bluuebunny/crossref_metadata_2025_split huggingface dataset:
Imaging characteristics of pathologically proven adrenal adenomas with myelolipomatous degeneration: correlation with clinical and pathologic features
Authors: Guccione Jeffrey , Soliman Moataz , Zhang Miao , Habra Mouhammed Amir , Collins Katrina , Zhao Jianping , Elsayes Khaled M 
Published: October 2021

Objectives
Adrenal adenoma with myelolipomatous degeneration (AMD) is a rarely reported and often overlooked entity. The aim of this study is to improve understanding of these lesions by characterizing the imaging findings with pathologic and clinical correlation.

Methods
In the largest series to date, we report 11 nodules in 11 patients confirmed with a pathologic diagnosis of AMD. The available cross-sectional imaging and histopathologic features were reviewed by two radiologists and two pathologists, respectively. Clinical and laboratory data for each patient were obtained from the electronic medical records, when available.

Results
All 11 patients had a CT prior to resection or biopsy of the adrenal nodule, with five having received an adrenal mass protocol study. An MRI was available in three patients. The median size of the nodules on imaging was 4.5 cm (range 2.8–8.7) and all but one had macroscopic fat. The largest focus of macroscopic fat had a median size of 0.7 cm (range 0.2–1.6) and on average was 14.4% the size of the tumor, using greatest dimensions. Four (36.4%) patients had a diagnosis of Cushing syndrome prior to nodule resection.

Conclusions
Not all adrenal nodules with macroscopic fat on imaging are pure myelolipomas. An AMD should be considered, especially if the foci of fat are small and other features of an adenoma are present. Some may also be associated with Cushing syndrome.

Advances in knowledge:
Myelolipomatous degeneration within an adrenal adenoma has only rarely been previously reported with very few reports emphasizing the imaging features. There may be an association with cortisol hypersecretion and improved recognition of this entity could lead to changes in clinical management.
The radiologic roadmap for treatment of an acute appendicitis patient who tested positive for coronavirus disease 19
Authors: Arik Şeref Barbaros , Gunaydin Elif , Bİlgiç Celal İsmail , Güvenç İnanç 
Published: October 2021

Objective: In this study, we aimed to emphasize the role of radiological imaging in determining the treatment of a patient, who tested positive for COVID-19 and diagnosed with acute appendicitis during the pandemic. Methods: A 31-year-old patient presented to the emergency department due to abdominal pain. Ultrasound examination, thoracic and pelvic CT scan were performed. Results: Non-complicated appendicitis can be treated conservatively with antibiotics. Treatment can be maintained by starting with IV antibiotics and bridging therapy with oral antibiotics. Conclusion: This studysummarize how radiological follow-up can be used to decide on the suitability of the patient for appropriate medical treatment as an alternative to surgery in a patient, whose gold standard treatment is emergency surgical intervention, which is frequently encountered in the emergency department during the COVID-19 pandemic. Healthcare workers need to be protected to ensure the continuity of the health system. On the other hand, patients requiring emergency healthcare should also be provided with appropriate treatment. Healthcare professionals should choose the most appropriate treatment method, protecting themselves and their patients as much as possible.
Em torno - ruínas de uma cidade em eterna reconstrução
Authors: Sá Alexandre , Racy João Paulo Alvaro 
Published: October 2021

Esse artigo pretende investigar as transformações atravessadas pela cidade do Rio de Janeiro durante processo de reforma urbanística preparatória para os Jogos Olímpicos (2016) e a Copa do Mundo (2014), estabelecendo possíveis relações de aproximação e distanciamento com a Reforma Pereira Passos, realizada entre 1902 e 1906. Destruições intencionais que erigiram novos monumentos, consideravelmente questionáveis.
A “Diplomacia das Armas”: Um Olhar Realista Sobre a Política Externa Argentina do Período Militar (de 1976 a 1983) l “Diplomacy Of Arms”: A Realistic Look at Argentine Foreign Policy During The Military Period (From 1976 To 1983)
Authors: Espósito Neto Tomaz 
Published: October 2021

Em agosto de 1976 um golpe militar derrubou Isabel Perón e instalou um dos regimes militares mais violentos da América do Sul (1976-1983). A política internacional do Estado argentino sofreu alterações relevantes, tais como o alinhamento com o “Mundo Ocidental Cristão”, o qual era capitaneado pelos Estados Unidos. Em poucos anos, a Argentina se tornou um “pivot” de diversos momentos de tensão e de conflito no Cone Sul, como o litígio de Itaipu-Corpus, o conflito argentino-chileno pelo controle do canal de Beagle e a Guerra das Malvinas/Falklands (1982). Como resultado dessa estratégia, o país se isolou profundamente do restante da sociedade internacional. O presente texto apresenta os eixos das relações exteriores argentinas entre 1976 e 1983, com ênfase nas tensões entre a Argentina e os países contíguos, com objetivo de analisar criticamente a atuação internacional da Casa Rosada a partir da ótica do realismo clássico.Palavras-Chave: Argentina; Política externa argentina; História da Argentina. ABSTRACTIn August 1976 a military coup overthrew President Isabel Perón, installing one of the most violent military regimes in South America (1976-1983). When compared to previous Peronist governments, the international policy of the Argentine State has undergone relevant changes, such as an alignment with the Western Christian World. In a few years, Argentina has become a pivot of different moments of tension and conflict in the Southern Cone, such as the dispute over Itaipu-Corpus, the Argentine-Chilean conflict over the Beagle channel and the Malvinas/Falklands War (1982). As a result of this strategy, the country has profoundly isolated itself from the rest of international society. This text presents the axes of Argentine foreign relations between 1976 and 1983, with an emphasis on tensions between Argentina and the contiguous countries, with the aim of critically analyzing the international performance of Casa Rosada from the perspective of classical realism.Keywords: Argentina; Argentine foreign policy; History of Argentina. Recebido em: 12/08/2020 | Aceito em: 10/02/2021.
O Debate Contemporâneo Sobre o Princípio de Soberania na Literatura Ocidental de Relações Internacionais l The Contemporary Debate on the Principle of Sovereignty in the Western Literature of International Relations
Authors: Oliveira Alice Castelani de 
Published: October 2021

A soberania representa uma das articulações políticas mais importantes da Modernidade, a qual convencionou a separação entre as políticas interna e externa. Posto isso, entendemos que para compreender o mundo em que vivemos é necessário pensar essa categoria à luz do contexto contemporâneo, então, com o objetivo de contribuir para o estudo desse conceito, no presente artigo apresentaremos uma revisão do debate atual sobre a categoria de soberania. Para esse fim, nos apoiaremos em um exame da literatura ocidental de Relações Internacionais (RI), com foco em autores americanos, considerando que a produção de conhecimento dos Estados Unidos (EUA) é preponderante dentro deste campo. Esclarecemos que o debate na esfera destacada pode ser dividido em duas linhas de pesquisa que serão exploradas neste texto. A primeira aborda o aprofundamento da globalização e os efeitos desse processo sobre soberania e a segunda discute como são socialmente construídos os discursos sobre essa categoria.Palavras-Chave: Teoria; Relações Internacionais; Soberania.ABSTRACTSovereignty represents one of the most important political articulations of Modernity, which established the separation between internal and external policies. That said, we understand that in order to understand the world in which we live, it is necessary to think about this category in the light of the contemporary context, so, in order to contribute to the study of this concept, in this article we’ll present a review of the current debate on the category of sovereignty. To that end, we’ll rely on an examination of the Western International Relations (IR) literature, focusing on American authors, considering that the production of knowledge from the United States (USA) is predominant within this field. We clarify that the debate in the highlighted sphere can be divided into two lines of research that will be explored in this text. The first addresses the deepening of globalization and the effects of this process on sovereignty and the second discusses how the speeches about this category are socially constructed.Keywords: Theory; International Relations; Sovereignty. Recebido em: 27/03/2021 | Aceito em: 18/05/2021.
Cultura árabe - islâmica e o aprendizado em saúde na fronteira entre o Brasil e o Paraguai
Authors: Mansour Noura Reda , Fabriz Luciana Aparecida , Morales Paulo Cesar Mayer , Wysocki Anneliese Domingues , Zilly Adriana , Silva-Sobrinho Reinaldo Antonio 
Published: October 2021

As comunidades árabe-islâmicas guardam costumes que são transmitidos aos descendentes em seus espaços familiares e comunitários. O estudo objetivou analisar a influência da cultura árabe-islâmica no aprendizado em saúde emduas escolas em Foz do Iguaçu - Brasil e uma escola em Cidade de Leste - Paraguai. Trata-se de um estudo quantitativo-descritivo, realizado em 2017. Utilizou-se um questionário estruturado. Participaram 37 alunos do ensino médio de origem árabe-islâmica. Na análise de dados foi calculada a frequência, percentual, média, mediana e desvio padrão das observações. Dos 37 participantes, 67,6% são femininos, com média de idade de 17,2 anos. Os dados foram organizados em três quesitos avaliativos: 1) Higiene Saúde (nas três escolas, foi atribuído nota 5 (mediana) para a grande maioria das assertivas, associando o aprendizado ao convívio social); 2) Água/Saneamento Básico (a disciplina de Ciências Biológicas teve a maior frequência de notas 5 (mediana) nas três escolas, e o item que recebeu maior pontuação foi “a água de consumo deve ser potável” e o com a menor foi o “descarte correto do lixo” com nota 3). 3) Alimentação Saudável (a disciplina de Ciências Biológicas foi a que menos influenciou nas respostas, obteve baixa de frequência de notas 5 (mediana), diferente da disciplina de Religião com maiores escores). A cultura árabe-islâmica contribui para o aprendizado em saúde, demonstrando que o trabalho junto à líderes religiosos pode ser estratégico, em especial sobre os itens, água/saneamento básico, descarte do lixo e a importância de evitar água parada para prevenção da dengue.
Campanhas sanitárias como instrumentos da educação em saúde no Brasil: algumas reflexões para uma educação popular em saúde
Authors: Costa Jefferson Silva , Carneiro-Leão Ana Maria Dos Anjos 
Published: October 2021

No Brasil, o embrião do que é conhecido na atualidade por “Educação em Saúde” surge apenas na segunda metade do século XIX, após a chegada da família real portuguesa. Apesar disso, as campanhas sanitárias, definidas como publicidades que objetivam à orientação para execução de práticas de cuidado com a propria saúde, portanto instrumentos essenciais da Educação em Saúde, surgem apenas no começo do século XX, pautadas em um modelo coercitivo e fiscalizador. Com o passar das décadas, a utilização de campanhas sanitárias como instrumentos da Educação em Saúde foi tendo seus objetivos, publico-alvo e espaços de atuação modificados. Dessa forma, a veiculação desse tipo de campanha, da maneira como ocorre hoje, é fruto de um processo histórico que se entrelaça com os modelos de saúde e educação defendidos em cada época da história brasileira. Na atualidade, é defendido um modelo de Educação em Saúde mais dialógico e inclusivo, denominado de Educação Popular em Saúde, sendo necessário aplicar esse modelo para os instrumentos que compõem as campanhas sanitárias. Diante disto, ficou evidente a necessidade de refletir sobre a utilização, produção e mensagens veiculadas em campanhas sanitárias para compreender a necessidade desse material caminhar, de fato, para uma Educação Popular em Saúde.
O que aconteceu com os que ensinam? O impacto da COVID-19 sobre a rotina e a saúde dos professores universitários
Authors: Mozzato Anelise Rebelato , Sgarbossa Maira , Mozzato Fernanda Rebelato 
Published: October 2021

A pandemia da COVID-19 atingiu de modo distinto docentes e discentes, bem como o sistema educacional, agravando as muitas assimetrias já existentes. Com a necessidade do distanciamento social, o ensino universitário foi levado a rever suas práticas educacionais, que já clamavam por mudanças há muito tempo. Em curto espaço temporal, professores e alunos universitários precisaram se adaptar ao modelo remoto de ensino. Desse modo, este ensaio teórico tem como objetivo debater e alçar reflexões sobre o impacto da COVID-19 na rotina e na saúde do professor universitário. Por meio da revisão de literatura, destacou-se algumas das diversas consequências que a pandemia trouxe para a sociedade e, sobretudo, para a educação, cujas fragilidades, são expostas frente à pandemia, a qual impõe incertezas e desafios diversos (visíveis e invisíveis), que acometem a saúde física e mental dos professores universitários, seja pela intensificação do trabalho, aumento da monotonia, riscos ergonômicos, conturbação entre espaço pessoal e laboral, entre outros. Diante disso, por meio de algumas indagações e provocações, leva-se o leitor a pensar sobre as situações e consequências (im)postas pela COVID-19, em busca de respostas, caso houverem. Nessa lógica, por mais que paradoxal, visualiza-se a promoção de um processo de ensino-aprendizagem mais criativo e reflexivo, seja na modalidade presencial, ou mesmo no ensino remoto.Palavras-chave: Covid-19, pandemia, ensino universitário, professor, saúde, rotina.
P-doped 1300  nm InAs/GaAs quantum dot lasers directly grown on an SOI substrate
Authors: Huang Jing-Zhi , Wei Wen-Qi , Chen Jia-Jian , Wang Zi-Hao , Wang Ting , Zhang Jian-Jun 
Published: October 2021

The realization of monolithic integration of a stable III–V laser on a standard silicon-on-insulator (SOI) substrate has been regarded as a challenging technology for silicon-based photonic integration circuits (PICs). Here, we successfully demonstrated the electrically pumped P-doped 1300 nm InAs/GaAs quantum dot (QD) laser epitaxially grown on {111}-faceted SOI hollow substrates. These III–V QD lasers, which are epitaxially grown on an SOI substrate, generally exhibit strong thermal accumulation due to the oxide layer underneath. By applying a double-side heat dissipation design, the maximum operation temperature of the SOI-based InAs/GaAs QD laser under a continuous-wave (CW) operation mode is ramped up to 35°C from 20°C. Moreover, the thermal profile simulation of three different structures has also been carried out to show the effectiveness of the top heat sink design in order to improve laser performance. An integrated thermal shunt design is proposed to improve heat dissipation without using the external top heat sink. The successful realization of room-temperature SOI-based InAs/GaAs QD lasers pave a viable way for integrating light sources in PICs.
Impact of a care bundle for patients with blunt chest injury (ChIP): A multicentre controlled implementation evaluation
Authors: Curtis Kate , Kourouche Sarah , Asha Stephen , Considine Julie , Fry Margaret , Middleton Sandy , Mitchell Rebecca , Munroe Belinda , Shaban Ramon Z. , D’Amato Alfa , Skinner Clare , Wiseman Glen , Buckley Thomas 
Published: October 2021

Background
Blunt chest injury leads to significant morbidity and mortality. The aim of this study was to evaluate the effect of a multidisciplinary chest injury care bundle (ChIP) on patient and health service outcomes. ChIP provides guidance in three key pillars of care for blunt chest injury—respiratory support, analgesia and complication prevention. ChIP was implemented using a multi-faceted implementation plan developed using the Behaviour Change Wheel.

Methods
This controlled pre-and post-test study (two intervention and two non-intervention sites) was conducted from July 2015 to June 2019. The primary outcome measures were unplanned Intensive Care Unit (ICU) admissions, non-invasive ventilation use and mortality.

Results
There were 1790 patients included. The intervention sites had a 58% decrease in non-invasive ventilation use in the post- period compared to the pre-period (95% CI 0.18–0.96). ChIP was associated with 90% decreased odds of unplanned ICU admissions (95% CI 0.04–0.29) at the intervention sites compared to the control groups in the post- period. There was no significant change in mortality. There were higher odds of health service team reviews (surgical OR 6.6 (95% CI 4.61–9.45), physiotherapy OR 2.17 (95% CI 1.52–3.11), ICU doctor OR 6.13 (95% CI 3.94–9.55), ICU liaison OR 55.75 (95% CI 17.48–177.75), pain team OR 8.15 (95% CI 5.52 –-12.03), analgesia (e.g. patient controlled analgesia OR 2.6 (95% CI 1.64–3.94) and regional analgesia OR 8.8 (95% CI 3.39–22.79), incentive spirometry OR 8.3 (95% CI 4.49–15.37) and, high flow nasal oxygen OR 22.1 (95% CI 12.43–39.2) in the intervention group compared to the control group in the post- period.

Conclusion
The implementation of a chest injury care bundle using behaviour change theory was associated with a sustained improvement in evidence-based practice resulting in reduced unplanned ICU admissions and non-invasive ventilation requirement.

Trial registration
ANZCTR: ACTRN12618001548224, approved 17/09/2018
Global surgery for medical students – is it meaningful? A mixed-method study
Authors: Kühner Sofia , Ekblad Solvig , Larsson Jan , Löfgren Jenny 
Published: October 2021

Introduction
There has been an increase in global health courses at medical universities in high-income countries. Their effect on students, however, is poorly understood. In 2016 an elective global surgery course was introduced for medical students at Karolinska Institutet in Sweden. The course includes a theoretical module in Sweden and a two-week clinical rotation in Uganda. The present study aimed to assess the format and determine its effect on students’ knowledge of global surgery and approach towards patients of non-Swedish origin.

Method
A mixed-methods design was used. Semi-structured case-based interviews were conducted individually with 18 students and analysed using qualitative content analysis. Examination scores and the course evaluation were analysed with Kruskal Wallis one-way analysis of variance, Pearson’s Chi-square and a Wilcoxon signed-rank test as appropriate.

Results
The course was appreciated and students reported gained insights and interest in global surgery. Students’ ability to reason about global surgery issues was improved after the course. Students considered complicating aspects in the meeting with patients of non-Swedish origin. Students with abroad clinical experience felt less compelled to act on preconceptions.

Discussion
The global surgery course at Karolinska Institutet is appreciated and students gained valuable knowledge. The case-based interviews acted as a catalyst for reflection and showed that students felt insecure as they lacked knowledge about globally common surgical conditions and struggled with generalized preconceptions of patients of non-Swedish origin. To further support students to integrate theoretical knowledge and professional development, we suggest the introduction of problem-based learning.

Conclusion
The ability of the course to inspire students’ commitment to global surgery is promising as this engagement is the key to reaching the goal of equitable health globally. Offering such courses is a step towards inspiring and recruiting the future clinicians and researchers needed for expanding the field of global surgery.
Magnitude of metabolic syndrome in Gondar town, Northwest Ethiopia: A community-based cross-sectional study
Authors: Abebe Solomon Mekonnen , Demisse Abayneh Girma , Alemu Shitaye , Abebe Bewketu , Mesfin Nebiyu 
Published: October 2021

BackgroundMetabolic syndrome (MetS) is becoming a major public health problem globally; it is clear that the burden of MetS is rapidly increasing the rates of non-communicable diseases (NCD). In Ethiopia studies done so far have shown a large disparity in magnitude of the prevalence of MetS and were mainly institution-based studies. Therefore, this study assess the prevalence of MetS among adults who are residing in Gondar city using Adult Treatment Panel III (ATP III) and the International Diabetes Federation (IDF) assessment tool. The findings are imperative to developing and strengthening national NCD prevention and control programs.MethodsThis study was conducted in Gondar city Northwest Ethiopia in 2018. It employs a community-based cross-sectional study design among 3,227 individuals 18 years of age or older. Data was collected using the WHO stepwise tool, lipid profile, blood pressure (BP), waist circumference (WC) body mass index (BMI), fasting blood glucose levels (FG), and anthropometric measurements. The prevalence estimation was made along with a 95% confidence interval (CI). The Kappa statistic was used to analyze the statistical agreement between ATP III and IDF definitions of the MetS. Stratified analysis was also performed for description and analysis components using ATP III and IDF as an outcome.ResultOf the total study participants (3227), 3059 (94.8%) were included in the final analysis and 52.5% were female. The mean (±SD) age of the study participant was 40.8 years (16.2 ±SD). The overall prevalence of MetS using ATP III was 11.2% [95%CI: 10.1, 12.3] and using IDF was 11.9% [95%CI: 10.8, 13.2]. The sex-specific proportion was high in females rather than males irrespective of the criteria. The overall level of agreement between ATP III and IDF prevalence was 91.7% and the Kappa statistics was 0.594. Older age, low-density lipoprotein cholesterol, body mass index, being female, born in an urban area, consumption of an alcoholic drink in the preceding 30 days, and non-fasting practice was significantly associated with MetS.Conclusion and recommendationThere was a higher prevalence of metabolic syndrome among females than males irrespective of metabolic syndrome diagnostic criteria. This also shows good agreement between ATP III and IDF. Being female, urban birthplace, frequent alcohol consumption in the last 30 days, and non-fasting practice are factors associated with higher rates of metabolic syndrome. Hence, awareness campaigns, physical exercise, and nutrition education intervention should be undertaken to promote health behavioral practice.