bluuebunny/crossref_metadata_2025 huggingface dataset:
The description of condyle position in disc displacement with reduction using Cone Beam Computed Tomography 3D radiographic analysis
Authors: Rahmayani Liana , Kurnikasari Erna , Rikmasari Rasmi
Published: October 2017

One of the temporomandibular joint disorders that mostly occurs is disc displacement with reduction. Disc displacement that causes the displacement of condyle position can be evaluated by using radiograph. The Cone Beam Computed Tomography (CBCT-3D) is a radiograph equipment which is able to capture the condyle position from many directions. This research was aimed to see the condyle position in patients with disc displacement with reduction symptoms. This research was conducted to 11 patients with symptoms of disc displacement with reduction and 3 patients without symptoms of disc displacement with reduction as the counterpart. What was conducted to the sample was the radiographic imaging using CBCT-3D radiography, followed by measuring the joint space distance in the sagittal and coronal directions. The result of the research was analyzed using the T-test. Statistically, the result of the test showed a significant difference ( = 0.05) between patients with disc displacement with reduction symptoms and the patients without symptoms, in sagittal and coronal views. The conclusion led to the difference in condyle positions in patients with the disc displacement with reduction and patients without the symptoms which meant there was a condyle position displacement that caused the distance alteration in joint space in sagittal and coronal directions.
Root fracture resistance test of cast post using seat and non-seat preparation design in central maxillary incisor
Authors: Pramanik Rifki Kania , Subrata Gantini , Kurnikasari Erna
Published: October 2017

Post-placement is one of the treatment plans supporting the success of a restoration. The design of root canal preparation is a factor in the success of post-use. The purpose of this study was to investigate the root fracture resistance of the root canal preparation for cast post with a seat and non-seat preparation. The study was a laboratory experimental study using 20 upper central incisors that met the criteria in the study. Ten incisors were prepared using seat design while the other ten were prepared using non-seat design. Then tested the compressive test by Universal Testing Machine with test speed 0,5 mm/min. The results of the fracture strength were analyzed using t student statistical test. The analysis showed a significant difference between the non-seat group and the seat group (α=0.05). The average force in the non-seat group was 852.27 N with a standard deviation of 112.6 N while the seat group showed a value of 495.78 N and 82.90 N, respectively. It was concluded therefore that the root fracture resistance in the non-seat root canal preparation design was higher than the seat preparation design.
The effect of apple (Malus Domestica) juice on the damage of mice liver cells due to paracetamol treatment
Authors: Hartanto Anthony , Dardjan Murnisari , Kintawati Silvi
Published: October 2017

The liver is an important organ for body metabolism process. Liver disease is one of serious health problems in developing countries including Indonesia. Liver damage is caused by viral infection, toxic agent exposure (medications, alcohol), hormonal disturbance, neoplasm and autoimmune diseases. The use of high dose paracetamol to reduce pain also leads to liver damage. Apple (Malus domestica) juice is a natural anti oxidant agent. This laboratory experimental study was performed to discover the effect of giving apple juice on damaged cell regeneration due to the use of paracetamol. The study was performed in 21 male mice from Swiss-Webster strain that were divided into group I, II, and III. Group, I served as control while group II received 1 mg/ml paracetamol dose for 5 days and Group III received 1 mg/ml paracetamol for 5 days and 1 ml of apple juice on the 5th to 10th day. The observation of the mice liver cells was conducted using a light microscope with 400x magnification to get the number of necrotic liver cells per view field. The results of this study showed a difference in the number of necrotic liver cells between Group II and III. ANOVA statistical test ( = 0.05) concluded that apple juice significantly helps regeneration process in damaged liver cells caused by paracetamol.
Patrones de la votación de México en la Asamblea General de la ONU entre 1994 y 2015: cuestiones de Oriente Medio y Palestina
Authors: Paredes Frías Enrique , Contreras Piña Ezequiel
Published: October 2017

El artículo propone el Índice de Controversia (ico) como una herramienta para medir el desacuerdo en una resolución aprobada por la Asamblea General de la onu, a más de estudiar la votación de México en las resoluciones sobre Oriente Medio y Palestina entre 1994 y 2015. Los autores demuestran que México tiende a abstenerse de votar, cuando las resoluciones son controvertidas, a menos de que haya de por medio un interés determinado.
Avaliação das temperaturas mínimas e máximas para eventos de friagem no Pantanal
Authors: Santos Müller Júnior Martins dos , Pinto Luciana Barros , Irribarem Gabriela Barbosa , Conceição Lucas Fernando Carvalho da , Monteiro Carolina de Aguiar
Published: October 2017

Apesar da importância do Pantanal, estudos sobre friagens na região são escassos na literatura. Vários estudos são orientados para a região amazônica, mostrando menos influência em relação ao Pantanal. O estudo objetivou avaliar eventos de friagem no Pantanal, com base na distribuição anual e mensal dos eventos, considerando o El Niño e o comportamento das temperaturas mínimas e máximas, em Coxim-MS. Foram identificados 75 eventos em 294 dias sob efeito de friagem. A maior frequência anual ocorreu em 2009 e 2010, totalizando 12 eventos para cada ano, coincidindo com o período de El Niño ativo. A maior frequência mensal ocorreu em agosto, totalizando 16 eventos. Foi relatada uma média de dois dias, com queda de temperatura, em decorrência da friagem e, posteriormente, acréscimo na temperatura máxima e decréscimo na temperatura mínima nos dias seguintes. O maior número de sistema frontal anual não implicou em um número maior de dias frios. Julho de 2013 apresentou o menor valor de temperatura mínima no período. Valores com reduções significativas de temperatura, em relação à normal climatológica não apresentaram menores temperaturas mínimas e máximas.
KEMISKINAN SEBAGAI SALAH SATU PENYEBAB TIMBULNYA TINDAK KEJAHATAN
Authors: Sugiarti Yayuk
Published: October 2017

Timbulnya kejahatan disebabkan oleh banyak hal yang melatarbelakanginya,diantaranya adalah kejahatan yang disebabkan oleh watak seseorang. Kasus yangterjadi saat ini, kemiskinan seseorang atau latar belakang lain yang menyebabkanseseorang melakukan kejahatan, namun dalam penelitian ini membahas tentangkejahatan yang disebabkan oleh kemiskinan saja, hal ini dilakukan guna membatasipembahasan penulisan yang dilakukan, yaitu berkenaan dengan “Kemiskinan SebagaiSalah Satu Penyebab Timbulnya Tindak Kejahatan”. Apabila diamati dari kedua istilah“KEMISKINAN” dan “KEJAHATAN” tersebut, kemiskinan mempunyai arti tidakberharta benda, serba kekurangan, atau perihal miskin, kemelaratan, dan kelaparan.Sedangkan kejahatan mempunyai arti perbuatan yang bertentangan dengan keadilan.Wilayah hukum Kepolisian Sektor Kecamatan Talango. Faktor kejahatan yangdilatarbelakangi oleh kemiskinan seseorang sehingga melakukan kejahatan sebagaialternatif penyelesaian guna untuk memenuhi kehidupan mereka dalam menjalanikehidupannya, ini sudah terbukti atau memang ada dalam kenyataannya. Adapunkejahatan yang dilakukan oleh masyarakat di wilayah hukum Kepolisian SektorKecamatan Talango khususnya, hanya ada empat macam kejahatan, yaitu pencurian,penggelapan, penipuan, dan penganiayaan. Namun tidak menutup kemungkinankejahatan lain akan terjadi tergantung pada apa yang melatarbelakangi merekasehingga melakukan kejahatan tersebut, artinya kejahatan apa saja bisa saja terjadiselain dari kejahatan-kejahatan yang ada di wilayah hukum Kepolisian SektorKecamatan Talango.Kata Kunci : Kemiskinan, Tindak Kejahatan.
Anatomia foliar, fisiologia e produtividade de cafeeiros em diferentes níveis de adubação
Authors: Da Gama Tamara Cubiaki Pires , Sales Junior José Carlos , Castanheira Dalyse Toledo , Silveira Helbert Rezende de Oliveira , De Azevedo Harianna Paula Alves
Published: October 2017

A nutrição mineral é importante para o desenvolvimento da estrutura interna das folhas do cafeeiro, podendo favorecer as características fisiológicas necessárias para otimizar o desenvolvimento e a produtividade da cultura. Objetivou-se identificar as possíveis modificações na anatomia, fisiologia e produtividade em cafeeiros irrigados em diferentes níveis de adubação aplicados em três anos consecutivos, a partir do segundo ano após a implantação da lavoura. A lavoura de Coffea arabica cultivar Topázio MG-1190 foi formada seguindo a recomendação padrão de Guimarães et al. (1999) para adubação em função de análise do solo, até o primeiro ano após implantação (2010-2011). A partir daí, no segundo ano após a implantação (2011-2012), os níveis de adubação utilizados foram: 40, 70, 100, 130 e 160% da adubação padrão. Repetiram-se os tratamentos nos anos de 2012-2013 e 2013-2014. As plantas foram avaliadas quanto às trocas gasosas e anatomia foliar em agosto de 2014. Também foi avaliada a produtividade dos anos de 2013 e 2014. Os diferentes níveis de adubação NPK provocaram diferenças na anatomia foliar do cafeeiro. A produtividade e trocas gasosas do cafeeiro não foram afetadas pelos diferentes níveis de adubação NPK.
Perfil sensorial de cultivares de café processados por via seca e via úmida após armazenamento
Authors: Ribeiro Bruno Batista , Nunes Cleiton Antônio , Jesus Souza Antonio Jackson , Montanari Fernanda Faria , Silva Virgílio Anastácio da , Viana Madeira Raul Antônio , Piza Clovis De
Published: October 2017

Os diferentes tipos de processamentos pós-colheita empregados nos frutos de café podem originar diferentes bebidas, cujo perfil sensorial depende de fatores ambientais e do manejo no processo de produção. Todos os processos envolvidos na produção de café, desde as características edafoclimáticas da área de cultivo até o sistema de armazenamento adotado, interferem na qualidade de bebida do café. Objetivou-se neste trabalho descrever o perfil sensorial de diferentes cultivares de café processados por via seca (natural) e via úmida (desmucilado), após um ano de armazenamento. Foram avaliados sensorialmente quatro cultivares de café (Catuaí Vermelho IAC 144, Iapar 59, Bourbon Amarelo e Paraíso MG H 419-1), da espécie Coffea arabica L. da safra de 2012/2013, com a realização de dois processamentos pós-colheita (natural e cereja desmucilado) após um ano de armazenamento. A análise sensorial foi realizada por dois provadores credenciados e habilitados por meio do protocolo da Specialty Coffee Association of America – SCAA. As cultivares se comportam de maneira diferenciada na qualidade em função do processamento adotado. Os cafés do processamento natural se destacaram na maioria dos atributos sensoriais avaliados em relação aos cafés desmucilados após um ano de armazenamento. As cultivares Catuaí Vermelho IAC 144 e Iapar 59 apresentaram melhor qualidade quando submetidas ao processamento natural. Já nos cafés desmucilados, maiores notas foram atribuídas às cultivares Bourbon Amarelo e Paraíso.
Irrigação por gotejamento e manejo do fósforo no progresso da ferrugem do cafeeiro
Authors: Barbosa Junior Mauro Peraro , Pozza Edson Ampélio , Souza Paulo Estevão de , Silva Mirian De Lourdes Oliveira e , Pozza Adélia Aziz Alexandre , Guimarães Rubens José
Published: October 2017

A ferrugem é a principal doença do cafeeiro, sendo sua ocorrência e intensidade afetada em razão do fornecimento de água e equilíbrio nutricional das plantas. Dessa forma objetivou-se avaliar a incidência da ferrugem, em lavoura cafeeira com diferentes manejos de irrigação e adubação. O estudo foi realizado em Lavras-MG, em cafeeiro da cultivar MGS Travessia. As avaliações da doença foram realizadas no período de março de 2012 a novembro de 2014. O delineamento experimental foi em blocos casualizados, com doze tratamentos, sendo 3 manejos de adubação, 4 manejos de irrigação e 3 repetições, totalizando 36 parcelas. O resultado referente a media da incidência da doença durante o período avaliado foi plotado em gráfico. Os dados de incidência foram integrados em área abaixo da curva de progresso da doença (AACPIF). Foi observada maior AACPIF (P<0,05) no tratamento sem irrigação no ano de 2013. A ausência da adubação com fósforo também proporcionou maior progresso da ferrugem. 
Impacto do controle de plantas espontâneas sobre propágulos de fmas e micorrização de cafeeiro
Authors: Melloni Rogério , Silve Emilienne Margueritte , Alvarenga Maria Inês Nogueira , Melloni Eliane Guimarães Pereira , De Alcântara Elifas Nunes
Published: October 2017

A manutenção de uma comunidade diversificada e ativa de fungos micorrízicos arbusculares (FMAs) em ecossistemas agrícolas é importante para a sustentabilidade de culturas como a do cafeeiro. Este trabalho teve como objetivo avaliar o efeito de técnicasde controle de plantas espontâneas, aplicadas na entrelinha do cafeeiro, sobre a ocorrência de propágulos de FMAs e, consequentemente, namicorrização desta cultura. Esta avaliação foi realizada em uma lavoura de café da Fazenda Experimental da Empresa de Pesquisa Agropecuária de Minas Gerais (Epamig), em São Sebastião do Paraíso (MG). As técnicas de controle de plantas espontâneas foram: 1) roçadora, 2) grade, 3) enxada rotativa, 4) herbicida de pré-emergência, 5) herbicida de pós-emergência, 6) capina manual e 7) controle sem capina. As variáveis analisadas foram: intensidade e porcentagem de colonização, comprimento de micélio ativo e total no solo, densidade e diversidade de esporos. Entre as técnicas de controle de plantas espontâneas nas entrelinhas de cafeeiro, a aplicação de roçadora, de grade e de capina manual foram as que mais favoreceram a manutenção dos propágulos de FMAs e a micorrização das plantas, contrariamente ao uso de herbicidas de pré-emergência.
Estatística multivariada aplicada em dados de custos da fase de pós-colheita do café
Authors: Santos Rafael Vargas , Vieira Henrique Duarte , Borém Flávio Meira , Prado Mariele Vilela Bernardes
Published: October 2017

A escolha do modo de processamento do café é decisiva na rentabilidade da atividade cafeeira, e dependerá de diversos fatores. Assim, em decorrência da existência de tantas variáveis é comum o produtor questionar a viabilidade de determinados tipos de processamentos. Desse modo, o objetivo deste trabalho foi realizar um estudo dos principais fatores influenciadores no custo da pós-colheita do café. Quarenta e seis fazendas das regiões do Cerrado, Matas de Minas e Sul de Minas Gerais responderam a um questionário elaborado no sentido de possibilitar esta análise. A aplicação das técnicas multivariadas de análise de agrupamento, análise de fatores e análise de componentes principais, possibilitou concluir que as fazendas com maiores custos simulados foram as que possuíam as maiores porcentagens de produção de café via úmida.
Ambiente e variedades influenciam a qualidade de cafés das matas de minas
Authors: Zaidan Úrsula Ramos , Corrêa Paulo Cesar , Ferreira Williams Pinto Marques , Cecon Paulo Roberto
Published: October 2017

O café é um produto agrícola que tem seu valor de mercado ajustado de acordo com a qualidade final da bebida, que pode ser influenciada por vários fatores, tais como: fatores ambientais e variedade. Diante disso, objetivou-se com este trabalho avaliar os efeitos da orientação da encosta da montanha, altitude e variedade da planta, sobre a qualidade potencial dos cafés produzidos na região das Matas de Minas (entre altitudes que variam de 600 a 1200 m). Frutos de café (Coffea arabica) das variedades “Catuaí Vermelho” e “Catuaí Amarelo”, provenientes de 14 municípios da região, foram colhidos manualmente no ponto de maturação fisiológica, os quais foram processados, beneficiados e armazenados. Em seguida foram feitas análises descritivas qualitativas por Juízes Certificadores, pelo teste de degustação segundo critérios da Brazil Specialty Coffee Association. Por meio da análise sensorial da bebida, foram atribuídas notas aos atributos de qualidade dos cafés objetivando classificá-los de acordo com a influência dos fatores do ambiente e da variedade. Para análise das notas foi adotada a “Estatística Descritiva” e o “Método de Tocher”. A partir dos resultados obtidos, pode-se observar que os fatores ambientais e a variedade não exercem influência sobre a qualidade da bebida de forma isolada, todavia, contribuem de forma conjunta para formar as características da bebida produzida na região. A maior pontuação média foi obtida pela combinação de fatores, variedade “Catuaí Amarelo” estrato de altitude abaixo de 700 m e encosta Noruega da montanha, mostrando grande potencial de expressão da qualidade sensorial da bebida.
Ácido naftalenoacético associado à adubação potássica na brotação de café conilon
Authors: Força Baroni Danilo , Silva dos Reis Luciléa , Corona Baitelle Diego , Moraes Vieira Kezia , Celestino Meireles Robson , Verdin Filho Abraão Carlos , Ramalho Haddade Ismail
Published: October 2017

Os gastos com mão de obra podem representar mais de 50% do custo total de produção do café Conilon, sendo a poda e a desbrota responsáveis por maior parte desses custos, ficando atrás somente dos gastos com colheita. Alguns fitorreguladores de crescimento do grupo das auxinas associados ao potássio (K2O) podem reduzir a emissão de brotos. Objetivaram-se com o trabalho verificar o efeito do ácido naftalenoacético (ANA) associado à adubação potássica na brotação de café Conilon. O experimento foi realizado de junho de 2014 a dezembro de 2015, em lavoura adulta de café Conilon não irrigada, da cultivar “G35-Verdebrás”, localizada no Instituto Federal do Espírito Santo – Campus Santa Teresa. Utilizaram-se o delineamento em blocos casualizados, com o arranjo fatorial 5x4 entre níveis de ANA e níveis de K2O, respectivamente. Foram empregadas cinco doses de ANA (0, 50, 100, 250 e 500 mg L-1), e quatro de K2O na adubação, (60, 120, 240 e 480 kg ha-1). Observou-se que a aplicação de ANA influencia a emissão de brotos por favorecer a dominância apical das plantas. Os níveis aplicados de K2O interferem na ação do ANA, sendo que a aplicação de dosagens elevadas do nutriente pode inibir a ação deste fitorregulador. A aplicação de 344 mg L-1 de ANA associada à adubação de 120 Kg ha-1 de K2O reduziu o número de brotos por planta sem interferir na produtividade e desenvolvimento das brotações remanescentes.
Primeira aproximação para solo cultivado com cafeeiro conilon na região atlântica da Bahia
Authors: Cayô Cavalcanti André , Góes de Oliveira Marcos , Monzoli Covre André , Gontijo Ivoney , Braun Heder , Partelli Fábio Luiz
Published: October 2017

O Sistema Integrado de Diagnose e Recomendação (DRIS), apesar de ser comumente utilizado na interpretação de análises foliares, pode ser empregado em análise química de solo, existindo potencial do uso da metodologia em solos cultivados com cafeeiros. Objetivou-se estabelecer faixas de suficiência e normas DRIS para solos cultivados com cafeeiro conilon na região Atlântica do Estado da Bahia. Coletaram-se 24 amostras de solo em 2012 e 2013, na profundidade de 0-20 cm, sendo quantificados os teores de matéria orgânica, Ca, Mg, K, P, S, Zn, B, Cu, Fe, Mn, saturação de bases e capacidade de troca catiônica a pH 7. Estabeleceram-se normas DRIS e faixas de suficiência para os nutrientes do solo, a partir de lavouras com produtividade, igual e superior a 100 sacas beneficiadas ha-1 de café conilon, sendo aplicáveis na recomendação de adubação da cultura na região. A maioria dos parâmetros estabelecidos apresentou discrepância em relação ao referencial teórico que se tem atualmente para o café conilon. Os resultados sugerem o desenvolvimento de normas regionais e específicas para a aplicação do método DRIS e faixas de suficiência no solo, para lavouras de café conilon.
Drying kinetics of processed natural coffee with high moisture content
Authors: Siqueira Valdiney Cambuy , Borém Flávio Meira , Alves Guilherme Euripedes , Isquierdo Eder Pedroza , Pinto Afonso Celso Ferreira , Ribeiro Diego Egidio , Ribeiro Fabiana Carmanini
Published: October 2017

Objetivou-se, com o presente trabalho, propor um novo método de processamento e secagem, assim como avaliar o comportamento dos grãos submetidos a este processo, por meio da taxa de redução de água e do ajuste de diferentes modelos matemáticos aos dados experimentais da secagem. Os frutos colhidos no estágio maduro foram divididos em três lotes. O primeiro foi seco continuamente à temperatura de 40±1 °C. O segundo consiste na secagem do café natural até os teores de água de 0,56±0,02, 0,41±0,02, 0,28±0,02 e 0,20±0,02 decimal (base seca, b.s.), seguido de beneficiamento e secagem contínua nas temperaturas de 35±1 ºC e 40±1 ºC. O terceiro lote correspondeu à secagem contínua do café descascado e desmucilado na temperatura de 40±1 °C. Em todos os lotes, a secagem foi encerrada quando os grãos atingiram o teor de água de 0,12±0,05 (b.s.). Aos dados experimentais da secagem foram ajustados dez modelos matemáticos utilizados para representação da secagem dos produtos agrícolas. Além da representação da cinética de secagem foi avaliada a taxa de redução de água dos grãos. Conclui-se que a taxa de redução de água é maior para a temperatura de secagem de 40±1 °C, especialmente para maiores teores de água. O tempo total de secagem do café beneficiado com alto teor de água é expressivamente reduzido, quando comparado ao tempo de secagem completa do café natural. O modelo de Midilli descreve satisfatoriamente a cinética de secagem do café beneficiado.
A Broader Perspective of Musculoskeletal Conditions in Children
Authors: Williams Christopher M. , Kamper Steven J.
Published: October 2017

Musculoskeletal conditions are responsible for a significant disability burden, and recent data show that this is also the case for children and adolescents. Importantly, though, musculoskeletal conditions rarely occur in isolation; they often coexist with other health issues. There is potentially great benefit of an approach to research and practice that considers musculoskeletal pain in children and adolescents from a broader perspective. Considering the role of musculoskeletal pain in the broader picture of child and adolescent health offers new perspectives for researchers and clinicians in the public health and clinical fields. J Orthop Sports Phys Ther 2017;47(10):699–701. doi:10.2519/jospt.2017.0108
Musculoskeletal Pain in Children and Adolescents: A Way Forward
Authors: Kamper Steven J. , Williams Christopher M.
Published: October 2017

There are substantial gaps in our understanding of musculoskeletal pain in children and adolescents. While there are challenges to performing research in this space, the prevalence, burden, and lack of available evidence to inform clinical practice mean that overcoming these challenges is important. The editors see the collection of work in this special issue as a step in the right direction.

J Orthop Sports Phys Ther 2017;47(10):702–704. doi:10.2519/jospt.2017.0109
Lumbar Spine Osteomyelitis in an Adolescent Girl With Nonspecific Low Back Pain
Authors: Wall Christopher M. , Paterno Mark V. , Sturm Peter F.
Published: October 2017

A 13-year-old adolescent girl presented to the emergency department with low back pain of acute onset after bending forward. Lumbar spine radiographs were taken and found to be unremarkable, and the patient was referred to physical therapy. Following examination, the patient was referred to her physician for a suspected nonmechanical cause. Magnetic resonance imaging assessment revealed L3-4 discitis, with osteomyelitis extending into the adjacent right iliopsoas muscle. Further testing and bone biopsy confirmed osteomyelitis.

J Orthop Sports Phys Ther 2017;47(10):814. doi:10.2519/jospt.2017.6883
Parâmetros de qualidade físico-química de óleos e análise morfométrica de frutos e sementes da espécie Orbignya phalerata Martius por região ecológica
Authors: Santos Débora Silva , Da Silva Ilna Gomes , Barbosa Maria do Carmo Lacerda , Nascimento Maria do Desterro Soares Brandão , Costa Maria Célia Pires
Published: October 2017

Este trabalho teve como objetivo analisar as características físico-químicas de óleos e as características morfométricas de frutos e sementes (amêndoas) do babaçu (Orbignya phalerata Martius), por região ecológica do estado do Maranhão. Para isso, foram obtidas amostras de babaçu oriundas das regiões: Litoral, Cocais, Baixada, Cerrado e Pré-Amazônia maranhense e analisados os parâmetros físico-químicos: índice de acidez, índice de saponificação, índice de refração e umidade. Dasmesmas regiões foram coletados, para análise das características morfométricas, frutos inteiros e de amêndoas da espécie estudada. Os resultados apontam que os índices de acidez estão dentro do limite máximo estabelecido pela norma nacional da ANVISA(2009); os índices de saponificação indicam a presença de lipídeos (ácidos graxos) de médio a alto peso molecular na composição química dos óleos, os resultados refratométricos estão condizentes com as normais atuais vigentes e o teor de umidade foi inferior a1%. Os lotes de babaçu Orbignya phalerataMartius não apresentaram variabilidade significativa (p>0,05) em tamanho (cm) para os frutos e amêndoas por região. Os parâmetros físico-químicos dos óleos aqui avaliados poderão contribuir com as indústrias que utilizam o óleo de babaçu em seus produtos manufaturados.
Coronary dominance and predictors of adverse events during coronary interventional procedures: an observational study
Authors: Paudel Navaraj , Jha G.S. , Alurkar V.M. , Kafle Ramchandra , Sapkota Subash
Published: October 2017

Background: Coronary dominance is associated with adverse peri-procedural events during coronary interventions. There are limited data regarding events during coronary angiography in Nepal.Aims and methods: The aim of this article is to get information regarding events during invasive procedures of this region which has a large feeder population. All the cases undergone cardiac interventional procedures were included and analyzed.Results: Out of 200 cardiac interventional procedures, 160 cases underwent coronary angiography (CAG) and 20 percutaneous coronary intervention (PCI). 54% of the study populations were male. The mean age of study population was 61.2 years (range: 29-85 years). Most common indication for performing CAG was for post ACS (69%) followed by chronic stable angina (CSA) (16%). Most common finding in CAG was SVD (35%) LAD was the commonest (55% of SVD), DVD (19%), non-critical CAD (13%), TVD (14%) and left main (2%). Myocardial bridging was seen in 2% and 15% had normal coronaries. Commonest risk factor for CAD was Hypertension (45%) followed by smoking (35%) and diabetes (16%). CAG was most commonly performed from right radial (70%) followed by right femoral (24%), left radial (5%) and left femoral (1%). 78% of patients had right dominance, 16% had left dominance while 6% had co-dominance. Out of 40 non-right dominant (left or co-dominant) patient twenty three (57.5%) were female. There was no significant association of left dominance with the gender although the odds ratio was high (1.8) in female gender (P=0.12). Considering Left dominant patients only, the odds ratio of Tiger catheter versus Judkins Right (JR) is 8.33 but not statistically significant (P=0.17). Major complications encountered were ventricular tachycardia (VT) in 4 cases. The odds for VT with left dominance and right dominance was high with statistical significance [OR: 53.48, C.I :( 2.79-1023.4); P=0.002].Conclusion: Ventricular tachycardia which is among the major complication is found to be significantly associated with left dominance. Further studies are necessary to evaluate the evidence provided by this study.
Cadaveric Donation and Post-mortem Reuse of Pacemakers and Defibrillators in Nepal: Medical, Legal and Ethical Challenges
Authors: Sedhai Yub Raj , Ochasi Aloysius , Basnyat Soney , Acharya Deepak , Clark Peter
Published: October 2017

Cardiovascular diseases (CVDs) are the number one cause of death globally. An estimated 17.5 million people died from CVDs in 2012, representing 31% of all global deaths. Over three quarters of all deaths related CVDs take place in low- and middle-income countries (LMICs). Studies have estimated that 1 to 2 million people worldwide die each year due to lack of access to cardiac rhythm management devices (CRMDs) i.e. implantable cardiac defibrillator (ICD) or a pacemaker. The principal challenge is the high cost of these devices and the resource constraint in LMICs. A growing body of literature, mostly single center, uncontrolled and retrospective studies has suggested reuse of CRMDs from deceased donors as a safe and effective alternative. This paper seeks to propose the concept of post-mortem CRMD donation and reutilization program within Nepal as a life-saving initiative. Though the spirit of the program is in line with the ethical principles of respect for persons, beneficence, justice, and the common good, it is challenged with several logistical barriers and legal concerns. In this paper we have discussed the clinical, legal and ethical perspectives with a literature review on similar programs.
Resection of posterior clinoid meningioma through retrosigmoid approach: concepts and nuances
Authors: Nanda Anil , Patra Devi Prasad , Savardekar Amey , Maiti Tanmoy K. , Kalakoti Piyush
Published: October 2017

Meningiomas arising from the posterior clinoid process pose a great surgical challenge because of their location and propensity to cause critical neurovascular compression. The authors’ patient was a 66-year-old female who had a large posterior clinoid meningioma with significant brainstem compression that was operated on through the retrosigmoid approach. This 3D surgical video emphasizes the various technical concepts that are important to preserving compressed neural and vascular structures during the surgery. It would also be interesting to note the extent of visualization around the posterior clinoid region gained through a retrosigmoid corridor.

The video can be found here: https://youtu.be/CBmT_0ov0YA.
Combined petrosal approach for petroclival meningioma
Authors: Arnaout Omar , Al-Mefty Ossama
Published: October 2017

The authors present the case of a 56-year-old patient who presented with a large petroclival meningioma and clinical symptoms of brainstem compression and hydrocephalus. The authors describe a two-stage combined petrosal approach for complete resection of the tumor. The nuances of the approach and microsurgical technique are discussed, as well as the radiographic and clinical outcomes.

The video can be found here: https://youtu.be/T90vUIPKQsA.
Endoscopic endonasal pituitary gland hemi-transposition for resection of a dorsum sellae meningioma
Authors: Montaser Alaa S. , Revuelta Barbero Juan M. , Todeschini Alexandre , Beer-Furlan André , Lonser Russell R. , Carrau Ricardo L. , Prevedello Daniel M.
Published: October 2017

A 69-year-old female with incidental diagnosis of a dorsum sellae meningioma had shown significant tumor growth after initial conservative management. The procedure started with a microscopic sublabial transsphenoidal approach to the sella and the suprasellar space. Due to limitations to a safe dissection and removal of the retrosellar component, the surgery was converted to a purely endoscopic endonasal approach with left hemi-transposition of the pituitary gland, followed by drilling of the dorsum sellae and removal of the left posterior clinoid process. A complete tumor resection was achieved, and a multilayer skull base reconstruction was performed without complications.

The video can be found here: https://youtu.be/BEolyK-To_A.
Extended middle fossa approach with anterior petrosectomy for resection of upper petroclival meningioma involving Meckel’s cave: operative video and technical nuances
Authors: Liu James K.
Published: October 2017

The surgical management of petroclival meningiomas remains a formidable challenge. These tumors are deep in the base of the skull and arise medial to the fifth cranial nerve. In this operative video, the author demonstrates the extended middle fossa approach with anterior petrosectomy to resect an upper petroclival meningioma extending into Meckel’s cave with brainstem compression. This approach is very useful for accessing deep tumors located above and below the tentorium, and between the fifth and seventh cranial nerves. Access to Meckel’s cave is readily achieved by opening the fibrous ring of the porous trigeminus. This video demonstrates the operative technique and surgical nuances of the skull base approach, useful anatomic landmarks of the middle fossa rhomboid for safe petrosectomy drilling, pearls for cranial nerve and neuro-otologic preservation, and exposure of Meckel’s cave. A gross-total resection was achieved, and the patient was neurologically intact. In summary, the extended middle fossa approach with anterior petrosectomy is an important strategy in the armamentarium for surgical management of petroclival meningiomas.

The video can be found here: https://youtu.be/jttwJIYPHC8.
Extradural clinoidectomy for resection of clinoidal meningioma
Authors: Buttrick Simon , Morcos Jacques J. , Elhammady Mohamed S. , Wang Anthony C.
Published: October 2017

Extradural anterior clinoidectomy is a versatile technique to increase exposure of the sellar and parasellar region. It is of particular use in the resection of clinoidal meningiomas, as sphenoidal and clinoidal hyperostosis can cause compression of the optic nerve. Extradural clinoidectomy follows a series of steps, consisting of (1) unroofing of the superior orbital fissure, (2) unroofing of the optic canal, (3) removal of the optic strut, and (4) removal of the anterior clinoid process. The authors show these steps in detail, as well as their application to the resection of a large clinoidal meningioma.

The video can be found here: https://youtu.be/O1Fcef29ETg.
Resection of middle petroclival meningioma via combined anterior transpetrosal and retrosigmoid approaches at two separate stages: 3D operative video
Authors: Dogan Ihsan , Ocak Pinar Eser , Pyle G. Mark , Başkaya Mustafa K.
Published: October 2017

Surgical access to the petroclival region poses a challenge to neurosurgeons. A wide range of approaches has been demonstrated in the past. In this video, the authors present a 69-year-old male patient who presented with 3-month history of worsening left-sided numbness. The tumor was totally removed in 2 sessions via anterior transpetrosal and retrosigmoid approaches, respectively. The authors demonstrate 2 separate skull base approaches to resect a petroclival meningioma and discuss pitfalls and problems of management for challenging meningiomas. The authors suggest that surgical approaches to petroclival meningiomas should be selected based on an individual case. A skull base team should be versatile in performing all these approaches.

The video can be found here: https://youtu.be/BCVrn3TeNvE.
Introduction: surgical management of skull base meningiomas
Authors: Zada Gabriel , Başkaya Mustafa K , Shah Mitesh V.
Published: October 2017

Meningiomas represent the most common primary intracranial neoplasm treated by neurosurgeons. Although multimodal treatment of meningiomas includes surgery, radiation-based treatments, and occasionally medical therapy, surgery remains the mainstay of treatment for most symptomatic meningiomas. Because of the intricate relationship of the dura mater and arachnoid mater with the central nervous system and cranial nerves, meningiomas can arise anywhere along the skull base or convexities, and occasionally even within the ventricular system, thereby mandating a catalog of surgical approaches that neurosurgeons may employ to individualize treatment for patients. Skull base meningiomas represent some of the most challenging pathology encountered by neurosurgeons, on account of their depth, invasion, vascularity, texture/consistency, and their relationship to bony anatomy, cranial nerves, and blood vessels. Resection of complex skull base meningiomas often mandates adequate bony removal to achieve sufficient exposure of the tumor and surrounding region, in order to minimize brain retraction and optimally identify, protect, control, and manipulate sensitive neurovascular structures. A variety of traditional skull base approaches has evolved to address complex skull base tumors, of which meningiomas are considered the paragon in terms of both complexity and frequency.

In this supplemental video issue of Neurosurgical Focus, contributing authors from around the world provide instructional narratives demonstrating resection of a variety of skull base meningiomas arising from traditionally challenging origins, including the clinoid processes, tuberculum sellae, dorsum sellae, petroclival region, falco-tentorial region, cerebellopontine angle, and foramen magnum. In addition, two cases of extended endoscopic endonasal approaches for tuberculum sellae and dorsum sellae meningiomas are presented, representing the latest evolution in accessing the skull base for selected tumors. Along with key pearls for safe tumor resection, an equally important component of open and endoscopic skull base operations for meningiomas addressed by the contributing authors is the reconstruction aspect, which must be performed meticulously to prevent delayed cerebrospinal fluid leakage and/or infections. This curated assortment of instructional videos represents the authors’ optimal treatment paradigms pertaining to the selection of approach, setup, exposure, and principles to guide tumor resection for a wide spectrum of complex meningiomas.
Adolescent idiopathic scoliosis: risk factors for complications and the effect of hospital volume on outcomes
Authors: Menger Richard P. , Kalakoti Piyush , Pugely Andrew J. , Nanda Anil , Sin Anthony
Published: October 2017

OBJECTIVE

Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis. Limited literature exists defining risk factors associated with outcomes during initial hospitalization in these patients. In this study, the authors investigated patient demographics, clinical and hospital characteristics impacting short-term outcomes, and costs in adolescent patients undergoing surgical deformity correction for idiopathic scoliosis. Additionally, the authors elucidate the impact of hospital surgical volume on outcomes for these patients.

METHODS

Using the National Inpatient Sample database and appropriate International Classification of Diseases, 9th Revision codes, the authors identified adolescent patients (10–19 years of age) undergoing surgical deformity correction for idiopathic scoliosis during 2001–2014. For national estimates, appropriate weights provided by the Agency of Healthcare Research and Quality were used. Multivariable regression techniques were employed to assess the association of risk factors with discharge disposition, postsurgical neurological complications, length of hospital stay, and hospitalization costs.

RESULTS

Overall, 75,106 adolescent patients underwent surgical deformity correction. The rates of postsurgical complications were estimated at 0.9% for neurological issues, 2.8% for respiratory complications, 0.8% for cardiac complications, 0.4% for infections, 2.7% for gastrointestinal complications, 0.1% for venous thromboembolic events, and 0.1% for acute renal failure. Overall, patients stayed at the hospital for an average of 5.72 days (median 5 days) and on average incurred hospitalization costs estimated at $54,997 (median $47,909). As compared with patients at low-volume centers (≤ 50 operations/year), those undergoing surgical deformity correction at high-volume centers (> 50/year) had a significantly lower likelihood of an unfavorable discharge (discharge to rehabilitation) (OR 1.16, 95% CI 1.03–1.30, p = 0.016) and incurred lower costs (mean $33,462 vs $56,436, p < 0.001) but had a longer duration of stay (mean 6 vs 5.65 days, p = 0.002). In terms of neurological complications, no significant differences in the odds ratios were noted between high- and low-volume centers (OR 1.23, 95% CI 0.97–1.55, p = 0.091).

CONCLUSIONS

This study provides insight into the clinical characteristics of AIS patients and their postoperative outcomes following deformity correction as they relate to hospital volume. It provides information regarding independent risk factors for unfavorable discharge and neurological complications following surgery for AIS. The proposed estimates could be used as an adjunct to clinical judgment in presurgical planning, risk stratification, and cost containment.
Temporary occipital fixation in young children with severe cervical-thoracic spinal deformity
Authors: Kelley Brian J. , Minkara Anas A. , Angevine Peter D. , Vitale Michael G. , Lenke Lawrence G. , Anderson Richard C. E.
Published: October 2017

OBJECTIVE

The long-term effects of instrumentation and fusion of the occipital-cervical-thoracic spine on spinal growth in young children are poorly understood. To mitigate the effects of this surgery on the growing pediatric spine, the authors report a novel technique used in 4 children with severe cervical-thoracic instability. These patients underwent instrumentation from the occiput to the upper thoracic region for stabilization, but without bone graft at the craniovertebral junction (CVJ). Subsequent surgery was then performed to remove the occipital instrumentation, thereby allowing further growth and increased motion across the CVJ.

METHODS

Three very young children (15, 30, and 30 months old) underwent occipital to thoracic posterior segmental instrumentation due to cervical or upper thoracic dislocation, progressive kyphosis, and myelopathy. The fourth child (10 years old) underwent similar instrumentation for progressive cervical-thoracic scoliosis. Bone graft was placed at and distal to C-2 only. After follow-up CT scans demonstrated posterior arthrodesis without unintended fusion from the occiput to C-2, 3 patients underwent removal of the occipital instrumentation.

RESULTS

Follow-up cervical spine flexion/extension radiographs demonstrated partial restoration of motion at the CVJ. One patient has not had the occipital instrumentation removed yet, because only 4 months have elapsed since her operation.

CONCLUSIONS

Temporary fixation to the occiput provides increased biomechanical stability for spinal stabilization in young children, without permanently eliminating motion and growth at the CVJ. This technique can be considered in children who require longer instrumentation constructs for temporary stabilization, but who only need fusion in more limited areas where spinal instability exists.
Evaluation and management of adolescent idiopathic scoliosis: a review
Authors: Jada Ajit , Mackel Charles E. , Hwang Steven W. , Samdani Amer F. , Stephen James H. , Bennett James T. , Baaj Ali A.
Published: October 2017

Adolescent idiopathic scoliosis (AIS) is a 3D spinal deformity affecting children between the ages of 11 and 18, without an identifiable etiology. The authors here reviewed the available literature to provide spine surgeons with a summary and update on current management options.

Smaller thoracic and thoracolumbar curves can be managed conservatively with observation or bracing, but corrective surgery may be indicated for rapidly growing or larger curves. The authors summarize the atypical features to look for in patients who may warrant further investigation with MRI during diagnosis and review the fundamental principles of the surgical management of AIS.

Patients with AIS can be managed very well with a combination of conservative and surgical options. Outcomes for these children are excellent with sustained longer-term results.
Risk factors associated with short-term complications and mortality after pediatric spinal arthrodesis
Authors: Abu-Bonsrah Nancy , Goodwin C. Rory , Ortega Gezzer , Abdullah Fizan , Cornwell Edward , De la Garza-Ramos Rafael , Groves Mari L. , Ain Michael , Sponseller Paul D. , Sciubba Daniel M.
Published: October 2017

OBJECTIVE

Spinal arthrodesis is routinely performed in the pediatric population. However, there is limited information on the short-term outcomes of pediatric patients who have undergone spine fusion. Thus, the authors conducted a retrospective review of the Pediatric National Surgical Quality Improvement Program (NSQIP) database to determine the short-term mortality, complication, reoperation, and readmission rates of pediatric patients who underwent spinal arthrodesis for all indications.

METHODS

The Pediatric NSQIP database was queried for all patients who underwent spinal arthrodesis between 2012 and 2014. Patient demographics, comorbidities, body mass index, American Society of Anesthesiologists classification, and operative time were abstracted. Short-term mortality, reoperation, and readmission rates and complications were also noted. Univariate and multivariate analyses were performed to delineate patient risk factors that influence short-term mortality, complications, reoperation, and readmission rates.

RESULTS

A total of 4420 pediatric patients who underwent spinal fusion were identified. Common indications for surgical intervention included acquired/idiopathic scoliosis or kyphoscoliosis (71.2%) and genetic/syndromic scoliosis (10.7%). The mean patient age was 13.7 ± 2.9 years, and 70% of patients were female. The overall 30-day mortality was 0.14%. Multivariate analysis showed that female sex and pulmonary comorbidities significantly increased the odds of reoperation, with odds ratios of 1.43 and 1.78, respectively.

CONCLUSIONS

In the NSQIP database for pediatric patients undergoing spinal arthrodesis for all causes, there was a 3.6% unplanned reoperation rate, a 3.96% unplanned readmission rate, and a 9.0% complication rate. This analysis provides data for risk stratification of pediatric patients undergoing spinal arthrodesis, allowing for optimized care.