bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Layer Number on Stray Inductance of DC-link Busbar in Power Converters
Authors: Zhu Yi-feng , Zheng Zheng , GE Qiong-xuan
Published: November 2013

In high power converter design, low-inductance busbar connecting DC capacitors and power devices is the
main concern to improve the quality of the whole power electronics system. This paper analyzes the impact of layernumber
on the stray inductance of busbar taking a subway traction converter as example. The method of partial element
equivalent circuit and the Q3D software are used to extract the stray inductance. The simulation and experimental results
show that the stray inductance of three-layer busbar is lower than two-layer busbar with other same conditions.
Effects of Nutritional Supplementation on Prealbumin Concentrations in
Pediatric Burn Patients: A Randomized, Controlled Trial
Authors: Williams Jennifer A. , Yankina Anna , Choe Yong S. , Dokukina Lyudmila , Brazol Marina , Altshuler Evgeniy , Gordon Mikhail , Ostrovskiy Nikolay , Kuraev Evgeniy , Marriage Barbara J.
Published: November 2013

Introduction:

This prospective, randomized study was designed to measure the effect of nutritional supplementation
on serum prealbumin (transthyretin) in pediatric burn patients in seven burn centers in Russia. The primary measure
was change in serum prealbumin from baseline to Day 7.

Methods:

Fifty-four children age 1-10 years with a TBSA burn of at least 15% were enrolled into this study. Patients had
baseline serum prealbumin levels > 10 mg/dL and were capable of exclusive oral feeding within 72 hours of hospitalization.
One-hundred-sixteen children were screened, with 54 meeting eligibility criteria, 28 subjects in the control group and
26 in the supplement group. Patients were randomized to receive the typical hospital diet for mild to moderate burn patients
or the same diet plus additional oral nutritional supplementation. The additional enteral supplementation was 299
kcal/day for most of the subjects.

Results:

Nutritional supplementation significantly increased serum prealbumin levels of the subjects from baseline to Day
7. At Day 7, children consuming the supplementation had a mean ± standard error change in prealbumin concentration of
8.44 ± 1.13 mg/dL and children on hospital diet only had a change of 5.47 ± 0.80 mg/dL, with a difference of 2.97 mg/dL
(p=0.0265). There were no significant differences in baseline serum prealbumin concentration, nor were there differences
for adverse events or safety concerns related to study product.

Conclusions:

The increase of prealbumin related to enteral supplementation may provide future guidance for nutritional
management of pediatric burn patients or patients with increased energy and protein needs.
Turbidity of Landlocked Fall Chinook Salmon Ovarian Fluid in Relation
to Egg Survival
Authors: Nero Patrick A. , Barnes Michael E. , Wipf Matthew M.
Published: November 2013

This study evaluated the use of ovarian fluid turbidity as a potential indicator of landlocked fall Chinook
Salmon Oncorhynchus tshawytscha egg survival. A total of 21 females were spawned, with nine of the spawns containing
between one and ten broken eggs per spawn. Ovarian fluid turbidity ranged from 55.1 to 159 nephelometric turbidity units
(NTU), and egg survival to the eyed-stage of egg development ranged from 0 to 68%. There was no significant correlation
between ovarian fluid turbidity and egg survival. Mean survival of eggs from the spawns containing broken eggs was
12.3%, which was significantly lower than the 32.9% mean survival from spawns without broken eggs. These results indicate
ovarian fluid turbidity cannot be used to predict egg survival in spawns of landlocked fall Chinook Salmon, but the
presence of even a small number of broken eggs may be indicative of poor survival to the eyed-egg stage of development.
Environmental Technology Licensing Under Emission-Equivalent Environmental Taxes and Standards
Authors: Chang Ming-Chung , Hu Jin-Li
Published: November 2013

We use a two-stage game with an outsider patentee and n homogeneous firms to study the effects of
environmental taxes and standards under an equivalent emission on environmental technology licensing behavior. Counter
to the intuition, a stricter environmental policy hinders technology licensing since a stricter environmental regulation
weakens the licensee's payment ability. When the innovation size is small, there exists a preference inconsistency on the
environmental instrument between the government and the patentee. The patent owner has a higher incentive to license
under an environmental standard than under an emission tax with an equivalent emission amount.
New Combined Serum Creatinine and Cystatin C Quadratic Formula for GFR Assessment in Children
Authors: Chehade Hassib , Cachat Francois , Jannot Anne-Sophie , Meyrat Blaise-Julien , Mosig Dolores , Bardy Daniel , Parvex Paloma , Girardin Eric
Published: November 2013

Background and objectives

The estimated GFR (eGFR) is important in clinical practice. To find the best formula for eGFR, this study assessed the best model of correlation between sinistrin clearance (iGFR) and the solely or combined cystatin C (CysC)– and serum creatinine (SCreat)–derived models. It also evaluated the accuracy of the combined Schwartz formula across all GFR levels.

Design, setting, participants, & measurements

Two hundred thirty-eight iGFRs performed between January 2012 and April 2013 for 238 children were analyzed. Regression techniques were used to fit the different equations used for eGFR (i.e., logarithmic, inverse, linear, and quadratic). The performance of each model was evaluated using the Cohen κ correlation coefficient and the percentage reaching 30% accuracy was calculated.

Results

The best model of correlation between iGFRs and CysC is linear; however, it presents a low κ coefficient (0.24) and is far below the Kidney Disease Outcomes Quality Initiative targets to be validated, with only 84% of eGFRs reaching accuracy of 30%. SCreat and iGFRs showed the best correlation in a fitted quadratic model with a κ coefficient of 0.53 and 93% accuracy. Adding CysC significantly (P<0.001) increased the κ coefficient to 0.56 and the quadratic model accuracy to 97%. Therefore, a combined SCreat and CysC quadratic formula was derived and internally validated using the cross-validation technique. This quadratic formula significantly outperformed the combined Schwartz formula, which was biased for an iGFR≥91 ml/min per 1.73 m2.

Conclusions

This study allowed deriving a new combined SCreat and CysC quadratic formula that could replace the combined Schwartz formula, which is accurate only for children with moderate chronic kidney disease.
Body Fat Content and Distribution and Urinary Risk Factors for Nephrolithiasis
Authors: Pigna Federica , Sakhaee Khashayar , Adams-Huet Beverley , Maalouf Naim M.
Published: November 2013

Background and objectives

Obesity is associated with a higher risk of nephrolithiasis. However, it is not known whether higher body fat mass or abnormal fat distribution influences stone risk independent of dietary factors.

Design, setting, participants, & measurements

In this cross-sectional study, non–stone-forming men with no known kidney disease and with a wide range of body weight collected a 24-hour urine specimen while consuming a fixed metabolic diet. They underwent dual-energy x-ray absorptiometry to assess body composition and fat distribution. Urinary risk factors for nephrolithiasis and urine saturation with respect to calcium oxalate and uric acid (assessed as supersaturation index [SI]) were correlated with various measures of adiposity.

Results

Study participants included 21 men with a mean age of 52.1 years, mean weight of 91.1 kg, and mean total fat mass of 24.3 kg. Twenty-four-hour urine pH and SI uric acid were more closely correlated with fat mass than with lean mass or total body weight. Both 24-hour urine pH and SI uric acid were also significantly correlated with truncal fat mass but not with leg fat mass. Moreover, there was a significant negative correlation between truncal/leg fat mass and NH4
+/net acid excretion ratio (R=−0.62; P=0.009). However, there was no significant association between SI calcium oxalate and body weight, lean mass, fat mass, trunk fat mass, or leg fat mass.

Conclusions

The association between 24-hour urine pH and SI uric acid and various measures of adiposity suggest that total body fat and trunk fat are more strongly associated with risk factors for uric acid stone formation than are total body weight and lean body mass. Under a controlled metabolic diet, adiposity is not associated with risk factors for calcium oxalate stones. Further studies are needed to confirm these findings in larger populations that include women and patients who form stones.
Forbidden sets of planar rational systems of difference equations with common denominator
Authors: Bajo Ignacio
Published: November 2013

The forbidden sets of systems of first order rational difference equations in
the plane in which the denominators are common for all the components of the
system is studied. Such forbidden sets are composed of lines which, depending
of some spectral properties of an associated matrix, can either be a finite
number or lines or an infinity of lines converging to either an invariant
line or to a finite number of lines itersecting in a fixed point or else it
can be dense in a large subset of R2.
Development and validation of a reduced mechanism for methane using a new integral algorithm in a premixed flame
Authors: Wu Zuozhu , Qiao Xinqi , Huang Zhen
Published: November 2013

A new algorithm based on Computational Singular Perturbation (CSP) is
proposed to construct global reduced mechanism. The algorithm introduces
species concentrations, species net production rates and heat release rates
as integral weighting factors to integrate CSP-pointers, including radical
pointers and fast reaction pointers, throughout the computational domain. A
software package based on the algorithm was developed to make the reduction
process more efficient. Input to the algorithm includes (i) the detailed
mechanism, (ii) the numerical solution of the problem for a specific set of
operating conditions, (iii) the number of quasi steady state (QSS) species.
The proposed algorithm was applied to the reduction of GRI3.0 involving 53
species and 325 reactions leading to the development of a 15-species reduced
mechanism with 10 lumped steps. Then the reduced mechanism was validated in a
one-dimensional, unstretched, premixed, laminar steady flame over a wide
range of equivalence ratio, and excellent agreements between results
calculated with the detailed and the reduced mechanisms can be observed.
Oxidation of lignin-carbohydrate complex from bamboo with hydrogen peroxide catalyzed by Co(salen)
Authors: Zhou Xue-Fei
Published: November 2013

The reactivity of salen complexes toward hydrogen peroxide has been long
recognized. Co(salen) was tested as catalyst for the aqueous oxidation of a
refractory lignin-carbohydrate complex (LCC) isolated from sweet bamboo
(Dendrocalamushamiltonii) in the presence of hydrogen peroxide as oxidant.
Co(salen) catalyzed the reaction of hydrogen peroxide with LCC. From the
spectra analyses, lignin units in LCC were undergoing ring-opening, side
chain oxidation, demethoxylation, ?-O-4 cleavage with Co(salen) catalytic
oxidation. The degradation was also observed in the carbohydrate of LCC. The
investigation on the refractory LCC degradation catalyzed by Co(salen) may be
an important aspect for environmentally-oriented biomimetic bleaching in pulp
and paper industry.
Early Onset of Diabetes in the Proband Is the Major Determinant of Risk in HLA DR3-DQ2/DR4-DQ8 Siblings
Authors: Gillespie Kathleen M. , Aitken Rachel J. , Wilson Isabel , Williams Alistair J.K. , Bingley Polly J.
Published: November 2013

Islet autoimmunity is initiated in infancy, and primary prevention trials require children at high genetic risk to be identified before autoantibodies appear. To inform screening strategies, we evaluated risks of autoimmunity and diabetes associated with HLA DR3-DQ2/DR4-DQ8 in U.K. families. Extended HLA haplotypes were determined in 2,134 siblings from the Bart’s-Oxford Study followed to a median age of 22 years. Risks of diabetes and islet autoimmunity (more than two antibodies) were estimated by survival analysis. Of 138 informative DR3-DQ2/DR4-DQ8 siblings, 63% shared both haplotypes with their diabetic proband, 29% shared one, and 8% shared neither. In HLA-identical DR3-DQ2/DR4-DQ8 siblings, the cumulative risk of diabetes by age 15 was 17% (vs. 6% in those sharing one haplotype or none; P = 0.095). Risk varied, however, with the age at the onset of diabetes in the proband; the cumulative risk of autoimmunity and/or diabetes by age 15 was 61% in siblings of probands diagnosed when younger than 10 years old compared with only 4.7% in those diagnosed after age 10 years (P < 0.001). The age of the proband at diagnosis, but not HLA haplotype sharing, was an independent determinant of sibling risk. This suggests that non-HLA genes or epigenetic/environmental factors that accelerate the progression of type 1 diabetes in the proband strongly affect risk in siblings.
Cerebral White Matter Integrity and Resting-State Functional Connectivity in Middle-aged Patients With Type 2 Diabetes
Authors: Hoogenboom Wouter S. , Marder Thomas J. , Flores Veronica L. , Huisman Susanne , Eaton Hana P. , Schneiderman Jason S. , Bolo Nicolas R. , Simonson Donald C. , Jacobson Alan M. , Kubicki Marek , Shenton Martha E. , Musen Gail
Published: November 2013

Early detection of brain abnormalities at the preclinical stage can be useful for developing preventive interventions to abate cognitive decline. We examined whether middle-aged type 2 diabetic patients show reduced white matter integrity in fiber tracts important for cognition and whether this abnormality is related to preestablished altered resting-state functional connectivity in the default mode network (DMN). Diabetic and nondiabetic participants underwent diffusion tensor imaging, functional magnetic resonance imaging, and cognitive assessment. Multiple diffusion measures were calculated using streamline tractography, and correlations with DMN functional connectivity were determined. Diabetic patients showed lower fractional anisotropy (FA) (a measure of white matter integrity) in the cingulum bundle and uncinate fasciculus. Control subjects showed stronger functional connectivity than patients between the posterior cingulate and both left fusiform and medial frontal gyri. FA of the cingulum bundle was correlated with functional connectivity between the posterior cingulate and medial frontal gyrus for combined groups. Thus, middle-aged patients with type 2 diabetes show white matter abnormalities that correlate with disrupted functional connectivity in the DMN, suggesting that common mechanisms may underlie structural and functional connectivity. Detecting brain abnormalities in middle age enables implementation of therapies to slow progression of neuropathology.
sRAGE is associated with low waist circumference and Hb levels in NAFLD
Authors: Hyogo Hideyuki , Yamagishi Sho-ichi , Maeda Sayaka , Nakahara Takashi , Kimura Yuki , Chayama Kazuaki
Published: November 2013

Advanced glycation end products (AGEs) and the receptor RAGE interaction is involved in nonalcoholic fatty liver disease (NAFLD). Although exogenously administered soluble RAGE (sRAGE) has been shown to block the harmful effects of AGEs in animal models, there is still controversy about the role of sRAGE in humans. We examined here which anthropometric, metabolic and clinical variables were independent correlates of sRAGE levels in NAFLD patients. The study involved 77 biopsy-proven, unmedictaed NAFLD patients (44 male and 33 female) with a mean age of 43.4±13.0 years old. We examined which anthropometric, metabolic and clinical variables, including liver steatosis and fibrosis markers, are independently associated with serum levels of sRAGE. Mean serum levels of sRAGE were 710.7±290.2 pg/mL. Univariate analysis revealed that waist circumference (inversely), hemoglobin (inversely), number of white blood cells (inversely), total-bilirubin (inversely), free fatty acid (inversely), ferritin (inversely), and HbA1c (inversely) were significantly correlated with serum levels of sRAGE. In multiple stepwise regression analysis, waist circumference (p<0.01, inversely) and hemoglobin (p<0.01, inversely) were independently associated with serum levels of sRAGE (R2=0.176). The present study reveals that low serum levels of sRAGE are independently associated with waist circumference and hemoglobin in patients with NAFLD.
Ischemic and non-ischemic dilated cardiomyopathy
Authors: Fazio Giovanni , Vernuccio Federica , Grassedonio Emanuele , Grutta Giuseppe , Lo Re Giuseppe , Midiri Massimo
Published: November 2013

Dilated Cardiomyopathy is a high-incident disease, which diagnosis of and treatments are clinical priority. The aim of our study was to evaluate the diagnostic potential of cardiac magnetic resonance (CMR) imaging; echocardiography and the biochemical parameters that can help us differentiate between the post-ischemic and non-ischemic dilated cardiomyopathy. Materials and methods. The study enrolled 134 patients with dilated cardiomyopathy: 74 with the post-ischemic form and 60 with the non-ischemic one. All patients underwent a coronary imaging test, with echocardiogram, cardiac magnetic resonance and a blood test. Pro-inflammatory cytokines were evaluated using Luminex kit. Data was compared between the two groups. Results. Echocardiography allowed recognition of Left Ventricular Non Compaction in 2 patients. Longitudinal and circumferential strains were significantly different in the two groups (p<0.05). Using CMR imaging a post-myocarditis scar was diagnosed in 2 patients and a post-ischemic scar in 95% of patients with the chronic ischemic disease. The interleukin IL-1, IL-6 and TNF-α levels were higher in the post-ischemic group compared with the non-ischemic one. Conclusions. The use of second level techniques with a high sensitivity and specificity would help distinguish among different sub-forms of dilated cardiomyopathy.
Thyroid dysfunction and cardiovascular risk factors in Bulgarian adults
Authors: Shinkov Alexander , Borissova Anna-Maria , Kovatcheva Roussanka , Vlahov Jordan , Dakovska Lilia , Atanassova Iliana , Vukov Mirtcho , Aslanova Nina
Published: November 2013

The aim of this study was to determine the prevalence of thyroid dysfunction and its association with cardiovascular risk factors in an adult Bulgarian population. 2402 subjects were studied, 1347 female, 20–94y (median: 48.0y) and 1055 male, 20–91y (median: 45.5y). Body weight, height, waist circumference, arterial blood pressure, TSH, FT4 and lipids were measured. Known hypothyroidism was reported by 53 subjects (2.2%) and hyperthyroidism by 20 (0.8%). New hypothyroidism was found in 98 (4.1%), [subclinical (3.2%), overt (0.9%)]. New hyperthyroidism was found in 68 (2.9%), [subclinical (2.5%), overt (0.4%)]. New diagnosis of hypothyroidism and hyperthyroidism was entered in 84% and 87% in male subjects and 60% and 65% in the females respectively. Arterial hypertension was present in 40% of the women and in 47% of the men (p<0.001) and was more prevalent in hypothyroidism. Abdominal obesity and dyslipidemia were more prevalent in males and hypothyroid subjects. Arterial hypertension depended on age, gender and lipid status but not on thyroid function. CHD history depended on thyroid function and age. Conclusion: Most cases of thyroid dysfunction were undiagnosed, especially in the males. CV risk factors were more prevalent in the males with thyroid dysfunction a major determinant of CHD, but not hypertension.
World Bank’s 2012 Ganges Strategic Basin Assessment: A View from Nepal
Authors: Pun S. B.
Published: November 2013

The World Bank’s 2012 Ganges Strategic Basin Assessment (GSBA) is an interesting but contentious document with a wealth of information. The basin has a population of 656 million; and 47 percent of Indians, 576 million, live in this basin. Nepal’s three bordering States of Uttar Pradesh, Bihar and West Bengal with a population of 199, 104 and 91 million respectively have a staggering combined population of 385 million, far greater than that of the USA. The Ganges basin has the world’s highest population density and, as a consequence, poverty level borders that of Sub-Sahara. This is India’s Hindu cow belt where water is increasingly getting scarce.With the strategic resource, water, getting scarce in the Ganges, the Bank’s GSBA has some startling findings: storages in Nepal store ‘significantly little’ water, so flood control in India is ‘very limited’. Storages in Nepal can ‘double lean season flows’, but agricultural productivity in India is ‘currently very low’ from such augmented flows. The Bank believes that ‘hydropower and trade’ is ‘significant’ and negotiation ‘simpler than previously thought’. The Bank recommends that Nepal push her hydropower development on a fast track. Many believe it is not the ‘significant’ power trade that counts. What really counts is whether or not the traded Energy will be at a Significant Rate. By pushing Nepal’s significant hydropower, the Bank is advocating a policy whereby India avail free lean season water stored in Nepal’s fertile valleys submerged for perpetuity. I n the Bank’s opinion, as India’s agricultural productivity is currently very low and flood control very limited, Nepal’s downstream benefits are also very low. Nepal is, thus, very disappointed with the Bank’s such Indo-centric GSBA report.Hydro Nepal: Journal of Water, Energy and EnvironmentVol. 12, 2013, JanuaryPage: 6-12DOI: http://dx.doi.org/10.3126/hn.v12i0.9025Uploaded Date : 10/28/2013
National River Linking Project of India
Authors: Joshi Naveen M.
Published: November 2013

India plans to transfer water from the water surplus region of the north-east to the water scarce regions of western and southern India. The plan is called the National River Linking Project (NRLP). Sixteen links in the Himalayan region and 14 links in the Peninsular region are proposed that will transfer annually about 174 Billion m3 (Bm3) of water through a canal network of 14,900 km. It will involve connecting 37 rivers and construction of dams/storages in 3,000 places. It is estimated to cost US$ 120 Billion (in 2000 price). The projected benefits are additional irrigation to 34 million hectares of land, generation of 34,000 MW of electricity, reduction of floods, and social upliftment. Many prominent experts and personalities have criticized the project claiming that it will be a financial, social and environmental disaster. Both the proponents and opponents think that India will be doomed depending on whether the NRLP is implemented or not (Amarsinghe 2009). The International Water Management Institute (IWMI) in collaboration with the Challenge Program for Water & Food (CPWF) undertook a three year Strategic Analysis of the NRLP to evaluate the NRLP concept with a detailed analysis. This paper is a general description of the NRLP, and it summarizes the findings of the Strategic Analysis of this Project undertaken by IWMI-CPWF. Further, it explores the possible consequences to India's neighbors in general and Nepal in particular.Hydro Nepal; Journal of Water, Energy and EnvironmentVol. 12, 2013, JanuaryPage: 13-19DOI: http://dx.doi.org/10.3126/hn.v12i0.9026Uploaded Date : 10/28/2013
Predicting Tunnel Squeezing: A Discussion based on Two Tunnel Projects
Authors: Panthi Krishna Kanta
Published: November 2013

Tunnel squeezing is a phenomenon, which is frequently confronted while tunneling through Himalayan rock mass. Weak and schistose rocks like mudstone, shale, slate, phyllite, schist, highly schistose mica gneiss and the rock mass of the tectonic fault zones are incapable of sustaining high stresses. A reliable and trustworthy prediction on the extent of squeezing is therefore essential. The reliable prediction results help to make strategy regarding stabilizing measures and optimization of tunnel rock support well in advance. This paper is mainly focused in analyzing the tunnel squeezing that took place in connection with the two tunnel cases; i.e. Kali Gandaki 'A' and Middle Marsyangdi headrace tunnels. The main focus is given to look on the applicability of squeezing analysis using Hoek and Marinos approach in combination with the equation proposed by Panthi for the estimation of rock mass strength for highly schistose rocks of the Himalaya. The measured tunnel convergence (squeezing) and lab tested mechanical properties of the rocks from these two headrace tunnels have been used to verify the applicability of the proposed methods and also the uncertainty analysis approach on squeezing introduced by Panthi.Hydro Nepal; Journal of Water, Energy and EnvironmentVol. 12, 2013, JanuaryPage: 20-25DOI: http://dx.doi.org/10.3126/hn.v12i0.9027Uploaded Date : 10/28/2013
Monte Carlo Simulation for Economic Analysis of Hydropower Pumped Storage Project in Nepal
Authors: Vereide Kaspar , Lia Leif , Ødegård Laras
Published: November 2013

Investments in hydropower pumped storage projects (PSP) are subjected to a high degree of uncertainty. In addition to normal uncertainties in hydropower schemes, the profit of a pumped storage scheme is dependent on the margin between power prices for buying and selling, which is difficult to predict without a power purchase agreement (PPA). A PSP without a PPA and without known construction costs requires quantification of the uncertainties in order to make qualified decisions before investing in such projects. This article demonstrates the advantages of using Monte Carlo (MC) simulations as a tool in the economic analysis of PSPs. The method has been tested on a case study, namely the Tamakoshi-3 Hydropower Project (HPP) in Nepal. The MC method is used to calculate the probability distribution of the net present value of installing reversible units in the Tamakoshi-3 HPP. The calculations show that PSPs may be profitable in Nepal, given a beneficial development of the power market. The MC method is considered to be a useful tool for economic analysis of PSPs. In this case study of installing reversible units in the Tamakoshi-3 HPP, there are many uncertainties, which the MC simulation method is able to quantify. Hydro Nepal; Journal of Water, Energy and Environment Vol. 12, 2013, January Page: 39-44DOI: http://dx.doi.org/10.3126/hn.v12i0.9031 Uploaded Date : 10/29/2013
Flooding and Inundation in Nepal Terai: Issues and Concerns
Authors: Adhakari Basistha Raj
Published: November 2013

During the monsoon months from June to September, all the rivers in Terai are in spate with bank-full discharges and cause flooding and inundation. The problems of flooding and inundation in the Terai are more critical due to change in climate in general and change in rainfall pattern/intensity in particular. This article tries to highlight the issues and concerns of flooding and inundation in the Terai and suggests measures to mitigate these issues in light of climate change adaptation. Hydro Nepal; Journal of Water, Energy and Environment Vol. 12, 2013, January Page: 59-65DOI: http://dx.doi.org/10.3126/hn.v12i0.9034 Uploaded Date : 10/29/2013
Experimental Investigation of Erosion and Performance of Turgo Impulse Turbine
Authors: Khurana Sourabh , Varun Dr , Kumar Anoop
Published: November 2013

he present study has been carried out to investigate the effect of silt size, concentration, jet velocity, nozzle angle and operating hour on the erosive wear as well as on the performance of the Turgo impulse turbine in actual flow conditions. Samples of silt were collected from the Beas River (India) near the Pandoh dam. It has been found experimentally that silt parameters, nozzle angle and operating hour of the Turgo turbine increases the erosive wear rate in the turbine components causing efficiency loss in the Turgo impulse turbine and final breakdown of hydro turbines. Hydro Nepal; Journal of Water, Energy and Environment Vol. 12, 2013, January Page:76-79DOI: http://dx.doi.org/10.3126/hn.v12i0.9038 Uploaded Date : 10/29/2013
Performance Evaluation of Sewage Treatment Plants in Lucknow City
Authors: Tripathi Mansi , Singal S.
Published: November 2013

The present study was conducted to evaluate the performance of existing sewage treatment plants (STPs) in Lucknow City of India. Currently, two STPs are operating in Lucknow, i.e., UASB reactor and FAB reactor, with total operating capacity of 345MLD and 56MLD, respectively. Since, the wastewater get mix with the domestic effluent while directing towards the STPs, therefore, the concentration of BOD is relatively very low, and hence the amount of biogas production by the UASB reactor is also reduced than its design value. Two approaches, evaluating the treatability performance and Life-Cycle Assessment (LCA) have been used to determine the plants efficiencies. All the results have been interpreted graphically. The results of this study conclude that the UASB reactor is better than the FAB, however in terms of LCA the FAB seems to be more reliable. Hydro Nepal; Journal of Water, Energy and Environment Vol. 12, 2013, January Page: 80-86DOI: http://dx.doi.org/10.3126/hn.v12i0.9039 Uploaded Date : 10/29/2013
International Watercourse Law and A Perspective on Nepal-India Relation
Authors: Thanju Jeewan P.
Published: November 2013

Hydro Nepal; Journal of Water, Energy and Environment Vol. 12, 2013, January Page: 89-91DOI: http://dx.doi.org/10.3126/hn.v12i0.9041 Uploaded Date : 10/29/2013
Properties of aluminium coatings produced using manual and robotized flame spraying processes
Authors: Glogović Zlatko , Kožuh Zoran , Kralj Slobodan , Alar Vesna , Stojanović Ivan
Published: November 2013

Aluminium coatings applied using arc or flame spraying processes are frequently employed for protection of steel structures in maritime applications. Results of comparative testing of aluminium coatings produced by manual and robotized flame spraying on steel substrate are reported in the contribution. Particular attention during the investigation of coating properties has been given to the uniformity of coating thickness, adhesion and corrosion resistance. Analysis of the results yielded conclusions on the quality, adhesion and corrosion resistance of the aluminium coating when the coating is applied to the flat steel plate.
Misdiagnosing recurrent medulloblastoma: the danger of examination and imaging without histological confirmation
Authors: Weintraub Lauren , Miller Todd , Friedman Ilana , Abbott Rick , Levy Adam S.
Published: November 2013

The screening and detection of recurrent medulloblastoma presents the clinician with significant diagnostic challenges, including the risk of misdiagnosis. The authors present the case of a young girl with a history of a treated standard-risk medulloblastoma that highlights the risk of assuming recurrence has occurred when clinical and/or imaging changes are observed. This girl developed both new clinical deficits and had radiographic evidence of recurrence. She subsequently experienced a complete resolution of symptoms and radiographic findings with steroids alone.
Risk of infection following posterior instrumented lumbar fusion for degenerative spine disease in 817 consecutive cases
Authors: Chaichana Kaisorn L. , Bydon Mohamad , Santiago-Dieppa David R. , Hwang Lee , McLoughlin Gregory , Sciubba Daniel M. , Wolinsky Jean-Paul , Bydon Ali , Gokaslan Ziya L. , Witham Timothy
Published: November 2013

Object

Posterior lumbar spinal fusion for degenerative spine disease is a common procedure, and its use is increasing annually. The rate of infection, as well as the factors associated with an increased risk of infection, remains unclear for this patient population. A better understanding of these features may help guide treatment strategies aimed at minimizing infection for this relatively common procedure. The authors' goals were therefore to ascertain the incidence of postoperative spinal infections and identify factors associated with postoperative spinal infections.

Methods

Data obtained in adult patients who underwent instrumented posterior lumbar fusion for degenerative spine disease between 1993 and 2010 were retrospectively reviewed. Stepwise multivariate proportional hazards regression analysis was used to identify factors associated with infection. Variables with p < 0.05 were considered statistically significant.

Results

During the study period, 817 consecutive patients underwent lumbar fusion for degenerative spine disease, and 37 patients (4.5%) developed postoperative spine infection at a median of 0.6 months (IQR 0.3–0.9). The factors independently associated with an increased risk of infection were increasing age (RR 1.004 [95% CI 1.001–1.009], p = 0.049), diabetes (RR 5.583 [95% CI 1.322–19.737], p = 0.02), obesity (RR 6.216 [95% CI 1.832–9.338], p = 0.005), previous spine surgery (RR 2.994 [95% CI 1.263–9.346], p = 0.009), and increasing duration of hospital stay (RR 1.155 [95% CI 1.076–1.230], p = 0.003). Of the 37 patients in whom infection developed, 21 (57%) required operative intervention but only 3 (8%) required instrumentation removal as part of their infection management.

Conclusions

This study identifies that several factors—older age, diabetes, obesity, prior spine surgery, and length of hospital stay—were each independently associated with an increased risk of developing infection among patients undergoing instrumented lumbar fusion for degenerative spine disease. The overwhelming majority of these patients were treated effectively without hardware removal.
Hypoglossal-facial nerve “side”-to-side neurorrhaphy for persistent incomplete facial palsy
Authors: Wan Hong , Zhang Liwei , Li Dezhi , Hao Shuyu , Feng Jie , Oudinet Jean Paul , Schumacher Michael , Liu Song
Published: November 2013

Object

Hypoglossal-facial nerve neurorrhaphy is a widely used method for treating complete facial palsy. However, the classic surgical procedure using a “side”-to-end neurorrhaphy is not suitable for incomplete facial palsy (IFP), because sectioning of the facial nerve for neurorrhaphy compromises remnant axons and potential spontaneous reinnervation. For the treatment of persistent IFP, the authors investigated in rats a modified method using hypoglossal-facial nerve “side”-to-side neurorrhaphy.

Methods

An IFP model was created by crushing the facial nerve and then ligating the injury site to limit axonal regeneration. After 9 weeks, rats with IFP were submitted to hypoglossal-facial nerve “side”-to-side neurorrhaphy: The gap between the 2 nerves was bridged with a predegenerated peroneal nerve graft, which was sutured to only one-half of the hypoglossal nerve and to the remnant facial nerve through a small window created by removing the epineurium, thus preserving regenerating facial axons.

Results

Four months after repair surgery, double innervation of the target whisker pad by hypoglossal and facial motor neurons was supported by the recording of muscle action potentials and their retrograde labeling. Regenerated hypoglossal and facial motor neurons effectively participated in the reinnervation of the whisker pad, significantly improving facial symmetry without evident synkinesis, compared with rats that underwent IFP without hypoglossal-facial nerve neurorrhaphy.

Conclusions

This study demonstrates that hypoglossal-facial nerve “side”-to-side neurorrhaphy with a predegenerated nerve graft can lead to rapid functional benefits for persistent IFP without compromising the remnants of facial axons, thus providing a proof-of-feasibility for further studies in humans.
Cilostazol, a selective Type III phosphodiesterase inhibitor: prevention of cervical myelopathy in a rat chronic compression model
Authors: Yamamoto Shinji , Kurokawa Ryu , Kim Phyo
Published: November 2013

Object

Regional blood flow is decreased in experimental models of chronic spinal cord compression, and the alteration presumably contributes to the development of myelopathy. Cilostazol (Otsuka Pharmaceuticals Co.), a selective Type III phosphodiesterase inhibitor, has been shown to be neuroprotective in cerebral hypoperfusion animal models and clinically effective in preventing the recurrence of cerebral infarction. To investigate the neuroprotective effect of cilostazol on cervical spondylotic myelopathy, the preventive effect against progressive motor dysfunction and the loss of anterior horn motor neurons were assessed using a chronic cord compression model in rats.

Methods

To produce chronic cervical cord compression in male Wistar rats, thin polyurethane sheets (3 × 5 × 0.7 mm) that gradually expand over 48–72 hours by absorbing water were implanted under the C5–6 laminae. In sham operations, the sheets were momentarily placed and then immediately removed. This model has been shown to reproduce characteristic features of clinical cervical myelopathy, with progressive motor disturbances after a latency period and insidious neuronal loss preceding the onset of symptoms. In the treatment group, cilostazol (30 mg/kg/day) was orally administered to the rats once a day, starting the day after surgery and continuing through the entire observation period of 25 weeks. In the control group, vehicle solution was administered under the same protocol. Changes in motor function were monitored by measuring bilateral forepaw grip strength and the duration of forced running on a treadmill. Twenty-five weeks after surgery, cervical spinal cords were examined histopathologically.

Results

Cilostazol preserved both forepaw grip strength and forced running capability. The drug also preserved anterior horn motor neurons in the C5–6 spinal cord segment, which diminished in number in the untreated chronic compression group. The drug decreased the number of TUNEL-positive apoptotic cells.

Conclusions

These results indicate that cilostazol is neuroprotective in the chronically compressed cervical cord and is potentially useful in the treatment of cervical spondylotic myelopathy.
Predictive value of E-PASS and POSSUM systems for postoperative risk assessment of spinal surgery
Authors: Hirose Jun , Taniwaki Takuya , Fujimoto Toru , Okada Tatsuya , Nakamura Takayuki , Okamoto Nobukazu , Usuku Koichiro , Mizuta Hiroshi
Published: November 2013

Object

The Estimation of Physiological Ability and Surgical Stress (E-PASS) and Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) systems are surgical risk scoring systems that take into account both the patient's preoperative condition and intraoperative variables. While they predict postoperative morbidity and mortality rates for several types of surgery, spinal surgeries are currently not included. The authors assessed the usefulness of E-PASS and POSSUM algorithms and compared the predictive ability of both systems in patients with spinal disorders considered for surgery.

Methods

The E-PASS system includes a preoperative risk score, a surgical stress score, and a comprehensive risk score that is determined by both the preoperative risk score and surgical stress score. The POSSUM system is composed of a physiological score and an operative severity score; its total score is based on both the physiological score and operative severity score. The authors calculated the E-PASS and POSSUM scores for 601 consecutive patients who had undergone spinal surgery and investigated the relationship between the individual scores of both systems and the incidence of postoperative complications. They also assessed the correctness of the predicted morbidity rate of both systems.

Results

Postoperative complications developed in 64 patients (10.6%); there were no in-hospital deaths. All EPASS scores (p ≤ 0.001) and the operative severity score and total score of the POSSUM (p < 0.03) were significantly higher in patients with postoperative complications than in those without postoperative complications. The morbidity rates correlated linearly and significantly with all E-PASS scores (p ≤ 0.001); their coefficients (preoperative risk score, ρ = 0.179; surgical stress score, ρ = 0.131; and comprehensive risk score, ρ = 0.198) were higher than those for the POSSUM scores (physiological score, ρ = 0.059; operative severity score, ρ = 0.111; and total score, ρ = 0.091). The area under the receiver operating characteristic curve for the predicted morbidity rate was 0.668 for the E-PASS and 0.588 for the POSSUM system.

Conclusions

As E-PASS predicted morbidity more correctly than POSSUM, it is useful for estimating the postoperative risk of patients considered for spinal surgery.
Factors affecting survival in 267 consecutive patients undergoing surgery for spinal metastasis from renal cell carcinoma
Authors: Tatsui Claudio E. , Suki Dima , Rao Ganesh , Kim Stefan S. , Salaskar Abhijit , Hatiboglu Mustafa Aziz , Gokaslan Ziya L. , McCutcheon Ian E. , Rhines Laurence D.
Published: November 2013

Object

Renal cell carcinoma (RCC) frequently metastasizes to the spine, and the prognosis can be quite variable. Surgical removal of the tumor with spinal reconstruction has been a mainstay of palliative treatment. The ability to predict prognosis is valuable when determining the role and magnitude of surgical intervention in cancer patients. To better identify factors affecting survival in patients undergoing surgery for spinal metastasis from RCC, the authors undertook a retrospective analysis of a large patient cohort at a tertiary care cancer center.

Methods

Relevant clinical data on a consecutive series of patients who had undergone surgery for spinal metastasis of RCC between 1993 and 2007 at The University of Texas MD Anderson Cancer Center were retrospectively reviewed. Demographic data, histopathological grade of primary tumor, timing of spinal surgery relative to diagnosis, treatment history prior to surgery, neurological status, and systemic disease burden were analyzed to determine the impact of these factors on survival outcome.

Results

The authors identified 267 patients who met the study criteria. Five-year overall survival (OS) after spine tumor resection was 7.8%, with a median OS of 11.3 months (95% CI 9.5–13.0 months). Patients with Fuhrman Grade 4 RCC had a median OS of 6.1 months (95% CI 3.5–8.7 months), which was significantly lower than the 14.3 months (95% CI 9.1–19.4 months) observed in patients with Fuhrman Grade 3 or less RCC (p < 0.001). Patients with preoperative neurological deficits had a median survival of 5.9 months (95% CI 4.1–7.7 months), which was significantly lower than the 13.5 months (95% CI 10.4–16.6 months) observed in patients with a normal neurological examination (p < 0.001). Patients whose spine was the only site of metastasis had a median OS of 19 months (95% CI 9.8–28.2 months) after surgery, significantly longer than the 9.7 months (95% CI 8.1–11.3 months) observed in patients with additional extraspinal metastasis sites (p < 0.001). Patients with nonprogressing extraspinal metastasis (no metastasis, stable, or concurrent) had a median survival of 20.6 months (95% CI 15.1–26.1 months), compared with 5.6 months (95% CI 4.4–6.8 months) in patients with progressing metastasis (p < 0.001).

Conclusions

The authors identified several factors influencing survival after spine surgery for metastatic spinal RCC, including grade of the original nephrectomy specimen, activity of the systemic disease, and neurological status at the time of surgery. These clinical features may help to identify patients who may benefit from aggressive surgical intervention.
Surgical manifestations of thoracic arachnoid pathology: series of 28 cases
Authors: Griessenauer Christoph J. , Bauer David F. , Moore Thomas A. , Pritchard Patrick R. , Hadley Mark N.
Published: November 2013

Object

Various pathologies involving the thoracic arachnoid mater uniformly manifest as thoracic myelopathy and may present a significant management dilemma. The authors undertook this study to assess outcome in cases of thoracic myelopathy due to thoracic arachnoid pathology.

Methods

The authors have cared for and followed 28 patients with thoracic myelopathy from thoracic arachnoid pathology over the last 17 years. A chart review and contemporary follow-up of these patients was performed and outcomes were reported.

Results

Patients with thoracic myelopathy from thoracic arachnoid pathology often have improvement in their condition after surgical decompression/detethering procedures. While not universal, patients in this series had improvement in mJOA scores at 1 year after surgery (p = 0.0001) and at last follow-up (p = 0.04). Results indicated that across a wide variety of pathologies the extent of thoracic spinal cord involvement is a predictor of the disease course and outcome. Comparison of the group of patients with cord involvement limited to 2 vertebral segments (short-segment pathology) versus the group with cord tethering of more than 2 segments (long-segment pathology) showed that patients in the short-segment group more frequently had ventral or dorsal arachnoid bands (p = 0.003), more frequently had signal change in the cord on MRI (p = 0.02), and less frequently presented with a syrinx (p = 0.02), and a smaller percentage of patients in this group underwent reoperation (p = 0.02). While patients with short-segment pathology typically improved after a single operative intervention, patients with long-segment pathology typically improved after multiple operations, frequently for CSF diversion.

Conclusions

Thoracic arachnoid pathology causing thoracic cord dysfunction and myelopathy is varied, has multiple etiologies, and can be difficult to treat over the long term. Surgical management, when indicated, is case specific. Serial long-term follow-up is essential to document enduring clinical and radiographic success.
Why are there different versions of the Oswestry Disability Index?
Authors: Fairbank Jeremy C. T.
Published: November 2013

This article updates readers on the current state of the Oswestry Disability Index (ODI) and the impact of unvalidated versions. The ODI is now licensed to the Mapi Research Trust in order to preserve a standard version in English and in validated translations. A proposed threshold of “normality” is potentially helpful as an outcome for both audit and research. There is an application of the sex section as a quality measure in Germany.

The ODI is an important international shared resource for clinicians and investigators and should not be abused. Its current status will not be enhanced by further modification. It is now registered with the International Consortium for Health Outcomes Measurement as a standard outcome measure.
Sans-domicile : une cible mouvante [Une typologie de l’histoire résidentielle des individus]
Authors: de Peretti Gaël
Published: November 2013

Au cours des années 1990, la demande d’informations sur la population des « sans-domicile » s’est multipliée, aboutissant à la création d’un groupe de travail du Conseil national de l’information statistique sur les sans-abri. Dans ce cadre, une équipe de travail s’est focalisée sur l’élaboration d’un classement de situations de logement, non spécifique aux sans-domicile, afin de ne pas les exclure statistiquement de la population générale. En s’appuyant sur ces travaux et les données d’une enquête menée par l’INSEE en janvier 2001 auprès des personnes fréquentant les services d’hébergement et de distribution de repas chauds, l’auteur dresse une typologie des personnes dites « sans-domicile » qui, au regard des caractéristiques des différentes classes, confirme la forte hétérogénéité de cette notion justifiant l’appellation de « cible mouvante ».