bluuebunny/crossref_metadata_2025 huggingface dataset:
Determination of Tangeretin in Rat Plasma: Assessment of Its Clearance and Absolute Oral Bioavailability
Authors: Elhennawy Mai , Lin Hai-Shu
Published: December 2017

Tangeretin (TAN) is a dietary polymethoxylated flavone that possesses a broad scope of pharmacological activities. A simple high-performance liquid chromatography (HPLC) method was developed and validated in this study to quantify TAN in plasma of Sprague-Dawley rats. The lower limit of quantification (LLOQ) was 15 ng/mL; the intra- and inter-day assay variations expressed in the form of relative standard deviation (RSD) were all less than 10%; and the assay accuracy was within 100 ± 15%. Subsequently, pharmacokinetic profiles of TAN were explored and established. Upon single intravenous administration (10 mg/kg), TAN had rapid clearance (Cl = 94.1 ± 20.2 mL/min/kg) and moderate terminal elimination half-life (t1/2 λz = 166 ± 42 min). When TAN was given as a suspension (50 mg/kg), poor but erratic absolute oral bioavailability (mean value < 3.05%) was observed; however, when TAN was given in a solution prepared with randomly methylated-β-cyclodextrin (50 mg/kg), its plasma exposure was at least doubled (mean bioavailability: 6.02%). It was obvious that aqueous solubility hindered the oral absorption of TAN and acted as a barrier to its oral bioavailability. This study will facilitate further investigations on the medicinal potentials of TAN.
MATHEMATICAL MODELING OF STROKE VOLUME FROM THE PERIPHERAL BLOOD FLOW FOR NON INVASIVE PLETHYSMOGRAPHIC MEASUREMENT OF CARDIAC OUTPUT AND ITS VALIDATION
Authors: Choudhari Pranali , Panse M. S.
Published: December 2017

The ability to accurately measure Cardiac Output (CO) is important in clinical medicine as it helps in improving diagnosis of abnormalities and appropriate disease management. In spite of being an important vital parameter, it is still missing from the screens of the bedside monitors employed today. This could be due to the invasiveness of the method or the discomfort in the measurement. Invasive methods are most accurate but can be best suited for the intensive care units (ICUs) and surgeries, but for bedside measurement these methods add an unnecessary risk to the life of the patient. The existing non-invasive method employed for CO measurement is the thoracic bioimpedance method, which is risky for patients with cardiovascular diseases and inaccurate for patients with extra vascular lung water. This paper presents a novel method of CO measurement from the peripheral blood flow, which fairly overcomes the disadvantages of the existing method. The impedance pulse has been acquired across the wrist, instead of the thorax. A new stroke volume equation has been modeled by carrying out the finite element simulation of the blood flow and multiple variable regression to incorporate the patient specific factors. The stroke volume thus obtained has been validated for 57 subjects.
INTRODUCING A DECISION SUPPORT SYSTEM FOR MULTIPLE SCLEROSIS BASED ON POSTURAL TREMOR: A HOPE FOR SEPARATION OF PEOPLE WHO MIGHT BE AFFECTED BY MULTIPLE SCLEROSIS IN THE FUTURE
Authors: Sarbaz Yashar , Pourakbari Hakimeh , Vojudi Mohammad Hossein , Ghanbari Ahmad
Published: December 2017

Multiple Sclerosis (MS) is a progressive and disabling autoimmune disease of the Central Nervous System (CNS). Regretfully, no reliable MS diagnostic test has been proposed so far. Early diagnosis of the disease has significant benefits. Based on studies, it seems that the movement disorders have a good potential to help the researchers diagnose MS in its early stages. The main objective of this study was to propose a decision support system (DSS) for MS based on balance disorder. To this end, 14 MS patients and 20 healthy subjects were recruited in this study. An infrared marker was set on the participants’ forehead and in between eyebrows. They were asked to stand silently in front of a black background for 3[Formula: see text]min with their feet shoulder-width apart. Their balance disorder was recorded with a camcorder. Then, the video images were analyzed using MATLAB software and an image processing algorithm was used to get the marker position on images. In the next step, appropriate features that had the ability to separate healthy subjects from patients were extracted. Finally, an artificial neural network classifier was designed that could separate the patients from healthy subjects with high accuracy (92.35%). Due to the high accuracy of the classifier, it can be used as a system in order to introduce a DSS for the diagnosis of MS. Besides, an intermediate state between healthy and diseased states was imagined and people belonging to this state were simulated based on their features behaviors. Hence, another classifier was designed with accuracy of 84.8%. It seems that the second classifier is capable of separating people suspected of having MS in the future. The main contribution of this study is the classification of suspected cases of having MS in the future. Moreover, the presented DSS is simple, easy to use and has high accuracy. As the presented test method is simple and the duration of imaging time is only 3[Formula: see text]min, it can be performed annually as a routine checkup and immediately after the observation of the slightest disturbances in the postural behavior the person can be asked to visit a specialist for a more detailed examination.
MOLECULAR HETEROGENEITY IN ACUTE PROMYELOCYTIC LEUKEMIA - A SINGLE CENTRE EXPERIENCE FROM INDIA
Authors: Rabade Nikhil , Raval Goutham , Chaudhary Shruti , Subramanian PG , Kodgule Rohan , Joshi Swapnali , Tembhare Prashant , Jain Hasmukh , Sengar Manju , Hasan K Syed , Amare Kadam Pratibha , Shetty Dhanalaxmi , Narula Gaurav , Banavali Shripad , Gujral Sumeet , Patkar Nikhil
Published: December 2017

Atypical breakpoints and variant APL cases involving alternative chromosomal aberrations are seen in a small subset of acute promyelocytic leukemia (APL) patients. Over 7 different partner genes for RARA have been described. Although rare, these variants prove to be a diagnostic challenge and require combination of advanced cytogenetic and molecular techniques for accurate characterization. Heterogeneity occurs not only at the molecular level but also at clinico-pathological level influencing treatment response and outcome. In this case series we describe the molecular heterogeneity of APL seen in a single tertiary referral centre with a focus on seven variant APL cases from a single tertiary cancer center in India over a period of two and a half years. We discuss five cases with PLZF-RARA fusion and two novel PML-RARA variants, including a Bcr3 variant involving fusion of PML exon4 and RARA exon3 with an additional 40 nucleotides originating from RARA intron2, another involving exon 6 of PML and exon 3 of RARA with addition of 126 nucleotides, which mapped to the central portion of RARA intron 2  To the best of our knowledge this is the first of kind case series from India
Lower Ordovician to Middle Devonian stratigraphy, Macdonald Platform-Ospika Embayment transect, Halfway River, Ware, and Trutch map areas, northeastern British Columbia
Authors: Pyle L J , Barnes C R
Published: December 2017

This study describes a transect across the Macdonald Platform to Ospika Embayment. At least two periods of renewed extension along the early Paleozoic Cordilleran margin occurred in the latest Cambrian and late Early Ordovician, marked by deposition of the
Kechika Formation and the abrupt platform-to-basin transition marking deposition of the Skoki-Ospika formations. Alkalic volcanic rocks associated with abrupt facies changes are consistent with multiphase rifting. Several prominent unconformities punctuate the succession. Conodont biostratigraphy
provides new age control for the Skoki, Beaverfoot, McCusker, and Nonda formations. The Robb, Kenny, and Laurier formations are transitional facies of the Road River Group. The lower part of the Kenny Formation is coeval with the McCusker Formation, and the upper part interfingers with the Nonda
Formation. The Laurier Formation is correlative with the upper Nonda Formation. The Deserters Formation (Road River Group) was deposited in a linear sub-basin of the Ospika Embayment.
Lower and Middle Devonian outcrop stratigraphy of northeast British Columbia
Authors: Nadjiwon L M , Morrow D W , McCracken A D , Coniglio M
Published: December 2017

Presqu'ile Barrier reef strata are documented in six measured sections from southern Trutch and Halfway River map areas, Rocky Mountain Thrust Belt, northeastern British Columbia. They contain abundantly stromatoporoidal strata as young as mid-Givetian.
Presqu'ile Dolomite is commonly developed in large masses within thick 'Upper Chinchaga to Slave Point Undivided' limestone successions in outcrop. Less extensive, white, hydrothermal dolospar is developed within relatively thin Dunedin Formation strata, particularly in slope settings immediately
basinward of the Presqu'ile Barrier reef complex. Manetoe Dolomite occurs within Dunedin strata, even in northernmost sections. The Dunedin Formation's basal unconformity and its diachronous and gradational upper contact with the Besa River Formation are confirmed and documented. Lower to Middle
Devonian siliciclastic units occur within the Laurier Embayment, a broad bypass channel through the Presqu'ile Barrier reef complex. Extensive Presqu'ile Dolomite occurs south of Laurier Embayment, similar to that in the nearby Clarke Lake gas field.
Introduction to stratigraphic sections from the Central Foreland NATMAP Project area: Proterozoic to Devonian successions
Authors: Lane L S , MacNaughton R B
Published: December 2017

The NATMAP Program (1991-2003) of the Geological Survey of Canada had a mandate to support field-based bedrock and surficial mapping projects. The Central Foreland NATMAP Project (1997-2002) focused on the bedrock and surficial geology of two contrasting
transects across the Cordilleran foothills, one in the northern Rocky Mountain of British Columbia, the other across the Liard Plateau of southeast Yukon and adjacent Northwest Territories. Numerous stratigraphic sections were measured in support of this work. The present Bulletin provides detailed
descriptions and photographic documentation of most of the Proterozoic to Devonian sections measured during the Project, as well as a number of sections measured in the project area in the 1960s and 1970s but not previously published in detailed form. This introductory chapter summarizes the
Bulletin and points the reader to additional Central Foreland NATMAP Project stratigraphic sections that have been published in other venues.
Intracranial translucency as a sonographic marker for detecting open spina bifida at 11–13+6 weeks scan: Our experience
Authors: Teegala Madhavi L , Vinayak Dhamangaonkar G
Published: December 2017

Aims and Objectives: The fourth ventricle, seen as intracranial translucency (IT) at 11–13+6 weeks, has been reported to be obliterated in cases of open spina bifida (OSB). Our aim was to assess its role in detecting OSB at 11–13+6 weeks. Materials and Methods: This prospective study was conducted at foetal medicine unit from January 2014 to June 2015. All women who underwent both first and mid-trimester scan in our unit were included in the study. IT was categorized as normal, obliterated or not clear. Spine was examined during both scans. Results: Totally, 341 cases were included in the study. IT was found to be obliterated in four cases and not clear in one case. There was demonstrable OSB at 11–13+6 weeks in two cases, at 15–16 weeks in two cases and at 24 weeks in one case. In the remaining 336 cases with normal IT, spine was found to be normal at target scan. Conclusion: Mid-sagittal view of face that is routinely used to measure nuchal translucency (NT) can also be used to detect OSB. It is feasible to integrate IT into the routine 11–13+6 weeks scan.
Dilemma of diagnosing thoracic sarcoidosis in tuberculosis-endemic regions: An imaging-based approach. Part 2
Authors: Bhalla Ashu S , Das A , Naranje P , Goyal A , Guleria R , Khilnani Gopi C
Published: December 2017

The second part of the review discusses the role of different existing imaging modalities in the evaluation of thoracic sarcoidosis, including chest radiograph, computed tomography, magnetic resonance imaging, endobronchial ultrasound, and positron emission tomography. While summarizing the advantages and pitfalls of each imaging modality, the authors propose imaging recommendations and an algorithm to be followed in the evaluation of clinically suspected case of sarcoidosis in tuberculosis-endemic regions.
Abdominal aorta aneurysm with hostile neck: Early outcomes in outside instruction for use in patients using the treovance® stent graft
Authors: Rossi Umberto G , Torcia Pierluca , Dallatana Raffaello , Santuari Davide , Mingazzini Pietro , Cariati Maurizio
Published: December 2017

Purpose: The efficacy and safety of endovascular aneurysm repair (EVAR), in patients outside instruction for use (IFU), is very challenging and widely debated. The aim of this study was to evaluate the placement of the Treovance® abdominal aorta stent-graft in patients with hostile proximal necks considered outside IFU. Materials and Methods: Between May 2013 and August 2014, 5 patients with outside IFU underwent EVAR with the Treovance® stent-graft. Technical and clinical successes were evaluated. All 5 patients underwent clinical and imaging follow-up. Results: Technical and clinical successes were achieved in all 5 patients without adjunctive endovascular procedures or surgical conversion. During the mean follow-up of 21 months, no type I/III endoleaks, stent-graft migration nor kinking/occlusion were observed. In all 5 patients, a reduction of the proximal neck angle was observed. Conclusion: In our small series of selected outside IFU patients, EVAR with the Treovance® stent-graft was technically feasible and safe, with satisfactory short-term follow-up results, when performed by experienced operators. Long-term follow-up will be necessary to confirm the durability of our preliminary promising results.
Comparison of fractional anisotropy and apparent diffusion coefficient among hypoxic ischemic encephalopathy stages 1, 2, and 3 and with nonasphyxiated newborns in 18 areas of brain
Authors: Kushwah Supriya , Kumar Ashok , Verma Ashish , Basu Sriparna , Kumar Ashutosh
Published: December 2017

Purpose: To determine the area and extent of injury in hypoxic encephalopathy stages by diffusion tensor imaging (DTI) using parameters apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values and their comparison with controls without any evidence of asphyxia. To correlate the outcome of hypoxia severity clinically and significant changes on DTI parameter. Materials and Methods: DTI was done in 50 cases at median age of 12 and 20 controls at median age of 7 days. FA and apparent diffusion coefficient (ADC) were measured in several regions of interest (ROI). Continuous variables were analyzed using Student's t-test. Categorical variables were compared by Fisher's exact test. Comparison among multiple groups was done using analysis of variance (ANOVA) and post hoc Bonferroni test. Results: Abnormalities were more easily and accurately determined in ROI with the help of FA and ADC values. When compared with controls FA values were significantly decreased and ADC values were significantly increased in cases, in ROI including both right and left side of thalamus, basal ganglia, posterior limb of internal capsule, cerebral peduncle, corticospinal tracts, frontal, parietal, temporal, occipital with P value < 0.05. The extent of injury was maximum in stage-III. There was no significant difference among males and females. Conclusion: Compared to conventional magnetic resonance imaging (MRI), the evaluation of FA and ADC values using DTI can determine the extent and severity of injury in hypoxic encephalopathy. It can be used for early determination of brain injury in these patients.
Cardiac magnetic resonance techniques: Our experience on wide bore 3 tesla magnetic resonance system
Authors: Auti Onkar B , Bandekar Kalashree , Kamat Nikhil , Raj Vimal
Published: December 2017

Cardiovascular magnetic resonance (CMR) has become a widely adapted imaging modality in the diagnosis and management of patients with cardiovascular diseases. It provides unparalleled data of cardiac function and myocardial morphology. Majority of CMR imaging is currently being performed on 1.5 Tesla (T) MR systems. Over the last many years, the cardiac imaging protocols have been standardized and optimized in the 1.5T systems. 3T MR systems are now being used more and more in small and large institutions in our country due to their proven advantages in the field of neuro, body, and musculoskeletal imaging. Cardiac imaging on 3T system can be a double-edged sword. On one hand, it may provide nondiagnostic images due to significant artifacts, and on the other hand, it may complete the examination in quick time and provide excellent quality images. It is therefore important for the user to be aware of the potential pitfalls of CMR in 3T systems and also the necessary steps to avoid them. In this study, we discuss various challenges and advantages of performing CMR in a 3T system. We also present potential technical solutions to improve the image quality.
Reinforcing Effects of Calcium Silicate-based Cement and Dual Cure Composite Resin in Simulated Immature Teeth with an Open Apex: An in vitro Study
Authors: Zhabuawala Murtuza S
Published: December 2017

Aim

To evaluate the fracture resistance of simulated immature teeth with an apical plug of biodentine followed by composite resin vs total obturation with biodentine tested immediately and after 3 months of aging and also to find out the chemical composition of dentin in contact with these materials.

Materials and methods

Extracted human maxillary central incisors with simulated immature apex with radicular dentin thickness (RDT) of 1 to 1.5 mm selected and divided into three groups of 20 each. Group I (control)—4 mm biodentine apically and thermoplasticized gutta-percha. Group II—4 mm biodentine apically and composite resin. Group III—complete obturation with biodentine. About 10 samples from each group were tested immediately and remaining 10 stored in phosphate buffered solution (PBS) and tested after 3 months for fracture resistance and chemical analysis of dentin.

Results

No significant difference in fracture resistance between the groups was observed when tested immediately. After 3 months of aging, only biodentine group showed a significant reduction in fracture resistance with increased Ca/P ratio of root dentine.

Conclusion

Biodentine group has shown drastic reduction in fracture resistance after 3 months of aging, and hence, cannot be recommended as a reinforcement material in immature teeth with thin dentin walls.

How to cite this article

Zhabuawala MS, Nadig RR, Pai VS, Gowda Y, Aswathanarayana RM. Reinforcing Effects of Calcium Silicate-based Cement and Dual Cure Composite Resin in Simulated Immature Teeth with an Open Apex: An in vitro Study. Int J Clin Pediatr Dent 2017;10(4):351-357.
Impacted Lower Second Permanent Molars at the Ramus and Coronoid Process: A New Clinical Symptom of the WNT10A Mutation in Ectodermal Dysplasia
Authors: Aboujaoude Samia
Published: December 2017

Aim

Hidrotic ectodermal dysplasia (ED) with the WNT10A mutation produces variable dentofacial symptoms. The aim of this study was to describe a new clinical symptom, i.e., specific to the WNT10A mutation in hidrotic ED. The study investigated the migratory trend of the lower second permanent molars to the ramus or coronoid process. To the best of authors' knowledge, no data in the literature describe this trend in cases of hidrotic ED.

Materials and methods

A three-generation family pedigree was established for seven families after the diagnosis of hidrotic ED in a 10-year-old boy. Thereafter, a genetic and clinical study was conducted on three families with at least one individual affected by hidrotic ED (20 individuals). We selected the children with molar germs 37 and 47. The eruption axes of these germs were then traced on the panoramic images at the initial time (T0) and 1 year later (T0+ 1 year), and the deviations between these axes were measured.

Results

A significant familial consanguinity was shown. Eight subjects presented with the hidrotic ED phenotype. Among them, three individuals carried germs 37 and 47. Over time, the measured deviations between the eruption axes of the latter displayed, in the majority of the cases, a distal inclination toward the ramus.

Limitations

A larger sample size is mandatory to assess the frequencies and treatment modalities.

Conclusion

The presence of germs in the lower second permanent molars in patients with hidrotic ED is an important clinical symptom that should be monitored to detect and prevent ectopic migration of these teeth.

Clinical significance

In hidrotic ED cases, the study of the presence of the second lower permanent germs must include clinical and radiological examinations. Establishing an interceptive treatment is necessary to prevent the migration of the molars in question.

How to cite this article

Sfeir E, Aboujaoude S. Impacted Lower Second Permanent Molars at the Ramus and Coronoid Process: A New Clinical Symptom of the WNT10A Mutation in Ectodermal Dysplasia. Int J Clin Pediatr Dent 2017;10(4):363-368.
Evaluation of Knowledge, Awareness, and Occurrence of Dental Injuries in Participant Children during Sports in New Delhi: A Pilot Study
Authors: Kumar Puneet
Published: December 2017

Aim

To evaluate the occurrence of dental injuries in children, the level of knowledge of the participants about preventive measures, and management of dental trauma during sports, in New Delhi.

Materials and methods

A cross-sectional study was carried out among 450 children aged 6 to 16 years. A structured interviewer-guided questionnaire was used to determine the prevalence of oral injuries sustained during sport activities, the use of mouthguard as well as the athlete's awareness regarding use of mouthguard. The respondents consisted of 313 males (69.6%) and 137 females (30.4%) with a mean age of 12.6 years.

Results

Out of the total participants, 27 (6%) had chipping or fracture of teeth, 25 (5.6%) had soft-tissue laceration, 24 (5.4%) had avulsion of teeth, and 18 (4%) had suffered fracture of jaw/bones. Out of the total participants, 263 (58.4%) knew that it was possible to replant the teeth and 187 (41.6%) did not know that it was possible to replant the teeth. Out of the total participants, 203 (45.1%) did not know what is the best time to put the teeth back in the mouth and 247 (54.9 %) answered in affirmative with variable answer. Of the total participants, 223 (49.6%) answered that they would carry avulsed tooth in water, 94 (20.8%) wrapped in cloth, 57 (12.6%) in mouth/saliva, 9 (2%) in Hanks' balanced salt solution (HBSS), and 67 (14.8%) answered others. Of the total participants, 321 (71.3%) were aware that mouthguards prevent injury and 129 (28.7%) did not know about mouthguards. Out of the total participants, 94 (20.9%) used mouthguards and 356 (79.1%) had never used mouthguards.

Conclusion

Level of awareness and knowledge about sports-related orofacial injury is very poor among children in New Delhi. Education on prevention of orofacial trauma should be given to the coaches and children. Wearing of mouthguards during sport activities should be compulsory during practice and competition events.

How to cite this article

Goswami M, Kumar P, Bhushan U. Evaluation of Knowledge, Awareness, and Occurrence of Dental Injuries in Participant Children during Sports in New Delhi: A Pilot Study. Int J Clin Pediatr Dent 2017;10(4):373-378.
Management of Mandibular Angle Fracture in a 9-year-old with Miniplate and Monocortical Screws: A Clinical Challenge
Authors: Shunmugavelu Karthik , Subramaniam Kumaravel
Published: December 2017

The main characteristic feature of the pediatric mandible is that of decreased dimension, which leads to compromises in the open reduction and internal fixation (ORIF). In the dental segment, the cervically bulbous short stature primary teeth might act an obstacle during the maxillomandibular fixation conventionally. An increased osteogenic potential of bones favors rapid consolidation and remodeling in the affected region. The mixed dentition of the ugly duckling stage adds more burden while stabilizing the fractured segments. The main goal of the clinician is to achieve and restore the facial appearance and function. Hereby, we present a clinical challenge depicting a 9-year-old male with mandibular angle fracture managed by miniplate and monocortical screws fixation.

How to cite this article

Shunmugavelu K, Subramaniam K. Management of Mandibular Angle Fracture in a 9-year-old with Miniplate and Monocortical Screws: A Clinical Challenge. Int J Clin Pediatr Dent 2017;10(4):391-393.
The Effect of Non-Peforming Loans Management on the Financial Performance of Commercial Banks in Rwanda: A Case Study of ECOBANK Rwanda
Authors: Harelimana Jean Bosco
Published: December 2017

The study assessed the impact of Non-Performing Loans management on the financial performance of commercial Banks in Rwanda: a case study of ECOBANK Rwanda throughout the period from 2013 -2015. Qualitative and quantitative data were collected from the total population of 295 of employees of ECOBANK Rwanda where a sample of 170 of respondents was selected. The findings were summarized below in accordance of research objectives. Methods such as questionnaires, structured interview were used under this study. From the findings, the results confirmed there are many factors account for the incidence of non-performing loans in ECOBANK. The profit ratios performance of ECOBANK RWANDA from 2013 to 2015 indicated an increase from 2013 to 2014 where it came from on 9.24% to 14.92% of profit, while in 2014 to 2015 are characterized by increasing in profit from 14.92% to 15.18% of profit. There is an evidence of association between NPLs management and financial performance of ECOBANK Rwanda which was 0.741. ECOBANK Rwanda should look if it is necessary the participation of all stakeholders in the implementation of credits delivery principles. It should continue to do an improvement since NPLs management contributes 54.9% on financial performance at ECOBANK, they could reach even on 100.0% when improvement is done well at this commercial bank.
Reviewer Acknowledgements for International Journal of Statistics and Probability, Vol. 7, No. 1
Authors: Smith Wendy
Published: December 2017

International Journal of Statistics and Probability wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal is greatly appreciated.Many authors, regardless of whether International Journal of Statistics and Probability publishes their work, appreciate the helpful feedback provided by the reviewers.Reviewers for Volume 7, Number 1 Afsin Sahin, Gazi University, TurkeyAli Reza Fotouhi, University of the Fraser Valley, CanadaBibi Abdelouahab, University Mentouri Constantine, AlgeriaFelix Almendra-Arao, UPIITA del Instituto Politécnico Nacional , MéxicoLuiz Ricardo Nakamura, University of Sao Paulo, BrazilMaryam Eskandarzadeh, Persion Gulf Boshehr University, IranShatrunjai Pratap Singh, John Hancock Financial Services, USAVilda Purutcuoglu, Middle East Technical University (METU), Turkey Wendy SmithOn behalf of,The Editorial Board of International Journal of Statistics and ProbabilityCanadian Center of Science and Education
The role of the blue economy in Pomorskie Region
Authors: Graban Michał
Published: December 2017

The aim of this article is to discuss the role of the blue economy, also known as “blue growth”, as related to the traditional maritime economy in Pomorskie Region. The potential of the latter is comprised by transport infrastructure centres consisting mainly of two ports – in Gdańsk and Gdynia – with a fundamental role for the national economy. These ports in recent years have seen intensified growth as evidenced by their increased throughput – mainly in terms of containerized cargo volumes. The modern approach to the maritime economy is based not only on heavy, large-scale investment in the infrastructure and cargo handling capacities, but also on sustainable development related to sophisticated technology and energy saving. The importance of the latter has been highlighted by Pomorskie Region’s four Intelligent Specializations aimed at ensuring sustainable growth in the region. Although the maritime economy is the focus mainly of Intelligent Specialization No. 1 “Offshore, port and logistics technologies,” there is in fact a synergy effect which has led to establishing mutual relations between all intelligent specializations. This approach combines the shipbuilding industry with energy production and biotechnology through innovative solutions. Meanwhile, IT supports logistics and marine tourist helps modernize and revamp sea ports as well as stimulates Pomeranian shipyards to manufacture specialist ferries and passenger ships.
Simple and facilitated diffusion of long chain fatty acids
in the pathogenesis of nonalcoholic fatty liver disease
Authors: Berk Klaudia , Iłowska Nicoletta , Konstantynowicz-Nowicka Karolina , Chabowski Adrian
Published: December 2017

Nonalcoholic fatty liver disease (NAFLD) is defined as lipid accumulation in hepatocytes, in the absence of alcohol use, that exceeds 5% of liver size. The most frequent comorbidities of NAFLD include diabetes mellitus, insulin resistance and hyperlipidemia. The accumulation of various lipid fractions results from excessive hepatic uptake of long chain fatty acids (LCFA) that is not compensated by oxidation. The cellular influx of LCFA occurs in the mechanism of passive diffusion through fenestrations in sinusoidal endothelium, and is due to caveolae system which participates in the endocytosis of macromolecules. The dynamic character of fenestration and their changes caused by the application of a different dietary pattern may indicate that they contribute to the development of metabolic disturbances. The second way
of the LCFA entrance to the cells is through a facilitated transport that involves fatty acid
transporters: translocase FAT/CD36, fatty acid binding protein FABPpm, fatty acid transport
proteins FATP2 and FATP5, which are localized in the cell. It has been proven that changes in
the expression of these transporters are strongly associated with abnormal lipid metabolism
in the liver. The key aim of this review is to describe the possible ways of intracellular lipid
uptake to the liver in terms of NAFLD development and accompanying obesity. The role of
facilitated diffusion, being necessary for the efficient function of the liver, is also presented.
Reading and writing for healers
Authors: Horvath Zsuzsa , Salter Cynthia , Resick Judith , Fan Xiaohan , Mehta Tanvi , Sgro Gaetan , Trachtenberg Peter
Published: December 2017

Aims, background and objectives: A growing body of research demonstrates that teaching close-reading and reflective writing to clinicians improves their ability to provide patient- and person-centered care. Through narrative medicine workshops, providers gain skills that can improve relationships with patients, increase empathy among clinicians and enhance clinical care. The goal of the event series (book discussion and reflective writing sessions) offered at the University of Pittsburgh School of Dental Medicine, USA was to provide participants an interactive opportunity to practise and reflect upon the basic tenets of narrative medicine. Methods: The objectives were to recognize how a written text can inform and enhance empathetic and humanistic thinking and to develop an increased appreciation for the importance of humanistic thinking in healthcare. The goal of this article was to share the outcomes of a unique program, which was offered in an interprofessional setting and organized by collaborators across disciplines within and outside of the healthcare professions. To evaluate the overall effectiveness of the introductory presentation, book discussion and reflective writing sessions, anonymous surveys were employed to study participants’ perception about the role of literature in healthcare, the role of reflection in the provision of care and insights gained in the sessions. Results: The study revealed overwhelmingly positive responses by the participants to the programming. Qualitative data analysis revealed multiple areas of learning. Discussion and Conclusion: Due to the success of the workshop series, the School of Dental Medicine will offer the event again and expects it to become a sustained yearly event that fosters collaborations across different schools of the University.
Social Media: A rich resource for understanding patients’ disease and treatment frame and building (on) patient-centricity models
Authors: Batzel Pamela
Published: December 2017

Research and initiatives within healthcare are increasingly focused on integrating the voice of patients with the recognition that understanding patients’ experiences and values are essential to providing meaningful treatment and treatment programs. In this paper, I address the nature of existing research relative to the concepts of Patient Centered Care and Patient Reported Outcomes as well as the degree to which that research integrates patients’ voices as heard through social media. The article argues that while there is increasing recognition of the internet as a location through which to reach patients - such as for delivery of information and healthcare management tools - there are great opportunities for conducting significantly more and much deeper analyses of patients’ (and healthy people’s) vantage point via the discussions they have online with peers in social media. Social media locations range from open communities within Facebook and Reddit to much smaller open-access .org and .com communities. Analyses can provide insight into a range of questions from patients’ cognitive orientation and ways of making sense of or working with their disease to the physician-patient relationship as signaled by patients’ positioning of the physician.
The meaning of life in medicine: non-religious spiritual care in Japan
Authors: Chilson Clark
Published: December 2017

Within the context of a growing global interest in the role of spirituality in medicine, “spiritual care” has developed as a form of patient-centered care that addresses existential suffering. This paper provides an introduction to spiritual care in Japan. On the basis of publications by leading Japanese authors on spiritual care, it first shows how spiritual care developed in Japan and how it is understood as a way of providing meaning and comfort distinct from “religious care.” Then it introduces some common methods used for spiritual care in Japan. Overall, it argues that the way spiritual care is conceptualized and offered in Japan provides suggestions for how spiritual care might be offered to patients who are non-religious and do not see themselves as “spiritual”.
Bo Hejlskov Elvén & Sophie Abild McFarlane. (2017). Frightened, Disturbed, Dangerous? Why working with patients in psychiatric care can be really difficult and what to do about it. London: Jessica Kingsley Publishers. ISBN 9781785922145
Authors: Lindsay Margot Elizabeth Virginia
Published: December 2017

No abstract
A self-help based Acceptance and Commitment Therapy programme using Internet delivery: effect on adults intending to work who have utilized their sick leave due to depressive symptoms
Authors: Tei-Tominaga Maki
Published: December 2017

Rationale: The aim of this study was to develop a self-help based Acceptance and Commitment Therapy (ACT) programme using Internet delivery, which can be practised at the workplace or at home and to examine its effect on adults intending to work who have utilized their sick leave due to depressive symptoms. Method: A one-group, baseline-to-post-intervention design was utilized with participants in Japan. Among the participants (N = 35), 26 completed the self-help based programme and answered all questionnaire surveys on 3 occasions: baseline (T1), after 3 weeks (T2) and after 6 weeks when the programme ended (T3). As the primary outcome, depressive symptoms were assessed using the Zung Self-Rating Depression Scale. As the secondary outcome, psychological flexibility was assessed using the Japanese version of the revised Acceptance and Action Questionnaire. Additionally, 3 items to assess process were administered and participants’ written comments were organized by content.Results: Although the number of participants who showed mild and moderate depressed states decreased, depressive symptom scores did not significantly change over time. Psychological flexibility at T3 significantly improved compared to baseline, while the effect size was relatively low (Cohen’s d = 0.35). One of the scores from the process measures showed a significant difference between T2 and T3. There were 5 positive and 5 negative comments. Conclusions: Along with participants’ comments, the findings suggested the effectiveness of the self-help based ACT programme using Internet delivery. This has the potential to help develop mindfulness and acceptance skills in adults who are intending to return to work after taking sick leave for depressive symptoms.
: Evaluation of the Validity and Reliability of the Suicide Opinion Questionnaire as a Measure of Korean Nurses’ Attitudes toward Suicide
Authors: Lee Eun Nam , Kim Jang Mi
Published: December 2017

Background: The aim of this study was to investigate the validity and reliability of the Korean version of the Suicide Opinion Questionnaire to measure Korean nurses’ attitudes toward suicide attempters.Methods: The questionnaire data were collected from 191 nurses who worked in emergency rooms, emergency wards and psychiatry wards. The internal consistency reliability and construct validity were evaluated using exploratory and confirmatory factor analysis.Results: The Cronbach’s α values regarding internal consistency were 0.51-0.79 for the subscales of the Korean version of the Suicide Opinion Questionnaire. The factor loadings of 18 items on the 6 subscales ranged from 0.54 to 0.84. The 6 subscale model was validated by a confirmatory factor analysis. The goodness-of-fit indexes were verified to be χ2/df = 1.56, root mean square residual = 0.04, goodness of fit index = 0.91, adjusted goodness of fit index = 0.86, Tucker-Lewis index = 0.9, comparative fit index = 0.92 and root mean squared error of approximation = 0.05.Conclusion: The findings indicated relatively satisfactory construct validity for the Korean version of the Suicide Opinion Questionnaire, whereas the reliability was not high. The current study indicates that the questionnaire should be used with caution when measuring nurses’ attitudes toward suicide attempters.
Effects on self-management behaviour after an individual nurse-led counselling programme for patients discharged early after myocardial infarction: A 12-month randomised controlled follow-up
Authors: Brørs Gunhild , Norekvål Tone M , Skotnes Liv Heidi , Romild Ulla , Fridlund Bengt
Published: December 2017

Rationale, aims and objectives: Secondary prevention programmes reduce cardiovascular risk, but few studies have evaluated whether a nurse-led intervention for patients discharged early after myocardial infarction (MI) promotes self-management behaviour. The aim of this study was to evaluate the effect of an individual nurse-led counselling programme combined with usual care versus usual care alone on self-management behaviour of patients discharged early after MI.Methods: Seventy-one patients were randomised to either the usual care (control group) or to the usual care combined with a 6-month follow-up individual nurse-led counselling programme (intervention group). The latter consisted of 3 face-to-face sessions and 2 telephone contacts over 6 months, starting 2 weeks after discharge. Primary outcome measures at 6- and 12-month follow-up was the difference in self-management behaviour assessed by the patient activation measure (PAM). Secondary outcomes included physical activity and diet habit.Results: The median age of patients was 63 years and 70% were males. The intervention group had a greater effect on their PAM scores and had higher average intensity and longer duration of physical activity at 6-months and a higher summary index of weekly physical activity at 6- and 12-month follow-up compared to the control group. There was a clinically relevant effect on diet score within the intervention group at 6- and 12-month follow-up.Conclusions: An individual nurse-led counselling programme combined with usual care for post-MI treatment, had an effect on self-management behaviour at 6-month follow-up. The results also indicate an effect on health behaviour at 12-month follow-up.
What is needed to support bariatric surgery recipients’ long-term health and wellbeing? Bariatric clinic staff’s perspectives
Authors: Liu Rebecca H , Irwin Jennifer D
Published: December 2017

Rationale and Aim: Not all bariatric surgery recipients are able to sustain long-term weight loss and weight maintenance. The purpose of this study was to explore what bariatric clinic staff perceive is needed to best support the long-term health and wellbeing of bariatric surgery recipients. Methods: Thirteen bariatric clinic staff completed an online questionnaire, adapted from a previously created tool. The revised tool was evaluated by 3 bariatric clinic staff prior to implementation and contained 5 close-ended demographic items and 6 open-ended questions. Demographic items were analyzed using descriptive statistics and inductive content analysis was used to identify emerging themes in participants’ in-depth open ended responses. Methods were employed throughout to support data trustworthiness. Results: All participants were female, ranged from 45-59 years old and worked in the field of bariatric surgery on average for approximately 3 years and 3 months (± 32.2 months). Bariatric clinic staff believed follow-up appointments, bariatric surgery-related education and assessing readiness to change were the most helpful aids. A lack of: ongoing counselling, financial support for excess skin removal, family physicians with expertise in bariatric surgery and access to allied health professionals were deemed needed but unavailable. Recommendations to address challenges included offering one-on-one counselling and providing education and resources for Family Health Teams and others.Conclusions: This is the first study detailing the perspectives of bariatric care-specific providers on bariatric surgery recipients’ needs. Overall, this study provides a complementary viewpoint to the needs and perspectives of surgery recipients and develops our understanding of optimal, feasible and person-centered bariatric care.
Doing no harm: Addressing the quality of evidence in translating research to practice in preliminary research fields
Authors: Lim Mei'En , Reid Corrine
Published: December 2017

Background: Current evidence appraisal rating systems, such as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, are oriented toward and anchored by randomized controlled trials (RCTs) as the gold standard methodology. In many fields, this standard of evidence is rarely, if ever, met. Often, research at the clinical application end of the translational process is embedded in real world practice that does not lend itself to RCTs and is characterised by more pragmatic research using mixed methodologies. Arguably, accountability through research evaluation is even more important in such cases where research design is preliminary and clinical impact is, often, already a reality. Further, practice translation must be privileged as the central goal of the research synthesis under such circumstances in that the destination of all clinical science is the person of the patient.. Methods: In response to these demand characteristics, a practitioner-informed research framework was used to drive and pilot development of an evidence quality grading system that could accommodate a disparate and oblique evidence base. Reid’s person-centered framework was used to establish whether clinician-derived criteria for quality research practice had been met. Results: This brief report presents the Quality of Evidence Rating System (QERS) in the hope of facilitating discussion about accountability pathways for translational scientist-practitioners.Conclusion: The QERS provides a scaffold to help when looking for evidence that researchers have consciously addressed the issues of evidence quality when reporting their research in the published literature.
Interdisciplinary Work at Pitt: Humanities in Health Conference
Authors: Stricker Edward
Published: December 2017

no abstract
An interdisciplinary approach to cultural competence education in an academic health center
Authors: Soudi Abdesalam , South-Paul Jeannette
Published: December 2017

Described in this paper is an example of integrating humanities into health interventions or clinical care via a Masters course for graduate students in medical education. The paper outlines the background of the authors (a linguist and a family physician) and explores how their diverse experiences have impacted course development. It describes an increasing number of clinical cases in a large academic health center that spotlight cultural discordancy and subsequent barriers to quality clinician-patient communication and decision-making. It focuses on cultural and linguistic competency and demonstrates how these skills enhance our understanding of social determinants of health. Lastly, it identifies new areas for improving the quality of care in our increasingly diverse community.
Simulated Patient (SP) methodology for communication training in any discipline
Authors: Fulmer Val
Published: December 2017

Introduction: The University of Pittsburgh School of Medicine Standardized Patient (SP) Program has assisted with communication skills training in medical and other health science departments since 2002. We will explore how the realism of training interpersonal communication skills with Simulated/Standardized Patient (SP) “role play” can enhance the quality and versatility of any communication-based evaluation or training in health and a variety of other environments. Description: Since the early 1960s, collaborations with the dramatic arts have been leveraged in “educational acting” within medical schools around the world. Formal programs that employ SPs to teach and test interpersonal skills using educational “role play” techniques are now common. An SP is defined as “a person trained to consistently portray a patient or other individual in a scripted scenario for the purposes of instruction, practice, or evaluation”. SP methodology is a powerful tool to utilize when training objectives relate to the understanding of individual perspectives, cultural, technical and professional behaviors.Program Results: Initially formed to support the School of Medicine, the desire for collaborative and interprofessional learning has expanded our program’s scope to include seven other health sciences within the University. As interpersonal communication skills have been shown to improve patient-centric care and customer satisfaction, this training provides experiential practice and measurable outcomes of these foundational skills. Implications: As all disciplines move more towards improving the experience of the “consumer”, an increased concern with end user satisfaction is essential. The transferability of SP methodology is applicable across many fields, including Law, Business and Social Work among other programs. Continued collaboration has significant potential for training professionals in all disciplines.
Humanities in Health
Authors: Beeson Patricia E
Published: December 2017

No abstract