bluuebunny/crossref_metadata_2025_split huggingface dataset:
Embedded Commissioning©
Authors: Akin Omer 
Published: July 2016

Embedded Commissioning (ECx) a new digital technology promises to transform capital project delivery (CPD) and its evaluation in the years to come. The primary strategy in ECx is to create an entirely new approach to building evaluation by merging building commissioning methods and information technologies into a new framework. The vision of such broad innovations must include not just new digital tools and techniques but also advances in AEC practices that utilize these innovations. We envision design and engineering practices that are in the service of sound economy, environmental conservation, improved value, greater efficiency, and satisfied occupants. CPD is no longer about competence in delivering just conventional services. Engineers and Architects have to rise to the challenges of our time and insure the best economy in providing the greatest value to stakeholders. Performance needs have to be optimized against first and lifecycle cost of designs. Value must be assessed not just for the bottom line but for other tangible (health, productivity) and intangible (comfort, happiness, recognition) stakeholders benefits. Last but not least, their products must meet the three pillars of the CPD market place: quality, cost, and schedule.
Caleidoscópio à guisa da consolidação: Comunicação, História Oral e Tempo Presente
Authors: Soares Fagno da Silva , Rovai Marta Gouveia de Oliveira , Porto Junior Francisco Gilson Rebouças 
Published: July 2016

A Revista Observatório chega com vigor ao seu segundo ano inaugurando seu primeiro dossiê “Comunicação, História Oral e Tempo Presente”, que objetiva dar visibilidade a trabalhos que perscrutam temáticas diversas interseccionadas pelo viés metodológico da história oral, pela discussão do tempo presente e da comunicação, bem como por suas implicações para a historiografia. Para além disto, apresenta estudos capazes de esquadrinhar a criação de acervos audiovisuais e usos de novas mídias na realização de entrevistas e de sua publicização, numa perspectiva transdisciplinar amalgamando Comunicação, Jornalismo e Educação.

Disponível em:Url:http://opendepot.org/2766/

Abrir em (para melhor visualização em dispositivos móveis - Formato Flipbooks):
Issuu / Calameo
Ethics of the Physician’s Role in Health-Care Cost Control
Authors: Bosco Joseph , Iorio Richard , Barber Thomas , Barron Chloe , Caplan Arthur 
Published: July 2016

Abstract:
The United States health-care expenditure is rising precipitously. The Congressional Budget Office has estimated that, in 2025, at our current rate of increased spending, 25% of the gross domestic product will be allocated to health care. Our per-capita spending on health care also far exceeds that of any other industrialized country. Health-care costs must be addressed if our country is to remain competitive in the global marketplace and to maintain its financial solvency. If unchecked, the uncontrolled rise in health-care expenditures will not only affect our capacity to provide our patients with high-quality care but also threaten the ability of our nation to compete economically on the global stage. This is not hyperbole but fiscal reality.
As physicians, we are becoming increasingly familiar with the economics impacting health-care policy. Thus, we are in a unique position to control the cost of health care. This includes an increased reliance on creating and adhering to evidence-based guidelines. We can do this and still continue to respect the primacy of patient welfare and the right of patients to act in their own self-interest. However, as evidenced by the use of high-volume centers of excellence, each strategy adapted to control costs must be vetted and must be monitored for its unintended ethical consequences.
The solution to this complex problem must involve the input of all of the health-care stakeholders, including the patients, payers, and providers. Physicians ought to play a role in designing and executing a remedy. After all, we are the ones who best understand medicine and whose moral obligation is to the welfare of our patients.
Effect of Hip Reconstructive Surgery on Health-Related Quality of Life of Non-Ambulatory Children with Cerebral Palsy
Authors: DiFazio Rachel , Shore Benjamin , Vessey Judith A. , Miller Patricia E. , Snyder Brian D. 
Published: July 2016

Background:
The primary aim of this study was to evaluate the relationship of the migration percentage (a radiographic metric quantifying hip displacement) in children with Gross Motor Function Classification System (GMFCS) level-IV or V cerebral palsy and spastic hip dysplasia to the acetabular index and the health-related quality of life (HRQOL) as measured with the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) before and after reconstructive hip surgery.

Methods:
In a prospective cohort study (n = 38), the migration percentage, acetabular index, and CPCHILD scores were analyzed using the Pearson correlation analysis immediately before reconstructive hip surgery and at 6 weeks and 3, 6, 12, and 24 months after the surgery. Subgroup analysis was used to compare patients who had a preoperative migration percentage of ≥50% with those who had a preoperative migration percentage of <50% and to compare the acetabular index between patients who had a pelvic osteotomy and those who had not. Linear mixed models were used to analyze changes in the migration percentage, acetabular index, and CPCHILD scores over time.

Results:
The preoperative migration percentage negatively correlated with the preoperative CPCHILD score (r = −0.50; p = 0.002). This relationship continued throughout the follow-up period such that, for each additional 1% correction in migration percentage, the CPCHILD total score increased by 0.2 point (p < 0.001). There was no correlation between the acetabular index and CPCHILD total score before or after surgery (p = 0.09 to 0.71). The preoperative CPCHILD total scores differed between the migration-percentile groups (mean difference = 13 points; 95% confidence interval = 3.3 to 22.8; p = 0.01). However, after hip surgery, the CPCHILD score improved similarly for both groups.

Conclusions:
These data support the effectiveness of reconstructive hip surgery for the treatment of spastic hip dysplasia to improve the HRQOL of non-ambulatory children with severe cerebral palsy.

Level of Evidence:
Prospective Level IV. See Instructions for Authors for a complete description of levels of evidence.
The Anatomic Midpoint of the Attachment of the Medial Patellofemoral Complex
Authors: Tanaka Miho J. , Voss Andreas , Fulkerson John P. 
Published: July 2016

Background:
The medial patellofemoral ligament varies in attachment of its fibers to the patella and vastus intermedius tendon. Our aim was to identify and describe its anatomic midpoint. To account for the variability of the attachment site, we refer to it as the medial patellofemoral complex.

Methods:
Using AutoCAD software, we identified the midpoint of the medial patellofemoral complex attachment on photographs of 31 cadaveric knee dissections. The midpoint was referenced relative to the superior articular surface of the patella (P1) and was described in terms of the percentage of the patellar articular length distal to this point. A second point, at the junction of the medial border of the vastus intermedius tendon with the superior articular border of the patella, was identified (P2). The distances of the midpoint to P1 and P2 were calculated and were compared using paired t tests.

Results:
Twenty-five images had appropriate quality and landmarks for digital analysis. The midpoint of the medial patellofemoral complex was located a mean (and standard deviation) of 2.3% ± 15.8% of the patellar articular length distal to the superior pole and was at or proximal to P1 in 12 knees. In all knees, the midpoint was at or proximal to P2. After exclusion of 2 knees with vastus intermedius tendon attachments only, the medial patellofemoral complex midpoint was closer to P2 (5.3% ± 8.6% of the patellar articular length) than to P1 (9.3% ± 8.5% of the patellar articular length) (p = 0.06).

Conclusions:
The midpoint of the medial patellofemoral complex was 2.3% of the articular length distal to the superior pole of the patella. Additionally, we describe an anatomic landmark at the junction of the medial border of the vastus intermedius tendon and the articular border of the patella that approximates the midpoint of this complex.

Clinical Relevance:
Our study shows that the anatomic midpoint of the attachment of the medial patellofemoral complex is proximal to the junction of the medial vastus intermedius tendon and the articular border of the patella, suggesting that graft placement may be more anatomic on the vastus intermedius tendon rather than on the patella.
A Novel Radiographic Indicator of Developmental Cervical Stenosis
Authors: Horne Phillip H. , Lampe Lukas P. , Nguyen Joseph T. , Herzog Richard J. , Albert Todd J. 
Published: July 2016

Background:
Developmental cervical stenosis of the spinal canal predisposes patients to neural compression and loss of function. The Torg-Pavlov ratio has been shown to provide high sensitivity but low specificity for identifying developmental cervical stenosis. A more sensitive and specific radiographic index has not been reported to our knowledge. The objective of this study was to develop and provide an objective, sensitive, and specific radiographic index to assess for developmental cervical stenosis.

Methods:
The C3 through C6 levels of the cervical spine were analyzed on lateral radiographs of 150 adult patients to determine the spinolaminar line-to-lateral mass distance (SL), lateral mass-to-posterior vertebral body distance (LM), spinolaminar line-to-vertebral body (canal) diameter (CD), and vertebral body diameter (VB). Ratios of these measurements were calculated to eliminate magnification effects. The corresponding true spinal canal diameter was measured using computed tomography (CT) midsagittal sections. Receiver operating characteristic (ROC) curve analysis was performed to identify a radiographic measurement ratio with optimal sensitivity and specificity, using a true canal diameter of <12 mm to define developmental cervical stenosis.

Results:
Several of the measured ratios demonstrated a strong correlation with the true canal diameter at all cervical levels. However, ROC curve analysis showed that only an LM/CD ratio of ≥0.735 indicated a canal diameter of <12 mm (developmental cervical stenosis). The sensitivity of this ratio at C5 was 83% and its specificity at C5 was 74%. An LM/CD ratio of ≥0.735 measured only at the C5 level also indicated developmental cervical stenosis at any cervical level from C3 through C6 with 76% sensitivity and 80% sensitivity. Other ratios, including the Torg-Pavlov ratio, did not demonstrate an adequate statistical profile to indicate developmental cervical stenosis. The accuracy of the LM/CD ratio was not adversely affected by the patient’s sex.

Conclusions:
This analysis provided a novel index for identifying developmental cervical stenosis: the C5 lateral mass/canal diameter (LM/CD) ratio. We believe that this ratio is the best radiographic measurement available to screen for developmental cervical stenosis in the adult spine patient population. It provides an objective radiographic screening tool for physicians to detect developmental cervical stenosis and decide whether additional imaging or surgical referral is appropriate.

Level of Evidence:
Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
El indígena en la dogmática penal peruana del siglo XIX
Authors: Momethiano Santiago Javier Ysrael 
Published: July 2016

La raza india sometida a los conquistadores tuvo como secuela un proceso de destrucción de lasestructuras de la sociedad indígena, dando origen jurídico a la república de indios, pero gobernadospor una sociedad hispana como legado. La consideración de seres humanos a los indígenasno fue reconocido de inmediato, pues fueron tratados como animales o seres sin alma, ya que elderecho de conquista se imponía como una sociedad de castas, basada en la discriminación étnicay la diferenciación cultural que se practicaba en el siglo XVIII, entonces lo esencial de aplicar underecho penal foráneo es su unilateralidad y coacción, aunque no podemos indicar que se trata deuna simple aplicación de este derecho, dado que los españoles encontraron a su llegada una culturadesarrollada, donde el creador del derecho era el Inca. Tampoco, es una mera aceptación deun derecho penal extranjero, porque los miembros de la sociedad nativa que fueron vistos comoobjetos de legislación, se resistieron al nuevo orden rebelándose. La independencia del Perú nosignificó la ruptura del sistema socioeconómico consolidado en tres siglos de coloniaje, es decirque la emancipación solo produjo la destrucción de las relaciones políticas con la metrópoli, sinque cambie de manera relevante las estructuras internas del país, situación esta que se extendió enel siglo XIX, en tal sentido la construcción del Derecho Penal criollo resulta una ficción, ya queera producto de la educación europea de ese entonces, que nace con mentalidad teológica, desarrolladacon la metafísica, la que discrimina al indígena por no tener autodeterminación comorequisito de la culpabilidad al iniciar el siglo XIX, y que a mediados de esta centuria, termina porapreciar a los “indios” como potencialmente criminales desde la óptica de la escuela positivista,siendo estas ideas empleadas por la república oligárquica de 1895, y que determinan el tratamientolegislativo penal respecto a los indígenas del siglo XIX, convirtiéndolos en más miserables queen la colonia, pues las ideas de los liberalistas llegaron a dañarlos, logrando que las comunidadessubsistentes se atrasen.Palabras clave: indígena, inimputabilidad, culpabilidad, peligrosidad, escuela clásica, escuela positivista,tesis indigenista, tesis colonialista, sanción penal.
Correlación entre el contrato de auspicio y el objeto física y jurídicamente posible como elemento del negocio jurídico
Authors: Hermoza Calero Jessica Pilar 
Published: July 2016

El contrato de auspicio es atípico porque no existe una norma legal peruana que lo regule. Es más, en los hechos las partes hacen uso del término sponsor sin darse cuenta de que se trata de un negocio de esponsorización, y califican al contrato ya sea como un común contrato de publicidad o como un contrato de prestación de servicios. En otros casos, diría límites pero no infrecuentes, se ignora la naturaleza contractual del acuerdo y se estima que una empresa dada ha colaborado con un evento, sin advertir que el propio sujeto auspiciado ha realizado, como contraprestación, un retorno publicitario en favor del auspiciador. De otro lado, la obligación del sponsee o sponsor también podría ser una prestación de no hacer, como por ejemplo tolerar que el auspiciador haga uso de la imagen o del nombre del auspiciado o permitir que, que sin exigir alguna otra contraprestación adicional, aquel promocione su empresa o sus productos con la calidad de auspiciador oficial de un determinado evento. En el contrato de auspicio, tratándose de contratos atípicos mixtos, se han formulado los métodos de absorción y de la combinación. De acuerdo con primero, es menester determinar cuál es la prestación principal que contiene el contrato atípico mixto para aplicar el régimen del contrato típico que contempla dicha prestación con la que lo caracteriza y distingue de los demás. Según el método de la combinación, dado que no siempre es posible establecer cuál es la prestación principal en un contrato atípico mixto, con el riesgo de subordinar deberes que son igualmente importantes, es más adecuado aplicar individualmente a cada prestación el tratamiento del contrato típico que da lugar a un débito igual. No obstante, sería extremadamente dificultoso, por no decir improbable, que dicha aplicación sea pacífica y libre de serios obstáculos, hasta llegar al punto de invocar normas incompatibles o contradictorias.
Betriebssichere Auslegung von Fahrwerksbauteilen aus AFP-Stahl am Beispiel eines NFZ-Achsschenkels
Authors: Küppers Martin , Streicher Manfred , Herbert Andreas , Schönborn Steffen , Wisotzky Axel 
Published: July 2016

Kurzfassung
AFP-Stähle (ausscheidungshärtende ferritisch-perlitische Stähle) bieten gegenüber geschmiedeten Vergütungsstählen mitunter erhebliche Kostenvorteile, stoßen aber bislang auf Vorbehalte bei Anwendungen, bei denen eine schlagartige Belastung nicht ausgeschlossen werden kann. Insbesondere sicherheitskritische Bauteile der Radaufhängung und -lenkung müssen so dimensioniert werden, dass ein Versagen im Betrieb sicher ausgeschlossen werden kann.
Study of Impact of Socio-Economic Condition of Patients on Rhinosporidiosis in a Tertiary Level Hospital of Bangladesh
Authors: Chowdhury Abdul Qayum 
Published: July 2016

Background: Rhinosporidiosis has been known for over a hundred years since its first description in Argentina. It is a chronic granulomatous,non contagious infective condition characterized by a production of nasal polyps and other manifestation of nasal hyperplasia, with frequent recurrence after surgery. The objective of this present study was Impact of Socio-economic condition of patients on Rhinosporidiosis.Methods: 34 number of patients were included in this study with symptomatic Rhinosporidiosis.The main outcome of study were age, sex, socioeconomic status, Occupation, bathing habit and living area of patients.Results: The study showed that 61.76 percent of patients were in the age group of 6-20 years. The mean age of 20.62 (SD±13.87) years. Most of the Rhinospridiosis patiets were from lower economic class 24(70.59%) followed by middle class 9(26.47%) and 1(2.94%) patients were upper class of socioeconomic status.Student was the most common occupation of Rhinosporidiosis 17(50%) followed by farmer 7(20.59%). Most of the Rhinosporidiosis patients 31(91.18%) were taking bath in pond where cattle also take bath.Conclusion: Rhinosporidiosis are very common in male and frequent age incidence are 6-20 years. Most of the Rhinospridiosis patient were from lower economic class and most of the Rhinosporidiosis patient were taking bath in pond where cattle also take bath.Chatt Shi Hosp Med Coll J; Vol.15 (1); Jan 2016; Page 12-16
Pattern of Smoking Among Tuberculosis Patients : An Analysis in A Tertiary Care Hospital
Authors: Islam Ahmed Tanjimul , Haque Md Jawadul , Hoque Md Azizul , Islam Rubab Tarannum 
Published: July 2016

Background: Tuberculosis is among the major causes of illness and death worldwide especially in Asia. Smoking is associated with recurrent tuberculosis and its related mortality. Also, it could affect clinical manifestations, bacteriological conversion and outcome of treatment. This study aimed to evaluate the pattern of tobacco smoking, history of previous quit attempts and attitude towards quitting in tuberculosis patients.Materials and Methods: It was a cross-sectional study done amongst tuberculosis patients presented to DOTS corner of Rajshahi Medical College Hospital. 315 patients entered the study as "First Come First Serve". Selfreported questionnaires were designed according to the standard questionnaires of smoking pattern.Results: Sixty one percent (61%) patients (n=192) were smoker before the diagnosis of tuberculosis. 51.1% were current smokers at the time of interview and were continuing smoking after the diagnosis of tuberculosis. Only 10.2% discontinued smoking after diagnosis. 68.2% smokes less than 10 cigarettes per day. 53.1% was between 31-50 age group. 21-30 is the commonest age group (62%) to start smoking is and 66.1% smoked less than 10 years before diagnosis. To reduce stress was the most common cause to continue smoking (48.9%). 71.9% smokers showed keen interest to stop smoking.Conclusion: Considering the prevalence of smoking in tuberculosis patients, evaluation of tobacco smoking status in such patients and motivating them to quit smoking could be considered as important steps in their treatment process.Chatt Shi Hosp Med Coll J; Vol.15 (1); Jan 2016; Page 22-25
Knowledge on Menstruation Among Adolescent School Girls in A Selected Area of Dhaka City
Authors: Parvin Nadira , Parvin Bonita , Haque Md Monoarul , Islam Mohammad Shahinoor 
Published: July 2016

Background: Menstruation is one of the natural changes that occur in female in her normal life. Though it is a natural phenomenon, most of the adolescent girls have some wrong beliefs and behavior regarding menstruation.Objective: To assess knowledge on menstruation among adolescence school girls in a selected area of Dhaka City.Methods: A descriptive cross sectional study was conducted among conveniently selected 240 adolescent girls. A pre-tested modified questionnaire was used to get data by face to face interview. Knowledge level was determined by predefined scoring.Results: Mean age of respondents was 15.46 + 1.17 years. Mean monthly family income of respondents was 22500±4256 BDT. Majority of the respondents (88%) did not have knowledge about menstruation before the onset of their menarche. Most of the respondents (88%) were not mentally prepared for the first period. About 5.6% of the respondents felt good or normal during menstruation followed by 51%, 39.4% and 4% had uncomfortable, afraid and disgusting feeling respectively. Majority of the respondents (44%) knew about menstruation from TV.Conclusion: Most of the respondents had poor knowledge/no knowledge about menstruation.Chatt Shi Hosp Med Coll J; Vol.15 (1); Jan 2016; Page 31-34
Status of Ocular Complications in Type 2 Diabetes and Relationship Between Other Comorbidities
Authors: Nath Jishu Deb , Sharifi Mozammel Hogue 
Published: July 2016

Introduction : Diabetes Mellitus is a multifactorial disease, associated with a number of micro vascular (Retinopathy, Neuropathy and Nephropathy) and macro vascular (Ischemic Heart Disease, Cerebrovascular Disease and Peripheral Vascular Diseases) complications. Duration of diabetes, current smoking and presence of co morbidities such as HTN, IHD all are significantly associated with the ocular complications in this study.Objective: The purpose of the study is to see the glycaemic status and co morbidities influencing the ocular complications.Methods: The patients for the study were randomly recruited from the Eye outpatient clinics in Chattagram Maa Shishu-O-General Hospital, Chittagong, Bangladesh, from July 2014 to October 2014. Risk factors of DR like age, sex, duration of diabetes and hypertension, IHD, smoking status were evaluated.Results: The study showed that 53 are male and 47 are female. Maximum age is 85 and minimum age is studied at 28. Cataract was the predominant complications presented our study. 22% patient had unilateral and 20% had bilateral cataract. 29% had retinopathy. Mean FPG , PPG & HBA1c levels in unilateral cataract were 7.0 mmol/L, 8.9 mmol/L and 7.03 mmol/L in comparative to retinopathy group was 8.4 mmol/L, 10.6 mmol/L and 8.6 mmol/L respectively. Major complications are retinopathy are found in 26% hypertensive and 24% IHD patients, prevalence of Diabetic retinopathy is 6.9% after 5 years onset of DM and 73.9% after 15 years of diabetes.Conclusion : Prevalence of Diabetic ocular complications is high in our country, Ocular complications increases proportionately to duration and presence of co morbidities. Tight control of DM and periodic eye examination can prevent complications.Chatt Shi Hosp Med Coll J; Vol.15 (1); Jan 2016; Page 35-39