bluuebunny/crossref_metadata_2025 huggingface dataset:
Estudio descriptivo de la traducción de referencias culturales vitivinícolas en la traducción alemán-español de textos de promoción enoturística
Authors: SÁNCHEZ NIETO María Teresa
Published: July 2016

Este trabajo pretende ser una aportación al estudio de la traducción vitivinícola. Su finalidad es observar las técnicas empleadas para la traducción al español de referencias culturales vitivinícolas en textos de promoción enoturística generados en Alemania y en Suiza y, en segundo lugar, trata de elaborar inferencias sobre el método traductor empleado y explorar la organización conceptual de dichas referencias. Con este fin se han estudiado cuantitativa y cualitativamente los datos de un corpus especializado paralelo, bilingüe y unidireccional (DE-ES), compilado ad hoc, que contiene ejemplos del género “texto de promoción enoturística”. Tras el estudio se observa que existen casos de variación terminológica en los textos alemanes para los que la búsqueda de equivalentes terminológicos españoles resulta por una razón u otra, más difícil. Por otra parte, se constata que predomina el recurso a técnicas de traducción con un alto nivel de información (amplificación y traducción literal), si bien se localizan usos muy concretos de las técnicas del préstamo y de la adaptación. Se infiere, por último, que el método traductor predominante es el interpretativo-comunicativo con algunas injerencias coyunturales del método filológico.
La influencia de Robert Burns en Coleridge y Wordsworth: textos traducidos
Authors: HUERTAS ABRIL Cristina , CASTELLANO MARTÍNEZ José M.
Published: July 2016

El presente trabajo se ocupa de la figura del poeta escocés Robert Burns, que influencia a los poetas "lakistas", especialmente a Coleridge y a Wordsworth. Tras una breve referencia a la vida y a la obra de Burns, se analiza el patriotismo en Reino Unido a finales del siglo XVIII. Finalmente, se traducen al español tres poemas, "Lament of Mary Queen of the Scots On the Approach of Spring" de Burns, "To the Exiled Patriots" de Coleridge y "When I have borne in memory" de Wordsworth, que ponen de manifiesto la relación entre los tres autores.
Adiós a la lectura de poesía. Thomas De Quincey y William Hazlitt, críticos de los poetas de los lagos
Authors: LASTRA Antonio
Published: July 2016

Este artículo trata de establecer, con la perspectiva de la ecología de la cultura, una relación entre la lectura de la poesía lakista y la escritura de ensayo de Thomas de Quincey y William Hazlitt.
Oxytocin blocks pet dog (Canis familiaris) object choice task performance being predicted by owner-perceived intelligence and owner attachment.
Authors: Oliva Jessica Lee , Rault Jean-Loup , Appleton Belinda , Lill Alan
Published: July 2016

A positive association has been found between owner-rated dog cognition and owner-perceived closeness to their dog, using the Perceptions of Dog Intelligence and Cognitive Skills (PoDIaCS) survey and the Monash Dog Owner Relationship Scale (MDORS). Oxytocin has been positively associated with bonding in mammals and with non-verbal intelligence in humans and could therefore explain this relationship between owner-rated questionnaires. The aims of this study were to ascertain: i) whether a pet dog’s performance on an object choice task (OCT), which objectively measures dogs’ ability to use human non-verbal, social gestures to find a food reward, could be predicted by their owners’ scores on three different surveys: (a) the MDORS, (b) the Pet Attachment Questionnaire (PAQ), which measures levels of anxious and avoidant attachment styles, and (c) a modified version of the PoDIaCS, and ii) if intranasal administration of oxytocin to dogs, known to enhance dogs’ performance on such tasks, would disable the ability of an owner to predict their dogs’ performance. It was hypothesized that higher ratings of owner-reported closeness to their dog, and higher ratings of owner-perceived intelligence of their dog, would positively predict dog OCT performance after saline, but not after oxytocin. Seventy-five pet dogs and their owners were recruited to participate in two OCTs, 5-15 days apart, once after the dog received intranasal oxytocin and once after receiving saline. Owners completed the PoDIaCS and another survey relating to pet ownership before OCT 1, and the MDORS and PAQ before OCT 2. After saline administration, scores on the anxious subscale of the PAQ were a negative predictor of dog OCT performance using pointing cues, while subscale 6 of the PoDIaCS, ‘contagion of human emotions’, positively predicted performance using gazing cues. None of the questionnaire subscales were predictive of performance on the OCT after oxytocin administration. Results suggest that a dog’s ‘natural’ ability to follow human pointing cues and anxious attachment in owners are inversely related, whilst a dog’s ‘natural’ ability to follow human gazing cues is positively related to owner-rated empathic ability of the dog.
IMPACTO DO PROGRAMA MAIS MÉDICOS NA ATENÇÃO BÁSICA DE UM MUNICÍPIO DO SERTÃO CENTRAL NORDESTINO
Authors: Agostinho Alencar Ana Paula , Lustoza Xavier Samyra Paula , Agostinho da Silva Laurentino Patrícia , Frazão Lira Petrúcya , Barbosa do Nascimento Vânia , Carneiro Nivaldo , Fonseca Alexandre , Affonso Fonseca Fernando Luiz
Published: July 2016

Tendo em vista os problemas inerentes à atenção primária a saúde, o Governo Federal implantou o “Programa mais médicos para o Brasil” em busca de melhoria na assistência e do acesso á atenção primária a saúde com vistas de proporcionar qualidade de vida aos usuários do Sistema Único de Saúde - SUS através da prevenção e promoção da saúde. Este estudo visou identificar os impactos causados pela implementação do Programa Mais Médicos em um município do sertão central nordestino. O estudo foi constituído a partir da análise estatística dos indicadores registrados no Sistema de informação da Atenção Básica SIAB. Os dados foram processados no software Stata®, na versão 11.0, onde, a partir da análise estatística descritiva, os resultados foram analisados e apresentados em tabelas.  O estudo identificou que a partir da implementação do Programa Mais Médicos houve um aumento considerável no número de consultas e atendimentos realizados pelos médicos, tendo destaque os atendimentos prestados aos pacientes portadores de tuberculose e hanseníase e impacto nas solicitações dos exames complementares que sofreu uma queda bastante considerável. Outro ponto identificado é o aumento de visitas domiciliares. Pode se realizar uma análise de forma geral de melhoria dos indicadores da saúde no município depois do programa mais médicos implantado segundo resultados estatísticos apresentados.
Application of a Novel Hyperbranched-Polymer Fracturing-Fluid System in a Low-Permeability Heavy-Oil Reservoir
Authors: Liu Yueliang , Li Huazhou Andy
Published: July 2016

Hydraulic fracturing can be used for stimulating low-permeability heavy-oil reservoirs. It is challenging to achieve a high degree of fracturing-fluid flowback, as well as a low degree of formation damage, in low-permeability heavy-oil reservoirs. This research investigates the application of a novel hyperbranched-polymer fracturing fluid in low-permeability heavy-oil reservoirs. Such hyperbranched polymer is characterized by Fourier-transform infrared (FTIR) spectrophotometry. It has numerous end groups and possesses a 3D spherical molecular structure with many branches. Laboratory tests are conducted to evaluate the thermal stability and shearing resistance, reversible-crosslinking performance, salinity tolerance, static-filtration performance, gel-breaking performance, and sand-carrying performance. The degrees of core damage are evaluated through conducting coreflooding experiments, where the cores are treated with two kinds of gel-breaking fluids formed by hyperbranched-polymer fracturing fluid and guar fracturing fluid, respectively.

Laboratory tests show that the hyperbranched-polymer fracturing fluid has good rheological characteristics, a high swelling ratio, a high proppant-carrying performance, and good thermal stability and shearing resistance. After being sheared for 90 minutes under 170 s−1 at 150°C, it can still reverse to gel with high strength because of its good reversible-crosslinking performance. This fracturing fluid exhibits a high-salinity tolerance. Furthermore, the hyperbranched polymer has a high swelling ratio. Field applications in some wells in China show that the friction loss of this fracturing fluid during fracturing is approximately 30 to 50% of that of the normal guar fracturing fluid. Thus, it has an ultralow friction-loss feature. As for the same reservoir, hyperbranched-polymer fracturing fluid has a higher flowback ratio compared with the guar fracturing fluid. Besides, its cost is approximately 75% of that of normal guar fracturing fluid, making it a clean and cost-effective system. The fracturing fluid prepared with hyperbranched polymer possesses outstanding technical advantages and good cost effectiveness, implying a promising application in the large-scale fracturing stimulation of low-permeability heavy-oil reservoirs.
CO2 Capture and Usage: Harnessing the CO2 Content in Natural Gas for Environmental and Economic Gains
Authors: Agiaye Emmanuel O. , Othman Mohammed
Published: July 2016

Carbon dioxide (CO2) capture and usage (CCU) is currently a global topical issue, and is viewed as one possible route to reduction of CO2 concentrations in the atmosphere. The core issues facing the world in current times--development, economy, and environment--are identified as being dependent on the provision of clean, efficient, affordable, and reliable energy services. Currently, the world is highly dependent on fossil fuels for provision of energy services, and the amount of which renewable energies can sufficiently replace is minimal. The deployment of appropriate CO2-separation technologies for the processing of natural gas is viewed as an abatement measure toward global CO2-emissions reduction. Selection of the optimum technology among the several separation technologies for a particular separation need requires special attention to harness the economic and environmental benefits. The captured CO2 would also require appropriate disposal or usage so as to sequester or ’delay’ its re-entry into the atmosphere. These challenges of CCU--involving natural gas particularly during processing, which has become an area of intense research--shall be discussed in the paper with respect to the selected technique for CO2 capture. A typical natural-gas-production scenario in Nigeria shall be analyzed for potential CO2 capture. Further discussion shall be on the identification of the recovered CO2 gas-usage framework, such as CO2 flooding [in enhanced oil recovery (EOR)], for additional revenue generation, assessment of the CO2 savings, and the contribution to the clean development mechanism (CDM).
Diversifying Soybean Production Risk Using Maturity Group and Planting Date Choices
Authors: Weeks Wes , Popp Michael P. , Salmeron Montserrat , Purcell Larry C. , Gbur Edward E. , Bourland Fred M. , Buehring Normie W. , Earnest Larry , Fritschi Felix B. , Golden Bobby R. , Hathcoat Daniel , Lofton Josh , McClure Angela Thompson , Miller Travis D. , Neely Clark , Shannon Grover , Udeigwe Theophilus K. , Verbree David A. , Vories Earl D. , Wiebold William J. , Dixon Bruce L.
Published: July 2016

While soybean [Glycine max (L.) Merr.] production risk is typically managed by planting a range of maturity groups (MGs) across a few different planting dates (PDs), there have been no reports that have quantified changes in risk and profitability using this diversification strategy. Three years of field‐trial data from eight locations in six states were analyzed to determine risk–return tradeoffs across MG and PD. Producer revenue expectations were adjusted by soybean harvest date, assessing oil and meal premiums or discounts, and differential irrigation requirements by MG and PD, whereas costs for seed, fuel, fertilizer, equipment, and chemicals were held constant. Using portfolio theory, an efficient frontier—maximizing net returns for a given level of risk or minimizing risk for a given level of net return—was estimated by location. Cultivars from MG III and MG IV had higher expected net returns than MG V and VI at all locations. Early‐season planting combinations were found to be riskier than the three successive planting dates but led to oil, protein, and seasonal sale price premiums. Across different environments, selecting two to six MG×PD combinations was sufficient to lower risk by 29 to 40% when compared to the single, profit‐maximizing MG×PD choice. Depending on location, this risk reduction decreased net returns between 2 and 22% when compared to the profit‐maximizing MG×PD choice.

Core Ideas

Producers often like to diversify by planting across a range of dates and maturity groups.

Diversification is common but risk–return tradeoffs have not been meaningfully quantified.

Early‐season planting combinations were riskier but led to sale price premiums.

Using two to six combinations lowered risk by 29–40% but decreased returns by 2–22%.
Una extensión del algoritmo MIMIC mediante Cópulas
Authors: Salinas Gutiérrez Rogelio , Hernández Aguirre Arturo , Villa Diharce Enrique Raúl
Published: July 2016

Una nueva manera de modelar dependencias probabilísticas en el algoritmo de Maximización de Información Mutua mediante Clústeres de Entrada (MIMIC) es presentada. Mediante cópulas es posible separar la estructura de dependencia de las distribuciones marginales en una distribución conjunta. El uso de cópulas como un mecanismo para modelar distribuciones y su aplicación a MIMIC es ilustrado en la función de prueba Rosenbrock.
Diseño y evaluación de un arreglo lineal de antenas miniaturizada para cubrimiento de pasillos
Authors: Ruiz García Jorge Enrique , Páez-Rueda Carlos Iván
Published: July 2016

Este artículo describe el diseño y evaluación de un arreglo de dipolos impresos Broadside con alimentación en serie para aplicaciones WLAN. La técnica utilizada permite diseñar una antena de tamaño reducido ideal para radiar en pasillos, como los presentes en centros comerciales. La antena diseñada fue construida en tecnología tradicional conformada por substratos FR-4 y caracterizada por medio de una cámara anecoica, comprobando su efectividad para la banda de 2.4 GHz. Los resultados experimentales difieren solo 1.18 dBi con respecto a la ganancia máxima y 1.7% con respecto a la frecuencia de resonancia diseñada.
Implicaciones de la teoría motivacional de la Autodeterminación en el ámbito laboral
Authors: Vargas Téllez Juan Alberto
Published: July 2016

Dada su importancia y pertinencia para la motivación en el trabajo, se aborda la Teoría de la Autodeterminación (TAD) en relación con el ámbito laboral. Se argumenta sobre las implicaciones positivas que puede tener para esclarecer algunas controversias que generaron los conceptos de motivación extrínseca e intrínseca, así como para abordar ciertos temas fundamentales de la organización contemporánea: los sistemas de incentivos, la cultura organizacional, el aprendizaje organizacional y la gestión del conocimiento; se concluye que estos procesos organizacionales contribuirán más a la productividad en la medida que sean congruentes con un cultura laboral que favorezca la satisfacción de tres necesidades psicológicas básicas relacionadas con el trabajo: la autonomía, la competencia y la socialización o relación, conceptos que postula la Teoría de la Autodeterminación.
Caracterización bioquímica de AmiJ33, una amilasa de Bacillus amyloliquefaciens aislada de suelos cultivados con caña de azúcar en la región del Papaloapan
Authors: Montor-Antonio J. J. , Olvera-Carranza C. , Reyes-Duarte D. , Sachman-Ruiz B. , Ramírez-Coutiño L. , Del Moral S.
Published: July 2016

La amilasa (E.C. 3.2.1.1) de Bacillus amyloliquefaciens JJC33M (AmiJ33) fue producida por fermentación sumergida. Se probó el efecto de peptona, extracto de levadura, Ca+2 y glicina en la producción de AmiJ33. El extracto de levadura y Ca+2 tuvieron un efecto positivo sobre la síntesis de AmiJ33. La enzima fue recuperada mediante precipitación a saturación al 60% con (NH4)2SO4. El peso molecular aproximado de la enzima purificada fue de 50 kDa. Así mismo, se evaluó el efecto del pH y la temperatura sobre la actividad enzimática, concluyendo que los valores más altos de actividad se observaron a pH 6.0 y 80°C, respectivamente. En condiciones ligeramente ácidas (pH 4.0 y 5.0), AmiJ33 mantuvo el 72% de su actividad. AmiJ33 fue estable por 3 h a 40°C, y por 30 min a 45 y 50°C, conservando el 88 y 82% de actividad residual. A 60°C, la actividad disminuyó 40%. La actividad de AmiJ33 se incrementó 50.27% con b-mercaptoetanol, no fue inhibida por EDTA y se inhibió totalmente con SDS
Reconversión de la cadena agroindustrial de la caña de azúcar en Veracruz México
Authors: Aguilar Rivera Noé
Published: July 2016

La agroindustria azucarera de Veracruz participa con 40 % de la producción nacional de sacarosa e integra actividades agrícolas de crecimiento, cosecha y transporte de caña de azúcar con la producción industrial en ingenios azucareros, destilerias y trapiches piloncilleros. Sin embargo, enfrenta retos con la caída de la productividad y aspectos socioeconómicos que ponen en riesgo la seguridad alimentaria y la reconversión de la agroindustria.  El objetivo del presente trabajo es evaluar la capacidad y estrategias de reconversión de la agroindustria azucarera de Veracruz mediante el análisis de la productividad de la cadena agroindustrial en el contexto nacional con el uso de diversas herramientas de análisis como Matriz de ponderación de productividad en campo, ingenios azucareros y municipios productores, zonificación agroecológica y diamante de competitividad. Los  resultados establecen que el  40 % de los ingenios azucareros poseen indicadores por encima de la media nacional. Las zonas de abasto cañero presentan en su conjunto 12 % menor productividad en relación a su potencial agroecológico, a pesar que en Veracruz el 57.5 % de su zona productora tiene aptitud edafoclimática al cultivo de media a alta y 30 municipios (33.7 %) poseen recursos y capacidades para reconvertirse. Se concluye que las acciones y estrategias para incrementar la  productividad para bioenergía y alimentos en Veracruz debe abordarse desde una perspectiva interdisciplinaria como una interfaz entre la optimización del rendimiento, la ecología, limitantes  técnicos y socioeconómicos y la nutrición humana como una cuestión de eficiencia de los recursos disponibles.
Inter-laboratory validation of automated SPME-GC/MS for determination of pesticides in surface and ground water samples: sensitive and green alternative to liquid–liquid extraction
Authors: Rodriguez-Lafuente Angel , Piri-Moghadam Hamed , Lord Heather L. , Obal Terry , Pawliszyn Janusz
Published: July 2016

An automated solid-phase microextraction gas chromatography/mass spectometry (SPME-GC/MS) method was developed for the determination of semi-volatile pesticides from several classes with a wide range of polarities in an environmental matrix, and validated according to the rigorous standards of a large commercial laboratory reporting data requiring regulatory acceptance with the purpose of being used as a standard test protocol. The target analytes showed a detection limit of 0.05–1 μg L−1, good calibration linearity (R2 > 0.99) with a wide linear range of 0.05–20 μg L−1, and accuracy in the range of 80–110 at three levels of calibration with relative standard deviation below 7% by commercial polydimethylsiloxane/divinylbenzene (PDMS/DVB) SPME fiber. An extensive study between SPME and liquid–liquid extraction as a reference US EPA method was performed from several analytical aspects including sensitivity, accuracy, repeatability, and greenness. The SPME method was validated through split blind analyses of 16 fortified surface and ground water samples within 4 months at Maxxam Analytics, the reference laboratory, and the University of Waterloo. Both methods were shown to be very accurate, with the highest frequency of results falling in the 70–130% accuracy range. The SPME method was shown to be more sensitive than the LLE, while requiring a lower volume of sample.
PENGEMBANGAN PERANGKAT PEMBELAJARAN UNTUK MENINGKATKAN MOTIVASI BELAJAR DAN KARAKTER BERSAHABAT SISWA KELAS IV SD
Authors: Setyorini Diana , Izzaty Rita Eka
Published: July 2016

Penelitian ini bertujuan untuk (1) menghasilkan perangkat pembelajaran collaborative learning berbasis kearifan lokal yang layak untuk meningkatkan motivasi belajar dan karakter bersahabat siswa dan (2) mengetahui keefektifan perangkat pembelajaran collaborative learning berbasis kearifan lokal untuk meningkatkan motivasi belajar dan karakter bersahabat siswa. Penelitian ini merupakan penelitian dan pengembangan mengacu pendapat Borg dan Gall (1983, p.775), namun desain pengembangan perangkat pembelajaran ini hanya meliputi 9 langkah, yaitu (1) penelitian pendahuluan dan pengumpulan informasi, (2) perencanaan, (3) pengembangan draft produk, (4) uji coba terbatas, (5) merevisi hasil uji coba terbatas, (6) uji coba lapangan, (7) penyempurnaan produk hasil uji coba lapangan, (8) uji coba lapangan operasional, dan (9) penyempurnaan produk akhir. Subyek penelitian adalah siswa kelas IV SD Piyungan Bantul. Hasil penelitian menunjukan bahwa perangkat pembelajaran ini layak digunakan menurut ahli materi dan ahli pembelajaran dengan kategori valid. Berdasarkan hasil penelitian diketahui, bahwa terdapat perbedaan yang signifikan terhadap motivasi belajar dan karakter bersahabat antara siswa yang mengikuti pembelajaran dengan perangkat pembelajaran collaborative learning berbasis kearifan lokal dan yang tidak menggunakan perangkat pembelajaran hasil pengembangan.

 

 

Abstract

This study aims to (1) produce a collaborative learning kit based on local wisdom that is feasible to increase learning motivation and friendly character and (2) determine the effectiveness of the collaborative learning kit based on local wisdom to improve learning motivation and friendly character. This study is a research and development refering to the opinion of Borg and Gall (1983, p. 775), but this developing learning kit only consisting of nine steps including (1) research and information collection, (2) planning, (3) developing preliminary form of draft product, (4) preliminary field testing, (5 ) main product revision, (6) main field testing, (7) operational product testing, (8) operational field testing, and (9) final product revision. Subjects were fourth grade students Piyungan Bantul. The results show that the learning kit is effective to increase the motivation to learn and friendly character of students according to the material expert and learning expert with valid assessment category. The operational field testing obtained p <0.05, which means that there are significant differences on motivation to learn and friendly character of the students who take the collaborative learning with learning kits based on local wisdom and those who do not use the results of the development of learning kits.
A literature review of Happiness and Economics and guide to needed research
Authors: Wiese Thomas
Published: July 2016

Happiness and Economics as a new branch of behavioural economics has had a major impact on economic theory and economic policy: Several studies have been published in the last 20 years in leading journals. Furthermore, several governments have decided to collect data about the well-being of their citizens. The author claims that utility cannot only be measured by the choices individuals do: Reported happiness and life satisfaction data is also an acceptable empirical estimate for individual utility. Consequently, happiness research can bear new knowledge and important understanding of human welfare. Therefore, this paper gives an overview of the existing literature. Methods and approach of scholars is critically analysed and shortcomings are discussed. Thereafter, findings on major economic issues like growth, unemployment and inflation are presented. Besides, governmental policy and implications for society are debated. Lastly, future research possibilities are mentioned. Journal of Economic Literature (JEL) Classification: D60 D63 I31
Az Észak-magyarországi régió munkaerő-piaci folyamatainak vizsgálata A
Authors: Lipták Katalin
Published: July 2016

A tanulmány az Észak-magyarországi régió pozícióját vizsgálja országos viszonylatban a főbb munkaerőpiaci indikátorok figyelembe vételével. Számításokat végeztem a régióban lezajló munkaerő-piaci folyamatok szemléltetésére. A tanulmány célja az Észak-magyarországi régió munkaerő-piaci helyzetének megértéséhez kapcsolódóan a munkanélküliség főbb tényezőinek mélyebb feltárása, valamint afoglalkoztatási szerkezetben bekövetkezett változások számszerűsítése, értékelése.

Journal of Economic Literature (JEL) kódok: J21, R23
Az áfa-rezidensek helye a magyar külkereskedelmi termékforgalomban
Authors: Baghy Eleonóra
Published: July 2016

A külföldi vállalatok egyre nagyobb volumenű külkereskedelmi forgalmat bonyolítanak le a gazdasági tevékenységet nem folytató, magyar adószámmal rendelkező áfa-rezidenseiken keresztül. Ezek a speciális célra létrehozott vállalkozások a gazdaság több területén vannak jelen – ilyen például a raktározás, vagy a reexport –, legjelentősebb működési területük azonban a különféle bérmunka ügyletek lebonyolításában való részvétel. Különleges jogi helyzetükből fakadóan az áfa-rezidensek tevékenységének megfigyelése a külkereskedelmi statisztikában, valamint a GDP-számításoknál eltérő, ami a különböző területek adatai között lényeges eltérést okoz. Az áru-, a tulajdonjog-, illetve a pénzmozgás napjakban tapasztalható különválása szintén nehezíti a gazdasági folyamatok nyomon követését. Emiatt a gazdaságstatisztika egyik legfontosabb módszertani feladata lett az áfa-regisztrációk tevékenységének mérése, és az adatkonzisztencia megteremtése mind nemzeti, mind nemzetközi szinten. Az egyre bonyolultabbá váló ügyleteket a cikk utolsó részében három esttanulmányon keresztül mutatjuk be.

Journal of Economic Literature (JEL) kódok: F10, F23
Mi a közös az deflációban, a vállalkozásban, az EU-ban és a jog közgazdaságtanában?
Authors: Czeglédi Pál
Published: July 2016

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Ease-of-care from the physical therapists’ perspective comparing fentanyl iontophoretic transdermal system versus morphine intravenous patient-controlled analgesia in postoperative pain management
Authors: Hartrick Craig T , Abraham Jeffrey , Ding Li
Published: July 2016

Aim:
To compare the ease-of-care (EOC) examining time efficiency, convenience and satisfaction of fentanyl iontophoretic transdermal system ([ITS] IONSYS
®
) and morphine intravenous patient-controlled analgesia (iv. PCA) in postoperative pain management using a validated physical therapist (PT) EOC questionnaire.
Materials & methods:
This meta-analysis assessed EOC of fentanyl ITS versus morphine iv. PCA using data from two randomized, active-comparator studies (fentanyl ITS: n = 720 and morphine iv. PCA: n = 739) which used the PT EOC questionnaire (22 items grouped into three subscales; time efficiency, convenience and satisfaction). Each item was scored on a 6-point Likert scale. For time efficiency, PT whose average scores were ≤2 on all items of the time efficiency and convenience subscales or ≥4 on both satisfaction items were considered responders.
Results:
There were EOC questionnaires from 264 (fentanyl ITS) and 254 (morphine iv. PCA) PTs. There were significantly greater proportions of PTs classified as responders for fentanyl ITS than morphine iv. PCA for overall EOC (81.0 vs 55.7%, respectively), time efficiency (83.1 vs 59.5%, respectively), convenience (87.4 vs 72.0%, respectively) and satisfaction (51.9 vs 30.0%, respectively), all p < 0.0001.
Conclusion:
In this meta-analysis, fentanyl ITS is associated with a superior EOC profile (overall, time efficiency, convenience and satisfaction) from the PTs’ perspective when compared with morphine iv. PCA.
The reduction of oil pollutants of petroleum products storage-tanks sludge using low-cost adsorbents
Authors: Mokhtari-Hosseini Zahra , Hosseinabadi Razieh , Zarmi Ashrafalsadat
Published: July 2016

Disposal of storage tank sludge in oil depots is a major environmental concern due to the high concentration of hydrocarbons involved. This paper investigates the reduction of the sludge oil pollutants with initial oil and grease concentration of about 50 mass% using low cost adsorbents. Among the examined adsorbents, sawdust indicated the maximum removal of oil and grease. The screening and optimizing of process parameters were evaluated employing Plackett-Burman design and response surface method. For the optimized conditions, more than 60 mass% of oil and grease from the sludge was removed. Moreover, it was found that sawdust adsorption of the oil and grease approximately followed the Freundlich isotherm. The results indicated that oil pollutants of sludge could be reduced using sawdust as a low-cost, available and flammable adsorbent so that thus saturated adsorbents could be used as fuel in certain industries.
Are butyrophenones effective for the treatment of primary headache in the emergency department?
Authors: Leong Lim Beng , Kelly Anne-Maree
Published: July 2016

Objectives:

Butyrophenones have been reported to provide effective migraine relief in the emergency department (ED). We conducted a systematic review of the evidence for their use in the ED.

Data source:

We searched theCochrane,Medline,Embase, andCINAHLdatabases.

Study selection:

Included studies were randomized trials of a parenteral butyrophenone (droperidol, haloperidol) versus placebo or a comparator in migraine or benign headache with results available in English. Study quality was determined using the Jadad score. Six articles were included.

Data extraction:

Primary outcomes were subjective or objective headache relief (> 50% improvement in visual analogue scale scores). Secondary outcomes included side effects. We reported pooled odds ratios (ORs) with their 95% confidence intervals (CIs) for subjective or objective headache relief for butyrophenones versus placebo or comparator agents.

Data synthesis:

Three studies reported subjective headache relief with a butyrophenone versus placebo or meperidine in migraine. Two studies reported objective headache relief with droperidol versus prochlorperazine, whereas one study compared droperidol versus olanzapine in benign headache. The pooled OR for subjective headache relief was 8.08 (95% CI 1.54–42.30) for a butyrophenone versus placebo, whereas it was 1.50 (95% CI 0.33–6.77) for droperidol versus meperidine in migraine. The pooled OR for objective headache relief was 2.96 (95% CI 1.36–6.43) for droperidol versus prochlorperazine in benign headache. Rates of side effects were 10 to 45%; akathesia and sedation were the most common.

Conclusions:

Butyrophenones are effective for the relief of migraine or benign headache. However, adverse effects make it difficult to recommend butyrophenones above agents with similar effectiveness and fewer problems.
Practice variability in the management of complex febrile seizures by pediatric emergency physicians and fellows
Authors: Sales Justin W. , Bulloch Blake , Hostetler Mark A.
Published: July 2016

Objective:

Febrile seizures are the most common type of childhood seizure and are categorized as simple or complex. Complex febrile seizures (CFSs) are defined as events that are focal, prolonged (> 15 minutes), or recurrent. The management of CFS is poorly defined. The objective of this study was to determine the degree of variability in the emergency department evaluation of children with CFSs.

Methods:

An online survey questionnaire was developed and sent to physicians identified via the listserv of the emergency medicine section of the American Academy of Pediatrics and the pediatric emergency medicine discussion list. The questionnaire consisted of five hypothetical case vignettes describing children under 5 years of age presenting with a CFS. Following review of the first four vignettes, participants were asked if they would (1) obtain blood and urine for evaluation; (2) perform a lumbar puncture; (3) perform neurologic imaging while the child was in the emergency department; (4) admit the child to the hospital; or (5) discharge with follow-up as an outpatient, with either the primary care provider or a neurologist. The final vignette determined if antiepileptic medication would be prescribed by the physician on discharge.

Results:

Of the 353 physicians who participated, 293 (83%) were pediatric emergency medicine attending physicians and 60 (17%) were pediatric emergency medicine fellows. Overall, 54% of participants indicated that they would obtain blood for evaluation, 62% would obtain urine, 34% would perform a lumbar puncture, and 36% would perform neurologic imaging. The overall hypothetical admission rate for the case vignettes was 42%.

Conclusions:

This study indicates that extensive variability exists in the emergency department approach to patients with CFS. Our findings suggest that optimal management for CFS remains unclear and support the potential benefit of future prospective studies on this subject.
Failed validation of the Quebec shoulder dislocation rule for young adult patients in an Australian emergency department
Authors: Ong Siang , Kelly Anne-Maree , Gunn Barry
Published: July 2016

Objective:

The Quebec shoulder dislocation rule is a recently derived clinical decision rule to guide physicians on the selective use of radiography in patients with shoulder dislocation. The aim of this studywas to validate the Quebec shoulder dislocation rule.

Methods:

This was a secondary analysis of data collected in a retrospective cohort study. All patients presenting to the emergency department (ED) between January 1, 2003, and October 31, 2008, with a diagnosis of shoulder dislocation or fracture-dislocation were identified from ED management databases. Data collected included demographics, mechanism of injury, and presence of fracture. The outcome of interest was predictive performance of the Quebec shoulder dislocation rule for patients aged under 40 years on this cohort. Data analysis is descriptive.

Results:

Of the 346 patients identified, 196 were aged under 40 years, and 174 (89%) were male; the median age was 25 years (interquartile range 21–29 years), and 58 were recurrent dislocations. One hundred sixteen patients (59%) met the Quebec high-risk criteria, and 80 (41%) were classified as low risk. In the 196 patients aged less than 40 years, 12 fractures as defined were identified (6%). When applied to this cohort, the Quebec clinical decision rule had a sensitivity of 0.42 (95% CI 0.16–0.71), a specificity of 0.40 (95% CI 0.33–0.47), and a negative predictive value of 0.91 (95% CI 0.82–0.96).

Conclusion:

The Quebec shoulder dislocation rule had poor sensitivity for clinically significant fractures associated with shoulder dislocations in young patients (aged 16–39 years) presenting to an Australian emergency department. Its use cannot be recommended.
Neuropathic ankle fractures
Authors: Tucker Allison , Stone N. Craig
Published: July 2016

A 65-year-old diabetic female presented with a 3-week history of a left swollen foot after a minor inversion injury and was found to have a minimally displaced fibular fracture. Despite casting and strict instructions to remain non-weight bearing, the patient continued to bear weight and later developed a significantly more displaced fracture with a draining ulcer. This injury eventually required a tibiotalocalcaneal arthrodesis using a retrograde hindfoot nail. Neuropathy and neuropathic fractures can be devastating complications of diabetes and thus require early diagnosis and intervention because they may result in significant morbidity for the patient. Thorough assessment involving imaging, a complete history and physical examination, and tools such as a 129 Hz tuning fork and the 10 g Semmes- Weinstein monofilament are paramount to establishing an accurate initial diagnosis. These tactics aid in future followup of the patient's injury and can be employed in both the clinic and the emergency department. Although management remains controversial for neuropathic ankle fractures because both conservative and surgical treatment regimens have high complication rates, open reduction and internal fixation continues to be the treatment of choice once closed reduction has been attempted and fails. Education is essential because diabetic patients have compromised pain and pressure sensation, which can lead to injuries and subsequent complications of which they are simply unaware. Physicians must be diligent when evaluating the diabetic foot and be explicit when providing instructions to these patients because preventing these injuries and their complications is the best patient care available.
How do I improve the quality of in-training assessment of learners?
Authors: Bandiera Glen
Published: July 2016

Assessing a learner in the course of a hectic emergency department (ED) rotation is a daunting task for both experienced and new supervisors. This is particularly true if the learner is not doing well. In light of numerous impediments provided by the modern ED environment, sticking to basic principles can result in marked improvement in both the process and the outcome of in-training assessment. This article addresses these important principles for assessment as they apply in the clinical realm of the ED, with a focus on matching expectations to both the trainee and the available assessment strategies. It is critical that teachers strive for clarity, consistency, honesty, and adherence to due process in their learner assessments. This article provides an evidence-informed approach to succeeding with such an approach to clinical assessment.
Use of the Ottawa Ankle Rules in children: a survey of physicians’ practice patterns
Authors: Dowling Shawn K. , Wishart Ian
Published: July 2016

Introduction:

A number of studies have assessed the diagnostic accuracy of the Ottawa Ankle Rules (OAR) in children; however, the role of the OAR in guiding physician radiograph use is unclear.

Objectives:

The primary purpose of this study was to determine the extent to which Canadian pediatric emergency physicians report using the OAR. Secondary goals included determining current diagnostic and management strategies for Salter-Harris 1 (SH-1) injuries of the ankle and which fractures physicians deem to be clinically significant.

Methods:

A self-administered piloted survey was distributed by mail to 215 Canadian pediatric emergency physicians using a modified Dillman technique. Participants were selected through Pediatric Emergency Research Canada (PERC), a national network of health care professionals with an interest in pediatric emergency medicine research.

Results:

Of 209 surveys, 144 were returned, for a response rate of 68.9%. Of those, 87.5% (126 of 144) reported applying the OAR in children to determine the need for radiographs in acute ankle or midfoot injuries. Of those, 65.1% reported using the OAR always or usually, and 64.5% (93 of 144) of physicians stated that they believe all ankle fractures are clinically significant. Although physicians report that they most commonly order the radiographs, 36.2% of participants indicated that radiographs were requisitioned by nurses or other health care providers at their facilities. SH-1 fractures were reported to be most commonly managed by immobilization (83.3%; 120 of 144), with most patients going on to follow-up with an orthopedic surgeon.

Conclusions:

The majority of Canadian pediatric emergency physicians indicate that they use the OAR when assessing children with acute ankle and midfoot injuries. Most physicians believe that all ankle fractures, including SH-1, are clinically significant and have a management preference for immobilization and orthopedic follow-up.
Bedside ultrasonography detects significant femoral vessel overlap: implications for central venous cannulation
Authors: Beaudoin Francesca L. , Merchant Roland C. , Lincoln James , Gardiner Fenwick , Liebmann Otto , Cohn Jamieson
Published: July 2016

Objective:

Our goal was to gain a better understanding of the femoral vessel anatomy as it relates to central venous cannulation. The primary objective of this study was to use bedside ultrasonography to determine the amount of exposed femoral vein at three sites corresponding to surface anatomy of the landmark-based procedure.

Methods:

This cross-sectional study enrolled a random sample of 180 adult patients presenting to a large urban academic emergency department. Subjects underwent standardized ultrasonography to identify and measure the depth and diameter of the femoral vessels and amount of exposed femoral vein at the level of the inguinal ligament (0 cm) 2 cm and 4 cm below. Repeated measures analysis of variance was used to determine significant relationships between vessel measurements and distance from the inguinal ligament.

Results:

The median age was 44.5 (range 19–90) years; 101 patients were male. The mean (± SD) percentage of exposed vein at the inguinal ligament was 83% (± 21). This decreased significantly (p< 0.01) with increasing distance from the inguinal ligament: 65% (± 25) at 2 cm and 56% (± 30) at 4 cm. At every distance away from the inguinal ligament, there were some subjects with no vein exposed.

Conclusion:

This study demonstrates significant overlap of the femoral vessels at sites where landmark-based femoral vein cannulation is often attempted. Our results suggest that ultrasound guidance would be beneficial as femoral vein cannulation may be difficult or impossible in certain individuals owing to anatomic variations.
Bell palsy in Lyme disease–endemic regions of Canada: a cautionary case of occult bilateral peripheral facial nerve palsy due to Lyme disease
Authors: Ho Karen , Melanson Michel , Desai Jamsheed A.
Published: July 2016

Lyme disease caused by the spirocheteBorrelia burgdorferiis a multisystem disorder characterized by three clinical stages: dermatologic, neurologic, and rheumatologic. The number of known Lyme disease–endemic areas in Canada is increasing as the range of the vectorIxodes scapularisexpands into the eastern and central provinces. Southern Ontario, Nova Scotia, southern Manitoba, New Brunswick, and southern Quebec are now considered Lyme disease–endemic regions in Canada. The use of field surveillance to map risk and endemic regions suggests that these geographic areas are growing, in part due to the effects of climate warming. Peripheral facial nerve palsy is the most common neurologic abnormality in the second stage of Lyme borreliosis, with up to 25% of Bell palsy (idiopathic peripheral facial nerve palsy) occurring due to Lyme disease. Here we present a case of occult bilateral facial nerve palsy due to Lyme disease initially diagnosed as Bell palsy. In Lyme disease–endemic regions of Canada, patients presenting with unilateral or bilateral peripheral facial nerve palsy should be evaluated for Lyme disease with serologic testing to avoid misdiagnosis. Serologic testing should not delay initiation of appropriate treatment for presumed Bell palsy.
Ontario children have outgrown the Broselow tape
Authors: Milne William Ken , Yasin Abeer , Knight Janine , Noel Daniel , Lubell Richard , Filler Guido
Published: July 2016

Objective:

The Broselow Pediatric Emergency Tape (Armstrong Medical Industries, Inc., Lincolnshire, IL) (BT) is a well-established length-based tool for estimation of body weight for children during resuscitation. In view of pandemic childhood obesity, the BT may no longer accurately estimate weight. We therefore studied the BT in children from Ontario in a large recent patient cohort.

Methods:

Actual height and weight were obtained from an urban and a rural setting. Children were prospectively recruited between April 2007 and July 2008 from the emergency department and outpatient clinics at the London Health Science Centre. Rural children from junior kindergarten to grade 4 were also recruited in the spring of 2008 from the Avon Maitland District School Board. Data for preschool children were obtained from three daycare centres and the electronic medical record from the Maitland Valley Medical Centre. The predicted weight from the BT was compared to the actual weight using Spearman rank correlation; agreement and percent error (PE) were also calculated.

Results:

A total of 6,361 children (46.2% female) were included in the study. The median age was 3.9 years (interquartile range [IQR] 1.56-7.67 years), weight was 17.2 kg (IQR 11.6-25.4 kg), and height was 103.5 cm (IQR 82-124.4 cm). Although the BT weight estimate correlated with the actual weight (r = 0.95577, p < 0.0001), the BT underestimated the actual weight by 1.62 kg (7.1% ± 16.9% SD, 95% CI -26.0-40.2). The BT had an ≥ 10% PE 43.7% of the time.

Conclusions:

Although the BT remains an effective method for estimating pediatric weight, it was not accurate and tended to underestimate the weight of Ontario children. Until more accurate measurement tools for emergency departments are developed, physicians should be aware of this discrepancy.
Emergency physician estimates of the probability of acute coronary syndrome in a cohort of patients enrolled in a study of coronary computed tomographic angiography
Authors: Lee Chuen Peng , Hoffmann Udo , Bamberg Fabian , Brown David F. , Chang Yuchaio , Swap Clifford , Parry Blair A. , Nagurney John T.
Published: July 2016

Introduction:

Little information exists regarding how accurately emergency physicians (EPs) predict the probability of acute coronary syndrome (ACS). Our objective was to determine if EPs can accurately predict ACS in a prospectively identified cohort of emergency department (ED) patients who met enrolment criteria for a study of coronary computed tomographic angiography (CCTA) and were admitted for a “rule out ACS” protocol.

Methods:

A prospective observational pilot study in an academic medical centre was carried out. EPs caring for patients with chest pain provided whole-number estimates of the probability of ACS after clinical review. This substudy was part of the now published Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography (ROMICAT) study, a study of CCTA and admission of patients for a rule out ACS protocol after a nondiagnostic evaluation. Predictions were grouped into probability groups based on the validated Goldman criteria. ACS was determined by an adjudication committee using American Heart Association/American College of Cardiology/European Society of Cardiology guidelines.

Results:

A total of 334 predictions were obtained for a study population with a mean age of 54 (SD 12) years, 63% of whom were male. There were 35 ACS events. EPs predicted ACS better than by chance, and increasingly higher estimates were associated with a higher incidence of ACS (p = 0.0004). The percentage of patients with ACS was 0%, 6%, 7%, and 17%, respectively, for very low, low, intermediate, and high probability groups. EPs' estimates had a sensitivity of 63% using a > 20% probability of ACS to define a positive test. Lowering this threshold to > 7% to define a test as positive increased the sensitivity of physician estimates to 89% but lowered specificity from 65% to 24%

Conclusions:

Our data suggest that for a selected ED cohort meeting eligibility criteria for a study of CCTA, EPs predict ACS better than by chance, with an increasing proportion of patients proving to have ACS with increasing probability estimates. Lowering the estimate threshold does not result in an overall sensitivity level that is sufficient to send patients home from the ED and is associated with a poor specificity.