bluuebunny/crossref_metadata_2025 huggingface dataset:
Sequencing and Scheduling in Railway Classification Yards
Authors: Li Haodong , Jin Mingzhou , He Shiwei
Published: October 2015

Three sequencing decisions are involved in railway classification yards: inspection, hump, and assembly. Those sequencing decisions are important for smooth and efficient railyard operations and are interrelated. This research concentrates on the optimization of those sequences in an integrated way. A sequencing and scheduling model is proposed by considering multiple engines and inspection groups. This model can be solved by existing commercial optimization solvers for one typical planning horizon, such as 24 h. Numerical experiments and a case study based on historical data from a U.S. Class I railroad demonstrate that the proposed solution method yields better sequences and schedules, as measured by the total dwell time, compared with the practice of static sequencing. Furthermore, the results indicate that the handling capacity should be balanced among different classification steps to maximize the overall yard capacity.
Enhancing Rail Competitiveness with Online Rail Freight Exchange
Authors: Endemann Peter
Published: October 2015

In many European countries, rail freight demand has increased considerably during the past 10 to 15 years though only a few countries have reached considerable levels such as those observed in the United States. A closer look at the German case reveals that, given a considerable amount of empty wagons and a nontransparent market, there is still some potential to increase efficiency and competitiveness of rail freight and to overcome knowledge and information barriers in the rail freight market. Embedded in the strategy of the transnational project titled “CODE 24” (Corridor 24 Development Rotterdam–Genoa), an online rail freight exchange appears to be the appropriate instrument to cope with these challenges. The exchange is a market platform through which rail freight services are offered and requested online. At the start of the project, except for some initial business and case studies, the market relevance of such a tool and the requirements of potential users (predominantly shipping companies, transport logistics providers, and rail operators) had yet to be explored. Therefore, a workshop was held with these groups and other experts in 2011. From the outcome, potential operators of the platform had to be identified. In September 2012, CODE 24 identified two companies that were interested in cooperating with the CODE 24 network and developing such an online rail market ready for commercialization. CODE 24 decided to support both companies and emphasize their neutrality. Both platforms have been available since October 2013 and were presented at a joint workshop with the European Union Interreg IVB Programme in November 2013. A preliminary appraisal by February 2015 showed that both platforms were working well and had up to 94 registered companies.
What Makes A Bacterial Oral Vaccine a Strong Inducer of High-Affinity IgA Responses?
Authors: Moor Kathrin , Slack Emma
Published: October 2015

Oral vaccination against bacterial pathogens that infect via the gastrointestinal tract is highly desirable for both economic reasons and the supposed benefits of local mucosal immunity. However, the majority of oral vaccine trials in humans result in failure. Here we try to assimilate our current knowledge to generate a model to improve vaccine development strategies. A model previously postulated describes the “immunogenicity” of intestinal bacterial species as a sum of the ability of the species to compete with the microbiota, the “pathogenicity index,” and the uniqueness of the species. While this model quite neatly explains the difficulties in generating appropriately attenuated live vaccine strains, it cannot explain the success of fully apathogenic or inactivated high-dose vaccines. We therefore propose a step away from focusing on bacterial traits, and towards the most basic requirements of mucosal vaccines: i.e., the delivery of antigen to the gut-associated lymphoid tissues and the ability of that antigen to induce germinal center formation. While the models seem trivial, both suggest that vaccination strategies permitting uncoupling of disease-causing phenomena from immune stimulation will have a much broader safety margin in a diverse human population. Our modified model further suggests the benefits of delivering antigen in the form of high-dose fully apathogenic or sterile particles, combined with relevant adjuvants.
Two-Dimensional N-Glycan Distribution Mapping of Hepatocellular Carcinoma Tissues by MALDI-Imaging Mass Spectrometry
Authors: Powers Thomas , Holst Stephanie , Wuhrer Manfred , Mehta Anand , Drake Richard
Published: October 2015

A new mass spectrometry imaging approach to simultaneously map the two-dimensional distribution of N-glycans in tissues has been recently developed. The method uses Matrix Assisted Laser Desorption Ionization Imaging Mass Spectrometry (MALDI-IMS) to spatially profile the location and distribution of multiple N-linked glycan species released by peptide N-glycosidase F in frozen or formalin-fixed tissues. Multiple formalin-fixed human hepatocellular carcinoma tissues were evaluated with this method, resulting in a panel of over 30 N-glycans detected. An ethylation reaction of extracted N-glycans released from adjacent slides was done to stabilize sialic acid containing glycans, and these structures were compared to N-glycans detected directly from tissue profiling. In addition, the distribution of singly fucosylated N-glycans detected in tumor tissue microarray cores were compared to the histochemistry staining pattern of a core fucose binding lectin. As this MALDI-IMS workflow has the potential to be applied to any formalin-fixed tissue block or tissue microarray, the advantages and limitations of the technique in context with other glycomic methods are also summarized.
Molecular Simulation Studies of Flue Gas Purification by Bio-MOF
Authors: Li Zhi , Xu Gangqiang , Liu Bei , Lv Xin , Chen Guangjin , Sun Changyu , Xiao Peng , Sun Yifei
Published: October 2015

As a new branch of MOFs which are composed of biocompatible metal ions and organic ligands, bio-metal-organic frameworks (bio-MOFs) have attracted much attention recently. Bio-MOFs feature multiple Lewis basic sites which have strong interaction with CO2 molecules, thus they have great potential in the separation and purification of gas mixtures containing CO2. In this work, molecular simulation studies were carried out to investigate the adsorption and diffusion behaviors of CO2/N2 gas mixtures in bio-MOF-11. Results show that bio-MOF-11 displays excellent adsorption selectivity towards CO2 in CO2/N2 gas mixtures which was dominated by electrostatic interaction between material and CO2. In addition, we found both CO2 and N2 molecules were preferably adsorbed around the pyrimidine ring and exocyclic amino and transferred to the secondary favorable adsorption sites (methyl groups) with increasing pressure. Bio-MOF-11 membranes show superior permeation selectivity, but low permeability for CO2/N2 gas systems. The reason is that the small pores restrict the movement of gas molecules, leading to the observed low permeability. The information obtained in this work can be applied to other theoretical and experimental studies of bio-MOFs adsorbents and membranes in the future.
Biomass Stock and Carbon Sequestration in a Chronosequence of Pinus massoniana Plantations in the Upper Reaches of the Yangtze River
Authors: Justine Meta , Yang Wanqin , Wu Fuzhong , Tan Bo , Khan Muhammad , Zhao Yeyi
Published: October 2015

Planted forest plays a significant role in carbon sequestration and climate change mitigation; however, little information has been available on the distribution patterns of carbon pools with stand ages in Pinus massoniana Plantations. We investigated the biomass stock and carbon sequestration across a chronosequence (3-, 5-, 7-, 9-, 12-, 15-, 19-, 29-, 35- and 42-year) of stands with the main objectives: (1) to determine the biomass and carbon stock of the forest ecosystem; and (2) to identify factors influencing their distribution across the age series. Simple random sampling was used for collecting field data in the ten (10) stand ages. Three 20 × 20 m standard plots were laid out in February 2015 across the chronosequence. The diameter at breast height (DBH) and tree height (H) of each tree within each plot were measured using calipers and height indicator. Sub-plots of 2 × 2 m were established in each main plot for collecting soil samples at a 0–30- and 30–60-cm depth. Plantation biomass increased with increasing stand ages, ranging from 0.84 tonnes per hectare (t·ha−1) in the three-year stand to 252.35 t·ha−1 in the 42-year stand. The aboveground biomass (AGB) contributed 86.51%; the maximum value is 300-times the minimum value. Carbon concentrations and storage in mineral soil decreased with increasing soil depth, but were controlled by the management history of the ecosystem. The total ecosystem carbon storage varies with stand ages, ranging from 169.90 t·ha−1 in the five-year plantation to 326.46 t·ha−1 in the 42-year plantation, of which 80.29% comes from the mineral soil carbon and 19.71% from the vegetation. The ratio of the total carbon sequestration by the 42-year to the three-year stand was 1.70, implying substantial amounts of carbon accumulation during the transition period from young to mature-aged trees. The forest ecosystem had the capacity of storing up to 263.16 t·ha−1 carbon, assisting in mitigating climate change by sequestrating 965.83 t·ha−1 of CO2 equivalents, indicating that the forest is an important carbon sink.
Household Air Pollution and Under-Five Mortality in Bangladesh (2004–2011)
Authors: Naz Sabrina , Page Andrew , Agho Kingsley
Published: October 2015

Household air pollution (HAP) is one of the leading causes of respiratory illness and deaths among children under five years in Bangladesh. This study investigates the association between HAP from cooking fuel and under-five mortality using Bangladesh Demographic and Health Survey (BDHS) datasets over the period 2004–2011 (n = 18,308 children), and the extent to which this association differed by environmental and behavioral factors affecting level of exposure. The association between HAP and neonatal (age between 0–28 days), infant (age between 0 and 11 months) and under–five (age between 0 and 59 months) mortality was examined using multilevel logistic regression models. HAP was not strongly associated with overall neonatal (OR = 1.49, 95% CI = 1.01–2.22, p = 0.043), infant (OR = 1.27, 95% CI = 0.91–1.77, p = 0.157) or under-five mortality (OR = 1.14, 95% CI = 0.83–1.55, p = 0.422) in the context of overall decreasing trends in under-five mortality. The association was stronger for households with an indoor kitchen using polluting fuels, and in women who had never breastfed. Reductions in exposure to pollution from cooking fuel, given it is a ubiquitous and modifiable risk factor, can result in further declines in under-five mortality with household design and behavioural interventions.
Evidence for Public Health Risks of Wastewater and Excreta Management Practices in Southeast Asia: A Scoping Review
Authors: Lam Steven , Nguyen-Viet Hung , Tuyet-Hanh Tran , Nguyen-Mai Huong , Harper Sherilee
Published: October 2015

The use of wastewater and excreta in agriculture is a common practice in Southeast Asia; however, concerns remain about the potential public health risks of this practice. We undertook a scoping review to examine the extent, range, and nature of literature, as well as synthesize the evidence for associations between wastewater and excreta management practices and public health risks in Southeast Asia. Three electronic databases (PubMed, CAB Direct, and Web of Science) were searched and a total of 27 relevant studies were included and evaluated. The available evidence suggested that possible occupational health risks of wastewater and excreta management practices include diarrhea, skin infection, parasitic infection, bacterial infection, and epilepsy. Community members can be at risk for adverse health outcomes through consuming contaminated fish, vegetables, or fruits. Results suggested that practices including handling, treatment, and use of waste may be harmful to human health, particularly farmer’s health. Many studies in this review, however, had limitations including lack of gender analyses, exposure assessment, and longitudinal study designs. These findings suggest that more studies on identifying, quantitatively assessing, and mitigating health risks are needed if sustainable benefits are to be obtained from wastewater and excreta reuse in agriculture in Southeast Asia.
Small RNAs in Plant Responses to Abiotic Stresses: Regulatory Roles and Study Methods
Authors: Ku Yee-Shan , Wong Johanna , Mui Zeta , Liu Xuan , Hui Jerome , Chan Ting-Fung , Lam Hon-Ming
Published: October 2015

To survive under abiotic stresses in the environment, plants trigger a reprogramming of gene expression, by transcriptional regulation or translational regulation, to turn on protective mechanisms. The current focus of research on how plants cope with abiotic stresses has transitioned from transcriptomic analyses to small RNA investigations. In this review, we have summarized and evaluated the current methodologies used in the identification and validation of small RNAs and their targets, in the context of plant responses to abiotic stresses.
Role of New Antifungal Agents in the Treatment of Invasive Fungal Infections in Transplant Recipients: Isavuconazole and New Posaconazole Formulations
Authors: Li Julius , Nguyen Cynthia , Garcia-Diaz Julia
Published: October 2015

Invasive fungal infections are a major cause of morbidity and mortality among solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients. Transplant patients are at risk for such invasive fungal infections. The most common invasive fungal infections are invasive candidiasis in the SOT and invasive aspergillosis in the HSCT. In this article, we will discuss the epidemiology of invasive fungal infections in the transplant recipients and susceptibility patterns of the fungi associated with these infections. Additionally, the pharmacology and clinical efficacy of the new antifungal, isavuconazole, and the new posaconazole formulations will be reviewed. Isavuconazole is a new extended-spectrum triazole that was recently approved for the treatment of invasive aspergillosis and mucormycosis. Advantages of this triazole include the availability of a water-soluble intravenous formulation, excellent bioavailability of the oral formulation, and predictable pharmacokinetics in adults. Posaconazole, a broad-spectrum triazole antifungal agent, is approved for the prevention of invasive aspergillosis and candidiasis in addition to the treatment of oropharyngeal candidiasis. Posaconazole oral suspension solution has shown some limitations in the setting of fasting state absorption, elevated gastrointestinal pH, and increased motility. The newly approved delayed-release oral tablet and intravenous solution formulations provide additional treatment options by reducing interpatient variability and providing flexibility in these set of critically ill patients. This review will detail these most recent studies.
Relaxation Mechanisms, Structure and Properties of Semi-Coherent Interfaces
Authors: Shao Shuai , Wang Jian
Published: October 2015

In this work, using the Cu–Ni (111) semi-coherent interface as a model system, we combine atomistic simulations and defect theory to reveal the relaxation mechanisms, structure, and properties of semi-coherent interfaces. By calculating the generalized stacking fault energy (GSFE) profile of the interface, two stable structures and a high-energy structure are located. During the relaxation, the regions that possess the stable structures expand and develop into coherent regions; the regions with high-energy structure shrink into the intersection of misfit dislocations (nodes). This process reduces the interface excess potential energy but increases the core energy of the misfit dislocations and nodes. The core width is dependent on the GSFE of the interface. The high-energy structure relaxes by relative rotation and dilatation between the crystals. The relative rotation is responsible for the spiral pattern at nodes. The relative dilatation is responsible for the creation of free volume at nodes, which facilitates the nodes’ structural transformation. Several node structures have been observed and analyzed. The various structures have significant impact on the plastic deformation in terms of lattice dislocation nucleation, as well as the point defect formation energies.
Effects of Rhodomyrtus tomentosa Leaf Extract on Staphylococcal Adhesion and Invasion in Bovine Udder Epidermal Tissue Model
Authors: Mordmuang Auemphon , Shankar Shiv , Chethanond Usa , Voravuthikunchai Supayang
Published: October 2015

Bovine mastitis is one of the most important infectious diseases in dairy herds, and staphylococci are the most important etiologic agents of this disease. Antibiotics and chemical agents used in livestock for prevention and cure of the disease can accumulate in milk and give rise to food safety concerns. Rhodomyrtus tomentosa leaf extract was studied as an alternative approach to reduce the bacterial infections. The ethanolic extract of this plant demonstrated antibacterial activity with minimum inhibitory concentration (MIC) values as low as 16–64 μg/mL against staphylococcal isolates. In addition, the extract had an effect on the bacterial cell surface properties by increasing its hydrophobicity in a concentration dependent manner. To further extend the antibacterial efficacy, silver nanoparticles synthesized with the extract, a pure rhodomyrtone, and liposomal encapsulated rhodomyrtone were applied and their inhibitory effects on bacterial adhesion and invasion were determined by ex vivo study in a bovine udder epidermal tissue model. These agents exerted remarkable antibacterial activity against staphylococci and decreased the adhesion of the bacterial cells to the tissues. These results supported that R. tomentosa ethanolic extract could be applied as an alternative agent for bovine udder care in dairy farms.
Effects of Dietary Plant Sterols and Stanol Esters with Low- and High-Fat Diets in Chronic and Acute Models for Experimental Colitis
Authors: Te Velde Anje , Brüll Florence , Heinsbroek Sigrid , Meijer Sybren , Lütjohann Dieter , Vreugdenhil Anita , Plat Jogchum
Published: October 2015

In this study, we evaluated the effects of dietary plant sterols and stanols as their fatty acid esters on the development of experimental colitis. The effects were studied both in high- and low-fat diet conditions in two models, one acute and another chronic model of experimental colitis that resembles gene expression in human inflammatory bowel disease (IBD). In the first experiments in the high fat diet (HFD), we did not observe a beneficial effect of the addition of plant sterols and stanols on the development of acute dextran sulphate sodium (DSS) colitis. In the chronic CD4CD45RB T cell transfer colitis model, we mainly observed an effect of the presence of high fat on the development of colitis. In this HFD condition, the presence of plant sterol or stanol did not result in any additional effect. In the second experiments with low fat, we could clearly observe a beneficial effect of the addition of plant sterols on colitis parameters in the T cell transfer model, but not in the DSS model. This positive effect was related to the gender of the mice and on Treg presence in the colon. This suggests that especially dietary plant sterol esters may improve intestinal inflammation in a T cell dependent manner.
A Wireless Sensor Network for Urban Traffic Characterization and Trend Monitoring
Authors: Fernández-Lozano J.J. , Martín-Guzmán Miguel , Martín-Ávila Juan , García-Cerezo A.
Published: October 2015

Sustainable mobility requires a better management of the available infrastructure resources. To achieve this goal, it is necessary to obtain accurate data about road usage, in particular in urban areas. Although a variety of sensor alternates for urban traffic exist, they usually require extensive investments in the form of construction works for installation, processing means, etc. Wireless Sensor Networks (WSN) are an alternative to acquire urban traffic data, allowing for flexible, easy deployment. Together with the use of the appropriate sensors, like Bluetooth identification, and associate processing, WSN can provide the means to obtain in real time data like the origin-destination matrix, a key tool for trend monitoring which previously required weeks or months to be completed. This paper presents a system based on WSN designed to characterize urban traffic, particularly traffic trend monitoring through the calculation of the origin-destination matrix in real time by using Bluetooth identification. Additional sensors are also available integrated in different types of nodes. Experiments in real conditions have been performed, both for separate sensors (Bluetooth, ultrasound and laser), and for the whole system, showing the feasibility of this approach.
A New Model Based on Adaptation of the External Loop to Compensate the Hysteresis of Tactile Sensors
Authors: Sánchez-Durán José , Vidal-Verdú Fernando , Oballe-Peinado Óscar , Castellanos-Ramos Julián , Hidalgo-López José
Published: October 2015

This paper presents a novel method to compensate for hysteresis nonlinearities observed in the response of a tactile sensor. The External Loop Adaptation Method (ELAM) performs a piecewise linear mapping of the experimentally measured external curves of the hysteresis loop to obtain all possible internal cycles. The optimal division of the input interval where the curve is approximated is provided by the error minimization algorithm. This process is carried out off line and provides parameters to compute the split point in real time. A different linear transformation is then performed at the left and right of this point and a more precise fitting is achieved. The models obtained with the ELAM method are compared with those obtained from three other approaches. The results show that the ELAM method achieves a more accurate fitting. Moreover, the involved mathematical operations are simpler and therefore easier to implement in devices such as Field Programmable Gate Array (FPGAs) for real time applications. Furthermore, the method needs to identify fewer parameters and requires no previous selection process of operators or functions. Finally, the method can be applied to other sensors or actuators with complex hysteresis loop shapes.
RETRACTED: A New Method to Energy Saving in a Micro Grid
Authors: Vallati Andrea , Grignaffini Stefano , Romagna Marco
Published: October 2015

Optimization of energy production systems is a relevant issue that must be considered in order to follow the fossil fuels consumption reduction policies and CO2 emission regulation. Increasing electricity production from renewable resources (e.g., photovoltaic systems and wind farms) is desirable but its unpredictability is a cause of problems for the main grid stability. A system with multiple energy sources represents an efficient solution, by realizing an interface among renewable energy sources, energy storage systems, and conventional power generators. Direct consequences of multi-energy systems are a wider energy flexibility and benefits for the electric grid, the purpose of this paper is to propose the best technology combination for electricity generation from a mix of renewable energy resources to satisfy the electrical needs. The paper identifies the optimal off-grid option and compares this with conventional grid extension, through the use of HOMER software. The solution obtained shows that a hybrid combination of renewable energy generators at an off-grid location can be a cost-effective alternative to grid extension and it is sustainable, techno-economically viable, and environmentally sound. The results show how this innovative energetic approach can provide a cost reduction in power supply and energy fees of 40% and 25%, respectively, and CO2 emission decrease attained around 18%. Furthermore, the multi-energy system taken as the case study has been optimized through the utilization of three different type of energy storage (Pb-Ac batteries, flywheels, and micro—Compressed Air Energy Storage (C.A.E.S.).
L’Amérique, désert des traductions
Authors: Cusset François
Published: October 2015

The US has the Western world's lowest percentage of translated books out of its total title production, but more titles are translated from the French in the US than from any other language.
Scalar vs. Epistemic Vagueness: Evidence from Approximators
Authors: Sauerland Uli , Stateva Penka
Published: October 2015

n/a
Percutaneous Screw Fixation of Distal Tibia Fractures â€“ Functional Results in Sixteen Patients
Authors: Kaftandziev Igor , Trpeski Simon , Arsovski Oliver , Spasov Marko
Published: October 2015

INTRODUCTION: An important feature of distal tibia fractures is the relevance of the soft tissue coverage. In order to maintain good functional outcome, several operative techniques have been established. Among them, percutaneous screw fixation has the advantage of causing less biological damage of the soft tissues with lower rates of complications.MATERIAL AND METHODS: We reviewed 16 patients with distal tibia fracture. Operative treatment consisted of indirect reduction and percutaneous fixation of the tibia followed by cast immobilization for approximately 3-4 months. Minimum follow up period was 12 months. Functional outcome was evaluated using Olerud-Molander Ankle Score (OMAS) and American Orthopaedic Foot and Ankle Society ankle-hindfoot score (AOFAS).RESULTS: Twelve out of 16 fractures healed within 6 months of the injury. In 3 cases, delayed union was evident, but the fractures healed in less than nine months. There was one case of malunion, two cases of superficial skin infections, two cases of DVT and two cases of gross swelling. According to OMAS score, the functional result was excellent in 7 (43.75%), good in 5 (31.25%) and fair in 4 (25%) patients.CONCLUSION: Percutaneous screw fixation can be a safe and effective method for operative treatment of distal tibia fractures.
Diagnostic Assessment of Movement Disorders and Psychomotor Deficiency in Residual Schizophrenia
Authors: IlankoviÄ‡ Vera , IlankoviÄ‡ Andrej N. , IlankoviÄ‡ Nikola N.
Published: October 2015

Movement disorders and motor deficiency is highly represented among patients in Schizophrenia â€“ residual type (DSM IV):Â  37% of patients examined in our research had psychoâ€‘motor disturbances. Dominant disturbances are the following: disturbed tonus among 65% of patients, abnormal postural reactions among 90%, abnormal voluntary movements among 75%, disturbed speech among 85%, disturbed static and dynamic postures among 90%. Involuntary movements are present among 20% of patients.Classic neurological diagnostics offers general assessment of the motor status. Standardized clinical motor scales only register the presence and intensity of the motor disturbance. Rehabilitation treatment requires individual and up to date functional diagnostics of the motor deficiency.We would like to stress that psychiatric patients in psychotic, (prepsychotic) and postpsychotic states, besides being mentally ill, also suffer from serious movement disordersÂ  (psychomotor disturbances and deficits) which put them into the category ofÂ  disabled persons, who besides requiring psychiatric (neuropsychiatric) treatment, also require systematic psychomotor and speechÂ  rehabilitation.
Common Carotid Artery Thickness in Chronic Kidney Disease
Authors: Lubomirova Mila , Djerassi Rejina , Bogov Boris
Published: October 2015

AIM: Previous studies showed that patients with chronic kidney disease (CKD) > 2 dergee had increased intima-media thickness (IMT).Â  We evaluate the relationship between IMT and parameters for renal function.METHODS: 130 subjects were examined â€“ 66 with CKD, 44 without CKD, as well as 20 healthy volunteers. The first group- patients with CKD were with creatinine clearance (CrCl) over 20 ml/min and below 90 ml/min. The second group included 44 pts. with normal renal function, CrCl > 90 ml/min. All examined patients with and without CKD had hypertension.Â Â  The two groups were streamed into two subgroups: with and without vascular disease. To evaluate the renal function creatinine clearance was calculated in ml/min. IMT was measured in both common carotid artery (CCA) using high resolution sonography in all examined subjects.RESULTS: CCA IMT increased in pts. with CKD and was > 0.75 ( 0.76 Â± 0.14 v.s contols 0.59 Â± 0.10) Patients with vascular disease (VD) had higher IMT which increased significant when CKD with GFR < 90 ml/min was included (0.77 Â± 0.06/0.81 Â± 0.10, p < 0.05). Multiple regression analysis proved that renal function deterioration directly affected CCA IMT (R2=0.208, p=0.022).CONCLUSION: Increased IMT is presented in mild renal dysfunction. CKD â€“GFR< 90 ml/min could be an independent vascular risk factor.
Mental Health, Physical Health and Other Individual Risk Factors for Elder Maltreatment: Findings from the National Study
Authors: Markovik Marijana , Jordanova Peshevska Dimitrinka , Serafimovska Eleonora , Sethi Dinesh
Published: October 2015

OBJECTIVES: The first Macedonian National Prevalence study of elder maltreatment in private settings was conducted in 2011 and 2012. This article provides an overview of the risk factors on individual level regarding the ecological model of human development.METHOD: The study involved 960 respondents who provided answers to a face-to-face survey questionnaire and a Geriatric Depression Scale. Â The Mini-Mental State Examination test was used as a pre selection criterion. The achieved sample was weighted to be representative on the Macedonian population aged 65 and over. Â RESULTS: Being women, being married, with elementary school education, suffering from certain chronic diseases, sensory impairment, are potential risk factors on individual level for elderly Maltreatment.CONCLUSION: The findings support the previous quantitative data obtained in other countries, as well as the concept of ecological framework.
Childhood Abuse, Household Dysfunction and the Risk of Attempting Suicide in a National Sample of Secondary School and University Students
Authors: Raleva Marija , Jordanova Peshevska Dimitrinka , Filov Izabela , Sethi Dinesh , Novotni Antoni , Bonevski Dimitar , Haxhihamza Kadri
Published: October 2015

OBJECTIVES: One of the main objectives of this paper is to analyze the associations between childhood abuse, household dysfunction and the risk of attempting suicide among young adolescents in the country.METHOD: A representative sample consisted of total 1277 students (58.6% female and 41.6% male), aged 18 and above in year four of 664 secondary school and 613 first- and second-year university students. The data were obtained using Adverse Childhood Experiences Study Questionnaires (Family Health History Questionnaire) for collecting information on child maltreatment, household dysfunction and other socio-behavioural factors, applying WHO/CDC-recommended methodology. Statistical significance was set up at p<0.05.RESULTS: Emotional neglect, physical abuse and physical neglect were the most frequent abusive experiences students had. Overall, suicide attempts were reported by 3.1 % of respondents (4.7% by females and 0.8% by males). Those respondents who had been emotionally abused were almost three times as likely to attempt suicide, physical abuse almost doubles the chances of attempting suicide, substance abuse in the family increased the chances 2.3 times for attempting suicide, violent treatment of the mother almost quadrupled them for attempted suicide, having a family member who had been in prison increased the odds of almost 3.5 times for attempting suicide. Attempted suicide was found to be 1.5 times more likely as the number of ACEs reached 3 and 3.4 times more likely as the number of adverse childhood experiences reached four or more.Â CONCLUSION: Identifying and treating children, adolescents and young adults who have been affected by adverse childhood experiences may have substantial value in our evolving efforts to prevent suicide.
Molecular Diagnosis of Toxoplasmosis in Non Immune Pregnant Females
Authors: Abdel Aal Amany A. , Attia Samar S. , Hanafy Nihal A. , Al-Antably Abeer S. , Hassan Marwa A. , El-Sherbiny Walid , Nasr Aml S.
Published: October 2015

BACKGROUND AND AIM: Infection with the protozoan parasite Toxoplasma gondii has a worldwide distribution. Congenital infection is the most important part of the disease burden due to Toxoplasma infection in humans. Early diagnosis of maternal infection helps to prevent severe complications of toxoplasmosis. In the present study, three PCR assays (conventional, nested & quantitative) were evaluated for diagnosis of recent toxoplasmosis based on detection of Toxoplasma B1 gene.MATERIAL AND METHODS: The present study was carried out on 150 pregnant females who were serologically negative for anti-Toxoplasma IgG and IgM antibodies.RESULTS: The results revealed that out of 12 true positive cases (by 2 out of the 3 PCR protocols), 8 cases were positive by cPCR, 11 cases were positive by nPCR and 12 cases were positive by qPCR. Accurate estimation of genomic Toxoplasma DNA in positive samples was achieved by qPCR. In general, PCR assays offer a sensitive alternative of serological methods for diagnosis of recent maternal toxoplasmosis. In addition, qPCR decreases the risk of contamination of PCR products being a closed tube method and helps in estimation of infection load.CONCLUSIONS: We recommend screening of high-risk pregnant women by qPCR for early diagnosis of toxoplasmosis and proper management.
Variations in the Position and Shape of the Basilar Artery
Authors: MehinoviÄ‡ Anel , IsakoviÄ‡ Eldar , DeliÄ‡ Jasmin
Published: October 2015

OBJECTIVE: Anomalies of vertebrobasilar vessels arise as early embryonal developmental deteriorations. The majority of them concern the position, origin and shape of the basilar artery. Therefore the present study was carried out to find out the variations in position and shape of the basilar artery using Magnetic Resonance Imaging and CT Angiography.MATHERIAL AND METHODS: The study included 130 consecutive patients, adults of both sexes, treated in UKC Tuzla.Â Patients were divided into two groups.Â In one group (100) were patients without aneurysm in the vertebrobasilar tree, and in the second group (30) patients with aneurysm.RESULTS: Three types of variations in the shape of basilar artery were recorded: those with arched course, S-shaped course, and the straight course type.Â All the three types are approximately of the same percentage prevalence in the group of subjects without aneurysm in the vertebral-basilar tree, as well as in the group with aneurysm.Â Basilar artery at 89.33% of respondents was located in medial or in paramedial position.CONCLUSION: Attention is drawn to the practical importance of such variations as a possible source of diagnostic errors during cerebral arteriography. We highlight the morphological aspects of the basilar artery, the knowledge of which would help neurosurgeons safely diagnose, as well as plan and execute vascular bypass and shunting procedures for the treatment of stenosis, aneurysms and arteriovenous malformations.
Gastroesophageal Reflux Symptoms in Patients with Chronic Obstructive Pulmonary Disease
Authors: Goseva Zlatica , Gjorcev Angelko , Jovanovska-Janeva Elena , Arbutina Suzana
Published: October 2015

BACKGROUND: It is known that there is some relation between airways obstruction and gastroesophageal reflux symptoms (GER) symptoms in patients with chronic obstructive pulmonary disease (COPD).AIM: The aim was to determine frequency of GER symptoms and correlation with pulmonary function tests in patients with COPD.MATERIAL AND METHODS: The study included 58 patients. First group had 20 patients with mild COPD, second group had 18 patients with moderate COPD and third group had 20 patients with severe COPD. We had also a control group with 12 healthy subjects. All subjects completed their self-reported questionnaire about symptoms like: acid-regurgitation, heartburn, dysphagia, dyspnea and chronic cough.RESULTS: COPD patients with airways obstruction and significant GER symptoms had their respiratory symptoms associated with reflux events. More of COPD patients had significant GER symptoms defined as regurgitation and dysphagia once or more per week. Patients with FEV1 less than 50% showed more prevalent GER symptoms compared to those with values of FEV1 grater then 50%.CONCLUSION: GER symptoms are more prevalent in patients with severe airways obstruction when compared to less airways obstructed group and controls. We could suggest an association between the degree of airways obstruction in patients with COPD and the increased rate of GER symptoms.
Specific Triggers of Migraine Headache in Adolescents
Authors: Knezevic-Pogancev Marija , Jovic Nebojsa , Stojadinovic Aleksandra
Published: October 2015

AIM: Purpose of the study was to recognize specific migraine triggers in adolescents.MATERIAL AND METHODS: Study was conducted on 20,917 adolescents in Serbia.RESULTS: Lack of sleep, passive tobacco smoking, alcohol intakes, and "not eating in time" are triggers that provoke migraine in adolescents.CONCLUSION: Avoiding migraine triggers in 68% of adolescents reduced drug therapy for 75%.
Treatment Algorithm for Chronic Anal Fissure â€“ A Review of Literature and itâ€™s Apply in University Clinical Center Mother Teresa â€“ Skopje
Authors: Dzeparoski Marjan
Published: October 2015

Chronic anal fissure is one of the most frequent anorectal disorders. Symptoms vary but typically include bright red rectal bleeding, itching and discomfort or pain during and after defecation. Treatment has undergone a transformation in recent years from surgical to medical, all approaches sharing the goal of reducing the spasm.According to the researched treatment guidelines and the experience at the â€œUniversity Clinical Center Mother Teresaâ€ (Clinic of Gastroenterohepatology and Clinic of Abdominal Surgery) in Skopje, Macedonia, we propose the following algorithm for treatment of chronic anal fissure in three steps: from topicalÂ  nifedipine + lidocaine cream (first-line) to second course of nifedipine + lidocaine cream or digital anal dilatation or botulinum toxin type A injection (second-line) to lateral internal sphincterotomy (third-line).The proposed treatment algorithm allows patients to start with the least invasive treatment. There is no doubt that patients are willing to try less invasive modalities with the hope of avoiding surgery, with its risk of permanent disability. It should be up to the patients to decide which treatment they prefer. Although chemical sphincterotomy is less successful from lateral internal sphincterotomy, the algorithm allows feasibility, efficacy and cost-effectiveness, as well as risk reduction for surgical morbidity.
Bronchial Hyperresponsiveness in Farmers: Severity and Work-Relatedness
Authors: Stoleski Saso , Minov Jordan , Karadzinska-Bislimovska Jovanka , Mijakoski Dragan
Published: October 2015

OBJECTIVE: To evaluate the prevalence of respiratory symptoms, lung function and bronchial hyperresponsiveness in farmers, with emphasize to their severity and work-relatedness due occupational risk factors and farming characteristics.METHODS: A cross-sectional survey was performed including 60 cow breeders aged 21 to 65 years, compared to an equal number of agricultural farmers matched by age, job exposure duration, and smoking status. We have used a questionnaire to record the chronic respiratory symptoms, detailed work history, specific farming activities and tasks performed, and smoking history. Evaluation of examined subjects also included lung function spirometry tests, and bronchial hyperresponsiveness testing.RESULTS: We found higher prevalence of work related respiratory symptoms in the last 12 months in cow breeders with significant difference for phlegm (P = 0.039), and wheezing (P = 0.026). Mean values of all spirometric parameters were lower in cow breeders, reaching significance for MEF50 (P = 0.001) and MEF75 (P = 0.000). Significant difference was found for mild bronchial hyperresponsiveness among cow breeders with job exposure of more than 15 years. The risk of developing work-related respiratory symptoms increased significantly with full-time farming, exposure to gases and vapors, and keeping more than 10 cows.CONCLUSION: Our data suggest that workplace exposure in farmers may cause respiratory impairment which is closely related to its duration, characteristics, and intensity. The results suggest that cow breeders in general have higher rates of work-related respiratory symptoms and bronchial hyperresponsiveness than agricultural farmers, whereas their severity increases with an increase in frequency and duration of animal contact.
Different Tools for the Assessment of Bone Mass among Egyptian Adults
Authors: Hassan Nayera E. , El-Masry Sahar A. , El-Banna Rokia A. , El Hussieny Mohamed S.
Published: October 2015

BACKGROUND: Several tools such as, dual X-ray absorptiometry (DXA), quantitative computed tomography (QCT) and self-assessment tool (OST), are being used for diagnosis of osteoporosis.OBJECTIVE: to compare the sensitivity and specify detection rate of bone mineral density (BMD) changes for DXA versus QCT and OST among a sample of Egyptian adults of both sexes.SUBJECTS AND METHODS: This study is a cross sectional one, which included 62 Egyptians, aged 20-65 years.Â  Each individual was assessed for BMD using DXA at femur and spine sites; QCT and OST which take into account body weight and age. Accordingly they were diagnosed as either osteoporotic/osteopenic or normal.RESULTS: The highest prevalence of osteopenia or osteoporosis was diagnosed among menopause women. DXA at femur has diagnosed more cases of osteoporosis (both osteopenic and osteoporotic) as compared to spine DXA or QCT, but OST is out of rang; as it failed to diagnose any case.CONCLUSION: DXA has been found to be more efficacious than QCT scan in the diagnosis of osteoporosis. DXA in femur is better than DXA-spine and QCT. Generally, DXA is the "gold standard" when assessing osteoporosis. Further studies are needed to modify the equation of OST and confirm its efficiency in Egyptians population.
Body Composition Changes after Weight-Loss Interventions among Obese Females: A Comparison of Three Protocols
Authors: Hassan Nayera E. , El-Masry Sahar A. , El-Banna Rokia , Elshebini Salwa M. , Al-Tohamy Muhamed , El-Batrawy Salwa , Ahmed Nihad H. , Adel Dalia , Rasheed Enas Abdel , Selim Mohamed , El Hussieny Mohamed S. , Khalil Aya , Ali Manal Mouhamed
Published: October 2015

AIM: To evaluate body composition changes after use of three different types of obesity management protocols: dietary measures and physical activity; acupuncture or laser acupuncture with healthy diet; aiming at achieving stable weight loss among obese Egyptian females.METHODS:Â  A randomized longitudinal prospective study included 76 obese adult females; aged 26 up to 55 years. Anthropometric, body composition, ultrasonographic and biochemical assessments were done.RESULTS: The three types of obesity management protocols showed significant improvement in body composition (decrease in fat% and increases in FFM and TBW) and visceral fat by US. However, nutritional intervention showed highly significant improvement in the skin fold thickness at triceps and biceps sites and peripheral adiposity index.Â  Acupuncture intervention showed highly significant improvement in fasting blood glucose (decreased) and lipid profile (decreased triglycerides, total cholesterol and LDL, and increased HDL). Laser intervention showed highly significant improvement in all the skin fold thickness and some parameters of lipid profile (decreased total cholesterol and LDL). CONCLUSIONS: The three obesity management protocols have significant effect on body composition, but acupuncture has the best effect in improving the lipid profile and fasting blood sugar. In addition, Laser intervention was recommended to improve skin fold thickness and subcutaneous fat.
Influence of Testosterone Replacement Therapy on Metabolic Disorders in Male Patient with Type 2 Diabetes Mellitus and Androgen Deficiency
Authors: Janjgava Shota , Zerekidze Tamar , Uchava Lasha , Giorgadze Elene , Asatiani Ketevan
Published: October 2015

INTRODUCTION: Multiple epidemiological studies have shown that low testosterone levels are associated with and predict the future development of T2DM.AIM: The aim of study was to show the influence of testosterone replacement therapy on anthropometric characteristics, glycosylated hemoglobinlevel level, blood pressure and dyslipidemia in patients with T2DM and Androgen deficiency.MATERIALS AND METHODS:Â  From 125 male patients with T2DM were randomized 85 subjects with age 49.8 Â± 6.74 and BMI from 35.83 Â± 3.65 kg/m2 in placebo-controlled study. We divided patients into two groups: 1) Treatment group, where was used testosterone replacement therapy. 2) Placebo group, where was used placebo. In both groups was added Life style modification, but Antidiabetic therapy was unchanged.RESULTS: After six months of treatment we repeated the diagnostic assessments: lipid profile was improved in both groups but in group I it was statistically significant. Free testosterone level increased in all groups but in group I it was statistically significant. HbA1c decreased in both group but in group I we had the best result. Blood pressure was reduced in both groups, results were similar.CONCLUSION: Our study demonstrated that it is possible to regulate blood pressure, lipid profile, HbA1c, BMI - by raising testosterone in diabetic men with androgen deficiency.
Stigma Associated with Tuberculosis Disease in Republic of Macedonia â€“ Results from a Cross-Sectional Study
Authors: Gudeva Nikovska Dance , Tozija Fimka
Published: October 2015

BACKGROUND: Stigma and discrimination are interrelated and are breaking the fundamental human rights. Both are associated with tuberculosis (TB) disease since ever and have negative influence on activities aimed at TB prevention, treatment and control, both at individual, community and societal level.AIM: To determine the magnitude of TB stigma in Republic of Macedonia, identify root causes and detect main determinants associated with it.MATERIAL AND METHODS: Cross-sectional study was performed on 315 TB patients registered in the period Jul, 2012-Jun, 2013, using selected module from World Health Survey questionnaire. Self-reported data is collected through face to face interview conducted by trained directly observed treatment (DOT) nurses in the patientsâ€™ home.RESULTS: 16.7% TB patients have not received any assistance when diagnosed with TB and 8.4% were treated badly by a member of the family or close friends because of the disease, consequences ranging from living the patient completely, refusal to talk or telling other people that the person is infected. An odd for such behavior were higher if the patient is male, married, have no formal education or have completed only primary school, is unemployed and lives in rural area.CONCLUSION: Understanding the origins of TB stigma is integral to reducing its impact on health. Our survey has provided a baseline on the magnitude of existent stigma associated with TB disease and has identified main determinants that trigger stigmatizing behavior.