bluuebunny/crossref_metadata_2025 huggingface dataset:
Tympanoplasty Type-I using tragal perichondrium graft: Our experience
Authors: Wahid Fazali , Nagra Sajid Rashid
Published: June 2019

Objective: To determine the efficacy of tragal perichondrium graft used in tympanoplasty Type-I at a tertiary care hospital.

Methods: This descriptive case-series study was performed at the department of E.N.T, Head and Neck Surgery, Medical Teaching Institution/Lady Reading Hospital (MTI/LRH), Peshawar, Pakistan from June 2017 to May 2018. After approved from IREB, a well informed consent was taken. Pure Tone Audiometry (PTA) was performed before surgery and post-operatively at three and six months interval. The mean ± SD Air-Bone Gap (ABG) was calculated in pre- and postoperative PTA. The data were analyzed using SPSS (version 20). Chi-square (X2) test of significance was used taking confidence interval at 95%. The p-value ≤0.05 was considered significant.

Results: Total patients were 36; male 21 (58.3%), female 15(41.7%) with male: female ratio of 1.4:1. Mean ± SD age was 27.14 ± 7.49 years (Range 15 – 50Years). Tympanic membrane perforation was commonly found on right side 22 (61.1%), predominantly involving anterioinferior site 19 (52.8%) and medium sized perforation outnumbered 22 (61.1%). Mean pre-operative air-conduction of 49.72 dB was significantly reduced to 18.27 dB with pvalue of <0.05. Similarly the pre-operative mean air bone gap on PTA of 45.63 ± 8.35dB was also reduced to statistically significant level of 7.41 ± 3.51 dB on post-operative PTA with p-value of <.05. Graft was taken up well in 34 cases (94.4%).

Conclusion: Tragal perichondrial graft is an effective grafting material used for tympanoplasty due to its possessing qualities.

doi: https://doi.org/10.12669/pjms.35.4.421

How to cite this:Wahid FI, Nagra SR. Tympanoplasty type I using tragal perichondrium graft: Our experience. Pak J Med Sci. 2019;35(4):1076-1080.  doi: https://doi.org/10.12669/pjms.35.4.421

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
210Po and 210Pb concentration in zooplankton of the Syrian coastal waters (eastern Mediterranean Sea)
Authors: AL-MASRI MOHAMMAD SAID , MAMISH SAMER , ABDEL-HALEEM MOHAMMAD , HANI DURGHAM HANI
Published: June 2019

210Po and 210Pb activity concentrations and their concentration ratio (CR) in marine zooplankton collected for the first time from the Syrian coastal waters (the eastern Mediterranean Sea) have been determined. The average activity concentrations of 210Po and 210Pb were 243±36 and 26.4±4.3 Bqkg-1 dw. The 210Po/210Pb activity ratio was found to be more than one  in all zooplankton samples with an average of 9.2 (8.4 to 10), which indicates that the accumulation of 210Po in zooplankton does not come from the decay of the 210Pb only, and reflects a preferential bioaccumulation of 210Po over 210Pb. In addition, the Concentration Ratio (CR) for 210Po and 210Pb reached 104 and 103, respectively. This study will contribute to the radioecological reference database for zooplankton in the Mediterranean Sea.
First description of a new worm bait fishery in the NW Mediterranean Sea
Authors: BAETA MARC , NAVARRETE AROA , BALLESTEROS MANUEL
Published: June 2019

Most commercial clam stocks in the NW Mediterranean Sea have collapsed over the last few decades and, as a result, most clam dredge fishermen have been forced to leave the fishing sector. Recently, in order to sustain their economic activity, some fishermen have modified dredges to target sea worms to sell as bait for recreational fisheries. This study provides the first information about this new worm bait fishery on the Catalan Maresme coast (NE Spain). The local administration has regulated only a few aspects of the fishery: users (2 boats), geographical limits (40 km; between 0-7 m depth), fishing time (6:00-14:00) and dredge design (the same as those used for smooth clams but with interior structures to retain worms and an open back). Fishing activity takes place throughout the year. Fishermen target three worm bait species: Sigalion squamosus, Ophelia neglecta and Halla parthenopeia. A mean of 233.37 individuals of S. squamosus, 167.93 of O. neglecta and 2.17 of H. parthenopeia are gathered per boat and day. Worm baits are sold directly to local recreational fishing shops as a quality product at the highest prices on the market. This fishery has a high social and economic value for the Maresme coast, helping to maintain small-scale fishermen jobs with an economic benefit similar to clam fishing.
What’s new in HIV dermatology?
Authors: Coates Sarah J , Leslie Kieron S
Published: June 2019

HIV has long been associated with a number of inflammatory, infectious, and neoplastic skin conditions. In the era of anti-retroviral therapy, we have discovered even more about the relationship between skin disease and chronic immunosuppression. In particular, clinicians still face the propensity of persons living with HIV to develop difficult-to-control viral infections, chronic skin inflammation, and pruritus and—particularly as patients age—various types of skin cancers. Here, we summarize recent updates in the field of HIV dermatology and make recommendations to providers caring for these patients.
Scale sequentially CLEAN for Mingantu Spectral Radioheliograph
Authors: Цзюнь Чэн , Jun Cheng , Йихуа Йан , Yihua Yan , Дун Чжao , Dong Zhao , Лун Сюй , Long Xu
Published: June 2019

MingantU SpEctral Radioheliograph (MUSER) is a solar-dedicated radio heliograph, adopting aperture synthesis technique to image the Sun in the frequency range of 0.4 GHz to 15 GHz. MUSER has extremely high spatial resolution, temporal resolution, and frequency resolution beyond those of contemporary devices of the same category. For aperture synthesis, the number of antennas is limited, so sparse sampling of Fourier components is actually obtained for solar observation, which corresponds to the situation that a clean image is convolved by a dirty beam with strong sidelobe in a spatial domain. Thus, the deconvolution, such as CLEAN, is generally required for imaging the aperture synthesis to remove artifacts caused by the convolving dirty beam. The traditional Högbom CLEAN is based on the assumption that an observed object is only composed of point sources. This assumption does not hold for solar observation, where the solar disk is an extended source containing complex structures and diffuse features. In this paper, we make the first attempt to employ scale sequentially CLEAN for MUSER imaging, including Multi-Resolution CLEAN and Wavelet CLEAN. The experimental results demonstrate that the scale sequentially CLEAN, especially wavelet CLEAN, is superior to the traditional CLEAN algorithm in smaller number of iterations and improved image quality. We provide optimized wavelet parameters to further improve the performance of wavelet CLEAN.
Impact of typhoon Vongfong 2014 on the ionosphere and geomagnetic field according to Swarm satellite data: 1. Wave disturbances of ionospheric plasma
Authors: Захаров Виктор , Zakharov Viktor , Пилипенко Вячеслав , Pilipenko Vyacheslav , Грушин Валерий , Grushin Valeriy , Хамидуллин Аскар , Khamidullin Askar
Published: June 2019

The article considers the influence of large atmospheric processes on the ionosphere by the example of tropical typhoon Vongfong 2014. We use data obtained from three SWARM satellite missions (450–500 km altitude). We discuss two possible mechanisms of transfer of atmospheric disturbances to ionospheric heights. The first mechanism is the generation of acoustic-gravity waves (AGWs); the second mechanism considers the excitation of electric fields in the atmosphere. We propose new techniques for detecting the ionospheric response to AGW, which rely on low-orbit satellite data. The first technique is based on determination of relative electron density variations in the frequency band from 15 to 150–180 s, corresponding to certain scales of AGW. The second technique estimates space-time derivatives of the electron density, measured by two nearby SWARM satellites. We present and estimate the characteristic magnitudes of ionospheric response effects, their localization and spatial-temporal characteristics for the large tropical cyclone under study.
STRUCTURE OF HIGH-CARBON STEEL AFTER WELDING WITH RAPID COOLING
Authors: Kalinin Yurii , Brykov Michail , Petryshynets Ivan , Efremenko Vasily , Hesse Olaf , Kunert Maik , Andrushchenko Michail , Osipov Michail , Berezhnyy Stanislav , Bykovskiy Oleg
Published: June 2019

In this paper the effect of rapid cooling during arc welding on the structure of fusion layer and heat affected zone (HAZ) of high-carbon low alloyed steel have been studied. The main idea was that despite of high carbon content (1.2%) it is necessary to achieve quenching in HAZ. Due to proper chemical composition of welded steel martensite start temperature Ms is about 20 oC, therefore austenitic structure of quenched metal is preserved after rapid cooling. Exposition of HAZ to excessive heat during welding cycle leads to local precipitation of carbides from austenite and thus raising of Ms. In this case some amount of martensite was present in structure after cooling along with austenite and carbides. Microstructure, microhardness and chemical composition of remelted electrode metal, fusion zone and HAZ were studied by means of optical microscopy, SEM, EDX and microhardness testing.
EFFECT OF BINDER COMPOSITION AND SINTERING TEMPERATURE ON THE MICROSTRUCTURE AND MECHANICAL PROPERTIES OF WC-7(Ni,Fe) HARD ALLOYS
Authors: Doan Phuong Dinh , Tran Trung Bao , Le Chung Danh , Tran Hung Ba
Published: June 2019

In this research, WC-7(Ni,Fe) hard alloys were prepared by ball milling, cold compaction and finally consolidated by hot isostatic pressing. The effect of binder composition and sintering temperature were investigated in term of the microstructure, density and mechanical properties of sintered samples. Density of hard alloys was measured by the Archimedes' principle while the microstructure was observed using a scanning electron microscope. The Vickers hardness was investigated at load of 30KG and the fracture toughness was calculated based on the Palmqvist crack method. The results revealed that the density of sintered samples was obtained in the range of 14.65 to 14.8 g/cm3 meanwhile the measured Vicker hardness and fracture toughness were respectively achieved from 1260 to 1520 HV30 and 11,7 to 17,5 MPa.m1/2 depending on the binder composition and sintered temperature.
Reducing Unneeded Clinical Variation in Sepsis and Heart Failure Care to Improve Outcomes and Reduce Cost: A Collaborative Engagement with Hospitalists in a MultiState System
Authors: Yurso Michael , Box Brent , Burgon Trever , Hauck Loran , Tagg Krystyna , Clem Kathleen , Paculdo David , Acelajado M Czarina , Tamondong‐Lachica Diana , Peabody John W
Published: June 2019

OBJECTIVE

To (1) measure hospitalist care for sepsis and heart failure patients using online simulated patients, (2) improve quality and reduce cost through customized feedback, and (3) compare patient‐level outcomes between project participants and nonparticipants.

METHODS

We conducted a prospective, quasi‐controlled cohort study of hospitalists in eight hospitals matched with comparator hospitalists in six nonparticipating hospitals across the AdventHealth system. We provided measurement and feedback to participants using Clinical Performance and Value (CPV) vignettes to measure and track quality improvement. We then compared length of stay (LOS) and cost results between the two groups.

RESULTS

107 providers participated in the study. Over two years, participants improved CPV scores by nearly 8% (P < .001), with improvements in utilization of the three‐hour sepsis bundle (46.0% vs 57.7%; P = .034) and ordering essential medical treatment elements for heart failure (58.2% vs 72.1%; P = .038). In study year one, average LOS observed/expected (O/E) rates dropped by 8% for participants, compared to 2.5% in the comparator group, equating to an additional 570 hospital days saved among project participants. In study year two, cost O/E rates improved from 1.16 to 0.98 for participants versus 1.14 to 1.01 in the comparator group. Based on these improvements, we calculated total cost savings of $6.2 million among study participants, with $3.8 million linked to system‐wide improvements and an additional $2.4 million in savings attributable to this project.

CONCLUSIONS

CPV case simulation‐based measurement and feedback helped drive improvements in evidence‐based care that translated into lower costs and LOS, above‐and‐beyond other improvements at AdventHealth.
Nurse Responses to Physiologic Monitor Alarms on a General Pediatric Unit
Authors: Schondelmeyer Amanda C , Daraiseh Nancy M , Allison Brittany , Acree Cindi , Loechtenfeldt Allison M , Timmons Kristen M , Mangeot Colleen , Brady Patrick W
Published: June 2019

BACKGROUND

Hospitalized children generate up to 152 alarms per patient per day outside of the intensive care unit. In that setting, as few as 1% of alarms are clinically important. How nurses make decisions about responding to alarms, given an alarm's low specificity for detecting clinical deterioration, remains unclear.

OBJECTIVE

Our objective was to describe how bedside nurses think about and act upon monitor alarms for hospitalized children.

DESIGN, SETTING, PARTICIPANTS

This was a qualitative study that involved the direct observation of nurses working on a general pediatric unit at a large children's hospital.

MEASUREMENTS

We used a structured tool that included predetermined categories to assess nurse responses to monitor alarms. Data on alarm frequency and type were pulled from bedside monitors.

RESULTS

We conducted 61.3 patient‐hours of observation with nine nurses, in which we documented 207 nurse responses to patient alarms. For 67% of alarms heard outside of the room, the nurse decided not to respond without further assessment. Nurses most commonly cited reassuring clinical context (eg, medical team in room), as the rationale for alarm nonresponse. The nurse deemed clinical intervention necessary in only 14 (7%) of the observed responses.

CONCLUSION

Nurses rely on clinical and contextual details to determine how to respond to alarms. Few of the alarm responses in our study resulted in a clinical intervention. These findings suggest that multiple system‐level and educational interventions may be necessary to improve the efficacy and safety of continuous monitoring.
Exact and Heuristic Solution of the Consistent Vehicle-Routing Problem
Authors: Goeke Dominik , Roberti Roberto , Schneider Michael
Published: June 2019

Providing consistent service by satisfying customer demands with the same driver (driver consistency) at approximately the same time (arrival-time consistency) allows companies in last-mile distribution to stand out among competitors. The consistent vehicle-routing problem (ConVRP) is a multiday problem addressing such consistency requirements along with traditional constraints on vehicle capacity and route duration. The literature offers several heuristics but no exact method for this problem. The state-of-the-art exact technique to solve VRPs—column generation (CG) applied to route-based formulations in which columns are generated via dynamic programming—cannot be successfully extended to the ConVRP because the linear relaxation of route-based formulations is weak. We propose the first exact method for the ConVRP, which can solve medium-sized instances with five days and 30 customers. The method solves, via CG, a formulation in which each variable represents the set of routes assigned to a vehicle over the planning horizon. As an upper bounding procedure, we develop a large neighborhood search (LNS) featuring a repair procedure specifically designed to improve the arrival-time consistency of solutions. Used as stand-alone heuristic, the LNS is able to significantly improve the solution quality on benchmark instances from the literature compared with state-of-the-art heuristics.
Cemented Exeter total hip arthroplasty with a 32 mm head on highly crosslinked polyethylene
Authors: Clement N. D. , Bardgett M. , Merrie K. , Furtado S. , Bowman R. , Langton D. J. , Deehan D. J. , Holland J.
Published: June 2019

Objectives

Our primary aim was to describe migration of the Exeter stem with a 32 mm head on highly crosslinked polyethylene and whether this is influenced by age. Our secondary aims were to assess functional outcome, satisfaction, activity, and bone mineral density (BMD) according to age.

Patients and Methods

A prospective cohort study was conducted. Patients were recruited into three age groups: less than 65 years (n = 65), 65 to 74 years (n = 68), and 75 years and older (n = 67). There were 200 patients enrolled in the study, of whom 115 were female and 85 were male, with a mean age of 69.9 years (sd 9.5, 42 to 92). They were assessed preoperatively, and at three, 12 and, 24 months postoperatively. Stem migration was assessed using Einzel-Bild-Röntgen-Analyse (EBRA). Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), EuroQol-5 domains questionnaire (EQ-5D), short form-36 questionnaire (SF-36,) and patient satisfaction were used to assess outcome. The Lower Extremity Activity Scale (LEAS), Timed Up and Go (TUG) test, and activPAL monitor (energy expelled, time lying/standing/walking and step count) were used to assess activity. The BMD was assessed in Gruen and Charnley zones.

Results

Mean varus/valgus tilt was -0.77⁰ and axial subsidence was -1.20 mm. No significant difference was observed between age groups (p ⩾ 0.07). There was no difference according to age group for postoperative WOMAC (p ⩾ 0.11), HHS (p ⩾ 0.06), HOOS (p ⩾ 0.46), EQ-5D (p ⩾ 0.38), patient satisfaction (p ⩾ 0.05), or activPAL (p ⩾ 0.06). Patients 75 years and older had a worse SF-36 physical function (p = 0.01) and physical role (p = 0.03), LEAS score (p < 0.001), a shorter TUG (p = 0.01), and a lower BMD in Charnley zone 1 (p = 0.02).

Conclusion

Exeter stem migration is within normal limits and is not influenced by age group. Functional outcome, patient satisfaction, activity level, and periprosthetic BMD are similar across all age groups. Cite this article: N. D. Clement, M. Bardgett, K. Merrie, S. Furtado, R. Bowman, D. J. Langton, D. J. Deehan, J. Holland. Cemented Exeter total hip arthroplasty with a 32 mm head on highly crosslinked polyethylene: Does age influence functional outcome, satisfaction, activity, stem migration, and periprosthetic bone mineral density? Bone Joint Res 2019;8:275–287. DOI: 10.1302/2046-3758.86.BJR-2018-0300.R1.
Fissure Detection and Measurement in Rough Rice Using X-Ray Imaging
Authors: Shi Hu , Siebenmorgen Terry  J. , Luo Hengliang , Odek Zephania
Published: June 2019

Abstract. Fissures in rice kernels that develop prior to harvest and post-harvest processing significantly reduce head rice yield, a crucial parameter for evaluating rice quality and economic value in the rice industry. In this study, fissures in rough rice were revealed by scanning approximately 50 rough rice kernels at a time using an x-ray system. An algorithm was developed to detect and measure fissures in rough rice kernels in the x-ray images using the Python programming language coupled with the OpenCV library. This algorithm successfully segmented individual rice kernels in the x-ray images using the gap-filling method. The algorithm detected fissures by adaptive thresholding of each rice kernel and applying a series of filters. Data on kernel parameters (number, area, length, and width) and fissure parameters (percentage of kernels fissured and fissure number, area, and length per kernel) were produced for the images to characterize kernel size and fissuring levels of the rice sample. This algorithm demonstrated good repeatability in measuring kernel and fissure parameters, with relative standard deviations of less than 4% and 9%, respectively. The accuracy of the developed algorithm in measuring fissures was validated by visual inspection of rough rice, with a deviation of less than 2% in percentage of kernels fissured. The fissure detection and measurement algorithm provides a useful tool for quantifying fissures in rough rice samples using x-ray imaging. This information could be used to quantify fissuring levels and predict head rice yield for rough rice samples without a cumbersome milling process. Keywords: Cracks, Fissure, Imaging, Rice, X-ray.
A ascensão do judiciário brasileiro: uma análise sobre seu posicionamento no cenário político histórico
Authors: Pimentel Diego Ferreira
Published: June 2019

O presente trabalho aborda o desenvolvimento do Estado constitucional brasileiro, sob o enfoque de demonstrar como ocorreu a ascensão do poder judiciário ao patamar atual de ampla judicialização da política e ativismo judicial, bem como seu posicionamento ao longo da história. Inicialmente, aborda-se o desenvolvimento do constitucionalismo mundial e a separação de poderes apontado a posição subalterna do judiciário naquele período e sua posterior ascensão com o regime neoconstitucional. Demostrado esses pressupostos, é traçado um recorte histórico pelo qual se evidencia desde o período imperial ao neoconstitucionalismo da Constituição Federal de 1988 os fatores político-normativos que culminaram na concessão de atributos que possibilitaram o controle da atividade política pelos órgãos judiciários, como a criação de ações como a ação popular ou a ampliação do sistema de controle constitucional das normas. Ao final, concluindo-se que esse processo não se inicia com a Constituição Cidadã, mas se concretiza após um longo desenvolvimento histórico.Palavras-chave: História constitucional; Judiciário brasileiro; Expansão judiciária; Supremo Tribunal Federal.
AGROTÓXICOS NO BRASIL: VIOLAÇÃO DO DIREITO FUNDAMENTAL À SAÚDE E AO MEIO AMBIENTE ECOLÓGICAMENTE EQUILIBRADO.
Authors: Folgado Cleber Adriano Rodrigues
Published: June 2019

Este trabalho tem como objetivo apresentar brevemente a problemática em relação à questão dos agrotóxicos no Brasil, bem como, refletir sobre as violações decorrentes do uso de agrotóxicos aos direitos fundamentais à saúde e ao meio ambiente ecologicamente equilibrado. Tais direitos encontram-se expressamente previstos na Carta Magna de 1988, com atribuições ao Estado e a coletividade, no sentido de cuidar e de proteger tais direitos. O uso de agrotóxicos gera inevitavelmente violação de ambos direitos, de modo que se faz importante refletir, no âmbito do Direito, sobre tais questões.Palavras-chave: Agrotóxicos. Direitos Fundamentais. Saúde. Meio Ambiente Ecologicamente Equilibrado.
UM NOVO OLHAR SOBRE AS SÚMULAS VINCULANTES: A APROXIMAÇÃO ENTRE COMMON LAW E CIVIL LAW E OS HARD CASES
Authors: Oliveira Neuza Vitoria de Andrade
Published: June 2019

O presente artigo é fruto de uma pesquisa cimentada na investigação da possível aproximação entre os dois sistemas de ordenamento jurídico consolidados ao longo da história, o common law, predominante em países de tradição anglo-saxônica como os Estados Unidos e a Inglaterra e o civil law que é o sistema jurídico mais disseminado no mundo ocidental e baseado no direito romanístico, adotado no Brasil, e com influência da atividade do jurisdicional, principalmente após o advento da Súmula Vinculante pelo ordenamento jurídico pátrio através da  Emenda Constitucional nº 45/2004, permitindo suceder se essa aproximação está ensejando mudanças de paradigmas nos sistemas investigados e quais seriam as consequências e reflexos desta, primordialmente no que diz respeito aos hard cases (casos difíceis).
Comparison of biotechnological culture of hypoxia-conditioned rat mesenchymal stem cells with conventional in vitro culture of normoxia-conditioned rat mesenchymal stem cells for testicular failure therapy with low libido in rats
Authors: Safitri Erma , Hariadi Mas'ud
Published: June 2019

Aim: Biotechnological culture of hypoxia-conditioned (CH) rat mesenchymal stem cells (rMSC-CH) for testicular failure therapy with low libido improves the functional outcome of the testicle for producing spermatogenic cells and repairs Leydig cells in rats (Rattus norvegicus). Materials and Methods: In the first group (T1), rats with testicular failure and low libido were injected with normoxia-conditioned (CN) rMSCs (21% oxygen); in the second group (T2), rats with testicular failure and low libido were injected with rMSC-CH (1% oxygen); in the negative control group (T–), rats with normal testis were injected with 0.1 mL phosphate-buffered saline (PBS); and in the sham group (TS), rats with testicular failure and low libido were injected with 0.1 mL of PBS. Results: Vascular endothelial growth factor expression, as the homing signal, in the groups T2, T–, T1, and TS was 2.00±0.5%, 2.95±0.4%, 0.33±0.48%, and 0±0%, respectively. The number of cluster of differentiation (CD)34+ and CD45+ cells in the groups T– and TS was <20%, whereas that in T1 and T2 groups was >30% and >80%, respectively, showing the mobilization of hematopoietic stem cells (HSCs). The number of spermatogenic cells (spermatogonia, primary spermatocytes, secondary spermatocytes, and spermatid) decreased significantly (p<0.05) in TS compared with that in T–, T1, and T2, whereas that in T2 did not show a significant (p>0.05) decrease compared to that in T–. The improvement in libido, based on the number of Leydig cells producing the hormone testosterone for libido expression, did not increase in T1, whereas T2 was able to maintain the number of Leydig cells significantly compared to that between TS and T1. Conclusion: rMSC-CH culture for testicular failure with low libido showed improvement in the functional outcome of the testicle and in repairing Leydig cells.
Acute Dermato-Lymphangio-Adenitis Following Administration of Infliximab for Crohn's Disease
Authors: Liyanage I.K. , Niriella M.A. , de Silva A.P. , de Silva N. , de Silva H.J.
Published: June 2019

Tumor necrosis factor-α inhibitor (TNF-α) is frequently used for Crohn's disease and other autoimmune conditions. Increased risk of infection is an accepted adverse effect of TNF-α, and routine screening for potential infections are carried out before initiation of therapy. We report the case of a patient who developed a localized painful swelling near the injection site, which was diagnosed as acute dermato-lymphangio-adenitis due to filarial infection. This adds to the limited number of case reports on parasitic complications following TNF-α therapy.
Eosinophilic Cholangitis Without Biliary Stricture After the Treatment of Eosinophilic Esophagitis
Authors: Tanaka Shunta , Sakai Arata , Masuda Atsuhiro , Ashina Shigeto , Yamakawa Kouhei , Tsujimae Masahiro , Kurosawa Manabu , Satou Yuu , Nakano Ryouta , Tanaka Takeshi , Yamada Yasutaka , Ikegawa Takuya , Fujigaki Seiji , Kobayashi Takashi , Tanaka Shinwa , Shiomi Hideyuki , Kodama Yuzo
Published: June 2019

Eosinophilic cholangitis (EC) is an uncommon, benign, self-limiting disease, which typically causes bile duct stricture with eosinophil infiltration. We report the case of a 70-year-old woman who presented with abdominal pain diagnosed with EC after treatment for eosinophilic esophagitis. All previous reported cases of EC had bile duct stricture seen on magnetic resonance cholangiopancreatography or cholangiogram during endoscopic retrograde cholangiopancreatography, but only wall thickness of the common bile duct was noted in our case. Although rare, EC should be considered when wall thickening of the bile duct is observed, even without stricture.
Concurrent Placements of a Duodenal-Jejunal Bypass Liner and an Intragastric Balloon Among Severely Obese Patients: A Case Series
Authors: Sartoretto Adrian , Marinos George , Sui Zhixian
Published: June 2019

The duodenal-jejunal bypass liner and the intragastric balloon are endoscopically deployed devices used in the treatment of obesity and diabetes. These devices use differing mechanisms of action, and concurrent use may lead to improved efficacy. Three obese patients who suffered from weight loss plateau with the liner had the intragastric balloon inserted concurrently. All 3 patients reported subsequent significant weight loss. None of the patients reported any symptom that indicate the interference between the devices. This is the first case series in humans of successfully combining 2 independent endoscopic bariatric therapies to overcome weight loss plateau in the primary treatment of obesity.
Colonic Mucosubmucosal Elongated Polyp in the Sigmoid Colon on Surveillance Colonoscopy
Authors: Fan Xiaowen , Hershman Melissa , Levi Gabriel , Weisberg Ilan
Published: June 2019

Colonic mucosubmucosal elongated polyp (CMSEP) is a newly designated colorectal polyp. It has unique endoscopic features of a worm- or drumstick-shaped appearance. Histologically, it is composed of normal colonic mucosa and expanded submucosa with a prominent vascular component and no significant inflammation. CMSEP is usually detected incidentally on screening colonoscopy or colonoscopy for other causes. Differential diagnoses that need to be considered include mucosal prolapse syndrome, filiform polyposis, hamartomatous polyp, colon leiomyoma, inverted diverticulum, and residual stalk of a pedunculated adenoma. We present a case of CMSEP on surveillance colonoscopy and literature review.
Clinicopathologic and Racial/Ethnic Differences of Colorectal Cancer Among Adolescents and Young Adults
Authors: Holowatyj Andreana N. , Lewis Mark A. , Pannier Samantha T. , Kirchhoff Anne C. , Hardikar Sheetal , Figueiredo Jane C. , Huang Lyen C. , Shibata David , Schmit Stephanie L. , Ulrich Cornelia M.
Published: June 2019

OBJECTIVES:

Despite overall reductions in colorectal cancer burden, incidence rates continue to rise among younger patients, and causes remain unknown. We examined differences in clinicopathologic and racial/ethnic characteristics within the adolescent and young adult (AYA) population diagnosed with colorectal cancer in the United States.

METHODS:

Using the National Cancer Institute's Surveillance, Epidemiology, and End Results program data, we identified individuals diagnosed with first primary colorectal cancer between ages 15 and 39 years from 2010 to 2015. Adjusted multivariable logistic regression models were used to quantify clinicopathologic and racial/ethnic differences across age at onset subgroups (15–19, 20–24, 25–29, 30–34, and 35–39 years).

RESULTS:

We identified 5,350 AYA patients diagnosed with colorectal cancer. Of note, 28.6% of AYA cases were diagnosed with right-sided tumors (cecum to transverse colon). The proportion of right-sided colorectal cancers differed significantly by age group at diagnosis (38.3% vs 27.3% of AYAs aged 15–19 vs 35–39 years, respectively; P trend = 0.01). Proportions of cases with mucinous adenocarcinoma and signet ring cell carcinoma histopathologic subtypes significantly increased with younger age at onset (P trends = 0.01 and 0.03, respectively). Differences in clinical stage were observed across AYA age groups, with stage II disease increasing with younger age (P trend = 0.01). The proportion of Hispanic AYAs was higher within younger patients, accounting for 21.0% of the AYA population aged 35–39 years up to 28.3% of 15–19-year-old individuals (P trend = 0.003).

DISCUSSION:

Within the AYA population, colorectal cancers differ by clinicopathologic and racial/ethnic characteristics. Further investigation of the clinical and biologic diversity of colorectal cancers that partially underlie age- and race-related differences in cancer susceptibility and outcomes is warranted.
Transjugular Liver Biopsy: Safe Even in Patients With Severe Coagulopathies and Multiple Biopsies
Authors: Sue Megan J. , Lee Edward W. , Saab Sammy , McWilliams Justin P. , Durazo Francisco , El-Kabany Mohamed , Kaldas Fady , Busuttil Ronald W. , Kee Stephen T.
Published: June 2019

OBJECTIVES:

To investigate the safety profile and diagnostic efficacy of transjugular liver biopsy (TJLB), with a focus on patients with severe coagulopathies and with multiple biopsies.

METHODS:

Clinical, laboratory, and demographic information was collected on 1,321 TJLBs in 932 patients (mean age 43.5 ± 23.2 years) performed between January 2009 and May 2017 to determine the diagnostic success rate and incidence of both major and minor complications in the 3-day and 30-day period post-biopsies. These outcomes were also analyzed for severely coagulopathic patients and a subgroup of patients who underwent multiple biopsies.

RESULTS:

The overall success rate (diagnostic yield) of the TJLB procedure was 97.7% (1,291/1,321). Overall, the major and minor complication rates were 1.0% (13/1,321) and 9.5% (126/1,321), respectively. In patients with multiple biopsies, the overall complication rate was similar to the entire study cohort, which was 10.4% (57/550). Patients were also stratified according to the platelet counts of 0–50, 51–100, 101–200, 201–300 and >300 × 103 platelets/μL. The overall complication rates were 8.0% (10/124), 11.6% (36/310), 9.9% (54/547), 11.9% (28/235), and 14.3% (11/77), respectively, and these were not statistically significant from each other. Patients were also stratified by international normalized ratio into 0–1, 1.1–2, 2.1–3, and >3. The overall complication rates of these patients were 8.0% (19/237), 11.8% (113/954), 16.3% (7/43), and 0% (0/9), respectively, and were not statistically significant from each other.

DISCUSSION:

TJLB is a highly efficacious, well-tolerated and safe procedure. It can be safely performed multiple times in the same patient or in critically ill, severely coagulopathic patients with no significant increase in the rate of complication while maintaining an extremely favorable diagnostic yield.
Occlusion Probability in Operational Forest Inventory Field Sampling with ForeStereo
Authors: Montes F. , Rubio-Cuadrado A. , Sánchez-González M. , Aulló-Maestro I. , Cabrera M. , Gómez C.
Published: June 2019

Field data in forest inventories are increasingly obtained using proximal sensing technologies, often under fixed-point sampling. Under fixed-point sampling some trees are not detected due to instrument bias and occlusions, hence involving an underestimation of the number of trees per
hectare (N). The aim here is to evaluate various approaches to correct tree occlusions and instrument bias estimates calculated with data from ForeStereo (proximal sensor based on stereoscopic hemispherical images) under a fixed-point sampling strategy. Distance-sampling and the new hemispherical
photogrammetric correction (HPC), which combines image segmentation-based correction for instrument bias with a novel approach for estimating the proportion of shadowed sampling area in stereoscopic hemispherical images, best estimated N and basal area (BA). Distance-sampling slightly overestimated
N (11% bias, 0.60 Pearson coefficient with the reference measures) and BA (4%, 0.82). HPC provided less biased N estimates (-6%, 0.61) but underestimated BA (-8%, 0.83). HPC most accurately retrieved the diameter distribution.
Examining the Effectiveness of Spectrally Transformed SMA in Urban Environments
Authors: Deng Yingbin , Wu Changshan
Published: June 2019

Spectral transformation has been applied to address the spectral variability in spectral mixture analysis. However, there is not a study addressing the necessity and applicability of transformed models. This article, therefore, aims to answer two questions: whether significantly different
results will be generated through applying a spectral transformation, and which spectral transformation performs better in urban environments. In particular, 26 spectrally transformed schemes were examined in three cities. Results of paired-sample t tests demonstrated that normalized spectral
mixture analysis performed significantly better than the untransformed scheme in all three study areas. Derivative analysis, independent component analysis, and minimum noise fraction outperformed the untransformed scheme in one or two study areas but underperformed in others. Other schemes
are unnecessary, as they have significantly lower accuracy compared to the untransformed scheme.
Formación inicial de Profesores de Historia y Geografía: sus enfoques formativos, la construcción de su saber pedagógico y profesional. Análisis desde las voces del profesorado en Chile
Authors: Arrepol Cristian Marcelo
Published: June 2019

El artículo expone los resultados de la investigación que buscó indagar en la formación inicial de los profesores de historia, geografía, quienes nos darán luces sobre las características tanto del enfoque disciplinar y pedagógico en su formación, la pertinencia de la misma, y de cómo construyen su saber pedagógico y profesional. Los análisis se realizan bajo un ejercicio comprensivo-hermenéutico, a partir de una entrevista semi estructurada aplicada a tres profesores de historia y geografía, de tres universidades con tradición en la formación de profesores de la especialidad. Los resultados dan cuenta de una fuerte formación disciplinar, desarticulada con la formación pedagógica y el contexto educativo; la privatización de la construcción del saber pedagógico, y que éste, junto al saber profesional se construye principalmente a partir de las inquietudes epistemológicas propias del profesor de historia y geografía, minimizando las influencias del contexto educativo.
Acerca del sentido, los saberes y la praxis de la enseñanza de la Historia en las aulas de Córdoba
Authors: Toibero Desireé , Chauerba Laura
Published: June 2019

En una indagación previa nos propusimos indagar sobre las representaciones acerca de los sentidos y saberes necesarios para la enseñanza de la Historia de seis profesores de historia de tres generaciones diferentes y con experiencia de trabajo en más de una institución en la ciudad de Córdoba, Argentina. En el marco de un nuevo proyecto de investigación nos proponemos profundizar en la comprensión del vínculo entre esas representaciones y la praxis, a partir de análisis de propuestas de enseñanza y del registro etnográfico de una clase de  inicio y otra de desarrollo de la propuesta de enseñanza de los docentes. En definitiva, nos proponemos interpretar para este universo seleccionado, el vínculo entre los decires docentes, las propuestas docentes (lógicas pedagógico-didácticas) y la praxis (interacciones y producción del conocimiento). Con esta orientación, sumamos las categorías de propuesta metodológica y configuraciones didácticas.
Cuerpo, sujeto y saber en un Espacio de Formación Integral
Authors: Dogliotti Paola , Malán Paula , Muiño Juan , Silva Giannina
Published: June 2019

El trabajo presenta los principales avances analíticos y problematizaciones llevadas adelante por el Espacio de Formación Integral “Cuerpo y Educación en Malvín Norte” desarrolladas durante el año 2018 en el barrio Malvín Norte, en la ciudad de Montevideo, Uruguay. El análisis gira en torno a cuatro categorías centrales: cuerpo, enseñanza, educación y sujeto. Se parte de un trabajo de inmersión territorial que permitió construir una serie de registros de observación participante, entrevistas y documentos institucionales. Se problematiza sobre la tensión entre la producción y la reproducción de prácticas educativas, y en especial sobre el lugar del cuerpo, el saber y el sujeto en la educación y en la enseñanza, mostrando los principales ejes y aristas según la problemática específica seleccionada por cada una de las cuatro instituciones socioeducativas que formaron parte de la experiencia de este Espacio.
Stanowisko Parlamentu Europejskiego wobec pomocy humanitarnej
Authors: Kaczmarek Filip
Published: June 2019

Unia Europejska wraz z państwami członkowskim tej organizacji jest największym dawcą pomocy humanitarnej na świecie. Parlament Europejski jest jedną z kluczowych instytucji UE i jedyną spośród nich, wyłanianą w wyniku wyborów bezpośrednich. Celem tekstu jest zbadanie stanowiska Parlamentu wobec pomocy humanitarnej, począwszy od przyjęcia Konsensusu europejskiego w sprawie pomocy humanitarnej w 2007 r. do końca czerwca 2018 r. Metodą badawczą jest analiza różnych form działalności Parlamentu w badanym zakresie. Jedną z konkluzji jest zdefiniowanie dylematu Parlamentu, polegającego na próbie pogodzenia zasad pomocy humanitarnej i partykularnych interesów państw członkowskich UE.
Promotion of regional and traditional products
Authors: Oleksiuk Inga , Werenowska Agnieszka
Published: June 2019

Podstawowym celem studiów opisanych w artykule była analiza specyfiki procesów promocyjnych produktów regionalnych i tradycyjnych z wykorzystaniem oznaczeń regulowanych przez prawo europejskie: Gwarantowana Tradycyjna Specjalność (GTS), Chroniona Nazwa Pochodzenia (ChNP), oraz Chronione Oznaczenie Geograficzne (ChOG). Dokonano krytycznego przeglądu narzędzi promocji produktów tradycyjnych i regionalnych odnosząc się do roli ochrony prawnej oznaczeń wyrobów  w UE. Zwrócono uwagę, że na kształt systemu promocyjnego i informacyjnego mają wpływ uwarunkowania społeczno-kulturowe, które oddziałują na rozpoznawalność i renomę produktów, co znalazło potwierdzenie w wynikach przeprowadzonych badań sondażowych. Na uwagę zasługuje istnienie korelacji jakości z tradycją, czego wyrazem były między innymi deklaracje dotyczące motywu wyboru tych produktów: poczucie dumy i kontynuowanie tradycji wybrało 45% badanych. Najbardziej rozpoznawalnym europejskim oznaczeniem był symbol Gwarantowanej Tradycyjnej Specjalności (38%).
Saturation of the media with conspiracy narratives: content analysis of selected Polish news magazines
Authors: Czech Franciszek
Published: June 2019

Artykuł ma trzy płaszczyzny: metodologiczną, teoretyczną i empiryczną. Punktem wyjścia do refleksji metodologicznej jest charakterystyka trzech głównych nurtów badawczych prowadzonych w ramach dynamicznie rozwijających się interdyscyplinarnych badań nad teoriami spiskowymi. Na takim tle omówiona jest analiza zawartości treści jako metoda badawcza pozwalająca w innowacyjny sposób uchwycić kluczowe zjawisko. W części teoretycznej przybliżona jest koncepcja narracji spiskowych w odniesieniu do potocznego rozumienia teorii spiskowych. Głównym celem części empirycznej jest określenie w jakim stopniu media są nasycone różnego rodzaju narracjami spiskowymi. Analiza obejmuje ponad 200 artykułów z dwóch opiniotwórczych tygodników („Sieci” i polska edycja „Newsweeka”), które znajdują się po dwóch stronach politycznego konfliktu w Polsce spolaryzowanych między innymi przez spiskowe podejrzenia dotyczące katastrofy prezydenckiego samolotu w 2010 roku w Rosji.
Lewy-Stampacchia’s inequality for a pseudomonotone parabolic problem
Authors: Guibé Olivier , Mokrane A. , Tahraoui Y. , Vallet G.
Published: June 2019

The main aim of this paper is to extend to the case of a pseudomonotone operator Lewy-Stampacchia’s inequality proposed by F. Donati [7] in the framework of monotone operators. For that, an ad hoc type of perturbation of the operator is proposed.
Correlations between serum and CSF pNfH levels in ALS, FTD and controls: a comparison of three analytical approaches
Authors: Wilke Carlo , Pujol-Calderón Fani , Barro Christian , Stransky Elke , Blennow Kaj , Michalak Zuzanna , Deuschle Christian , Jeromin Andreas , Zetterberg Henrik , Schüle Rebecca , Höglund Kina , Kuhle Jens , Synofzik Matthis
Published: June 2019

Background

Phosphorylated neurofilament heavy (pNfH), a neuronal cytoskeleton protein, might provide a promising blood biomarker of neuronal damage in neurodegenerative diseases (NDDs). The best analytical approaches to measure pNfH levels and whether serum levels correlate with cerebrospinal fluid (CSF) levels in NDDs remain to be determined.

Methods

We here compared analytical sensitivity and reliability of three novel analytical approaches (homebrew Simoa, commercial Simoa and ELISA) for quantifying pNfH in both CSF and serum in samples of amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD) and control subjects.

Results

While all three assays showed highly correlated CSF measurements, Simoa assays also yielded high between-assay correlations for serum measurements (ϱ = 0.95). Serum levels also correlated strongly with CSF levels for Simoa-based measurements (both ϱ = 0.62). All three assays allowed distinguishing ALS from controls by increased CSF pNfH levels, and Simoa assays also by increased serum pNfH levels. pNfH levels were also increased in FTD.

Conclusions

pNfH concentrations in CSF and, if measured by Simoa assays, in blood might provide a sensitive and reliable biomarker of neuronal damage, with good between-assay correlations. Serum pNfH levels measured by Simoa assays closely reflect CSF levels, rendering serum pNfH an easily accessible blood biomarker of neuronal damage in NDDs.
The Transformation of the Christian Right’s Moral Politics
Authors: Lewis Andrew R.
Published: June 2019

For at least the past four decades, the Christian Right’s political advocacy has epitomized morality politics in the US. In recent years, however, the Christian Right has transformed how it approaches various moral and cultural issues, appealing to the language and process of political rights. This reframing of cultural concerns has coincided with the declining cultural status of conservative Christianity. This article analyzes three issue areas—abortion, free speech, and religious freedom—documenting how conservative Christianity has altered its approach to public politics, coming to embrace individual rights language and arguments over and above common morality. The article also analyzes the whether this growing rights talk has contributed to extending support to the rights of others, finding mixed results. As conservative Christians have embraced the rights commitment for themselves, there has been a corresponding growth of political tolerance for others. At the same time, there remain prominent challenges to supporting pluralistic politics. While questions about the commitment to pluralism remain, the evolution of the Christian Right’s cultural style of politics has important implications, as the last vestige of communitarian politics routinely engages politics using the language of liberalism. Moral politics are now routinely rights politics.
Morality Politics and New Research on Transgender Politics and Public Policy
Authors: Haider-Markel Donald , Taylor Jami , Flores Andrew , Lewis Daniel , Miller Patrick , Tadlock Barry
Published: June 2019

Recent political debate over transgender military service and gendered bathroom use highlights a dramatic increase in salience over transgender issues in the US. In this essay, we examine a potential new front in the culture wars by reviewing recent empirical research in social science on the politics of transgender rights in the context of morality politics. Research on morality politics has often focused on LGBT rights, with an emphasis on gay and lesbian rights and little attention to transgender issues. We highlight the progress of research on transgender issues in the US, focusing on the study of attitudes about transgender people and rights, transgender rights in states and localities, and broader findings affecting transgender populations. Although there is ample research still needed, the current state of empirical social science on transgender issues has made great advancements in the past decade and shows that morality continues to shape LGBT politics and policy.