bluuebunny/crossref_metadata_2025 huggingface dataset:
Salvage of a TRAM breast reconstruction flap using the retrograde internal mammary artery system
Authors: Hassan Sameena , Rasheed Tuabin , Raurell Anna
Published: September 2019

Background: Free tissue transfer provides an optimal means for breast reconstruction in creating an aesthetically natural appearance that is durable over time. The choice of donor vessels vary from surgeon to surgeon, but the internal mammary axis is one of the most popular choices together with the thoracodorsal vessels. Aims and Results: We present the case of a salvaged free transverse rectus abdominis myocutaneous breast reconstruction in which end-to-end antegrade anastomosis to the internal mammary artery (IMA) was not possible due to frail vessel walls, but retrograde anastomosis to the IMA and antegrade anastomosis of internal mammary vessel resulted in a perfused and viable flap. Conclusion: We suggest the use of the retrograde internal mammary arterial system for microsurgical anastomosis when the anterograde flow is not adequate, the vessel wall is friable, and when other more common options are not available.
Post-operative brachial plexus neuropraxia: A less recognised complication of combined plastic and laparoscopic surgeries
Authors: Thomas Jimmy
Published: September 2019

This presentation is to increase awareness of the potential for brachial plexus injury during prolonged combined plastic surgery procedures. A case of brachial plexus neuropraxia in a 26-year-old obese patient following a prolonged combined plastic surgery procedure was encountered. Nerve palsy due to faulty positioning on the operating table is commonly seen over the elbow and popliteal fossa. However, injury to the brachial plexus has been a recently reported phenomenon due to the increasing number of laparoscopic and robotic procedures. Brachial plexus injury needs to be recognised as a potential complication of prolonged combined plastic surgery. Preventive measures are discussed.
Current trends of liposuction in India: Survey and Analysis
Authors: Methil Bijoy
Published: September 2019

Background: Liposuction is the commonest aesthetic procedure performed by Indian plastic surgeons. However, there exists substantial disparity amongst Indian surgeons about guidelines concerning liposuction.To address this disparity, a nationwide email survey (Association of Plastic Surgeons of India [APSI] database) was started in December 2013 and continued for 5 months. Material and Methods: The survey was developed with software from www.fluidsurveys.com. The study was designed to cover most aspects of patient selection, perioperative management, technical considerations, postoperative management and complications. This is the first survey to be conducted in India for an extremely popular procedure. It is also one of the most exhaustive surveys that have been conducted in terms of the topics covered. Results and Conclusions: One hundred and eighteen surgeons (including a majority of the cosmetic surgery stalwarts in the country) completed the survey. As expected, the results show a disparity in most parameters but also consolidation on some issues. Liposuction is considered extremely safe (86.1%). The majority of surgeons (70.3%) aspirated >5 L at onetime.The majority (80.2%) felt that the limits for liposuction should be relative and not absolute. The survey highlights lack of standardization with respect to infiltration solutions. The commonest complications observed were contour irregularities, followed by seroma and inadequate skin redrape. The amount of aspirate is the only factor, which achieves statistical significance with respect to major complications. A review of the current evidence and recommendations has been incorporated, along with an in depth analysis of the survey.
Simple device to determine the pressure applied by pressure clips for the treatment of earlobe keloids
Authors: Sasidharan Aashish , David Ann , Gohil Amish , Gupta Ashish Kumar
Published: September 2019

Background: Keloids of the ear are common problems. Various treatment modalities are available for the treatment of ear keloids. Surgical excision with intralesional steroid injection along with compression therapy has the least recurrence rate. Various types of devices are available for pressure therapy. Pressure applied by these devices is uncontrolled and is associated with the risk of pressure necrosis. We describe here a simple and easy to use device to measure pressure applied by these clips for better outcome. Objectives: To devise a simple method to measure the pressure applied by various pressure clips used in ear keloid pressure therapy. Materials and Methods: By using a force sensitive resistor (FSR), the pressure applied gets converted into voltage using electrical wires, resistors, capacitors, converter, amplifier, diode, nine-volt (9V) cadmium battery and the voltage is measured using a multimeter. The measured voltage is then converted into pressure using pressure voltage graph that depicts the actual pressure applied by the pressure clip. Results: The pressure applied by different clips was variable. The spring clips were adjustable by slight variation in the design whereas the pressure applied by binder clips and magnet discs was not adjustable. Conclusion: The uncontrolled/suboptimal pressure applied by certain pressure clips can be monitored to provide optimal pressure therapy in ear keloid for better outcome.
Management of asymptomatic silicone-injected breast with reduction mammoplasty
Authors: Prasetyono Theddeus Octavianus Hari , Sadikin Patricia Marcellina
Published: September 2019

Even though Silicone injection for breast augmentation has been related to disastrous long-term effects and complications, some patients do not develop significant symptoms at all (asymptomatic). Unfortunately, the management of asymptomatic Silicone-injected breast is still unclear and has never been reported exclusively. We present two cases of asymptomatic patients with a history of liquid Silicone injections who refused to have a mastectomy. They were concerned with the breast ptosis and chose to undergo reduction mammoplasty to improve the appearance of the breasts. Magnetic resonance imaging may be useful as an additional screening tool to confirm the diagnosis and exclude the presence of malignancy in breasts with injected Silicone. We believe that breast reduction may be the alternative option for women with a history of liquid Silicone injection who have no symptoms but desire to preserve their breasts and improve their aesthetics.
High-dose chemotherapy followed by autologous stem cell transplant for multiple myeloma
Authors: Kumar Lalit , Ramavath Dev , Kataria Babita , Tiwari Akash , Raj Abhishek , Chellapuram Santosh Kumar , Mookerjee Anjali , Sahoo Ranjit Kumar , Malik Prabhat S. , Sharma Atul , Gupta Ritu , Sharma Om dutt , Biswas Ahitagni , Kumar Rakesh , Thulkar Sanjay
Published: September 2019

Background & objectives:

Survival of patients with multiple myeloma (MM) has improved in the past two decades following use of novel agents and autologous stem cell transplantation. To determine predictors of long-term outcome, data of MM patients who underwent autologous stem cell transplantation (ASCT) at a tertiary care centre in north India were retrospectively analyzed.

Methods:

Between 1995 and 2016, 349 MM patients underwent ASCT. Patients' median age was 52 yr, ranging from 29 to 68 yr, 68.2 per cent were males. Thirty three per cent patients had international staging system (ISS) Stage III and 68.5 per cent had received novel agents-based induction. High-dose melphalan (200 mg/m2) was used for conditioning; patients with renal insufficiency (estimated glomerular filtration rate <40 ml/min) received melphalan 140-150 mg/m2.

Results:

Post-transplant, 317 of 349 (90.8%) patients responded; complete [complete response (CR)] −213 (61%)], very good partial response (VGPR) −62 (17.8%) and PR in 42 (12%)]. Induction with novel agents, pre-transplant chemosensitive disease, transplant in first remission and serum albumin (≥3.5 g/dl) were predictors of significant response. At a median follow up of 73 months, median overall survival (OS) was 90 months [95% confidence interval (CI) 70.8-109.2], and progression-free survival (PFS) was 41 months (95% CI 33.0-49.0). On multivariate analysis, achievement of CR post-transplant, transplant in first remission, ISS Stages I and II (vs. III), absence of extramedullary disease and serum albumin ≥3.5 g/dl were predictors of prolonged OS. For PFS, achievement of post-transplant CR and transplant in first remission were predictors of superior outcome.

Interpretation & conclusions:

Treatment with novel agents, achievement of complete remission post-transplant, ISS Stages I and II, absence of extramedullary disease and transplant in first remission were predictors of long-term survival for patients with MM.
High-altitude pulmonary oedema
Authors: Yanamandra Uday , Sharma Manisha , Katoch Deeksha , Yanamandra Sushma , Bhattachar Srinivasa A. , Gupta Amul , Patyal Sagarika , Grewal Rajan , Kumar Suman , Nair Velu
Published: September 2019

Background & objectives:

High-altitude pulmonary oedema (HAPE) continues to challenge the healthcare providers at remote, resource-constrained settings. High-altitude terrain itself precludes convenience of resources. This study was conducted to evaluate the rise in peripheral capillary saturation of oxygen (SpO2) by the use of a partial rebreathing mask (PRM) in comparison to Hudson's mask among patients with HAPE.

Methods:

This was a single-centre, randomized crossover study to determine the efficiency of PRM in comparison to Hudson's mask. A total of 88 patients with HAPE referred to a secondary healthcare facility at an altitude of 11,500 feet from January to October 2013 were studied. A crossover after adequate wash-out on both modalities was conducted for first two days of hospital admission. All patients with HAPE were managed with bed rest and stand-alone oxygen supplementation with no adjuvant pharmacotherapy.

Results:

The mean SpO2 on ambient air on arrival was 66.92±10.8 per cent for all patients with HAPE. Higher SpO2 values were achieved with PRM in comparison to Hudson's mask on day one (86.08±5.15 vs. 77.23±9.09%) and day two (89.94±2.96 vs. 83.39±5.93%). The difference was more pronounced on day one as compared to day two.

Interpretation & conclusions:

Mean SpO2 values were found to be significantly higher among HAPE patients using PRM compared to those on Hudson's mask. Further studies to understand the translation of this incremental response in SpO2 to clinical benefits (recovery times, mortality rates and hospital stay) need to be undertaken.
Evaluation of new non-invasive & conventional invasive methods of haemoglobin estimation in blood donors
Authors: Rout Diptiranjan , Sachdev Suchet , Marwaha Neelam
Published: September 2019

Background & objectives:

The non-invasive method of haemoglobin (Hb) estimation has unique advantages of exemption of finger prick and associated pain, over invasive methods. This study was done to compare invasive and non-invasive methods of Hb estimation in blood donors keeping haematology analyzer (HA) as a reference method.

Methods:

The blood donors selected or deferred on the basis of CuSO4 method (Hb ≥12.5 g/dl), were included in the study. Hb values of the donors were estimated by HemoCue and then by OrSense methods. An immediate post-donation venous sample was drawn for analysis on HA.

Results:

The mean Hb value was 13.98±1.27 g/dl on HA, 14.87±1.03 g/dl on OrSense and 15.03±1.31 g/dl on HemoCue. CuSO4, HemoCue and OrSense demonstrated sensitivities of 18.7, 18.7 and 13.1 per cent, positive predictive values (PPV) of 64.5, 83.3 and 60.9 per cent and specificities of 98.9, 99.6 and 99.1 per cent, respectively. The intra-class correlation coefficient for OrSense was 0.726 while that for HemoCue was 0.851. Bland-Altman plots demonstrated 2SD difference of >2.0 g/dl in Hb estimations between HA and HemoCue/OrSense.

Interpretation & conclusions:

The non-invasive modality may provide the near-ideal pre-donation Hb screening platform if an improvement can be done in the sensitivity and PPV of the non-invasive method keeping in view its unique advantages.
Differential susceptibility & replication potential of Vero E6, BHK-21, RD, A-549, C6/36 cells & Aedes aegypti mosquitoes to three strains of chikungunya virus
Authors: Sudeep Anakkathil Balan , Vyas Pratik B. , Parashar Deepti , Shil Pratip
Published: September 2019

Background & objectives:

Chikungunya virus (CHIKV), a mosquito-borne arthritogenic virus causes infections ranging from febrile illness to debilitating polyarthralgia in humans. Re-emergence of the virus has affected millions of people in Africa and Asia since 2004. During the outbreak, a new lineage of the virus has evolved as an adaptation for enhanced replication and transmission by Aedes albopictus mosquito. A study was designed to compare the susceptibility of four vertebrate cell lines, namely Vero E6 (African green monkey kidney), BHK-21 (Baby hamster kidney), RD (human rhabdomyosarcoma), A-549 (human alveolar basal epithelial cell) and C6/36 (Ae. albopictus) to Asian genotype and two lineages of East, Central and South African (E1:A226 and E1:A226V) of CHIKV.

Methods:

One-step growth kinetics of different CHIKV strains was carried out in the above five cell lines to determine the growth kinetics and virus yield. Virus titre was determined by 50 per cent tissue culture infectious dose assay and titres were calculated by the Reed and Muench formula. Growth and virus yield of the three strains in Ae. aegypti mosquitoes was studied by intrathoracic inoculation and virus titration in Vero E6 cell line.

Results:

Virus titration showed Vero E6, C6/36 and BHK-21 cell lines are high virus yielding with all the three lineages while RD and A-549 yielded low virus titres. C6/36 cell line was the most sensitive and yielded the maximum titre. Ae. aegypti mosquitoes, when inoculated with high titre virus, yielded an almost equal growth with the three strains while rapid growth of E1:A226V and Asian strain was observed with 1 log virus.

Interpretation & conclusions:

C6/36 cell line was found to be the most sensitive and high yielding for CHIKV irrespective of lineages while Vero E6 and BHK-21 cell lines yielded high titres and may find application for vaccine/diagnostic development. Infection of Ae. aegypti mosquitoes with the three CHIKV strains gave almost identical pattern of growth.
A systematic review of standard treatment guidelines in India
Authors: Koli Paresh Girdharlal , Kshirsagar Nilima A. , Shetty Yashashri C. , Mehta Dhvani , Mittal Yashaswini , Parmar Urwashi
Published: September 2019

Background & objectives:

Standard treatment guidelines (STGs) are the cornerstone to therapeutics. Multiple agencies in India develop STGs. This systematic review was conducted to find out STGs available in India, evaluate if these were as per World Health Organization (WHO) recommendations for STGs and compare these with National Institute for Health and Care Excellence (NICE) guidelines. Information on legal authority and responsibility for formulating STGs was also sought.

Methods:

PRISMA guidelines were followed. Publications from PubMed and Google Scholar were searched for STGs using terms 'Standard Treatment Guidelines AND India'. Data from STGs were compiled in excel as per the WHO and authors' criteria for STGs and compared with NICE guidelines.

Results:

PubMed and Google Scholar search provided 56 publications (out of 1695 search results) mentioning 27 STGs. Google search and replies from authors led us 36 STGs, totalling to 63 STGs. No STG mentioned any specific period of revision, eight STGs were not evidence-based, 55 had some Indian references, 48 STGs were for single disease and the remaining multi-disease, three STGs did not include diagnostic criteria, 16 STGs did not give prescribing information of recommended treatment and 16 STGs provide no referral criteria for patients. Fifty five STGs did not mention level of health care. While NICE is a single legal authority in England and guidelines are as per WHO recommendations for STGs, in India although Acts and rules do not vest authority, National Health Systems Resource Center is generally designated responsible for STGs.

Interpretation & conclusions:

In India, although there are multiple STGs developed by various authorities and professionals for the same conditions, these fulfil WHO recommendations only partially. Authority with statutory duty collaborating with professional organizations, a standard methodology for adopting international guidelines, Indian data for evidence base, attention to local needs will help in developing better STGs and their acceptance.
Molecular characterization of influenza A(H1N1)pdm09 viruses circulating at various geographical locations in India, 2017
Authors: Potdar Varsha , Vijay Neetu , Gupta Nivedita , Arunkumar G. , Borkakoty Bishwajyoti , Malhotra Bharti , Rabha Debajit , Hinge Dilip , Kaur Harmanmeet , Chadha Mandeep
Published: September 2019

Background & objectives:

Influenza virological surveillance is an essential tool for the early detection of novel genetic variants of epidemiologic and clinical significance. This study was aimed to genetically characterize A(H1N1)pdm09 virus circulating in 2017 and to compare it with the global data.

Methods:

The regional/State Viral Research and Diagnostic Laboratories (VRDLs) provided influenza diagnosis for referred clinical samples and shared influenza A(H1N1)pdm09 positives with the Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, India, for hemagglutinin (HA) gene phylogenetic analysis. Sites at Manipal, Jaipur and Dibrugarh performed the sequencing and shared the sequence data for analysis. The antiviral susceptibility of influenza viruses was assessed for known molecular marker H275Y at the ICMR-NIV, Pune.

Results:

All the eight VRDLs had well-established influenza diagnostic facilities and showed increased activity of influenza A(H1N1)pdm09 during 2017. Phylogenetic analysis showed that the viruses from the different regions of the country were similar to A/Michigan/45/2015 strain which was the 2017-2018 recommended vaccine strain and were clustered with the globally circulating clade 6B.1 with signature mutations S84N, S162N and I216T. The clade 6B.1 showed further subgrouping with additional mutations S74R, S164T and I295V; however, there was no significant association between the presence of these mutations and severity of disease due to influenza. All the study viruses were sensitive to oseltamivir.

Interpretation & conclusions:

During the study period, all the study sites reported globally circulating A/Michigan/45/2015 vaccine strain of influenza A(H1N1)pdm09 viruses and remained sensitive to oseltamivir. Further genetic and antigenic characterization of influenza viruses is recommended to address public health concerns.
Apatinib Combined with Local Irradiation Leads to Systemic Tumor Control via Reversal of Immunosuppressive Tumor Microenvironment in Lung Cancer
Authors: Liang Li-jun , Hu Chen-xi , Wen Yi-xuan , Geng Xiao-wei , Chen Ting , Gu Guo-qing , Wang Lei , Xia You-you , Liu Yong , Fei Jia-yan , Dong Jie , Zhao Feng-hua , Ahongjiang Yiliyar , Hui Kai-yuan , Jiang Xiao-dong
Published: September 2019

PurposeThis study aimed to investigate the potential systemic antitumor effects of stereotactic ablative radiotherapy (SABR) and apatinib (a novel vascular endothelial growth factor receptor 2 inhibitor) via reversing the immunosuppressive tumor microenvironment for lung carcinoma.Materials and MethodsLewis lung cancer cells were injected into C57BL/6 mice in the left hindlimb (primary tumor; irradiated) and in the right flank (secondary tumor; nonirradiated). When both tumors grew to the touchable size, mice were randomly divided into eight treatment groups. These groups received normal saline or three distinct doses of apatinib (50 mg/kg, 150 mg/kg, and 200 mg/kg) daily for 7 days, in combination with a single dose of 15 Gy radiotherapy or not to the primary tumor. The further tumor growth/regression of mice were followed and observed.ResultsFor the single 15 Gy modality, tumor growth delay could only be observed at the primary tumor. When combining SABR and apatinib 200 mg/kg, significant retardation of both primary and secondary tumor growth could be observed, indicated an abscopal effect was induced. Mechanism analysis suggested that programmed death-ligand 1 expression increased with SABR was counteract by additional apatinib therapy. Furthermore, when apatinib was combined with SABR, the composition of immune cells could be changed. More importantly, this two-pronged approach evoked tumor antigen–specific immune responses and the mice were resistant to another tumor rechallenge, finally, long-term survival was improved.ConclusionOur results suggested that the tumor microenvironment could be managed with apatinib, which was effective in eliciting an abscopal effect induced by SABR.
Evaluation of patients treated by nutrition support teams and its effect on treatment costx
Authors: Gönderen Kamil , Tokgöz Gamze , Çankaya Merve , Öztoprak Kol Elif , Gönderen Aysun
Published: September 2019

Objective: Malnutrition is a condition that increases morbidity and mortality in patients, prolongs hospital stay, and increases treatment costs. The incidence of malnutrition remains a major problem in hospitalized patients despite improvements in nutritional support therapies. Previous studies have shown that treatment standardization can be achieved by using a multidisciplinary team that consists of doctors, pharmacists, nurses, and dieticians, which positively affects hospital costs and patients’ health. In this study, we aimed to investigate the effect of nutritional support teams on treatment cost in our hospital.
Methods: A nutrition support team was established in April 2017 at our hospital and all patients who consulted the team between April 2017 and December 2018 were investigated retrospectively. In this period, the patients were evaluated for incidence of mortality, body mass index, changes in NRS-2002 score, enteral and parenteral nutrition rates, nutritional changes, and annual enteral and parenteral product costs and the effect of multidisciplinary nutrition on these parameters was assessed. Results of quantitative variables were defined as mean, median, and standard deviation. Qualitative variables were represented by frequency and percentage.
Results: A total of 511 patients were enrolled in the study. The mean age of the patients was 68.6 years (18–99) and 49.5% of them were female. Out of 511 subjects, 251 patients were hospitalized in intensive care units and 260 were in wards. Enteral nutrition was recommended in 275 patients, oral nutrition in 71 patients, and parenteral nutrition in 70 patients. The mortality rate was 61.6% in high-risk patients with an NRS2002 score >5 and 38.4% in moderate-risk patients with a score of 3–5. A total of 164 patients who received inappropriate parenteral nutrition were switched to oral or enteral nutrition. The NRS-2002 score was maintained in 267 patients and was decreased in 202 patients. The number of patients receiving parenteral nutrition was 8783 in 2016, which decreased to 6104 in 2018 with a decreasing rate of 30.5%. The number of patients receiving enteral nutrition were 4376 in 2016, which increased to 7582 in 2018 with an increasing rate of 42.2%. The total cost of enteral and parenteral products was decreased.
Conclusion: Giving the nutritional support to malnourished patients or those at high risk of malnutrition could have positive effects on many parameters such as reduction the NRS-2002 scores and hospital costs and choosing the correct nutritional route.
Is deoxygenation detectable before warming in the thermocline?
Authors: Hameau Angélique , Frölicher Thomas L. , Mignot Juliette , Joos Fortunat
Published: September 2019

Abstract. Multiple lines of evidence from observation- and model-based studies show that anthropogenic greenhouse gas emissions cause ocean warming and oxygen depletion, with adverse impacts on marine organisms and ecosystems. Temperature is considered as one of the main indicators of climate change, but, in the thermocline, anthropogenic changes in biogeochemical tracers such as oxygen may emerge from the bounds of natural variability before changes in temperature. Here, we compare the local time of emergence (ToE) of anthropogenic temperature and oxygen changes in the thermocline within an ensemble of Earth system model simulations from the fifth phase of the Coupled Model Intercomparison Project (CMIP5). Anthropogenic deoxygenation emerges from natural internal variability before warming in 35 ± 11 % of the global thermocline. Earlier emergence of oxygen than temperature change is simulated by all models in parts of the subtropical gyres of the Pacific and the Southern Ocean. Earlier detectable changes in oxygen than temperature are typically related to decreasing trends in ventilation. The supply of oxygen-rich surface waters to the thermocline is reduced as evidenced by an increase in apparent oxygen utilisation over the simulations. Concomitantly, the propagation of the warming signal is hindered by slowing ventilation, which delays the warming in the thermocline. As the magnitudes of internal variability and simulated temperature and oxygen changes, which determine ToE, vary considerably among models, we compute the local ToE relative to the global mean ToE within each model. This reduces the inter-model spread in the relative ToE compared to the traditionally evaluated absolute ToE. Our results underline the importance of an ocean biogeochemical observing system and that the detection of anthropogenic impacts becomes more likely when using multi-tracer observations.
Two millennia of Main region (southern Germany) hydroclimate variability
Authors: Land Alexander , Remmele Sabine , Hofmann Jutta , Reichle Daniel , Eppli Margaret , Zang Christian , Buras Allan , Hein Sebastian , Zimmermann Reiner
Published: September 2019

Abstract. A reconstruction of hydroclimate with an annual
resolution covering millennia for a geographically limited region in
continental Europe significantly improves our knowledge of past climate
dynamics. With the use of an extensive collection of oak ring-width series
(Quercus robur and Quercus petraea) from living trees, historic timbers and subfossil alluvial wood
deposits from the Main River region in southern Germany, a regional,
2000-year long, seasonally resolved hydroclimate reconstruction for the
Main region has been developed. Climate-growth response analysis has been
performed with daily climate records from AD 1900 onwards. To test the
stability of the developed transfer function, a bootstrapped transfer
function stability test (BTFS) as well as a classical calibration/verification approach have been implemented to study climate-growth model
performance. Living oak trees from the Main River region show a significant
sensitivity to the precipitation sum from 26 February to 6 July (spring to
midsummer) during the full (r=0.49, p<0.01, N=116) and
split (r=0.58, p<0.01, N=58) calibration periods. BTFS
confirmed the stability of the developed transfer function. The developed
precipitation reconstruction reveals high variability on a high- to
mid-frequency scale during the past two millennia. Very dry spring to
midsummer seasons lasting multiple years appeared in the decades AD 500/510s, 940s, 1170s, 1390s and 1160s. At the end of the AD 330s, a
persistent multi-year drought with drastically reduced rainfall (with regard to 1901–2000) could be identified, which was the driest decade over the past
2000 years in this region. In the AD 550s, 1050s, 1310s and 1480s,
multi-year periods with high rainfall hit the Main region. In spring to
midsummer of AD 338, precipitation was reduced by ∼38 %
and in AD 357 it increased by ∼39 %. The presented
hydroclimate reconstruction and its comparison to other records reveal
interesting insights into the hydroclimate dynamics of the geographically
limited area over the Common Era, in addition to revealing noticeable temporal
differences.
Reassessing long-term drought risk and societal impacts in Shenyang, Liaoning province, Northeast China (CE 1200–2015)
Authors: Tang LingYun , Macdonald Neil , Sangster Heather , Chiverrell Richard , Gaulton Rachel
Published: September 2019

Abstract. The occurrence of two severe droughts in Northeastern China since CE 2000 has raised attention in the risk presented by droughts. This paper presents a historic drought series for Shenyang in the Liaoning province, NE China since CE 1200 to present, with a reconstructed long precipitation series (1906–2015), augmented with historical documentary accounts. Analysis of the instrumental series using a standardised precipitation index (SPI) and extending it using historical records has produced a combined series spanning over eight centuries. The combined long series was analysed for patterns in drought frequency, severity and typology. Three droughts comparable to those since CE 2000 occur in the instrumental series during early twentieth century (e.g. 1907, 1916–18 and 1920–21), and coeval archival sources reveal the human impacts of these severe droughts. The archival sources demonstrate how reduced vulnerability resulting from societal and cultural changes in the early twentieth century helped prevent the loss of life experienced during comparable severe droughts at the end of the nineteenth century (1887 and 1891). Incorporating a longer temporal perspective to drought analysis shows that onset is often earlier than is documented explicitly within the archives, and so combined SPI series for a region could provide an early warning of drought development expressed as a water deficit in the previous year. Analysis of archival data provides a rich historical description of impacts and societal responses to severe drought. The archives provide a rich historical description of drought impacts and responses at the personal and community level, whilst also detailing the different roles played by communities, state and international organisations in responding to events.
Anarchism in the Web of Transnational Social Movements
Authors: Chase-Dunn Christopher , Aldecoa John , Breckenridge-Jackson Ian , Herrera Joel S.
Published: September 2019

Anarchists have played a visible and significant role in global civil society since the 19th century and in the New Global Left since it emerged in the 1990s. Horizontalism and social libertarianism have been central components of the contemporary World Revolution and were also important in the world revolutions of 1968 and 1989. Anarchists have participated in the Social Forum process at the global, national and local levels and, in various ways, have influenced the contemporary world revolution far beyond their numbers. We use surveys from Social Forums to examine how self-identified actively involved anarchists are similar or different from other attendees. We also conduct a formal network analysis to examine the links that the anarchists have with other social movement themes. Despite the small number of self-identified anarchists, our findings suggest that anarchist organizational approaches and political values are widely shared among the activists who have been involved in the Social Forum process.
Rethinking Samir Amin’s Legacy and the Case for a Political Organization of the Global Justice Movement
Authors: Juego Bonn
Published: September 2019

Juego argues that the new Internationale’s “primary organizational function should be the global coordination of actions of progressive grassroots movements from country to country.” He calls for a ‘learning organization,’ where the new Internationale supports “a continuous dialogue between bottom-up and top-down approaches to decision-making.” He sees it as “[a]kin to a global coordinating council” meaning that it works to integrate and synthesize the “varying initiatives, campaigns, and mass actions at all geographical levels of membership” while remaining mindful of the “dialectics between reform and revolution.” The new Internationale must, moreover, be “grounded on a pragmatic understanding of realpolitik especially in struggles at national and local scales,” and institutionalize a commitment to dialogue, research, and discussion.
Path Analysis and Correlation of Influential Socioeconomic Factors in the Production of Sugarcane
Authors: Nacife Jean Marc , Soares Frederico Antônio Loureiro , Castoldi Gustavo
Published: September 2019

The analysis of the economic viability of agriculture and sugar cane is necessary to understand the techniques of measuring the financial return on the activities of rural establishments. The authors aimed to examine the direct and indirect associations of socioeconomic factors on the benefit/cost index in sugarcane activity and their significant correlations. The methodological approach of research was quantitative, applying statistical techniques of inferential and multivariate analysis (path analysis) under statistical significance (P<0.05). A model of path diagram was developed that presented a structural adjustment of quality, obtaining relevant R2 (0.74). The analysis showed that the characteristics of the successors of the farms impact on the economic factors of the productive system of the sugar cane. There was a total association between the successor's vocation and the benefit/cost index, presenting a substantial path coefficient (-0.90), in which the direct and indirect effect (51% and 49%) was inversely proportional and had a significant impact (P<0.05). A total association between the successor's practical ability and the benefit/cost index was obtained, which presented a strong and directly proportional path coefficient (0.70). In the dynamics of the socioeconomic factors of the sugarcane productive system, the influence of social variables on the economic result is expressive, and the indirect effects impact in a manner similar to the direct ones, as evidenced by the analysis of the benefit/cost, implying the adoption of actions that prepare the successors for agricultural management and for the management of agribusiness.
The Recognition of Animal Sentience by the Law
Authors: Blattner Charlotte E.
Published: September 2019

In order to protect nonhuman animals effectively, animal law must overcome many hurdles, be it the balance of human and nonhuman interests, the use paradigm, or narrow definitions of legal personhood or basic rights. A fact often overlooked in this uphill struggle is that the laws of most states recognize that animals must be protected because and to the extent that they are sentient. The legal recognition of animal sentience seems to nullify all and any attempts to deny them legal protection simply because they are not sufficiently appealing, emotionally close, or economically useful to us. However, the legal recognition of animal sentience does not overcome all our cognitive prejudices about animals. Using a comparative law method and insights from moral philosophy, this article analyzes the nature and scope of the legal recognition of animal sentience. It identifies its advantages in challenging arbitrariness and inconsistency and championing intrinsic animal protection and points to the most pressing shortcomings, including some states’ refusal to commit themselves to animal sentience and remaining prejudices in society and science. In concluding, the article offers ways to address and remedy these shortcomings and points to ways in which the concept can be used more effectively by academics and practitioners.
Beyond Competition: An Indigenous Perspective on Organized Sport
Authors: Rice Brian
Published: September 2019

This paper is about participation in sport from the perspective of several Indigenous societies and includes a comparative analysis with mainstream competitive sport. The author utilizes his experiences from his own Kenienkè:haka society and includes the seven teachings of the Anishnabè along with other examples from other Indigenous societies. The paper emphasizes the differences between an Indigenous cultural understating about sport that is rooted in community teachings over a mainstream individualistic one. There is an emphasis on how good community and team leaders are thought of and evolve within Indigenous societies.
Engaging (with) Indigeneity: Decolonization and Indigenous/Indigenizing Sport History
Authors: MacLean Malcolm
Published: September 2019

The drive to decolonize the academy has led to the reconstruction of old understandings, yet much of the critical studies tradition does little more than add “data” from colonially suppressed peoples without re-examining the dominant discursive narratives. This paper explores the historiography of indigenous sport to pose questions about the ways the Imperial Archive has shaped our understandings and the manner of access to that source material, suggesting ways that they might be used to disrupt the dominant epistemologies of colonial(ist) sport history. It constructs a sixfold typology and explores each type through the analysis of a single representative source. In doing so, it tests the limits of researchers’ moral responsibility to include research communities in the process of development and production of data and critiques the view that responsibility for and conduct of the analysis rests solely with the researcher. In posing the problem of “the archive, “ the paper explores ways in which the decolonization of sport history and the indigenization of the subject can help reconfigure the meaning of modern sport and develop a more fluid, dialogic approach to historiographical practice.
Enduring Legacies and Convergent Identities: The Male-Dominated Origins of the Kenyan Running Explosion
Authors: Sikes Michelle
Published: September 2019

The colonial era in Kenya was a pivotal and transitional period during which aspects of local peoples’ existing gender roles and relations were challenged, renegotiated and, in the case of running, confirmed. British colonial intent to introduce running as sport to men aligned with Rift Valley societies that condoned male, though not female, running. Indigenous ideas and ways of living could operate in tandem with the historically masculine orientation of Western athletics, leaving a legacy of cultural synthesis that significantly constrained Kenyan women’s sporting prospects. Histories of sport in Kenya, and elsewhere, should take into account both external and local gender norms, as they existed prior to colonial contact, to understand better the gendered mechanisms through which sport “diffused” to empire.
The eigenvalues’ function of the family of Sturm-Liouville operators and the inverse problems
Authors: Harutyunyan Tigran
Published: September 2019

We study the direct and inverse problems for the family of Sturm-Liouville operators, generated by fixed potential q and the family of separated boundary conditions. We prove that the union of the spectra of all these operators can be represented as a smooth surface (as the values of a real analytic function of two variables), which has specific properties. We call this function ”the eigenvalues function of the family of Sturm-Liouville operators (EVF)”. From the properties of this function we select those, which are sufficient for a function of two variables be the EVF a family of Sturm-Liouville operators.
Współczesne zagrożenia dla zdrowia psychicznego młodzieży – nowymi wyzwaniami edukacyjnymi
Authors: Łuczak Elżbieta
Published: September 2019

The article focuses on two fundamenta\l issues, which are primarily related to modern threats resulting from mental disorders analysed mainly in terms of addiction (both substantial and behavioural) as well as educational interactions, applicable in preventing and minimising mental disorders. Apart from the issues mentioned in the study, the article presents the approximate rate and determinants of the phenomenon of mental disorders in the Polish society.
Management for leadership – on the need for proactivity
Authors: Cybal-Michalska Agnieszka
Published: September 2019

The discourse presented in this article is focused on the subjects of leadership and management, as well as relationships between these two. This discourse requires the inclusion of multicontextual changes of the neoliberal world which make leaders face new requirements. The most important requirements are: the increasing role of leadership, management for leadership and need of proactivity. The arguments put forward in this article show that there is a need to generate new attitudes that will go beyond the boundaries determined by partial paradigms so that they are relevant to the dynamics of changes in the contemporary world.
Avaliação da balneabilidade das Praias do Farol da Barra e Porto da Barra, Salvador (BA)
Authors: Alves Luciano da Silva , Rabelo Isabela Santos
Published: September 2019

O termo ‘balneabilidade’ consiste na qualidade da água destinada à recreação de contato primário. O presente artigo tem por objetivo relatar a condição de balneabilidade das Praias do Farol da Barra e Porto da Barra, localizadas em Salvador (BA), e relatar sobre as possíveis influências. Para a realização deste trabalho, além das pesquisas bibliográficas realizadas, foram utilizados como objetos de estudo os dados de monitoramento de Balneabilidade disponibilizados pelo INEMA. De acordo com os resultados apresentados, a Praia do Porto da Barra, própria em 88% do tempo de monitoramento, e classificada como regular, é a mais indicada para receber atividades que envolvem o contato direto com a água, enquanto a praia do Farol da Barra, monitorada no ponto 02, apontada como imprópria em 53% do tempo de monitoramento, foi classificada como péssima para a realização de atividades recreativas. Diante da análise dos resultados estatísticos e das imagens obtidas em visitas ao local, conclui-se que a qualidade da água das praias aqui estudadas sofre interferência da carência de saneamento básico presente no local. Nos pontos estudados foi observado a existência de canais de drenagem operando em condições precárias e de redes clandestinas de esgoto.
Comparative Analysis of Manual, Rotary and Reciprocal Systems on Primary Teeth Root Canals: An In Vitro Scanning Electron Microscopy Study
Authors: ARSLAN İpek , AYDINOĞLU Sema , BAYGIN Ozgul , TÜZÜNER Tamer , ŞİRİN Murat
Published: September 2019

Objective:
To evaluate the residual debris and smear layer
formation, and also preparation time of one or multifile manual, rotary, and
reciprocal systems on primary teeth.

Materials and methods: A total of 75
primary mandibular molar teeth were randomly divided to five groups (n=15). The
distal canals of teeth were shaped with each of the K file, Protaper, Twisted
File, OneShape, and Reciproc systems. Preparation time was also recorded. Longitudinal
sections groups were prepared and processed for observation under scanning
electron microscopy (SEM) at a standard magnification of X1000 for smear layer
and X200 for residual debris. The presence of smear layer and residual debris was
evaluated by two trained operators. The data of preparation time and also
debris and smear scores were analyzed using ANOVA and the Kruskal-Wallis test,
respectively.

 

Results: Reciproc and OneShape systems had significantly less
instrumentation time than all other groups (p<0.001). The results of
statistical analyses were the same for the residual debris and smear layer scores.
In the coronal thirds of the canals, the canal preparation with the Protaper
system resulted in significantly less debris and smear layer compared with the
OneShape system (p=0.015). In the middle thirds of the canals, OneShape and
Reciproc systems had more residual debris and smear layer than the Protaper
system (p<0.05). In the apical thirds of the canals, the use of the Protaper
instruments resulted in less debris and smear layer than the Reciproc system
(p=0.034).

Conclusion:
Within the limits of this study, the Protaper system,
which showed better cleaning efficacy and was also faster than the manual
system, can be an effective alternative to other systems in the root canal
treatment of primary molars. More in vitro and clinical investigations are
needed on root canal treatment of primary teeth.
War Breaks Out
Authors: Crombé Xavier , Kuper Joanna
Published: September 2019

This article seeks to document and analyse violence affecting the provision of healthcare by Médecins Sans Frontières (MSF) and its intended beneficiaries in the early stage of the current civil war in South Sudan. Most NGO accounts and quantitative studies of violent attacks on healthcare tend to limit interpretation of their prime motives to the violation of international norms and deprivation of access to health services. Instead, we provide a detailed narrative, which contextualises violent incidents affecting healthcare, with regard for the dynamics of conflict in South Sudan as well as MSF’s operational decisions, and which combines and contrasts institutional and academic sources with direct testimonies from local MSF personnel and other residents. This approach offers greater insight not only into the circumstances and logics of violence but also into the concrete ways in which healthcare practices adapt in the face of attacks and how these may reveal and put to the test the reciprocal expectations binding international and local health practitioners in crisis situations.
All Lives Are Equal but Some Lives Are More Equal than Others
Authors: Bradley Miriam
Published: September 2019

In 2015, Action Contre la Faim launched a campaign calling on the UN to create a new post, that of a Special Rapporteur for the protection of humanitarian aid workers. Critics of the proposal claimed, inter alia, that creating such a post would imply that aid workers were a special category of civilians, worthy of protection over and above that accorded the wider population in the contexts in which they work.1 This raises an important issue which runs deeper than the campaign for a Special Rapporteur. The present article argues that, with or without such a post, the current situation is one in which humanitarian agencies treat aid workers as distinct and separate from the wider civilian population, and take significantly different measures for the safety of their staff from those they take for other civilians. For the most part, the distinction and associated differences are uncritically accepted, and this article sets out to challenge such acceptance by highlighting the nature of the differences, assessing possible explanations for the underlying distinction and considering its implications. Through this analysis, the article argues that this distinction not only reflects but also reinforces an unequal valuing of lives internationally.
The Duties of an NGO Security Advisor
Authors: Strub Emmanuelle
Published: September 2019

A security advisor for Médecins du Monde France between 2012 and 2016, Emmanuelle Strub recalls her experience and some of the major shifts in risk management in the NGO sector in recent years. In particular, at a time of global normalisation of the aid sector, she describes her own efforts to streamline security management in her organisation: empowering field teams and, in particular, heads of mission, emphasising the crucial role of obtaining consent from the various stakeholders in the countries of intervention, and developing security trainings, crisis-management tools and a risk-management methodology. Yet, she warns, the trend today, with the advent of the duty-of-care concept, is to shift the use of risk management from enabling operations and facilitating access to populations to protecting the organisation from legal or reputational risks.