bluuebunny/crossref_metadata_2025 huggingface dataset:
Information Management Through a Multidimensional Information Systems Architecture
Authors: Bessa José , Branco Frederico , Costa António Rio , Martins José , Gonçalves Ramiro
Published: July 2017

Portuguese Higher Education Institutions have more and more data that needs to be processed in order to get information and, therefore, Knowledge. In order to respond to this need, over time there have been several types of IS supported by ICT, which enables them to achieve these features and, at the same time, help with their daily activities. However, the continuous evolution of this technological component has led to a current high degree of complexity, from which the Information Systems Architectures emerged as means of increasing the effectiveness of its management and maintenance. Using the University of Trás-os-Montes e Alto Douro as a case study, the research team proposed a generic ISA that enabled it to have a transversal vision of its IS, allowing the validation of existence/need IS focused on Information Management and decision-making under a multidimensional perspective, i.e., geared towards the various organizational levels, since the Operational level to the Strategic level, taking into account the information needs associated with each player.
Investigation on Fracture Toughness of Coating/Substrate Interface - Case Study: Thermally Sprayed Nickel Based Superalloy on Variety of Substrates
Authors: Abualigaledari Sahar , Salimi Jazi Mehdi , Azarmi Fardad
Published: July 2017

Nickel based superalloy materials have being extensively used in aerospace and other high tech industries. In the present work, the effect of different substrates on the mechanical properties of the coating-substrate interface has been studied. To this end, alloy 718, commercially known as Inconel 718, was deposited on alloy 718 and low carbon steel substrates using High Velocity Oxygen Fuel (HVOF) technique at the same condition. The bonding strength of the interfaces evaluated using Vickers indentation test on the coating-substrate interface. Hardness results were subjected to a valid empirical method to estimate the fracture toughness. Results illustrated that using the same material as coating and the substrate led to stronger interface bonding strength due to higher hardness, fracture toughness, and less crack propagation.
Biocomposites Formulated with Virgin/Recycled Acrylonitrile Butadiene Styrene
Authors: Nikmatin Siti , Syafiuddin Achmad , Irmansyah Irmansyah , Irwanto Dwi Arso Yedi
Published: July 2017

This study aims to examine mechanical properties of biocomposites formulated with virgin/recycled acrylonitrile butadiene styrene (ABS). Neat virgin ABS (VABS), neat recycled ABS (RABS), VABS with 15% palm long fiber (VABS/15PLF), and RABS with 10% palm short fiber (RABS/10PLF) were fabricated and examined. Twin extruder machine was used to manufacture granular composite. Impact, tensile, and hardness tests were carried out. This study found that the incorporating palm fiber into the matrix polymer increased brittleness of the composites. Impact strength of the composites increases with the rise filler loadings. Increasing filler loading in VABS was found to be able to increase the composite hardness. Conversely, for RABS, the composite hardness was found to decrease with the rise filler loadings.
Synthesis and Pore Structure Characterisation of Novel Mesoporous MgO-CeO2/SBA-15 as a Potential Catalyst Support
Authors: Efavi Johnson Kwame , Yaya Abu , Bowen-Dodoo Elsie , Damptey Lois Afua , Abrokwah Richard Yeboah
Published: July 2017

The high interest in the synthesis of mesoporous catalyst demands that novel materials are developed with simple methods capable of improving process yields. In this work, a novel heterogeneous mesoporous catalyst support has been synthesized using mesoporous SBA-15 loaded with mixed bimetal oxides of CeO2 and MgO. Formation of the SBA-15 was actuated in air at room temperature (25°C) and in oven conditions at 100°C after which cerium nitrate and magnesium nitrate precursors were then impregnated into the SBA-15 framework and calcined at 550°C for each of the air and oven crystallization processes. XRD peak patterns confirmed SBA-15 formation and dispersion of nanocrystallites of CeO2 and MgO within the porous framework of SBA-15. Both the air and oven dried processes produced mesoporous MgO-CeO2/SBA-15 catalysts with isotherms that exhibit typical H1 type hysteresis confirming that they possess open-ended cylindrical mesopores. The structural data extracted gave average pore size, pore volume and surface area values in the ranges of 3-5.2 nm, 0.600-2.500 cc/g and 400-500 m2/g respectively which is ideal for several industrial applications.
Engineering the Electronic and Magnetic Properties of Sc2CF2 MXene Material through Vacancy Doping and Lattice Straining
Authors: Ao Lei , Pham Anh , Zu Xiao Tao , Li Sean
Published: July 2017

MXenes is a new group of two-dimensional materials via etching of the ‘A’ element from MAX phases. Depending on the functional group, MXenes can be semiconductors or metals. In this paper, first-principles calculations have been performed to investigate the effects of single vacancy defects on a semiconducting MXene, Sc2CF2 monolayer. The theoretical results show that V-Sc can induce magnetism in the host monolayer, while V-C and V-F result in n-type conductivity. For V-Sc doped Sc2CF2, tensile strains enhance the total magnetic moment which remains constant with applied compressive strains. As a result, by manipulating the fabrication parameters, the magnetic and conductive properties of Sc2CF2 can be tuned without the need of chemical doping.
Nonlinear Refraction and Absorption Properties of ZnS Semiconductor Quantum Dots
Authors: Tan Heng Yu , Chang Qing , Liu Xi Wen
Published: July 2017

The nonlinear absorption and nonlinear refraction properties of water soluble ZnS semiconductor quantum dots are studied by using Z-scan technique with the action of 400 nm and 532 nm femtosecond laser pulses. The experimental results show that the three order nonlinear effect of ZnS semiconductor quantum dot is stronger in 400 nm laser pulse, and it is weaker in 532 nm laser pulse. The three order nonlinear polarization coefficient of ZnS semiconductor quantum dot is 4.58×10-13 esu with the action of 400 nm laser pulse, it is 9.22×10-14 esu with the action of 532nm laser pulse. The ZnS semiconductor quantum dot has a relatively good three order optical nonlinear effect with the action of 400nm wavelength laser pulse.
Gold Nanoparticles Resistance Induced by Femtosecond Pulse Laser
Authors: Zhang Cheng Yun , Hai Jie , Liu Zuo Lian , Liu Zhi Yu
Published: July 2017

We presented a new method to fabricate gold nanoparticles resistance using the deposition technique of Laser Induced Backward Transfer (LIBT). The femtosecond laser was focused on the surface of the gold film covered by a receiving substrate. The ablation was carried out by scanning the laser beam and the expanded plasma can be transferred to the receiving substrate, which forms nanoscale resistance composed of gold nanoparticles lines. Gold nanoparticles were characterized by optical microscope, scanning electron microscope (SEM) and atomic force microscope (AFM). Femtosecond laser fluence, scanning speed, and the space between the scanned lines can influence gold nanoresistance. The resistance of gold nanoparticles with different parameters varied from ~ 8 GΩ to ~ 40 GΩ, which was measured by the picoammeter. Linetype resistance with nanostructured particles can be widely used in the field of microelectronics and optoelectronic devices.
Synthesis and Antibacterial Activities of N-Phenylpyrazolines from Veratraldehyde
Authors: Suma Artania Adnin Tri , Wahyuningsih Tutik Dwi , Pranowo Deni
Published: July 2017

Some novel N-phenylpyrazolines were synthesized and investigated for their antibacterial activitiy. Chalcones 2-4 which were prepared from acetophenone and veratraldehyde derivatives were reacted with phenylhydrazine to give N-phenylpyrazolines 5-7. All of the synthesized compounds were characterized using FTIR, GC-MS, and NMR spectrometers. Further, antibacterial activity of N-phenylpyrazolines were evaluated by agar well-diffusion method against Staphylococcus aureus, Bacillus cereus, Bacillus subtilis, Escherichia coli, and Shigella flexneri. The highest activity (highest inhibition zone) of compound 5 was 2.6 mm (at 1000 ppm) against B. subtillis, compound 6 was 7.25 mm (at 1000 ppm) against S. aureus, and compound 7 was 6.75 mm (at 500 ppm) against S. aureus. The results indicated that compound 6 and 7 exhibited promising antibacterial activity.
Coconut Shell Charcoal as a Bioreductor in Roasting Process of Nickel Laterite from Pomalaa, Southeast Sulawesi: Performance and Kinetics Study
Authors: Putera Andreas Diga Pratama , Sugiarto Edi , Sutijan Sutijan , Warmada I Wayan , Petrus Himawan Tri Bayu Murti
Published: July 2017

In facing the scarcity of sulfide nickel ore, processing nickel laterite to form nickel pig iron becomes an important issue. Also, Indonesia inherits 10% of nickel laterite in the world, assigning as the third biggest country of nickel laterite possession in the world. Nickel pig iron is one of nickel products involving massive high-grade metallurgical coke consumption that is commonly being used as stainless steels. Consequently, high amount of carbon dioxide is also produced in this process. And so, substituting of the coke using bioreductor material – in this study, Coconut Shell Charcoal – is important.
The study is done by conducting several variables. The reductors used were Coconut Shell Charcoal and Anthracite Coal. The process was conducted in 800°C and 1000°C, in a muffle furnace, and between 15 to 240 minutes of reduction time.
Results from all reductors show that higher temperature indicates a better reduction process. Moreover, X-Ray Powder Diffraction (XRD) analysis data shows that there is no significant difference in the final product between two reductors. By replacing metallurgical coke using bioreductor, the carbon emission in the process can be reduced. Hence, providing a better process and environment to the next generation.
Optimization of Chitosan/PVA Concentration in Fabricating Nanofibers Membrane and its Prospect as Air Filtration
Authors: Shalihah Himayatus , Kusumaatmaja Ahmad , Nugraheni Ari Dwi , Triyana Kuwat
Published: July 2017

Chitosan/polyvinyl-alcohol (Chitosan/PVA) based nanofibers were successfully produced using electrospinning machine and investigated their application as air filtration. Firstly, 2 wt% chitosan was dissolved to 1 wt% acetic acid followed by mixing with PVA solution to produce fiber mats or membrane. Secondly, the morphology and diameter of the electrospun fiber were analyzed by using a scanning electron microscopy (SEM), while the chemical compounds in the membrane were characterized using Fourier transform infrared spectroscopy (FTIR). It was found that the conductivity of solution increased by the concentration of chitosan. Meanwhile, the average diameter and percentage of porosity decreased due to the upsurge of the conductivity of the solution. The average diameter of PVA 13 wt% was and the percentage of porosity were 50.32%. The maximum condition of chitosan/PVA was obtained at 20/80 wt%, in line with the average of fiber diameters and the percentage of porosity were 25.32%. Physicochemical properties of chitosan/PVA solution, such as conductivity, morphology, and chemical absorption were investigated before and after the air filtration. The porosity percentage of PVA 13wt% after air filtration changed to 35.85% and the percentage of porosity of chitosan/PVA 20/80 became 25.32%. Remarkable absorption peaks of PVA 13wt% exhibited and - shifted after the air filtration test, it was indicating that functional groups had been reduced. The chemical absorption of chitosan/PVA 20/80 wt% showed at the the region then disappeared after the air filtration test.
Obesity Does Not Exacerbate the Protumorigenic Systemic Environment in Sarcoma Subjects
Authors: Buchta Claire M , Boi Shannon K , Miller Benjamin J , Milhem Mohammed M , Norian Lyse A
Published: July 2017

Sarcomas are a rare but fatal tumor type that accounts for <1% of adult solid malignancies and ∼15% of childhood malignancies. Although the use of immunotherapy is being actively investigated for other solid tumors, advances in immunotherapy for sarcoma patients are lacking. To better understand the systemic immune environment in sarcoma patients, we performed a detailed multiplex analysis of serum cytokines, chemokines, and protumorigenic factors from treatment-naive subjects with localized, high-grade sarcoma. Because obesity is a major healthcare issue in the United States, we additionally examined the effects of obesity on serum protein profiles in our sarcoma subject cohort. We found that the systemic host environment is profoundly altered to favor tumor progression, with epidermal growth factor, angiopoietin-2, vascular endothelial growth factor A, IL-6, IL-8, and MIP-1β all increased relative to tumor-free controls (all p < 0.05). Surprisingly, we found that obesity did not exacerbate this protumorigenic profile, as epidermal growth factor and IL-8 decreased with increasing subject body mass index (both p < 0.05 versus normal or overweight subjects). The Th2-related cytokines IL-4, IL-5, and IL-13 were also decreased in the presence of obesity. Thus, although the systemic environment in sarcoma subjects favors tumor progression, obesity does not further aggravate the production of protumorigenic factors.
Factitious hypoglycemia post-bariatric surgery: Self-harm behavior two case reports and literature review
Authors: Almazrouei Raya , Alkaabi Fatima , Afandi Bachar
Published: July 2017

Hypoglycemia after bariatric surgery is currently recognized as a common post-surgical complication. Here we present two cases of post-surgical factitious hypoglycemia secondary to insulin administration. This report recommends comprehensive evaluation of post-bariatric hypoglycemia and highlights the potential self-harm behavior in patients undergoing bariatric procedures.
Cancer incidence in Western Libya: First results from Tripoli medical center
Authors: Benyasaad Taha , Altrjoman Firvouz , Enattah Nabil , Eltaib Farag , Ashammakhi Nureddin , Elzagheid Adam
Published: July 2017

Background: Cancer is a major problem and monitoring of its incidence is important. Aim: To estimate cancer incidence in western Libya. Methods: Data were collected retrospectively from Tripoli Medical Center during 2008. Classification of cancer diagnosis was made according to the International Classification of Disease. Results: A total of 1051 cancer cases were found (50.1% males and 49.9% females). Age-wise, 31% were younger than 15 years, 64.6% between 15 and 64 years and 4.2% above 64 years old. In females, most common cancers were breast (23.7%), colorectal (9.4%) and uterine (8.6%). In males, they were lung (15.6%), colorectal (12.3%) and prostate (9.9%). In females there were two peaks (in age group 40-44 and in those older than 75). Conclusions: Cancer incidence in western Libya increases with age. Most common cancer in men was lung cancer and in women was breast cancer. Further larger studies are needed to confirm such findings. Public health education, including antismoking and tobacco control, as well as awareness campaigns regarding early detection of cancer are needed to reduce cancer mortality.
Knowledge, attitude and practice regarding folic acid among pregnant women in Benghazi, Libya
Authors: Abdulmalek Lubna
Published: July 2017

Periconceptional folic acid supplementation has been shown to decrease the occurrence of neural tube defects (NTD’s). In a cross-sectional study, the knowledge attitude and practice regarding the peri-conceptional use of folic acid were assessed among the pregnant women in Benghazi, Libya. 131 women attending antenatal clinics in three main polyclinics were interviewed through three polyclinics. Seventy-three percent of the participants had heard about folic acid, and only 37% could correctly identify the effect of folic acid when used periconceptionally. 27% of the pregnant women did not take folic acid during their present pregnancy. Only 6% of the women who took folic acid were taking it consistently before pregnancy with the aim of preventing NTDs. This study shows that the interviewed pregnant women reveal high positive attitude (88%) toward retaking folic acid supplements in their next pregnancy. The overall knowledge regarding the periconceptional use of folic acid was relatively low when compared to other studies worldwide. Health education regarding the periconceptional use of folic acid among newly married couples is recommended.
Acquired hypogonadotrophic hypogonadism and bipolar disorder in a middle-aged man: Unresolved and perplexing management issues
Authors: El-Houni Ali , O'Connell Ian
Published: July 2017

A case of acquired hypogonadotropic hypogonadism (AHH) associated with bipolar disorder in a middleaged man is presented and the unresolved and perplexing management issues are discussed. The area of care in endocrinology is immensely neglected and currently understudied. We hope to attract attention, focused care and perhaps research to look into the etiologic approach for managing such cases with this considerable amount of complexity, which endocrinologists and psychiatrists commonly encounter in their practice.
Effects of simvastatin and omega 3-fatty acids on blood pressure, plasma lipid profiles, liver and renal function in type 2 diabetes
Authors: Roaeid Ragab , Menesi Fadya , Elbadri Safa , Denna Esam , Othman Ghazala , Younis Mustafa , El-Shari Faraj , El Debani Abdulkader , Abdellatif Awad , Meghil Saleh
Published: July 2017

A group of patients with and hyperlipidemia were divided into male and female groups and further subdivided into 3 groups. These groups received, either simvastatin (20 mg daily), Omega3-fatty acid (2g/day), or both. The blood pressure and lipid profile were measured before and after 4 weeks of treatment. Our data showed that treatment with simvastatin did not produce significant effect on blood pressure, however the blood pressure was significantly reduced in patients received omega 3-fatty acid or simvastatin plus omega3-fatty acid. The total cholesterol (TC), triglycerides (TG), and low density lipoprotein (LDL) significantly decreased in all treated groups. The high density lipoprotein (HDL) significantly increased in all treated groups except in the group of males receiving simvastatin. Alanine transaminase (ALT) increased significantly in female and male groups receiving simvastatin, but significantly decreased in same groups receiving omega 3-fatty acid and in the males receiving simvastatin plus omega3-fatty acid. The aspartate transaminase (AST) levels significantly decreased in all treated groups except in the female group given omega3-fatty acid. The alkaline phosphatase (ALP) significantly increased only in the groups given simvastatin alone. The levels of urea and creatinine were not affected in all groups. In our prospective study we found that simvastatin decreased TC, TG and LDL, and resulted in elevation of liver transaminases. Omega3- fatty acid alone or in combination with simvastatin has similar effect on lipid profile and it significantly reduces blood pressure without affecting liver or renal function.
Vitamin D deficiency among adults attending primary health care centers in Abu Dhabi, United Arab Emirates
Authors: Al Hammadi Khuloud , Al Maamari Shamma , Al Marzouqi Kawthar , Al Senani Arwa , Al Mazrouei Abdulla , Ofiaeli Nwanneka , Darwish Ibtihal
Published: July 2017

Background: Deficiency of vitamin D is very common. It has been recognized as a pandemic worldwide.Although it's sunny throughout the year, it is more common in the Middle East and Gulf region. Objectives: The goal of this study is to ascertain the prevalence of vitamin D deficiency in adults aged 21 to 60 years of age and to explore its relationship to different variables. Patients and Methods: A cross sectional study of 370 adults, aged 21-60 years,was conducted. A random selection of individuals was done from six primary health care clinics in the city of Abu Dhabi, United Arab Emirates, in the year of 2012.Serum levels of 25-hydroxy vitamin D, demographic data, body mass index, presence or absence of diabetes mellitus, hypertension, dyslipidemia, chronic kidney disease and inflammatory bowel disease were the variables of interest.The cutoff values for vitamin D were defined as follows: deficient (<50nmol/L), insufficient (50-75 nmol/L) and normal (. 75 nmol/L). Results: 237 (64%) of subjects were vitamin D deficient, 98 (26.5%) were vitamin D insufficient and only 35 (9.5%) were vitamin D sufficient. Vitamin D deficiency was more frequent in females than males [181(65.6%)vs. 56(59.6%)]. Higher prevalence of vitamin D deficiency was particularly noted in the age group 21-30 years (73.6%). No statistically significant relationships were noted between deficiency of vitamin D and ethnicity, diabetes mellitus, hypertension, dyslipidemia, chronic kidney disease and inflammatory bowel disease. Conclusions: Deficiency and insufficiency of vitamin D are very common among adults attending primary health care centers. It is more common in females and younger age groups. No other statistically significant relationships were noted.
Pharmacists' management of diabetes during ramadan fasting
Authors: Adnan Muhammad , Khaliq Asif , Fahad Muhammad , Hussaini Syed , Karim Shahid
Published: July 2017

Background: Proper management of diabetes requires a set of preventive and therapeutics measures that include proper diet, regular exercise, monitoring of blood glucose and insulin administration however, significant counseling and education of patients are required to be provided by pharmacists if patients are fasting. Objectives: This study investigated pharmacists' knowledge and practices towards diabetes management during the month of Ramadan. Methods: A cross sectional pre-validated questionnaire-based study was carried out among pharmacists practicing in hospital settings and pharmaceutical industry pharmacists. Data were collected from June 2015 to November 2015. The questionnaire covered: a) demographics, b) knowledge of diabetic risk factors and c) knowledge of blood glucose levelssuch as normal, diagnostic, target levels require during fasting and during complications. Results: 288 pharmacists participated in the study; 69.1% were practicing pharmacists and 30.9% were industrial pharmacists. The majority qualified as Pharm D (70.5%) and most respondents (85.5%) have experience ranging between 1 to 5 years. A significant difference has been found between practicing pharmacists and industrial pharmacists regarding knowledge of diabetes risk factors, complications, normal and target blood glucose levels. The mean knowledge score for industrial pharmacist was higher than hospital and clinical pharmacists [9.5 (3.4) versus 6.8 (2.7); p<0.05]. Conclusion: The barriers that hinder the role of pharmacists in Pakistan should be addressed especially for practicing pharmacists. Initiation of education and training programs related to diabetic care for practicing pharmacists is required on urgent basis. Pre-Ramadan training is essential to enable pharmacists to counsel fasting diabetic patients effectively.
Medicinal properties of the sesbania grandiflora leaves
Authors: Arfan Nafisa , Julie Azima , Mohiuddin A , Khan Shah , Labu Zubair
Published: July 2017

Background: The leaves of Sesbania grandiflora have been used in local traditional medicine since ancient times. In the present study we investigated, in vivo and in vitro, the potential health benefits of various fractions of the ethanolic extract of these leaves. Materials and methods: Crude ethanolic extract (CEE) of S. grandiflora leaves was partitioned into ethyl acetate soluble fraction (EASF), petroleum ether soluble fraction (PSF), carbon tetrachloride soluble fraction (CTSF), chloroform soluble fraction (CSF), and water soluble fraction (WSF). The extracts were evaluated for their thrombolytic, membrane stabilizing (anti-inflammatory), antimicrobial, and antidiarrheal activities. The results were compared to the effects of standard drugs: streptokinase for the thrombolytic, acetylsalicylic acid (ASA) for the membrane stabilizing, kanamycin for antimicrobial, and loperamide for the antidiarrheal activities. Results: For thrombolysis, EASF showed the highest % of clot lysis (59.6%) among all fractions, while streptokinase and water resulted in 69.2% and 3.1% clot lysis respectively. With respect to the membrane stabilizing activity, the EASF significantly inhibited the hemolysis of human erythrocytes induced by hypotonic solution (64.3±0.6%) or by heat (57.2±0.7%). The other fractions exhibited no membrane stabilizing effect. By contrast ASA resulted in 73.9±0.3% inhibition of osmotically induced hemolysis and a slightly lower level of inhibition in the case of heat-induced hemolysis (70.1±0.3%). The antidiarrheal activity was evaluated in the mouse model. The unfractionated, CEE reduced the number of defecation episodes by 25.0% at a dose of 200 mg/kg and by 41.1% at dose 400 mg/kg body weight. All extract fractions exhibited significant antibacterial activity, which was higher against Gram negative bacteria than Gram positive bacteria. Since the pharmacological activities of S. grandiflora are due to the presence of bioactive compounds we detected and quantified the presence of significant levels of flavonoid and tannin substances. Conclusion: Leaves of Sesbania grandiflora have the potential to be used as a remedy for thrombosis, diarrhea, and inflammatory diseases and against few important bacterial pathogens.
Priapism: A very rare complication of dual antiplatelet therapy after percutaneous coronary intervention
Authors: Ali Fathi , Elbarouni Basem
Published: July 2017

Context: Dual antiplatelet therapy (DAPT), with aspirin and P2Y12 receptor inhibitors, is standard of care in patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). However, its use is associated with increased risk of bleeding. We herein report an unusual bleeding complication associated with DAPT after primary PCI. Case Report: A 42-year-old man, who presented with acute inferior wall MI and underwent a successful bare metal placement in circumflex coronary artery, was discharged on dual antiplatelet therapy. However, he presented 2 weeks later with priapism for 20 hours that needed surgical drainage of large amount of blood from his penis. There were no other causes to explain priapism, but since this was not known complication of DAPT, it was not discontinued given his recent stent placement. However, 3 weeks later he suffered another episode of priapism that also needed surgical drainage. Therefore, given its high antiplatelet potency, Prasugrel was eventually discontinued, and the patient was maintained on aspirin only. The decision was guided by optical coherence tomography evaluation of his recent stent to rule out local risks for stent thrombosis. The patient has done well over 14 months of follow up with no cardiac symptoms or recurrence of priapism. Conclusion: To the best of our knowledge, the association between priapism and DAPT was never reported previously. Given the wide use of DAPT after coronary intervention, we believe that interventional cardiologist should be aware of this rare, yet potentially devastating, complication.
Protease inhibitor-induced acute pancreatitis in post liver transplant hepatitis C Patients
Authors: Dillon Jayne , Mumtaz Khalid , Renner Eberhard
Published: July 2017

Drug induced pancreatitis (DIP) is a serious adverse effect of many commonly used drugs. Pegylated interferon (peg- IFN) and ribavirin used for treatment of chronic hepatitis C (CHC) infection and various protease inhibitors (PIs) such as indinavir, nelfinavir, ritonavir and saquinavir used for HIV infection have been reported to cause DIP; although the mechanism of pancreatitis is not well known. Recently, telaprevir and boceprevir are introduced for treatment of HCV genotype 1 infection along with peg-IFN and ribavirin. There are no reports of acute pancreatitis due to telaprevir and boceprevir in liver transplant setting. We managed two such cases; both were male with HCV genotype 1 infection, had living donor liver transplantation for hepatocellular cancer few years ago and stable on cyclosporine. Both developed AP a month after adding one of PI to their combination therapy. First patient had past history of partial response with peg-IFN and ribavirin and retreated with addition of telaprevir to combination therapy. Second patient received peg-IFN and ribavirin for 4 months and then boceprevir was added. Patients were managed conservatively, the culprit PI was stopped and they recovered. We used the Naranjo Probability Scale for Adverse Drug Events to estimate the probability that a drug was the cause of the acute pancreatitis. A score of 7 was calculated in both patients, indicating a probable adverse drug reaction. The algorithm devised by Trivedi et al to diagnose drug-induced pancreatitis was also used and confirmed that this was likely to be a drug reaction. There is adequate circumstantial evidence pointing to telaprevir and boceprevir as the cause of their acute pancreatitis. Further evidence is needed but in the meantime we would recommend routine monitoring of amylase levels for all patients on triple therapy and advise patients of potential symptoms for which they should seek medical advice.
Management of acute necrotizing lung infections: The role of surgery
Authors: El-Baz Ayman , El-Damati Ahmed , Aljehani Yasser , Alsubhi Raji , Al-Shammari Turki , Regal Mohamed
Published: July 2017

Background: There has been an increasing role of surgical intervention in managing patients with acute necrotizing lung infections and their complications, such as lung abscess and lung gangrene. Patients and Methods: In this retrospective study, conducted between 2003 and 2013, we presented patients of acute necrotizing pneumonia (ANP) and its complications, who required surgical interventions. Results: Twenty five patients required surgical management of their ANP. At the time of referral to cardiothoracic surgery all patients had evidence of ongoing sepsis despite the antibiotic therapy or have already developed complications. Patients presented with; persistent fever (n=18), cough with or without expectoration (n=25), hemoptysis (n=8), empyema (n=8), persistent air leak (n=3), severe hypoxia (n=3), septic shock (n=2), cachexia (n=6), leucocytosis (n=19), severe leuckopenia (n=3) and severe anemia (n=6). All patients were initially managed by internists, pneumologists and infectious disease teams for periods ranging from 1- 6 weeks prior to referral to cardiothoracic surgery. These patients required one or more of the following surgical procedures; anatomical lung resection (n=10), nonanatomical lung resection & debridement (n=15), and other procedures (n=10). No pneumonectomies were done in our series. There was no intra-operative mortality and only one post-operative mortality in our series. Conclusion: Surgical intervention including major or limited lung resection, for unilateral necrotizing lung infections is a safe procedure for patients with persistent sepsis who are not responding adequately to medical therapy or who have already developed complications.
Idiopathic laryngeo-tracheal stenosis: An illustrative case report
Authors: Al Ghamdi Zeead , Alshammary Shadi , El-Baz Ayman , Regal Mohamed
Published: July 2017

Idiopathic laryngeo-tracheal stenosis (ILTS) is characterized by the formation of a scar-like circumferential stenosis affecting the subglottic area and extending to a variable length in the upper trachea. We report an illustrative case of ILTS in a 33 years old lady who presented with progressive dyspnea and stridor and was managed as bronchial asthma for the prior 2 years. Her bronchoscopic and radiologic imaging revealed extensively narrowed subglottic segment 5 mm below the vocal cords that extended into the upper trachea. Definitive laryngeo-tracheal resection and reconstruction (Pearson's repair) was performed with a satisfactory result. She remained free of symptomatic and radiologic recurrence over 4 years of follow up.
Lipid profiles of hemodialysis patients in the jenin district of Palestine
Authors: Abumwais Jamal , Idris Omer
Published: July 2017

Objectives: We aimed to 1) compare the lipid profiles in hemodialysis patients and healthy controls, 2) find out if there are any differences in lipid profiles between diabetic and non-diabetic patients on hemodialysis and 3) investigate the effects of age, sex, and duration of dialysis on the lipid profiles in hemodialysis patients. Settings: The study was conducted in the hemodialysis unit in Jenin district at The Martyr Dr. Khalil Sulaiman Hospital of Jenin city for one calendar year. Patients and Methods: Seventy one patients who were not receiving any lipid lowering therapy were included; of these 26 had diabetes. Age-matched 98 healthy persons served as controls. Total cholesterol, triglycerides, HDL-cholesterol, and LDL-cholesterol levels were determined and two atherogenic indices (i.e. TC/HDL-C and LDL-C/HDL-C ratios) were calculated for patients and controls. Independent sample T-test, Pearson's correlation factor, one way ANOVA, and LSD multiple comparison test was used to test the significance of the results. P values < 0.05 were considered as significant. Results: The results showed that hemodialysis patients have a significantly higher triglycerides and VLDL-C levels and lower HDL-C levels compared to controls. There were no statistically significant differences in total cholesterol or LDL-C levels, on the other hand, hemodialysis patients have a significantly higher TC/HDL-C and LDL-C/HDL-C ratios compared to controls. The lipid profile of diabetic hemodialysis patients is generally similar to the lipid profile of non-diabetics except that diabetic hemodialysis patients have a significantly lower HDL-C levels and a significantly higher TC/HDL-C and LDL-C/HDL-C ratios compared to non-diabetics reflecting the additional impact of diabetes on lipid profile. The lipid profile of hemodialysis patients seems to be independent of age, sex, or duration of dialysis. Conclusions: Hemodialysis patients, particularly those with diabetes, have an adverse lipid profile. This is likely contributing to the increased mortality rates. Further studies are needed to ascertain the cardiovascular abnormalities and elucidate the causes of death among hemodialysis patients specifically in our population.
Pneumomediastinitis following right subclavian vein central line insertion
Authors: Sadaqa Wael
Published: July 2017

Background: Complications related to central venous catheters in the intensive care unit can be fatal. Case Report: An 18 years old lady with acute myeloid leukemia was admitted to An-Najah National University Hospital for a second course chemotherapy. On the day of admission, central line insertion was planned for starting the chemotherapy. The central line was inserted in right subclavian vein. One hour after the insertion, the patient complained of mild chest pain, difficulty breathing, and mild tachypnea. Anteroposterior chest radiography did not reveal neumothorax, infiltration, consolidation, or collapse. The chest computed tomography scan (CT) detected anterior and superior pneumomediastinum. Minimal pleural effusion was also detected in the right lung, especially in the dependent area. The tip of the catheter was seen lying free in the left side of the mediastinum indicative of perforation with mild air collection suggestive of pneumomediastinum. The central venous line was removed after proving its malpositioning. The patient recovered within two days with conservative treatment and a new central venous line was inserted with guidance of ultrasound. Chemotherapy was then resumed. Conclusions: This case highlights the importance of inserting the central line under the guidance of ultrasound and the superiority of CT scan over the chest x-ray accuracy in diagnosing the chest complications.
Basic body awareness in postnatal depression: A case study
Authors: Khatri Subhash , Kubavat Komal
Published: July 2017

Currently, there is limited evidence that a physiotherapy intervention may reduce depressive symptoms as well as the conventional interventions of medications and psychotherapy. We describe the effect of basic body awareness, a form of physiotherapy intervention, on the physical and psychological well-being of a 32 year old mother with postnatal depression. After six weeks of basic body awareness intervention, there was considerable reduction in her depressive symptoms, thus enhancing physical and psychological well-being. Hence, we propose that basic body awareness may be considered as an adjunct to the management of postnatal depression.
Adiponectin and adiponectin receptor-1 in patients with polycystic ovarian syndrome: Impact of insulin sensitization by metformin
Authors: Kamal Manal , Hamed Hossam , Salama Ragaa
Published: July 2017

Background: Abdominal obesity, insulin resistance and hyperinsulinemia play a central role in the pathogenesis of polycystic ovarian syndrome (PCOS). Abdominal adipose tissue is a source of adiponectin. Metformin has been widely used in the treatment of PCOS and has been shown to improve the metabolic and hormonal disturbances of PCOS. Objective: The current study aimed to investigate the relationships between serum adiponectin and adiponec-tin receptor-1 (AdipoR1) with insulin resistance, hormonal variables, and anthropometric measures in patients with polycystic ovarian syndrome (PCOS), and to find the shortterm effect of metformin treatment on adiponectin and Adi-poR-1 levels in these patients. Patients and Methods: 38 PCOS patients and 14 age- and body mass index (BMI)-matched healthy controls were recruited. In all participants, BMI, waist circumference, serum levels of fasting glucose, insulin, adiponectin, AdipoR1, total testosterone, luteiniz-ing hormone (LH), and follicle stimulating hormone (FSH) were assessed. PCOS patients received metformin treatment (1500 mg/daily) for two menstrual cycles followed by measurement of all previous parameters. All subjects gave informed consent. Results: PCOS patients had higher waist circumference, fasting glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), testosterone, LH and LH/FSH ratio than did controls. In PCOS patients, adiponectin and AdipoR1 were lower than in controls, and both correlated negatively with waist circumference, insulin, and HOMA-IR (P=0.048, P=0.0003, P=0.0003, respectively for adiponectin and P=0.039, P=0.023, P=0.025, respectively for AdipoR-1). HOMA-IR followed by testosterone were independent predictors of adiponectin while HOMA-IR was an independent predictor of AdipoR1. Metformin decreased fasting glucose (P=0.003), insulin (P=0.042), HOMA-IR (P=0.006), testosterone (P=0.001), LH (P=0.0001) and LH/ FSH ratio (P=0.003) and increased adiponectin (P=0.014) and AdipoR1 (P=0.001) levels in PCOS patients. Conclusion: Reduced adiponectin and Ad-sipoR1 in PCOS patients is independently associated with insulin resistance and the improvement of insulin sensitivity by short-term metformin treatment results in increased adiponectin and AdipoR-l.
McCune albright syndrome with severe facial disfigurement
Authors: Chentli Farida , Zentar Yamina , Fedala Nora , Azzoug Said
Published: July 2017

Introduction: McCune Albright syndrome (MAS) is a rare disease due to post zygotic somatic activating mutation in the Gs protein. It includes skin patches, bone dysplasia, and hyperfunctioning endocrinopathies. Our objective is to report an unusual disfiguring form with precocious pseudo puberty (PPP), and hot thyroid nodule. Case report: A 19 year-old girl was hospitalized for the first time at the age of 5.5 years for breast development and vaginal bleeding which began when she was 6 months old. The diagnosis was PPP due to MAS. In addition to ovarian hyperfunction, there were multifocal disfiguring bone dysplasia, and brown skin patches. As aromatase inhibitors were not available, she was treated by cyproterone acetate, which was efficient on the ovarian function, but not on bone maturation (final height: 1.35m, bone deformities, and recurrent fractures). Fortunately, bone dysplasia was stabilized under biphosphonates. But, ovarian hyper functioning relapsed, because of polycystic ovaries. Following that, a hot thyroid nodule with normal thyroid function appeared. Conclusion: This patient has MAS with severe bone dysplasia leading to a disfiguring face, hot thyroid nodule, and ovarian hyper function causing PPP then polycystic ovaries. So, in future checking for tumours development due to estrogens excess is mandatory.
Emerging concepts in metformin therapy: Hyperglycaemia and beyond
Authors: Fiad Tarek , Al Hammadi Fatema , Al Nuaimi Asma , Al Dhuhouri Jamila
Published: July 2017

Metformin has been extensively used in the management of type 2 diabetes mellitus (T2DM). A number of properties combined, including cost effectiveness, safety, weight neutrality, low risk of Hypoglycemia and cardiovascular protection moved metformin to the forefront of diabetes management and is now accepted as the standard first line therapy. Although other classes of glucose lowering medications were introduced to clinical practice in the recent times, none of such therapies has as yet demonstrated superiority to metformin to justify being considered as a first line therapeutic option. The use of metformin has extended in the last 2 decades to include diabetes prevention, gestational diabetes mellitus (GDM) and polycystic ovary syndrome (PCOS). There is accumulating evidence from observational studies to suggest a possible role for metformin in cancer prevention and in the management of non-alcoholic fatty liver disease. We reviewed the role of metformin in the prevention and treatment of T2DM and allied metabolic disorders and examined the non- glycaemic effects of metformin. In addition, we reviewed safety aspects pertinent to the usage of metformin in special clinical settings.
Assessing NARCCAP climate model effects using spatial confidence regions
Authors: French Joshua P. , McGinnis Seth , Schwartzman Armin
Published: July 2017

Abstract. We assess similarities and differences between model effects for the North American Regional Climate Change Assessment Program (NARCCAP) climate models using varying classes of linear regression models. Specifically, we consider how the average temperature effect differs for the various global and regional climate model combinations, including assessment of possible interaction between the effects of global and regional climate models. We use both pointwise and simultaneous inference procedures to identify regions where global and regional climate model effects differ. We also show conclusively that results from pointwise inference are misleading, and that accounting for multiple comparisons is important for making proper inference.
Freunde führen einander – Der kommunalpolitische Dialog mit dem „Islam“ im Modus einer Gouvernementalität der Freundschaft
Authors: Winkler Jan
Published: July 2017

Abstract. Drawing on Foucault's notion of governmentality and on ethnographic fieldwork in a German city, this paper addresses practices of governing Muslims and Islam at the level of local politics. It conceptualises these practices as a governing through friendship, that is, a type of liberal conduct-of-conduct that focuses on trust-building and practised togetherness. The paper analyses techniques of governance and processes of subjectivation, putting an emphasis on how emotionality becomes integrated into governmental practices. I show how governing through friendship unfolds in the spatio-political context of a local dialogue with Islam, how the latter is linked to the interfaith paradigm and thus becomes a religiously-sensitive, post-secular political technology in which religious sensibilities are becoming elements of governmentality.
Evaluation of oceanic and atmospheric trajectory schemes in the TRACMASS trajectory model v6.0
Authors: Döös Kristofer , Jönsson Bror , Kjellsson Joakim
Published: July 2017

Abstract. Three different trajectory schemes for oceanic and atmospheric general circulation models are compared in two different experiments. The theories of the trajectory schemes are presented showing the differential equations they solve and why they are mass conserving. One scheme assumes that the velocity fields are stationary for set intervals of time between saved model outputs and solves the trajectory path from a differential equation only as a function of space, i.e. stepwise stationary. The second scheme is a special case of the stepwise-stationary scheme, where velocities are assumed constant between general circulation model (GCM) outputs; it uses hence a fixed GCM time step. The third scheme uses a continuous linear interpolation of the fields in time and solves the trajectory path from a differential equation as a function of both space and time, i.e. a time-dependent scheme. The trajectory schemes are tested offline, i.e. using the already integrated and stored velocity fields from a GCM. The first comparison of the schemes uses trajectories calculated using the velocity fields from a high-resolution ocean general circulation model in the Agulhas region. The second comparison uses trajectories calculated using the wind fields from an atmospheric reanalysis. The study shows that using the time-dependent scheme over the stepwise-stationary scheme greatly improves accuracy with only a small increase in computational time. It is also found that with decreasing time steps the stepwise-stationary scheme becomes increasingly more accurate but at increased computational cost. The time-dependent scheme is therefore preferred over the stepwise-stationary scheme. However, when averaging over large ensembles of trajectories, the two schemes are comparable, as intrinsic variability dominates over numerical errors. The fixed GCM time step scheme is found to be less accurate than the stepwise-stationary scheme, even when considering averages over large ensembles.
Long-term ensemble forecast of snowmelt inflow into the
Cheboksary reservoir under the differently constructed weather
scenarios
Authors: Gelfan Alexander , Moreydo Vsevolod , Motovilov Yury
Published: July 2017

Abstract. Development and verification of the long-term ensemble forecast of snowmelt water inflow into the Cheboksary reservoir – one of the eleven major river reservoirs of the Volga-Kama Reservoir Cascade, are described. The used forecasting procedure is based on a combination of semi-distributed hydrological model ECOMAG that allows for ensemble calculation of inflow hydrographs with two types of weather ensembles for the lead-time period: (1) observed weather data constructed on the basis of the ESP methodology and (2) synthetic weather data simulated by a weather generator. Ensemble forecasts represented both in deterministic and probability forms were verified by producing hindcasts of water inflow into the Cheboksary reservoir for 35 seasons in 1982–2016 from the 1st of April for 3 months ahead. Four inflow characteristics were forecasted: volume and maximum discharge of the inflow, as well as amount of days with inflow above two specified thresholds. Results of operational forecast of the recent freshet of 2017 are additionally presented. We found that statistical distributions of the forecasted ensembles calculated under both types of weather scenarios are very close to each other. However, confidence intervals of the forecast statistics is much larger for the ESP-based ensemble. Sensitivity of the forecast performance to changes in the forecast horizon and issue date is analyzed and so-called forecastability maps are presented as useful tool for such analysis.