bluuebunny/crossref_metadata_2025 huggingface dataset:
A Concurrent Exposure to Arsenic and Fluoride from Drinking Water in Chihuahua, Mexico
Authors: González-Horta Carmen , Ballinas-Casarrubias Lourdes , Sánchez-Ramírez Blanca , Ishida María , Barrera-Hernández Angel , Gutiérrez-Torres Daniela , Zacarias Olga , Saunders R. , Drobná Zuzana , Mendez Michelle , García-Vargas Gonzalo , Loomis Dana , Stýblo Miroslav , Del Razo Luz
Published: April 2015

Inorganic arsenic (iAs) and fluoride (F−) are naturally occurring drinking water contaminants. However, co-exposure to these contaminants and its effects on human health are understudied. The goal of this study was examined exposures to iAs and F− in Chihuahua, Mexico, where exposure to iAs in drinking water has been associated with adverse health effects. All 1119 eligible Chihuahua residents (>18 years) provided a sample of drinking water and spot urine samples. iAs and F− concentrations in water samples ranged from 0.1 to 419.8 µg As/L and from 0.05 to 11.8 mg F−/L. Urinary arsenic (U-tAs) and urinary F− (U-F−) levels ranged from 0.5 to 467.9 ng As/mL and from 0.1 to 14.4 µg F−/mL. A strong positive correlation was found between iAs and F− concentrations in drinking water (rs = 0.741). Similarly, U-tAs levels correlated positively with U-F− concentrations (rs = 0.633). These results show that Chihuahua residents exposed to high iAs concentrations in drinking water are also exposed to high levels of F−, raising questions about possible contribution of F− exposure to the adverse effects that have so far been attributed only to iAs exposure. Thus, investigation of possible interactions between iAs and F− exposures and its related health risks deserves immediate attention.
Single Cell Confocal Raman Spectroscopy of Human Osteoarthritic Chondrocytes: A Preliminary Study
Authors: Kumar Rajesh , Singh Gajendra , Grønhaug Kirsten , Afseth Nils , De Lange Davies Catharina , Drogset Jon , Lilledahl Magnus
Published: April 2015

A great deal of effort has been focused on exploring the underlying molecular mechanism of osteoarthritis (OA) especially at the cellular level. We report a confocal Raman spectroscopic investigation on human osteoarthritic chondrocytes. The objective of this investigation is to identify molecular features and the stage of OA based on the spectral signatures corresponding to bio-molecular changes at the cellular level in chondrocytes. In this study, we isolated chondrocytes from human osteoarthritic cartilage and acquired Raman spectra from single cells. Major spectral differences between the cells obtained from different International Cartilage Repair Society (ICRS) grades of osteoarthritic cartilage were identified. During progression of OA, a decrease in protein content and an increase in cell death were observed from the vibrational spectra. Principal component analysis and subsequent cross-validation was able to associate osteoarthritic chondrocytes to ICRS Grade I, II and III with specificity 100.0%, 98.1%, and 90.7% respectively, while, sensitivity was 98.6%, 82.8%, and 97.5% respectively. The overall predictive efficiency was 92.2%. Our pilot study encourages further use of Raman spectroscopy as a noninvasive and label free technique for revealing molecular features associated with osteoarthritic chondrocytes.
BMP Signaling Regulates Bone Morphogenesis in Zebrafish through Promoting Osteoblast Function as Assessed by Their Nitric Oxide Production
Authors: Windhausen Thomas , Squifflet Steeve , Renn Jörg , Muller Marc
Published: April 2015

Bone morphogenetic proteins (BMPs) control many developmental and physiological processes, including skeleton formation and homeostasis. Previous studies in zebrafish revealed the crucial importance of proper BMP signaling before 48 h post-fertilization (hpf) for cartilage formation in the skull. Here, we focus on the involvement of the BMP pathway between 48 and 96 hpf in bone formation after 96 hpf. Using BMP inhibitors and the expression of a dominant-negative BMP receptor, we analyze whether the loss of BMP signaling affects osteoblastogenesis, osteoblast function and bone mineralization. To this end, we used the transgenic zebrafish line Tg(osterix:mCherry), detection of nitric oxide (NO) production, and alizarin red staining, respectively. We observed that inhibition of BMP signaling between 48 and 72 hpf led to a reduction of NO production and bone mineralization. Osteoblast maturation and chondrogenesis, on the other hand, seemed unchanged. Osteoblast function and bone formation were less affected when BMP signaling was inhibited between 72 and 96 hpf. These results suggest that for the onset of bone formation, proper BMP signaling between 48 and 72 hpf is crucial to ensure osteoblast function and ossification. Furthermore, detection of NO in developing zebrafish larvae appears as an early indicator of bone calcification activity.
Modulation of the RNA Interference Activity Using Central Mismatched siRNAs and Acyclic Threoninol Nucleic Acids (aTNA) Units
Authors: Alagia Adele , Terrazas Montserrat , Eritja Ramon
Published: April 2015

The understanding of the mechanisms behind nucleotide recognition by Argonaute 2, core protein of the RNA-induced silencing complex, is a key aspect in the optimization of small interfering RNAs (siRNAs) activity. To date, great efforts have been focused on the modification of certain regions of siRNA, such as the 3'/5'-termini and the seed region. Only a few reports have described the roles of central positions flanking the cleavage site during the silence process. In this study, we investigate the potential correlations between the thermodynamic and silencing properties of siRNA molecules carrying, at internal positions, an acyclic L-threoninol nucleic acid (aTNA) modification. Depending on position, the silencing is weakened or impaired. Furthermore, we evaluate the contribution of mismatches facing either a natural nucleotide or an aTNA modification to the siRNA potency. The position 11 of the antisense strand is more permissive to mismatches and aTNA modification, in respect to the position 10. Additionally, comparing the ON-/OFF-target silencing of central mismatched siRNAs with 5'-terminal modified siRNA, we concluded: (i) central perturbation of duplex pairing features weights more on potency rather than silencing asymmetry; (ii) complete bias for the ON-target silencing can be achieved with single L-threoninol modification near the 5'-end of the sense strand.
Game Analysis and Simulation of the River Basin Sustainable Development Strategy Integrating Water Emission Trading
Authors: Liu Liang , Feng Cong , Zhang Hongwei , Zhang Xuehua
Published: April 2015

Water emission trading (WET) is promising in sustainable development strategy. However, low participation impedes its development. We develop an evolutionary game model of two enterprise populations’ dynamics and stability in the decision-making behavior process. Due to the different perceived value of certain permits, enterprises choose H strategy (bidding for permit) or D strategy (not bidding). External factors are simplified according to three categories: rH-bidding related cost, G-price and F-penalty. Participation increase equals reaching point (H,H) in the model and is treated as an evolutionarily stable strategy (ESS). We build a system dynamics model on AnyLogic 7.1.1 to simulate the aforementioned game and draw four conclusions: (1) to reach ESS more quickly, we need to minimize the bidding related cost rH and price G, but regulate the heavy penalty F; (2) an ESS can be significantly transformed, such as from (D,D) to (H,H) by regulating rH, G and F accordingly; (3) the initial choice of strategy is essential to the final result; (4) if participation seems stable but unsatisfying, it is important to check whether it is a saddle point and adjust external factors accordingly. The findings benefit both water management practice and further research.
Le prologue du Commentaire sur les petits prophètes de Théophylacte d’Achrida
Authors: Cassin Matthieu , Aussedat Mathilde
Published: April 2015

Le présent article propose une nouvelle édition des pièces liminaires du Commentaire sur les petits prophètes de Théophylacte d’Achrida (lettre d’envoi à Marie d’Alanie et prologue), réalisée à partir des deux manuscrits dont dépend toute la tradition conservée et d’une copie de l’un deux, qui permet de pallier partiellement les pertes dues à l’humidité dans son modèle. L’édition est accompagnée d’une traduction française et d’un commentaire qui analyse les méthodes employées par Théophylacte pour récrire et réagencer ses sources patristiques. L’auteur s’inspire en particulier de Jean Chrysostome, Hésychius de Jérusalem et Théodoret de Cyr.
Variation autour du Thessalonicensis Vlatadon 14: un manuscrit copié au xénon du Kral, peu avant la chute de Constantinople
Authors: Pietrobelli Antoine
Published: April 2015

The rediscovery of Thessalonicensis Vlatadon 14 has drawn great attention amongst experts on Galen, for this manuscript preserves texts of this author which were believed to have been completely lost. The study presents the precise contents of the manuscript and places the text in its cultural context. By analysis of a diagram illustrating the ‘ latitude of health’, one can determine the relation of the manuscript of Salonica to the teaching given by John Argyropoulos at the xenon of the Kral in Constantinople. Palaeographical identification of the three scribes, students of Argyropoulos, allows us to date the manuscript between 1448 and 1453, and provides prosopographical information concerning the career of the young Constantine Lascaris and another little-known physician called Andreiomenos.
L’anticipation comme procédé littéraire et comme indice rédactionnel dans l’Histoire de Georges Pachymérès
Authors: Failler Albert
Published: April 2015

Chronological anticipation is employed by George Pachymeres in his History as an historical process which introduces movement and separation in the narrative and thus breaks the monotony and linearity of the temporal framework. In addition, chronological anticipation gives a precious editorial indication by linking various events with one another – albeit in an imprecise and ambiguous manner – and provides information concerning the date of a given passage. Out of many examples, six have been chosen with the most pronounced characteristics, comprising both longer periods of time and larger sections of the History.
Un livre reçu par le patriarche Athanase Ier et retourné à l’expéditeur
Authors: Golitsis Pantelis
Published: April 2015

The (unedited) prooimion of the Philosophia of George Pachymeres permits the identification of this author with the addressee of a letter of Athanasius I in which the patriarch mentions returning a book to the sender on account of its contents. We can thus follow the development of the conflict between the two men and better understand the historical context of Pachymeres’s Philosophia.
A non-existent Byzantine-style historian in a new encyclopaedia of Ottoman historians
Authors: Sakel Dean
Published: April 2015

The article reviews well-documented evidence to show that the work on the basis of which the sixteenth-century writer Damascenus Studites has been catalogued as an historian was actually authored by his contemporary Manuel Malaxos.
Le lieu et la date de naissance de Théophane le Confesseur
Authors: Yannopoulos Panayotis A.
Published: April 2015

Les biographes de Théophane le Confesseur restent en général muets sur son lieu de naissance et divergent sur sa date de naissance. Toutefois, grâce à une adaptation du 10e siècle de la biographie de Théophane rédigée par Méthode le patriarche, on sait que Théophane est né dans le thème de la mer Égée, dont son père Isaakios était gouverneur. Puisque Chio était la capitale du thème, il est possible que Théophane y soit né. Quant à sa date de naissance, elle peut être établie grâce aux données chronologiques fournies par ses biographes : Théodore Stoudite, Méthode le patriarche et l’Adaptateur anonyme de Méthode. Ces données paraissent à première vue disparates, car ces trois sources sont chacune de nature différente et visent un public différent. Mais, après une lecture attentive, elles s’avèrent convergentes : Théophane est né en 759.
Remote Lab Experiments in Electronics for Use and Reuse
Authors: Zimmer Thomas , Billaud M. , Pic M. , Geoffroy D.
Published: April 2015

This paper presents a new approach for the use of an already existing remote lab in the field of electrical engineer education. About 70 experiments representing a wide domain of electronic functions are easily accessible and can be incorporated in an existing teaching environment by an easy copy/paste action of a dedicated URL. The corresponding data base structure is explained and a typical result is given highlighting the procedure to follow.
Implementation of Online Optoelectronic Devices Course and Remote Experiments in UC1 iLab
Authors: Rebiai Saida , Touidjen Nour El Houda , Mouissat Smail
Published: April 2015

The aim of this paper is to present a remote experience on light emitting diodes programmed in practical works of optoelectronic devices available online course of electronic department of University Constantine 1 (UC1). This course is one of three online courses proposed among contributions of UC1 in e-Sience Tempus project.

“Optoelectronic components” is an e-course dedicated to students from “master electronic” training. This e-course will be implemented in UC1’s Moodle LMS (learning management system) platform. Its objective is to introduce and consolidated students’ knowledge in optoelectronic devices used in optical transmissions.

LED’s experiment is one of the practical works proposed to be implemented in the remote laboratory of UC1. The remote e-courses and experiments are in progress and will be available on-line since October 2015.
Web-Based Information Exploration of Sensor Web Using the HTML5/X3D Integration Model
Authors: Yoo Byounghyun
Published: April 2015

This chapter investigates how the visualization of sensor resources on a 3D Web-based globe organized by level-of-detail can enhance search and exploration of information by easing the formulation of geospatial queries against the metadata of sensor systems. The case study provides an approach inspired by geographical mashups in which freely available functionality and data are flexibly combined. The authors use PostgreSQL, PostGIS, PHP, X3D-Earth, and X3DOM to allow the Web3D standard and its geospatial component to be used for visual exploration and level-of-detail control of a dynamic scene. The proposed approach facilitates the dynamic exploration of the Sensor Web and allows the user to seamlessly focus in on a particular sensor system from a set of registered sensor networks deployed across the globe. In this chapter, the authors present a prototype metadata exploration system featuring levels-of-detail for a multi-scaled Sensor Web and use it to visually explore sensor data of weather stations.
Characterizing the IT Artefact through Plato's Ontology
Authors: Marchand Marie , Raymond Louis
Published: April 2015

Based on ontological principles enunciated by Plato more than 2300 years ago, yet at a time when Web 3.0 technology is seen to impact the management of organizations and especially the management of organizational performance, the authors propose in this chapter to characterize the IT artefact with an approach that returns the user perspective to the forefront. As an illustration, the Performance Measurement Systems (PMS) of 16 Small and Medium-Sized Enterprises (SMEs) are investigated and characterized from their users' perspective in terms of their specific attributes as systems dedicated to managing organizational performance in the Web 3.0 era. The variety of contexts and configurations of these systems is of particular interest while looking for the principles that underlie their empirical manifestations. Results provide a framework of reference for the characterization, design, and evaluation of IT artefacts that is applicable in particular within a Web 3.0 technological context.
IT Alignment Intelligence
Authors: van Blerk Eben , de la Harpe Andre , Cronje Johannes
Published: April 2015

Above average analytical and mathematical ability are highly sought-after human attributes required from IT professionals at work in the Systems Development Life Cycle (SDLC). These attributes are perceived to be ingredients for a successful career in Information Technology (IT). When companies hire IT professionals, they often focus on the “hard” skills needed to perform the work (Joseph, Ang, Chang, & Slaughter, 2010). There is a growing awareness that technical skills alone are insufficient for success in IT. Technical skills and experience are becoming an entry-level requirement. Being technically competent is no longer enough. For IT professionals, to improve business, a wider set of skills are required. This research aimed to determine what the human attributes are that contribute most to the improvement of business, namely IT alignment. It was found that Emotional Intelligence (EI) of business analysts, systems analysts, and project managers does play a role in the non-delivery of business needs by the IT department. Further, human attributes found to contribute to business-IT alignment were experience, communication skills, professionalism, and collaboration skills. A taxonomy of IT alignment intelligence for business analysts, systems analysts, and project managers is proposed.
The National Ocean Service: Positioning America for the Future
Authors: Bamford Holly A. , Kavanagh Carol
Published: April 2015

AbstractThe National Ocean Service (NOS), a line office of the National Oceanic and Atmospheric Administration (NOAA), is the nation's ocean and coastal agency. Our activities span a broad range that includes charting our nation's coastline; defining the National Spatial
Reference System; providing the national network of coastal tide and water level sensors; serving as the lead federal agency of the U.S. Integrated Ocean Observing System; administering the Coastal Zone Management Program; providing the scientific foundation and socioeconomic information to
local, state, and regional decision makers to adapt to the impacts of coastal hazards and climate change; serving as the authoritative resource for science related to debris, oil, and chemical spills; managing marine sanctuaries; and supporting the management of estuarine research reserves,
coral reefs, and marine protected areas. Today, our coasts and coastal communities face increasingly significant impacts of higher intensity coastal storms; changing sea levels and Great Lakes levels; increased coastal development; increased demand on natural resources and infrastructure;
and increased demands on our marine transportation system. In response to these issues, NOS aligns its activities along three priorities: (1) supporting coastal resilience; (2) advancing coastal intelligence; and (3) promoting place-based conservation. NOS relies on coastal observations and
data products to carry out our mission. Characteristics of future coastal observations include lower cost coupled with greater efficiency, diverse platforms, multiuse data collection, and crowdsourcing. Data products will need to be increasingly geographically tailored; result from a greater
degree of coordination and integration; and result in greater data access.
Modernizing the Datums of the National Spatial Reference System
Authors: Smith Dru A. , Roman Daniel R. , Childers Vicki A.
Published: April 2015

AbstractThe National Spatial Reference System (NSRS) is the official coordinate system for all geospatial activities performed by civilian federal agencies of the United States, including National Oceanic and Atmospheric Administration's navigational charts. Two of the datums
that make up the bulk of the NSRS, the North American Datum of 1983 (NAD 83) and the North American Vertical Datum of 1988 (NAVD 88), were created with the most accurate surveying technology available in the 1970s and 1980s. However, analysis over the last decade has proven that both datums
contain systematic errors at the few meters level. While there have been improvements to these datums over the years, they have all been restricted to adjusting subsets of coordinates within the datum, rather than replacing the datum itself. However, the rise of near-real-time positioning
technologies at the few centimeter level has made it no longer viable to maintain the two datums.The National Geodetic Survey is engaged in a decade-long effort to prepare the NSRS user community and collect the necessary data to define two new datums that will not only replace NAD 83
and NAVD 88 but also reduce the overall reliance of those two datums on passive control. The two new datums are expected to be completed and jointly released in 2022.
Technology Use in NOAA's National Marine Sanctuary System
Authors: Basta Daniel J. , LaFeir Letise , Gittings Stephen , Broughton Kathy , Casserley Tane , Chetirkin Paul , Delgado James , DeVogelaere Andrew , Green Russ , Hickerson Emma , Hoyt Joseph , Lawrence Matthew , Lillestolen Ted , Pickett Matt , Reyer Tony , Rohmann Steve , Schmahl George , Thompson Kate , Wiley David , Wilkes Dana
Published: April 2015

AbstractThe National Oceanic and Atmospheric Administration's Office of National Marine Sanctuaries employs constantly evolving marine technologies to meet its requirements for observing and tracking changing ocean conditions and resource qualities. Vessels, submersibles,
and a host of unmanned platforms, including satellites, buoys, remotely operated vehicles, and in-water instrument arrays, are providing information that helps us better understand and manage activities that affect the ocean, Great Lakes, and adjacent coasts. Platforms and sensors track animals
and ship traffic, send alerts to at-sea operators, map the seabed and its natural and archaeological resources, track spills, sample water, and define ocean soundscapes. Technologies are also employed to support complex diving operations, record marine life, document shipwrecks, log data,
produce map products, and broadcast live feeds to the world. The sanctuaries frequently work with commercial, federal, academic, and nonprofit partners to focus a broad range of observing assets on the many issues of concern to marine conservation and protection.
The National Oceanographic Partnership Program: Successes in Partnerships
Authors: Keylon Rachel , Hollister John
Published: April 2015

AbstractThe National Oceanographic Partnership Program (NOPP) was initiated in the 1990s when decades of work in ocean sciences by dedicated scientists converged with numerous ocean challenges that cut across scientific disciplines, government agencies, and congressional
jurisdictions. A timely push for increased partnerships in ocean science led to the inclusion of the National Oceanographic Partnership Act in the FY 1997 Defense Authorization Act, formally establishing the NOPP. Since its inception, the NOPP has spurred strong, long-term collaborations across
federal agencies and among various sectors, including academia, local and tribal governments, industry, and nongovernmental organizations. The NOPP has allowed the partnering agencies to leverage their funds, facilities, and infrastructures, increasing the impact of their investments and expanding
their abilities to meet high-priority goals. Through the NOPP, the number of multiagency partnerships has increased, resulting in large-scale multidisciplinary research projects and the development of new and sophisticated tools for ocean research. Furthermore, and most importantly, the NOPP
provides a forum for dialogue, debate, and decision making regarding the most pressing ocean research and technology challenges and provides a strong voice for the oceanography community on a national scale.
Two-Million-Liter Tank Expands the Boundaries of Marine Technology Innovation: National Resource Available for Advancing Marine Science
Authors: Demer David A. , Cutter George Randall , Stierhoff Kevin L. , Renfree Josiah S.
Published: April 2015

AbstractWith one small move across a street, NOAA Fisheries, our nation's steward of marine ecosystems, made a giant leap into the future of ocean science and technology development. The new Southwest Fisheries Science Center facility in La Jolla, California, houses dozens
of interdisciplinary research and engineering groups and features a world-class Ocean Technology Development Tank that expands the possibilities for advancing marine industry and science. This 20 × 10 × 10-meter, two-million-liter, freshwater or seawater “Tech Tank”
is clear, quiet, and large enough to calibrate and test a wide variety of sensitive instruments with minimal boundary effects. The tank's temperature, salinity, and circulation can be made to mimic the broad range of water conditions encountered in the field, its water conditioning system
greatly mitigates microbubbles and turbidity, and it can accommodate live marine animals. This unique combination of features opens doors to efficient engineering and scientific experimentation. The Tech Tank, supported by scientists and engineers and co-located with other state-of-the-art
laboratory facilities, is a unique national resource for marine research and development and a catalyst for government, academic, and industry partnerships. The broad range of new possibilities is exemplified by multiple recent collaborative developments of acoustic and optical sensors and
sensor platforms that effectively expand the boundaries of oceanic sampling, particularly near the sea surface, seabed, and seashore, to more efficiently and accurately monitor large marine ecosystems.
Misdiagnosed Injuries in the Prehospital Trauma Care: Better Training needs to be Implemented
Authors: Nasr Adonis , Abreu-Reis Phillipe , Collaço Iwan , Tomasich Flavio Saavedra
Published: April 2015

Background

It is not always that prehospital trauma life support (PHTLS) principles are applied to daily practice. Lack of training to health care providers and a high amount of patients overwhelming the system capacity may let malpractice behavior to happen. It is the aim of this study to assess injuries misdiagnosed by prehospital trauma care in a capital city in southern Brazil.

Study design

A prospective observational non-controlled study with 174 random trauma cases that were brought to a level 1 trauma center in the city of Curitiba, between May 28th and June 10th 2006. We analyzed data registered in the prehospital rescue team form. The including criteria were all patients delivered to the trauma center by ambulances. The excluding criteria were patients not transported by ambulances and those without the proper form filled out. Statistical analysis was performed using the Chi-square for discrete, and the students’ t-test for continuous variables.

Results

Of the 174 patients who met the including criteria, 75% were men with a mean age of 27-year-old. Of the 11 injuries to the neck identified in the Hospital evaluation, eight were missed by the prehospital care (OR 0.26 CI 95% 0.07-0.94). Also, only 7/20 injuries to the back were identified by the PHTLS team (OR 0.32 CI 95% 0.13-0.78). Similarly, only 6/26 injuries to the chest (OR 0.20 CI 95% 0.08-0.50), 4/15 to the abdomen (OR 0.24 CI 95% 0.08-0.76), 4/16 to the pelvis (OR 0.23 CI 95% 0.07-0.70), 13/33 to the upper body (OR 0.34 CI 95% 0.17- 0.68),7/39 to the lower body (OR 0.14 CI 95% 0.06-0.33) and 17/55 (OR 0.23 CI 95% 0.12-0.42) were correctly identified in the prehospital scenario.

Conclusion

Although it is known PHTLS principles, which save lives when applied in practice, further training and remarks to its importance is needed to fully implement efficient trauma systems. Electronic data collection shall make checklists consistently filled out, so that patient care will be improved.

How to cite this article

Abreu-Reis P, Nasr A, Tomasich FS, Collaco I. Misdiagnosed Injuries in the Prehospital Trauma Care: Better Training needs to be Implemented. Panam J Trauma Crit Care Emerg Surg 2014;3(3):93-96.
Surgical Challenges associated with the use of Illicit Street Drugs
Authors: Lucas Charles E
Published: April 2015

Antecedentes

Las drogas callejeras ilícitas son omnipresentes. Los estereotipos de drogas son la heroína, la clásica ‘depresora’ y la cocaína, la clásica ‘estimulante’. Su mezcla con el alcohol mejora sus efectos.

Método de estudio

Este estudio evalúa las complicaciones quirúrgicas del uso de la heroína y la cocaína.

Resultados

Las complicaciones de la heroína se deben a la contaminación de la heroína durante la dilución realizada con fines de lucro. Las inyecciones de ‘droga mixta’ causan abscesos y celulitis. La infección poli-microbiana puede propagarse rápidamente y requerir desbridamiento extenso. La amputación del antebrazo o miembros inferiores puede ser requerida. La inyección intravenosa produce tromboflebitis, miembros post-flebíticos, neumonía y endocarditis. Una inyección intra-arterial errante, ‘meñique’, causa embolias capilares distales con dígitos gangrenosos y pseudoaneurismas debido a la hemorragia del absceso perivascular. Estos requieren excisión. La endocarditis es a menudo refractaria a los antimicrobianos requiriéndose de una valvulectomía. Se requiere de una esplenectomía para un absceso para prevenir la reinfección de las válvulas del corazón.

Las complicaciones de la cocaína reflejan sus intensas propiedades vasoconstrictoras. Esto puede causar despolarización cardiaca con arritmias y muerte súbita, accidente cerebrovascular isquémico, y perforación esplácnica debida a isquemia focal dentro del duodeno, intestino delgado o el colon. Perforaciones esplácnicas requieren resección. El infarto esplénico inducido por la cocaína con o sin hemorragia requiere de una esplenectomía. La cocaína puede causar oclusión vascular por vasoespasmo de los vasa vasorum causando isquemia de la íntima y trombosis; esto puede implicar a la aorta. ‘Empacadores Cuerpo’ que se tragan los paquetes de cocaína de contrabando se encuentran en grave peligro si se rompe el paquete antes de ser excretada con la defecación; requieren operación rápida.

Conclusión

El conocimiento de las complicaciones de drogas de la calle permite un abordaje quirúrgico racional.

How to cite this article

Lucas CE. Surgical Challenges associated with the use of Illicit Street Drugs. Panam J Trauma Crit Care Emerg Surg 2014;3(3):114-123.
Regional Anesthesia for Antipersonnel Landmines: A Military Hospital Experience in Colombia
Authors: Velez-Escobar Camilo Eduardo , Muñoz-Barrios Dora Milena , Perez Norton
Published: April 2015

Background

Lower extremity blast injuries are frequent in Colombia as a result of the ongoing internal conflict. General anesthesia has been the preferred method of anesthesia for the surgical treatment of these injuries; spinal anesthesia is a safe alternative, which allows hemodynamic management.

Design

A retrospective cross-sectional trial was designed, reviewing clinical charts of patients with lower extremity blast injuries in a military hospital in Villavicencio, Colombia, from June 2005 to June 2012. Descriptive and bivariate analysis was performed. Chi-square or Fisher's exact test or Student's t-tests were used to establish statistical significance when p < 0.05.

Results

The medical records of 63 male patients were included for analysis. The average age was 25 years; the majority were professional soldiers, who had selective (unilateral) spinal anesthesia. Additionally, 39 of them received sedation with midazolam. Hypotension was observed in 36% of the patients. This was easily handled with crystalloids and in 5% of the cases with vasopressors. None of the patients required postoperative admission to the intensive care unit. The patients that received blood transfusions had more infections than those patients who did not receive blood transfusions (47 vs 26%). However, the risk of infection was lower when preoperative antibiotic prophylaxis, that included penicillin and amikacin, was utilized (17 vs 33%). The difference was not statistically significant.

Conclusion

Spinal anesthesia is a safe technique in lower extremity blast injuries. Transfusion might be restricted, and the incidence of infection might be lowered when a regimen of preoperative antibiotic prophylaxis with penicillin and amikacin is utilized.

How to cite this article

Velez-Escobar CE, Muñoz-Barrios DM, Perez N. Regional Anesthesia for Antipersonnel Landmines: A Military Hospital Experience in Colombia. Panam J Trauma Crit Care Emerg Surg 2014;3(3):132-138.
Trends in the Management of Intertrochanteric Femur Fractures in the United States 2005-2011
Authors: Werner Brian C. , Fashandi Ahmad H. , Gwathmey F. Winston , Yarboro Seth R.
Published: April 2015

Objectives

In the last 2 decades, surgical treatment of intertrochanteric (IT) femur fractures has shown a continuing trend towards the increased use of intramedullary nails (IMN) and decreased use of sliding hip screws (SHS). Recent trends in the United States regarding the use of these implants, including charges and reimbursement, have not been investigated.

Methods

A national database of Medicare patients (PearlDiver, Inc.) was queried using Current Procedural Terminology (CPT) codes for patients with surgical dates from 2005-2011.

Results

A total of 34,759 SHS or IMN procedures for intertrochanteric femur fractures were identified from 2005-2011. There was a significant increase in the percentage of IMN compared to SHS, from 46.9% IMN in 2005 to 79.1% in 2011. The average charges for IMN and SHS increased. Statistically higher rates of PE (p<0.001), DVT (p<0.001), MI (p<0.001), respiratory failure (p<0.001), UTI (p<0.001), pneumonia (p<0.001), CVA (p<0.001) and blood transfusion (p<0.001) were noted in the IMN group. The SHS group had higher 1 year (4.3% vs 3.8%, p = 0.012) and 2 year (5.8% vs 5.0%, p = 0.002) mortality rates.

Conclusions

The previously recognised trend of increasing use of IMN for IT femur fractures has continued. The overall incidence of operative IT femur fractures is not increasing at this time. The cost of IMN remains higher than SHS.
Cementless Total Hip Arthroplasty in Developmental Dysplasia of the Hip with End Stage Osteoarthritis: 2-7 Years’ Clinical Results
Authors: Yildirim Tugrul , Guclu Berk , Karaguven Dogac , Kaya Alper , Akan Burak , Cetin Ilker
Published: April 2015

Between 2006 and 2011, 102 hips of 78 patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip (DDH) underwent cementless total hip arthroplasty (THA). According to the Crowe's classification, 22 hips (21%) were type 1, 19 hips (18%) were type 2, 22 hips (21%) were type 3 and 39 hips (38%) were type 4 respectively. Functional and clinical analyses were performed by Harris Hip Scores (HHS). There were 73 (71%) excellent or good results according to HHS. The postoperative HHS was significantly lower in patients who underwent femoral shortening (p<0.01). We observed 25 (24.5%) complications in total, 15 (14.7%) of which required revision surgery. The authors concluded that THA for DDH is a safe and a reliable procedure with good clinical outcomes.
A Commentary on Interstitial Pneumonitis Induced by Docetaxel: Clinical Cases and Systematic Review of the Literature
Authors: Genestreti Giovenzio , Di Battista Monica , Trisolini Rocco , Denicolò Fabio , Valli Mirca , Lazzari-Agli Luigi Arcangelo , Dal Piaz Giorgia , De Biase Dario , Bartolotti Marco , Cavallo Giovanna , Brandes Alba A.
Published: April 2015

Background

Pulmonary toxicity is a well-known complication observed with several anticancer drugs. Docetaxel, a taxane chemotherapy drug widely used in the treatment of many types of solid tumors including non-small cell lung cancer (NSCLC), rarely causes infiltrative pneumonitis. The exact mechanism by which docetaxel develops this side effect is not well understood; probably it is produced by type I and IV hypersensitivity responses. Here we describe 2 cases of infiltrative pneumonitis induced by docetaxel as second-line chemotherapy in advanced NSCLC.

Materials and Methods

Two patients with advanced NSCLC were treated with weekly docetaxel as second-line chemotherapy. After 3 courses of chemotherapy, restaging computed tomography (CT) of the chest revealed bilateral diffuse ground-glass opacities with a peribronchial distribution possibly indicative of hypersensitivity pneumonitis. No evidence of pulmonary embolus or pleural effusion was found. Fiberoptic bronchoscopy showed normal bronchi without lymphangitis; biopsies showed interstitial fibrosis without tumor cells. Bronchial tissue laboratory tests for fungi or bacilli were negative. No malignant cells were found at bronchoalveolar lavage. The patients were given high-dose corticosteroid therapy with prednisone 0.7 mg per kilogram per day.

Results

After 1 month of therapy, contrast-enhanced chest CT showed complete disappearance of the pulmonary changes in both patients. Spirometry and blood gas analysis revealed complete recovery of pulmonary function. The patients continued their oncological follow-up program.

Conclusions

Pulmonary injury is a rare adverse event during docetaxel chemotherapy. Prompt treatment with high-dose corticosteroids is needed to avoid worsening of respiratory performance.
The Other Heroine Is Memory (A Conversation with Agata Tuszyńska)
Authors: Wróbel Best Jolanta
Published: April 2015

The article consists of an interview with Agata Tuszyńska, the author of a book regarded in Poland as both important and controversial. Vera Gran: The Accused presents the testimony of the aged, reclusive eponymous Polish singer who spent part of World War II in the Warsaw Ghetto and thereafter lived in the shadow of accusations that she had collaborated with the Nazi occupation. Grant not only disputed these charges but leveled similar if unsubstantiated allegations against her sometime accompanist, Władysław Szpilman, celebrated as the hero of the memoir and film The Pianist. Tuszyńska describes her book as a study in human memory and acknowledges that memory could be necessarily subjective and contradictory but asserts that only by collecting the memories of many witnesses can the truth of the war and Holocaust be grasped.
In Memoriam Anna M. Cienciala (November 8, 1929–December 24, 2014)
Authors: Pease Neal
Published: April 2015

Anna M. Cienciala died on December 24, 2014, in Fort Lauderdale, Florida, en route from vacation to her home in Lawrence, Kansas. She was Professor Emerita of History and at the Center for Russian, East European and Eurasian Studies at the University of Kansas, where she had taught for nearly four decades, and became one of the world’s most eminent and respected scholars on the recent history of Poland and international relations. She was also a longtime mainstay of the Polish Institute of Arts and Sciences of America and The Polish Review.
UNIDADES DE CONSERVAÇÃO PROMOVEM POBREZA E ESTIMULAM AGRESSÃO A NATUREZA NA AMAZÔNIA
Authors: Freitas Josimar Silva , Rivas Alexandre Ferreira
Published: April 2015

O estudo analisou os efeitos da intervenção governamental de duas décadas (1990 a 2010) na Reserva Extrativista do Alto Juruá - REAJ (AC), bem como informou as condições de sobrevivência das famílias. No sentido de entender as relações entre a instituição e a percepção das pessoas da unidade, se priorizou o grupo social, econômico, cultural e ambiental, ao passo de utilizar a matriz de SWOT para perceber as forças e fraquezas, e externas - as oportunidades e ameaças. A pesquisa se orientou por uma pesquisa de natureza qualitativa efetivando-se em quatorze das oitenta comunidades registradas e, por sua vez, o método dialético confrontou os sistemas em sua essência a partir da realidade local, tanto quanto considerou não só a preservação ambiental, mas as condições de bem-estar das famílias inseridas nas comunidades da Resex.
Experimental Study of the Jet Engine Exhaust Flow Field of Aircraft and Blast Fences
Authors: Wang Haifu , Cai Liangcai , Chong Xiaolei , Geng Hao
Published: April 2015

A combined blast fence is introduced in this paper to improve the solid blast fences and louvered ones. Experiments of the jet engine exhaust flow (hereinafter jet flow for short) field and tests of three kinds of blast fences in two positions were carried out. The results show that the pressure and temperature at the centre of the jet flow decrease gradually as the flow moves farther away from the nozzle. The pressure falls fast with the maximum rate of 41.7%. The dynamic pressure 150 m away from the nozzle could reach 58.8 Pa, with a corresponding wind velocity of 10 m/s. The temperature affected range of 40°C is 113.5×20 m. The combined blast fence not only reduces the pressure of the flow in front of it but also solves the problems that the turbulence is too strong behind the solid blast fences and the pressure is too high behind the louvered blast fences. And the pressure behind combined blast fence is less than 10 Pa. The height of the fence is related to the distance from the jet nozzle. The nearer the fence is to the nozzle, the higher it is. When it is farther from the nozzle, its height can be lowered.
Express Services Market Analysis Based on the Lotka-Volterra Model – Case Study Serbia
Authors: Jovanović Bojan , Mostarac Katarina , Šarac Dragana , Rakić Estera
Published: April 2015

This paper provides a preview of the former stages through which the market of express postal services had gone and the possibilities of further development, both on the global and local level. The aim of this paper is to complete an estimation of the need for this type of express services using the competitive Lotka–Volterra model in Serbia. In order to reduce the complexity of the process, the division of competition was conducted in two segments: the public operator and the private segment (comprised of all private operators). The given model provides a description of a dynamic competition relationship by indicating the existence of the equilibrium point between the public and the private sectors, and the conditions of its stability. The obtained values indicate that the private sector affects the public operator. The existing predator-prey relationship gives preference to the private sector and can be described by the Lotka-Volterra model.
Value of Sonographic Bidirectional Arterial Flow Combined With Elastography for Diagnosis of Breast Imaging Reporting and Data System Category 4 Breast Masses
Authors: Liu Da , Huang Ying , Tian Dan , Yin Jing , Deng Li-jun
Published: April 2015

Objectives

The purpose of this study was to evaluate the role of bidirectional arterial flow combined with ultrasound elastography for differentiation of American College of Radiology Breast Imaging Reporting and Data System (BI‐RADS) category 4 masses.

Methods

A total of 116 BI‐RADS category 4 breast masses were evaluated with color Doppler sonography, spectral analysis, and elastography. The sensitivity, specificity, accuracy, positive and negative predictive values, and receiver operator characteristic curve were used to estimate the diagnostic performance for each modality and the combination method.

Results

The combination method had the best sensitivity (81.1%) but less specificity (94.9%) and the best accuracy (90.5%). The discriminating power of the combined method (area under the curve [AUC], 0.880; 95% confidence interval [CI], 80.0%–96.0%) was significantly higher than that of bidirectional arterial flow (AUC, 0.818; 95% CI, 72.0%–91.6%; P< .01) and elastography (AUC, 0.765; 95% CI, 65.9%–87.0%; P< .01).

Conclusions

Bidirectional arterial flow evaluation, when combined with elastography, could potentially improve diagnostic accuracy for BI‐RADS category 4 breast masses.
Effect of dry large‐scale vertical motions on initial MJO convective onset
Authors: Powell Scott W. , Houze Robert A.
Published: April 2015

Anomalies of eastward propagating large‐scale vertical motion with ~30 day variability at Addu City, Maldives, move into the Indian Ocean from the west and are implicated in Madden‐Julian Oscillation (MJO) convective onset. Using ground‐based radar and large‐scale forcing data derived from a sounding array, typical profiles of environmental heating, moisture sink, vertical motion, moisture advection, and Eulerian moisture tendency are computed for periods prior to those during which deep convection is prevalent and those during which moderately deep cumulonimbi do not form into deep clouds. Convection with 3–7 km tops is ubiquitous but present in greater numbers when tropospheric moistening occurs below 600 hPa. Vertical eddy convergence of moisture in shallow to moderately deep clouds is likely responsible for moistening during a 3–7 day long transition period between suppressed and active MJO conditions, although moistening via evaporation of cloud condensate detrained into the environment of such clouds may also be important. Reduction in large‐scale subsidence, associated with a vertical velocity structure that travels with a dry eastward propagating zonal wavenumbers 1–1.5 structure in zonal wind, drives a steepening of the lapse rate below 700 hPa, which supports an increase in moderately deep moist convection. As the moderately deep cumulonimbi moisten the lower troposphere, more deep convection develops, which itself moistens the upper troposphere. Reduction in large‐scale subsidence associated with the eastward propagating feature reinforces the upper tropospheric moistening, helping to then rapidly make the environment conducive to formation of large stratiform precipitation regions, whose heating is critical for MJO maintenance.
Delta channel networks: 2. Metrics of topologic and dynamic complexity for delta comparison, physical inference, and vulnerability assessment
Authors: Tejedor Alejandro , Longjas Anthony , Zaliapin Ilya , Foufoula‐Georgiou Efi
Published: April 2015

Deltas are landforms that deliver water, sediment and nutrient fluxes from upstream rivers to the deltaic surface and eventually to oceans or inland water bodies via multiple pathways. Despite their importance, quantitative frameworks for their analysis lack behind those available for tributary networks. In a companion paper, delta channel networks were conceptualized as directed graphs and spectral graph theory was used to design a quantitative framework for exploring delta connectivity and flux dynamics. Here we use this framework to introduce a suite of graph‐theoretic and entropy‐based metrics, to quantify two components of a delta's complexity: (1)Topologic, imposed by the network connectivity and (2)Dynamic, dictated by the flux partitioning and distribution. The metrics are aimed to facilitate comparing, contrasting, and establishing connections between deltaic structure, process, and form. We illustrate the proposed analysis using seven deltas in diverse morphodynamic environments and of various degrees of channel complexity. By projecting deltas into a topo‐dynamic space whose coordinates are given by topologic and dynamic delta complexity metrics, we show that this space provides a basis for delta comparison and physical insight into their dynamic behavior. The examined metrics are demonstrated to relate to the intuitive notion of vulnerability, measured by the impact of upstream flux changes to the shoreline flux, and reveal that complexity and vulnerability are inversely related. Finally, a spatially explicit metric, akin to a delta width function, is introduced to classify shapes of different delta types.