bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of mental disability using Indian Disability Evaluation Assessment Scale among general population in an urban area of Puducherry, India
Authors: Kumar SG , Premarajan KC , Kattimani S , Kar SS 
Published: January 2018

Background:
There is paucity of information on epidemiology of mental disability in India.

Objective:
The objective of this study was to assess mental disability, and to study the association between sociodemographic and comorbid chronic conditions with mental disability.

Materials and Methods:
This community-based cross-sectional study was conducted among ≥5 years age group in an urban area attached to a Tertiary Care Medical Institute in Puducherry, India. Mental disability was assessed using Indian Disability Evaluation and Assessment Scale. Chronic morbid conditions and other associated factors were collected using pretested questionnaire.

Statistical Analysis:
Univariate and multiple logistic regression analysis.

Results:
About 2537 subjects were covered with a response rate of 94.1%. Overall, the prevalence of mental disability was found to be 7.1% (181/2537). Among them, majority had mild mental disability (151, 83.4%), followed by moderate (21, 11.6%), severe (8, 4.4%), and profound (1, 0.6%) mental disability. Univariate analysis showed that age group status, marital status, education level, occupation, family type, religion, hypertension, joint pain, backache, current smoking, current alcohol use, and conflicts were associated with mental disability (P < 0.05). Multiple logistic regression analysis showed that male gender (adjusted odds ratio [AOR] =2.064), widowed status (AOR = 27.022), separated/divorced status (AOR = 16.674), currently married status (AOR = 18.487), being illiterate (AOR = 4.352), having 1st–10th standard education (AOR = 2.531), being in an unskilled (AOR = 0.287) or semiskilled/skilled occupation (AOR = 0.025), belonging to a nuclear family (AOR = 1.816), and absence of family conflicts (AOR = 0.259) were significantly associated with mental disability compared to their counterparts.

Conclusion:
Mental disability is more common in this area. Males, lesser education level, skilled or unskilled occupation, nuclear family, and conflicts were associated with mental disability after adjusting other variables. Multicentric cross-sectional analytical studies will explore the mental disability burden and its associated factors at regional or country level.
A Case of Alveolar Rhabdomyosarcoma with Multifocal Pyomyositis Following Chemotherapy
Authors: Sharma Vibhor , Subi TS , Chaudhary Debashish , Patel Mehul 
Published: January 2018

AbstractPyomyositis is extremely rare after chemotherapy for nonhematological malignancies. We report a patient of alveolar rhabdomyosarcoma, who developed multifocal pyomyositis in bilateral lower limbs after the first cycle of neoadjuvant chemotherapy with vincristine, ifosfamide, mesna, and etoposide. The diagnosis of pyomyositis was reached after ultrasound and contrast-enhanced computed tomography scan of bilateral lower limbs. Staphylococcus and Streptococcus were isolated from pus. This patient was treated with 4 weeks of antibiotics, besides ultrasound-guided pus aspiration and open surgical debridement. To the best of our knowledge, no case of rhabdomyosarcoma with pyomyositis following chemotherapy has been reported so far.
Eosinophilic Liver Abcesses and Pyrexia of Unknown Origin in Idiopathic Hypereosinphilic Syndrome: Myeloproliferative or Mimic?
Authors: Sen Chetana , Chatterjee Krishnarpan 
Published: January 2018

AbstractWe report a case which presented with pyrexia of unknown origin (PUO) with eosinophilia and multiple hypoechoic lesions in the liver resembling secondaries. After secondary causes were ruled out, aspiration of liver lesions revealed eosinophilic abcesses. A diagnosis of idiopathic hypereosinophilic syndrome (HES) was made and the patient responded to steroid therapy. HES remains a diagnosis of exclusion. HES presenting with PUO and liver abcesses is very rare. A high index of suspicion is required to recognize the involvement of different organ systems due to HES.
Neutrophil-to-lymphocyte Ratio: A Surrogate Marker for Prognosis of Oral Squamous Cell Carcinoma
Authors: Mahalakshmi R , Boaz Karen , Srikant N , Baliga Mohan , Shetty Premalatha , Prasad Mukul , Yellapurkar Shweta , Lewis Amitha J 
Published: January 2018

Abstract
Context: Recent studies show that enzymatic contents of the neutrophil granules have a remarkable ability to modulate the tumor microenvironment by causing apoptosis of T-lymphocytes which leaves the host's cell-mediated immunity at stake. The preoperative neutrophil to lymphocyte ratio (NLR) is considered to be an indicator of the immune status of the patients with oral squamous cell carcinoma (OSCC), which will thereby help in predicting the course of the disease. Aims: The aim is to assess the NLR and histopathological prognostic factors pertinent to infiltration of the surrounding structures and correlate them with the clinical prognostic outcomes of OSCC. Settings and Design: This retrospective study involved the retrieval of formalin-fixed, paraffin-embedded, hematoxylin, and eosin-stained sections of 55 cases of OSCC from the departmental archives from 2006 to 2014. Subjects and Methods: Grading of each case was done by Bryne's grading system. The preoperative complete blood counts, relevant case history, and clinical data of the patients involved in the study were collected from the institutional medical records. The NLR was calculated by dividing the serum neutrophil count by the serum lymphocyte count. Statistical Analysis Used: The median NLR was compared between the controls and OSCC cases using Wilcoxon-signed rank test, and the Kaplan-Meier survival analysis was carried out to predict the survival and recurrence status of OSCC. Results: Higher NLR was seen in lymph node and margin-involved cases and also in patients who had tumor recurrence. Kaplan-Meier survival analysis showed that the mean survival dropped from 26 to 4.5 months when NLR ≥5 (P = 0.052). Conclusion: Neutrophil-to-lymphocyte ratio can be used as a prognosticator of survival, recurrence, lymph node status, and margin status in OSCC.
Multifocal Osseous Epithelioid Hemangioendothelioma Involving
Extremities and Spine with Visceral Metastasis
Authors: Roy Maitrayee , Yadav Rajni , Kumar Tarun 
Published: January 2018

AbstractEpithelioid hemangioendothelioma (EH) is a rare locally aggressive intermediate grade malignant vasoformative tumor. Bone is a rarer primary site accounting for less than 1% of all malignant bone tumors. Multicentricity and/or multifocality are a relatively frequent occurrence, most commonly clustered in the bones of lower extremities. The axial skeleton is less commonly affected, and concomitant visceral involvement is rarer. We report a unique case of a 20-year-old male who presented with multiple lytic lesions in the skull vault, vertebral bones, bilateral proximal femur, and both radii and humerii with metastasis to the lungs and liver. A final diagnosis of EH was established on biopsy from the right iliac bone. He initially received multiagent chemotherapy and is currently on antiangiogenic therapy. On follow-up positron emission tomography–computerized tomography done 6 months later, marked reduction in fluoro-D-glucose avidity of the hepatic and most skeletal lesions was noted.
Outcomes with Palliative Weekly Paclitaxel in Advanced, Recurrent, and Metastatic Esophageal Cancer - Real World Experience
Authors: Joshi Amit , Noronha Vanita , Pandey Avinash , Patil Vijay , Samar Aseem , Mahajan Abhishek , Janu Amit , Prabhash Kumar 
Published: January 2018

Abstract
Background: In advanced esophageal cancer, combination chemotherapy regimens provide effective palliation but result in substantial toxicity. Aim: The aim of the study was to evaluate outcomes of recurrent and metastatic esophageal carcinoma treated with weekly paclitaxel. Objectives: The objective of the study was to determine the clinical and laboratory factors predicting response and affecting overall survival (OS) in patients receiving palliative chemotherapy for advanced esophageal/gastroesophageal cancer. Materials and Methods: Retrospective analysis of patients with advanced esophageal cancer, not amenable to definitive intent therapy that was treated with intravenous weekly paclitaxel was done. Progression-free survival (PFS) and OS were calculated with Kaplan–Meir analysis while factors affecting outcome were subjected to log rank test and multivariate analysis. Results: Between September 2010 and October 2014, 350 patients were included in analysis. Median follow-up is 8 months. Median age was 55 years, with a male:female ratio of 2.4:1. Nearly 34.5% were mid esophageal and 51% were lower third and gastroesophageal junction tumors. Almost 58% of the tumors had squamous histology. Performance status was >2 in 25.4%. Almost 62% patients had received prior therapy. Median number of cycles of weekly paclitaxel delivered was 12 with median duration of 3 months. Nearly 51% of patients had improvement in dysphagia, with time to symptom improvement of 20 days. In 31% patients, feeding nasogastric tube could be removed. Overall response rate was 32% (complete remission, 2.5% + partial remission, 29.5%). Median PFS was 4.0 months (95% confidence interval [CI]: 3.6–4.3 months) and median OS was 10 months (95% CI: 8.5–11.4 months). Performance status and pretreatment albumin significantly affected OS. Conclusion: Metronomic weekly paclitaxel chemotherapy provides good palliative benefit in advanced unresectable/metastatic esophageal cancer with minimal toxicity. Eastern Cooperative Oncology Group Performance Status (PS 0 and 1) and baseline serum albumin level >3.7 g/dl significantly improved survival.
Retroperitoneal Mature Cystic Teratoma in a 3-month-old Infant: A Case Report and Literature Review
Authors: Tripathy Prasanta Kumar , Pattnaik Kaumudee , Jena Pradeep Kumar , Mohanty Hiranya Kishore 
Published: January 2018

AbstractRetroperitoneal teratoma (RPT) is an exceedingly rare neoplasm in infancy. We came across a 3-month-old infant with large RPT in the left suprarenal area. The tumor was completely excised, and the patient was successfully discharged. Histopathological examination suggested the diagnosis of mature cystic teratoma.
Androgen Receptor Expression in Triple Negative Breast Cancer - Study from a Tertiary Health Care Center in South India
Authors: Patnayak Rashmi , Jena Amitabh , Bhargavi Dandumudu , Chowhan Amit Kumar 
Published: January 2018

Abstract
Background: The treatment of breast cancer is based on a multi-modality approach. Analysis of the hormone receptor has been accepted as a standard procedure, in the routine management of breast cancer patients. Triple negative breast cancers (TNBCs) are those which are negative for expression of all three markers, i.e., estrogen receptor, progesterone receptor (PR), and human epidermal growth factor receptor. High expression of Ki-67, a proliferation index, has been associated with a worse prognosis in TNBC. TN cancers are aggressive in nature as they do not respond to routine targeted therapy. The role of the androgen receptor (AR) in breast carcinomas is important as AR has been suggested as a potential therapeutic target. We did this study to assess AR immunoreactivity in TNBCs and correlate with Ki-67 index. Materials and Methods: In this study group, there were 45 cases of TN invasive breast carcinomas. These tumors were analyzed with respect to AR and Ki-67 index. Results: Of 45 TN breast carcinomas analyzed, 42 were infiltrating duct cell carcinoma (IDCC) of not otherwise specified type. There were one medullary and two metaplastic carcinomas. The median age was 46 years. AR was positive in 20% (9/45) of cases. All the AR positive cases were an IDCC (nos). Out of the nine AR positive cases, six showed positivity for Ki-67. The statistical analysis using Pearson's Chi-squared method did not reveal any correlation between AR and Ki-67 index (P = 0.574). Conclusion: Although our study did not reveal any statistically significant correlation between AR and Ki-67 index, assessment of AR status in TNBC patients is desirable as it may help to develop a targeted therapy in future in these aggressive cancers.
Ovarian Torsion as an Unusual Presentation of Primary Bilateral Ovarian Lymphoma
Authors: Siddiqui Mohammed Azfar , Sartaj Sara , Ali Rizvi Syed Wajahat , Khan Iraj Alam 
Published: January 2018

AbstractPrimary ovarian involvement by Burkitt's lymphoma is rare and accounts for 0.5% of nonHodgkin lymphoma and 1.5% of ovarian tumors. We herein describe a very rare case of primary bilateral ovarian lymphoma in a 14-year-old presenting as ovarian torsion.
Contributo ad una rilettura dello statto di necessità
Authors: Nonne Luigi 
Published: January 2018

Una rilettura dello stato di necessità nel diritto privato aspira a ricomporre il ruolo sistematico dell’istituto nella disciplina della responsabilità extracontrattuale, là dove è collocato l’art. 2045 c.c., oltre a verificarne l’ipotetico àmbito di applicazione in quella contrattuale.
Dalla relativa trattazione, cui saranno dedicate queste riflessioni, sarà esclusa la necessità come presupposto del rimedio rescissorio nel contratto concluso in stato di pericolo ai sensi dell’art. 1447 c.c., in relazione al quale è sufficiente constatare in questa sede che l’indennità prevista dalla norma come obbligo eventuale in capo a chi agisce per la rescissione, a differenza di quanto previsto dall’art. 2045 c.c., in cui la medesima mira a compensare il danneggiato incolpevole della lesione subita, è invece stabilita a favore di chi intendeva sfruttare a proprio vantaggio le circostanze nelle quali il contratto fu concluso, nei termini di un equo compenso per l’opera prestata.
Um desvio do sentido: o primitivo e o civilizado em Bergson
Authors: Paiva Rita 
Published: January 2018

O intuito deste texto é explorar o modo pelo qual, em seu último livro, Bergson afasta-se dos significados atribuídos à condição de civilizado e de primitivo seja no âmbito do senso comum, seja nas ciências a ele contemporâneas. Pretende, pois, mostrar que o filósofo só logra desviar-se dos sentidos assim cristalizados pela linguagem se, esquivando-se da circunscrição estrita a certas regiões do saber, ousar uma transgressão metodológica que, para além da objetividade científica, a um só tempo realize um esforço de introspecção e contemple a perspectiva mais geral da vida. Nesse movimento, irrompe a noção de “função fabuladora”, reveladora de uma dimensão arcaica do primitivo, a qual não apenas persevera no civilizado, mas se constitui, em última instância, como um dos elementos que viabiliza a sobrevivência da espécie. Ademais, veremos que, segundo o autor, atributos em geral associados ao desenvolvimento da civilização, ao homem ocidental e contemporâneo são igualmente experienciados pelos assim chamados primitivos ou incivilizados.
O Curso de Pedagogia: permanências e novas tensões
Authors: Micheletti Elisângela Lisboa , Galian Cláudia Valentina A. 
Published: January 2018

Este artigo trata da formação dos pedagogos no Brasil, cujas bases estão parcialmente definidas na implementação de Diretrizes Curriculares Nacionais para o curso. Buscamos identificar as mudanças na formação inicial e na percepção dos pedagogos quanto às contribuições da formação inicial para a sua atuação profissional, fomentadas em alguma medida pelas Diretrizes Curriculares Nacionais para o curso de Pedagogia (DCNP). A pesquisa, de natureza qualitativa, envolveu os seguintes procedimentos: análise documental, questionários e entrevistas desenvolvidos junto a dois grupos de pedagogos, formados e concluintes do curso nos períodos anterior e posterior à promulgação dos referidos documentos legais, de uma Universidade da cidade de São Paulo. Evidenciou-se uma série de mudanças significativas na composição do currículo, influenciadas essencialmente pelas demandas do trabalho docente, que conferiram ao currículo do curso uma base docente, especialmente em função de necessidades materiais impostas pelo contexto histórico e social. As mudanças evidenciadas alteraram a natureza e a organização do curso e esta foi a principal mudança ao longo da história desse curso, na busca por romper, de uma maneira peculiar, com a dualidade entre o bacharelado e a licenciatura. Como consequência, evidenciaram-se também alterações na sua organização, o que se deu por meio de um processo de redução do tempo de formação, sustentado por um “enxugamento” do currículo. Por fim, identificou-se uma mudança na percepção dos pedagogos quanto às contribuições da formação inicial para sua atuação profissional, essencialmente coerentes com a guinada do curso em direção ao preparo para as atividades docentes no âmbito escolar.
A TEIA e a REDE: aprendizagens nas/em redes locais de educação ambiental
Authors: Borges Marcelo Gules 
Published: January 2018

A partir de uma etnografia realizada com duas redes de educação ambiental atuantes no contexto escolar no sul do Brasil, a TEIA e a REDE, o artigo analisa os modos pelos quais estes coletivos se constituem nos termos de suas identidades, modos de ação e aprendizagem nas/em redes. Para isso, apresento um conjunto referencial que tematiza os elementos sócio-históricos e da aprendizagem na dinâmica cotidiana de constituição e de ação destes coletivos. As redes que atuam no contexto escolar têm papel vital na formação dos educadores ambientais e nos processos de ambientalização da educação.
Reducing Patient No-Shows: An Initiative at an Integrated Care Teaching Health Center
Authors: Mehra Ashwin , Hoogendoorn Claire J. , Haggerty Greg , Engelthaler Jessica , Gooden Stephen , Joseph Michelle , Carroll Shannon , Guiney Peter A. 
Published: January 2018

AbstractBackgroundPatient no-shows impede the effectiveness and efficiency of health care services delivery.ObjectiveTo evaluate a 2-phase intervention to reduce no-show rates at an integrated care community health center that incorporates a teaching program for osteopathic family medicine residents.MethodsThe Elmont Teaching Health Center (ETHC) is 1 of 5 community-based health centers comprising the Long Island Federally Qualified Health Centers. In August 2015, the ETHC implemented a centerwide No-Show Rates Reduction Initiative divided into an assessment phase and implementation phase. The assessment phase identified reasons most frequently cited by patients for no-shows at the ETHC. The implementation phase, initiated in mid-September, addressed these reasons by focusing on reminder call verification, patient education, personal responses to patient calls, institutional awareness, and integration with multiple departments. To assess the initiative, monthly no-show rates were compared by quarter for 2015 and against rates for the previous year.ResultsWe recorded 27,826 appointments with 6147 no-shows in 2014 and 31,696 appointments with 5690 no-shows in 2015. No-show rates in the first 3 quarters of 2015 (range, 18.2%-20.0%) were slightly lower than the rates in 2014 (20.1%-23.4%) and then changed by an increasingly wide margin in the last quarter of 2015 (15.3%), leading to a significant year (2014, 2015) by quarter (Q1, Q2, Q3, Q4) interaction (P=.004). Also, the change observed in Q4 in 2015 differed significantly from Q1 (P=.017), Q2 (P=.004), and Q3 (P=.027) in 2015, while Q1, Q2, and Q3 in 2015 did not significantly differ from one another.ConclusionNo-show rates were successfully reduced after a 2-phase intervention was implemented at 1 health center within a larger health care organization. Future directions include dismantling the individual components of the intervention, evaluating the role of patient volumes in no-show rates, assessing patient outcomes (eg, costs, health) in integrative care settings that treat underserved populations, and evaluating family medicine residents’ training on continuity of care and no-show rates.
Prevalence of Homelessness by Gender in an Emergency Department Population in Pennsylvania
Authors: Feldman Brett J. , Craen Alexandra M. , Enyart Joshua , Batchelor Timothy , Friel Timothy J. , Dusza Stephen W. , Greenberg Marna Rayl 
Published: January 2018

Abstract

Context
According to the US Department of Housing and Urban Development, nearly 1.5 million people spend at least 1 night in an emergency shelter or transitional housing each year, and more than 500,000 people are homeless on a given night in the United States. To our knowledge, limited data exist regarding the prevalence of homelessness in ED patients by gender (male, female, and transgender)

Objective
To assess the prevalence of homelessness by gender in 3 EDs in Pennsylvania.

Methods
From May 2015 through February 2016, patients in 3 EDs were approached to take a 5-question homelessness screening survey. To participate, patients had to be aged at least 18 years, speak English, have capacity to complete the survey, be willing to participate, and not be critically ill. Frequency comparisons were made using χ2 analysis. Statistical significance was defined as P≤.05.

Results
A total of 4395 patients were included in the analysis. The mean (SD) age of the participants was 50.8 (20.5) years; 2557 (58.2%) were women and 3 (0.07%) were transgender. No difference in the rate of homelessness was observed between men and women, with 135 of 1835 men (7.4%) and 173 of 2557 women (6.8%) screening positive for homelessness (P=.472). Forty of 2557 women (1.6%) and 41 of 1835 men (2.2%) admitted they had slept outside or in an abandoned building, their car, an emergency shelter, or a hotel due to financial hardship in the past 60 days (P=.26). One transgender patient screened positive for homelessness. The mean age of participants who screened positive for homelessness was 40.9 (15.9) years.

Conclusion
No significant difference was observed in the rate of homelessness between men and women in this ED population, which defies the perception that this issue primarily affects men. Public health interventions aimed at homeless populations should consider that both men and women may be equally affected by homelessness.