bluuebunny/crossref_metadata_2025 huggingface dataset:
The rich get richer and the poor get poorer - the Matthew mechanism as an approach to explain selection effects and the occurrence of multiple medalists in the "production" of international success in alpine ski racing
Authors: Barth Michael , Güllich Arne , Emrich Eike
Published: October 2019

The study addresses two questions that are under debate in the literature and exemplifies their examination in alpine ski racing. Firstly, are successful athletes the product of a long-term continuous intervention and/or socialization process or do they rather emerge via repeated selection processes? Secondly, to which extent is a nations’ collective success composed of many athletes’ singular successes or of a few athletes’ multiple successes?The study involved the national squad of the Austrian Ski Federation. Data collection comprised membership in a national squad and World or Olympic medal success and was carried out via document analysis (seasons: 1986-2016).The mean annual athlete turnover rate ranged from 24-57% across squad levels while the turnover rate varied substantially over time within each squad level. Among all national squad athletes, the incidence of being a successful (i.e., medal winning) National Team athlete was 8.9% (95% CI: 6.0%; 12.5%). Twenty-eight athletes won a total of 112 medals, 21 athletes achieved winning two or more medals. The six most successful athletes won 56 medals, comprising 50% of all medals won.The study suggests that successful elite athletes emerge from repeated selection and filtering processes. The observation of multiple medalists and a high concentration of exceptional success among a few athletes is reflected with regard to potential causes that rest on characteristics of the individual athlete, on social mechanisms (e.g., Matthew mechanism) of the elite sports system, or both.
Monitoring body temperature during moderate intensity exercise and inactive recovery in the cold: a pilot study
Authors: Procter Emily , Strapazzon Giacomo , Gatterer Hannes , Wallner Bernd , Brugger Hermann , Burtscher Martin
Published: October 2019

Exposure to cold ambient conditions during outdoor recreation can lead to significant heat loss. It is unknown how fast body temperature decreases or how fast a person could become hypothermic in cold temperatures. We present a series of pilot tests involving moderate intensity exercise and inactive recovery in the cold to monitor how body temperature changes with exposure to -10°C. The primary aim of this pilot study was to test the feasibility of the proposed protocol with the intention to design a main study. The primary questions were: (i) to what degree does body temperature increase or decrease with this protocol, (ii) whether epitympanic temperature is a suitable measure of core temperature using a recently developed, non-invasive device and (iii) if participants are able to tolerate the cold during inactive recovery. This pilot series included seven participants. After an acclimatization phase (15 minutes), participants exercised at 60% peak heart rate (20 minutes) followed by a seated, inactive recovery phase (15 minutes) in the cold. The mean ambient conditions were -10.0±0.4°C and 66.1±8.6% relative humidity and no wind. The primary findings based on the feasibility criteria were that body temperature increased while exercising at an intensity of 60% HRpeak and decreased during inactive recovery by -0.3±0.1°C (epitympanic temperature). Secondly, the agreement between epitympanic and esophageal temperature (mean difference 0.2°C, 95% confidence interval -0.5 to 0.0, p=0.095) was better than in previous studies. Finally, all participants were able to tolerate the cold and complete the study despite thermal discomfort and shivering in the recovery phase. This protocol was successful in showing small changes in body temperature during exercise and recovery in the cold, though some modifications to the current protocol are recommended to elicit a larger effect size.
Running impact forces: from half a leg to holistic understanding – comment on Nigg et al.
Authors: Clark Kenneth P. , Udofa Andrew B. , Ryan Laurence J. , Weyand Peter G.
Published: October 2019

Running impact forces have immediate relevance for the muscle tuning paradigm proposed here and broader relevance for overuse injuries, shoe design and running performance. Here, we consider their mechanical basis. Several studies demonstrate that the vertical ground reaction force-time (vGRFT) impulse, from touchdown to toe-off, corresponds to the instantaneous accelerations of the body’s entire mass (Mb) divided into two or more portions. The simplest, a two-mass partitioning of the body (lower-limb, M1=0.08•Mb; remaining mass, M2=0.92•Mb) can account for the full vGRFT waveform under virtually all constant-speed, level-running conditions. Model validation data indicate that: 1) the non-contacting mass, M2, often accounts for one-third or more of the early “impact” portion of the vGRFT, and 2) extracting a valid impact impulse from measured force waveforms requires only lower-limb motion data and the fixed body mass fraction of 0.08 for M1.
Metabolite analysis-aided diagnosis of papillary thyroid cancer
Authors: Chen Jian , Hu Qingyuan , Hou Hongwei , Wang Shuo , Zhang Yunfei , Luo Yanbo , Chen Huan , Deng Huimin , Zhu Hongfu , Zhang Lirong , Liu Hansong , Wang An , Liu Yong
Published: October 2019

Thyroid cancer is the most frequent endocrine tumor with a growing incidence worldwide. However, common diagnostic strategy for thyroid cancer classification is hardly to make a proper diagnosis in some cases. To assist classical approach, this study used metabolomics to screen and validate biomarkers from serum and urinary for papillary thyroid cancer (PTC). Overall, 124 untreated PTC, 76 untreated benign thyroid nodule (BTN), and 116 healthy control (HC) were collected in this study. Thirty-six differential metabolites were screened from non-targeted metabolomics with a discovery sample set in comparison with HC and BTN. Serum β-hydroxybutyrate (BHB), docosahexaenoic acid (DHA), 1-methyladenosine (1-MedA), pregnanediol-3-glucuronide (PdG), urinary nicotinic acid mononucleotide (NAM) and xanthosine (Xan) were validated to be significantly differential by targeted metabolomics in validation set. The logistic regression model incorporating six biomarkers had excellent discrimination from receiver-operating characteristics (ROC) analysis, with area under the receiver-operating characteristic curve (AUC) of 0.943 (95% CI 0.902 to 0.983) and 0.952 (95% CI 0.921 to 0.983) for female alone and female + male samples, respectively. The prediction accuracy and false-negative rate in the real setting of one PTC to ten suspicious nodules were 84.7 and 17.7% with the threshold at probablity of 0.5. Results of a double-blind study for PTC and BTN had true positive value of 100% and true negative value of 91.7%. To conclude, BHB, DHA, 1-MedA, PdG, NAM and Xan are suitable biomarkers for PTC, and logistic regression models with the six biomarkers can be potentially used as clinical diagnosis.
The effects of terrorism on happiness: Evidence from Turkey
Authors: Yildirim Jülide , Kose Tekin , Tanrivere Gizem
Published: October 2019

The economic effects of terror attacks have been extensively examined in the literature. Yet there is a paucity of empirical research investigating their effect on welfare. Existing studies suggest that, in addition to economic costs, terror also imposes social costs. Using both micro-level data at the individual level and macro-level data at the provincial level, this article examines the association of terror and happiness in Turkey. To address income endogeneity, the conditional mixed process estimation method is employed. The results indicate that while a bidirectional relationship between happiness and income level exists, terror negatively affects happiness. Additional factors such as perceived relative income, gender, employment status, and household size have significant effects on individual wellbeing as well. The findings suggest that measuring only the economic costs of terror fails to capture the full extent of the costs imposed on society.
Prevalencia de anomalías dentomaxilares en dentición primaria y mixta primera fase en la Facultad de Odontología de la Universidad de Chile, 2018
Authors: Campos Pardo Mauricio , Maldonado Araya Felipe , García Prado Andrea , Cereceda Miranda María Angélica
Published: October 2019

Objetivo. El presente estudio tuvo como objetivo analizar la prevalencia de las anomalías dentomaxilares en niños de 3 a 10 años que solicitaron atención en la Facultad de Odontología de la Universidad de Chile en el año 2018. Métodos. Se realizó un estudio descriptivo y de tipo transversal, donde el universo correspondió a los pacientes atendidos en la UTE (Unidad de Trabajo del Estudiante) Clínica del niño y adolescente de 4to año de la Facultad de Odontología de la Universidad de Chile. Cohorte 2018. Para la evaluación de anomalías dentomaxilares se consideró la Clasificación Biogenética de Bonn Modificada. Anomalías intermaxilares. Resultados. Del total de la muestra analizada (n: 106), el 45,1% de los pacientes presentaron alteraciones de tipo transversal, vertical y/o sagital. Conclusiones. La anomalía transversal más prevalente fue la mordida cruzada unilateral. La anomalía vertical más prevalente fue la sobremordida. Las anomalías sagitales más prevalente fueron las distoclusiones y la mordida invertida simple.
Distracción osteogénica maxilar con distractor rígido externo en pacientes con fisura labio-palatina. Revisión bibliográfica
Authors: Leiva-Villagra Noemí , Ayala-Jiménez Francisca , Stange-Dempster Carolina , Fuentes-Flores Vanessa
Published: October 2019

La fisura labio-palatina es la malformación congénita más común entre las anomalías craneofaciales y causa una serie de alteraciones a nivel funcional, fisiológico, estético y social. Una de las características comúnmente asociada a estos pacientes, es la hipoplasia maxilar severa producto de la gran resistencia opuesta por los tejidos cicatrizales de labio y paladar, como consecuencia de la cirugía primaria. Tradicionalmente, el tratamiento ha sido la cirugía ortognática convencional al término del crecimiento, sin embargo, este enfoque ha demostrado tener ciertas limitaciones. La distracción osteogénica mediante un distractor rígido externo ha resultado ser una buena alternativa para el manejo de estos pacientes, ya que permite la distracción gradual del maxilar y de los tejidos asociados, mejorando los resultados a corto y largo plazo. Se realizó una revisión de la literatura actual disponible con el objetivo de describir el alcance del tratamiento de la distracción osteogénica maxilar con distractor rígido externo en los pacientes con fisura labio-palatina e hipoplasia maxilar severa. Se concluye que la distracción osteogénica maxilar con distractor rígido externo es un procedimiento efectivo, confiable y relativamente estable, con mínimas complicaciones asociadas y que podría superar a la cirugía convencional en el manejo de pacientes que requieran un avance maxilar severo.
Soporte tecnológico de clase mundial en las universidades peruanas para procesos de gestión
Authors: Aldana Yarlequé Cristhian Nicolás , Verastegui Huanca Lucio Leo
Published: October 2019

Objetivo: Evaluar las características de la propuesta para la mejora de los procesos de gestión administrativa en una institución universitaria con los sistemas de planificación de recursos empresariales de clase mundial (ERP), 2016. Método: El tipo de investigación es descriptiva; se empleó un diseño cuasi experimental y transversal. Se administró dos cuestionarios: Procesos actuales de su gestión administrativa y Sistemas de Planificación de Recursos Empresariales (ERP); además, una encuesta para determinar la seguridad de su información basada en la norma ISO 17799, aportando datos que generaron una base en SPSS v.20 procesada con Análisis Factorial. Resultados: Las herramientas de dichos cuestionarios, fueron evaluados a partir de una muestra piloto, cuyo Alfa de Cronbach fue de 0,964 y 0,907 respectivamente, probabilidades que califican a los instrumentos de recolección de datos como altamente confiables. Seguidamente, el análisis factorial definió cuatro factores para la gestión y cinco factores para la planificación de recursos empresariales. Conclusiones: Dar pie a una propuesta que gestione el incremento del nivel de cumplimiento en protocolos de Gestión Administrativa y de Seguridad de la Información, pues su cumplimiento es del 11,79% y las correlaciones de factores identificados son superiores a 0,50 indicando patrones de conducta latentes en los trabajadores que interrelacionan la gestión administrativa y los procesos de planificación y cumplimiento de protocolos.
Efecto de la rentabilidad financiera y operativa en el precio de las acciones de las empresas industriales
Authors: Casamayou Calderón Elisabeth Teresa
Published: October 2019

Objetivo: El estudio de investigación tiene como objetivo determinar el efecto simultáneo e independiente de la rentabilidad financiera y operativa sobre el precio de la acción (PA) de las empresas en estudio. Método: El diseño de estudio es no experimental, con enfoque cuantitativo. El nivel de la investigación es transversal por ser datos de un periodo de 10 años y de tipo correlacional porque sirvió para establecer relación entre las variables. Se tomaron en cuenta las 34 empresas del sector industrial que cotizan en la Bolsa de Valores de Lima. Para la tabulación de los datos se realizó el análisis de correlación, posteriormente el modelo de regresión simple (ROE con PA y ROA con PA) y regresión múltiple (ROE y ROA con PA), para la comprobación de las hipótesis se realizó el análisis de Anova para observar si influyen o no positivamente, finalmente se realizó el análisis de coeficientes para determinar los valores de la ecuación de la recta. Resultados: Los resultados obtenidos son los siguientes: El ROE y el ROA de manera independiente influyen positivamente y explican el comportamiento del precio de la acción en un 27,14 % y 26,03 %. En el análisis simultáneo del ROE y ROA sobre el precio de la acción también influyen positivamente en el PA, y explican un 21,80 % del comportamiento del precio de la acción. Conclusiones: Se concluye que el comportamiento del precio de la acción no es un referente de la rentabilidad financiera (ROE), ni la rentabilidad operativa (ROA) de las empresas del sector industrial analizadas, debido a que su impacto no es significante, pero si positivo.
El VaR para la gestión del riesgo del portafolio de inversiones
Authors: Chambi Condori Pedro Pablo
Published: October 2019

Objetivo: Analizar cómo la rentabilidad diaria, la varianza de cada uno de los componentes de una cartera de inversiones y la correlación entre los activos de la cartera tienen incidencia en el VaR del portafolio de inversiones. Método: Es un tipo de investigación descriptiva, explicativa con enfoque cuantitativo; ya que tiene como base la cuantificación del valor promedio y del VaR de la cartera de inversiones. La muestra seleccionada por convención estuvo conformada por 8 títulos que cotizan en el mercado de valores del Perú, de los cuales, se seleccionó 3 activos de renta variable con los que se ha conformado una cartera de inversiones de renta variable, con los datos de cotización diaria desde enero 2014 hasta diciembre del 2017. Resultados: El VaR del portafolio y el valor promedio de la cartera se obtienen mediante el método de simulación de Montecarlo para un escenario de variación de rentabilidad promedio diaria del 10%, se constata que la volatilidad de la cartera tiene incidencia directa en el VaR y la rentabilidad influye en el VaR de manera directa. Conclusiones: Aplicando la teoría de diversificación de Harry Markowitz y la simulación de Montecarlo, los resultados obtenidos muestran el efecto de la variación de rentabilidad y la volatilidad en el valor del VaR y sobre el valor promedio del portafolio.
Ácidos grasos en cepas de microalgas del Banco de Germoplasma de Organismos Acuáticos del Instituto del Mar del Perú (IMARPE)
Authors: Hernández Acevedo Hanna Elizabeth , Flores Ramos Leenin , Ruiz Soto Anthony
Published: October 2019

Se determinó la composición de ácidos grasos de 54 cepas microalgales colectadas del Perú y mantenidas en el Banco de Germoplasma de Organismos Acuáticos (IMARPE) con la finalidad de determinar su uso nutricional en la acuicultura. Para ello se realizaron cultivos en un volumen de 50 mL y se determinaron los porcentajes relativos de ácidos grasos mediante transesterificación directa y cromatografía de gases. En el grupo Chlorophyta las microalgas que presentaron los mayores valores de porcentaje relativo de ácidos grasos fueron Chlamydomonas reinhardtii (16:0; 41.2%), Scenedesmus obtusus (18:1n-7; 33.6%), Acutodesmus dimorphus (18:1n-9; 37.1%), Desmodesmus armatus (18:3n-3; 32.2%) y Tetraselmis contracta (16:4n-3; 16.5%). En cambio en el grupo Bacillariophyta, los ácidos grasos más abundantes fueron 16:1n-7 en Chaetoceros didymus (20.2%), 18:4n-3 en Navicula sp. (28.3%) y EPA en Asterionellopsis sp. (31.5%). Por otro lado, en el grupo Dinophyta, todas las cepas superaron el 20% de DHA, en particular, la cepa de Akashiwo sanguinea presentó el mayor porcentaje relativo de este ácido graso (29.9%) y de los ácidos grasos 16:0 (24.8%) y EPA (16%). Se discute el uso de estas cepas según su contenido de ácidos grasos.
Aportes sobre la dieta y distribución del Ocelote Leopardus pardalis (Linné 1758) en los altos Andes de Ecuador
Authors: Nivelo-Villavicencio Carlos Hernán , Fernández de Córdova Torres Carlos Javier , Jiménez Alisson , Astudillo Webster Pedro Xavier
Published: October 2019

El Ocelote, Leopardus pardalis es un carnívoro con amplia distribución en América del sur. En Ecuador, los registros se concentran en bosques tropicales de tierras bajas y en estribaciones de los Andes (< 900 m de elevación), en donde disponen de una variedad de preseas, particularmente de pequeños mamíferos. Sin embargo, en las regiones alto-Andinas no se conoce sobre su presencia ni tampoco sobre su dieta. El 8 de noviembre de 2016 un macho adulto de L. pardalis que fue colectado muerto en la localidad de Usho, provincia del Cañar; el registro está localizado en la región alto-Andina al sur del Ecuador a 2818 m de elevación. Durante la evaluación del espécimen se encontraron varias púas digeridas y asociadas a la especie de Puerco espín de cola corta, Coendou rufescens. Este registro demuestra que L. pardalis ocurre al menos estacionalmente en la región alto-Andina del Ecuador; además demuestra la predación de especies alto-Andinas dentro de sus hábitos alimenticios.
Germinación de Phacelia secunda (Boraginaceae) y Eryngium paniculatum (Apiaceae), hierbas perennes de la Patagonia Argentina
Authors: Chichizola Giselle Ailin , Rovere Adriana Edit , Gonzalez Sofía Laura
Published: October 2019

El objetivo fue evaluar los requerimientos de germinación de Phacelia secunda J.F. Gmel. y Eryngium paniculatum Cav. y Dombey ex F. Delaroche, herbáceas perennes colonizadoras de ambientes degradados del noroeste patagónico argentino y de interés para la restauración ecológica. Se evaluó el porcentaje, tiempo medio e inicio de germinación en un control (C) y dos tratamientos pre-germinativos: escarificación mecánica con bisturí (EM) y estratificación húmeda fría durante 45 días (EHF). En P. secunda, el porcentaje de germinación en el tratamiento EHF (2%) fue menor que en el C (24%) y el tratamiento EM (16%). En E. paniculatum se encontraron diferencias entre el C (94%) y el tratamiento EHF (82%), pero no entre el C y EM (91%). El tratamiento EHF aceleró el inicio de la geminación en ambas especies. Las semillas de P. secunda mostraron baja capacidad de germinación siendo necesario evaluar nuevos tratamientos. Eryngium paniculatum mostró alta capacidad germinativa aún en el control, lo que evidencia que no requiere tratamientos pre-germinativos específicos.
Diversidad y actividad horaria de mamíferos medianos y grandes registrados con cámaras trampa en el Parque Nacional Tingo María, Huánuco, Perú
Authors: Cossios E. Daniel , Ricra Zevallos Alex
Published: October 2019

La mastofauna del Parque Nacional Tingo María (PNTM) es conocida principalmente por entrevistas a pobladores locales. Este artículo presenta una lista de mamíferos medianos y grandes en base a evaluaciones con cámaras trampa y su verificación con entrevistas. Las evaluaciones se realizaron entre diciembre del 2014 y noviembre del 2018, con un esfuerzo de 2970 trampas cámara/día, consiguiéndose 1640 registros independientes. Se registró 19 especies silvestres, cuatro de las cuales son nuevos registros para el PNTM (la zarigüeyita acuática Chironectes minimus, el margay Leopardus wiedii, la tigrina Leopardus tigrinus y el osito cangrejero Procyon cancrivorus), tres son nuevos para las yungas peruanas (L. wiedii, el ronsoco Hydrochoerus hydrochaeris y la nutria Lontra longicaudis) y dos (H. hydrochaeris y L. wiedii) tienen el récord de altitud en el Perú. Se elaboró patrones de actividad horaria para las nueve especies con más de 10 registros. Ocho de ellos coinciden con lo publicado anteriormente, mientras que el patrón conseguido para el machetero Dynomis branicki es el primero elaborado en condiciones de silvestría. Tanto la presencia de varias especies de predadores como la normalidad de los patrones de actividad encontrados sugieren un buen estado de conservación del bosque en el PNTM. En conclusión, el muestreo con cámaras trampapermitió la obtención de una lista confiable y bastante completa de los mamíferos medianos y grandes de hábitos terrestres del PNTM, además de datos sobre su distribución y ecología.
Development and Validation of the Pediatric Resuscitation and Escalation of Care Self-Efficacy Scale
Authors: Zurca Adrian D. , Olsen Nils , Lucas Raymond
Published: October 2019

OBJECTIVES:

To validate a scale to assess pediatric providers’ resuscitation and escalation of care self-efficacy and assess which provider characteristics and experiences may contribute to self-efficacy.

METHODS:

Cross-sectional cohort study performed at an academic children’s hospital. Pediatric nurses, respiratory therapists, and residents completed the Generalized Self-Efficacy Scale (GSES) and Pediatric Resuscitation Self-Efficacy Scale (PRSES) as well as a survey assessing their experiences with pediatric escalation of care.

RESULTS:

Four hundred participants completed the GSES and PRSES. A total of 338 completed the survey, including 262 nurses, 51 respiratory therapists, and 25 residents. Cronbach α for the PRSES was 0.905. A factor analysis revealed 2 factors within the scale, with items grouped on the basis of expertise required. Multiple logistic regression analyses controlling for GSES score, number of code blue events participated, number of code blue events activated, number of rapid response team events participated, number of rapid response team response events called, performance on a knowledge assessment of appropriate escalation of care, and years of experience demonstrated that PRSES performance was significantly associated with GSES scores and number of escalation of care events (code blue and rapid response) previously participated in (R2 = 0.29, P < .001).

CONCLUSIONS:

The PRSES can be used to assess pediatric providers’ pediatric resuscitation self-efficacy and could be used to evaluate pediatric escalation of care interventions. Pediatric resuscitation self-efficacy is significantly associated with number of previous escalation of care experiences. In future studies, researchers should focus on assessing the impact of increased exposures to escalation of care, potentially via mock codes, to accelerate the acquisition of resuscitation self-efficacy.
Translating Discharge Instructions for Limited English–Proficient Families: Strategies and Barriers
Authors: Davis Seethalakshmi H. , Rosenberg Julia , Nguyen Jenny , Jimenez Manuel , Lion K. Casey , Jenicek Gabriela , Dallmann Harry , Yun Katherine
Published: October 2019

BACKGROUND:

Access to written hospital discharge instructions improves caregiver understanding and patient outcomes. However, nearly half of hospitals do not translate discharge instructions, and little is known about why.

OBJECTIVES:

To identify barriers to and potential strategies for translating children’s hospital discharge instructions.

METHODS:

We conducted a mixed-methods, multimodal analysis. Data comprised closed- and open-ended responses to an online survey sent to Children’s Hospital Association language services contacts (n = 31), an online environmental scan of Children’s Hospital Association translation policies (n = 22), and county-level census data. We examined quantitative data using descriptive statistics and analyzed open-ended survey responses and written policies using inductive qualitative content analysis.

RESULTS:

Most survey respondents (81%) reported having a written translation policy at their hospital, and all reported translating a subset of hospital documents, for example, consent forms. Most but not all reported translating discharge instructions (74%). When asked how inpatient staff typically provide translated discharge instructions, most reported use of pretranslated documents (87%) or staff interpreters (81%). Reported barriers included difficulty translating uncommon languages, mismatched discharge and translation time frames, and inconsistent clinical staff use of translation services. Strategies to address barriers included document libraries, pretranslated electronic health record templates, staff-edited machine translations, and sight translation. Institutional policies differed regarding the appropriateness of allowing interpreters to assist with translation. Respondents agreed that machine translation should not be used alone.

CONCLUSIONS:

Children’s hospitals experience similar operational and organizational barriers in providing language-concordant discharge instructions. Current strategies focus on translating standardized documents; collaboration and innovation may encourage provision of personalized documents.
Association of the FilmArray Meningitis/Encephalitis Panel With Clinical Management
Authors: Nabower Aleisha M. , Miller Sydney , Biewen Benjamin , Lyden Elizabeth , Goodrich Nathaniel , Miller Alison , Gollehon Nathan , Skar Gwenn , Snowden Jessica
Published: October 2019

OBJECTIVES:

To determine the association of the use of the multiplex assay meningitis/encephalitis panel with clinical management of suspected meningitis.

METHODS:

A cross-sectional study was conducted with children 0 to 18 years of age who received a lumbar puncture within 48 hours of admission for an infectious workup. Patient demographic and presenting information, laboratory studies, and medication administration were collected. The primary measure was length of stay (LOS) with secondary measures: time on antibiotics, time to narrowing antibiotics, and acyclovir doses. LOS and antibiotic times were stratified for outcomes occurring before 36 hours. Logistic regression analysis was used to account for potential confounding factors associated with both the primary and secondary outcomes. A value of P < .05 was considered statistically significant.

RESULTS:

Meningitis panel use was associated with a higher likelihood of a patient LOS <36 hours (P = .04; odds ratio = 1.7; 95% confidence interval [CI]: 1.03–2.87), a time to narrowing antibiotics <36 hours (P = .008; odds ratio = 1.89; 95% CI: 1.18–2.87), and doses of acyclovir (P < .001; incidence rate ratio = 0.37; 95% CI: 0.26–0.53). When controlling for potential confounding factors, these associations persisted.

CONCLUSIONS:

Use of the meningitis panel was associated with a decreased LOS, time to narrowing of antibiotics, and fewer acyclovir doses. This likely is a result of the rapid turnaround time as compared with cerebrospinal fluid cultures. Additional studies to examine the outcomes related to this change in management are warranted.
Update on Prenatal Laboratory Screening: Joint Commission Required Elements
Authors: Tepper Jared L. , Puopolo Karen M.
Published: October 2019

The Centers for Disease Control and Prevention, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics recommend routine screening for pregnant women for evidence of infection with human immunodeficiency virus, hepatitis B and syphilis, and vaginal-rectal colonization with group B Streptococcus. For each of these pathogens, there are important opportunities to provide maternal treatment, prevent vertical transmission of the pathogen during the prenatal or intrapartum periods, and/or administer neonatal treatment immediately after birth. Such prevention and/or treatment measures are critical to limiting maternal and neonatal morbidity; however, this is dependent on recognition of maternal disease status. A significant number of women in the United States receive either inadequate prenatal care or inadequate screening for these pathogens. The time of admission to labor and delivery units represents an important opportunity to detect at-risk pregnant women and infants. To optimize both maternal and neonatal health, the Joint Commission issued new guidance effective July 1, 2018, mandating documentation of maternal disease status for these pathogens in the maternal medical record and documentation of positive results in the newborn medical record. Immediate peripartum testing for women with inadequate screening is also required. These measures should allow for timely interventions to improve maternal health and ideally to prevent perinatal disease transmission to the newborn.
LIMITE MÁXIMO DA LEI DE RESPONSABILIDADE FISCAL COM DESPESAS DE PESSOAL: ESTUDO DO CASO DOS ESTADOS BRASILEIROS
Authors: Costa Abimael De Jesus Barros , Silva Thayanne Costa da , Silva Alana Alves da , Pinori Raquel Pereira , Borges Marco Aurélio Barros , Santos Debora De Sousa dos
Published: October 2019

Um dos grupos de dispêndios com maior preocupação por partes dos gestores é a despesa com pessoal, dessa forma, com as mudanças relevantes da LRF, acompanhar os limites para as referidas despesas torna-se importante no âmbito do estudo do controle no setor público. O objetivo geral desse estudo de caso foi verificar o que os estados que ultrapassaram o limite máximo de gastos com pessoal permitidos pela LRF estão realizando para administrar sua despesa e voltar ao limite permitido. Os objetivos específicos envolveram fazer uma análise histórica dos gastos com pessoal dos estados em questão, identificar as sanções previstas, assim como as medidas tomadas pelos gestores dos estados, respondendo a seguinte problemática: De que forma os estados que mais se destacam no ranking de gasto com pessoal estão atuando para administrar seus gastos com a folha? O trabalho foi desenvolvido através de um estudo de caso com metodologia exploratória e descritiva. Ao analisar a despesa dos estados, foi possível observar que os estados Tocantins, Paraíba, Rio Grande do Norte, Acre e Mato Grosso lideram o ranking de gastos com pessoal e estão acima do limite máximo permitido pela LRF, o que os tornam objeto desse estudo de caso. Conclui-se que os estados abordados, apesar de estarem acima do limite imposto pela LRF para gasto com pessoal, estão implementando medidas para adequar seus gastos e retornar as exigências da Lei de Responsabilidade Fiscal e já é visível o efeito dessas medidas em alguns deles.
Gestão e processo decisório: as mudanças nas estruturas organizacionais da Universidade Federal de Goiás
Authors: Santos Mário Rosa , Chaves Manoel Rodrigues , Silva André Vasconcelos
Published: October 2019

Estudar a instituição universitária justifica-se pelo papel que ela representa em qualquer lugar, e especificamente no Brasil, como organização que deve empenhar na construção e reconstrução do conhecimento, em sua transmissão e disseminação. Além disso, há pouca produção de trabalhos teóricos/empíricos que abordem o tema da evolução das estruturas organizacionais das universidades federais. Diante desse desafio, trata-se de uma pesquisa exploratória e qualitativa, onde foi realizado um mapeamento bibliográfico sobre o tema em artigos científicos e de levantamento de dados secundários nos documentos constituídos externa e internamente. Este estudo tem como objetivo identificar as mudanças externas e seus efeitos na reestruturação interna da organização universitária, e que se manifesta nos estatutos e regimentos, compreendendo por mudanças as alterações das formas e funções impetradas por uma organização, decorrentes de pressões externas e internas. Como resultado desta pesquisa, pode-se concluir que os fatores contingenciais externos determinam os arranjos funcionais e estruturais internos como causadores da mudança nas estruturas da organização.
Technique of Informative Features Selection in Geoacoustic Emission Signals
Authors: Senkevich Yuri , Marapulets Yuri , Lukovenkova Olga , Solodchuk Alexandra
Published: October 2019

Studies of geoacoustic emission in a seismically active region in Kamchatka show that geoacoustic signals produce pronounced pulse anomalies during the earthquake preparation and post-seismic relaxation of the local stresses ﬁeld at the observation point. The qualitative selection of such anomalies is complicated by a strong distortion and weakening of the signal amplitude. A review of existing acoustic emission analysis methods shows that most often researchers turn to the analysis of more accessible to study statistical properties and energy of signals. The distinctive features of the approach proposed by the authors are the extraction of informative features based on the analysis of time and frequency-time structures of geoacoustic signals and the description of various forms of recognizable pulses by a limited pattern set. This study opens up new ideas to develop methods for detecting anomalous behavior of geoacoustic signals, including anomalies before earthquakes.

The paper describes a technique of information extraction from geoacoustic emission pulse streams of sound frequency range. A geoacoustic pulse mathematical model, reﬂecting the signal generation process from a variety of elementary sources, is presented. A solution to the problem of detection of geoacoustic signal informative features is presented by the means of description of signal fragments by the matrixes of local extrema amplitude ratios and of interval ratios between them. The result of applying the developed algorithm to describe automatically the structure of the detected pulses and to form a pattern set is shown. The patterns characterize the features of geoacoustic emission signals observed at IKIR FEB RAS ﬁeld stations. A technique of reduction of the detected pulse set dimensions is presented. It allows us to ﬁnd patterns similar in structure. A solution to the problem of processing of a large data ﬂow by unifying pulses description and their systematization is proposed. A method to identify a geoacoustic emission pulse model using sparse approximation schemes is suggested. An algorithmic solution of the problem of reducing the computational complexity of the matching pursuit method is described. It is to include an iterative reﬁnement algorithm for the solution at each step in the method. The results of the research allowed the authors to create a tool to investigate the dynamic properties of geoacoustic emission signal in order to develop earthquake prediction detectors.
A new, sensitive and disposable electrochemical immunosensor based on Benzaldehyde side group containing phosphazene polymer modified ITO substrate for Interleukin 1β detection
Authors: AYDIN Muhammet
Published: October 2019

Bu çalışmada, interlökin 1β (IL 1β) tespiti için tek kullanımlık benzaldehit ikameli fosfazen polimeri (BSPP) ile modifiye edilmiş ITO elektrot temelli yeni bir elektrokimyasal ultrahassas immünosensör geliştirilmiştir. Aldehit yan grupları içeren fosfazen polimeri (BSPP) halka açma polimerizasyonu yöntemi ile sentezlenmiştir. Bu aldehit grupları, anti-IL 1β antikorları için bir bağlantı noktaları sağlamıştır. Önerilen immünosensörün üretim süreci, Elektrokimyasal Empedans Spektroskopisi (EIS) ve Döngüsel Voltammetri (CV) gibi elektrokimyasal tekniklerle izlendi. Ek olarak, bu üretim aşamaları, Taramalı Elektron Mikroskobu (FE-SEM) ve Atomik Kuvvet Mikroskobu (AFM) kullanılarak karakterize edildi. Ayrıca, polimer kaplı elektrot yüzeyindeki BSPP polimer tabakası, Enerji Dağıtıcı X-ışını (EDX) kullanılarak araştırıldı. Üretilen immünosensör düşük bir tespit sınırına (9,3 fg / mL) ve geniş bir doğrusal tayin aralığına (0,03-7,5 pg / mL) sahiptir. Ayrıca, iyi tekrarlanabilirlik (% 1.82), mükemmel tekrarlanabilirlik (% 1.56), iyi seçicilik ve yüksek stabiliteye sahipti. Deney sonuçları, BSPP polimerinin, klinik teşhis ve pratik uygulamalarda IL1β antijen tespiti için arzu edilen bir platform olduğunu gösterdi. Önerilen biyosensörün uygulanabilirliği, insan serumunda IL 1β seviyesi ölçülerek test edildi ve önerilen immünosensör, nicel analiz için kabul edilebilir sonuçlara sahipti.
Long-term indapamide retard therapy in adolescents with Stage I arterial hypertension
Authors: Logacheva I. V. , Gunicheva E. A.
Published: October 2019

Aim. To study the dynamics of office blood pressure (BP) levels, autonomic balance, endothelial dysfunction, and vascular remodelling in adolescents with Stage I arterial hypertension (AH), treated with indapamide retard (IR). Material and methods. In total, the study included 41 adolescent boys, aged 16-18 years, with Stage I AH (main group, MG), and 27 healthy adolescents (control group, CG). The MG participants received, IR (1,5 mg/day) for 6 months. At baseline and in the end of the study, all participants underwent office BP measurement, echocardiography, veloergometry, and the assessment of heart rate variability (HRV), endothelial dysfunction (reactive hyperemia test, endotelin-1 levels), microalbuminuria (MAU), and vascular parameters, such as large artery rigidity and intima-media thickness. Results. Target BP levels were achieved in all MG patients by Week 4 of the treatment, with normal BP values registered throughout the follow-up period. Indapamide therapy was associated with decreased hemodynamic cardiovascular load, normalized endothelial function, and MAU disappearance. IR monotherapy had beneficial effects on HRV, due to moderate parasympathetic stimulation. Conclusion. IR is an effective and safe medication for long-term treatment of adolescents with Stage I AH.
Cardiovascular prevention: development strategies
Authors: Oganov R. G. , Gerasimenko N. F. , Pogosova G. V. , Koltunov I. E.
Published: October 2019

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β-blockade with nebivolol for prevention of acute ischaemic events in elderly patients with heart failure
Authors: Ambrosio G. , Flather M. D. , Böhm M. , Coats A. J.S. , Tavazzi L. , Van Veldhuisen D. J. , Conti M. G. , Spinucci G. , Mascagni F. , Murrone A. , Cohen-Solal A.
Published: October 2019

Aim. This subanalysis of the Study of the Effects of Nebivolol Intervention on Outcomes and Hospitalisation in Seniors with Heart Failure (SENIORS) investigates whether treatment with nebivolol, a β-blocker with nitric oxide-releasing properties, can provide additional benefits besides its effects on heart failure (HF), by reducing cardiac ischaemic events in patients with HF of ischaemic aetiology. Material and methods. A double-blind, randomised, placebo-controlled, multicentre trial of nebivolol in 2128 elderly patients. For this analysis, data were extracted for 2128 elderly (≥70 years) HF patients in whom coronary artery disease (CAD) was the underlying aetiology (68,2 %; 717 placebo-treated patients and 735 assigned to nebivolol). The main endpoint was the composite of cardiac ischaemic events at 2 year follow-up: death/hospitalisation for myocardial infarction, unstable angina or sudden death, as originally identified in the case report form. Results. At follow-up, nebivolol treatment was associated with a one-third reduction in the risk of ischaemic events, the composite endpoint occurring in 15,9 % of placebo and 10,7 % of nebivolol-treated patients (HR 0,68; 95 % CI 0,51 to 0,90; p=0,008). This effect was independent of age, gender and ejection fraction. No difference in this composite endpoint was observed in the subgroup of patients of non-ischaemic aetiology. Conclusion. Nebivolol was effective in reducing cardiac ischaemic events in patients with HF of ischaemic aetiology. The prevention of ischaemic events can be an additional beneficial effect of β-blockade in HF patients with underlying CAD.
Dynamics of lipid and carbohydrate metabolism parameters in women with menopausal metabolic syndrome, receiving glucose-lowering therapy
Authors: Starodubova A. V. , Kislyak O. A. , Matyukhina M. N.
Published: October 2019

Aim. To assess the tolerability and the impact of various glucose-lowering medications on carbohydrate and lipid profile and anthropometric parameters in women with menopausal metabolic syndrome (MMS). Material and methods. The baseline examination included 122 women in early postmenopause. Thirty three patients with MS, carbohydrate metabolism disturbances, and/or insulin resistance (IR) were included in the 12-week open comparative study. Group I (n=15) received acarbose (150 mg/d) for 12 weeks, while Group II (n=18) was administered metformin (850 mg/d) for 12 weeks. At baseline and 12 weeks later, anthropometry, oral glucose tolerance test with insulin and C-peptide level measurement, and lipid profile assessment were performed. Results. Acarbose therapy was associated with a reduction in body weight (BW), body mass index (BMI), waist circumference (WC), fasting insulin, post-load insulin, post-load C-peptide, and HOMA-IR index. However, no significant improvement in lipid metabolism parameters was observed in the acarbose group. Metformin treatment was linked to a significant reduction in BW, WC, glycated hemoglobin, post-load glucose, C-peptide, and insulin, as well as to an increase in post-load Caro index. Conclusion. Women with MMS, carbohydrate metabolism disturbances, and/or IR, require not only non-pharmaceutical lifestyle modification, but also glucose-lowering pharmaceutical therapy with acarbose or metformin. In particular, it should be considered that metformin, but not acarbose, reduces the levels of total cholesterol and triglycerides.
Urapidil: management of complicated hypertensive crises and effects on renal function. Therapeutist’s view
Authors: Arutyunov G. P. , Oganezova L. G.
Published: October 2019

Aim.To compare the effectiveness of urapidil and enalaprilat in cardiac patients with complicated hypertensive crise (HC), including the effect of the medications on renal function.Material and methods.During 6 months, 70 patients with essential arterial hypertension (EAH), hospitalised with a diagnosis of complicated HC, were included in the study.Results.The therapy response rates were significantly higher in the urapidil vs. enalaprilat group (96,7% vs. 73,3%,p<0,001). During the first hour of the urapidil treatment, the levels of systolic blood pressure (SBP) decreased from 210,5±13,6 to 157,8±8,3 mm Hg (p<0,05), while the levels of diastolic blood pressure (DBP) decreased from 115,7±8,5 to 86,9±9,1 mm Hg (p<0,05). In the enalaprilat group, the respective SBP and DBP reduction was from 208,1 to 182,5 mm Hg (p<0,05) and from 114,8 to 95,0 mm Hg (p<0,05). Mean BP levels in the urapidil and enalaprilat groups decreased from 147,3±6,3 to 101,7±6,4 mm Hg and from 145,9±6,1 to 118,4±7,3 mm Hg, respectively. Over 6 hours, urapidil group patients demonstrated a more prolonged, sustained antihypertensive effect. Both medications did not affect heart rate (HR) levels. In neither group, clinically significant adverse effects were registered. The changes in glomerular filtration rate (GFR) or natriuresis were non-significant. Since after 6 hours, the patients were administered other combination therapy, the risk of acute vascular events was assessed during the following hours (up to 72 hours). No cases of acute cerebrovascular events or acute myocardial infarction were registered in either study group.Conclusion.Urapidil was more effective than enalaprilat in terms of responder number per 1 dose or BP reduction rate. Both medications did not affect HR, GFR, or natriuresis.
Taurine effects on the occurrence of cardiac arrhythmias and QT interval dispersion in patients with postinfarction cardiosclerosis and chronic heart failure: a comparative randomised study
Authors: Gordeev I. G. , Pokrovskaya E. M. , Luchinkina E. E.
Published: October 2019

Aim. To study the effects of taurine therapy on the occurrence of cardiac arrhythmias and QT interval dispersion (dQT) among patients with postinfarction cardiosclerosis (PICS) and subsequent chronic heart failure (CHF). Material and methods. The study included 40 patients with previous myocardial infarction (MI), left ventricular ejection fraction (LVEF) <45 %, and Functional Class (FC) II-III CHF (NYHA). The participants were randomised into two groups: the main group (MG) included 20 patients receiving standard CHF treatment and taurine, while the control group (CG; n=20) was administered standard CHF treatment only. Both groups were comparable by the main clinical and anamnestic parameters. The therapy phase lasted 3 months. The analysis of taurine effects on the occurrence of cardiac arrhythmias and dQT was performed in the subgroups defined according to the CHF FC. dQT was assessed by 12-lead electrocardiography (ECG), while the arrhythmia occurrence was assessed by Holter ECG monitoring. The examined parameters were measured at baseline and after 3 months of the therapy. Results. In PICS patients with CHF, taurine demonstrated beneficial effects on the dynamics of dQT and cardiac arrhythmia occurrence. Conclusion. Taurine could be included in the complex treatment of PICS patients with FC II-III CHF.
Oral health and heart failure
Authors: Vashurin I. V. , Wagner V. D. , Gurevich K. G. , Gurevich M. V.
Published: October 2019

Aim. To investigate the association between heart failure (HF) and oral health. Material and methods. The study included 57 patients, aged 50-81 years (mean age 63,6±8,2 years), with Functional Class 0-II HF. Stomatological clinical status and functional status of circulatory system were assessed. Results. HF progression was associated with increased number of carious teeth and missing teeth. In HF-II, the disorders of temporomandibular joint and masseter muscles were 8 and 5 times more prevalent, respectively, than in HF-0.
Circadian blood pressure rhythm and increased body weight in patients with arterial hypertension and obstructive sleep apnoea syndrome
Authors: Ivanov A. P. , Elgardt I. A. , Rostorotskaya V. V.
Published: October 2019

Aim. To assess the specifics of 24-hour blood pressure monitoring (BPM) parameters and their association with body mass index (BMI) in patients with arterial hypertension (AH) and obstructive sleep apnoea (OSA) syndrome. Material and methods. The study included 120 AH patients with BMI under or over 25 kg/m2, who underwent 24-hour BMP and combined monitoring of electrocardiogram (ECG) and breathing. Results. AH patients with OSA syndrome demonstrated increased mean daytime and nighttime levels of systolic and diastolic BP (SBP, DBP) and a 1,5-fold increase in SBP and DBP pressure load indices. Patients with increased BMI had disturbed circadian BP profile, with reduced mean 24-hour difference, more pronounced for DBP (2,4-fold difference), and an increase in the “over-dipper” prevalence (from 13,3 % to 42,1 %). Conclusion. The combination of AH, OSA syndrome, and increased BMI substantially affected 24-hour BPM parameters. Increased BMI was associated with disturbed circadian BP profile and increased levels of mean 24-hour BP and nighttime BP