bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimation of mean ND: Yag laser capsulotomy energy levels for membranous and fibrous posterior capsular opacification
Authors: Bhargava R , Kumar P , Prakash A , Chaudhary KP
Published: February 2012

Introduction: Posterior capsule opacification (PCO) is a visually-disabling complication of cataract surgery. Objective: To estimate energy levels for capsulotomy in various subtypes of PCO (membranous, fibrous and fibro-membranous). Materials and methods: A total of 215 patients with PCO were randomly selected and evaluated for Nd: Yag laser capsulotomy, after a quiet post-operative course of 3 months. The ocular area was arbitrarily divided into three zones: YAG zone (3mm), Optical zone (6 mm) and the peripheral zone (12mm). A colour code was assigned to the subtype of PCO in these zones: fibrous green and membranous blue. The type of PCO in each quadrant of YAG zone was estimated in percentage. Results: The statistic mean values of initial energy levels were 1.80 mJ for membranous PCO, 3.17 mJ for fibrous PCO and 2.73 mJ for fibro-membranous PCO. The mean summated energy levels for membranous PCO was 22.80 mJ for membranous PCO, 80.06 mJ for fibrous PCO and 80.48 mJ for fibro-membranous type. Conclusion: Colour coding is extremely helpful for quantification of the type of PCO and in deciding the initial energy level necessary to create capsulotomy. Fibro-membranous PCO required more summated energy despite a lower starting energy. Therefore, we recommend firing the initial shot in fibrous portion in case of fibrous-membranous type of PCO. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5861 NEPJOPH 2012; 4(1): 108-113
Outcomes of manual small incision cataract surgery under topical anesthesia with lignocaine 2% jelly
Authors: Mithal C , Agarwal P , Mithal N
Published: February 2012

Introduction: The manual small incision cataract surgery (MSICS) is the surgery of choice in countries with a huge back-log of cataract blindness. Objective: To evaluate the outcome of manual small incision cataract surgery (MSICS) under topical anesthesia with lignocaine 2 % jelly. Materials and methods: This study was a prospective interventional case series. One hundred and twenty eight patients of senile cataract were operated by MSICS under topical anesthesia using lignocaine 2% jelly. No intra-cameral anesthesia was used. The patients and the single operating surgeon were given a questionnaire to evaluate their experience in terms of pain, surgical experience and complications. Results: The mean pain score was 0.82 (SD ± 0.97). Seventy-one patients (55.4 %) had a pain score of zero, that is, no pain. One hundred and twenty one patients (94.5 %) had a score of 3 or less, that is, mild to none pain. All the surgeries except two were complicationfree and the surgeon’s experience was favorable in terms of the patient’s cooperation, anterior chamber stability, difficulty, and complications. Conclusions: MSICS can be performed under topical anesthesia with lignocaine jelly, which makes the surgery patient-friendly, without compromising the outcome. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5862 NEPJOPH 2012; 4(1): 114-118
Causative organisms in microbial keratitis, their sensitivity pattern and treatment outcome in western Nepal
Authors: Dhakwa K , Sharma MK , Bajimaya S , Dwivedi AK , Rai S KC
Published: February 2012

Introduction: Corneal infection is one of the major causes of monocular blindness in developing countries. Objective: To determine the epidemiological characteristics, predisposing factors, microbiological pattern, sensitivity pattern and treatment outcome of microbial keratitis. Materials and methods: A retrospective analysis of hospital records of 414 patients with diagnosed infective keratitis was done. The outcome measures were microbial isolates, their sensitivity to therapeutic agents and treatment outcome. Results: Of the total, 312 (75.4 %) patients were farmers by profession, 138 (33.3 %) had a history of ocular trauma and 17(4.1 %) were using topical corticosteroids. Among the 138 cases of the corneal ulcer with trauma, 52 (37.68 %) had fungi isolated in culture (RR=0.54, 95% CI = 0.44 – 0.68) and 32 (23.19 %) had a bacterial growth. Cultures were positive in 300 (72.5 %) cases, having 138 (33.3 %) patients with pure fungal infection, 121 (29.2 %) with pure bacterial and 41 (9.9 %) with mixed infection. Fusarium spp was the most common fungal pathogen while Staphylococcus epidermidis was the commonest bacterial isolate. The most sensitive antibiotics for the Gram positive bacteria was cephazolin (84.92 %), while for Gram negative, ciprofloxacin and ofloxacin were the most effective (79.31 %). Of 414 cases of corneal ulcers, 363 (87.7 %) cases healed completely. Conclusion: Microbial keratitis is mostly seen in farmers in this part of the world. Fusarium and Staphylococcus epidermidis were the most common isolates. Cephazoline and ofloxacin were the most effective antibiotics for Gram positive and Gram negative organisms respectively. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5863 NEPJOPH 2012; 4(1): 119-127
Optical coherence tomographic assessment of macular thickness and morphological patterns in diabetic macular edema: Prognosis after modified grid photocoagulation
Authors: Shrestha A , Maharjan N , Shrestha A , Thapa R , Poudyal G
Published: February 2012

Introduction: The topographic mapping is useful for monitoring patients for the development of macular edema and following the resolution of edema after laser treatment. Objectives: To evaluate the usefulness of optical coherence tomography (OCT) for mapping of macula after laser therapy in clinically significant macular edema (CSME). Materials and methods: A prospective study was carried out enrolling 60 eyes of 35 patients with the diagnosis of CSME. OCT was performed at first visit and every successive follow up visit. The retinal thickness was measured automatically using OCT retinal mapping software. Statistics: Correlation between vision status and central macular thickness (CMT) was done using the Spearman’s correlation test. The analysis of variance (ANOVA) and independent t-test were used for comparison of groups. Results: The OCT revealed sponge like thickening pattern (ST) in 67.4 % followed by cystoid macular edema (CME) in 19.6 %. Best corrected visual acuity (BCVA) improved in 89.1 % after 6 months of treatment. There was high correlation between vision status and CMT (P =<0.001). The mean values of baseline CMT were 301.68 (±134.738), 434.83 (±180.758), 518.67 (±275.184), 327 (±108.393) and 334.85 (±158.91) microns for the OCT patterns of ST, CME, sub-foveal detachment (SFD), vitreo-macular interface abnormality (VMIA) and average CMT respectively (p=0.042). Conclusion: OCT is a useful tool for evaluating CSME. It can show the various morphological variants of CSME while the BCVA and CMT are fairly different. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5864 NEPJOPH 2012; 4(1): 128-133
Profile of pediatric ocular trauma in mid western hilly region of Nepal
Authors: Dulal S , Ale JB , Sapkota YD
Published: February 2012

Introduction: Majority of blinding ocular injuries can be prevented. Objective: To describe the epidemiology of ocular trauma in children. Material and methods: A retrospective review of medical records of the patients aged below 16 years who attended the Himalaya Eye Hospital, Pokhara with history of ocular injury. Results: Of 6,829 pediatric patients, 554 (8.1 %) had ocular trauma. The ocular trauma was more prevalent (38.1 %) in the age group of 5 – 10 years followed by 10-15 years (16.6 %). The boys (62 % vs 38 %) were more prone to ocular trauma than girls (RR = 1.7 and 95 % CI = 1.41 - 2.02). Of 554 ocular injuries, 32 (5.8 %) were open globe injuries. Sub-conjunctival hemorrhage was the commonest presenting finding in 96 (17.3 %) subjects. Forty-seven (8.5 %) of them attended the hospital after 15 days of injury. Home was the most common place for trauma (n =204, 36.8%), followed by playground (n = 140, 25.3 %). Conclusion: Children between the ages of 5-10 years are most vulnerable to ocular trauma. Home is the commonest place for ocular injury followed by playground. By adopting some common safety factors or by reducing the ocular injury risks factor, ocular trauma can be greatly reduced. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5865 NEPJOPH 2012; 4(1): 134-137
Cataract surgery in children: Controversies and practices
Authors: Shrestha UD
Published: February 2012

Pediatric cataract is totally different from adult cataract. The objective of this review article is to describe the peculiarities of pediatric cataract and the controversies and practices in pediatric cataract surgery. The differences in the surgical technique are discussed in the article. There are lots of controversies regarding IOL implantation in children. The result of the review is that the pediatric cataract surgery should be performed in between 6-8 weeks of age. There is no contra-indication for IOL implantation. Surgeons can implant either polymethylmethacrylate (PMMA) or Acrysoft foldable IOL. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5866 NEPJOPH 2012; 4(1): 138-149
Ocular changes in pregnancy
Authors: Garg P , Aggarwal P
Published: February 2012

Pregnancy is often associated with ocular changes which may be more commonly transient but occasionally, permanent. The ocular effects of pregnancy may be physiological or pathological or may be modifications of pre-existing conditions. Physiological changes include increased pigmentation around the cheeks, ptosis, changes in cornea and refractive status, decreased intraocular pressure. These usually resolve post partum. Pre-existing diseases such as Graves’ disease, Retinitis pigmentosa, Optic neuritis, should be monitored due to their remission or relapses in pregnancy. There may be worsening of Diabetic retinopathy, and Central serous chorio-retinopathy with increased risk of Retinal detachment. Conditions like Glaucoma and Non infectious uveal inflammatory disorders may even improve transiently. Pre-eclampsia and eclampsia could result in hypertensive retinopathy, exudative retinal detachment and cortical blindness. Neuro-ophthalmological disorders such as venous sinus thrombosis, benign intracranial hypertension, pituitary adenoma, meningioma and optic neuritis should be kept in mind as differential diagnosis in pregnant women presenting with visual acuity loss, visual field loss, persistent headaches or oculomotor palsies. Use of ophthalmic drugs can affect fetal health during pregnancy. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5867 NEPJOPH 2012; 4(1): 150-161
Hooch blindness: a community study report on a few indoor patients of toxic optic neuropathy following consumption of adulterated alcohol in West Bengal
Authors: Samanta SK , Fariduddin K , Mahapatra N , Bhunia J , Mondal P
Published: February 2012

Introduction: Hooch blindness following consumption of adulterated alcohol has been known for centuries. Objective: To study cases of mass alcohol intoxication followed by Hooch blindness in eastern India. Materials and methods: Ten patients of toxic amblyopia collected from a community mass intoxication following consumption of adulterated alcohol were studied. The parameters studied were the findings of ocular examination, applanation tonometry, automated perimetry and visual-evoked potential (VEP). As a part of the special investigations fundus photography and OCT were done. Routine blood examination, fasting lipid profile, postprandial blood sugar estimation were done . All patients were treated with injections of methyl prednisolone and Hydroxy cobalamine, antioxidants and local neuro-protective agents. Results: Along with diminished vision (from NPL to 3/60), marked pallor of the disc without any other retinal change were noted. The amplitude on VEP was significantly reduced. However, visual improvement (up to 6/18) in 7 patients was observed within 6 weeks of treatment. Conclusion: Hooch blindness in India can be prevented by creating awareness among the target population and reducing the cost of country liquor. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5868 NEPJOPH 2012; 4(1): 162-164
Keratoprosthesis, Dohlman Type I device for a patient with repeated corneal graft failure
Authors: Bajracharya L , Gurung R , Tabin G
Published: February 2012

Background: Keratoprosthesis (Kpro) surgery is performed in patients in whom traditional penetrating keratoplasty (PK) surgery has no hope for graft survival. The burden of corneal blindness is high in a developing country like Nepal. Case: A thirty-year-old man, with multiple graft failure in his only eye, underwent Kpro surgery. He had ambulatory vision and a stable Kpro 29 months after the surgery. Conclusion: Kpro surgery has been introduced in the country with this as the first case. Patients with poor prognosis for PK can benefit from this type of surgery. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5869 NEPJOPH 2012; 4(1): 165-169
A case of nocardia keratitis treated successfully with topical amikacin
Authors: Bajracharya L , Gurung R
Published: February 2012

Background: Keratitis caused by the nocardia species is rare in clinical practice and can cause confusion during treatment because it often mimics fungal keratitis. Case: This is a case of nocardia keratitis occurring in a forty-year-old lady without any predisposing factors. It was initially treated as fungal keratitis, then as herpes simplex viral keratitis, but once the organism was known, it was successfully treated with topical fortified amikacin 14 mg/ml (1.4 %). Conclusion: Delay in diagnosis can occur in nocardia keratitis due to its rarity in occurrence. It responds well if proper therapy is instituted on time. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5870 NEPJOPH 2012; 4(1): 170-173
Corneal stromal pseudohypopyon in a pseudophakic patient
Authors: Agrawal A , Pratap VB , Suman S , Pal VK
Published: February 2012

Background: Corneal stromal pseudohypopyon is a rare entity. Case: A 65-year-old female developed a suture abscess in her pseudophakic right eye, three years after conventional extra-capsular cataract extraction with posterior chamber intraocular lens implantation. Pus from the suture abscess tracked down the corneal stromal layers and formed a pus level leading to the appearance of a corneal intra-stromal pseudo-hypopyon. Conclusion:This case is unique due to its unusual clinical presentation and highlights the fact that corneal pseudohypopyon may occur without any associated anterior chamber hypopyon or Descemet’s detachment. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5871 NEPJOPH 2012; 4(1): 174-175
Aberrant regeneration of the third cranial nerve
Authors: Shrestha UD , Adhikari S
Published: February 2012

Background: Aberrant regeneration of the third cranial nerve is most commonly due to its damage by trauma. Case: A ten-month old child presented with the history of a fall from a four-storey building. She developed traumatic third nerve palsy and eventually the clinical features of aberrant regeneration of the third cranial nerve. The adduction of the eye improved over time. She was advised for patching for the strabismic amblyopia as well. Conclusion: Traumatic third nerve palsy may result in aberrant regeneration of the third cranial nerve. In younger patients, motility of the eye in different gazes may improve over time. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5872 NEPJOPH 2012; 4(1): 176-178
A rare case of collodion baby with ophthalmic involvement
Authors: Bhardwaj U , Phougat A , Dey M , Raut S , Srivastav G , Gupta Y
Published: February 2012

Background: Ichthyosis is an infrequent clinical entity worldwide (1:300,000 births). When diagnosed in a newborn, two forms can be identified: collodion baby and its most severe form, harlequin fetus or maligna keratoma. In both cases, clinical manifestations are thick and hard skin with deep splits. The splits are more prominent in the flexion areas. Case: We report a case of a 4- day-old baby who was referred to JNMC Eye OPD by the Pediatric Department of the JNMC. He was having severe bilateral ectropion of the upper lids and chemosis of conjuntiva, without corneal involvement. There was distortion of the pinna and peeling of the skin, more over the chest around the neck region and over the flexor aspect of limbs. Conclusion: Management of collodion baby requires a multi-disciplinary approach. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5874 NEPJOPH 2012; 4(1): 184-186
Post-traumatic endophthalmitis with retained intraocular foreign body – a case report with review of literature
Authors: Aggarwal P , Garg P , Sidhu HK , Mehta S
Published: February 2012

Introduction: Endophthalmitis following penetrating eye injuries has a poor prognosis and presents a diagnostic and therapeutic challenge. The aim of reporting this case was to identify the causative organism of post-traumatic endophthalmitis due to retained iron foreign body and to highlight the importance of carrying out diagnostic investigations. Case: A 20-year-old male presented with tenderness and blurring in the right eye 3 days after injury with an iron particle. Visual acuity was perception of light with accurate projection of rays in all quadrants. The slit-lamp examination revealed ciliary and conjuctival congestion. There was a verticallyoriented self-sealed, full-thickness laceration in the cornea adjacent to the limbus. The anterior chamber evaluation revealed + 4 cells, +3 flare and a 2 - mm hypopyon. There was cataract with a ruptured anterior lens capsule. Posterior synechae was present at 5’0 clock position. B-scan showed echogenic metallic foreign body in the posterior chamber, with vitreous opacities. The vitreous tap was done and intra-vitreal antibiotics injections of 1 mg in 0.1 ml vancomycin and 2.25 mg in 0.1 ml ceftazidime were given. Culture and sensitivity of the tap revealed staphylococcus as the causative agent. The patient was put on moxifloxacin eye drops, fortified tobramycin and cephazolin eye drops 1 hourly along with atropine eye drops. The patient was referred to the vitreoretinal surgeon urgently for pars plana vitrectomy and foreign body removal. At follow up, the patient’s BCVA was improved. Conclusion: The causative organism isolated was similar to that documented in other reports. Endophthalmitis must be treated with vitrectomy and intra-vitreal injections of antibiotics after a proper vitreous tap. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5875 NEPJOPH 2012; 4(1): 187-190
Epithelial iris cyst after cataract surgery
Authors: Chaudhry M , Grover S , Sood N , Gupta R
Published: February 2012

We report a case of an epithelial inclusion cyst of the iris following cataract surgery that was successfully treated with en bloc excision, after an unsuccessful attempt with Neodymiumdoped Yttrium Aluminium Garnet (Nd YAG) Laser. A 60-year-old man had undergone cataract surgery two years back. One year later, he developed a pigmented epithelial inclusion cyst of the iris which progressively increased in size. His vision reduced to finger counting close to face as the cyst grew over the pupil. We performed Nd YAG laser cystotomy of the cyst wall initially, but the treated lesion recurred. So we performed an en bloc iris excision of the cyst with sector iridectomy. There was no recurrence as determined by slit lamp examination at six months after treatment. Hence, we conclude that en bloc excision can be used to effectively treat epithelial inclusion cyst of the iris. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5876 NEPJOPH 2012; 4(1): 191-193
Congenital isolated bilateral upper lid coloboma
Authors: Shrestha JB , Shrestha GS , Joshi N , Karmacharya PC
Published: February 2012

A case of congenital isolated coloboma of both the upper lids from just lateral to the lacrimal punctum up to the medial half, with symblepharon in the region of lower eyelid, was studied in a 7-year-old female child. She did not have any other associated anomalies. The birth and family histories were normal. The puncta were normal in position and well apposed to the globe. The closure of the lid coloboma was done by release of symblepharon along with direct closure of the defect, for the right eye first, and one month later, for the left eye. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5877 NEPJOPH 2012; 4(1): 194-196
Vancomycin-resistant Staphylococcus aureus (VRSA) from Nepal: a cocktail story
Authors: Dumre SP
Published: February 2012

DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5879 NEPJOPH 2012; 4(1): 199-200
Role of low dose mitomycin C in pterygium surgery
Authors: Thakur SKD , Kaini KR , Panda A
Published: February 2012

DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5881 NEPJOPH 2012; 4(1): 203-205
Preparedness for patient safety in orbital regional anesthesia in Nepal
Authors: Bhattarai BK
Published: February 2012

DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5882 NEPJOPH 2012; 4(1): 206-207
Digital archive project to catalogue exported Japanese decorative arts
Authors: Bincsik Monika , Maezaki Shinya , Hattori Kenji
Published: February 2012

In Europe, Japanese ceramic and lacquer objects have been collected and used as interior decoration since the early seventeenth century. In the nineteenth century, the worldwide fashion for Japonisme generated an extensive trade in various Japanese decorative arts. Consequently, museums and private collections all over the world have rich holdings of Japanese decorative arts. Despite their popularity and profound influence on Western applied arts, the systematic research of Japanese decorative arts in Western collections is backward compared to the investigation of other art forms. It is actually difficult to gain access to the objects scattered in numerous collections or to achieve high-quality images, not to mention that there are only a few specialists capable of documenting the objects. Generally, that is why there are only very few online databases dedicated to decorative arts. The Art Research Centre, Ritsumeikan University (Kyoto, Japan), has developed databases of various Japanese cultural assets, tangible as well as intangible art forms and, based on the expertise in developing scholarly databases, has launched online image databases of three-dimensional art objects. The purpose of the project is to advance searchable, academic databases and to foster international cooperation between researchers and students of Japanese art by sharing high-quality images on the Web.
A Screening Method for Assessing Cumulative Impacts
Authors: Alexeeff George V. , Faust John B. , August Laura Meehan , Milanes Carmen , Randles Karen , Zeise Lauren , Denton Joan
Published: February 2012

The California Environmental Protection Agency (Cal/EPA) Environmental Justice Action Plan calls for guidelines for evaluating “cumulative impacts.” As a first step toward such guidelines, a screening methodology for assessing cumulative impacts in communities was developed. The method, presented here, is based on the working definition of cumulative impacts adopted by Cal/EPA [1]: “Cumulative impacts means exposures, public health or environmental effects from the combined emissions and discharges in a geographic area, including environmental pollution from all sources, whether single or multi-media, routinely, accidentally, or otherwise released. Impacts will take into account sensitive populations and socio-economic factors, where applicable and to the extent data are available.” The screening methodology is built on this definition as well as current scientific understanding of environmental pollution and its adverse impacts on health, including the influence of both intrinsic, biological factors and non-intrinsic socioeconomic factors in mediating the effects of pollutant exposures. It addresses disparities in the distribution of pollution and health outcomes. The methodology provides a science-based tool to screen places for relative cumulative impacts, incorporating both the pollution burden on a community- including exposures to pollutants, their public health and environmental effects- and community characteristics, specifically sensitivity and socioeconomic factors. The screening methodology provides relative rankings to distinguish more highly impacted communities from less impacted ones. It may also help identify which factors are the greatest contributors to a community’s cumulative impact. It is not designed to provide quantitative estimates of community-level health impacts. A pilot screening analysis is presented here to illustrate the application of this methodology. Once guidelines are adopted, the methodology can serve as a screening tool to help Cal/EPA programs prioritize their activities and target those communities with the greatest cumulative impacts.
Antioxidant-Induced Stress
Authors: Villanueva Cleva , Kross Robert D.
Published: February 2012

Antioxidants are among the most popular health-protecting products, sold worldwide without prescription. Indeed, there are many reports showing the benefits of antioxidants but only a few questioning the possible harmful effects of these “drugs”. The normal balance between antioxidants and free radicals in the body is offset when either of these forces prevails. The available evidence on the harmful effects of antioxidants is analyzed in this review. In summary, a hypothesis is presented that “antioxidant-induced stress” results when antioxidants overwhelm the body’s free radicals.
Antimicrobial Peptides: Multifunctional Drugs for Different Applications
Authors: Brandenburg Lars-Ove , Merres Julika , Albrecht Lea-Jessica , Varoga Deike , Pufe Thomas
Published: February 2012

Antimicrobial peptides (APs) are an important part of the innate immune system in epithelial and non-epithelial surfaces. So far, many different antimicrobial peptides from various families have been discovered in non-vertebrates and vertebrates. They are characterized by antibiotic, antifungal and antiviral activities against a variety of microorganisms. In addition to their role as endogenous antimicrobials, APs participate in multiple aspects of immunity. They are involved in septic and non-septic inflammation, wound repair, angiogenesis, regulation of the adaptive immune system and in maintaining homeostasis. Due to those characteristics AP could play an important role in many practical applications. Limited therapeutic efficiency of current antimicrobial agents and the emerging resistance of pathogens require alternate antimicrobial drugs. The purpose of this review is to highlight recent literature on functions and mechanisms of APs. It also shows their current practical applications as peptide therapeutics and bioactive polymers and discusses the possibilities of future clinical developments.
Gait Analysis Using Wearable Sensors
Authors: Tao Weijun , Liu Tao , Zheng Rencheng , Feng Hutian
Published: February 2012

Gait analysis using wearable sensors is an inexpensive, convenient, and efficient manner of providing useful information for multiple health-related applications. As a clinical tool applied in the rehabilitation and diagnosis of medical conditions and sport activities, gait analysis using wearable sensors shows great prospects. The current paper reviews available wearable sensors and ambulatory gait analysis methods based on the various wearable sensors. After an introduction of the gait phases, the principles and features of wearable sensors used in gait analysis are provided. The gait analysis methods based on wearable sensors is divided into gait kinematics, gait kinetics, and electromyography. Studies on the current methods are reviewed, and applications in sports, rehabilitation, and clinical diagnosis are summarized separately. With the development of sensor technology and the analysis method, gait analysis using wearable sensors is expected to play an increasingly important role in clinical applications.
A Clinical Prediction Rule for Lymphoma Development in Primary Sjögren’s Syndrome
Authors: BALDINI CHIARA , PEPE PASQUALE , LUCIANO NICOLETTA , FERRO FRANCESCO , TALARICO ROSARIA , GROSSI SARA , TAVONI ANTONIO , BOMBARDIERI STEFANO
Published: February 2012

Objective.

To develop and validate a practical prediction rule for the progression from primary Sjögren’s syndrome (pSS) to B cell non-Hodgkin’s lymphoma (B cell NHL) based on the combination of routinely available clinical and serological disease variables.

Methods.

The case records of 563 patients with pSS were reviewed, and their demographic, clinical, and immunologic features were collected. Multivariate logistic regression analysis was performed to identify independent risk factors for lymphoma development and to create a propensity score for discrimination between patients at risk of B cell NHL and those patients not at risk. The model was internally validated by resampling procedures.

Results.

Out of 563 patients with pSS, 387 fulfilling the American European Consensus Group criteria (12 with B cell NHL, 375 without B cell NHL) were included in our study. Salivary gland enlargement (p = 0.001), low C3 (p = 0.035) and/or C4 levels (p = 0.021), and disease duration (p = 0.001) were identified as independent risk factors for B cell NHL in pSS. The optimal threshold of the propensity score was determined at Y = 4.26, which allowed us to identify patients who develop B cell NHL with a sensitivity of 78% and specificity of 95%. The leave-one-out cross-validated prediction error was 6%, and the median bootstrapped sensitivity and specificity were 71% and 95%, respectively.

Conclusion.

We created a “bedside” prediction model for the identification of patients with pSS who are at risk for B cell NHL, which revealed an excellent discriminative ability and a good internal and external reproducibility.
Hypothyroidism as a Risk Factor for Development of Cardiovascular Disease in Patients with Rheumatoid Arthritis
Authors: McCOY SARA S. , CROWSON CYNTHIA S. , GABRIEL SHERINE E. , MATTESON ERIC L.
Published: February 2012

Objective.

To determine the frequency of hypothyroidism in patients with rheumatoid arthritis (RA), and to elucidate the association of hypothyroidism and development of cardiovascular disease (CVD) in these patients.

Methods.

A retrospective medical record review was performed using all incident cases of adult-onset RA from Olmsted County, MN, USA, that fulfilled criteria for RA in the years 1988–2007. Patients with and without thyroid disease were followed longitudinally for the development of CVD.

Results.

A cohort of 650 patients with RA and an age and sex-matched comparison cohort of 650 patients without RA was assembled (both cohorts mean age 55.8 yrs; 69% were women). There was no significant difference between cohorts in the presence of hypothyroid disease or subclinical hypothyroidism at time of RA diagnosis. No significant difference was found in the cumulative incidence of hypothyroid disease between the 2 cohorts. Hypothyroid disease was found to be significantly associated with CVD in patients with RA (hazard ratio 2.0; 95% CI 1.1, 3.6). This difference remained significant and unchanged after adjustment for traditional CV risk factors (HR 2.0; 95% CI 1.1, 3.6).

Conclusion.

No significant difference was found in either incidence or prevalence of hypothyroidism between patients with and those without RA. Hypothyroid disease was significantly associated with CVD in patients with RA, even after adjustment for other traditional CV risk factors.
Life Cycle Assessment for ecodesign of ecological roof made with Intemper TF Ecological Water-Tank System
Authors: Rivela B. , Cuerda I. , Olivieri F. , Bedoya C. , Neila J.
Published: February 2012

The construction industry is one of the less sustainable activities on the planet: with a consumption of 40% of the materials entering the global economy and the generation of 40–50% of the global output of greenhouse gases. The biggest environmental impact caused by buildings is generated during their use phase due to the energy consumption for thermal conditioning. Addition of green elements to buildings is used to improve energy efficiency of buildings. In this study Life Cycle Assessment (LCA) methodology has been applied to quantify the environmental impact of the green roofs materials to analyze its environmental profile. The identification of hot spots of the system permits an ecodesign strategy that effectively reduces environmental burdens associated with roof construction, optimizing the environmental performance. The results identify the high environmental impact associated to the structure, the important contribution of the felt wick irrigation system and the extruded polystyrene thermal insulation.
Production of Autoantibodies against Citrullinated Antigens/Peptides by Human B Cells
Authors: Bellatin Maria F. , Han Mei , Fallena Margarita , Fan Lin , Xia Donglan , Olsen Nancy , Branch Valerie , Karp David , Stastny Peter
Published: February 2012

Autoantibodies against citrullinated protein Ags (ACPA) are associated with the development of rheumatoid arthritis (RA). This immune response against citrullinated protein Ags, which is thought to be facilitated by certain MHC HLA-DR alleles, is highly specific for this disease and has been speculated to be involved in the pathogenesis. We have previously studied cultures of B cells for the production of Abs against HLA Ags. The aim of the current study was to examine the role of B cells in the production of ACPA in patients with RA. Peripheral blood B cells from RA patients and healthy people were cultured with EL4-B5, a murine cell line expressing human CD40L, and with T cell factors to stimulate the in vitro production of Abs by B cells isolated from peripheral blood. ACPA were produced by cultured B cells from RA patients, as determined by reactivity to cyclic citrullinated peptide (CCP). The results showed that 22% of the healthy persons tested also had B cells that could produce ACPA. Patients with HLA-DR alleles carrying the RA-associated shared epitope appeared to have more B cells with autoimmune potential for CCP than those without such HLA alleles (odds ratio 8.1, p = 0.001). In healthy individuals, anti-CCP–producing B cells were also observed more frequently if the RA-associated MHC genes were present (odds ratio 8.0, p = 0.01). Analysis of B cells in cultures may shed light on the interaction of genetic and environmental factors in the development of RA.
A 17q12 Allele Is Associated with Altered NK Cell Subsets and Function
Authors: Xia Zongqi , Liu Qingquan , Berger Christoph T. , Keenan Brendan T. , Kaliszewska Anna , Cheney Patrick C. , Srivastava Gyan P. , Castillo Irene Wood , De Jager Philip L. , Alter Galit
Published: February 2012

NK cells play an important role in innate immunity. A previous genome-wide association study demonstrated an association between a 17q12 allele (rs9916629C) and lower frequency of CD3−CD56+ NK cells in peripheral blood. We performed an analysis that not only replicates the original result of the genome-wide association study (p = 0.036) but also defines the specific cell subpopulations and functions that are modulated by the rs9916629 polymorphism in a cohort of 96 healthy adult subjects using targeted multiparameter flow cytometric profiling of NK cell phenotypes and functions. We found that rs9916629C is associated with alterations in specific NK cell subsets, including lower frequency of predominantly cytotoxic CD56dim NK cells (p = 0.011), higher frequency of predominantly regulatory CD56bright NK cells (p = 0.019), and a higher proportion of NK cells expressing the inhibitory NKG2A receptor (p = 0.0002). Functionally, rs9916629C is associated with decreased secretion of macrophage inflammatory protein-1β by NK cells in the context of Ab-dependent cell-mediated cytotoxicity (p = 0.039) and increased degranulation in response to MHC class I-deficient B cells (p = 0.017). Transcriptional profiling of NK cells suggests that rs9916629 influences the expression of transcription factors such as TBX21, which has a role in NK cell differentiation, offering a possible mechanism for the phenotypic and functional differences between the different alleles. The rs9916629C allele therefore has a validated effect on the proportion of NK cells in peripheral blood and skews NK cells toward a specific phenotypic and functional profile, potentially influencing the impact that these innate immune cells have on infection and autoimmunity.
Quality of life of People living with HIV and AIDS attending the Antiretroviral Clinic, University College Hospital, Nigeria
Authors: Folasire Oluyemisi F. , Irabor Achiaka E. , Folasire Ayorinde M.
Published: February 2012

Background: Quality of life (QOL) is an important component in the evaluation of the well-being of people living with HIV and AIDS (PLWHA), especially with the appreciable rise in longevity of PLWHA. Moreover, limited studies have been conducted in Nigeria on how PLWHA perceive their life with the World Health Organisation Quality of Life Brief Scale (WHOQOL-Bref) instrument. Objective: This study assessed the QOL of PLWHA attending the antiretroviral (ARV) clinics, UCH Ibadan, Nigeria.Method: A cross-sectional study was conducted from June to September 2008 that involved 150 randomly selected HIV-positive patients who were regular attendees at the antiretroviral clinic, UCH Ibadan. An interviewer administered questionnaire was used to collect information on sociodemographic data, satisfaction with perceived social support, medical records, and QOL was assessed with WHOQOL-Bref.Results: The mean age of the respondents was 38.1 ± 9.0 years and the male : female ratio was 1:2. The mean CD4 count was higher in female patients than in male patients, 407 cells/mm3 : 329 cells/mm3 (p = 0.005). The mean QOL scores on the scale of (0–100) in three domains were similar: psychological health, 71.60 ± 18.40; physical health, 71.60 ± 13.90; and the environmental domain, 70.10 ± 12.00; with the lowest score in the social domain, 68.89 ± 16.70. Asymptomatic HIV-positive patients had significantly better mean QOL scores than symptomatic patients in the physical (74.04 ± 16.85 versus 64.47 ± 20.94, p = 0.005) and psychological domains (76.09 ± 12.93 versus 69.74 ± 15.79, p = 0.015). There was no significant difference in the mean QOL scores of men compared to those of women, in all domains assessed.Conclusion: High QOL scores in the physical, psychological and environmental domains may be reflective of the effectiveness of some of the interventions PLWHA are exposed to at the ARV clinic, UCH Ibadan (on-going psychotherapy, free antiretroviral drugs). Relatively low social domain scores may suggest ineffective social support networks, because PLWHA are still exposed to stigmatisation and discrimination. An improvement in social support for PLWHA, therefore, will improve their quality of life further.
Density Functional Theory Study on Metal-Binding Energies for Human Serum Transferrin-Metal Complexes
Authors: Sakajiri Tetsuya , Yajima Hirofumi , Yamamura Takaki
Published: February 2012

The absolute values of the metal-binding energies of human serum transferrin (Tf) N-lobe, |ΔE|, were calculated using the density functional theory and were found to increase in magnitude in the following order: Fe(III)>Ga(III)>Al(III)>Cu(II)>Zn(II)>Ni(II). The calculated energies were well correlated with the logarithmic values of the reported metal-binding constants of Tf, which had been experimentally determined, with a correlation coefficient of 0.96. In the estimation of the binding energies, the solvation energies (solvent effect) of free metal ions were a very important factor. The results provide a theoretical explanation for the binding of Fe(III) to Tf, which produces sufficient energy to induce a conformational transition of the Tf molecule, making it possible to interact with Tf receptor 1.
Experimental Study of Effects of Coflow Air and Partial Premixing on Liquid Petroleum Gas Flames
Authors: Sreenivasan R. , Koli Sumit Kumar , Raghavan Vasudevan
Published: February 2012

Investigation of the influence of coflow and partial air premixing on liquid petroleum gas (LPG) flames in a lab-scale co-flow burner is presented. Primary air is supplied along with LPG in the inner core, and secondary air is supplied through the annulus region of the burner. Digital images are analyzed to study the flame shape, color, height, radius, and qualitative laminar flame speed. Concentrations of product gases and emission species are measured using a digital gas analyzer. Results indicate that in a dual air stream configuration, the partial premixing is optimum at % primary air value of around 45%.
Cubic Spline Iterative Method for Poisson’s Equation in Cylindrical Polar Coordinates
Authors: Mohanty R. K. , Kumar Rajive , Dahiya Vijay
Published: February 2012

Using nonpolynomial cubic spline approximation in x- and finite difference in y-direction, we discuss a numerical approximation of O(k2+h4) for the solutions of diffusion-convection equation, where k>0 and h>0 are grid sizes in y- and x-coordinates, respectively. We also extend our technique to polar coordinate system and obtain high-order numerical scheme for Poisson’s equation in cylindrical polar coordinates. Iterative method of the proposed method is discussed, and numerical examples are given in support of the theoretical results.
Luxury Uptake and Removal of Phosphorus from Water Column by Representative Aquatic Plants and Its Implication for Wetland Management
Authors: Shardendu Shardendu , Sayantan D. , Sharma Deepti , Irfan Sufia
Published: February 2012

Aquatic plants with their high relative growth rates efficiently absorb nutrients from their surrounding media, thereby providing a simple and inexpensive solution for nutrient-polluted aquifers. The present study determined the P accumulation efficiencies of four different aquatic plants namely, Eleocharis plantaginea, Eichhornia crassipes, Pistia stratiotes, and Hydrilla verticillata from the 6043 ha Kabar Wetland (86°05′ E to 86°09′ E, 25°30′ N to 25°32′ N). The aim of the study was to select the most efficient P accumulator. Water, sediment, and plant samples from Kabar were monthly analyzed for P content for 13 months from July 2009 to July 2010. Pistia stratiotes L. accumulated the highest amount of tissue P (1.06±0.22 mg/g dw). The maximum capacity of luxury uptake of P under greenhouse conditions as exhibited by Pistia was further tested. Pistia individuals tolerated up to 50 mg/L phosphate medium and accumulated 6.12±0.95 mg/g dw P after 35 days under greenhouse conditions. Up to 91% phosphate was removed from the surrounding medium within 60 days at 50 mg/L supply. Tissue P levels increased with increasing phosphate levels in the surrounding media but variation with incubation period was statistically insignificant. Our studies present Pistia as more efficient than other common wetland species like Eichhornia, Phragmites, Typha, and so forth when grown in the sub-tropics and confirm its ability to ameliorate P-polluted subtropical wetlands.
Characterization and Modelling of Circular Piezoelectric Micro Speakers for Audio Acoustic Actuation
Authors: Mendoza-López J. , Sánchez-Solano S. , Huertas-Díaz J. L.
Published: February 2012

A study of circular piezoelectric micro speakers is presented for applications in the audio frequency range, including values for impedance, admittance, noise figures, transducer gain, and acoustic frequency responses. The micro speakers were modelled based on piezoelectric micro ultrasonic transducer (pMUT) design techniques and principles. In order to reach the audio frequency range, transducer radii were increased to the order of one centimetre, whilst piezoelectric layer thicknesses ranged the order of several μm. The micro actuators presented might be used for a variety of electroacoustic applications including noise control, hearing aids, earphones, sonar, and medical diagnostic ultrasound. This work main contribution is the characterization of the design space and transducer performance as a function of transducer radius, piezoelectric layer thickness, and frequency range, looking towards an optimized fabrication process.
Models for Population Growth Curves
Authors: Eberhardt L. L. , Breiwick J. M.
Published: February 2012

We examined models for population growth curves, contrasting integrated versions with various other forms. A sizable number of data sets for birds and mammals were considered, but the main comparisons were based on 27 data sets that could be fit to the generalized logistic curve. Akaike's information criterion was used to rank fits of those data sets to 5 integrated models. We found that the integrated models gave the best fits to the data examined. The difference equations examined gave much poorer fits as judged by AICc and coefficients of variation. We conclude that the integrated models should be used when possible.
Impedance and Electrical Modulus Study of Microwave-Sintered Ceramic
Authors: Senthil V. , Badapanda T. , Chandra Bose A. , Panigrahi S.
Published: February 2012

Bismuth layered structure SrBi2Ta2O9 ceramic is prepared by the microwave sintering technique via solid state route at 1100°C for 30 mins. X-ray diffraction analysis is used to analyze the phase purity, which identifies the orthorhombic structure with A21am space group. The fracture surface of the sintered pellet is visualized by scanning electron microscopy. Impedance spectroscopy is used to analyze the sample behavior as a function of frequency and temperature. Impedance and modulus study reveals the temperature-dependent non-Debye type relaxation phenomenon. The Nyquist plot shows a single arc representing the grain effect in the material, and the conductivity increases with increase in temperature. The Nyquist plot is fitted with an equivalent circuit, and the simulated parameters are well agreed with the calculated parameters. Arrhenius plot shows two different activation energies at below and above 300°C which identifies the phase transition of SrBi2Ta2O9 ceramic. The fatigue property is explained by the basis of activation energies, which shows that SBT sintered by microwave technique is more fatigue resistant than conventional sintering.
Characterizing Tukey and -Distributions through -Moments and the -Correlation
Authors: Headrick Todd C. , Pant Mohan D.
Published: February 2012

This paper introduces the Tukey family of symmetric and asymmetric -distributions in the contexts of univariate -moments and the -correlation. Included is the development of a procedure for specifying nonnormal distributions with controlled degrees of -skew, -kurtosis, and -correlations. The procedure can be applied in a variety of settings such as modeling events (e.g., risk analysis, extreme events) and Monte Carlo or simulation studies. Further, it is demonstrated that estimates of -skew, -kurtosis, and -correlation are substantially superior to conventional product-moment estimates of skew, kurtosis, and Pearson correlation in terms of both relative bias and efficiency when heavy-tailed distributions are of concern.
Consultando o Artigo
Authors: Santos José Agostinho
Published: February 2012

O conceito de clube de leitura é conhecido entre os médicos desde os anos de Licenciatura, particularmente pelas apresentações de journal club em reuniões de serviço durante diferentes estágios clínicos. Um paralelismo pode ser estabelecido entre a prática clínica do médico da família e comunidade e o clube de leitura. De fato, do mesmo modo que uma consulta ao seu paciente, um journal club implica ler (ou mesmo ouvir) o artigo, questionar determinados aspectos perante dados que vai obtendo, aguardar uma resposta orientadora, estar atento a detalhes e captar o essencial (subjetivo). Como um exame objetivo, pressupõe-se inspecionar o seu desenho, palpar as suas limitações e percutir os resultados sobre a sua comunidade (objetivo). Após a leitura completa, o médico da família e comunidade vai avaliá-lo (avaliação) e planejar (plano) uma alteração na sua prática. Este processo decorre com a fluidez natural de uma consulta normal, cujo paciente seria, neste caso, o próprio artigo.