bluuebunny/crossref_metadata_2025_split huggingface dataset:
CETICISMO NA FILOSOFIA DE BLAISE PASCAL
Authors: Mantovani Ricardo Vinícius Ibañez 
Published: July 2019

O ceticismo desempenha um papel decisivo na filosofia pascaliana. De fato, amplamente influenciado por autores como Michel de Montaigne e Pierre Charron, Blaise Pascal acaba por contrariar a tendência geral do século do grande Racionalismo, levantando profundas objeções relativamente à pretensão – tipicamente cartesiana – de se conhecer a Verdade de maneira certa e segura. Como se pode depreender mesmo de uma rápida leitura de seus escritos, a obra pascaliana é toda perpassada por uma notável desconfiança de nossa suposta capacidade de adquirir certezas inabaláveis sobre o que quer que seja: desconfiança esta que, diga-se de passagem, está em profunda sintonia com a chocante posição do autor concernente às consequências do pecado original. Assim sendo, o que pretendemos neste artigo é: i) apresentar os argumentos céticos subscritos por Pascal em sua principal obra filosófica – os Pensamentos; e ii) analisando a obra Do espírito geométrico e da arte de persuadir, indicar que nem mesmo os conhecimentos oferecidos pela luz natural são capazes de nos livrar das dúvidas suscitadas pela argumentação cética.
Private Think Tanks and Public–Private Partnerships in Chinese Public Diplomacy
Authors: Li Li , Chen Xuefei , Hanson Elizabeth C. 
Published: July 2019

Summary
This article examines private think tanks as instruments of public diplomacy in China. It analyses relationship-building in three cases of a hybrid form of public diplomacy that combines government agencies and non-state actors and involves multiple stakeholders, both domestic and transnational. Emphasis is upon the actors in China that initiated the projects and developed the networks for each initiative, but the building of the projects’ transnational relationships is also considered. The cases involve three top-ranking Chinese private think tanks: the Charhar Institute’s City Diplomacy projects; the Center for China and Globalization’s Green Card initiative; and the Chongyang Institute for Financial Studies’ Think 20 Transnational Network. The analysis demonstrates how and why the public-private partnerships in each case produced shared positive outcomes with synergistic results and advanced China’s public diplomacy objectives. The cases illustrate the advantages of a hybrid form of non-state public diplomacy that combines state and non-state actors.
Optimization of Gravity Wave Source Parameters for Improved Seasonal Prediction of the Quasi-Biennial Oscillation
Authors: Barton Cory A. , McCormack John P. , Eckermann Stephen D. , Hoppel Karl W. 
Published: July 2019

AbstractA methodology is presented for objectively optimizing nonorographic gravity wave source parameters to minimize forecast error for target regions and forecast lead times. In this study, we employ a high-altitude version of the Navy Global Environmental Model (NAVGEM-HA) to ascertain the forcing needed to minimize hindcast errors in the equatorial lower stratospheric zonal-mean zonal winds in order to improve forecasts of the quasi-biennial oscillation (QBO) over seasonal time scales. Because subgrid-scale wave effects play a large role in driving the QBO, this method leverages the nonorographic gravity wave drag (GWD) parameterization scheme to provide the necessary forcing. To better constrain the GWD source parameters, we utilize ensembles of NAVGEM-HA hindcasts over the 2014–16 period with perturbed source parameters and develop a cost function to minimize errors in the equatorial lower stratosphere compared to analysis. Thus, we may determine the set of GWD source parameters that yields a forecast state that most closely agrees with observed QBO winds over each optimization time interval. Results show that the source momentum flux and phase speed spectrum width are the most important parameters. The seasonal evolution of optimal parameter value, specifically a robust semiannual periodicity in the source strength, is also revealed. Changes in optimal source parameters with increasing forecast lead time are seen, as the GWD parameterization takes on a more active role as QBO driver at longer forecast lengths. Implementation of a semiannually varying source function at the equator provides RMS error improvement in QBO winds over the default constant value.
Gender differences in the perceived effectiveness of female-focused graphic health warnings against smoking in South Korea
Authors: Hwang Ji-eun , Choi Youjin , Yang Yu-seon , Oh Yumi 
Published: July 2019

Objective: Numerous studies have examined the effectiveness of graphic health warnings on different population segments, including male and female smokers, in an effort to reduce health disparities in Europe and the USA. However, research exploring the impact of gender-specific tobacco control interventions on Asian smokers is lacking. This study aimed to assess the perceived effectiveness of graphic health warning images featuring women smokers compared to gender-neutral warnings on South Korean women and men, by smoking status. Setting: Online survey with 1,200 adults (500 women; 475 smokers) in South Korea Design: A survey with four graphic health warnings (two female-focused and two gender-neutral warnings). Method: Participants were assigned to view two female-focused warnings (depicting smoking during pregnancy and risk of premature skin aging) or two gender-neutral warnings (depicting lung cancer and oral cancer), and rated their effectiveness in terms of persuading smokers to quit smoking and non-smokers to not begin smoking. Results: A significant interaction between gender and smoking status was found with the pregnancy warning. A post hoc comparison showed a significant difference between female smokers and female non-smokers, between male smokers and male non-smokers, and between female non-smokers and male non-smokers in their perceptions of warning effectiveness. Female non-smokers showed higher perceived effectiveness than male non-smokers and female smokers. Male non-smokers rated its perceived effectiveness lower than male smokers. Regarding the gender-neutral warnings, a participant’s age affected their perceived effectiveness of the cancer warnings. Conclusion: Findings suggest that graphic health warnings of smoking during pregnancy are perceived more effective by female non-smokers than female smokers and male non-smokers. Gender-neutral warnings with cancer images are perceived differently by age group. Future studies need to examine how social and cultural factors surrounding female smokers in South Korea affect their perceptions about female-focused warnings and the effects of the warnings on their motivation to quit smoking.
Lessons learned from The Spirit Catches You and You Fall Down: Student perspectives on how cultural differences can lead to health disparities
Authors: Uy Tricia , Dimaano Christian 
Published: July 2019

Objective: The Spirit Catches You and You Fall Down by Anne Fadiman is a critically acclaimed book describing the importance of understanding cultural influence on health care and health outcomes. Although this book has been incorporated into standard curriculum in the university and medical school training settings, consideration of how The Spirit Catches You and You Fall Down might change undergraduate student perceptions on health disparities, specifically among students at a minority-serving institution in the USA, has yet to be explored. Method: A qualitative, thematic analysis, using a pre-/post-test study design, assessed undergraduate students’ perceptions of topics of health disparities, spirituality and trust in healthcare providers. A total of 43 student responses characterising their perceptions on these topics were used to define themes both before and after a course utilising Fadiman’s book as a teaching tool. Results: Changes within the themes present in the post-test data showed that students had a deeper understanding of the need for communication with healthcare providers, as well as the need to build bridges between traditional spirituality and faith with modern medicine, in the context of respecting one’s culture, to effectively promote health outcomes in a multicultural society. Conclusion: An undergraduate course with directed lesson plans taken from The Spirit Catches You and You Fall Down afforded undergraduate students at a US minority-serving institution with a way to contextualise why and how cultural differences can lead to health disparities.
From Victims to Beneficiaries: Shaping Postconflict Subjects through State Reparations in Peru
Authors: Ramírez Zapata Ivan , Scott-Insúa Rogelio 
Published: July 2019

The political and institutional coordinates that appear in official classifications of the victims of the Peruvian armed conflict (1980–2000) affect their subsequent recognition as beneficiaries of reparations programs. A review of the conceptual bases of the Comprehensive Reparations Program calls attention to the tension in the design and implementation of this program between a strictly reparative approach and another that addresses the structural disparities present in the aftermath of the war. Examination of the effects of that tension in two cases shows that the early stages of implementing housing reparations equated the concept of “victim” with that of “poor” and later made poverty a prerequisite for receiving housing reparations and points to the difficulty of making an appropriate offer of reparations for displaced persons, whose specific problems are not properly addressed by the traditional agenda of transitional justice. Las coordenadas políticas e institucionales que atraviesan la calificación oficial de las víctimas del conflicto armado peruano (1980–2000) afectan su consiguiente reco-nocimiento como beneficiarios de programas de reparación. Al revisar los fundamentos conceptuales del Programa Integral de Reparaciones destacamos una tensión tensión en el diseño e implementación de este programa entre una perspectiva propiamente de reparación y una perspectiva de combate a las disparidades estructurales presentes en el período posconflicto. Examinamos la presencia y efectos de esta tensión en dos casos concretos. El primero muestra cómo los inicios en la implementación de reparaciones en vivienda equipararon la figura de la víctima con la de pobre, y posteriormente pusieron a la pobreza como requisito para recibir reparaciones en vivienda. El segundo muestra la dificultad de proponer una oferta adecuada de reparaciones para personas desplazadas, al ser una población cuyas características no encajan en la agenda clásica de la justicia transicional.
The role of antimicrobial prophylaxis in patients with head and neck cancer undergoing chemoradiation
Authors: Jaeger Alina T , Connelly James E , Jin Ruyun , Jacobson Samuel N , Leidner Rom S 
Published: July 2019

Background/objective National guidelines do not recommend the routine use of antimicrobial prophylaxis in patients with solid tumors, yet prophylactic agents are still sometimes prescribed for head and neck cancer patients. The purpose of this study is to determine the effect of prophylactic antimicrobials on the incidence of infection in patients undergoing chemoradiation for head and neck cancer. Methods Between 2013 and 2016, patients receiving chemoradiation for head and neck cancer at three outpatient oncology clinics were identified by retrospective review. Cohorts were based on administration or absence of prophylactic antimicrobials. The primary outcome of this study was incidence of infection. Secondary outcomes included incidence of hospitalization and length of hospital stay. Results Seventy-seven patients were analyzed, 47% (n = 36) were not prescribed antimicrobial prophylaxis and 53% (n = 41) were prescribed prophylaxis. Infection occurred in 31 patients in the no prophylaxis cohort and in 34 patients in the prophylaxis cohort (86.1% vs. 82.9%, p = 0.945). Twenty patients in the no prophylaxis cohort were hospitalized versus 16 patients in the prophylaxis cohort ( p = 0.222). The average length of hospital stay was 6 days in the no prophylaxis cohort and 10.6 days in the prophylaxis cohort ( p = 0.007). Conclusion The use of antimicrobial prophylaxis did not significantly impact the incidence of infection when compared to patients who were not prescribed prophylaxis. There was no difference in the incidence of hospitalization, however, the patients in the prescribed prophylactic group had longer length of hospital stay.
Symmetric dimethylarginine in hyperthyroid cats before and after treatment with radioactive iodine
Authors: DeMonaco Stefanie M , Panciera David L , Morre Wendy A , Conway Tina , Werre Stephen 
Published: July 2019

Objectives The purpose of this study was to evaluate symmetric dimethylarginine (SDMA) in hyperthyroid cats before and after treatment with radioactive iodine and to determine how pretreatment SDMA relates to the development of post-treatment azotemia. Methods Eighty-four non-azotemic hyperthyroid cats had serum SDMA and creatinine evaluated before and 1, 3 and 6 months after treatment with radioiodine therapy. Results Baseline SDMA was increased in 7% (n = 6/84) of cats, whereas SDMA was increased in 19% (n = 15/81), 20% (n = 16/80) and 32% (n = 26/81) at 1 month, 3 months and 6 months after treatment, respectively. Creatinine was not elevated in any of the cats at baseline because of the study design, and was elevated in 6% (n = 5/81), 15% (n = 12/80) and 15% (n = 12/81) of cats at 1, 3 and 6 months after treatment, respectively. SDMA (median 11 μg/dl, range 1–22 μg/dl) was significantly higher at 3 (12 μg/dl, range 6–45 μg/dl; P = 0.005) and 6 months (11 μg/dl, 6–25 μg/dl; P <0.001) compared with baseline (11 μg /dl, range 1–21 μg/dl). The median baseline SDMA was significantly higher in the azotemic group (13 μg/dl, range 11–22 μg/dl) compared with the non-azotemic group (10 μg/dl, range 1–21 μg/dl, P = 0.002). The sensitivity of SDMA for detecting azotemia after treatment was 15.4%, with a specificity of 94.4%. Baseline serum SDMA concentration had a moderately positive association with baseline creatinine concentration ( P <0.001, r = 0.437). At 6 months, there was a strong positive correlation between SDMA and creatinine concentrations ( P <0.001, r = 0.721). There was no significant correlation with SDMA and thyroxine at baseline ( P = 0.772, r = −0.034) or 6 months ( P = 0.492, r = −0.078). Conclusions and relevance SDMA increases in cats treated for hyperthyroidism with radioactive iodine and likely reflects associated changes in glomerular filtration rate. An increased SDMA concentration above the reference interval prior to treatment has a high specificity but poor sensitivity for the prediction of post-treatment azotemia.
Initial metal ion levels predict risk of elevation in metal on metal total hip arthroplasty
Authors: Martin J. Ryan , Odum Susan M , Springer Bryan D , Griffin William L 
Published: July 2019

Introduction: Screening protocols for asymptomatic patients with metal on metal (MoM) total hip arthroplasty (THA) are evolving. Most surgeons began screening patients around 2010 by obtaining cobalt (Co) and chromium (Cr) metal ion levels. There is currently no data available to guide repeat screening in this familiar clinical scenario. Therefore, the following study evaluated how metal ion levels change after an initial metal ion level in patients with MoM THAs. Materials and methods: 171 consecutive patients (265 hips) underwent primary MoM THA. All patients had at least one Co and Cr ion level draw. 84 patients (136 hips) had 2 ion level draws. Ion levels were divided into elevated levels (⩾4.5 ppb) and normal levels (<4.5 ppb). The probability of an ion level returning elevated after an initial normal level was identified. Additionally, a threshold value was determined that reliably identified every patient that did not subsequently rise above 4.5 ppb. Results: 12 metal ion levels were ⩾4.5 ppb on the first lab draw. On the second draw, all 12 remained ⩾4.5 ppb. Of the 121 hips with initial metal ion levels <4.5 ppb, 5 metal ion levels became ⩾4.5 ppb. Utilising an initial screening cutoff of 3.0 ppb, no patient was identified with a second lab value ⩾4.5 ppb. Discussion: Initial metal ion levels reliably predicted those that would remain elevated or remain normal with a subsequent metal ion level. An initial metal ion level above 3.0 ppb may represent a cutoff at which further workup is necessary.
Accepting the Challenge—Moderate-Intensity Exercise with Individuals with Dementia: A Case Series
Authors: Dawson Nicole , Judge Katherine 
Published: July 2019

Background and purpose: The global impact of dementia demands a response from researchers and clinicians to not only assist with prevention and a cure, but also to assist in the management of symptoms related to this progressive disease. The purpose of this case series is to highlight the participation of 3 individuals with varying levels of dementia in a moderate-intensity functional exercise program. Intervention: The intervention, developed using principles from exercise science and a Strength-Based Approach, consisted of 24 sessions of moderate-intensity exercises delivered in participant’s home. Outcomes: Each participant completed a pre- and post-assessment including gait speed, strength, balance, depressive symptoms, cognition, and perceived difficulty with activities of daily living. Despite various clinical presentations, each participant successfully completed all 24 sessions with noted improvements in at least two measures. Discussion: These findings highlight the flexibility of using the Strength-Based Approach to enhance participation in a standardized exercise program.
Activos para la salud en cuidadores familiares de enfermos de Alzheimer: desarrollo de un mapa de activos para la salud
Authors: Agulló-Cantos José Manuel , García-Alandete Joaquín , Paredes-Carbonell Joan J. 
Published: July 2019

El Alzheimer es la enfermedad más prevalente en mayores de 65 años, siendo una enfermedad neurodegenerativa progresiva. El cuidado de estas personas enfermas se sustenta, en la mayoría de los casos, desde el núcleo familiar, siendo éste quien sufre las consecuencias del cuidado. Tradicionalmente, el estudio y análisis de las personas cuidadoras se ha realizado desde perspectivas de déficit o negativas. El presente estudio introduce el modelo salutogénico y de activos para la salud, e intenta comprender el valor positivo del cuidado y la superación de las circunstancias adversas, a través de aquellas habilidades o recursos del cuidador o de su entorno que le ayudan a afrontar de forma positiva esta enfermedad. En el estudio participaron cuidadores familiares ( n=45) de tres Centros de Estancias Diurnas para enfermos de Alzheimer diferentes, donde fueron entrevistados en grupos (de 5 a 13 participantes por entrevista) y grabados en audio, para su posterior trascripción y análisis de contenido temático. Los resultados muestran que los cuidadores familiares a pesar de vivir bajo una fuente de estrés, también puedn obtener consecuencias positivas de la experiencia del cuidado, siendo capaces de identificar activos para la salud, tanto internos como externos, que les ayudan a mejorar y/o mantener su salud como cuidador.
Outcomes of Discectomy in Young Adults With Large Central Lumbar Disc Herniations Presenting With Predominant Leg Pain
Authors: Kulkarni Arvind G. , Tapashetti Sandeep 
Published: July 2019

Study Design: Retrospective cohort study. Objectives: Discectomy alone or discectomy with fusion have been 2 polarized options in the management of large lumbar disc herniations presenting with leg-dominant pain in young patients. The objective of the study was to evaluate the outcomes of discectomy in young patients with large central lumbar disc herniation (CLDH) presenting with predominant leg pain. Material and Methods: Young patients (<45 years) presenting with predominant leg pain and MRI confirmed diagnosis of CLDH between April 2007-January 2017 were included in the study. All patients underwent tubular microdiscectomy. Outcomes of surgery were evaluated using visual analogue score (VAS) for leg and back pain, Oswestry Disability Index (ODI), and Macnab’s criteria. Results: Ninety patients fulfilled the inclusion criteria. The mean age of patients was 34.9 years (range 19-45 years). Mean follow-up was 5.09 years (range 2-10 years). The incidence of CLDH in young adults was 30% and incidence among all “operated” lumbar disc herniations was 15.9%. The mean VAS for leg pain improved from 7.48 ± 0.9 to 2.22 ± 0.84 ( P < .05) and the mean ODI changed from 60.53 ± 7.84 to 18.33 ± 6.20 ( P < .05). Fifty-nine patients (65.6%) reported excellent, 25 patients (27.8%) reported good, 3 patients each (3.3%) as fair and poor outcomes respectively. Conclusion: Discectomy alone for CLDH with predominant leg pain is associated with high success rate and low need for a secondary surgical procedure. Patient selection in terms of leg-dominant pain may be the main attribute for lower incidence of recurrence, postoperative back-pain, and instability needing a secondary procedure. Minimally invasive discectomy may provide an added advantage of preserving normal spinal anatomy, thus minimizing the need for primary spinal fusion in these patients.
Preoperative Performance of PROMIS in Patients With Patellofemoral Malalignment and Chondral Disease
Authors: Carender Christopher N. , Bollier Matthew J. , Wolf Brian R. , Duchman Kyle R. , An Qiang , Westermann Robert W. 
Published: July 2019

Background: Use of the Patient-Reported Outcomes Measurement Information System (PROMIS) instrument has not yet been validated in patients undergoing operative treatment for patellofemoral malalignment and chondral disease. Purpose: To evaluate the PROMIS Physical Function Computer Adaptive Testing (PF CAT) instrument in a population of patients with patellofemoral malalignment and chondral disease relative to established patient-reported outcome (PRO) instruments. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Eligible patients were prospectively enrolled at the time of indication for surgery and completed 5 PRO instruments preoperatively: 36-Item Short Form Health Survey (SF-36); Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC); Marx activity rating scale (Marx); EuroQol 5-dimension, 5-level instrument (EQ-5D-5L); and PROMIS PF CAT. Convergent and discriminant validity was assessed by measuring correlations between PROMIS PF CAT and other PRO instruments, including the Knee injury and Osteoarthritis Outcome Score (KOOS). Strength of correlation was measured by use of Spearman correlation coefficients. Results: In total, 37 patients (40 knees) were enrolled in the study. All knees underwent Fulkerson osteotomy and concomitant cartilage procedure (29 chondroplasty, 6 allograft, 5 microfracture). Mean patient age was 33.4 years, and 73% of knees were in female patients. Correlations ( r) between PROMIS PF CAT and knee PRO instruments were as follows: SF-36 PF ( r = 0.80; P < .01); KOOS Pain ( r = 0.74; P < .01); KOOS Symptoms ( r = 0.47; P < .01); KOOS Quality of Life ( r = 0.68; P < .01); KOOS Sports and Recreation ( r = 0.72; P < .01); KOOS Activities of Daily Living (ADL) ( r = 0.80; P < .01); WOMAC Function ( r = 0.80; P < .01); WOMAC Pain ( r = 0.72; P < .01); WOMAC Stiffness ( r = 0.38; P = .02); Marx ( r = 0.22; P = .31); and EQ-5D-5L ( r = 0.72; P < .01). Neither floor nor ceiling effects were observed in PROMIS PF CAT or KOOS ADL. Mean (±SD) question burden with PROMIS PF CAT was 5.6 ± 0.6 questions. Conclusion: In patients with patellofemoral malalignment and chondral disease, PROMIS PF CAT is an efficient and reliable PRO instrument to preoperatively assess patients across a spectrum of knee function without floor or ceiling effects.