bluuebunny/crossref_metadata_2025 huggingface dataset:
Purchase Intentions of Consumer towards Foreign Brand Apparel
Authors: Giridhar V. , Joshi Rohit , Sadarangani Pradip H.
Published: December 2015

Clothing is an important product category through which people express their interests, status, and lifestyle. With the advance of consumerist culture in India, expression of identity and social standing through clothing is becoming imminent. In this context, we have identified the factors relating to self-concept, like the need for uniqueness and clothing interest are insignificant, but the perceived quality of foreign brand apparel is a significant factor in determining the purchase intention. The construct of perceived quality forms a significant component in the modified Ajzen (1991) Model, which along with its traditional constructs suit the Indian consumer. We also find that perceived behavioural control (PBC) if split into external PBC and internal PBC become insignificant to the model. We therefore recommend that foreign entrants into the Indian market adopt suitable segmentation, distribution and operational strategies to leverage on the high quality perception of foreign brand apparel in the Indian market.
Development of Key Performance Measures for Sustainable Manufacturing in Global SMEs
Authors: Singh Sujit , Olugu Ezutah Udoncy , Musa Siti Nurmaya
Published: December 2015

Sustainable manufacturing strives to produces the goods by minimizing negative environmental impact and reducing the resource consumptions. It also strives for safety of employee and community while maintaining an affordable cost. This study focuses on the development of a set of measures and metrics for assessing sustainability performance of manufacturing SMEs. In this study, various literatures on sustainable manufacturing performance measurement, green manufacturing, traditional manufacturing performance measurement and performance measurements in manufacturing small and medium enterprises (SMEs) are reviewed. Triple Bottom Line (TBL) is considered as framework in order to establish the relevant measures in an effective and comprehensive manner. The measures for performance measurements are classified in the three aspects of TBL known as economic, environmental and social. Therefore, 6 measures with 26 indicators, 8 measures with 31 indicators and 3 measures with 23 indicators were identified for economic, environmental and social aspects respectively. To establish the importance and applicability of developed measures, a survey will be conducted among the experts from academics and industries. Using survey results, a sustainability performance measurement model will be developed and presented.
Microbial Response against Metal Toxicity
Authors: Bhakta Jatindra Nath
Published: December 2015

Damage of microbial communities caused by metal toxicity in different domains of the environment is a growing challenge worldwide. The present chapter attempted to elucidate how microorganisms tackle and response against the metals toxicity. In response to metal toxicity, microorganisms exhibit a vast array of acclimatization, adaptation and resistant strategies at genetic, cellular and community levels to detoxify metals toxicity and survival. Microorganisms detoxify metals by various mechanisms (sequestration, inhibition of influx, efflux, accumulation, precipitation and chemical modification, repair, and metabolic by-pass) and showed resistance properties (by protein/enzyme synthesis) encoded by genes located in chromosome, plasmid or transposon. Thus, metal toxicity hampers the microbial metabolism, growth, activity and species diversity resulting in severe damage in environmental microbial community. Apart from detrimental consequences of metal toxicity, the novel metal- and antibiotic- resistant microorganisms could be used in environmental and human health benefits.
Biodegradation of Phenol
Authors: Dhatwalia Vinod K. , Nanda Manisha
Published: December 2015

Aromatic compounds are widely distributed in nature. Free phenols are frequently liberated as metabolic intermediates during the degradation of plant materials. In recent years the natural supply of phenolic substances has been greatly increased due to the release of industrial byproducts into the environment. Phenolic compounds are hazardous pollutants that are toxic at relatively low concentration. Effluents from petrochemical, textile and coal industries contain phenolic compounds in very high concentration; therefore there is a necessity to remove phenolic compounds from the environment. Microorganisms capable of degrading phenol are common and include both aerobes and anaerobes. The use of microbial catalysts in the biodegradation of organic compounds has advanced significantly during the past three decades. The efficiency of biodegradation of organic compounds is influenced by the type of the organic pollutant, the nature of the organism, the enzyme involved, the mechanism of degradation and the nature of the influencing factors.
Phyto-Remediation: Using Plants to Clean Up Soils
Authors: Jagdale Swati , Chabukswar Aniruddha
Published: December 2015

In this chapter authors have discussed the role of plants to develop contaminant free environment. This concept is also known as Phytoremediation. Phytoremediation is a word formed from the Greek prefix “phyto” meaning plant, and the Latin suffix “remedium” meaning to clean or restore. This technology has been receiving attention lately as an innovative, cost-effective alternative to the more established treatment methods used at hazardous waste sites. Phytoremediation can be classified into different applications, such as phytofiltration or rhizofiltration, phytostabilization, phytovolatilization, phytodegradation and phyto-extraction etc. The chapter will deal with phytoremediation, its advantages, limitations and in detail techniques of classification and application.
Fighting Ecomafias
Authors: Di Paola Nadia , Spanò Rosanna , Caldarelli Adele , Vona Roberto
Published: December 2015

Innovation processes are becoming increasingly central, and newer industries have become already less resource-intensive in comparison with the traditional ones. Nevertheless, this alone does not assure sustainability, which requires a step further towards economically viable, environmentally compatible, and socially responsible behaviours. This chapter addresses the issues relating to sustainable development to provide a critical discussion on the potential role played by networking relationships in the biotech field. For the purposes of the study, we employ the co-management and multi-stakeholder perspectives. We demonstrate that the biotechnology research results may be enhanced thanks to cooperation dynamics and interactions among heterogeneous actors, with undeniable cultural and social positive impacts. Also, we discuss social implications and open concerns, both with regard to the relationships within innovative networks and between institutional professional actors, allowing the identification of any grey areas and limitations, especially relevant to policy makers.
Effective Waste Water Treatment and its Management
Authors: Prabu Sakthivel Lakshmana , Suriyaprakash TNK , Kandasamy Ruckmani , Rathinasabapathy Thirumurugan
Published: December 2015

Worldwide there is an increasing industrialization leads to increased disposal of uncontrolled waste products into the environment which made the environment more pollute and creates hazards. Industrial wastewater is having a major role in the environmental pollution. The major physical, chemical and biological products of the wastewater are solid content, organic matter, in-organic compounds, detergents, soap, cleaning products, metals, gases, volatile compounds, numerous pathogenic microorganisms, nutrients and toxic compounds. Untreated wastewater can cause various environment pollutions problems such as eutrophication or oxygen depletion in the environment. Hence a effective wastewater treatment process and its management is necessary to reduce the contaminants in the permissible levels in the treated waste streams. The final outcome of an effective wastewater treatment and its management is to ensure and provide an appropriate environment protection to the living things and public human beings in the world.
How Corporate Standardisation Shapes Tomorrow's Business
Authors: de Casanove Alice , Lambert Isabelle
Published: December 2015

Corporate standardisation function coordinates and supports experts involved in standardisation bodies. It sets up Standardisation strategy in Alignment with global strategy of the company. In this chapter, the authors illustrate how a company can embrace standardisation and leverage it to increase its position in a competitive business environment. The authors first present an overview of corporate standardization strategy: how is standardization considered in a private company, how to capture the ins and outs of a corporate standardisation, how to define, implement and manage standardization strategy, etc. Then the authors present the benefits of standardization development for a company. Finally an example of commitment in ISO TC 279 innovation management is presented.
An Innovative Approach to the Development of Project Management Processes for Small-Scale Projects in a Large Engineering Company
Authors: Laporte Claude Y. , Chevalier Frédéric
Published: December 2015

A 400-employee Canadian division of a large American engineering company has developed and implemented project management processes for their small-scale and medium-scale projects. The company was already using a robust project management process for their large-scale projects. The objectives of this project were to reduce cost overruns and project delays, standardize practices to facilitate the integration of new managers, increase the level of customer satisfaction and to reduce risk-related planning deviations. For this project, the engineering organization used the ISO/IEC 29110 standards developed specifically for very small entities, i.e. organizations, having up to 25 people. An analysis of the cost and the benefits of the implementation of small and medium scale project management processes was performed using the ISO economic benefits of standard methodology. The engineering enterprise estimated that, over a three-year timeframe, savings of about 780,000$ would be realized due to the implementation of project management processes using the ISO/IEC 29110 standard.
Standardizing Knowledge Work
Authors: Sandholtz Kurt W.
Published: December 2015

This chapter analyzes how standards were implemented among design engineers in two divisions of the same corporation. Although both divisions achieved ISO 9000 certification, engineers in one of the divisions resisted the standard work practices and a culture of cynicism developed. In the other division, the standardized work practices were internalized by engineers and are still voluntarily, and often enthusiastically, followed. Analysis of the contrasting cases results in three recommendations for managers who wish to increase the acceptance of external work standards among professional workers.
Standardization, Innovation, and Organization
Authors: Abdelkafi Nizar , Makhotin Sergiy
Published: December 2015

Companies that intend to leverage standardization to drive innovation have to set up their organizations appropriately. Data from four German companies reveal different ways for organizing the standardization activities. Companies may allocate a high level of resources by dedicating a specialized department; they may assign the standardization task to top managers; they may treat standardization within occasional projects; or create sophisticated solutions to facilitate the use of standards. Contingency theory is used to narrow down the number of factors that influence the organization of the standardization function. There are three relevant contingency factors: competition, size, and strategy. Company's age, technological complexity and volatility of customer demand are found to be less important. Instead, maturity of technology and the period of time, during which the company has been actively engaged in standardization work seem to be better contingencies. Another finding is that innovation appears to be a by-product and not the main driver of standardization work.
Assessing population structure of European Anchovy (Engraulis encrasicolus) in the Central Mediterranean by means of traditional morphometry
Authors: Traina A. , Basilone G. , Saborido-Rey F. , Ferreri R. , Quinci E. , Masullo T. , Aronica S. , Mazzola S.
Published: December 2015

For the first time the structure of the anchovy stock was investigated in the Strait of Sicily: sampling locations were in Sicily, in Tunisia and in the Adriatic Sea. A morphological approach to stock discrimination which involves morphometric landmarks analysis was adopted. The aim of this work is to describe any morphological variations between the samples areas and individuate possible different populations in order to obtain useful information for management of shared resources between Tunisian and Italian waters. Furthermore sexual dimorphism was investigated. Results of morphometric landmarks may suggest a high level of overlapping among Sicily and Tunisia. Instead, between the Sicilian and Adriatic population, it was observed a certain degree of isolation, suggesting the existence of two anchovy sub-populations connected by a possible migration of a small number of individuals. No differences between male and female individuals was observed. Results support the likely existence of an anchovy metapopulation with several sub-populations, one inhabiting the northern and southern parts of the Strait of Sicily. From a management perspective and under the ‘precautionary approach’, these sub-populations should be treated as shared stocks and conserved.
Temporal variation of seston biomarkers within the Humboldt Current System off northern Chile (21
Authors: Rossi Sergio , Isla Enrique , Fietz Susanne , Martìnez-Garcia Alfredo , Sañé Elisabet , Teixidò Nùria
Published: December 2015

Proportions and concentrations of seston fatty acids, n-alkanes and glycerol dialkyl glycerol tetraethers (GDGTs) were used to assess potential differences in the phytoplankton composition and food quality in the Humboldt Current System (winter 2006, summer 2007 and winter 2007) in surface, oxycline, intermediate and bottom water layers. The zone below the intermediate depth was poorer in fatty acids (minimum 15 – maximum 117mg fatty acids L
Expression of death-related genes and reactive oxygen species production in Skeletonema tropicum upon exposure to the polyunsaturated aldehyde octadienal
Authors: Gallina Alessandra A. , Chung Chih-Ching , Casotti Raffaella
Published: December 2015

The effects of 4E/Z-octadienal (OCTA) on ScDSP-1 and ScDSP-2 gene expression and reactive oxygen species (ROS) production were investigated in the marine diatom Skeletonema tropicum (formerly costatum) using qRTPCR and flow cytometry. ScDSP-1 and ScDSP-2 genes have been previously shown to be involved in cell death in ageing cells and in response to photosynthetic stress. OCTA induced a differential, concentration-dependent DSP gene expression associated to ROS production, 821.6 and 97.7 folds higher for ScDSP-1 and ScDSP-2, respectively. Among the concentrations tested, only 8 μM OCTA, which caused a reduction of 50% in cell concentrations at 24 h, was able to elicit an expression pattern consistent with a signalling role. Interestingly, only intermediate levels of reactive oxygen species (ROS) (i.e., 1.5±0.1 increase) were observed to be elicited by such concentration. These results suggest that ROS are key components of the molecular cascade triggered by polyunsaturated aldehydes (PUA) and leading to cell death. This could have implications for bloom final stages at sea, where PUA may act as effectors of diatom population dynamics through ROS acting as modulators.
Alternative pharmacological treatment options for agitation in Alzheimer’s disease
Authors: Panza Francesco , Solfrizzi Vincenzo , Imbimbo Bruno P. , Santamato Andrea , Lozupone Madia , Logroscino Giancarlo
Published: December 2015

In patients with dementia and Alzheimer’s disease (AD), treatment of neuropsychiatric symptoms (NPS) is a major concern in the management of these devastating diseases. Among NPS in AD, agitation and aggression are common with earlier institutionalization, increased morbidity and mortality, and greater caregiver burden. Pharmacological treatments for AD-related agitation, specifically off-label use of atypical antipsychotics, showed only modest improvements, with increased side-effect burden and risk of mortality. Non-pharmacological treatment approaches have become the preferred firstline option. However, when such treatments fail, pharmacological options are often used. Therefore, there is an urgent need to identify effective and safe pharmacological treatments for agitation/aggression in AD and dementia. Unfortunately, progresses have been slow, with a small number of methodologically heterogeneous randomized controlled trials (RCTs), with disappointing results. However, evidence coming from recently completed RCTs on novel or repositioned drugs (mibampator, dextromethorphan/ quinidine, cannabinoids, and citalopram) showed some promise in treating agitation in AD, but still with safety concerns. Further evidence will come from ongoing Phase II and III trials on promising novel drugs for treating these distressing symptoms in patients with AD and dementia.
To translate pharmacogenetics in geriatrics: towards a personalized medicine
Authors: Seripa Davide , Paroni Giulia , Lauriola Michele , Greco Antonio
Published: December 2015

Geriatric wards represented a very interesting clinical setting in which an increased drugs use rise the prevalence of adverse drug reactions (ADRs) and therapeutic failures (TFs). These are not independent phenomena, but the severe counterposed manifestations of a continuum of phenotypes in which the better drug response is the midpoint. Age-related changes in the regulation of cytochrome P450 (CYP) genes, encoding the most common drugmetabolizing enzymes, might be responsible of the observed age-associated drift towards ADRs and TFs. In this review article, a complete impression of the CYP pharmacogenetics and epigenetics is reported in the context of increasing age, in which epigenetic CYP-gene regulation might change. Physiological age-related changes in DNA-methylation, the main epigenetic mechanisms regulating gene expression in humans, results in a physiological decrease in CYP gene expression with advancing age. This may be one of the physiological changes that, together with an increased drug use, contributed to raise the prevalence of severe responder phenotypes in older age.
Lower urinary tract symptoms and benign prostatic hyperplasia and their impact on quality of life
Authors: Carbone Antonio , Errico Massimo , Ludovico Giuseppe M. , Fuschi Andrea , Spatafora Sebastiano
Published: December 2015

LUTS is an acronym that refers to symptoms affecting the lower urinary tract, which are very common in elderly subjects (between 60 and 70%), and often associated with, but not always caused by, benign prostatic hypertrophy (BPH). BPH is a chronic condition characterized by an increase in the number of cells, particularly in the transition area of the prostate. BPH involves a compression of the surrounding tissues, consequently obstructing vescical voiding. Nycturia and urgency represent the most prevalent symptoms and those with the greatest impact on quality of life measured as urinary-specific health-related quality. The prevalence of BPH is directly proportional to age; therefore, the absolute number of subjects affected is growing throughout the world. BPH is one of the most common medical conditions affecting those over 50. The overall cost for the diagnosis and treatment of BPH-related LUTS, in the US, has been estimated at approximately 1.1 billion US$/year, compared to total annual expenditure for urological conditions of some 9 billion and this cost continues to increase. The quick prostate test, which was developed by the Italian Urology Society (SIU), is an easy to use instrument that can be utilized in first-level screening for evaluation of the male population with LUTS. This test can be used both in patients not on pharmacological treatment and as a therapy-monitoring instrument. A positive response to one of the questions is sufficient for requesting a more in-depth investigation, which may provide indications on the therapeutic strategy to be taken.
Presentation of the Psycho-Cardiological Schedule and convergence levels analyses among the psycho-cardiological screening and the psychological assessment
Authors: Pierobon Antonia , Callegari Simona , Giardini Anna , Ferrari Marina , Olmetti Francesca , Corbellini Daniela , Febo Oreste , Majani Giuseppina
Published: December 2015

In Cardiovascular Rehabilitation the increasing inpatients complexity suggests the necessity to develop screening methods which allow to identify those patients that require a psychological intervention. Material and methods: A Psycho-Cardiological Schedule (PCS) was developed with the aim of detecting the critical situation indicators or the presence of psychological, social and cognitive problems. The PCS, compiled by a nurse or cardiologist in collaboration with a psychologist, allows to assess the need for a deeper psychological examination, clinical and/or with tests. Aim of the present study is to identify the convergence levels among the observational and anamnestic data of the PCS collected by a nurse and the clinical and/or test data of the psychological deeper assessment. Results: Among the 87 patients recruited in January- February 2010, 28 (aged 53.5±12.6, M=20, F=8) fulfilled the criteria for a deeper psychological examination: age <50, manifestation of psychological/behavioural problems, neuropsychological disorders, low adherence to prescriptions, inadequate disease knowledge/representation. From data comparisons emerged convergence levels with 100% concordance as to smoke habits and problems in social-family support. High convergence levels also resulted as to emotional and/or behavioural problems (92.8%) and inadequate adherence to prescriptions (89.3%). Lower levels of concordance (82.1%) emerged when considering disease knowledge/ representation, issues specifically linked to cognition and subjective illness experience, not directly detectable from behaviour. Conclusions: our data confirm the synergic efficacy of the two evaluations: the Psycho-Cardiological Schedule reliably identifies the problematic macro-categories, mainly if they are characterized by behavioural indicators, which facilitate the detection. The psychological approach appears more suitable for better specifing macro-categories characteristics and for detecting critical aspects not overt but not less important, providing therefore advice for a therapeutic psychological management.
Measuring change in rehabilitative cardiology: reliability of a short questionnaire to assess an outcome
Authors: Bettinardi Ornella , Vidotto Giulio , Moroni Loretta , Pedretti Roberto F.E. , Maini Maurizio , Rosi Alessandro , Bertolotti Giorgio
Published: December 2015

The present Italian health planning demands the use of tools, care and treatments useful for the National Health Service, but with empirical effectiveness scientifically sustained. Aim of the present paper is to verify the validity, the reliability and the responsiveness of the factor “Perception of positive change” (named Schedule C) in cardiovascular rehabilitation. Method. The reliability of the Schedule C of the CBA VE has been examined comparing the mean scores obtained from each item at the entry and just before the discharge through the t-Student for paired sample. To assess the concurrent validity we used the AD Short Scale to measure anxiety and depression. 100 patients who underwent cardiac surgery were enrolled during hospitalization for a Cardiac Rehabilitation Programme. Cronbach’s alpha was used to assess internal consistency of each item. Results. Each item of the Schedule C demonstrated good internal consistency (Cronbach Alpha >.88) and elevated correlations item-total for each item. The strong correlation of anxiety and depression scores with the Schedule C points out appropriate concurrent validation. Conclusions. We believe that the Schedule C of the CBA VE is endowed with suitable metric validity and then useful as outcome evaluation in cardiovascular rehabilitation settings.
Infective endocarditis or myxoma? Description of a patient with new diagnosis of congestive heart failure
Authors: Testa Marzia , Lombardo Enrico , Avogadri Enrico , Agostini Marco , Forte Giuseppe , Piccolo Salvatore , Feola Mauro
Published: December 2015

ABSTRACT: Infective endocarditis (IE) is an inflammatory disease which interests heart endothelium and mostly heart valves. IE is not a uniform disease, but presents in a variety of different forms that makes the diagnosis difficult. Echocardiography is a crucial diagnostic tool for the diagnosis, especially in those patients who have no typical symptoms as in the case here presented, in which the possibility of a myxoma was also considered.
Surficial geology, coastal waters, Island of Newfoundland, Newfoundland and Labrador
Authors: Shaw J , Potter D P
Published: December 2015

This bulletin is a synthesis of several decades of Geological Survey of Canada research into the surficial geology of the inner continental shelf around the Island of Newfoundland, and the geomorphology of adjacent coastlines. Based on analyses of data from
multibeam-sonar surveys, other marine surveys, and from coastal mapping, the island is divided into fourteen regions, each with distinctive surficial geology and coastal geomorphology. The evidence of glaciation is dominant in all regions, and includes: 1) streamlined landforms formed in the onset
areas of ice streams; 2) arcuate submarine moraines formed by glacial standstills at the mouths of west and south coast fiords; 3) transverse moraines formed by standstills within fiords; and 4) swarms of De Geer moraines formed during ice retreat. The seafloor of the inner shelf is imprinted by
relict iceberg furrows and pits in all fourteen regions, but a modern population is recognized only off the east and northeast coasts. Evidence of lowered postglacial sea levels is found in submerged deltas and wave-cut platforms at various depths off the southwest and south coasts. The zone of
modern sediment mobility is relatively wide on the shallow inner shelves off southwest and northeast Island of Newfoundland, and relatively narrow elsewhere. The multibeam-sonar imagery reveals a wide range of submarine landforms and processes, including active submarine fans in west coast fiords,
an inner-shelf submarine canyon off the southwest coast, and large-scale erosion of the seafloor in Placentia Bay and off Bay of Islands. Anthropogenic modification of the seafloor is most intense near Corner Brook (Bay of Islands) and in parts of Placentia Bay, and includes submarine landslides
triggered by port construction.
On Flat and Gorenstein Flat Dimensions of Local Cohomology Modules
Authors: Rahro Zargar Majid , Zakeri Hossein
Published: December 2015

Let a be an ideal of a Noetherian local ring R and let C be a semidualizing R-module. For an R-module X, we denote any of the quantities fdR X, GfdR X and GC-fdR X by T(X). Let M be an R-module such that for all i ≠ n. It is proved that if T(M) < ∞, then , and the equality holds whenever M is finitely generated. With the aid of these results, among other things, we characterize Cohen–Macaulay modules, dualizing modules, and Gorenstein rings.
A Influência do Gênero nas Características E Gravidade do Trauma
Authors: Handa Alina Yukie , Domingues Cristiane de Alencar , Nogueira Lilia de Souza
Published: December 2015

Embora a literatura mostre resultados cada vez mais sugestivos de que as mulheres traumatizadas apresentem melhores desfechos em relação aos homens, algumas conclusões ainda são inconsistentes. Este estudo comparou os sexos (masculino/ feminino) segundo características e gravidade do trauma e identificou a influência desta variável na mortalidade. Trata-se de um estudo retrospectivo, quantitativo, das vítimas de trauma atendidas em um hospital terciário localizado em São Paulo, Brasil, entre janeiro/2006 e dezembro/2010. Os testes Qui- Quadrado de Pearson, Mann-Whitney, t-Student e regressão logística múltipla foram aplicados no tratamento dos dados, considerando-se um nível de significância de 5%. A casuística foi composta por 2.380 pacientes, a maioria masculina (79,70%), c om i dade m édia d e 3 9,93 a nos ( DP = 17,81). A causa externa mais frequente foi pedestre traumatizado (24,54%). Atendimento pré-hospitalar foi recebido pela maioria das vítimas (91,22%) e 50,21% dos pacientes foram admitidos na Unidade de Terapia Intensiva (UTI). A taxa de mortalidade hospitalar foi de 16,43%. Diferenças significativas entre os grupos (masculino e feminino) ocorreram em relação ao tipo de trauma, causa externa, admissão na UTI, injury severity score (iss), new injury severity score (NISS), revised trauma score (RTS) e idade. As variáveis NISS, idade e número de regiões corpóreas acometidas foram fatores de risco para mortalidade hospitalar das vítimas de trauma e o tempo de permanência hospitalar foi considerado fator de proteção para este desfecho. O sexo, variável de interesse do estudo, não foi preditor de mortalidade nesta casuística. Como conclusão, variáveis relacionadas às características e gravidade do trauma, além da idade, diferiram entre os sexos e o gênero não foi considerado fator de risco para mortalidade nesta população.

How to cite this article

Handa YA, de Alencar Domingues C, de Souza Nogueira L. A Influência do Gênero nas Características E Gravidade do Trauma. Panam J Trauma Crit Care Emerg Surg 2015;4(2):43-47.
Pneumothoraces on Computed Tomography Scan: Observation using the 35 Millimeter Rule is Safe
Authors: Cropano Catrina , Mesar Tomaz , Turay David , King David , Yeh Daniel , Fagenholz Peter , Velmahos George , de Moya Marc A
Published: December 2015

Introduction

The management of a pneumothorax (PTX) either by observation or with a tube thoracostomy (TT) has long been dictated by practitioner discretion rather than objective criteria. Many physicians elect to routinely place a TT for traumatic PTX, particularly when patients undergo positive pressure ventilation (PPV). Placement of unnecessary TT exposes patients to avoidable morbidity and may prolong hospitalization. Based on prior work establishing a cutoff, we hypothesized that all PTXs ≤35 mm in patients who have no physiologic derangement may be safely observed without TT regardless of the need for PPV.

Materials and methods

Retrospective review of all patients diagnosed with a PTX between 1/2009 and 2/2013. All PTXs visible on chest computed tomography (CT) were identified. Any patient with an associated significant hemothorax or those patients who were moribund were excluded. All PTXs were measured by measuring the perpendicular distance of the largest air pocket between the chest wall and the mediastinal or pulmonary structure. Management of the PTX was categorized as observation or TT. Observed PTXs were labeled as success or failure with failure defined as enlargement of the PTX or physiologic deterioration, requiring a TT.

Results

Out of 165 PTXs, 17 (10.3%) measured >35 mm, whereas 148 (89.7%) measured ≤35 mm. Of the 17 > 35 mm, 15 (88.2%) received immediate TT. Of the two PTXs >35 mm which were observed, one received a delayed TT for a pleural effusion (6 days after PTX diagnosis) and one (5.9 %) was safely observed. Of the 148 PTXs which measured ≤35 mm, 10 (6.8%) received immediate TT. Of the 138 remaining PTXs, 129 (93.5%) were safely managed without TT. Six (4.3%) of the PTXs initially observed eventually required TT placement for enlargement of the PTX. Only one of those six had manifested ongoing desaturations prior to TT. The remaining three cases received TT for reasons unrelated to the PTX. Of the 27 PPV cases in the ≤35 mm cohort, none contributed to the six failures. A cutoff measurement of 35 mm demonstrated a negative predictive value (NPV) of 95.7% in its ability to predict successful observation of the PTX with an area under the receiver operating characteristic (ROC) curve of 0.90.

Conclusion

All PTXs measuring ≤35 mm perpendicular to the chest wall without physiologic derangement may be safely observed independent of the need for mechanical ventilation.

How to cite this article

Cropano C, Mesar T, Turay D, King D, Yeh D, Fagenholz P, Velmahos G, de Moya MA. Pneumothoraces on Computed Tomography Scan: Observation using the 35 Millimeter Rule is Safe. Panam J Trauma Crit Care Emerg Surg 2015;4(2):48-53.
FAST-E en Pacientes con Trauma Abdominal Cerrado Estable, en un Departamento de Urgencias en Colombia
Authors: Vivas-Giraldo Diego Alejandro , Linares-Mendoza Gerardo , Navarrete-Aldana Norberto , Carmargo-Mila Carlos Hernan , Stephany-Perdomo Karen , Cortés-Puentes Luis Arcadio
Published: December 2015

El impacto que ha generado el trauma en Colombia a lo largo de la historia, nos ha obligado a mejorar y adaptar diferentes tipos de sistemas de atención en trauma, basados en los lineamientos internacionales, los cuales buscan evitar el significativo aumento en las tasas de mortalidad y discapacidad que se obtienen de este, especialmente en los servicios de Emergencias en los cuales se reciben el 100% de estos pacientes con traumatismo múltiple o politraumatismo, a quienes se les debe dar un abordaje rápido, efectivo y eficaz que beneficie tanto al propio paciente, como al mismo sistema de salud.

Dentro de este grupo de pacientes hay un subgrupo que son las pacientes con trauma de abdomen que cursan con estabilidad hemodinámica y además son clasificados de bajo riesgo, ya sea por índices de trauma o por otros métodos como la medición sérica de lactato, los cuales tienen un papel poco despreciable al momento de ver mortalidad y discapacidad por trauma, ya sea penetrante o cerrado; en este trabajo específicamente nos centramos en las personas que consultan al servicio de Emergencias con trauma cerrado de abdomen los cuales son considerados de bajo riesgo, siendo este subgrupo de pacientes uno de los mas difíciles de abordar y enfocar al momento de la valoración inicial, ya que se debe tener la seguridad de que no hay lesiones que comprometen la vida y por consiguiente estos pacientes puedan ser dados de alta.

Una de las practicas que mas se han venido haciendo en los últimos años en la valoración del paciente con trauma de abdomen cerrado es la ultrasonografía (FAST), la cual ha logrado disminuir los tiempos en la toma de decisiones, además de disminuir tasa de complicaciones en estos pacientes; con base en esto se ha implementado en la Fundación Cardioinfantil este procedimiento en el servicio de Emergencias, encabezado por el grupo de ultrasonido a la cabecera del paciente (Emergenciólogos), con lo cual se busca medir el impacto del trauma cerrado de abdomen clasficado de alta energia y de bajo riesgo.

How to cite this article

Vivas-Giraldo DA, Linares-Mendoza G, Navarrete-Aldana N, Carmargo-Mila CH, Stephany-Perdomo K, Cortés-Puentes LA. FAST-E en Pacientes con Trauma Abdominal Cerrado Estable, en un Departamento de Urgencias en Colombia. Panam J Trauma Crit Care Emerg Surg 2015;4(2):59-65.
Complex Perineal Injuries in Blunt Trauma Patients: The Value of a Damage Control Approach
Authors: Mori Newton Djin , Jr Frederico José Ribeiro Teixeira , Netto Sérgio Dias do Couto , Silva Francisco Salles Collet e , Fontes Belchor , Poggetti Renato Sergio , Birolini Dario , Bernini Celso Oliveira
Published: December 2015

Purpose

In a previous work, we presented a protocol for the management of patients with complex pelviperineal injuries (CPI) resulting from blunt trauma. This treatment protocol included: early hemorrhage control, surgical debridement of devitalized tissue, selective loop transverse colostomy according to the location of the perineal wound, distal colonic irrigation with saline solution, pulsatile saline solution irrigation of the perineal wound, maintenance of the perineal wound open, management of bone fractures and visceral injuries, surgical revisions at intervals of 24 to 48 hours, presumptive antibiotic therapy, early nutritional support, and definitive repair of wound defect and visceral injuries after infection control and metabolic recovery. In order to determine whether the evolution of the authors's protocol for the assessment and management of patients with CPI is associated with improved patient outcome we conduct this review.

Materials and methods

The medical records of 42 patients with CPI resulting from blunt trauma admitted in the level I trauma center at the HC-USPSM, were reviewed. Demographic data, mechanism of trauma, revised trauma score (RTS) and injury severity score (ISS), classification of perineal injuries, associated systemic trauma, infection complications and mortality rates (overall, early and late) were collected.

Results

The early mortality was 19% and the late mortality was 17%. The overall mortality was 36%. Patients who died had higher average ISS (average ISS = 45) comparing to patients who survived (average ISS = 25) with significant statistical difference (p < 0.05). Damage control principles applied to CPI was the standard of care and a selective approach to perform fecal stream diversion were used.

Conclusion

The results of this study showed that the use of this protocol was effective and reinforced the importance of the priority in early control of hemorrhage, early fecal diversion in selected cases, multiple surgical perineal revisions, and avoidance of complex visceral injury repair at the first surgical intervention.

How to cite this article

Teixeira Jr FJR, do Couto Netto SD, Collete e Silva FS, Mori ND, Fontes B, Poggetti RS, Birolini D, Bernini CO, Utiyama EM. Complex Perineal Injuries in Blunt Trauma Patients: The Value of a Damage Control Approach. Panam J Trauma Crit Care Emerg Surg 2015;4(2):87-95.
Análise Retrospectiva de Pacientes Vítimas de Trauma Cervical Penetrante Submetidos À Cervicotomia
Authors: Nasr Adonis , Manfrinato Marília França Madeira , Barros Ana Cláudia Marchi , Pereira Guilherme Damaceno , Savio Mariane Christina , Justini Camila de Souza , Molteni Rafaela de Araujo , Carvalho Fábio Henrique de
Published: December 2015

Objetivos

As lesões cervicais penetrantes são, em sua maioria, causadas por armas de fogo ou armas brancas, e o conceito de um manejo cirúrgico seletivo é o empregado atualmente no tratamento destes pacientes. O presente trabalho tem como objetivos avaliar o perfil demográfico dos pacientes vítimas de traumas cervicais penetrantes submetidos à cervicotomia, quanto à presença ou não de lesão, o tipo de lesão encontrada durante o ato cirúrgico, além da evolução e mortalidade.

Métodos

Foram estudadas 57 vítimas de trauma cervical penetrante atendidas no Hospital do Trabalhador, em Curitiba (Brasil), nos períodos de abril de 2009 até março 2014, que foram submetidas à cervicotomia.

Resultados

Os principais mecanismos de trauma foram: ferimento por arma branca (52,6%), ferimento por arma de fogo (40%); 61% deles ocorreram em zona II. 91% dos pacientes eram do sexo masculino, com uma média de idade de 33,1 anos. 43,8% destes apresentavam alguma lesão associada e 46% realizaram exame de imagem pré-operatório. Em 82,5% das cervicotomias foi encontrada lesão. As injúrias mais comuns foram: vascular (68%), de vias aéreas (47%) e de esôfago (11%). O tempo operatório médio foi de 118 minutos. 17,5% dos pacientes apresentaram algum tipo de complicação pós-operatória. O tempo médio de internamento foi de 9 dias. Óbito ocorreu em 7% dos pacientes, sendo que todos estes apresentavam lesões associadas.

Conclusão

Homens adultos jovens são os mais acometidos. Todos os pacientes que foram à óbito apresentavam algum tipo de lesão associada, mostrando que a cervicotomia foi terapêutica quando existiam lesões cervicais isoladas. No entanto, em uma parte (17,5%) dos pacientes submetidos à cirurgia, nenhuma lesão foi encontrada. Isto mostra que, apesar dos avanços tecnológicos referentes aos exames complementares, mais estudos são necessários para orientar a conduta frente ao paciente vítima de trauma cervical penetrante.

How to cite this article

Barros ACM, Pereira GD, Manfrinato MFM, Savio MC, de Souza Justini C, de Araujo Molteni R, de Carvalho FH, Nasr A. Análise Retrospectiva de Pacientes Vítimas de Trauma Cervical Penetrante Submetidos À Cervicotomia. Panam J Trauma Crit Care Emerg Surg 2015; 4(2):96-102.
Avanços teórico-empíricos na comparação entre Teoria da Ontologia e Teoria da Terminologia
Authors: Aganette Elisângela Cristina , Almeida Maurício Barcellos
Published: December 2015

A complexidade de certos domínios do conhecimento, como a Biomedicina, demanda a aplicação de teorias e técnicas de representação avançadas, as quais são objeto de pesquisa no campo da Organização do Conhecimento. A Teoria da Terminologia e a Teoria da Ontologia Aplicada são exemplos de teorias amplamente utilizadas em Biomedicina para fundamentar a representação e construir sistemas de organização do conhecimento. O presente artigo descreve e compara os diferentes “dialetos” adotados pelas duas teorias nos processos de definir e de relacionar entidades. De forma a evidenciar as diferenças e as similaridades entre as duas teorias, apresenta-se um caso prático real no escopo de um projeto científico, no qual são criadas definições para entidades biomédicas. Os resultados demonstram a existência de convergência entre as duas teorias, ainda que algumas questões permaneçam em aberto. Espera-se contribuir para um melhor entendimento das duas teorias, bem como auxiliar ao profissional da informação em sua aplicação prática.
Características das atividades de pesquisa dos professores dos Institutos Federais de Educação, Ciência e Tecnologia
Authors: Perucchi Valmira , Mueller Suzana Pinheiro Machado
Published: December 2015

Objetiva identificar a posição dos professores dos Institutos Federais de Educação, Ciência e Tecnologia sobre a origem de estímulos para desenvolverem pesquisas, sua opinião sobre a atuação dos organismos de apoio às pesquisas e ainda formas de divulgação de sua produção. O universo da pesquisa é composto dos 24.335 professores lotados nos 38 Institutos Federais existentes no país, dentre os quais foi retirada uma amostra aleatória simples de 165 indivíduos, distribuída proporcionalmente ao número de professores em cada um dos Institutos Federais. Um levantamento na Plataforma Lattes do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), nos currículos dos 165 professores da amostra identificou 96 professores com currículos atualizados e com produção cadastrada. Para esses 96 professores foi realizada a coleta dos dados via questionários, com perguntas abertas e fechadas enviadas por e-mail. Os dados obtidos foram submetidos à análise qualitativa e quantitativa. Resultados mostram que os professores/pesquisadores dos Institutos Federais identificam como principal estímulo para desenvolver suas pesquisas as necessidades da carreira acadêmica; contam com a pouca atuação dos núcleos de inovação tecnológica e das coordenações ou departamentos de pesquisa no apoio ao desenvolvimento de suas pesquisas e divulgam o conhecimento produzido por meio de apresentação oral de trabalhos, seguida de trabalhos publicados em anais de eventos. A produção bibliográfica é o canal preferencial utilizado pelos professores dos Institutos Federais.
Uma experiência de assessoria junto às comunidades atingidas pelo Minerdouto da Ferrous na zona da mata mineira
Authors: Oliveira Marcelo Leles Romarco de , Sousa Dayane Neves
Published: December 2015

http://dx.doi.org/10.5007/1807-0221.2015v12n19p61Este trabalho procura mostrar a experiência do Projeto de Assessoramento as Comunidades Atingidas por Barragens e Mineração (PACAB) junto às comunidades que poderão ser atingidas pelo mineroduto da empresa Ferrous na microrregião de Viçosa, Minas Gerais. Os integrantes do PACAB entendem que a assessoria é compreendida como uma ação de mediação e aprendizado coletivo. Como ações foram realizadas reuniões e mobilizações junto às comunidades atingidas pelo empreendimento. Dentre os resultados, verificou-se que o trabalho de assessoria realizado pelo PACAB contribuiu para a criação da Campanha pelas Águas e Contra o Mineroduto da Ferrous e ofereceu suporte técnico as famílias atingidas por tal empreendimento.
Shakespeare’s "Othello" beyond the boundaries of the page: An analysis of two filmic productions
Authors: Camilotti Camila Paula
Published: December 2015

http://dx.doi.org/10.5007/2175-7917.2015v20n2p11O objetivo deste artigo é observar e analisar duas produções fílmicas da obra Otelo, de William Shakespeare. A primeira, intitulada Othello, foi dirigida, produzida e estrelada por Orson Welles em 1952, e a segunda, também intitulada Othello, foi dirigida por Oliver Parker, em 1995. O interesse principal do estudo dessas produções é observar - à luz dos princípios de adaptação teatral de Jay Halio (2000), Patrice Pavis (1992), e Allan Dessen (2002) - como cada diretor construiu em suas produções fílmicas o momento da sedução que acontece na Cena III, Ato III, do texto shakespeariano. A análise aponta que duas concepções diferentes, separadas no tempo e no espaço, são capazes de fazer com que a atemporalidade de Shakespeare transcenda e mostra aos espectadores modernos que a capacidade artística humana é capaz de atravessar fronteiras inimagináveis de criatividade e transformar uma grande obra literária em um exímio espetáculo (fílmico ou teatral).
A implementação do serviço de tradução e interpretação de libras-português nas universidades federais
Authors: Santos Silvana Aguiar dos
Published: December 2015

http://dx.doi.org/10.5007/2175-7968.2015v35nesp2p113Este artigo propõe-se a descrever elementos importantes da operacionalização dos serviços de tradução e de interpretação em universidades federais da região sul do Brasil. Tomando como referência alguns autores do campo disciplinar dos Estudos da Tradução, como Ozolins (2010), Baker e Saldanha (2009), Baker (2006) e Tymoczko (2007), discutem-se questões que envolvem a interpretação comunitária, seus desafios, e as perspectivas de implementá-la no âmbito do serviço público. A orientação metodológica segue a abordagem qualitativa com foco na pesquisa descritiva. Nesse sentido, foi realizado um levantamento utilizando como corpus de análise os servidores efetivos tradutores e intérpretes de Libras-Português das universidades federais da região sul. As perguntas norteadoras foram as seguintes: quem são os tradutores e os intérpretes de Libras-Português na região sul? Qual o nível de formação desses profissionais? Os resultados constataram 76 servidores tradutores e intérpretes de Libras-Português efetivos nas universidades estudadas, a maioria com graduação ou especialização. Uma parcela menor desses profissionais tem mestrado e doutorado. Outro resultado apresentado foi o percentual de servidores distribuídos por estados e por universidades federais da região sul. Por fim, apontamos em quais áreas do conhecimento os servidores tradutores e intérpretes desenvolveram suas pesquisas até o momento.
Tradução intermodal, intersemiótica e interlinguística de textos escritos em Português para a Libras oral
Authors: Quadros Ronice Müller de , Segala Rimar Romano
Published: December 2015

http://dx.doi.org/10.5007/2175-7968.2015v35nesp2p354Neste artigo apresentamos alguns tipos de tradução envolvidos na tradução de textos em português para a língua brasileira de sinais (Libras).  Discutimos esses diferentes tipos e destacamos a tradução intermodal, específica das traduções que envolvem uma língua de sinais. A tradução intermodal trata de aspectos visuais e operacionais implicados na tradução para Libras em forma de vídeo e aspectos linguísticos essencialmente visuais-espaciais que envolvem o uso do espaço em línguas de modalidade visual-espacial, ou seja, línguas de sinais. Neste artigo, apresentamos uma análise das implicações da modalidade a partir de exemplos de tradução realizados no contexto do Curso de Letras Libras da Universidade Federal de Santa Catarina (UFSC).