bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nas trilhas da resistência:
Authors: Colasante Tatiana , Pereira Amanda Gomes , Castro Helena Maria de 
Published: November 2024

Apresentamos nesse ensaio os resultados de uma pesquisa de ação extensionista que privilegia comunidades do interior do Maranhão. Nosso objetivo envolve mulheres que vivem em contextos de vulnerabilidade social, marcadas pelas mais distintas dificuldades em seu cotidiano. Privilegiamos uma abordagem qualitativa que envolve elementos transcritos e analíticos de entrevistas realizadas em parceria com a Secretaria da Mulher de Santana do Maranhão. Com isso, desvendamos a relação das mulheres com o território do Baixo Parnaíba Maranhense levando em consideração dimensões econômicas, sociais e culturais permeadas pela experiência de ser mulher. Os resultados apontam obstáculos àquelas que são mães trabalhadoras e ocorrências de vários tipos de violência que são impostas a elas. Ao nos aproximarmos da realidade dessas sujeitas, buscamos uma pesquisa-ação com viés cidadão, que possa contribuir para que se tenham políticas públicas que atendam às reais necessidades dessas mulheres, assegurando a proteção dos seus direitos e trazendo oportunidades para melhoria de qualidade de vida.
Impact of Surgeon Volume on Perioperative Complications and Survival to Total Hip Arthroplasty Following Femoral Head Core Decompression
Authors: Sanchez Joshua G. , Jiang Will M. , Dhodapkar Meera M. , Radford Zachary J. , Seddio Anthony E. , Li Mengnai , Wiznia Daniel , Grauer Jonathan N. 
Published: November 2024

Introduction:
Core decompression is a minimally invasive procedure considered in the treatment of early-stage femoral head osteonecrosis. This procedure is theorized to relieve vascular pressure and promote angiogenesis. Although a less invasive procedure, there are considerations related to learning curve, technique variations, etc. that may affect postoperative complications and longer term adverse events.

Methods:
Adult patients who underwent core decompression with a diagnosis of femoral head osteonecrosis were identified in the 2010-Q3 2021 PearlDiver M157 database. Core decompression surgeon volumes over the entire study period were assessed and divided into ranges: low (<5 procedures), medium (5 ≤ x ≤ 19 cases), and high (>19 cases) volumes. A 1:1:1 match based on age, sex, and Elixhauser Comorbidity Index was completed. Rates of 90-day complications were compared with univariable and multivariable analyses. Survival to total hip arthroplasty (THA) and to subsequent hip fracture at both 2 and 5 years were compared by Kaplan-Meier survival analysis.

Results:
The low-volume, medium-volume, and high-volume surgeon groups made up 87.5%, 11.9%, and 0.2% of core decompression volume, respectively. This was indicative of 6333 patients undergoing core decompression, and matching based on the surgeon-volume category led to 486 patients per group. No statistically significant differences were observed in shorter term complications and survival to THA or hip fracture at 2 or 5 years.

Conclusion:
Core decompression is a treatment option often considered for early-stage osteonecrosis. Critically, no differences were found in rates of any assessed complications between the surgeon-volume matched cohorts. These findings suggest that core decompression is a relatively safe procedure for surgeons of varying volume with this technique. Furthermore, this study suggests that higher volume surgeons are not conducting the procedure with expanded indications that might result in greater rates of conversion to THA.
Rethinking the Role of Formal Physical Therapy in Glenohumeral Osteoarthritis: A Nationwide Study Comprising More than Two Million Patients in the United States
Authors: Hoveidaei Amir Human , Ghaseminejad-Raeini Amirhossein , Kanaani Nejad Fatemeh , Moosaie Fatemeh , Mohammadi Sara , Saeid Khonji Mohammad , Nwankwo Basilia Onyinyechukwu , Gilotra Mohit N. , Conway Janet D. 
Published: November 2024

Introduction:
This study aims to determine whether incorporating physical therapy into a nonsurgical approach can effectively manage the course of glenohumeral osteoarthritis (OA) and potentially prevent patients from requiring total shoulder arthroplasty (TSA).

Methods:
This retrospective cohort consisted of patients diagnosed with glenohumeral OA between 2010 and 2021 using ICD-9, ICD-10, and current procedural terminology codes in the PearlDiver database. Two- and five-year TSA rates were compared between patients who had physical therapy within 1 year after glenohumeral OA diagnosis and patients who did not.

Results:
The study consisted of 2,710,463 patients with glenohumeral OA. After propensity score matching, among patients with corticosteroid injection, patients who received physical therapy had significantly higher 2- and 5-year TSA rates compared with those without physical therapy (2-year TSA: 0.60% vs. 0.35%, OR [95% CI]: 1.74 [1.50, 2.01] and 5-year TSA: 1.13% vs. 0.65%, OR [95% CI]: 1.74 [1.56, 1.93]). A similar association was also significant among patients without corticosteroid injection (0.35% vs. 0.16%, OR [95% CI]: 2.17 [2.03, 2.21] and 0.78% vs. 0.37%, OR [95% CI]: 2.11 [2.01, 2.21]).

Conclusion:
Individuals who had physical therapy as a part of their nonsurgical treatment did not have any decrease in the probability of requiring TSA.
Disparities in 1-Year Follow-up Rates After Proximal Humerus Fractures Treated With Open Reduction and Internal Fixation
Authors: Tornberg Haley , Derector Evan , Bhat Vipul , Roelker Leandra , Fedorka Catherine J. 
Published: November 2024

Background:
Proximal humerus fractures (PHFs) impose a serious burden on patients and are commonly treated with open reduction and internal fixation (ORIF). Several factors influence functional outcomes in treating PHFs. This study aims to evaluate how social determinants of health affect postoperative follow-up rates of patients treated with ORIF for PHF.

Methods:
A single-center retrospective review included 92 patients treated with ORIF for PHF. Loss to follow-up was defined as failing to return after the last advised follow-up. Patient zip codes were used to determine median household income as determined by the US Department of Housing and Urban Development (HUD) and the Federal Reserve and social disadvantage using the Social Deprivation Index (SDI).

Results:
A significant difference was observed in 12-month loss to follow-up rates between HUD and SDI subgroups. No difference was found in 6-month loss to follow-up rates or the reasons that patients were lost to follow-up among HUD, Federal Reserve, and SDI subgroups.

Conclusion:
Patients from areas of greater socioeconomic deprivation exhibited the highest 12-month loss to follow-up rates, emphasizing the importance of targeted interventions, such as in-house social workers and improved visit reminders, to address postoperative attrition and enhance patient care.
Congenital Curly Toes in the Pediatric Population: A Management Algorithm and Systematic Review
Authors: Morcos Mary M. , Paek Samuel , Ting Caleb , Mo Michelle , Hogue Grant D. 
Published: November 2024

Purpose:
This study aims to formulate a systematic management algorithm for pediatric congenital curly toes (CCTs), addressing the lack of standardized guidelines. By synthesizing the existing literature, the study evaluates CCT presentation, evaluation, treatment options, and outcomes.

Methods:
A systematic review on PubMed identified nine articles, involving 346 patients younger than 18 years with CCTs. Data extraction included presentation, evaluation, treatment modalities, and outcomes.

Results:
The analysis revealed that pediatric CCTs predominantly present in younger children. Clinical presentation often involves family concerns or referrals from primary care physicians, emphasizing the aesthetic nature of the condition. The most affected toes are the fourth (43.8%) and fifth (25%). Evaluation methods vary, with the Hamer grading scale and Satake imaging system being prominent. Nonsurgical treatments, including taping and observation, are favored for mild cases (grade 0 to 1), whereas surgical interventions, such as tendon transfer and flexor tenotomy, are reserved for moderate to severe cases (grade 2 to 3). Results indicate that conservative treatments yield varied outcomes, with surgical interventions demonstrating more favorable and permanent results, especially for Grades 2 to 3 deformities.

Conclusion:
This study proposes a stepwise management algorithm integrating clinical presentation, severity grading, and age-specific considerations for pediatric CCTs. The aim is to guide both nonsurgical and surgical interventions, enhancing clinical decision making for improved patient outcomes. Further research is recommended for algorithm validation.
Combined Single-Shot Intra-articular Injection of Ropivacaine and Contrast Media for Magnetic Resonance Imaging: Surgical Decision Making for Hip Arthroscopy in Young Patients
Authors: Sarna Neil , Onor Gabriel I. , Schenker Kathleen E. , Su Alvin W. 
Published: November 2024

Introduction:
Hip impingement syndrome with labral tear is debilitating for young patients. When magnetic resonance arthrogram (MRA) is equivocal for surgical decision making, an additional intra-articular diagnostic injection (IA) can further confirm the diagnosis. We assessed the effectiveness on surgical decision making by combining hip MRA + IA in one single procedure.

Methods:
We conducted a retrospective review of a prospectively enrolled cohort of patients with hip impingement syndrome who underwent a combined MRA + IA procedure. A 10-mL cocktail containing 0.2% ropivacaine and Omnipaque 300 contrast media was injected into the hip joint, followed by magnetic resonance scanning, in one single outpatient procedure. Patient demographics and MRA findings were documented. Preinjection pain and immediate postinjection pain were assessed using the visual analog scale (VAS). Surgical finding under hip arthroscopy was documented in those who had positive symptomatic relief after injection.

Results:
26 patients (7 adolescent boys, 19 adolescent girls, median age 17 years) were analyzed. The VAS score improved from before injection to after injection (5.0 ± 2.6 vs. 2.2 ± 2.1, mean ± SD, P < 0.0001). 1 patient reported no postinjection improvement and had no labral tear identified under hip arthroscopy; all the other 25 patients reported postinjection improvement and had labral tears repaired under hip arthroscopy; 4 among these 25 had negative MRA findings. The average Cam lesion alpha angle was 63.4 ± 7.1°.

Conclusions:
Combined hip MRA + IA is effective for surgical decision making. One single injection procedure is efficient for both patients and surgeons by eliminating an additional visit and saving costs and lead time for surgical decision making. Avoiding a second needle insertion is also preferable among pediatric and adolescent patients.
CHRONIC DIARRHOEA: NOT A RARE PRESENTATION OF VITAMIN B 12 DEFICIENCY
Authors: Adil Noreen , Mehraj Adil , Khan Jamila , Bhutta Sohail , Jamil Muzamil , Aslam Mujahid 
Published: November 2024

Background: Diarrhoea is defined as stool frequency of more than three times in twenty-four hours or a stool weight of more than two hundred grams and it is labelled as chronic diarrhoea if it persists for more than four weeks. Chronic diarrhoea is a common gastrointestinal problem worldwide that affects three to fifteen percent of population. Objective was to determine the efficacy of vitamin B 12 replacement in treatment of chronic diarrhoea in vitamin B deficient patients. It was a Quasi-experimental study carried out at Pakistan Ordinance Factory (POF) Hospital Wah Cantt, from September 2023 to February 2024. Methods: All the new patients of chronic diarrhoea of ages between 12–65 years who had low serum vitamin B 12 and normal serum folate levels were included in the study. The patients were booked from Medicine and Allied outpatient and they were given parenteral vitamin B12. The sub-set of patients in whom diarrhoea was settled was followed up till six months. The efficacy was defined as settlement of diarrhoea with parenteral vitamin B12 within one week. The secondary outcomes were adequacy of serum vitamin B12 levels at 2 weeks, three months and six months after treatment. All patients (100%) had adequate B12 levels till follow up. Data was analyzed through SPSS. Results: Efficacy of parenteral B12 supplementation was seen in 16 (76.2%) patients. Out of sixteen patients who responded to vitamin B12 supplementation, 10 (47.6%) patients showed improvement in less than two days, 5 (23.8%) showed improvement in less than four days and 1 (4.8) patient stopped experiencing diarrhoea within seven days of intramuscular vitamin B12 with p-value of <0.001. Conclusion: Replacement of vitamin B 12 in patients with chronic diarrhoea having low vitamin B 12 results in settlement of diarrhoea.
Multidimensional Challenges and its Impacts on the Security of Pakistan
Authors: Ali Naeem , Arshad Faiza 
Published: November 2024

Over the last decades, internal challenges faced by Pakistan include a fractured state and society, weak governance, fragile institutions, extremism and poor economy which are also affecting the image of Pakistan in the outer world as well. This research explains the nature of security challenges and its impacts on the stability of the society and the state. It is an attempt to dig out the security issues and its influence on the state and society of Pakistan. According to complex mix of the nature of challenges has created the security threats for Pakistan, these are divided into two types, internal and external. The technological, cultural, political, social, religious, economic environmental and self-security are internal, while defense, nuclear proliferation, geography and foreign threats including in the major external threats or challenges for Pakistan. The greatest challenge that the Pakistani government and its people are facing, concerned with the national security. The inability of Pakistani security institutions are may not fully equip and ready to meet the internal and external security challenges effectively. The research is an attempt to create an alternative reading of various security threats related to the people at the social, political and economic levels in Pakistan. All these elements are negatively influencing the image of Pakistan at the international level as well
Impact of Deep Diaphragmatic Breathing with Virtual Reality on Blood Pressure in Patient with Hypertension: A mini Review
Authors: Younan Mona Eid , Ahmed Ahmed M , Ahmad Shimaa Hassan Hamdy , Abdel Ghaffer Heba Ali 
Published: November 2024

Virtual Reality (VR) offers a promising drug-free approach to relaxation for people with psychiatric issues. Studies show VR relaxation not only helps manage stress but also promotes positive emotions and decreases blood pressure.
Compared to traditional relaxation techniques, VR requires less mental effort and delivers a more significant boost in positive feelings.
The results of the current review indicate that VR with deep diaphragmatic breathing may be associated with a blood pressure-lowering effects for adult people with hypertension. Also VR technology can be used as a good facilitator of different practices for stress reduction and treatment of chronic pain (for example by meditation practices). The immersive and interactive nature of VR adds a positive effects for different modalities as it creates a semi-real environment and give the patient the sense of achievement.
Fisioterapia na paralisia facial periférica ou paralisia de bell
Authors: Rocha Elisangela da Silva , Silva Fabiana Rosa da , Almeida Fernanda Barbosa de , Andrade Gláucia de Jesus , Freitas Iohana Nunes de , Barros Izabela de Souza , Pereira Leidiana Avila , Rodrigues Laura de moura , Cavalcante Fabrício Vieira 
Published: November 2024

A paralisia facial periférica (PFP) ou paralisia de Bell (PB) é determinada pela fraqueza facial, ocasionada pela paralisia do sétimo par craniano de forma aguda, sem causa detectável, no qual controla os músculos da face. O objetivo desse trabalho é analisar como os fisioterapêuticos que estão na prática profissional, em relação as pessoas com paralisia facial periférica, com o intuito da melhoria do desenvolvimento funcional, psicossociais e físicos das pessoas com essa paralisia. Este trabalho será realizado através de uma revisão da literatura, com o propósito de examinar as evidências científicas relacionadas a fisioterapia na paralisia facial periférica ou paralisia de bell. A revisão da literatura possibilita um levantamento teórico sistemático e abrangente, integrando diversas fontes para consolidar o entendimento acerca do tema em discussão. Os resultados do estudo foram categorizados e planejados com base nos principais re-sultados clínicos observados, como a recuperação da simetria facial, a melhora da fun-cionalidade muscular e a redução de complicações, como a sincinesia. Foram utilizados como critérios de inclusão, artigos publicados no período de janeiro de 2018 a dezembro de 2023, que contemplavam o tema abordado, com data de publica-ção dentro dos padrões, sendo utilizados 11 (onze) artigos. Por fim, a fisioterapia desempenha um papel fundamental no tratamento da Paralisia Facial Periférica, também conhecida como Paralisia de Bell. Ela é essencial para a recuperação do paciente, oferecendo benefícios que vão além do aspecto físico, incluindo suporte psicológico e ajuda na reintegração social.
Tributação de produtos importados no Brasil: uma análise de seus efeitos econômicos
Authors: Sousa Felipe Dias de , Santos Lucas Gabriel Costa , Silva Matheus Brammer dos Santos , Silva Rhafaella Cleisma Costa , Carmo Vanessa Ferreira do , Luz Crislene Divina dos Santos 
Published: November 2024

A tributação de produtos importados é um assunto de grande relevância para a economia brasileira, uma vez que as políticas fiscais relacionadas a esse tema podem impactar diversos setores e influenciar o comércio internacional do país. Neste artigo, realizamos uma análise das regras sobre tributação de produtos importados no Brasil e seus impactos econômicos. Exploramos as principais leis e regulamentações vigentes, examinando os impostos incidentes sobre as importações, como o Imposto de Importação, o Imposto sobre Produtos Industrializados (IPI) e o Programa de Integração Social (PIS) e a Contribuição para o Financiamento da Seguridade Social (COFINS) incidentes sobre as importações, hipótese de incidência, o fato gerador e a competência tributária. Neste estudo, serão analisados os impactos econômicos dessas políticas, como o efeito sobre os preços dos produtos importados, a demanda doméstica, a produção local, o investimento estrangeiro e o crescimento econômico, como também as regras de tributação das plataformas digitais (SHEIN, SHOPEE E ALIEXPRES). Será discutido as práticas de sonegação fiscal e descaminho e a informalidade no comércio exterior, o que pode gerar perda de receita para o governo e prejuízos para a indústria nacional e como a tributação é um mecanismo de desenvolvimento econômico.
A study on the difficulties of practicing reverse logistics by an association of waste pickers in the city of Manaus
Authors: Souza Roberta de Oliveira , Nascimento-e-Silva Daniel 
Published: November 2024

Sustainability has been a growing concern worldwide, with reverse logistics being its most relevant ally. This study aimed to analyze the difficulties encountered in the practice of reverse logistics by an association of solid waste collectors operating in the city of Manaus. It used the survey method, whose data was collected from interviews and observations, analyzed using the content analysis technique, and presented through photographs. The results showed five stages of the reverse logistics process: reception, sorting, separation, and mixing of the material and pressing of the raw material produced, as well as the difficulties encountered in all phases of reverse logistics (internally and externally). The conclusion shows that the difficulties can be summarized in the lack of personal protective equipment, machines, and equipment for handling the material and storage of the collected material and the lack of vehicles for transporting and moving the waste internally and externally and the finished product to the association's customers.
Incidência de sífilis congênita na região norte do Brasil nos anos de 2012-2023
Authors: Silva Bianca Beatriz Moreira da , Bertelli Ellen Vanuza Martins , Oliveira Jacqueline Voltolini de 
Published: November 2024

Objetivo: Descrever a incidência de sífilis congênita notificada nos estados da região norte do Brasil nos anos de 2012-2023. Metodologia: Trata de um estudo epidemiológico do tipo ecológico de série temporal dos casos de Sífilis Congênita nos sete estados da Região Norte do Brasil do ano de 2012 a 2023 com base nos dados do Sistema Informação de Agravos de notificação, (SINAN), extraídos do site do Departamento de Informática do SUS (DataSUS), na aba Tabnet. Para o cálculo das taxas utilizou-se o número de Casos Notificados Por Unidade Federativa e ano, dividido pelo número de nascidos vivos no mesmo estado e ano, multiplicado por 1.000 na análise da tendência utilizou-se o método de regressão linear segmentada Joinpoint. Resultados: No período do estudo a maior taxa de incidência de sífilis congênita foi identificada no ano de 2021 no estado do Amapá (18,74/1.000NV). O maior incremento das taxas foi visualizado no período de 2014-2017 no estado do Amazonas com 78,13% ao ano (p:0,037). Conclusão: Houve crescimento em toda a região norte. A pandemia interferiu nas taxas de sífilis congênita. Roraima teve a maior constante de crescimento, provavelmente impulsionado pelo movimento migratório. Tal fator é a evidência de que as ações dos estados e seus respectivos municípios não tem surtido efeitos esperados, cujo primeiro seira estagnar o crescimento, para então reduzir a incidência.
Aprendizaje basado en la indagación (STEAM) para la enseñanza de la multiplicación
Authors: Márquez Vaquera Graciela , Mata Ríos David 
Published: November 2024

El trabajo por proyectos, hoy en día representa el principal medio de planificación a través del cual se lleva a cabo el proceso de enseñanza-aprendizaje en las aulas de educación primaria en México. La SEP (2022) ha propuesto para ello, la implementación de cuatro metodologías, de las cuales, el presente escrito enfatiza a la Metodología del Aprendizaje Basado en Indagación (STEAM), conformada por cinco fases: introducción al tema, diseño de la investigación, organizar y estructurar las respuestas a las preguntas, presentación de los resultados y metacognición. La presente investigación documenta una experiencia de aprendizaje para el abordaje de la enseñanza de la multiplicación con niños de segundo grado de primaria, a partir de la metodología a que se hace referencia. La enseñanza de la multiplicación mediante la Metodología del Aprendizaje Basado en Indagación (STEAM), permite a los alumnos consolidar un aprendizaje significativo, por medio de experiencias basadas en el contexto real y la resolución de diferentes problemas. El alumno, al aprender haciendo, indagando y construyendo, fomenta su autonomía, su interés, y su creatividad hacia la construcción de aprendizajes que cobran sentido al ponerlos en práctica en la vida cotidiana. Al gestionar la clase a través de esta metodología el aprendizaje de la multiplicación se construye como parte de las necesidades de los alumnos, lo cual lo hace significativo, debido a que éstos sienten motivación y gusto por aprenderlo.