bluuebunny/crossref_metadata_2025 huggingface dataset:
Ética y sustentabilidad
Authors: Cantú-Martínez Pedro César
Published: October 2015

Este artículo explora la relación entre la ética y la sustentabilidad, en un escenario donde todas las relaciones subsisten en un marco de gran complejidad. Así mismo, el propósito es explorar la forma de edificar un nuevo entendimiento social y productivo a través de un diálogo con fundamentos éticos, con el propósito de comprender la relación de las distintas representaciones sociales, que son evidentes en diferentes circunstancias y territorios, y así constituir nuevas representaciones de pensamiento con una racionalidad distinta, con una sucesión de deberes naturales de orden moral hacia otras personas, conforme a la conciencia personal y social, debido a que pueden ser perjudicados o beneficiados por lo que forjamos como colectividad. Este problema se consideraba solucionado al arribo del nuevo milenio; sin embargo, aún persiste la miseria, desnutrición, desocupación, injusticia social, deterioro ambiental, entre otros sucesos, que no se han resuelto y ponen en duda cómo lograr el desarrollo sustentable.
Bioética, proximidad e investigación social
Authors: Cuevas Silva Juan María
Published: October 2015

Miguel Kottow, invitado especial en este número, sostiene que “precisamente uno de los aspectos por dilucidar es la escasa incorporación de lo social en la reflexión bioética, ampliando la brecha entre teoría y práctica, así como reduciendo el impacto real de la bioética sobre las prácticas sociales que son ante todo de su incumbencia: medicina clínica, investigación biomédica, salud pública”. Pero no es solamente lo social comprendido dentro de las reglas de juego ético-morales que surgen gracias a la práctica médico-científica, sino que es una comprensión de lo social como un sistema complejo de fenómenos caracterizados por las formas y dinámicas inter-relacionales, donde se plantea una “bioética proximal”, en la que el valor de la dignidad en las relaciones entre los seres vivos con los demás seres de la naturaleza es responsabilidad propia del hombre, ratificada esta concepción por los planteamientos de Germán Vargas y Teresa Arbeláez. Estos últimos sostienen que “Los seres humanos son los únicos susceptibles de dignidad y por esto no se les puede valorar económica o mercantilistamente. Lejos de un discurso religioso, y en cambio ético, corresponde al hombre establecer límites centrados en no dañar al otro y en poder discernir y hacer uso de su libertad”. Más enfáticamente al establecer que se debe saltar de un discurso bioético antropocentrista a un discurso bioético proximal, en el que el prójimo no es solamente el otro ser humano, sino el otro ser, en toda su dimensión de dignidad.
La enseñanza de una bioética proximal
Authors: Kottow Miguel
Published: October 2015

La enseñanza de la bioética pierde contacto con la realidad social en la cual se ejercen las actividades de su ámbito (medicina, investigación biomédica, salud pública). Su reflexión práctica se vuelve esquemática y cortocircuitada en principios y dogmas, incluso proponiendo modos algorítmicos de decisión. El original discurso sobre la depuración moral del encuentro clínico, la relación paciente-médico y probando-investigador comandados por decisiones informadas pierde relevancia por cuanto estas práctica se han distorsionado por efecto de la biomedicina impersonal.
Por otro lado, la bioética se deja seducir por el lenguaje holístico de la ética global, adhiriendo al coro de buenas intenciones que se estrellan con una realipolitik que permite el aumento de inequidades, el deterioro ambiental, la inseguridad ciudadana. La ética debe recuperar su enfoque proximal, intermediando entre la teoría y las prácticas con un discurso atingente a los problemas reales y de suficiente rigor como para influir sobre su entorno social.
Bioética y Salud Mental: reflexiones sobre la afección y la responsabilidad en la relación profesional-paciente
Authors: Sánchez Vasquez María José , Lahitte Héctor Blas , Ortiz Oria Vicente
Published: October 2015

En este artículo exponemos una lectura crítica sobre la responsabilidad y la afección mutua en encuadre profesional de salud mental. El marco referencial es la antropología cognitiva relacional y la ética de tipo hermenéutico. Proponemos un modelo conceptual-aplicado que supere una visión bioética centrada solo en la agencialidad y la competencia autónoma para tomar decisiones, donde lo que prima es el juicio médico. Sobre la base del principio de reconocimiento entendemos la importancia del encuentro profesional-paciente como un espacio intersubjetivo donde cada uno pueda responder desde su ser-capaz y decidir conjuntamente. El encuentro profesional con el que sufre un padecimiento mental se inserta en la vía del acontecimiento. Desde esta perspectiva, el restaurar un supuesto equilibrio perdido no es el objetivo profesional; más bien, atender las posibles formas de reestructuración particular que el individuo llamado “enfermo” ha desarrollado como recursos de convivencia. Desde estas ideas principales, se concluye en la necesaria convicción bioética de un profesional solícito, humanista y personalista para poder responder así a las problemáticas particulares del paciente en salud mental.
Bioética: nuevas tendencias.
Authors: Escobar López María Teresa
Published: October 2015

En menos de cincuenta años, la bioética se ha constituido en un nuevo saber que intenta articular las ciencias de la vida con las humanidades, saliéndole al paso a grandes problemas creados en las sociedades modernas en contextos donde se fracturó el saber, preconizo la ciencia, se potenció la utilidad en detrimento de los ecosistemas y se incrementó el rompimiento entre naturaleza, individuos y poblaciones al interior de sociedades cada vez más desiguales e inequitativas.
En poco tiempo, la bioética se ha ido convirtiendo en territorio para la reflexión y la construcción de dinámicas prácticas donde, si bien se ha privilegiado el análisis bioético de los grandes avances técnicos y científicos en el área de la salud, también, y de manera significativa, se entrelazan y construyen puentes con otros espacios del conocimiento, ciencias y disciplinas, por ejemplo, biopolítica, ecología, educación, economía o sociología, sólo por mencionar algunas de las interacciones más notorias en la búsqueda de sentidos más humanos y en mejor correspondencia con la naturaleza que los actuales.
La bioética comisionada revisitada
Authors: Novoa Edgar
Published: October 2015

El artículo propone reconocer la importancia que tiene para la consolidación de la bioética como un campo de conocimiento e intervención, la trayectoria que por diversas vías ha tenido la llamada bioética comisionada. Se enfatizan las condiciones históricas que condujeron a la creación de comités de ética hospitalaria y de la investigación, lo que posteriormente conducirá a la creación de comités, concejos o comisiones nacionales e internacionales. Se resaltan los aportes que esa bioética comisionada tiene para el desarrollo legislativo, el trazado de políticas, la construcción de una cultura deliberante e informada públicamente, la bioética comisionada como un movimiento de reforma social.
El sentido de las enfermedades por parásitos intestinales en poblaciones americanas, identificando dilemas bioéticos
Authors: Díaz Murillo María del Pilar , Ramírez Sánchez Nohora Aidée , Osorio García Samuel David
Published: October 2015

Objetivo: Identificar sentidos que pueblos del continente americano le asignan a las parasitosis intestinales y plantear posibles conflictos o dilemas en las tomas de decisiones en diferentes actividades de salud producto del encuentro de valores distintos, campo de acción de la bioética. Metodología: Revisión bibliográfica de artículos sobre parasitosis intestinales que cumplieran los criterios de inclusión establecidos y suministraran aportes para la comprensión hermenéutica de las parasitosis intestinales y permitieran identificar dilemas bioéticos para actividades en salud resultantes del contacto entre las visiones émica y ética (de la biomedicina). Resultados: La construcción social de las parasitosis intestinales influye en su percepción de causalidad, nocividad y como problema de salud, lo cual afecta las acciones que la gente emprenda ante ellas. Se advierte que tales construcciones sociales pueden no coincidir con la perspectiva biomédica. Se observó que en algunas poblaciones la construcción social del cuerpo se relaciona con la percepción de efectos benéficos de los parásitos. La gente reconoce factores de riesgo pero esto no necesariamente conduce a comportamientos preventivos. Algunos estudios reconocen que la educación ha sido de tipo informativo, sin participación comunitaria, lo cual impide que la gente se identifique con ella y se sienta motivada a transformar su realidad. Se identificaron diversos dilemas bioéticos producto del contacto entre visiones de las poblaciones, y la biomedicina. Conclusiones: La aproximación émica permite entender la lógica de la población sobre las parasitosis intestinales e identificar disyuntivas bioéticas. Aunque la gente reconozca los riesgos de infección, la falta de comprensión de la perspectiva émica de los parasitismos por parte del personal de salud y las deficientes condiciones de vida permiten que no se produzcan transformaciones que incidan en la disminución de sus prevalencias. Eso mismo afectará el éxito de programas de atención, prevención, promoción y educación en la salud. Pero el análisis de la visión émica, aunque es fundamental, no lo es todo. En el problema de las parasitosis intestinales intervienen también condiciones infraestructurales, que conllevan situaciones conflictivas para los profesionales de la salud, como agentes externos a las comunidades. Se pueden hacer campañas de educación que efectivamente mejoren la prevención, pero realidades socio-económicas (por ejemplo, pobreza, participación comunitaria, empoderamiento,) y políticas (compromisos y acciones de líderes y gobiernos a diferentes niveles) pueden incidir para que lo que se aprendió no surta el efecto deseado o que se modifiquen las condiciones estructurales que generan los problemas. En este punto se generan problemas morales que deberían ser analizados por la bioética.
La Bioética como ética del siglo XXI
Authors: Cuevas Silva Juan María
Published: October 2015

Hoy la bioética se ha convertido en un escenario interdisciplinar epistémico, transversal en la formación de profesionales, en la formulación y aplicación de políticas económicas, en el establecimiento de principios educativos en pro del cuidado del cuerpo, de la naturaleza, del medio ambiente. En otras palabras, el siglo XX deja la bioética como un espacio que favorece la reflexión sobre la vida, pero no la vida exclusivamente de los seres humanos, sino que se adentra en el escenario de desmitificar el antropocentrismo y posicionar un discurso que se centre en considerar la naturaleza como el núcleo central para que la vida se desarrolle. Este aspecto hace que la bioética se desempeñe en un contexto ideológico y socio-cultural cada vez más complejo y dinámico, que al mismo tiempo le exige cuidarse de establecer diálogos sin fundamento alrededor de las problemáticas que surgen gracias a la complejidad y dinamicidad de dichos contextos.
Desde la bioética a la neuro-ética: ¿neuro-ética o persono-ética?.
Authors: Pautassi Grosso Jorge Sebastián
Published: October 2015

Hay una continuidad desde la ética a la bioética y hacia la neuro-ética en cuanto esta, por medio de las últimas tecnologías, muestra las bases neurológicas que posibilitan la dimensión moral del ser humano. Este artículo pretende hacer una reflexión sobre la incursión de las neurociencias con relación a la ética, da respuestas a ciertas cuestiones, pero aún quedan muchas preguntas por responder. Aquí se hace ver cómo la naturaleza biológica humana posibilita el juicio y la conducta moral. Se presentan así las bases neurológicas del juicio moral especificando las funciones del córtex pre-frontal con relación al conocimiento social y los juicios éticos en compleja trama no solo con la corteza y el encéfalo sino con el todo de la persona humana y su ambiente. Se pasa luego a estudiar la evolución de la conciencia en general y la conciencia moral desde la neurología, la influencia social y las decisiones personales del sujeto moral. Se afirma la vida como valor biológico primario desde el cuerpo-cerebro en interrelación compleja con la vida psíquica y espiritual, es decir, la vida holística como valor supremo de la ética. Se concluye que no es suficiente estudiar los aspectos neurológicos sino la totalidad del ser humano para abordar lo que hemos llamado la persono-ética. Tenemos una naturaleza biológica que posibilita el juicio y la conducta moral. Lo natural biológico necesita lo cultural, es decir, una estructura educacional, pues el progreso moral es responsabilidad de cada hombre y de la sociedad en la formación epi-genética del cerebro.
¿Ha cambiado la esencia de la medicina con los adelantos modernos?
Authors: Arango Restrepo Pablo
Published: October 2015

La sociedad a lo largo de los siglos ha tenido cambios progresivos y en la actualidad estos son rápidos e incluyen el ejercicio de la profesión médica, que ha perdido su enfoque inicial en el paciente para centrarse en un interés principalmente comercial en detrimento de la atención respetuosa al paciente. En el presente artículo se revisa cuál ha sido considerada la esencia de la profesión a lo largo de los siglos, se contrasta con la situación actual y se invita a recuperar el ejercicio médico centrado en el paciente
De las ciudadanías formales a las vindicaciones sociales por el derecho al agua en la ciudad: “Relaciones complejas entre agua, hábitat y ciudad”
Authors: Cubillos Alvarado Vanessa Andrea , Llano Fabián Andrés
Published: October 2015

El presente artículo de revisión es el resultado de la investigación titulada “Prácticas sociales del agua en Bogotá. Tras la adversa cultura del agua y los estilos de vida bogotanos (1850-1888)”. En este texto se encontrará una revisión conceptual a la problemática sobre los usos sociales del agua en torno a las categorías hábitat y significaciones del agua en la ciudad. El despliegue de estos conceptos propone una metodología basada en el análisis documental dirigida a la rehistorización de las prácticas de los bogotanos en torno a los usos sociales del agua, de la higiene y de sus costumbres con relación a la ciudadanía y al discurso de la civilización.
Dark Tourism in Lebanon: A Bright Opportunity to be Pursued
Authors: Ghadban Dr Socrat , Zaki Manar Abou
Published: October 2015

Tourism in Lebanon has always been a key contributor to the national economy. It is one of the main sectors Lebanon depends on besides banking.

In this research, dark tourism was approached as an important type of tourism that has a significant potential role in Lebanon. Unfortunately, this is not reflected in the Ministry of Tourism list of tourist’s attractions. The interviews were done in this research showed that the Lebanese government gives no attention to such sites, and even dark places’ owners do not give their sites the needed attention in term of tourism development strategies. 100 questionnaires were collected in three different locations.

Results showed that the youth generation in Lebanon is interested in visiting dark-related destinations. The motivations and willingness to pay were studied for four different sites. Sources of information had a very important effect on visiting dark-related sites. As for payment, a randomized complete block design test revealed that visitors’ willingness to pay depends on the visited site.

Finally, an important aspect in this research treated the ethical dilemma in promoting dark-related sites which have an impact on the way dark tourism should be promoted.
Tourism Entrepreneurial Development and Flight Frequency at a Destination: Case Study of Malawi
Authors: Chilembwe James Malitoni , Gondwe Frank Wadilika
Published: October 2015

This paper assesses the role of flight frequency on tourism entrepreneurial development in Malawi. The air transport industry in other African countries is growing stronger and helps to promote tourism entrepreneurial development. Countries such as South Africa, Ethiopia, and Kenya, have developed strong air transport network which is vital in tourism development.

On the other hand, many African countries, Malawi inclusive are struggling to develop such air transport network which directly affects tourism entrepreneurial development. Businesses such as travel agencies, tour operators, ground handlers, and airports are highly depending on the airline’s operation to survive.

In an attempt to analyze the scenario in the tourism industry between airline’s frequency and tourism entrepreneurial development there was a measure of the relationship between the two hence the employment of quantitative approach in addition to in-depth interviews conducted with airline, travel, and tour operations managers to compare the results.

The study revealed that airlines have a vital role in tourism entrepreneurial development and that without airlines operating, many businesses would not have existed and should all airlines stop operating in the country, many companies would follow suit.

The study also ascertained that high frequency of flights at a destination means more opportunities and revenue for tourism entrepreneurs.
Genetic diversity in wild Lens spp. using inter simple sequence repeat (ISSR) marker
Authors: Gore Padmavati G. , Rana M. K. , Tripathi Kuldeep , Singh Mohar , Bisht I. S. , Bhalla Shashi
Published: October 2015

Genetic diversity was assessed in 50 accessions of seven Lens species using ISSR markers. The collection included accessions of the cultivated species L. culinaris and six wild species, viz., L. culinaris ssp. odemensis, L. culinaris ssp. orientalis, L. orientalis, L. nigricans, L. lamottei and L. ervoides. The 23 ISSR primers amplified a total of 368 bands with an average of 16 bands per primer. Maximum number of 20 bands was amplified using each of the primers ISSR-34 and ISSR-835. All the primers were found to be polymorphic. PIC values ranged from 0.02 to 0.80. The primers ISSR-807, ISSR- 809, ISSR- 827, ISSR- 847, ISSR-28 and ISSR- 37 were found to be very useful for analyzing the molecular diversity of the genus Lens. Cluster Analysis and Principal Coordinates Analyses placed the 50 accessions into two groups and complemented each other.
National Graduate Nursing Survey: Chronic Disease, Symptoms, and Self-Management
Authors: Kuebler Kim , Shilling Dellarie , Champ Charles
Published: October 2015

The purpose of this project is to compare graduate nursing students’ self-perceived knowledge with actual knowledge of chronic disease, symptom, and self-management through a psychometrically reliable and valid 45-item objective examination. Methodology included three separate e-mail communications to more than 800 U.S.-based graduate nursing school or program chairs, deans, or directors encouraging their student participation. Two hundred and fifty respondents provided demographic information from the survey, and 120 graduate nurses completed the survey in its entirety to include a self-perceived knowledge evaluation and objective examination. Graduate nurses in their last year of academic preparation were targeted in both master’s- and doctoral-level course work. The results showed an overall mean score of less than 70% pass rate from the psychometrically valid and reliable objective examination and no statistical difference between graduate nursing student self-perceived knowledge from actual knowledge.
Doctor of Nursing Practice Practice Improvement Project: A Simulation-Based Emergency Preparedness Program in Immediate Care
Authors: Hart Jessica Lynn , Braband Barbara
Published: October 2015

This practice improvement project was aimed at implementing a simulation-based education program at an immediate care clinic to better prepare staff for emergency situations and to determine whether simulation-based training could positively impact the confidence of participating staff members. Six staff members participated in a 2-phase program. The first phase included an educational component with practice mock code scenarios, whereas the second phase consisted of a spontaneous mock code drill 2 weeks later. Results revealed significant differences in participants’ overall reported comfort and confidence levels (percentages) in performing during a medical emergency pre- and postprogram. In addition, when individual skills were evaluated, there was a significant increase in participants’ comfort in initiating cardiopulmonary resuscitation (CPR), confidence in performing bag-to-mouth ventilation, and confidence in following basic life support guidelines during emergency situations. Findings suggest that a simulation-based learning program in immediate care can enhance the confidence of staff members in responding to emergent situations.
Decision Support for Women With Early Breast Cancer
Authors: Donnelly-Strozzo Mary K. , Belcher Anne
Published: October 2015

Approximately 100,000 new cases of lymph node–negative, estrogen receptor–positive breast cancer are diagnosed each year in the United States (Jemal et al., 2007). Adjuvant treatment for these patients is recommended and may include chemotherapy, hormonal therapy, combined chemotherapy plus hormonal therapy, or observation alone. Patient uncertainty plus dissatisfaction with the level of decision-making control over treatment options is common. This evidence-based practice change project focuses on improving the decision-making confidence of women with early stage breast cancer by increasing active participation in the discussion of treatment options. Seven participants’ decision control preferences were determined using a Control Preferences Scale. The effect of this intervention on satisfaction with the process was evaluated by using a 6-question Satisfaction With Decision instrument. There was a significant difference p < .05 in satisfaction with the decision process using a 2-tailed t test. This test was used to evaluate the effect of the intervention on satisfaction with the decision-making process compared to a group of women who did not receive the intervention. Women with early breast cancer can benefit from nursing interventions targeted at supporting their preferred level of decision control when making decision regarding treatment choices.
Deciding in Advance
Authors: Flanagan Abigail
Published: October 2015

Discussions about advance directives should begin before a hospitalization occurs, yet are sometimes initiated at the time of imminent death or during a life-altering medical event. A lack of knowledge in the general public perpetuates this practice because most people do not think about end-of-life choices and do not want to discuss the topic. Yet, family members naturally undertake surrogacy but often find themselves ill equipped to handle the moral and ethical situations that arise. Hence, it is important that health care providers engage patients to consider the completion of health care proxy and living will documents. Provider awareness about general perceptions will facilitate the approaches to initiating conversations about advance directives. This case study highlights the ethical dilemma of an octogenarian whose poor prognosis and lack of an advance directive contributed to an uncertain medical course.
Induced sheath voltages in 110 kV power cables – case study
Authors: Czapp Stanislaw , Dobrzynski Krzysztof , Klucznik Jacek , Lubosny Zbigniew
Published: October 2015

This paper considers electric shock hazard due to induced sheath voltages in 110 kV power cables. The purpose of this paper is to find an optimal configuration of the power cable system, taking into account electric shock hazard and ability of the system to transfer maximal power. A computer simulations on a computer model of the local power system, comprising high voltage power cables, were carried out. This model enables to analyse various configurations of the metallic cable sheaths bonding and earthing (single-point bonding, both-ends bonding, cross-bonding) and their impact on induced voltages in the cable sheaths. The analysis presented in the paper shows, that it is possible to find an optimal configuration of the complicated power cable system, in terms of electric shock hazard, maximal power transfer as well as economic aspects.
The gearless, grid-connected, 6-phase asymmetric wind turbine generator system
Authors: Gołębiowski Lesław , Gołębiowski Marek , Mazur Damian , Humer Matthias
Published: October 2015

In this paper a system of a grid side and a generator side converters, both working with a common capacitor, is presented. The 6-phase asymmetric inset-type SMPMSM generator is used. A large pole pair number of this generator enables a gearless wind turbine operation. The fundamental and 3rd harmonic cooperation is used to increase the generator performance. This is accomplished by means of the 3rd harmonic current injection. For that reason the generator side converter must have a neutral connection.
Multi-objective optimal reactive power dispatch to maximize power system social welfare in the presence of generalized unified power flow controller
Authors: Suresh Chintalapudi Venkata , Sivangaraju Sirigiri
Published: October 2015

In this paper a novel non-linear optimization problem is formulated to maximize the social welfare in restructured environment with generalized unified power flow controller (GUPFC). This paper presents a methodology to optimally allocate the reactive power by minimizing voltage deviation at load buses and total transmission power losses so as to maximize the social welfare. The conventional active power generation cost function is modified by combining costs of reactive power generated by the generators, shunt capacitors and total power losses to it. The formulated objectives are optimized individually and simultaneously as multi-objective optimization problem, while satisfying equality, in-equality, practical and device operational constraints. A new optimization method, based on two stage initialization and random distribution processes is proposed to test the effectiveness of the proposed approach on IEEE-30 bus system, and the detailed analysis is carried out.
Flux-weakening control methods for hybrid excitation synchronous motor
Authors: Mingming Huang , Xinjun Guo , Ping Jin , Quanzhen Huang , Yuping Liu , Na Li
Published: October 2015

The hybrid excitation synchronous motor (HESM), which aim at combining the advantages of permanent magnet motor and wound excitation motor, have the characteristics of low-speed high-torque hill climbing and wide speed range. Firstly, a new kind of HESM is presented in the paper, and its structure and mathematical model are illustrated. Then, based on a space voltage vector control, a novel flux-weakening method for speed adjustment in the high speed region is presented. The unique feature of the proposed control method is that the HESM driving system keeps the q-axis back-EMF components invariable during the flux-weakening operation process. Moreover, a copper loss minimization algorithm is adopted to reduce the copper loss of the HESM in the high speed region. Lastly, the proposed method is validated by the simulation and the experimental results.
Intraparenchymal ultrasound application and improved distribution of infusate with convection-enhanced delivery in rodent and nonhuman primate brain
Authors: Mano Yui , Saito Ryuta , Haga Yoichi , Matsunaga Tadao , Zhang Rong , Chonan Masashi , Haryu Shinya , Shoji Takuhiro , Sato Aya , Sonoda Yukihiko , Tsuruoka Noriko , Nishiyachi Keisuke , Sumiyoshi Akira , Nonaka Hiroi , Kawashima Ryuta , Tominaga Teiji
Published: October 2015

OBJECT

Convection-enhanced delivery (CED) is an effective drug delivery method that delivers high concentrations of drugs directly into the targeted lesion beyond the blood-brain barrier. However, the drug distribution attained using CED has not satisfactorily covered the entire targeted lesion in tumors such as glioma. Recently, the efficacy of ultrasound assistance was reported for various drug delivery applications. The authors developed a new ultrasound-facilitated drug delivery (UFD) system that enables the application of ultrasound at the infusion site. The purpose of this study was to demonstrate the efficacy of the UFD system and to examine effective ultrasound profiles.

METHODS

The authors fabricated a steel bar-based device that generates ultrasound and enables infusion of the aqueous drug from one end of the bar. The volume of distribution (Vd) after infusion of 10 ml of 2% Evans blue dye (EBD) into rodent brain was tested with different frequencies and applied voltages: 252 kHz/30 V; 252 kHz/60 V; 524 kHz/13 V; 524 kHz/30 V; and 524 kHz/60 V. In addition, infusion of 5 mM gadopentetate dimeglumine (Gd-DTPA) was tested with 260 kHz/60 V, the distribution of which was evaluated using a 7-T MRI unit. In a nonhuman primate (Macaca fascicularis) study, 300 μl of 1 mM Gd-DTPA/EBD was infused. The final distribution was evaluated using MRI. Two-sample comparisons were made by Student t-test, and 1-way ANOVA was used for multiple comparisons. Significance was set at p < 0.05.

RESULTS

After infusion of 10 μl of EBD into the rat brain using the UFD system, the Vds of EBD in the UFD groups were significantly larger than those of the control group. When a frequency of 252 kHz was applied, the Vd of the group in which 60 V was applied was significantly larger than that of the group in which 30 V was used. When a frequency of 524 kHz was applied, the Vd tended to increase with application of a higher voltage; however, the differences were not significant (1-way ANOVA). The Vd of Gd-DTPA was also significantly larger in the UFD group than in the control group (p < 0.05, Student t-test). The volume of Gd-DTPA in the nonhuman primate used in this study was 1209.8 ± 193.6 mm3. This volume was much larger than that achieved by conventional CED (568.6 ± 141.0 mm3).

CONCLUSIONS

The UFD system facilitated the distribution of EBD and Gd-DTPA more effectively than conventional CED. Lower frequency and higher applied voltage using resonance frequencies might be more effective to enlarge the Vd. The UFD system may provide a new treatment approach for CNS disorders.
Neuroimaging characteristics of ruptured aneurysm as predictors of outcome after aneurysmal subarachnoid hemorrhage: pooled analyses of the SAHIT cohort
Authors: Jaja Blessing N. R. , Lingsma Hester , Steyerberg Ewout W. , Schweizer Tom A. , Thorpe Kevin E. , Macdonald R. Loch
Published: October 2015

OBJECT

Neuroimaging characteristics of ruptured aneurysms are important to guide treatment selection, and they have been studied for their value as outcome predictors following aneurysmal subarachnoid hemorrhage (SAH). Despite multiple studies, the prognostic value of aneurysm diameter, location, and extravasated SAH clot on computed tomography scan remains debatable. The authors aimed to more precisely ascertain the relation of these factors to outcome.

METHODS

The data sets of studies included in the Subarachnoid Hemorrhage International Trialists (SAHIT) repository were analyzed including data on ruptured aneurysm location and diameter (7 studies, n = 9125) and on subarachnoid clot graded on the Fisher scale (8 studies; n = 9452) for the relation to outcome on the Glasgow Outcome Scale (GOS) at 3 months. Prognostic strength was quantified by fitting proportional odds logistic regression models. Univariable odds ratios (ORs) were pooled across studies using random effects models. Multivariable analyses were adjusted for fixed effect of study, age, neurological status on admission, other neuroimaging factors, and treatment modality. The neuroimaging predictors were assessed for their added incremental predictive value measured as partial R2.

RESULTS

Spline plots indicated outcomes were worse at extremes of aneurysm size, i.e., less than 4 or greater than 9 mm. In between, aneurysm size had no effect on outcome (OR 1.03, 95% CI 0.98–1.09 for 9 mm vs 4 mm, i.e., 75th vs 25th percentile), except in those who were treated conservatively (OR 1.17, 95% CI 1.02–1.35). Compared with anterior cerebral artery aneurysms, posterior circulation aneurysms tended to result in slightly poorer outcome in patients who underwent endovascular coil embolization (OR 1.13, 95% CI 0.82–1.57) or surgical clipping (OR 1.32, 95% CI 1.10–1.57); the relation was statistically significant only in the latter. Fisher CT subarachnoid clot burden was related to outcome in a gradient manner. Each of the studied predictors accounted for less than 1% of the explained variance in outcome.

CONCLUSIONS

This study, which is based on the largest cohort of patients so far analyzed, has more precisely determined the prognostic value of the studied neuroimaging factors. Treatment choice has strong influence on the prognostic effect of aneurysm size and location. These findings should guide the development of reliable prognostic models and inform the design and analysis of future prospective studies, including clinical trials.
Hemispheric surgery for refractory epilepsy: a systematic review and meta-analysis with emphasis on seizure predictors and outcomes
Authors: Hu Wen-Han , Zhang Chao , Zhang Kai , Shao Xiao-Qiu , Zhang Jian-Guo
Published: October 2015

OBJECT

Conflicting conclusions have been reported regarding several factors that may predict seizure outcomes after hemispheric surgery for refractory epilepsy. The goal of this study was to identify the possible predictors of seizure outcome by pooling the rates of postoperative seizure freedom found in the published literature.

METHODS

A comprehensive literature search of PubMed, Embase, and the Cochrane Library identified English-language articles published since 1970 that describe seizure outcomes in patients who underwent hemispheric surgery for refractory epilepsy. Two reviewers independently assessed article eligibility and extracted the data. The authors pooled rates of seizure freedom from papers included in the study. Eight potential prognostic variables were identified and dichotomized for analyses. The authors also compared continuous variables within seizure-free and seizure-recurrent groups. Random- or fixed-effects models were used in the analyses depending on the presence or absence of heterogeneity.

RESULTS

The pooled seizure-free rate among the 1528 patients (from 56 studies) who underwent hemispheric surgery was 73%. Patients with an epilepsy etiology of developmental disorders, generalized seizures, nonlateralization on electroencephalography, and contralateral MRI abnormalities had reduced odds of being seizure-free after surgery.

CONCLUSIONS

Hemispheric surgery is an effective therapeutic modality for medically intractable epilepsy. This meta-analysis provides useful evidence-based information for the selection of candidates for hemispheric surgery, presurgical counseling, and explanation of seizure outcomes.
Penetrating head injuries in children due to BB and pellet guns: a poorly recognized public health risk
Authors: Kumar Ravi , Kumar Ramesh , Mallory Grant W. , Jacob Jeffrey T. , Daniels David J. , Wetjen Nicholas M. , Foy Andrew B. , O’Neill Brent R. , Clarke Michelle J.
Published: October 2015

OBJECT

Nonpowder guns, defined as spring- or gas-powered BB or pellet guns, can be dangerous weapons that are often marketed to children. In recent decades, advances in compressed-gas technology have led to a significant increase in the power and muzzle velocity of these weapons. The risk of intracranial injury in children due to nonpowder weapons is poorly documented.

METHODS

A retrospective review was conducted at 3 institutions studying children 16 years or younger who had intracranial injuries secondary to nonpowder guns.

RESULTS

The authors reviewed 14 cases of intracranial injury in children from 3 institutions. Eleven (79%) of the 14 children were injured by BB guns, while 3 (21%) were injured by pellet guns. In 10 (71%) children, the injury was accidental. There was 1 recognized assault, but there were no suicide attempts; in the remaining 3 patients, the intention was indeterminate. There were no mortalities among the patients in this series. Ten (71%) of the children required operative intervention, and 6 (43%) were left with permanent neurological injuries, including epilepsy, cognitive deficits, hydrocephalus, diplopia, visual field cut, and blindness.

CONCLUSIONS

Nonpowder guns are weapons with the ability to penetrate a child’s skull and brain. Awareness should be raised among parents, children, and policy makers as to the risk posed by these weapons.
Young adults with spina bifida transitioned to a medical home: a survey of medical care in Jacksonville, Florida
Authors: Aguilera Antonio M. , Wood David L. , Keeley Cortney , James Hector E. , Aldana Philipp R.
Published: October 2015

OBJECT

The transition of the young adult with spina bifida (YASB) from pediatric to adult health care is considered a priority by organized pediatrics. There is a paucity of transition programs and related studies. Jacksonville Health and Transition Services (JaxHATS) is one such transition program in Jacksonville, Florida. This study’s purpose was to evaluate the health care access, utilization, and quality of life (QOL) of a group of YASBs who have transitioned from pediatric care.

METHODS

A survey tool addressing access to health care and quality of health and life was developed based on an established survey. Records of the Spinal Defects Clinic held at Wolfson Children’s Hospital and JaxHATS Clinic were reviewed and YASBs (> 18 and < 30 years old) were identified.

RESULTS

Ten of the 12 invited YASBs in the Jacksonville area completed the surveys. The mean age of respondents was 25.1 years. All reported regular medical home visits, 8 with JaxHATS and 2 with other family care groups. All reported easy access to medical care and routine visits to spina bifida (SB) specialists; none reported difficulty or delays in obtaining health care. Only 2 patients required emergent care in the last year for an SB-related medical problem. Seven respondents reported very good to excellent QOL. Family, lifestyle, and environmental factors were also examined.

CONCLUSIONS

In this small group of YASBs with a medical home, easy access to care for medical conditions was the norm, with few individuals having recent emergency visits and almost all reporting at least a good overall QOL. Larger studies of YASBs are needed to evaluate the positive effects of medical homes on health and QOL in this population.
Genetic divergence in Brassica rapa L.
Authors: Naznin S , Kawochar MA , Sultana S , Zeba N , Bhuiyan SR
Published: October 2015

Different multivariate analysis techniques were used to classify 33 Brassica rapa L. genotypes. The genotypes were grouped into five clusters. Cluster I contained the maximum number of genotypes. Cluster III earned the highest cluster mean value for number of primary branches/plant, number of secondary branches/plant, number of siliquae/plant and seed yield/plant. Therefore, more emphasis can be given on cluster III for selecting genotypes as parents for the hybridization program. The highest intra-cluster distance (3.822) was found in cluster I and the lowest (0.000) in cluster V. The highest inter-cluster distance (15.705) was observed between clusters III and V showing wide diversity among the groups. Principal component analysis (PCA) showed that the first three principal components accounted for 99.38 % of the total variation observed. Analysis of the factor loading of the component character indicated that the characters number of siliquae/plant, plant height and days to maturity were found responsible for genetic divergence. The role of number of siliquae/plant in both the vectors was important components for genetic divergence in these materials. Among the possible 528 combinations, the highest inter-genotypic distance (1.5975) was observed between G-27 (BARI sarisha-9 x BARI sarisha-6 S-62) and G-31 (BARI sarisha-15). Considering group and inter-genotypic distance, cluster mean, contribution of different characters towards the total divergence and other agronomic performance the genotypes G- 19 (BARI sarisha-6 x TORI-7 S-48), G-20 (F6 x BARI sarisha-9 S-52), G-27 and G-30 (BARI sarisha-6 x TORI-7 S-37) from cluster III; G-26 (F6 x BARI sarisha-9 S-15) and G-31 from cluster IV and G-33 (BARI sarisha-6) from cluster V would be considered as better parents for future hybridization program.Bangladesh J. Agril. Res. 40(3): 421-433, September 2015
Incidence, damage potential and management of jassids in groundnut field
Authors: Biswas GC
Published: October 2015

Abstract not availableBangladesh J. Agril. Res. 40(3): 507-512, September 2015
Screening of mungbean genotypes for tolerance to waterlogging under field condition
Authors: Amin MR , Karim MA , Khaliq QA , Islam MR , Aktar S
Published: October 2015

Abstract not availableBangladesh J. Agril. Res. 40(3): 513-519, September 2015
Management of Various Patients in Day Care Transfusion Center at Transfusion Medicine Department of Dhaka Medical College Hospital, Dhaka - Annual Audit of 2013
Authors: Karim Shanaz , Hoque Md Mazharul , Hoque Ehteshamul , Deb Sudip Ranjan , Begum Husne Ara
Published: October 2015

Objective: This study was carried out to improve day care transfusion facilities day by day as well as it is very time consuming and cost benefit both for patient and hospital authority, also government.Methods: According to instruction of the attending physicians, patients who were coming for day care transfusion all were recorded in prescribed data like name, age, sex, disease, number of transfusion ,transfusion reaction, etc. After proper cross matching and screening of donated blood, transfusion should be started, and monitor the patient every 15 minutes. If there is any transfusion reaction during or after transfusion, it should be noted and managed immediately. During this study, data was collected from record registered.Results: In this study, we found 742 patients were attended at Day Care Transfusion Center at DMCH, Dhaka, Bangladesh,in 2013. Among total patients male and female were 432 (58.23%)and 310 (41.77%) respectively. Age ranges of patients were 10-40 years 120 (16.17%) and 41-80 years 622 (83.82%).Among total patients, 548 (73.85%) were malignant. Other disease were aplastic anaemia, thalassaemia, myeloproliferative disease, Chronic kidney disease, Dysfunctional uterine bleeding, severe anemia due to unknown cause were 24(3.23%), 23(3.099%),50(6.73%), 43(5.79%),28(3.77%), 16 (2.15%) respectivelyJ Dhaka Medical College, Vol. 23, No.2, October, 2014, Page 191-193
Comparison of 24 Hour Urinary Protein and Spot Urinary Protein- Creatinine Ratio in the Assessment of Proteinuria in Patients with Glomerulonephritis
Authors: Ahmed Parvez Iftekhar , Islam Md Nazrul , Alam Md Babrul , Bhuiya Ferdous Kamal , Noman Mesbah Uddin , Chowdhury Md Nizamuddin
Published: October 2015

Context: Glomerulonephritis is an important cause of morbidity and mortality among all age group in Bangladesh. This cross sectional study was carried out with an aim to observe the comparison of 24 hour urinary protein and spot urinary protein- creatinine ratio in patients with glomerulonephritis in 3 group: on basis of 24 hour total protein, GFR level and serum albumin level.Methods: A total number of 128 consecutive patients having glomerulonephritis with 18 to 70 years who came in the Nephrology Unit, Dhaka Medical College Hospital, Dhaka, during the period of January to December of 2011 were included in this study. Patients with proteinuria other than glomerulonephritis like DM, UTI and Hypertension and <18 years of age were excluded from the study.Results: A significant positive correlation was found between 24 hour Urine Protein with Protein Creatinine Ratio on the patients having 24 hour Urinary protein <0.2 gm, 0.2-<1 gm, 1- 3.4 gm and 3.5-6 gm respectively. No correlation was found between 24 hr Urine Protein with Protein Creatinine Ratio on the patients having 24 hour Urinary protein >6 gm. A significant positive correlation was also found between 24 hour Urine Protein (gm/24 hour) with Protein Creatinine Ratio, which were in patients having GFR <15 ml/min/1.73m2 body surface area, 15-29 ml/min/1.73m2 body surface area, 30-59 ml/min/1.73m2 body surface area, 60-89 ml/ min/1.73m2 body surface area and e90 ml/min/1.73m2 body surface area respectively. However, the result of the group having GFR <15 ml/min/1.73m2 body surface was positively correlated but not very convincing. In this present series it was observed that a significant positive correlation was found between 24 hr Urine Protein (gm/24 hour) with Spot Urinary Protein Creatinine Ratio in relation to serum albumin level; r=0.658; (p<0.001) and r=0.707; (p<0.001) in patients having serum albumin level >30gm/dl and 20-30 gm/dl respectively. But because of only one sample in the group having <20 gm/dl serum albumin, no comparison could be carried out.Conclusion: P/C ratio provided a very useful, simple and convenient method for quantitative assessment of protein and can replace 24 hour urine collection method in indoor, outpatients and in follow up clinics as it gives quick and reliable results and avoids the inconvenience and short comings associated with 24 hour urine collection.J Dhaka Medical College, Vol. 23, No.2, October, 2014, Page 194-202
Pathoepidemiology of Cervical Cancer in National Institute of Cancer Research and Hospital of Bangladesh
Authors: Jabeen Suraiya , Islam Md Johirul , Talukder Md Habibullah , Nurunnabi Abu Sadat Mohammad , Haque Musarrat
Published: October 2015

A study was conducted to find out the descriptive epidemiological and pathological characteristics among the incidental cases of cervical cancer patients attending National Institute of Cancer Research & Hospital (NICRH), Dhaka, Bangladesh, during January to December, 2012. In this hospital based case-control study 278 patients with histologically, cytopathologically or by the oncologists confirmed cervical cancer were compared with equal number of controls, who had cancers other then cervical, form the same hospital. The mean ages for the cervical cancer cases were 44.90±7.217 years. The morphological categorization of the cervical cancer patients was squamous cell carcinoma (93%) and rest adenocarcinoma (7%). The majority of cases presented with moderately differentiated or grade 2 lesions (45.9%). There were no in-situ cases. Almost all the cancers cases (90.9%) had regional lymph node involvement. Odds ratios (OR) and 95% confidence intervals (CI) were obtained from multivariate logistic regression analysis. Compared with controls, it was found that cases having higher education (OR=1.46, 95% CI: 1.35-6.42), more personal income (OR=0.129, 95% CI: .02-.24), small family size (OR=0.018, 95% CI: 27.88-120.95) had a decreased risk for cervical cancer. However, marital status (OR=1.97, 95% CI: 4.21-20.69), age at marriage (OR=2.57, 95% CI: 11.45-118.29), age at 1st child (OR=9.33, 95% CI: 0.14-0.65), had more risk for cervical cancer. This study concludes that the majority of the cervical cancer sufferers at NICRH were from lower- socioeconomic group having less education with a late cancer presentation mostly with squamous cell carcinoma.J Dhaka Medical College, Vol. 23, No.2, October, 2014, Page 203-210