bluuebunny/crossref_metadata_2025_split huggingface dataset:
CARACTERIZAÇÃO PSICOMOTORA DE CRIANÇA AUTISTA PELA ESCALA DE DESENVOLVIMENTO MOTOR
Authors: Santos Évelyn Crys Farias dos , Mélo Tainá Ribas 
Published: October 2018

Crianças com Transtorno do Espectro Autista (TEA) apresentam habilidades motoras reduzidas, sendo a avaliação de crianças com TEA ainda um desafio na avaliação fisioterapêutica, especialmente no que se refere à avaliação e acompanhamento do desenvolvimento neuropsicomotor.Como objetivos pretendeu-se verificar o desenvolvimento psicomotorde uma criança autista. Trata-se de uma pesquisade estudo de caso, descritiva, que analisou o desenvolvimento psicomotor de um menino de 10 anos com diagnóstico TEA por meio da Escala de Desenvolvimento Motor (EDM). Para a criança autista avaliada, de forma geral a idade motora foi negativa de 2 anos, ou seja, inferior a sua idade cronológica.Os itens psicomotores de maior atraso foram motricidade global, equilíbrio e linguagem/organização temporal. A criança com autismo do estudo apresentou atraso no desenvolvimento psicomotor, possível de detectar por meio do uso da EDM.
Prescription Opioid Type and the Likelihood of Prolonged Opioid Use After Orthopaedic Surgery
Authors: Basilico Matthew , Bhashyam Abhiram R. , Harris Mitchel B. , Heng Marilyn 
Published: October 2018

Introduction:
A common belief is that some narcotic medications have a higher association with prolonged use. We assessed whether the initial opiate type prescribed to postoperative, opiate-naive orthopaedic trauma patients was associated with prolonged opioid use.

Methods:
We studied 17,961 adult, opiate-naive patients treated for a surgical musculoskeletal injury. Discharge prescription in morphine milligram equivalents (MMEs, a standardized dosing unit that allows for comparison across opioid types) was calculated. Opioid prescribing beyond 90 days after injury was defined as prolonged use.

Results:
Initial analysis demonstrated a higher likelihood of prolonged use for patients discharged on hydromorphone or morphine versus hydrocodone. However, when we adjusted for discharge MME, only opioid quantity was predictive of prolonged use (P < 0.001). In addition, discharge MME was associated with opioid type (P < 0.01).

Discussion:
Persistent opiate use was associated with discharge opioid quantity, not the opioid type. These results highlight the importance of calculating equivalence doses when selecting opioid types and considering amount of narcotics prescribed.

Level of Evidence:
Level III
Cigarette availability to minors
Authors: Naum George P. , Yarian David O. , McKenna James P. 
Published: October 2018

Abstract
Each year, more than 1 million children and adolescents begin smoking, and an average of 24% of high school students report smoking, despite existing laws that prohibit the sale of tobacco to minors. In this study, the authors observed an 11-year-old boy attempt to purchase cigarettes at 57 retail establishments in western Pennsylvania to determine if the existing laws do, indeed, limit children's access to buy cigarettes. This study took place between August 15, 1993, and October 2, 1993. The establishments included convenience stores, gas stations, liquor distributors, and restaurants. One of the researchers entered each establishment to look for the posting of the state law prohibiting the sale of cigarettes to minors after their underage subject had requested cigarettes from the salesclerks. The researcher also inquired of the salesclerks if they were aware of the state law. In 30 of the 57 attempts (53%), the 11-year old student would have been able to purchase cigarettes. Of these attempts, 53% would have sold them on his first request, while 47% would have sold them to him if he indicated that the cigarettes were for his dad. Only 3 of the 57 establishments (5.2%) posted the law, and 54 of the 57 clerks (95%) were aware of the cigarette law.
Functional abilities of elderly survivors of intensive care
Authors: Broslawski Gregory E. , Elkins Michele , Algus Michael 
Published: October 2018

Abstract
In a prospective, randomized study undertaken to determine if age, length of hospital stay, or severity of illness are predictors of future functional status after intensive care unit (lCU) admission, 45 patients were evaluated. Pre-ICU functional status was determined by using Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Geriatric Depression Scale (GDS), and Mini-Mental State (MMS) examinations. Severity of illness was assessed by using the Acute Physiology Assessment and Chronic Health Evaluation (APACHE-II) system. There were no significant differences in age or APACHE-II score at 6-month followup. However, in those patients who had decreased ADL and IADL scores, ICU and total hospital length of stay were two and three times longer, respectively. Functional status at 6-months was unrelated to age or severity of illness, but correlated with the length of ICU and total hospital stay. Advanced age and severity of illness should not be used to predict future functional ability.
Standardization of the hospital record for osteopathic structural examination: Recording of musculoskeletal findings and somatic dysfunction diagnosis
Authors: Friedman Harry D. , Johnston William L. , Seffinger Michael A. 
Published: October 2018

Abstract
The diagnosis of somatic dysfunction is supported by the recording of positive musculoskeletal findings (altered structure, motion, tissue). We conducted a national survey to assess the status of the documentation of this relationship in the hospital setting. The 26 participating osteopathic training hospitals submitted 719 admitting physical examination forms, of which 417 (58%) met study criteria (adult patients on medicine or surgical service with a musculoskeletal examination documented on the chart). On 234 charts (56%), at least one positive finding was recorded but no diagnosis of somatic dysfunction was stated. Of 14 charts with a diagnosis of somatic dysfunction, 10 had a positive musculoskeletal finding recorded. The relationship between positive musculoskeletal findings and somatic dysfunction is not being documented on osteopathic training hospital admitting physical examination forms. Proper documentation of a somatic dysfunction diagnosis and related positive musculoskeletal findings will enable multi-site research on the relationship between somatic dysfunction and other health problems documented on the hospital medical record. A multiple data collection system that is workable, reliable, and reproducible was developed as a result of this study.
Nonprescription, padded, lightweight support socks in treatment of mild to moderate lower extremity venous insufficiency
Authors: Brown Jack R. , PharmD Alice M. Brown 
Published: October 2018

Abstract
Currently, strength greater than 20 mm Hg of compression is considered necessary for support hose used to treat symptomatic venous insufficiency in lower extremities. This strength is frequently uncomfortable, which reduces compliance and therefore clinical effectiveness. Whether more comfortable, nonprescription, light compression support hose is effective in the treatment of mild to moderate venous insufficiency was investigated in 36 men with subjective complaints and objective signs (per Doppler ultrasound) of lower extremity venous insufficiency. All participants wore padded, light-compression (6 mm Hg), crew-height socks for 1 month. Then, participants were assigned to one of two groups on the basis of initial Doppler results. The half with the worst results wore stronger-compression (12 mm Hg) over-the-calf support socks, on the assumption that patients with worse venous insufficiency would require more support; those with the better Doppler results continued to wear the light-compression socks. Participants were retested at monthly intervals for 3 months. In each group, data indicated that the venous insufficiency for all patients improved objectively and subjectively. Many of the objective venous values improved with either statistical or highly statistical significance-specifically deep venous valve function, superficial venous valve functions, and venous capacity-without statistically altering arterial function. Improvement occurred in the first month of the trial and continued throughout the study. The use of light-compression support socks is effective and should be considered as a first line of therapy in treatment of mild to moderate venous insufficiency.
Ciguatera: Current concepts
Authors: Levine David Z. 
Published: October 2018

Abstract
Ciguatera poisoning develops after ingestion of certain coral reef-associated fish. With travel to and from the tropics and importation of tropical food fish increasing, ciguatera has begun to appear in temperate countries with more frequency. The causative agents are certain varieties of the protozoan dinoflagellate Gambierdiscus toxicus, but bacteria associated with these protozoa may have a role in toxin elaboration. A specific "ciguatoxin" seems to cause the symptoms, but toxicosis may also be a result of a family of toxins. Toxicosis develops from 10 minutes to 30 hours after ingestion of poisoned fish, and the syndrome can include gastrointestinal and neurologic symptoms, as well as chills, sweating, pruritus, bradycardia, tachycardia, and long-lasting weakness and fatigue. More severe features are rare. In this review, the pathophysiologic features and symptoms of ciguatera are reviewed and compared with those of other seafood-related syndromes. Although no definitive therapy is known, the most promising treatment for ciguatera is intravenous administration of mannitol. Physicians should warn patients who are traveling to endemic areas about this toxicosis.
Unplanned splenectomy—harbinger of complications
Authors: Spencer CDR David D. , Ragland CAPT Jerry J. , Limjoco CAPT Uriel R. , Rubio LCDR Carlos E. 
Published: October 2018

Abstract
Splenectomy alone or in combination with other major operative procedures has been implicated as the cause of excessive morbidity and mortality. We retrospectively studied 151 consecutive patients with splenectomy performed between 1985 and 1992. Subsets of patients according to indication for splenectomy were compared with a cohort of patients having elective open cholecystectomy. Morbidity with elective splenectomy (11.5%) was not significantly increased over that with elective open cholecystectomy (6.8%). Morbidity with nonelective splenectomy (40.4%) was increased when compared with that of elective splenectomy (11.5%) or with elective open cholecystectomy (6.8%). Mortality was significantly worse for nonelective (10.6%) than for elective splenectomy (1%). Nonelective splenectomy should be recognized as one event in a cascade of events leading to excessive morbidity and mortality. Splenectomy should not be implicated as the sole or primary cause of such excesses.
Acute myocarditis presenting as acute myocardial infarction
Authors: Silverman Alan J. , Kapadia Nafisa , Borin Andrew J. 
Published: October 2018

Abstract
Myocarditis, often caused by an infectious agent, may have a presentation mimicking that of acute myocardial infarction. The authors describe a young man who, when first seen in the emergency department, appeared to have an acute myocardial infarction with normal coronary arteries. At autopsy, the histologic findings were diagnostic of active myocarditis, mixed-cell type. Neutrophilic infiltration with microabscess suggested an infectious cause, although the etiology was uncertain. The patient's clinical course, pathologic' findings, and several treatment modalities are discussed The differentiation between acute myocardial infarction and acute myocarditis can be difficult. Electrocardiographic changes and enzyme elevations are common in both. Therefore, clinicians should consider myocarditis in all patients-particularly young patients with normal coronary arteries and suspected myocardial infarction.
Effects of different intermittent mandatory ventilation rates on oxygen consumption in premature infants recovering from respiratory distress syndrome
Authors: Greenspan Jay , Locke Robert G. 
Published: October 2018

Abstract
Oxygen consumption at intermittent mandatory ventilation (IMV) rates of 10 and 20 breaths per minute was evaluated to determine whether a higher IMV rate in mechanically ventilated premature infants with apnea and respiratory insufficiency would reduce metabolic expenditure. Ten studies were performed in seven infants, with three infants studied twice after a trial of failed elective extubation. The mean birth weight was 952 ± 183 kg (SD), and the mean postnatal age was 12 ± 8 days (SD). Mean oxygen consumption per kilogram of body weight was not significantly related to pulmonary resistance, dynamic lung compliance, or resistive work of breathing. Mean oxygen consumption was not altered at the different IMV rates. The oxygen consumption difference at the two IMV rates was not significantly related to dynamic lung compliance, resistance, or work of breathing. These results demonstrate that mechanically dependent premature infants without bronchopulmonary dysplasia do not have significant alteration in oxygen consumption with changes in IMV. This finding suggests that there is no potential metabolic energy balance benefit in use of moderately higher IMV rates to achieve improved growth rates in this population of infants.
Performance of osteopathic medical school graduates on the American Osteopathic Board of Internal Medicine certifying examinations 1985 to 1994
Authors: Slick Gary L. , Dolan Sandra , Draba Robert E. 
Published: October 2018

Abstract
This study examined the trends in the medical knowledge of osteopathic internal medicine residents in American Osteopathic Association-approved residency programs during a recent 10-year period and compared these trends with the declining medical knowledge observed for internal medicine residents graduated from allopathic medical schools and trained in allopathic residency programs. These results demonstrate a similar pattern of declining medical knowledge that appears to have leveled off during the past few years of the study. These trends occurred among candidates from both large and smaller training institutions. Various factors may have contributed to these observations.
Obstructive sleep apnea: A multisystemic disorder
Authors: D’Alonzo Gilbert E. , Kaluza Charles L. , Krachman Samuel L. 
Published: October 2018

Abstract
Obstructive sleep apnea is a multisystemic disorder with pathologic sequelae that become apparent after a number of years. Patients with obstructive sleep apnea generally present with hypersomnolence, and diagnosis is eventually established through observation of the patient during sleep. Patients with obstructive sleep apnea snore loudly and experience nocturnal oxygen de saturation and repetitive disruptions from sleep that eventually lead to daytime hypersomnolence. Numerous complex interactive pathophysiologic events occur during each obstructive episode, and it is important for the clinician to be aware of the cardiopulmonary, neurologic, and anatomic abnormalities associated with this condition. The anatomic configuration of the pharynx and the physiologic response to occlusion of the upper airway have a major role in the pathogenesis of this disorder. Alveolar ventilation during an apneic episode is immediately reduced to zero, and the metabolic demands for oxygen must be met by oxygen stores within the body. With repetitive episodes of obstruction, the oxygen stores within the lungs are diminished and the rate of arterial oxyhemoglobin desaturation increases. During apneic episodes, the systemic blood pressure increases while heart rate and cardiac output decrease. Bradydysrhythmias have been noted with the obstructive apneic episodes, and ventricular dysrhythmias are associated with episodes of severe oxyhemoglobin de saturation. Coexisting cardiopulmonary or neuromuscular disease in patients with obstructive sleep apnea contributes to the development of hypoventilation, serious gas exchange derangement, and general cardiovascular instability
The application of antitrust laws to the healthcare industry
Authors: Kiss Lois E. , Ross-Lee Barbara , Weiser Michael A. 
Published: October 2018

Abstract
The move toward managed care initiatives and multi provider networks has intensified in recent years in response to escalating healthcare costs and increasing market dominance by the insurance industry. As a consequence, the antitrust laws have played a significant role in defining the limits of physician cooperation. An understanding of the application of antitrust laws to evolving healthcare delivery systems and a knowledge of the specific areas where providers must exercise caution are essential to physicians' strategic planning. This article looks at the major areas of innovation emerging in the healthcare delivery market and details some of the most important guidelines for safeguarding physician collaborations. The authors compare the ability of physicians and insurers to organize integrated care systems and question the continued protection of the insurance industry under the McCarran-Ferguson Act.
Pneumoscrotum: An unusual complication of pulmonary resection
Authors: Raudat Charles W. , Katris Francis , Woodhall Dennis 
Published: October 2018

Abstract
Pneumoscrotum occurred in a 53-year-old man as a complication after pulmonary resection for carcinoma. Recognition of this entity and its conservative management are crucial to a positive outcome and prevention of unnecessary interventions based on the differential diagnosis. A review of the literature is included with this description of an unusual complication.
Spontaneous hemoperitoneum
Authors: Lucha LCDR Paul A. 
Published: October 2018

Abstract
Massive hemoperitoneum seen without an obvious precipitating event is rare. A 21-year-old man was seen with diffuse abdominal pain of 48 hours' duration. He had no fever, nausea, or vomiting, and most laboratory values were normal. Exploration of the abdomen revealed free intraperitoneal blood with clotting but failed to reveal a source. The patient could recall no trauma or other inciting event. The only abnormalities found during laparotomy were multiple adhesions of the omentum to the lateral abdominal wall and localization of most of the clot within the greater omentum. The author cautions that a high index of suspicion followed by laparotomy are the management tools for controlling spontaneous hemoperitoneum. Conservative management produces a high mortality rate.
Osteopathic manipulative treatment applications for the emergency department patient
Authors: Paul Frank A. , Buser Boyd R. 
Published: October 2018

Abstract
The emergency department (ED) setting offers osteopathic physicians multiple opportunities to provide osteopathic manipulative treatment (OMT) as either the primary therapy or as an adjunct to the intervention. In doing so, osteopathic physicians can decrease or eliminate the morbidity and symptoms associated with protracted dysfunction. Low back pain, chest pain, torticollis, asthma, and sinusitis are some of the illnesses in which OMT should be implemented as part of the management plan, note the authors. They provide a guide to the general usage of OMT when the aforementioned illnesses present themselves in ED patients, but also emphasize the importance of first ruling out any underlying illnesses that could be manifested by musculoskeletal symptoms.
Effects of thyroid hormone treatment on 31P-NMR spectroscopy of muscle and on nerve conduction studies in a patient with long-standing severe hypothyroidism
Authors: Reeves, Roy 
Published: October 2018

Abstract
Hypothyroidism exerts a significant effect on several body systems, including the functioning of muscle and nerve. Described here is the case of a severely hypothyroid patient with weakness and numbness of the legs who showed marked clinical improvement with thyroid hormone treatment. Concurrently obtained phosphorus 31-nuclear magnetic resonance (NRM) spectra and nerve conduction studies showed changes in muscle phosphorus metabolism with increases in conduction velocities. Phosphorus 31-NMR spectroscopy is useful for evaluating metabolism in muscle in hypothyroid patients.
Acute appendicitis secondary to non-0 group I Vibrio cholerae
Authors: Cook Michael A. , Nedunchezian Deeptha , Manfredi Orlando L. 
Published: October 2018

Abstract
Acute appendicitis is the most common abdominal surgical condition and is usually associated with colonic flora. The patient described had acute appendicitis associated with an uncommon microorganism. This report underscores the importance of obtaining an adequate occupational, travel, and dietary history.
МОРФОСТРУКТУРНЫЙ АНАЛИЗ ПРИ РЕШЕНИИ ГЕОЛОГИЧЕСКИХ ПРОБЛЕМ ВОСТОКА АЗИИ, "Геоморфология"
Authors: Изосов Л.А. , Чупрынин В. И. , МЕЛЬНИЧЕНКО Ю.И. , Ли Н.С. 
Published: October 2018

Окраинные моря Западно-Тихоокеанской зоны перехода континент-океан рассматриваются как вихревые структуры. В Япономорском регионе (ЯР) применение линеаментного анализа (комплекса геоморфологических, геологических и геофизических методов) позволило выявить в континентальной части Япономорского региона рудоконтролирующие зоны (эндогенного оруденения, месторождений алмазов и др.), скрытых разломов фундамента и магматических очаговых структур, а на дне Японского моря разломных структур. В регионе: 1) выявлены три литосферные вихревые морфоструктуры - Япономорская (ЯМ), Нижнеамурская (НА) и Сунляо (СЛ), 2) выделены два структурных этажа: мантийный и литосферный, включающие, соответственно, тектонический каркас и вихревые структуры, тесно связанные с подстилающей астеносферой. ЯМ морфоструктура отражает процесс раскрытия Японского моря - как результат взаимодействия Евроазиатской и Тихоокеанской плит; НА - соответствует межгорная впадина, с которой на западе сочленяется нефтегазоносная депрессия Сунляо вихревого типа. В ЯР развиты нефтегазоносные мезокайнозойские осадочные бассейны, представляющие литосферные вихри. Линеаментный анализ позволит по-новому прогнозировать характер миграции углеводородов в земной коре и выявлять предполагаемые места их скопления. Этот метод может быть использован в процессе подготовительного этапа при исследовании нефтегазоносности Западно-Тихоокеанских окраинных морей, а также Арктических бассейнов.
Vibration measurement and structural performance evaluation of a 17th century timber guest house in Japan
Authors: Toyoda Takahiro , Fujita Kaori , Takano Kiyoshi 
Published: October 2018

AbstractTo clarify the actual structural performance of an existing traditional timber structure in Japan, vibration measurements were carried out at a 17th century timber guest house (Gekkouden of Gokokuji temple). The results of the micro tremor measurement, earthquake monitoring, and analysis are discussed in this paper. For minute angles of less than 1/5000 rad, it was revealed through earthquake monitoring that each dominant frequency was strongly dependent on the vibration amplitude. It was also confirmed that the dominant frequencies of the lower vibration modes in 1/1000 rad declined to 65%‐75% of the frequencies obtained through micro tremor measurement. We propose a structural model that consists of a joint spring, column, beam, and hanging wall, based on previously reported experiments. In this study, it was clarified that the dominant frequencies determined by the analysis of the proposed structural model were in good agreement with the frequencies obtained through earthquake monitoring.