bluuebunny/crossref_metadata_2025_split huggingface dataset:
O movimento anacrônico da personagem Claudia na cena teatral de <i>O Deszerto</i>
Authors: Ribas Jéssica 
Published: April 2019

O presente trabalho utiliza a definição de anacronismo, empregada pelo filósofo francês Didi-Huberman em Diante do tempo (2011), para discutir a questão dos tempos implicados pela imagem na cena teatral. A utilização da palavra “movimento” funcionou como uma tentativa de enfatizá-la no contexto do teatro. Um movimento do anacronismo, portanto, que se apresente também no campo do visível, como acontecimento, extrapolando o campo das ideias. Para melhor aplicação da proposta, esta investigação centrou-se em torno da personagem “imagem-malícia” (DIDI-HUBERMAN, 2005) Claudia, retirada do espetáculo O Deszerto (2016), de autoria do grupo Mulheres Míticas. Essa personagem, que desencadeia uma reunião de tempos expressos por imagens literárias e plásticas (ROJO, 2016) que se formam dos dispositivos utilizados na cena, possibilitou pensar como esses conflitos temporais permitiriam que épocas fossem revisitadas, e se eles poderiam interferir nos modos de fazer dos sujeitos, com a proposta de ressignificar a história e “renovar o pensamento” (DIDI-HUBERMAN, 2012). PALAVRAS-CHAVE: anacronismo; política; imagem; memória.
A loucura redentora em <i>Henrique IV</i>: uma perspectiva moderna
Authors: De Vargas Andrea Quilian , Umbach Rosani Ketzer 
Published: April 2019

Henrique IV é um dos textos mais geniais de Luigi Pirandello em função da perfeita combinação entre reflexões filosóficas e uma intensa dramaticidade. Além disso, coexistem, na peça, dois níveis interpretativos que se complementam: um que diz respeito ao drama burguês do final do século XIX e primórdios do XX, o qual compreende os conflitos individuais do homem moderno; outro que depreende a loucura como possibilidade de fuga dessa realidade perturbadora. Partindo da concepção do louco como “o conhecedor das verdades”, explicitada por Michel Foucault, em História da loucura na Idade Clássica, exploramos, neste trabalho, de que forma a loucura se manifesta e qual sua utilidade para o protagonista de Henrique IV.
From fistula to disability. Severe infection due to anal fistula treated with NPWT — case report
Authors: Szyntor Mateusz , Wojciechowski Radosław , Surudo Magdalena 
Published: April 2019

Negative pressure wound therapy (NPWT) is increasingly used to facilitate wound healing. There are various types of wounds - primarily closed or open, clean or infected, superficial or deep-penetrating, open abdomen, enteroatmospheric fistulae, burns etc. and almost each of these might be healed with the help of NPWT. It seems to be the most beneficial in hard-to-heal wounds. Using sub-atmospheric pressure, we can significantly accelerate the separating of necrotized tissues, stop inflammation,promote granulation, and drain the difficult wounds effectively. Typically, an optimum pressure range of –80 to –125 mmHg is administered. Few contraindications for the use of NPWT are challenged by new reports showing benefits in situations where NPWT was previously forbidden, (i.e. malignancy or bleeding in the wound), increasing the quality of life and avoiding wound infections. There is a growing body of data for new methods of treating anal fistula in the literature, but there is no data for elective treatment with NPWT. Attempts to develop NPWT protocols are problematic due to the diversity of cases and the frequent need for a personalized therapeutic approach.
This paper presents a 56-year-old male patient suffering from severe, purulent inflammation of groin, inguinal, anal and left gluteal sites; septic, malnourished, depressed, in worsening general status for 3 years. Computed tomography and colonoscopy did not reveal pathology except for purulent inflammation. At the beginning, the patient was treated symptomatically with antibiotics, colostomy and surgical excision facilitated with NPWT. Anal fistulae were found after a large excision. A medium-thick skin transplantation was performed and well accepted in over 90%. This was a 103-day-long treatment with numerous complications. Finally, the wound healed completely and the patient was restored to his full physical and mental abilities.
NPWT used in this case allowed for inflammation control, extensive wound healing and closing the anal fistula with no recurrence.
The role of negative pressure wound therapy in the treatment of pilonidal disease
Authors: Chmielecki Jan , Ferenc Josephine , Banasiewicz Tomasz 
Published: April 2019

Pilonidal disease is a particularly difficult disorder to treat. Guidelines and recommendations for the treatment of pilonidal disease neglects the use of negative pressure wound therapy (NPWT), but studies strongly support the role of NPWT in prevention of surgical site infection in high-risk groups.
During a webinar on the pilonidal disease, we asked 51 participants to complete a questionnaire about the treatment of pilonidal disease. They answered questions about the way they treat their patients with pilonidal disease, and about using NPWT.
The study showed that relatively large number of surgeons use NPWT to treat patients with pilonidal disease, the majority of them are satisfied at maintaining the tightness and effectiveness of a vacuum dressing and would use the single-use NPWT systems, if they was more available. It seems that the NPWT in the pilonidal disease is increasingly used and this method is gaining more and more popularity.
A case of late manifestation of primary adrenal insufficiency in the autoimmune polyglandular syndrome type 1
Authors: Troshina V. V. , Grebennikova T. A. , Belaya Zh. E. 
Published: April 2019

The article describes a clinical case of primary adrenal insufficiency which manifested at an atypically advanced age. Primary adrenal insufficiency combined with other clinical symptoms suggested the autoimmune polyendocrine syndrome type 1. Subsequently, the diagnosis was confirmed by the results of genetic testing. The particulars of the clinical case include the age of patient at manifestation of the disease (49 years). The lack of treatment resulted in dramatic clinical decompensation. This clinical case is intended to draw clinicians' attention to the necessity of detection of primary adrenal insufficiency and appropriate and timely treatment. Taking into account eventual diagnostic problems, it is necessary to raise awareness about this disease among practicing doctors of various specialties.
Микроцистины в литорали Куршского залива в 2017 г. по данным иммунохроматографического анализа
Authors: Смирнова М. М. 
Published: April 2019

Присутствие гепатотоксичных цианотоксинов группы микроцистинов регистрируется в южной части Куршского залива ежегодно с 2010 г. Куршский залив имеет высокое рекреационное значение; национальный парк «Куршская коса» включён в список объектов Всемирного наследия ЮНЕСКО. Таким образом, потенциальная опасность для здоровья, обусловленная присутствием микроцистинов, ― неотъемлемая проблема этого района. Содержание микроцистинов в пробах воды из литоральной зоны определяли с помощью иммунохроматографических экспресс-тестов (Microcystin Strip Test, Abraxis Ltd). Пробы воды отбирали в мае ― ноябре 2017 г. дважды в месяц на шести прибрежных мониторинговых станциях. Впервые показано присутствие микроцистинов в летне-осенний период во всей литорали южной части Куршского залива в течение вегетационного периода. В мае микроцистины отсутствовали. Самые высокие значения (5–10 мкг·л-1) отмечены в конце июня и в сентябре на Куршской косе. За период наблюдений в 2017 г. микроцистины встречались реже и в меньших количествах, чем в 2011–2016 гг. В середине и конце октября микроцистины выявлены только дважды, на Куршской косе. На восточном и южном побережьях максимальное значение составляло 5 мкг·л-1 (отмечено один раз в конце сентября). В других пробах токсины не были обнаружены или их значения не превышали 2,5 мкг·л-1.
Can an allied health expanded scope Treatment Access Pathway (TAP) improve health outcomes for people with persistent pain? Study protocol for a pragmatic randomised controlled trial
Authors: Vandermost Margaret Anne , Sterling Michele , Bagraith Karl , Kennedy Hannah , Doherty Darren , Kilner Simon 
Published: April 2019

Abstract
Background

Persistent pain is a public health crisis. Demand for services frequently exceeds supply and many individuals miss out on timely treatment resulting in longer than recommended wait times. The Interdisciplinary Persistent Pain Centre (IPPC) (Queensland, Australia) implemented a Treatment Access Pathway (TAP), an allied health first point of contact model of care to allow patients access to empirically supported allied health treatment without Pain Specialist assessment. The primary aim of this research project is to understand the clinical and cost effectiveness of TAP in a real-world setting. Method: Participants referred to the IPPC are randomly allocated to treatment or waitlist control groups and self-report and objective physical outcome measures are collected at baseline and 6 months’ time. A total of 196 patients will be recruited for the study (treatment group, n=98 and control group, n=98) to allow a 20% attrition rate to gain 156 participants for the study. Discussion: The results of this study will determine the clinical outcomes and cost effectiveness of the TAP as a model of care to inform future clinical decision making and program development. Ethics approval was provided by the Research Governance Office at Gold Coast Hospital and Health Service (RGOGCHHS) on the 19/10/2016 (HREC/16/QGC/156).
Skeletal Muscle Hypertrophy and Attenuation of Cardio-Metabolic Risk Factors (SHARC) Using Functional Electrical Stimulation-Lower Extremity Cycling in Persons with Spinal Cord Injury. Study Protocol for a randomized clinical trial
Authors: Gorgey Ashraf , Khalil Refka E , Davis John C , Carter William , Gill Ranjodh , Rivers Jeannie , Khan Rehan , Goetz Lance , Castillo Teodoro , Lavis Timothy , Sima Adam , Lesnefsky Edward , Cardozo Christopher , Adler Robert A 
Published: April 2019

Abstract
Background
Persons with spinal cord injury (SCI) are at heightened risks of developing unfavorable cardiometabolic consequences due to physical inactivity. Functional electrical stimulation (FES) and surface neuromuscular electrical stimulation (NMES)-resistance training (RT) have emerged as effective rehabilitation methods that can exercise muscles below the level of injury and attenuate cardio-metabolic risk factors. Our aims are to: determine the impact of 12 weeks of NMES+12 weeks of FES-Lower extremity cycling (LEC) compared to 12 weeks of passive movement + 12 weeks of FES-LEC on 1) oxygen uptake (VO2), insulin sensitivity and glucose disposal in adults with SCI; 2) skeletal muscle size, intramuscular fat (IMF) and visceral adipose tissue (VAT) and; 3) determinants of energy metabolism, protein molecules involved in insulin signaling, muscle hypertrophy and oxygen uptake (IRS-1, AMPK, GLUT-4, IGF-1, mTOR, Akt and PGC-1 α) and electron transport chain (ETC) activities.
Methods/Design
Forty-eight persons aged 18-65 years with chronic (> 1 year) SCI/D (AIS A-C) at the C5-L2 levels, equally sub-grouped by cervical or sub-cervical injury levels and time since injury, will be randomized into either NMES+FES group or Passive + FES (control group). The NMES+FES group will undergo 12 weeks of evoked RT using twice-weekly NMES and ankle weights followed by twice-weekly progressive FES-LEC for an additional 12 weeks. The control group will undergo 12 weeks of passive movement followed by 12 weeks of progressive FES-LEC. Measurements will be performed at baseline (B; week 0), post-intervention 1 (P1; week 13) and post-intervention 2 (P2; week 25) and will include VO2 measurements, insulin sensitivity and glucose effectiveness using intravenous glucose tolerance; magnetic resonance imaging to measure muscle, IMF and VAT areas; muscle biopsy to measure protein expression and intracellular signaling as well as mitochondrial ETC function.
Discussion
Training through NMES+RT may evoke muscle hypertrophy and positively impact oxygen uptake, insulin sensitivity and glucose effectiveness. This may result in beneficial outcomes on metabolic activity, body composition profile, mitochondrial ETC and intracellular signaling related to insulin action and muscle hypertrophy. In the future, NMES-RT may be added to FES-LEC to improve the workloads achieved in the rehabilitation of SCI persons and further decrease muscle wasting and cardio-metabolic risks.
Clinical trials # NCT02660073
Symptom profiles in patients with Alzheimer’s disease with and without concomitant cerebrovascular disease: an observational study
Authors: Eldholm Rannveig Sakshaug , Barca Maria Lage , Persson Karin , Knapskog Anne-Brita , Engedal Knut , Selbæk Geir , Skovlund Eva , Saltvedt Ingvild 
Published: April 2019

Abstract
Background: Diagnostic criteria of Alzheimer’s disease (AD) and vascular cognitive impairment (VCI) describe different cognitive profiles. AD patients often have concomitant cerebrovascular disease (CVD) and these patients could therefore be expected to display symptoms of both AD and VCI. AD patients with concomitant CVD display symptoms of cognitive impairment with less AD pathology than those without CVD. Medial temporal atrophy (MTA) on magnetic resonance imaging (MRI) is a biomarker of neurodegeneration in AD, and we would expect less MTA in AD patients with CVD. The first aim was to examine whether there were differences in the results of cognitive tests for memory, executive function, and processing speed, or in depressive symptoms, between AD patients with and without CVD. Secondly, to assess whether MTA on MRI is more pronounced among AD patients without CVD.

Methods: A total of 192 AD patients with amnestic mild cognitive impairment or mild dementia underwent cognitive assessment and depression screening. Cerebral MRIs were assessed for MTA, white matter hyperintensities, and lacunar and cortical infarcts. CVD was defined as the presence of white matter hyperintensities Fazekas scale ≥2 or any infarct. To study the effect of CVD, several multiple linear regression analyses were carried out using CVD adjusted for age and sex as the independent variable, and cognitive test scores, depression scores, and MTA as dependent variables.

Results: Mean age was 72.2 (SD 8.3) years. The number of AD patients with and without concomitant CVD was 121 and 71, respectively. The group with CVD scored significantly lower on tests of attention, executive function and immediate recall compared with the group without CVD. In analyses controlled for age and sex, concomitant CVD was not associated with significant differences in any cognitive test nor in depressive symptoms. A statistically significant association between AD with concomitant CVD and more pronounced MTA was identified.

Conclusions: The results indicate that cognitive test profiles, depressive symptoms, and MTA scores cannot be used to distinguish AD patients with and without CVD.
Effect of the Blood Pressure Management Application (BPMAP) on Hypertension Self-Management Enhancement: A Randomized Clinical Trial
Authors: Ashoorkhani Mahnaz , Majdzadeh Reza , Hosseini Hamed , Eftekhar Hassan , Ramezankhani Ali , Yoonessi Ali , Mansouri Mehdi , Bozorgi Ali 
Published: April 2019

Abstract
Background

self-management of Blood pressure is of great significance given the increasing incidence of hypertension and associated disabilities. With the increased use of mobile health in medicine, the present study evaluated the effect of the self-management application on patient adherence to hypertension treatment.

Methods

This clinical trial was performed on 120 hypertensive patients who were provided with BPMAP for 8 weeks and followed-up to 24th weeks. Data on the primary outcome (adherence to treatment) and secondary outcomes (adherence to the DASH diet, regular monitoring of blood pressure, and physical activity) were collected using a questionnaire and a mobile application, respectively. The inter-group change difference over time was analyzed using repeated measures ANOVA (General Linear Model).

Results

The treatment adherence score increased by an average of 5.9 (95%CI: 5.0-6.7) in the intervention group compared to the control group. Scores of adherence to the low-fat and low-salt diet plans were 1.7 (95%CI: 1.3-2.1) and 1.5 (95%CI: 1.2-1.9), respectively. Moreover, moderate physical activity increased to 100.0 minutes (95%CI: 61.7-138.3) per week in the intervention group.

Conclusion

The treatment and control of blood pressure require a multifaceted approach given its complexity and multifactorial nature. Considering the widespread use of smartphones, m-Health interventions can be effective in self-management and better patient adherence to treatments. Our results showed that BPMAP can be used as a successful tool for hypertension self-management in patients attending public hospitals in developing countries.
Ultrasound assessment of the effect of pharyngeal packing on perioperative gastric volume in nasal surgery
Authors: Temel Mehmet Emrah , TOTOZ Tolga , ERKALP KEREM , TEMEL Gulen Safiye , SELCAN Aysin 
Published: April 2019

Abstract
Background

Pharyngeal packing (PP) is commonly performed to reduce the incidence of perioperative blood ingestion (PBI) in nasal surgery (NS), and thus the incidence and severity of postoperative nausea and vomiting (PONV). This study examined the effects of PP on the perioperative gastric volume (GV) and PONV in patients undergoing NS by ultrasound assessment.

Methods

Patients undergoing elective NS [septoplasty, septo-rhinoplasty (SRP) and functional endoscopic sinus surgery (FESS)] were randomised to receive or not receive PP. In the PP group, pharyngeal packs were placed after orotracheal intubation. Ultrasound assessments were performed for all patients preoperatively (before anaesthesia induction) and postoperatively (before extubation). The antero-posterior (AP) and cranio-caudal (CC) antral diameters, antral cross-sectional area (ACSA), and total GV were calculated. PONV incidence and severity were rated. These variables were compared between timepoints and groups, and in subgroup analyses according to surgery type. Pearson correlation analysis was performed to assess correlations between variables.

Results

AP and CC diameters and ACSAs were greater postoperatively than preoperatively in the PP and non-PP groups (n = 44 each; all p < 0.05). Postoperative AP and CC diameters and the ACSA were greater in the non-PP than in the PP group (all p < 0.05). Postoperative AP diameters were greater than preoperatively in patients undergoing SRP and FESS, and the postoperative CC diameter and ACSA were greater than preoperatively in patients undergoing SRP (all p < 0.05). Surgery duration was correlated positively with the postoperative AP diameter (r = 0.380, p < 0.05), CC diameter (r = 0.291, p < 0.05), and ACSA (r = 0.369, p < 0.05).

Conclusions

The study findings indicate that PP reduces the increase in the perioperative GV due to PBI in elective NS. It is thus a useful and safe means of reducing the risk of perioperative pulmonary aspiration in such surgeries.
Retrograde inferior vena caval perfusion for total aortic arch replacement surgery (RIVP-TARS): study protocol for a multicenter, randomized, controlled trial
Authors: Lin Jing , Tan Zhaoxia , Yao Hao , Hu Xiaolin , Zhang Dafa , Zhao Yuan , Xiong Jiyue , Dou Bo , Zhu Xueshuang , Wu Zhong , Guo Yingqiang , Kang Deying , Du Lei 
Published: April 2019

Abstract
Background: During total aortic arch replacement surgery (TARS) for patients with acute type A aortic dissection, organs in the lower body such as the viscera and spinal cord are at risk of ischemia even when antegrade cerebral perfusion (ACP) is performed. Combining ACP with retrograde inferior vena caval perfusion (RIVP) during TARS may improve outcomes by providing the lower body with oxygenated blood.
Methods: This study is designed as a multicenter, computer-generated randomized, controlled, assessor-blind, parallel-group study with a superiority framework in patients scheduled for TARS.A total of 636 patients will be randomized on a 1:1 basis to a moderate hypothermia circulatory arrest (MHCA) group, who will receive selective ACP with moderate hypothermia during TARS; or to an RIVP group, who will receive the combination of RIVP and selective ACP under moderate hypothermia during TARS. The primary outcome will be a composite of early mortality and major complications, including paraplegia, postoperative renal failure, severe liver dysfunction and gastrointestinal complications. All patients will be analyzed according to the intention- to-treat protocol.
Discussion: This study aims to assess whether RIVP combined with ACP leads to superior outcomes than ACP alone for patients undergoing TARS under moderate hypothermia. This study seeks to provide high-quality evidence for RIVP to be used in patients with acute type A aortic dissection undergoing TARS.
Trial registration. Clinicaltrials.gov, NCT03607786. Registered on 30 July 2018.
Effects of Initial Soil Moisture, Clod Size, and Clay Content on Ammonia Volatilization after Subsurface Band Application of Urea
Authors: Pelster D. E. , Watt Devon , Strachan Ian B. , Rochette P. , Bertrand N. , Chantigny M. H. 
Published: April 2019

Ammonia losses from broadcast urea vary based on soil physical and chemical properties; however, less is known about how soil properties affect NH3losses after subsurface banding of urea. Therefore, three field trials were established to determine how initial soil moisture, clod size, and clay content affect NH3volatilization from subsurface‐banded (0.025‐m depth) urea using wind tunnels. The first study measured volatilization after banding in a loamy mixed frigid Typic Humaquept at 50, 100, 150, 200, or 250 g kg−1gravimetric water content (WC). Study 2 measured volatilization from the same soil after covering the bands with soil clods that ranged from <2 to >24 mm in diameter, whereas Study 3 measured volatilization from transplanted, acidic soils with clay contents ranging from 5 to 57%. Cumulative 17‐d NH3losses for study one ranged from 8.3 to 20.8% of applied N, with the soil wetted to 200 g kg−1WC experiencing the greatest losses. For Study 2, cumulative NH3volatilization losses ranged from 10.8 to 20.8% of applied N, with the greatest losses from the largest clod sizes. For Study 3, NH3losses ranged from 2.5 to 51.7% of applied N, with the NH3losses correlated to the maximum pH measured in the band (P< 0.001), and to the soil cation exchange capacity (P= 0.054), titratable acidity (P= 0.072), and clay content (P= 0.100). However, the soil with high silt, not sand, content had the highest volatilization losses, suggesting that high silt soils may have the greatest potential for NH3volatilization.Core IdeasGreater NH3losses from soils at 200 g kg−1water content than at ≤150 g kg−1.Covering the urea band with clods <6 mm reduced NH3losses.Soil NH3losses correlated closely to the maximum pH reached in the band and soil CEC.The highest NH3losses were from soils with low clay and high silt content.Previous Canadian studies on NH3loss from banded urea may overestimate losses.