bluuebunny/crossref_metadata_2025 huggingface dataset:
The Endoscopically Assisted Pharyngeal Flap
Authors: Cable Benjamin B. , Canady John W.
Published: October 2018

Objective

To describe a modification of the Hogan lateral port control technique for pharyngeal-flap surgery.

Results and Conclusions

Use of a 70-degree nasal endoscope to assist in the determination of lateral port diameter allows for better control of flap and port construction.
Influence of Early Hard Palate Closure in Unilateral and Bilateral Cleft Lip and Palate on Maxillary Transverse Growth during the First Four Years of Age
Authors: Lehner Bernhard , Wiltfang Joerg , Strobel-Schwarthoff Karin , Benz Michaela , Hirschfelder Ursula , Neukam Friedrich-Wilhelm
Published: October 2018

Objective

To evaluate and compare the effects of early primary closure of the hard palate on the anterior and posterior width of the maxillary arch in children with bilateral (BCLP) and unilateral (UCLP) cleft lip and palate during the first 4 years of life.

Design

A retrospective, mixed-longitudinal study.

Setting

Cleft Palate Center of the University of Erlangen-Nuremberg.

Subjects and Methods

The present investigation analyzes longitudinally 42 children with UCLP and 8 children with BCLP between 1996 and 2000 with early simultaneous primary closure of lip and hard palate (4 to 5 months). Palatal arch width was measured on dental casts with a computer-controlled three-dimensional digitizing system, and their growth velocities were calculated from consecutive periods (mean follow-up 39 months). Differences in growth velocities were compared with those of 25 children with UCLP and 15 children with BCLP with delayed closure of hard palate (12 to 14 months).

Results and Conclusions

There was no significant difference in terms of anterior and posterior maxillary width between early and delayed closure of hard palate within the first 4 years of life.
Do the Reading Disabilities of Children with Cleft Fit into Current Models of Developmental Dyslexia?
Authors: Richman Lynn C. , Ryan Susan M.
Published: October 2018

Objective

The purpose of this study was to determine whether the reading problems of children with cleft fit models of developmental dyslexia.

Design

The study compared children with nonsyndromic cleft lip and palate who had reading disability (n = 46) with those who did not have reading disability (n = 46). The children were matched for age, sex, and grade. The two groups were compared (t tests) on measures of verbal expression, phonemic awareness, and rapid naming. Also, regression analyses compared the relative relationships of these variables to reading disability.

Participants

Children were selected from 154 patients originally screened.

Results

Children with reading disability scored significantly lower on rapid naming and verbal expression, with no differences found on phonemic awareness. Rapid naming was shown to have the most significant association with reading disability.

Conclusion

Children with nonsyndromic cleft lip and palate show symptoms similar to a naming-memory deficit model of developmental dyslexia. Reading treatment should avoid sight word approaches and focus on oral phonics treatment.
Is Isolated Palatal Anomaly an Indication to Screen for 22q11 Region Deletion?
Authors: Reish Orit , Finkelstein Yehuda , Mesterman Ronit , Nachmani Ariela , Wolach Baruch , Fejgin Moshe , Amiel Aliza
Published: October 2018

Objective

Velocardiofacial syndrome (VCFS) is the most common multiple anomaly disorder associated with palatal clefting. Cytogenetic hemizygous deletion of 22q11 region is found in 80% of patients. The frequency of 22q11 deletion in patients presenting with isolated palatal anomalies has not been fully assessed. Our objective was to determine the frequency of the deletion in patients with isolated palatal anomalies.

Design

Patients were referred because of velopharyngeal insufficiency because of isolated congenital palatal anomalies. Diagnosis of palatal anomalies was confirmed by videonasopharyngoscopy, multiview videofluoroscopy and cephalometry. Other clinical findings suggestive of VCFS were sought, and subjects with these characteristics were excluded from the study. Peripheral blood samples from all patients were analyzed cytogenetically utilizing fluorescent in situ hybridization for the 22q11 region.

Results

Thirty-eight patients aged 3 to 31 years were included in the study. Nine had cleft palate, 7 cleft lip and palate, 10 overt and 11 occult submucous cleft palate, and 1 had a deep nasopharynx. No deletion of 22q11 region was detected in any of the evaluated patients.

Conclusions

A routine screening for the 22q11 deletion in older children and adults presenting with an isolated palatal anomaly may not be required. Because other signs related to VCFS such as facial dysmorphism and behavioral or psychiatric disorders may evolve at an older age, young patients should be followed up and reevaluated for additional relevant symptoms that may lead to deletion evaluation. In light of the fact that the current literature is inconsistent, the relative small size of this study and the significant consequences of missed 22q11.2 deletion, more information is needed before definitive recommendations can be made.
Specific Language Impairment in Children with Velocardiofacial Syndrome: Four Case Studies
Authors: Goorhuis-Brouwer Siena M. , Dikkers Frederik G. , Robinson Peter H. , Kerstjens-Frederikse Wilhelmina S.
Published: October 2018

Objective

To describe specific language impairment in four children with velocardiofacial syndrome (VCFS).

Design

A descriptive, retrospective study of four cases.

Setting

University Hospital Groningen, tertiary clinical care.

Patients

Of 350 patients with cleft plate, 18 children were diagnosed with VCFS. Four children are described.

Interventions

In all children, cardiac and plastic surgery was carried out in the first year of life. Afterward, interventions consisted of hearing improvement, pharyngoplasty, and speech therapy.

Main Outcome

Inadequate and uncharacteristic development of articulation and expressive language in four children with VCFS were observed. They differed from the majority in two ways: their nonverbal IQ was in the normal range, and their language skills were below expectations for their IQ.

Results

Four of 18 patients with VCFS (22%) showed poor response to therapy and did not develop language in accordance with their normal learning abilities (nonverbal learning capacities and language comprehension). Persistent hypernasal resonance and severe articulation problems remained in all four children. In two children the expressive language profile was also not in agreement with the nonverbal profile: they produced only two- and three-word utterances at the age of 6.0 and 5.3 years. The other two children at the age of 6.8 and 6.4 years produced very long sentences, but they were unintelligible.

Conclusions

The speech and language impairment of the four children may be characterized as a phonological or verbal programming deficit syndrome and as such can be described as a specific language impairment in conjunction with VCFS.
Delivery of Transforming Growth Factor-β2-Perturbing Antibody in a Collagen Vehicle Inhibits Cranial Suture Fusion in Calvarial Organ Culture
Authors: Moursi Amr M. , Winnard Phillip L. , Fryer Doug , Mooney Mark P.
Published: October 2018

Objective

To determine whether antibody perturbation of Tgf-β, delivered in a collagen gel, could inhibit cranial suture fusion.

Design

Attachment and proliferation of osteoblasts cultured on a collagen gel with or without anti-Tgf-β2 antibody were determined by AlamarBlue dye assay and cell morphology by toluidine-blue staining. In rat calvarial organ culture, collagen gel with and without anti-Tgf-β2 antibody was injected subperiosteally over the posterior frontal suture of postnatal day 15 rat calvariae. A quantitative analysis of suture fusion was used to measure suture bridging in histological serial sections at various time points.

Results

Attachment and proliferation for cells cultured on collagen gel with anti-Tgf-β2 antibody were similar to collagen gel controls. Although proliferation was lower than on tissue culture plastic, cells treated with anti-Tgf-β2 antibody maintained an osteoblastic morphology. After 7, 10, and 15 days in organ culture, anti-Tgf-β2 antibody treatment caused a reduction in the percent bridging of posterior frontal sutures, compared with controls. Sutures exposed to anti-Tgf-β2 antibody and fibroblast growth factor-2 concurrently did not show an inhibition of bony bridging.

Conclusions

These results support previous reports suggesting a role for Tgf-β2 in cranial suture fusion. In cell culture the collagen gel, both with and without anti-Tgf-β2 antibody, promoted similar osteoblast attachment, proliferation, and osteoblastic morphology. In organ culture anti-Tgf-β2 antibody was delivered in a bioactive state via a collagen gel to inhibit cranial suture fusion. Also, the results suggest that the inductive effect of fibroblast growth factor-2 is not dependent on Tgf-β2 activity. Together, these results provide further support for the role of Tgf-β2 in cranial suture fusion.
Cephalometric and Occlusal outcome in Adults with Unilateral Cleft Lip, Palate, and Alveolus after Two Different Surgical Techniques
Authors: Gaggl Alexander , Feichtinger Matthias , Schultes Günter , Santler Gert , Pichlmaier Margit , Mossböck Rudolf , Kärcher Hans
Published: October 2018

Objective

To assess differences in the aesthetic and functional long-term results of one-stage and two-stage surgical and orthodontic treatment in patients with cleft lip, palate, and alveolus.

Design

Sixty adult patients who were operated on as children for unilateral cleft lip, palate, and alveolus were examined. In every patient the lip was closed using Tennison's technique. Thirty patients had soft and hard palate closure in two stages and 30 patients in a single stage. Lateral cephalometric and model analyses were conducted at a mean age of 18.4 years.

Results

In the model analysis, transverse narrowing was seen in all patients after two-stage operations and in three patients after one-stage operations. The deficit was more severe in the molar region in the two-stage group and nearly similar in the premolar and molar region in the one-stage group. A sagittal deficiency in the anterior maxilla was found in 26 patients after two-stage operations and in 16 patients after one-stage operations. In the lateral cephalometric analysis, the mean sella-nasion-point A angle in the one- and two-stage group was 78.2 degrees and 76.8 degrees, respectively. The ANB angle was normal in both groups. In both groups the inclination of the midface was low. There was a low posterior facial height. Minor scarring was seen in the single-stage group.

Conclusion

A more severe impairment of growth of the maxilla in the sagittal and frontal plane was observed after two-stage operations on the cleft palate.
Unilateral Moore Pharyngoplasty in the Treatment of Unilateral or Asymmetric Velopharyngeal Incompetence
Authors: Mehendale Felicity V. , Sommerlad Brian C.
Published: October 2018

Objective

To describe the use of a unilateral modification of the Moore pharyngoplasty in the treatment of unilateral or asymmetric velopharyngeal incompetence (VPI) and analyze the results in a consecutive series of patients operated on by a single surgeon.

Design

Blind assessment of randomized speech and nasendoscopy recordings.

Setting

A two-site tertiary referral cleft unit.

Patients

Eighteen consecutive patients with asymmetrical or unilateral VPI of varying etiology.

Interventions

A unilateral Moore pharyngoplasty was performed in all patients. Three patients underwent radical dissection and retropositioning of the velar muscles at the same time as the unilateral Moore pharyngoplasty.

Main Outcome Measures

Pre- and postoperative nasality and nasal airflow using the CAPS score, assessment of nasendoscopy recordings, and the rate of further surgery.

Results

There was a significant improvement in hypernasality (p = .014). There was a highly significant decrease in the size of the velopharyngeal gap on the side on which the Moore pharyngoplasty was performed (p = .004) as well as a highly significant decrease in the total gap size (p = .003). The Moore flap was effective in obliterating the lateral pharyngeal recess in 11 of 12 patients (p = .004). Three patients required further velopharyngeal surgery.

Conclusions

In appropriately selected patients, a unilateral Moore pharyngoplasty is a safe and effective treatment for unilateral or asymmetric VPI. If indicated, a radical dissection and retropositioning of the velar muscles may be combined with a Moore pharyngoplasty.
Longitudinal Follow-Up of Obstructive Sleep Apnea following Furlow Palatoplasty in Children with Cleft Palate: A Preliminary Report
Authors: Liao Yu-Fang , Yun Claudia , Huang Chiung-Shing , Chen Philip K. T. , Chen Ning-Hung , Hung Kai-Fong , Chuang Ming-Lung
Published: October 2018

Objective

To longitudinally investigate the incidence and severity of obstructive sleep apnea (OSA) following Furlow palatoplasty for velopharyngeal insufficiency (VPI) in children with cleft palate.

Subjects

Ten children, six boys and four girls, mean age 5.1 years, at Furlow palatoplasty.

Design

Prospective analysis.

Main Outcome Measures

Overnight polysomnographic studies were used to determine the incidence and severity of sleep apneas 1 day prior to Furlow palatoplasty, 1 week postoperatively, and approximately 3 and 6 months postoperatively.

Results

None of the patients suffered OSA prior to Furlow palatoplasty. A high incidence of mild OSA (100%) occurred during the early postoperative period (p < .001) but resolved within 3 months in all but two patients (20%). Only one OSA (10%) persisted 6 months postoperatively.

Conclusions

Furlow palatoplasty for VPI in children with cleft palate might induce temporary and mild OSA.
Association of Distinct Craniofacial Features in Nonsyndromic Cleft Lip and Palate Family Members
Authors: Perkiomaki Marja R. , Yoon Young-Jooh , Tallents Ross H. , Barillas Ingrid , Herrera-Guido Roberto , Moss Mark E. , Fong Chin-To , Kyrkanides Stephanos
Published: October 2018

Objective

To assess the relationship of distinct craniofacial features among family members with cleft lip and palate (CLP).

Methods

Lateral cephalometric and anthropometric measurements of the members of 28 Costa Rican families with CLP were analyzed. The distinct craniofacial features in subjects with CLP were identified by comparing their craniofacial measurements with published normative values. The presence of these features was assessed in the unaffected family members. Regression coefficients were computed to evaluate the association of the distinct craniofacial measurements between parents and their offspring with and without CLP.

Results

The male and female subjects with CLP were characterized by shortened head (HL), anterior cranial base (S-N), and palatal length (ANS-PNS, A-PNS) measurements as well as hyperdivergent angle of S-N plane to palatal plane (<SN-PP). All unaffected family members also had shortened S-N and ANS-PNS measurements and mothers of affected daughters also shortened HL. Mothers had a significant association in S-N, ANS-PNS, and <SN-PP measurements with their affected daughters (p < .05 for all), and fathers had a significant association in A-PNS measurement with their affected sons (p < .05). None of the associations of the distinct craniofacial measurements were significant between mothers and their unaffected daughters or between fathers and their unaffected sons.

Conclusion

Unaffected family members of subjects with CLP also have some distinct craniofacial features, however in lesser degree. Mothers contribute more to their affected daughters’ and fathers to their affected sons’ distinct craniofacial morphology.
Occurrence of Cleft Lip and Palate in the Faroe Islands and Greenland from 1950 to 1999
Authors: Jakobsen Linda P. , Mølsted Kirsten , Christensen Kaare
Published: October 2018

Objective

To describe the occurrence of cleft lip with or without cleft palate (CL/P) and isolated cleft palate (CP) in the Faroe Islands and Greenland over a 50-year time period that has included substantial changes in lifestyle.

Design

A prevalence study based on patient records obtained from the Institute of Speech and Hearing Disorders in Copenhagen, Denmark, at which the treatment of patients with CP and CL/P from Greenland, the Faroe Islands, and Denmark is coordinated.

Participants

All live-born children in the Faroe Islands, Greenland, and Denmark with CL/P or CP born in the period 1950 to 1999 (Faroe Islands and Greenland) and 1950 to 1987 (Denmark).

Results and Conclusion

The mean prevalence of CL/P in the Faroe Islands and Greenland during the period 1950 to 1999 was 1.0 and 0.6 per 1000 live births, respectively. This is significantly lower than the mean prevalence of 1.4 (p < .05 and p < .001) per 1000 live births found in Denmark. The mean prevalence of CP in the Faroe Islands and Greenland was 1.5 and 1.1 per 1000 live births, respectively, which is significantly higher than the Danish prevalence of 0.5 per 1000 live births (p < .001 in both tests). There was no clear time trend in the prevalence, indicating that genetic factors or timetable environmental factors play a dominating role in the etiology of CL/P and CP in the Faroe Islands and Greenland.
Colonization of the Cleft Nasal Floor by Anaerobic Oral Flora in Patients with Oronasal Fistulae
Authors: Brennan Peter A. , Willy Peter , Anand Rajiv , Markus Anthony F.
Published: October 2018

Objectives

Aerobic oral bacteria only rarely colonize the cleft nasal floor in patients with patent oronasal fistula. There are no studies that have investigated whether anaerobic oral flora colonize this site and whether attempting to culture them is useful for assessing the patency of oronasal fistulae in the clinic.

Design

A prospective study of 13 patients with cleft with patent unilateral oronasal fistulae. Microbiological culture swabs were taken from the oral cavity and both nasal floors, with the unaffected side being used as a control. Following aerobic and anaerobic culture, bacterial isolates were identified and compared.

Main Outcome Measure

A significant growth of anaerobic oral bacteria from the cleft nasal floor when compared with the unaffected side.

Results

Aerobic oral flora was cultured from the oral cavity in all 13 patients. A light growth of aerobic oral flora was found in the cleft nasal floor in two patients, and anaerobic oral flora was cultured from the cleft nasal floor in the same two patients. No statistical correlation was found between growth of anaerobic flora and the cleft nasal floor (p = .48).

Conclusions

Like aerobic oral flora, anaerobic oral bacteria would appear to only rarely colonize the cleft nasal floor in patients with oronasal fistulae. This additional investigation does not appear to be helpful in the assessment of oronasal fistulae in the clinic.
Reflections on the Cleft Experience by South African Adults: Use of Qualitative Methodology
Authors: Patel Zakkiya , Ross Eleanor
Published: October 2018

Objective

This study explored the perceptions of a group of South African adults with repaired cleft lip, cleft palate, or both regarding their quality of life by considering the domains of communication, education, employment, family and marital life, social life, and emotional issues.

Design

An exploratory-descriptive, qualitative research design was employed.

Setting

Individual, semistructured interviews were conducted in the homes of participants.

Respondents

Twenty adults with repaired cleft lip, cleft palate, or both aged between 18 and 50 years participated in the study.

Results

Participants were generally satisfied with their communicative abilities and perceived their speech to be intelligible. They also felt that speech therapy had improved the quality of their lives. Although they had experienced teasing during childhood, they did not feel that their cleft had affected their relationships with teachers and were generally satisfied with their educational attainments. Socially they reported being greatly affected by negative societal perceptions and prevailing cultural myths regarding etiology of clefts. Generally employment did not appear to be affected by the presence of a cleft. With regard to family life, participants reported being treated differently by parents in comparison with their siblings. For the majority of respondents, marital relationships and dating did not seem to be adversely affected. In terms of emotional factors, both positive and negative reactions were experienced in relation to the cleft. They also felt that the competent and compassionate care received from the multidisciplinary team had definitely enhanced the quality of their lives.

Conclusions

These findings have important clinical implications for a multidisciplinary approach to treatment; counseling of patients and their families; education of the community regarding cleft lip, cleft palate, or both; and further research.
Association of Nasomaxillary Asymmetry in Children with Unilateral Cleft Lip and Palate and Their Parents
Authors: Yoon Young-Jooh , Perkiomaki Marja R. , Tallents Ross H. , Barillas Ingrid , Herrera-Guido Roberto , Fong Chin-To , Kyrkanides Stephanos
Published: October 2018

Objective

It has been suggested previously that increased width of midfacial structures is associated with the development of palatal clefting. The aim of this study was to evaluate the association of transverse craniofacial asymmetry between children with unilateral cleft lip and palate (UCLP) and their parents. Specifically, we hypothesized that parental transverse craniofacial asymmetry is a risk factor associated with the development of asymmetry in children with UCLP.

Design

Retrospective cross-sectional investigation including affected children and their noncleft parents.

Patients, Participants

A total of 64 children-parent sets of data (32 child-biological mother + 32 child-biological father) were included. Subject records included posteroanterior cephalometric radiographs obtained from 29 Costa Rican families with UCLP.

Main Outcome Measures

The side of parental nasal asymmetry was significantly associated with the side of cleft in their children. For the majority of parents with children suffering from a left cleft, nasal width was larger on the left, compared with the right side. Similarly, in the majority of parents with children suffering from a right cleft, nasal width was larger on the right, compared with the left side.

Conclusion

The results suggest that unilaterally increased nasomaxillary width in parents may play a key role in the development of ipsilateral palatal clefting in their offspring, therefore underscoring the importance of craniofacial form as a genetic etiologic factor in the genesis of clefting. Better understanding of the role of craniofacial form in cleft development will ultimately allow for the assessment of risk for cleft lip and palate.
Velopharyngeal Morphology of Patients with Persistent Velopharyngeal Incompetence following Repushback Surgery for Cleft Palate
Authors: Nakamura Norifumi , Ogata Yuko , Kunimitsu Kyoko , Suzuki Akira , Sasaguri Masaaki , Ohishi Masamichi
Published: October 2018

Objective

To characterize the velopharyngeal morphology of patients with persistent velopharyngeal incompetence (VPI) following repushback surgery for cleft palate.

Participants

Seven patients with moderate to severe VPI following repushback surgery for secondary correction of cleft palate, and 14 patients who had already obtained complete velopharyngeal closure function (VPF) were enrolled. Control data were obtained from the longitudinal files of 20 normal children in Kyushu University Dental Hospital.

Main Outcome Measures

Skeletal landmarks and measurements were derived from tracing of lateral roentgenographic cephalograms. The measurements included velar length, pharyngeal depth, and pharyngeal height and the ratio of velar length to pharyngeal depth. Additionally, the configuration of the upper pharynx (pharyngeal triangle) involving the cranial base, cervical vertebrae, and the posterior maxilla and also the position of posterior pharyngeal wall (PPW) in the pharyngeal triangle were analyzed.

Results

The VPI group had a significantly shorter velar length and greater pharyngeal depth, resulting in a smaller length/depth ratio than the controls. The points of PPW and cervical vertebrae of the VPI group were located more posteriorly and inferiorly than those in the group with complete VPF after the primary operation and the controls. The positions of cranial base and maxilla were not significantly different. Additionally, the position of PPW in the pharyngeal triangle was located significantly posteriorly and superiorly in the VPI group, compared with the controls.

Conclusions

The craniopharyngeal morphology of patients with persistent VPI was characterized by a short palate, wide-based and counterclockwise-rotated pharyngeal triangle, and posteriorly and superiorly positioned PPW. These might be contributory factors for the prediction of VPF before repushback surgery for cleft palate.
Projektalapú információtechnológiai kompetenciafejlesztés: digitalizálás, hálózati tájékoztatási rendszerek létrehozása a könyvtár- és információtudományi képzésben
Authors: Fodor János , Kiszl Péter
Published: October 2018

Napjaink könyvtár- és információtudományi képzésének szerves része a hálózaton elérhető adatbázisok, a számítógépes tájékoztatási rendszerek használata. Létrehozásuk, a komplex webfelületek programozása elsősorban informatikai feladat. A szolgáltatástervezés szakmai és tartalmi előkészítése, a tartalomszolgáltató eszközök testre szabása és hatékony használata viszont könyvtáros kompetencia marad, s a képzés interdiszciplináris részterülete. A tanulmány az Eötvös Loránd Tudományegyetem informatikus könyvtáros diszciplináris (alap- és mesterképzés) oktatási rendszerébe integrált – a digitális írástudást és az információs műveltséget is fejlesztő – elektronikus tájékoztatási rendszereket szervező projektek elemzését adja, majd röviden kitér az elektronikus könyvek oktatási vetületeire, végül pedig bemutatja a 2017-ben megalakult Digitális Bölcsészet Központ törekvéseit.
Prediction of breast cancer metastasis risk using circulating tumor markers: A follow-up study
Authors: Cetintas Sibel , Tezcan Gulcin , Tunca Berrin , Egeli Unal , Gokgoz Mustafa Sehsuvar , Cecener Gulsah
Published: October 2018

Distant organ tumor dissemination is a major cause of breast cancer-related deaths. In 2010, we analyzed the prognostic importance of the circulating tumor markers (CTMs) cytokeratin 19 (CK19), CK20, epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2) in relation to the clinical and pathological characteristics of patients with breast cancer (BC). To assess the clinical utility of CK19, CK20 and EGFR in predicting distant metastasis in BC, here we report 7-year follow-up results of 77 patients. The patients with at least one positive CTM were classified as CTM(+) and those negative for all CTMs were assigned to CTM(-) group. In patients who received no treatment following CTM analysis, 25.0% had metastasis in CTM(+) and 10.0% in CTM(-) group. In patients who received one of the following therapies: chemotherapy, radiotherapy or hormone therapy, or the combinations of these therapies, the rate of metastasis was 33.3% in CTM(+) and 20.0% in CTM(-) group. Disease-free time was shorter in CTM(+) patients compared to CTM(-) group (28.83 ± 10.76 and 41.38 ± 9.5 months, respectively). According to multivariate Cox proportional hazard regression analysis, the presence of regional lymph node metastasis, Ki-67 expression, higher tumor grade and CTM expression status were predictors of poor prognosis associated with distant metastasis (p < 0.05). Also, CTM positivity was a factor associated with metastasis-related poor prognosis (HR = 0.492, p = 0.026). The mean survival for CTM(+) patients was shorter than that for CTM(-) patients (90.671 ± 2.66 and 101.23 ± 3.92 months, respectively; p > 0.05). Our findings demonstrate that CTM positivity may indicate a high metastasis risk; however, CTM negativity does not guarantee low metastasis risk. These results may encourage further preclinical investigation of CTMs, to evaluate the possible implications of these findings to the clinical setting.
Risk factors for complications and graft failure in kidney transplant patients with sepsis
Authors: Syu Syuan-Hao , Lin Yung-Wei , Lin Ke-Hsun , Lee Liang-Ming , Hsiao Chi-Hao , Wen Yu-Ching
Published: October 2018

Immunosuppressive therapies decreased the incidence of acute kidney rejection after kidney transplantation, but also increased the risk of infections and sepsis. This study aimed to identify the risk factors associated with complications and/or graft failure in kidney transplant patients with sepsis. A total of 14,658 kidney transplant patients with sepsis, identified in the National Inpatient Sample (NIS) database (data from 2005–2014), were included in the study and classified into three groups: patients without complications or graft failure/dialysis (Group 1), patients with complications only (Group 2), and patients with complications and graft failure/dialysis (Group 3). Multinomial logistic regression analyses were conducted to evaluate factors associated with kidney transplant recipients. Multivariate analysis showed that, compared to Group 1, patients from Group 2 or Group 3 were more likely to be Black and to have cytomegalovirus infection, coagulopathy, and glomerulonephritis (p ≤ 0.041). Also, Group 2 was more likely to have herpes simplex virus infection, and Group 3 was more likely to have hepatitis C infection and peripheral vascular disorders, compared to Group 1 (p ≤ 0.002). In addition, patients from Group 3 were more likely to be Black and to have hepatitis C infection, peripheral vascular disorders, coagulopathy, and hypertension compared to Group 2 (p ≤ 0.039). Age and female gender were associated with lower odds of complications after kidney transplantation regardless of graft rejection/dialysis (p ≤ 0.049). Hyperlipidemia and diabetes decreased the chance of complications and graft failure/dialysis after kidney transplant (p < 0.001). In conclusion, the study highlights that black race, male gender, and specific comorbidities can increase the risk of complications and graft failure in kidney transplant patients with sepsis.
Beyond the Cosmopolis: Sustaining Hyper-Diversity in the Suburbs of Peel Region, Ontario
Authors: Dean Jennifer , Regier Kristen , Patel Asiya , Wilson Kathi , Ghassemi Effat
Published: October 2018

Globalization has increased the flow of transnational migrants into many European and North American cities. These shifting socio-demographic patterns have resulted in the rapid development of ‘cosmopolitan’ urban centres where difference and diversity are ubiquitous (Sandercock, 2003). However, as ethnic enclaves form outside the urban core in suburban communities, there is uncertainty about whether cultural homogeneity is desirable or sustainable in a multicultural country. Indeed, planning communities for increasing diversity and difference will remain, what Leonie Sandercock (2004) calls, “one of the greatest tasks for planners of the 21st century”. Thus, this article uses the theory of hyper-diversity to illuminate how immigrants’ interactions with their local suburban community represents cultural pluralism and diversity beyond ethnicity. Specifically, this study explores differing attitudes, activities and lifestyles among diverse immigrant populations in the Region of Peel, one of the fastest growing and most culturally diverse areas in Canada. Focus groups with 60 immigrant youth and 55 immigrant adults were conducted to qualitatively capture perspectives and experiences in ethnic enclaves. The findings highlight the existence of attitudes in favor of multicultural lifestyles, activities that take newcomers beyond the borders of their enclaves, and lifestyles that require additional infrastructure to support sustainability of immigration in the suburbs. In conclusion, this article adds to the debate on cultural pluralism and ‘homogeneous’ ethnic enclaves by using the emergent concept of hyper-diversity as a way to think about the future sustainability of suburbs in an era of global migration.
Estudo in silico das atividades de triterpenos e iridoides isolados de Himatanthus articulatus (Vahl) Woodson
Authors: Dolabela Maria Fâni , Da Silva Amanda Roberta Palheta , Ohashi Letícia Hiromi , Bastos Mírian Letícia Carmo , Da Silva Milena Cristina Martins , Vale Valdicley Vieira
Published: October 2018

O presente trabalho realizou estudos in silico para predição das atividades farmacocinética, toxicológica e biológica de triterpenos e iridoides isolados de Himatanthus articulatus, utilizada popularmente contra malária, afecções na pele, helmintíases, úlceras gástricas, gastrites, tumores e sífilis. As comparações foram realizadas através dos programas: ChemSketch, PreADMET e PASS online. As características físico-químicas dos compostos foram estimadas pelos servidores online Mcule property calculator e Chemicalize.org. Os resultados revelaram que os triterpenos e os iridoides não glicosilados (plumericina e isoplumericina) apresentaram absorção intestinal acima de 90%. Apenas a plumericina e a isoplumericina seguem a regra de Lipinsk, além de apresentarem atividade antineoplásica, antibacteriana e antifúngica.  O cinamato de lupeol, cinamato de α-amirina e acetato de lupeol provavelmente atuam nos sinais e sintomas da malária, porém, o acetato de lupeol apresentou maior número de reações adversas. Todas as substâncias mostraram carcinogenicidade, mas apenas os triterpenos demonstraram mutagenicidade. Em termos farmacocinético, toxicológico e biológico, apenas a plumericina e a isoplumericina apresentaram resultados satisfatórios.
Bilgi Sistemlerinin Toplam Sahip Olma Maliyetini Hesaplamak İçin Bir Çerçeve
Authors: GİRAY Görkem
Published: October 2018

Giderek
daha fazla sayıda organizasyonun faaliyetleri bilgi sistemlerine bağımlı duruma
gelmektedir. Bu da bilgi sistemlerini hayatımızın önemli bir bileşeni durumuna
getirmektedir. Küreselleşme ve zorlaşan rekabet nedeniyle, rekabet avantajı
elde etmek ya da bunu korumak için stratejik maliyet yönetimi vazgeçilmez bir
konuma gelmiştir. Bu iki eğilim, bilgi sistemlerinin toplam sahip olma
maliyetlerinin (TSOM) hesaplanmasını önemli kılmaktadır. Bu doğrultuda, bir
organizasyonun gereksinimleri doğrultusunda genişletilebilecek bir TSOM
hesaplama çerçevesi bu çalışma kapsamında sunulmuştur. Böylece mühendislerin
uygun maliyetli bilgi sistemleri geliştirmelerine ve/veya mevcut sistemlerin
maliyetlerini azaltmak için farklı çözümler uygulamalarına destek olunması
hedeflenmiştir. Çerçevenin, uluslararası bir şirkette kullanımını anlatan ve
nasıl genişletilebileceğine dair bir örnek oluşturan vaka çalışması ile
geçerlilik denetimi yapılmıştır.
Developing Ethereum Blockchain-Based Document Verification Smart Contract for Moodle Learning Management System
Authors: KARATAŞ Erinç
Published: October 2018

In the traditional educational understanding, individuals follow the path of getting graduate or post-graduate education if they wish, after continuing their education from kindergarten to high school. Today, by getting out of this stereotype, every literate person can choose different learning environments. Now, learning any subject is up to the tip of the fingers of an individual without depending on a school building with four walls or on certain time frame. In this study, it is aimed to verify digital certificates given to the participants at the Turkish stage of the International Informatics and Computational Thinking event by using Ethereum Block Chain based smart contract. The tasks in the event were transmitted to the students in Turkey via using exam module of the Moodle Learning Management System. For this study, first a smart contract was developed in which the certificate information could be stored on the Ethereum blockchain and could be check for control purposes if necessary. Then the certificate module developed by the researcher in 2014 which uses block structure in the Moodle Learning Management System was updated and then provided to work in accordance with the smart contract in the Ethereum blockchain.
Forensic medical evaluation of the role of the formation of ascending amniotic infection in the event of intrauterine fetal death
Authors: Davydova Zlata V. , Sokolova Olga V.
Published: October 2018

The analysis of expert practice and scientific research conducted during the last decade show that the greatest number of claims to the correctness of the provision of medical care are made by doctors of surgical specialties, including obstetrician-gynecologists, and, at the same time, inspections for “medical cases”, including profile “obstetrics and gynecology” are complex and time-consuming. The article considers the problem of the unfavorable outcome of medical care in obstetric practice. The questions of etiology, pathogenesis, diagnosis of intrauterine infection (VUI), which largely determines the frequency of perinatal morbidity and mortality, are also analyzed and analyzed questions of the prescription of the pathological process in the amniotic membranes, its role in the formation of fetal death. On a concrete example, expert practice shows how the forensic medical commission, taking into account the data of medical documents, as well as the results of macroscopic and microscopic studies, solves the problem of the immediate cause of antenatal death and establishes the role of intrauterine infection in the death of the fetus, the timing and causes of its formation. The information that is relevant to the practice of forensic medical examinations is presented, which allows us to formulate objective and scientifically substantiated conclusions about the existence of cause-effect relationships between the defects in the provision of medical care and the onset of an unfavorable outcome of medical care in similar cases.
Self-relation and relation to other people among women who have AIDS virus
Authors: Titova Maria D. , Zakharova Maiia L.
Published: October 2018

The human immunodeficiency virus (HIV) is a stigmatizing disease that will remain with a person for life, turning it into a series of stressful situations and strong, often negative experiences. People living with HIV are under pressure of public stereotypes, pressure of feelings of guilt, shame and social exclusion. The new situation requires adaptation. It is success depends not only on the external factors of the environment in which the person resides, but also on subjective factors, on how the person perceives what is happening, how he assesses himself in the current situation. The aim is to study the characteristics of self – relation and relation to other people among women who living with HIV-positive status. The study involved 30 women living with HIV and 30 healthy women. The results show that self-incrimination and guilt predominate in the self-relation of women living with HIV-positive status. Attitudes towards other people can be called distrustful and alienated. Features of the emotional status of women are mistrust of surrounding people, incertitude in the situation of communication and feelings of anxiety. For women of this group, it is characteristic to evaluate yourself as unattractive in the eyes of others, expecting disrespect from others and attributing to oneself a low social reputation. The results make it possible to pay attention to the need to provide psychological help that promotes a sense of self-worth and self-confidence. Psychological help can have a significant impact on the physical condition of women with HIV-positive status.
Contemporary aspects of innovative visualization digital medical technologies’ introduction into clinical practice and education
Authors: Aronov Alexander M. , Pastushenko Vladimir L. , Ivanov Dmitry O. , Rudin Yaroslav V. , Drygin Alexey N.
Published: October 2018

The paper portrays the elaboration and characters of digital hardware and software complex targeted at automatic forming, registration and processing of biomedical object images for non-invasive diagnostics based upon digital microscopy and endoscopia. Digital hardware and software complex is collecting, preliminary analyzing and compressing video-information for transmission along telecommunication channels. Complexes of this kind may serve as a basis for elaboration and introduction of new prospective medical technologies like visual and digital databases for education programs and atlases for discrimination of pathological cells and states. For a starter an aggregation of clinical and laboratory diagnostics systems has been chosen utilizing images from the outputs of digital microvisual and endoscopical systems for elaboration of optical digital diagnostics complexes. Microvisional digital multispectral analysis system ensures forming and visualization of biological tissues’ and medical slides’ microimages. The videoendoscopic system is intended for endoscopic examination of gastrointestinal tract with forming and visualization of endoscopic images, documenting and archiving of data. This system is networked according to TCP/IP protocol. The microvisional and vi deoendoscopic systems grant distant access to images and control functions for remote users from local networks or through WEB-interface.
The stomach as the target organ of celiac disease
Authors: Novikova Valeria P. , Shapovalova Natalia S. , Revnova Maria O. , Melnikova Valentina F. , Lapin Sergey V. , Guseva Veronika I. , Gurina Olga P. , Dementieva Elena A. , Klikunova Ksenia A.
Published: October 2018

The aim of this study was to observe the features of chronic gastritis in children with celiac disease (СD).

Materials and methods. 176 children with chronic gastritis (CG) aged from 3 to 16 years were examined. Group I consisted 58 child ren with CG and newly diagnosed CD not adherent to the gluten-free diet (GFD), group II consisted 49 children with CG and CD, adherent to the GFD. In the group III of comparisons were 69 children with CG and excluded CD. The exa mination included serological, morphological methods to confirm or exclude CD. The histological examination of the biopsy specimens of the gastric mucosa, the determination of antiparietal antibodies by the method of iIFR and ELISA (antibodies to Castle’s intrinsic factor and Anti-H+/K+ ATPase antibodies) were carried out.

Results. Helicobacter pylori infection was diagnosed in vast majority of patients in all groups. Autoantibodies to the gastric mucosa were found in every tenth patient in groups I and III, and did not occur in group II. In group II statistically significant the etiology of gastritis remained not determined. Endoscopically the gastric mucosa in groups I and II often remained intact. Accor ding to the morphological study in groups I and II, the pathological process was more often localized in the body of the stomach, and in group III in the antrum. Autoimmune gastritis is presented in groups without a statistically significant difference.

Conclusion. Chronic gastritis is a frequent co-morbid pathology in СD, and it is also not uncommon in these patients. Data of endoscopy in children, regardless of diet, does not reflect the complete picture of CG. All children with CD, regardless of compliance with GFD, are recommended to take biopsy specimens of the gastric mucosa for histological examination in order to exclude CG, and in case of detecting atrophic changes in the gastric mucosa to define the antiparietal antibodies.
The prevalence of neurocirculatory astheniaamong adolescents and young men of military age with bradyarrhythmia based on the results of screening diagnostics
Authors: Klubkova Inna A. , Avdeeva Marina V. , Shcheglova Larisa V. , Kiryanova Dina R. , Erina Marina Yu.
Published: October 2018

The article presents the results of clinical and instrumental examination of adolescents and young men of military age with bradyarrhythmia. The study involved 2067 people (mean age19,7 ± 2,7 years), subject to conscription (from 17 to 27 years) and potential conscripts (16-year-olds). According to the results of the screening ECG, bradyarrhythmia (sinus bradycardia, sinus bradyarrhythmia, rhythm and conduction disorders) was diagnosed in 630 adolescents and young men of military age. We studied the functional status of the autonomic nervous system on the device “Cardiometry-MT” (Russia). The functional state of the autonomic nervous system was studied on the basis of cardiointervalography and correlation rhythmography. Evaluation of the functional state of the autonomic nervous system was carried out according to three parameters: the type of vegetative regulation of the heart rhythm (normotonic, vagotonic, sympathicotonic); reactivity of the sympathetic and parasympathetic parts of the autonomic nervous system (normal reactivity, hyperreactivity, low reactivity, and paradoxical reactions); nature of vegetative maintenance of cardiac activity (normal vegetative maintenance of cardiac activity, vegetative maintenance with adaptation, vegetative maintenance with disadaptation). According to the results of respiratory samples from 81,9% of adolescents and young men of military age with bradyarrhythmia diagnosed neurocirculatory asthenia, of whom 63,6% – light, while 18,3% – severe degree. With a mild form of neurocirculatory asthenia, compensatory mechanisms are connected, so vegetative homeostasis is not generally disturbed and the heart rhythm responds adequately to the effect of physiological stimuli. Severe form of neurocirculatory asthenia is characte rized by disadaptation of vegetative maintenance of cardiac activity. Such patients need regular follow-up because they are at risk for developing cardiovascular diseases.
Water loss in transit in an intermittent river in brazilian semi-arid
Authors: Toledo Cristian Epifanio , Moura Silva Almeida Emanuelly De , Lopes Neto Alexandre Vicente , Gonçalves Rodrigues Silva Thályta Lharyssa Gonçalves Rodrigues , Rodrigues Santos Filipe Augusto
Published: October 2018

Riverwater often comes into contact with the underground flow in aquifers. When this contact

occurs, the river and aquifer are considered to be hydraulically connected. In recent decades, there has

been great interest in trying to to improve understanding of the interactions occuring between superficial and

subterranean water systems. A variety of analytical solutions have been proposed to describe the interaction of

confined and free aquifers with adjacent rivers, including the quantification of the decrease of river flow along

its course. The objective of the current study was to calibrate and validate a loss-in-transit flow model for rivers,

and to evaluate the minimum flow that still permits connectivity between water sources in the Alto Jaguaribe

basin. The methodology used was based on the equation of continuity and mass balance along the study river.

A modified Araújo and Ribeiro equation showed strong applicability to loss-in-transit generation, with a mean

loss in transit of 3.6% km-1, and a Nash and Sutcliffe Efficiency value of 0.29. On the other hand, the classbased

loss of upstream flow generated 4 classes with a mean of 2.6% km-1 and showed great improvement,

reaching an NSE of 0.74 - high efficiency. Minimum flows were below the regular flow recorded by the Ceará

Secretariat of Water Resources, showing that the ability exists in the region hydrological connectivity between

reservoirs in the Alto Jaguaribe basin and for alluvial aquifers to be recharged.