bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-operative treatment of splenic injury in patients with blunt abdominal trauma
Authors: Wani Munir Ahmad , Shah Mudassar , Malik Ajaz Ahmad 
Published: December 2016

Background: Few decades back splenectomy was the sole treatment for splenic injury. But with the recognition of OPSI and mortality related to it, attempts have been made to preserve the spleen whenever possible. Patients with blunt abdominal trauma and splenic injury can be treated non-operatively in selected cases.Methods: One hundred (100) patients of blunt abdominal trauma with splenic injuries were treated non-operatively between 2013 and 2015. Patients were between 18 and 60 years of age and 95 were males. Patients having signs of peritonism or free intraperitoneal fluid on FAST were subjected to contrast CT abdomen. Patients having life threatening extra-abdominal injuries were excluded from the study. Similarly, patients having Grade V splenic injury, pneumoperitoneum or contrast extravasation were operated and hence excluded from study. The patients were monitored, transfused blood when necessary and discharged when stable enough.Results: We had 20 Grade I, 26 Grade II, 44 Grade III and 10 Grade IV splenic injuries. Associated thoracic injuries were seen in 20 patients, orthopaedic injuries in 13 patients, head/maxillofacial injuries in 4 patients and other abdominal injuries in 22 patients. The hospital stay was between 5 and 20 days. 23 patients needed blood transfusion. There was no operative intervention and no mortality in 100 patients.Conclusions: Patients with splenic injury who are haemodynamically stable can be effectively managed non-operatively under meticulous monitoring and ever readiness for operative intervention if need arises. Saving spleen saves the patient from laparotomy and some life threatening infections.
Palliative surgery in management of advanced carcinoma stomach and its outcome
Authors: Pattanayak Sibaprashad , Saha Debabrata , Bara Bipin Kishore , Nayak Sanjit Kumar 
Published: December 2016

Background:Gastric cancer is the second leading cause of death from malignant disease World-wide and most frequently discovered in advanced stages. The incidence of gastric cancer in India is low compared to developed countries. But in India southern and northeast area more number of cases was diagnosed. More cases of cancer stomach are diagnosed in the early stages in Japan due to effective screening programme. Lack of such screening programme, ignorance about the disease and lack of awareness of warning signs of cancer lead to the detection of many cases in the advanced stage of gastric cancer. Where palliation is the mainstay of treatment. We discussed the different methods of palliative surgery and its outcome in this paper. Methods: This is a prospective study over 5 years February 2011 - 2016 January including 6 months follow up. 104 advanced carcinoma stomach patients were included in this study. To evaluate role of palliative surgery in advanced gastric cancer we analyse the data in the basis of presentation of disease, sex distribution, type of palliative surgery, relive of symptoms, preventions of complications, post-operative mortality morbidity, and overall survival.Results:In our study mean age of presentation is 58 years. Most common affected are male. Stage III disease are more common. Immediate post-operative mortality is 4 patients 7.14% comparable to the non-resection group 1 patients (2.63%). Symptoms relived 46 patients in resection group (82.14%), in non-resection group it is 16 (42.1%). Overall survival is (6 moths - 1 years) 19 (33.9%) patients, and in non-resection group it is only 2 (5.26%) patients. Median survival rate is 10 months.Conclusions:Palliative resection should be carried out for betterment of quality of life where it is possible. Relief from symptoms and complications can be achieved by resection of tumour mass in advanced carcinoma stomach.
Pride and the city
Authors: Morrison Philip S 
Published: December 2016

Pride in one’s city is an individual, and collective as well as institutional response to urban conditions which may be harnessed in support of expanding urban facilities and services. Pride is likely to be felt most keenly by those who have a stake in the city and for this reason anecdotal reporting of urban pride in the media is subject to likely bias in favour of vested interests. In practice however we know very little about urban pride. The vast literature on urbanism does not appear to have identified any role for urban pride let alone indicating which cities gather pride or who among its inhabitants exhibit such prideThis paper applies a multi-level statistical model to large random sample of residents in twelve New Zealand cities. From the results we learn that, although financial stake holding is relevant, urban pride is concentrated more broadly among those whose social and cultural identity is closely tied to the city. Where financial stake holding is most influential is when it is absent, for those experiencing financial difficulties are the most likely to disavow urban pride. Urban pride is a therefore a distributional property of cities in which the currencies are emotional and cultural as well as financial. Urban pride is relatively absent among those who fail to have a stake in the city as well as being weaker among those who live in relatively unattractive cities, and less attractive neighbourhoods. As a barometer of rewards to living and investing in the city, urban pride certainly warrants closer attention than it has received to date.
Pilot Study on the Genetic Background of an Active Matrix Metalloproteinase‐8 Test in Finnish Adolescents
Authors: Heikkinen Anna Maria , Raivisto Teija , Kettunen Kaisa , Kovanen Leena , Haukka Jari , Pakbaznejad Esmaeili Elmira , Elg Jessica , Gieselmann Dirk‐Rolf , Rathnayake Nilminie , Ruokonen Hellevi , Tervahartiala Taina , Sorsa Timo 
Published: December 2016

Background: In periodontitis, genetics and smoking play important roles in host immune system response. The aim of this study is to determine whether the genetic background of initial periodontitis and caries could be detected using an active matrix metalloproteinase (aMMP)‐8 chairside test in Finnish adolescents.Methods: Forty‐seven participants gave approval for analysis of both oral fluid collection and DNA. An aMMP‐8 chairside test was performed on participants (adolescents aged 15 to 17 years), and full‐mouth clinical parameters of oral health were assessed including periodontal, oral mucosal, and caries status in Eastern Finland from 2014 to 2015. DNA was extracted from oral fluid samples and genotyped for 71 polymorphisms in 29 candidate genes for periodontitis. Results were analyzed using a logistic regression model. P values were corrected for multiple testing using false discovery rate (<0.05).Results: aMMP‐8 chairside test positivity and three or more ≥4 mm pockets were associated with vitamin D receptor (VDR) (rs2228570, P = 0.002, q = 0.04) and MMP3 (rs520540, rs639752, rs679620, P = 0.0009, 0.003, 0.003, q = 0.04, respectively). None of the other single‐nucleotide polymorphisms studied showed a significant association with the aMMP‐8 chairside test and at least one caries lesion positivity.Conclusion: Genetic polymorphisms of MMP3 and VDR are linked to initial periodontitis in Finnish adolescents, and the aMMP‐8 chairside test can eventually detect initial periodontitis in young patients with predisposing genetic background.
The financial challenges of clinical legal education: an example from a Zagreb law clinic
Authors: Preložnjak Barbara , Brozović Juraj 
Published: December 2016

<p class="Body">Authors lay out the debate over the composition and direction of legal education in an era of law school’s curriculum reform and limited financial resources. Croatian Legal Aid Act created an opportunity for law students to become more actively involved in delivering primarily legal aid to local community. If law schools are not sufficiently financially resourced, they can hardly equip students with the needed skills to practice law and provide legal aid. Finally, the authors argue who should play a guiding role in financing a clinical legal education in law schools that are focused on educating students as social justice lawyers.</p><p class="p0">Keywords: clinical legal education, legal aid, financial sustainability </p>
Eliminating Tuberculosis One Neighborhood at a Time
Authors: Cegielski J. Peter , Griffith David E. , McGaha Paul K. , Wolfgang Melanie , Robinson Celia B. , Clark Patricia A. , Hassell Willis L. , Robison Valerie A. , Walker Kerfoot P. , Wallace Charles 
Published: December 2016

Objectives. We evaluated a strategy for preventing tuberculosis (TB) in communities most affected by it. Methods. In 1996, we mapped reported TB cases (1985–1995) and positive tuberculin skin test (TST) reactors (1993–1995) in Smith County, Texas. We delineated the 2 largest, densest clusters, identifying 2 highest-incidence neighborhoods (180 square blocks, 3153 residents). After extensive community preparation, trained health care workers went door-to-door offering TST to all residents unless contraindicated. TST-positive individuals were escorted to a mobile clinic for radiography, clinical evaluation, and isoniazid preventive treatment (IPT) as indicated. To assess long-term impact, we mapped all TB cases in Smith County during the equivalent time period after the project. Results. Of 2258 eligible individuals, 1291 (57.1%) were tested, 229 (17.7%) were TST positive, and 147 were treated. From 1996 to 2006, there were no TB cases in either project neighborhood, in contrast with the preintervention decade and the continued occurrence of TB in the rest of Smith County. Conclusions. Targeting high-incidence neighborhoods for active, community-based screening and IPT may hasten TB elimination in the United States.
Las generaciones de inmigrantes y sus descendientes y el riesgo de diabetes en la población de los Estados Unidos de origen o ascendencia mexicana: el Estudio sobre Envejecimiento en Latinos del Área de Sacramento (estudio SALSA)
Authors: Afable-Munsuz Aimee , Mayeda Elizabeth Rose , Pérez-Stable Eliseo J. , Haan Mary N. 
Published: December 2016

Objetivo. Se investigó si la aculturación de los inmigrantes y sus descendientes y la generación a la que pertenecen, un marcador de la asimilación, se relacionan con el riesgo de diabetes en una población de adultos mayores de ascendencia u origen mexicano.Métodos. Se analizaron los datos sobre 1 789 adultos de 60 a 101 años de edad del Estudio sobre Envejecimiento en Latinos del Área de Sacramento (estudio SALSA). Se determinó la presencia de diabetes tipo 2 con base en el uso de medicamentos antidiabéticos, la mención por el paciente del diagnóstico de un médico, o una glucosa en ayunas de 126 mg/dL o mayor. Se aplicó un modelo de regresión logística para la prevalencia de diabetes.Resultados. Tras ajustar por edad y sexo, se observaron asociaciones significativas pero divergentes entre las generaciones de inmigrantes y sus descendientes, la aculturación y el riesgo de diabetes. En relación con los adultos de la primera generación, los de la segunda tuvieron una razón de posibilidades (odds ratio, OR) de padecer diabetes de 1,8 (intervalo de confianza [IC] de 95% = 1,4, 2,4) y los adultos de la tercera generación tuvieron una OR de 2,1 (IC de 95% = 1,4, 3,1). Sin embargo, una mayor aculturación a los Estados Unidos se relacionó con una tasa ligeramente menor de diabetes. En el modelo completo, tras la incorporación de ajustes para tener en cuenta los factores socioeconómicos y del modo de vida, la relación entre la generación y la diabetes seguía siendo significativa, no así la relación de esta última con la aculturación.Conclusiones. El presente estudio respalda la idea, anteriormente cuestionada, de que la asimilación se relaciona con un mayor riesgo de diabetes entre los inmigrantes de origen mexicano. Los investigadores deben analizar más detalladamente la presencia de una relación causal entre la asimilación y la salud.
Increasing Children’s Physical Activity During School Recess Periods
Authors: Chin John J. , Ludwig David 
Published: December 2016

Objectives. We examined whether schools’ participation in the Recess Enhancement Program (REP) in the spring of 2011 was associated with higher rates of children’s vigorous physical activity. Methods. In REP, a coach guides children through age-appropriate games aimed at increasing their physical activity. During recess at 25 New York City public elementary schools (15 REP, 10 non-REP), researchers visually scanned predetermined areas (n = 1339 scans), recording the number of sedentary, walking, and very active children. Results. Multivariate statistical analysis found that participation in REP was a significant predictor (P = .027) of the rate of vigorous physical activity (percentage very active in scan area) whose least-squares means were 41% in REP schools and 27% in non-REP schools. A significantly higher rate in REP schools persisted when the coach was not in the scan area, suggesting a change in the recess culture of REP schools. Conclusions. The rate of vigorous physical activity in REP schools was 14 percentage points, or 52%, higher than the rate in non-REP schools. This low-cost intervention might be a valuable addition to the tools for combating childhood obesity and worth replicating elsewhere.
Cómo aumentar la actividad física de los niños durante el período del recreo en las escuelas
Authors: Chin John J. , Ludwig David 
Published: December 2016

Objetivos. Analizamos si la participación de las escuelas en el Programa de Mejoramiento del Recreo (PMR) en la primavera del año 2011 estuvo asociada a tasas más altas de actividad física intensa en los niños. Métodos. En el PMR, un coordinador dirige a los niños para que practiquen juegos adecuados para la edad a fin de aumentar su nivel de actividad física. Durante el recreo en 25 escuelas primarias públicas de la ciudad de Nueva York (15 participantes en el PMR, 10 no participantes en el PMR) los investigadores observaron algunas áreas predeterminadas (n = 1 339 observaciones) y registraron el número de niños que estaban sedentarios, caminando o muy activos. Resultados. Tras el análisis estadístico con múltiples variables se encontró que la participación en el PMR era una variable predictiva significativa (P = 0,027) de la tasa de actividad física intensa (porcentaje de niños muy activos en las áreas de observación) cuyas medias de los mínimos cuadrados fueron de 41% en las escuelas participantes en el PMR y de 27% en escuelas no participantes en el PMR. En las escuelas participantes en el PMR se siguió registrando una tasa significativamente superior incluso cuando el coordinador de juegos no estaba en el área de observación, lo que sugiere un cambio en la cultura del recreo en las escuelas que participan en este programa. Conclusiones. La tasa de actividad física intensa en las escuelas participantes en el PMR fue 14 puntos porcentuales (o 52%) superior a la tasa registrada en las escuelas no participantes en el PMR. Esta intervención de bajo costo podría ser un agregado valioso a las herramientas para combatir la obesidad infantil y podría valer la pena reproducirla en otros sitios.
Comprehensive HIV Prevention for Transgender Persons
Authors: Neumann Mary Spink , Finlayson Teresa J. , Pitts Nicole L. , Keatley JoAnne 
Published: December 2016

Transgender persons are at high risk for HIV infection, but prevention efforts specifically targeting these people have been minimal. Part of the challenge of HIV prevention for transgender populations is that numerous individual, interpersonal, social, and structural factors contribute to their risk. By combining HIV prevention services with complementary medical, legal, and psychosocial services, transgender persons’ HIV risk behaviors, risk determinants, and overall health can be affected simultaneously. For maximum health impact, comprehensive HIV prevention for transgender persons warrants efforts targeted to various impact levels—socioeconomic factors, decision-making contexts, long-lasting protections, clinical interventions, and counseling and education. We present current HIV prevention efforts that reach transgender persons and present others for future consideration.
Impact of a Text-Messaging Program on Adolescent Reproductive Health: A Cluster–Randomized Trial in Ghana
Authors: Rokicki Slawa , Cohen Jessica , Salomon Joshua A. , Fink Günther 
Published: December 2016

Objectives. To evaluate whether text-messaging programs can improve reproductive health among adolescent girls in low- and middle-income countries. Methods. We conducted a cluster–randomized controlled trial among 756 female students aged 14 to 24 years in Accra, Ghana, in 2014. We randomized 38 schools to unidirectional intervention (n = 12), interactive intervention (n = 12), and control (n = 14). The unidirectional intervention sent participants text messages with reproductive health information. The interactive intervention engaged adolescents in text-messaging reproductive health quizzes. The primary study outcome was reproductive health knowledge at 3 and 15 months. Additional outcomes included self-reported pregnancy and sexual behavior. Analysis was by intent-to-treat. Results. From baseline to 3 months, the unidirectional intervention increased knowledge by 11 percentage points (95% confidence interval [CI] = 7, 15) and the interactive intervention by 24 percentage points (95% CI = 19, 28), from a control baseline of 26%. Although we found no changes in reproductive health outcomes overall, both unidirectional (odds ratio [OR] = 0.14; 95% CI = 0.03, 0.71) and interactive interventions (OR = 0.15; 95% CI = 0.03, 0.86) lowered odds of self-reported pregnancy for sexually active participants. Conclusions. Text-messaging programs can lead to large improvements in reproductive health knowledge and have the potential to lower pregnancy risk for sexually active adolescent girls.
Incidence of Mental Health Diagnoses in Veterans of Operations Iraqi Freedom, Enduring Freedom, and New Dawn, 2001–2014
Authors: Ramsey Christine , Dziura James , Justice Amy C. , Altalib Hamada Hamid , Bathulapalli Harini , Burg Matthew , Decker Suzanne , Driscoll Mary , Goulet Joseph , Haskell Sally , Kulas Joseph , Wang Karen H. , Mattocks Kristen , Brandt Cynthia 
Published: December 2016

Objectives. To evaluate gender, age, and race/ethnicity as predictors of incident mental health diagnoses among Operations Iraqi Freedom, Enduring Freedom, and New Dawn veterans. Methods. We used US Veterans Health Administration (VHA) electronic health records from 2001 to 2014 to examine incidence rates and sociodemographic risk factors for mental health diagnoses among 888 142 veterans. Results. Posttraumatic stress disorder (PTSD) was the most frequently diagnosed mental health condition across gender and age groups. Incidence rates for all mental health diagnoses were highest at ages 18 to 29 years and declined thereafter, with the exceptions of major depressive disorder (MDD) in both genders, and PTSD among women. Risk of incident bipolar disorder and MDD diagnoses were greater among women; risk of incident schizophrenia, and alcohol- and drug-use disorders diagnoses were greater in men. Compared with Whites, risk incident PTSD, MDD, and alcohol-use disorder diagnoses were lower at ages 18 to 29 years and higher at ages 45 to 64 years for both Hispanics and African Americans. Conclusions. Differentiating high-risk demographic and gender groups can lead to improved diagnosis and treatment of mental health diagnoses among veterans and other high-risk groups.
OS SISTEMAS DE PROTEÇÃO AOS DIREITOS HUMANOS E O BRASIL: DA PARTICIPAÇÃO NO SISTEMA GLOBAL AO (DES) CUMPRIMENTO NA ESFERA REGIONAL
Authors: Noschang Patricia Grazziotin 
Published: December 2016

<p>A proteção aos direitos humanos ocorre em duas esferas: universal e regional. No plano universal/global a Organização das Nações Unidas através do Conselho de Direitos Humanos exerce o papel de fiscalização do cumprimento da Declaração Universal de Direitos Humanos e do Pacto de Direitos Civis e Políticos e do Pacto de Direitos Econômicos, Sociais e Culturais através do Revisão Periódica Universal. Na esfera regional a competência cabe à Organização dos Estados Americanos através da Comissão Interamericana de Direitos Humanos e da Corte Interamericana de Direitos Humanos, que recebe denuncias do descumprimento da Convenção Americana de Direitos Humanos e demais tratados firmados nesse plano. O Brasil reconhece e integra os dois sistemas, global e regional. O objetivo desse trabalho é apresentar o dinâmica funcional desses dois sistemas do universal ao regional bem como a participação do Brasil nessas duas esferas observando se o Estado brasileiro está cumprindo com as determinações oriundas dos dois sistemas, pois o problema está no descumprimento das normas internacionais em que o Estado se propôs a respeitar quando firmou tratados sobre a matéria. O método de abordagem utilizado é o indutivo e o de procedimento o bibliográfico e documental.</p>
Elimination of nitrate in secondary effluent of wastewater treatment plants by Fe0 and Pd-Cu/diatomite
Authors: Yun Yupan , Li Zifu , Chen Yi-Hung , Saino Mayiani , Cheng Shikun , Zheng Lei 
Published: December 2016

Abstract
Because total nitrogen (TN), in which nitrate (NO3–) is dominant in the effluent of most wastewater treatment plants, cannot meet the requirement of Chinese wastewater discharge standard (&lt;15 mg/L), NO3– elimination has attracted considerable attention. In this research, the novel diatomite-supported palladium-copper catalyst (Pd-Cu/diatomite) with zero-valent iron (Fe0) was tried to use for catalytic reduction of nitrate in wastewater. Firstly, specific operational conditions (such as mass ratio of Pd:Cu, catalyst amounts, reaction time and pH of solution) were optimized for nitrate reduction in artificial solution. Secondly, the selected optimal conditions were further employed for nitrate elimination of real effluent of a wastewater treatment plant in Beijing, China. Results showed that 67% of nitrate removal and 62% of N2 selectivity could be obtained under the following conditions: 5 g/L Fe0, 3:1 mass ratio (Pd:Cu), 4 g/L catalyst, 2 h reaction time and pH 4.3. Finally, the mechanism of catalytic nitrate reduction was also proposed.