bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimising fast track care for proximal femoral fracture patients using modified early warning score
Authors: Ollivere B , Rollins K , Brankin R , Wood M , Brammar TJ , Wimhurst J
Published: May 2012

INTRODUCTION

The care for patients with a proximal femoral fracture has been dramatically overhauled with the introduction of ‘fast track’ protocols and the British Orthopaedic Association guidance in 2007. Fast track pathways focus on streamlining patient flow through the emergency department where the guidance addresses standards of care. We prospectively examined the impact these protocols have on patient care and propose an alternative ‘streamed care’ pathway to provide improved medical care within existing resource constraints.

METHODS

Data surrounding the treatment of 156 consecutive patients managed at 4 centres were collated prospectively. Management of patients with a traditional fast track protocol allowed 17% of patients to leave the emergency department with undiagnosed serious medical pathology and 32% with suboptimal fluid resuscitation. A streamed care pathway based on the modified early warning score was developed and employed for 48 further patients as an alternative to the traditional fast track system.

RESULTS

The streamed care pathway improved initial care significantly by treating patients according to their physiological parameters on admission. Targeted medical reviews on admission instead of the following day reduced the rates of undiagnosed medical pathology to 2% (p=0.0068) and inadequate fluid resuscitation to 11% (p<0.0001).

CONCLUSIONS

Implementation of a streamed care pathway can allow protocol driven improvement to initial care for patients with a proximal femoral fracture and results in improved access to initial specialist medical care.
A perforated duodenal ulcer presenting as inferior lead ST elevation following amphetamine use
Authors: Jones HG , Hopkins L , Clayton A , McKain E
Published: May 2012

Typical symptoms of duodenal ulcers include epigastric pain, nausea, vomiting, chest pain and shortness of breath. Here we present the case of a 39-year-old man who had a sudden onset of chest and epigastric pain following the use of recreational amphetamines. There were ST changes in the inferior leads of his electrocardiogram, indicating the possibility of a myocardial infarction. Following double contrast computed tomography of the abdomen and an urgent laparotomy, a diagnosis of a perforated duodenal ulcer was made. We discuss the aetiologies, presentation, investigation and treatment of the disorder, and make recommendations on the management.
Primary angiosarcoma of the larynx: a rare entity
Authors: Katna R , Deshmukh A , Sridhar E , Chaukar D , D’Cruz A
Published: May 2012

Angiosarcomas are extremely rare malignant tumours of the larynx. We present a case of laryngeal angiosarcoma in a 58-yearold man who presented with hoarseness of voice, dysphagia and neck swelling. The patient underwent a total laryngectomy with a pre-operative and frozen section diagnosis of a poorly differentiated carcinoma of the larynx. Histopathological and immunohistochemical evaluation revealed features of a laryngeal angiosarcoma. The case is presented for its rarity and diagnostic difficulty.
A rare case of perforated caecum after acute pancreatitis
Authors: Martin LCE , Stavrou M , El-Madani F , Naik V , Jain K , Gupta S
Published: May 2012

Isolated caecal perforation following pancreatitis is a rare event. We report a case of severe non-necrotising pancreatitis complicated by caecal perforation that was managed successfully.
Curtain gastroplasty as an option in high risk emergency hiatus hernia repair
Authors: Pollard JS , Lewis CJ
Published: May 2012

Introduction

We describe a novel surgical technique used in the case of an 86-year-old Caucasian man with multiple comorbidities who presented with upper intestinal obstruction caused by a large paraoesophageal hiatus hernia and concurrent urinary sepsis.

Methods

The technique, which minimises both operative time and surgical trauma in this situation, uses the fundus of the stomach in a modified Dor anterior fundoplication as a gastric fundoplasty to close the defect. The total operative time was 70 minutes.

Results

The patient’s recovery was complicated by a lower respiratory tract infection but he was discharged 14 days after surgery with a premorbid oral intake and activity level.

Conclusions

We believe this curtain gastroplasty technique represents another surgical option to reduce operative time and trauma in a subgroup of high risk patients presenting with life threatening complications of a large hiatus hernia who have limited physiological reserve and evidence of current ongoing sepsis.
A National Survey of Ultra Clean Air Theatre Use in Orthopaedic Trauma
Authors: Jarvis N , Dheerendra S , Chappell D , Goel A , Pidikiti P
Published: May 2012

The consequences of deep surgical site infection (SSI) following orthopaedic operations can be devastating. Trauma patients, especially those suffering fragility fractures, tend to have less reserve and more co-morbidities than elective patients; infection in their case may be even more catastrophic. It is also expensive: Dreghorn et al calculated that revising infected arthroplasties was up to four times the cost of a primary total joint replacement. Maintaining low infection rates in trauma surgery depends on meticulous surgical technique, peri-operative antibiotics and scrupulous theatre standards, including the use of laminar or ultra clean air (UCA) operating theatres for sterile orthopaedic procedures.
Could Telephone Reviews Reduce Read Mission Rates After Laparoscopic Colorectal Surgery?
Authors: Stewart J , Lloyd GM , Smith JK , Acheson AG , Williams JP , Maxwell-Armstrong CA
Published: May 2012

Significant advances have been made recently in the management of patients undergoing colorectal surgery. demonstration of the advantages of laparoscopic colorectal surgery over the open approach in terms of faster patient recovery, shorter length of hospital stay, less pain and fewer wound problems with identical oncological outcome has led to the widespread adoption of the technique. Simultaneously, based on the original work of Kehlet, enhanced recovery after surgery (ERAS) programmes that capitalise on the reduced physiological insult stimulated by laparoscopic surgery have gained in popularity. Coupled, laparoscopic surgery and ERAS allow many patients undergoing major colorectal resections to be discharged from hospital on the first to third post-operative day.
The Impact of the European Working Time Regulations on Orthopaedic Trainee Operative Experience
Authors: Wraighte PJ , Forward DP , Manning P
Published: May 2012

Trauma and orthopaedic surgery (T&O) has the largest number of trainees of any individual surgical specialty in the UK. It is a craft-based specialty, with 'hands-on' training, based on an apprenticeship model involving operative and procedural skills. In 1992 Kenneth Calman, then Chief Medical Officer, set up a working group to reform the specialist curriculum, placing more emphasis on structured teaching, supervised learning and surgical experience.
Making the Operating Theatre a 'High-Reliability' Environment
Authors: Baxendale Bryn , Lovett Bryony
Published: May 2012

The public, healthcare commissioners and regulators rightly seek assurances about delivery of reliable, high-quality surgical care. The Department of health's 'never events' framework 1 specifically lists patient misidentification, wrong-site surgery and retained swabs and instruments as unacceptable occurrences. Professional conversations reveal many seemingly inconsequential daily occurrences that have an impact on patient outcome and ongoing management. Unfortunately, many of these incidents are not reported formally by those involved, which limits the opportunity for professionals and organisations to learn from subsequent analysis.
Supporting your teaching, learning and CPd: news from the RCS Library
Authors: Howard Eric
Published: May 2012

In January 2012, more electronic journals became available to fellows, members, postgraduate affiliates and associates of the RCS. Since January, the College's Library and Surgical Information Services have provided access to another key learning resource and plan to find out more about your usage and opinions of the electronic resources to ensure we are providing services that match your needs as closely as possible.
Dracula’s Eastern Legacy: Japanese Vampire Films of the 1970s
Authors: Hutchings Peter
Published: May 2012

This paper explores three Japanese vampire films directed by Michio Yamamoto for Toho Studios, Chi o suu ningyo (Legacy of Dracula 1970), Chio suu me (Lake of Dracula 1971), and Chi o suu bara (Evil of Dracula 1974). These films raise interesting issues about the international nature
of horror production during this period, and, in particular, the ways in which Japanese cinema incorporates generic conventions developed in the West. The paper identifies indeterminate qualities within the films and argues that this makes it difficult to place them definitively within either
a national or an international context. It is suggested that accounts of horror would benefit from taking fuller account of the playful, improvisatory elements evident not just within Yamamoto’s work but more widely in the genre.
Nation and Corruption: The Politics of Citizenship in Popular Telugu Cinema
Authors: Ramesh K. Sree
Published: May 2012

This article examines the effects of political corruption in India, perceiving it as one of the major detriments for the nation’s growth and a major obstacle to the functioning of democracy and the rule of law, and arguing that its effect on the social fabric of society is the
most damaging as it undermines people’s trust in the political system, institutions, and its leadership. This article examines the portrayal of corruption and the alienation of the citizen in recent popular Telugu films, focusing in particular on Bharateeyudu (Shankar, 1996), Tagore
(VV. Vinayak, 2003) and Aparichitudu (Shankar, 1996), arguing that corruption, political as well as bureaucratic, has been the sub text if not the main theme of many Telugu films over the decades. It argues that the films are an attempt to reinstate the citizens, the middle class with both
their rights and responsibilities, as the bulwark of the polity.
Male Subjectivities: The Idealization of the Democratic Public Sphere: Crossroads (1937) and The Trouble Shooters (1988)
Authors: Jing Shen
Published: May 2012

This paper explores male subjectivities that encompass primordial democratic consciousness in both 1930s and 1980s China. Drawing on Jurgen Habermas’s conceptualization of the public sphere, this paper identifies an imagined modern public sphere against Chinese urban representations.
In both Crossroads (1937) and The Trouble Shooters (1988), male protagonists adopt the role of torchbearer in the vibrant urban sphere, working toward a newly defined social justice. Asserting a new male subjectivity evolved with the imaginative public good, providing a training ground for
Chinese democracy. All of the above mirror some prominent features of the public sphere, including the masculine aspect of Habermas’s idealisation of the concept, as pinpointed by Nancy Fraser (1992).
Policing Sexuality: Confession, Power, and the Heterosexist Authority in East Palace, West Palace
Authors: Chiang Mei-Hsuan
Published: May 2012

This article examines the changes in the Chinese government’s attitude to homosexuality in the last 20 years, in relation to the Zhand Yuan’s film East Palace, West Palace (1996). It argues that the real controversy of the movie lies in the power relationship between the
heterosexual male authority and gay men, which is illustrated by the police officer and the gay writer he catches in the park. This paper will first examine the figure of the heterosexist authority and its disciplinary power. Following the discussion of the heterosexist authority’s potential
homosexuality, the paper will further illustrate how the gay man plots and stages a sadomasochistic play during the police questioning. Finally, this paper will focus on the verbal exchange between the police officer and the gay man during the interrogation to discuss the power relationship
between the heterosexist authority and gay men.
Tracing Tradition in Korean Horror Film
Authors: Peirse Alison
Published: May 2012

What makes a Korean horror film Korean? Relatively little has been published to date in English on this topic, and what has been discussed frequently concentrates on Korean horror film’s renaissance at the millennial fin-de-siècle. This paper considers the inception of
the horror genre in 1960s’ Korean cinema through a detailed case study of A Devilish Murder (Salinma 1965, dir. Lee Yong-min). By returning to the 1960s, a specific strand of Korean horror cinema can be traced, one created through associations between modernity, changing ideas of domestic
space, and gendered relationships on one hand, and cinematic techniques predicated upon melodrama and flashbacks on the other.
Agantuk: Ray’s Modernist Coda
Authors: Ray Binayak
Published: May 2012

This article will focus on the way Satyajit Ray’s films are almost invariably concerned with man’s viable connection with his society, his world, his universe. They advocate not the self’s mindless submission to contemporary society, but a new alignment between them.
His heritage might have contributed to this libertarian stance. Belonging to a family with strong links to the Bengal Renaissance, Ray inherited the world-view of a class deeply committed to the European Enlightenment philosophies of progress. Expected therefore is the progressive, secular,
cosmopolitan, liberal-humanist ideal of his work. Ray’s self-confessed credo is to present “not just single aspects of our life today, like contemporary politics, but a broader view of Indian history”. Hence, his persistent efforts to describe the making of a nation as it
emerges from its feudal and colonial past, and embraces modernity to become a new, hybrid postcolonial society.
EXHIBITION REVIEW
Authors: Dillon Patricia A
Published: May 2012

A journey through the visible and invisible: A review of ‘Lost in Lace’ Gas Hall, Birmingham Museum & Art Gallery, Birmingham, 29 October 2011–19 February 2012
Digital practice in material hands: How craft and computing practices are advancing digital aesthetic and conceptual methods
Authors: Harris Jane
Published: May 2012

Craft practitioners have deftly navigated a wide range of digital media tools as they have evolved, to enhance and originate forms of practice. Human centric and analogue methods are informing digital creation, which in some cases is softening a prevalent signature aesthetic evidenced
in the use of computer fabrication processes. This article observes recent applications of computing media in making spheres consistent with this progression, and evidences new roles for makers as they drive technology use and related agendas, which is leading to craft skill influencing wider
realms of practice and industry.
Reviews DVDs
Authors: Agostino Louise , Mertens Jacob , Chatham Hugh , Cassella Dan
Published: May 2012

Shock Corridor (1963) USA Director Samuel Fuller Runtime 101 Minutes USA, 2010 Fish Tank (2009) UK Director Andrea Arnold Runtime 122 minutes USA, 2011 Green Street Hooligans (2005) UK Director Lexi Alexander Runtime 108 minutes USA, 2006 Moon (2009) UK Director Duncan Jones Runtime
97 minutes USA, 2009
The impact of post-Saddam Iraq on the cause of democratization in the Arab world
Authors: Selim Gamal M.
Published: May 2012

This article examines the effect of the Iraqi political order built following the Anglo-American invasion of Iraq in 2003, on the cause of Arab democratization. One of the rationales for the US invasion of Iraq was that it would lead to a democratic Iraq that would serve as a model
of democracy to be emulated within the Arab world. The George W. Bush administration described its intervention in Iraq as a democratizing mission that would transform Iraq into a pro-Western state and create a democratic example for the rest of the Arab world. With the outbreak of the Arab
popular uprisings from late 2010 onward, a number of neoconservative pundits have even praised such uprisings as an outcome of the Bush administration’s freedom agenda in the Middle East, including his democratizing mission in Iraq. This article argues that post-Saddam Iraq did not emerge
as an exemplary political order that could be adopted in the Arab world. Rather, Iraq represented a negative model for emulation, resulting in major setbacks for the cause of democracy in the region.
Constructing narratives as a means of legitimizing political power: Contextualizing the propaganda model in Iraq
Authors: Miller Noah W. , Ko Rosa S.
Published: May 2012

This article examines the media coverage produced by several international news organizations about four bombings carried out in Baghdad in the months preceding Iraq’s national election conducted in March 2010. In particular, it utilizes the propaganda model postulated by Noam
Chomsky and Edward Herman to analyse the construction of narratives of various government actors, and it seeks to determine the extent to which select news organizations were complicit in propagating an elite view. Iraqi and US government and military elites had a strong incentive to co-opt
the media as they sought to convince, particularly the Iraqi public, that insurgent activity could not undermine the security that the Iraqi army and police forces maintained. Moreover, applying the five filters comprising the propaganda model suggests that elites positioned themselves to
disseminate their narratives due, in part, to the high reliance by the media on official sources. Although the media coverage generally did not challenge various elitist views and did not provide alternative viewpoints, this article demonstrates that elites nevertheless failed to establish
a homogenous consensus view. Several observations suggest that elite narratives lacked credibility because of incomplete, contradictory or false information. By revealing the inconsistencies within and between various elite narratives, the media thus fulfilled its basic functions as the fourth
estate.
Experiences of disabled artists doing art in a community art centre
Authors: Reid Denise , Anderson Ellen
Published: May 2012

How adults with disabilities and health conditions experience creating art in a community art centre was explored in this qualitative study. Areas of interest included the influence of place on art making and art making on personal well-being. Eleven adults who regularly engaged in their own art at the Creative Spirit Art centre in Toronto, Canada were interviewed. Interviews were recorded and analysed thematically. Major themes were found: ‘presence in art’; ‘a culture for expression’; and ‘personal benefits’. Participants described how they were present with their art, which emphasized a sense of awareness while they were creating their art. They described how the relationship between the environment and personal energies influenced their art and sense of being valued and respected as artists. The findings from this study contribute to the power that art making in an enabling, supportive community setting as a valued activity influences identity, mindful occupational engagement and the well-being of individuals with disability and health conditions.
Mediating memory: Strategies of interaction in public art and memorials
Authors: Björgvinsson Erling , Hansen Anders Høg
Published: May 2012

This article addresses how a selection of participatory art and memorial projects have engaged with public memory and interaction. The intention is to explore the tension between the artists’ strategies and the actual lifespan and use of the artworks by their audiences. The authors interviewed the artists Esther Shalev-Gerz, Alfredo Jaar and Rafael Lozano-Hemmer (during 2008 and 2009) and examined specific works. In addition, one of the literally ‘groundbreaking’ works of process art by Robert Smithson, Partially Buried Woodshed, was included in the analysis of cases that have provoked interesting social or collective memory debates and community interaction around public art.
Rab3A Mediates Vesicle Delivery at Photoreceptor Ribbon Synapses
Authors: Tian Miao , Xu C. Shan , Montpetit Rachel , Kramer Richard H.
Published: May 2012

Rab3A is a synaptic vesicle-associated protein found throughout the nervous system, but its precise function is unknown. Genetic knock-out studies show that Rab3A is not necessary for vesicular release or replenishment at conventional synapses in the brain. Here we explore the function of Rab3A at ribbon synapses in the retina of the tiger salamander (Ambystoma tigrinum). Fluorescently labeled Rab3A, delivered into rods and cones through a patch pipette, binds to and dissociates from synaptic ribbons. Experiments using nonphosphorylatable GDP analogs and a GTPase-deficient Rab3A mutant indicate that ribbon binding and dissociation are governed by a GTP hydrolysis cycle. Paired recordings from presynaptic photoreceptors and postsynaptic OFF-bipolar cells show that the Rab3A mutant blocks synaptic release in an activity-dependent manner, with more frequent stimulation leading to more rapid block. The frequency dependence of block by exogenous Rab3A suggests that it acts competitively with synaptic vesicles to interfere with their resupply to release sites. Together, these findings suggest a crucial role of Rab3A in delivering vesicles to Ca2+-dependent release sites at ribbon synapses.
Developmental Changes in Medial Auditory Thalamic Contributions to Associative Motor Learning
Authors: Ng Ka H. , Freeman John H.
Published: May 2012

Eyeblink conditioning (EBC) was used in the current study to examine the mechanisms underlying the ontogeny of associative motor learning in rats. Eyeblink conditioning emerges ontogenetically between postnatal day 17 (P17) and P24 in rats. Previous studies used electrical stimulation to show that the ontogeny of EBC is influenced by developmental changes in input from the medial auditory thalamus to the pontine nuclei, which in turn affects input to the cerebellum. The current study used tetrode recordings to examine the ontogeny of medial auditory thalamic sensory responses to the conditioned stimulus (CS) and learning-related activity during EBC. Rat pups were implanted with multiple tetrodes in the medial nucleus of the medial geniculate (MGm) and suprageniculate (SG) and trained on delay EBC on P17–P19, P24–P26, or P31–P33 while recording spike activity. Developmental changes in MGm and SG sensory-related activity were found during a pretraining session with unpaired presentations of the auditory CS and periorbital stimulation unconditioned stimulus (US). Substantial developmental changes were observed in learning-related activity in the MGm and SG during CS–US paired training. The ontogenetic changes in learning-related activity may be related to developmental changes in input to the medial auditory thalamus from the amygdala and cerebellum. The findings suggest that the ontogeny of associative motor learning involves developmental changes in sensory input to the thalamus, amygdala input to the thalamus, thalamic input to the pontine nuclei, and cerebellar feedback to the thalamus.
Visual Attentional Load Influences Plasticity in the Human Motor Cortex
Authors: Kamke Marc R. , Hall Michelle G. , Lye Hayley F. , Sale Martin V. , Fenlon Laura R. , Carroll Timothy J. , Riek Stephan , Mattingley Jason B.
Published: May 2012

Neural plasticity plays a critical role in learning, memory, and recovery from injury to the nervous system. Although much is known about the physical and physiological determinants of plasticity, little is known about the influence of cognitive factors. In this study, we investigated whether selective attention plays a role in modifying changes in neural excitability reflecting long-term potentiation (LTP)-like plasticity. We induced LTP-like effects in the hand area of the human motor cortex using transcranial magnetic stimulation (TMS). During the induction of plasticity, participants engaged in a visual detection task with either low or high attentional demands. Changes in neural excitability were assessed by measuring motor-evoked potentials in a small hand muscle before and after the TMS procedures. In separate experiments plasticity was induced either by paired associative stimulation (PAS) or intermittent theta-burst stimulation (iTBS). Because these procedures induce different forms of LTP-like effects, they allowed us to investigate the generality of any attentional influence on plasticity. In both experiments reliable changes in motor cortex excitability were evident under low-load conditions, but this effect was eliminated under high-attentional load. In a third experiment we investigated whether the attentional task was associated with ongoing changes in the excitability of motor cortex, but found no difference in evoked potentials across the levels of attentional load. Our findings indicate that in addition to their role in modifying sensory processing, mechanisms of attention can also be a potent modulator of cortical plasticity.
Regulation of Fasciclin II and Synaptic Terminal Development by the Splicing Factor Beag
Authors: Beck Erin S. , Gasque Gabriel , Imlach Wendy L. , Jiao Wei , Jiwon Choi Ben , Wu Pao-Shu , Kraushar Matthew L. , McCabe Brian D.
Published: May 2012

Pre-mRNA alternative splicing is an important mechanism for the generation of synaptic protein diversity, but few factors governing this process have been identified. From a screen forDrosophilamutants with aberrant synaptic development, we identifiedbeag, a mutant with fewer synaptic boutons and decreased neurotransmitter release.Beagencodes a spliceosomal protein similar to splicing factors in humans andCaenorhabditis elegans. We find that bothbeagmutants and mutants of an interacting genedsmu1have changes in the synaptic levels of specific splice isoforms of Fasciclin II (FasII), theDrosophilaortholog of neural cell adhesion molecule. We show that restoration of one splice isoform of FasII can rescue synaptic morphology inbeagmutants while expression of other isoforms cannot. We further demonstrate that this FasII isoform has unique functions in synaptic development independent of transsynaptic adhesion.beaganddsmu1mutants demonstrate an essential role for these previously uncharacterized splicing factors in the regulation of synapse development and function.
Dopaminergic Modulation of Mitral Cells and Odor Responses in the Zebrafish Olfactory Bulb
Authors: Bundschuh Sebastian T. , Zhu Peixin , Schärer Yan-Ping Zhang , Friedrich Rainer W.
Published: May 2012

In the olfactory bulb, the modulatory neurotransmitter dopamine (DA) is coexpressed with GABA by local interneurons, but its role in odor processing remains obscure. We examined functions of DA mediated by D2-like receptors in the olfactory bulb of adult zebrafish by pharmacology, whole-cell recordings, calcium imaging, and optogenetics. Bath application of DA had no detectable effect on odorant-evoked sensory input. DA directly hyperpolarized mitral cells (MCs) via D2-like receptors and slightly increased their response gain. Consistent with this effect on input–output functions of MCs, small odorant responses were suppressed, whereas strong responses were enhanced in the presence of DA. These effects increased the root-mean-square contrast of population activity patterns but did not reduce their correlations. Optical stimulation of interneurons expressing channelrhodopsin-2 evoked fast GABAergic inhibitory currents in mitral cells but failed to activate D2receptor-mediated currents when stimuli were short. Prolonged stimulus trains, however, activated a slow hyperpolarizing current that was blocked by an antagonist of D2-like receptors. GABA and DA are therefore both released from interneurons by electrical activity and hyperpolarize MCs, but D2-dependent dopaminergic effects occur on slower timescales. Additional effects of DA may be mediated by D1-like receptors. These results indicate that DA acts on D2-like receptors via asynchronous release and/or volume transmission and implicate DA in the slow adaptation of circuit function. The shift of the membrane potential away from spike threshold could adapt mitral cells to background input without compromising their sensitivity.
Broadband Rotational Spectroscopy for Molecular Structure and Dynamics Studies
Authors: Schnell Melanie
Published: May 2012

Recent technological advances enabled the development of a new broadband Fourier transform microwave spectrometer in 2006. Since then, more than 15 broadband spectrometers have become operational worldwide and have also been extended to the millimeter wave and the terahertz frequency range. In the experiment, the microwave frequency is linearly swept within a short chirp covering up to 12 GHz so far. This chirped pulse efficiently polarizes the molecular sample at all frequencies lying within this frequency range. Fourier transformation of the molecular response from the time domain to the frequency domain gives the broadband rotational spectrum. This new instrument removes one of the major disadvantages of cavity-based Fourier transform microwave spectroscopy, which has been its slowness. As a consequence, rotational spectroscopy is now concentrating on even larger and more complex molecules. Also double-resonance experiments are now facilitated. Furthermore, the broadband technique opens the door towards new directions of rotational spectroscopy, i.e., towards dynamics studies such as the investigation of isomerization reactions.
Studying Li Dynamics in a Gas-Phase Synthesized Amorphous Oxide by NMR and Impedance Spectroscopy
Authors: Epp Viktor , Brünig Christian , Binnewies Michael , Heitjans Paul , Wilkening Martin
Published: May 2012

Li diffusion parameters of a structurally disordered Li-Al-Si-oxide prepared by gas-phase synthesis were complementarily investigated by both time-domain NMR techniques and impedance spectroscopy. The first include 7Li NMR spin-lattice relaxation (SLR) measurements in the laboratory as well as in the rotating frame of reference. An analysis of variable-temperature NMR line widths point to an activation energy Ea
of approximately 0.6 eV. The value is confirmed by rotating-frame SLR NMR data recorded at approximately 11 kHz. Above room temperature the low-temperature flank of a diffusion-induced rate peak shows up which can be approximated by an Arrhenius law yielding Ea=0.56(1) eV. This is in very good agreement with the result obtained from 7Li spin-alignment echo (SAE) NMR being sensitive to even slower Li dynamics. For comparison, dc-conductivity measurements, probing long-range motions, yield Ea=0.8 eV. Interestingly, low-temperature SAE NMR decay rates point to localized Li motions being characterized with a very small activation energy of only 0.09 eV.
Prediction, prevention and management of shoulder dystocia
Authors: Csorba Roland
Published: May 2012

Shoulder dystocia is one of the most tragic, fatal and unexpected obstetrical events, which is mostly unpredictable and unpreventable. This clinical picture is defined as a delivery that requires additional obstetric maneuvers to release the shoulders after gentle downward traction has failed. Shoulder dystocia occurs when the fetal shoulder impacts on the maternal symphysis or sacral promontory. The incidence of shoulder dystocia is 0.2–0.6%. High perinatal mortality and morbidity is associated with the condition, even when it is managed appropriately. Obstetricians should be aware of the existing risk factors, but should always be alert to the possibility of shoulder dystocia in all labors. Maternal morbidity is also increased, particularly postpartum hemorrhage, rupture of the uterus, injury of the bladder, urethra and the bowels and fourth-degree perineal tears. Complications of the newborn include asphyxia, perinatal mortality, fracture of the clavicula and the humerus. Brachial plexus injuries are one of the most important fetal complications of shoulder dystocia, complicating 4–16% of such deliveries. The purpose of this article is to review the current evidence regarding the possible prediction, prevention and management of shoulder dystocia. Orv. Hetil., 2012, 153, 763–767.
The efficacy and safety of acenocoumarol and warfarin therapy in patients with lower limb deep vein thrombosis
Authors: Bernát Sándor Iván , Rókusz László
Published: May 2012

Only few studies are available on the comparison of the efficacy and safety of the acenocoumarol and warfarin. The authors treated patients with deep vein thrombosis according to latest recommendations using D-dimer measurements and duplex ultrasound exams. Aims: To examine the efficacy and safety of the two anticoagulants in patients with lower limb deep vein thrombosis. Methods: The authors included 100 consecutive patients with lower limb dee deep vein thrombosis. The patients were treated with acenocoumarol or warfarin in doses to achieve INR values between 2 and 3.5 for six months. After 6 months the authors performed physical examination, D-dimer measurements and ultrasound exams, and determined the rate of unchanged thrombotic process, as well as the rate of complete and incomplete recanalisations. Results: There was no significant difference in the number of INR determinations during treatment between the two groups (acenocoumarol group 442, warfarin group 416). The INR values were in the therapeutic range in 71.2% and 75.4% of patients in the acenocoumarol and warfarin groups, respectively. Dose adjustment was necessary in 129 and 84 times in the acenocoumarol and warfarin groups, respectively (p = 0.0025). The therapy was optimally effective (INR value was within the therapeutic range throughout the treatment period) in 46% and 52% of patients in the acenocoumarol and warfarin groups, respectively. The thrombotic vein was completely recanalised in 91.9% of patients treated optimally, and only 80.4% of patients treated not optimally. There were 3 minor bleedings in the acenocoumarol and 4 minor bleedings in the warfarin groups, while one major bleedings occurred in both groups. Conclusions: The INR values were more stable in the warfarin group than in the acenocumarole group. In both groups the rate of complete vein recanalization was related to the rate of optimally stable INR values within the therapeutic range. Orv. Hetil., 2012, 153, 786–790.
Binding Mechanisms of As(III) on Activated Carbon/Titanium Dioxide Nanocomposites: A potential method for arsenic removal from water
Authors: Özlem Kocabaş Z. , Açıksöz Burcu , Yürüm Yuda
Published: May 2012

Novel nanocomposite materials where titanium dioxide nanoparticles were inserted into the walls of a macroporous activated carbon were produced and their efficiency for the removal of As(III) from water was compared with pure activated carbon and titanium dioxide nanoparticles. The nanocomposites were synthesized with different molar ratios by using sol-gel method and were characterized by x-ray diffraction (XRD) and scanning electron microscopy (SEM). The nanocomposite system showed excellent capability for the removal of As(III) ions from water by considering feasibility, efficiency and cost. The maximum As(III) removal percentages were ∼4.7% at pH 8 for activated carbon, ∼38 % for titanium dioxide at pH 6, and ∼98 % at pH 7 for activated carbon/titanium dioxide (AC/TiO2) nanocomposite, respectively. According to kinetic sorption data, the higher regression coefficients (R2) were obtained after the application of pseudo-second order to the experimental adsorption data for all adsorbent materials. The equilibrium data were modeled with the help of Langmuir and Freundlich equations. Overall, the data are well fitted with both the models, with a slight advantage for Langmuir model. The maximum arsenic uptake (qmax) value computed from slope of the linearized Langmuir plot was 26.62 mg/g for the adsorption of As(III) onto AC/TiO2 nanocomposite.
Desenvolvimento larval de Brycon hilarii (Characiformes, Characidae)
Authors: Oliveira Fernando G. de , Bialetzki Andréa , Gomes Luiz C. , Santin Miriam , Taguti Tátia L.
Published: May 2012

O presente estudo caracterizou o desenvolvimento inicial de Brycon hilarii (Valenciennes, 1850) através de caracteres morfométricos e merísticos e analisou as relações entre as características morfométricas das larvas ao longo do desenvolvimento usando modelos de regressão linear, quadrática e linear por partes. O material foi obtido nas bacias dos rios Cuiabá e Manso, Mato Grosso, Brasil, entre março de 2000 e março de 2004. Os indivíduos foram identificados e separados de acordo com o grau de desenvolvimento da notocorda e, posteriormente, medidos e contados os caracteres morfométricos e merísticos, respectivamente. O comprimento padrão variou entre 3,25 e 26,00 mm. Inicialmente, as larvas apresentaram maior concentração de pigmentos dendríticos ao longo do intestino e, em flexão e pós-flexão, intensificaram-se no dorso do corpo. Uma mancha umeral e outra no pedúnculo caudal foram observadas no final do estágio de pós-flexão. O intestino apresentou-se longo, o focinho curto, o órgão adesivo presente em larval vitelino e pré-flexão e a boca terminal por todo o desenvolvimento. O número total de miômeros variou de 41 a 50 (23 a 30 pré e 16 a 24 pós-anal). O número de raios das nadadeiras foi: dorsal 11; anal 30; peitoral 15 e ventral oito. A análise do crescimento indicou maior metamorfose no estágio de flexão.
Operações laparoscópicas conservadoras do baço para tratar dor esplênica por isquemia
Authors: Petroianu Andy , Cabezas-Andrade Marco Antonio , Berindoague Neto René
Published: May 2012

RACIONAL: Desde 1979 este grupo de autores executa esplenectomia conservadora através de esplenectomia sub-total e autotransplante esplênico. Estes procedimentos foram realizados em mais de 300 pacientes para tratar diferentes condições patológicas. OBJETIVO: Apresentar proposta original e inédita em seres humanos de esplenectomia subtotal, preservando apenas o pólo superior do baço por via laparoscópica e esplenectomia total complementada por implante autógeno de tecido esplênico, também pela via laparoscópica, como nova forma de tratamento da dor severa devida à isquemia do baço. MÉTODOS: Três pacientes com intensa dor no hipocôndrio esquerdo foram submetidos a grande número de exames para concluir que sua dor era provocada por isquemia de parte do baço. A dor era resistente a todos os métodos conservadores utilizados. Decidiu-se, então, pelo tratamento cirúrgico por meio da esplenectomia subtotal, preservando o pólo superior do baço suprido pelos vasos esplenogástricos em dois casos, e esplenectomia total complementada por implante no omento maior de 20 fragmentos retirados desse baço, no terceiro caso. As três operações foram realizadas por via laparoscópica. Os três doentes foram acompanhados com exames hematológicos, imunológicos, tomográficos e cintilográficos. RESULTADOS: Esses procedimentos foram conduzidos sem risco para os paciente e com sangramento mínimo. Não houve dificuldade técnica nem complicações per ou pós-operatórias. No seguimento, não foram constatadas anormalidades, comprovando-se a vitalidade e a função dos remanescentes esplênicos. A dor esplênica desapareceu desde o dia da operação e não retornou durante o período de acompanhamento. CONCLUSÃO: A esplenectomia subtotal e os auto-implantes esplênicos são factíveis por via laparoscópica, de maneira segura para os doentes e devem deve ser considerados no tratamento da dor de origem isquêmica do baço.
Carcinoma basalóide escamoso: uma forma rara e agressiva de câncer do esôfago e revisão da literatura
Authors: Henry Maria Aparecida Coelho de Arruda , Lerco Mauro Masson , Oliveira Walmar Kerche de , Rodrigues Maria Aparecida Marchesan
Published: May 2012

RACIONAL: O carcinoma basalóide escamoso ocorre com maior freqüência no trato aerodigestivo superior e raramente acomete o esôfago. OBJETIVO: Apresentar os aspectos clínico-patológicos e os atributos imunoistoquímicos de um paciente com carcinoma basalóide escamoso do esôfago. RELATO DO CASO: Dos 134 pacientes com câncer do esôfago atendidos no Hospital Universitário de Botucatu-Unesp, São Paulo, de 1990 a 1999, somente um paciente (0,74%) apresentou carcinoma basalóide escamoso do esôfago. Tratava-se de paciente masculino, 41 anos, branco, lavrador com disfagia, regurgitação e emagrecimento há três meses. Referia tabagismo e etilismo há muitos anos. O esofagograma e o exame endoscópico revelaram lesão vegetante no terço distal do esôfago. A biópsia demonstrou neoplasia intraepitelial de alto grau associada a blocos de células basalóides que infiltravam o cório da mucosa, caracterizando o carcinoma basalóide escamoso. Os marcadores imunoistoquímicos foram positivos para o antígeno carcinoembriônico e para citoceratinas de alto peso molecular. A tomografia computadorizada revelou múltiplas metástases nos pulmões, fígado, e nódulos linfáticos regionais, documentando a fase avançada de evolução da doença. O tratamento consistiu apenas na realização de gastrostomia. O paciente apresentou queda acentuada do estado geral e evoluiu para óbito com quadro de melena quatro meses após o diagnóstico. CONCLUSÃO: O carcinoma basalóide escamoso é uma forma rara e agressiva de câncer do esôfago e o prognóstico depende do estadiamento da lesão e das condições clínicas do paciente no momento do diagnóstico.
Geomorfologia, cobertura sedimentar e transporte de sedimentos na plataforma continental interna entre a Ponta de Saquarema e o Cabo Frio (RJ)
Authors: Muehe Dieter , Carvalho Vânia Guaycuru de
Published: May 2012

A plataforma continental interna defronte à restinga da Massambaba - um sistema de duplos cordões litorâneos localizados entre Saquarema e Arraial do Cabo, com 48 km de extensão - apresenta topografia regular, interrompida por raros afloramentos de rochas do embasamento cristalino e por ocorrências localizadas de arenitos de praia. Um amplo afloramento destes últimos ocorre na faixa batimétrica de 48 a 60 m, correspondendo à posição da linha de costa cerca de 10.000 anos atrás. Outro afloramento de arenitos de praia, de reduzida dimensão, ocorre próximo ao perfil S-4, à distância de 50 m da face da praia, em profundidade de 4 m. A cobertura sedimentar, sem aporte significativo de sedimentos terrígenos, é constituída predominantemente por areias quartzosas reliquiares. O gradiente batimétrico apresenta declividade elevada, atípica para uma plataforma passiva, atingindo o limite distai da plataforma continental interna, a isobatimétrica de 60 m, a uma distância da ordem de 4 milhas náuticas da linha de praia. O padrão de distribuição granulométrico apresenta gradientes de decréscimo em direção a leste, isto é, em direção ao Cabo Frio, e em direção a maiores profundidades. A diminuição do tamanho granulométrico em direção ao Cabo Frio é atribuída como sendo resultado do aporte de sedimentos terrígenos através de um sistema de drenagem pleistocênico, interrompido pela construção do cordão litorâneo mais interiorizado, e à remobilização dos sedimentos por ação de ondas e correntes com transporte residual em direção a leste.
O CAPM e o CAPM condicional na precificação de índices acionários: evidências de mudanças nos coeficientes estimados de 2005 a 2008
Authors: Silva Wendel Alex Castro , Pinto Edimeire Alexandra , Melo Alfredo Alves de Oliveira
Published: May 2012

Este estudo testa e compara duas versões da relação de equilíbrio geral para a predição dos retornos esperados: o CAPM na versão estática e o CAPM na versão condicional, que considera não estacionárias as estimativas dos coeficientes ao longo de um determinado período. A primeira preocupação foi quanto ao poder explicativo de cada modelo e em relação aos efeitos das variáveis econômicas, e a segunda foi examinar a ocorrência de mudanças estruturais e quais os períodos impactaram no comportamento dos coeficientes. A análise foi feita em dados diários de índices representativos de papéis negociados na Bovespa no período compreendido entre 1º de dezembro de 2005 e 31 de outubro de 2008 (721 observações). Para ter um número mínimo de observações e estimar, de forma consistente, os parâmetros dos modelos de regressão e para que a correção de Newey-West pudesse corrigir o problema de ineficiência dos coeficientes quando fossem violados os pressupostos clássicos de ausências de autocorrelação e heterocedasticidade dos resíduos, em alguns casos, teve-se de considerar as quebras que fossem estatisticamente mais significativas por meio do controle do período de monitoramento. Assim, após a aplicação dos testes para verificação das hipóteses clássicas de MQO, constatou-se que o modelo escolhido seria o CAPM condicional, por apresentar menores critérios de informações de Akaike (AIC) e Schwarz (BIC), sem a presença de quebra estrutural. Quando se considerou a presença de quebra estrutural na série temporal, observaram-se mudanças nos riscos sistêmicos e totais ao longo do período observado. Diante desses resultados, recomenda-se investigar os possíveis eventos que provocaram ruptura nas séries, observando os fatores que contribuíram para tal interferência.
A biomecânica em educação física e esporte
Authors: Amadio Alberto Carlos , Serrão Júlio Cerca
Published: May 2012

Trata o artigo da contextualização da biomecânica enquanto disciplina acadêmica que compõe o corpo de conhecimento da Educação Física e do Esporte. São discutidos aspectos relacionados à fundamentação metodológica da avaliação do movimento humano; aspectos históricos; e as perspectivas da aplicação dos conhecimentos de natureza biomecânica para a prática profissional na Educação Física e no Esporte. No que se refere às aplicações profissionais, especial ênfase é dada aos esforços objetivando a otimização do desempenho esportivo, a detecção de soluções para promover a qualidade de vida, e o controle das lesões.
Efeitos da terapia fotodinâmica e de uma única aplicação de laser de baixa potência em bactérias in vitro
Authors: Benvindo Rogério Gubert , Braun Graziela , Carvalho Alberito Rodrigo de , Bertolini Gladson Ricardo Flor
Published: May 2012

O laser de baixa potência vem sendo usado para acelerar a cicatrização em úlceras de pressão devido a seus efeitos cicatrizante, antiinflamatório, antiedematoso e analgésico. No entanto, não há consenso quanto a seu efeito em úlceras infectadas. O objetivo deste estudo foi verificar o efeito bactericida da laserterapia e da terapia fotodinâmica (TFD) com laser de baixa potência, InGaP, 670 nm, em doses de 2, 4 e 6 J/cm², em bactérias gram-positivas e gram-negativas in vitro. Foram preparadas 32 placas de Petri com bactérias, 16 com Pseudomonas aeruginosa e 16 com Staphilococcus aureus. Aleatoriamente dividiu-se cada grupo em oito subgrupos (duas placas cada): três subgrupos tratados só com laserterapia, em doses de 2 J/cm², 4 J/cm² e 6 J/cm²; três subgrupos tratados com TFD, em doses de 2 J/cm², 4 J/cm² e 6 J/cm²; um tratado apenas com fotossensibilizante (azul de metileno a 0,1 µg/ml); e um subgrupo não tratado (controle). Os subgrupos laser e TFD foram irradiados uma única vez e incubados por 24 horas. Os outros dois subgrupos não receberam irradiação. As culturas foram analisadas visualmente para verificação ou não do halo de inibição. Em todos os subgrupos, de ambas as bactérias, não foi observado qualquer halo de inibição nem de crescimento. Conclui-se que a terapia a laser e a fotodinâmica de baixa potência (InGaP, 670 nm) não produziram efeitos bactericidas e/ou bacteriostáticos, tampouco tendo havido efeito bioestimulante sobre as bactérias.