bluuebunny/crossref_metadata_2025 huggingface dataset:
Material multimídia para orientação dos cuidadores de bebês com fissura labiopalatina sobre velofaringe e palatoplastia primária
Authors: Costa Tarcila Lima da , Souza Olivia Mesquita Vieira de , Carneiro Homero Aferri , Chiquito Netto Cristianne , Pegoraro-Krook Maria Inês , Dutka Jeniffer De Cássia Rillo
Published: April 2016

RESUMO Objetivo: O objetivo deste trabalho é apresentar e discutir a elaboração e a avaliação de material multimídia, destinado à orientação dos cuidadores de bebês com fissura labiopalatina, mais especificamente orientação sobre a velofaringe, palatoplastia primária e fala com relação às fissuras labiopalatinas. Métodos: A elaboração do material envolveu interdisciplinarmente as áreas de Fonoaudiologia, Odontologia e Arte. Permeados por princípios da arte-educação, houve definição e execução dos seguintes aspectos: caracterização do público alvo, caracterização do conteúdo, identificação e elaboração de ilustrações didáticas, caracterização da abordagem educacional, elaboração do texto/narração, definição da sequência audiovisual e conversão em vídeo. A avaliação do material foi conduzida com a participação de 41 cuidadores de pacientes com fissura labiopalatina e envolveu a comparação dos conhecimentos dos participantes por meio de um roteiro avaliativo, aplicado antes e depois da apresentação do material. Resultados : Ocorreu aumento para as respostas corretas referentes ao papel da velofaringe e a importância da palatoplastia primária na fala. Conclusão: O material multimídia mostrou-se efetivo na otimização dos conhecimentos dos cuidadores, sugerindo a relevância de seu papel em momentos de orientação.
Questionário Condição de Produção Vocal - Professor: comparação entre respostas em escala Likert e em escala visual analógica
Authors: Giannini Susana Pimentel Pinto , Latorre Maria do Rosário Dias de Oliveira , Ferreira Léslie Piccolotto
Published: April 2016

RESUMO Objetivo: Comparar as respostas referentes aos sintomas vocais em duas versões do questionário Condição de Produção Vocal - Professor (CPV-P), com respostas em escala Likert e em escala visual analógica (EVA), para avaliar qual é a melhor forma de aferição. Métodos: Estudo observacional transversal realizado com professoras em atendimento por distúrbio de voz no período de julho de 2011 a julho de 2012. Todas responderam ao questionário CPV-P em duas versões: com respostas em escala Likert de quatro pontos e em escala analógico-visual em régua de 50 mm. Foram analisadas as questões referentes à dimensão de sintomas vocais. Resultados: A maioria dos sintomas apresentou concordância boa (rouquidão, voz fina, voz variando, voz fraca, esforço ao falar, pigarro, ardor na garganta, dor ao falar) ou regular (perda de voz, falha na voz, voz grossa, cansaço ao falar, garganta seca, bola na garganta, secreção na garganta, dor ao engolir, dificuldade engolir, tosse seca). Conclusão: O questionário CPV-P com respostas em escala Likert mostrou-se mais indicado em relação às respostas em EVA pela facilidade de compreensão e interpretação, bem como por facilitar o registro das respostas para o investigador. Pelo exposto, opta-se pela recomendação de manutenção das respostas em escala Likert para o questionário CPV-P, considerando-se validado quanto à maneira de aferição das respostas. A dimensão de aspectos vocais avaliada no presente estudo, que hoje constitui o Índice de Triagem de Distúrbio de Voz (ITDV), pode ser utilizada em estudos epidemiológicos para estimar a prevalência de sintomas vocais bem na clínica fonoaudiológica ou acompanhamento de professores ao longo da carreira.
ESTUDOS ORGANIZACIONAIS E FILOSOFIA: A CONTRIBUIÇÃO DE DELEUZE
Authors: CAVALCANTI MARIA FERNANDA RIOS
Published: April 2016

RESUMO O presente trabalho tem como objetivo examinar algumas das contribuições da Filosofia deleuzeana para os Estudos Organizacionais. Para tanto, primeiro farei uma leitura geral de sua obra, examinando três marcos de sua filosofia: seu conceito de diferença e suas implicações, a concepção de sujeito engendrada por ela e, finalmente, o papel e relevância de sua parceria com Guattari para concretização de seu projeto filosófico. Concluo que a Filosofia de Deleuze pode contribuir especialmente para estudos empíricos em organizações, fornecendo premissas básicas que podem orientar tais estudos. O artigo visa não só contribuir para uma melhor compreensão do complexo pensamento de um dos filósofos mais importantes do século XX no meio dos Estudos Organizacionais, mas também deseja preencher uma lacuna nesse campo que diz respeito à pungente necessidade de que a reflexão filosófica faça-se presente nele.
OS SENTIDOS DO TRABALHO PARA PROFISSIONAIS DE ENFERMAGEM: UM ESTUDO MULTIMÉTODOS
Authors: RODRIGUES ANDREA LEITE , BARRICHELLO ALCIDES , MORIN ESTELLE M.
Published: April 2016

RESUMO O propósito original deste estudo foi realizar uma análise exploratória do sentido do trabalho para profissionais de enfermagem comparando-os por nível hierárquico (níveis técnico e superior) e por características do ambiente de trabalho. Aplicou-se um questionário estruturado contendo escalas para sentido do trabalho, comprometimento afetivo e estresse no trabalho. Os resultados foram tratados com estatística descritiva, análise fatorial exploratória, análise de correlações e comparação de médias, e confirmaram que o nível hierárquico e o ambiente definem diferenças na percepção do sentido do trabalho e de construtos relacionados a ele. Como o trabalho de campo demandou longas horas de permanência nos hospitais, o estudo foi enriquecido por observações e conversas durante o acompanhamento do serviço. A conjunção de métodos permitiu ampliar o conhecimento sobre fatores que suscitam a experiência de sentido do trabalho em enfermagem. Ele pode emergir de fatores como aumento de empregabilidade, distinção social, conciliação trabalho-família e natureza da relação com gestores e líderes. A perda do sentido, além da queda da produtividade, pode estar associada a comportamentos de resistência ou mesmo de retaliação na forma de absenteísmo e troca de emprego.
Mimosa caesalpiniifolia intercropping, weeds removal and nitrogen fertilization on maize
Authors: Monteiro Alex L , Silva Paulo SL , Tavella Leonardo B , Oliveira Fábio HT , Silva Paulo IB
Published: April 2016

ABSTRACT: Weeding is expensive and laborious, and some weeds may re-establish themselves afterwards. Arboreal leguminous plants can control weeds, and fertilization with nitrogen can increases the competitive ability of the maize. The aim of this work was to evaluate the effects of weed-removal and intercropping with sabiá (Mimosa caesalpiniifolia) on control of weed plants and maize productivity. A randomized complete block design in a split-plot arrangement was used with five replications. Cultivar AG 105, fertilized with nitrogen (30 and 120 kg/ha of N applied to the plots) was subjected to the following treatments (subplots): A) no weeding; B) intercropping with sabiá (30 viable seeds/m2, broadcast between the rows of maize); C) hoeing {20 and 40 days after sowing (DAS)} with no removal of weeds (nROW); D) two hoeings at 20 and 40 DAS with ROW at 20 DAS; E) two hoeings at 20 and 40 DAS with ROW at 40 DAS; F) and two hoeings at 20 and 40 DAS with ROW after each hoeing. Increasing the dose of nitrogen reduced the growth of the sabiá (30%) and weeds (32%) and increased the corn green ear yield (115%) and grain yield (40%) of maize. Sabiá did not reduce the growth of weeds, but it was beneficial to corn because increased the number of green ears. Carrying out two hoeings, with or without the removal of weeds, reduced weed growth (92%) and provided the highest yields of green ears (5.6 t/ha) and grains (6.0 t/ha).
EPIDEMIOLOGY OF SPINE FRACTURES IN MOTORCYCLE ACCIDENT VICTIMS
Authors: Oliveira Tiago Argolo Bittencourt de , Andrade Sérgio Murilo dos Santos , Prado Gabriel Oliveira , Fernandes Rony Brito , Gusmão Maurício Santos , Gomes Eduardo Gil França , Amorim Junior Djalma Castro de , Pimentel Maurício Guimarães , Simões Marcus Thadeu Venâncio , Gomes Joilda Fontes , Freire Jayme Batista , Sampaio Glauco Landim Batista , Lima Marcelo de Luna Freire , Matos Marcos Almeida
Published: April 2016

ABSTRACT Objective: To analyze the incidence of spinal injuries between 2000-2010 due to motorcycle accidents and the relation to the increase in motorcycle sales in the same period, as well as the anatomical distribution of these spinal injuries. Methods: Data were collected from 1,295 records of patients who have suffered spinal injury resulting from motorcycle accidents admitted to the ward TRM (Spinal Cord Trauma) of the Hospital Geral do Estado da Bahia from 2000 to 2010 in this retrospective study. We selected 110 medical records and collected information on sex, age, neurological deficit on admission (according to Frankel scale), diagnosis, and level of injury. Results: Between 2000 and 2010 there was an increase of almost five times in the incidence of patients who have suffered spinal injury due to motorcycle accidents. More than half (51.4%) had cervical spine injury, 37.2% thoracic spine injury and 11.34% had lumbar spine injury. Only 34.3% of patients had no neurological deficit on admission and patients with thoracic spine fracture had a higher incidence and severity of lesion. The average age of patients was 30 years. Conclusions: The increased incidence of spinal injuries due motorcycle accidents occurred in the same period in which there was an increase in motorcycle sales in the country. Patients who have suffered those injuries were young, with higher incidence in the cervical and thoracic spinal levels and high rates of neurological deficit.
COMPARISON OF COBB ANGLE MEASUREMENT IN SCOLIOSIS BY RESIDENTS AND SPINE EXPERTS
Authors: Ritter Rafael , Nagasse Yoshinobu , Ribeiro Iberê , Yamazato Clovis , Oliveira Fabio Mastromauro de , Kusabara René
Published: April 2016

ABSTRACT Objective: The adolescent idiopathic scoliosis (AIS) is a spine deformity that occurs in both the coronal plane and the sagittal plane of patients between 10 and 17 years. The Cobb method is the most widely used to determine the angular value of scoliosis and it is defined as the "gold standard". The goal is to verify the reproducibility of the measured angles between orthopedic residents and spinal pathologies specialists, comparing the variability of the angles measured by professionals with greater and lesser experience. Method: A total of 10 radiographs of patients diagnosed with AIS were assessed. Radiographs were handed over to 7 orthopedists specialized in spine and 14 orthopedic residents. The measurement of the angles for each of the examiners was described using means and standard deviations and intraclass correlations were calculated, as well as the measure of repeatability, and Bland-Altman plots were designed with the results of the measurements of each group of examiners, according to experience, to assess the agreement/reproducibility of Cobb angle measurements. Results: Each examiner obtained a resulting average of 10 cases summation. In order to assess trends in variability of the measurements of the angles of each group graphs were plotted based on the arithmetic mean of each of the 10 cases by the total number of participants in the group versus the standard deviation in each case. Conclusion: There was a poor correlation (ICC=0.4) in the measurement of Cobb in both groups, demonstrating difficulties in the method, which cannot be overcome by the expertise.
THORACOLUMBAR BURST FRACTURE: STRUCTURAL CHANGES AND CLINICAL OUTCOME OF TREATMENT
Authors: Tisot Rodrigo Arnold , Vieira Juliano Silveira Luiz , Tisot Orley Fauth , Santos Renato Tadeu dos , Badotti Augusto Alves , Berardi Andrius , Collares Diego da Silva
Published: April 2016

ABSTRACT Objective: To evaluate the correlation between structural changes in burst fractures of thoracic and lumbar spine with clinical outcome of the treatment. Methods: A retrospective study in 25 patients with fractures of thoracic and lumbar spine burst fractures without neurological deficit. Eleven patients underwent conservative treatment and for the remaining the treatment was surgical. All patients were followed up for at least 24 months. The cases were evaluated by a protocol that included: posttraumatic measurement of kyphosis, vertebral body collapse and narrowing of the spinal canal, the visual analog scale of pain, and the quality of life questionnaire SF-36 at the follow-up. For statistical analysis, the significance level was 5% and the software SPSS 18.0 was used. Results: No statistically significant difference was observed when comparing the clinical outcomes of one treatment over another. Similarly, there was no statistically significant correlation between kyphosis and post-traumatic narrowing of the spinal canal with clinical worsening in the follow-up, regardless of the treatment used. We found a positive correlation (p<0.05) between initial collapse and SF-36 domains in both groups (operated and non-operated). Conclusion: There was no significant superiority of one treatment over the other, and no correlation was found between kyphosis and spinal canal narrowing in burst fractures of the thoracic and lumbar spine without neurological deficit. However, there was correlation between initial collapse and clinical outcome in some domains of the SF-36 questionnaire.
ADOLESCENT IDIOPATHIC SCOLIOSIS: EVALUATION ON THE EFFECT OF SCREW DENSITY IN THE CORRECTION
Authors: Garcia Enguer Beraldo , Garcia Liliane Faria , Garcia Jr Enguer Beraldo , Gonçalves Roberto Garcia , Giesbrecht Saulo Terror , Oliveira Fernando Henrique Rocha de , Batista Vinícius Augusto , Costa Wendel Parreira
Published: April 2016

ABSTRACT Objective: The objective was to investigate implant density or the number of screws correlated with the correction of the main curve in patients undergoing surgery for adolescent idiopathic scoliosis (AIS). Methods: We evaluated 112 medical records: 33 patients with screw density of up to 50%, and 79 patients with a density of 100%; all patients underwent surgical correction by posterior approach with transpedicular fixation. Results: In the group of patients with screw density of up to 50% the residual Cobb median was 10°; in the group with 100% density, the median was 7°. Conclusion: Biostatistical analysis showed that the group with up to 50% of screw density presented correction rate of 82.1% and the group with 100% density had correction of about 86.8%. It is therefore concluded that the difference is statistically significant in favor of the fixation with 100% density (p =0.010).
NONOPERATIVE VERSUS OPERATIVE TREATMENT OF PATIENTS WITH DEGENERATIVE SPONDYLOLISTHESIS
Authors: Corredor Jose Alfredo , Araújo Fernando Flores de , Mendonça Rodrigo Góes de , Foni Noel Oizerovici , Astur Nelson , Gotfryd Alberto Ofenheim , Umeta Ricardo Shigueaki Galhego , Caffaro Maria Fernanda Silber , Avanzi Osmar , Meves Robert
Published: April 2016

ABSTRACT Objective: To evaluate clinical and functional results of patients with lumbar degenerative spondylolisthesis treated with operatively or nonoperatively. Methods: Patients with degenerative spondylolisthesis treated either nonoperatively or operatively from 2004 to 2014 were selected from databases and a cross-sectional evaluation was performed. Outcome measures included back and leg visual analogue scales (VAS), Fischgrund criteria, Short Form-36 (SF-36) function score, and the modified Oswestry Disability Index (ODI). Results: 43 patients were evaluated: 20 with nonoperative treatment and 23 with operative treatment. Baseline characteristics were similar without significant differences between groups. Mean follow-up time was 43 months (range 10 - 72) for the nonoperative group and 36 months (range 6-80) for the operative group. Significant statistical difference in favor of operative group were found in back VAS (mean 4 versus 8, p = 0.000), leg VAS (mean 3 versus 6, p = 0.0015), SF-36 function score (mean 77 versus 35, p = 0.000), and ODI (mean 17 versus 46, p = 0.000). On the basis of the Fischgrund criteria, only 10 % of patients reported excellent or good health post nonoperative treatment versus 83% for those treated operatively (p = 0.000). Conclusion: In this cross-sectional study, we observed that symptomatic patients with degenerative spondylolisthesis who underwent operative treatment have superior clinical and functional scores compared to those that underwent nonoperative treatment.
THORACOLUMBAR BURST FRACTURES, SHORT X LONG FIXATION: A META-ANALYSIS
Authors: Assunção Filho Carlos Alberto , Simões Filipe Cedro , Prado Gabriel Oliveira
Published: April 2016

ABSTRACT The number of fixed segments in the surgical treatment of thoracolumbar burst fractures remains controversial. This study aims to compare the results of short and long fixation in thoracolumbar burst fractures through a meta-analysis of studies published recently. MEDLINE and Cochrane databases were used. Randomized controlled trials and non-randomized comparative studies (prospective and retrospective) were selected. Data were analyzed with the software Review Manager. There was no statistically significant difference in the Cobb angle of preoperative kyphosis. Long fixation showed lower average measurements postoperatively (MD = 1.41; CI = 0.73-2.08; p<0.0001) and in the last follow-up (MD = 3.98; CI = 3.22-4.75; p<0.00001). The short fixation showed the highest failure rates (RD = 4.03; CI = 1.33-12.16; p=0.01) and increased loss of height of the vertebral body (MD = 1.24; CI = 0.49-1.98; p=0.001), with shorter operative time (MD = -24.54; CI = -30.16 - -18.91; p<0.00001). There was no significant difference in blood loss and clinical outcomes. The high rates of kyphosis correction loss with short fixation and the lower correction rate in the immediate postoperative period were validated. There was no significant difference in the blood loss rates because arthrodesis was performed in a short segment in the analyzed studies. The short fixation was performed in a shorter operative time, as expected. No study has shown superior clinical outcomes. The short fixation had worse rates of kyphosis correction in the immediate postoperative period, and increased loss of correction in long-term follow-up, making the long fixation an effective option in the management of this type of fracture.
Gastrointestinal parasites of cats in Brazil: frequency and zoonotic risk
Authors: Monteiro Maria Fernanda Melo , Ramos Rafael Antonio Nascimento , Calado Andréa Maria Campos , Lima Victor Fernando Santana , Ramos Ingrid Carla do Nascimento , Tenório Rodrigo Ferreira Lima , Faustino Maria Aparecida da Glória , Alves Leucio Câmara
Published: April 2016

Abstract Gastrointestinal helminths are considered to be the most common parasites affecting cats worldwide. Correct diagnosis of these parasites in animals living in urban areas is pivotal, especially considering the zoonotic potential of some species (e.g. Ancylostoma sp. and Toxocara sp.). In this study, a copromicroscopic survey was conducted using fecal samples (n = 173) from domestic cats living in the northeastern region of Brazil. Samples were examined through the FLOTAC technique and the overall results showed positivity of 65.31% (113/173) among the samples analyzed. Coinfections were observed in 46.01% (52/113) of the positive samples. The most common parasites detected were Ancylostoma sp., Toxocara cati, Strongyloides stercoralis, Trichuris sp., Dipylidium caninum and Cystoisospora sp. From an epidemiological point of view, these findings are important, especially considering that zoonotic parasites (e.g. Ancylostoma sp. and Toxocara sp.) were the nematodes most frequently diagnosed in this study. Therefore, the human population living in close contact with cats is at risk of infection caused by the zoonotic helminths of these animals. In addition, for the first time the FLOTAC has been used to diagnosing gastrointestinal parasites of cats in Brazil.
Lymphocytic meningoencephalomyelitis associated with Myxobolus sp. (Bivalvulidae: Myxozoa) infection in the Amazonian fish Eigenmannia sp. (Sternopygidae: Gymnotiformes)
Authors: Sindeaux Neto José Ledamir , Velasco Michele , Silva José Mauro Vianna da , Santos Patricia de Fátima Saco dos , Sanches Osimar , Matos Patricia , Matos Edilson
Published: April 2016

Abstract The genus Myxobolus, parasites that infect fishes, which cause myxobolosis, includes spore organisms belonging to the phylum Myxozoa and represents approximately 36% of all species described for the entire phylum. This study describes lymphocytic meningoencephalomyelitis associated with Myxobolus sp. infection in the brain and spinal cord (the central nervous system, CNS) of Eigenmannia sp., from the Amazon estuary region, in the Administrative District of Outeiro (DAOUT), Belém, Pará, Brazil. In May and June 2015, 40 Eigenmannia sp. specimens were captured from this region and examined. The fish were anesthetized, slaughtered and dissected for sexing (gonad evaluation) and studying parasites and cysts; after diagnosing the presence of the myxozoans using a light microscope, small fragments of the brain and spinal cord were removed for histological processing and Hematoxylin-Eosin and Ziehl-Neelsen staining. Histopathological analysis of the brain and spinal cord, based on histological sections stained with Hematoxylin-Eosin, pronounced and diffuse edema in these tissues, and congestion, degeneration, and focal necrosis of the cerebral cortex. The present study describes lymphocytic meningoencephalomyelitis associated with infection by Myxobolus sp. in the central nervous system of Eigenmannia sp.
Collaborative framework for road infrastructure management
Authors: Adetola Alaba , Goulding Jack
Published: April 2016

Managing major public infrastructure projects presents considerable challenges for governments/associated stakeholders, particularly where resources are limited. Consequently, many countries are now exploring various approaches to engaging the private sector in the delivery of essential infrastructure projects crucial to economic growth/development. Given these, a conceptual collaborative engagement framework is developed to overcome the challenges/contextual constraints associated with road infrastructure management in Nigeria. The study adopted a pragmatist philosophical positioning that involved a sequential mixed-methods research approach. The ‘quality function deployment’ systematic integration tool was employed to determine the degree of correlation between the ‘pivotal drivers’ and the ‘voice of the customer’. Research findings identified 12 important priorities of collaboration that constitute the nucleus of the conceptual Collaborative Engagement Framework for Road Infrastructure Management (Cefrim). These priorities reaffirm the need for ‘good/harmonious relationships’, ‘collective understanding’, ‘shared responsibility’, ‘innovative capacity’, ‘accountability’ and ‘value-for-money’ as essential rubrics for collaborative engagement. The Cefrim presents new knowledge that would help practitioners understand the fundamental elements in developing collaborative projects. Key implications include the need to help stakeholders appreciate the importance of people-centric forces in relationships. In doing so, traditional ‘lose-lose’ and ‘win-win’ relationships can be more effectively understood ergo the pivotal measures of success.
Relationship between eGFR Decline and Hard Outcomes after Kidney Transplants
Authors: Clayton Philip A. , Lim Wai H. , Wong Germaine , Chadban Steven J.
Published: April 2016

Trials designed to assess the effect of interventions on death and graft failure in kidney transplant recipients are not feasible, because these are predominantly late events. Here, we examined the potential of percentage decline in eGFR as a surrogate for hard outcomes. We obtained deidentified data from the Australia and New Zealand Dialysis and Transplant Registry and studied 7949 transplants performed from 1995 to 2009, including 71,845 patient-years of follow-up, 1121 graft losses, and 1192 deaths. We used adjusted Cox proportional hazards models to determine risks of death or death–censored graft failure related to percentage change in eGFR between years 1 and 3 after transplant. Percentage change in eGFR was modeled as a restricted cubic spline. Rate of eGFR decline associated with exponentially increased risks of graft failure and death. Compared with stable eGFR, a ≥30% decline in eGFR, detected in 10% of patients, strongly associated with subsequent death (hazard ratio, 2.20; 95% confidence interval, 1.87 to 2.60) and death–censored graft failure (hazard ratio, 5.14; 95% confidence interval, 4.44 to 5.95). Decline in eGFR was superior to other surrogates, including acute rejection, doubling of serum creatinine level, and eGFR at year 1 or year 2. We conclude that 30% decline in eGFR between years 1 and 3 after kidney transplant is common and strongly associated with risks of subsequent death and death–censored graft failure, which mirrors findings in CKD. Percentage decline in eGFR should be considered for use as a surrogate outcome in kidney transplant trials.
Recession Risk and the Excess Bond Premium
Authors: Favara Giovanni , Gilchrist Simon , Lewis Kurt F. , Zakrajšek Egon
Published: April 2016

In this FEDS Note, we evaluate the information content for recession risk of a component of credit spreads that is not directly attributable to expected default risk and thus to news about future cash flows.
Effect of tranexamic acid in perioperative blood loss associated with total knee replacement: Our experience
Authors: AHA Kumar , G Bandari , IV Reddy IV
Published: April 2016

Introduction: Costs of allogeneic blood transfusions and the associated risks mandate strategies to reduce blood loss in surgery. The objective of this study was to assess the efficacy of anti-fibrinolytic treatment in reducing perioperative blood loss during total knee replacement. Materials and methods: A retrospective and prospective study was carried out on 148 patients undergoing total knee replacement. 88 patients received tranexamic acid (10 mg/kg, iv) just before the cementation, 3 hours post operatively and 6 hours later. 60 patients did not receive tranexamic acid. Perioperative blood loss was measured the amount of post-operative drain, and drop in hemoglobin levels. The number of patients who needed blood transfusion and number of packed red cell (PRC) units transfused was recorded and possible postoperative thromboembolic complications were studied clinically. Results: Amongst 88 patients who were given tranexamic acid, only 35 (39.7%) were given blood transfusions and the average transfusion was 0.5 units. Amongst 60 patients who were not given tranexamic acid, 45 (75%) were given blood transfusions and the average transfusions were 1.3 units. The average blood loss in the group of patients who were given tranexamic acid was 164.97ml while in the group which were not given, the average blood loss was 305.48ml. The average drop in Hemoglobin in tranexamic acid given group was 1.5 grams%, and in tranexamic acid not given group was 1.8 grams%. Clinical assessment did not reveal any thromboembolic complications. Conclusions: Antifibrinolytic agents produce a significant decrease in blood loss in patients undergoing total knee replacement, reflected in the reduction in the number of blood transfusions required. Keywords: Tranexamic acid; perioperative blood loss; knee replacement
Spontaneous transanal externalization of ventriculoperitoneal shunt
Authors: H Raghavendra , S Pendyala , T Punit , MK Panigraghi
Published: April 2016

Aim of this paper is to report a case of spontaneous externalization of Ventriculoperitoneal shunt tube through anus in an eighteen months female child (k/c/o Dandy-Walker malformation) treated with placement of ventriculoperitoneal shunt for hydrocephalus. The exact cause of such externalization is not known. Unusual migration of distal catheter tip of VP shunt is a rare and bowel perforation is reported to occur between 0.1% and 0.7%. In view of the potential risk for meningitis prompt and aggressive management is essential to avoid morbidity and mortality. Keywords: Transanal externalization; ventriculoperitoneal; Dandy-Walker; hydrocephalus
Blount’s disease: A case report
Authors: K Krishnaiah , S Rathore , V Quadri
Published: April 2016

Introduction: Blount’s disease is defined as a growth disorder of medial aspect of proximal tibia physis with abrupt medial angulation of proximal tibia distal to epiphysis, leading to varus angulation of proximal tibia and medial rotation of tibia. Epidemiology is not well established and very rarely cases have been reported from Indian subcontinent. Presentation of case: A 3-years-old female child presented with deformity in both the legs and altered walking pattern for the past one year. On examination there was 15 degrees of varus deformity in both the knees. There was 25 degrees of internal tibial torsion bilaterally. The child was managed by surgical intervention. Oblique proximal tibial osteotomy was done. Fixation was done with a single cancellous screw on both sides and immobilisation was done in above knee plaster cast. Child recovered well with correction of deformity and could walk with normal gait pattern. Discussion: The cause of Blount’s disease is still not well established. Treatment depends upon age at presentation, severity of varus deformity as determined by Langenskiold staging, and progression of the disease. Early intervention is required to avoid progression of the disease and permanent deformity. Conclusion: Blount’s disease is a very rarely encountered condition in Indian subcontinent but has a characteristic presentation. It should be included in differential diagnosis in cases presenting with pathological bowing of legs. Radiological findings and normal blood biochemistry can guide us towards the diagnosis of Blount’s disease. Keywords: Blount’s disease; Indian subcontinent; bilateral Blount’s disease, infantile Blount’s disease
Concurrent traumatic brain injury with aortic injury: Management dilemmas
Authors: M Vaja , MK Panigrahi , RK Jain , A Campos
Published: April 2016

Background: Occurrence of concurrent traumatic brain injury and aortic injury is rare and potentially fatal trauma pattern. The incidence of traumatic brain injury associated with aortic injury is likely to be underestimated because many patients with this pathology die prior to hospital admission or imaging study. Even after diagnosis, there are difficulties in managing such a patient as different approaches are required to treat each of them. Case report: A 68-year-old man with head injury and blunt chest injury was operated. He had right frontotemporal subarachnoid haemorrhage with fracture of left temporal bone with hemopneumothorax and multiple rib fractures on the left side of the chest. Patient was evaluated with plain CT scan and CT angiogram of brain. Contrast enhanced CT scan of chest revealed rupture of the arch of aorta. Head injury was managed conservatively and emergency aortic stent grafting was done. Discussion and conclusion: Aortic injury may be missed, so the emergency physician should have high index of suspicion while dealing with polytrauma patient instead of just focussing on head injury. Head injury and aortic injury occurring together need different treatment methods which can have conflict. (A) In aortic injury, maintaining a lower systolic blood pressure is essential to prevent further haemorrhage. On the contrary blood pressure should be maintained at normal level for adequate cerebral perfusion in head injury. (B) Sedation required for aortic injury can interfere with the clinical assessment of a patient with traumatic brain injury. (C) Anticoagulants used in the treatment of aortic injury are usually contraindicated in head injury. The treatment needs a team approach by neurosurgeon, endovascular cardiologist, cardiac surgeon, emergency physician, and critical care intensivist etc., to manage patients of traumatic brain injury with aortic injury. Keywords: Traumatic brain injury; aortic injury; fatal combination
http://jmsronline.com/archive-article/diffuse-alveolar-hemorrhage-cryoglobulinaemia-and-thrombotic-microangiopathy
Authors: S Kasha , VPN Krishna , G Bandari , M Shailaja
Published: April 2016

Glomus tumor is a rare benign tumor commonly involving fingers and toes. While it has also been reported to have occurred elsewhere, there are only a handful reported cases. Diagnosis may be uncertain due to non-specific symptoms, inability to detect on physical examination or routine investigations and radiographs. This case report highlights the importance of awareness of this rare tumor and its presentation in rare locations. Keywords: glomustumor; benign tumor;
Skull radiographs as a guide for diagnosing systemic disorders (Pictorial Atlas)
Authors: S Kakarla
Published: April 2016

Coming soon
Interdepartmental Interaction in Realization of Social and Educational Inclusion for Vulnerable Groups
Authors: Rubtsov V.V.
Published: April 2016

Report on the Meeting of the Russian Federation Government Council for Patronage in Social Sphere at the House of the Government of the Russian Federation, September 28, 2015.
S.V. Alyokhina (Moscow State University of Psychology & Education), N.V. Dvoryanchikov (Moscow State Univer- sity of Psychology & Education), E.Yu. Klochko, A.A. Margolis (Moscow State University of Psychology & Educa- tion), G.V. Semya (Moscow State Pedagogical University ), R.V. Chirkina (Moscow State University of Psychology & Education) participated in content discussion and preparation.
Structure and function relationships of proteins based on polar profile: a review.
Authors: Polanco Carlos , Buhse Thomas , Uversky Vladimir N
Published: April 2016

Proteins in the post-genome era impose diverse research challenges, the main are the understanding of their structure-function mechanism, and the growing need for new pharmaceutical drugs, particularly antibiotics that help clinicians treat the ever- increasing number of Multidrug-Resistant Organisms (MDROs). Although, there is a wide range of mathematical-computational algorithms to satisfy the demand, among them the Quantitative Structure-Activity Relationship algorithms that have shown better performance using a characteristic training data of the property searched; their performance has stagnated regardless of the number of metrics they evaluate and their complexity. This article reviews the characteristics of these metrics, and the need to reconsider the mathematical structure that expresses them, directing their design to a more comprehensive algebraic structure. It also shows how the main function of a protein can be determined by measuring the polarity of its linear sequence, with a high level of accuracy, and how such exhaustive metric stands as a "fingerprint" that can be applied to scan the protein regions to obtain new pharmaceutical drugs, and thus to establish how the singularities led to the specialization of the protein groups known today.
Organisational Patterns in the Mishnah in Light of their Toseftan Parallels
Authors: Kulp Joshua
Published: April 2016

This article examines the relationship between two sets of parallel chapters in theMishnah and Tosefta, uncovering phenomena which imply the primacy of the Tosefta over its mishnaic parallels.

In the first chapter of Ketubbot the mishnaic editors deal simultaneously with the two subjects of the chapter, virginity claims and ketubbah size, thereby creating definitions of virginity which can be broadly applied. Furthermore, the editing of the mishnah paved the way for some halakhic modifications. In contrast, while the parallel toseftan passage also displays editorial organisation, its organisation is that of a simple list. It conveys information, but not the pedagogic agenda of the Mishnah.

Mishnah Yebbamot 5 is a unique chapter of Mishnah whose editorial agenda was to explore the relationship between rabbinically innovative activities and those ordained by the Torah.While ostensibly providing halakhic information, theMishnah’s editors place at the heart of the chapter a position which ascribes some efficacy to the innovations of the rabbis, while preserving the primacy of those institutions contained more explicitly in the Torah. In contrast, the Tosefta merely provides information as to the order in which the various acts of levirate marriage are performed, and does not offer any coherent ideological message.
Metaphorical Law in Pseudo-Jonathan and the Case for Targumic Midrash
Authors: Novick Tzvi
Published: April 2016

Targum as a literary genre is subject to a unique set of constraints. This article studies how these constraints impact the exegetical practices of the targumim. The data set upon which the study draws is comprised of cases in which Pseudo-Jonathan renders biblical laws both literally and metaphorically. This data set is itself of interest, since such cases have not heretofore been examined as a group.
From Markets to Marvels: Jews on the Maritime route to China ca. 850–ca. 950 CE
Authors: Silverstein Adam
Published: April 2016

In this article it is argued that Jewish travellers to China between 850 and 950 CE contributed to—and were the products of—a Judeo-Islamic culture, both in their mercantile activity and in the literary output that it spawned. It is argued that events in the Near East and in China in the late 9th and early 10th centuries had an irreversible effect on trade relations between the Near East (from which most Jewish traders of the time emanated) and China. The decline in trade missions to the Far East coincided with an eruption of literary activity in the Islamic world that encouraged works of ‘fiction’ and marvels. The travelogue of Eldad ha-Dānī is considered within this Arabo-Islamic context and reinterpreted accordingly.
Traditions are Born: A Medieval Samaritan Poem Takes on a New Form
Authors: Florentin Moshe
Published: April 2016

This article introduces a previously unknown Samaritan liturgical poem which was composed in the 14th century by the poet Sā’əd El. The poem, whose main parts were discovered by my learned Samaritan informant Mr Y. Tsedaka in the Firkovich collection in St Petersburg, contains words and phrases not attested before in the existing Samaritan Aramaic and Hebrew texts. However, it is not only the importance of the text itself which should attract our attention but rather its peculiar formation. We were lucky enough to witness a very interesting case of creation of a new text comprising on one hand some old fragmented materials and on the other hand a totally new part composed by the same Samaritan who put together the old pieces.

This case teaches us how cautious should we be while dealing with seemingly old texts: the poem in question does indeed include important old material, but its whole total version and pronunciation is a result of a (very successful) reconstruction performed by a contemporary Samaritan sage.
Phinehas' Intercessory Prayer: A Rabbinic and Targumic Reading of the Baal Peor Narrative
Authors: Bernat David A.
Published: April 2016

A number of Rabbinic texts, along with Targum Pseudo-Jonathan, portray Phinehas as interceding with God, through prayer, on Israel’s behalf, in the aftermath of the Baal Peor apostasy, recounted in Numbers 25 and Psalm 106. This tradition constitutes an exegetical innovation, as nowhere in scripture is Phinehas represented in the act of prayer. The Phinehas-prayer nexus is explored, with attention to the creative reading of the verb פּﬥﬥ in Ps. 106:31; the significance of prayer in the Rabbinic and Targumic worldview; and the changing role of the priesthood in a post-Temple environment. The article also considers the implications of intercessory prayer as an aspect of Phinehas’ zealotry.
Structure and Form in Kohelet Rabbah as Evidence of Its Redaction
Authors: Kiperwasser Reuven
Published: April 2016

The long midrash on Ecclesiastes, known today as ‘Kohelet Rabbah’ (EcclesiastesRabbah), is broken down into sections or ‘sedarim‘ according to theMasoretic division of the Ecclesiastes text. This paper intends to show that Kohelet Rabbah acquired the form we know today as a result of the intentional labour of its late redactor. The redactor structured his book in accordance with the reading practices current in his time, added an introduction consisting of proems that had been borrowed from another source, and made comments and added short expositions of his own. This edited composition is made up of heterogeneous elements, in which, side by side with amoraic material, a variety of fragments are to be found, placed there by the later redactor, who took them from his immediate cultural surroundings. This is why we find novel material next to textual units of ancient origin which were preserved intact, and at times the innovations creep into the body of the old text and contaminate it, making it difficult to disentangle these different strands of the text. The Midrash assumed its form during the final stages of the redaction, with the text providing clear evidence of the process by which it had been formed.
Shem Tov ibn Shem Tov on ‘Sefer Yeṣira’
Authors: Freedman Daphne
Published: April 2016

Shem Tov ibn Shem Tov’s commentary on
Sefer Yeṣira
examines man’s faculty of language in which he resembles and most closely approaches the deity. Language is seen as the imprint of the deity in creation. Shem Tov’s commentary sets out to distinguish and define the bounds of human knowledge, denying the illicit extension of logic beyond the limits of human understanding and attempting to delimit the respective spheres of activity of philosophical thought and traditional religious practice. His propensity to harmonise philosophical and cabalistic thought also reveals an acute awareness of the contradictions between these opposed points of view which he does not attempt to rationalise or diminish.
Second Temple Period Ritual Baths Adjacent to Agricultural Installations: The Archaeological Evidence in Light of the Halakhic Sources
Authors: Adler Yonatan
Published: April 2016

Ritual baths (
miqwa’ot
) built adjacent to winepresses and olive-presses have been unearthed at about twenty sites dating to the Second Temple period, most of them in Judea and the environs of Jerusalem. While much has been written in recent years on the form and function of ancient ritual baths in general, little scholarly attention has been paid to
miqwa’ot
found in agricultural contexts. The presence of these
miqwa’ot
suggests that the ritual purity of the wine and olive oil processed in these installations was of particular importance. The fact that these ritual baths were situated adjacent to winepresses and olive-presses suggests that agricultural labourers made use of these
miqwa’ot
immediately prior to commencing work in these installations, a practice which accords with the Pharisaic concept of
tevul yom
. These finds thus provide rare archaeological evidence for the observance of ritual purity laws based on the Pharisaic system of
halakhah
.
Publius Quinctilius Varus in Jewish Sources
Authors: Eshel Hanan
Published: April 2016

Varus was the Roman governor of Syria between 7 and 4 BCE. After Herod’s death in 4 BCE, Varus ruthlessly suppressed the riots that broke out in Judaea, during which Roman soldiers razed the porticos of the temple in Jerusalem. These events are described in detail in Josephus’ writing, and are mentioned in the pseudoepigraphical work the
Assumption of Moses
and in the rabbinic chronicle work
Seder ’Olam Rabbah
. Between 6 and 9 CE Varus was the legate of Germania. In 9 CE, while Varus was leading three legions from the areas north of the Rhine to their winter quarters on the Lippe and Rhine rivers, the Germanic tribes at the Teutoburg Forest ambushed him. The Germanic forces slaughtered the Roman legionaries; during the battle Varus committed suicide. We have not found in the writings of Josephus or in the apocryphal and rabbinic works the claim that Varus was killed in Germania because of his actions in Jerusalem. Therefore, it seems as though Josephus and Jews in Judaea were not aware of what befell Varus in the Teutoburg Forest in 9 CE.
‘The Lord Has Forsaken the Land’: Radical Explanations of the Military and Political Defeat of the Jews in Tannaitic Literature
Authors: Schremer Adiel
Published: April 2016

Scholarly literature devoted to ‘Jewish responses to the destruction of the Second Temple’ rarely attempts to explore the full range of explanations given by Palestinian Jews of the late first and second century CE to their political and military defeats in their wars against the Roman empire. Rather, it is commonly assumed that these Jews followed the old prophetic line of self-accusation, and ascribed the downfall to the people’s own transgressions. As a result, only slight attention is given to other, much less ‘pious’, explanations, existing in classical rabbinic literature. This paper explores some of these explanations and points at the existence of a state of mind among first- and second-century Palestinian Jews which came to question God’s very existence, His interest in the world or His ability to rule it. Although as a rule these stances were rejected by the Rabbis, surprisingly some of them appear to have been embraced by some of the Rabbis themselves.
Creation Imagery in Qumran Hymns and Prayers
Authors: Gordley Matthew E.
Published: April 2016

The hymns and prayers found in the Dead Sea Scrolls provide examples of the ways Second Temple Jewish poets both preserved and adapted earlier traditions. This study explores one specific motif, biblical creation imagery, to examine how it is utilised across the corpus of Qumran hymns and prayers. By observing the deployment of creation imagery in liturgical and non-liturgical texts, both those composed at Qumran and those composed prior to the founding of the community, this study demonstrates the ways that Qumran creation imagery echoes the biblical models. Further, this study shows that creation imagery is deployed in ways that go beyond the biblical models only in the Qumran hymns and prayers which serve an instructional purpose. These didactic hymns and prayers provide examples of how some Second Temple Jewish writers drew upon earlier, honoured traditions about creation and creatively adapted them to meet the needs of the day.
Brothers in Arms: Josephus’ Portrait of Moses in the ‘Jewish Antiquities’ in the Light of His Own Self-Portraits in the ‘Jewish War’ and the ‘Life’
Authors: Damgaard Finn
Published: April 2016

In the
Jewish Antiquities
, Josephus is surprisingly keen to amplify the rebellions and factions against Moses. The Israelites time and again accuse Moses of acting tyrannically, and the worst seditions ever are said to have happened while Moses was a general. When it comes to handling civil war, the picture of the experienced general recurs in Josephus’ own self-portraits in the
Jewish War
and the
Life
. The present article explores the similarities between Josephus’ portrait of Moses and Josephus’ own self-portraits. Though Josephus does not himself explicitly direct his readers’ attention to the parallels between his portrait of Moses and his own self-portraits, we may assume that his readers were able to grasp the parallels because of the common use of
σύγκρισις
in the Greco-Roman world. Josephus’ rhetorical strategy may indirectly have been to praise his own conduct in his praise of Moses.