bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental Investigation of Tire Slap Noise
Authors: Cao Rui , Bolton J. Stuart
Published: April 2018

Tire noise is an important issue both in the vehicle interior and to the vehicle exterior, since it affects passenger comfort and environmental noise levels, respectively. Such noise is increased when a tire encounters discontinuities on the road surface, the discontinuity being either a gap or a bump. The relatively high frequency (e.g., approximately 1 kHz and above) airborne tire noise generated by such discontinuities is defined as tire slap noise in this study.

Most previous research on noise generated by surface discontinuities has been focused on lower frequency tire noise, typically below 600 Hz, and, in particular, on structural-borne noise transmitted from the tire into the vehicle associated with the acoustic modes of the tire interior. Here, instead, the focus is on higher frequency airborne transmission. Further, the study here is conducted from the perspective of tire structural vibration, which concerns the vibration of and sound radiation from the tire treadband structure, rather than tire pattern noise, for example.

The high frequency tire slap noise was investigated in a laboratory environment. The measurements were conducted by using the Ray W. Herrick Laboratories' Tire Pavement Test Apparatus (TPTA), on which a loaded tire can be run on realistic road surfaces at speeds up to 50 km/h; the resulting tire noise was measured using the On-Board Sound Intensity (OBSI) method. A gap between two different concrete surfaces was chosen as the road discontinuity, and both narrow band and one-third-octave band spectra were recorded over the gap and over the adjacent smooth road surface segments.

Several tires were tested on the TPTA, and their slap noise was recorded. Surface noise and slap noise were compared up to 1600 Hz to show the impact of the discontinuity on the tire noise radiation. Generally, slap noise is of a higher level than the surface noise, especially between 800 and 1400 Hz, but some tires showed distinct differences between the noise response on the surface and over the gap, while other tires radiated similar noise on both the surface and over the gap. Moreover, static tire mobility measurements were performed to investigate the wave type responsible for the different responses on the gap and the surface.
Uniaxial Compression on Salted Snow
Authors: Giudici Henri , Wåhlin Johan , Klein-Paste Alex
Published: April 2018

During snowfall loose snow sticks to the underlying pavement, forming a hard crust that can be difficult to remove. In order to ensure good road traffic safety, winter maintenance personnel use several operations, such as mechanical removal and chemical altering, to keep snow plowable. One chemical, commonly applied on roads, is sodium chloride (salt). Recent studies establish that very small amounts of salt are sufficient to weaken compacted snow substantially, meaning that the mechanical properties of salted snow are different from dry snow. This change in the mechanical properties of salted snow, however, has not been considered when studying tire–pavement interaction in snowy conditions.

In an attempt to better understand salt snow as a material, this paper presents an experimental investigation of salted snow under uniaxial compression. The study examines the density and the loss of mass of snow after compression for different solution contents and compression speeds.

Samples of snow were mixed with sodium chloride solution at different liquid contents. The snow samples were then compressed by an MTS uniaxial compression machine, up to an applied load of approximately 2 bars, roughly corresponding to the pressure applied by a car. Applied forces and dry density were measured for each test after compression. Based on the results carried out in this study, we found that: Salted snow gets a higher density after compaction compared to dry snow, also flows easier than dry snow, giving a larger loss of mass during uniaxial compression. The dry density after compaction increases with compaction speed for dry snow but decreases with compaction speed for salted snow.

The effect of the solution on the compressibility and flowability of the material and its relevance for tire–pavement interaction are discussed.
Öğrencilerin Geleceğinde Kariyer Günleri Etkinliklerinin Rolü: Turizm İşletmeciliği ve Rehberlik Lisans Öğrencileri Üzerine Bir Araştırma
Authors: Eşitti Bekir , Buluk Buket
Published: April 2018

Çalışmanın
temel amacı, turizm işletmeciliği ve rehberlik lisans öğrencilerinin, istihdam
ve kariyer günleri etkinliklerine bakış açıları ve kariyer planlamayla ilgili
algılamalarını belirlemektir. Bu kapsamda çalışma, Çanakkale Onsekiz Mart
Üniversitesi ve Akdeniz Üniversitesi Turizm fakültelerinde lisans eğitimi alan
420 lisans öğrencisiyle gerçekleştirilmiştir. 29 Şubat- 1 Mart 2016 tarihleri
arasında nicel araştırma yöntemi uygulanarak veriler anket tekniği ile elde
edilmiştir. Çalışma sonucunda öğrencilerin, kariyer kararlarında istihdam ve
kariyer günleri etkinliklerinin yeterli düzeyde yönlendirici olduğu,
öğrencilerin kariyer kararlarını vermelerinde öğretim elemanlarının da etkili
bir rol üstlendiği görülmüştür. Ayrıca öğrencilerin istihdam ve kariyer
günlerinde maddi kaygılarla kariyer olanaklarını değerlendirdikleri ve erkek
öğrencilerin içtepisel kararlara katılımlarının kız öğrencilere göre daha
yüksek olduğu bulgularına ulaşılmıştır. Sonuç olarak istihdam ve kariyer
günlerinin, turizm öğrencilerinin kariyerlerini planlamalarında yeterli bir
farkındalık oluşturduğu ve öğrenciler tarafından önemsendiği görülmüştür.
Efficient management of a dehumidifier in a greenhouse under warm weather conditions
Authors: J.M. Cámara-Zapata  , J.A. Sánchez-Molina  , F. Rodríguez  , J.C. López
Published: April 2018

The reduction of humidity inside a greenhouse is a key factor to ensure the quality of the crop and avoid the incidence of cryptogamic diseases. The method commonly used is a combination of heating and natural ventilation, although it is very deficient from the energy and environmental points of view. In cold and humid climates the use of a heat pump dehumidifier (HPD) can reduce energy consumption. To evaluate this technology in a Mediterranean climate, an HPD was installed in a greenhouse of the Cajamar Experimental Station in Almería. The environmental humidity inside the greenhouse decreased when using the HPD. The efficiency of the HPD was related to the value of the condensation temperature of the water vapor and to the temperature and humidity of the air inside the greenhouse. In addition, it was found that the energy efficiency of the system varied according to climate. For efficient management of HPD it is essential to know the influence of climate on energy efficiency. The flow of condensed water vapor and the power consumed presented differing behaviors. Thus, the production of liquid water correlated linearly with the condensation temperature, increasing the slope of the linear relationship with the temperature of the air inside the greenhouse. However, the power consumption was correlated linearly with the air temperature. The management of the system is efficient when the air temperature is above 15.0ºC and the relative humidity is less than 90%.
HUBUNGAN KEYAKINAN DIRI MENGELOLA KONFLIK KERJA-KELUARGA, DUKUNGAN ATASAN, DUKUNGAN KELUARGA DENGAN PENGAYAAN KERJA-KELUARGA
Authors: Artiawati Artiawati , Astutik Neni Puji
Published: April 2018

Perkembangan jaman mengakibatkan banyak terjadi pergeseran dalam bidang kehidupan, salah satunya adalah terjadinya pergeseran peran dalam rumah tangga, seperti semakin banyaknya pasangan dual karir. Dual karir tentunya akan menimbulkan tantangan tersendiri dalam pengelolaan domain kerja dan rumah tangga. Penelitian ini bertujuan untuk menguji hubungan keyakinan diri mengelola konflik kerja-keluarga, dukungan atasan dan dukungan keluarga besar dengan pengayaan kerja-keluarga. Partisipan penelitian ini sebanyak 250 guru di Surabaya. Penelitian ini menggunakan pendekatan kuantitatif dan pengumpulan data melalui kuisioner. Alat ukur yang digunakan dalam penelitian ini, yaitu kuesioner pengayaan kerja-keluarga dibuat oleh Carlson, Kacmar, Waybe & Grzywacz (2006) dan keyakinan diri mengelola konflik kerja-keluarga dibuat oleh Cinamon (2003) yang diadaptasi oleh Artiawati dan Andhini (2016). Kuesioner dukungan atasan dan dukungan keluarga besar yang dibuat oleh Antani dan Ayman (2003) dengan tim project 3535 dan didaptasi oleh Artiawati (2012). Data yang diperoleh diolah menggunakan SPSS dengan teknik analisis regresi ganda. Hasil yang didapatkan,antara lain:(1)ada hubungan yang signifikan antara keyakinan diri mengelola konflik kerja-keluarga, dukungan atasan, dan dukungan keluarga besar dengan pengayaan kerja-keluarga (F = 25.032; p < 0.05; R square = 0.234). (2) keyakinan diri mengelola konflik kerja-keluarga memiliki hubungan paling kuat dengan pengayaan kerja-keluarga (r parsial 0.259 ; p < 0,05). Saran untuk penelitian selanjutnya perlu melibatkan variabel lain seperti kepribadian, konflik kerja-keluarga, juga mempertimbangkan latar belakang kultural. Kata kunci: keyakinan diri mengelola konflik kerja-keluarga, dukungan keluarga besar, dukungan atasan, guru.
Safety and immunogenicity of rabies pre- and postexposure intradermal regimens using Abhayrab, a purified vero cell rabies vaccine (PVRV) produced in India in healthy volunteers: towards greater affordability of rabies prophylaxis
Authors: Magpantay Rio L. , Bermal Nancy , Medina Plebeian , Quiambao Beatriz P.
Published: April 2018

Background: Rabies is 100% fatal, but is preventable. However, due to the high cost of vaccines and immunoglobulins, as well as their limited availability, many dog-bite victims in the Philippines do not complete the required PEP regimen. This concern may be addressed by the introduction of various new brands of affordable rabies vaccines and biologicals for use with the ID regimen. Objective: Study the safety and immunogenicity of rabies pre- and post-exposure intradermal regimens using Abhayrab, a purified vero cell rabies vaccine (PVRV) produced by the human biological institute of Ooty India in healthy volunteers. Methods: In a randomized, single blind, unicentric trial, 149 healthy volunteers (5 - 50 years in age) were recruited to the study. The subjects were then randomized into two groups. Group 1 (pre-exposure) (73 subjects) followed the standard ID regimen using a dose of 0.1 mL PVRV (Abhayrab) given intradermally on either deltoid on days 0, 7 and 28. Group 2 (post-exposure) (76 Subjects) followed the modified Thai Red Cross ID regimen (2-2-2-0-2) using a dose of 0.1 mL PVRV (Abhayrab) each given intradermally on both deltoids on days 0, 3, 7, and 28. Following administration of vaccine, subjects were observed closely for 30 minutes at the site for adverse reactions. Four ml of blood from each subject was drawn on days 0, 14, and 28 for anti-rabies antibody titres. Safety and immunogenicity were assessed through follow-up of adverse events and anti rabies antibody response, respectively. Results: Eventually, 120 subjects, 60 in each group, completed the day 28 ID immunization. All the 120 subjects demonstrated seroconversions with antibody titers greater than the WHO recommended cut-off level of 0.5 IU/mL on days 14 and 28. The GMC values for Group 1 were 3.30 IU/ml and 4.37 IU/mL on days 14 and 28, respectively, while those of Group 2 were 3.73 IU/mL and 4.82 IU/mL, respectively. These GMC values were within their 95% CIs. Only a few mild adverse events were observed with no incidences of moderate or severe events. Conclusion: Abhayrab is a safe and immunogenic rabies vaccine when administered intradermally.
Walk performance in Thai men and women: physical activity dependence
Authors: Suwanachaiy Sitamanats , Kulaputana Onanong , Chaiwanichsiri Dootchai
Published: April 2018

Background: Six-minute walk test (6MWT) is a measure of functional capacity and a predictor of morbidity and mortality in the elderly. Published reference equations for the six-minute walk distance (6MWD) were derived from healthy subjects with sufficient physical activity, and may not be valid for patients with limited physical activity. Objective: To measure 6MWD in healthy individuals with sufficient (Suff) and insufficient (Insuff) levels of physical activity in Thai, and to compare the measured 6MWD with those calculated using published reference equations. Methods: Healthy volunteers aged 45-65 years (77 men and 85 women) performed three standard 6MWT. Physical activity levels were determined using a one-week recall physical activity questionnaire. The subjects were classified as having sufficient or insufficient levels of physical activity. Results: 6MWD of the Suff group was greater than the Insuff group in both men (701+89 m vs. 652+55 m, p = 0.005) and women (619+49 m vs. 571+35 m, p <0.001). The predicted 6MWD from published reference equations underestimated the measured 6MWD of men in Suff group, while it overestimated the measured 6MWD of women in Insuff group. Conclusion: Level of physical activity affected 6MWD of the subjects. Published references must be carefully applied for predicting 6MWD of individuals with various levels of physical activity.
Comparing anterior cervical fusion using titanium cage with hydroxyapatite and with autograft
Authors: Tienboon Prakit , Atiprayoon Surapon
Published: April 2018

Background: Anterior cervical discectomy and fusion using autogenous iliac bone graft may lead to donor site pain. This has led some surgeons to use hydroxyapatite but it has greater rates of complications. Objective: Analyze results of the treatment of cervical spine spondylosis by anterior cervical discectomy, and to compare fusion using titanium cage with hydroxyapatite and with autograft. Methods: We evaluated eighty patients (at 146 cervical levels) that had been treated by anterior cervical discectomy and fusion with hydroxyapatite or autograft. In a prospective study, patients were divided into two groups: 1) 77 levels of anterior cervical fusion from in 40 patients who were treated with cage and hydroxyapatite, and 2) 69 levels of anterior cervical fusions in 40 patients who were treated with cage and autograft. Results were evaluated using the Japanese Orthopedic Association (JOA) scoring system before and after surgery, subsidence, non-union and complication. Results: According to JOA score, the first group (hydroxyapatite) had improved from 9.8 preoperation to 14.5 postoperation. The subsidence rate was 26.0%, the non-union rate was 10.4%, and there was no intra and post-operative complication. In the other group (autograft), the preoperative JOA score had improved from 9.3 to 14.1. The subsidence rate was 11.6%, and there were no non-union and complications. Statistical significance was found in non-union and subsidence aspect between groups, but the clinical outcome of JOA score was not significantly different. Conclusion: Anterior cervical discectomy and fusion in cervical spondylosis patients, titanium cage implantation with hydroxyapatite is a highly useful alternative to autograft.
Mutations of ATP7B gene in two Thai siblings with Wilson disease
Authors: Treepongkaruna Suporn , Pienvichit Paneeya , Phuapradit Pornpimon , Kodcharin Porawee , Wattanasirichaigoon Duangrurdee
Published: April 2018

Background: Wilson disease (WD) is an autosomal recessive disorder of copper metabolism caused by mutations in ATP7B gene. Objective: Report the clinical data and mutation analysis of two Thai siblings suspected of WD. Subject and methods: A 13-year-old boy who presented with cirrhosis, arthralgia, hypoalbuminemia, and coagulopathy, and his 11-year-old sister who was asymptomatic but had hepatomegaly with elevation of transaminases, were studied. Mutation analysis of ATP7B gene and mRNA analysis was performed in both patients and their parents. Results: Investigations were consistent with WD, and their liver diseases improved after standard treatment for WD. DNA analyses in these two patients revealed two novel mutations, which were a deletion of the first 2bp of exon 6 (c.1870_1871delGA), and a single base substitution from A to G at nucleotide 4075 (c.4075A>G) in the exon 20 (p.M1359V). PCR-restriction digestion with NcoI restriction enzyme was employed as the second method for confirmation of the c.4075A>G mutation and for rapid screening in 100 chromosomes from unrelated healthy controls, and this variant was not present in the controls. The c.1870_1871delGA deletion caused a frameshift effect, which results in a premature stop codon (p.E624fsX753), and the p.M1359V mutation is a substitution of methionine with valine, which may have effects upon its orientation and interaction with other adjacent amino acids. Conclusion: Two novel mutations of ATP7B gene were identified in two Thai siblings with WD.
The prevalence of unrecognized congenital heart disease among healthy elementary school students in northern Thailand
Authors: Sayasathid Jarun , Supachokchaipattana Pentip , Pipatvech Kraminee , Sukonpan Kanchapan , Somboonna Naraporn , Pannarunothai Supasit
Published: April 2018

Background: Congenital heart disease (CHD) is one of the major congenital anomalies among newborns. Although many infants with CHD are symptomatic and identified soon after birth, others remain undiagnosed until the disease becomes severe. Objectives: Unravel the number of CHD cases among 7-12 years old students who reported neither clinical complication nor history about cardiac diseases, stressing the importance for regular cardiac examination in children, even if they appeared healthy. Methods: The study selected students without clinical history of heart disease from 1,041 elementary schools in northern Thailand (Tak, Nakhon Sawan and Uttaradit). Certified nurses and health officers examined the students for abnormal heart conditions. Pediatric cardiologists scrutinized the students with suspected CHD for confirmation and characterization of cardiac lesion types. Results: Out of 144,293 students included in the study, 851 students showed atypical heart symptoms, and 87 were verified to have the CHD. This conferred the prevalence rate of unrecognized CHD among the elementary school children to be 0.60 per 1,000. The frequently-detected heart defects were ventricular septal defect (41.4%) and pulmonary stenosis (16.1%). Fifty-one children (58.6%) required surgery for cardiovascular correction. The prevalence of the CHD in elementary school students ranged from 0.41 to 1.05 cases per 1000 study subjects. The greatest number of incidences was found in Tak province where medical resources are inadequate. Conclusion: This study highlights the significance of routine cardiac examination among school-aged students, particularly in the regions with limited medical facilities, providing information essential for appropriate health care planning and managements.
Novel genetic marker in TGFB2 gene associated with expression of TGF-β2 in leukocyte and SLE susceptibility
Authors: Hirankarn Nattiya , Hemwijit Krongkamol , Benjachat Thitima , Avihingsanon Yingyos
Published: April 2018

Background: TGF-β2 has a role in immune regulation, and genetic variance within the gene might contribute to systemic lupus erythematosus (SLE) pathogenesis. The TGFB2 gene is one candidate gene within the major SLE genetic susceptibility loci. Objective: Investigate the TGFB2 gene located on chromosome 1q41 as a SLE susceptibility gene. Materials and methods: One hundred fifty three SLE patients and 133 healthy controls participated in this study. Four markers selected in two haplotype blocks that have a minor allele frequency greater than 5% in Thai population were genotyped and analyzed in the association study. Results: There was no significant association between SLE susceptibility and the polymorphism in the promoter area (+67_68insACAA) and +89835 (A/G) at the intron 5 of TGFB2 gene. Instead, minor allele of the two new genetic markers at the intron 1 (+720) (corrected p-value = 0.024, OR = 0.4141, 95%CI = 0.22-0.80) and intron 6 (+94399_94400) (corrected p-value = 0.000143, OR = 0.3367, 95%CI = 0.20-0.58) were independently associated as a protective factor to SLE. Additionally, the real time RT-PCR results showed that patients with the protective allele (minor allele) at the +94399_94400 position have higher TGF-β2 mRNA level in leukocytes than patients with the risk allele (p=0.011). Conclusion: Two new genetic markers at intron1 (+720) and intron 6 (+94399_94400) were independently associated with SLE. The observed results have to be confirmed in other populations with a large sample size.
Co-expression of human malaria parasite Plasmodium falciparum orotate phosphoribosyltransferase and orotidine 5’-monophosphate decarboxylase as enzyme complex in Escherichia coli: a novel strategy for drug development
Authors: Kanchanaphum Panan , Krungkrai Jerapan
Published: April 2018

Background: Human malaria parasite Plasmodium falciparum operates de novo pyrimidine biosynthetic pathway. The fifth and sixth enzymes of the pathway form a heterotetrameric complex, containing two molecules each of orotate phosphoribosyltransferase (OPRT) and orotidine 5’-monophosphate decarboxylase (OMPDC). Objective: Define the function of OPRT-OMPDC enzyme complex of P. falciparum by co-expressing the enzymes in Escherichia coli. Methods: The constructed plasmids containing either P. falciparum OPRT or OMPDC were cloned in E. coli by co-transformation. Both genes were co-expressed as OPRT-OMPDC enzyme complex and the complex was purified by chromatographic techniques, including N2+-NTA affinity, Hi Trap Q HP anion-exchange, uridine 5’- monophosphate affinity, and Superose 12 gel-filtration columns. Physical and kinetic properties of the enzyme complex were analyzed for its molecular mass. Results: Co-transformation of PfOPRT and PfOMPDC plasmids in E. coli were achieved with a clone containing DNA ratio of 1:2, respectively. Both plasmids remained stable and were functionally expressed in the E. coli cell for at least 20 weeks. The P. falciparum OPRT-OMPDC enzyme complex were co-expressed and the complex was co-eluted in all chromatographic columns during purification and physical analysis. The molecular mass of the complex was 130 kDa, whereas the PfOPRT and PfOMPDC component were 35.6 and 41.5 kDa, respectively. The enzymatic activities of the complex were competitively inhibited by their products of each enzyme component. Conclusion: P. falciparum OPRT and OMPDC in E. coli as an enzyme complex were co-transformed and functionally co-expressed. These have similar properties to the native enzyme purified directly from P. falciparum, and this character is different from that of the human host organism. The enzyme complex would be suitable as new target to research selective inhibitors as suitable drugs to better control this disease.
Intranasal location of lacrimal sac in Thai cadavers
Authors: Tanamai Napas , Ratanaanekchai Teeraporn , Thanaviratananich Sanguansak , Chaisiwamongkol Kowit , Chantaumpalee Thanarat
Published: April 2018

Background: Many current literatures have described that the lacrimal sac is located just anterior to the anterior attachment (axilla) of the middle turbinate. However, there was no data on the exact boundary of the sac, especially the distance related with a permanent landmark such as the middle turbinate attachment. Objective: Determine the intranasal location of the lacrimal sac related to the middle turbinate attachment in Thai fresh cadavers. Methods: The study was performed in 26 Thai fresh cadavers, donated to Khon Kaen University, Thailand between July 2006 and July 2007. The height and width of the lacrimal sac were recorded, as well as the distances from the upper, lower, anterior and posterior border of the lacrimal sac to the axilla of the middle turbinate were measured. Results: The mean height and width of 52 lacrimal sacs were 11.2 and 6.2 mm. The mean distances from the upper, lower, anterior, and posterior border of lacrimal sac to the axilla of the middle turbinate were 4.9 mm (95%CI=4.4-5.4), 5.6 mm (95%CI=5.1-6.1), 3 mm (95%CI=2.4-3.6), and 2.9 mm (95%CI=2.3-3.5), respectively. The upper border of all lacrimal sacs were located superior to the axilla of the middle turbinate (95%CI=93.1-100), and posterior border of 44 sacs (85%, 95%CI=72.5-92.0) were located posterior to the axilla. Additionally, the anterior wall did not extend anterior to the anterior attachment of the middle turbinate in 21% of the sac. Conclusion: This study revealed the more exact intranasal location of lacrimal sacs. This is useful for surgeons to perform adequate endoscopic dacryocystorhinostomy to prevent postoperative lacrimal sump syndrome.
Effect of omeprazole, rabeprazole, and rebamipide on the accuracy of urea breath test in patients with Helicobacter pylori infection
Authors: Thong-Ngam Duangporn , Chayanupatkul Maneerat , Thongbai Thirada
Published: April 2018

Background: The urea breath test (UBT) has been widely used for H. pylori eradication after treatment. The breath test could be adversely affected by various factors including proton pump inhibitors (PPIs) that are also used in the therapy for H. pylori infection. Objective: Determine the effect of omeprazole, rabeprazole and the mucoprotective agent rebamipide, on the UBT. Methods: Fifty-six patients with dyspepsia and positive for H. pylori by rapid urease test were enrolled. They were classified into three groups: Group 1 (n=25) received omeprazole 20 mg once daily, group 2 (n=13) received rabeprazole 20 mg once daily, and group 3 (n=18) received rebamipide 100 mg three times a day. All patients received a 14-day course of their medications. UBT was performed on day 0 as a baseline and on day 14 in all patients. In patient with negative results of UBT on day 14, the UBT was performed in consecutive week until the test became positive. Results: Fifty-six patients (20 men and 36 women) participated in the study. Their mean age was 46.77±14.3 years. False negative rate after 14-day treatment in omeprazole, rabeprazole and rebamipide group were 20.0%, 30.8%, and 0% respectively. There was a significant difference between 13C level in patients with negative and positive UBT results (2.7±0.7 vs.22.9±3.7/mL, p=0.025). The reversal of false negative to true positive tests occurred within two weeks after discontinuation of omeprazole and rabeprazole. Conclusion: Proton pump inhibitors had an effect on the accuracy of H. pylori detection using UBT. Rabeprazole revealed a higher false negative rate in the UBT than omeprazole. The mucoprotective drug, rebamipide, did not influence negative results in the UBT.
Modeling tuberculosis incidence in Nepal
Authors: Kakchapati Sampurna , Yotthanoo Sulawan , Choonpradup Chamnein
Published: April 2018

Background: Tuberculosis (TB) constitutes a large burden of infectious disease in Nepal. Objective: Model incidence of TB between 2003 and 2008 in Nepal. Methods: A retrospective study was conducted in Nepal of tuberculosis incidence by gender and location over the six years period. Data were obtained for 198,719 tuberculosis cases from the Nepal Tuberculosis Center (NTC). A negative binomial model with two multiplicative components as predictors was used and provided a good fit. Results: The model extracted a decreasing trend during the first five years followed by a drop in 2008.The overall incidence of TB was 1.31 cases per 1,000 population with a male to female incidence rate ratio of 1.86. There were pronounced spatial variations with higher rates occurring in the Terai region, followed by the Hill, and Mountain regions. Conclusion: Tuberculosis incidence showed a steady decreasing trend, but the number of cases was still very high. Gender differences existed in TB incidence in Nepal. Higher rates were observed in the Terai Region and urban areas. These findings highlight the need for the tuberculosis control measures to remain on a sustained and long-term basis for the high TB burden rate of Nepal.
Association of high sensitivity C-reactive protein concentrations and metabolic syndrome among Thai adults
Authors: Hillman Andrew J. , Lohsoonthorn Vitool , Hanvivatvong Orrawadee , Jiamjarasrangsi Wiroj
Published: April 2018

Background: Limited information is available regarding associations of metabolic syndrome with C-reactive protein (CRP) concentrations among Asian populations. Objective: Investigate the association of high sensitivity CRP (hsCRP) concentrations and metabolic syndrome among Thai adults. Methods: This cross-sectional study was comprised of 467 Thai participants (209 men and 258 women) receiving annual health check-up. Spearman’s rank correlation coefficients were used to assess the associations between metabolic parameters (age, waist circumference, blood pressure, triglycerides, HDL-C, fasting plasma glucose, fasting insulin and uric acid) with hsCRP concentrations for men and women, respectively. Multivariable logistic regression procedures were used to estimate the risk (odds ratios (OR), and 95% confidence intervals (CI) of metabolic syndrome according to low, moderate, and high hsCRP concentrations (<1.0, 1.0-3.0, and >3.0 mg/L, respectively). Results: Measures of adiposity and fasting insulin were positively and significantly correlated with hsCRP concentrations among women with and without metabolic syndrome. Similar associations were observed among men without metabolic syndrome. After controlling for confounders, moderately elevated hsCRP concentrations were associated with a 2.38-fold increased risk of metabolic syndrome (OR=2.38, 95%CI=1.20-4.72) among men. Men with high hsCRP concentrations had a 5.45-fold increased risk of metabolic syndrome (OR=5.45, 95%CI=2.24- 13.27) when compared with those who had low hsCRP concentrations. The corresponding OR for women with moderately elevated and high hsCRP concentrations were 4.92 (OR=4.92, 95%CI=2.34-10.35) and 11.93 (OR=11.93, 95%CI=5.54-25.72), respectively. Conclusions: These findings are consistent with the literature suggesting a role of hsCRP as a biomarker for metabolic syndrome.
Stapes fixation surgery: stapedectomy versus stapedotomy
Authors: Thamjarayakul Taweekiat , Supiyaphun Pakpoom , Snidvongs Kornkiat
Published: April 2018

Background: Stapedectomy and stapedotomy are the standard techniques for stapes fixation surgery. Both techniques depend on the size of window opening (total, partial stapedectomy and small-hole stapedotomy) and the type of prosthesis used. Outcome of technique and prosthesis are controversy. Objective: Evaluate the outcomes of the two surgical techniques (stapedectomy/stapedotomy) and two sizes of prosthesis (Cawthorn 0.6mm/0.3mm) in terms of effectiveness and safety. Material and methods: Sixty-four medical records of patients undergoing stapedectomy or stapedotomy between the year 1995 and 2005 were reviewed. The subjects were classified into three groups including 0.6-mm stapedectomy, 0.6-mm and 0.3-mm stapedotomy group. The pre and post operative air-conduction threshold (AC) and air-bone gap (A-B gap) were compared for each group. The pre-and post-operative differences in pure tone average of AC, pure tone average of bone conduction threshold (BC), AB gap, AC at 4KHz, BC at 4KHz, AC at 8KHz, and speech discrimination score (SDS) were analyzed. The surgical complications were also compared. Results: Means of post-operative AC, and A-B gap were significantly better in all three groups. The mean of postoperative AC at 4KHz was significantly improved only in stapedotomy groups (0.6-mm and 0.3-mm stapedotomy). To compare the hearing outcomes among the three groups, there were no statistically significant differences between 0.6-mm stapedectomy vs. 0.6-mm stapedotomy, and between 0.6- mm vs. 0.3-mm stapedotomy. The complications were found in all three groups. The 0.3-mm stapedotomy had the lowest rate. Conclusion: Stapedectomy versus stapedotomy yields comparable hearing outcomes but stapedotomy results had a better success rate than the stapedectomy. For 0.6-mm stapedotomy vs. 0.3-mm stapedotomy, the overall results in both groups are not significantly different, in terms of both the hearing outcomes and the success rate. In terms of complication rate, 0.6-mm stapedectomy had the highest rate, while 0.3-mm stapedotomy had the lowest.
Safety and efficacy of a new imidazole fungicide, Sertaconazole, in the treatment of fungal vulvo-vaginitis: a comparative study using Fluconazole and Clotrimazole
Authors: Roongpisuthipong Anuvat , Chalermchockcharoenkit Amphan , Sirimai Korakot , Wanitpongpan Prapat , Jaishuen Atthapon , Foongladda Suporn , Kongkergkiat Nisit , Prymanee Jeerawan
Published: April 2018

Background: Sertaconazole is a new imidazole fungicide introduced for vulvo-vaginal candidiasis. It has an azole group with benzothiophene that inhibits biosynthesis of ergosterol and brings about a massive leak of cytoplasm with consequent fungal cell death. Objective: Assess the safety and efficacy of Sertaconazole in the treatment of fungal vulvo-vaginitis for comparison with Fluconazole and Clotrimazole. Subjects and methods: One-hundred eighty-eight outpatients with fungal vulvo-vaginitis were recruited at Siriraj Hospital, Thailand between August 31, 2004 and January 30, 2006. The patients were given Sertaconazole, Fluconazole, or Clotrimazole, and received vaginal swab and culture for fungus at seventh and 28th days after treatment. Results: Out of 188 cases, 177 cases were followed-up completely. Sertaconazole group included 66 cases where 35 cure, 20 fail, and 7 recurrent cases. Fluconazole group included 60 cases and had 37 cure, six fail, and 20 recurrence cases. Clotrimazole group included 55 cases and had 32 cure, nine fail and 11 recurrent cases. There were risk factors of fungal vulvo-vaginitis, including frequent micturition and small toilet shower flushing. Conclusion: Sertaconazole had similar effectiveness and less side-effect as compared with Fluconazole and Clotrimazole. It appeared to work well with lowest recurrence.
Postoperative opacification of polymethylmethacrylateintraocular lens
Authors: Thanathanee Onsiri , Ratanapakorn Tanapat , Suwan-apichon Olan
Published: April 2018

Background: Opacification of ophthalmic devices has been previously reported in silicone scleral buckle, Molteno implant, and intraocular lens opacification. However, there is no report on polymethyl methacrylate (PMMA) intraocular lens (IOL) calcification. Objective: Report the clinical feature, histopathologic and spectrophotometer analysis of opacified three-piece PMMA IOL. Method: A 60-year-old diabetic patient reported decreased visual acuity in her right eye, which had undergone phacoemulsification with PMMA IOL implantation. The ophthalmic examination revealed a white homogeneous opacification of posterior surface of the IOL. The explanted IOL was analyzed using scanning electron microscopy, energy dispersive spectroscopy, and alizarin red staining. Results: The scanning electron microscope analysis showed granular deposits on posterior surface of the IOL. Using energy dispersive spectroscopy analysis, calcium and phosphate peaks were revealed, which was confirmed by positive for alizarin red staining. Conclusion: This case report provided evidence of PMMA IOL calcification caused by calcium and phosphate deposits. The possible etiologies were extrinsic and/or intrinsic factors.
Broadening our perspectives as physicians: one world-one medicine-one health
Authors: Dedmon Robert E.
Published: April 2018

There are no passengers on spaceship earth. We are all crew ! (Marshall Mcluhan). Understanding the emergence of new zoonotic agents requires knowledge of pathogen biodiversity in wildlife, human-wildlife interactions, anthropogenic pressures on wildlife populations, and changes in society and human behavior [1].
d4T: keep it or abandon it?
Authors: Hill Andrew
Published: April 2018

Stavudine is a nucleoside analogue used widely for first-line treatment of HIV in developing and middleincome countries. The World Health Organization recommended that all patients should switch to stavudine (30mg BID). However, there is evidence from the dose-ranging trials that patients with body weight below 60kg should use a dose of 20mg BID. For patients who show adverse events on stavudine, a switch to other nucleoside analogues can be considered. This article reviews d4T to study if it should be kept or abandoned.
Cost-effectiveness of budesonide/formoterol maintenance and rescue therapy in Thailand
Authors: Boonsawat Watchara
Published: April 2018

Background: The prevalence of asthma has increased significantly in Thailand. Budesonide/formoterol maintenance and reliever therapy has been available for several years. However, cost-effectiveness of such treatment has never been examined in Thailand. Objective: Design a cost-effectiveness (CE) analysis conducted from a Thai healthcare perspective as a piggyback study accompanying a recent clinical trial. Methods: The CE analysis was conducted from the healthcare provider’s perspective. Data were collected from a six-month, double-blind, multi-national study involving 3321 symptomatic asthma patients randomized to either: bud/form maintenance and reliever therapy, bud/form 320/9 μg bid plus terbutaline as needed, or salmeterol/ fluticasone (salm/flut) 25/125 μg two inhalations bid plus terbutaline as needed. Efficacy was determined as the number of exacerbations per patient during a six-month period. Thai unit costs were collected from the national sources and expert opinions, and applied to the resource use data for a deterministic economic evaluation. Results: There were significantly fewer exacerbations in the bud/form maintenance and reliever therapy (0.12 events/patient/6 months) group vs. the bud/form (0.16 events/patient/6 months, p <0.01), or salm/flut groups (0.19 events/patient/6 months, p <0.001). Total direct costs (healthcare visits and drug costs) were 27.0% and 5.9% lower in the bud/form maintenance and reliever therapy group than in the bud/form and salm/flut groups, respectively. Conclusion: Bud/form maintenance and reliever therapy was associated with significantly fewer exacerbations, compared to other fixed combination treatments in a recent multi-national clinical trial. This might result in lower direct costs if applied to the Thai healthcare system.
Anterior displacement of anus: a common association with constipation in infancy
Authors: Rerksuppaphol Sanguansak , Rerksuppaphol Lakkana
Published: April 2018

Background: Anterior displacement of the anus (ADA), a common congenital abnormality of anorectal region, has been recognized as a common cause of constipation. However, the more recent studies have failed to demonstrate an association between the anterior displacement and constipation self. Objective: Investigate the association between ADA and constipation. Methods: Four hundred and three neonates have been examined and their anal position index (API) has been determined. API less than 0.46 and 0.34 in males and females, respectively, is defined as ADA. A 6-month prospective cohort study has been conducted to evaluate the association between ADA and constipation. Results: Overall incidence of ADA is 24.8%, while the incidence is significantly higher in females than males (32.0% and 17.7%, respectively; p <0.01). Compared to the first child, later birth order, especially the second child, trends to have an increased risk of ADA (Odd ratio=1.75; 95%CI=1.06-2.90). Average maternal age of ADA is higher than control (28.2 and 26.6 years, respectively; p=0.02). Overall incidence of constipation is 10.1% without any difference between ADA group and control (12.0 and 9.5%, respectively). Nevertheless, at six months incidence of constipation is higher in ADA than in control (6.7% and 0.8%, respectively; p < 0.01). The incidences of ADA in infants with constipated events at 2, 4 and 6 months of age are 10.0%, 33.3%, and 71.4%, respectively. Conclusion: ADA is a common finding with reported incidence of one-quarter of neonates. Female genre, later birth order and higher maternal age are risk factors of ADA. Children with ADA have an increased tendency toward constipation corresponding with increasing age. API measurement during pediatric examination is recommended to achieve a complete evaluation of infancy constipation.
Association of Helicobacter pylori with colorectal cancer development
Authors: Alsamak Fadi Fouad , Abdulamir Ahmed Sahib , Mahdi Laila Khalid , Alnaib Khalid , Bakar Fatimah Abu
Published: April 2018

Background: Helicobacter pylori (H. pylori) may be associated with colorectal cancer. However, the underlying mechanisms are still unclear. Objectives: Explore the serostatus of H. pylori cytotoxicity-associated gene A product (CagA) in patients with colorectal carcinoma, and assess the association of H. pylori with colorectal cancer via c-Myc and MUC-2 proteins at tumor tissues. Methods: H. pylori CagA IgG antibodies were screened using enzyme-linked immunosorbent assay (ELISA) in 30 patients with colorectal carcinoma and 30 cancer-free control subjects. Paraffin-embedded blocks were examined for the expression of c-Myc and MUC-2 protein by immunohistochemistry. Results: H. pylori CagA seropositivity increased significantly among colorectal cancer patients (p <0.05). The expression of c-Myc and MUC-2 in colorectal carcinoma patients was over-expressed (80%), and downexpressed (63%) in resection margins (p <0.05). c-Myc over-expression and MUC-2 down-expression were associated with CagA-positive rather than CagA-negative H. pylori patients. In 16 CagA seropositive vs. 14 CagA seronegative patients, the expression rate was 97.3% vs. 64.2% and 33.3% vs. 78.5% for cMyc and MUC-2, respectively. CagA IgG level was significantly higher in positive than in negative c-Myc patients (p= 0.036), and in negative than in positive MUC-2 patients (p= 0.044). c-Myc and MUC-2 were positively and inversely correlated with CagA IgG level (p <0.05). Conclusions: CagA-seropositive H. pylori is most probably associated with colorectal cancer development. Part of the underlying mechanism for such association might be via alterations in expression of MUC-2, which depletes the mucous protective layer in the colo-rectum, and c-Myc, which stimulates the growth of cancerous cells.
Effects of intense exercise on biochemical and histological changes in rat liver and pancreas
Authors: Praphatsorn Panu , Thong-Ngam Duangporn , Kulaputana Onanong , Klaikeaw Naruemon
Published: April 2018

Background: Exercise has various effects on hepatic and pancreatic function. There is little information available for effects of exercise on histopathological changes in the liver and pancreas. Objective: Investigate the effect of intensive exercise on blood biochemical changes and histopathology in rat liver and pancreas. Materials and methods: Male Sprague-Dawley rats were randomly divided into five groups: 1 (normal control): no exercise, 2 (exercise 75% VO2max): running on treadmill at 75% VO2max and sacrificed immediately after exercise, 3 (exercise 75% VO2max+6 hours): running on treadmill at 75% VO2max and sacrificed at six hours after exercise, 4 (exercise 90% VO2max): running on treadmill at 90% VO2max and immediately sacrificed after exercise, 5 (exercise 90% VO2max+6 hours): running on treadmill at 90% VO2max and sacrificed at six hours after exercise. Samples of blood, liver and pancreas were collected at the end of each experiment. Results: The levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) increased significantly in group 2 and 4, compared with normal control. Serum total bilirubin (TB) and enzyme lipase increased significantly in group 4 compared with normal control. In all group of exercise, liver histopathology showed hepatocyte edema and necroinflammation, and pancreas showed congestion and edema. Conclusion: High-intensity exercise at 75% and 90% VO2max caused an increase of biochemical parametes in liver and pancreas. The levels of exercise also caused histopathology changes in the liver and pancreas.
Airflow inside the nasal cavity: visualization using computational fluid dynamics
Authors: Zubair Mohammed , Riazuddin Vizy Nazira , Abdullah Mohammed Zulkifly , Ismail Rushdan , Shuaib Ibrahim Lutfi , Hamid Suzina Abdul , Ahmad Kamarul Arifin
Published: April 2018

Background: It is of clinical importance to examine the nasal cavity pre-operatively on surgical treatments. However, there is no simple and easy way to measure airflow in the nasal cavity. Objectives: Visualize the flow features inside the nasal cavity using computational fluid dynamics (CFD) method, and study the effect of different breathing rates on nasal function. Method: A three-dimensional nasal cavity model was reconstructed based on computed tomographic images of a healthy Malaysian adult nose. Navier-Stokes and continuity equations for steady airflow were solved numerically to examine the inspiratory nasal flow. Results: The flow resistance obtained varied from 0.026 to 0.124 Pa.s/mL at flow-rate from 7.5 L/min to 40 L/min. Flow rates by breathing had significant influence on airflow velocity and wall shear-stress in the vestibule and nasal valve region. Conclusion: Airflow simulations based on CFD is most useful for better understanding of flow phenomenon inside the nasal cavity.
Adenosine pretreatment attenuates angiotensin II-mediated p38 MAPK activation in a protein kinase A dependent manner
Authors: Yaghooti Hamid , Firoozrai Mohsen , Fallah Soudabeh , Khorramizadeh Mohammad Reza
Published: April 2018

Background: Adenosine is known as a protective and anti-inflammatory nucleoside. Angiotensin II is the main hormone of the renin-angiotensin system. It is associated with endothelial permeability, recruitment, and activation of the immune cells through induction of inflammatory mediators. Matrix metalloproteinase-9 (MMP-9) plays an important role in inflammatory processes mediated by macrophages. Objectives: Investigate whether adenosine pretreatment modulates angiotensin II-induced MMP-9 expression and activation of signaling molecules. Methods: Human monocytic U-937 cells were treated with either adenosine or angiotensin II alone or angiotensin II following a pretreatment with adenosine. Supernatants were analyzed for MMP-9 activity by zymography method. MMP-9 gene expression was analyzed using real-time PCR. Activation of inflammatory mediators IκB-α, NF-κB, JNK, p38 MAPK, and STAT3 were analyzed by a multi-target ELISA kit. Association of Protein kinase A (PKA) in adenosine effects was studied by pre-incubation with H89, a selective PKA inhibitor. Results: Treatment of the cells with angiotensin II significantly increased MMP-9 production (p <0.05). Adenosine pretreatment did not attenuate this angiotensin II effect. Angiotensin II treatment induced NF-κB, JNK and p38 activation. Pretreatment with adenosine prior to angiotensin II stimulation showed a 40% inhibitory effect on p38 induction (p <0.05). This effect was reversed by PKA inhibition. Conclusion: The present data confirmed that monocytic MMP-9 was a target gene for angiotensin II. Adenosine pretreatment did not inhibit MMP-9 increase in response to angiotensin II. However, it showed a potential inhibitory effect on angiotensin II inflammatory signaling.