant differences between subgroups of participants as well as a negative association between the HLQ dimension Appraisal of Health Information and the number of consultations with healthcare professionals (incidence rate ratio: 0.66; p = .027).Conclusions: The results highlight the need to improve older adults HL, in order to improve their health status and use of healthcare services.
A New Eighth Order Runge-Kutta Family Method
Authors: Hippolyte Séka , Richard Assui Kouassi
Published: March 2019

In this article, a new family of Runge-Kutta methods of 8^th order for solving ordinary differential equations is discovered and depends on the parameters b_8 and a_10;5. For b8 = 49/180 and a10;5 = 1/9, we find the Cooper-Verner method [1]. We show that the stability region depends only on coefficient a_10;5. We compare the stability regions according to the values of a_10;5 with respect to the stability region of Cooper-Verner.
A review of Dendrocephalus (Dendrocephalinus) (Crustacea: Anostraca) with the first records of male-male anostracan aggressive competition
Authors: Rogers D. Christopher , Dunn Ann , Price W. Wayne
Published: March 2019

We present a review of Dendrocephalus (Dendrocephalinus) with an updated diagnosis for the subgenus and a key to all known species. We provide new records of Dendrocephalus alachua, which was previously supposed to be extinct, and we describe a new species, Dendrocephalus proeliator sp. nov., which is separated from all other species based on the form of the male frontal appendage. Dendrocephalus proeliator sp. nov. appears to be morphologically intermediate between D. alachua and D. lithaca. In addition, we provide conservation assessments for all four species in the subgenus, according to IUCN Red List standards. We also report for two species the first known examples of direct male-male agonistic behaviour and competition for access to areas frequented by receptive females.
Editor’s Corner
Authors: Sare Laura
Published: March 2019

In planning this editorial I was reflecting on the new year. I began thinking about what was happening a hundred years ago, back in 1919. The most significant diplomatic event was the Paris Peace Conference, (image 1) and domestically the ratification of the 18th and 19th Amendments, but that seemed a bit much to cover in an editorial. In a quest for different ideas, I looked through the February 1919 edition of the Monthly Catalog—or Monthly Catalogue United States Public Documents. As I looked at what was published, it amazed me how many issues that we are dealing with now were also being addressed back then.
“Hidden Collections” in your Collection: World War II Depository Maps at Texas A&M University Libraries
Authors: Laddusaw Sierra , Littlejohn Garrett
Published: March 2019

A project to identify and inventory the World War II Era Map Collection held by Texas A&M University Libraries began in Fall 2018. While the project is in its beginning stages, the number of unique and interesting government printed maps that have been rediscovered has been exciting. These maps hold tremendous research value: providing snapshots of shifting boundaries, showing movements of troops, and serving as a visual history of the knowledge both the Allies and Axis powers had of the land, commerce, and military of their adversaries.
QIM19-115: Barriers and Trends in Cancer Patients` Pain Management in Qatar: A Randomized Cohort Prospective Study
Authors: Abdelwahab Rehab , Hamad Anas , Al Okka Randa , Wahid Mohd A. , Shibli Khalil Ullah , Saleem Wael , El Geziry Ahmed , Saleh Fathi , Rasul Kakil , Elazzazy Shereen
Published: March 2019

Background: Up to 70% of cancer patients experience pain during the course of illness (Fallon, Support Care Cancer 2008). Studies showed that 40%–50% of patients with cancer pain receive insufficient analgesia due to different factors. Physicians are facing different challenges to accurately assess pain which might affect drug selection and pain control (Beyeler et al, Support Care Cancer 2008; Salminen et al, Support Cancer Care 2008; Stewart, Ulster Med J 2014). In NCCCR, treating physicians may prescribe analgesics to their patients or refer them to the Pain Management Service (PMS) based on their evaluation or as requested by patients. This study explored the factors which might lead to undertreatment of cancer pain in Qatar. In addition, focused on cancer patients’ pain management satisfaction and PMS awareness. Objectives: To assess the existing PMS at NCCCR from patients' perspective. Methods: In this study, we evaluated patients’ pain management perception via a validated written (Arabic and English) questionnaire (SF-MPQ-2; available at https://eprovide.mapi-trust.org/instruments/short-form-mcgill-pain-questionnaire#DESCRIPTIVE_INFORMATION; Gauthier et al, J Pain 2014) and a structured interview by outpatient pharmacists at a single point of time, to assess patients` awareness towards the PMS, if they are receiving pain medications or not, if they are experiencing any pain regardless on pain medications or not, pain severity, and patients’ level of satisfaction towards their medications. A sample of 400 patients was randomly selected amongst the total cancer population visiting NCCCR Pharmacy over a specific period of time. Participants were consented and interviewed. Results: 400 patients agreed to participate; the median age was 50. Male to female ratio was 3 to 7. Data showed that 61% (245/400) of participants were not aware of the existence of the PMS. Only 20% (78/400) were aware and followed by PMS, with a satisfaction rate of 76% (59/78). Although 69% (276/400) of the patients were on pain medications, only 70% (191/276) were satisfied with their current medications. However from the satisfied patients, 57% (109/191) rated their pain as 4–10 at the time of interview (ATI). In the 31% (124/400) that were not taking any pain medications; 77% (96/124) didn’t know about the PMS, and 44% (55/124) had 4–10 pain severity (ATI). Conclusion: These findings provide clear evidence that factors leading to undertreating of cancer pain in Qatar might be unawareness of the PMS existence, pain treatment by unspecialized physicians, and patients’ reluctance to express their pain. Thus, raising patients’ awareness and standardizing the referral criteria can improve pain control and quality of life amongst cancer patients.
EPR19-072: Breast Cancer Laterality and Immunohistochemical Characteristics
Authors: Safi Tarek , Salameh Pascale , Aoude Lea , Waked Mirna ,   FCCP, Kobrossy Bassim
Published: March 2019

Background: Differences between left and right breast cancer have been investigated in the past in terms of incidence; it is higher on the left side than on the right. This difference has ranged from 2% to 5%. However, there are no publications looking at differences in immunohistochemical characteristics between left and right sided breast cancer. This study aims to assess the incidence and age distribution as well as the following immunohistochemical characteristics: estrogen receptor (ER), progesterone receptor (PR), and epidermal growth factor 2 (HER-2). We compared the age distribution to U.S. population as well as other Arab populations. In addition we compared these and other characteristics with respect to the laterality of the breast cancer. Methods: In this pilot retrospective descriptive study, data was collected anonymously on 300 patients who presented to the Saint George Hospital University Medical Center in Beirut. They were extracted from the inpatient files with a diagnosis of breast cancer in order of presentation from 2012 until the total number of files was reached. The measured parameters included the sex of the patient, the age at diagnosis, breast cancer laterality and stage, the need for surgical treatment, and ER status, PR status, and HER-2 status as shown on the official biopsy results of the cases studied. Results: HER-2, PR-, and ER-positive receptors were found to be more frequent by 4%, 9%, and 1% on the left side as compared with the right side, respectively. These numerical differences, however, were not statistically significant. Moreover, our data analysis shows that the Lebanese population distribution of breast cancer is skewed towards a younger age when compared to the U.S., with a median age of diagnosis of 53 and 62, respectively. Finally, in term of incidence, there was a 12% increase in incidence of left side breast cancer over the right side but this value did not reach statistical significance. Conclusions: This is the first study to show the relationship between hormonal receptors and laterality of breast cancer. We concluded that there is a trend towards statistically significant differences between laterality immunohistochemical characteristics. Epidemiological relationships between the Lebanese population, the Arab population, and the U.S. population were discussed. Further researches on larger population may be needed to show some of the trends presented in this article to be statistically significant.
QIM19-133: Assessing and Reducing FDG PET/CT Radiotracer Infiltrations: Lessons in Quality Improvement Sustainability
Authors: Kiser Jackson W. , Crowley James , Benefield Thad , Lattanze Ronald , Perrin Steve , Ryan Kelley , Knowland Josh
Published: March 2019

Background: Oncologic PET/CT studies require a prescribed 18F-fluorodeoxyglucose (FDG) dose delivered as a bolus prior to imaging; this same dose is used in the standardized uptake value (SUV) calculation. An infiltration is the misadministration of FDG outside the systemic circulation and will result in underestimating the SUV. Interpreting and treating physicians are often unaware of infiltrations when the injection site is outside the imaging field of view. Despite existing quality control (QC) efforts to ensure accuracy of the administered dose, there is no routine QC method that confirms complete delivery of the dose into the patient's circulation. 5 technologists in our center participated in a quality improvement project that reduced infiltration rates from 13.3% to 2.9% (P-value for difference in rates <.0001). Our objective was to evaluate sustainability of the improvement. Methods: 8 new technologists joined the team during the sustainability period. Infiltration rates in the sustainability period were calculated, controlling for technologist- and patient-level correlations (SAS v. 9.4). Infiltration rates were compared between QI participants and nonparticipants. Results: 13 technologists administered 1,240 injections in the sustainability period (10/7/2017–9/26/2018) with a 3.1% infiltration rate. The Infiltration rate for technologists who did not participate in the QI project was higher (6.08%; SE: 1.31%; 95% CI: 3.19%–8.97%) compared to the QI project technologists (2.05%; SE: 0.0055%; 95% CI: 0.83%–3.26%). This 66% decrease in rates was found to be statistically significant (P=.017). Conclusions: Although the overall infiltration rate remained low in the sustainability period, rates among new technologists who joined after the QI project were higher, compared to their QI project counterparts. This is especially important given the number of new technologists (n=8) compared to the QI project technologists (n=5). Quality improvement is a continuous process, and dissemination of lessons learned from the QI project should be provided as new technologists are onboarded. Because proper injections are critical to PET/CT images, ongoing monitoring is essential to ensuring that injection quality remains high, as infiltration rates can change over time.
CLO19-050: Risk of Health- Related Quality of Life (HRQOL) Events in Patients With Advanced Solid Tumors Treated With Cabozantinib: A Combined Analysis of Four Phase 3 Randomized Controlled Trials
Authors: Swarup Sriman , Sultan Anita , Jahan Nusrat , Sharma Upama , Adhikari Nimesh , Myat Yin M. , Aung Ye , Zaw Myo H. , Thein Kyaw Z.
Published: March 2019

Background: VEGFR, KIT, RET, and MET pathways are implicated in several solid tumors. Cabozantinib is an oral inhibitor of these kinase pathways, and hence has found its use in treatment of multiple malignancies. However, it has several side effects that can limit tolerance amongst patients. We performed a systematic review and meta-analysis of randomized controlled trials (RCT) to determine the risk of health-related quality of life (HRQOL) events in patients with advanced solid tumors treated with cabozantinib. Methods: We systematically conducted a comprehensive literature search using MEDLINE, EMBASE databases, and meeting abstracts through September 30, 2018. Phase 3 trials that mention HRQOL events like pain, arthralgia, fatigue, and reduced appetite as adverse effects were incorporated in the analysis. Mantel-Haenszel method was used to calculate the estimated pooled risk ratio (RR) with 95% CI. Random effects model was applied. Results: 4 phase 3 RCTs with a total of 2,703 patients with medullary thyroid cancer, prostate cancer, renal cell carcinoma, and hepatocellular carcinoma were eligible. Studies comparing cabozantinib (C) vs everolimus, C vs placebo, C vs prednisone were included in the analysis. The relative risks of all-grade side effects were as follows: fatigue, 1.378 (95% CI: 1.236–1.536; P<.0001); asthenia, 1.704 (95% CI: 1.190–2.441; P=.004); reduced appetite, 2.088 (95% CI: 1.471–2.964; P<.0001); back pain, 1.047 (95% CI: 0.871–1.259; P=.626); pain in limbs, 1.444 (95% CI: 1.128–1.847; P=.004); arthralgia, 0.982 (95% CI: 0.707–1.363; P=.912). The RR of high-grade side effects were as follows: fatigue, 1.937 (95% CI: 1.483–2.528; P<.0001); asthenia, 2.211 (95% CI: 1.536–3.184; P<.0001); reduced appetite, 4.329 (95% CI: 2.372–7.900; P<.0001); back pain, 1.227 (95% CI: 0.738–2.040; P=.431); pain in limbs, 2.933 (95% CI: 1.127–7.635; P=.028); arthralgia, 0.820 (95% CI: 0.394–1.709; P=.597). Conclusion: Our meta-analysis showed that cabozantinib contributed to significant toxicity of all grades of fatigue, asthenia, pain in limbs, and reduced appetite. Identifying and addressing these toxicities will be important in improving quality of life for these patients.
HSR19-092: Adjuvant Radiotherapy Is Associated with Improved Overall Survival for Resected Alveolar Ridge Squamous Cell Carcinoma With Adverse Pathologic Features
Authors: Jacobs Corbin D. , Rocke Daniel J. , Kahmke Russel R. , Williamson Hannah , Suneja Gita , Mowery Yvonne M.
Published: March 2019

Background: Alveolar ridge (AR) squamous cell carcinoma (SCC) is poorly represented on prospective clinical trials. Adjuvant management is extrapolated from more common head and neck SCC, including those with a stronger influence from the human papillomavirus. The objective of this analysis is to determine the association between adjuvant radiotherapy (RT) and overall survival (OS) for resected ARSCC based on adverse pathologic features. Methods: Adult subjects in the National Cancer Database diagnosed with invasive nonmetastatic ARSCC between 2010–2014 were identified. Exclusion criteria included prior malignancy, no/unknown surgery, unknown receipt of RT, RT dose <50 Gy or >80 Gy, RT fractions >68, T1–2N0 disease without identifiable NCCN-defined risk factors (positive margin, lymphovascular invasion, pT3–4, N2–3, extranodal extension, or level IV/V nodal metastasis), and unknown/missing NCCN risk factor data. Log-rank test stratified by RT and Cox regression analyses with respect to OS were performed. Results: 1,450 subjects met inclusion criteria, of which 825 (57%) received RT. Median follow-up was 27 months. Adjuvant RT was associated with improved OS (72% vs 65% at 2 years, log-rank P=.004). Stratified by number of NCCN-defined risk factors, adjuvant RT was associated with improved OS for subjects with 2 (74% vs 58% at 2 years, log-rank P<.001) and ≥3 (54% vs 29% at 2 years, log-rank P<.001) risk factors. Adjuvant RT was significantly associated with improved OS on univariate (HR, 0.80; 95% CI, 0.68–0.94; P=.008) and multivariate (HR, 0.72; 95% CI, 0.60–0.87; P=.001) analyses, the latter adjusted for age, comorbidity score, and adverse pathologic features. Each NCCN-defined risk factor, high tumor grade, primary tumor ≥3 cm, and ≥5% nodal positivity (number of pathologic nodes positive among nodes resected) were significantly associated with worse OS on univariate and multivariate analyses. Conclusions: Adjuvant RT for resected ARSCC with adverse pathologic features is associated with significantly improved OS. Subjects with a primary tumor ≥3 cm, high tumor grade, and ≥5% nodal positivity in addition to the NCCN-defined risk factors should be considered for adjuvant RT.
QIM19-136: Developing an Ideal CAR-T Cell Therapy Patient Experience Through Human-Centered Design and Innovation
Authors: Matthews Allison , Sidana Surbhi , Seymour Lauren , Pick Nancy , Pringnitz James , Argue David , Lange Gina , Brandes Eva , McClanahan Allison , Nedved Adrienne , Hayman Suzanne , Kenderian Saad , Kumar Shaji , Dingli David , Kourelis Taxiarchis , Warsame Rahma , Kapoor Prashant , Shah Mithun , Alkhateeb Hassan , Johnston Patrick , Ansell Stephen , Bennani Nabila , Siddiqui Mustaqeem , Lin Yi
Published: March 2019

Background: The patient/caregiver experience during CAR-T therapy is stressful, overwhelming, terrifying, and often a patient’s last treatment option. The Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Innovation and Design team has worked with the CAR-T therapy clinical team to develop a patient experience that provides patients with a sense of caring, supportive environment, timely knowledge, and realistic expectations. Using a human-centered design approach, the Innovation and Design team worked with patients and caregivers to understand latent and unspoken needs in order to develop an ideal CAR-T therapy patient journey. Methods: With qualitative interviewing techniques, patient observation, and low fidelity experimentation, 21 patients/caregiver pairs were interviewed throughout their CAR-T therapy experience in 2018. Patients were interviewed at several touch points as well as encouraged to reach out to the Innovation and Design team at any point with reflections on their experiences. Patients were recruited as they began their evaluation phase for CAR-T therapy. The interviews were unscripted to allow for a breadth of discovery by not constraining the conversations to previously developed themes. As themes emerged from patient/caregiver interviews, artifacts and interventions were designed to alleviate pain points and improve the patient/caregiver experience. These artifacts and interventions were integrated into the clinical processes in real time and patient/caregivers were interviewed to understand the impact of these activities. Results: Several themes emerged from qualitative interviews with patients and caregivers. From the themes, interventions were developed. We were able to demonstrate a qualitative improvement in patient/caregiver experience through these interventions (Figure 1). Conclusions: Patients/caregivers undergoing CAR-T therapy have unique issues surrounding the logistics of care, emotional burden, and physical effects of treatment. We implemented processes to address these issues and observed a qualitative improvement via patient interviews/feedback. Ongoing work includes optimizing remote monitoring, digital platforms for patient education, and a quantitative study looking at patient reported outcomes (PROs) in such patients. To our knowledge, this is the first report for care delivery optimization in real-world practice for this new therapy.