bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increasing granular flow rate with obstructions
Authors: Murray Alan , Alonso-Marroquin Fernando 
Published: March 2016

We describe a simple experiment involving spheres rolling down an inclined plane towards a bottleneck and through a gap. Results of the experiment indicate that flow rate can be increased by placing an obstruction at optimal positions near the bottleneck. We use the experiment to develop a computer simulation using the PhysX physics engine. Simulations confirm the experimental results and we state several considerations necessary to obtain a model that agrees well with experiment. We demonstrate that the model exhibits clogging, intermittent and continuous flow, and that it can be used as a tool for further investigations in granular flow.Received: 22 November 2015, Accepted: 19 February 2016; Edited by: L. A. Pugnaloni; Reviewed by: C. M. Carlevaro, Instituto de Física de Líquidos y Sistemas Biológicos, La Plata, Argentina; DOI: http://dx.doi.org/10.4279/PIP.080003Cite as: A Murray, F Alonso-Marroquin, Papers in Physics 8, 080003 (2016)This paper, by A Murray, F Alonso-Marroquin, is licensed under the Creative Commons Attribution License 3.0.
Reporte del Registro de Trauma de la Sociedad Panamericana de Trauma. Un año de Experiencia en dos Hospitales de la Ciudad de Cali
Authors: Uribe Amadeus , Aboutanos Michael , Ivatury Rao , Morales Mónica , Rodriguez Claudia Steiia 
Published: March 2016

RESUMEN

Introducción
En Latinoamérica el trauma es la principal causa de muerte. Esta situación social obliga a optimizar los sistemas de información para implementar sistemas de atención en trauma. En Cali se inició el registro de trauma de la SPT. Se presenta el reporte del primer año en dos hospitales de alta complejidad de la ciudad.

Metodología
Se realizó un análisis descriptivo de los datos obtenidos del registro de trauma en dos hospitales de la ciudad, uno privado (FVL) y otro publico (HUV), en el período comprendido entre el 01-01-12 y el 31-12-12, incluyendo información demográfica, mecanismos de trauma, severidad (ISS) y mortalidad.

Resultados
Se registraron 17.288 pacientes, 10.417 (60,26%) en FVL y 6.871 (39,74%) en HUV, el promedio de edad fue 29,9 ± 19,8 años. Menores de 18 años 4.920 (28,5%), y 6.777 (39,2%) entre los 18–35 años. La sospecha de violencia fue 0,8% en FVL vs 28,7% en HUV. Las lesiones relacionadas al trabajo fueron 49% la FVL vs 5,6% el HUV. Se hospitalizaron el 29,7% (5.131), de ellos, 1251 (12%) en FVL y 3.880 (56,5%) en HUV. 463 pacientes requirieron UCI en FVL (4,4%). y 194 en HUV (2,8%). El mecanismo más frecuente, las caídas con 37,2%. El mecanismo mas letal fueron las HPAF. La mortalidad global fue del 444 (2,6%), 112 (112%) en FVL y 332 (4.8%) en HUV.

Conclusiones
En el primer año se registraron 17.288 pacientes, las características del trauma son muy similares en el hospital público y el privado. Encontrándose una baja mortalidad en ambos pero mas hospitalizaciones en el publico, asociados a un mayor numero de muerte de moderada severidad. Se logro la implementación de un registro de trauma en Colombia.

How to cite this article
Uribe A, Rodriguez CS, Ordoñez CA, Morales M, Ivatury R, Aboutanos M. Reporte del Registro de Trauma de la Sociedad Panamericana de Trauma. Un año de Experiencia en dos Hospitales de la Ciudad de Cali. Panam J Trauma Crit Care Emerg Surg 2015;4(3):109-123.
Reporte de la Tendencia del Trauma Pediátrico en dos Hospitales de Cali en el 2012
Authors: Uribe Amadeus , Aboutanos Michael , Ivatury Rao , Morales Mónica , Gómez Claudia Stella Rodríguez 
Published: March 2016

RESUMEN

Introducción
Los accidentes son la primera causa de mortalidad y el principal problema de salud pública a nivel mundial en niños mayores de un año, dado el impacto de las discapacidades permanentes que ocasionan las lesiones traumáticas en los niños. En Colombia, la mayoría de los traumatismos en pacientes pediátricos pueden ser evitados, por lo cual es importante la implementación de estrategias de promoción y prevención que podrían reducir la incidencia de casos en trauma hasta en un 80%.

Objetivo
Estimar el panorama del trauma pediátrico y los mecanismos de lesión, identificando posibles estrategias de prevención a futuro, en dos hospitales de la ciudad de Cali en el año 2012.

Metodología
Estudio descriptivo retrospectivo con población del registro de trauma en el año 2012 <18 años en dos hospitales de Cali (HUV y FVL). Se toman como variables la información socio-demográfica, la etiología, lugar del evento y región anatómica afectada.

Resultados
Se registraron 4920 pacientes (28,5%). El promedio de edad fue 9 (±5,2) años; el 12,1% fueron lactantes, el 16,2% pre-escolares, el 46,3% escolares y el 25,4% adolescentes. Siendo las calles, avenidas y el domicilio los lugares más frecuentes del evento, las primeras causas de consulta fueron las caídas n = 2647 (56,3%) y el aplastamiento n = 567 (12,1%). Las zonas más afectadas fueron los miembros superiores n = 1421 (28,9%) y el 21,4% (n = 1054) fueron heridas múltiples. El 26,6% (n = 1072) se hospitalizaron y el 2,4 requirió UCI. La mortalidad global fue del 1,2%, secundaria principalmente a lesión por arma de fuego 12,9% (35/271).

Conclusiones
La causa principal de consulta fueron las caídas (56,3%); la mortalidad estuvo asociada a lesiones por arma de fuego. Implementar el registro de trauma pediátrico facilita la búsqueda de medidas de prevención para minimizar el riesgo de accidentes causados por factores predecibles creando conciencia e interés del impacto social, económico y familiar que se genera.

How to cite this article
Gómez CSR, Uribe A, Ordoñez CA, Morales M, Ivatury R, Aboutanos M. Reporte de la Tendencia del Trauma Pediátrico en dos Hospitales de Cali en el 2012. Panam J Trauma Crit Care Emerg Surg 2015;4(3):124-135.
Características Clínico—Epidemiológicas del Trauma en Adolescentes, Durante el Período 2012 – 2013 en el Hospital General Del Este ‘Dr Domingo Luciani’ Caracas, Venezuela
Authors: González Adalid , Rosendi Noedvith , Rodríguez Luis , Medina Laura , Bello Emilio , Camacho Luis , Richard Luis 
Published: March 2016

RESUMEN
Los traumatismos a nivel mundial representan la principal causa de muerte en niños, adolescentes y adultos jóvenes, siendo un problema relevante de salud pública, ya que sus consecuencias son trascendentes en magnitud e impacto.

Objetivo
Determinar las características clínico—epidemiológicas del trauma en adolescentes, durante el período 2012– 2013 en el Hospital General del Este ‘Dr Domingo Luciani’, Caracas – Venezuela.

Métodos
Se realizó un estudio retrospectivo y descriptivo, donde se incluyeron 1.521 adolescentes de edades comprendidas entre 13 y 18 años, ingresados en la Unidad de Politraumatizados ‘Dr Fernando Rodríguez Montalvo’ del Hospital General del Este, durante el período comprendido de enero de 2012 a diciembre de 2013, tomado como variables grupo etario, sexo y cinemática del trauma como son: accidentes automovilísticos, motocicleta, bicicleta, arrollamientos, caídas de altura, quemaduras, heridas por arma blanca y de fuego, así como mecanismo desconocido.

Resultados
Se encontró un predominio de trauma en varones de 77,9% y el grupo etario más frecuente fue 18 años con 30,8%. De acuerdo al mecanismo de lesión se obtuvieron con mayores porcentajes accidentes en motocicleta (39,5%) y heridos por arma de fuego (28,4%).

Conclusiones
El número de adolescentes politraumatizados ha venido en ascenso, conllevando a pérdida e incapacidades permanentes del futuro aparato productivo del país, por lo cual es importante incrementar el número de medidas educativas, preventivas y de seguridad así como su cumplimiento, para lograr disminuir todas las consecuencias conocidas.

How to cite this article
González A, Ottolino P, Rosendi N, Rodríguez L, Medina L, Bello E, Camacho L, Richard L. Características Clínico—Epidemiológicas del Trauma en Adolescentes, Durante el Período 2012 – 2013 en el Hospital General Del Este ‘Dr Domingo Luciani’ Caracas, Venezuela. Panam J Trauma Crit Care Emerg Surg 2015;4(3):180-187.
Manejo Conservador del Trauma Penetrante de Tórax, Casuística de 2 Años en Hospital Universitario del Valle en Cali, Colombia, un Importante Centro de Trauma
Authors: Gruezo Raúl Barros , Martínez Jair Díaz 
Published: March 2016

RESUMEN
El traumatismo torácico representa uno de los mayores desafíos en el manejo integral del paciente politraumatizado debido a la alta morbilidad y mortalidad generada por sus complicaciones y los altos costos de la atención de salud. La mayoría de las lesiones torácicas son manejadas con maniobras simples como el tubo de toracostomía, apenas el 10 al 15% de los pacientes necesitan tratamiento quirúrgico. El hemo-neumotórax es la lesión más comúnmente encontrada en el trauma de tórax con una prevalencia del 52.3%, seguido por el Hemotórax 23.4% y el neumotórax del 20% de los casos. Hasta el 30–80% de los pacientes con lesiones traqueobronquiales fallecen en el lugar del accidente. Este estudio de colección retrospectiva de datos incluyo a los pacientes del registro de trauma, que sufrieron trauma penetrante de tórax en un periodo de 2 años y que fueron atendidos en el hospital universitario del valle, encontrándose 587 pacientes con este tipo de trauma, con un total de pacientes operados 257 de los cuales 224 fueron dados de alta y 33 fallecieron; de los 330 pacientes que no fueron operados 262 egresaron y 62 murieron. La mayoría eran hombres 557 y mujeres 30; con 2 tipos de heridas 247 punzocortantes y 340 heridas por proyectil de arma de fuego. Esta importante casuística de las pocas en el mundo, nos permite analizar que el trauma penetrante de tórax es mortal dependiendo de la estructura comprometida y que sin embargo es factible realizar manejo conservador en pacientes seleccionados; no guarda relación a las estadísticas mundiales pues los pacientes operados rebasan el 15%, la importancia radica en que el volumen de pacientes muy graves con necesidad quirúrgica es muy grande por lo que es prioritario identificar quienes se beneficiarían de manejo conservador.

How to cite this article
Gruezo RB, Martínez JD. Manejo Conservador del Trauma Penetrante de Tórax, Casuística de 2 Años en Hospital Universitario del Valle en Cali, Colombia, un Importante Centro de Trauma. Panam J Trauma Crit Care Emerg Surg 2015;4(3):188-193.
Perceptions of US and Australian Medical Students and Instructors About Clinical Professional Attire: LAPEL Study
Authors: Bramstedt Katrina A. , Colaco Clinton M.G. , Silva Eve De , Rehfield Patricia L. , Blumenthal-Barby Jennifer S. 
Published: March 2016

Abstract

Context: White coats have long been the professional uniform of physicians. However, when physicians opt to remove the white coat, their clothing underneath is brought to the forefront and can influence how they are perceived by their patients.

Objective: To explore the perceptions of medical students and their instructors about appropriate clinical professional attire.

Methods: An anonymous, voluntary 55-question survey was electronically distributed to medical students and their instructors at 2 US and 2 Australian medical schools. The survey incorporated 30 images of sample attire, 9 demographic questions, and 16 questions regarding culture and context of clothing and accessories.

Results: In total, 411 students and 73 instructors participated in this study. The data revealed that white coats and neckties are nearly absent in Australian clinical attire. Overall, students were significantly more supportive of full facial coverage due to religious or cultural values compared with instructors (P<.001), and US medical students were significantly more supportive than Australian students (P<.001). All cohorts preferred dress code policies that directed students to avoid but not prohibit the use of perfume or cologne. Nose rings were controversial with significantly more support for use from medical students than instructors (pooled cohorts, P=.002). Medical students in both the United States and Australia indicated that they were most influenced by observing the attire of physicians at work (155 [38%]), compared with courses in medical ethics (19 [5%]), school policy (16 [4%]), or hospital policy (9 [2%]).

Conclusion: Although regional dress code practices are different in the United States compared with Australia, medical students were overall most influenced by their instructors’ attire in clinical settings.
Color Doppler Sonographic and Cadaveric Study of the Arterial Vascularity of the Lateral Upper Arm Flap
Authors: Sun Ruimei , Ding Yu , Sun Chuanzheng , Li Xiaojiang , Wang Jinde , Li Lei , Yang Jie , Ren Yanxin , Zhong Zhaoming 
Published: March 2016

ObjectivesTo determine the importance of adequate preoperative assessment with color Doppler sonography to assist in the successful transfer of lateral upper arm flaps by studying the lateral upper arm flap with color Doppler sonography and analyzing the anatomic features of the radial collateral artery.MethodsA clinical case‐control study was performed. The radial collateral artery was studied with color Doppler sonography in 15 healthy volunteers. The origins, courses, variations, and locations of the perforators of the radial collateral artery were recorded. The results and data from the color Doppler sonographic investigation were compared with an anatomic study that was performed on 22 adult cadaveric upper limb specimens.ResultsThe volunteer group (14 of 15 volunteers) and the cadaveric group (19 of 22 upper arm specimens) clearly showed that the branch pattern of the arterial supply was as follows: brachial artery → deep brachial artery → radial collateral artery → posterior radial collateral artery → myocutaneous perforator. Variations in the origin of the radial collateral artery were identified in 1 volunteer bilaterally and in 3 upper arm specimens. The diameters of the artery and vein measured at the distal insertion of the deltoid and the origin of the deep brachial artery were not significantly different between the volunteer and cadaver groups (P > .05). Due to the difference in measuring methods, the length of the vascular pedicles was significantly different between the groups (P < .05).ConclusionsColor Doppler sonography can facilitate the preoperative assessment of the origin, course, variations, and locations of the radial collateral artery and therefore may increase the success rate of lateral upper arm flap transfer.
Portable A‐Mode Ultrasound for Body Composition Assessment in Adolescents
Authors: Ripka Wagner Luis , Ulbricht Leandra , Menghin Lucas , Gewehr Pedro Miguel 
Published: March 2016

ObjectivesUltrasound (US) imaging is a low‐cost, highly feasible alternative method for monitoring the nutritional status of a population; however, only a few studies have tested the body composition agreement between US and reference standard methods, especially in adolescents. The purposes of this study were to assess the agreement of portable US with a reference standard method, dual‐energy x‐ray absorptiometry (DXA), for body fat percentage (BF%) in adolescents and to verify whether the use of a new mathematical model, based on the anatomic thickness obtained by US, is capable of improving BF% prediction.MethodsThis research was a descriptive study. Measures of total body mass, BF% on DXA, and BF% on US were collected from 105 adolescents.ResultsThe participants included 71 male adolescents (median age ± interquartile range, 14.0 ± 2.0 years) and 34 female adolescents (13.0 ± 2.3 years). Ultrasound yielded significantly lower BF% values than DXA for male (mean ± SD, US, 9.6% ± 6.6%; DXA, 20.0% ± 7.2%; R= 0.848; P< .05) and female (US, 22.5% ± 5.7%; DXA, 30.3% ± 4.9%; R = 0.495; P < .05) participants. In addition, Bland‐Altman analysis showed low concordance. When a multivariate regression was tested, the results improved for both sexes (US, 20.3% ± 4.6%; R= 0.848; P= .503) and female participants (US, 29.0% ± 5.7%; R = 0.712; P = .993) with a standard estimate of error of 1.57%.ConclusionsThis study has shown that US applied in a specific regression for BF% prediction in adolescents has a strong correlation with DXA as well as concordance with Bland‐Altman analysis.
Relationship Between Third‐Trimester Sonographic Estimate of Fetal Weight and Mode of Delivery
Authors: Yee Lynn M. , Grobman William A. 
Published: March 2016

ObjectivesSome have suggested, based on limited data, that knowledge of an estimated fetal weight from a sonogram in a low‐risk population, particularly in the setting of a larger fetus, is associated with increased risk of cesarean delivery. We aimed to investigate, among women delivering neonates weighing greater than 3500 g, whether having had a sonographically estimated fetal weight in temporal proximity to delivery was associated with the risk of cesarean delivery.MethodsWe conducted a retrospective cohort study of term nulliparous women delivering live‐born, cephalic, singleton, nonanomalous fetuses with birth weights of greater than 3500 g. The study was powered to detect a 30% change in cesarean delivery frequency with the presence of a sonographic examination after 36 weeks' gestation.ResultsOf the 2099 women meeting inclusion criteria, 419 (20%) had a sonographic examination after 36 weeks' gestation. Women were similar with respect to demographic and obstetric characteristics regardless of whether they underwent sonography. There were no differences in rates of cesarean delivery regardless of whether women had or did not undergo sonography after 36 weeks (33.2% versus 29.4%, respectively; P = .13). There also were no differences in rates of chorioamnionitis, postpartum hemorrhage, episiotomy, third‐ or fourth‐degree perineal laceration, or neonatal adverse outcomes based on sonographic status. Findings were similar in a multivariable analysis, as well as when the study population was restricted to those with birth weights of greater than 4000 and 4500 g.ConclusionsIn this population of neonates weighing greater than 3500 g, the presence of a sonographic examination was not associated with the frequency of cesarean delivery.
Third‐ or Fourth‐Degree Intrapartum Anal Sphincter Tears Are Associated With Levator Ani Avulsion in Primiparas
Authors: Valsky Dan V. , Cohen Sarah M. , Lipschuetz Michal , Hochner-Celnikier Drorith , Daum Hagit , Yagel Itai , Yagel Simcha 
Published: March 2016

ObjectivesWe evaluated primiparous women with clinically diagnosed third‐ and fourth‐degree and anal sphincter tears, to evaluate the rate of levator ani muscle injury compared to primiparous women without sphincter tears.MethodsPrimiparous women delivering in our maternity ward with intrapartum diagnoses of third‐ or fourth‐degree anal sphincter tears, repaired by the overlapping technique, were recruited to undergo 3‐dimensional transperineal sonography of the pelvic floor anatomy, including the anterior and posterior compartments. Primiparas with uncomplicated vaginal deliveries were recruited as a comparison group. Patient files were examined, and maternal backgrounds and delivery and neonatal details were extracted for all patients.ResultsNinety‐four women with tears were recruited to the study group, and 464 women with normal vaginal deliveries constituted the comparison group. The groups differed significantly in the rates of levator ani defects: 38 of 94 women (40.4%) in the study group versus 75 of 464 (16.2%) in the comparison group (P < .001; odds ratio, 3.53; 95% confidence interval, 2.18–5.7). Neonatal head circumference differed significantly between the study and comparison groups: (mean ± SD, 34.5 ± 1.3 cm in the study group versus 33.9 ± 1.3 cm in the comparison group; P= .005), as did birth weight (3322 ± 430 g in the study group versus 3169 ± 458 g in the comparison group; P = .007). The groups did not differ in maternal age, gestational age at delivery, length of second stage of labor, and rates of epidural anesthesia, episiotomy, and vacuum extraction.ConclusionsThird‐ and fourth‐degree intrapartum sphincter tears are associated with levator ani avulsion. Knowledge of complex pelvic floor damage may allow for prompt referral to secondary preventive measures for pelvic floor disorders.
Predictors of Malignancy in Hyperechoic Breast Lesions
Authors: Nassar Lara , Issa Ghada , Farah Zeina , El Zein Youssef , Berjawi Ghina 
Published: March 2016

ObjectivesHyperechogenicity has been strongly associated with benign breast lesions. Although it is correct in most cases, hyperechogenicity must not always be considered synonymous with benignancy, as hyperechoic breast cancers do occur. The purpose of this study was to review clinical and imaging characteristics of hyperechoic breast lesions, looking for features associated with malignancy.MethodsInstitutional Review Board approval was granted for this research. A total of 19,417 sonographic examinations were performed between January 2009 and June 2013. Among these, hyperechoic lesions with histologic diagnoses, stability on long‐term followup, or characteristic imaging appearances were included in the study. The patients' clinical charts, mammograms, and sonograms were reviewed. The clinical and imaging features were recorded, and the data was analyzed by the χ2 test, Fisher exact test, and independent‐samples t test, looking for statistically significant predictors of malignancy.ResultsAmong the 19,417 scans, 42 patients (0.2%) with 44 hyperechoic lesions were identified. Twenty‐six lesions fulfilling the inclusion criteria were included in the study: 5 malignancies (3 invasive ductal carcinomas, 1 invasive lobular carcinoma, and 1 invasive mucinous cancer) and 21 benign lesions. An irregular shape, a nonparallel orientation, and noncircumscribed margins were significantly associated with the risk of malignancy (P = .002, .02, and .01, respectively).ConclusionsA hyperechoic breast lesion must not always be assumed to be benign. Instead, a full sonographic assessment according to the American College of Radiology Breast Imaging Reporting and Data System descriptors is needed for correct characterization and avoidance of misdiagnosis.
Routine Screening for Callosal Dysgenesis in the Second Trimester Is Achievable With Intensive Training
Authors: Lavender Ilona , Coombs Peter R. , Van Haltren Keith , Robinson Alice J. 
Published: March 2016

ObjectivesThe purpose of this study was to determine whether routine direct visualization of the corpus callosum is achievable during second‐trimester sonography when performed by a large group of sonographers in a general second‐trimester sonographic screening program. The secondary aim was to determine the time taken to obtain a sagittal corpus callosum image.MethodsWe conducted a retrospective cohort study of visualization of the corpus callosum before and after intensive training. Images from 150 consecutive second‐trimester scans were reviewed before and after training to evaluate the image quality of the corpus callosum.ResultsA total of 300 cases were evaluated before and after training. There was a significant increase in the rate of complete visualization of the corpus callosum after intensive training (P < .0001). Before training 35 of 150 cases (23%) had complete visualization of the corpus callosum versus 107 of 150 (71%) after training. The mean time to perform the corpus callosum views was 53.4 seconds before training compared to 56.2 seconds after training.ConclusionsAssessing the corpus callosum in the sagittal view is difficult and requires appropriate training and patience; however, this view is feasible without adding substantial time to the examination and provides additional information during a routine second‐trimester morphologic scan.