bluuebunny/crossref_metadata_2025 huggingface dataset:
La producción de líderes políticos situados en dos comunidades políticas mexicanas
Authors: Guevara Sánchez Brenda Griselda , Verduzco Miramón Francisco Javier
Published: June 2018

En este escrito reflexionamos sobre las condiciones históricas que influyeron para que en dos espacios geográficos, organizativos y económicos distintos existan importantes similitudes en la producción de complejos liderazgos agrarios. Por un lado, la comunidad agraria de Zirahuén en Michoacán, nos centraremos en la figura política de Marcos Paz Calvillo; por el otro el ejido de Campos, Colima con Armín Núñez Meza. Estas organizaciones son analizadas como comunidades políticas perennes, en las cuales su propia historia y las biografías de los sujetos estudiados estuvieron en constante producción y disputa. Con base en nuestros resultados etnográficos proponemos la noción de liderazgos políticos situados, cuyo rango de influencia depende, en gran medida, de los objetivos, espacios, públicos y condiciones históricas específicas de sus respectivas formaciones.

Abstract

This paper analyzes the historical conditions that allowed two very different geographic, organizational and economic spaces to develop important similarities in the production of complex agrarian leaderships; on one hand, the agrarian community of Zirahuén in Michoacán, centered in the political figure of Marcos Paz Calvillo; on the other, the Campos ejido in Colima with its leader, Armín Núñez Meza. These organizations are examined as perennial political communities in which local history and the biographies of the subjects studied emerged through an ongoing process of production and dispute. Based on our ethnographic results we propose the notion of situated political leadership in these communities; the degree of influence exerted by such leaderships depends largely on the objectives, spaces, publics and specific historical conditions of their respective formation.
Territorialidades campesinas en Loja, Ecuador: análisis de sus dinámicas organizativas a partir de tres casos
Authors: Alvarado Torres Marco Antonio
Published: June 2018

En la provincia de Loja, al sur de Ecuador, desde de los años 90 del siglo pasado, varias familias campesinas han creado organizaciones locales que impulsan territorialidades alternativas como la producción ecológica, finanzas solidarias, gestión comunitaria del agua, defensa de territorios ancestrales, empoderamiento de mujeres, entre otras. Este trabajo se pregunta de qué manera se estructuran estas experiencias, y a partir de la construcción participativa de sociogramas, analiza las dinámicas internas de tres organizaciones, y sus interacciones con otros actores. Se encuentra que estas territorialidades, más que simples prácticas de producción o gestión, son complejas trayectorias de subjetivación política.

Abstract

In the province of Loja, located south of Ecuador, since the 90s of the last century, several peasant families have created local organizations through which promote alternative territorialities, how ecological production, solidarity finance, community management of water, defense of ancestral lands, empowerment of rural women, amongst other activities. This paper asks how these experiences are structured, and from participatory elaboration of sociograms, analyzes the internal dynamics of three organizations, and its interactions with other actors. These territorialities are more than simple practices of production, or management, these are also complex phats of political subjectivation.
Presentación
Authors: Martínez Valle Luciano
Published: June 2018

Introducción al Dossier
Preparasi dan Karakterisasi Kitosan-Karboksi Metil Selulosa Iradiasi untuk Scaffold
Authors: Abbas Basril , Warastuti Yessy
Published: June 2018

Scaffold umumnya digunakan sebagai matrik pelepasan obat, penelitian perilaku sel dan material dalam bidang rekayasa jaringan. Scaffold berdimensi tiga (3D) biasanya berupa material berpori, biokompatibel, biodegradable dan berfungsi untuk memberikan lingkungan mikro yang cocok, yaitu dukungan mekanik, fisik, dan rangsangan biokimia untuk pertumbuhan sel optimal. Pada penelitian ini scaffold dibuat dari kitosan dan karboksimetil selulosa (KMS) dengan teknik liofilisasi. Selanjutnya, scaffold diiradiasi dengan sinar gamma dan dikarakterisasi dengan Fourier-Transform- Infrared, Scanning Electron Microscope (SEM), serapan air dan porositas. Hasil yang diperoleh menunjukkan bahwa  pada spektrum FTIR  diperoleh kedua bahan tersebut tanpa terjadi reaksi, ukuran pori berkisar 130-467 µm, serapan air 803-1722%, dan porositas berkisar 70-74%. Iradiasi mempengaruhi ukuran pori, porositas, dan serapan air. Berdasarkan besaran porinya, komposit ini layak menjadi scaffold.
“West” or “Vest”? Pronunciation of English Consonants [w] and [v] in the Utterances of Slovak EFL Speakers
Authors: Metruk Rastislav
Published: June 2018

The paper investigates the pronunciation of the labiodental fricative [v] and the labial-velar approximant [w] in the word-initial position in English utterances by Slovak speakers. The objective of the study is to explore which of the two consonants appear to be more problematic for Slovak learners of English. 40 students from a Slovak university produced spontaneous monologues in English, which were recorded using a computer and a standard microphone. Afterwards, two native English speakers conducted a subjective auditory analysis in an attempt to identify errors in the subjects’ pronunciation. The results demonstrate that Slovak learners of English frequently encounter difficulties in pronouncing the two consonants, sometimes substituting [v] for [w] and vice versa. The data obtained indicate that the subjects were beset with problems mispronouncing the two sounds to almost the same degree. Possible causes of the erroneous pronunciation seem to involve native language interference, devoting extra effort to approach authentic English pronunciation, and the neglect of pronunciation instruction.
Impact of Mobile Assisted Language Learning on Learner Autonomy in EFL Reading Context
Authors: Hazaea Abduljalil Nasr , Alzubi Ali Abbas
Published: June 2018

Traditional classrooms confine English as a Foreign Language (EFL) reading to the textbook and the classroom setting, something that demotivates active reading. With the advent of mobile technology, however, such boundaries can be broken to include external reading materials where students could read and share anytime and anywhere. This paper investigates the role of mobile technology in enhancing Learner Autonomy (LA) in the EFL reading context among students in the Preparatory Year (PY) of Najran University in Saudi Arabia. A reading class of 30 students utilised mobile applications (WhatsApp and internet search engines such as Google) to access external reading materials and interact with their peers and teachers outside the classroom. Qualitative data collection underwent a number of procedures. The baseline data was constructed from the students’ portfolios, which reported the participants’ traditional reading practices and use of mobiles. Then, the participants were encouraged to use internet search engines and WhatsApp group to share their readings. Finally, five participants were interviewed. The data analysis revealed that the participants’ LA is improved through the use of selected mobile applications in terms of taking responsibility for and making decisions about reading materials and the time and place of reading. The study recommends further investigation into the role of mobile applications for generating learners’ own tasks and writing skills.
The Relationships Between the Accuracy of Self-Evaluation, Kanji Proficiency and the Learning Environment for Adolescent Japanese Heritage Language Learners
Authors: Aiko Mizue
Published: June 2018

This paper focuses on Japanese heritage language (JHL) learners in an Australian context. The paper reports on a research project in a hoshuu-koo institution, a Japanese supplementary school, and explores the experiences of a group of Year 7 students. This study was initiated by identifying to what extent JHL learners can recognise their own skills, especially in proficiency in kanji, one of the Japanese scripts. It was predicted that several elements could relate to the accuracy of self-evaluation. By exploring levels of self-evaluation skills and the elements concerned in Japanese learning, the aim of the research was to help develop differentiated curriculum in the future. Data were based on student performance on kanji tests and answers to questionnaires, and the Excel Correl Function was used to calculate correlation coefficients. Graphs were also used to analyse the data. It was found that students who had relatively high kanji proficiency, especially in higher year levels, recognised their own skills but an overall overestimation was found amongst other students. Specific areas of kanji learning, such as okurigana and radicals, were identified as areas that need to be enhanced for appropriate self-evaluation for most of the students. Learning environment related to evaluation skills was also identified. Concluding comments centre on implications for further teaching approaches and research on the enhancement of kanji self-evaluation skills.
A Study on the Attributes of Effective English Lecturers as Perceived by EFL Learners: The Case of Indonesia
Authors: Mudra Heri
Published: June 2018

This study aims to uncover the attributes of effective English lecturers and any significant differences between male and female EFL learners in determining the attributes of effective EFL lecturers. The study utilized a descriptive study design by asking 52 EFL learners to be respondents by filling in a questionnaire. The results depicted that the attributes associated with the ‘rapport’ category were friendliness, relationship, experiences, positive attitudes, and sense of humour. An independent t-test also showed there was no significant difference between male and female EFL learners in determining these attributes. The attributes of the ‘delivery’ category included enthusiasm, clarity, correction, and encouragement. The attributes of the ‘fairness’ category included treatment and standard. The attributes of the ‘knowledge and credibility’ category included proficiency and knowledge. The attributes of the ‘organization and preparation’ category included preparation, course contents, objectives, and materials. As for the implications, the attributes enable EFL lecturers to figure out various strategies for teaching English. Moreover, it is advantageous for EFL learners in that they can adjust their learning styles with the attributes.

This article is published under the Creative Commons Attribution 4.0 International License.
Judicialização da Saúde: argumentos utilizados nas ações judiciais em desfavor do Sistema Único de Saúde, no Tribunal de Justiça do Distrito Federal e dos Territórios, pelos atores processuais.
Authors: Cordeiro Michelle Ferreira
Published: June 2018

Objective: To analyze the speeches of the procedural actors in lawsuits in the Court of Justice of the Federal District and Territories in which they prosecute actions in detriment of the public health policies, in the period between 2012 and 2013, in order to know the arguments most commonly used for the judgment of these actions. Methodology: A descriptive, analytical, documentary and bibliographic research was carried out using secondary data. The data were collected through a research on judicialization in Brazil in the years of 2012 and 2013. The quantitative data available were already treated in tables and graphs and the qualitative data were made available without due treatment, which was done from the method of Idiosyncratic Analysis. Results: The three actors analyzed author, defendant and judge, deal with logical issues that occur in the system and that discrepancies may occur. Each author has his or her points of view and experience and their particularities that should not be discarded, so that there may be visible conflicts, but if it comes to health, the common ground, is the best decision for the user. The requests to be judicialized do not directly correspond to the diseases that most affect the patients. Conclusion: It is possible to gauge from the discourses the imprudence with the patients that are in the process and it is perceived that many of the services rendered are still in deficit with their care, being that the Brazilian state is not yet universal guarantor of the users in your needs.
Os desafios da regionalização do SUS no contexto federativo brasileiro
Authors: Souza Julio Cesar Donisete Santos , Santos Alethele
Published: June 2018

Objective: This article discusses the development of SUS´s regionalization and maintains that the process followed three stages: decentralization towards a structuring of municipal health networks; the structuring of the regions with hierarchical networks of health services and the institutional designs of negotiated participation (Health Pact); and of contractualized regionalization, in which the Public Action Organizational Contract (PAOC) constitutes a reference instrument. Methodology: The methodological approach undertaken in the elaboration of this article was qualitative, resulting in a bibliographical analysis of specialized literature captured from the descriptors Brazilian Federalism and Regionalization of Health. Results: The Brazilian federalism introduce dysfunctions and lack of coordinating capacity. Conclusion: It can be inferred that the SUS’s regionalization process suffers from the misconduct of the national federative pact, in addition to the tensions related to the dispute itself about the public fund of health.
A (in)visibilidade do direito sanitário na formação de profissionais da enfermagem e do direito
Authors: De Araújo Dias Maria Socorro , Gomes Diógenes Farias , Dias Thaís Araújo , Carneiro Neto Manoel De Castro , Coelho Brito Maria Da Conceição , Chagas da Silva Liélma Carla
Published: June 2018

Objetivo: Este artigo investiga o ensino do direito sanitário nos bacharelados em Enfermagem e em Direito. Metodologia: Construído numa interface exploratória, compreensiva, e documental, de natureza qualitativa, realizado no período de maio de 2015 a fevereiro de 2016. A coleta de informações pautou-se em duas unidades de análise, uma documental (Projetos Pedagógicos de Curso), e de docentes e discentes de Cursos Bacharelados de Direito e de Enfermagem de um estado do Nordeste brasileiro. Participaram 108 (57,2%) discentes e 81 (42,8%) docentes, que compreendeu um total de 189 participantes, para os quais foram enviados questionários online por meio do Survey Monkey. A análise do material coletado foi orientada pela Análise Temática. Resultados: Os resultados identificados a partir dos Projetos Pedagógicos dos Cursos demonstram a incipiência na indução da formação para o campo do Direito Sanitário enquanto instrumento de operacionalização do direito à saúde, vinculada a escassas discussões que se dão, por vezes, em disciplinas/módulos optativos e direcionadas ao entendimento do direito à saúde. Resultado semelhante foi obtido com os docentes e discentes, no qual 100 participantes afirmaram a inexistência do ensino do direito sanitário e 89 que o direito sanitário é conteúdo associado há outras abordagens, não configurando uma disciplina específica, traduzindo uma inexpressividade do ensino daquele no estudo. Conclusão: Pondera-se que o ensino do direito sanitário nos cursos estudados evidencia que a formação em Enfermagem e Direito estão em descompasso com a tendência fenomenológica das situações jurídicas cada vez mais crescente na saúde.
O modelo de cuidado centrado no paciente sob a perspectiva do paciente idoso
Authors: Paranhos Denise Gonçalves de Araújo Mello , Oliveira Aline Albuquerque Sant'Anna
Published: June 2018

Objective: It has been highly discussed in the academic sphere the need to change the traditional standard of care, asymmetric and paternalistic, for a patient-centered model, in which the patient, recognized as the central actor of care, is stimulated by health professionals and family members to actively participate in their therapy. This paper focuses on the elderly patients because they face more frequent health problems and, due to their increased vulnerability, are subject to violations of rights in the care setting. The objective is to discuss the adoption of a patient-centered care model for elderly patients that meets their specificities and enables them to be self-determined. Methodology: This research was based on the survey, systematization and analysis of scientific studies on models of patient-centered care. Initially, a general perspective on the disease was presented, and a stipulation of a conceptual basis for patient-centered care was discussed, based on several discourses contained in the scientific literature. Finally, based on the peculiarities of the elderly patients, we sought to understand their position in relation to the disease, in order to think about the institution of a model of care shaped for them, in which they are recognized as the principal actor of the treatment. Conclusion: It was concluded that elderly patients can be active protagonists of their therapy, if the model of care offered recognizes them as vulnerable, as the central actor of the treatment, and enables them to share decisions and to be self-determined.
A conformação protetiva dos direitos fundamentais em pesquisas científicas com seres humanos: Um olhar face aos fundamentos autonomia e vulnerabilidade
Authors: Meireles Araújo Ana Thereza , Alegria Lívia
Published: June 2018

Objective: It seeks to identify the fundamental rights of research participants that should be protected in the course of experiments. It is also intended to address autonomy and vulnerability, as inherent assumptions to the research situation, clarifying its relevance for the maximization of guardianship. Methodology: The research has a bibliographic nature, in books and articles of the legal area, in ordinary legislations and related resolutions, as well as in articles published in periodicals in the area of Health. Results: Scientific research with people must have as a primary presupposition adequate and effective observance of their inherent fundamental rights, considering that in this relationship, the exercise of autonomy, revealed by obtaining consent, and the condition of vulnerability should not be ruled out. Conclusion: The preservation of the fundamental rights of the research participants should strive to capture the externalization of a truly enlightened will, considering, including conditions of vulnerability that are materialized from different circumstances and from different social and economic aspects. Such a guarantee depends on the collection of an adequate and effective consent from the researcher in charge, protecting more broadly the dignity and the rights of those subjects who participate in the research.
Judicialização do Acesso aos Serviços de Saúde: análise de caso da Secretaria de Saúde de Pernambuco
Authors: Oliveira Fábio Henrique Cavalcanti de , Lorena Sobrinho José Eudes de , Lima Maria Cristina Sette de , Montarroyos Ulisses Ramos , Neves Mirlene Giovanna Aragão Baía das , Silva Paula Rodrigues da , Xavier Laís Navarro , Jorge Filho Geraldo , Guedes Diego Medeiros , Almeida Flavio José Cintra de
Published: June 2018

Objective: This article aimed to analyze the judicialization of access to health services in the State Department of Health of Pernambuco in the year 2016. Methodology: This was a cross-sectional, quantitative and analytical study with data from the Judicial Actions Center of the State Health Secretariat of Pernambuco in 2016. The variables were: the product; the establishment of care; ICD-10; municipalities of the region; municipality of residence; sex; product group and action driver. Results: Of the 2,560 cases, the medications corresponded to 63.5% of the actions. 42% of the demands were concentrated in the 1st Health Region; 39.3% and 31.5% came from public health and philanthropic units, respectively. The data corroborate with findings from the literature regarding the item most sued in court and the trend of concentration in metropolitan regions. It differs as to the nature of the complainant organ because in this case it was the public authority itself and the public health units. Conclusions: Incorporating the objects of lawsuits into the regular provision of health services can contribute to the reduction of processes and increase citizens' access to legal rights. In some cases, ensuring compliance with the standards already published favors the tendency to decrease the judicialization, being necessary for this analysis the longitudinal studies.
Responsabilidade solidária dos entes federativos pela obrigação de prestar serviço de saúde e vedação do chamamento ao processo: análise jurídica e econômica dos entendimentos do STF e STJ
Authors: Almeida Lilian
Published: June 2018

This article deals with current jurisprudential understandings on the responsibility of federal entities for the provision of health services in Brazil and its procedural consequences. The Principle of Solidarity is related as the foundation of the Cooperative Federalism and its meaning is confronted with the solidarity obligation, legal category conceptualized in the Civil Code. The material consequences of the decisions are verified, combining the economic approach with the criterion of justice, in order to evaluate the need for revision of the understandings and adoption of legislative measures, in search of the maximization of results.
Female Bodies Adrift: Violation of the Female Bodies in Becoming a Subject in the Western Media
Authors: Parikka Tuija
Published: June 2018

This article focuses on how the violation of female bodies in the case of mass harassment of women is rendered intelligible by the Western media and the refugees. Violation of female bodies is approached as a site for politicizing possibilities of becoming a subject in the Western media. Informed by Deleuzian notion of “becoming” and the subjectivation of the refugees, I argue that the understanding of “violation” is a central component in contributing to possibilities of becoming affirmed as a subject in the Western media. Empirical material subjected to critical text analysis includes a key text form the Finnish daily newspaper Helsingin Sanomat and refugee interviews. The analysis suggests that the repression of irreducible conceptions of “violation,” and the subsequent erasure of the uncertainty of a “self” in the process of becoming, yields to offering possibilities of becoming primarily in Western terms and the affirmation of Western ideological certainty in understanding mass harassment of European women by the refugees.
Watchdogs, Advocates and Adversaries: Journalists’ Relational Role Conceptions in Asylum Reporting
Authors: Ojala Markus , Pöyhtäri Reeta
Published: June 2018

Journalistic role conceptions are usually understood as internalised professional conventions about the tasks reporters pursue in society. This study insists that more attention be put on the relational and context-dependent nature of journalistic role conceptions. Adopting a social-interactionist approach to journalistic roles, the study examines how Finnish journalists conceived of their professional roles when covering asylum issues during the so-called “refugee crisis” of 2015–2016. Based on an analysis of open-ended, semi-structured interviews with 24 journalists, we highlight how considerations of the political context and interactions with three key reference groups—officials, asylum seekers and anti-immigrant publics—shaped the journalists’ conceptions of their tasks and duties. The article contributes to the study of journalistic role conceptions by illustrating how the conceptualisation of journalistic roles in relation to reference groups takes place in practice. It also sheds light on the tensions involved in journalistic balancing and negotiation between various available role conceptions, especially in the shifting societal and political contexts of a Europe marked by multiculturalism and the simultaneous rise of anti-immigrant movements.
The Meaning of the Feminist T-Shirt: Social Media, Postmodern Aesthetics, and the Potential for Sociopolitical Change
Authors: Kvidal-Røvik Trine
Published: June 2018

This article examines the potential for political or social change as part of postmodern cultural expression in consumer culture. Throughout the article, I discuss the way sociopolitical messages, circulating in contemporary culture, represent an interesting element in terms of their intertextual referencing and postmodern blurring. Postmodern aesthetic features merge commodifying, resistive, and identifying processes, which can enable sociopolitical messages to spread into new arenas of resistance and fly under the radar, so to speak. In particular, I claim that new forms of engagement in social media communication produce an alternative venue for politics—one created by neoliberalism itself. I explain that sociopolitical messages presented via postmodern aesthetics in consumer culture, particularly when circulated using social media, can function counter-hegemonically, even while using hegemonic structures to gain commercial success. With this, the potential for change can come about; power lies in the hands (or social media accounts) of consumers.<
The Complementary Generalized Transmuted Poisson-G Family of Distributions
Authors: Alizadeh Morad , Yousof Haitham M. , Afify Ahmed Z. , Cordeiro Gauss M. , Mansoor M.
Published: June 2018

We introduce a new class of continuous distributions called the complementary generalized transmuted Poisson-G family, which extends the transmuted class pioneered by Shaw and Buckley (2007). We provide some special models and derive general mathematical properties including quantile function, explicit expressions for the ordinary and incomplete moments, generating function, Rényi and Shannon entropies and order statistics. The estimation of the model parameters is performed by maximum likelihood. The flexibility of the new family is illustrated by means of two applications to real data sets.
Bayesian Analysis of Topp-Leone Generalized Exponential Distribution
Authors: Khan Najrullah , Khan Athar Ali
Published: June 2018

The Topp-Leone distribution was introduced by Topp-Leone in 1955. In this paper, an attempt has been made to fit Topp-Leone Generalized Exponential distribution. Since, Topp-Leone distribution contains only one parameter and its support set is restricted to (0,1), because of this, in most practical situations it is not a better fit for the lifetime modelling. So an extension of this distribution is required. A Bayesian approach has been adopted to fit this model as survival model. A real survival data set is used to illustrate. Implementation is done using R and JAGS and appropriate illustrations are made. R and JAGS codes have been provided to implement censoring mechanism using both optimization and simulation tools.
COMPUTATIONAL BLOOD FLOW SIMULATIONS IN CARDIOLOGY AND CARDIAC SURGERY
Authors: Geydarov N. A. , Gainullova K. S. , Drygina O. S.
Published: June 2018

The review provides the current state and benefits of the computational fluid dynamics (CFD) applications in cardiovascular surgery. The review covers the milestones of CFD and novel achievements in the development of both numerical algorithms and computational models. Basic methods of flow modeling, including immersed-boundary methods and finite-difference methods, allow solving most core tasks, even using commercially available software packages. Future research prospects of CFD are associated with detailed modeling of the pathological processes affecting functional properties of medical devices, namely thrombus formation and embolism. However, current computational and mathematical systems are limited to address fully all these processes.
IN SITU VASCULAR TISSUE REMODELING USING BIODEGRADABLE TUBULAR SCAFFOLDS WITH INCORPORATED GROWTH FACTORS AND CHEMOATTRACTANT MOLECULES
Authors: Antonova L. V. , Sevostyanova V. V. , Mironov A. V. , Krivkina E. O. , Velikanova E. A. , Matveeva V. G. , Glushkova T. V. , Elgudin Ya. L. , Barbarash L. S.
Published: June 2018

Background Currently, the search for the bioactive molecules capable of promoting formation of the vascular tissue is still ongoing. We have previously demonstrated that incorporation of the growth factors and chemoattractant molecules into the biodegradable tubular scaffolds can increase their primary patency upon the implantation into rat abdominal aorta. However, further studies are required to investigate tissue remodeling using functionalized vascular grafts with the same diameter as a replaced native vessel. Aim To investigate the specific aspects of de novo vascular tissue formation and calcification employing rat abdominal aorta interposition model and vascular grafts with 1.5 mm diameter with incorporated vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and stromal cell-derived factor (SDF)-1α. Methods Tubular grafts with a diameter of 1.5 mm were blended of poly(3-hydroxybutyrateco-3-hydroxyvalerate) and poly(ε-caprolactone) (PHBV/PCL). Grafts without growth factors were fabricated using standard electrospinning technique whilst grafts with incorporated growth factors were prepared utilizing emulsion electrospinning. VEGF was incorporated into the inner third, whereas bFGF and SDF-1α were incorporated into the outer two-thirds of the graft. Grafts were implanted into the abdominal aortas of Wistar rats for 1, 3, 6, and 12 months following scanning electron microscopy along with histological and immunofluorescent examination. Results Primary patency of the grafts with VEGF, bFGF, and SDF-1α reached 93% indicative of structural integrity of the vascular tissue. Neither signs of inflammation nor severe calcification was detected. Conclusion As in 2 mm diameter vascular grafts, incorporation of bioactive factors into 1.5 mm diameter grafts increased their long-term primary patency and improved vascular tissue formation in comparison with non-modified grafts.
IMMEDIATE AND LONG-TERM OUTCOMES AFTER BIOPROSTHETIC MITRAL VALVE REPLACEMENT WITH THE PRESERVATION OF THE SUBVALVULAR APPARATUS
Authors: Odarenko Yu. N. , Rutkovskaya N. V. , Kokorin S. G. , Stasev A. N. , Barbarash L. S.
Published: June 2018

Aim. To assess the immediate and long-term outcomes after bioprosthetic mitral valve replacement with the preservation of the subvalvular apparatus. Methods. 304 patients who underwent primary bioprosthetic mitral valve replacement in the period from 2001 to 2009 were included in the study. Patients were enrolled into two groups with either preserved subvalvular structures (Group 1. n = 142, 47%) or resected structures (Group 2, n = 162) during bioprosthetic mitral valve replacement. For the unbiased assessment of the efficiency of valve-preserving approach, randomly selected patients from Group 1 (n = 75) and Group 2 (n = 40) underwent preoperative and postoperative invasive monitoring of the central hemodynamics using the Swan-Ganz thermodilution catheter. Results In-hospital mortality was 1.4% (n = 2) in Group 1 and 4.3% in Group 2. The most common cause of death was acute left ventricular failure. We found that the preservation of subvalvular structures allows ensuring the optimal linear and volumetric echocardiography parameters in the immediate postoperative period, despite the hemodynamic profile of the defect. However, the positive effects were more pronounced in patients with more severe mitral regurgitation. Patients with preserved subvalvular structures had more durable surgical mitral valve replacement according to the echocardiographic findings in the long-term period. The invasive monitoring of central hemodynamics allowed determining that total subvalvular apparatus preservation was associated with more significant pressure decline in the pulmonary circulation (mean pulmonary arterial pressure and pulmonary capillary wedge pressure) and improved cardiac index and output. Posterior leaflet preservation was associated with less pronounced changes and patients who underwent routine mitral valve replacement had the worst intermediate outcomes. Conclusion The results of the presented study suggest that the preservation of subvalvular apparatus, unless otherwise indicated, is associated with improved immediate and long-term outcomes after mitral valve replacement.
COMPARATIVE ASSESSMENT OF CLINICAL AND HEMODYNAMIC OUTCOMES AFTER AORTIC HEART VALVE REPLACEMENT WITH XENOAORTIC AND XENOPERICARDIAL BIOLOGICAL PROSTHESES FOR DEGENERATIVE AORTIC VALVULAR DISEASE
Authors: Fedorov S. A. , Medvedev A. P. , Chiginev V. A. , Zhurko S. A. , Gamzaev A. B. , Lashmanov D. I. , Tselousova L. M.
Published: June 2018

Aim. To assess clinical and hemodynamic outcomes of aortic valve replacement with xenoaortic biological prosthesis “Aspire Vascutek” and xenopericardial biological prosthesis “UniLine”. Methods. 130 patients who underwent aortic valve replacement with bioprostheses in the period from October 2012 to March 2016 were included in the study. All patients were enrolled into two groups according to the model of the implanted device. 65 recipients of xenoaortic bioprostheses “Aspire Vascutek” were included in Group 1, whereas patients (n = 65) xenopericardial bioprostheses “UniLine” were assigned in Group 2. Males prevailed in Group 1 (63%, the mean age - 66.4±5.5 years). 85% of Group 1 patients had heart failure Strazhesko-Vasilenko IIA grade and 94% of patients had chronic heart failure NYHA III. Similarly, male patients (58%) prevailed in Group 2. The mean age of Group 2 patients was 66.5±3.65 years. All patients in Group 2 II had heart failure Strazhesko-Vasilenko IIA grade and chronic heart failure NYHA III. Results Two patients in Group 1 died in the early postoperative period (the overall mortality was 1.5%). All patients had chronic heart failure NYHA I-II at discharge. Peak transvalvular pressure gradient significantly decreased in the in-hospital period, particularly in Group 2 patients (82,3±22,7 mm Hg vs. 28.8±7.6 mm Hg). 88% of Group 1 patients underwent the 60-month follow-up, and 96% of Group 2 patients - the 48-month follow-up. Transvalvular pressure gradients decreased progressively in both study groups within 60 months follow-up. This decrease was more pronounced in recipients of xenopericardial biological prostheses. Conclusion. Aortic valve replacement with xenopericardial bioprostheses “UniLine” and xenoaortic bioprostheses “Aspire Vascutek” for aortic valvular disease allows treating intracardiac hemodynamic derangements and achieving good clinical and hemodynamic outcomes.
LONG-TERM RESULTS OF MITRAL AND AORTIC VALVE REPLACEMENT WITH XENOPERICARDIAL PROSTHESIS «BIOLAB»
Authors: Babenko S. I. , Soboleva N. N. , Bakuleva N. P. , Titov D. A. , Muratov R. M.
Published: June 2018

Background Heart valve replacement with mechanical prostheses in elderly patients is associated with increased risk of bleeding due to the need of lifelong indirect anticoagulant therapy. Therefore, biological heart valve prosthesis is an option of choice. Aim To estimate long-term results of aortic and mitral valve replacement with xenopericardial prosthesis «BioLAB». Methods 150 stented biological prostheses «BioLAB» were implanted into the aortic and mitral position in the Department of Emergency Surgery for Acquired Heart Disease in the period from January 1993 to December 2008. 50 stentless biological prostheses «BioLAB» were implanted in the aortic position in the period from January 2008 to December 2012. Results 1-, 5- and 10-years survival in the recipients of stented xenopericardial prostheses «BioLAB» implanted in aortic position was 91.1±2.9%, 85.3±6.1% and 85.3±6.1%, respectively. 5-, 10- and 15-years survival among those who received mitral valve replacement was 72.31%±5.56%, 55.18%±6.61%, and 22.77%±12.13%, respectively. There were no cases of redo surgeries for valve tissue degeneration among the recipients of stented and stentless aortic valve prostheses within the follow-up. 10-, 12- and 15-years freedom from mitral valve degeneration was 61.08±7.32%, 50.21±9.56%, and 43.6±10.65%. Conclusion Stented xenopericardial bioprostheses «BioLAB» implanted in the aortic position provide good and encouraging hemodynamic results in the long-term period time. There were no signs of tissue degeneration of the stented heart valves within the 10-years follow-up. Similar results were obtained for the stentless bioprosthesis within the 7-years follow-up. The period of 8.5 years after mitral valve replacement with «BioLAB» is critical for tissue degeneration of bioprosthesis.
POTENTIAL BENEFITS FOR USING ePTFE AS A MATERIAL FOR PROSTHETIC HEART VALVES
Authors: Klyshnikov K. Yu. , Ovcharenko E. A. , Rezvova M. A. , Glushkova T. V. , Barbarash L. S.
Published: June 2018

Background The current study highlights potential benefits of using ePTFE, a polymeric material, as the main component suitable for fabrication of prosthetic heart valves. Novel polymeric materials seem to be promising for replacing biological elements commonly used in medical products for cardiovascular surgery. High biocompatibility and mechanical properties prolong their lifespan during direct blood contact. Nevertheless, it is necessary to conduct a series of specific tests to determine their properties and benefits of their application. Despite well-known biological properties of ePTFE, there are few studies assessing it as a material for heart valve leaflets. Aim To evaluate the mechanical properties of the commercially available sample of ePTFE and to conduct a numerical experiment assessing its potential for the application. Methods The polymer properties (Gore & Associates Inc., USA) were evaluated under uniaxial tension in two mutually perpendicular directions to determine the degree of anisotropy of the material. A xenopericardial patch (ZAO “NeoCor”, Russia), routinely used for the fabrication of bioprosthetic leaflets, was taken as the control sample. The spatial model of the investigated material was carried out in CAD SolidWorks 2016 (Dassault Systemes, USA). Numerical modeling of the samples was performed with the finite element method using the orthotropic material model in the Abaqus/CAE (Dassault Systemes, USA). Results There are significant difference found in the mechanical properties of the studied materials: the tension at stretching of ePTFE in the longitudinal and transverse directions differed from xenopericardium by 1.9 and 7.5 times, respectively (p<0.05). The elongation before rupture of ePTFE in direction I and direction II was greater than that of xenopericardium (2.39 vs. 1.9 times, respectively). Numerical modeling demonstrated insignificant qualitative differences in the valve opening while applying pressure equal to normal physiological pressure>< 0.05). The elongation before rupture of ePTFE in direction I and direction II was greater than that of xenopericardium (2.39 vs. 1.9 times, respectively). Numerical modeling demonstrated insignificant qualitative differences in the valve opening while applying pressure equal to normal physiological pressure and low pressure. In addition, the zones of high stress in commissural racks, which are critical zones for fatigue resistance, have been identified, albeit require additional in vitro research. Conclusion Mechanical properties of ePTFE suggests it to be a promising polymeric material suitable for fabrication of flexible leaflets of the heart valve prosthesis. It has similar leaflet functioning, compared with the xenopericardium sample, routinely used in manufacturing. ePTFE is more resistant to rupture, which confirms its greater fatigue strength. However, it requires further study by advanced methods.
Biyolojide Uygulanan Dizgeli Eğitimin Yaratıcı Düşünce Erişisine Etkisi
Authors: ÖZALEMDAR Lütfiye , SESLİ Ertuğrul
Published: June 2018

Bu araştırmanın amacı, biyolojide uygulanan dizgeli eğitimin
yaratıcı düşünce erişisine etkisini incelemektir. Deneysel modellerden “tek
grup öntest-sontest” deseni kullanılan araştırma Artvin ilçe merkezindeki bir
Anadolu lisesinde 9. sınıfa devam eden 30 öğrenciyle yürütülmüştür. Veri
toplama aracı olan Torrance Yaratıcı Düşünce Testleri [TYDT] sözel ve şekilsel
A formu öğretim süreci başında gruba öntest olarak uygulanmıştır. Biyolojideki
“Bilinçli Birey ve Yaşanabilir Çevre” ünitesi dizgeli eğitim modeline uygun
olarak işlenmiştir. TYDT sözel ve şekilsel B formu öğretim süreci sonunda
gruba sontest olarak uygulanmıştır. Grubun ön test-son testlerinin
karşılaştırılmasında; bağımlı gruplar t testi kullanılmıştır. Araştırma
bulgularına göre; TYDT sözel forma ait; akıcılık 1, esneklik 1 ve 3,
orijinallik 2 puan ortalamalarında son testler lehine anlamlı bir farklılık
varken, orijinallik 7 puan ortalamalarında anlamlı bir azalma vardır. TYDT
şekilsel forma ait; akıcılık, çizgilerin sentezi, sınırları uzatma veya geçme
ve fantazi puan ortalamalarında sontestler lehine anlamlı bir farklılık
vardır. Araştırma bulgularına göre; dizgeli eğitimin yaratıcı düşüncenin bazı
boyutlarını arttırmada etkili olduğu sonucuna varmak mümkündür. Benzer
araştırmalar için; verilerin okul dışı ortamlarda toplanması ve veri toplama
süreci sonunda ödüllendirmeye gidilmesi önerilir.
An Investigation of Turkish 2013 Early-Childhood Curriculum Regarding Values Education: Teacher Views and Practices
Authors: Ünişen Ali , Kontaş Hakkı , Akdağ Tülay
Published: June 2018

The study aims to present teachers’ views on 2013 Turkish early-childhood
curriculum in values education context. It was conducted in qualitative method
with 90 preschool teachers. The participants categorized the values in four
groups in terms of their existence in the curriculum and their teaching. Of
the values exiting in the curriculum, the participants reported that they did
not have any difficulty in teaching being voluntary to take responsibilities,
physical hygiene, kindness, asking for help, love and learning to obey the
rules whereas they had problems in teaching communication, compromising,
defending their own rights and of others, empathy and stick to their
responsibilities.  Environmental
cleaning, politeness in communication, sharing, accepting mistakes,
apologising, concentrating on duties, accepting apologies, offering help,
job-sharing, acting as group members, caring entrusted materials, being
sincere, thriftiness, being considerate, love for the country and flag and
learning unity and solidarity were counted among the values not existing in
the curriculum but the participants had negligible problems in their teaching.
The last set of values, which do not exist in the curriculum, but the
participant regarded necessary to teach were reported as learning to compete
without harming, appreciating beauties, controlling emotions, being peaceful,
complimenting and learning sexual privacy.
Delayed complications after open inguinal hernia repair: a comparison of two techniques
Authors: Dikshit Vashisht , Jadhav Digvijay , Ali Iqbal , Mody Pratham , Srivastava Neha
Published: June 2018

Background: The open preperitoneal repair offers the benefits of placing the mesh in the preferred position while avoiding the disadvantages of laparoscopic repair.Methods: A total of 60 patients with bilateral inguinal hernias were randomized to undergo either the standard Lichtenstein meshplasty or the modified iliopubic tract repair in a teaching hospital. Outcomes measured were chronic inguinal pain, groin numbness, and recurrence.Results: Delayed complications like chronic inguinal pain and numbness were not seen in the iliopubic tract group. However, this difference was not statistically significant (p>0.05). One patient in the Lichtenstein repair group had recurrence of hernia. There were no recurrences in the iliopubic tract repair group. This difference again, was not statistically significant (p>0.05).Conclusions: The iliopubic tract repair offers an excellent alternative to the Lichtenstein meshplasty, and is associated with lower incidence of delayed neurological complications, recurrence rates on par with the gold standard Lichtenstein meshplasty.
Prevalence and clinical predictors of silent myocardial ischemia in asymptomatic type 2 Diabetes Mellitus patients at Puducherry, India
Authors: Hussain K. Shaik Anwar
Published: June 2018

Background: Silent MI is common among diabetics due to autonomic dysfunction and loss of pain alert mechanism. There are various risk factors associated with silent MI in diabetes which needs screening earlier to prevent unanticipated cardiovascular mortality. The objective of the present investigation was to study the prevalence and clinical factors associated with silent myocardial ischemia as diagnosed by TMT among type 2 diabetics who had no previous history or symptoms of cardio-vascular disease.Methods: A total of 200 type 2 diabetes affected subjects with duration of diabetes for at least 6 months, above 18 years of age, attending to the diabetology OPD, during the time period June 2017 to May 2018 were included in the study. Blood investigations and TMT were done for all the participants and documented in a proforma.Results: Silent MI was documented by using TMT in 36.5% (n=73) of patients with type 2 diabetes mellitus. The factors like age (59.1±16.3 years), duration of diabetes (8.2±2.6 years), obesity (BMI=29.6±4.7 kg/m2), Glycated haemoglobin (9.7±2.8 %), lipid levels and post-prandial blood sugar levels (236±11.8 mg/dl) associated well with silent MI as predicted by TMT. Fasting blood sugar did not show significant association with Silent MI.Conclusions: The prevalence of silent MI was higher among the type 2 diabetic individuals compared to non-diabetics. Age, duration of diabetes, HbA1c levels, BMI, dyslipidemia and post prandial blood glucose levels were associated significantly with incidence of silent MI in patients with type 2 diabetes.
Study of pulmonary functions with DLco in acute respiratory distress syndrome/ acute lung injury syndrome
Authors: Chabukswar Praveen , Baviskar Jaya
Published: June 2018

Background: The objective of this is to study the lung functions with DLco in ARDS/ALI survivors; to study and analyse the lung functions in different diseases causing ARDS/ ALI survivors and to analyse the effect of treatment strategies on lung functions with DLco in survivors.Methods: All patients who survived ARDS/ALI illness from January 2008 to July 2009 are selected and follow up for pulmonary function at discharge, 3 months and 6 months were performed post illness were recorded and compared.Results: In the study period, 37 cases were enrolled in the prospective cohort study, out of which 9(24.3%) were suffering from ALI according to American European Consensus definition. There was varied infections etiology causing ARDS/ ALI. Pulmonary function test at discharge were showing normal flow rates and volumes (94.6%), mild restriction in some cases (8.4%) as the patients included in the study does not have any past respiratory illness out of 37(100%) patients of ARDS/ALI discharged from Hospital 21(56.8%) had low DLco and 16 (43.2%) had normal DLco.Conclusions: Diffusion defect is found to be more common in the patients who had mixed infections than the patients who had single infection. There was no effect of steroids on the outcome of the patients in terms of diffusion defect.
İslam Düşünce Geleneğinde Şia-Mutezile Etkileşimi Şerif el-Murtaza Örneği
Authors: Savaş Damla
Published: June 2018

Şia-Mutezile etkileşiminde kilit isim olarak Şerif el-Murtaza değerlendirmesi