bluuebunny/crossref_metadata_2025 huggingface dataset:
ПЕЈЗАЖНИ ДЕТАЉИ У ДЕЛУ М. ЦРЊАНСКОГ ДНЕВНИК О ЧАРНОЈЕВИЋУ
Authors: Лукић Галина М.
Published: December 2015

Пејзаж у књижевном делу је уметникова импресија о природи. Уметничка слика пејзажа настаје када се на елементе опажене у природи надгради уметников доживљај, када се предметима и појавама природе удахне пишчев душевни свет осећања и расположења. У овом раду нас је занимало како се у роману Црњанског рефлектују пејзажни детаљи и које основне функције они носе. Такође смо разматрали у којем су обиму пејзажни детаљи присутни у роману, како су они уграђени у структуру текста, каква је њихова улога и које појаве и факте они скривају у себи. Свака прича у роману захваљујући скупу одређених пејзажних детаља добија своју емоционалну позадину и ствара одређену атмосферу или директно одсликава душевно стање јунака.
К ВОПРОСУ О ПОСТРОЕНИИ ИМЕНОСЛОВА В ЛИТЕРАТУРЕ РУССКОГО СОВРЕМЕННОГО ФЭНТЕЗИ
Authors: Левинова Татьяна В.
Published: December 2015

Статья посвящена анализу именослова в литературе современного русского фэнтези. Авторы тщательно продумывают систему антропонимов, которые являются одним из основных способов создания фантастического мира. Предмет рассмотрения: славянские имена в цикле романов Марии Семеновой о Волкодаве и именослов в романе Михаила Успенского Там, где нас нет. Сопоставление различий именослова позволяет говорить, что антропонимические предпочтения автора обусловлены жанровой спецификой романов. Большинство имен в произведениях М. Семеновой являются реальными славянскими антропонимами, зафиксированными в словарях. Их функции – обозначить  принадлежность персонажа к определенному роду и подчеркнуть характер или другие отличительные особенности героев. Имена в романе М. Успенского создают комический эффект и указывают на наличие литературной игры автора с читателем.
Integrated Field-Scale Production and Economic Evaluation Under Subsurface Uncertainty for the Pattern-Driven Development of Unconventional Resources With Analytical Superposition
Authors: Gao Guohua , Vink Jeroen C. , Alpak Faruk O.
Published: December 2015

The in-situ upgrading process (IUP) is a thermal-recovery technique that relies on a pattern-based development process, a complicated physical process that involves thermal and mass transfer in porous media, which renders full field-scale reservoir simulations impractical. Although it is feasible to quantify the impact of subsurface uncertainties on recovery for small-scale sector models with experimental design (ED), it is still a very challenging problem to quantify their impact on field-scale quantities. Straightforward upscaling to field scale does not work because such conventional superposition-based methods do not capture the effects of spatial variability in rock and fluid properties and the time delay in sequential pattern development.

In this paper, we show that, under certain mild assumptions, an analytical superposition formulation can be developed that propagates the uncertainties of production forecasts and economic evaluations generated from a sector model to full field-scale quantities. One can simplify this formulation further so that the variance of a field-scale quantity is analytically expressed as the variance of the same single-pattern quantity multiplied by a (computable) scaleup factor. This makes it possible to implement a practical uncertainty quantification work flow in which single-pattern results are upscaled to accurate full field results with reliable uncertainty ranges, without the need for full field-scale simulations.

We apply the proposed novel superposition and uncertainty-propagation method to a multipattern IUP development, and demonstrate that this work flow produces reliable results for field-scale production and economics as well as realistic uncertainty ranges. Moreover, these results indicate that the scaleup factor for single-pattern results can accurately capture the impact of spatial correlations of subsurface uncertainties, the size of the field-scale model, the time-delay in pattern development, and the discount rate.

Uncertainty quantification of field-scale production and economics is a key factor for the successful development of unconventional resources such as extraheavy oil and oil shale with significant rewards in terms of risk management and project profitability. With minor modifications, the proposed method can also be applied to other pattern-driven processes such as the in-situ conversion process (ICP) and steam-assisted gravity drainage.
Factors That Control Condensate Production From Shales: Surrogate Reservoir Models and Uncertainty Analysis
Authors: Panja Palash , Deo Milind
Published: December 2015

Rapid development of shales for the production of oils and condensates may not be permitting adequate analysis of the important factors governing recovery. Understanding the performance of shales or tight oil reservoirs producing condensates requires numerically extensive compositional simulations. The purpose of this study is to identify important factors that control production of condensates from low-permeability plays and to develop analytical “surrogate” models suitable for Monte Carlo analysis. In this study, the surrogate reservoir models were second-order response surfaces functionally dependent on the nine main factors that most affect condensate recovery in ultralow-permeability reservoirs. The models were developed by regressing the results of experimentally designed compositional simulations. The Box-Behnken (Box and Behnken 1960) technique, a partial-factorial method, was used for design of these experiments or simulations. The main factors that controlled condensate recovery from ultralow-permeability reservoirs were reservoir permeability, rock compressibility, initial condensate/gas ratio (CGR), initial reservoir pressure, and fracture spacing. Another main outcome of this paper was the generation of probability-density functions, and P10, P50, and P90 values for condensate recovery on the basis of the uncertainty in input parameters. The condensate-recovery P50 for rate-based outcome of a 5-B/D per fracture was found to be less than 10%.
Optimization of total trihalomethanes' (TTHMs) and their precursors' removal by granulated activated carbon (GAC) and sand dual media by response surface methodology (RSM)
Authors: Rasheed Sajida , Campos Luiza. C. , Kim Jong. K. , Zhou Qizhi , Hashmi Imran
Published: December 2015

A response surface methodology (RSM) applying central composite design with rotatable full factorial (14 non-center and six center points) was used to discern the effect of granular activated carbon (GAC), sand and pH on total trihalomethanes (TTHMs) and humic acid (HA) removal from drinking water. Results showed efficient TTHMs and HA removal by GAC while a sand column showed little effect for TTHMs but was significant for total organic carbon (TOC) removal. With GAC and a sand column of 4 cm, a pH increase from 6 to 8 caused an increase in TTHM removal from 79.8 to 83.6% while a decrease in HA removal from 26.6 to 6.6% was observed. An increase in GAC column depth from 10 to 20 cm caused a slight increase in TTHM removal from 99.4 to 99.7%, while TOC removal was increased from an average of 38.85% to 57.4% removal. The developed quadratic model for TTHM removal (p = 0.048) and linear model for TOC removal (p = 0.039) were significant. GAC column depth (p < 0.0117) and column depth2 (p < 0.039) were the most significant factors. A 98% TTHMs, 30%TOC and 51% residual chlorine removal were optimized at 9 cm GAC and 4 cm sand column depth at pH 8 with desirability factor (D) 0.64.
Hg(II) adsorption using amidoximated porous acrylonitrile/itaconic copolymers prepared by suspended emulsion polymerization
Authors: Ji Chunnuan , Qu Rongjun , Chen Hou , Liu Xiguang , Sun Changmei , Ma Caixia
Published: December 2015

Initially, porous acrylonitrile/itaconic acid copolymers (AN/IA) were prepared by suspended emulsion polymerization. Successively, the cyano groups in AN/IA copolymers were converted to amidoxime (AO) groups by the reaction with hydroxylamine hydrochloride. The structures of the AN/IA and amidoximated AN/IA (AO AN/IA) were characterized by infrared spectroscopy, scanning electron microscopy, and porous structural analysis. The adsorption properties of AO AN/IA for Hg(II) were investigated. The results show that AO AN/IA has mesopores and macropores, and surface area of 11.71 m2 g−1. It was found that AO AN/IA has higher affinity for Hg(II), with the maximum adsorption capacity of 84.25 mg g-1. The AO AN/IA also can effectively remove Hg(II) from different binary metal ion mixture systems. Furthermore, the adsorption kinetics and thermodynamics were studied in detail. The adsorption equilibrium can quickly be achieved in 4 h determined by an adsorption kinetics study. The adsorption process is found to belong to the second-order model, and can be described by the Freundlich model.
A Preclinical Consortium Approach for Assessing the Efficacy of Combined Anti-CD3 Plus IL-1 Blockade in Reversing New-Onset Autoimmune Diabetes in NOD Mice
Authors: Gill Ronald G. , Pagni Philippe P. , Kupfer Tinalyn , Wasserfall Clive H. , Deng Songyan , Posgai Amanda , Manenkova Yulia , Bel Hani Amira , Straub Laura , Bernstein Philip , Atkinson Mark A. , Herold Kevan C. , von Herrath Matthias , Staeva Teodora , Ehlers Mario R. , Nepom Gerald T.
Published: December 2015

There is an ongoing need to develop strategic combinations of therapeutic agents to prevent type 1 diabetes (T1D) or to preserve islet β-cell mass in new-onset disease. Although clinical trials using candidate therapeutics are commonly based on preclinical studies, concern is growing regarding the reproducibility as well as the potential clinical translation of reported results using animal models of human disorders. In response, the National Institutes of Health Immune Tolerance Network and JDRF established a multicenter consortium of academic institutions designed to assess the efficacy and intergroup reproducibility of clinically applicable immunotherapies for reversing new-onset disease in the NOD mouse model of T1D. Predicated on prior studies, this consortium conducted coordinated, prospective studies, using joint standard operating procedures, fixed criteria for study entry, and common reagents, to optimize combined anti-CD3 treatment plus interleukin-1 (IL-1) blockade to reverse new-onset disease in NOD mice. We did not find that IL-1 blockade with anti–IL-1β monoclonal antibody or IL-1trap provided additional benefit for reversing new-onset disease compared with anti-CD3 treatment alone. These results demonstrate the value of larger, multicenter preclinical studies for vetting and prioritizing therapeutics for future clinical use.
Hyperglycemia Abrogates Ischemic Postconditioning Cardioprotection by Impairing AdipoR1/Caveolin-3/STAT3 Signaling in Diabetic Rats
Authors: Li Haobo , Yao Weifeng , Liu Zipeng , Xu Aimin , Huang Yu , Ma Xin-liang , Irwin Michael G. , Xia Zhengyuan
Published: December 2015

Signal transducer and activator of transcription 3 (STAT3) activation is key for ischemic postconditioning (IPo) to attenuate myocardial ischemia-reperfusion injury (MIRI), but IPo loses cardioprotection in diabetes in which cardiac STAT3 activation is impaired and adiponectin (APN) reduced. We found that IPo increased postischemic cardiomyocyte-derived APN, activated mitochondrial STAT3 (mitoSTAT3), improved mitochondrial function, and attenuated MIRI in wild-type but not in APN knockout (Adipo−/−) mice subjected to 30 min coronary occlusion, followed by 2 or 24 h of reperfusion. Hypoxic postconditioning–induced protection against hypoxia/reoxygenation injury was lost in Adipo−/− cardiomyocytes but restored by recombinant APN, but this APN beneficial effect was abolished by specific STAT3 or APN receptor 1 (AdipoR1) gene knockdown, or caveolin-3 (Cav3) disruption. APN activated cardiac STAT3 and restored IPo cardioprotection in 4-week diabetic rats where AdipoR1 and Cav3 were functionally interactive but not in 8-week diabetic rats whose cardiac Cav3 was severely reduced and AdipoR1/Cav3 signaling impaired. We concluded that IPo activates mitoSTAT3 through APN/AdipoR1/Cav3 pathway to confer cardioprotection, whereas in diabetes, IPo loses cardioprotection due to impaired APN/AdipoR1/Cav3 signaling. Therefore, effective means that may concomitantly activate APN and repair APN signaling (i.e., AdipoR1/Cav3) in diabetes may represent promising avenues in the treatment of MIRI in diabetes.
Gestational Diabetes Mellitus Is Associated With Changes in the Concentration and Bioactivity of Placenta-Derived Exosomes in Maternal Circulation Across Gestation
Authors: Salomon Carlos , Scholz-Romero Katherin , Sarker Suchismita , Sweeney Emma , Kobayashi Miharu , Correa Paula , Longo Sherri , Duncombe Gregory , Mitchell Murray D. , Rice Gregory E. , Illanes Sebastian E.
Published: December 2015

Although there is significant interest in elucidating the role of placenta-derived exosomes (PdEs) during pregnancy, the exosomal profile in pregnancies complicated by gestational diabetes mellitus (GDM) remains to be established. The aim of this study was to compare the gestational-age profile of PdEs in maternal plasma of GDM with normal pregnancies and to determine the effect of exosomes on cytokine release from human umbilical vein endothelial cells. A prospective cohort of patients was sampled at three time points during pregnancy for each patient (i.e., 11–14, 22–24, and 32–36 weeks' gestation). A retrospective stratified study design was used to quantify exosomes present in maternal plasma of normal (n = 13) and GDM (n = 7) pregnancies. Gestational age and pregnancy status were identified as significant factors contributing to variation in plasma exosome concentration (ANOVA, P < 0.05). Post hoc analyses established that PdE concentration increased during gestation in both normal and GDM pregnancies; however, the increase was significantly greater in GDM (∼2.2-fold, ∼1.5-fold, and ∼1.8-fold greater at each gestational age compared with normal pregnancies). Exosomes isolated from GDM pregnancies significantly increased the release of proinflammatory cytokines from endothelial cells. Although the role of exosomes during GDM remains to be fully elucidated, exosome profiles may be of diagnostic utility for screening asymptomatic populations.
Discovery of a Selective Islet Peptidome Presented by the Highest-Risk HLA-DQ8trans Molecule
Authors: van Lummel Menno , van Veelen Peter A. , de Ru Arnoud H. , Pool Jos , Nikolic Tatjana , Laban Sandra , Joosten Antoinette , Drijfhout Jan W. , Gómez-Touriño Iria , Arif Sefina , Aanstoot Henk J. , Peakman Mark , Roep Bart O.
Published: December 2015

HLA-DQ2/8 heterozygous individuals are at far greater risk for type 1 diabetes (T1D) development by expressing HLA-DQ8trans on antigen-presenting cells compared with HLA-DQ2 or -DQ8 homozygous individuals. Dendritic cells (DC) initiate and shape adaptive immune responses by presenting HLA-epitope complexes to naïve T cells. To dissect the role of HLA-DQ8trans in presenting natural islet epitopes, we analyzed the islet peptidome of HLA-DQ2, -DQ8, and -DQ2/8 by pulsing DC with preproinsulin (PPI), IA-2, and GAD65. Quality and quantity of islet epitopes presented by HLA-DQ2/8 differed from -DQ2 or -DQ8. We identified two PPI epitopes solely processed and presented by HLA-DQ2/8 DC: an HLA-DQ8trans–binding signal-sequence epitope previously identified as CD8 T-cell epitope and a second epitope that we previously identified as CD4 T-cell epitope with increased binding to HLA-DQ8trans upon posttranslational modification. IA-2 epitopes retrieved from HLA-DQ2/8 and -DQ8 DC bound to HLA-DQ8cis/trans. No GAD65 epitopes were eluted from HLA-DQ. T-cell responses were detected against the novel islet epitopes in blood from patients with T1D but scantly detected in healthy donor subjects. We report the first PPI and IA-2 natural epitopes presented by highest-risk HLA-DQ8trans. The selective processing and presentation of HLA-DQ8trans–binding islet epitopes provides insight in the mechanism of excessive genetic risk imposed by HLA-DQ2/8 heterozygosity and may assist immune monitoring of disease progression and therapeutic intervention as well as provide therapeutic targets for immunotherapy in subjects at risk for T1D.
Variation in SLC19A3 and Protection From Microvascular Damage in Type 1 Diabetes
Authors: Porta Massimo , Toppila Iiro , Sandholm Niina , Hosseini S. Mohsen , Forsblom Carol , Hietala Kustaa , Borio Lorenzo , Harjutsalo Valma , Klein Barbara E. , Klein Ronald , Paterson Andrew D. ,   for the DCCT/EDIC Research Group, Groop Per-Henrik ,   on behalf of the FinnDiane Study Group
Published: December 2015

The risk of long-term diabetes complications is not fully explained by diabetes duration or long-term glycemic exposure, suggesting the involvement of genetic factors. Because thiamine regulates intracellular glucose metabolism and corrects for multiple damaging effects of high glucose, we hypothesized that variants in specific thiamine transporters are associated with risk of severe retinopathy and/or severe nephropathy because they modify an individual’s ability to achieve sufficiently high intracellular thiamine levels. We tested 134 single nucleotide polymorphisms (SNPs) in two thiamine transporters (SLC19A2/3) and their transcription factors (SP1/2) for an association with severe retinopathy or nephropathy or their combination in the FinnDiane cohort. Subsequently, the results were examined for replication in the DCCT/EDIC and Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) cohorts. We found two SNPs in strong linkage disequilibrium in the SLC19A3 locus associated with a reduced rate of severe retinopathy and the combined phenotype of severe retinopathy and end-stage renal disease. The association for the combined phenotype reached genome-wide significance in a meta-analysis that included the WESDR cohort. These findings suggest that genetic variations in SLC19A3 play an important role in the pathogenesis of severe diabetic retinopathy and nephropathy and may explain why some individuals with type 1 diabetes are less prone than others to develop microvascular complications.
Delayed Intervention With Pyridoxamine Improves Metabolic Function and Prevents Adipose Tissue Inflammation and Insulin Resistance in High-Fat Diet–Induced Obese Mice
Authors: Maessen Dionne E. , Brouwers Olaf , Gaens Katrien H. , Wouters Kristiaan , Cleutjens Jack P. , Janssen Ben J. , Miyata Toshio , Stehouwer Coen D. , Schalkwijk Casper G.
Published: December 2015

Obesity is associated with an increased risk for the development of type 2 diabetes and vascular complications. Advanced glycation end products are increased in adipose tissue and have been associated with insulin resistance, vascular dysfunction, and inflammation of adipose tissue. Here, we report that delayed intervention with pyridoxamine (PM), a vitamin B6 analog that has been identified as an antiglycating agent, protected against high-fat diet (HFD)–induced body weight gain, hyperglycemia, and hypercholesterolemia, compared with mice that were not treated. In both HFD-induced and db/db obese mice, impaired glucose metabolism and insulin resistance were prevented by PM supplementation. PM inhibited the expansion of adipose tissue and adipocyte hypertrophy in mice. In addition, adipogenesis of murine 3T3-L1 and human Simpson-Golabi-Behmel Syndrome preadipocytes was dose- and time-dependently reduced by PM, as demonstrated by Oil Red O staining and reduced expression of adipogenic differentiation genes. No ectopic fat deposition was found in the liver of HFD mice. The high expression of proinflammatory genes in visceral adipose tissue of the HFD group was significantly attenuated by PM. Treatment with PM partially prevented HFD-induced mild vascular dysfunction. Altogether, these findings highlight the potential of PM to serve as an intervention strategy in obesity.
Altered Peripheral B-Lymphocyte Subsets in Type 1 Diabetes and Latent Autoimmune Diabetes in Adults
Authors: Deng Chao , Xiang Yufei , Tan Tingting , Ren Zhihui , Cao Chuqing , Huang Gan , Wen Li , Zhou Zhiguang
Published: December 2015

OBJECTIVE

B lymphocytes play an important role in the immunopathogenesis of autoimmune diabetes. We hypothesized that the altered B-cell subset phenotype is associated with autoimmune diabetes.

RESEARCH DESIGN AND METHODS

Patients with type 1 diabetes (T1D) (n = 81), latent autoimmune diabetes in adults (LADA) (n = 82), or type 2 diabetes (T2D) (n = 95) and healthy control subjects (n = 218) with normal glucose tolerance (NGT) were recruited. We determined the percentage of circulating B-lymphocyte subsets, including CD19+CD23−CD21+ (marginal zone B [MZB]), CD19+CD23+CD21− (follicular B [FoB]), and CD19+CD5+CD1dhi (interleukin-10–producing regulatory B [B10]) cells by flow cytometry.

RESULTS

Patients with T1D or LADA had increased percentages of MZB cells and decreased percentages of FoB cells compared with healthy control subjects with NGT and patients with T2D. Moreover, patients with T1D showed the lowest frequency of B10 cells compared with patients with LADA or T2D, whereas healthy control subjects expressed the highest frequency of B10 cells. Of note, the frequency of MZB cells was negatively associated and the frequency of FoB cells was positively associated with fasting C-peptide (FCP). The frequency of B10 cells was positively correlated with FCP and negatively correlated with hemoglobin A1c.

CONCLUSIONS

The data show that patients with T1D or LADA express an altered frequency of B-cell subsets, which is associated with islet function and glycemia. These findings suggest that B lymphocytes may be involved in loss of self-tolerance and β-cell destruction and could be used as a biomarker and potential target for immunological intervention.
Risk factors for the development of aspiration pneumonia after unilateral arytenoid lateralization in dogs with laryngeal paralysis: 232 cases (1987–2012)
Authors: Wilson David , Monnet Eric
Published: December 2015

OBJECTIVE To identify risk factors for the development of aspiration pneumonia after unilateral arytenoid lateralization in dogs with laryngeal paralysis.

DESIGN Retrospective case series.

ANIMALS 232 client-owned dogs with a diagnosis of laryngeal paralysis treated with lef-tsided unilateral arytenoid lateralization.

PROCEDURES Medical records were reviewed. Signalment, medical history, surgical complications, and outcome data were collected. Follow-up was performed via review of medical records and by telephone interview with the owner, referring veterinarian, or both.

RESULTS At the 1-, 3-, and 4-year follow-up periods, aspiration pneumonia occurred in 18.6%, 31.8%, and 31.8% of dogs, respectively. The 1-, 3-, and 4-year survival rates for dogs with postoperative aspiration pneumonia were 83.1%, 51.5%, and 25.8%, respectively. None of the dogs with aspiration pneumonia before surgery developed clinical signs of aspiration pneumonia after surgery. Postoperative megaesophagus (hazard ratio [HR], 2.58; 95% confidence interval [CI], 1.56 to 3.93) and postoperative administration of opioid analgesics prior to discharge (HR, 1.69; 95% CI, 1.12 to 2.80) were significant risk factors for the long-term development of aspiration pneumonia in this study. Perioperative metoclopramide administration did not significantly decrease the risk for development of aspiration pneumonia (HR, 0.94; 95% CI, 0.67 to 1.37).

CONCLUSIONS AND CLINICAL RELEVANCE In the present study, aspiration pneumonia was the most commonly reported postoperative complication of unilateral lateralization in dogs treated for laryngeal paralysis; however, preexisting aspiration pneumonia was not associated with an increased risk for development of aspiration pneumonia after surgery. Megaesophagus was identified as an important risk factor for eventual development of aspiration pneumonia. Administration of an opioid analgesic may increase the risk of aspiration pneumonia in dogs treated surgically for laryngeal paralysis.
Clinical signs associated with ingestion of black walnut tree (Juglans nigra) wood, nuts, and hulls in dogs: 93 cases (2001–2012)
Authors: Coleman Adrienne E. , Merola Valentina
Published: December 2015

OBJECTIVE To identify clinical signs associated with oral exposure to black walnut tree (Juglans nigra) wood, nuts, or nut hulls in dogs and to compare clinical syndromes between dogs that ingested wood and dogs that ingested the walnuts or nut hulls.

DESIGN Retrospective case series.

ANIMALS 93 dogs.

PROCEDURES Records of dogs with oral exposure to black walnut wood, nuts, or nut hulls between November 2001 and December 2012 were retrieved from the Animal Poison Control Center database. Records were reviewed, and data regarding signalment; exposure; time of onset, type, and duration of clinical signs; serum biochemical abnormalities; treatment; and response to treatment were collected. Results were compared statistically between dogs that ingested wood and those that ingested nut components.

RESULTS 28 cases involved exposure to wood, and 65 involved exposure to nuts or hulls. Spontaneous vomiting was commonly observed (13/28 [46%] and 31/65 [48%] dogs that ingested wood and nut components, respectively). Neurologic or musculoskeletal signs were significantly more common in dogs that ingested wood (26/28 [93%]) than in those that ingested nuts or hulls (15/65 [23%]). Relative risk of developing neurologic signs after ingestion of wood was approximately 4 times that after ingestion of nuts or hulls.

CONCLUSIONS AND CLINICAL RELEVANCE Ingestion of black walnut wood by dogs resulted in a clinical syndrome in which neurologic or musculoskeletal signs were most frequently reported, whereas ingestion of black walnuts or their hulls was most commonly associated with vomiting. To our knowledge, this is the first report describing 2 different clinical syndromes associated with exposure to black walnut tree components in dogs.
An Application of M2 Statistic to Evaluate the Fit of Cognitive Diagnostic Models
Authors: Liu Yanlou , Tian Wei , Xin Tao
Published: December 2015

The fit of cognitive diagnostic models (CDMs) to response data needs to be evaluated, since CDMs might yield misleading results when they do not fit the data well. Limited-information statistic M2 and the associated root mean square error of approximation (RMSEA2) in item factor analysis were extended to evaluate the fit of CDMs. The findings suggested that the M2 statistic has proper empirical Type I error rates and good statistical power, and it could be used as a general statistical tool. More importantly, we found that there was a strong linear relationship between mean marginal misclassification rates and RMSEA2 when there was model–data misfit. The evidence demonstrated that .030 and .045 could be reasonable thresholds for excellent and good fit, respectively, under the saturated log-linear cognitive diagnosis model.
Stipulating citizen's fundamental right to healthcare: Inference from the Constitution of Federal Republic of Nepal 2015
Authors: Simkhada Padam , Regmi Pramod R , Pant Puspa Raj , Van Teijlingen Edwin , Sathian Brijesh
Published: December 2015

Nepal has a great opportunity to learn from, and collaborate with, non-governmental development partners and private sectors, and from other governments and organizations around the world, but we must move promptly.
Birthing centre infrastructure in Nepal post 2015 earthquake
Authors: Mahato Preeti , Regmi Pramod , Van Teijlingen Edwin , Simkhada Padam , Angell Catherine , Sathian Brijesh
Published: December 2015

We suggest that a focus on improving facility delivery services starting from the most severely affected districts could be the necessary step towards achieving universal health care. Technical and financial support offered by international development partners can play a crucial role in enhancing the capabilities of health care facilities including birthing centres.
Role of Diagnostic Laparoscopy in Unexplained Chronic Abdominal Pain
Authors: Alam Mohammad Shafiul , Rahman Md Mahbubur , Ahmad Md Siddique
Published: December 2015

Introduction: Patients with chronic abdominal pain get repeated hospitalization. They fail to perform their duties continuously and thus become burdens for their families. These patients are occupying a good number of indoor beds with dilemmatous diagnosis. This indirectly creates pressure on health care facility and plays a notable negative role to our economy.Aim: To determine the usefulness of diagnostic laparoscopy for diagnosis and also to find out the therapeutic scope in unexplained abdominal pain.Method: This is a prospective cross-sectional observational study and was carried out in the Department of surgery, CMH, Dhaka over a period of 2 years from July 2008 to June 2010.Results: Among the study population, 8 (26.67%) patients underwent abdominal and pelvic operation in the past for various diseases. The duration of chronic abdomen pain in these patients was between 6 months to 24 months or more. Twenty five (83.5%) cases out of 30 were diagnosed. Postoperative band & adhesions (28%), recurrent appendicitis (24%), endometriosis (16%), abdominal tuberculosis (16%) were the most frequently found etiologies of unexplained chronic abdominal pain in these patients. Eighteen (59.4%) patients underwent therapeutic procedure during Diagnostic Laparoscopy and biopsy was taken from 7 (23.1%) patients. Patients were provided treatment according to histopathology report. Patients were followed up for 2 years at Out Patient Department (OPD) at CMH. Around 75% cases became symptom free following therapy, 15% had short term minimal symptom for 6 months and persistent pain was present in small percent of patients (10%). 09 JAFMC Bangladesh. Vol 10, No 2 (December) 2014Conclusion: Laparoscopy is a safe diagnostic modality. It is useful to establish diagnosis or for exclusion of suspected abdominal pathology whenever chronic abdominal complaints remain undiagnosed. It also provides an opportunity for definitive treatment by laparoscopy or open surgery in unsuspected lesions.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014
Effect of Tramadol and Pethidine on Shivering during Cesarean Section under Spinal Anaesthesia
Authors: Maruf Abdullah Al , Islam Md Saiful , Hoq Naimul
Published: December 2015

Introduction: Shivering is a common complication observed in post spinal anaesthesia. Shivering can be very unpleasent and physiologically stressful for the patients. Different drugs are used for prevention and treatment of post spinal shivering.Objective: This study was designed to evaluate the efficacy and side effects of tramadol comparing pethidine in treatment of shivering on pregnant patients during cesarean section under spinal anaesthesia.Methods: This prospective clinical type of study was conducted in the department of Anaesthesia and Intensive Care at Combined Military Hospital, Dhaka from July 2011 to June 2012. One hundred twenty American Society of Anaesthesiologist (ASA) grade I and II pregnant patients of cesarean section under spinal anaesthesia, who had shivering, were included in this study. Patients were divided into two groups. Group T(n=60) received tramadol 0.5mg/kg and Group P(n=60) received pethidine 0.5mg/kg body weight intravenously for treatment of shivering. Grade of shivering, disappearance of shivering and side effects were recorded and subsequently analyzed.Results: Disappearance of shivering after treatment was significantly earlier in Group T (3.09±0.86 minutes) than Group P (5.11±1.08 minutes) (P<0.01). Recurrence of shivering after treatment was significantly less in Group T 2(3,33%) than Group P 7(11.67%) (P<0.01). Side effects were significantly higher in Group P than Group T. Nausea in 5(8.33%) patients and vomiting in 4(6.67%) patients found in Group P and nausea in 1(1.67%) patient and vomiting in 1(1.67) patient found in Group T. Differences were statistically significant in case of nausea (P<0.05) and vomiting (P<0.05). Dizziness and pruritus observed in no patient of group of T and in Group P dizziness observed in 6(10%) patients and pruritus observed in 3(5%) patients. Differences were statistically highly significant in case of dizziness (P<0.001) and pruritus (P<0.001).Conclusion: Both tramadol and pethidine effectively controlled shivering in patients during cesarean section under spinal anaesthesia. But tramadol offered rapid onset, less recurrence and fewer side effects when compared to pethidine.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014
Nonsteroidal Anti-Inflammatory Drugs (NSAIDS) Induced Acute Kidney Injury (AKI): Patient Profile and Outcome in Bangladesh Armed Forces
Authors: Nessa Azizun , Fakir Md Amzad H
Published: December 2015

Introduction: In military environment where musculoskeletal injury is more common, NSAIDs abuse and subsequent AKI carries a special risk. This study of NSAIDs induced AKI was carried out to highlight this issue.Objective: To find out the incidence, risk factors, diagnostic approach, clinical course, management and outcome of patients of Bangladesh Armed Forces.Methods: This longitudinal study was carried out in nephrology centre, combined military hospital (CMH) Dhaka from July 2010 to Jun 2013. Total 59 patients of NSAIDs induced AKI were included in this study. Any patient having pre existing renal pathology or chronic kidney disease was excluded from the study.Results: Total 59 patients were included in this study. Mean age of the patient was 36±7.12 yrs. Forty five patients (76.27%) took NSAIDs at their own and 14 patients (23.73%) were prescribed by physician. Fifty one patients (86.44%) took NSAIDs because of musculoskeletal pain. Dehydration due to physical exertion (30.50%), gastroenteritis (15.25%) and nil per os (NPO) (5.08%) were the common predisposing factors. Common symptoms were swelling of the body (40.67%), headache (32.20%), fatigue (27.11%) and vomiting (13.55%). Oedema was the most common sign (40.67%). Blood urea and serum creatinine were raised in all patients. Treatment includes drug withdrawl (100%), fluid resuscitation (86.44%), fluid restriction (61.01%), short course of steroid (13.55%) and haemodialysis (10.16%). Forty seven patients (79.66%) had complete recovery within two weeks of therapy whereas nine patients (15.25%) required more than two weeks to one month for complete recovery. Three patients (5.09%) developed chronic kidney disease (CKD).Conclusion: NSAIDs induced AKI carries a good prognosis with early diagnosis and proper management and it can be prevented by limiting the availability of over the counter drugs and creating awareness both in physicians and patients.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014
Socio-Demographic Characteristics of Mentally ill Patients Admitted to Different Hospitals of Dhaka City
Authors: Hakim Maksumul , Airin Jinnatul , Naher Salma , Ali Mohammad , Ahmad Mushtaq , Azad Md Abdus Samad Al
Published: December 2015

Introduction: Mental health is essentially as important as the physical health required of an individual to maintain. There are many factors that seem to play a role in the genesis of mental illness.Objective: This study was conducted among the mentally ill patients admitted to four hospitals of Dhaka city with a view to find out their socio demographic characteristics of mental illness.Materials and Methods: It was a descriptive type of cross sectional study. A total number of 81 patients and their near relatives were interviewed at four medical institutions through a structured questionnaire. A checklist was used for clinical diagnosis of the patients. A master sheet was prepared followed by questionnaire plotting all the information. Then data were analyzed according to objectives and necessary tables were prepared accordingly by case appropriate variables of the study using Microsoft office program.Results: The study results showed that 81.49% patients were male and 18.51% patients were female. Of the total patients 71.61% were found in the age group of unto 30 years. Maximum patients (61.73%) were found within the monthly family income of BDT 2500/- to 4500/- only. 53.03% of patients were married followed by 39.51% of unmarried. The study revealed that 58.02% patients hailed from urban area. 61.73% patients were educated up to secondary level and only 8.64% patients were illiterate. Regarding occupation 27.17% patients were cultivator and 16.05% were students. The study reflected that 48.15% patients were smokers and very few (6.17%) were drug drug addicts. 61.73% patients were living in joint families.50.62% patients did not receive treatment prior to admission. Of the total 49.38% treated cases (prior to admission), 25% cases were treated from the homeopath and only 25% were consulted with specialist.Conclusion: The lower and middle socio economic group and literate group from urban areas living in joint family suffered more from mental illness. There is need for appropriate policy to address the problems of families with mentally ill patients at the family and community levels.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014
Current Trends of Urinary Pathogens and their Antimicrobial Susceptibility Pattern in a Tertiary Care Hospital
Authors: Nabi Syed Nurun , Haider KMTS , Rahimgir Md , Uddin Md Nizam , Shapla Nahid Reaz
Published: December 2015

Introduction: Urinary Tract Infection (UTI) is one of the most common bacterial diseases worldwide that can present as asymptomatic or symptomatic characterized by a wide range of symptoms from mild irritative voiding to bacteremia, sepsis or even death. Increase in resistance of urinary pathogens to conventional antimicrobial agents is gaining the attention of many microbiologists worldwide in respect to treatment of urinary tract infection. Since the pattern of bacterial resistance is continuously changing, the monitoring of antibiotic susceptibility pattern becomes more important.Objective: The objective of this study was to update the distribution of current urinary pathogens and to find out their antimicrobial susceptibility pattern.Methods: A Cross sectional descriptive study was conducted at Border Guard Hospital (BGB Hospital) Peelkhana, Dhaka during the period of February 2013 to September 2013. A total of three hundred ninety urine samples were collected from patients with suspected UTI. All the samples were clean catch mid stream urine. Urine samples were cultured on MacConkey agar medium and blood agar medium. Colony counts yielding single type of bacterial growth of 105 CFU/ml were deemed significant.Results: Out of 390 samples, 49(12.56%) samples were culture positive. The isolated organisms were identified by conventional methods and were subjected to determine antimicrobial susceptibility testing by Kirby Bauers disc diffusion method. Escherichia coli (E.coli) was found as the most prevalent isolates 31(63.26%) followed by klebsiella spp 06(12.24%), Enterobacter spp o4(8.17%), Pseudomonas aeruginosa 04(8.17%), Staphylococcus aureus (Staph aureus) 02(4.08%) and Enterococcus spp 02(4.08%). Eight antimicrobial agents namely Amoxycillin, Co-trimoxazole, Levofloxacin, Nitrofurantoin, Gentamicin, Ceftriaxone, Imipenem and Amikacin were used for antimicrobial susceptibility testing. The most effective drug found against urinary isolates was Imipenem (95.91%), followed by Amikacin (81.63%) and Ceftriaxone (69.38%). None of the drug found was 100% effective against urinary pathogens. E.coli was found to be fairly sensitive to Ceftriaxone, Gentamicin and Nitrofurantoin.Conclusion: Urinary tract infection remains one of the most common bacterial infections. Antimicrobial drug resistance is increasing among urinary pathogens. This study updated the current occurrence of urinary pathogens and their antibiotic sensitivity pattern. We recommend periodical determination of antimicrobial sensitivity pattern of urinary pathogens in a particular hospital or area.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014
Comparison of Laparoscopic versus Open Appendicectomy
Authors: Hossain SM Shahadat , Jahan Farhana Israt , Rahman Munshi M Mujibur , Azad Md Abdus Samad Al , Rahman Md Shahinur , Hossain SM Shakhwat
Published: December 2015

Introduction: The advent of laparoscopic surgery has dramatically changed the field of surgery. With improvements in the equipment and increasing clinical experience it is now possible to perform almost any kind of procedure under laparoscopic visualization. The idea of minimal surgical trauma, resulting in significantly shorter hospital stay, less postoperative pain, faster return to daily activities, and better cosmetic outcome have made laparoscopic surgery for acute appendicitis very attractive.Objective: The aim of the present study was to compare the laparoscopic approach and the conventional technique in the treatment of acute appendicitis.Method: This prospective randomized clinical trial was conducted at CMH, Savar Cantonment and Navy Hospital, BNS Patenga, Chittagong. A total of 86 patients who underwent appendicectomy during December 2009 to March 2011 were included in this study. A total of 40 patients had laparoscopic appendicectomy and 46 underwent open procedure. Clinical outcome measures were compared between the two groups with respect to several variables.Results: Among the study population, the operating time was shorter for the OA patients than for the LA patients (LA, 35 min vs. OA, 30 min; p value 0.33), which is not statistically significant. The differences in hospital stay of 4 days for the LA group and 8 days for the OA group and p value 0.01 which is statistically significant. Return to oral diet was same in both groups with no statistical difference LA, 20 h vs. OA, 22 h; return to work LA was 14 days vs. OA 18 days. Although the rate for overall complications was lower in the LA group 5% vs. 18% in OA; p value 0.001 which is statistically significant.Conclusion: The laparoscopic approach to appendicectomy in patients with acute appendicitis does offer a significant advantage over the open approach in terms of length of hospital stay, postoperative complications, or quality of life, which are considered as the major advantages of minimally invasive surgery.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014
Real Time PCR HBV-DNA Analysis in HBsAg Positive Patients
Authors: Rahman Wasila , Hossain Muhammad Rabiul , Khan Arif Ahmed , Saha Debashish , Alam SM Mahbubul , Yasmin Farhana
Published: December 2015

Introduction: The hepatitis B virus is a global public health concern and leading cause of chronic liver disease in Bangladesh. For the diagnosis and monitoring of treatment of Hepatitis B virus infection, HBV-DNA detection and quantification is now extensively used worldwide.Objectives: The objective of this study was to detect HBV-DNA by real time PCR method in HBsAg positive patients, to compare the results of HBVDNA detection with HBeAg and Anti-HBe and to monitor the response after antiviral therapy in chronic hepatitis B patients and also to observe the intensity of hepatitis B infection in relation to age and sex.Methods: This was a cross sectional type of study conducted in Armed Forces Institute of Pathology (AFIP), Dhaka Cantonment. In this study, 56 sera of HBsAg positive patients were selected who all were subjected to do HBV-DNA (real time PCR) analysis during the period of 29 July to 30 0ctober, 2013.Results: Out of 56 HBsAg positive patients, HBV-DNA was detected in 34 patients. Among these, 8 (23.5%) patients were HBeAg positive, 16 (47%) patients were anti-HBe positive and 10 (29.5%) were negative for both HBeAg and anti-HBe. Age limit of patients was up to 60 years. HBV-DNA positive patients showed male predominance; 26 (76.5%) patients were male and 8 (23.5%) patients were female. Mean age of the patients was 35±14 years. Among 56 HBsAg positive patients, fifteen were receiving antiviral therapy. Out of them, HBV-DNA was decreased among 4 patients and could not be detected among 11 patients.Conclusion: Real time PCR method of detection of HBV-DNA is very important in patients who are HBeAg negative and this method is also applied to monitor treatment response to antivirals and to detect occult HBV infections immune control phase and also to detect reactivation of HBV cases.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014
Congenital Nephrotic Syndrome and Peripheral Veno-occlusive Disease Secondary to Congenital Cytomegalovirus Infection: A Case Report
Authors: Begum Nurun Nahar Fatema , Hossain Muhammad Rabiul , Sarker Md Ferdousur Rahman , Alam Jahangir
Published: December 2015

Abstract not availableJournal of Armed Forces Medical College Bangladesh Vol.10(2) 2014
Transversus Abdominis Plane (TAP) Block for Postoperative Analgesia in Acute Pulmonary Oedema Following Caesarean Section- A Case Report
Authors: Murshed Hasan , Sultana Rokshana , Haque Mozibul , Masud Sharif Mohammad Rezaul
Published: December 2015

A thirty six years old woman admitted in ICU following emergency lower uterine caesarean section under subarachnoid block (SAB). After 03 hours of surgical procedure, the patient develops severe respiratory distress. Patient was evaluated and diagnosed as a case of acute pulmonary oedema. In ICU, she was aggressively treated with intravenous Morphine, frusemideand parenteral antibiotic. After 1 hour of intensive care management, respiratory distress decreased but not significantly, in addition, she complains of severe pain on surgical operative site. Post operative analgesia was maintained with parectamol (500 mg) suppositories six hourly and intramuscular pathedine 75 mg 8 hourly. Instead of this her pain scores were 7/10 at rest and 8/10 on coughing along with respiratory distress. Then in ICU under all aseptic precaution bilateral TAP block was performed using landmark technique with 0.25% plain bupivacine 20 ml. Thirty minutes later, her pain subsided significantly and pain score became 1/10 at rest and 2/10 on coughing. Thereafter patient was slept for 4 hours, pain free and could take care of herself. After 48 hours patient was shifted to ward and discharged on 7th post operative day. TAP block is relatively easy, safe techniques. Because of simplicity and low cost, TAP block is likely to be an effective adjunct to multimodal postoperative analgesia for abdominal surgery.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014
South Asian Countries in Regional Integration Perspective: A Critical Review
Authors: Sultana Sharmin , Asrat Jumana
Published: December 2015

This article focuses on regional integration among the eight South Asian countries i.e. Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka. This study attempts to undertake an in-depth assessment of the potential of South Asian Free Trade Agreement (SAFTA) in South Asian Association for Regional Cooperation (SAARC) countries. The study is based on secondary data collected from different reliable sources. SAFTA can be a strong source of economic development and it can also enhance socio-economic opportunities throughout the region. Larger and economically stronger countries can achieve better bargaining power on trade negotiations by utilizing existing competitive advantages and regional expertise of the region as a unit. This approach can also help less developed countries to develop their economies and also can ensure the best possible use of the existing resources.Journal of Business and Technology (Dhaka) Vol.9(2) 2014; 43-59