bluuebunny/crossref_metadata_2025_split huggingface dataset:
Axillary Temperature, as Recorded by the iThermonitor WT701, Well Represents Core Temperature in Adults Having Noncardiac Surgery
Authors: Pei Lijian , Huang Yuguang , Mao Guangmei , Sessler Daniel I. 
Published: December 2017

BACKGROUND:
Core temperature can be accurately measured from the esophagus or nasopharynx during general anesthesia, but neither site is suitable for neuraxial anesthesia. We therefore determined the precision and accuracy of a novel wireless axillary thermometer, the iThermonitor, to determine its suitability for use during neuraxial anesthesia and in other patients who are not intubated.

METHODS:
We enrolled 80 adults having upper abdominal surgery with endotracheal intubation. Intraoperative core temperature was measured in distal esophagus and was estimated at the axilla with a wireless iThermonitor WT701 (Raiing Medical, Boston MA) at 5-minute intervals. Pairs of axillary and reference distal esophageal temperatures were compared and summarized using linear regression and repeated-measured Bland–Altman methods. We a priori determined that the iThermonitor would have clinically acceptable accuracy if most estimates were within ±0.5°C of the esophageal reference, and suitable precision if the limits of agreement were within ±0.5°C.

RESULTS:
There were 3339 sets of paired temperatures. Axillary and esophageal temperatures were similar, with a mean difference (esophageal minus axillary) of only 0.14°C ± 0.26°C (standard deviation). The Bland–Altman 95% limits of agreement were reasonably narrow, with the estimated upper limit at 0.66°C and the lower limit at −0.38°C, thus ±0.52°C, indicating good agreement across the range of mean temperatures from 34.9°C to 38.1°C. The absolute difference was within 0.5°C in 91% of the measurements (95% confidence interval, 88%–93%).

CONCLUSIONS:
Axillary temperature, as recorded by the iThermonitor WT701, well represents core temperature in adults having noncardiac surgery and thus appears suitable for clinical use.
Comparison of DNA Damage and Oxidative Stress in Patients Anesthetized With Desflurane Associated or Not With Nitrous Oxide: A Prospective Randomized Clinical Trial
Authors: Nogueira Flávia R. , Braz Leandro G. , Souza Kátina M. , Aun Aline G. , Arruda Nayara M. , Carvalho Lídia R. , Chen Chung-Yen O. , Braz José Reinaldo C. , Braz Mariana G. 
Published: December 2017

BACKGROUND:
Little is known about the effects of desflurane associated or not with nitrous oxide (N2O) on oxidative stress and patient genetic material. The aim of this study was to compare the effects of anesthesia maintained with desflurane associated or not with N2O on DNA damage (as a primary outcome) and oxidative stress (as a secondary outcome) in patients who underwent an elective minimally invasive surgery.

METHODS:
This prospective randomized clinical trial analyzed 40 patients of both sexes with an American Society of Anesthesiologists physical status I who were 18–50 years of age and scheduled for septoplasty. The patients were randomly allocated into 2 groups according to anesthesia maintenance as follows: desflurane (n = 20) or desflurane/N2O (n = 20). Blood samples were collected before anesthesia (T1 = baseline), 1.5 hours after anesthesia induction (T2), and on the morning of the postoperative first day (T3). Basal and oxidative DNA damage (determined using formamidopyrimidine DNA glycosylase to detect oxidized purines and endonuclease III to detect oxidized pyrimidines) were evaluated using the comet assay. Oxidative stress markers were evaluated based on lipid peroxidation (by assessing 4-hydroxynonenal and 8-iso-prostaglandin F2α [8-isoprostane] using enzyme linked immunosorbent immunoassay), protein carbonyls (assessed by enzyme linked immunosorbent immunoassay), and antioxidant defense (ferric-reducing antioxidant power by spectrophotometry). The effect size was expressed as the mean differences between groups and the corresponding 95% confidence interval (CI).

RESULTS:
There was no significant mean difference between groups in relation to DNA damage (−1.7 [95% CI, −7.0 to 3.5]), oxidized DNA pyrimidines (−1.8 [95% CI, −12.5 to 8.9]) and purines (−1.9 [95% CI, −13.9 to 10.1]), 4-hydroxynonenal (−0.2 [95% CI, −2.8 to 2.4]), 8-isoprostane (549 [95% CI, −2378 to 3476]), protein carbonyls (0.2 [95% CI, −2.1 to 2.3]), or ferric-reducing antioxidant power (24 [95% CI, −52.0 to 117.2]).

CONCLUSIONS:
The coadministration of 60% N2O with desflurane did not seem to impair the effects on DNA or the redox status compared with desflurane anesthesia, suggesting that both studied anesthetic techniques can be suitable options for healthy individuals who undergo minimally invasive surgery lasting at least 1.5 hours. However, due to the low power of the study, more research is necessary to confirm our findings.
Anesthesia for Cesarean Delivery: A Cross-Sectional Survey of Provincial, District, and Mission Hospitals in Zimbabwe
Authors: Lonnée Herman A. , Madzimbamuto Farai , Erlandsen Ole R. M. , Vassenden Astrid , Chikumba Edson , Dimba Rutenda , Myhre Arne K. , Ray Sunanda 
Published: December 2017

BACKGROUND:
Cesarean delivery is the most common surgical procedure in low- and middle-income countries, so provision of anesthesia services can be measured in relation to it. This study aimed to assess the type of anesthesia used for cesarean delivery, the level of training of anesthesia providers, and to document the availability of essential anesthetic drugs and equipment in provincial, district, and mission hospitals in Zimbabwe.

METHODS:
In this cross-sectional survey of 8 provincial, 21 district, and 13 mission hospitals, anesthetic providers were interviewed on site using a structured questionnaire adapted from standard instruments developed by the World Federation of Societies of Anaesthesiologists and the World Health Organization.

RESULTS:
The anesthetic workforce for the hospitals in this survey constituted 22% who were medical officers and 77% nurse anesthetists (NAs); 55% of NAs were recognized independent anesthetic providers, while 26% were qualified as assistants to anesthetic providers and 19% had no formal training in anesthesia. The only specialist physician anesthetist was part time in a provincial hospital. Spinal anesthesia was the most commonly used method for cesarean delivery (81%) in the 3 months before interview, with 19% general anesthesia of which 4% was ketamine without airway intubation. The mean institutional cesarean delivery rate was 13.6% of live births, although 5 district hospitals were <5%. The estimated institutional maternal mortality ratio was 573 (provincial), 251 (district), and 211 (mission hospitals) per 100,000 live births. Basic monitoring equipment (oximeters, electrocardiograms, sphygmomanometers) was reported available in theatres. Several unsafe practices continue: general anesthesia without a secure airway, shortage of essential drugs for spinal anesthesia, inconsistent use of recovery area or use of table tilt or wedge, and insufficient blood supplies. Postoperative analgesia management was reported inadequate.

CONCLUSIONS:
This study identified areas where anesthetic provision and care could be improved. Provincial hospitals, where district/mission hospitals refer difficult cases, did not have the higher level anesthesia expertise required to manage these cases. More intensive mentorship and supervision from senior clinicians is essential to address the shortcomings identified in this survey, such as the implementation of evidence-based safe practices, supply chain failures, high maternal morbidity, and mortality. Training of medical officers and NAs should be strengthened in leadership, team work, and management of complications.
Airway Management by Laryngeal Mask Airways for Cervical Tracheal Resection and Reconstruction: A Single-Center Retrospective Analysis
Authors: Schieren Mark , Egyed Enikö , Hartmann Burkhard , Aleksanyan Armen , Stoelben Erich , Wappler Frank , Defosse Jerome M. 
Published: December 2017

BACKGROUND:
Supraglottic airway devices (SADs) may have advantages over endotracheal intubation for tracheal resection and reconstruction in cases of severe and proximally located subglottic stenosis. This retrospective case series examines the feasibility of using SADs as a novel approach to airway management in tracheal resections.

METHODS:
All patients who were managed with SADs for cervical tracheal resection and reconstruction during the study period (2010–2015) in our university hospital were included.
To examine the feasibility of airway management with SADs for tracheal resection, medical records were obtained from our institution’s electronic database and reviewed.

RESULTS:
SADs were used in 10 patients who had extensive tracheal stenosis and a high prevalence of severe comorbidities. SAD insertion and subsequent positive pressure ventilation were successful in all patients, although 1 patient with preoperative respiratory failure had persistent hypercarbia. During the phase of resection and reconstruction, high-frequency jet ventilation was used to ensure adequate oxygenation. There were no intraoperative complications related to anesthetic management, apart from transient hypercarbia during and after jet ventilation. Most patients (n = 6; 60%) had an uneventful postoperative course. In this high-risk cohort, postoperative complications (ie, vocal cord edema, postoperative hemorrhage, pneumonia) occurred in 4 patients (40%).

CONCLUSIONS:
This retrospective case series demonstrates the feasibility of using supraglottic airways alongside high-frequency jet ventilation for airway management in at least some cases of cervical tracheal resection and reconstruction. However, the small number of cases examined limits conclusions regarding indications, contraindications, and periprocedural safety.
Dexmedetomidine for Improved Quality of Emergence From General Anesthesia: A Dose-Finding Study
Authors: Aouad Marie T. , Zeeni Carine , Al Nawwar Rony , Siddik-Sayyid Sahar M. , Barakat Hanane B. , Elias Sandra , Yazbeck Karam Vanda G. 
Published: December 2017

BACKGROUND:
Dexmedetomidine provides smooth and hemodynamically stable emergence at the expense of hypotension, delayed recovery, and sedation. We investigated the optimal dose of dexmedetomidine for prevention of cough, agitation, hypertension, tachycardia, and shivering, with minimal side effects.

METHODS:
In this prospective, randomized, double-blind trial, 216 adult patients were randomly assigned to dexmedetomidine 1 µg/kg (D 1), 0.5 µg/kg (D 0.5), 0.25 µg/kg (D 0.25), or control (C). During emergence, cough, agitation, hemodynamic parameters, shivering, time to extubation, and sedation scores were recorded.

RESULTS:
A total of 190 patients were analyzed. The respective incidences for the groups D 1, D 0.5, and D 0.25 versus group C were 48%, 64%, and 64% vs 84% for cough—corrected P < .003 between groups D 1 and C; 33%, 34%, and 33% vs 72% for agitation—corrected P < .003 between group C and each of the study groups; and 4%, 2%, and 7% vs 22% for shivering—corrected P = .03 and corrected P = .009 between groups D 1 and D 0.5 versus group C, respectively. The percent increase from baseline blood pressure on extubation for the 3 treatment groups was significantly lower than group C. Percent increase in heart rate was lower than control in groups D 1 and D 0.5 but not in group D 0.25. Time to extubation and sedation scores were comparable. However, more hypotension was recorded during the emergence phase in the 3 treatment groups versus group C.

CONCLUSIONS:
D 1 at the end of surgery provides the best quality of emergence from general anesthesia including the control of cough, agitation, hypertension, tachycardia, and shivering. D 0.5 also controls emergence phenomena but is less effective in controlling cough. The 3 doses do not delay extubation. However, they cause dose-dependent hypotension.
Characteristics of Desaturation and Respiratory Rate in Postoperative Patients Breathing Room Air Versus Supplemental Oxygen: Are They Different?
Authors: Taenzer Andreas H. , Perreard Irina M. , MacKenzie Todd , McGrath Susan P. 
Published: December 2017

BACKGROUND:
Routine monitoring of postoperative patients with pulse oximetry–based surveillance monitoring has been shown to reduce adverse events. However, there is some concern that pulse oximetry is limited in its ability to detect deterioration quickly enough to allow for intervention in patients receiving supplemental oxygen. To address such concerns, this study expands on the current limited knowledge of differences in desaturation and respiratory rate characteristics between patients breathing room air and those receiving supplemental oxygen.

METHODS:
Pulse oximetry–derived data and patient characteristics were used to examine overnight desaturation patterns of 67 postoperative patients who were receiving either supplemental oxygen or breathing room air. The 2 modalities with respect to the speed of desaturation, in addition to magnitude and duration of desaturation events, are compared. Night-time pulse rate, oxygen saturation, respiratory rate, and the transition times from normal oxygen saturation levels to desaturated states are also compared. The behavior of respiratory rate in proximity to desaturation events is described. Statistical methods included multivariable regression and inverse probability of treatment weighted to adjust for any imbalance in patient characteristics between the oxygen and room air patients and linear mixed effect models to account for clustering by patient.

RESULTS:
The study included 33 patients on room air and 34 receiving supplemental oxygen. The speed of desaturation was not different for room air versus oxygen for 2 types of desaturation (adjusted % difference, 95% confidence interval [CI]: type I; 22.4%, −51.5% to 209%; P = .67, type II; −17.3%, −53.8% to 47.6%; P = .52). Patients receiving supplemental oxygen had a higher mean oxygen saturation (adjusted difference, 95% CI, 2.4 [0.7–4.0]; P = .006). No differences were found for the average overnight respiratory or pulse rate, or proportion of time in desaturation states between the 2 groups.
The time to transition from a normal oxygen saturation (92%) to 88% or below was not longer for supplemental oxygen patients (P = .42, adjusted difference 26.1%: 95% CI, −28.1% to 121%). Respiratory rates did not differ between the overall mean and desaturation or recovery phases or between the oxygen and room air group.

CONCLUSIONS:
In this study, desaturation characteristics did not differ between patients receiving supplemental oxygen and breathing room air with regard to speed, depth, or duration of desaturation. Transition time for desaturations to reach low oxygen saturation alarms was not different, while respiratory rate remained in the normal range during these events. These findings suggest that pulse oximetry–based surveillance monitoring for deterioration detection can be used equally effectively for patients on supplemental oxygen and for those on room air.
Prophylactic Platelet Transfusions for Critically Ill Patients With Thrombocytopenia: A Single-Institution Propensity-Matched Cohort Study
Authors: Warner Matthew A. , Chandran Arun , Frank Ryan D. , Kor Daryl J. 
Published: December 2017

BACKGROUND:
Thrombocytopenia is frequently encountered in critically ill patients, often resulting in prophylactic transfusion of platelets for the prevention of bleeding complications. However, the efficacy of this practice remains unclear. The objective of this study was to determine the relationship between prophylactic platelet transfusion and bleeding complications in critically ill patients.

METHODS:
This is a retrospective cohort study of adults admitted to surgical, medical, or combined medical-surgical intensive care units (ICUs) at a single academic institution between January 1, 2009, and December 31, 2013. Inclusion criteria included age ≥18 years and a platelet count measured during ICU admission. Propensity-matched analyses were used to evaluate associations between prophylactic platelet transfusions and the outcomes of interest with a primary outcome of red blood cell transfusion in the ensuing 24 hours and secondary outcomes of ICU and hospital-free days and changes in sequential organ failure assessment scores.

RESULTS:
A total of 40,693 patients were included in the investigation with 3227 (7.9%) receiving a platelet transfusion and 1065 (33.0%) for which platelet transfusion was prophylactic in nature. In propensity-matched analyses, 994 patients with prophylactic platelet transfusion were matched to those without a transfusion. Patients receiving prophylactic platelets had significantly higher red blood cell transfusion rates (odds ratio 7.5 [5.9–9.5]; P < .001), fewer ICU-free days (mean [standard deviation] 20.8 [9.1] vs 22.7 [8.3] days; P = .004), fewer hospital-free days (13.0 [9.7] vs 15.8 [9.4] days; P < .001), and less improvement in sequential organ failure assessment scores (mean decrease of 0.2 [3.6] vs 1.8 [3.3]; P < .001) in the subsequent 24 hours. These findings appeared robust, persisting in multiple predefined sensitivity analyses.

CONCLUSIONS:
Prophylactic administration of platelets in the critically ill was not associated with improved clinical outcomes, though residual confounding may exist. Further investigation of platelet transfusion strategies in this population is warranted.
Can Functional Movement Assessment Predict Football Head Impact Biomechanics?
Authors: FORD JULIA M. , CAMPBELL KODY R. , FORD CASSIE B. , BOYD KENNETH E. , PADUA DARIN A. , MIHALIK JASON P. 
Published: December 2017

ABSTRACT

Purpose
The purposes of this study was to determine functional movement assessments’ ability to predict head impact biomechanics in college football players and to determine whether head impact biomechanics could explain preseason to postseason changes in functional movement performance.

Methods
Participants (N = 44; mass, 109.0 ± 20.8 kg; age, 20.0 ± 1.3 yr) underwent two preseason and postseason functional movement assessment screenings: 1) Fusionetics Movement Efficiency Test and 2) Landing Error Scoring System (LESS). Fusionetics is scored 0 to 100, and participants were categorized into the following movement quality groups as previously published: good (≥75), moderate (50–75), and poor (<50). The LESS is scored 0 to 17, and participants were categorized into the following previously published movement quality groups: good (≤5 errors), moderate (6–7 errors), and poor (>7 errors). The Head Impact Telemetry (HIT) System measured head impact frequency and magnitude (linear acceleration and rotational acceleration). An encoder with six single-axis accelerometers was inserted between the padding of a commercially available Riddell football helmet. We used random intercepts general linear-mixed models to analyze our data.

Results
There were no effects of preseason movement assessment group on the two Head Impact Telemetry System impact outcomes: linear acceleration and rotational acceleration. Head impact frequency did not significantly predict preseason to postseason score changes obtained from the Fusionetics (F
1,36 = 0.22, P = 0.643, R
2 = 0.006) or the LESS (F
1,36 < 0.01, P = 0.988, R
2 < 0.001) assessments.

Conclusions
Previous research has demonstrated an association between concussion and musculoskeletal injury, as well as functional movement assessment performance and musculoskeletal injury. The functional movement assessments chosen may not be sensitive enough to detect neurological and neuromuscular differences within the sample and subtle changes after sustaining head impacts.
A semiótica greimasiana sob aspectos fenomenológicos: uma relação de sentido
Authors: Vasconcelos Suani De Almeida 
Published: December 2017

O presente trabalho apresenta considerações que envolvem a relação entre a fenomenologia com os estudos em linguagem, mais especificamente no campo da significação, focalizando o trabalho do lingüista Algirdas-Julien Greimas – Semiótica Textual. Para tal, fez-se um breve retrospecto teórico, a partir da filosofia platônica (séc. V a.C), chegando até os filósofos contemporâneos no campo da Filosofia da Linguagem, os quais serviram de base para o arranjo lógico-semiótico e fenomenológico moderno, desembocando na teoria greimasiana sobre a significação e o processo interpretativo. Palavras-chaves: Linguagem. Filosofia da Linguagem. Semiótica Textual
Léxico e cultura: as denominações das culturas agrícolas do feijão e do milho por agricultores do município de Ocara-CE
Authors: Lima Francisco Cleziano Mendes de , Xiemenes Expedito Eloísio 
Published: December 2017

O presente artigo objetivou levantar e analisar as formas de nomear as culturas agrícolas, por trabalhadores rurais do município de Ocara-Ceará, especificamente as culturas do feijão e do milho. Para tanto, foi coletado um corpus, por meio de entrevistas realizadas com 6 agricultores. Apresentamos as lexias informadas pelos entrevistados, as interpretações e as análises do léxico que fizemos à luz dos métodos filológicos, especificamente o método Wörter und Sachen (Palavras e Coisas) e o Onomasiológico, desenvolvidos pelos romanistas no final do século XIX. Os teóricos que aplicaram os tais métodos consideram a língua oral, as vivências e o conhecimento de mundo dos sujeitos como elementos fundamentais para a nomeação das coisas, dos objetos, das práticas etc. e para o enriquecimento vocabular das línguas. Isso é importante para estabelecermos a relação corrente entre língua, léxico e cultura.PALAVRAS-CHAVE: Léxico. Cultura. Método Onomasiológico. Método Palavras e Coisas.
Aplicação de métodos de dimensionamento de pavimentos aeroportuários da FAA ao Aeroporto Internacional Presidente Juscelino Kubitschek
Authors: Ramos Bernardo Antonio Silva , Lima Dario Cardoso de , Pitanga Heraldo Nunes , Silva Taciano Oliveira da 
Published: December 2017

Neste artigo, aborda-se o dimensionamento da pista de pouso e decolagem 11R/29L, em pavimento flexível, do Aeroporto Internacional Presidente Juscelino Kubitschek, empregando-se os métodos de dimensionamento da Federal Aviation Administration (FAA) divulgados na AC 150/5320-6D, de 1995, e na AC 150/5320-6E, de 2009, consi­derando-se os tráfegos aéreos do dimensionamento original e aquele atualizado para o ano de 2013. Foi possível observar a sensibilidade do procedimento da FAA de 2009 no que diz respeito à obtenção de estruturas mais fiéis às solicitações impostas pelos tráfegos analisados. Em relação às estruturas obtidas, pode-se observar: (i) a espessura de projeto obtida com o emprego do programa computacional FAARFIELD v. 1.305, para o mesmo tráfego aéreo de projeto, foi 10 cm menor do que aquela determinada com o emprego do procedimento da FAA de 1995; (ii) a espessura de projeto oriunda da utilização do procedimento da FAA de 1995, mas empregando-se o tráfego aéreo atual, foi 2,5 cm maior àquela determinada empregando-se o tráfego aéreo original de projeto; e (iii) a espessura de projeto determinada com o programa computacional FAARFIELD v. 1.305, considerando-se o tráfego aéreo atual, foi 21,5 cm menor do que aquela obtida com o emprego do procedimento da FAA de 1995.