bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of Emergency Physicians to Deliver Anesthesia for Orthopaedic Surgery in Austere Environments
Authors: Pierre Ogedad , Lovejoy John F. , Stanton Robert , Skupski Richard , Previl Harold , Bernard Jerry , Losonczy Lia , Walsh Mark 
Published: April 2018

Background:
Five billion people, primarily in low-income and middle-income countries, cannot access safe, affordable surgical and anesthesia care, particularly for orthopaedic trauma. The rate-limiting step for many orthopaedic surgical procedures performed in the developing world is the absence of safe anesthesia. Even surgical mission teams providing surgical care are limited by the availability of anesthesiologists. Emergency physicians, who are already knowledgeable in airway management and procedural sedation, may be able to help to fulfill the need for anesthetists in disaster relief and surgical missions.

Methods:
Following the 2010 earthquake in Haiti, an emergency physician was trained using the Emergency Physician’s General Anesthesia Syllabus (EP GAS) to perform duties similar to those of certified registered nurse anesthetists. The emergency physician then provided anesthesia during surgical mission trips with an orthopaedic team from February 2011 to March 2017, in Milot, Haiti. This is a descriptive overview of this training program and prospectively collected data on the cohort of patients whom the surgical mission teams treated in Haiti during that time frame.

Results:
A single emergency physician anesthetist provided anesthesia for 71 of the 172 orthopaedic surgical cases, nearly doubling the number of cases that could be performed. This also allowed the anesthesiologists to focus on pediatric and more difficult cases. Both immediately after the surgical procedure and at 1 year, there were no serious adverse events for cases in which the emergency physician provided anesthesia.

Conclusions:
Given emergency physicians’ baseline training in airway management and sedation, well-supervised and focused extra training under the vigilant supervision of a board-certified anesthesiologist may allow emergency physicians to be able to safely administer anesthesia. Using emergency physicians as anesthetists in this closely supervised setting could increase the number of surgical cases that can be performed in a disaster setting.
Mortality Following Periprosthetic Proximal Femoral Fractures Versus Native Hip Fractures
Authors: Boylan Matthew R. , Riesgo Aldo M. , Paulino Carl B. , Slover James D. , Zuckerman Joseph D. , Egol Kenneth A. 
Published: April 2018

Background:
The number of periprosthetic proximal femoral fractures is expected to increase with the increasing prevalence of hip arthroplasties. While native hip fractures have a well-known association with mortality, there are currently limited data on this outcome among the subset of patients with periprosthetic proximal femoral fractures.

Methods:
Using the New York Statewide Planning and Research Cooperative System, we identified patients from 60 to 99 years old who were admitted to a hospital in the state with a periprosthetic proximal femoral fracture (n = 1,655) or a native hip (femoral neck or intertrochanteric) fracture (n = 97,231) between 2006 and 2014. Within the periprosthetic fracture cohort, the indication for the existing implant was not available in the data set. We used mixed-effects regression models to compare mortality at 1 and 6 months and 1 year for periprosthetic compared with native hip fractures.

Results:
The risk of mortality for patients who sustained a periprosthetic proximal femoral fracture was no different from that for patients who sustained a native hip fracture at 1 month after injury (3.2% versus 4.6%; odds ratio [OR], 0.90; 95% confidence interval [CI], 0.68 to 1.19; p = 0.446), but was lower at 6 months (3.8% versus 6.5%; OR, 0.74; 95% CI, 0.57 to 0.95; p = 0.020) and 1 year (9.7% versus 15.9%; OR, 0.71; 95% CI, 0.60 to 0.85; p < 0.001). Among periprosthetic proximal femoral fractures, factors associated with a significantly increased risk of mortality at 1 year included advanced age, male sex, and higher Deyo comorbidity scores.

Conclusions:
In the acute phase, any type of hip fracture appears to confer a similar risk of death. Over the long term, however, periprosthetic proximal femoral fractures are associated with lower mortality rates than native hip fractures, even after accounting for age and comorbidities.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Determination of Elbow Laxity in a Sequential Soft-Tissue Injury Model
Authors: Schnetzke Marc , Bergmann Moritz , Wegmann Kilian , Müller Lars-Peter , Grechenig Stephan , Grützner Paul-Alfred , Guehring Thorsten 
Published: April 2018

Background:
The objective of our study was to analyze, under fluoroscopy, joint angulation of uninjured elbows and elbows with distinct induced collateral ligament injury.

Methods:
Twelve elbow specimens were tested for varus and valgus joint angulation using 4 different examination methods (application of both varus and valgus stress by each of 2 examiners [Examiner 1 and Examiner 2] and application of 1 and 2 Nm of torque using a calibrated electric force scale) in 4 elbow positions (in full extension with 90° of supination and 90° of pronation, and in 30° of flexion with 90° of supination and 90° of pronation). Six elbow specimens were examined under varus stress at each of 5 sequential stages: (1) intact, (2) transection of the lateral ulnar collateral ligament (LUCL), (3) complete transection of the lateral collateral ligament complex (LCLC), (4) transection of the anterior aspect of the capsule (AC), and (5) transection of the medial collateral ligament (MCL). An additional 6 elbow specimens were examined under valgus stress at 5 sequential stages: (1) intact, (2) transection of the anteromedial collateral ligament (AML), (3) complete transection of the MCL, (4) transection of the AC, and (5) transection of the LCLC. Examinations under fluoroscopy were made to measure the joint angulation. Intraclass correlation coefficients (ICCs) were calculated.

Results:
Testing of the intact elbow specimen by both examiners showed a joint angulation of <5°. Transection of the LUCL led to a varus joint angulation of 4.3° to 7.0°, and transection of the AML resulted in a valgus joint angulation of 4.9° to 8.8°. Complete dissection of the respective collateral ligament complex resulted in a joint angulation of 7.9° to 13.4° (LCLC) and 9.1° to 12.3° (MCL), and additional transection of the AC led to a joint angulation of >20° in some positions in both the medial and the lateral series. Under varus stress, elbow dislocations occurred only after dissection of the LCLC+AC (26% of the examinations) and additional dissection of the MCL (59%). Under valgus stress, elbow dislocations occurred only after dissection of the MCL+AC (30%) and additional dissection of the LCLC (47%). Very good to excellent ICCs were found among Examiners 1 and 2 and the tests done with the standardized torques at stages 1 through 4.

Conclusions:
Dynamic fluoroscopy makes it possible to distinguish among different stages of collateral ligament injury of the elbow and therefore might be helpful for guiding treatment of simple elbow dislocations.

Clinical Relevance:
Assessment of collateral ligament injury with varus and valgus stress testing under fluoroscopy is an easily available method and is often used as the imaging modality of choice to determine the degree of elbow laxity. The technique and results described in this study should form the basis for additional clinical studies.
Studi Kasus Analisis Kegagalan Material Piston Sepeda Motor
Authors: Munaji Munaji , Winardi Yoyok 
Published: April 2018

This paper presents the failure anaylisis on the motorcycle’s piston.The analysis procedure consists of physical observation (metallography), mechanical testing (hardness testing, and chemical composition testing (spectrometry). Result physcal observation shows there are scratches and changes in color on the surface of the piston wall. Based on spectrometer test, piston is made from Al-Si-Cu-Mg alloy with AA336.0 series. Hardness vickers testing showed the distribution ofHVN on the walls and heads of pistonare not decrease significantly. Hardness on the head of piston is 136.06 HVN, while on the wall of piston is 134.3 HVN. Based on the analysis, the failure is caused by lubrication failure that causes piston over heat and burning.
A Modelagem de Negócio com UML de uma Central de Monitoração de Diabéticos
Authors: Ito Márcia , Martini José Sidnei C. , Iochida Lúcia C. 
Published: April 2018

A modelagem de negócio com a UML ( Unified Modeling Language) permite uma melhor compreensão dos sistemas de informação que realmente agreguem valor ao negócio do cliente. Os artefatos gerados nesta modelagem permitem uma validação precoce do sistema a ser desenvolvido e uma clara visão do negócio, além de mecanismos padronizados para definir, de forma adequada, os requisitos do sistema. Assim, neste trabalho as vantagens obtidas através da aplicação de técnicas de modelagem de negócio numa central de monitoração de diabéticos são apresentadas. Um método para derivar a arquitetura inicial do software é aplicado, demonstrando a sua viabilidade e o quanto este auxilia no desenvolvimento de software adaptado às necessidades dos usuários e clientes.
Mineração de Dados usando o software WizRule em Base de Dados de Compras de TI
Authors: Barbosa Denise Chaves Carvalho , Machado Maria Augusta 
Published: April 2018

Esta pesquisa tem como objetivo validar a hipótese de que a Mineração de Dados pode ser aplicada em base de dados de compra, gerando a descoberta do conhecimento oculto, como uma grande contribuição ao processo decisório da gestão de compras. Para melhor compreensão desse trabalho abordamos, na Revisão de Literatura, primeiramente, um histórico sobre o processo decisório, bem como a evolução dos estudos deste tema e da relação entre a Tomada de Decisão e os Sistemas de Informação. Posteriormente, ainda na Revisão da Literatura, nos voltamos para a abordagem sobre as ferramentas, objeto deste estudo, Data Warehouse e Data mining, passando pelo processo KDD, por constituírem uma recente geração de Sistemas de Apoio à Decisão. O Data Warehouse por tratar-se de um banco de dados apropriado para objetivos gerenciais e o Data Mining por permitir a análise dos dados armazenados para a descoberta das relações ocultas, revelando informações valiosas sobre as compras já efetuadas. Por fim, demonstraremos, no último capítulo deste trabalho, a aplicação prática do Data Mining em base de dados de compras de TI de uma empresa de grande porte, incluindo a análise dos resultados gerados e comprovando ser de grande utilidade o uso dessas ferramentas na obtenção de informação útil sustentando o processo decisório e a estratégia de negócios na área de compras de produtos.
Uma Metodologia para Avaliação Computacional do Nível de Compreensão de Textos
Authors: Wojciechowski Jaime , Ávila Bráulio , Enembreck Fabrício , Scalabrin Edson , Dias João Da S. 
Published: April 2018

Este artigo apresenta um sistema computacional capaz de avaliar, em um ambiente de aprendizagem colaborativa, o nível compreensão que um indivíduo possui sobre um dado assunto. Uma questão difícil e essencial é o modo de avaliação, que em geral é realizada por meio de trabalhos coletivos ou em grupo ou ainda por meio de exames individuais. Entretanto, estas técnicas estão sujeitas a fatores subjetivos relacionados ao tutor (nível de experiência, humor, afinidade, etc.) e ao membro da equipe, além de requerer um considerável esforço de leitura por parte do tutor. A realização deste objetivo envolveu, essencialmente, técnicas de processamento de linguagem natural baseadas em conceitos tais como: memória dinâmica, raciocínio baseado em casos e parser semântico. Finalmente, uma discussão é mostrada sobre experimentos realizados em um ambiente de aprendizagem colaborativa. Os resultados obtidos foram coerentes de acordo com a opinião dos tutores em envolvidos.
Diseño de Sistemas Tutores Inteligentes con Tecnología de Agentes: Los Agentes Docentes en el Módulo Tutor
Authors: Cataldi Zulma , Calvo Patricia , Salgueiro Fernando A. , Lage Fernando J. 
Published: April 2018

A partir de un esquema básico, de interacción del alumno con los docentes, se estudian las diferentes características de los agentes para llevar a cabo una sesión de aprendizajes de tipo “uno a uno”. Se propone un modelo de agente docente en el módulo tutor, y se reconoce a la herramienta a utilizar para el diseño de este sistema en el campo de los agentes, a fin de continuar con la siguiente etapa en la investigación. A partir de un esquema básico, de interacción del alumno con los docentes, se estudian las diferentes características de los agentes para llevar a cabo una sesión de aprendizajes de tipo “uno a uno”. Se propone un modelo de agente docente en el módulo tutor, y se reconoce a la herramienta a utilizar para el diseño de este sistema en el campo de los agentes, a fin de continuar con la siguiente etapa en la investigación.
Ferramenta Rad para Geração de Código em Php
Authors: Berg Alexandre Cruz , Ferraz Rodrigo Santos 
Published: April 2018

Neste artigo descreve-se o estudo e a construção de uma ferramenta para desenvolvimento rápido de aplicação (RAD), durante o ciclo de vida do desenvolvimento de software, utilizando a geração de código unidirecional. O presente trabalho aborda conceitos, reutilização de classes existentes e consolidadas na comunidade software livre, motivação para a sua elaboração e um estudo de viabilidade para validação da ferramenta desenvolvida.
Impactos Computacionais de uma Implementação de Criptografia Visual
Authors: Marques Giuliano Berlatto , Ribeiro Vinicius Gadis , Zabadal Jorge Rodolfo 
Published: April 2018

Este artigo realiza breve estudo sobre a Criptografia Visual, vindo a implementar um protótipo para fins de identificar características de processamento quando do emprego dessa tecnologia. Foi avaliado o impacto de recursos computacionais quando do uso do protótipo. Destaca-se já haver aplicações reais em mercado, o que pode oportunizar situações interessantes de investigação. Para o desenvolvimento do protótipo, considerando-se o seu emprego para fins didáticos, implementou-se em Object Pascal – no caso, Delphi, mas poder-se-ia empregar Lazarus ou Kylix - e, para fins de configurações do tratamento gráfico, a linguagem Lua. Medições de desempenho não se revelaram elevadas.
A quantitative analysis of swimming pool recirculation system efficiency
Authors: Alansari Amir , Amburgey James , Madding Nathan 
Published: April 2018

Abstract
The primary objective of this study was to conduct a quantitative analysis of the hydraulic efficiency of a 1:25 bench-scale swimming pool and to determine whether the recirculation efficiency could be increased by modifying parameters such as turnover rate, inlet/out configuration, and extent of mixing within the pool. Salt tracer studies were conducted using KCl to determine the residence time distribution and describe the hydraulic characteristics of the pool. The results indicated that the removal of the tracer always followed an exponential decay curve, i.e. 63, 86, 95% for the first, second, and third turnover periods, respectively. In the majority of experiments, the exponential decay rate matched the inverse of the theoretical hydraulic detention time of the system. The results showed that none of the investigated parameters had any significant impact on the tracer removal efficiency. Increasing removal efficiencies of current treatment technologies such as sand and cartridge filters from approximately 25–90% would provide significant improvements in the rate of removal of Cryptosporidium-sized particles. Improving the treatment efficiency beyond 90% would have little additional impact, but further improvements could be achieved by decreasing the system turnover rate.
O Lugar do Interculturalismo nas Políticas Imigratórias em Portugal e Espanha
Authors: Ennes Marcelo , Ramos Natalia , Suaréz Belén 
Published: April 2018

A questão central deste artigo refere-se ao lugar do intercultura- lismo nas políticas de integração e gestão da diversidade produ- zida pelos imigrantes em Portugal e na Espanha nos primeiros anos do século XXI. Nosso objetivo principal foi conhecer como o interculturalismo, em sua polissemia, ganhou materialidade em avanços e recuos de normas e práticas desenvolvidas por órgãos governamentais visando a gestão da diversidade. Procuramos também conhecer a perspectiva de outros atores sociais, como representantes de associações ligadas ao tema da imigração. A pesquisa que deu origem ao artigo foi desenvolvida com base em pesquisa bibliográfica e documental, entrevistas qualitati- vas com base em roteiro pré-estruturado e observação direta. Os dados e os argumentos apresentados neste artigo permitem sustentar que se não é a solução definitiva para os problemas de racismos e xenofobia contra imigrantes, o interculturalismo tem sido um avanço no que diz respeito às políticas de imigração e integração do imigrante quando comparada, por exemplo, às políticas baseadas na ideia de assimilação.
Glycosides from Medicinal Plants as Potential Anticancer Agents: Emerging Trends Towards Future Drugs
Authors: Khan Haroon , Saeedi Mina , Nabavi Seyed Mohammad , Mubarak Mohammad S. , Bishayee Anupam 
Published: April 2018

Background:Cancer continues to be a global burden, despite the advancement of various technological and pharmaceutical improvements over the past two decades. Methods for treating cancer include surgery, radiotherapy and chemotherapy in addition to other specialized techniques. On the other hand, medicinal plants have been traditionally employed either as the complementary medicine or dietary agents in the treatment and management of cancer. Medicinal plants are a rich source of secondary metabolites with interesting biological and pharmacological activities. Among these metabolites, glycosides are naturally occurring substances and have outstanding therapeutic potential and clinical utility.Methods:Different medical research engines such as, GoogleScholar, PubMed, SpringerLink, ScienceDirect were used to collect related literature on the subject matter. In this regard, only peer-reviewed journals were considered.Results:Emerging results showed that numerous glycosides isolated from various plants possessed marked anticancer activity against a variety of cancer cell lines. Accordingly, the aim of the present review is to shed light on the anticancer effects of glycosides, analyze possible mechanisms of action, and highlight the role of these natural agents as complementary and alternative medicine in combating and managing cancer.Conclusion:The glycosides isolated from different plants demonstrated potent cytotoxic effects against various cancer cell lines in initial preclinical studies. The anticancer effect was mediated through multiple mechanisms; however further detailed studies are needed to understand the full potential of glycosides for clinical utility.
UJI EFEK ANALGETIK EKSTRAK METANOL DAUN MANGGA ARUM MANIS (Mangifera indica L. Var. Arum manis) TERHADAP MENCIT PUTIH BETINA
Authors: Marjoni Mhd Riza 
Published: April 2018

<p class="Default">Penggunaan tanaman sebagai salah satu bahan pengobatan di Indonesia sudah dikenal sejak lama dan sampai sekarang masih banyak dilakukan oleh masyarakat secara luas. Mangga varietas arumanis yang merupakan produk asli Indonesia merupakan salah satudari tanaman tersebut yang telah digunakan secara tradisional oleh masyarakat untuk meredakan rasa nyeri. Penelitian ini bertujuan untuk mengetahui efek analgetik dari ekstrak methanol daun mangga arumanis menggunakan 3 variasi dosis.</p><p class="Default">Penelitian ini menggunakan 15 ekor mencit putih betina sebagai hewan uji yang dikelompokan menjadi 5 kelompok. Kelompok pertama diberi obat analgetik tramadol sebagai kontrol positif, kelompok kedua diberi aquades sebagai kontrol negatif, dan kelompok ketiga sampai kelima diberi ekstrak methanol daun mangga arumanis dengan 3 variasi dosis 25 mg, 50 mg, 100 mg setiap 0,5 ml secara oral. Pengamatan yang dilakukan terhadap hewan uji adalah respon berupa melompat dan atau menjilat kaki sebelum perlakuan, dan pada menit ke-30, 60, 90, 120 setelah diberi rangsangan nyeri berupa suhu panas 55 <sup>0</sup> C menggunakan metoda <em>hot plate</em>. Hasil penelitian menunjukkan bahwa ketiga dosis ektrak metanol daun mangga arum manis memiliki efek analgesik pada mencit putih betina</p>
Avaliação de corante fluorescente benzazólico para detecção em parasitos diagnosticados por flutuação simples
Authors: Marques Sandra , Barros Hélio Lopes Barbosa , Glasenapp Raquel , Stefani Valter 
Published: April 2018

This study shows the use of 4-hydroxy-3- (6-methylbenzo [d] oxazol-2-yl) benzenesulfonic acid (HB-9), a fluorescent dye, for the detection and visualization of helminth eggs and protozoan oocysts diagnosed in domestic animals, by epifluorescence microscopy. Eggs of Acuaria spiralis, Strongyloides papillosus, Capillaria spp., Bertiella spp., Strongyloidea and Eimeria spp., were previously identified through the flotation method and used for analysis. The fluorescence of the eggs was visualized in a BEL R Photonics com sistema de Epi-FluorescênciaINV-100 FL Plus. Only eggs of Acuaria spiralis, Capillaria spp., and Bertiella spp. presented fluorescence when visualized by epifluorescence microscopy. The results indicate that the fluorescente dye used in this study permits a easy, clear and selective detection and visualization ofparasitic structures.
Influence of Diabetes on Trends in Perioperative Cardiovascular Events
Authors: Newman Jonathan D. , Wilcox Tanya , Smilowitz Nathaniel R. , Berger Jeffrey S. 
Published: April 2018

OBJECTIVE
Patients undergoing noncardiac surgery frequently have diabetes mellitus (DM) and an elevated risk of cardiovascular disease. It is unknown whether temporal declines in the frequency of perioperative major adverse cardiovascular and cerebrovascular events (MACCEs) apply to patients with DM.

RESEARCH DESIGN AND METHODS
Patients ≥45 years of age who underwent noncardiac surgery from January 2004 to December 2013 were identified using the U.S. National Inpatient Sample. DM was identified using ICD-9 diagnosis codes. Perioperative MACCEs (in-hospital all-cause mortality, acute myocardial infarction, or acute ischemic stroke) by DM status were evaluated over time.

RESULTS
The final study sample consisted of 10,581,621 hospitalizations for major noncardiac surgery; DM was present in ∼23% of surgeries and increased over time (P for trend &lt;0.001). Patients with DM experienced MACCEs in 3.3% of surgeries vs. 2.8% of surgeries for patients without DM (P &lt; 0.001). From 2004 to 2013, the odds of perioperative MACCEs after multivariable adjustment increased by 6% (95% CI 2–9) for DM patients, compared with an 8% decrease (95% CI −10 to −6) for patients without DM (P for interaction &lt;0.001). Trends for individual end points were all less favorable for patients with DM versus those without DM.

CONCLUSIONS
In an analysis of &gt;10.5 million noncardiac surgeries from a large U.S. hospital admission database, perioperative MACCEs were more common among patients with DM versus those without DM. Perioperative MACCEs increased over time and individual end points were all less favorable for patients with DM. Our findings suggest that a substantial unmet need exists for strategies to reduce the risk of perioperative cardiovascular events among patients with DM.