bluuebunny/crossref_metadata_2025 huggingface dataset:
Produção de forragem, morfogênese e eficiência agronômica do adubo em capim BRS Quênia sob doses de nitrogênio
Authors: Martuscello J. A. , Ribeiro Y. N. , Braz T. G. S. , Ferreira M. R. , Assis J. A. , Jank L. , Reis G. A.
Published: August 2018

A adubação nitrogenada modifica os padrões morfogênicos de crescimento das forrageiras. Logo, estudos sobre a resposta de plantas recém lançadas, como a capim BRS Quênia, à adubação podem contribuir sobremaneira com a recomendação estratégias de manejo e doses mais apropriadas do adubo.  Objetivou-se com este trabalho avaliar a alocação de biomassa aérea e radicular, resposta morfogênica e a eficiência agronômica da adubação em plantas de Panicum maximum cv. BRS Quênia, sem adubação e adubadas com 50, 100 e 200 mg.dm-3 de nitrogênio. O experimento foi conduzido em casa de vegetação, em delineamento inteiramente casualizado com quatro repetições. As proporções de folha foram maiores que as proporções de colmo, independentemente da adubação nitrogenada. Houve maiores incrementos na produção de parte aérea em detrimento a produção de raiz. O aumento da adubação implicou em menor intervalo entre o surgimento das folhas do capim BRS Quênia, bem como aumentou o número de perfilhos por planta.  A medida que se incrementa a adubação nitrogenada há diminuição da eficiência de uso do adubo. A adubação nitrogenada influencia positivamente a produção de forragem em plantas de Panicum maximum BRS Quênia e, independentemente da dose de adubação nitrogenada, a parte aérea funciona como principal dreno de nitrogênio.
Personality Development in the Context of University Training: A Comparative Study
Authors: Kulagina I.Y. , Apasova E.V.
Published: August 2018

Using the concept of the zone of proximal development, the paper attempts to describe the process of development of professionally significant personality traits in military students (future officers of special operation forces) and in psychology students during their university training. In keeping with their conscious choice of military university, future officers display high levels of development of personality traits important for military professions. It is assumed that the zone of proximal development for these qualities is wide enough. Thus, mastering the content of academic programs and inclusion in the specific system of social interactions at university result in the actualization of personal resources, defining the vector of personality development and the overall level of professionally significant qualities development, as well as the individual’s readiness for professional activity. As for students of universities for humanities training in the field of human-human relationships, the development of professional qualities is less intense in those individuals with initially low levels of the qualities’ development but with a relatively wide zone of proximal development.
L.I. Bozhovich's Concept of Personality Structure and Formaition (Cultural-Historical Approach)
Authors: Goutkina N.I.
Published: August 2018

The paper is devoted to analysis of the scientific work of Lydia Ilyinichna Bozhovich, a renowned Soviet academic psychologist who belonged to the cultural-historical school of thought and began a student of Lev Semenovich Vygotsky. Bozhovich’s research implemented cultural-historical methodology for study of the human mind and was focused on the problems of the structure and formation of child’s personality in ontogeny. The present paper links together theoretical statements that were proposed by Bozhovich in different periods of her work but nevertheless form an integral understanding of the personality formation in the childhood. The paper includes analyses of several Bozhovich’s concepts: the concept of personality; the hypothesis of the new personality formations in ontogenesis; her understanding of the affective (based on needs) sphere as the foundation of the personality development; the developmental phases of personality formation; and central newly formed personality structures at each developmental phase. The review outlines the large scale character of the research conducted in Bozovich’s laboratory
Entre uma seta e um círculo: algumas considerações sobre o tempo em Baudelaire
Authors: Barros Alice Vieira
Published: August 2018

Este artigo objetiva construir uma leitura da poética de Baudelaire tomando como base a relação entre o “eu poético baudelairiano” e a História. Escolhi como principais aportes teóricos e ferramentas de leitura as reflexões do filósofo Walter Benjamin nas “Teses sobre o conceito de história”, que são avessas a um historicismo tradicional e linear e possuem muitos pontos de tangência com as ideias baudelairianas, e o ensaísmo crítico da poeta russa Marina Tsvetáieva, com suas considerações a respeito da relação entre o “poeta e o tempo”. Tencionamos desenvolver a hipótese segundo a qual a nostalgia do tempo mítico – por oposição a um tempo profano – configura, em Baudelaire, uma resposta crítica aos automatismos sobre a visão de progresso vigentes em seu contexto cultural, mediante a retomada  consciente que o poeta faz de símbolos e mitemas da narrativa bíblica judaico-cristã.
A estética da obra de arte e do objeto na época da reprodução biopolítica
Authors: Amaral da Silva Tiago
Published: August 2018

O presente artigo tem como objetivo discutir como a estetização dos objetos cotidianos e a fusão entre obra de arte e mercadoria influenciaram os modos de reprodução das relações sociais desde o advento da segunda revolução industrial até a contemporaneidade. Baseado nos conceitos de aura e da estética da guerra apresentados por Walter Benjamin no ensaio A obra de arte na época de sua reprodutibilidade técnica, traça-se um panorama do avanço das estratégias biopolíticas praticadas pela sociedade da produção em massa e do hiperconsumo, e sua relação com o esforço histórico de estetização do capital. Discute-se, por fim, os artifícios de ressignificação do ofício da arte por intermédio de seu amálgama com objetos de fabricação serial de caráter perverso, e como tal processo é utilizado para a perpetuação do poder subreptício das sociedades de controle.
Sıra Dışı Bir Kaza ile Meydana Gelen ve Ölümle Sonuçlanan Alüminyum Fosfit Zehirlenmesi: Olgu Sunumu
Authors: Karadeniz Hülya , Boz Halil , Ketenci Hüseyin Çetin
Published: August 2018

Aluminium phosphide is an insecticide that shows highly toxic activity when it reacts with water or moister and becomes phosphine. Because it has high diffusion capacity, it can kill all the organisms in different growth phases in the area that it is used. However, it is used frequently due to not to find rests on plants. There is not a specific antidote for aluminium phosphide and mortality from 30% to 100% in poisoning and it is related with exposure. In this study, we present 13 years girl case who was poisoned by aluminium phosphide. He was found in his apartment which is at first floor, after fumigation of food store at the basement. We aim to evaluate by autopsy findings, chemical and histopathological findings together and to discuss with literature results. In addition, we want to discuss about solution of uncontrolled dealing and using of aluminium phosphide in our country.
Ani Bebek Ölüm Sendromu ve Adli Hemşirelik Yaklaşımı
Authors: Yıldız İlknur
Published: August 2018

Sudden infant death syndrome (SIDS), is a sudden death of infants under one year of age with no health problems and unexplained autopsy. The frequency of SIDS in the world varies according to societies. SIDS may develop due to developmental, environmental and biological risk factors. Preterm birth of infant, mother’s tobacco use, bed-sharing and prone sleeping position are some of the factors that increase the SIDS risk the risk of. In the case of suspected SIDS cases that require further investigation and evaluated within the scope of the forensic case, the educated forensic nurses in the forensic medicine to be included in the research team has an important role in the evaluation and resolution of the case. The forensic nurse should explain to the parents that the questions in the interviewing are designed to gather information and determine risk factors, not accuse the parents. Parents have difficulty in accepting the death of their baby and experience stress, anger and guilt. In this context, it should be allowed to express the feelings of the family, to explain that death is not is not the result of their own fault and to reduce family’s guilt feelings.
Baby Death Due to Esophagotracheal Fistula Created by An Alkaline Battery: A Case Report
Authors: Teke Hacer Yaşar , Can Muhammet , Renklidağ Tülay , Temel Nevriye , Gökmen Asude
Published: August 2018

There is a limited number of case presentations in literature related to esophagus burns and complications as a result of swallowing an alkaline battery. The main purpose of this case presentation was to discuss the autopsy findings of late-developing complications of swallowing an alkali battery in the light of the relevant literature.
On the chest radiography of a 9-month old baby with complaints of vomiting for three days, an opacity was observed consistent with a foreign body in the esophagus. Esophagoscopy was applied and the swallowed battery was removed. On the fifth day after the operation, no complication has been observed to oral feeding was started and on the following day the patient was discharged. Four days after discharge, the patient was again brought to hospital with complaints of blood in vomit and was again hospitalized with a diagnosis of chemical esophageal burn. The patient died on the following day....
Profiles Associated with Sarcopenia in Hepatoma Patients Underwent Transcatheter Arterial Chemoembolization: A Data‐Mining Analysis
Authors: Hirota Keisuke , Kawaguchi Takumi , Hashida Ryuki , Koya Shunji , Bekki Masafumi , Goshima Norihiro , Yoshiyama Teruhito , Otsuka Takashi , Nozoe Ryosuke , Nakano Dan , Shirono Tomotake , Shimose Shigeo , Iwamoto Hideki , Niizeki Takashi , Matsuse Hiroo , Koga Hironori , Shiba Naoto , Torimura Takuji
Published: August 2018

Aims

Sarcopenia is a prognostic factor in patients with hepatocellular carcinoma (HCC). Transcatheter arterial chemoembolization (TACE) may aggravate sarcopenia because of post‐embolization syndrome. The aims of this study are to investigate changes in skeletal muscle mass after TACE and its risk profiles in patients with HCC.

Methods and results

We enrolled 104 HCC patients (age 73.5 [41.0–88.0] years, female/male 35/69, body mass index 22.4 [16.0–32.7]). Changes in skeletal muscle mass were evaluated by Δskeletal muscle index (SMI) using computed tomography before and after TACE. Factors correlated with ΔSMI were evaluated. Independent factors and profiles associated with a decrease in SMI were evaluated by multivariate analysis and decision‐tree analysis, respectively. SMI was significantly decreased after TACE in patients with HCC (32.8 vs. 30.6 cm2/m2; P=0.0001). However, there was no significant correlation between the ΔSMI and other variables including Δalbumin. In the logistic regression analysis, no factor was significantly associated with a decrease in SMI. In the decision‐tree analysis, sex was selected as the initial split and, in female, 74% of subjects showed a decrease in SMI. While, in male, an estimated glomerular filtration rate (eGFR) ≤81.7 ml/min/1.73 m2 was the second split; of these patients, 74% of subjects had a decreased SMI.

Conclusions

We demonstrated that skeletal muscle mass was decreased after TACE in patients with HCC. “female” and “male who had a lower eGFR” were profile for a decrease in skeletal muscle mass. Thus, such patients who have HCC treated with TACE may benefit from preventive treatment for sarcopenia.
Innovación organizativa y gestión del conocimiento en hospitales públicos en el Estado de México (2011)
Authors: Fierro Moreno Erendira , Mercado Salgado Patricia
Published: August 2018

Estudios previos constatan que la gestión del conocimiento se relaciona con la innovación, aunque es poca la atención que ha recibido la innovación organizativa, la cual es un tipo de innovación dentro de las organizaciones. El objetivo de este artículo es analizar la asociación entre innovación organizativa y gestión del conocimiento en hospitales públicos, para lo cual se aplicó un cuestionario de 55 reactivos en escala de Likert a 158 mandos medios y directivos de siete nosocomios. Se hipotetizó asociación entre ambas variables.
Empresa social basada en alianzas.El caso del mercado de saneamiento como modelo de cambio e innovación social
Authors: Flores Castro Alejandro
Published: August 2018

Las oportunidades para mejorar la calidad de vida en la base de la pirámide pueden ser capitalizadas, además de la subvención del Estado, por las alianzas de tipo Público-Privado-Social (PPS). El objetivo de este trabajo es diseñar un nuevo modelo de empresa -la empresa social- que cubre lo que el Estado y el sector privado solos no logran alcanzar. La propuesta está basada en alianzas con diferentes stakeholders, y se plantea un modelo de empresa para promover el acceso a servicios de saneamiento sostenible de calidad, a partir de incluir el cambio como elemento sustancial
Ambiente regional y desempeño innovador de las firmas. Una propuesta de análisis multinivel
Authors: Zuluaga Jiménez Julio César , Sánchez Manchola Iván Darío , Barrios Aguirre Fernando
Published: August 2018

El objetivo del artículo es proponer un modelo de análisis multinivel de la innovación. Se exponen los debates acerca de los efectos del ambiente regional sobre el desempeño innovador de las firmas y se sostiene que la innovación se debe comprender desde una óptica multinivel que incluyan las características del ambiente regional así como las capacidades de la firma. Para lograr este objetivo, se construyó un modelo estadístico multinivel, el cual arrojó evidencia sobre los beneficios de este enfoque en la innovación empresarial. Los resultados sugieren el enfoque multinivel para futuras investigación sobre innovación.
Innovación en los gobiernos locales en Iberoamérica. Posibilidades a partir de la nueva gerencia pública
Authors: Torres Fragoso Jaime
Published: August 2018

El artículo pretende demostrar, a través de la revisión de tres estudios de caso, que los gobiernos locales de Latinoamérica vienen desarrollando interesantes programas de innovación y que éstos se sustentan en el modelo de Nueva Gerencia Pública (NGP). Para lograr ese objetivo, se presentan las características de la innovación, los rasgos que definen la gestión de los gobiernos locales y los elementos de la NGP. Los resultados señalan que las posibilidades para construir mejores programas y servicios públicos son amplias, y que la NGP representa un modelo referencial valioso para enfrentar ese reto.
Co-occurrence of extreme ozone and heat waves in two cities from Morocco
Authors: KHOMSI Kenza , NAJMI Houda , SOUHAILI Zineb
Published: August 2018

Temperature is the first meteorological factor to be directly involved in leading ozone (O3) extreme events. Generally, upward temperatures increase the probability of having exceedance in ozone adopted thresholds. In the global climate change context more frequent and/or persistent heat waves and extreme ozone (O3) episodes are likely to occur during in coming decades and a key question is about the coincidence and co-occurrence of these extremes. In this paper, using 7 years of surface temperature and air quality observations over two cities from Morocco (Casablanca and Marrakech) and implementing a percentile thresholding approach, we show that the extremes in temperature and ozone (O3) cluster together in many cases and that the outbreak of ozone events generally match the first or second days of heat waves. This co-occurrence of extreme episodes is highly impacted by humidity and may be overlapping large-scale episodes.
Test and evaluation of a simple parameterization to enhance air-sea coupling in a global coupled model
Authors: Xu 1 Fanghua
Published: August 2018

A simple temperature-dependent wind stress scheme is implemented in National Center for Atmospheric Research (NCAR) Community Earth System Model (CESM), aiming to enhance positive wind stress and sea surface temperature (SST) correlation in SST-frontal regions. A series of three-year coupled experiments are conducted to determine a proper coupling coefficient for the scheme based on the agreement of surface wind stress and SST at oceanic mesoscale between model simulations and observations. Afterwards, 80-year simulations with/without the scheme are conducted to explore its effects on simulated ocean states and variability. The results show that the new scheme indeed improves the positive correlation between SST and wind stress magnitude near the large oceanic fronts. With more realistic surface heat flux and wind stress, the global SST biases are reduced. The global ocean circulation represented by barotropic stream function exhibits a weakened gyre circulation close to the western boundary separation, in agreement with previous studies. The simulation of equatorial Pacific current system is improved as well. The overestimated El Niño Southern Oscillation (ENSO) magnitude in original CESM is reduced by ~30% after using the new scheme with an improved period.
(Online First)A study of temperature profiles and trends as revealed by COSMIC RO technique and balloon –borne radiosonde instrument
Authors: Kumar V. Naveen , Rao M. Purnachandra , Kumar G. Anil , K. Samatha  , P. S. Brahmanandam
Published: August 2018

This research presents atmospheric temperature profiles and trends retrieved using COSMIC RO techniqueand balloon-borne radiosonde instrument in 2007 and a few cases during 2017. By effectively using ‘wet’ temperatureproduct available at COSMIC Data Analysis and Archive Center (CDAAC) website, an analysis has been made topresent temperature profiles and trends at various regions including, Indian, Taiwan and Japan. A one-to-onecorrespondence is, clearly, seen between temperature profiles retrieved with COSMIC RO and radiosonde instrument. But, few and dominant differences in temperature profiles are found below at an altitude of ~5 km and above aroundtropopause (~16-17 km). The dominant differences found at below ~5km could be due to the inhomogeneousdistribution of humidity present, generally, at the tropical regions, whereas above the tropopause altitudes, differencesmight be due to the ionospheric residual correction as reported by other researchers. Further, temperature monthlytrends at various regions show distinct characteristics including, a sharp temperature inversion up to tropopause altitude. In addition, it is also observed maximum temperatures (peaks) during the northern summer seasons (May, June, July, and August) and minimum temperatures (troughs) during the northern winter seasons (November, December, January, and February) near to the surface of the Earth. Interestingly, although it is generally observed that the tropopausealtitude is located at ~ 16-17 km at various regions, a keen observation reveals that distinct seasonal and latitudinalvariations can be witnessed. With this case study, it may be concluded that the COSMIC RO technique is able toprovide very accurate measurement, which reiterates its importance as a powerful tool to explore the Earth’s atmosphereon the local and global scale.
Testing DOI activation
Authors: Burns Montgomery
Published: August 2018

This is an abstract
Changing Trends in Hyperacute Stroke Treatment and Early Clinical Outcomes Reflecting Recent Improvement in Endovascular Thrombectomy Techniques
Authors: Davidson Travis William , Chakraborty Santanu
Published: August 2018

Objective: Ischemic stroke is a major disease causing death and permanent neurological disability with the mainstay treatment being to re-established blood flow as quickly as possible. Recent changes in the efficiency of endovascular devices performing thrombectomies have led to it now being considered the gold standard. Nevertheless, successful endovascular thrombectomy (EVT) requires access to many resources and expertise which may impact its effectiveness. The objective of the current study is to describe the application and utility of EVT in the clinical treatment of ischemic stroke at a single tertiary care hospital.

Methods: This is a descriptive retrospective cohort study from a stroke database. A total of 548 patients diagnosed with an ischemic stroke affecting large cerebral arteries between January 2010 and June 2016 were included. National Institute of Health Stroke Scale (NIHSS) score was used to evaluate stroke severity upon admission. Modified Ranking Scale was used to determine the functional status of patients upon discharge. Successful reperfusion defined as a TICI score of 2B or 3, age, thrombolytic use and time- to-treatment were all considered for analysis.

Results: Thrombectomies became more frequent (p<0.001) with shorter time-to-treatment in recent years (p=0.001). A successful thrombectomy has significantly improved functional status at discharge (p<0.001), even when thrombolytics were not given (p=0.003) or when patients were over 80 years old (p=0.021).

Conclusion: The current work provides evidence that this single hospital has increased its frequency of application of EVT for ischemic stroke, leading to a better functional outcome at discharge independent of prior thrombolysis or age.
Professionalism and the Use of Social Media
Authors: Mathies Nicole
Published: August 2018

Social media has rapidly expanded over the last few years. Active users know of the benefits and potential to do good but may be less aware of the insidious risks. When misused, social media can contribute to anxiety, depression, and even threaten physical safety. Of late, professionalism in social media has become a sensitive topic, especially in medicine. Ethical guidelines regarding the appropriate use of this constantly evolving platform have not been clearly implemented, resulting in significant uncertainty for both the consumers and governing bodies. In this commentary, I will discuss my personal experience with the controversial use of social media and propose novel methods to improve professionalism at the University of Ottawa.
Descriptive Analysis of Patient Experience in Shanghai Primary and Tertiary Care Settings
Authors: Ng Kyle Kai Ho , Gendron Jonathan , Meng Chao , Zhou Yan , Kuling Peter , Wang Yuwei , Delva Dianne
Published: August 2018

Context: China has recently undertaken a nationwide healthcare reform of primary care for its citizens. The new Ottawa-Shanghai Joint School of Medicine (OSJSM) entered this context of reform by developing family medicine training centres for its students.Objective: This study seeks to understand patients’ demographic, perceptions of family medicine, and alignment of needs and values towards family medicine to inform the creation of these new centres.Study Design: To this end, a culturally and linguistically appropriate patient experience survey was created and administered at two primary (CaoJiaDu and TangQiao Community Health Centers) and at a tertiary care centre (Renji Hospital). The survey consisted of questions on demographics, frequency of healthcare usage, satisfaction of care, barriers to access, prioritized values and percep­tions of family medicine. It was administered to 400 patients conveniently sampled to have a balance of primary/tertiary settings.Results: Despite common assumptions that Chinese patients may prefer specialist services, this study revealed a 68.3% preference for General Practitioners (GP) over Specialists. There was also overall agreement and preference for values of continuity, comprehen­siveness, and coordination in healthcare.Conclusion: These findings reveal that primary care is present in Shanghai and that the core values of family medicine are desired by a majority of respondents. Further analysis, qualitative corroboration and repeating the study in a wider population may be re­quired for more generalizable conclusions, as this study in its current design was limited by convenience sampling.
A Cry for Help: Suicide Attempts by an Iraqi Refugee and the Role of Community Service Learning
Authors: DCruz Jennifer T
Published: August 2018

Community Service Learning (CSL) is a method of teaching where students learn through active participation in thoughtfully organized community service. CSL has emerged as a promising training method to address the changing needs of medical students and to improve their social accountability (1,2). Medical schools are beginning to incorporate community service learning into their curriculums as a way to introduce students to the complicated world of delivering care to vulnerable populations.

Mr. A, a refugee from Iraq, immigrated to Canada in June 2015 with his family. Five months later, during a CSL medical intake interview with two medical students and an Arabic interpreter, he revealed to have ongoing suicidal ideation and multiple suicide attempts. Due to significant cultural taboos and stigma around mental illness, Mr. A was initially very hesitant to seek medical help. However, with the help of the CSL program he was able to get much needed medical care.
The Power of Global Surgery: A Medical Student’s Experience At Save A Child’s Heart (SACH)
Authors: Karol Dalia
Published: August 2018

This elective report provides an overview of the experience of a 1st year medical student completing a global pediatric cardiac surgery elective at Save A Childs Heart (SACH), an Israeli Non-Governmental Organization (NGO). SACH provides life saving cardiac surgery to children from developing countries who would otherwise not have access to care. Children are screened in their home countries, and brought to Israel for these complex surgical procedures. This elective is unique, as it exposes medical students to leading experts in cardiac surgery, cardiology, pediatric ICU, as well as international residents and international patients.
Experiences of Transgender People in the Healthcare System: A Complex Analysis
Authors: Rotzinger Kathryn
Published: August 2018

A nursing perspective following McIntyre and McDonald’s framework was used to unpack the complex issue of challenges faced by transgender people in the Canadian healthcare system, considering historical, ethical, legal, social, cultural, political, and economic perspectives. Transgender people have unique healthcare needs which are often misunderstood or unaddressed by healthcare professionals, leading to poorer outcomes and inequities. Issues concerning transgender people are becoming a focus and a higher priority for society. This literature review reveals the complexity of this issue as the roots in historical, ethical, legal, social, cultural, political, and economic contexts are explored. A variety of barriers and facilitators exist to addressing and resolving this issue, including transgender people avoiding healthcare, intolerance, lack of knowledge and understanding, lack of healthcare provider training, media representation, and economic costs. The analysis of this issue can be used to inform resolution strategies to utilize facilitators and overcome barriers, including increasing awareness and knowledge, improving education and healthcare provider competency, and utilizing nurse leaders as advocates, role models, and agents of change. Improving care of transgender people is a nursing leadership priority. By implementing the suggested resolution strategies, the healthcare system can begin to move towards a more inclusive, understanding, and holistic model of care to improve healthcare access and outcomes for transgender people.
Transplantation and Surgery: A Discussion on the Current and Future Direction of Renal Transplantation
Authors: Mookerji Nikhile , Malhi Gurpreet
Published: August 2018

Dr. Jeff  Warren, MD, FRCPC, is an associate professor at the University of Ottawa within the Department of Surgery, Division of Urology. He has been a staff Urologist since 2009 and obtained his fellowship in multi-organ transplants, including kidneys and pancreases, from the University of Western Ontario. He received his MD from the University of Ottawa in 2002 and also completed his residency at the University of Ottawa in 2007. He is currently the head of surgical foundations for all surgical residency programs at the University of Ottawa. His clinical interests are in kidney transplantation surgery, minimally invasive surgery, and medical education.

Dr. Tom Skinner, MD, FRCPC, is a transplant fellow at the University of Ottawa within the Department of Surgery, Division of Urology. He received his MD from Dalhousie University in 2012 and completed his Urology residency at Queen’s University in 2017. He has a BSc. from the University of British Columbia and a MSc. from McGill University. His clinical interests are in minimally invasive surgery, renal transplantation, surgical education, and healthcare economics. During this interview, Dr. Skinner and Dr. Warren discuss the current state of transplant surgery, the biggest challenges to transplanting patients, and the future of the specialty. They also discuss robotic surgery and the Spanish model for organ donation.
Save a Child’s Heart: A Unique Global Health Model
Authors: Shuster Shirley , Brickman Zane , Karol Dalia , Malkin Itai
Published: August 2018

Save a Child’s Heart (SACH) is a UN-sponsored Israeli non-pro t organization that provides free, life-saving cardiac treatment to children from developing countries who would otherwise be unable to receive sufficient medical care in their home country. SACH utilizes a unique model of care involving several areas of focus including a tertiary care centre in Israel, international screening missions, training local healthcare professionals (HCPs), establishing local care facilities in partner countries, and engaging local and international volunteers. Through these efforts, SACH has been successful in providing cardiac care to 4599 children, training 116 HCPs, and establishing four independent surgical centres internationally. This model has proven its efficacy and can be applied to other tertiary surgical endeavors.
Devido processo legal e trabalhadores migrantes no Brasil
Authors: Mialhe Jorge Luís , Zedes Carolina Marzola Hirata
Published: August 2018

No presente artigo utiliza-se o método dedutivo-normativo para tratar dos migrantes internacionais e seu acesso à justiça. Destaca-se a mobilidade do trabalhador migrante internacional e sua situação de vulnerabilidade, o que faz com que as lesões trabalhistas envolvendo os migrantes possam ocorrer com maior intensidade e frequência, mormente diante da relação assimétrica do contrato de trabalho, razão pela qual lhe deve ser garantido o acesso à justiça, assegurando-se seus direitos fundamentais de cunho processual, pois o estrangeiro não deve ser tratado de forma hostil. No texto abordam-se os principais óbices processuais para o acesso do trabalhador migrante à Justiça do Trabalho, como a forma de acionamento, o idioma, os custos do processo, o tempo de tramitação e a necessidade de prática pessoal de determinados atos processuais, bem como os mecanismos existentes na ordem jurídica para superá-los, como a cooperação jurídica internacional, a disponibilização de intérprete, a assistência judiciária gratuita e a modulação dos atos processuais, aplicando-se o devido processo legal.
O “direito à desindexação”: repercussões do caso González vs Google Espanha
Authors: Luz Pedro Henrique Machado da , Wachowicz Marcos
Published: August 2018

O objetivo com este estudo foi investigar a decisão proferida no ano 2014, pelo Tribunal de Justiça da União Europeia, no que ficou conhecido como o caso González vs Google Espanha. Para tanto, fez-se uma análise sistematizada dos principais aspectos do caso, consistindo em uma introdução ao conflito entre as partes, alguns fatos  relevantes, a história processual da lide, as questões jurídicas presentes somadas aos precedentes utilizados pela Corte decisória, a decisão adotada pelo Tribunal de Justiça da União Europeia, informações complementares sobretudo acerca do impacto desse caso e, finalmente, considerações críticas e inquietações sobre o surgimento do chamado direito à desindexação e sua potencial recepção no cenário brasileiro. Escolheu-se tal julgado como fonte de estudo. pois ele bem representa a tensão entre as novas tecnologias próprias da sociedade informacional e o direito, em sua missão de proteção de direitos fundamentais, especialmente, para o caso, os direitos de personalidade, na modalidade de resguardo aos dados pessoais.
Discurso de ódio pelo Facebook: transparência e procedimentos de contenção
Authors: Marinho Maria Edelvacy Pinto , Souza Stella Regina Coeli de
Published: August 2018

No presente artigo teve-se por escopo investigar quão transparentes se apresentam os procedimentos pelos quais passa um usuário do Facebook denunciado por propagação de discurso de ódio na referida plataforma, até que, eventualmente, receba uma sanção por tal comportamento. Para tanto, foram analisados documentos disponibilizados publicamente pela aludida rede social em sua página a fim de se buscarem dados acerca da qualificação dos moderadores, sanções aplicáveis especificamente àqueles que incorrem em cometimento de hate speech e o procedimento de análise das denúncias recebidas pelos examinadores. A pesquisa é de base bibliográfica documental e foi desenvolvida a partir do raciocínio indutivo. Concluiu-se que os mecanismos disponibilizados pelo Facebook para controle da propagação do discurso de ódio em sua rede necessitam de aperfeiçoamento tanto quanto ao grau e clareza dos critérios definidores de discurso de ódio aplicados aos usuários, quanto ao grau de transparência relativo ao julgamento pela própria rede no que toca à referida prática e à política de exclusão da conta do usuário.
Proteção da personalidade no ambiente digital: uma análise à luz do caso do assim chamado Direito ao Esquecimento no Brasil
Authors: Sarlet Ingo Wolfgang
Published: August 2018

Tendo em conta que os direitos da personalidade são particularmente vulneráveis no contexto da assim chamada era digital, designadamente em face do impacto das cada vez mais sofisticadas tecnologias de informação, e que a capacidade do Direito, na condição de estrutura normativo-regulatória, de fornecer respostas com a necessária rapidez e um mínimo de eficácia, também está cada vez mais colocada à prova. Um dos problemas que tem sido, também no caso brasileiro, de particular atualidade e relevância, diz respeito ao conflito entre as liberdades de expressão e de informação e os direitos de personalidade, assumindo aqui destaque a controvérsia em torno do reconhecimento do assim chamado direito ao esquecimento. Nessa perspectiva, partindo da premissa de que tal direito encontra fundamento na ordem jurídica brasileira na condição de um direito fundamental implícito, com o presente texto visa-se, mediante uma análise crítica das principais decisões dos Tribunais Superiores brasileiros, discutir e avaliar os aspectos mais relevantes concernentes ao conteúdo e limites do direito ao esquecimento na internet e dos critérios utilizados para a sua aplicação em casos concretos.
Maria do Rosário vs. Jair Bolsonaro: uma leitura (anti) democrática do Inquérito Penal n. 3.932
Authors: Cunha e Cruz Marco Aurélio Rodrigues da , Tramontina Robison , Schmitz Grazieli Ana Paula
Published: August 2018

No presente trabalho teve-se por objetivo analisar, em forma de estudo de caso, algumas projeções (anti)democráticas da frase desferida pelo deputado federal Jair Bolsonaro em direção à igualmente deputada federal Maria do Rosário: “Não merece porque ela é muito ruim, porque ela é muito feia, não faz meu gênero, jamais a estupraria. Eu não sou estuprador, mas, se fosse, não iria estuprar, porque não merece.” Essa frase deu ensejo a uma ação de natureza civil e ao Inquérito Penal n. 3.932, em trâmite no Supremo Tribunal Federal, objeto deste escrito. Neste texto, o estudo do Inquérito Penal n. 3.932 é lido com as lentes das obras Desonra, de J. M. Coetzee, e Sobre a Democracia, de Robert Dahl. Esse diálogo visa não somente fazer uma ligação entre as obras, mas demonstrar como a honra masculina é ponto forte e presente na questão da diferenciação do homem em relação à mulher. Empregando o método lógico-dedutivo, foi realizada uma pesquisa teórica, de cunho descritivo, com o levantamento bibliográfico e documental, buscando a análise e interpretação do referencial teórico e do caso em apreço.
O "Protocolo do Diálogo" entra em vigor
Authors: Posenato Naiara
Published: August 2018

No dia 1º de agosto de 2018 entrou em vigor o Protocolo n. 16 à Convenção Europeia dos Direitos Humanos (Convenção EDH), graças ao depósito do décimo instrumento de ratificação pela França, em abril. Em conformidade com o art. 8 do Protocolo opcional, o mesmo encontra-se vigente com relação aos Estados da Albânia, Armênia, Eslovênia, Estônia, Finlândia, França, Geórgia, Lituânia, San Marino e Ucrânia.O novo instrumento, que inova profundamente em relação ao mecanismo consultivo já previsto pelos arts. 47 a 49 do Título II da Convenção EDH, permite que órgãos jurisdicionais de cúpula solicitem pareceres à Corte Europeia dos Direitos Humanos sobre questões de princípio relacionadas à interpretação e à aplicação dos direitos e liberdades previstos no texto convencional e nos protocolos adicionais. A competência atribuída à Grande Câmara, com base no Protocolo, é de natureza híbrida: consultiva, porque o ato com o qual o procedimento é concluído não tem caráter vinculante; e prejudicial, porque necessariamente relacionado a um procedimento judiciário pendente no tribunal superior nacional que formulou a demanda. A Corte Europeia tem margem de discricionariedade para aceitar ou não o pedido, o que, além de perseguir um objetivo deflacionário, permite a seleção substancial das demandas a fim de privilegiar somente aquelas que levantem questão de princípio ou de interesse geral relativa à interpretação ou à aplicação da Convenção, como, por exemplo, as que refletem problemas estruturais ou sistêmicos dos Estados que podem se repetir e/ou que afetem potencialmente diversas partes contratantes.
Evaluación bibliométrica de la investigación formativa en la Facultad de Medicina Veterinaria y Zootecnia de la Universidad Peruana Cayetano Heredia en el periodo 2012-2017
Authors: Llalla Vidal Thalía , Mendoza Torres Galy , Falcón Pérez Néstor
Published: August 2018

El objetivo del estudio fue evaluar las tesis desarrolladas en la Facultad de Medicina Veterinaria y Zootecnia de la Universidad Peruana Cayetano Heredia (FAVEZ-UPCH) durante el periodo 2012-2017. Para ello se diseñó un estudio observacional, descriptivo, retrospectivo, que utilizó herramientas bibliométricas para sistematizar la información de la base de datos del Banco de Tesis de la FAVEZ-UPCH. Se estudiaron las siguientes variables: año de sustentación, calificación de la tesis, línea de investigación, diseño de estudio, individuos u objeto de estudio, especie o muestra especifica evaluada, área o laboratorio del asesor principal, literatura utilizada, literatura actualizada y tesis transformada en artículos. La información obtenida se resumió mediante estadística descriptiva. Se evaluaron 195 tesis. El mayor número de tesis se sustentó durante el año 2014 (22,6%). Las líneas de investigación priorizadas fueron Animales de Compañía y Animales de Producción (36,4%), Salud Ambiental y Salud Pública (30,2%) y Especies Productivas Nativas y Animales Silvestres (28,2%), Los estudios observacionales fueron los más frecuentes (90,3%), destacando los observacionales de corte transversal (39,5%) y los descriptivos (30,8%). Los animales domésticos fueron los más estudiados (43,6%), seguidos de los silvestres (30,3%), siendo los canes (29,2%) y el hombre (15,4%) las especies más estudiada. El Área de Epidemiología y Salud Pública (30,7%) y la Clínica Veterinaria Docente Cayetano Heredia (21,0%) desarrollaron la mayoría de tesis. Se utilizó 6548 referencias, predominando artículos científicos en idioma ingles (32,1%) y español (20,4%). Del total, solo el 29% fueron consideradas actualizadas. El 23,1% de las tesis se convirtieron en artículos científicos y la mayoría se publicó en revistas nacionales (91,2%). Los resultados permiten identificar áreas de la carrera que pueden ser estimuladas a desarrollar, mejorando la cobertura de la investigación formativa de la FAVEZ-UPCH en el campo de las competencias de las ciencias veterinarias.
Free Vascularized Medial Femoral Condyle Bone Graft After Failed Scaphoid Nonunion Surgery
Authors: Pulos Nicholas , Kollitz Kathleen M. , Bishop Allen T. , Shin Alexander Y.
Published: August 2018

Background:

Outcomes following revision surgery for scaphoid nonunions with osteonecrosis are guarded. We hypothesized that use of free vascularized medial femoral condyle (MFC) bone grafts can lead to healing of the nonunion, increase vascularity of the proximal pole, and restore scaphoid architecture, resulting in acceptable functional outcomes.

Methods:

We performed a retrospective review of 49 patients who were treated with an MFC bone graft, between May 2005 and September 2016, after prior failure of operative treatment for scaphoid nonunion. The mean time from the injury to the revision surgery with the MFC bone graft was 24 months, and the mean time from the prior, failed surgery was 15 months. Thirty-six of the 49 patients had had a prior bone graft procedure and 6 patients had had 2 previous surgical procedures for the nonunion. The initial internal fixation of the scaphoid fracture was with a scaphoid screw in 43 patients. All patients had documented osteonecrosis of the proximal pole at the time of our surgery. Carpal indices, time to union, pain scores, functional outcomes, and complications were recorded.

Results:

Forty-one (84%) of the 49 previously operated on scaphoid nonunions healed at a mean of 16 weeks (range, 9 to 31 weeks) after the MFC bone-grafting as confirmed on computed tomography (CT). Radiographs demonstrated significant improvement in carpal alignment following the surgery with the MFC bone graft. Comparison between preoperative and postoperative values showed a trend toward improved grip strength and no important change in total wrist range of motion. Subsequent procedures were performed in 29 patients, 21 of whom had planned Kirschner wire removal. All 24 patients in whom scaphoid union had been achieved and who were available for follow-up were able to work or attend school full-time, and 88% were satisfied or very satisfied with their wrist function. Age, smoking status, body mass index, time to surgery, and preoperative radiographic findings were not found to be significant predictors of failure.

Conclusions:

MFC grafts increase vascularity and restore scaphoid architecture, promoting union in most patients with the combination of proximal pole osteonecrosis, carpal collapse, and failed prior scaphoid nonunion surgery.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Type of Anticoagulant Used After Total Knee Arthroplasty Affects the Rate of Knee Manipulation for Postoperative Stiffness
Authors: Kahlenberg Cynthia A. , Richardson Shawn S. , Schairer William W. , Sculco Peter K.
Published: August 2018

Background:

The aim of this study was to perform a population-level analysis on the effect of different types of anticoagulation on postoperative stiffness after total knee replacement, requiring manipulation under anesthesia. We hypothesized that patients receiving warfarin would have a higher rate of manipulation under anesthesia compared with patients receiving low-molecular-weight heparin. We also hypothesized that aspirin, direct factor Xa inhibitors, and fondaparinux would have no effect on the rate of manipulation under anesthesia.

Methods:

Using the PearlDiver patient database, we analyzed 32,320 patients who underwent a primary unilateral total knee replacement from 2007 to 2015. Patients were included if they filled a prescription for anticoagulation medication within 2 days of their discharge and were excluded if they were taking a prescription anticoagulation medication (except for aspirin) in the 3 months before total knee replacement. The primary outcome was manipulation under anesthesia performed within 6 months after a primary total knee replacement.

Results:

The most commonly prescribed postoperative anticoagulation was warfarin (38.0%), followed by low-molecular-weight heparin (33.8%). There were 1,178 patients (3.64%) who underwent manipulation under anesthesia within 6 months of total knee replacement. In multivariable analysis using low-molecular-weight heparin as a comparison group and accounting for age, sex, comorbidities, and length of stay, there was a significant increase in the risk of manipulation under anesthesia for patients who received warfarin (hazard ratio [HR], 1.17 [95% confidence interval (CI), 1.01 to 1.36]; p = 0.032), direct factor Xa inhibitors (HR, 1.42 [95% CI, 1.20 to 1.66]; p < 0.001), or fondaparinux (HR, 1.33 [95% CI, 1.01 to 1.72]; p = 0.038). Although patients who received aspirin had the same risk estimate as patients who received warfarin, there was not a significantly increased risk of manipulation under anesthesia in patients who received aspirin compared with low-molecular-weight heparin (HR, 1.17 [95% CI, 0.72 to 1.80]; p = 0.493).

Conclusions:

We found an increased rate of manipulation under anesthesia after total knee replacement in patients who received oral anticoagulants including warfarin, direct factor Xa inhibitors, and fondaparinux, in comparison with patients who received aspirin or low-molecular-weight heparin. We recommend that patients receiving oral anticoagulants after total knee replacement should be counseled about associated stiffness. Furthermore, surgeons should take these data into account when selecting thromboprophylaxis for patients after total knee replacement.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Medical Costs of Delayed Hip Fracture Surgery
Authors: Pincus Daniel , Wasserstein David , Ravi Bheeshma , Huang Anjie , Paterson J. Michael , Jenkinson Richard J. , Kreder Hans J. , Nathens Avery B. , Wodchis Walter P.
Published: August 2018

Background:

Waiting for hip fracture surgery is associated with complications. The objective of this study was to determine whether waiting for hip fracture surgery is associated with health-care costs.

Methods:

We conducted a population-based, propensity-matched cohort study of patients treated between 2009 and 2014 in Ontario, Canada. The primary exposure was early hip fracture surgery, performed within 24 hours after arrival at the emergency department. The primary outcome was direct medical costs, estimated for each patient in 2013 Canadian dollars, from the payer perspective. The costs in the early and delayed groups were then compared using a difference-in-differences approach: the baseline cost in the year prior to the hip fracture that had been accrued by patients with early surgery was subtracted from the cost in the first year following the surgery (first difference), and the difference was then compared with the same difference among propensity-score-matched patients who had received delayed surgery (second difference). The secondary outcome was the postoperative length of stay (in days).

Results:

The study included 42,230 patients who received hip fracture surgery from a total of 522 different surgeons at 72 hospitals. The mean cost (and standard deviation) attributed to the hip fracture was $39,497 ± $46,645 per person. The matched patients who underwent surgery after 24 hours had direct 1-year medical costs that were an average of $2,638 higher (95% confidence interval [CI] = $1,595 to $3,680, p < 0.0001) and a postoperative length of stay that was an average of 0.610 day longer (95% CI = 0.1749 to 1.0331 days, p = 0.0058) compared with those who underwent surgery within 24 hours.

Conclusions:

Waiting >24 hours for hip fracture surgery was associated with increased medical costs and length of stay. Costs incurred by waiting may provide a financial incentive to mitigate delays in hip fracture surgery.

Level of Evidence:

Economic Level III. Please see Instructions for Authors for a complete description of levels of evidence.