bluuebunny/crossref_metadata_2025 huggingface dataset:
Failures in Contingent Reasoning: The Role of Uncertainty
Authors: Martínez-Marquina Alejandro , Niederle Muriel , Vespa Emanuel
Published: September 2019

We propose a new channel to account for the difficulties of individuals with contingent reasoning: the presence of uncertainty. When moving from an environment with one state of known value to one with multiple possible values, two changes occur. First, the number of values to consider increases. Second, the value of the state is uncertain. We show in an experiment that this lack of certainty, or the loss of the Power of Certainty, impedes payoff maximization and that it accounts for a substantial portion of the difficulties with contingent reasoning. (JEL D12, D81, D91)
The Dynamics of Discrimination: Theory and Evidence
Authors: Bohren J. Aislinn , Imas Alex , Rosenberg Michael
Published: September 2019

We model the dynamics of discrimination and show how its evolution can identify the underlying source. We test these theoretical predictions in a field experiment on a large online platform where users post content that is evaluated by other users on the platform. We assign posts to accounts that exogenously vary by gender and evaluation histories. With no prior evaluations, women face significant discrimination. However, following a sequence of positive evaluations, the direction of discrimination reverses: women’s posts are favored over men’s. Interpreting these results through the lens of our model, this dynamic reversal implies discrimination driven by biased beliefs. (JEL C93, D83, J16, J71)
Equilibrium Effects of Firm Subsidies
Authors: Rotemberg Martin
Published: September 2019

Subsidy programs have two countervailing effects on firms: direct gains for eligible firms and indirect losses for those whose competitors are eligible. In 2006, India changed the eligibility criteria for small-firm subsidies, and the sales of newly eligible firms grew by roughly 35 percent. Competitors of the newly eligible firms were affected, with almost complete crowd-out within products that were less internationally traded, but little crowd-out for more-traded products. The newly eligible firms had relatively high marginal products, so relaxing the eligibility criteria for subsidies increased aggregate productivity by around 1−2 percent. Targeting different firms could have led to similar gains. (JEL D22, D24, H25, L25, L52, L60, O14)
Avaliação de progressão da competência de estudantes de medicina na realização de pontos cirúrgicos em simulador de laparoscopia
Authors: Costa Grijalva Ferreira da , Rocha Hermano Alexandre Lima , Moura Junior Luiz Gonzaga de , Medeiros Francisco das Chagas
Published: September 2019

Objetivo: avaliar a progressão da competência e a curva de aprendizagem de estudantes de Medicina submetidos a treinamento para a realização de nós e pontos cirúrgicos. Métodos: estudo prospectivo, longitudinal, intervencionista, realizado de abril/2016 a janeiro/2017, com a participação de 29 estudantes de Medicina, do primeiro ao terceiro ano, com progressão de habilidades para realização de nós e pontos laparoscópicos em ambiente de simulação em quatro etapas, com duração de 16 horas. Foi estabelecida a tarefa de realizar pontos laparoscópicos, com cinco seminós, em molde de sutura, em 18 minutos. Foram realizados os testes de ANOVA, Mann-Whitney e o qui-quadrado. Foram realizadas regressões lineares simples e múltiplas, sendo consideradas significativas as comparações com valor de p ≤ 0,05. Resultados: foram analisadas as médias do número de seminós (1,0 a 14,0, (IC-95%) 4,49 (3,80/5,19), pontos laparoscópicos intracorpóreos (0,1 a 2,7, (IC-95%) 0,87 (0,72/1,02), os tamanhos dos cotos dos fios (0,1 a 2,9, (IC-95%) 0,95 (0,72/1,18) e ajustes dos seminós iniciais (0,2 a 2,9, (IC-95%) 0,92 (0,76/1,07) e sequenciais (0,3 a 10,0, (IC-95%) 3,32 (2,84/3,80), entre as etapas do treinamento. Houve significância estatística em todos os parâmetros avaliados. A progressão na execução de pontos laparoscópicos foi evidente com coeficiente de regressão linear igual a 0,511. A curva de aprendizagem demonstrou que 96,3% dos estudantes realizaram, pelo menos, um ponto laparoscópico ao final do treinamento. Conclusão: o estudo revelou que os alunos apresentaram progressão na competência e evolução na curva de aprendizagem na realização de pontos laparoscópicos em ambiente de simulação ao final do treinamento.
Vesiculobullous exanthema in a 3-month-old child with probable acute chikungunya infection
Authors: Farias Luis Arthur Brasil Gadelha , Pires Neto Roberto da Justa , Leite Robério Dias
Published: September 2019

Objective: to report a rare case of a 3-month-old child with acute chikungunya infection presenting as vesiculobullous rash. Case description: herein we report a case of a 3-month-old infant which developed a diffuse erythematous rash involving the trunk and limbs within two days after sudden acute fever, and also presented striking irritability with inconsolable crying, hyporexia, cough, and coryza.  Hematological and biochemical investigations were undertaken and were found to be normal. Serum samples were tested for Chikungunya revealing positive IgM. He was treated with supportive therapy, mainly with antipyretics, venous hydration and rest evolving with entirely resolution of the symptoms after four days. Comments: Chikungunya fever is a disease caused by the Chikungunya virus which can be found in endemic areas such as Brazil. Atypical manifestations can affect various systems including the skin and may be more frequent in children. The role of dermatological manifestations related to Chikungunya infection is not completely understood.  The reported case is an unusual case of Chikungunya infection which highlights the importance of  to know and to be aware of this manifestation in children mainly in new endemic areas such as Brazil.
Epidermólise bolhosa: suas repercussões restritivas na vida diária do paciente
Authors: Lima Layse Fraga , Vasconcelos Pedro Fonseca de
Published: September 2019

Objetivo: abordar aspectos clínicos, diagnósticos e terapêuticos dessa patologia, para compreender como essa doença limita os pacientes e afeta a sua qualidade de vida, sendo um assunto ainda pouco estudado e, por isso, escolhido para contribuir na divulgação de informações esclarecedoras. Métodos: dessa forma, foi elaborada uma revisão de literatura narrativa crítica, selecionando artigos das seguintes bases de dados: LILACS (Literatura Latino-americana e do Caribe em Ciências da Saúde), PubMed e SciELO (Scientific Electronic Library Online), entre os anos de 2005 e 2018. Os descritores usados foram: “Epidermólise Bolhosa” e “Epidermolysis Bullosa” Resultados: os resultados mostram que os pacientes portadores da EB convivem com vários sintomas restritivos, envolvendo manifestações cutâneas e extracutâneas. O prurido e a dor localizada, devido à fragilidade das lesões, incapacitam as atividades diárias. A estenose do esôfago gera dificuldade para a deglutição dos alimentos, causando um estado de má nutrição, que culminará em uma cadeia de complicações metabólicas. As bolhas, ao se romperem, contribuem para a instalação da anemia ferropriva. As infecções ocorrem pela perda da barreira do estrato córneo, tornando esse indivíduo sempre vulnerável. A mão em forma de luva de boxe (deformidade de Mitten) impede a sensação tátil e favorece atos discriminatórios. Somado a isso, o componente psicológico é muito afetado, desde o diagnóstico, pela impossibilidade de cura e complexidade da patologia, até as restrições enfrentadas, a autoaceitação da imagem corporal e o preconceito. Conclusão: o estigma social e as alterações múltiplas na pele, bem como a baixa expectativa de vida configuram-se como fatores limitantes da EB, necessitando de ações de assistência e preventivas mais efetivas para minimizar os efeitos dessa afecção.
Efeitos do jejum intermitente no peso corporal e perfil lipídico em Rattus norvergicus
Authors: Reis Renandro , Pinho Tamilla , Rocha Diego , Oliveira Fernando , Sabino Eliamara
Published: September 2019

Objetivo: verificar as possíveis alterações no peso corporal e perfil lipídico em ratos submetidos a jejum intermitente. Métodos: foram utilizados ratos Wistar da espécie Rattus norvergicus (n=24), divididos por grupos. Um grupo teste (6 machos e 6 fêmeas), submetidos ao jejum intermitente de 42 dias, e um grupo controle (6 machos e 6 fêmeas) com alimentação ad libitum de igual período. O jejum utilizado foi realizado em regime de dias alternados (24h) e com água disponível durante todo o estudo e sem prática de exercícios. Foi realizada a dosagem sérica de colesterol total, triglicerídeos e HDL, além do peso corporal antes e após a conclusão do estudo em todos os grupos. Os resultados foram analisados para um índice de significância de p<0,05. Resultados: o grupo teste não apresentou significância para a variação do peso corporal tanto em machos quanto em fêmeas que praticaram o JI; índices séricos de triglicerídeos se mostraram, estatisticamente, menores tanto em fêmeas (t(10)=3.856; p=0.003179) quanto em machos (t(10)=4.192; p=0.001853) em comparação ao controle. Não houve significância no HDL e no colesterol total entre os machos. Em contrapartida, as fêmeas apresentaram aumento significativo do HDL (t(10)=3.348; p= 0.007394) e redução, significativamente, estatística (de t(10)=2.867; p=0.016758) do colesterol total. Conclusão: o emprego do jejum intermitente se mostrou eficaz no controle do peso e do triglicerídeo em ambos os sexos e eficaz para o aumento do HDL em fêmeas.
Difficult to treat epilepsy: Could it be Dravet?
Authors: Williamson Neil
Published: September 2019

Dravet syndrome remains relatively unknown and under-diagnosed. Neil Williamson provides a brief overview of the condition and a diagnosis and management guide for school nurses.
Managing stress and burnout in your nursing role
Authors: jane Palmer Sarah
Published: September 2019

In this article, Sarah Palmer discusses the signs and symptoms of stress and burnout, and effective ways to manage this
Control of infectious lameness in sheep
Authors: Duncan Jennifer , Angell Joseph
Published: September 2019

Lameness in sheep remains a significant welfare and economic issue for many UK sheep farms. The principle causes of lameness are the infectious foot diseases footrot and contagious ovine digital dermatitis. This article will review the recent research on the microbial aetiology, epidemiology, prevention and treatment of both diseases and the application of this knowledge into farm specific control plans utilising the Five Point Plan framework.
African swine fever — a year on
Authors: Carr John , Howells Mark
Published: September 2019

Last year we reported on the spread of the African swine fever virus in Europe and Asia. Unfortunately, as expected the situation has only got much worse. African Swine Fever is now threatening human protein resources. Here we discuss our thoughts on the current situation.
Cruciate ligament disease and the role of the Balto Knee Brace
Authors: Corral Cheryl
Published: September 2019

Cruciate disease is the most prevalent cause of hindlimb lameness amongst the canine population. As a result of the prevalent nature of the condition, improved management strategies are continually being sought from both a surgical and conservative perspective. This article discusses cruciate disease, and the KVP ‘Balto’ brace in relation to its use as part of conservative management strategy.
How to perform fluid therapy
Authors: Bloor Claire
Published: September 2019

Veterinary nurses play an important role in infusion therapy and they are involved in all stages of intravenous fluid therapy (IVFT) provision. Examples of tasks undertaken within their role include pre-infusion blood sampling and testing, pre-infusion patient assessment, preparation of infusions, obtaining intravenous access, administering infusions safely and monitoring patient progress. This article will explore each of these tasks in turn, examining considerations to be mindful of to ensure a safe and efficient procedure, while highlighting any potential pitfalls and how they can be avoided.
The Impact of Academic, Personal, and Professional Attributes on the Occupational Identity of School Counselors in Israel
Authors: Heled Einat , Davidovitch Nitza
Published: September 2019

This article focuses on the influence of academic training, job issues, personality and demographic characteristics of school counselors on their professional identity construction, which is developed in a theoretical model based on educational-psychological theories. Most of the training in Master's degree studies in school counseling is incompatible with actual job demands; Consequently, when beginning work, school counselors lack suitable training and relevant professional tools. Moreover, in Israel and elsewhere, the definition of school counseling is unclear and inconclusive, and this affects the counselors' professional identity and the quality of their work. The proposed model of the variables that affect school counselors’ professional identity may enhance the relationship between academia and the field, with the aim of promoting academic excellence and a well-formulated professional identity for the profession of school counseling, as well as improving the employment terms of school counselors, in light of the challenges facing higher education systems in the 21st century.
Posterior cruciate ligament resection in total knee arthroplasty
Authors: Kayani Babar , Konan Sujith , Horriat Saman , Ibrahim Mazin S. , Haddad Fares S.
Published: September 2019

Aims

The aim of this study was to assess the effect of posterior cruciate ligament (PCL) resection on flexion-extension gaps, mediolateral soft-tissue laxity, fixed flexion deformity (FFD), and limb alignment during posterior-stabilized (PS) total knee arthroplasty (TKA).

Patients and Methods

This prospective study included 110 patients with symptomatic osteoarthritis of the knee undergoing primary robot-assisted PS TKA. All operations were performed by a single surgeon using a standard medial parapatellar approach. Optical motion capture technology with fixed femoral and tibial registration pins was used to assess gaps before and after PCL resection in extension and 90° knee flexion. Measurements were made after excision of the anterior cruciate ligament and prior to bone resection. There were 54 men (49.1%) and 56 women (50.9%) with a mean age of 68 years (sd 6.2) at the time of surgery. The mean preoperative hip-knee-ankle deformity was 4.1° varus (sd 3.4).

Results

PCL resection increased the mean flexion gap significantly more than the extension gap in the medial (2.4 mm (sd 1.5) vs 1.3 mm (sd 1.0); p < 0.001) and lateral (3.3 mm (sd 1.6) vs 1.2 mm (sd 0.9); p < 0.01) compartments. The mean gap differences after PCL resection created significant mediolateral laxity in flexion (gap difference: 1.1 mm (sd 2.5); p < 0.001) but not in extension (gap difference: 0.1 mm (sd 2.1); p = 0.51). PCL resection significantly improved the mean FFD (6.3° (sd 4.4) preoperatively vs 3.1° (sd 1.5) postoperatively; p < 0.001). There was a strong positive correlation between the preoperative FFD and change in FFD following PCL resection (Pearson’s correlation coefficient = 0.81; p < 0.001). PCL resection did not significantly affect limb alignment (mean change in alignment: 0.2° valgus (sd 1.2); p = 0.60).

Conclusion

PCL resection creates flexion-extension mismatch by increasing the flexion gap more than the extension gap. The increase in the lateral flexion gap is greater than the increase in the medial flexion gap, which creates mediolateral laxity in flexion. Improvements in FFD following PCL resection are dependent on the degree of deformity before PCL resection. Cite this article: Bone Joint J 2019;101-B:1230–1237
Interpreting and reporting fracture classification and operation type in hip fracture
Authors: Masters James , Metcalfe David , Parsons Nick R. , Achten Juul , Griffin Xavier L. , Costa Matt L. ,   WHiTE Collaborative Investigators
Published: September 2019

Aims

This study explores data quality in operation type and fracture classification recorded as part of a large research study and a national audit with an independent review.

Patients and Methods

At 17 centres, an expert surgeon reviewed a randomly selected subset of cases from their centre with regard to fracture classification using the AO system and type of operation performed. Agreement for these variables was then compared with the data collected during conduct of the World Hip Trauma Evaluation (WHiTE) cohort study. Both types of surgery and fracture classification were collapsed to identify the level of detail of reporting that achieved meaningful agreement. In the National Hip Fracture Database (NHFD), the types of operation and fracture classification were explored to identify the proportion of “highly improbable” combinations.

Results

The records were reviewed for 903 cases. Agreement for the subtypes of extracapsular fracture was poor; most centres achieved no better than “fair” agreement. When the classification was collapsed to a single option for “extracapsular” fracture, only four centres failed to have at least “moderate” agreement. There was only “moderate” agreement for the subtypes of intracapsular fracture, which improved to “substantial” when collapsed to “intracapsular”. Subtrochanteric fracture types were well reported with “substantial” agreement. There was near “perfect” agreement for internal fixation procedures. “Perfect” or “substantial” agreement was achieved when the type of arthroplasty surgery was reported at the level of “hemiarthroplasty” and “total hip replacement”. When reviewing data submitted to the NHFD, a minimum of 5.2% of cases contained “highly improbable” procedures for the stated fracture classification.

Conclusion

The complexity of collecting fracture classification data at a national scale compromises the accuracy with which detailed classification systems can be reported. Data around type of surgery performed show similar tendencies. Data capture, reporting, and interpretation in future studies must take this into account. Cite this article: Bone Joint J 2019;101-B:1292–1299
Prevalence and diagnostic accuracy of in-toeing and out-toeing of the foot for patients with abnormal femoral torsion and femoroacetabular impingement
Authors: Lerch Till D. , Eichelberger Patric , Baur Heiner , Schmaranzer Florian , Liechti Emanuel F. , Schwab Joe M. , Siebenrock Klaus A. , Tannast Moritz
Published: September 2019

Aims

Abnormal femoral torsion (FT) is increasingly recognized as an additional cause for femoroacetabular impingement (FAI). It is unknown if in-toeing of the foot is a specific diagnostic sign for increased FT in patients with symptomatic FAI. The aims of this study were to determine: 1) the prevalence and diagnostic accuracy of in-toeing to detect increased FT; 2) if foot progression angle (FPA) and tibial torsion (TT) are different among patients with abnormal FT; and 3) if FPA correlates with FT.

Patients and Methods

A retrospective, institutional review board (IRB)-approved, controlled study of 85 symptomatic patients (148 hips) with FAI or hip dysplasia was performed in the gait laboratory. All patients had a measurement of FT (pelvic CT scan), TT (CT scan), and FPA (optical motion capture system). We allocated all patients to three groups with decreased FT (< 10°, 37 hips), increased FT (> 25°, 61 hips), and normal FT (10° to 25°, 50 hips). Cluster analysis was performed.

Results

We found a specificity of 99%, positive predictive value (PPV) of 93%, and sensitivity of 23% for in-toeing (FPA < 0°) to detect increased FT > 25°. Most of the hips with normal or decreased FT had no in-toeing (false-positive rate of 1%). Patients with increased FT had significantly (p < 0.001) more in-toeing than patients with decreased FT. The majority of the patients (77%) with increased FT walk with a normal foot position. The correlation between FPA and FT was significant (r = 0.404, p < 0.001). Five cluster groups were identified.

Conclusion

In-toeing has a high specificity and high PPV to detect increased FT, but increased FT can be missed because of the low sensitivity and high false-negative rate. These results can be used for diagnosis of abnormal FT in patients with FAI or hip dysplasia undergoing hip arthroscopy or femoral derotation osteotomy. However, most of the patients with increased FT walk with a normal foot position. This can lead to underestimation or misdiagnosis of abnormal FT. We recommend measuring FT with CT/MRI scans in all patients with FAI. Cite this article: Bone Joint J 2019;101-B:1218–1229
Single versus dual Kirschner wires for closed reduction and intramedullary nailing of displaced fractures of the fifth metacarpal neck (1-2 KiWi): a randomized controlled trial
Authors: Eisenschenk Andreas , Spitzmüller Romy , Güthoff Claas , Obladen Adrian , Kim Simon , Henning Esther , Dornberger Jenny E. , Stengel Dirk ,   1-2-KiWi Investigators
Published: September 2019

Aims

The aim of this study was to investigate whether clinical and radiological outcomes after intramedullary nailing of displaced fractures of the fifth metacarpal neck using a single thick Kirschner wire (K-wire) are noninferior to those of technically more demanding fixation with two thinner dual wires.

Patients and Methods

This was a multicentre, parallel group, randomized controlled noninferiority trial conducted at 12 tertiary trauma centres in Germany. A total of 290 patients with acute displaced fractures of the fifth metacarpal neck were randomized to either intramedullary single-wire (n = 146) or dual-wire fixation (n = 144). The primary outcome was the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire six months after surgery, with a third of the minimal clinically important difference (MCID) used as the noninferiority threshold. Secondary outcomes were pain, health-related quality of life (EuroQol five-dimensional questionnaire (EQ-5D)), radiological measures, functional deficits, and complications.

Results

Overall, 151/290 of patients (52%) completed the six months of follow-up, leaving 83 patients in the single-wire group and 68 patients in the dual-wire group. In the modified intention-to-treat analysis set, mean DASH scores six months after surgery were 3.8 (sd 7.0) and 4.4 (sd 9.4), respectively. With multiple imputation (n = 288), mean DASH scores were estimated at 6.3 (sd 8.7) and 7.0 (sd 10.0). Upper (1 - 2α)) confidence limits consistently remained below the noninferiority margin of 3.0 points in the DASH instrument. While there was a statistically nonsignificant trend towards a higher rate of shortening and rotational malalignment in the single wire group, no statistically significant differences were observed across groups in any secondary outcome measure.

Conclusion

A single thick K-wire is sufficient for intramedullary fixation of acute displaced subcapital fractures of the fifth metacarpal neck. The less technically demanding single-wire technique produces noninferior clinical and radiological outcomes compared with the dual-wire approach. Cite this article: Bone Joint J 2019;101-B:1263–1271
Universidades Corporativas e o ensino para a sustentabilidade
Authors: Martão Monica Aparecida De Sordi , Demajorovic Jacques
Published: September 2019

Este artigo tem por objetivo verificar como universidades corporativas promovem a educação para a sustentabilidade de seus colaboradores e stakeholders externos de forma a integrar esta temática nas estratégias organizacionais. Para esta pesquisa qualitativa, a técnica de coleta de dados escolhida foi a entrevista semiestruturada, realizada com 16 Gestores de universidades corporativas sediadas no Estado de São Paulo. Os resultados apontam que, embora a sustentabilidade seja um componente estratégico presente no discurso organizacional, é praticamente inexistente modelos específicos e ações educacionais, relacionados propriamente com o tema. Destaca-se a falta de uma cultura para a sustentabilidade efetiva nas organizações e concentração do conhecimento relativo ao tema nos departamentos específicos de sustentabilidade, que contribui para um aprendizado fragmentado e pontual, dificultando a apropriação deste conhecimento nas demais unidades organizacionais e a incorporação da temática na estratégia das organizações pesquisadas. O principal desafio encontrado se refere à construção de diálogo colaborativo entre as universidades corporativas, áreas de sustentabilidade e demais setores organizacionais que facilite um processo formativo efetivo nas organizações, conciliando objetivos econômicos, ambientais e sociais.
Objetivos de Desenvolvimento Sustentável das Nações Unidas: Reflexões e Soluções Oferecidas pela Área de Ensino em Administração
Authors: Kanashiro Patricia
Published: September 2019

Editorial da edição especial Achieving Sustainable Development
Oral medicine and stomatology in Hong Kong and China
Authors: Wu Zheng Li , Thomson Peter
Published: September 2019

A review of the development, organisation, training and contemporary practice of oral medicine and stomatology in Hong Kong and China.
A Call for Better Data on Prevalence and Health Surveillance of People With Intellectual and Developmental Disabilities
Authors: Krahn Gloria L.
Published: September 2019

The U.S. approach to the health of people with intellectual and developmental disabilities (IDD) is fraught with paradox. The health of this population has been of longstanding concern, yet we understand their health less well than many other groups. The U.S. spends much more per person on the well-being of people with IDD compared to the general population, yet the outcomes of those expenditures are disappointing and include significant preventable health disparities. Even as expectations for people with IDD have changed to include better health and greater participation in their communities, eligibility for services that support these outcomes is rooted in expectations of dependence and poverty. This article is a call for better data that considers a series of questions to provide context for understanding the need and directions for better health surveillance of people with IDD.
Identifying People With Intellectual and Developmental Disabilities in National Population Surveys
Authors: Havercamp Susan M. , Krahn Gloria L. , Larson Sheryl A. , Fujiura Glenn , Goode Tawara D. , Kornblau Barbara L. ,   the National Health Surveillance for IDD Workgroup
Published: September 2019

Public health and policy planning for adults with intellectual and developmental disabilities (IDD) is imperiled by the lack of ongoing national surveillance data on prevalence and health status. In 2018, the Administration on Intellectual and Developmental Disabilities appointed a workgroup of representatives from key federal agencies and national experts to recommend strategies to improve prevalence estimates and health surveillance for people with IDD. This article presents the workgroup findings on the availability of prevalence and health surveillance data for adults with IDD and suggested items that could identify respondents with IDD on national surveys with special attention to modifications in the National Health Interview Survey. We identify core constructs that must be measured to identify sample members with IDD in population surveys, and additional constructs which, if measured, would support more comprehensive identification of sample members and enhance ongoing surveillance of the health status, outcomes, and unmet needs of this population. We conclude with a brief review of methodological considerations to improve IDD national surveillance including cultural and linguistic sensitivity and the inclusion of U.S. territories in national surveillance protocols.
Characteristics of Medicare Beneficiaries With Intellectual or Developmental Disabilities
Authors: Reichard Amanda , Haile Elsa , Morris Andrew
Published: September 2019

Gaps in knowledge and systematic tracking of the prevalence of intellectual and developmental disabilities (IDD) and characteristics that may affect the health of this disability group limits our ability to address the health disparities they experience in comparison to people without disability. The purpose of this study is to begin to fill one relevant critical gap in knowledge: understanding the demographics and health outcomes of adults with IDD who receive services under Medicare Fee-for-Service (FFS), many of who are also eligible for Medicaid. Using 2016 Medicare administrative claims, we examined the prevalence and characteristics of five diagnosis groups of IDD, in those under 65 and those 65 and over, as well as their health outcomes. We found that the IDD Medicare FFS group had high prevalence rates for chronic physical and mental health conditions, overuse of emergency departments, and high rate of 30-day readmission. These findings highlight the need for evidence-based health care coordination, improved and increased public health interventions, and continued surveillance.
Data Linkage: Canadian and Australian Perspectives on a Valuable Methodology for Intellectual and Developmental Disability Research
Authors: Balogh Robert , Leonard Helen , Bourke Jenny , Brameld Kate , Downs Jenny , Hansen Michele , Glasson Emma , Lin Elizabeth , Lloyd Meghann , Lunsky Yona , O'Donnell Melissa , Shooshtari Shahin , Wong Kingsley , Krahn Gloria
Published: September 2019

Data linkage holds great promise for generating new information about people with intellectual and developmental disabilities (IDD) as a population, yet few centers have developed the infrastructure to utilize this methodology. Two examples, from Canada and Australia, describe their efforts in building data linkage capabilities, and how linked databases can be used to identify persons with IDD and used for population-based research. The value of data linkage is illustrated through new estimates of prevalence of IDD; health service utilization patterns; associations with sociodemographic characteristics, and with physical and mental health conditions (e.g., chronic diseases, injury, fertility, and depression); and findings on equity in medical treatments. Examples are provided of findings used for governmental policy and program planning.
Technology Tools: Increasing Our Reach in National Surveillance of Intellectual and Developmental Disabilities
Authors: Wagner Jordan B. , Kim Minje , Tassé Marc J.
Published: September 2019

Challenges in collecting comprehensive health surveillance data on people with intellectual and developmental disabilities (IDD) are numerous. A number of important issues and strategies are discussed in the articles contained in this special issue of Intellectual and Developmental Disabilities. In this article, we focus on the advances and tools available in the area of technology. We explore a number of possible sources including accessing big data such as analyzing health information contained in Medicaid and Medicare health databases. We also discuss some of the possibilities afforded to us by complementing Medicaid/Medicare database information with health information available in the myriad of electronic health records. Lastly, we explore other technologies available that might yield valuable health supports and information, including wearable devices, remote supports and other smart home technologies, telehealth and telepsychiatry, as well as looking at ways to access other technologies that collect health information (e.g., glucometer, health apps, connected exercise devices, etc.).
Clinical Use of a New High-Sensitivity Cardiac Troponin I Assay in Patients with Suspected Myocardial Infarction
Authors: Boeddinghaus Jasper , Twerenbold Raphael , Nestelberger Thomas , Koechlin Luca , Wussler Desiree , Meier Mario , Troester Valentina , Zimmermann Tobias , Badertscher Patrick , Wildi Karin , Rubini Giménez Maria , Lopez-Ayala Pedro , Potlukova Eliska , Miró Òscar , Martin-Sanchez F Javier , Kawecki Damian , Geigy Nicolas , Keller Dagmar I , Reichlin Tobias , Mueller Christian , du Fay de Lavallaz Jeanne , Walter Joan Elias , Freese Michael , Puelacher Christian , Hafner Benjamin , Strebel Ivo , Kozhuharov Nikola , Rentsch Katharina , Gualandro Danielle M , Schaerli Nicolas , Stelzig Claudia , Meissner Kathrin , Kulangara Caroline , Hillinger Petra , Grimm Karin , Michou Eleni , Flores Dayana , Czmok Rafael , Osswald Stefan , López Beatriz , Fuenzalida Carolina , Rodriguez Adrada Esther , Ganovská Eva , Lohrmann Jens , Kloos Wanda , Christ Michael , Steude Jana , Fahrni Gregor , Buser Andreas , von Eckardstein Arnold , Morawiec Beata , Nowalany-Kozielska Ewa , Muzyk Piotr
Published: September 2019

BACKGROUND

We aimed to validate the clinical performance of the high-sensitivity cardiac troponin I [VITROS® Immunodiagnostic Products hs Troponin I (hs-cTnI-VITROS)] assay.

METHODS

We enrolled patients presenting to the emergency department with symptoms suggestive of acute myocardial infarction (AMI). Final diagnoses were centrally adjudicated by 2 independent cardiologists considering all clinical information, including cardiac imaging: first, using serial hs-cTnT-Elecsys (primary analysis) and, second, using hs-cTnI-Architect (secondary analysis) measurements in addition to the clinically used (hs)-cTn. hs-cTnI-VITROS was measured at presentation and at 1 h in a blinded fashion. The primary objective was direct comparison of diagnostic accuracy as quantified by the area under the ROC curve (AUC) of hs-cTnI-VITROS vs hs-cTnT-Elecsys and hs-cTnI-Architect, and in a subgroup also hs-cTnI-Centaur and hs-cTnI-Access. Secondary objectives included the derivation and validation of an hs-cTnI-VITROS-0/1-h algorithm.

RESULTS

AMI was the adjudicated final diagnosis in 158 of 1231 (13%) patients. At presentation, the AUC for hs-cTnI-VITROS was 0.95 (95% CI, 0.93–0.96); for hs-cTnT-Elecsys, 0.94 (95% CI, 0.92–0.95); and for hs-cTnI-Architect, 0.92 (95% CI, 0.90–0.94). AUCs for hs-cTnI-Centaur and hs-cTnI-Access were 0.95 (95% CI, 0.94–0.97). Applying the derived hs-cTnI-VITROS-0/1-h algorithm (derivation cohort n = 519) to the validation cohort (n = 520), 53% of patients were ruled out [sensitivity, 100% (95% CI, 94.1–100)] and 14% of patients were ruled in [specificity, 95.6% (95% CI, 93.4–97.2)]. Patients ruled out by the 0/1-h algorithm had a survival rate of 99.8% at 30 days. Findings were confirmed in the secondary analyses using the adjudication including serial measurements of hs-cTnI-Architect.

CONCLUSIONS

The hs-cTnI-VITROS assay has at least comparable diagnostic accuracy with the currently best validated hs-cTnT and hs-cTnI assays.

ClinicalTrials.gov Identifier

NCT00470587.
Molecular techniques for sex identification of captive birds
Authors: Purwaningrum Medania , Nugroho Herjuno Ari , Asvan Machmud , Karyanti Karyanti , Alviyanto Bertha , Kusuma Randy , Haryanto Aris
Published: September 2019

Background and Aim: Many avian species are considered sexually monomorphic. In monomorphic bird species, especially in young birds, sex is difficult to identify based on an analysis of their external morphology. Accurate sex identification is essential for avian captive breeding and evolutionary studies. Methods with varying degrees of invasiveness such as vent sexing, laparoscopic surgery, steroid sexing, and chromosome inspection (karyotyping) are used for sex identification in monomorphic birds. This study aimed to assess the utility of a non-invasive molecular marker for gender identification in a variety of captive monomorphic birds, as a strategy for conservation. Materials and Methods: DNA was isolated from feather samples from 52 individuals representing 16 species of 11 families indigenous to both Indonesia and elsewhere. We amplified the chromodomain helicase DNA-binding (CHD) gene using polymerase chain reaction with MP, NP, and PF primers to amplify introns with lengths that differ between the CHD-W and the CHD-Z genes, allowing sex discrimination because the W chromosome is exclusively present in females. Results: Molecular bird sexing confirmed 33 females and 19 males with 100% accuracy. We used sequencing followed by alignment on one protected bird species (Probosciger aterrimus). Conclusion: Sex identification may be accomplished noninvasively in birds, because males only have Z sex chromosomes, whereas females have both Z and W chromosomes. Consequently, the presence of a W-unique DNA sequence identifies an individual as female. Sexing of birds is vital for scientific research, and to increase the success rate of conservation breeding programs.
CAPACIDADES DINÂMICAS NA INOVAÇÃO DOS MODELOS DE NEGÓCIO DE STARTUPS
Authors: Gomes Couto Marcelo Henrique , Freire Teberga Pedro Marins , De Castro Amanda Cristina , Oliva Fábio Lotti
Published: September 2019

Este artigo busca investigar e descrever como as startups residentes no CUBO, um espaço de coworking localizado na cidade de São Paulo, desenvolvem suas capacidades dinâmicas e como essas capacidades contribuem para a inovação em seus modelos de negócio. Para o cumprimento do objetivo proposto, adotam-se a abordagem qualitativa, o método de múltiplos casos e o caráter exploratório-descritivo, além da entrevista semiestruturada como estratégia para coleta de dados e do método de análise de conteúdo para leitura dos dados. A partir dos quatro casos investigados, observou-se que, no geral, o desenvolvimento das capacidades dinâmicas operacionalizou-se por meio da capacidade da empresa de perceber e, em seguida, aproveitar as oportunidades e gerenciar ameaças, combinando e recombinando ativos. Além disso, observou-se também que o próprio processo de inovação em modelos de negócio comportou-se como uma capacidade dinâmica, contribuindo para a formação e a criação de processos, rotinas e comportamentos organizacionais para a inovação e desenvolvimento do negócio de forma sistemática e proposital. Conclui-se, portanto, que as capacidades dinâmicas podem ser propulsoras da inovação em modelos de negócio, especialmente em ambientes caracterizados pela alta dinâmica competitiva e tecnológica.
COLLINS DISTRIBUIDORA: OS DESAFIOS NA GESTÃO DE PESSOAS
Authors: Passos Ana Paula Pereira dos , Wollinger Helena
Published: September 2019

Este caso para ensino tem por objetivo oportunizar aos alunos a discussão de situações pertinentes à gestão de pessoas por meio da Empresa Collins Distribuidora, relatando suas dificuldades na gestão dos funcionários ao longo do seu crescimento e as consequências acarretadas pela falta de posicionamento dos gestores. Em 2016, após a perda de um dos principais clientes da empresa, Marlon acredita ser o momento propício de discutir sobre a administração de recursos humanos, deste modo convoca os demais sócios, Carlos e Marcos, para uma reunião. É preciso decidir o que fazer e quais as possíveis soluções, levando em consideração o posicionamento divergente entre os sócios. A proposta é fazer com que os alunos se coloquem no lugar dos gestores, a fim de promover o debate sobre estratégias de curto e longo prazo para os desafios vivenciados pela Collins. Assim, o caso apresenta uma situação na qual o leitor é levado a refletir sobre diversos conceitos inerentes à motivação, ao comprometimento e à produtividade, e relacioná-los com a realidade do mundo corporativo. Propõe-se que o caso seja aplicado nos cursos de Graduação em Administração e Gestão de Recursos Humanos.
Synthesis and Molecular Docking Studies of Coumarinyl
Thiazole as Cell Division Protein Kinase 2 Inhibitor
Authors: Brindha J. , Fen Reji T.F. Abbs
Published: September 2019

A series of 2-alkylamino-4-(3-coumarinyl)thiazoles were synthesized, characterized and evaluated their anticancer activity through molecular docking studies. Cell division protein kinase 2 (PDB code: 1KE9) is selected as a target and the compounds which obeys Lipinski rule of five is selected as a ligand. Molecular docking study is carried out using AutoDock Vina in PyRx virtual screening tool. This study revealed that all the compounds are active against the molecular target and compounds 5a and 5c have the highest docking score.
Synthesis, Molecular Docking and Radical Scavenging
Activity of 1,2,4,5-Tetrasubstituted Imidazole Derivatives
Authors: Bhadrachar Somashekara , Vijayakumar Giriyapura R. , Mahadevan Kittappa M. , Basavaraja Thippeswamy
Published: September 2019

A series of 1,2,4,5-tetrasubstituted imidazoles (2a-g) were synthesized using 1,2-diketone,
1-naphthaldehyde, substituted aromatic amine and ammonium acetate in the presence of ceric ammonium nitrate as a catalyst. The synthesized compounds were characterized by FT-IR, 1H NMR, Mass spectra and explored for their antioxidant activity by DPPH free radical scavenging assay method. Among the synthesized compounds 2a, 2e and 2f exhibit good antioxidant activities. Molecular docking study was also been performed to know the possible interactions between the synthesized compound and antioxidant receptor 3MNG.
Distribution of Nutrients in Kelantan River Basin, Malaysia
Authors: Suratman S. , Hee Y.Y.
Published: September 2019

This study aims to assess the influences of land use on nutrient concentrations in Kelantan river basin (southern South China Sea), in addition to the effects of monsoon seasons on nutrient concentrations. The dissolved inorganic and organic nutrients in this river were demonstrated to be related to land use during the study period. The middle and lower reaches of the river, which are surrounded by urban areas with high population densities, have enhanced levels of both dissolved inorganic and organic nutrients. Increased rainfall decreased most of the nutrient concentrations in Kelantan river basin, probably due to the dilution effect. According to The Malaysia National Water Quality Standards (NWQS) classification, the mean concentrations of dissolved inorganic phosphorus, nitrite and nitrate in Kelantan river basin fell into Class 1, which is considered at natural levels in the water column.
Adsorption Capacity and Selectivity of Molecularly Imprinted Polymers towards β-Sitosterol
Authors: Fauziah St. , Soekamto N.H. , Budi P. , Taba P.
Published: September 2019

Molecularly imprinted polymers (MIP) as an adsorbent has been synthesized using β-sitosterol as molecule template on free radical polymerization reaction. The capacity and selectivity of the adsorption from MIP to β-sitosterol was studied in this study. The β-sitosterol concentration in the adsorption-desorption test and the MIP selectivity test were analyzed by UV-visible and HPLC. The MIP obtained from the synthesis results in a high adsorption capacity. Based on the Freundlich adsorption isothermal equation, the adsorption capacity (k) was found to be 1.24 mg/g. The MIP can adsorb 100 % β-sitosterol while cholesterol was only 3 %. The MIP is most selective to β-sitosterol, therefore, has high potential to apply as adsorbent at solid phase extraction method to isolate β-sitosterol from sample extract.
Optimization and Isolation of 4,8,12,16-Tetramethylheptadecan-4-olide from Deinbollia pinnata
Authors: Rufai Y. , Basar N. , Sani A.
Published: September 2019

Manual agitation on ultrasonic assisted extraction process, fractionation, isolation and purification afforded 4,8,12,16-tetramethylheptadecan-4-olide (1) along with 11 compounds 2-12 i.e., squalene (2), phytyl palmitate (3), lupeol (4), taraxasterol (5), myristic acid (6), palmitic acid (7), campesterol (8), stigmasterol (9), λ-sitosterol (10), stigmastan-3, 5-diene (11) and stigmasta-5,22-diene-3-ol acetate (12). Their structures were elucidated spectroscopically (2D NMR, IR, GC-MS and 1D NMR). The optimal conditions for high yield of extracts were obtained at 45 °C, after 35 min and solvent ratio 50:50 mL for 83.01 % yield; which was applied on agita-sonication process for bulk sample extraction of D. pinnata leaves with single solvent at a time. Thus, this work provides alternative method to
overcome large sample extraction for phyto-constituents of isolation of 4,8,12,16-tetramethylheptadecan-4-olide (1) with ten other compounds from this specie pinnata and
genius Deinbollia except stigmasterol (9).
Biomethane Production from Anaerobic Codigestion of Palm Oil Mill Effluent with Cattle Manure: A Review
Authors: Zaied B.K. , Siddique M.N.I. , Zularisam A.W. , Ahmad M.F. , Salih Y.M.
Published: September 2019

Biogas is conventionally utilized in a gas engine to convert the chemical energy into electricity and into thermal energy for heating purposes and is also pumped into the natural gas grid line after impurities are removed. Biogas production from palm oil mill effluent is one of the best options for economic expansion and this would reduce environmental impacts in developing countries like Malaysia. This study aims to perform an analysis of the economic and environmental prospects of biogas production from the anaerobic codigestion method from palm oil mill effluent mixed with cow manure. Anaerobic codigestion technology is considered a practical process by which to overcome the complications of substance properties and system optimization in particular substance digestion operations. Comparisons among various treatment technologies of palm oil mill effluent and their applications have been studied thoroughly. The factors that affect biogas production, along with strategies for their improvement, were studied in present report. The economic feasibility of biogas plant where palm oil mill effluent and cattle manure are main substrates and anaerobic codigestion is the method, has been successfully predicted. Results revealed this might be more feasible if this technology is used on a large scale. Construction of the proposed biomethanization plant is economically feasible because it is projected that about a four-year return-on-investment will be achieved. In conclusion, the present work demonstrates a comprehensive feasibility framework by which to integrate the different features needed to enhance biomethane generation.
Isolation, Characterization, Molecular Docking and in vitro Studies of Inhibitory Effect on the Growth of Struvite Crystal Derived from Melia dubia Leaf Extract
Authors: Jeyaleela G. Dayana , Vimala J. Rosaline , Senthil R. , Anandagopu P. , Manjula K.
Published: September 2019

Present work aimed to isolate bioactive principle and its inhibitory potential against struvite stone by single diffusion method as well as docking studies to determine the mode of interaction between the complex structure of urease and rutin. Flavonoid compound is isolated from Melia dubia leaf extract with the help of TLC and column chromatography, and then characterized by 1H & 13C NMR, and LC-MS. Inhibitory potential of isolated flavonoid against kidney stone (struvite) is confirmed by molecular docking approach. Rutin acts as a urease inhibitor and the residues of urease namely 463Asp and 466 Ala were found to bind with rutin through hydrogen bonding and van der Waals interactions. In vitro study, the results revealed that with an increase in concentration of flavonoid rutin (1-5 mg/mL) the weight of the harvested crystals were gradually reduced from 2.8 cm to 0.5 cm and weight 0.662 g to 0.322 g at 5 mg/mL concentration. The XRD result of C+5 shows well inhibition on struvite crystal in all the planes and in SEM analysis, rutin inhibited crystal, surface of the crystal was damaged, whereas control shows pure and no defects on it.
Efficient Catalytic Performance of Calcined Tungstophosphoric Acid for
the Claisen-Schmidt Condensation under Solvent-Free Reaction
Authors: Alharthi Abdulrahman I.
Published: September 2019

Effect of calcination of tungstophosphoric acid catalyst was evaluated in terms of the synthesis of chalcone derivatives via Claisen-Schmidt condensation using the reaction of acetophenone and several substituted aldehydes. The catalyst was characterized before and after calcination by FT-IR to assess the effectiveness of the synthesis of the desired products. The calcined tungstophosphoric acid catalyst (HPW-CL) showed a better performance and high yield of Claisen-Schmidt products in a short period of time. It was also found out that the calcined tungstophosphoric acid provides a chemo selective,
efficient and environmentally benign synthesis of chalcone in an excellent yield in a solvent-free system.