bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility and efficacy of an educational programme to increase awareness of stroke and heart attack in children
Authors: Mikulik Robert , Vondráčková Lucie , Pokorná Hana , Svobodová Veronika , Grecu Andreea Madalina , Vítovec Jiří , Neumann Jiří , Suchý Ondřej 
Published: May 2019

Objective: The objective of this study was to evaluate the feasibility and effectiveness of an innovative school stroke and heart attack educational programme for children. Design: Non-randomised controlled trial with intervention and control group conducted in set time periods. Results were compared among time periods in both groups and also between both groups. Setting: The study included children from 47 schools in Czech Republic. Children from 37 schools in one county ( N = 2,436) participated as the target population. The control group involved 900 pupils from 10 schools in another county. Methods: The 45-minute multimedia Web-based video programme was designed to teach the appropriate response to stroke and heart attack symptoms. The target population received education and testing. The control population received only testing and no education. Results: Baseline knowledge assessment was identical across the target and the control populations. After education, knowledge in the target population had improved significantly. After 3 months, knowledge assessment scored 65% in the target population and 66% in the control population (intergroup difference p = .75). Conclusion: The educational programme increased response to stroke and heart attack symptoms compared to the control group, although in the target group comprehension improved only in short term when compared to the baseline. Knowledge for heart attack was better than for stroke.
Two-Stage Revision Anterior Cruciate Ligament Reconstruction: A Systematic Review of Bone Graft Options for Tunnel Augmentation
Authors: Salem Hytham S. , Axibal Derek P. , Wolcott Michelle L. , Vidal Armando F. , McCarty Eric C. , Bravman Jonathan T. , Frank Rachel M. 
Published: May 2019

Background: No consensus is available regarding the optimal choice of bone graft material for bone tunnel augmentation in revision anterior cruciate ligament (ACL) surgery. Purpose: To compare the outcomes of different bone graft materials for staged revision ACL reconstruction. Study design: Systematic review. Methods: A systematic review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed. PubMed, EMBASE, and the Cochrane Library were queried through use of the terms anterior cruciate ligament and revision to identify all studies reporting outcomes of bone tunnel grafting in 2-stage revision ACL reconstruction. Data extracted included indications for 2-stage surgery, surgical technique, graft material, time between surgeries, rehabilitation protocols, physical examination findings, patient-reported outcomes, and radiographic and histologic findings. Results: The analysis included 7 studies with a total of 234 patients. The primary outcome in 2 studies was graft incorporation (mean follow-up, 8.8 months), whereas the other 5 studies reported clinical outcomes with follow-up mean ± SD of 4.2 ± 2.1 years. The indication for bone grafting and between-stage protocol varied among studies. Autograft was used in 4 studies: iliac crest bone autograft (ICBG, n = 3) and tibial bone autograft (TBA, n = 1). In 2 studies, the authors investigated the outcomes of allograft: allograft bone matrix (ABM) and allograft bone chips (AC). Finally, 1 study compared ICBG to a synthetic bone substitute. Radiographic evaluation of bone graft integration after the first stage was reported in 4 studies, with an average duration of 4.9 months. In 4 studies, the authors reported the time interval between first and second surgeries, with an average of 6.1 months for ICBG compared with 8.7 months for allogenic and synthetic grafts. Revision ACL graft failure rates were reported by 5 studies, including 1 study with ABM (6.1%), 1 study with AC (8.3%), 1 study with TBA (0%), and 2 studies with ICBG (0% and 2%). Conclusion: The indications for staged ACL reconstruction and the rehabilitation protocol between stages need to be clearly established. The available data indicate that autograft for bone tunnel grafting in 2-stage ACL revision may be associated with a lower risk of revision ACL reconstruction graft failure compared with allograft bone.
Constrained Choices? Menstrual Health and Hygiene Needs Among Adolescents in Mumbai Slums
Authors: Muralidharan Arundati 
Published: May 2019

Menstruation, an essential and healthy biological function, is cloaked in a culture of silence. Sociocultural norms at the family and community level play a pivotal role in shaping how young unmarried women understand and manage their monthly period. Less is known about how unmarried young women living in low-income urban areas in India seek help for their menstrual needs. This qualitative study seeks to understand how young unmarried women (aged 15–24) living in a slum settlement understand menstruation and perceive menstrual problems, and identifies factors that influence their help-seeking behaviour for menstrual needs and problems. It also proposes recommendations for national health programmes addressing menstrual health and hygiene. The findings echo previous research findings emphasising young unmarried women’s low levels of awareness and misconceptions about menstruation. These girls perceived menstrual problems as a key concern, as it significantly interfered with their daily routine and caused emotional distress. Young women’s ability and willingness to seek help to address menstrual needs is influenced by a culture of silence that surrounds menstruation, excessive scrutiny and blaming by the community, and restrictions on their mobility and interactions with peers. The findings underscore the role of mothers as gatekeepers who greatly influence young women’s perceptions of menstruation and menstrual problems and their ability to seek help. Existing interventions need to be expanded to address young women’s need for emotional and social support, and to involve significant gatekeepers such as mothers in promoting the health and well-being of young unmarried women in slum communities. Intervention strategies should be expanded to enhance the capacity of mothers to recognise, understand and address their teenage daughters’ needs for information, emotional support and access to essential clinical and social services.
Urinary markers in treatment monitoring of lung cancer patients with bone metastasis
Authors: Jin Pei Cheng , Gou Bo , Qian Wei 
Published: May 2019

Background: Bone metastasis remains critical for advanced stage non-small cell lung cancer (NSCLC)—a disease that is challenging to manage. Urinary markers present opportunities for non-invasive testing. Methods: Urine specimens were collected from patients prior to treatment. Urinary cell-free DNA was subsequently purified from these samples. To address the specificity of the test, driver mutations in epidermal growth factor receptor L858R and L861Q were analyzed. Clinical specificity was established by comparison with healthy volunteers. Regular monitoring was established during treatment with tyrosine kinase inhibitors. The overall survival of patients was correlated with changes in circulating tumor DNA (ctDNA). Results: Baseline clinical correlation of urinary ctDNA and matched tumor specimens achieved 89% concordance. The clinical specificity was 100%. The average background level of urinary ctDNA was 20.7 ng/mL. Comparing patients with and without bone metastasis, the latter had significantly lower baseline levels. During treatment, more pronounced decline in urinary ctDNA was observed in patients without bone metastasis. In our Kaplan–Meier estimator, we observed that patients with a more significant reduction in ctDNA had a better overall survival outcome. Conclusion: Our study demonstrates clear benefits and allows better risk profiling for NSCLC patients with bone metastasis. The non-invasive specimen collection is attractive and complements existing cancer management tools.
Use of Anatomical Landmarks in Ankle Arthroscopy to Determine Accuracy of Syndesmotic Reduction: A Cadaveric Study
Authors: Cassinelli Spenser J. , Harris Thomas G. , Giza Eric , Kreulen Christopher , Matheny Lauren M. , Robbins Colin M. , Clanton Thomas O. 
Published: May 2019

Background. The aim of this study was to determine the accuracy of ankle arthroscopy as a means for diagnosing syndesmotic reduction or malreduction and to determine anatomical landmarks for diagnosis. Methods. Six matched-pair cadavers (n = 12) with through-knee amputations were studied. Component parts of the syndesmosis and distal 10 cm of the interosseous membrane (IOM) were sectioned in each. The 12 specimens were divided into 2 groups: 6 specimens in the in-situ group fixed with suture button technique and 6 specimens in the malreduced group rigidly held with a 3.5-mm screw. Specimens were randomized to undergo diagnostic arthroscopy by 3 fellowship-trained foot and ankle orthopaedic surgeons in a blinded fashion. Surgeons were asked to determine if the syndesmosis was reduced or malreduced and provide arthroscopic measurements of their findings. Results. Of 36 arthroscopic evaluations, 34 (94%) were correctly diagnosed. Arthroscopic measurement of 3.5 mm diastasis or greater at the anterior aspect of the distal tibiofibular syndesmosis correlated with a posteriorly malreduced fibula. Arthroscopic evaluation of the Anterior inferior tibiofibular ligament (AITFL), IOM, Posterior inferior tibiofibular ligament (PITFL), lateral fibular gutter, and the tibia/fibula relationship were found to be reliable landmarks in determining syndesmotic reduction. An intraclass correlation coefficient (ICC) for interrater reliability of 1.00 was determined for each of these landmarks between 2 surgeons (P < .001). The ICCs between 2 surgeons’ measurements and the computed tomography measurements were found to be 0.896 (P value < .001). Conclusions. Ankle arthroscopy is a reliable method to assess syndesmotic relationship when reduced in situ or posteriorly malreduced 10 mm. Levels of Evidence: Level V: Cadaveric
Surgical Risk Assessment and Prevention in Elderly Spinal Deformity Patients
Authors: Thomas Kevin , Wong Ka Hin , Steelman Susan C. , Rodriguez Analiz 
Published: May 2019

Introduction: Prevalence of adult deformity surgery in the elderly individuals continues to increase. These patients have additional considerations for the spine surgeon during surgical planning. We perform an informative review of the spinal and geriatric literature to assess preoperative and intraoperative factors that impact surgical complication occurrences in this population. Significance: There is a need to understand surgical risk assessment and prevention in geriatric patients who undergo thoracolumbar adult deformity surgery in order to prevent complications. Methods: Searches of relevant biomedical databases were conducted by a medical librarian. Databases searched included MEDLINE, Web of Science, CINAHL, IPA, Cochrane, PQ Health and Medical, SocINDEX, and WHO’s Global Health Library. Search strategies utilized Medical Subject Headings plus text words for extensive coverage of scoliosis and surgical technique concepts. Results: Degenerative scoliosis affects 68% of the geriatric population, and the rate of surgical interventions for this pathology continues to increase. Complications following spinal deformity surgery in this patient population range from 37% to 62%. Factors that impact outcomes include age, comorbidities, blood loss, and bone quality. Using these data, we summarize multimodal risk prevention strategies that can be easily implemented by spine surgeons. Conclusions: After evaluation of the latest literature on the complications associated with adult deformity surgery in geriatric patients, comprehensive perioperative management is necessary for improved outcomes. Preoperative strategies include assessing physiological age via frailty score, nutritional status, bone quality, dementia/delirium risk, and social activity support. Intraoperative strategies include methods to reduce blood loss and procedural time. Postoperatively, development of a multidisciplinary team approach that encourages early ambulation, decreases opiate use, and ensures supportive discharge planning is imperative for better outcomes for this patient population.
Association between plasma lipid levels during acute coronary syndrome and long-term malignancy risk. The ABC-4* study on heart disease
Authors: Berton Giuseppe , Cordiano Rocco , Cavuto Fiorella , Bagato Francesco , Mahmoud Heba Talat , Pasquinucci Mattia 
Published: May 2019

Abstract
Background
Emerging evidence suggests that patients with coronary artery disease carry an increased risk of developing malignancy, with deleterious effects on long-term prognosis. Our aim was to ascertain whether baseline plasma lipid levels during acute coronary syndrome (ACS) are associated with malignancy in long-term.

Methods
This study included 589 patients admitted with ACS to three centers and discharged alive. Plasma lipid levels were assessed on the first morning after admission. Patients were followed for 17 years or until death.

Results
Five hundred seventy-one patients were free from malignancy at enrollment, of them 99 (17.3%) developed the disease during follow-up and 75 (13.1%) died due to it. Compared to patients without malignancy, those with malignancy showed lower plasma levels of total cholesterol (TC), low-density lipoprotein (LDL), and triglycerides (TG). The groups showed similar statin use rates at any time in follow-up. The incidence rate of neoplasia and neoplastic mortality was higher in patients with baseline TC or LDL values ≤ median; they showed 85 and 72% increased incidence rate of developing malignancy and 133 and 122% increased incidence rate of neoplastic death respectively. No differences were observed relative to HDL and TG levels. In survival analysis using Cox regression with parsimonious models, patients with baseline TC or LDL values > median, respectively, showed risks of 0.6(95% CI 0.4–0.9; p = 0.01) and 0.6(95%CI 0.4–0.9; p = 0.02) for malignancy onset, and 0.5(95% CI 0.3–0.8; p = 0.005) and 0.5(95% CI 0.3–0.8; p = 0.004) for neoplastic death. Similar results were obtained using competitive risk analysis with parsimonious models.

Conclusions
This long-term prospective study of an unselected real-world patient sample showed that neoplasia onset and mortality are independently associated with low plasma TC and LDL levels at admission for ACS.
Anorexia nervosa: 30-year outcome
Authors: Dobrescu Sandra Rydberg , Dinkler Lisa , Gillberg Carina , Råstam Maria , Gillberg Christopher , Wentz Elisabet 
Published: May 2019

BackgroundLittle is known about the long-term outcome of anorexia nervosa.AimsTo study the 30-year outcome of adolescent-onset anorexia nervosa.MethodAll 4291 individuals born in 1970 and attending eighth grade in 1985 in Gothenburg, Sweden were screened for anorexia nervosa. A total of 24 individuals (age cohort for anorexia nervosa) were pooled with 27 individuals with anorexia nervosa (identified through community screening) who were born in 1969 and 1971–1974. The 51 individuals with anorexia nervosa and 51 school- and gender-matched controls were followed prospectively and examined at mean ages of 16, 21, 24, 32 and 44. Psychiatric disorders, health-related quality of life and general outcome were assessed.ResultsAt the 30-year follow-up 96% of participants agreed to participate. There was no mortality. Of the participants, 19% had an eating disorder diagnosis (6% anorexia nervosa, 2% binge-eating disorder, 11% other specified feeding or eating disorder); 38% had other psychiatric diagnoses; and 64% had full eating disorder symptom recovery, i.e. free of all eating disorder criteria for 6 consecutive months. During the elapsed 30 years, participants had an eating disorder for 10 years, on average, and 23% did not receive psychiatric treatment. Good outcome was predicted by later age at onset among individuals with adolescent-onset anorexia nervosa and premorbid perfectionism.ConclusionsThis long-term follow-up study reflects the course of adolescent-onset anorexia nervosa and has shown a favourable outcome regarding mortality and full symptom recovery. However, one in five had a chronic eating disorder.
Reflexões acerca da estrutura curricular para a educação infantil
Authors: Cunha Myrtes Dias da , Silva Cecilia Rezende 
Published: May 2019

Este artigo buscar refletir sobre a função da escola, em especial, da Educação Infantil. Como seus currículos podem favorecer ou dificultar uma formação integral enquanto cidadãos críticos e ativos numa sociedade cada vez mais consumista. Sabemos que o currículo possui um caráter político e histórico, indo muito além de um simples processo de transmissão de conteúdo. Assim, refletimos sobre o papel docente enquanto agente de reprodução ou emancipação. A partir de uma breve análise da Base Nacional Curricular Comum e outros documentos legais questionamos como as culturas podem ser valorizadas e trabalhadas no contexto escolar, de que forma pode-se favorecer a construção das identidades. Uma reflexão importante deve ser feita em relação ao direito de ser criança, em contrapartida ao processo de escolarização precoce.
PALAVRAS-CHAVE: Currículo; Infância; Escolarização precoce; Emancipação.
Presença negra no material didático de História adotado pelo Estado de São Paulo: 2014-2017
Authors: Silva Neide Cristina da 
Published: May 2019

A presente pesquisa tem como objeto a análise dos efeitos da aplicação da Lei n.º 10.639/03 nos livros didáticos de História para o Ensino Médio. Pretendeu-se verificar se os componentes históricos das matrizes curriculares carregados de denotações ou de conotações racistas foram reformulados, alterados ou até mesmo banidos após a implantação da referida lei. O problema central é que, apesar da mudança nos conteúdos curriculares, a História do Brasil continua a ser narrada com a imposição da visão de mundo da classe dominante. Para a realização desta pesquisa foram trabalhadas, como categorias principais, conscientização/alienação e colonialidade/racialidade tendo como aportes teóricos Paulo Freire e Aníbal Quijano. A análise demonstrou que apesar dos avanços no ensino de história e cultura afro-brasileira, a partir da promulgação da Lei n.º 10.639/03, a racialidade do saber, presente na historiografia didática, não permite superar a perspectiva temporal da história que situa o negro como inferior.
PALAVRAS-CHAVE: Material didático. História. Racionalidade. Povo negro. Lei n.º 10.639/03.
Inquietações sobre gênero e sexualidade em espaços formativos: o caso do Pibid de Ciências
Authors: Souza Marcos Lopes de , Ferrari Anderson 
Published: May 2019

Neste artigo enfocamos os incômodos sobre gênero e sexualidade apresentados por participantes de um subprojeto do Pibid de Ciências dos anos iniciais do ensino fundamental de uma universidade federal mineira. O grupo era composto por professoras dos anos iniciais do ensino fundamental, licenciandas/os dos cursos de pedagogia, biologia, química e física e uma docente universitária da área de ensino de ciências. As inquietações trazidas pelo grupo nos encaminharam para perceber os investimentos feitos para o controle da sexualidade das crianças e o quanto a escola ainda tem se silenciado diante dos debates sobre sexualidade e quando opta por trazê-la, nas aulas de ciências, o enfoque ainda tem sido o da reprodução.
PALAVRAS-CHAVE: Formação docente. Ciências naturais. Ensino fundamental. Gênero. Sexualidade.
Orientação Sexual e Homofobia na Série Televisiva Glee
Authors: Carvalho Micaela Leite Santos Montezuma de , Teixeira Filomena 
Published: May 2019

O projeto que se apresenta pretendeu contribuir para a construção de conhecimentos que apelassem a uma melhor compreensão da violência e da discriminação homofóbicas e perceber as perspectivas dos/as alunos/as relativamente às mensagens discriminatórias e estereotipadas veiculadas pela série televisiva Glee. A intervenção, realizada no âmbito do Mestrado em Educação para a Saúde, envolveu uma turma de 9º ano de escolaridade, constituída por 19 alunos/as. A opção pela metodologia de projeto permitiu-nos sensibilizar os/as estudantes para a necessidade do reconhecimento das diferentes orientações sexuais, tendo ainda possibilitado, a reflexão acerca das manifestações de violência, preconceito e discriminação de que são alvo as pessoas que assumem identidades não heterossexuais.
PALAVRAS-CHAVE: Violência. Discriminação homofóbica. Série televisiva. Educação.
Radiochemical aspects of alpha emitting radionuclides for medical application
Authors: Ferrier Maryline G. , Radchenko Valery , Wilbur D. Scott 
Published: May 2019

Abstract
The use of α-emitting radionuclides in targeted alpha therapy (TAT) holds great potential for treatment of human diseases, such as cancer, due to the short pathlength and high potency of the α particle, which can localize damage to targeted cells while minimizing effects to healthy surrounding tissues. In this review several potential α-emitting radionuclides having emission properties applicable to TAT are discussed from a radiochemical point of view. Overviews of production, radiochemical separation and chelation aspects relative to developing TAT radiopharmaceuticals are provided for the α-emitting radionuclides (and their generator systems) 211At, 224Ra/212Pb/212Bi, 225Ac/213Bi, 227Th/223Ra, 230U/226Th, 149Tb and 255Fm.
Note on the permanence of stochastic population models
Authors: Kant Shashi 
Published: May 2019

Abstract
The concept of permanence of any system is an important technical issue. This concept is very significant to all kind of systems, e.g., social, medical, biological, population, mechanical, or electrical.
It is desirable by scientists and investigators that any system under consideration must be long time survival.
For example, if we consider any ecosystem, it is always pre-requisite that this system is permanent.
In general language, permanence is just the persistent and bounded system in a particular surface time frame.
But the meaning may vary with the type of systems.
For example, deterministic and stochastic biological systems have different concepts of permanence in an abstract mathematical platform.
The reason is simple: it is due to the mathematical nature of parameters, methods of derivations of the model, biological assumptions, details of the study, etc.
In this short note, we consider the stochastic models for their permanence.
To address stochastic permanence of biological systems, many different approaches have been proposed in the literature.
In this note, we propose a new definition of permanence for stochastic population models (SPM).
The proposed definition is applied to the well-known Lotka–Volterra two species stochastic population model.
The note is closed with the open ended discussion on the topic.