bluuebunny/crossref_metadata_2025_split huggingface dataset:
The stories clinicians tell
Authors: Krieger Stefan 
Published: July 2017

<p>Unbelievably, it has been more than 15 years since I last visited Palacký during the inaugural year of its Clinic. So, in preparation for today’s talk, I thought I should go back to my files to refresh my memory of events a decade-and-a-half ago. As I reviewed those documents, it struck me how the events of that time were much more complicated than I initially remembered. In fact, I saw how my retelling of the events reflected in those papers could be constructed – with appropriate spin -- into different stories -- some of which could be dramatically divergent from others.</p>
Klebsiella pneumoniae do Serotipo K1 e do Clone Hipervirulento ST23: Primeiro Caso Documentado em Portugal
Authors: Pereira Aida , Petrucci Tiago , Simões Maria João 
Published: July 2017

A estirpe híper-virulenta Klebsiella pneumoniae serotipo K1 é responsável por uma síndrome invasiva infeciosa, caracterizada por abcessos hepáticos com manifestações extra-hepáticas. Inicialmente identificada em Taiwan, tem aumentado significativamente em vários países da Ásia, e mais recentemente na Europa e América do Norte, conferindo a esta entidade um caracter emergente e global. Os autores apresentam o caso clinico de uma mulher de 64 anos, caucasiana, portuguesa, sem antecedentes pessoais ou epidemiológicos como viagens ou exposição a produtos asiáticos, na qual foi diagnosticada, abcesso hepático piogénico complicado de derrame pleural por esta estirpe híper-virulenta. Após conhecimento do diagnóstico e instituição de terapêutica antibiótica combinada com drenagem percutânea, foi possível a resolução do caso clínico com sucesso. Este caso permitiu a identificação do primeiro caso de síndroma invasiva infeciosa, por Klebsiella pneumoniae do clone híper-virulento ST23 documentado em Portugal.
Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?
Authors: Fonseca Andreia , Silva Rita , Rato Inês , Neves Ana Raquel , Peixoto Carla , Ferraz Zita , Ramalho Inês , Carocha Ana , Félix Nisa , Valdoleiros Sandra , Galvão Ana , Gonçalves Daniela , Curado Joana , Palma Maria João , Antunes Isabel Lobo , Clode Nuno , Graça Luís Mendes 
Published: July 2017

Introduction: The best route of delivery for the term breech fetus is still controversial. We aim to compare maternal and neonatal outcomes between vaginal and cesarean term breech deliveries.Material and Methods: Multicentric retrospective cohort study of singleton term breech fetuses delivered vaginally or by elective cesarean section from January 2012 - October 2014. Primary outcomes were maternal and neonatal morbidity or mortality.Results: Sixty five breech fetuses delivered vaginally were compared to 1262 delivered by elective cesarean. Nulliparous women were more common in the elective cesarean group (69.3% vs 24.6%; p < 0.0001). Gestational age at birth was significantly lower in the vaginal delivery group (38 ± 1 weeks vs 39 ± 0.8 weeks; p = 0.0029) as was birth weight (2928 ± 48.4 g vs 3168 ± 11.3 g; p < 0.0001). Apgar scores below seven on the first and fifth minutes were more likely in the vaginal delivery group (1st minute: 18.5% vs 5.9%; p = 0.0006; OR 3.6 [1.9 - 7.0]; 5th minute: 3.1% vs 0.2%; p = 0.0133; OR 20.0 [2.8 - 144.4]), as was fetal trauma (3.1% vs 0.3%: p = 0.031; OR 9.9 [1.8-55.6]). Neither group had cases of fetal acidemia. Admission to the Neonatal Intensive Care Unit, maternal postpartum hemorrhage and the incidence of other obstetric complications were similar between groups.Discussion: Although vaginal breech delivery was associated with lower Apgar scores and higher incidence of fetal trauma, overall rates of such events were low. Admission to the neonatal intensive care unit and maternal outcomes were similar.Conclusion: Both delivery routes seem equally valid, neither posing high maternal or neonatal complications’ incidence.
Hipertensão Arterial Sistémica Secundária: Incertezas do Diagnóstico
Authors: Dinis Paulo Gomes , Cachulo Maria Carmo , Fernandes Andreia , Paiva Luis , Gonçalves Lino 
Published: July 2017

A hipertensão arterial sistémica configura-se hoje como um problema de saúde pública mundial, sendo a taxa de prevalência em Portugal de 26,9%. De acordo com a sua etiologia classifica-se em hipertensão arterial sistémica primária ou secundária. Em cerca de 90% dos casos, não é possível estabelecer uma causa e por isso a hipertensão arterial sistémica denomina-se primária. Nos restantes 5% a 10%, pode ser identificada uma causa secundária, potencialmente tratável. Para que o estudo da hipertensão arterial sistémica secundária seja custo-eficaz, torna-se essencial perceber quais os doentes a investigar, com que meios, e qual a melhor estratégia a adotar. As principais causas apontadas como responsáveis pela hipertensão arterial sistémica secundária são: patologia renal; endócrina; vascular e síndrome da apneia obstrutiva do sono. Entre estas, algumas são consensuais e outras mais controversas na literatura. A este propósito apresentamos dois casos de hipertensão arterial sistémica, cuja etiologia potencialmente secundária ainda é foco de debate.
Functional, Sensorial, Mobility and Communication Difficulties in the Portuguese Oldest Old (80+)
Authors: Brandão Daniela , Ribeiro Óscar , Paúl Constança 
Published: July 2017

Introduction: The ageing of populations is evident in most developed countries, and the oldest old group is one of the segments with the fastest growing. The aim of this paper is to examine sociodemographic and health related characteristics of the portuguese oldest old, using a census-based approach.Material and Methods: A descriptive study considering all residents aged 80 years and older at the time of the 2011 Census (n = 532 219) was conducted. Information on sociodemographic characteristics, sensory functions (seeing, hearing), functional status (walking/climbing stairs, bathing/dressing alone), cognition (memory/concentration), and communication (understanding others/being understood) as assessed by the Portuguese census official questionnaires were analyzed.Results: Findings revealed that most of the oldest old are women (64.5%), widowed (53.9%), illiterate (46.1%) and live in private households (88.8%). Walking/climbing stairs (57.1%), vision (39.1%) and hearing (35.1%) were the dimensions where the oldest old presented major constrains. In parallel, understanding others/being understood (25.9%) and memory/concentration (34.4%) were the dimensions with lower percentages of difficulties. Significant differences were found between octogenarians/nonagenarians and centenarians for vision, walk/climb stairs, and bathing/dressing alone, with centenarians presenting a higher percentage of difficulties.Discussion: Portuguese oldest old showed significant difficulties in activities of daily living, nevertheless cognitive and communication capacities seem to be commonly maintained. Taken together, these findings suggest the need for functional assistance, which can be ultimately managed by the older person him/herself.Conclusion: Based on the observed differences between centenarians and younger oldest old, specific interventions should be equated to better respond to their potentially distinctive needs.
Inducing Critical Discourse Analysis in Speaking Syllabus for EFL Students of Indonesian Islamic Universities
Authors: Fauzan Umar 
Published: July 2017

Speaking courses are predominant to equip students oral proficiency and the stages of the improvement are required to include in the speaking syllabus. This study was conducted to see the weaknesses of speaking course and renewal of speaking syllabus as the revision. This study used content analysis and thematic analysis as the research design. The study involved speaking lecturers, students of speaking course, and head of English language education in IAIN Samarinda as research subjects. Data on syllabus documents were obtained from the document analysis and data on the subjects’ perceptions were collected using interviews and questionnaire. The study revealed that speaking courses were revised their names as: speaking for daily conversation, speaking for formal settings, speaking for academic settings, speaking for academic purposes, and public speaking. Three primary characteristics of the renewal speaking sources were termed: learning outcomes, needs analysis based course contents, and CDA inductions.
NONTHERMAL EFFECTS OF MOBILE PHONE RADIATIONS ON HUMAN HEART RATE, BLOOD PRESSURE, AND SUGAR LEVEL
Authors: D Basandrai , K Dhami A , K Bedi A 
Published: July 2017

Objective: A single-blinded pilot study has been conducted to investigate the effect of cell phone radiation on the human heart. Methods: Experimental work has been conducted in Jalandhar-based hospital under the supervision of a cardiologist. During experimental work, electrocardiogram (ECG), blood pressure (BP) level, and sugar level have been examined before and after cell phone radiation exposure. For ECG analysis, the parameters such as heart rate, rhythm, mechanism, axis, P wave, PR interval, QRS complex, ST segment, T wave, and QT interval have been examined in the study.Results: No significant variations in the results of above-mentioned parameter has been observed before and after acute exposure of cell phones radiations by placing cell phone closer to heart.Conclusion: The result of this study concludes that mobile phone radiations do not interfere with any electrical activity of the human heart, BP, and sugar level in healthy individuals.
FORMULATION AND IN-VITRO-IN-VIVO EVALUATION OF ALGINATE-CHITOSAN MICROSPHERES OF GLIPIZIDE BY IONIC GELATION METHOD
Authors: Sharma Maya , Pk Choudhury , Dev Suresh Kumar 
Published: July 2017

Objective: The present work is aimed to formulate and evaluate alginate-chitosan microspheres of glipizide for the effective use in the treatment of diabetes.Methods: Sustained release microspheres were prepared by gentle mixing of polymers in water phase with drug by agitation. The polymers used for preparation were sodium alginate and chitosan, which was extruded into 5% calcium chloride solution to produce microspheres by ionic gelation method.Results: Single unit dosage form of Glipizide causes gastric irritation. To convert it in to the multiple unit dosage form will release the drug evenly throughout the stomach which suppresses the irritation. The aim of study towards formulation and evaluation of alginate-chitosan microspheres, which can provide sustained release of the model drug. It shows better in-vitro and in-vivo activity than conventional dosage forms. The work also aims to study various parameters affecting the behavior of microspheres in oral dosage form. Conclusion: Drugs that are simply absorbed from the gastrointestinal tract (GIT) and having a short half life are eliminated rapidly from the blood flow. To avoid this trouble, the oral sustained release (SR) has been developed as these will release the drug slowly in to the GIT and maintain a stable drug concentration in the serum for a longer period of time.
A CLINICAL STUDY OF PATIENTS WITH IDIOPATHIC THROMBOCYTOPENIC PURPURA
Authors: Rao Karthik , Rao Gurukanth , Patil Navin , Ommurugan Balaji , Rao N R , Rao Jayaprakash , Nayak Satish 
Published: July 2017

OBJECTIVE To study the incidence, age and sex distribution among adults, various modes of presentation, correlation between thrombocytopenia and bleeding manifestations and various modalities of treatment of Idiopathic Thrombocytopenic Purpura in a tertiary care hospital in India.MATERIALS AND METHODSProspective study consisting of 4o cases of ITP admitted to Kasturba Medical College Hospital, Manipal from November 2005 to March 2007. Patients above 14 years of age admitted with thrombocytopenia in this institution were screened based on detailed clinical history, physical examination and laboratory investigations.RESULTSThe maximum incidence was in the 3 rd decade of life accounting for 27.5% of the patients. Ratio of male to female was 1:1.9 with female preponderance. Females in 3 rd decade had maximum incidence while males in 4th decade have maximum incidence. Majority 12 (85.71%) of male patients and 15(57.69%) of female patients developed purpura during the course of disease. The mean count was 17.8X109/L with range between 2.0 X109/L to 76 X109/L. Cutaneous bleeding spots were found to be assosiated with counts above 25000X109/L and hematuria with lowest counts around 4000 X109/L. 20 (50%) of the above 40 patients responded to corticposteroids alone and did not have any further relapse. Among the remaining patients 3 (7.5%) had a relapse of symptoms within next 6 months and responded to repeat prednisolone started at 1mg/kg. 2 (5%) patients were given steroids tapering dose with IV Immune globulins for initial 5 days as therapy to which they responded.CONCLUSIONIdiopathic thrombocytopenia is 1.9 times more common in females than males. Most common presentation is bleeding spots over body. Bleeding manifestations are more common with thrombocytopenia less than 30000/mm3. Corticosteroids are the mainstay in treatment. Complete remission is seen in up to 57.5% of the patients. Splenectomy is the second modality of treatment in ITP. Complete and sustained remission is seen 75% of patients.
Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes Predicts Poor Long-term Glycemic Control
Authors: Duca Lindsey M. , Wang Bing , Rewers Marian , Rewers Arleta 
Published: July 2017

OBJECTIVE
This study tested the hypothesis that diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in children predicts poor long-term glycemic control independently of established risk factors.

RESEARCH DESIGN AND METHODS
This was a prospective cohort study of 3,364 Colorado residents diagnosed with type 1 diabetes before 18 years of age, in 1998–2012, and monitored for up to 15 years. Of those, 1,297 (39%) had DKA at diagnosis (blood glucose &gt;250 mg/dL, and venous pH &lt;7.3 or bicarbonate &lt;15 mEq/L). Severity of DKA was further classified as mild/moderate (pH 7.10–7.29 or bicarbonate 5–14 mEq/L) or severe (pH &lt;7.10 or bicarbonate &lt;5 mEq/L). HbA1c levels were measured an average of 2.8 times/year (median 20 HbA1c values/patient). A linear mixed model was used to examine the effect of DKA on long-term HbA1c levels, adjusting for age, race/ethnicity, sex, family history of diabetes, health insurance, and insulin pump use.

RESULTS
DKA at diagnosis predicted persistently elevated HbA1c levels. Compared with children without DKA, HbA1c tracked 1.4% (15.3 mmol/mol) higher in those with severe DKA (P &lt; 0.0001) and 0.9% (9.8 mmol/mol) higher in those with mild/moderate DKA at diagnosis (P &lt; 0.0001). These effects were independent of ethnic minority status or lack of health insurance at diagnosis that predicted higher HbA1c by 0.5% (5.5 mmol/mol; P &lt; 0.0001) and 0.2% (2.2 mmol/mol; P &lt; 0.0001), respectively. Insulin pump use or having a parent or sibling with type 1 diabetes predicted lower long-term HbA1c by, respectively, 0.4% (4.4 mmol/mol; P &lt; 0.0001) and 0.2% (2.2 mmol/mol; P = 0.01).

CONCLUSIONS
DKA at diagnosis of type 1 diabetes in children predicts poor long-term glycemic control, independent of demographic and socioeconomic factors.
Luis Villoro y la transformación política a nivel ontológico
Authors: Ferreira González Jesús Emmanuel 
Published: July 2017

<p>Recibido: 21/09/2016 • Aceptado: 02/02/2017</p><p> </p><p>En este ensayo nos preguntamos si hay algún vínculo entre la moralidad social (que guarda relaciones con el poder político) y el ser-del-devenir. Exponemos las implicaciones ontológicas del planteamiento ético político de Luis Villoro y reflexionamos: ¿puede haber una política justa orientándonos en la potencia del Ser y no en el poder humano? Para proponer la tesis: la mejor vía para la transformación política es la vía ética, siempre y cuando ésta realice cambios en la política a nivel ontológico.</p><p> </p>
La propuesta arqueológica de Enrique Dussel en el contexto discursivo de la filosofía de la religión latinoamericana
Authors: Zielinski Juan Matías 
Published: July 2017

<p>Recibido: 13/05/2016 • Aceptado: 02/02/2017</p><p> </p><p>Se presenta un estudio filosófico dedicado al análisis del contexto discursivo en el que se inscribió e inscribe la propuesta arqueológica de Enrique Dussel: la filosofía de la religión expuesta en su obra filosófica temprana. Esta formulación se enmarca en el desarrollo histórico y conceptual de la disciplina en nuestro continente y, de modo más directo, en marco categorial de la filosofía de la religión como se presenta en la filosofía de la liberación. Con este objetivo principal, el trabajo se estructura del siguiente modo: en el primer apartado se presenta un análisis secuenciado históricamente de los principales «nudos filosóficos» de esta doctrina, puestos de relieve en el devenir histórico de la disciplina en nuestra región y, posteriormente, se realiza un bosquejo general de las líneas de investigación predominantes en la actualidad. En el segundo apartado, se analizan las notas esenciales de la formulación arqueológica de Enrique Dussel, tomando como referencia principal los análisis que otros destacados investigadores han realizado sobre su propuesta. En el tercer apartado, se muestra la pertenencia discursiva de la arqueológica dusseliana en el marco categorial de la filosofía de la religión de la liberación, demostrando que dicha formulación debe ser comprendida en un contexto discursivo específico. Finalmente, se presentan algunas reflexiones conclusivas.</p>
Truth, Inquiry and the Settlement of Belief: Pragmatist Accounts
Authors: Reyes Cárdenas Paniel O. 
Published: July 2017

<p>Recibido: 21/12/2016 • Aceptado: 02/02/2017</p><p> </p><p>Resumen</p><p>El pragmatismo es una doctrina que reúne a varios autores que sostienen posiciones distintas e, incluso, aparentemente irreconciliables. Los filósofos pragmatistas frecuentemente ofrecen perspectivas que, claramente, podrían aparecer como slogan opuesto al que defienden otros de sus pares que también se llaman a sí mismos pragmatistas. Pragmatistas como Richard Rorty, por ejemplo, creen que el falibilismo nos prohibe aceptar que la verdad pueda ser la meta de la investigación. Rorty se queja de la «metodolatría» de Peirce y propone avanzar una teoría libre de compromisos metafísicos como los de las teorías sobre la verdad. Contra esta opinión, otros pragmatistas seguidores de Peirce, tales como Cheryl Misak y Christopher Hookway, ofrecen una lectura del sentido en que la verdad puede ser la meta de la investigación y en cómo la creencia es racionalmente establecida. En este ensayo, ofrezco una lectura de los esfuerzos de Misak con el propósito adicional de dialogar con sus ideas con miras a establecer la necesidad de una perspectiva más sustantiva realista que es necesaria para conquistar lo que Peirce llamó «el método de la ciencia» para el establecimiento de las creencias.</p>
La experiencia de la náusea y de la obra de arte como evasión: Lévinas y Sartre
Authors: Macías Flores Alejandro 
Published: July 2017

<p>Recibido: 14/01/2016 • Aceptado: 02/02/2017</p><p> </p><p>Los análisis fenomenológicos de la experienciade la «náusea» que realizan Lévinas y Sartre nos llevan a la comprensión del fenómeno de la evasión como elemento constitutivo de dicha experiencia. Asimismo, la evasión también es constituyente de la función de la obra de arte para ambos fenomenólogos entre 1935 y 1945. Trataremos de mostrar cómo estos tres fenómenos (la náusea, la evasión y la obra de arte) están íntimamente relacionadas, según los análisis de ambos filósofos. En primer lugar, se presenta el planteamiento de Sartre, alrededor de su tratamiento filosófico y literario de la náusea. A continuación, se reelabora puntualmente el planteamiento de Lévinas, contemporáneo mas no imitativo del de Sartre y, en algunos casos, aún contrario. Sartre promovió, por aquel periodo, la superación del arte respecto de la filosofía, ofrecido como posibilidad de salvación desde su defensa del arte social e históricamente comprometido. Lévinas, por su parte, conduce a la náusea desde la vergüenza; o bien, la desnudez provoca vergüenza a la intimidad, o bien se vuelve indiferente y, entonces, es la intimidad la que es motivo de vergüenza. Para los dos autores, sin embargo, la vivencia de la náusea, sea que nos ponga en relación con nuestra contingencia o con la existencia como necesidad de la que evadirnos, sea que nos coloque «por encima» o «por debajo» del pensamiento, es la misma desnudez de ser lo que nos muestra: nuestra contingencia.</p>
Comparative Analysis of Physico-Chemical Parameters of Borehole, Pond and Well Water in Kashere Metropolis
Authors: Gidado Abdulkadir A. , Halliru Ibrahim , Kendeson Christiana Anawuese , Abdullahi Yusuf 
Published: July 2017

In a bid to ascertain the quality of water for human consumption in Kashere Metropolis, essential physico-chemical parameters were evaluated on samples of drinking water obtained from boreholes, pond and wells located at densely populated areas, labelled as: Kashere cattle market Pond, KP; Kashere cottage Hospital Borehole, HB; Kashere Market Borehole, MB; Federal University, Kashere (FUK) campus Borehole, CB; Kashere cottage Hospital Well, HW; Kashere Market Well, MW and FUK campus Well, CW. Standard procedure for the determination of chemical and physical characteristics of the water samples were used. The results of the investigated parameters in the samples were as follows: ρH 6.61‒7.96, Turbidity 0.0‒2568 FTU, Electrical Conductivity 60.5‒1151 Mhocm-1, Total Dissolved Solids (TDS) 25.9‒518.0 mgL-1, Ca 0.0033‒0.5446 ppm, Mg 0.0793‒1.2215 ppm, Cd 0.0010‒0.0030 ppm, Zn 0.0024‒0.l054 ppm, Pb 0.0002‒0.0026 ppm and Fe 0.0044‒0.5649 ppm. Except for the concentration of Fe (in CB; 0.5649 ppm), all the analyzed minor and major cations in the water samples were in very low concentration and below the permissible limits of WHO standard guidelines values for drinking water. It is recommended that, water from the pond should be properly treated before consumption due to its high turbidity. Also periodic assessment of the quality of drinking water from these water sources should be conducted, to ascertain that they are not contaminated by either or both organic and inorganic pollutants.
Study of Superficial Layers Obtained by Selective Transfer in the Friction Couples
Authors: Ilie Filip 
Published: July 2017

In the friction process of two materials and in the presence of some proper lubricants, the wear process manifest itself as a material transfer from an element of the friction couple on the other, process specific to the selective transfer mechanism. The selective transfer can be sure achieved in a friction couple if there is a favorable energy, the relative movement and if in the friction area is a material made by copper and the lubricant is adequate (glycerin).The selective transfer mechanism is characterized by the physicochemical processes, which take place in the contact zones of the friction couples, and which to allow the selective transfer of some elements of the materials from a surface to the other, forming a thin superficial layer with the superior properties at wear and friction. This is a condition for any friction couple of high efficiently and a normal self-adjusting phenomena. The forming of this layer on the contact surfaces makes as fiction force to be reduced. It is in closely related to the structure formed by the selective transfer, between the metallic friction surfaces and with the properties these surface layers metallic. The most important parameters concerning the physical state of the superficial layers are micro-tensions, the structure and its modification on friction surfaces, the structure defects as well as the way of distribution of the additions and of the alloying elements from alloy. The purpose of the present paper is research these parameters by the structural analysis with X-rays, as the research method of the thin superficial layers.