bluuebunny/crossref_metadata_2025_split huggingface dataset:
Apontamentos sobre a narratividade e a aspectualização do ato de jogar no jogo Super Mario World
Authors: Teodoro da Silva Junior Mário Sérgio 
Published: May 2019

RESUMO: Este artigo destina-se a identificar as marcações no enunciado do jogo de videogame Super Mario World, de 1990, que permitam enxergar o fluxo da ação de controle operada pelo jogador visado pela enunciação. Para tanto, deve-se estabelecer a distinção entre a instância enunciada do enunciatário, o narratário, a quem o narrador instrui e comanda, e a instância do enunciado enunciado, em que se localiza o herói Mario, aquele comandado pelo narratário. As categorias narrativas e discursivas ora são comuns, ora diversas para esses sujeitos, estruturando graus de sincretismo de suas identidades e de seus percursos. É no percurso do narratário em que são encontradas as dinâmicas sensíveis que demarcam o ritmo do processo de jogo, o tempo necessário para se tornar hábil e vencer.
PALAVRAS-CHAVE: semiótica; videogames; narratividade.

ABSTRACT: In this article, our goal is to identify the syntax of control which a video game player plays, in the game Super Mario World, from Nintendo (1990), basing our notes on the many marks left in the audiovisual text, in the form of figures and narrative programs. Therefore, two levels must be distinguished: one concerning the player, referred in the text as a naratee, and another concerning the enounced hero, Mario. The discursive categories and narrative patterns are sometimes the same and sometimes different for each actor, proposing syncretism degrees for their identities and their syntaxes. It is in the course of the naratee that the sensitive dynamics that mark the rhythm of the game process are found, besides the time needed to become skilled and to win.
KEYWORDS: semiotics; video games; narrativity.
Amplitud del surtido como generador de emociones negativas en el consumidor
Authors: Gálvez Martínez Marta , López López Inés 
Published: May 2019

La decisión de un consumidor de acudir a un establecimiento depende de factores tales como precio, proximidad, surtido, promociones. Cada vez existe mayor preocupación entre fabricante y distribuidor por tener un número de referencias óptimo y lo más diferenciado posible. El presente trabajo tiene como objetivo analizar los efectos que tienen la amplitud del surtido y la implicación con la categoría de producto sobre las emociones que experimenta el consumidor. Se ha aplicado la metodología experimental para la recogida de datos, planteando un diseño entre sujetos 2 x 2, siendo los factores manipulados la amplitud del surtido (amplio vs reducido) y el tipo de producto (baja implicación vs media implicación).
Los resultados indican que no solo el tamaño del surtido influye en el comportamiento, sino que también el tipo de producto juega un papel importante, originando en el consumidor emociones negativas cuando el surtido es grande y el producto es de implicación media. Así, un mayor abanico de posibilidades en términos de surtido no siempre es recomendable, pues puede llegar a saturar al consumidor y generar una respuesta emocional desfavorable. En consecuencia, los directivos de marketing deben encontrar un punto de equilibrio entre una oferta variada y una oferta excesiva, para que los clientes puedan procesar la información de las distintas alternativas y quedar satisfechos con su elección final.
Pilot Survey of Shared Decision-Making Between Orthopaedic Surgeons and Their Patients in Guatemala
Authors: Martinez-Siekavizza S.N. , Winter S.C. , Barchi F. 
Published: May 2019

Background:
Shared decision-making (SDM) is widely accepted as an essential feature of patient-centered care. However, to our knowledge, there has been no empirical research on the factors that influence orthopaedic surgeons’ use of SDM in Guatemala.

Methods:
Questions about physician attributes and SDM were included in a 2016 electronic survey distributed to the 221 members of the Asociación Guatemalteca de Ortopedia y Traumatología (AGOT).

Results:
A total of 114 (52%) of the AGOT-registered orthopaedic surgery residents and orthopaedic surgeons who were sent surveys returned them, and 79 of these surveys contained complete responses to study variables of interest. Of the 79 participants with complete responses, 73% reported that they discussed treatment options most of the time or always with their patients and 81% reported that they explained the reasons for treatment choices. Compared with residents, surgeons who had completed their residency in orthopaedic surgery or had subspecialty training had greater odds (odds ratio [OR] = 9.62; 95% confidence interval [CI] = 1.35, 68.53; p < 0.05) of explaining the reasons for their decisions rather than using other strategies when patients expressed different preferences. Residents and surgeons who discussed treatment choices with their patients were more likely to allow their patients to participate in treatment decisions than those who did not (OR = 2.88; 95% CI = 1.90, 4.36; p < 0.001).

Conclusions:
While findings from this exploratory study are limited by its small sample size and its narrow focus on physicians rather than on both patients and physicians, they nonetheless establish a roadmap for future study, particularly with respect to challenges in Guatemala to meaningful SDM that arise from context-specific cultural norms and practices.

Clinical Relevance:
SDM as a tool of practice remains underutilized by orthopaedic surgeons in clinical practice in Guatemala. This study may encourage more discussions regarding SDM in orthopaedic surgery elsewhere in Central America and prompt discussion in the region on the value of and need for postgraduate training in this area.
Multiflora and Gram-Negative Microorganisms Predominate in Infections Affecting Pelvic Endoprostheses Following Tumor Resection
Authors: Sanders P.T.J. , Bus M.P.A. , Scheper H. , van der Wal R.J.P. , van de Sande M.A.J. , Bramer J.A.M. , Schaap G.R. , de Boer M.G.J. , Dijkstra P.D.S. 
Published: May 2019

Background:
Periprosthetic infections after pelvic reconstruction are common, with reported rates ranging from 11% to 53%. Management of these infections is troublesome, as they commonly necessitate multiple surgical interventions and implant removal. The epidemiology and outcomes of these infections are largely unknown. The aim of this study was to analyze the causative microorganisms and the clinical outcome of treatment in a series of patients with pelvic endoprostheses affected by infection following tumor resection.

Methods:
In this retrospective, multicenter cohort study, we identified all patients who developed an infection after endoprosthetic reconstruction in periacetabular tumor resection, between 2003 and 2017. The microorganisms that were isolated during the first debridement were recorded, as were the number of reoperations for ongoing infection, the antimicrobial treatment strategy, and the outcome of treatment.

Results:
In a series of 70 patients who underwent pelvic endoprosthetic reconstruction, 18 (26%) developed an infection. The type of pelvic resection according to the Enneking-Dunham classification was type P2-3 in 14 (78%) of these patients and type P2 in 4 (22%). Median follow-up was 66 months. Fourteen (78%) of the 18 patients with infection had a polymicrobial infection. Enterobacteriaceae were identified on culture for 12 (67%). Of a total 42 times that a microorganism was isolated, the identified pathogen was gram-negative in 26 instances (62%). Microorganisms associated with intestinal flora were identified 32 times (76%). At the time of latest follow-up, 9 (50%) of the patients had the original implant in situ. Of these, 2 had a fistula and another 2 were receiving suppressive antibiotic therapy. In the remaining 9 (50%) of the patients, the original implant had been removed. At the time of final follow-up, 3 of these had a second implant in situ. The remaining 6 patients had undergone no secondary reconstruction.

Conclusions:
Infections that affect pelvic endoprostheses are predominantly polymicrobial and caused by gram-negative microorganisms, and may be associated with intestinal flora. This differs fundamentally from mono-bacterial gram-positive causes of conventional periprosthetic joint infections and may indicate a different pathogenesis. Our results suggest that prophylaxis and empiric treatment may need to be re-evaluated.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Perioperative Antibiotic Prophylaxis in Total Joint Arthroplasty
Authors: Siddiqi Ahmed , Forte Salvador A. , Docter Shgufta , Bryant Dianne , Sheth Neil P. , Chen Antonia F. 
Published: May 2019

Background:
The 2017 U.S. Centers for Disease Control and Prevention (CDC) guidelines for the prevention of surgical site infection (SSI) recommended against continuation of antibiotics postoperatively after total joint arthroplasty. This is disconcerting, as the revised guidelines are based on only 6 orthopaedic studies, of which 83% (5 of 6) were published from 1987 to 1991. The purpose of the current study was to conduct a systematic review and meta-analysis of the literature regarding the efficacy and duration of surgical antibiotic prophylaxis (SAP) in total joint arthroplasty.

Methods:
PubMed, Ovid MEDLINE, and Ovid Embase were screened for “surgical antimicrobial prophylaxis orthopedic,” in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, without a specified time frame with respect to publication date. A total of 693 studies were screened, and 32 studies were evaluated. Data were extracted regarding antibiotic type, number of doses, and duration. Prospective and retrospective studies examining perioperative antibiotics with subsequent SSI and periprosthetic joint infection (PJI) rates in total joint arthroplasty were included.

Results:
Twenty-three randomized controlled trials (RCTs) and 2 prospective cohort, 3 retrospective cohort, and 4 case-control studies with a total of 51,627 patients were included in this review. The overall pooled effect for the comparison between a single preoperative dose of antibiotic and continued (preoperative plus postoperative) administration was 0.96 (95% confidence interval [CI], 0.73 to 1.26), suggesting no difference in effect. However, the 95% CI for the relative risk would include a reduction of approximately 27% in either group. The overall pooled effect from the comparison between SAP of ≤24 and >24 hours postoperatively demonstrated no difference in effect. All included studies were underpowered and heterogenous regarding type of antibiotic used and duration.

Conclusions:
Our review confirms the benefit of SAP utilization in total joint arthroplasty. The available evidence does not show added benefit of postoperative SAP or continuation beyond 24 hours. However, the overall GRADE (Grading of Recommendations Assessment, Development and Evaluation) of evidence of the available literature was low (high risk of bias, high risk of publication bias, and low precision). The findings of this study demonstrate the need for Level-I studies with adequate power to evaluate the safety of shortened SAP duration after total joint arthroplasty and its effect on SSI/PJI prior to widespread implementation.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Implant Fracture Analysis of the TFNA Proximal Femoral Nail
Authors: Lambers Anton , Rieger Bertram , Kop Alan , D’Alessandro Peter , Yates Piers 
Published: May 2019

Background:
Mechanical failure of intramedullary nails is rare. This investigation was prompted by a series of cases of observed breakage of the recently introduced TFNA Proximal Femoral Nailing System (TFN [Trochanteric Fixation Nail]-Advanced; DePuy Synthes) in our region. Laboratory analysis and case data are presented, in contribution to post-market surveillance.

Methods:
Medical and imaging records from the 3 public tertiary orthopaedic trauma hospitals in Western Australia were reviewed. Relevant data of patients in whom breakage of the TFNA implant occurred between 2016 and 2018 were collected and analyzed. Laboratory review of retrieved implants was conducted at the Centre for Implant Technology and Retrieval Analysis (CITRA) in Western Australia.

Results:
A total of 16 cases of TFNA implant breakage were recorded and analyzed. The predominant OTA/AO fracture classification was 31A3 (12 cases, 75%). The reduction quality was good in 10 cases, acceptable in 4 cases, and poor in 2 cases. The mean time to failure (and standard deviation) was 5.0 ± 2.2 months (range, 2.2 to 9.8 months). The treatment modality for the breakage was revision nailing in 11 cases, arthroplasty in 3, and nonoperative management in 2. All nails broke at the proximal screw aperture, with 1 nail additionally breaking at the distal aperture. Of 8 patients treated with a second TFNA implant for nail breakage, 3 (38%) returned with breakage of the revision implant. Laboratory analysis of the broken nails demonstrated a unique fracture pattern, with a stepped propagation pathway.

Conclusions:
This study represents the largest series, to our knowledge, of proximal femoral nail breakages in the published English literature and is the first that we are aware of to involve laboratory analysis of the TFNA implant. Changes to the nail design and/or alloy may have contributed to the observed cases of breakage, and this study will be followed by an evaluation of breakage rates in comparison with those of previous generations of nailing systems. We advise close clinical and radiographic surveillance of patients with unstable hip fracture patterns who undergo osteosynthesis with use of a TFNA implant.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Pengaruh Model Pembelajaran Sentra Peran Terhadap Kemampuan Berbicara Anak Usia 5-6 Tahun di TK Islam Al-Khalifa Solerejo Mojowarno Jombang
Authors: Farikha Lailina , Karim Muhammad Busyro , Fajar Yulias Wulani , Puspitasari Ratna Nila 
Published: May 2019

<em>The purpose of this study was to determine the effect of learning models of role Centers on speech capabilities of child aged 5-6 years old at Al-Khalifa Islamic Kindergarten Ngepung backwoods, Solorejo Village, District Mojowarno, Jombang Regency. This research uses quantitative approach by using Experimental method with design pre-experimental research design(nondesigns) Type of one-grouppre-testpost-test.The subject of this study is a child aged 5-6 years old in Islamic Kindergarten Al-Khalifa Jombang as many as 17children’s which is representative from the whole number of research. Data collecting technique through the observation and documentation. By using t data experiment analysis (T-Test). The result of data analysis is obtained r = 0,55 and t-test obtained grade t-count Amount -0,88 and t-table 2,178. Then t-table is bigger than t-count(-2,178 &gt; -0,88), if t-table &gt; t-count H</em><em> is accepted on standard of significanse 5% which means there is significant influence between learning model of role center to child's speaking ability. </em>
SISTEM INFORMASI MANAJEMEN SANTRI DI PONDOK PESANTREN AL ISHLAH KOTA KEDIRI
Authors: Setiawan Ahmad Bagus , Sulaksono Juli 
Published: May 2019

<p><em>Penerapan sistem di pondok pesantren dilatarbelakangi dari penerapan pengarsipan data yang masih menggunakan sistem petok untuk pendataan pembayaran bulanan dan untuk pendataan biodata santri masih menggunakan buku folio, meskipun dalam perkembangannya sudah diterapkan aplikasi excel, tetapi masih belum </em><em>bisa</em><em> mendata secara rinci data santri, pembayaran santri dan tahun masuk dan keluar. Maka sistem Informasi Manajemen Pondok pesantren ini dapat kiranya membantu pondok pesantren dalam penerapan Sistem Integrasi Santri baik santri Madrasah maupun santri Pondok, terdapat data yang pasti, dapat memberikan informasi yang akurat dan cepat dalam menganalisa informasi.</em></p><p><strong><em>Kata kunci:</em></strong><strong><em> Pondok pesantren, Sistem Informasi, Santri</em></strong></p>
APLIKASI PENGELOLAAN BAHAN BAKU UNTUK EFISIENSI OPERASIONAL MENGGUNAKAN METODE ECONOMIC ORDER QUANTITY
Authors: Utami Ruli , Khadafi Shah 
Published: May 2019

<p align="justify"><em>Pengelolaan bahan baku yang tepat akan memberikan kontribusi yang cukup besar dalam proses industri, sehingga ha ini dianggap menjadi hal penting bagi pelaku industri. Permasalahan bahan baku ini jugalah yang ada pada industri UKM kerupuk terasi yang berada di wilayah Kabupaten Lamongan khususnya di Kecamatan Turi, yaitu diantaranya adalah sering terhambatnya operasional industri dikarenakan tidak adanya sistem pengelolaan bahan baku, dikarenakan sering terjadi kekurangan bahan baku atau kelebihan stok bahan baku setiap bulannya. Sehingga peneliti berinisiatif untuk membuat aplikasi yang berfungsi untuk memberikan solusi pada masalah tersebut diatas. Adapun metode yang akan diimplementasikan pada aplikasi ini adalah metode Economic Order Quantity (EOQ), kesimpulan yang dapat ditarik pada penelitian yang telah dilakukan pada aplikasi pengelolaan bahan baku pembuat kerupuk dengan metode Economic Order Quantity (EOQ) adalah terbukti aplikasi ini dapat membantu efisiensi biaya produksi dalam hal pengelolaan bahan baku pembantu proses produksi. Dengan hasil perbandingan TIC dengan metode EOQ sebesar Rp. 311.572.670 setiap tahun untuk seluruh bahan baku, dan TIC dengan metode klasik (Tanpa EOQ) sebesar Rp. 338.071500. sehingga diperoleh angka efisiensi biaya operasional produksi melalui pengelolaan bahan baku adalah sebesar Rp. 26.498.830 setiap tahunnya.</em><em></em></p><p align="justify"> </p><p><strong><em>Kata Kunci : Pengelolaan Bahan Baku, Efisiensi Biaya, EOQ</em></strong></p>
Accelerated Shoulder Rehabilitation after Reverse Total Shoulder Arthroplasty for Atraumatic Osteoarthritis: Study Protocol for a Single Center Randomized Controlled Trial
Authors: Raja Avais , Cambronne Travis , Walsh Michael R 
Published: May 2019

Abstract
Background

Reverse total shoulder arthroplasty has been successful in patients suffering from advanced degenerative osteoarthritis with rotator cuff insufficiency. The currently practiced physical rehabilitation after a shoulder rehabilitation does not allow shoulder motion until 6 weeks post-operatively. These patients are required to be in a sling to assist the patient in immobilizing the operated shoulder. An accelerated rehabilitation with immediate active shoulder motion has not been studied in the setting of a revere total shoulder arthroplasty.

Methods

This is a single center and single surgeon operated, randomized controlled trial. The primary objective is to compare patient reported shoulder function using the American Shoulder and Elbow Society (ASES) score and shoulder range of motion in patients undergoing the traditional physical rehabilitation and accelerated shoulder rehabilitation post reverse total shoulder arthroplasty. Secondary outcomes will include the Simple Shoulder Test (SST) score, Patient Reported Outcome Information System (PROMIS) Global Health-10, radiological parameters and subscapularis tear on ultrasound.

Discussion

The study will assess the effectiveness of an accelerated shoulder rehabilitation with immediate active shoulder motion after a reverse total shoulder arthroplasty in patients with atraumatic osteoarthritis.
Effect of corn cobs as external carbon sources on nitrogen removal in constructed wetlands treating micro-polluted river water
Authors: Yu Lu-ji , Chen Tao , Xu Yanhong 
Published: May 2019

Abstract
Micro-polluted river water is characterized as having limited biodegradability, low carbon to nitrogen ratio and little organic carbon supply, all of which makes it hard to further purify. Two bench scale constructed wetlands (CWs) with a horizontal subsurface flow mode were set up in the laboratory to evaluate their feasibility and efficiency on denitrification with and without corn cobs as external carbon sources. Micro-polluted river water was used as feed solution. The CW without corn cobs substrates possessed a good performance in removing chemical oxygen demand (COD, &lt;40 mg/L) and ammonia nitrogen (NH3-N, &lt;0.65 mg/L), but less efficiency in removing total nitrogen (TN) and nitrate nitrogen (NO3-N). In marked contrast, the CW with 1% (w/w) corn cobs substrates as external carbon sources achieved a significant improvement in the removal efficiency of TN (increased from 34.2% to 71.9%) and NO3-N (increased from 19% to 71.9%). The incorporation of corn cobs substrates did not cause any obvious increase in the concentrations of COD and NH3-N in the effluent. This improvement in the denitrification efficiency was owing to the released organic carbon from corn cobs substrates, which facilitated the growth of abundant microbes on the surface and pores of the substrate. The open area of the used corn chips is larger than that of the pristine ones, and corn cobs can continue to provide a carbon fiber source for denitrification.
The Description Of Diabetics’ Acceptance Stage Toward Diabetes Mellitus’ Diagnoses
Authors: Nistiandani Ana , Juniarto Achmad Zulfa , Dyan Niken Safitri 
Published: May 2019

<p class="Normal1" align="center"><strong>Abstract</strong></p><p class="Normal1" align="center"><strong> </strong></p><p>Diabetes Mellitus (DM) is a chronic condition which requires various kinds of lifetime treatment which cause grief. Grief has stages which can be passed though normally with the attainment of acceptance stage. Acceptance attainment renders a description maintaining that grief in its process is undergone normally through uncomplicated grief reaction and emotional responsiveness. A diabetics who manages to attain the acceptance stage will have a better glycemic control, while a diabetics with a low acceptance stage may experience an ineffective coping, improper self-treatment, and distress increase, all of which end up in a bad glycemic control which causes physical complications. This suggests that a description of s’ acceptance stage is important to identify. Accordingly, the aim of this research is to identify and analyze the description of diabetics’ acceptance of DM diagnoses. The method utilized is descriptive-observational, the data collected using the ‘Acceptance of Disease and Impairments Questionnaire’ (ADIQ). The analysis employed in this research is a descriptive analysis. The sampling technique used is consecutive sampling. The research result shows that, based on the diagram of ADIQ administered on 20 s, there are 30% found to be in the stage of acceptance, while there exist 70% to be in the stage of not yet attaining acceptance, which comprises denial (20%), resistance (10%), and sorrow (40%). Failure in attaining the acceptance stage is caused by the s’ still being in the states of denial, resistance, and sorrow. Based on the research result, it can be concluded that the s dominantly stay at the stage of not yet attaining acceptance. The diabetics who have attained acceptance may still be exposed to the risk of undergoing a maladaptive response which may trigger depression, anxiety, worsened physical health, self-treatment discontinuation, powerlessness, low self-esteem, social isolation, even suicidal drive. This is all caused by grief which constitutes a fluctuate condition where every diabetes can contribute to describing his or her condition at every stage.</p><p> </p><strong><em>Keywords</em></strong><em>: stages of grief, acceptance, denial, resistance, sorrow</em>